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with Diane Sheline, Independent Consultant, CTVI, CLVT.  www.strategytosee.com

Diane: The same child that is working on cruising also needs to increase his skills in the area of self-help.  His parents would like him to help with brushing his teeth.  The task would be to reach out and grasp his toothbrush.  This is also an example of integrating vision with function.  This child's bathroom sink area might look something like this.

[Video clip]

This bathroom sink area looks like most bathrooms: there are bottles scattered around, towels covering areas, the toothbrush is a translucent pink that is light in color like the counter, the mirror is big and reflective.  Given of what we know of this student, we could make the following adjustments, which might just encourage looking behavior as well as reaching and grasping behavior.  The mirror is blocked, so that the movement from his reflection doesn't distract him.  The black Invisiboard and mat helps to create contrast.  The toothbrush now stands out.  The red is a favored color for the student and the blinking light-up quality draws his visual attention.  Since he has difficulty locating visual targets when they are in his lower visual field, standing the toothbrush up on end helps bring it into his visual field.  Complexity is reduced within the array.  There are no other

with Diane Sheline, Independent Consultant, CTVI, CLVT.  www.strategytosee.com

Diane: Imagine you are working with a 3-year-old toddler who is cortically visually impaired.  You have a completed a CVI resolution chart, and found that he's functioning in Phase 2, integrating vision with function.  His parents would like to see him start walking.  And he will stand at the edge of the couch, but he has not yet taken his first step.  He is attracted to light, but can be redirected to other targets.  He alerts more quickly when there is slight movement associated with the target, but he is often distracted by the TV and other noise-producing toys.  The orientation and mobility instructor who's working with him would like to get the student to take a first step and to start cruising.  This is the task as we do our CVI Task Analysis.  The O&M instructor would like to integrate vision with function, mobility.  Here is a short clip showing the couch that he might be standing at, and some sample toys on that couch, and what it's like at his home environment.

[Video Clip]

[radio playing]

[end Video clip]

The toys seem to blend in with the couch color.  When sunlight is coming through the windows, he often stares at the windows.  The table light just behind the couch is also a distracter.  The TV is often on in his home, and he attends well and often using his auditory channel.  How can we encourage looking behavior which may help nudge the student into movement?  Let's think of some different strategies as we do a CVI Task Analysis.

We know by looking at our CVI resolution chart that he attends to targets that have light qualities and slight movement.  He does not attend to targets in his lower visual field, so we will need to keep the targets up at eye level.  He has some difficulty with complexity in his sensory environment, so we will need to reduce auditory as well as tactual input when visual learning is taking place.  Since this student seems attentive to lights, we will close the curtains, turn off the table lamp, as those are often a distracter, and use lighted targets or light paring techniques as a way to attract his visual attention.  Since this student attends to targets up to 24 to 36 inches away, we can place visually attractive targets just out of reach to encourage movement.  By modifying his learning environment, he may now attend to visual targets and move towards them.

with Diane Sheline, Independent Consultant, CTVI, CLVT.  www.strategytosee.com

Diane: Imagine you're working with an infant, 11 months old, who is cortically visually impaired.  You have completed a CVI resolution chart, and found that she is functioning in Phase 1.  She is building visual behaviors.  Her parents placed her on a colorful blanket on the floor with toys all around her, but she doesn't attend to them or reach for the toys.  She will gaze at the window where light is streaming through and occasionally, she looks at a bright red Elmo when it's within about 18 inches off her face and her parents shake it slightly.  The task you're trying to accomplish is to get her to increase her looking behavior.  Here's an example of what her play area might look like.

[Video clip]

[radio playing]

[end Video clip]

The toys seem to blend in with the design on this blanket.  The sunlight shining through the windows and the glare produced by the sunlight would be both attracting and distracting.  The noise-producing toys and the radio playing in the background would probably encourage auditory-attending behavior, but not visual-attending behavior.  How can we encourage looking behavior in this situation?  Let's think of some different strategies as we do our CVI Task Analysis.

We know by looking at our CVI resolution chart that she attends to single, brightly-colored targets presented against good color contrast most frequently.  She has a right visual field preference, so we will try to present visual targets on her right side.  She has difficulty with visual complexities, so we will try to present only one or possibly two simple single-colored visual targets at a time.  We will reduce sensory complexity, meaning we will reduce any auditory and tactual competing input when visual attending behavior is expected.  This student seems to be very attentive to light, so we will keep the learning area away from open windows where sunlight is streaming through.  And at times, we may even turn down or turn off the overhead room lights.  We will shine the light only on the visual target of interest or have the visual target light up.  Since we know this student attends to visual targets most frequently in near space, we will keep the presentation of visual targets within about 18 inches of her face.  We know that she responds to a red Elmo, so we will use red visual targets to begin with.  Then expand to include other bright, single-colored targets as more attending behavior takes place.  By changing her learning environment, she may now increase her looking behavior.

 with Diane Sheline, Independent Consultant, CTVI, CLVT.  www.strategytosee.com

Diane: When you observe your student during any activity, it might be helpful to do what I call a CVI Task Analysis.  First, determine what the task is that the student should be trying to accomplish.  This could be simply attending to a visual target or attending to targets more frequently, reaching for a visual target to complete a self-help task or completing an academic task in the classroom environment.  Then, think about each unresolved CVI characteristic for your student.  Next, figure out how you can change, modify or adapt the activity given the functioning level of your student with each CVI characteristic.

Diane: A child in phase 3 usually doesn't need movement as a cue at near, but targets presented at distance continue to be difficult to locate.  When expecting a student to attend to a distant target, add movement to attract visual attention.  So something bright like this with movement.  If you're trying to get their attention to a particular spot on the blackboard, shake something to get their visual attention.  Add some movement to try and get visual attention to distant targets.  Another example might be, when it's time for the pledge of allegiance in class and they can't locate where the classroom flag is, the teacher might give it a slight shake to attract visual attention.  The movement will help to cue them as to where they're supposed to be looking at distance.