Interventions

Working on:

• Consistent looking at a small set of objects 
• Examples may be: pinwheel, familiar character (ex. Elmo), windsock, slinky, single colored spoon, etc.
• Items can be used as part of a daily activity (ex. show the red spoon before using it to eat)
• Can teach phonemic awareness and alphabet with auditory scanning- student will not be able to see or understand the visual letter, can use objects as anchors (ex. A for apple)

Guidelines for presenting items:

• Use objects of a single, preferred color
• Use objects that are shiny or reflective
• Use a simple background (black or white)
• Use objects that are familiar
• Use of movement to gain and sustain attention
• Presented in strongest field (usually peripheral)
• Present objects on a light box or use a flashlight to cast light onto the item (make sure the flashlight is held from behind the child)
• May be able to regard simple moving images on an iPad
• Decreased background noise
• Seated away from light sources
• Materials present within 18 inches or less
• Provide ample wait time, provide verbal prompt prior to presentation and then silently wait for visual attention, sometimes up to 30 seconds

Next steps...

• Teach salient features of familiar objects (ex. what makes a spoon a spoon-see salient features books under the Adapted Books tab)
• Add more objects
• Add objects of another color
• Try increasing the complexity of objects (ex. 2 colored objects)
• Show similar objects to familiar objects (ex. other types of spoons) and talk about what makes them similar and different
• Have students identify or select a requested object out of the group of preferred objects “Which one is your spoon?” 
• Work on discrimination activities “Show me an object (spoon) like the one I am holding.” 
• Work on recognition activities “Look at these objects and find the spoon” 
• Work on identification activities (pairing with auditory scanning if needed) “What is this called?” 
• With this specific instruction and practice, an individual with CVI will eventually learn to generalize visual information

More example activities

Working On:

• Starting to introduce 2-d materials using photos of familiar favorite objects
• Continue to teach salient features, now with photos of familiar objects
• Work on discrimination activities with photos “Show me an object (spoon) like the one I am holding.” 
• Work on recognition activities with photos “Look at these objects and find the spoon” 
• Work on identification activities with photos (pairing with auditory scanning if needed) “What is this called?” 
• Continue teaching phonemic awareness and alphabet with auditory scanning- student will not be able to see or understand the visual letter until later in Phase II, can use objects and now photos as anchors (A for apple) 
• Note: Visual attention does not guarantee understanding

Guidelines for presenting items:

• Use objects of a gradually increasing complexity
• May still need preferred color as part of the object 
• May be able to use more complex backgrounds with familiar objects
• Use a simple background (black or white) with new items/photos
• Use of their favorite color for highlighting of salient features and word bubbling
• Movement may still be needed to gain attention
• Presented in strongest field, may be able to present more centrally
• It may still be difficult to see items exactly at mid-line, off set slightly to one side
• Present new objects on a light box or use a flashlight to cast light onto the item (make sure the flashlight is held from behind the child)
• Use of a iPad or light box to present 2-d images
• May still need slightly decreased background noise
• Seated away from light sources
• May be able to regard movement from further away 
• Wait time may still be needed when individual is ill, tired, or stressed

Working On:

• Continued refinement of CVI characteristics 
• It is very unlikely to reach a score of 9-10, **some characteristics may remain life-long
• Provide instruction in phonemic awareness of letters and sounds, now with letters using bubbling around the letters, can use objects and photos as anchors (A for apple) 
• Photos are still the easiest to perceive, but can start to introduce images like those used in a AAC device **images will need to be taught for understanding
• Teach salient features of letters, numbers, picture symbols, and/or whole words, with preferred color highlighting 
• Work on discrimination activities with letters, numbers, picture symbols, whole words “Show me one like ___” 
• Work on recognition activities with letters, numbers, pictures symbols, whole words “Show me the ___” 
• Work on identification activities with letters, numbers, pictures symbols, whole words (pairing with auditory scanning if needed) “What is this called?” 
• Matching printed word, number, or letter to the empty color outline shape of the word, number, or letter

Guidelines for presenting items:

• Use objects of a gradually increasing complexity
• May be able to use more complex backgrounds with less complex objects
• Use a simple background (black or white) with new items/images
• Use of their favorite color for highlighting of salient features and word bubbling for new words
• Movement may occasionally be needed to gain attention
• It may still be difficult to see items exactly at mid-line, off set slightly to one side
• Use of a iPad or light box may still help support attention
• May still need slightly decreased background noise, especially for complex or difficult activities
• Seated away from light sources
• Wait time may still be needed when individual is ill, tired, or stressed
• May be able to regard a non-moving target up to 10 feet and moving targets up to 20 feet