As the example below illustrates, students with CVI experience significant problems with most fundamental emergent literacy activities. Even though many emergent literacy activities may appear simple in nature, they can be visually and physically de- manding. “Dear Zoo” Unit. For many years Ms. Cook has used this book, Dear Zoo, ( A flap book, by Rod Campbell) with her kindergarten stu- dents. She brings out toys and puppets for students to play with and pretend to be the animals. Some of her students come to school already familiar with the book. They point to the words and the pictures (concepts of print). They talk about animal names and charac- teristics (vocabulary concepts). Students also learn about writing (functions of print). This year Ms. Cook is worried about a new student, Janie. When she was an infant Janie had an infection that resulted in brain damage. The occupational therapist reports that Janie does not have the physical skills to independently lift the book flaps or turn pages. She also doesn’t have the motor skills to write. Her vision teacher reports that Janie has late Phase 2 CVI and cannot visually discriminate the colored drawings in the book. Janie will need instruction that helps her learn to look for and identify visually salient features of each animal, starting with real photographs. Accord- ing to the speech/language pathologist, Janie’s verbal abilities are limited. During meeting time, shared reading and other academics, Janie can’t request, comment or ask questions. Teamwork will be necessary in order to plan specific CVI and communication interventions to include Janie in the kindergarten literacy activities without her CVI restricting her learning. This article will provide a discussion of student needs and adult roles and responsibilities for setting the stage for AAC. CONSIDERING COMPLEXITIES: VISION AND COMMUNICATION Many variables will affect a student’s ability to benefit from educational tasks. Team members will need to gather and share information about how the student uses his/her vision and how he/she communicates. This is particularly critical when students have limited verbal expression. Variables that affect functioning and have potential to restrict learning: • Intrinsic Difficulties – health issues (seizures, headaches, muscle spasms/cramps, inability to control body temperature), trou- ble initiating and coordinating movements, problems with word-finding, restricted ability to process visual features that dis- tinguish one item from another • Extrinsic Variables – busy environments that distract from learning, confusing or overwhelming verbal cues and prompts, tasks that are visually frustrating, etc. According to Tietjen (2019), the primary and most persistent educational impact of CVI often revolves around difficulties with the CVI characteristic: visual complexity. This impacts their ability to attend to literacy materials, communication systems and the environment. Planning a program that is designed to support growth in these areas must consider how complex tasks and envi- ronments are balanced throughout the day. Tietjen’s “What’s the Complexity Framework” (2019) offers teams a decision-making process for creating and modifying literacy materials. Tasks can be divided into three categories of complexity: comfortable, chal- lenging and frustrational (rating as green/yellow/red based on increasing complexity). Any task that would be considered “frus- trational” (in the red zone) must be modified, adapted or avoided all together. ‘Challenging’ tasks are learning opportunities, in the right environment where distractions are minimized and the student is engaged. Tasks that are rated as ‘comfortable’ can take place in environments that are more complex. Rating the complexity of an environment includes consideration of background noise, movements and visual considerations (i.e. light, distance, clutter or crowding). Rating scale results can be used to adjust students’ schedules to include appropriate levels of supports during literacy and communication instruction. More information is available through Perkins eLearning as a webinar or multi-week professional on-line courses. STUDENT STRESS IN THE CLASSROOM In addition to visual complexity challenges, students with CVI can experience stress which impacts their ability to interact with others. When students are uncomfortable or dysregulated, they may cry, shout, tantrum or withdraw (Dutton, 2015). In their homes and communities, families have identified ways to avoid temper tantrums and distress such as going shopping during less crowded hours, providing window shades in the car, using headphones with soft music and developing plans for fostering feelings of safety (such as sitting in the shopping cart facing mom). In the classroom, when students with CVI experience stress, professionals may not recognize the signals. Teachers and therapists may think that the student is not paying attention and may reprimand the student. Students with CVI may have significant problems paying attention to more than one thing at a time.
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