Introduction Students with Cortical Vision Impairment (CVI) and complex com- munication needs (CCN) pose a daunting challenge to professionals who are working to build students’ vision, communication and literacy skills. To facilitate student progress, professionals need to share their expertise. Building a solid emergent literacy foundation is essential for later conventional literacy learning. To promote balanced instruction which takes into consideration CVI interventions and comprehensive emergent literacy instruction, this article will provide an overview of CVI, as well as emergent literacy. To foster inter-professional collabo- ration, a trifocus model will be described to plan instruction that con- siders the learner, partner and environment. Five broad instructional strategies are emphasized in the trifocus framework proposed by Bruce and Bashinski (2017): enhancing (partner) sensitivity, utilizing routines, increasing communication opportunities, modifying the communica- tion environment, and augmenting input. These principles will be in- terwoven throughout this article.
Cortical Vision Impairment Characteristics and General Literacy Implications Professionals and communication partners need to understand and be sensitive to the impact of CVI in order to design the most appropriate literacy instruction and presentation of literacy materials. CVI is a neu- rological disorder which impacts the visual processing of information in the brain. It is frequently undiagnosed or unrecognized due to multiple physical/cognitive impairments. In the past decade, knowledge about CVI has grown rapidly (Roman, 2018; Lueck & Dutton, 2015). Observing a particular routine/task from the visual perspective of the learner can help guide interprofessional collaboration when designing adaptations. According to Roman-Lantzy (2018), there are 10 CVI Characteristics that can be measured by the CVI Range Assessment Tool (see Table 1 for char- acteristic descriptions and general literacy implications). Students’ abili- ties within and across the characteristics determine their severity of CVI. The 10 characteristics can be used to guide intervention and adaptations, using the CVI Characteristics: Teaching Strategies and Accommodations Planning Guides, found here (http://cvi.bridgeschool.org/interventions/).
Description
Literacy Implications
Characteristics
Color Preference
There may be specific colors that attract stu- dents vision
Preferred colors can be used within a literacy activity to facilitate visual interest
Visual Field Preferences
There are certain fields where students may not be able to see.
Identify the fields where students can see in order to effectively position literacy materials A personal tablet/screen may provide backlight that improves ability to sustain visual attention during reading and writing tasks Use digital books with animation. Reflective tape around the edges of a personal screen/tablet can draw visual gaze as the device is moved from peripheral to the student’s central vision Consider degree of complexity in books and other liter- acy materials. Use masks or occluders to minimize clutter When making activities, use pictures that are familiar to student. Choose media that allows a person to record a verbal description of the picture (salient feature descrip- tion) If students have trouble using their hands to manipu- late literacy materials, identify a different position or dif- ferent way for student to access materials, such as through using switches Give students uninterrupted time to look at books and other materials
Need for light
Students may stare up into the lights
Need for Movement
Students may need an item to move in order to get their visual attention
Visual Complexity
Students have difficulty with processing things with a busy, complex background.
Visual Novelty
Students don’t notice new things in their environment
Difficulty with Visually Guided Reach
Students may have difficulty reaching for some- thing while using their vision to guide their hand.
Visual Latency
Students may take a long time to process visual information . Students may have a delayed blink reflex. This is used for evaluation purposes only. Students have difficulty with complexity of array when viewing items at a distance
Atypical Visual Reflexes
No intervention strategies improve this reflex
Difficulty with Distance Viewing
Presenting information with a projector or Smart Board may not be visually accessible. Using a personal tablet/ screen or focusing on auditory input may be necessary during group time.
Table 1: CVI Characteristics and General Literacy Implications
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