school day can be found in the “What’s the Complexity” chapter by Tietjen (2018) and in the Bridge School Intervention Plans, under “Guide to Planning Accommodations Across the School Day.” Pulling it All Together As described in previous sections, all team members have a role in maximizing engagement and providing meaningful emergent literacy experiences for our students. This case exam- ple highlights how team members must take into consideration the communication partners and environment when making adaptations for CVI. It is impossible to describe learner needs and abilities without also considering how the environment has been modified and the role of communication partners. Amy and Jonas are both in a preschool classroom with stu- dents who have multiple disabilities, many of whom have some type of vision impairment along with significant cognitive de- lays. Amy has cerebral palsy, spastic quadriplegia, and mild CVI. Jonas had a brain injury as an infant and experiences more profound visual and auditory processing challenges. The pro- gram receives support from the state deaf-blind project and a teacher of the visually impaired, in addition to the SLP, OTR, and PT. Classroom materials are being adapted following team col- laborations that consider student preferences for types of media presentation. The team is working on using personal experience stories and home-school journaling for self-selected reading as well as providing a personally meaningful context for daily shared reading/writing tasks (including predictable chart writ- ing). Although her scores indicate a mild CVI, Amy is definitely a visual learner. She likes looking at pictures on her mom’s phone, raking her hand across the display to change the photos. Due to her motor challenges, she can’t really manipulate the cards with tactile enhancements that her teacher made for Jonas to represent names of their classmates. She needs to learn how letters of the alphabet work, but can’t see when her mom types on the phone. She was recently evaluated for a personal com- munication system since she is also physically unable to express herself verbally. The team will collaborate on adapting the al- phabet pages to make sure Amy can visually distinguish and physically target the letters. Her teacher uses a backlit tablet for instruction. When the teacher (or an instructional assistant) is modeling how to use the letters of the alphabet during a group session, they will need to consider the complexity of the array for distance viewing. One letter presented at a time, using glow coloring on a black background (so it looks like neon lights), is recommended during group instruction so that both Amy and Jonas can benefit. Communication partners will need instruc- tion on how to provide verbal choices/instructions or feedback for each student, based on individual needs. According to the occupational therapist, Amy will be able to visually discriminate and physically target more than one letter or symbol per page on her personal communication system, particularly since the
arrangement will become more and more familiar over time. At first, this option may only be appropriate when other students are not moving around or making a lot of noise, as Amy has trou- ble with coordination due to her cerebral palsy and startles to loud or sudden sounds. She also has trouble focusing her vision, even her near vision, when there are a lot of auditory distrac- tions. Jonas will benefit from presentation of the alphabet one letter at a time, even in settings where there are no other distrac- tions. The team will meet to consider whether auditory cues or tactile enhancements, such as adding textures or Braille, will be beneficial. In addition to modifying their letter boards, the team will also make alphabet books that include video models of se- lecting letters, using verbal descriptions that have been agreed upon by the team. These videos can be used to supplement partner models, since watching another person model use of communication displays or letter boards would be too visually complex for both Amy and Jonas. Summary Emergent literacy is a necessary foundation for the devel- opment of conventional literacy. Students with significant dis- abilities with CVI need rich, authentic emergent literacy oppor- tunities which teach them the joy and power of literacy. When designing instruction that will support students’ CVI, the learner, the partner and the environment need to be considered. Pro- fessionals need to ensure that the during literacy activities, the appropriate accommodations are made so that students’ CVI needs do not limit literacy learning. The most powerful com- mon thread across all of these concepts is the power of the social interaction with others around personally meaningful accessi- ble materials for many different types of literacy activities. With these things in place, there can truly be literacy learning for all! References Bridge School authors (undated). Critical Considerations of All CVI Intervention Plans. Retrieved from http://cvi.bridges- chool.org/interventions Bruce, S.M. & Bashinski, S.M. (2017). The trifocus framework and interprofessional collaborative practice in severe disabili- ties. American Journal of Speech-Language Pathology, 26 (2), 162-180. Buell, L. (2019). Making Movies on Your iOS Device [web log entry]. Retrievable from http://www.aacintervention.com/ page/180009852/180117546/Tips-2019#tip%202%202019 Erickson K.A. & Hanser, G. (2004). Writing with Alternative Pencils CD. Chapel Hill NC: Center for Literacy and Disabilities Studies, University of North Carolina. https://www.med.unc. edu/ahs/clds/products/available-for-purchase/ Erickson, K.A. (2000). All children are ready to learn: An emer- gent versus readiness perspective in early literacy assessment. Seminars in Speech and Language 21(3): 193-202. Erickson, K.A. (2017). Comprehensive literacy instruction, in-
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