had materials presented at the front of the room by the teacher. His TVI suggested making duplicate materials for his aide, Joe, to present to him, greatly increasing Jamal’s visual attention. This way Jamal and Joe are able to joint- ly attend to a specific letter, picking it up and moving it around against an uncluttered black background. Name Letters Letter naming is (relatively) easy for students who are able to talk. However, as Howery & Barros point out, ‘. . . many chil- dren with CCN have problems with their vision’(2020, p. 42). This means that students who are already struggling to distinguish letter shapes may also need to find a way to name them other than using their voice. Remember that when reporting progress and discussing performance with the team, compounding com- plexities of CVI must be considered. Mini Example: Jacob is a high school student with CVI who is nonspeaking. Jacob is able to use his hand to point. The teacher starts by naming the letter M, and asks students to say it with him. Jacob’s aide Mr. Dario quietly reminds him to ‘say it to your- self.’ The teacher then shows three lowercase letters placed on a black background and asks Jacob to ‘find the M.’ When Jacob is not successful, Mr. Dario says the prompt again and uses the black background, but presents only one letter at a time, hav- ing Jacob indicate yes /no (by using head gestures) to indicate whether each one is the letter M. Then Mr. Dario shows Jacob the uppercase M and names it, asking Jacob to ‘say it to yourself’, but does not have him try to find it. Mr. Dario does not check for understanding each time the teacher presents a target letter, but instead quietly tells Jacob 'That’s the letter S. Let’s say it to- gether. S.' as he shows Jacob the target letter, again against the black background. Mr. Dario uses both the lowercase and the uppercase version of each letter. Write Letters Many students with CVI have motor problems that make let- ter formation difficult if not impossible. Some students might be able to use keyboards, especially if they are modified by add- ing tactuals, removing un-needed keys (e.g., function keys, print key), enlarging letter labels, adding colors or using occluders. Many students with CVI will need ‘alternative pencils’ or uncon- ventional tools that give students access to all 26 letters of the alphabet, even if they can’t hold a pencil or type on a keyboard. Hanser (2020) has created a number of alternative pencils spe- cifically designed for use by students with CVI. Students can use different approaches (eye gaze, partner assisted scanning using gestures, vocalizations & facial expressions, or partner assisted scanning using a single message device) to indicate their letter selections. These alternative pencils differ based on features such as: • Colors : Both the color of letters and the color of the back- ground should be considered, based on input from the TVI
Distinguish Letter Shapes With regard to letter shapes, students must be able to distin- guish both lowercase and uppercase letters, as well as recogniz- ing letter shapes in various fonts. Students with CVI, especially Phase I and Phase II, will struggle to distinguish letter shapes. Professionals need to take great care in not letting letter shapes be the only alphabet instruction provided, as students also need other alphabet activities in parallel to help them understand what letters are for, even if instruction is primarily via auditory channels. Adaptations include: 1. Modify Size, Font, and Color: Ultimately, students will need to rec- ognize a range of type fonts, plus letters of various sizes and colors. For initial learning, these features can be manipulated to make letter learning as easy as possible. A functional vision assessment by the Teacher of the Visually Impaired (TVI) may give guidelines on ideal font size, color, background, font type, etc. for initial instruction, specific to individual students. 2. Reduce the Complexity: Even if we make letters as visually salient as possible re: size, simplicity of font, colors, etc. they may not be accessible if they are presented against a busy background (or in a busy environment). Placing a letter card on an appro- priate background (often, a black non-glare surface such as a Velcro board) may increase the possibility of distinguish- ing the shape. For some learners, reducing complexity also involves reducing all sounds and movements in the environ- ment (like other students talking or moving around) in order to visually focus on a single item. 3. Consider Other CVI Characteristics: Refer to the chart in Hanser, Wagner, and Musselwhite (2019a, p. 4) showing the literacy implications of CVI characteristics. Consider factors such as: • The Need for Movement: Mini Example: Roger observes visual stimuli best if moved from his peripheral to central vision, with occasional shaking. His teacher understands that movement helps initiate and direct his gaze, but he may not be able to see details until he engages his central visual system. Explicit instruction on the shapes of dif- ferent letters must be brief, taking into consideration the amount of visual effort required. • Visual Latency: Mini Example: Alejandra needs at least 10 seconds to look at a stimulus (such as a letter). Her aide knows to wait quietly and not to give a verbal directive until Alejandra has had enough time to look at the letter first. • Difficulty with Distance Viewing: Mini Example: For Hana, the Smartboard might as well be on Mars! With every- thing so far away, she couldn’t tell what was important to look at and could not see individual letters. When the teacher found an app to reflect the Smartboard on an iPad (e.g. Team Viewer, or simply using the iPad camera), her visual engagement grew significantly and she was able to visually attend to the same letters as the others in her class. Mini Example: Jamal’s classroom typically
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