Monday 27 February 2012

Pillars of Support

We come to point number two in this mini series. This one is not so much to do with children’s vision or eyesight, as it is to do with the way they feel about themselves, their self-esteem or self-image. Along with this it is to do with the way we as teachers treat them, which can have a big impact on the way they feel about themselves. Every teacher carries a heavy responsibility because our actions and our words can have such a powerful impact on the child’s thinking. We are all a product of so many things and one of the most influential things is what significant people say about us or to us. With this in mind please consider the following point, which I believe is such an important aspect of our role in looking after the children in our care.    

Pillar 2. Have a Policy of Non Discrimination

Treat the child as you would the rest of the class as much as you possibly can. Do not single them out. Do not make an example of them. Do nothing that might make them feel socially awkward. Unless absolutely necessary do not make them use special equipment that no others need to use. Punish them just as you would any other child. Give them detentions if necessary. Speak harshly to them if you must. Do not feel sorry for them or allow them to get away with anything that any other child would.  Keep your distance. 

The only rider I would add to this is that there need to be subtle changes in a teacher’s behaviour, which might be called ‘positive discrimination’. By this I mean that a teacher needs to subtly modify her or his behavior in class so that the child has the best access to the curriculum. For example take the case of a visually impaired child who cannot see the teacher’s face or hand gestures; the teacher needs to use the child’s name a little more than normal to ensure the child is aware that they are noticed and to include them.

Deliberately asking a visually impaired child to answer a few more questions in class sessions is not to single them out but it is to include them and make them feel part of the group. It is also a way of testing out if they are engaged and can see what is going on. By thinking of this child when making materials is again not singling them out, it is rather a way of making inclusion work. For example if the child needs point size 14 in Arial font why not give all the class the same modified materials. 

What is done for the SEN child always benefits everyone and all the children's learning materials are as a result clear and easy to read.  There are many children who may not have a visual impairment but who find it hard to read words close together on a page because of crowding or clutter. This will no doubt help them. Positive discrimination could also be giving that bit of extra description of pictures or board materials and as always this helps everyone.  There is also equipment that benefits all in class. A sound field system is designed for hearing impaired children but research shows that it has a beneficial effect on all children, including the partially sighted. It raises the attentional levels of all children not just those with hearing loss. A Visualiser (electronic enlarger) used in classes now instead of the old overhead projector captures the imagination of all children. I hope this has given you pause to think...

Sunday 26 February 2012

Pillars of Support

 In-Class Support

I will admit that the following is not rocket science. Also the focus is particularly on the transition into nursery so it may not appear all that relevant to older children. However much of it can apply and I leave the reader to work that out. In-class support is not as easy as it sounds. For a start, it is important that in school a child with a visual impairment is treated normally. There is a fine balance between inclusion and interference, between being a safety net and being ‘in-the-way’. An LSA (learning support assistant) providing support needs to have sensitivity and tact. Please remember that it is support. When a plant is growing you may put a stick to stop it toppling over. That stick is there to lean against, to support it, not to do all its growing for it. It does nothing else. Support does not mean doing things for children that they could and need to do themselves. Sometimes LSAs step in too quickly when a child is working things out. In time this approach will lead to an attitude of ‘learned helplessness’. They will become lazy and expect things to be done for them all the time. Adults will become the child’s servant at their beck and call. This is not helpful. It does help if the support workers can empathise with the child. For instance how would you (as an adult) like to have a ‘helper’ sitting with you in places and situations where you are sensitive about what others think about you? How would you like to have a stranger sit between you and your friend, preventing you chatting, talking to you so that miss what the teacher is saying? How would you like to be the only one in the class who can’t do things without help? It needs to be said for we take it so much for granted that there is nothing better in the world for a visually impaired child than to have a grown-up sitting next to them helping them. The truth is it is often not the best thing at all and frequently does nothing for the child. “But it says full time support on the statement so what am I supposed to do?” As you say, this is the dilemma. However there are in fact many ways to support a young person without being seated next to them and we must be astute and wise in our support and think of the child’s best interests at all times.

The Pillars of Support
With this in mind I want to put down what I see as some 'foundational principles': the fundamental principles or Pillars of Support, as I see them and this is the way that most parents and teachers really want it, believe me.I would as always be interested in any feedback on this article. Over the next week into March I shall add to it. This is the first pillar and I doubt anyone will argue with this one, but I hope you learn something from it.

 Pillar no. 1   Use Clear Visual Strategies 

Use very specific visual strategies and encourage them to develop their own. Some of these include: 

  • Sit the child close to the teacher, failing this next to the LSA to model the teacher's behaviour.
  • Bring reading materials up close to the eyes e.g. by tilting a book
  • Use reading materials with big and bold pictures and text
  • Allow a child their own small copy of a ‘big book’; in groups the LSA can sit with them and point out things as the teacher does
  • Draw attention to fine detail and test their understanding: let them play back to you what they have seen
  • Supervision should be targeted to certain areas - stairs, curbs, climbing equipment, outside play. Supervise those who are light sensitive in bright sunlight, ensure they wear the correct cap or sunglasses and cream
  • Be alert to signals of poor vision - wandering eyes and lack of concentration, lack of effort, underachievement, unfinished work
  • Keep the child challenged and interested, especially those who may need extra variety and challenge or may be ‘gifted and talented’
  • Allow the child opportunities to interact with peers and form good relationships
  • Observe the child in the early days to see what the obvious hazards are and make necessary modifications. There is usually no need to go overboard but tailor environmental changes to the child’s needs. Removing obstacles on the floor is an obvious example; lowering or raising light levels appropriately is another.
  • Head turning is a child’s own strategy and should be understood and encouraged. There are two reasons for this. In nystagmus there is a viewing angle where the eye movements slow down or even cease (called the null point); this is the child’s best viewing position. In other cases a head turn may reduce the light rays hitting the retina directly and so the image may be sharpened.

Friday 24 February 2012

Supporting the adolescent who has suddenly lost his sight

In one of my schools I have recently begun supporting a young man who has lost his sight due to a brain tumour.  He has no useful vision in one eye and the other is about 3/60 with restricted visual fields. He can only see detail three or four inches from his face. Print has to be ultra large (24point) and activities such as looking at texts and pictures on the white board or watching television have become a thing of the past. In many ways it is the worst case scenario, because all his life he has had perfect vision and has lost it in his early teens, in the midst of his adolescent years, just as exams are looking up and he is barely a couple of years from adulthood. In addition he is a very able student on track to gain high grades. Outwardly he seems to be coping remarkably well, though it is clear from comments he occasionally makes that he is going through a form of grieving for his loss (as you would for a close relative who has died). 

Support for such a young person in a setting that is quite unprepared for such a scenario has been a real challenge. For this reason I want to share today some ‘pointers’ that I sent to all his teachers so that they have a little more of an idea how to modify their teaching to suit his needs.  What follows is little more than a note I sent out to staff (unedited I might say), and a lot of the ideas have come from sitting in class with him over the past few weeks and seeing the struggles and frustrations he is having. 

Supporting Mo in class
Some pointers here, they may not all be practicable or you may have other suggestions yourself. It is envisaged that some of the modifying can be done by the support teacher, if received in time.  

1. Giant enlarged print is difficult to navigate quickly simply because fewer words are on the screen or page. Therefore clear precise instructions from the class teacher (CT) will help Mo and his support teacher (ST) to navigate a page of writing and find the right line/word when moving from one section to another quickly. If pages, paragraphs and/or lines are numbered it helps Mo / ST to find a section more quickly. 

2. Handouts / texts need to be modified in advance. If text is handwritten it may need to be retyped into print. A page of printed text can be scanned via an OCR programme and enlarged. Mo needs 26 point text in bold Arial font. 

3. ST can often seem to disturb the class / and the CT when talking to Mo; this needs to be kept to a minimum. Sometimes the ST needs to read a text to Mo; this may disturb pupils but it is a trade-off: reading a text is quicker and saves using equipment. 

4. CT should read out all text (or delegate it to pupil) when working from a handout or text book and when writing on the board. Reading it twice is even better! 

5. The pace of the lesson can be too fast for Mo. It might be considered to slow down the pace a little to match Mo’s speed of access.

6. Texts need to be provided to the ST well in advance of the lesson to allow time to modify them. Advance preparation is essential and judgements have to be made about whether to use A4 enlarged print, electronic magnifier, or a reader. 

7. It is really helpful if ST has a grasp of the subject matter to be able to assist Mo. Sometimes it may be appropriate for the ST to work directly with Mo in a small SEN room and go through the content on a one-to-one basis. Familiarity with the exam texts and subject matter will be very useful in those circumstances.  

8. Mo is unable to write independently without a scribe or at the very least a good quality magnifier. 

9. It will be useful for the ST to make notes in the lesson for Mo. These should be in giant print (26 point). 

10. Laptop. Mo has difficulty with the glare coming from the screen. He also finds it hard coming too close. Mo cannot read the letters on the keyboard and so will benefit from large high contrast letters on the laptop keyboard. Touch-typing will be a useful skill for Mo to learn. 

11. For the time being we will assume Mo cannot access the board, therefore a handout of what is on the board will be very helpful. 

To sum up:
a.    Advanced planning and modifying of work is essential
b.   Low vision electronic aids are not a substitute for modified texts. All texts should ideally be adapted to 24 point size.
c.   Handwritten texts on handouts should be adapted into print. Give Mo a copy of board notes.
d.   Ideally texts should be provided in electronic format for Mo to enlarge on the laptop. If he has a pen drive that he carries around all his work can be put there and he can take responsibility for collecting it.

Thursday 23 February 2012

Supporting a VI child in the transition to secondary school

Every stage of schooling has its particular difficulties for the visually impaired child and there is no one-size-fits-all solution. For this reason I am proud to be working with a highly skilled and dedicated workforce where I work. Charlotte is one such young graduate who was recently thrown into the deep end with this young man, whom we shall call Freddie. Charlotte very kindly agreed to share her initial thoughts on the challenges of working with Freddie, who started at his secondary school last September. This is a brief introduction to how she has found it. Thank you so much Charlotte for your contribution.
The challenges of working with a visually impaired boy in a secondary school

In September 2011 I began working with Freddie (pseudonym), a visually impaired boy who had just started secondary school. Freddie suffers from very low vision, caused by nystagmus, which means his eyes involuntarily dart from side to side. Having never worked with a child with a visual impairment before, this role presented itself as a big challenge to me, but 5 months down the line I can safely say that my time supporting Freddie has been rewarding and hugely enjoyable.
As Freddie attends a mainstream secondary school, the resources used by teachers (such as textbooks and test papers) are not designed with the visually impaired in mind. Consequently, one of the most important parts of my job is ensuring that resources are adapted for Freddie so that he can properly access them in class. In my early days of doing this I spent a lot of time acquainting myself with the photocopier and quickly became an expert at using its many enlargement functions! As Freddie also finds it difficult to read certain fonts and text colours, I edit and print out copies of the PowerPoint presentations that are to be used in his lessons so that he has a suitably adapted copy on his desk to refer to.
The Internet has proven itself to be a really useful tool for finding resources and equipment for the visually impaired. A website called has been particularly useful as it offers enlarged versions of hundreds of different popular books. I managed to order all of Freddie’s English texts from this website and believe this has really helped Freddie feel comfortable at his new school. Not only can he properly access the novels being studied, but he also fits in with the rest of the class as he has a normal book like everyone else. Online forums for professionals who work with visually impaired children have also been really helpful. When I was struggling to buy Freddie a suitably enlarged protractor to use in Maths, I discovered online that other people had had similar problems and came across the creative idea of photocopying and enlarging a normal sized protractor onto acetate and then laminating it.
Being an LSA (learning support assistant) is not just about making practical resources; a big part of my job is ensuring Freddie feels comfortable and happy at school. Something Freddie and I agreed at the start of the year was how important it was for him to not feel as if he stood out. Starting secondary school is hard enough without looking as though you are being given lots of extra attention and understandably Freddie wanted to be given space to settle in and make friends independently. This calls for a lot of tactical positioning in lessons on my part. I never sit by Freddie in lessons unless he asks me to; instead I help out the whole class, making sure I walk by Freddie every so often to check he is on track. As Freddie often suffers from headaches or tired eyes, I also made him a “Time-Out” card to show to his teachers when this happens. Strategies that may seem small like this actually have a big effect on how comfortable Freddie feels at school; rather than having to explain to the teacher in front of the whole class every time he has a headache, all Freddie has to do is show the card and he will be allowed a few minutes outside of the classroom. To ensure Freddie didn’t feel overwhelmed with questions and attention from his class teachers regarding his visual impairment, we set up fortnightly meetings between the two of us to discuss how he is getting on, which lessons and strategies are going well and which might need some extra adaptation.
Communicating with Freddie’s teachers about his needs and keeping them up-to-date on how he is getting on is a really essential part of my role, especially as Freddie attends such a big school with a large body of staff. In the past I have organised a training session with Maurice and Freddie’s teachers which gave them a space to raise their own questions about teaching a child with a visual impairment. I have also compiled handouts and ‘help sheets’ for teachers to ensure they are well informed about Freddie’s needs and the sorts of strategies that help him properly access his lessons.
Looking back on Freddie’s time so far at his new school, I feel really proud of him. He seems to be really enjoying school and is working hard in all his subjects, never letting his visual impairment stop him from achieving. I am really looking forward to the rest of the year with Freddy and from my chats with Maurice, have lots of ideas for other strategies to help him do his best at school.

Friday 10 February 2012

Mobility for the visually impaired child

To many people the role of the visually impaired teacher is a mystery. Indeed I was a mainstream secondary teacher for many many years and I have to say it never occurred to me that a person called  a VI teacher even existed. I rarely came across pupils with major difficulties with their eyesight so perhaps that is part of the reason; in those days of course the majority of VI children went to special schools. Am I giving away my age here...? 

This is surely an argument for one day in the future explaining the role of the VI teacher in some depth in this blog. To me I have to admit the same can be said for some other professionals, such as the OT or the physio. However the one professional that is seriously underestimated and even less understood is the mobility instructor. I do not even know the right term to use. Is it rehabilitation worker or habilitation worker? And what is the difference between the two? What is mobility? I know that it is more than learning how to get around. It is also, I am informed, very much to do with independence and also to do with doing everyday things for yourself.  My apologies for expressing my sheer lack of knowledge. I only say these things to show that though I work in the field of visual impairment I am not an expert on everything (let alone on VI!)  For this reason I have asked Charmaine to explain her role and I am truly grateful for her very kind contribution here. I know I will learn as much as anyone who reads her article. Thank you Charmaine. Enjoy. 

My name is Charmaine Sutton and I am the Educational Rehabilitation and Mobility Officer (ERMO) for the Sensory Education Support Service in Lincolnshire (SESS). My post was developed approximately 6 years ago when the Teachers for Visually Impaired Children (TVIs) put together a case for employing a mobility officer as part of the educational provision for children and young people with visual impairments in Lincolnshire; mobility training is an educational requirement for children with visual impairments if they are to develop independence. For the child with severe sight impairment it means they can attend the same school as their friends and be independent in the classroom, corridors and playground.

As the only ERMO in the team, I cover the whole of the Lincolnshire; Lincolnshire is a very rural and large county. I work with children and young adults from 0-19, teaching anything from long cane, symbol cane, general orientation, upper and our body protection, tracking and ball balance work.  Each TVI has a caseload and from that caseload they refer children/young adults to me.  Many of the children and young people with severe sight impairment will need ongoing mobility programmes, but some only need programmes at times of transition when they change classroom or move from nursery to primary school or primary school to secondary school.

My daily routine – well, I call it a routine but it isn’t. No two days are the same, which is exciting, although I do have regular visits to most of the children on my caseload - some have weekly some have fortnightly visits. I rely on teaching assistants to carry on practising the skills with the children in between visits. I am one of those very lucky people who absolutely loves her job. I love working with these inspirational children and young adults. I make mobility fun and introduce it at a very young age.  I try to start some long cane training as soon as children can walk so that it becomes part of who they are and not something that makes them different.

Here is an overview of a Day in the Life of an ERMO:

My first visit of the day is to a school where I am assessing a child for long cane use, so I observe them within their environment. As an assessment tool I use Steps to Independence which is an RNIB publication. This gives me some pointers as to where the child may need input. During the visit I will hopefully get the chance to observe a playtime, PE lesson and a classroom situation.

My next visit is providing balance ball training with a child that has a very wide gait. Using a balance ball and various exercises enables the child to building core strength and get used to the feeling of being off-balance.

My final visit of the day is to a young adult who is having long cane training. The cane training takes place in the educational environment, a place where the young person feels comfortable and at ease. This enables them to learn the skills in a safe controlled environment and then in time we move the skills on to a more unpredictable environment. This is done slowly, building the skills and confidence continually.

As you can see from this overview of my day, each visit brings its own challenges and rewards. My job is never the same day to day or visit to visit. This makes my job challenging, exciting and rewarding. The main thing I would like to achieve in being a mobility officer is to enable blind and severely sight impaired children and young people to feel empowered and full of confidence to tackle any area outside of the educational environment and also make the long cane more obvious in general society and so detach some of the stigma.

Charmaine Alice Sutton ERMO

Thursday 9 February 2012

Cerebral Visual Impairment CVI - A barrier to learning? Part Two

a. Human beings are bombarded constantly by sensory data. The CVI child has a greater difficulty in filtering visual input and cutting out what is not needed.

b. Present things visually in a sequence to the child, one by one, not at all at once.  Choice-making requires the skill of seeing and giving attention to several things at once. 

c. When a person cannot do this they have simultanagnosia, meaning the inability to see two things simultaneously. This may be related to what is sometimes called ‘neglect’.

d. Children up to four and a half cannot parallel process. Their brains can only cope with one piece of  visual input at one time. CVI children usually are developmentally delayed and their brains may  be operating at the level of a very young child.

The world we live in is a place of infinite variety. Daily we are battered by a constant barrage of sensory information; though we become so used to it we barely notice it. The same world however for a child with brain damage and visual impairment is a confusing place, filled with so much contradictory and conflicting data. So many things to distract the senses – sounds, pictures, smells, tastes ... For our CVI child this makes the world a very distracting place. It is difficult for them to concentrate when there is always something else to look at.

If we could only cut out what we don’t want our child to notice and only let them see what we do then we will make it easier for them to pay attention.

So that is precisely our challenge: what we have to do is present one thing, one toy to our child at a time. In other words everything has to be sequential, showing the child one thing after another rather than two or more things at once. Show a picture but only one picture at a time to your child. And the one picture must have only one element in it and a plain background. Don’t show two toys at once or it will only confuse him. Children with CVI have problems making choices. Have you noticed that? And yet we professionals so often put it in the child’s individual education plan: ‘develop choice-making skills’. But they can’t. How can you make a choice if you can only see one thing in front of you (the problem for so many CVI children)? Do not expect your child to make choices if he is not ready. And he is most probably not ready to make choices just yet. It is enough to show your child one toy, point to it and say, do you want this, instead of showing two and saying, which one do you want?

The word ‘simultanagnosia’ I first heard used by Professor Gordon Dutton. It means the inability to pay visual attention to (look at) more than one thing at any one time. Or to put it another way the opposite of attention is neglect, which means that when shown two objects a person will see the one and ‘neglect’ (not notice) the other. So while they can ‘see’ two objects they only really notice one object or worse they are confused by the whole scene.

How does this apply to computer games? I was discussing this with a teacher recently who was trying out switch programmes with a boy with complex needs and visual impairment. She had tried various programmes but only one really worked. One that didn’t work involved switching to add animals to a farm scene. Initially the boy pressed the switch but as soon as two animals appeared on the screen the boy lost interest. The switch operated computer game that was successful however, involved making a light flash on and off in a variety of ways: he really enjoyed this and it kept him focused. The first task presented more than one thing on the screen at once; the second had just one thing. The boy cannot cope with more than one thing at a time being presented to him.

This condition does not automatically depend on the ‘cognitive’ age level of the child. There are some children who are so developmentally delayed that they are operating no higher than the cognitive level of a baby of two to three months old. A child of that age has a very limited amount of 'Ram' in their 'computer' (brain). That is perhaps the best way to see the child's brain. It just can't handle much information. There are on the other hand other children with the same condition who, while still being cognitively delayed, are functioning at a much higher level. Even with these youngsters the ability of the brain to give attention may still be just as limited and we need to be thinking of just these areas as operating at a lower developmental level. As rule children under four years of age are all single processors and cannot cope with dual processing but the situation is just greatly amplified by CVI. As a point of fact there are adults who have suffered stroke who have precisely the same difficulty so it is not only linked with cognitive age.

This difficulty is acknowledged to a degree though actually little understood. The English National Curriculum has now included target setting for children at much lower levels of ability and there is some reference to these issues there. The document on ‘P levels’ was introduced to help teachers set appropriate targets for such children. Insights into this ‘one-at-a-time’ principle at a young developmental age can be gleaned by looking at some of the lower P levels descriptors.

In this extract it points to the difficulty children with complex needs have with sustaining attention: P1(ii) ‘Pupils show emerging awareness ... They may have periods when they appear alert and ready to focus their attention on certain people, events, objects or parts of objects, for example, grasping objects briefly when they are placed in their hand.’

Comparisons have also been with autism (ASD). Though I do not want to draw too many parallels with ASD, some of the approaches used with children on the autistic spectrum are similar to approaches I recommend with CVI children. Many children with ASD have difficulties handling multiple or complex visual information in the same way that children with CVI have. The picture exchange communication system (PECS) for children with autistic spectrum tendencies (ASD) works on a step-by-step (one-at-a-time) visual presentation.

We can also look at the media industry and find examples of this approach in programmes made for children’s television. One of the favourite children’s programmes is the Teletubbies and we can see there a clear one-at-a-time approach used. Events happen one after another not at the same time. The narrator speaks then a Teletubby speaks or moves. Then the narrator speaks again and so on. The characters fill the screen with their big bulgy shapes. The backgrounds are highly simplified. Actions and objects are portrayed so they do not merge into one continuous single action stream. This is great for kids who can’t process information simultaneously.

The above article is a chapter from my handbook for teachers, 'What can I do for my CVI Child?' - Maurice

Saturday 4 February 2012

Cerebral Visual Impairment CVI - A barrier to learning?

a.    While there may other issues to consider for our purposes it is the vision part of the brain that is damaged.
b.    A fundamental visual barrier to learning is caused by the inability to maintain focused or fixed visual attention.
c.     The issue with selective attention makes it difficult to filter out visual distractions and to make sense of a crowded scene.
d.    We can all relate to this because we all get distracted by incoming sensory input.

Cerebral visual impairment (CVI) is a difficulty seeing and making sense of the world, caused by damage to a part of the brain and not merely the eyes. It is not as easy to diagnose or explain as may be an ocular impairment. On the other hand there may be more improved vision over the years than might be expected with an ocular impairment.  CVI  can affect a child in some quite specific ways, in particular in relation to the brain’s attention system. The good news is that you can often dramatically modify the environment to enhance the child’s attention. The right environment encourages a child’s selective attention and in turn encourages the development of concept formation. Concepts formed in early childhood almost always are dependent on a child’s ability to maintain attention for a period of time. And by that I am chiefly referring to visual attention.  Whether it is the understanding of cause and effect or distinguishing similarities and differences or the ability to make choices, all are rooted in the ability to maintain and sustain focused visual attention. 

First you have to ask the right questions. With cerebral visual impairment (CVI) the question you want to ask concerning your child is what is stopping them learning? What is the ‘barrier to their learning’? What is causing them not to progress? It is the answer to this question, which is the core issue for the child. If you are not addressing the core issue then you will be off the mark in your solution. What I am saying is that your child with visual impairment due to brain damage has a fundamental problem with giving and keeping visual attention. To recognise that your child’s dominant problem is a difficulty with giving focused attention is the first step towards meeting their needs. The difficulty is not first and foremost a motor skill delay. It is not even primarily poor visual acuity (of course this may be part of it). It is not chiefly coordination. 

I am not by any means understating the significance of any of these in a child’s learning and development. But many people think of all kinds of things when they try to understand the child with CVI and the answers they come up with may well be good answers but they are secondary issues. The central and fundamental difficulty that your child faces is an inability to give and sustain visual attention. For example it is difficult for them to make sense of a crowded picture, or to pick out someone familiar in a crowd, or to see a favourite toy if it is surrounded by other toys or to pick out their sock from a basket of clothes. All these examples come down to the same thing. This is not rocket science but it does need to be fully appreciated. If you do not have the child’s focused attention at the point of learning your efforts will be wasted. The child’s mind will be elsewhere; their eyes will be looking elsewhere. Unless you have the child’s attention and they are focused solely on you or on the object or the task and they are not distracted by noises or clutter in the room, you may be wasting your time and the child’s time. 

You only have to look at your own experience to confirm its truth. Your mind wanders during a driving lesson so you don’t hear the instructor and you miss the key instructions or information. When it is a matter of a child and their learning they cannot afford to miss out on vital visual information. The situation is acute with a CVI child because of their severe difficulty in giving focused attention. It is clear that people have problems concentrating when there are competing sounds or sights. On the London Underground it is impossible to read when you are being bombarded by public announcements over the airwaves. People cannot parallel process. It is extremely difficult to listen to two people at once. When you see that you realise what the CVI child goes through. For it is one hundred times more difficult in their case.  For children with brain damage the problem is magnified a 100 times. They cannot see what is staring them in the face. So we need to look at ways of helping them to focus their attention. You will have to find ways of capturing and maintaining your children’s attention, enabling them to see and not to miss the obvious in their field of vision and you must do it in a way that matches their speed of thinking and their speed of analysing visual information. You must try to see the world as they see it. Once you do that the whole matter is logical and you will even begin to think up your own ideas and strategies for enhancing your child’s visual attention.

The above  article is the opening chapter of my handbook for teachers, called ‘What can I do for my CVI child.’ - Maurice

Wednesday 1 February 2012

Creating resources for a VI child in nursery

In these days of stringent cuts and insistent calls to economise we can all be thrown onto our own resources and inborn creativity. This is particularly true when working with young  visually impaired children in the nursery setting. In such a context and in view of the impact of vision loss on a child's cognitive development  in particular  routes must be found through the other senses to make up for the paucity of visual information.  it is a well known fact that 80% of all learning is though the visual system.  In view of this it is vital for educationalists to think very carefully about the appropriateness of their resources and to develop if possible their own visuo-tactile aids.  I have seen wonderful examples from visual impairment teacher colleagues who had a special flair for adapting lessons for the little ones. 

Today I want to share with you some more wonderful things that I have just had the pleasure of observing in one of the nurseries I visit. Zoe is working as a learning support assistant with a young boy and she has already written an article  about  her experiences, which I thoroughly commend to readers.  I have asked her to follow this up with some concrete examples of how she has adapted topics for her pupil. It will obvious  that she is blessed with some very practical gifts and these are matched by her creative flair. But I will let her describe what she has done herself. Click the picture to enlarge the image and see all the details - Enjoy.

Supporting Mark
In the nursery I work in we always have a 'story of the week'. Every day as a group we will read different versions of this story and all activities are based on the themes of the book. 'Mark' (the visually impaired boy I work with) regularly misses out during story time on the carpet as there are 43 children all crowded round one book and he cannot see the pictures. Of course he can listen but being so young he gets easily distracted with no pictures to keep his attention. To remedy this I make props related to the story of the week which we do activities with in both a small focus group (up to 5 other children) and one-to-one. 
These are my prince and princess dolls I made when the story of the week was Cinderella. Mark loves role play so I try to work that in as much as possible into everything we do. We re-told the story using these dolls and discussed alternative endings etc. The hair for the prince doll is detachable so I could change it to turn him into a different character.
I found the Cinderella story sequence online, printed the sequence off in A4 and stuck them onto hard black card. I then added block colours of felt to built up layers of texture and create depth. Mark enjoyed feeling these to explore the scenes. I would muddle the sequence up and get him and the rest of the group to rearrange it which was a great exercise for them.
When the story of the week was the Gingerbread Man I made a felt Gingerbread Man doll. I then printed and coloured the pages of an online version of the story and turned it into a book.
I added velcro to the doll and to the pages to make it interactive. I would read the story while Mark played the Gingerbread Man and moved from page to page.

For the Three Billy Goats Gruff I made a storyboard which I would ask Mark to use to tell the story. 
 I used card and felt and chopsticks for the bridge. I then used felt and fluffy fabrics to create the goats ...
and the troll. 
This week's story is Jack and the Beanstalk. For this I have made some new blonde hair out of felt to turn the prince doll into Jack. I have also made a felt giant and goose. 
The goose is hollow and its stomach is not sewn up. This is so that the golden egg I made can live inside its stomach until Mark decides its time for him to lay an egg. I filled an old jewellery bag of mine with beads to make the bag of magic beans. These have been great for telling the story, with each child in my small group playing a different character (Jack, giant, mum, man with beans, goose). 
Next week's story is the Three Little Pigs. For this I have attempted to make a set to tell the story with puppets. The house of straw was done with yellow shredded paper, the house of sticks was make with painted chopsticks and the house of bricks was painted and covered with foam rectangles. I have completed the pig puppets but I'm afraid the wolf is not yet photo-ready!
I bought some foam numbers which I stuck onto black card. I chose black so there would be no glare and so that there would be good contrast between the base and the numbers.I chose foam numbers simply because they are fun for children to feel. I glued buttons corresponding to the numbers on the other side. Mark recognises numbers through to 10 so I get him first to count the buttons then to check that he's right by turning the card over. Normally I give him two cards, get him to count the buttons on each card separately first and then altogether. This way he is being exposed to simple addition.
These are just simple alphabet cards. I stuck foam letters to card for him to feel and drew pictures that start with each letter on the other side. We pull a few cards out of a bag each day at random to practice letters and sounds.
This book is where I have placed A4 size portrait photos of all the children in my group including myself and recorded their voices saying "Hi, my name is ......". Mark studies this in our one-to-one time to help him learn to recognise his friends when they are around him. We would practice by studying the pictures and  pressing the buttons with recorded voices. We would play a game where we had to match the voice to the face. It only took around a week before he had progressed and he now knows all of these children by both their voices and faces.
I bought this bag of textured squares online when I first started working with Mark. The whole group loves it and its a great lesson in turn taking as I go round the circle for them to all have a go. However, I see now that I could very easily have created this myself with the wonderful resources that are available to me at nursery. The object of the game is to close your eyes and use your hands to feel around for two matching squares. This is something Mark really needed to practice since he is very tactile defensive and we need to increase sensitivity in his fingertips.
One of the resources Maurice brought into the nursery is a puzzle, which involves putting pieces into their correct places according to their different textures. I turn the pieces upside down and Mark feels the bottom and then decides where each piece should go. Mark manages very well to sort out the different pieces according to texture.

Thank you so much Zoe for all your hard work.

Other resources that readers can purchase can be found in the following sites:
Early years Resources
Tactile games
Games for young VI
Tactile animals

I am always interested in sharing good practice. If readers have similar things they would like to share please contact me. Thanks.