Sue Douglass. M.S. Vision Impairment Specialist, Blind Babies
Foundation Presented at CTEBVI April 24, 2010
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Sylvia Santin M.A. and Joyce Nesker Simmons, M. Ed. Originally
published in Journal of Visual Impairment and Blindness, 1977
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Better communication Better hand handling More information
about what he likes and doesnt like More communication between home
and school More involvement in the activities of his classroom The
ability to know what to expect Good materials to look at and play
with
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Communication Assessment The Communication Matrix, by Charity
Rowland, PhD Available at www.communicationmatrix.org
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The Communication Matrix assesses seven levels of communicative
competence Level I: Preintentional Behaviors Level II: Intentional
Behaviors Level III: Unconventional Communication Level IV:
Conventional communication using gestures and vocalizations Level
V: Concrete symbols includes use of tangible objects Level VI:
Abstract symbols such as Bliss symbols Level VII: Language used
conventionally Available in both hardcopy and on-line versions
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Assessments For fine and gross motor assessment: Functional
Scheme, by Lilli Nielsen, available from LilliWorks Active Learning
Foundation, 2517 Blanding Ave., Suite 110, Alameda, CA 94501. (510)
814-9111, Fax: (510) 814-3941. www.lilliworks.com. A vendor here at
CTEBVI. No longer available through Vision Associates. For
cognitive assessment: Home Inventory of Problem Solving Skills, by
Charity Rowland and Philip Schweigert. 3. For communication
assessment: The Communication Matrix, by Rowland and Schweigert. 4.
To help teachers design learning opportunities: Design to Learn, an
environmental inventory, by Rowland and Schweigert. All three
available from Design to Learn, www.designtolearn.com or call
1-888- 909-4030.
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How to handle CJs hands: hand-under-hand technique
www.wsdsonline.org/deafblind/huh/huh-overview.html
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A child and helper explore a teddy bear using the
hand-under-hand technique from Barbara Miles Talking the Language
of the Hands to the Hands
www.nationaldb.org/NCDBProducts.php?prodID=47
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Object cues Give C.J. the very same spoon he will eat with.
This specific spoon says, You are about to eat, C.J.
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Anticipation calendar Uses objects and dissimilar containers 1.
Now and Finished: Two containers. Take the object out of the Now
container, use it, then put it in the Finished container NOW
FINISHED
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Now, Next, and Finished: Three containers. Take the object out
of the Next container and move it to the Now container. Take the
object out of the Now container, use it, then put it in the
Finished container. NOW NEXT FINISHED NOW NEXT
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Activity Calendar Steps:Symbol: 1. Pour milk in blender.Milk
carton. 2. Pour chocolate syrup in blender. Syrup bottle. 3. Put
lid on blender.Blender lid. 4. Blend for ten seconds.Switch. 5.
Pour milk in glass.Glass. An example: making chocolate milk
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When is an event a routine? There is a clear signal to the
student that the activity is starting. The steps of the activity
occur in the same sequence. Each step is done in the same way each
time (same materials, same person, same place). Assistance is given
the same way each time until the student is ready for a lower level
of prompt. The pacing of instruction is precisely maintained until
the activity is finished (no side conversations, going off to get
something you forgot, or spontaneously adding new or different
steps that won't happen the next time the activity is done). There
is a clear signal to the student that the activity is finished.
Millie Smith, Routines,
www.tsbvi.edu/Education/vmi/routines.htm
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Routines build a positively bonded relationship between the
learner and the partner provide social experiences that facilitate
access to sensory information stimulate the learners curiosity
motivate the learners interaction maximize the learners social
availability increase the learners quality of life Millie Smith,
1-14-10
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Routines Develop agency skills: Cognitive skills Communication
skills Motor skills Millie Smith, 1-14-10 Agency skills: skills
that give individuals the ability to act independently and to make
their own free choices
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Going to bed 1. Child is put in crib. 2. Cover is pulled up
over him. 3. Child is invited to reach for favorite squeaky ball
and takes it. 4. Mother kisses child good-night. 5. Mother turns
out the light and leaves. You can see this routine for yourself at
www.wsdsonline.org/deafblind/routines/video.html# video_3
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Introducing a new object 1. Touch the object to a less
sensitive part of a childs body (e.g., upper arm) 2. Touch the
object to a part of the body closer to your eventual destination
(e.g. lower arm) 3. Move it closer (e.g. back of the hand) 4. Move
it to your final destination (e.g.,palm of hand)
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Millie Smiths three stages of interacting with objects 1.
Paying attention: increase the length of time and the number of
things the child will focus on 2. What does this thing do? The
child is a physicist. Does it fit in my mouth? Make a noise? Come
apart? What happens when I bang it, bite it, throw it? 3. What is
this thing for? Does it have wheels so I can roll it? Can I pretend
to feed it? Can you read it to me?
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CVI definition Cortical Visual Impairment (CVI) is a temporary
or permanent visual impairment caused by the disturbance of the
posterior visual pathways and/or the occipital lobes of the brain.
From the Blind Babies Pediatric Visual Diagnosis sheet on Cortical
Visual Impairment www.blindbabies.org
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Some characteristics children with CVI may demonstrate Eyes
look normal, but children do not appear to see well History of
interrupted oxygen to the brain or brain bleed May not have full
visual fields. May prefer objects of some colors over objects of a
different color Seem to see familiar objects better than new ones
Take awhile to focus in on an object
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More characteristics children with CVI may demonstrate Prefer
plain backgrounds and objects with one or two colors over objects
with many colors and much detail Look at an object, then turn away
from it before reaching for it Appear to look at faces but do not
really seem to see them recognize people by their voices, etc. See
better if an object is moving or they are moving (as in a swing)
Either avoid light or stare at them, especially overhead lights, in
preference to looking at other things
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Phase I: Building Visual Behavior Ranges 0-3 Discover what
child will look at Develop childs ability to use vision more
frequently to look at what he or she will look at Child only looks
at a small repertoire of objects usually having similar
characteristics (may be specific color, have reflective properties,
be moving objects, shown against a particular background, and
visible in a particular part of childs visual field)
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Phase II: Integrating vision with function Ranges 4-6 Child now
uses vision enough that he or she can use vision to explore objects
and do activities Child can use vision in choice-making, self-help
routines, fine motor tasks, cognitive tasks Still needs a
controlled environment to maximize use of vision Light Box a good
tool for children who look at lights Usually able to look at faces
and respond to facial expressions
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Phase III: Resolving remaining CVI characteristics Range 7-10
Child may not appear to casual observer to have vision difficulties
Still may have reduced visual fields, or be unable to see at great
distances Still may have difficulty seeing when there are lots of
objects to look at combined with a busy background May have trouble
recognizing photographs or drawings of objects he or she can see
May still have some O & M issues
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Long-range planning Keep in mind: How will the activities you
are doing now make a difference in the childs Control over her or
his life? Ability to do things independently? Connection with
others? Access to the world? In one year? In five or ten years? In
20-40 years?
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Long-range planning Was this activity planned together with the
childs family? Is this activity something the child can do at home
with the family?
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IEP goals and objectives By (date goal will be measured),
(conditions under which goal will be measured), (childs name) will
(do something observable and recordable) in (number of)
opportunities on (range of) days as measured by (how achievement or
non-achievement will be measured). By (June, 2010), (while seated
in his Tumbleform feeder seat), (Asher) will (look at an APH yellow
pompon for 10 seconds) in (4 of 5) opportunities on (4 of 5) days
as measured by (teacher record on teacher- made chart).
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IEP goals and objectives By (June, 2010), (when seated in her
high chair at the dinner table, and given her spoon), (Melania)
will (open her mouth in anticipation of being fed with the spoon)
in (5 of 5) opportunities on (4 of 5) days as measured by (parent
record). By (June, 2010), (when seated in his Rifton chair at
school) (Isaac) will (reach for a red Mylar-covered switch to turn
on his tape player when the music stops playing) on (4 of 5)
opportunities on (4 of 5) days as measured by (teacher record on
teacher-made chart).