CVI Mealtime Strategies

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As soon as I received my daughter’s Cortical Visual Impairment (CVI) diagnosis in 2018, I began researching, reading, and brainstorming ways to help her begin using her vision throughout her daily routines (you can check out my introductory CVI reading recommendations here). 

The very first adaptation I can recall implementing was the mealtime strategy of placing a shiny, red gift bow on the handle of Rosalie’s spoon (I think I got this idea from reading the Little Bear Sees book?). At the time, Rosalie was 7 months old and her mealtimes consisted largely of being fed purees on a spoon. Prior to my learning about CVI, she never seemed to open her mouth in anticipation of the spoon; rather, she would open her mouth only after I gently touched the spoon to her lips. In hindsight, it’s pretty obvious that she didn’t see the spoon coming! 

Fast forward to placing a red, shiny bow on her spoon…and voila! Rosalie began opening her mouth as I brought the spoon towards her. That first easy adaptation literally changed our lives – and reminds me that even the simplest changes can be made to provide my daughter access to the visual world.

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Our CVI mealtime strategies have evolved numerous times throughout the past 2+ years, so today I’m sharing some of what has worked for us. Perhaps it will spark new ideas for your own mealtimes!

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September is CVI Awareness Month!

It’s September, y’all! And you know what that means….

CVI Awareness Month

Happy CVI Awareness Month! This month is a great opportunity to raise awareness for this growing public health crisis. If you’re on social media, feel free to share this image. Let’s spread the word!

“CVI-friendly” Access to Life Skills: Choosing Outfits

I think we can all agree that being home-bound due to a global crisis like the Coronavirus pandemic is not ideal (to say the least). But, sometimes less-than-ideal circumstances can potentially have a silver lining for some.

In our case, my oldest child no longer needs to be at school by 8am(!), which means I can take my sweet time leading the kids through our morning routine of dressing, combing hair, and brushing teeth. My oldest two children need minimal assistance, so I have found myself better able to focus on these everyday life skills with Rosalie, my daughter that has Cortical Visual Impairment. Prior to our state’s school closures and stay-at-home orders, there was zero morning time to spend choosing outfits and Rosalie wore whatever I laid out the night before.

When I began introducing clothing options, Rosalie (2.5 years old) already knew the names of most colors – but that doesn’t mean you need to wait for this knowledge in order to begin! In fact, clothing could be a fun way to help teach colors (I do this frequently for Rosalie by describing the colors of shirts everyone in our family is wearing each day).

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Image of girl with braid and red bow looking at a wardrobe of red and white clothes. Text reads, “CVI-friendly” Access to Life Skills: Choosing Outfits {Everyday CVI}

How did I begin?

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Using Wall Decals to Promote 2D Processing

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Happy CVI Literacy Awareness Month!

When it comes to Cortical Visual Impairment (CVI) and literacy, it’s important to understand that anything we do to promote looking, visually recognizing, and interpreting what the eyes are seeing is creating a path to literacy. 

What do I mean by this?

To briefly summarize: CVI is a brain-based vision impairment. The eyes are healthy and function normally, but the brain has difficulty processing and understanding what the eyes see. But, how an individual with CVI uses and functions with their vision can improve as the brain makes new connections, learning to recognize and better interpret more visual input.

So, if you think about it, literally any time we get a child with CVI “looking” we are working towards literacy. A child must be able to look at something, maintain visual focus, and begin recognizing and interpreting what they are looking at in order to achieve literacy.

Keeping this in mind, I am always looking for creative ways to increase my daughter’s opportunities to use her vision throughout our everyday routines. Right now this means creating additional ways to get my daughter, Rosalie, looking at (and recognizing) more 2D images.

A recent strategy I’ve been using to promote extra 2D processing is: using wall decals around the house!

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CVI Strategies for Reading “Brown Bear, Brown Bear”

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In honor of CVI Literacy Awareness Month, I’d like to share some of the strategies I’ve used to introduce my daughter with Cortical Visual Impairment to the book Brown Bear, Brown Bear, What Do You See? by Bill Martin, Jr.

When I added a felt wall to my daughter’s defined play space, my mom gifted me a set of pre-cut Brown Bear felt pieces. I had fun immediately introducing the matching felt pieces to the pages in the story, which provided a fun tactile (and visual, obviously) learning experience.

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Pictured above are all of the animals from the book, but to address the CVI characteristic of “complexity” I present only one image on the felt wall at a time.

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April is CVI Literacy Awareness Month!

Happy CVI Literacy Awareness Month!

The topic of literacy is so important for the CVI community that it needs its own month (set apart from CVI Awareness Month in September) for recognition and awareness. After all, a path to literacy for an individual with CVI must look different than a path to literacy for an individual with any other type of vision impairment. Why? Because CVI is unlike any other vision impairment. With this neurological-based vision impairment, the eyes are healthy and see what everyone else sees, but the brain has difficulty processing, recognizing, and interpreting what the eyes can see.

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In other words, CVI is a disability of visual access. Appropriate strategies that adapt the environment and materials in consideration of the 10 characteristics of CVI and an individual’s unique functional vision are the key to providing access to materials. This is no different when it comes to literacy.

Literacy is defined as “the ability to identify, understand, interpret, create, communicate and compute, using printed and written materials associated with varying contexts.” (UNESCO Education Sector, 2004, p. 13)

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“CVI-friendly” Magnetic Stacking Blocks

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Back in the fall, I was thinking about some of the fine motor goals I have for my daughter’s play time. She is 2 years old and very much loves “cause and effect” toys – things where she can push a button and make it light up, sing, dance, etc. These are really fun, rewarding toys (“I make an effort and this cool thing happens!”), but I also want her to be able to move beyond simple cause and effect toys as she grows (something we take for granted with typically-sighted children, but must intentionally teach and/or provide access to for a child with CVI).

When I reflected on this, my mind came up with two major categories of play that I wanted to move towards: “pretend play” and “building.”

Today on the blog I want to focus on “building.”

Do I expect my two-year-old that has physical developmental delays and Cortical Visual Impairment (CVI) to suddenly become a mini engineer building the kind of elaborate Lego Duplo inventions her (typically-developing and sighted) big brothers began creating at age two? NO. But I often look to her typically-developing siblings and/or peers to generate ideas of where I’d like her to be able to go and/or what I’d like her to have access to in play (and life). 

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Highlighting Objects Around the Home

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As my young child with Cortical Visual Impairment (CVI) has become progressively mobile, it has become increasingly important for me to think about what I can do to help her visually orient herself within our home.

You may recall that some months ago I began using washi tape (like this glittery set) to highlight some light switches with pops of sparkly color. This provided a fun visual and fine motor activity of turning light switches on and off while I necessarily carried my daughter, Rosalie, from room to room with me. So, it was only natural for me to start looking around at other things it would make sense to highlight as Rosalie began moving around the house more independently.

Where did I begin? For starters, I gathered my supplies: scissors and tape. Really, that’s all it took!

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Pictured: white scissors and a roll of shiny, red duct tape.

As you will see, I ended up using various kinds of tape on different surfaces – depending on the material, color, and what the purpose of the tape was. Pictured above is a shiny red tape, similar to this one found on Amazon.

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CVI DIY: Adapting Puzzles

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Puzzles are such a great activity! They promote and fine-tune functional vision in conjunction with cognitive and motor skills…and they are never too visually complex for a child with Cortical Visual Impairment (CVI), right?! I mean…wait.

But seriously. Puzzles really are a fantastic activity that can assist with a child’s development (we’re talking visual and shape recognition, concentration, patience, fine motor skills, and more!)…when a child with CVI has access to them.

Every child with CVI has some type of medical history that has caused this brain-based visual impairment (whether that history is fully known or not), so I recognize that some children with CVI may not have physical access to traditional children’s puzzles, but in sharing how I have adapted puzzles for my daughter I am focusing solely on the issue of visual access.

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Celebrating Halloween (CVI style)

Happy Halloween!

Two of the “10 characteristics of CVI” are color and complexity. This means bright, highly-saturated hues that are solid colors (with little or no patterns) tend to be easier for someone with Cortical Visual Impairment to visually process.

Red is one of the first colors our brains learn to process as infants, so it’s no wonder Elmo is often a favorite of little ones with CVI! He is solid, bright red and easily identifiable with his simple eyes and big, orange nose.

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Pictured: little girl dressed in an Elmo costume, surrounded by 4 Elmo dolls.

Another CVI characteristic is noveltywhich means a child with CVI will be drawn to the familiar since new people/places/things are much more challenging to visually process. Someone with CVI cannot simply “look” and learn what something new is; they must learn the distinct, salient features that categorize objects for what they are, which means new things require building a new framework of understanding in the brain…whereas familiar objects are ones the brain has already learned to “see” (process).

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