ENCOURAGE USE OF VISION
in students with Multiple Disabilities

By Carmen Willings
teachingvisuallyimpaired.com
​Updated October 29, 2017

Visual skills instruction includes learning to use visual skills, such as tracking, scanning, and attending to visual stimuli. Visual efficiency refers to the extent to which a person makes the greatest use of the vision that is available to him or her. It is dependent on a number of factors. This includes a person's visual abilities as well as their cognitive, physical, psychological makeup, and prior experiences. It is also influenced by environmental conditions that can affect vision. For that reason, two people with identical eye conditions and visual acuities can have very different levels of visual efficiency, or a particular individual can have different levels of visual efficiency in different environments or situations.

Although progress will differ from student to student depending on the student's visual condition and other disabilities, ongoing practice within play and throughout the day will help a student develop their visual efficiency skills. The Functional Vision Evaluation will identify the characteristics of materials that the student is motivated to look at. There are many fun activities that can encourage a student to use their vision. The following pages provide suggestions for activities as well as materials to use. 

Of course practicing visual skills can also be incorporated into planned activities. These should be different than drills. Student's preferences can be incorporated into the activity or use materials related to the classroom theme or topic. Adding variety to the activities and changing the objects and materials used, will assist the student in building on and transferring skills. 

Physical Factors Affecting the Use of Vision: ​

There are a variety of physical factors that can affect how a student uses their vision. The following is a list of physical factors that can affect vision:

• Motivation
• Fatigue
• Behavioral State (upset, quiet, etc.)
• Physical State (hungry, thirsty, healthy, etc.)
• Positioning
• Medications (many medications have side effects that affect vision)
• Familiarity with materials being used
• Familiarity with the person the child is interacting with
• Level of alertness (active, sleepy, etc.)

Motivate Students to Use Their Vision

Students need a reason to look. Consider how the activity is meaningful to the student and consider if the student will be motivated to look. Encourage active participation to the extent possible. Encouraging the use of vision through daily activities will provide the student with repeated practice in using the skill within an actual activity in which they will need to use the skill. Students can be encouraged to scan in order to locate their name on the sign-in board, scan to locate partially hidden objects during clean up time, scan to locate food, attend to a cup in order to have a drink, scan to locate a friend on the playground, etc.

Communicate with the Student

Talk to the student whether they are non-verbal or not as your voice will help identify you and your tone will help convey meaning even if the student doesn't understand your words. Be sure to use short, simple phrases without overwhelming the student with excessive verbiage. Additionally, work with those who are familiar with the student to learn more about the student and interpret the student's response cues. When a student does not use verbal communication the team will need to determine a communication system. Not all student's will be able to use systems that are dependent on vision. For suggestions on using symbols that are visual or tactile, refer to the Individual Schedules page that provides suggestions for schedules and communication systems. ​

Positioning

If the student is focusing on holding their head up or otherwise coordinate movements, it will be more difficult for the student to use their vision.  Ensure the student has good head and truck support. It is always best to collaborate with the student's physical therapist to determine the optimal position or different positions. Secure positioning will also prevent fatigue and will help the student maintain their visual field for viewing presented materials.

Material Selection

Students with multiple disabilities and particularly those with Cortical Visual Impairment, have difficulty when they are presented with unfamiliar toys/materials. For these students, it is ideal to use the materials they are familiar with and gradually introduce toys with similar characteristics. Refer to the Cortical Visual Impairment page for more information on CVI. Using toys and materials with the  characteristics (reflective materials, things that move, materials with lights, high contrast, a certain color, etc.) that the student has demonstrated the ability to attend to, will assist a student in locating and looking at the item. When presenting books, it is ideal to create or select books with one picture per page and on a contrasting background. When introducing new materials, introduce only one new object at a time. Introduce the objects through touch and verbal description.

To encourage use of vision throughout the day, purchase tools used in everyday use (cup, spoon, bottle, toothbrush, etc) with those same characteristics, or attach materials that have those characteristics to the object. For example, placing a metallic hairband on a bottle or spoon will encourage the student to look at the item. Remember the first step is for the student to be aware of the object and visually fix on it. Once that is achieved, the student can be encouraged to visually track its slow movement (If the goal is to address visual tracking.).  ​

Eliciting Response

Although it can be difficult, it is important to allow extended response time. This means not talking, which can distract the student, while waiting for a response. Also, try different lighting including dimming the lights and highlighting the object with task lighting that comes from the side or from behind the student. You may need to wiggle the object slightly to gain the student's visual attention. 

Activities

Find opportunities to encourage the student with low vision to use their vision. When going for a walk, take with you a colored card or piece of colored material.  Point out colors around you that match the card or the material.  Encourage the student to join in the game.  On an “I see red” walk, you might see a red car, knock on a red door, look up at a red flag, etc. Bring kites outdoors on a windy day or hang windsocks, mobiles and chimes. Point out the leaves that are blown by the wind and the movement of birds and squirrels as they hop around. Also encourage the student to watch ball games and try to visually follow the ball. 

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TVI’s Guide to Teaching the ECC: An Activities Based Curriculum for Teaching Students who are Blind or Visually Impaired
The TVI’s Guide to Teaching the ECC is a digital pdf available for download. It is designed specifically for fellow itinerant Teachers of Students with Visual Impairments (TVI’s), and consists of over 400 activities and topic areas of discussion for instructing students in the Expanded Core Curriculum. The activities are age-neutral and multi-sensory and therefore can meet the needs of the broad range of students served on an itinerant caseload serving. The activities can be individualized to the students various learning modalities and scaffold in order to challenge students but ensure success. Select those activities that align with the student’s learning objects based on the student’s unique visual needs and academic and developmental level. In addition to the core activity areas, each of the 32 Thematic Units incorporates additional unique ECC concepts and skills providing you with a years’ worth of activities. These units are cyclical and can be used repeatedly to help students build on prior knowledge and develop a deeper understanding of concepts. Each unit includes suggestions for activity adaptation associated with the unit. These include lists of objects, possible community-based experiences, environmental print, poems, children & young reader books, children's songs, pop culture songs, movies, and websites.


In addition to the book, the following two supplements are included:
·      TVI’s Guide to the ECC Concept Checklist
·      TVI’s Guide to the ECC Activities Checklist


For complete product details and additional images, visit the TVI's Guide product page.


TVI's Guide to the ECC Product details
·      Digital pdf download: 346 pages (11 pt font)
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Visual Efficiency & Near Magnifier Fluency Worksheets: TVI's Guide to the ECC Grab and Go Supplements
The Near Magnifier Fluency Worksheets is a Grab and Go supplement to the TVI's Guide to Teaching the ECC. This workbook is a pdf download that can be printed on demand for use with students. It contains five different types of worksheets for developing visual motor skills and near magnifier fluency skills particularly with the use of a video magnifier. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to each of the 32 ECC Thematic units. The worksheets, along with a list of environmental print for each thematic unit, are designed to help students refine their visual motor skills while reinforcing ECC concepts presented in the thematic units.  


For complete product details and additional images, visit the Visual Efficiency & Near Magnifier Product Page.


Visual Efficiency & Near Magnifier Fluency Worksheet Details:
·      Digital pdf download: 210 pages
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Thematic Keyboarding & Braille Fluency and Maintenance Worksheets: A TVI’s Guide to Teaching the ECC Grab & go Supplement
The Thematic Keyboarding & Braille Fluency and Maintenance Grab and Go ECC worksheet packet is a print on demand workbook that contains worksheets in print and simulated braille to use for data collection. Present the student with a hard braille copy and use the worksheets to document accuracy and fluency in reading braille. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to the ECC Thematic activities presented in the curriculum guide. These word lists and sentences will help the student refine their keyboarding or braille reading skills while bridging ECC concepts presented in the thematic units. Although the lists and passages can be produced using a manual braillewriter, you may also copy and paste the passages into any braille translation software for quick production on an embosser. They may also be entered into a typing program such as APH’s Talking Typer to build keyboarding fluency.


For complete product details and additional images, visit the Thematic Keyboarding & Braille Fluency & Maintenance Product Page


Thematic Keyboarding & Braille Fluency Worksheet Details:
·      Digital pdf download: 338-page print and simulated braille worksheets
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Thematic Vocabulary Cards and Checklists: Grab & Go ECC Supplement
The Thematic Vocabulary Cards and Checklists Grab and Go ECC supplement is a 446 page pdf downloadable print on demand workbook that includes 2940 vocabulary card on 3 1/2" x 2" templates divided by each of the 32 Thematic Units along with a checklist of each unit words in print and simulated braille. As a companion to the TVI's Guide to the ECC, the vocabulary cards correspond to the ECC Thematic activities presented in the curriculum guide. 


Additional Use:
Teachers of Students with Visual Impairments can have a extremely varied caseloads. It is possible to go several years without having a student on your caseload who requires braille instruction. Like other skills, if you do not practice your braille regularly, it is easy to lose those skills. Use these checklists and cards to maintain your braille skills. Fold the checklist along the line dividing the print from the braille. Choose to either read the print and produce the word in braille using a braillewriter or read the simulated braille and decode it. Finally, these vocabulary cards and checklists may be used with family members or peers who are interested in learning and practicing the braille code.


For complete product details and additional images, visit the Thematic Vocabulary Cards & Checklists Product Page


Thematic Vocabulary Cards and Checklists Details:
·      Digital pdf download: 446-page print on demand resource
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


BONUS!
Lotto Cards
The LOTTO Cards Grab and Go Supplement includes 37 theme related unit cards along with activity suggestions that support activities within the TVI's Guide to Teaching the ECC.


On My Way File Folder Cards
Print and use these cards to represent locations the student may visit that are related to the current thematic unit. Use these with the On My Way File Folder Game outlined in the TVI's Guide to Teaching the ECC p. 27.

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