Embracing Vision: Liam’s Journey with CViConnect

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In the world of visual impairments, every small victory is a monumental achievement. Sandy Gillam, a dedicated TVI (Teacher of the Visually Impaired) and a passionate advocate for her son Liam, has shared their story on the Path’s to Literacy blog. Liam, who is deafblind and recently diagnosed with Cortical Visual Impairment (CVI), has found a new way to explore and understand his world through his functional vision.

Liam’s Journey With CViConnect

Liam’s journey with CViConnect began with a simple yet profound goal: to learn the extent of Liam’s functional vision. While being a braille learner his whole life, Liam is embracing the challenge of using his residual vision to identify and learn about various objects.

Liam has shown interest to his team in wanting to use his vision more, and gets elated with the opportunities to learn what he is seeing. One of the most heartwarming examples of this is when Liam uses the CViConnect app learning to visually identify the fruit choices given to him at school lunch. Liam could not wait to show his other teachers what he was looking at. The fruit shaking brought contagious laughter through the room.

Liam uses the CViConnect App

Through the CViConnect app, he explores the salient features of different foods, animals, and other items of interest, enhancing his understanding and interaction with his environment. This is only the beginning for Liam and his team. They are eager to learn what other things Liam will learn to identify and how this will support him academically and in his daily living skills. 

Sandy’s blog chronicles their deafblind journey and offers a wealth of resources and insights for other families navigating similar challenges. His story is a reminder that with the right tools and support, every child can unlock their potential and thrive.

Here is Liam in action utilizing the CViConnect app.

If you’re interested in learning more about these products or how they can benefit your students or children, don’t hesitate to reach out to the respective companies. Let’s continue to explore and embrace the innovations that make a difference in the lives of those with CVI!

 

Exploring Innovative Tools for CVI Access at ATIA 2025

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The ATIA 2025 conference was a hub of innovation and excitement, especially for those of us dedicated to improving access for children with Cortical Visual Impairment (CVI). Carly, CViConnect’s activity designer and Certified Teacher of the Visually Impaired (CTVI), took us on a tour of some remarkable booths showcasing tools that can make a significant difference in the lives of children with CVI. Here are some highlights from her visits.

Cosmo Switches: Versatile and Engaging

At the first booth, Carly introduced us to the Cosmo switches. These light-touch switches are designed to be highly responsive and customizable, making them ideal for students with CVI. Available in packs of one, three, or six, these switches can change colors to suit the visual preferences of each student. They also feature strong magnets, allowing them to be attached to various surfaces, including walls, floors, and even wheelchairs. The Bluetooth capability ensures they can be integrated with a wide range of programs, providing auditory feedback to enhance engagement. These switches are perfect for Braille learners and dual media users, offering a versatile tool to support their educational journey.

Adaptive Abilities: Independence Through Innovation

Next, Carly explored the offerings from Adaptive Abilities, a company dedicated to switch-adapting everyday products. Their DIY kits are cost-effective and allow for the adaptation of various items, from kitchen tools like apple peelers to art supplies and massagers. These adaptations are particularly beneficial for students with limited upper extremity mobility, enabling them to interact with their preferred toys and tools. This not only fosters independence but also enhances their cause-and-effect understanding, crucial for cognitive development.

Talking Keyboards for Children: A Voice for Every Child

Finally, Carly visited the booth for Talking for Children, showcasing their latest AAC (Augmentative and Alternative Communication) device. This tool is designed to accelerate learning and communication for children who are non-verbal or have limited speech capabilities. The device can be pre-programmed with phrases, making it an invaluable resource for postoperative patients and children alike. The newest model promises even more features and customization options, ensuring that every child’s unique needs are met.

Speak to Yourself LLC: Customizable Communication

Carly also stopped by the Speak to Yourself LLC booth, where she demonstrated their iOS AAC application. This app is particularly exciting because it allows for extensive customization to meet the needs of students with CVI. With the CVI setting enabled, users can easily enter edit mode by ensuring the purple bar is visible at the top of the screen. From there, they can select buttons to edit, change colors, and even add photos either by taking new ones or using existing images. This level of customization ensures that the communication tool is tailored to each student’s preferences and needs, enhancing their ability to communicate effectively.

  • The ATIA 2025 conference highlighted the incredible advancements being made in assistive technology for children with CVI. From versatile switches to adaptive tools and innovative communication devices, these products are paving the way for greater independence and engagement. For educators, therapists, and family members, these tools offer new opportunities to support and empower children with CVI.

If you’re interested in learning more about these products or how they can benefit your students or children, don’t hesitate to reach out to the respective companies. Let’s continue to explore and embrace the innovations that make a difference in the lives of those with CVI!

 

Exploring Technology Solutions for Individuals with CVI at CSUN 2024

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I recently had the privilege of attending the CSUN 2024 conference held in Anaheim. CSUN, the largest international conference on technology and disability, provided an invaluable platform for showcasing cutting-edge advancements in assistive technology. This year’s conference brought together a diverse array of professionals, researchers, and advocates, all dedicated to harnessing technology to improve the lives of those with visual impairments.

At the conference, I was particularly impressed by the array of innovative technologies. While these may have initially aimed to enhance the lives of individuals with ocular vision loss, there is certainly a use case for individuals with Cortical Visual Impairment (CVI) as well. From specialized apps to advanced wearable devices, the solutions showcased at CSUN have the potential to revolutionize the way children with CVI navigate and interact with the world around them.

In the realm of assistive technology, one size certainly does not fit all. While wearable devices may not be suitable for every individual with CVI due to factors like weight and calibration requirements, those who can utilize them may find immense value in their capabilities. From controlling environmental complexity to previewing complex environments and enhancing lighting conditions, wearable devices offer promising features for individuals with CVI who are able to benefit from them.

Wearable devices were just one aspect of the showcase, attendees had the opportunity to explore a variety of assistive technologies throughout the exhibit hall. Tactile equipment also emerged as a notable focal point.

Dot pads, in particular, generated significant interest and sparked conversations about their potential effectiveness in supporting the multi-sensory learning needs of learners with CVI. By providing tactile feedback and engagement, dot pads and similar tactile equipment offer promising avenues for promoting a balanced approach to learning for individuals with CVI.

For those seeking technology solutions for themselves or their learners with CVI, the CSUN exhibit hall provided a comprehensive resource. From augmented reality applications to specialized software and customizable assistive devices, there were options available to suit a range of preferences and requirements.

While CVI was not the intended target audience, the insights gained from being among the visual impairment community at the CSUN conference are invaluable. Some conversations among attendees brought opportunities for education and recognition of the difference between supporting ocular or brain-based visual impairments. Most conversations inspired hope, sparked innovation, and reaffirmed our commitment to improving the lives of children with CVI. As we continue to harness the power of technology and collaboration, we move closer to a future where all individuals, regardless of their visual abilities, have the opportunity to thrive and succeed.

Visit the exhibit directory here.

Unveiling the Impact of CVI Characteristics: A Systematic Approach with CViConnect

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A systematic approach is crucial when assessing the impact of characteristics on learners with cortical visual impairment (CVI). Teachers need to uncover how each characteristic impacts a learner’s functional vision. Teachers can do this by changing only one element at a time. This focused methodology, combined with the support of CViConnect, empowers educators to gain a comprehensive understanding of how CVI characteristics impact learners and tailor interventions accordingly.

The Importance of Changing One Element at a Time

According to Dr. Christine Roman-Lantzy, CVI encompasses ten distinct characteristics, each with its own potential impact on a learner’s visual perception and attention. Changing one element at a time allows teachers to isolate variables and observe the individual effects of each characteristic. By systematically altering one factor, educators can accurately assess its contribution to visual engagement, leading to more precise evaluations and interventions.

For instance, consider a scenario where a child is sitting in their wheelchair in the classroom, with the iPad positioned in their central field while engaging with a red activity. In the next session, the team should change only one element, such as moving the iPad slightly to the right of center. By focusing on altering a single variable, we can compare the child’s visual attention and gain valuable insights into the significance of the visual field for their visual engagement. If we were to change multiple factors like visual field, activity color, and environmental complexity simultaneously, it would be impossible to determine the independent impact of each element on the learner’s ability to utilize their vision effectively.

CViConnect: Supporting Teachers in the Process

CViConnect is a powerful tool that supports the systematic collection and analysis of data related to learners with CVI. With features such as the forward-facing camera, screen recording, and microphone, CViConnect enables educators to gather valuable data while learners engage with activities within the app. Here’s how CViConnect can support teachers in the process of changing one element at a time:

  • Data Collection: CViConnect’s data collection capabilities provide teachers with detailed insights into learners’ visual behaviors. The app captures session length, title, look times, and other relevant information, enabling educators to track and analyze visual engagement over time. This rich data serves as a foundation for assessing the impact of individual characteristics on learners.
  • Data Analysis: CViConnect’s web-based dashboard offers a user-friendly interface for data analysis. Teachers can review session results, analyze timeline graphs, and examine heat maps to understand the learners’ visual attention and preferences. These visual representations provide valuable insights that inform decision-making and interventions.
  • Assessing Specific Characteristics: Within CViConnect, teachers assess the impact of specific CVI Characteristics. Teachers can utilize the Activity designer to change one element at a time. For example, educators can modify the color of an activity or adjust the level of movement while collecting data on learners’ visual engagement. The data collected through CViConnect allows teachers to evaluate the influence of these individual characteristics and make informed decisions about interventions.
  • Tailoring Interventions: CViConnect’s data-driven approach enables teachers to tailor interventions to meet learners’ unique needs. By analyzing the impact of specific characteristics, educators can design interventions that target the identified areas of improvement. This personalized approach ensures learners receive the optimal visual environment and support to enhance their visual abilities.
  • Monitoring Progress: With CViConnect, teachers can monitor learners’ progress over time. By collecting and analyzing data regularly, educators can track changes in visual engagement, identify trends, and refine interventions accordingly. CViConnect’s video recordings of sessions further enhance the accuracy of progress monitoring, allowing for a more nuanced assessment of learners’ visual behaviors.

Changing one element at a time is paramount to understanding how specific characteristics impact learners’ visual abilities. CViConnect can be an invaluable resource, supporting teachers in this process by enabling systematic data collection and analysis. With CViConnect’s features, educators can gather comprehensive data, assess the impact of individual characteristics, tailor interventions, and monitor progress over time. By utilizing CViConnect with the one-element-at-a-time approach, teachers can unlock the potential of learners with CVI, providing them with targeted support and maximizing their visual development.

Guidelines for Determining the Frequency of Services to Support Learners with CVI

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As an educator supporting children with cortical visual impairment (CVI), you are aware of the unique challenges that come with providing appropriate interventions and services to meet their needs. One of the key considerations in supporting children with CVI is determining the appropriate frequency of services. This can be a complex task, as it requires a thorough understanding of the child’s visual functioning, as well as their overall development.

CViConnect’s Stephanie Steffer and TVI Chaesa MacWilliams, have released The Guidelines for Determining the Frequency of Services to Support Learners with CVI, to support educators in this task. This document provides a comprehensive overview of the factors that should be considered when determining the appropriate frequency of services for children with CVI.

The guidelines are based on the principles of the CVI Range, which is a comprehensive tool used to assess and support the visual functioning of children with CVI. The document outlines the various stages of the CVI Range, and provides specific recommendations for frequency of services based on the child’s stage of visual functioning.

The tool requires professionals to use the data they have collected about their students and their professional judgment to determine how the services should look, and what needs will be addressed during these service times. It was designed as a guideline, to assist Individualized Educational Programming (IEP) teams. At each IEP meeting, service time and delivery is ultimately the IEP team’s decision.

Overall, Guidelines for Determining the Frequency of Services to Support Learners with CVI is a valuable resource for educators who are looking to provide effective support for children with CVI. By taking into account the unique needs and abilities of each child, and using the principles outlined in this document, educators can provide meaningful interventions and services that help children with CVI to thrive.

Considering Light When Utilizing Technology

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What was once thought as non-purposeful gazing at light has now shown to be an important element in CVIers’ daily routines. Light can still be a distractor for our learners, but it also has a purpose. Learners with CVI have shown an ability to utilize light to access their functional vision. In either case, light will remain an important element for learners with CVI. 

Dr. Christine Roman Lantzy’s CVI Range score places students in what she refers to as one of the three Phases of CVI; Phase I, II, or III. Light can be used differently across these three phases. Light as a distractor can easily be forgotten after a learner is out of Phase I. Whether it be a bright light in the room, the sun shining in through the window, or a bright toy across the room, IEP teams should be mindful of various light sources. Consider where the lights are and observe how and if the lights impact the learner’s ability to locate/interact with visual targets.

One of our low tech options to support a learner’s need for light can be a light box or a flashlight. Visual targets can be placed on a light box with an occluder to block unnecessary light. Flashlights can be used by shining the light from behind the student on to the visual target.

Using Technology to Help Learners

More often, we are using technology to help our learners gain access to their curriculum. Various tablets and computers are backlit and offer a natural way to utilize light within technology to support your learner. The backlighting acts similar to the use of a light box. Unlike a lightbox, with technology, IEP teams are able to customize so many more details of the target to ensure it meets their learner’s needs.

Educators have many options to create accessible content; CViConnect, BoomCards, or presentations (Google Slides, Powerpoint, Keynote), etc. In addition to adding photographic images, teams can use these programs, or other similar options, to add special effects to utilize light. Effects such as fireworks and sparklers can utilize light, color, and movement. 

Using Special Effects and Background

By adding special effects when the screen is touched, light can be used to increase a learner’s hand eye coordination. For our learners in Phase I, these light effects can also be used during instruction to gain and maintain visual attention. Adding special effects briefly to a presentation for a learner in Phase II or III can be used to draw our learner’s attention to a specific part of the screen or a salient feature on a target. 

Teams should consider the background when truly making sure to utilize light. When considering backgrounds, we typically only think of the color that offers the most high contrast. While this is still very important, we also have to balance the amount of light coming from the background. A white background will emit more light than a black background. We want to offer a visible target, but be mindful that our learner could potentially be distracted by a bright white light too.  

When it comes to all accommodations, there isn’t a simple yes or no answer.  Each of these edits must be considered on an individual basis for what each learner needs.

Using Neural Networks to Assist Educators, Caregivers, and Parents to Better Understand What Their Child With a Visual Impairment Sees

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While at the Pediatric Cortical Visual Impairment Society’s conference in Omaha, Nebraska covering the current research in the field, I was speaking with a parent who has a child diagnosed with CVI. She spoke about how her child got a fishing pole this summer and caught his first fish.

He also had the opportunity to do a rope course that was designed for those with difficulty walking and or seeing. She went from storytelling to utmost pride when reflecting on how these opportunities had opened her child’s perception of what is possible in the world. This Brave New World sort of talk.

We also spoke about how unique of a sensorial experience it would be to feel a fish biting and pulling on a fishing line, or the sensation for him of falling through the air guided by a rope. One could only imagine how a child’s brain, if being analyzed by one of the very many doctors at this conference using MRI, would light up like a Christmas tree with unique patterns and communication pathways to interpret what in the world just happened.

“You know what is funny?” she said.

“We were walking at an event that was in a cornfield and we passed a porta-potty. My son immediately says, “What is a vending machine doing in a corn field?” Isn’t it amazing what he can see and how he sees it!?”

It really is. As she said this, I immediately thought to myself, if I was not paying attention to my surroundings, and quickly passed a porta-potty, I too could easily associate that visual outline as a vending machine. Having 20/20 vision and healthy visual pathways, my life’s experiences do not associate a corn field as having a vending machine, my brain would probably have never conjured the association.

BUT, what could make this association? What is not trained to omit certain possibilities, like my brain? 

Text to image neural networks can do just this.

Here is a potential example of how this parent’s child saw the cornfield via an image rendered by a neural network given the following instructions: “a blurred image of a vending machine in a corn field as seen by someone with poor vision.”

CVI child sees vending machine in cornfield CVI child sees vending machine in cornfield CVI child sees vending machine in cornfield

Over time, once the child is taught to recognize the context and associations of a porta-potty, this is potentially what they could see via an image rendered by a neural network given the following instructions: “a foggy image of a porta-potty in a corn field as seen by someone with poor vision.”

CVI child sees vending machine in cornfield CVI child sees vending machine in cornfield c

Then, hopefully with even more training and life experiences with a porta-potty, the sharpness and clarity could improve to something like this via an image rendered by a neural network given the following instructions: “a realistic photo of a blue porta-potty in a cornfield.”

porta-potty in cornfield porta-potty in cornfield porta-potty in cornfield

The potential here is having a tool that could, for the first time, create images for parents, caregivers, and educators to better visualize the world that a child with cortical visual impairment lives in. Each child is unique, and each experiences their own representation of the world. One that is often beyond our grasp.

The better we understand that world view representation, the more accurately we can work with children with CVI to make bridges to the generally accepted societal world. Having a better understanding of the world, as the general society experiences it, helps make every day independent living safer for the child.

Consider Novelty when Utilizing Technology

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According to Dr. Christine Roman-Lantzy, there are ten unique visual and behavioral characteristics of CVI. One of these is the characteristic of novelty, or how new a visual target is to the learner.

Learners with CVI show preference to targets they are familiar with or those that share visually familiar characteristics.  Depending on what Phase of CVI the learner is in, your accommodations to support this characteristic will likely vary greatly.   

One difficult, but huge progression is when learners with CVI can move from three dimensional visual targets to two dimensional targets. We are told to utilize realistic photographs of these familiar targets.  Unfortunately, for some of our learners, it isn’t as easy as taking a picture with our phones.  You must still consider the needs of other characteristics. Complexity of the array?; What is behind the target? Distance? How far away did you take the picture? 

I have found a few ways to take and edit images for my learners.  The first thing I try is a Google Image search with ‘PNG.’  PNG is an image file type like jpeg or bmp. PNG files are important to us because they have transparent backgrounds.  This means the image should already be clear of any competing visual stimuli in the background of your target.

If I want the visual target to be my student’s blue spoon. I might search for ‘blue children’s spoon png.’ 

CVI Biog Blue Spoons

Once I find the target that meets my needs, I left-click on the image.  This selects the image and opens it into a window on the side of my screen.  Next, I right-click and either select ‘Save Image As’ to save to my device or ‘Copy Image’ and paste the image directly to my project.

CVI Blog Saving Blue Spoon Image

If I cannot find the image I want doing this search, I might take a picture of the real item. To do this, try to place the image on a solid colored background.  Often, we will see people using black as the background.  Black is light absorbing allowing the target to typically stand out more.

If I find a realistic photograph I like, or one I have taken on my own, there are a few options to remove the background.  One of my favorites is remove.bg.  This website allows users to upload any image from their device (computer, tablet, etc.)  The website will automatically identify the focus of the image and remove any background information.

Remove BG website

Lastly, there are a few places you can manually remove the background or unnecessary information from your image.  One option on a tablet or phone is to use a background eraser app. There are several available in the app store.  Also, PowerPoint has a Remove Background option.  Once you click ‘Remove Background’, the image will show the background that will be removed in bright pink.  Users can further edit the image; add more areas to remove or mark areas to keep.

Are you using other resources to remove the backgrounds of images and support your learners?  What else can we be doing to support our learner’s needs for complexity of the array and novelty?

Intentional Access to Vision Throughout Daily Routines

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“I am a teacher, I was never trained in vision therapy.”

Luckily, for learners with a Cortical Visual Impairment (CVI), no one is suggesting vision therapy. Instead, in order to see improved use of functional vision, individuals with CVI require a balance of intentional access to vision throughout daily routines.

According to Dr. Christine Roman-Lantzy, CVI is a disability of access. These individuals, much like our students with ocular visual impairments, seek access to their education.

For a moment, ignore the label of CVI. You are presented with a new student who demonstrates use of functional vision when given certain targets. We are taught to help the child advocate for when their vision is usable, and when they need alternative forms of access (ie. tactile or auditory inputs).

Now add the label of CVI back into the picture. Armed with this information, you can now gather more specifics about the targets that elicit visual attention. As educators, we can rely on the information gathered during a CVI Range (functional vision evaluation) to guide us in selecting visual targets and environments. Further, when educating the child to advocate for their needs, we can help them identify the why and/or when to use alternative accessibility options (ie. tactile or auditory inputs).

Dr. Christine Roman-Lantzy has provided us with the CVI Range. Further, she indicates that the results of this assessment, place a child in Phase I, Phase II, or Phase III. Each of these CVI Phases, subsequently, have a goal.

Learners who have a CVI Range score between zero and three are placed in Phase I. During this Phase, the goal is to build consistent visual behavior. Learners who score above a three to a seven, are in Phase II. The goal of Phase II is to integrate vision with function. For learners who score anything above a seven, they are considered to be in Phase III. At this point, the goal is to facilitate refinement of the characteristics.

Why bother explaining these goals? For me, they are crucial in comparing vision therapy and accessibility. It is important that we align visual opportunities with the goal of the Phase the learner is presently in. Educational teams must understand this in order to ensure access for their learners. We cannot provide an Activity designed for Phase I to a learner who is actually in Phase II and think this is accessible.

In addition, learners move through these Phases sequentially. During Phase I, it is important for teams to learn what elicits visual attention. These characteristics then transfer into Phase II, when the learner is able to begin using vision with daily tasks. In Phase I, let’s say a child was able to sustain visual attention on targets with red mylar. Now in Phase II, we might adhere red mylar to a student’s spoon, switch, or locker to help them visually locate the target while completing daily routines.

Let’s revisit this child who doesn’t have a diagnosis of CVI. Based on the results of a learning media assessment, it is determined the tactile input is the learner’s primary learning modality. Does the school have Braille materials delivered with expectations the child can interpret the contents? No, we create a plan. We determine who is responsible for creating accessible content, and we begin explicit Braille instruction.

Return to our learner with Cortical Visual Impairment. Based on the results of a learning media assessment with consideration of the ten visual and behavioral characteristics of CVI, it is determined when the learner can access information visually, tactually, and auditorily. Not selecting a primary and secondary, but an outline for when each is appropriate. Still, does the school have print, tactile, and recorded materials delivered with expectations the child can interpret these contents? Sadly, I hear stories of this happening all too often. We must create a plan for these learners too. Who is responsible for creating the accessible content? Who will provide the explicit instruction to learn how to interpret the materials?

We wouldn’t label a student’s locker with Braille without explanation. Similarly, we cannot adhere red mylar material to a child’s locker without explaining this to a learner.

Most educators have no training in vision therapy, but they do have training in accessibility.

Make education accessible for all learners.

The Future of Look Detection Is Here

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The future of look detection is here for children with Cortical Visual Impairment (CVI). At this year’s ATiA annual conference, CViConnect’s Stephanie Steffer and Travis Spire-Sweets shared their newest vision for the field.  

Currently, while a learner utilizes the activities within the CViConnect iPad application, the system makes use of the forward facing camera to detect if the learner is looking or looking away from the iPad.  Teams are currently using this information from session to session to analyze what is impacting their learners ability to initiate and maintain visual attention.  No longer are teams guessing if the child is looking at the presented target.

For example, we might run the exact same activity in different positions, once in a stander and once while lying in supine position on a mat.  While in the stander, the look detection data indicates the user is experiencing frequent ‘look, look away’ behavior. Meanwhile, when laying in the supine position, the look detection data indicates the user has some ‘look, look away’ behaviors followed by sustained visual attention. 

This tells us the activity we selected may be a good fit, if the child is in the correct position.  Being positioned in a stander is appearing to add an increased environmental complexity.  If vision is expected while the student is in a stander, education teams will likely need to provide visual targets that are considered more comfortable to balance the complexity of the child’s position.

While this data is still available and truly meaningful for teams, the CViConnect team wanted to provide educational teams with even more.  This release will allow educational teams to make data based decisions by knowing where the learner is looking on the screen.  

With this new data, educators can provide their explicit instruction on salient features and comparative thought.  Educators can then review the data to determine if the student was in fact making eye to object contact on the salient features as they were being discussed.

Does the child tend to look off the screen during the instruction and look after the educator has finished speaking? Are you expecting the child to touch or draw the salient features?  With this data, you can now analyze if the child is utilizing look and reach at the same time or if these are being completed separately.  

As an educator for individuals with cortical visual impairment, this is a big game changer.

It doesn’t end here either.  With our CViConnect Activity designer, the intent is you may begin to take advantage of our event action blocks to build in scenarios such as ‘if looked at,’ ‘then say.’  

Participants during the ATiA session have expressed enthusiasm for understanding the learners use of vision in this way for a variety of scenarios.  One idea was to utilize this data when making additional assistive technology decisions.  However you see this best fit for your learners, we are excited to be a part of your journey to support learners with CVI.

Want to learn more?  ‘The Future of Look Detection For A Learner With CVI, is Here’ is a FREE recorded session available to all and is part of an ATIA 2022 Registration Package.

 

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