CVI first books

When it is both CVI Literacy awareness month and the time of the coronavirus, you know it is going to be a brief post. What follows is a description of one approach to early literacy and books that began with the use of familiar objects (because of the CVI characteristic, novelty) as suggested by Christine Roman-Lantzy, PhD.

You might first notice that these books are…books. These were created using plain black board books, they were not created on a tablet device. This is mostly because it was long before we had an iPad of our own.

To start, here was the thinking around literacy, from day one:

Books were read all the time, beginning in the neonatal intensive care unit. After  that, hard copy books were a daily routine. This was a time of unknowns: not knowing what he would be like when he was older. Not knowing what his vision would look like later on – would he be able to recognize pictures in books? Would he be able to read printed words? Those unknowns included CVI itself and not knowing enough about it at the time. Still, the priority was books and a love of books.

Hard copy books were preferred (again due to lack of technology at the time). Books we could sit with, books you could feel and touch and turn pages. And when he was a little older, books he could…chew. Babies mouth objects and in young children with visual impairments, this phase can be prolonged. So, many of the board books, including the black CVI ones, have well chewed corners, later trimmed and rounded with a pair of scissors.

As just mentioned, these books are books. We did not have the benefit of the iPad. Using a tablet device or iPad has advantages. A tablet provides backlighting. The CVI characteristic of light attracts visual attention, creates bright saturated color, and minimizes visual fatigue (Roman). Controlling size of object and reducing visual complexity is also easier on an iPad. For children with CVI who like sound, sounds can be added. Lastly – creating an e-book is so much easier than creating a hard copy book!

CVI first books included, per above, books of his familiar objects. Not always toys, but objects: a toy “radio,” a set of bright orange melamine measuring spoons, a favorite hanging stuffed animal, a sippy cup, a yellow ducky. Could he recognize a 2D representation of these familiar objects, against a black background? Given a choice of two objects, could he choose the correct object to match against the picture in the book? Later on, as described in Cortical Visual Impairment, An Approach to Assessment and Intervention, the subject of a book would be singular: balls. Balls of different colors, shapes, sizes, that all looked different but all represented “ball.”

In late Phase II CVI, he was ready to begin with 2D pictures. Also as a toddler, he was not yet verbal. We looked at the books and objects while sitting together on the floor (plain background) with two objects presented alongside the page in the book. He “matched” the correct object to the picture in the book by picking up the object and mashing it against the picture.

Objects were photographed against a plain black background, then literally cut and pasted (glued). Objects were photographed with even lighting and head on, for a recognizable perspective.

Objects were attached one per page spread, and always in a different spot from one page to the next to encourage visual search (as opposed to predictably placing each object in the same spot on the right page, for example). One time, a toy was glued on upside down, on the last page of the book. When he got to this page, the turned the book upside, recognizing the upside down orientation.

You might notice: some of these are multi colored objects! This is because often, CVI parents are struggling to learn themselves and do not know what they don’t know (“use objects with one to two colors”). Knowing of his left side homonymous hemianopia, as an infant I picked up a yellow/blue/etc giraffe toy to hang from the carseat/stroller/etc in the hope that he would look in that direction. You don’t know what you don’t know.  Same for the white, multicolored radio, which was a favorite toy for a long time.

Later on, books had more images, smaller sized pictures, and clusters of objects together, still against a black background. These were his first books and transitioning into recognizing two dimensional images as representations of real objects.

Roman-Lantzy, PhD., Christine (2017(. Cortical Visual Impairment, An Approach to Assessment and Intervention. NY: AFB Press.