Toolkit: Enhancing Vision

Although they share a common diagnosis, children with Visual Impairment (VI) may have a wide range of visual characteristics. Strategies that work for some may not work for others. Therefore, keen observation of children’s visual behaviors is a crucial aspect of any intervention or teaching strategy. By paying attention, you can learn a child’s unique, but subtle, response cues. For example, there might be changes in breathing patterns, or shifts of gaze or body position.

These are some ways to help a child with VI:

Toys and other items

Look for toys and activities that motivate your child. These are some items that may help:

  • A dark, solid-colored blanket (black or navy blue works great). Putting toys against a dark background helps the toys “pop” and makes them easier to see.
  • Simple cause-and-effect toys that light up or play music.
  • Simple toys that a child can easily manipulate such as a Slinky, Koosh ball, or rattle
  • Everyday items that are used in a child’s daily routine, such as diapers, bottles, cups, spoons, a favorite toy, toothbrush, or hairbrush. Exploring these items through play helps a child with VI become familiar with their uses. You can also use these items as “touch cues” during transitions. For example, give your child a diaper and say, “Okay, Johnny, it is time for a diaper change.” Over time, Johnny will learn what the diaper is for and when it is time to use it.
  • Mylar paper or pom-poms in your child’s favorite color. Many children with VI like the color red. However, each child is unique. As caregivers, we need to figure out what the child’s favorite color is. Mylar paper can be bought at craft stores, and it is colorfast, so the ink or dyes don’t come off when wet.
  • Books with simple, bright pictures (one picture to a page on a non-cluttered background). Some families make their own books, taking pictures of favorite items against a dark background. Again, using pictures of real objects is useful in providing information to your child about life and daily routines.
  • Headshots of familiar people. Keep them simple and use plain backgrounds.

Comfort and pacing

  • Allow for “break” times. Your child might tire easily when called upon to use his visual sense. That’s because a great deal of energy is needed for a child with VI to process information visually.
  • Keep your child comfortable and well supported when vision use is the goal. This will help ensure that “seeing” is the primary task. If a child with VI needs to pay attention to posture, vision may “take a back seat.”
  • If needed, provide head support during play or work sessions to avoid unintentional shifting of the visual field.
  • Try many different positions to find the one in which your child feels most secure. Infants and toddlers will demonstrate this by adaptive and moving to a position from which they see best.
  • If your child needs to use a lot of energy for fine motor tasks, work on fine motor and vision separately, until integration of the two systems is possible.
  • Allow lots of time for your child to see and respond to what she is seeing. Children with VI need more time to process the information and then shift their gaze toward the object.

Simplicity and predictability

  • Keep toys and the environment simple and uncluttered. Use books with one clear picture on a contrasting simple background. The simpler, more constant, and more predictable the visual information, the better the child with VI is likely to perceive and process it.
  • Use familiar real objects one at a time. These might include a bottle, bowl, plate, bath toy, diaper, cup, spoon, or favorite toy. Familiarity and simplicity aid perception.
  • Repetition leads to familiarity and security, which encourages visual response. So use the same objects and same process each time. But also be ready to expand upon routines whenever possible. This prevents your child from becoming fixated on non-productive repetitive behaviors.

A variety of cues

  • If color perception is intact, use bright and bold colors that your child prefers. Looking at colored Mylar paper may help trigger visual responses.
  • Auditory cues from handling Mylar may help attract your child’s attention. Vision is often best stimulated when paired with another sensory system.
  • Introduce new and old objects through touch and verbal description. Sometimes a child will be more likely to look at an object if he touches it first. Describing the object after asking the child to look at it can also encourage a visual response.
  • Children with VI are dazzled by very bright light. Therefore, regular ambient lighting might be better. Locate a light source behind or to the side of your child. This helps prevent glare and optimizes viewing conditions.
  • If your child is having trouble seeing an object, add movement to it. Or present it in different areas of your child’s visual field. However, be aware that some children with VI have trouble looking at moving objects.