A young boy sitting in his mom's lap reading a book and pointing to the photo. 
Chrissy CowanListen to Chrissy Cowan’s advice on how families can support their child’s visual efficiency skills.


My name’s Crissy Cowan. I am an Education Specialist with the Education Service Center Region 13 in Austin, Texas.

How can parents and other family members support their child learning how to use his or her vision in a productive way? What would you like to ask families to do at home?

Well, I think the first thing you could do, thinking of the external factors of visual efficiency—arrangement of the environment is a really huge thing. Organization is going to contribute to independence. It’s sort of like a Montessori philosophy too.

Control the Light

One of the things you can do is control the light. So if you, starting with infancy, if you have a crib right by a window and you have a child that’s very light sensitive, the room is going to be washed out by that light. Light should be controlled to some extent, and the best place for light to come is really from over the shoulder. If it comes from directly behind, your head is going to occlude the light. So, not standing in front of a window to talk to your child because when they’re trying to look at you, that’s going to be difficult for them to do.

Or, you might need more light, better light. Especially there are newer light bulbs now, and things where there’s not as much of a glare. Glare is also a real problem when it comes to being able to discriminate things visually.

Improve Organization and Color Contrast

I think parents definitely should arrange toys and books in cubbies. One of the worst possible scenarios is to throw toys in a box—the toy box—because that’s a blur visually. So little cubbies or shelves where things are not cluttered, but they’re arranged nicely.

High contrast between objects and background wherever possible. I once walked into a house where a child with low vision was doing very poorly—tripping—there were little bitty one step offs. And when I looked at the house, there was a white floor, a white rug, and white walls, and there was nothing to discriminate those articles, so the child was bumping into things, tripping over things, etcetera, and all we did was go in and increase contrast. Little rugs that were a different color from the white tile. It made all the difference in the world. So you have to think contrast and background wherever possible.

Decrease Visual Clutter

Avoid rugs with busy patterns. It’s real common for people to go to Target or Toys R Us or Walmart and buy those cute little bedroom rugs that have a little city on them or whatever. And when you put a toy on that background, it is very difficult for a child to be very efficient visually. So you want a plain colored rug. Toys with bright colors are nice to get. Allow the child time to explore—and I think I said that earlier—in a safe and predictable environment. Make things child-safe but also allow them time to explore.

Sunglasses and caps for sun-sensitive children—you know you really need to start early with that kind of modification so a child gets used to wearing a cap with a visor or sunglasses because they will reject them if you try to introduce that a little bit later.

I had talked about shelves to avoid clutter but also think in terms of cluttered rooms, clutter in the refrigerator, clutter in cabinets, desks, etcetera. So if you have an art center for the child, arrange things in nice little compartments in drawers; that helps them to be more efficient visually.

Another thing, in addition to arrangement of the environment, is to provide experiences to make up for the lack of incidental learning. Incidental learning is when we happen to be watching somebody do something, typically from a distance, and we learn how to do it.

Purposefully Arrange the Space

So think about the toddler that is sitting in the high chair in the kitchen while one or the other parent is cutting up something to make soup or washing dishes or doing other things on a counter beyond five feet that the child with typical vision is able to then do when they get a bit older, and they can do some of those things. They can just automatically do it because they’ve watched somebody do it.

The child with a visual impairment doesn’t have the advantage of that, and so, you have to assume that distance vision is poor. Number one. You have to assume that with almost all of the vision problems that children have, except for something that’s affecting their visual field. You want to allow the child to move within six feet of as much as possible. Encourage safe tactile exploration but avoid grabbing their hands and manipulating their hands; that’s very offensive to a child, and they will get to where they will pull their hands away from you.

Encourage and allow partial or full participation in as many household chores and activities as possible. If you’re changing a tire, allow them to take the lug nuts off. Have that little kid with the little diaper next to you, watching you. And then allow them hands on as much as possible.

Get Up Close

Label, describe people, jobs, sights in a non-complex language. So when you’re driving down a highway and you see a cow, you know, if you can pull over, stop and get as close as possible. Put out a low vision device or a telescope—which I’m going to be talking about in a minute—and stop and describe and, “That’s a cow. It has four legs. It gives us milk.” And keep it simple, not a huge lecture, and then do that with as many things as possible.

Use a digital camera, now that we have digital cameras, they’re just really great because I would carry, as a parent, a digital camera everywhere with me to capture visual images. Print them out when you get home, and study the pictures together: this is a cow. You couldn’t get close enough but let me do a picture of it—or I took a picture of it—and this is what it looks like up close. This is what Big Ben looks like. Or this is what a bridge looks like in its entirety. And so take camera images.

For one pre-school student that I had with low vision, I went through his community, and I took pictures of every place their parent frequented in the car so the gas station, the grocery store, the cleaners, the bank. And because this little—you know, little kids have to go on all those errands with us, and I wanted him to see the literacy that was involved. We’re pulling up to the bank. It’s First National Bank. We’re going to HEB. This is what it looks like. And made him an experience—I call that an “Experience Book.” But that also increases the child’s visual efficiency.

Read. Read books, including picture books, beginning with infancy. Try to choose books with clear, uncluttered images. There might be books that are very popular but are very confusing visually, and so, you wouldn’t start with those. Books like the Clifford books have real simple, straightforward images. The Dr. Seuss books where there’s just not a whole lot of clutter on a page. If there is, you can maybe use your hands to decrease some of that competing clutter on the page. And call your child’s attention to visual things and even the fine details within it. “Look, does that lady have a necklace on? Mommy has a necklace.” You know, try to draw those similarities in pictures.

Step Back

Step back. Give the child time to figure things out. Once you turn them loose on something you want them to explore, step back. Once you’ve, you know, kinda given them their intro to it, let them explore it and figure things out.

Another thing I think parents should do is avoid excusing your child from discipline and responsibilities. And so, if your other children have chores to do and responsibilities, the child with low vision should do that as well.

You know, there are things you’re going to do in the home, but you’re going to advocate for your child in a school environment as well. I think that parents need to be aware that different classrooms and subjects have differing visual demands. And that’s why you want to encourage your child to self-advocate—for distance, time, materials, tool use.

You know, you’re doing that at home, and you want it to carry over into the school environment as well. And that’s why, as a parent, it’s very difficult for you to step in and insist on certain things happening in the classroom. The child needs to be a part of that process so that they can advocate for their needs.

You’re going to encourage the use of low vision devices, such as a little telescope or a magnifier, at home so that when the child steps into the school environment, they’re going to use it, or they’re more likely to use it there as well.

Utilize Assessment-Based Accommodations

Avoid assuming that print size is the most important modification because it often is not; print size can be a piece of the puzzle, but a lot of children are going to refuse to use large print books in school. And so, insisting at home that the child will do that at school, to the child, “You will use those large print books.” It never works because you’re not with them in the room, and so, they’ll make a decision to ditch that kind of a modification. So you can’t force a modification on your child once they’re making those decisions at school. They are going to gravitate towards whatever they’re comfortable with. And that’s why you need to think in terms of a toolbox of strategies that are evaluated and on which the student has provided input.

I think as a parent you should ask your TVI to update the functional vision evaluation and the learning media assessment every three years or more frequently if your child has degenerative vision. And that you request that the TVI explain your child’s vision and its implications to all the teachers in the school, including the PE teacher.

Ask to see current assessment done by the TVI on the expanded core curriculum. And a good resource for you is the expanded core curriculum website on the TSBVI page.

Ask to provide input on the expanded core curriculum assessment in the area of visual efficiency.

I think that you would also want to discuss type and amount of service delivery with your TVI. And that means how frequently are you going to be working with my child on visual efficiency, and what’s that going to look like? Are you going to work with my child directly? And/or are you going to consult with the teachers? But keep in mind the fact that in Texas, where TVI caseloads are not capped by the state—that’s the situation in most states—if the TVI has an overload of students, they tend to give the most service to the students with the most severe visual impairments. And so, you will need to advocate for lower caseloads in your area.