Using an iPad as a part of a Functional Vision Assessment/Learning Media Assessment (FVA/LMA) for very young children can provide useful and sometimes unexpected information for the family, TVI and rest of the team. As a practitioner who has experience using an iPad and iPad apps, I offer the following ideas and suggestions for using these tools as a part of a FVA/LMA.
The iPad and iPad apps are fun, educational, motivational and exciting to use, but do not in any way replace the usual methods and techniques for assessing the functional vision of very young children or children who are operating in the very earliest stages of emerging literacy. Keep using the skills, tools, materials, toys, and equipment you’ve always used to complete FVA/LMAs. Because the iPad is very motivating for many children, it is a great opportunity to push the child’s visual and pre-academic skills a little.
When adding iPad and iPad app activities to your assessment, keep the following ideas in mind:
- Make sure your FVA/LMA does not sound like an adaptive technology assessment.
- Talk with the child’s teacher, parent and/or caretaker to determine whether or not the child is familiar with the app. Familiarity may affect how much the child uses vision to maneuver through an app. Armed with this information you will learn something whether or not the child is already familiar with the app.
- Find apps that child is able to use. Random touching and movements on the iPad can be somewhat informative (does the child respond to movement, lights on/off, understand how to move through the app), but using an app as it was intended is much more informative. Many apps involve skills far beyond cause and effect. Peekaboo Barn, for example, is an app that quietly and with simple motions lets the child go through a complete story of the animals and the sounds they make in the barn through one day and night. It is a good app to help you understand the child’s abilities for touch and wait, size, sequencing, scanning, field of vision and seeing movement.
This three year old with CVI and mitochondrial disorder is highly motivated to point specifically on the animal inside the barn, wait for the doors to close, and then touch again to open the door to see and hear the next animal on the app Peekaboo Barn. If you look carefully you can see my hand holding the iPad at the bottom of the screen, managing both behavior and positioning.
- Use a “tough love” approach to iPad use during your sessions. The FVA/LMA session is not a time to actually teach the use of the iPad. For many children it is important that the TVI hold the iPad, though the child can help determine the best distance and positioning. The TVI should also determine which app is to be used, and insist on managing the amount of time the iPad is used and/or whether meaningful motions to move through an app are required. Severely limit random touching until something happens. If the child cannot adapt to this tough love approach or if behaviors like these are dominating your session, turn the iPad off and tuck it away. You can always recommend that iPad exposure and intentional instruction with an iPad become a part of the instructional plan.
- Having the TVI hold the iPad allows you to control the positioning of the iPad. Many children will benefit from having the iPad at some kind of angle rather than flat on the table or floor. Try holding the iPad at a variety of distances and locations, watching for preferred fields and optimal viewing angles and distances.
- Use the apps last during a FVA/LMA session. I have found it most successful to keep the use of apps brief -- 5 minutes is frequently a good length of time. If behavior becomes an issue, turn the iPad off and tuck it away. The FVA/LMA sessions are not the time for a power struggle!
- Many children resist ending the iPad activities, so plan ahead for something that makes the transition easier for them. After telling the child that I’m going to turn the iPad off, I turn it off, put it in my bag and then physically move with the child to an activity away from the area where the iPad was used. Playing a game of roll the ball, moving to an outdoor space, or dancing are some activities I use to move away from the iPad session.
- Find ways to look at similar/same skills without using an iPad. Sometimes a child will show you she is able to accomplish more or stay with an iPad activity longer or at a higher level than you have seen otherwise. The Berenstein Bears Give Thanks app is a read aloud story where the names of many of the items in each picture are given aloud when touched. Some children are able to see and understand that the highlighted word in the text is the word being read aloud. The Dr. Suess books apps by the same company as Berenstein Bears are not as detailed, but are often successful with young children. I often only use one or two pages of these apps and limit the number of times a picture may be tapped to 3 or 5 times. The pictures in the apps are the same as in the print book. Try using both and see if there are any differences.
- Lighting is such an important issue to clarify for the readers of a FVA/LMA. Determine if the backlighting makes a significant difference in child’s ability to use an app. If the child is able to manage the lighting level on his or her own, let her. Can she tell you why she likes one level vs. another level?
- Writing Wizard, an app that lets children trace along lines of shapes, numbers and letters with auditory feedback while the child is touching along the line, is a good app for watching for visual tracking, scanning, and motor planning. For children who are able to identify letters, the letters on the keyboard vs the letters on the Writing Wizard app can provide information about visual field and appropriate letter size. Color Dots is an app where large dots appear and move about the screen. When each dot is touched, it makes a gentle popping sound. When all the dots have been popped, a new series of dots appear and move about the screen waiting to be popped. It is primarily a cause and effect type app, but because the dots appear in random places on the screen and move, the TVI can gain good information about field of vision, tracking, and eye-hand skills. The background and dot colors change, which may provide some information about color preferences and level of contrast needed.
- Try using the same app with and without sound. Sometimes sound helps to guide vision, sometimes sound is very distracting and contributes to the child shutting down. Itsy Bitsy Spider is a very noisy and appealing app that allows many different levels of engagement. When the child touches some part of the picture there is a consistent action and/or sound. There are many “pages” in this app, and the more the child moves through the pages the more activities appear. Some children do better without the sounds, however, and the sounds can be turned off in this app. The Berenstein Bears books are much quieter and have audio for many parts of the pictures.
This two year old with CVI and significant motor and cognitive impairments needs the support of my hand to keep her arm up to the screen, but she is doing the actual tapping with her knuckle on her own. She is also able to move her arm to other places on the screen. She is able to use her preferred field of vision with the iPad in a tilted upright position. Finally, she does best with the sound and music on the Itsy Bitsy Spider app turned down very, very low.
- Note if motions on the iPad engage the child’s visual attention. Fluidity is an app that has streaming colors and dots that the child changes by simply touching the screen. It is a big favorite for children with CVI and limited hand use. Record what happens after using an app visually. Some children with CVI for instance, seem more visually alert and capable after some exposure to Fluidity.
- I have avoided using eye chart apps during the FVA/LMA session. The size of your screen and the possibility of pinching the image in or out can influence the consistency of the figures. The resolution and backlighting may enhance or decrease visibility and affect accuracy of measurement. Color charts are also be affected by these variables.
- Be familiar enough with the app that you can use it smoothly. A FVA/LMA session is not the time to try to figure out a new app. You will frustrate yourself and the child and not get the information you need.
As with so much in our field, your imagination, sense of ingenuity, and fun along with your knowledge as a TVI is a springboard for adventure, learning, and greater awareness of a child’s visual skills.
Here is a list of the apps I mentioned. Of course, the sky is the limit where apps are concerned. Please share with us apps you’ve found to be useful and fun for use in a FVA/LMA setting.
- Berenstein Bears Give Thanks by Oceanhouse Media $3.99 https://itunes.apple.com/us/app/berenstain-bears-give-thanks/id404118797?mt=8
- Color Dots Infant Baby Starter Game Popping Bubbles by Ellie’s Games $2.99 https://itunes.apple.com/us/app/color-dots-infant-babys-starter/id415334566?mt=8
- Dr. Suess Bookshelf by Oceanhouse Media free https://itunes.apple.com/us/app/dr.-seuss-bookshelf/id543665995?mt=8
- Flow Free by Big Duck Games, LLC free https://itunes.apple.com/us/app/flow-free/id526641427?mt=8
- Fluidity by Nebulus Design Free https://itunes.apple.com/us/app/fluidity-hd/id399403909?mt=8
- Peekaboo Barn by Night and Day Studios $1.99 https://itunes.apple.com/us/app/peekaboo-barn/id300590611?mt=8
- Writing Wizard by L’Escapadu $4.99 https://itunes.apple.com/us/app/writing-wizard-kids-learn/id631446426?mt=8
- Itsy Bitsy Spider by Duck Duck Moose $1.99 https://itunes.apple.com/us/app/itsy-bitsy-spider-by-duck/id331863487?mt=8
* WonderBaby.org and Paths to Literacy collaborated to create a list of great apps for very young children: http://www.wonderbaby.org/articles/apps-for-children-who-are-visually-impaired. Paths to Literacy has numerous articles about materials and methods for conducting Functional Vision Assessments and Learning Media Assessments.