Creating the Optimal Vision Environment

Originally presented September 16, 2019

by Gordon Rovins, MS, CEAC, Lighthouse Guild

This presentation addresses the leading problems of vision loss in children such as central loss, peripheral loss, overall blur, color deficiencies and issues related to CVI and their implication for designing accessible environments.

Transcript

Gordon

Okay, cool. So, everyone sees this now. So, we’re all on the same screen. So, actually, you could go to the next slide.

Sheila

Showing poor contrast or glare?

Gordon

So, we’re all at poor contrast or glare. So, in fact, this is even a better illustration, if somebody has cataracts, or just generally there are so many vision impairments that are affected by poor contrast or glare. And you could see from some of these simulations how difficult it might be just negotiating because the world looks pretty washed out. And glare sensitivity and, I’ll talk about this again in a little while with lighting, it seems to be prevalent with almost any vision of impairment in my experience, so just something to keep in mind when negotiating the world.

So, here’s what somebody may experience if they have central vision loss, something like macular degeneration or Stargardt’s. And these simulations are like a perfect vision loss right in the middle. And it usually doesn’t look like that. It’s usually much more scattered. But I put this up there to show you the image on the bottom, where in other images, there’s a bucket and mop. But if you have a central vision loss, you’re not going to even see that as you’re negotiating your space.

Next, this peripheral loss that some children are experiencing could be with any kind of dystrophies, glaucoma or Usher’s. In fact, sometimes I think that a peripheral loss creates even more difficulties for a student that’s trying to negotiate the world- in some ways even more than a central loss. Because you’re only moving with what you see directly in the middle and you’re missing so much in negotiating your environment.

Let’s go to the next slide. And then as I mentioned earlier with diabetes, or if somebody has multiple vision impairments, which sadly does happen at times, so you could have a peripheral loss, you could have a central loss, and you could have an overall blur that comes with cataracts. And as I said, this is definitely more prevalent for somebody that may be developing diabetic retinopathy in the later years.

Go to the next slide. I don’t think this pertains to any of your children, but just to see the last simulation. This may come from any kind of head trauma, or some type of neurological damage where only somebody may lose half their vision on one side, they could lose a quarter of their vision, or they could even lose some of their vision just on the top or bottom. That could create some difficulties, which shows how much cane travel becomes very important. 

Now let’s talk about lighting. So, that’s the next slide. Lighting is tough, and thank you for telling me about all your kids, and they all have different types of vision impairments. So, I’m gonna give sort of like a general rule of thumb. So, generally, depending on your condition, you may have different lighting needs. But, I would say overall, as a general rule, having more light in your space is the best option. I’ve had it here for older people, but this is true for youngsters as well as, and for many vision impairments. I don’t know if particularly those of you that have older children, if they are experiencing this, do they have any difficulty adjusting to light levels as they go from one room to another?

But, I know many of the kids and that way in our school, in the past had this problem. And one of the solutions that I often recommend is keeping the lights on in every single room. So, your child doesn’t have to make an adjustment going from room to room. And this is an important safety feature as well. Now the example I give here, it’s like walking into a dark movie theater on a sunny day. I know, if I walked into a theater now from a bright sunny day, it’s going to take me a while to adjust. For many of your children, it’s going to be the same situation, it’s going to take them a little while to adjust from going from a dark room to a light room or vice versa.

Now the lighting solutions are pretty common sense in a lot of ways and as I mentioned, keeping the lighting uniform from room to room. I like using a bunch of different light sources, and you might be doing this already. So having a good overhead light, a good table lamp, make sure that you have good adjustable shades or blinds on the window so they’re not getting a lot of glare coming in. And the image on the bottom, it’s something that I like to use for kids. It’s a gooseneck lamp so it’s adjustable. Having a good light source, particularly an adjustable light source that you could put to the side or perhaps even behind your child when they’re doing a task is important. And I find that particularly adjustable lights like this are useful for everybody, but they’ve been very useful for youngsters with CVI just in terms of giving some adjustable light options. 

We’ll go to the next slide. So, these are some terms I’m sure you hear a lot. And just so if somebody’s talking to you about lighting, if you know these terms already, and you want me to move on, you could just tell me. Ambient light is basically the general lighting in a room. And task lighting, what I was talking about in terms of the adjustable light, gives you very specific lighting to do a task such as reading. Accent light is nice, but you can’t really use that as a primary light source. And really, the best type of lighting is sunlight, but unfortunately we can’t control it, so it’s one of the reasons to have good shades on your windows.

Here are some basic Lighting Facts, we’re going to start talking about light bulbs now, and if you have any questions, please please ask. We have a couple of images here. The one on the left is what you’re always going to find on a package of light bulbs. And any type of light bulbs that you buy nowadays in the US is going to have this type of label on it, which is Lighting Facts.

So, basically a couple of things to be concerned with without getting into any science about lighting. If you want a brighter light bulb, it says brightness, the higher that number is, that says lumens, the brighter the light bulb is going to be. In most cases you’re going to want a brighter light bulb. So this type of light bulb from this packaging, I’m guessing 440 lumens was probably equivalent to maybe a 60 watt bulb. So, it’s not giving you that much light. So, you want more light, always look at a higher lumen level.

And the next thing to pay attention to, there’s something a little further down says light appearance. A lot of people often complain about fluorescent lighting, or some types of LED lighting, that looks very blue, and they don’t really care for that. And that’s a cooler light. It’s not necessarily worse than a warmer light, it’s just a matter of preference. And for many of your children, you may have to go through some trial and error and try to figure out what’s the best lighting source for them- what they prefer to work with. Many people like a warmer type of bulb, which has a more yellow appearance. So, if you look at the package, it’s going to say 2,700k, or 3,000. And that’s how light is measured in terms of color. And that’s going to give you the warmer appearance. If you prefer a cooler bulb, if your child likes something that’s more of a blue light, the arrow is going to be under cool, and it’s going to probably say 5,000k. So, just a quick way to look at light bulbs. 

Now, let’s actually talk about light bulbs. As you know, incandescent bulbs really aren’t in existence, although I heard on the news recently that they’re trying to bring them back. And the reason why they were done away with was because incandescent bulbs are very inefficient and they cost more. They use more energy than any other light bulb. So, if you look at the picture with the blue background, it’s showing you what one LED bulb is equivalent to. So, you’re going to basically go through 25 incandescent bulbs during the life of one LED bulb, or two and a half to three compact fluorescent bulbs. Now, at first, LED bulbs were really expensive. They’ve since come down in price, you can get them in any home store, like Home Depot or any hardware store now and they’re really comparable with the cost of any incandescent bulb from the past. I happen to like them, because it gives you much more light.

So, if you have a light fixture in your child’s room that only takes a 60 watt bulb, you could put a very, very bright LED bulb now in that light fixture. And it’s going to use a fraction of the energy, so your child is getting much more light. The same is true in a lot of ways for compact fluorescent bulbs, too. But I think given the choice, an LED bulb is probably better because it’s also going to last you anywhere from up to 20,000 to perhaps even 40,000 hours depending on how much you use the light fixture. 

So, let’s go to the next slide. So, we’ve already been talking about light bulbs, we went through incandescent and compact fluorescent. Some of you may have halogen light fixtures. Halogen light is really nice. One of the problems with halogen bulbs is they burn very hot. So if you have a table lamp or a floor lamp that takes a halogen bulb, and you happen to touch the shade or your child may touch the bulb by the shade, it could burn very, very hot, actually hotter than most other light bulbs. So, my inclination is to stay away from that as a light source since there’s so many other choices.

Some people like full-spectrum lighting, which is a type of light bulb that mimics the natural light that you get from sunlight, which is a nice type of lighting. The full-spectrum bulbs tend to be a little expensive. So given the choice, I would stay with an LED bulb, which now comes in all kinds of color temperatures, so you could get warmer ones as well, or a compact fluorescent bulb. I’m not sure if I have it in the presentation, but if you’re able to install a dimmer switch that’s a good idea too, so you can control the lighting even more in your child’s space.

So, when we’re looking at lighting, the interior surfaces make a really big difference, meaning what type of flooring you have, what types of walls you have, how the walls and the ceiling are painted. As I said, a lot of this is common sense. So the lighter the color the walls and ceiling, the more the light is going to reflect off those walls, and you’re going to feel like you’re getting more light. Dark colors obviously absorb more light. So I wouldn’t paint somebody’s whole room in a darker color. You could make it appear like the room is larger and your child has much more light with lighter color walls. And this has an effect on on glare as well if you use flat finish paint as opposed to a high gloss paint. 

So then the next slide. I actually have a few slides just particularly related to youngsters with CVI.

Woman

Can I ask a question about the lighting?

Gordon

Sure, sure. Absolutely.

Woman

Yeah. So I’m wondering, and I don’t know, if you can’t speak to this, that’s okay, too. My daughter is young, she’s two she’s not very self-aware to tell me this, so maybe this is something people learn as their kids get older. One of the challenges for albinism is kind of this photophobia or dislike of really bright lights. But then of course, I want things to be well lit, so she can see them. But then I don’t want them to be too bright.

Gordon

So, the challenge is, I shouldn’t use the word challenge, when you’re working with somebody that’s photophobic, like a young person with albinism, or somebody with cataracts, having more light is great, but it’s really how well the light is shielded. So it’s really finding a really good light cover, and good lampshades as well. So you could still have a brighter light so your child could do whatever task they’re doing, as long as it’s covered, well, that will make a difference.

Woman

Okay.

Gordon

You could also play with different types of lamp shades. For instance, if you’re using a table lamp, you could play with slightly darker lampshades, or some that are more opaque than others. I would also always stay away from, you don’t see them as often, but some people still use them- they used to make these crystal clear light bulbs that you’d see a lot in bathroom fixtures and they weren’t opaque at all, it’s just totally clear. And people used to think that they were getting more light by using those bulbs, but they’re the worst light bulbs in the world. Because they create so much glare. So with somebody like your daughter, one of the bigger concerns would be preventing glare from the light.

Woman

Okay, thank you.

Gordon

You are welcome. So, just back to just a few things regarding CVI. There are, and you may know this already, those of you that have children with CVI, that they may respond better to certain colors in their environment. From what I understand, the children seem to respond better to red and yellow, especially if you’re using it as contrast colors for written material. And also cutting down, and this could be true for almost any children nowadays, is just trying to reduce as much outside sensory information as possible while they’re doing whatever task they’re doing, whether it’s homework, or they’re just playing. Basically, that’s just cutting down on unnecessary noise or visual distractions.

So, I know I mentioned this before, but how you place the light is really important for any child. It’s particularly true for children with CVI. Now, again, brighter light might work, but the light has to be adjusted so you’re not causing glare. And, as I mentioned, with any child, really experimenting, even with younger children, sometimes you could pick up cues from your child, if you’re trying out different bulbs or different light sources, you can see how they’re responding even if they can’t articulate that to you.

So, using controlled incandescent, or LED light, is probably better than fluorescent lighting. I know, in my experience over the years, that there’s a lot of students that respond negatively to fluorescent lighting, because fluorescent lighting has a ballast in the light fixture and it causes a buzz. You may not hear it, sometimes the kids hear it. Or, sometimes if you stop and really pay attention, you could hear this very, very annoying buzzing sound that’s coming from the lighting. So, something to keep in mind.

Go to the next slide. I know I’ve already been talking about glare, but glare is really the enemy of good lighting. So basically, it’s having too much light in your environment that your light fixture or your light source isn’t shielding the light well enough. Go to the next slide. So as I mentioned, you minimize glare by using curtain shades or blinds or using opaque bulbs all the time. If your child is doing a task, lots of times you get glare coming off your table top. So, without buying a new table, probably the easiest solution to deal with glare from a table, is to just put down a tablecloth, and right away you’re cutting down on the glare source. Go to the next slide.

You also get a lot of glare coming off the floors and the walls. For those of you that may still wax your floors, or if you have a high-gloss finish on your floors, they do sell floor wax and floor cleaners that have more of a matte finish. So you’re not going to get that shiny glare coming off the floor. Using carpets all over the floors are great just as long as it’s not a trip hazard. So make sure they adhere to the floor really well. 

We could go to the next slide. So, after I pay attention to lighting, and problems with glare, then the next thing I look at, which I think is really important, is color contrast. Now, how you use color contrast in your environment can make a huge difference. Now this slide with the color contrast is a basic chart that’s just showing you some colors that work much better together. The ones that obviously say yes, and then you have the images right below that say no, and you could see how difficult it is to see. Even if you’re not visually impaired, how difficult it is to see with certain colors that are matched with each other. So, definitely some color combinations work better than others.

We go to the next slide. Here’s some practical examples of color contrast. Now on this slide, the image in the lower right hand corner is a white cabinet. So you have a white counter, and you have white drawers and these chrome drawer pulls. This is something you’ll typically find in a kitchen or somebody’s bathroom, but there’s no color contrast at all. Now the image right above that is the optimal color contrast. So you have a dark countertop and lighter drawers underneath and they have dark drawer pulls. So there’s plenty of contrast. If I went into your house today, I wouldn’t tell you to rip out your cabinets. One of the solutions, and this is the image to the left, all I did for about two pennies worth or a penny’s worth of tape, I just took a dark color tape and taped it to the edge of the counter and I wrapped some dark tape around a drawer pull right below that as well. So, I created color contrast without spending a lot of money and putting in new cabinetry. Generally, I would avoid any white on white or beige on beige type of color schemes. 

Now we can go to the next slide. I’d also avoid any kind of bold patterns in your environment. So I don’t know if you could see, but there’s actually a set of keys on this bedspread. I use it as an example because it’s really difficult to see, and sometimes if you’ve been in a hotel or a meeting center, usually they have carpeting that’s very visually confusing on the floor. They do this because when you have bold patterns on your carpeting, it covers up a lot of dirt. So that’s their reasoning for using it. But in your space, I would try to stay away from any kind of wallpaper, or visually confusing carpeting in the space. Just keep it very clear in terms of lighting and contrast and it could really make a big difference. 

And we could go to the next slide. So, here are some other easy solutions. A contrasting toilet seat on the commode can make a really big difference. They cost exactly the same as a white toilet seat. And in any home center or hardware store you could buy dark green or black or brown toilet seats and it creates color contrast in your environment. Now this might be true if your child wakes up at night and they need to orient to the commode kind of quickly, they might be able to see the toilet faster if it’s a darker toilet seat as opposed to a white on white.

The image next to it has colored railing and colored base molding. And the one on the far right- if you’re painting your child’s room, or doing some painting in your own home, just painting your door as a different color from the walls can make a world of difference in terms of contrast. Now the image in the middle, I actually took this in a hospital, just to give you an example of very poor contrast. So here you have a white floor, and white walls and white base molding. And, if you have these very bright lights on top of it, like bright fluorescent lights, it becomes visually confusing. In fact, it’s like creating a type of artificial snow blindness, it’s like walking down a snowy, white tunnel. And sadly you do see things like this in many environments. But again, for very low cost, you can certainly paint the base molding and create some color contrast. 

And we could go to the next slide. Just quickly, I just wanted to give you an example. I’m sure as you go through different environments, you’ve seen the signs like these bathroom signs, and both the top signs are ADA compliant signs. So, it’s just a matter of whether somebody prefers regular contrast or reverse contrast, it’s just a matter of preference. But I just want to give you that as an example. The stop sign was an image that we took many years ago in our nursing home, and the folks living there were visually impaired, some with dementia, just so they could see it very clearly not to go through that particular door. 

We go to the next slide. Now stairs become really important. So, if you have steps in your home and you’re able to paint the edges, that would be great. If you could paint the railing, a darker color that’s really good in terms of your child orienting up and down the stairs.

Most schools, if they have steps, have to do this. They have to follow the ADA. So if they don’t have this in your child’s school, you know you could certainly mention it to the administration because it’s not a big fix to create contrast.

Go to the next slide. Now here’s some examples of poor contrast. The image on the left was actually taken in a hotel. I mentioned the confusing carpeting in hotels. This is a staircase that is carpeted, it’s more visually confusing, and it has very low light. So, if you’re trying to negotiate those stairs, that’s going to be really tough. The image next to that- they tried to create contrast, but it’s also very light. Now, the two images on the bottom, the one on the left, is basically you’re standing on the top, and you’re looking down. And, you can’t even tell that that’s a set of stairs, it looks more like a ramp. And, the image next to it is when you’re looking up towards that top step and you could see that it’s really a set of stairs.

Now unfortunately, I’ve seen stairways like this a lot in New York, and I imagine in other cities as well. Usually when this is in public spaces, and when they’re designing parks and ramps and stairways and public spaces, they’re really not thinking about people that may have some vision impairment. 

Go to the next slide. So, we’ve talked about lighting and glare and color contrast. So, then I’m concerned about how safe the space is. Now we can go to the next image. So, I will primarily look at stairs, floors, and doors to see how safe they are to make sure that things are secured and they are wood-colored contrast.

Now, the next image has a couple of doors. So, my philosophy about internal spaces is, just as I mentioned, that it’s a good idea to keep a light on from going from room to room, so your child could see where they’re going from room to room. It’s also a good idea if you have doors if each door is kept open, all the doors are open within your space, or all the doors are closed. This way as your child is negotiating the space, they’ll always know that the doors either open or closed within the space. Make sure that the doors aren’t halfway open either because that’s a dangerous situation as well.  If you have glass doors in your home, particularly shower doors, I would say bathrooms and kitchens are probably the two most dangerous rooms in any environment. Those tend to be the rooms where people may have the most accidents and people have more of a tendency to fall or trip. So, if you have glass shower doors, you could always put a dark decal on the door and then your child is going to be able to see where the door is.

We could go to the next slide. The other thing I look at in the environment is I’ve seen these types of images more in homes for seniors, particularly seniors that are living on their own with some vision impairment, where the wires and cords are overloaded or they’re running across the floor. I’m guessing in your own homes that you don’t have wires running all over the place. Just as a reminder- keep them all along the wall.

How your children negotiate space, you know much better than I do. You could move the furniture out of main traffic areas. I used to go into my mother’s home years ago and she had glaucoma and macular degeneration, and to me it was a nightmare. There was stuff everywhere and she never wanted me to move stuff because it worked for her and that I understand. So, you know your space, and you negotiate it, and your child negotiates it, but one of the issues is, particularly children that may have some kind of progressive vision loss like like RP for instance, it may be working now, but it may not work at a later time, so just something to set the tone now, as opposed to later. 

Go to the next slide. Back to bathrooms. One of the best things in a bathroom, in terms of a safety feature, is installing grab bars within the shower or bath area. If you’ve done that already, that’s great. I recommend grab bars for every bathroom. Some people are concerned about they don’t like the way it looks. You could get grab bars now in any color imaginable, so it could fit with the decor of your bathroom. Just one reminder, if you’re installing them, or you are having them installed, make sure that they’re installed into the studs in the wall, as opposed just into the tile, because they could eventually fall out. But again, I would recommend grab bars in the tub and shower, and around the commode also, which is a good idea.

I don’t know if this is the case with some of your children that they mean need to sit down in the shower, but a shower chair is great. Using a non-skid, high contrasting mat, both in and out of the tub is really important. So it’s going to prevent your child from slipping and falling. And, they’re also going to be able to see where they are in terms of the tub and outside the tub. Those of you that live in your own home, as opposed to in an apartment, you can control the temperature of the hot water on your boiler, which is a good thing to do. I would probably scale it down to maybe 120 degrees, so nobody’s gonna get scalded. For those of you that may live in an apartment and cannot control the hot water temperature, sometimes they do sell (we could go to the next slide) some basic, and I have an image a little further down, some basic anti-scald devices that you could screw on to your faucet. And they’re usually about $7 or $8 and it regulates the hot water coming in. So, after safety, then you know I am looking to see how accessible a space is. 

We can go to the next slide. So, a space that gives you some accessibility and control of the environment. Another thing to put in the shower is a handheld shower, which will give your child more independence. So, if you have a grab bar or chair in the shower, they could sit down and they could bathe themselves independently using a handheld one. Now this is what I mentioned just before, this is an anti-scald device. So, the longer piece just screws right into the faucet and you’re regulating your hot water temperature.

We are going to the next image. A couple of other things I like to use that are inexpensive to put in your environment are toggle light switches, as opposed to the small light switch. It’s basically a big button light switch and you’re able to control turning on the light. If your child’s having difficulty with their hands, they could even turn on the light switch with their elbows or their chin or almost any body part, even their head. They can turn the light on using a bigger light switch.

I don’t have an image here, but in terms of contrast, I would make sure that the light switch is a darker contrast and color, and they cost the same as the white ones. So the same 50 cents or $1 for the pad, you can get a darker one as opposed to a white one. The image next to that is some lever-handle door knobs. If your child is having some type of issue with their fine motor control with their hands, they do sell lever door knobs now that screw right on over your regular door knob. They cost about $5 or so. There’s a company called Maxi Aids that sells them. 

Okay, go to the next image. So, just sort of winding down – I always think that your child or any person for that matter is going to respond better to the environment, the more control they have over their space. So, if your child could open the windows and adjust the blinds, fit through doors, turn the lights on and off. If they’re able to regulate the water temperature, that’s great. Anything that gives them more control over their space, they’re gonna end up feeling better about it. And as I said, this is true for anybody. So, that’s it. Hopefully you were able to pick up little information from this presentation. If you have any questions, just let me know.

Sheila

Thank you, are there any questions now? Does anyone have any questions?

Carmen

One thing that I had found, I don’t know, if you’re aware, I have albinism. This is Carmen. And one thing that actually had helped me a lot are those Hue lights.

Gordon

I didn’t hear the last part, what type of light was that?

Carmen

The hue, the Philips Hue. Okay, because you adjust them according to the need. You can make them brighter, or you can change the color. And they’re actually pretty helpful.

Gordon

I actually have seen them. And I’m glad you mentioned that. I should probably include that in my next presentation. And do you have this throughout your house?

Carmen

I started in my bedroom and liked them so much that I now have them all over. Yeah.

Gordon

That’s a great idea.

Carmen

The color ones are expensive. So, I have the color ones like in the areas that I use the most like my bedroom or the kitchen. And then the other ones I use through the house because they are cheaper.

Gordon

In fact, now you mention that I may even go out tomorrow and try to get that myself for my own home. Thank you.

Carmen

And the other thing I like is that because like if it’s dark, and if you’re just getting home, you can just start them from outside so you don’t have to try to maneuver in the dark. So, I really like that.

Gordon

So, you control it with your phone?

Carmen

Mm hmm.

Gordon

Okay. Yeah, great. Thank you.

Sheila

I know some of our people in the albinism community have, because the kids are all going to school with those overhead fluorescent lights and the glare for our albinism is pretty intense sometimes, there’s some kind of a screen. Are you familiar with it? You can put over the – the school will let you…

Gordon

Over the light itself you mean? I’ve seen things like that. Yeah, that it’s actually shielding the light more, it’s cutting down on some of the glare. Another thing to use, it’s probably one of the easiest solutions, is if the child puts on a hat or a visor, you’re cutting down on glare by more than 50%. Now, some kids may not want to wear a hat in school or a visor, but it really does make a difference. In fact, there’s some folks within my own agency with vision impairment, and I have to admit, within our own building, we don’t necessarily have the best lighting. But one of the workarounds for them is that they’ve been using visors and caps, and they found that it makes a difference.

Woman

I have a question and it wasn’t covered in the presentation. So, it’s okay if this is beyond the scope- but I’m kind of wondering about, especially since my daughter is young, she’s two and trying to have a rich language environment and I didn’t know if you had any suggestions or anything about how to make it. A lot of us are seeing letters and words all the time and picking up on that, and I know obviously not being able to see at a distance.

Gordon

You’d mentioned she has a TVI twice a month is that it?

Woman

Yes.

Gordon

Okay. I am not a TVI. I mean, I know a lot about stuff, but I’m not a TVI. But, this is something I would definitely ask the TVI in terms of language development. In terms of my own experience with family. The more you talk to your child, to any child, the more language they’re going to develop. And also, the more you read to your child, the more language and vocabulary they’re going to develop as well. Actually wish that Linda Gerra was here. I’m here, Oh, yeah. So Linda is probably one of the best people to answer your question.

Linda

Yeah, I had trouble getting on the computer audio. I saw all the slides, but I had trouble getting on the audio on the computer. But anyway, I’m on the phone. Yeah, I mean, there are a number of things that you can do. Does your child, and you probably said this in the beginning, does your child have any vision at all?

Woman

Yeah, she has albinism, and so she has vision loss, but I would say it’s mild to moderate. She can’t see at a distance, but she can see within two feet of herself pretty well.

Linda

Okay, well, I mean, you’re probably already doing this, bringing her to the, whatever the print item is, and it’s a real distance. Explaining what it is, what the letters are, and what the building is. And maybe if her near vision is good, you can make replicas or drawings of what you are seeing and at a distance. And making 3D models, and, using dark magic markers, you know, thick line magic markers to do the letters and simple drawings.

I mean, really, you just have to think creatively about bringing in to her what you are seeing at the distance. And like Gordon said, language and description is going to be very important. And then, you know, being able to compare, once she has a pretty good vocabulary, you can do a lot of comparisons. This is like this building, or this tree is as big as the ceiling in our house, or – I’m not doing a very good job of comparisons but comparing to things that she might have already experienced. And, if you want to talk about it more, you could give me a call at Lighthouse Guild. I’m on the website also, I’m Linda Gerra. And I could probably give you a few more ideas.

Woman

Okay, thanks. I really appreciate it.

Sheila

Sure. Yeah, this Sheila. And just quickly, one of the things we did and we started with the TVI, but then we really liked the idea when my son was really young, and you make it a game, and we just found these the other day, he’s 21 now, so it was really funny. But we went and took pictures of all of our favorite places, like the library, and then we took pictures, because we’d always go to Storytime with the same person. And we took pictures of who they were and what they looked like. Because what we were finding was that he didn’t necessarily get really close up to see what everybody looks like close up. So, we did that so he could really hold it and look at people. We did his friends and he would know their names, he’s very intelligent. But this was a way that he could just, and then we played games with him, too. I didn’t do this, but I know for the language of bringing it in, like Linda was talking, once you want them to like, the sight words are what your word you like you go to preschool and their sight words everywhere. And they kind of miss that sometimes, right? So, they always give you what the sight words are and I know people who have put them on their own things at home. If the language wasn’t coming in so well, like on your refrigerator, you could put that just so they get – she’s young now. But as they get older, you could do that at home, they always give you those sight words ahead of time. And so, that’s a way to get it so that they can touch it and feel it and, and, you know, kind of get closer to it than they will at school.

Woman 2

One of the things that we did when Gabrielle, when my 12-year-old was young, and just like Sheila said, we used those magnetic letters on the fridge. And we had a whiteboard in his room as well. And that really helped him, like she said, make the language more tactile, because it was easier for him to feel the shape of the letters and things like that. And then we could form the sight words, and we didn’t necessarily have to write cue cards over and over again, we just rearranged the letters as we needed.

Sheila

Okay, I am cognizant of the time. So, any other questions?

Linda

I just have one more comment. Wikki Stix. Does anybody know what Wikki Stix are? They are like pipe cleaners, but they’re waxy. And you can form letters and shapes. And that’s very tactile also.

Sheila

Thank you. It’s a good idea. Okay, and if you have any questions, Linda is available. I’m available. And if you had any specific questions for Gordon, I can connect you offline if it’s okay with you, Gordon?

Gordon

Sure absolutely. I mean, they could email me, or call me at work. I’m always glad to answer questions. And if somebody is doing any kind of rehab in the future, in their home, and they want to incorporate certain things in their environment, I would even do a quick call to their contractor if they wanted that as well.

Sheila

Well, thank you. That’s very nice of you. And thank you for guest speaking tonight. It was great. And our next call will be next month. And I believe it’s Lily and Carmen who are doing Advocacy, I believe. Yeah. So hopefully everybody will join us for that. And again, if you have any questions, let me know. And thank you everyone for coming.