When I first began learning about Cortical Visual Impairment (CVI), there’s one thing that was immediately clear: it was an absolute must that my husband and I include opportunities for visual stimulation throughout our daughter’s daily routine. Our daughter’s visual therapist encouraged us to do so rather than try to dedicate a set number of hours for “visual therapy”. She assured us that this would expose her to more frequent doses of visual stimulation per day and that it was more sustainable over the long haul since CVI is a long-term visual disability.
A CVI assessment by our daughter’s CVI-endorsed visual therapist determined that she is currently in Phase 1 on the CVI Range. At this stage in the game, our primary goal is to help her build visual behavior. She currently prefers things that are shiny and single-colored, ideally red or yellow. She displays several seconds latency from the time we put the item in front of her to the time she glances towards it (if she does at all).
To be effective, we would need to incorporate red and shiny things into her routine, but we’d also have to give her lots of time to look at them, all while being quiet as a mouse since she needs to use all her brain power for looking.
Our daughter’s daily routine
I started by visualizing our daughter’s daily routine and wrote down all the things we generally do on a daily basis. I asked myself, where does she spend the most time? What do we do every day or frequently? Here’s what I came up with.
Daily or frequent activities
- Sleeping and waking up in crib
- Breastfeeding or bottle
- Changing diaper
- Changing clothes
- Combing hair
- Vitamin D drops given daily
- Mommy sipping her morning coffee 🙂
- Tummy time
- Physical therapy routine 3x per day
- Playtime 3x per day, including sound and music stimulation
- I let her smell scents such as lavender essential oil
- Sitting in car seat
- Being carried in baby carrier during daily outdoor walks
- Bath time
- Story time
- Lots of photos and videos taken of our daughter with our phones
- Entering and exiting rooms
- Constrained Induced Movement Therapy (CIMT)
- Relaxation time
I knew I could come up with creative ways to incorporate visual stimulation in most of the above activities. I found many ideas online and in books. Our visual therapist and physiotherapist shared plenty of excellent ideas as well.
As our daughter grows, we’ll have even more opportunities to include visual stimulation in her routine. For now, here are some of the ways we’ve incorporated visual stimulation in her daily routine:
Tummy time
To make tummy time more fun, I place some of her most familiar CVI-friendly objects in a plain white dish. I also add some water so she can feel around the different textures. For more of my tummy time ideas, click here.
Sleeping and waking up in crib
A CVI-friendly mobile is the perfect tool to get your baby looking from the minute they wake up or if they’re relaxing in the crib. You can easily make the one pictured below. See the how-to guide.
Vitamin D drops given daily
I wrapped the bottle’s busy label with sparkly red foam paper and added a shiny red ribbon. Every day, I hold the bottle in front of her until she looks towards it before I give her the drop.
Sitting in the car seat
A car-ride is the perfect time to practice looking. I make sure to switch up the hanging object every few weeks (we don’t use the car seat often) and we keep the music off. Before I was familiar with CVI, I had several different toys hanging but the visual therapist instructed us to limit it to just one CVI-friendly toy at a time. The shiny red Mardi Gras beads worked really well and so did a big red crystal beaded heart keychain that would catch the sunlight and sparkle.
Mommy sipping her morning coffee 🙂
I hate to say it but I feel like I “treat” myself to my daily morning coffee—every minute is so precious when it comes to stimulating our kiddos, after all! While I do, I place my daughter on this amazing foam wedge I purchased (see photo below). The incline allows her to comfortably gaze at the object I’m showing her.
Every once and a while, I change up the toys. Currently we’re using the Mardi Gras beads. As you can see in the photo below, I shine light from behind her so that the beads are “in the spotlight” and sparkle.
The LED clamp spotlight, green foldable playmat and baby gym with removable toys are from IKEA. I also found a solid black playmat on Amazon here.
I purchased the foam wedge from an online site called Mercado Libre while I was travelling in Mexico but you can probably find one on Amazon. The one in the photo below is 60cm (length) x 40 cm (width). Our daughter’s physical therapist had highly recommended we purchase one for our home and I’m so glad I did. I use it constantly throughout the day for tummy time, at-home therapies, playtime, story time, etc.
Feeding and bottle
My daughter just started eating solids—so fun! Every day, I use the exact same red spoon and bowl. I added a big sparkly bow to the spoon and I make sure she looks at the spoon before I feed her each time. Eventually, I’ll remove the bow but for now, I want to make sure I’m catching her attention. I believe I got this fantastic idea from the book “Little Bear Sees”.
I also added a bright red snap bracelet to her bottle.
Diaper changing routine
With the number of times I change a diaper in a day, I knew it would be a missed opportunity if I didn’t take full advantage of this regular routine. My daughter’s visual therapist suggested I add something shiny to a diaper and keep it aside to use as the “looking diaper”. The red shiny paper is meant to help catch her attention.
When it’s time to change a dirty diaper, I first show my daughter the one with the red sparkly paper. Once she looks at it, I hand her a clean diaper so she can feel the texture and “get to know it”.
Another tip from our visual therapist: Over time, gradually cut off bits of the red sparkly paper or ribbon until nothing remains.
I recently found this bright red and shiny floor to ceiling door curtain at Party City. I hung it next to her diaper changing station and she’s been turning her head to look at it since. I also shine a spotlight on it to make it sparkle even more.
Since I didn’t need the entire length of the curtain, I cut the extra bit and used it to make a pom pom which I show her during playtime.
Playtime with sound and music stimulation
Every day, we play with all the musical instruments you see here. I hold the instruments in her line of sight without making a sound until she looks at them. I believe the glossy red egg shakers and the silver metal catch her eye.
Daily outdoor walks in baby carrier
We take daily outdoor walks and I carry my daughter against my chest in a carrier. I think both the carrier and stroller offer unique benefits (although I don’t currently own a stroller). With a stroller, I could easily hang toys for my daughter to look at but with the carrier, she gets lots of practice looking directly at my face. Kids with CVI typically have the most difficulty with faces since they’re always changing, so she needs the practice anyway!
I wear this teething necklace every time we go out. It really stands out against my solid black clothing. It’s perfect for touching, feeling, teething and looking at.
Cruising in the stroller
When I first wrote this post, I didn’t own a stroller. As my daughter gained more and more weight, I thought it might be worth the investment. Plus, I figured I could dress it up with some shiny foam ornaments. I added velcro underneath the hood so I could switch up the decor every so often. This caught her eye immediately. I could tell because she went out of her way to reach as far as possible to touch the one on the far right.
Recently, I attached a yellow helium balloon to the footrest of the stroller and we rode around with it like that for a week. To the other small children passing us by, I was the coolest mom on the block.
Bath time
During bath time, I use a bright red cup to pour water over my daughter. It’s the matching cup to the bowl I use to feed her daily. Also, since repeated exposure of objects is very important, we only use this one crocodile toy and we don’t switch it up often.
Our visual therapist suggested we use a red hand towel to bathe her with but I have yet to find one in stores. Since the bathtub is all white, the red towel would stand out against the background much more than the white one I currently use.
Relaxation time with color-changing lights
Color-changing lights are great when used for relaxation, according to our daughter’s CVI-endorsed visual therapist. Our daughter seems to love this LED strobe light seen below. It’s a simple lightbulb you can plug into any lamp. Available on Amazon here.
Entering and exiting rooms
Not only have I taped shiny ribbon on the doors inside our home, but I also added a shiny red pom pom to the front door of our apartment. My hopes are that my daughter will eventually associate seeing the pom pom with arriving home. Since it usually takes me a bit of time to locate my keys and unlock the door, it’s a good opportunity for my daughter to do some looking from the comfort of her stroller in a quiet hallway.
Have any ideas of your own? Please share by commenting below!
Cindy has a deep interest in Cortical Visual Impairment (CVI) and is currently studying Early Childhood Education. She focuses most of her time on her energetic daughter: playing, cuddling and helping to make her world visually accessible. Cindy holds a degree in Marketing and has worked in the not-for-profit sector for many years.