# Tools and Activities
for
Development of Visual Skills
with 0-2-Year-Level Learners
PRACTITIONER'S GUIDEBOOK

by
Elaine Kitchel, M.Ed.
with consultation from
Millie Smith, M.Ed.

© 2009

The following people deserve grateful acknowledgment and thanks:

David McGee, Technical Research
Frank Hayden, Technical Research
James Robinson, Technical Research
Tom Poppe, Model Maker
Cary Crumpton, Planning Advisor
Lou Tingle, CD Production
Lila Adkins, Large Print
David Manteuffel, Purchasing
Steve Paris, Production Advisor
Anna Fox, Cost
Sandy Maerz, Purchasing
Phyllis Williams, Inventory
Jack Decker, Vice President
David Hines, Engineering
Tony Grantz, Sales
Pat Packer, Braille
John Aicken, Educational Research
Erica Rucker, Educational Research
Matthew Smith, Educational Research
Bisig Impact Group, Graphic Design
and
Millie Smith, M.Ed.
Tristan Pierce, B.F.A.
Rebecca Burnett, Ph.D.
LaRhea Sanford, Ph.D.
M. Beth Langley, M.Ed.

for the provision of talent, advice and expertise toward the development of this guidebook.

# Introduction

"Functional" is a word that was used in the community-based curriculum approach. It usually is meant to specify skills that the student would use in post-school environments such as home and work. For students with mild developmental delays who intend to finish school and go to assisted work and living situations, the "functional approach" works. The question is what does "functional" mean for a 0-2-year-level learner?

Any interaction with people and objects in the natural environment that gives the learner the opportunity to meaningfully participate in the events of his/her life is "functional." So, when a child plays with a mirror it is considered "functional" because it gives a learner the opportunity to understand that he has a face, just as everyone else does. He discovers that a mirror provides a way to see what others see.

"For a 0-2-year-level learner, play is the most powerful teaching method and in no way compromises the functionality of the outcome," says Millie Smith, a well-known expert on education of children with severe disabilities.

TADPOLE provides suggestions for play activities that caregivers and interventionists can do with 0-2-year-level learners. These activities were developed when teachers who field tested the ToAD program pointed out that ToAD did not provide activity suggestions that were appropriate for children ages 0-2, and students with multiple disabilities. TADPOLE was then developed to supplant the ToAD Guidebook for those who serve learners who fall into the 0-2-year-learner level. Its activities are built around natural, everyday, play and work activities that would be performed by children who are developmentally very young. The ToAD tools and TADPOLE activities will provide a framework for the development not only of visual and visual-perceptual skills, but foundational self-care and social skills as well.

While TADPOLE provides suggested activities, caregivers and interventionists are not limited to TADPOLE activities. The tools included in the ToAD Kit and TADPOLE kit can be used in unlimited ways to serve learners as they reach higher levels of achievement. Teachers, parents and interventionists are encouraged to explore new ways to use the tools and materials. A reporting form is included to assist practitioners as they track and report learners' progress.

General Preparation

It is difficult to say enough about the preparation of the environment and the child for functional vision activities. Most children who have severe disabilities will have several prerequisites before they can begin to use their vision.

- Support and alignment of the child's body, especially the head,
- appropriate lighting, with no blue or UV emissions
- limitation of distraction
- simplification of the visual environment
- and physical readiness of the child

are all necessary before vision and learning can take place.

The use of bolsters, pillows, and frames to support the child is encouraged. For several useful examples of how support and alignment of the child can be achieved, watch "Good Lookin'" and "ISAVE 101," two videos from APH.

Lighting should usually be soft and indirect, not too bright and not too dark, but this varies from child to child. Cool white fluorescent light should be avoided altogether, as should flashing light.

Incandescent light from behind or above the child's eye level is usually best, as long as the child is not allowed to light gaze.

Care should be taken to limit distraction and stimulation. The practitioner should wear a black apron and gloves when presenting stimuli to the learner. Use of a black corner or some other corner where the walls are a simple pastel color can be used as backgrounds for functional vision activities. Extraneous sounds should be absent and the practitioner will do best to talk in soft tones.

Even in the best of circumstances, the child must be ready to see. If he or she is hungry, sleepy, tired, or heavily medicated, peak visual function may be out of the question. Make sure the child is well-rested, well-fed, comfortable, supported and ready to see. When a child's needs are met, only then can he or she become a "learner."

Elaine Kitchel, M.Ed.
Low Vision Project Leader
American Printing House for the Blind

Photo of two young children and their teacher arranging toys on a table

Photo by Jason Metter/Blue Fruit

This classroom for young children is perfectly illuminated. The pink walls reflect soft, pink, incandescent and warm white fluorescent light from the lamps and ceiling fixture. This illumination allows most children with eye disease and CVI to function at their optimal abilities.

# Alignment and Position as Preparation to Use TADPOLE

From Individualized Systematic Assessment of Visual Efficiency (ISAVE) by M. Beth Langley

By obtaining an idea of how vision is used in both natural, unstructured and in optimal, structured settings, you will be able to delineate specific interventions to facilitate and encourage the development and optimal use of vision.

If the student is not physiologically available and prepared for interaction, you may learn only that he is visually unresponsive and very little about functional vision potential for further development and skill expansion.

Perhaps the most critical aspect of the assessment process is that of ensuring that basic physical principles have been met. Eliciting efficient, optimal behaviors will depend on whether the student is:

> 1) ready for perceiving and processing information,
> 2) provided with sufficient but appropriate amounts of sensory information, and
> 3) appropriately physically stabilized.

Preparing and organizing the student for attending, perceiving, processing, and responding to assessment tasks must occur prior to any presentation of stimuli. If the student is tired, has just been fed, is hungry, or medication is wearing off, his performance may not represent typical or optimal abilities; although, diagnostically, information obtained under these conditions is valuable in discerning conditions and barriers that affect the use of vision in everyday experiences.

It will be particularly important to be very attuned to the conditions that will facilitate optimal attending and to behaviors that signal stress.

- The background lighting should be dimmed and the use of very bright lights should be avoided.
- When severe physical limitations influence visual behavior, it may be helpful to support the student in a supine position so that his head is raised approximately 30 degrees from the supporting surface. This position is often effective in eliciting a state of readiness and attending.
- Stimuli should be introduced slowly, calmly, and presented for a short duration in appropriate intervals of time.
- Allow the student sufficient time to process and respond to the stimulus as well as time to reorganize between stimuli. Behavioral signals of over stimulation and stress include yawning, increased drowsiness, hiccupping, fussiness, eye aversion, and regurgitation. Jan (personal communication) noted that when children with cortical visual impairment are over-stimulated, they fade in and out of responsiveness and their vision may simply disappear for several seconds or longer, which may be thought to be seizure activity by those unfamiliar with the child.

Note the student's behavior and regulatory state prior to handling, positioning, and assessing and record it in the appropriate block on your assessment or skills development protocol. Reassess state and range of behaviors periodically as well as at the conclusion of the session. In addition to recording the specific state, it is helpful to describe the concomitant activity and/or stimuli accompanying the state.

Note:

- whether interaction altered the student's behavior state
- optimal attending, endurance, and processing time
- factors responsible for eliciting optimal attending behavior
- offer guidelines to the amount, quality, and nature of stimuli most appropriate to processing and organizational needs.

Positioning

If the student's sitting balance is poor, it will be critical to ensure stabilization of posture that results in better control of head movements. If independent head control is lacking, the student should be positioned supine with the occiput, or base of the skull, of his head secured over a small roll or pillow which will also facilitate midline orientation.

Photo of a teacher supporting the child's head and neck with a bolster pillow as he is lying on his back

Teacher positioning child with occiput over bolster pillow.

Positions other than supine or sitting should be considered and attempted when assessing the vision of students with athetosis or spasticity. Supported sidelying with the head in alignment with the body and slight lateral flexion on the non-weightbearing side is often a good position in which to elicit efficient eye movements in an athetoid student who cannot otherwise achieve any midline control.

Photo of a teacher holding a student in the sidelying position enabling him to best view a toy in front of him

Supported sidelying with the head in alignment with the body and slight lateral flexion on the non-weightbearing side.

Photo of a child lying prone and supported by an inflatable tube, and her teacher who is assisting her in viewing a toy

If sidelying is not appropriate, positioning in four-point, prone over a bolster promotes alignment of head and neck, brings the head into midline, and tends to help the eyes center when hyperextension of the head and neck are characteristic postures.

Because of the relationship between the vestibular system and oculomotor function, it is both desirable and often necessary to engage the student in rolling or other forms of vestibular activity prior to assessing visual behavior. The vestibular information serves as an alerting strategy to counteract a lethargic or a drowsy-alert state and to integrate oculomotor behaviors.

Photo of a teacher helping a child balance while sit-straddling a bolster and playing with a stack toy

Bolsters provide the opportunity for subtle weight shifts and postural adjustments that maintain mobility and force the visual system to adjust to movement while remaining upright against gravity.

Environmental Controls

The best environment is one which permits observation of the student as he functions in his natural surroundings and which affords a quiet, organized space in which to observe optimal visual functioning. Lighting should be adjustable, even minimally, through the lowering of blinds or dimming or eliminating direct lighting sources. There should be some background lighting available but, in general, during the assessment of functions such as pupillary reactions, alignment, binocular function, fixation, eye mobility, and pursuit behaviors, lighting should be subdued. In contrast, increased illumination may be needed to provide contrast between foreground and background, to highlight visual stimuli, or to provide sufficient lighting for visual functioning when a specific visual impairment is manifest.

For more information see the Preparation to Conduct ISAVE chapter of the ISAVE product.

# Definitions for TADPOLE SKILLS and TADPOLE Tools Chart

Pupillary response: Decrease in the size of the pupil when bright light is presented

Blink response: Closing the eyelids in a protective response to the movement of a hand or object toward the eyes

Pupillary reflection: Light is reflected off the pupil when a penlight is directed toward the bridge of the nose; location of reflections will indicate eye alignment.

Fixate: The ability of the eyes to directly gaze on an object and hold the gaze so the object remains in view

Convergence: The ability of the two eyes to maintain visual focus from distant to near

Ocular pursuit (fixates and follows; crosses midline): The ability of the eyes to fixate on an object and follow it as it moves; midline is the vertical plane that extends from the top of the center of the forehead to the navel.

Shift of gaze: The ability of the eyes to fixate on an object and then shift fixation to another object, especially across midline

Scan: The ability of the eyes to move from left-to-right and back again, to visually observe

Acuity: Measure of the ability to distinguish objects, shapes, pictures, numbers, or letters at a standard distance

Visual field: Total area in which objects can be seen while the eyes are focused on a central point; usually measured in degrees

Eye dominance: Preferred eye used to perform a variety of visual tasks

Depth perception: The visual ability to perceive relative distance of objects

Light sensitivity and preference: Visual efficiency under various lighting conditions

Visual closure: The ability to fill in the whole when only parts of the whole are provided

Visual discrimination: The ability of the eyes and brain to perceive similarities and difference in objects, shapes, sizes, colors, patterns and pictures. Visual discrimination can be demonstrated through activities such as matching, sorting, and identifying.

- Matching: The ability of the brain to perceive through vision that two items (objects, shapes, pictures, and others) have the same characteristics
- Sorting: The ability of the brain to discriminate between like and unlike items (objects, shapes, pictures and others) perceived visually and to categorize according to their similarities
- Identifying: The ability of the brain to recognize items (objects, shapes, pictures and others) visually and to label them appropriately

Figure-ground discrimination: The ability of the eyes and brain to perceive one aspect of a picture/scene in relation to the entire picture/scene

Visual attention: The ability of the brain to pay attention to visual stimuli

Visual memory: The ability of the eyes and brain to perceive an object visually and to recognize it at a later time; the ability to perceive an object visually and recognize it when it is only partly visible, or recognize that it is missing from the original scene; includes object permanence which is the ability of the brain to perceive something visually, then know that the object is still there when covered-up or blocked from view

Eye-hand coordination: The ability of the eyes and hands to work together to see objects and manipulate them

Visual association: The ability to group objects and pictures according to categories, functions and other features

Visual sequencing: The ability to recognize objects in a series or to categorize objects perceived visually, into a series or pattern

Reproduction of designs: First, the ability of the brain to perceive a design of objects, pictures, or parts of objects; second, the ability to reproduce those designs by manipulating objects, pictures or their parts.

Imitation: The ability to imitate an action, sound, expression or motion of a person, animal, or object

Activation: The ability to initiate action using physical movement such as the pressing of a switch

Social attentional gaze: The ability to orient and pay attention to faces and facial expression

# ToAD Mirror

Items Needed for this Activity:

- ToAD Mirror
- Squire ToAD's Puzzle Book Smiling Face Photo
- Invisiboard
- ToAD Black Cloth
- Pillows and bolsters for support (optional)

Photo of a mirror on a horizontal surface with a plastic red apple resting on it

Children need reflections of their faces both in a mirror and in the faces of adult caretakers. Reflected faces help children learn the nuances of facial expression.

Purpose: The purpose of the ToAD Mirror activity is to assist the student as he develops social attentional gaze behaviors, and fixation skills.

Activity

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised using the APH Invisiboard. Be sure to have the ToAD Mirror handy during this exercise.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Spread out a ToAD Black Cloth in front of the student to cut down on glare and/or distractions.
4. Take a position that is face-to-face with the student, about 16 inches away. Watch the student's face to determine if he sees you. If he does not, make little sounds to cue him on where to look. Once he sees you, he may smile, cry, or stop other activity. Watch for cues both subtle and overt.
5. It may be necessary to move closer or farther away, depending upon the student's vision. Once the child has you in his view, smile broadly. Note whether or not he smiles as well. Change expressions. Raise the eyebrows, purse the lips or open eyes widely. Note any changes in the student's expression.
6. When there is a certainty the student sees your face and responds to your expression, hold up the ToAD Mirror at the same distance. Note whether the student fixes his view upon his image in the mirror. If he does not, he may see light reflections from the mirror instead of his image. Make sure the mirror is at the right angle for him to see his own image.
7. Once the student fixates on his own image, note any changes in his behavior. Does he smile or attempt to engage with the child in the mirror? Note his responses. It may be fun to further engage the student with his image by putting a cap or piece of cloth on his head while he views the changes in the mirror.
8. When the student can consistently fixate and interact with his own reflection, perform the same steps as you substitute the Squire ToAD's Puzzle Book Smiling Face Photo. Follow the directions on the page opposite the photo.

Here's a little song to sing with the student after the ToAD Mirror Activity. Make up your own tune.

My Face
I like to see my face.
It's right where it should be.
Underneath my hair
Is just the perfect place.

# ToAD Billy Bird Puppet

Items Needed for these Activities:

- ToAD Billy Bird Puppet
- Tissue Paper
- ToAD Black Cloth
- ToAD Bell Bracelet
- ToAD Flashlight with white wand attachment
- Pillows and bolsters for support (optional)

Photo of a red bird head puppet with a pink mouth and bells around his neck

The ToAD Billy Bird Puppet and other puppets are excellent tools to engage learners visually and socially. Some children will look at a puppet when they will not look at other objects. Working on social/attentional gaze becomes easy when using a puppet.

Purpose: The purpose of these activities is twofold. The first is to create better access to the visual aspects of a familiar object so that it can be recognized and used in meaningful contexts. The second purpose is to assist the student with the practice of an appropriate social gaze.

Activities

Object Recognition

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. It is necessary to prepare the puppet before use. To do this, stuff its head with tissue paper, so the eyes are very visible. Put the ToAD Billy Bird Puppet on your hand and hold it in front of the student at a distance of about 16 inches. Note if the student fixes his vision on the puppet. If he does not, move the puppet a little closer or farther away, depending on his visual need. If the student still has difficulty put the ToAD Bell Bracelet in the puppet's mouth and shake it gently.

Social Attentional Gaze

4. When the student turns toward the ToAD Billy Bird Puppet, vocalize bird chirps, or conversation with the student. Encourage him to interact with the puppet as a character.
5. The student should smile at the puppet, and possibly reach for or make sounds at the puppet in an attempt to interact. If these actions are within the child's behavior repertoire and he does not use them with the puppet, make sure the puppet is within his field of view.
6. If the student still does not interact with the puppet, repeat the mirror activity, then move directly from it to the ToAD Billy Bird Puppet activity. In this way, the student will be accustomed to interaction with a face.
7. Dim the lights slightly and put the lighted ToAD Flashlight with white wand into the puppet's mouth. Once the student locates the light, his vision will be in the correct position to see the puppet face. Once the student fixes his gaze on the puppet, remove the wand and allow the puppet to talk softly and interact with the child.
8. Repeat the activity until the student acts interested when he sees the puppet, and smiles, or gives other cues of interaction.
9. Some students may find the puppet face unfamiliar or strange and may not want to interact. If this occurs, substitute a doll's face and repeat the activity.

ToAD Billy Bird Puppet Enrichment Activity (optional)

10. After the student becomes familiar with the ToAD Billy Bird Puppet and can establish social attentional gaze with the puppet, allow the puppet to play with the student. Let the puppet talk, present a stimulus, sing and rhythmically sway to music as methods of interaction. If the child is not tactually defensive, the puppet might be used to gently touch the student.
11. The student might like to hold items for the puppet to pluck from his hands. This can then be reversed and the puppet can hold things for the student to pluck, or can drop items on the table for the student to play with.

Here's a little song to sing when working with the ToAD Billy Bird Puppet.

Billy Bird Song
I'm Billy Bird and you can see
My feathers are red as red can be.
I like to sing and I like to play
And play with (child's name) every day.

# ToAD Spoon

Items Needed for this Activity:

- Student's personal spoon or ToAD Spoon
- Bits of dry cereal or banana. ALLERGY ALERT!
- Squire ToAD's Puzzle Book Spoon Photo
- ToAD Black Cloth
- Invisiboard
- Pillows and bolsters for support (optional)

Photo of a silver spoon against a black background

The spoon can be used in numerous contexts to allow the learner to function within his environment.

Purpose: The purpose of this activity is twofold. First, to create better access to the visual aspects of a familiar object so that it can be recognized and used in meaningful contexts. Secondly, the activity is designed to help the student develop visual fixation skills and object recognition through the use of a photograph.

Activity

Object Recognition

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have the student's spoon handy during this exercise.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Spread out the ToAD Black Cloth to provide contrast for the spoon.
4. Hold up the spoon within the student's field of vision, about 16 inches from her face. Note if the student fixates on the spoon. Watch for a smile, a reach, slower breathing, cessation of activity and other more subtle cues as indications that the student sees the spoon.
5. Say "spoon" often if you think the student sees the utensil.
6. If the student is already familiar with spoons, she may make movements to try to put the spoon to her mouth. Place a bit of banana or a morsel of dry cereal in her spoon. Allow the student to feed herself the morsel.
7. Repeat the exercise daily until the student recognizes the spoon and shows expectant or feeding behaviors when shown it.
8. When the student can consistently fixate on, and interact with her spoon, the teacher should open to the Squire ToAD's Puzzle Book Spoon Photo and follow the directions for use of the photo.

# Banana

Items Needed for this Activity:

- Ripe Banana. ALLERGY ALERT!
- ToAD Black Cloth
- ToAD Spoon or student's own spoon
- Invisiboard
- ToAD Match'n Sort Cardset, largest Banana Photo Card, (optional) or the 5" Banana Card from the TADPOLE Cards
- Pillows and bolsters for support (optional)

Photo of a banana resting on its convex arc

The banana, or any appropriate food item, can be skillfully used to help the learner perfect eating and food handling skills, while at the same time practicing visual skills.

Purpose: The purpose of these activities is to create better access to the visual aspects of a familiar object so that it can be recognized and used in meaningful contexts. The optional activity assists the student as he or she extends meaning from the real object to a photo of the object.

Activities

Object Recognition

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have a ripe banana handy during this exercise.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Spread out the ToAD Black Cloth to provide contrast for the banana.
4. Place the banana on the black cloth within the student's field of vision, about 16 inches from her face. Note if the student fixates on the banana. Watch for a smile, a reach, slower breathing, cessation of activity and other more subtle cues as an indication that the student sees the banana. It may be necessary to move the banana closer or farther away.
5. Say "banana" often when you think the student sees the fruit. Encourage the learner to reach for the banana if her motor skills allow it.
6. If the student is already familiar with bananas, peel the banana, but stay in the range of her vision. Break off a bit of banana and put it in her spoon. Allow the student to feed herself the bit of banana.
7. If the student is not familiar with bananas, peel the banana and give the student a bit of it to eat in her spoon. Make sounds to heighten the pleasure of the banana-eating experience. (If the student does not like bananas, skip the feeding part of the exercise, or use another fruit.)
8. Repeat the exercise daily until the student recognizes the banana and shows expectant or feeding behaviors when shown it.

Banana Object Enrichment Activity (optional)

9. Once the student is familiar with the banana and reacts to it, use the largest banana photo card from the Match'n Sort Cardset or the TADPOLE Cards. Place a real, unpeeled banana in front of the child. Show her the card. Say "banana" often as you point first to the card, and then to the real banana. Do this several times. Take away the real banana. Point to the banana photo card and say "banana." Give the student a bit of banana in her spoon and let her eat it.
10. Repeat item #8 several on several occasions; use other photos of bananas until the child associates the photo with the taste of the banana and exhibits anticipatory feeding behaviors when presented with the banana photo card.

Note: The sequence of training steps used in the Banana activity can be used with any number of objects that may be meaningful in the context of the student's environment.

Here's a little song to sing at the end of the banana activity. Make your own cha-cha style tune.

Cha Cha Bananas
Cha-cha-cha bananas
Are cha-cha very sweet.
Cha-cha-cha bananas
Are very good to eat.

# ToAD Blue Cup

Items Needed for these Activities:

- ToAD Cup or student's personal cup
- Water or juice. ALLERGY ALERT!
- ToAD Black Cloth
- Invisiboard
- TADPOLE Card — 5" × 5" blue cup on cream background from TADPOLE Cards (optional)
- Pillows and bolsters for support (optional)

Photo of a blue mug on a cream colored background

The cup, a familiar item to nearly all learners, is a handy tool for development of near and far vision in the learner's typical environment.

Purpose: The purpose of these activities is to create better access to the visual aspects of a familiar object so that it can be recognized and used in meaningful contexts. The optional activity helps the student extend meaning from the real object to a photo of the object.

Activities

Object Recognition

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have the student's cup handy during this exercise. If the ToAD Cup is used, make sure it is cleaned with antiseptic soap and dried well.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Spread out the ToAD Black Cloth to provide contrast for the cup.
4. Place the cup on the black cloth within the student's field of vision, about 16 inches from his face. Note if the student fixes his gaze on the cup. Watch for a smile, a reach, slower breathing, cessation of activity and other more subtle cues as an indication that the student sees the cup.
5. Say "cup" often if you think the student sees it. Now move the cup about 36" from the student and slowly move it closer. Notice the point at which he sees and anticipates the cup coming closer.
6. If the student is already familiar with a cup, he may make movements to try to put the cup to his mouth. Now place a little water or juice in the cup. Allow the student to feed himself the liquid.
7. Repeat the exercise daily until the student recognizes the cup and shows expectant or feeding behaviors when shown it.

Cup Object Enrichment Activity (optional)

8. Once the student is familiar with the cup and reacts to it, use the largest cup photo card from the Match'n Sort Cardset. Place the student's own cup in front of him. Next, show him the card. Say "cup" often and point first to the card, and then to the real cup. Do this several times. Take away the real cup. Point to the cup photo card and say "cup." Ask the student to say "cup" or point to the cup photo card. Once he does, give the student a bit of water or juice in his cup and let him drink it.
9. Repeat item #7 on several occasions; use one or two other photos of cups along with the ToAD Match'n Sort Cup Photo Card until the child associates the photo with an actual cup and exhibits anticipatory feeding behaviors when presented with the 3" cup photo card.
10. When the student has mastered these activities, he is ready for the first cup puzzle in Tasha Tadpole's Puzzle Book.

Here's a little song or poem to use for the cup activity, if desired:

My Little Cup
I have a little cup
I like to fill it up
with apple juice
and orange juice
and sometimes 7-UP.
This is my little cup.

# ToAD Toothbrush

Items Needed for this Activity:

- Student's personal toothbrush or ToAD Toothbrush
- Water in a cup
- ToAD Black Cloth
- Invisiboard
- ToAD Match'n Sort 3" Toothbrush Photo and Apple Cards (optional)
- The same 5" cards from the TADPOLE Cards
- Pillows and bolsters for support (optional)

Photo of a blue toothbrush on a white background

The toothbrush is a familiar object to most learners and therefore is helpful when practicing the use of vision through location and use of the object. Accommodation can be judged through the use of any object that comes toward the face. The light, compact toothbrush can also be used to bridge the gap between the object and other representations of the object, such as photos or drawings.

Purpose: The purpose of these activities is to create better access to the visual aspects of a familiar object so that it can be recognized and used in meaningful contexts. The optional activity helps the student extend meaning from the real object to a photo of the object.

Activities

Object Recognition

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have the student's toothbrush handy for this exercise.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Spread out the ToAD Black Cloth to provide contrast for the toothbrush.
4. Hold up the toothbrush within the student's field of vision, about 16 inches from his face. Move the toothbrush nearer or farther away if needed. Note if the student fixates on the toothbrush. Watch for a smile, a reach, slower breathing, cessation of activity and other more subtle cues as an indication that the student sees the toothbrush. Say "toothbrush" often when he sees it.
5. If the student is already familiar with a toothbrush, he may make movements to try to put the toothbrush into his mouth. Using the water in the cup, allow the student to brush his teeth if the toothbrush is his own. If it is not, allow him to rinse out the toothbrush as he would after brushing.
6. Repeat the exercise daily until the student recognizes the toothbrush and reaches for it, or gives other signs of interest when shown it.

Toothbrush Object Enrichment Activity (optional)

7. Once the student is familiar with the toothbrush and reacts to it, use the largest ToAD Match 'n Sort 3" Toothbrush Photo Card or matching TADPOLE Card. Place the student's own toothbrush in front of him. Next, show him the card. Say "toothbrush" often as you point first to the card, and then to the real toothbrush. Do this several times. Take away the real toothbrush. Point to the toothbrush photo card and say "toothbrush." If the student shows behaviors such as reaching, which show his desire to interact with the item in the picture, give the student a bit of water in his cup and let him brush his teeth with his toothbrush.
8. Repeat item #7 on several occasions until the child associates the photo with the real toothbrush and exhibits anticipatory reaching behaviors when presented with the 3" toothbrush photo card. When the child achieves consistent recognition and interaction, present him with a new toothbrush, if desired.
9. (Optional exercise) Now show the student the toothbrush card and the apple card. Ask the student to point to or otherwise indicate which one is the toothbrush card.

Here's a little song to sing before or after the toothbrushing activity.

Tooth Brushing Song
I really like to brush my teeth,
brushing all around.
It's so much fun to brush my teeth,
brushing up and down.

# ToAD Pompon

Items Needed for these Activities:

- ToAD Pompon
- ToAD Black Apron
- ToAD Black Gloves
- Music (optional)
- Pillows and bolsters for support (optional)

Photo of a gold pompon on a black background

The ToAD Pompon is an excellent tool because of its reflectivity and rustling sound. It is easy to capture the attention of a child with this big, bright, object. This is particularly helpful with learners who have difficulty locating objects with their vision, or those who have difficulty remaining visually engaged with the object.

Purpose: The purpose of these activities is to develop skill in fixation and visual pursuit, especially across midline.

Note: the ToAD Pompon is a clipped, mylar toy that may present a choking hazard. The teacher should always be present during use of the ToAD Pompon. The student should never hold the ToAD Pompon unless he/she is supervised by an adult.

Activities

Fixation:

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. You can have music handy to make the experience more enjoyable.
2. Make sure the student is aligned and supported and ready to use her vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Put on the ToAD Black Apron and ToAD Black Gloves. Stand in front of the student at a distance of 3-4 feet. Hold a ToAD Pompon in each hand at hip level. Hold the pompon in your left hand at the student's eye level; maintain the 3-4 foot distance. If the student does not look at the toy after 10 seconds, draw the student's attention to the toy as you rustle the ToAD Pompon. If the student still does not look at the pompon, move it closer or farther away depending upon the student's need. Give the student plenty of time to respond.

Pursuit:

4. Once the student has fixed her gaze on the ToAD Pompon move it gently to her right, in a straight line. Observe the student's eyes to determine if she visually follows the travel of the toy.
5. If the student fails to follow the toy to her right, place it again in the center, and give sound cues, if necessary, to get the student to gaze at the toy. Once she has achieved fixation, slowly move the ToAD Pompon to her left. Observe the student's eyes to determine if she visually follows the travel of the toy. If she has successfully followed the toy, stop the movement for a moment, then slowly move the ToAD Pompon back to center. Note if the student's eyes follow.
6. Repeat steps #4 and #5 until the student can follow the toy to the right, back to center, and then to the left and back to center. (For some children it may be necessary to put her own hand on the toy as you move it.)

Crossing Midline:

7. When the student can easily perform steps #4, #5 and #6, it is time to tackle the task of crossing midline. Hold the right-hand pompon at the student's eye level in the center of the established field of view. When the student has fixed her gaze on the pompon, slowly move it in a straight line to her right. If she follows the pompon with her eyes, then move it gently to her left, crossing midline. Repeat step #7, starting again in the center, but this time move in a straight line to the student's left, once she has achieved fixation and pursuit, move the pompon to her right, crossing midline. Hold the ToAD Pompon still, once it is at the far right side of her visual field. Rustle the pompon, if needed, to encourage directional viewing.
8. When the student can smoothly perform step #7 she has achieved the visual skill of crossing midline.

Enrichment Activity:

9. If the student enjoys the ToAD Pompon give her one to use while music plays. Show her how to rhythmically shake and/or move the pompon to the music. Use hand-under-hand technique to gently guide the student's hand slowly, to the left and then the right, as it crosses the midline plane. Watch her eyes to see if she follows the pompon from left-to-right and back again.

Note: Research done by the American Printing House for the Blind showed that children with visual impairments and CVI responded best to a yellow pompon with some strands of reflective material. The ToAD Pompon was designed to meet these specifications.

# Tangle Toy™

Items Needed for these Activities:

- Tangle Toys
- ToAD Black Cloth
- ToAD Foam Squares
- Anti-bacterial spray and soft cloth
- Music or bits of cereal (optional)
- Pillows and bolsters for support (optional)

Photo of a Tangle Toy with 12 ToAD Foam Squares

The Tangle Toy is a handy tool. It can be broken down into various sizes. Its complexity can be increased or decreased as desired. Its bright colors and multiple textures are helpful when the practitioner wants to keep a child engaged on multiple sensory levels.

Purpose: The purpose of these activities is to develop skill in fixation and the visual shift, especially across midline. An enrichment activity is included if the child has the capability to work on gross and fine motor skills.

Note: The Tangle Toy is a segmented toy that may present a choking hazard. When students use Tangle Toys they should be supervised at all times and never allowed to put the segments in their mouths.

Activities

Fixation:

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have cereal bits or music handy to make the experience more enjoyable.
2. Make sure the student is aligned and supported and ready to use her vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Spread out the ToAD Black Cloth to provide contrast from the toy. Be certain the toys you will use are clean because the child may play with the toys, then put her hands in her mouth. Place a closed Tangle Toy of at least 8 segments on the cloth, about 16 inches from the student.
4. If the student does not look at the toy after 10 seconds, tap on the toy to draw the student's attention to it.

Pursuit:

5. Once the student has fixed her gaze on the Tangle Toy, drag it gently to her right. Take care not to cover up the Tangle Toy with your hand. Observe the student's eyes to determine if she visually follows the travel of the toy.
6. If the student fails to follow the toy to her right, place it again in the center, and give sound cues, if necessary, to get the student to gaze at the toy. Once she has achieved fixation, slowly move the toy to her left; make sure not to cover the toy with your hand. Observe the student's eyes to determine if she visually follows the travel of the toy. Stop the movement for a moment, then slowly move the toy back to center. Note if the student's eyes follow.
7. Repeat steps #5 and #6 until the student can follow the toy to the right, back to center, and then to the left and back to center. (For some children it may be necessary to put her own hand on the toy as you move it.)

Crossing Midline:

8. When the student can easily perform steps #5, #6 and #7, it is time to tackle the task of crossing midline. This task will require two Tangle Toys. Untangle two toys and form them into oval shapes. Place one Tangle Toy on the child's right, and one on the child's left, just barely within the child's reach. When the child reaches for one of them allow her to grasp it. (Many students will try to put the toys to their mouths. If this occurs be sure to wash the Tangle Toys after use and use the antibacterial spray.) If she grasps the one on the right, gently tug on the other end of the Tangle Toy; keep the student's grasp engaged, and gently pull the toy toward the child's left, crossing midline until the toy is beside the other Tangle Toy. Note if the student's gaze follows the Tangle Toy as it moves from her right to left. If the student picks up the toy on the left initially, reverse direction of the activity.
9. Repeat step #8. Encourage the student to change directions, as she picks up the Tangle Toy on the opposite side from the side chosen initially. Assist her as she moves the Tangle Toy across midline to the other side.
10. Now place a Tangle Toy in the center and ask the child to move it to one side and then to the other, crossing midline. Assist the student if necessary.
11. When the student can smoothly perform steps #8, #9, and #10, she has achieved the visual skill of crossing midline.

Tangle Toys Enrichment Activity (optional)

12. Show the student how to open the Tangle Toy loop. Allow her to pop the segments apart and put them back together. Show the student how to slip the ToAd Foam Squares onto the tangle toy and snap it shut. The student can then rearrange the segments of the Tangle Toy or rearrange the ToAD Foam Squares and re-hang them on the Tangle Toy.
13. Build the skill of crossing midline by putting pieces of Tangle Toy on the student's left and ToAD Foam Squares on the student's right so she must cross midline to put them together. Play music or give bits of cereal to enhance the experience.

Here's a little Tangle Toy Poem to use with a learner.

Tangle Toys
Tangle Toys, Tangle Toys
You make fun for girls and boys.
You can pop.
You can snap.
Tangle Toys you make me laugh.

# ToAD Bowl and Ball

Items Needed for these Activities:

- ToAD Bowl or student's personal bowl
- Student's personal spoon
- ToAD Black Cloth
- Bits of banana or dry cereal. ALLERGY ALERT!
- Pillows and bolsters for support (optional)

Photo of three yellow ToAD bowls, a red plastic apple, a small blue ball with a smiley face, and a small yellow ball with a smiley face

The ToAD Bowls are particularly good for use in activities that give a learner experience with the concept of object permanence. Bowls are recognizable and comfortable objects to learners. Objects can be placed near or under overturned bowls for retrieval by the learner.

Purpose: The purpose of these activities is twofold. The first is to create better access to the visual aspects of a familiar object so that it can be recognized and used in meaningful contexts. The second purpose is to help the student learn object permanence.

Activities

Object Recognition

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have the student's spoon and cereal or banana bits handy during this exercise.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Spread out the ToAD Black Cloth to provide contrast with the bowl. Place the bowl on the cloth, about 12 inches from the student.
4. To draw the student's attention to the ToAD Bowl, tap or provide another sound cue, if needed. Say "bowl" often.
5. When the student visually attends to the bowl, drop a morsel of dry cereal into the bowl. Determine if the student reaches for the bowl or the cereal inside it. If the student shows no interest in the bowl, tip the bowl so the student can see the interior of the bowl. If the student does not see the cereal, pick up the morsel and drop it into the bowl again so it makes a sound when it hits. If the student is familiar with cereal, she should try to retrieve the cereal from the bowl. If she makes the attempt, allow her to eat the morsel. If she does not try to retrieve it, assist her and let her eat the morsel.
6. Repeat item #5 several times until the student is expert and shows interest in the cereal in the bowl, even if she does not have the motor skills to retrieve it. Repeat item #5 on several different occasions.

Object Permanence

7. When the student becomes familiar with the ToAD Bowl and expects to find food in the bowl, perform item #5. Then turn the bowl upside down. Pick up the bowl so the student sees that one can look under the bowl. Ask the student to peek under the bowl if she has the motor skills. If she does not, lift the edge of the bowl so she can see under it. If the student cannot see the morsel, use hand-under-hand technique to lead her hand so she can feel the morsel and its placement under the bowl.
8. Once the student becomes interested in peeking or turning over the bowl, let the student observe as you place a morsel of cereal under the bowl. Observe if the student tries to retrieve the cereal from under the bowl. If she does, she understands object permanence. If she does not try to retrieve the cereal, lift the bowl and show her the cereal underneath, and encourage her to get the cereal from beneath the bowl. Repeat this step so the student becomes efficient at retrieval of the cereal under the bowl. If the student does not have the motor skills to retrieve the cereal, observe if the student makes motions or sounds that show interest in retrieval of the cereal. Let the student eat the cereal.

Here's a little song or poem to sing at the beginning or end of the exercise. Make up your own tune.

My ToAD Bowl
My ToAD Bowl holds lots of stuff.
When it gets to the top I have enough.
My teacher turns it upside down
and I pick it up and look around.
ToAD Bowl, ToAD Bowl
you're lots of fun.
I'm glad that I have one.

# Slinky™

Items Needed for this Activity:

- Slinky™ from ToAD Kit or Sensory Learning Kit
- Music on tape or CD
- Pillows and bolsters for support (optional)
- ToAD Black Apron

Photo of a blue slinky

Many practitioners find the Slinky helpful as they assist a child in looking from one side to the other, or looking from up-to-down and vice versa. The Slinky is helpful when working to visually cross midline, while engaged in play.

Purpose: The purpose of this activity is to develop and perfect the visual skills of shift of gaze, crossing midline, and eye-hand coordination.

Activity

Shift of Gaze Across Midline, Eye-Hand-Coordination

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Put on the ToAD Black Apron. Be sure to have a tape or CD player nearby to play music when appropriate.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input. It is ideal to have the student in an upright position, with his back, neck, head, and shoulders supported.
3. Hold the Slinky stacked in one hand about 16 inches from the student. Once he fixes his gaze on the Slinky take half in the other hand and begin to make the Slinky flow from side to side. The student may have difficulty as he switches the direction of his gaze from side to side.
4. Place half of the Slinky in each of the student's hands. Help him facilitate the flow, very slowly, from side to side; use hand-helping-hand method. Link fingers with the student if needed.

   Photo of a boy laying on his back and holding a Slinky stretched in front of his face using both hands

   This boy receives help from his teacher through the use of the hand-helping-hand method.

5. If the child has difficulty, change his position to supine. Make sure his head, neck, spine and shoulders are aligned and supported. Repeat step #4 in the supine position. Some children will find this activity very difficult. For these students it is important to go very slowly and allow adequate time for the student to shift gaze from right-to-left, left-to-right, and to locate the Slinky after the shift. It may be helpful to use sound cues at first, to facilitate the shift of gaze across midline. When the child achieves shift of gaze across midline, arrange to have a snippet of music played, almost as if the student caused the music to play when he shifted his gaze. This is very helpful to students who have difficulty. Once shift of gaze becomes a part of the student's skill repertoire, the music can be phased out.
6. Repeat steps #4 and #5 until the student can easily shift gaze across midline.

# Swirly Mats™

Items Needed for these Activities:

- Swirly Mat Set CVI
- APH Mini Lite Box (optional)
- ToAD Black Apron
- Swirly White Vinyl Mat
- Black foam stars from the ToAD Star Puzzle

Photo of two Swirly Mats, one pink and one yellow & orange, against a white background

Swirly Mats engage children visually as they practice fixation and activation skills. Most learners love to play with swirly Mats.

Purpose: Swirly Mats were designed to allow the student to practice following a slow-moving target, to initiate movement, to discriminate between figure and background, and to engage in play during visual skill development activities.

Activities

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have the Swirly Mats, the Swirly White Vinyl Mat, and a Mini Lite Box handy during this exercise.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Put the white vinyl mat in front of the student to cut down on glare and/or distractions. Place the red Swirly Mat on the white vinyl mat. Watch the child's eyes closely to see if she looks at the mat. If she does not, move the mat closer or farther away until the child fixes her gaze on the Swirly Mat. Note the distance between the child's eyes and the Swirly Mat for future reference. This is the working distance.
4. Place the largest black, foam star from the ToAD Star Puzzle on the Swirly Mat. Encourage the child to pick up the star. If she cannot see it, place her index finger on the star. Encourage her until she can find the star and pick it up on her own.
5. Place the smallest black, foam star from the ToAD Star Puzzle on the Swirly Mat. Encourage the child to pick up the star. If she does not, repeat step #4.
6. Use hand-under-hand technique to allow the child's index finger to touch the mat. Help the student apply pressure to the mat to make the red fluid move and flow in some direction. Observe the child's eyes to see if she watches the fluid move. Make a note of her response to the moving fluid.
7. If the student does not watch the fluid, place the mat on the Mini Lite Box and repeat steps #5 and #6.
8. Switch to the Swirly Mat with the bingo chips inside. Ask the student to touch a bingo chip. If she does not, use hand-under-hand technique to help her touch a chip. Apply enough pressure to help the chip move. Employ the technique until the child can touch a chip on cue without assistance.

Swirly Mats Enrichment Activity:

9. Either ask the student to touch each chip, or assist her. As each chip is touched say the name of the color of the chip with the child. Do this exercise frequently to help the student understand the concept of color.

Here's a little poem to use with Swirly Mats:

Swirly Mats have things inside,
Red, green, and blue.
I like to touch the Swirly Mats,
How 'bout you?

# ToAD Match'n Sort Cards

Items Needed for these Activities:

- ToAD Black Cloth
- ToAD Black Apron
- ToAD Match'n Sort Cards
  - Large Apple Photo Card
  - Large Sock Photo Card
- Real apple (red). ALLERGY ALERT!

Photo of six piles of Match'n Sort cards, arranged as arrays

Once students have mastered the basics of looking, tracking, tracing, and activation, they are ready to learn that photos and drawings can represent real objects. The ToAD Match'n Sort Cards are very helpful with this task.

Purpose: ToAD Match'n Sort Cards were designed to allow the student to practice object identification, color identification, pre-matching and pre-sorting activities in a comfortable, familiar environment.

Activities

Prerequisite: Make certain to do the first five activities from Tasha TADPOLE's Puzzle Book as a prerequisite to these activities.

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have the ToAD Match'n Sort Cards and ToAD Black Cloth available. Remove one of the child's shoes so his sock shows.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Put the ToAD Black Cloth in front of the student to cut down on glare and/or distractions. Have these ToAD Match'n Sort Cards or the matching TADPOLE Cards ready for use:
   - largest apple photo card
   - largest sock photo card
4. Place the large, apple photo card and the large, sock photo card on the cloth. Watch the child's eyes closely to see if he looks at either or both of the cards. If he does not, then move the cards closer or farther away until the child fixes his gaze on one of the cards. Note the distance between the child's eyes and the cards for future reference.
5. Ask the child to put his stocking foot where he can see it. Tug on the sock on the child's foot. Say "sock." Then point to the sock card. Say "sock." Ask the child to point and say "sock," to the real sock, then to the picture of the sock. Talk about socks and what they are.
6. Point to the photo card of the apple. Say, "apple." Talk about an apple and what it does.
7. With both cards in front of the child, ask him to point to the sock card. Give him three chances. If the child does not point to the sock card, repeat steps #5 and #6 until he can consistently point to the sock card when asked.
8. Now remove the sock card and place the real apple and the large, apple photo card on the cloth in front of the student. Point to each and say, "apple." Ask the student to say, "apple" with you. Talk about how we use apples.
9. Now place the large sock photo card next to the apple and the large apple photo card. Remove the real apple. Ask the student to point to the sock card. Ask the student to point to the apple card. If the student cannot consistently identify the sock or the apple card, repeat steps #5-9 again daily until he can.
10. This exercise can be repeated with any two large cards from the ToAD Match'n Sort Cards or TADPOLE Cards.

# ToAD Flashlight and Accessories

Items Needed for this Activity:

- ToAD Flashlight and Accessories
- ToAD Black Cloth
- ToAD Black Apron
- ToAD Black Gloves
- ToAD Yellow or White Ball
- ToAD Cricket Module

Photo of the ToAD Flashlight and three different colored attachments

Some learners need continued practice to fixate, track, trace, and activate. Practice helps perfect skills and reinforce the physical and vestibular primal memory that forms as vision occurs.

Purpose: ToAD Flashlight and Accessories were designed to allow the student to practice skills of fixation, tracking, tracing and activation in a comfortable, familiar environment.

Activities

1. Make sure the student and you are in an environment that is quiet and has few distractions. A black corner can be devised with the APH Invisiboard. Be sure to have the ToAD Flashlight and Accessories and ToAD Black Cloth available. Wear ToAD Black Gloves.
2. Make sure the student is aligned and supported and ready to use his vision. Some students may benefit from a few minutes of physical activity such as rolling before the TADPOLE Activities, to prepare the vestibular system for visual input.
3. Put the ToAD Black Cloth in front of the student to cut down on glare and/or distractions. Put the ToAD Yellow or White Ball on the black cloth. Stand behind the student and shine the light from the flashlight on the ball.
4. Watch the child's movements to see if he looks at the ball. If he does not show any sign of seeing the ball, move it closer or farther away until the child fixes his gaze on it. Note the distance between the child's eyes and the ball for future reference.
5. Now put the red sphere attachment onto the ToAD Flashlight and remove the ball. Hold the flashlight at the same distance from the learner's eyes as the ball was in step #4. Watch the child's eyes to see if he fixes his gaze on the flashlight. If he does not, move it closer or farther away, or use the ToAD Cricket Module to chirp near the flashlight. Repeat these steps until the child fixes his gaze on the flashlight.
6. Once the student fixes his gaze on the flashlight, move it gently to the right. Watch carefully to determine if the child follows the flashlight. If he does, move the flashlight very slowly to the left. Record the child's eye movements.
7. If the child does not follow the flashlight, replace the red sphere attachment with the yellow cube or the white wand and repeat steps #5 and #6. If the child does follow the flashlight with the red sphere, move the flashlight farther and farther to the right until it crosses midline and moves as far to the right as the child's field of view will allow. Repeat this exercise until the student has gained skill in tracking from left-to-right and right-to-left with facility.
8. When the student can track horizontally, it is time to repeat the exercise moving in a vertical plane. Start on the student's left or right, whichever has the best vision. Move the flashlight from up-to-down and down-to-up alternately until the student has achieved facility. Then move to the side with the lesser amount of vision and repeat.
9. The student may be limited in his ability to move his gaze either in the horizontal or vertical plane. But continue to do the activity frequently. At some point, the student's visual processing may mature, or for some other reason, he may be able to perform the task.
10. When the student has completed the session, allow the student to close his eyes and listen to soft music, to rest his visual system.

# Tasha Tadpole's Puzzle Book

Image of the front cover of the TASHA TADPOLE's Puzzle Book

TASHA TADPOLE'S Puzzle Book was designed to provide structure for early activities of observation, identification, matching and sorting. In some instances, the practitioner will want to work with TASHA TADPOLE's Puzzle Book before moving on to Guidebook activities. Please follow the instructions designed for each puzzle in TASHA TADPOLE'S Puzzle Book. Instructions are directly opposite the page that displays the corresponding puzzle.

# TADPOLE Cards

Items Needed for these Activities:

- TADPOLE Card Set
- ToAD Bowls
- ToAD Balls
- ToAD Black Apron
- ToAD Black Gloves
- ToAD Black Cloth
- Invisiboard

Photo of three TADPOLE Cards showing a spoon on a red background, two yellow bananas on a black background and a yellow bowl filled with red strawberries

TADPOLE Cards were designed for those students for whom ToAD Match 'n Sort Cards are too small. They are also helpful with size sorting activities when used with ToAD Cards.

Purpose: The TADPOLE Cards may be useful to the teacher with the assessment and development of visual attending skills, size and shape identification, color and shape matching, sequencing, and sorting skills. They are valuable to the learner as they offer a link between real objects and printed representation of objects.

Activities

Identification and Matching

1. Set up the APH Invisiboard in an appropriately-lit corner. Put on the ToAD Black Apron and the ToAD Black Gloves. Place the ToAD Black Cloth on the table in front of the student.
2. Within the child's field and range of vision, show the child two ToAD Balls. Allow the child to touch and feel the shape and texture of the balls. Point out that these balls are round and look similar to one another. Use the word "ball" while handling each one. Depending upon the learning level of the child, it may be appropriate to talk about the colors of the balls.
3. Introduce the TADPOLE Card — 5" × 5" red ball with cream background. Point to the ball on the card and talk about the ways that it is similar to the two real balls.
4. Take away the real balls. Add the TADPOLE Card — 5" × 5" green bowl with black background alongside the TADPOLE Card — 5" × 5" red ball. Ask the learner to identify which object is the bowl and which is the ball from the cards.
5. Remove all the items from in front of the child. Again place the two selected TADPOLE Cards in front of the student. Ask him to point to the ball. If he succeeds, go on to the next step. If he does not succeed, repeat steps 3 and 4 again. Play music or sing when the learner masters the identification task.

Discrimination and Matching

6. Within the child's field and range of vision, show him the TADPOLE Card — 5" × 5" red ball with cream background and the TADPOLE Card — 5" × 5" yellow bowl with black background, and a real ball. Name each picture or object as you present it. Place the items down on the ToAD Black Cloth and let the learner play with them or touch them. As he touches each one, name it for him and encourage him to say the name as well.
7. Now ask the student to point to, or otherwise indicate the ToAD Ball. If he chooses either the real ball or the ball card, he is correct. Now ask him to point to the bowl. If he identifies it, play music. If he gets it wrong after 3 tries, take out the ToAD Yellow Bowl and show it to him alongside the TADPOLE Card — 5" × 5" yellow bowl with black background. Let him touch the bowl to get a sense of it. Now put the bowl away and ask him to point to the bowl visible on the TADPOLE Card — 5" × 5" yellow bowl with black background again. Repeat this exercise until he can identify both the ball and the bowl cards.

Color Matching

This activity should be done only after the first two activities have been done successfully.

8. Set up the APH Invisiboard in an appropriately-lit corner. Put on the ToAD Black Apron and the ToAD Black Gloves. Place the ToAD Black Cloth on the table in front of the student.
9. Within the student's field of view and preferred working distance, show the student the TADPOLE Card — 5" × 5" single banana on black background, and the TADPOLE Card — 5" × 5" yellow bowl with black background. Name the item on each card and ask the child to repeat the names of the items. When the child knows what each item is, point out that they are both yellow. Name another item which is yellow. If the learner has his own bowl or spoon or other item which is yellow, use it as an example. If you have the item nearby, put it on the table with the two cards. Continue to talk about how the items are all yellow. Now put away the real object and the TADPOLE Card — 5" × 5" yellow bowl with black background. Put the TADPOLE Card — 5" × 5" red toothbrush on cream background beside the TADPOLE Card — 5" × 5" single banana on black background. Ask the student which one is yellow. If he gives a correct answer, ask him to name the object on the yellow bowl card. Ask him to name the item on the red toothbrush card. If he cannot, it's okay. You can repeat this exercise and concentrate on the color red. Use the TADPOLE Card — 5" × 5" red toothbrush on cream background and the TADPOLE Card — 5" × 5" red ball on cream background for that exercise until the learner can identify all four cards and their colors.

Sorting

10. If the child successfully achieves the desired result in the TADPOLE Card Activities, place an array of bowls in front of him using the ToAD Bowls and the learner's own bowl. Include red ball from the ToAD Kit. Ask the student to retrieve all the bowls and put them in a pile.
11. Repeat this series of activities using cards instead of objects, that is the TADPOLE Bowl Cards and the TADPOLE Card — 5" × 5" red ball on cream background.
12. Repeat this exercise using TADPOLE Spoon Cards and the TADPOLE Card - 5" × 5" single banana on black background from the TADPOLE Card Set. Determine if the learner can differentiate the spoons from the banana. Repeat this exercise using different assortments of TADPOLE Cards.

# TADPOLE REPORT

Child's Name __________________________

Child's Age __________________________

Grade __________________________

Child's Eye Condition __________________________

Child's Parent or Guardian __________________________

Phone __________________________

Classroom Teacher's Name __________________________

Primary Eye Care Practitioner __________________________

Phone __________________________

Name of TVI or Interventionist __________________________

This form filled out by __________________________

School District __________________________

Phone __________________________

E-mail __________________________

TADPOLE Activity Performed | Tools Used | Distance/Environment | Skill Addressed | Results
--- | --- | --- | --- | ---

Comments __________________________

Recommendations __________________________

Send this form to __________________________

Address __________________________

Signature __________________________

Date __________________________

# Resources

1. Graham, C. H. (Ed.). (1965). Vision and Visual Perception. New York, NY: John Wiley & Sons, Inc.
2. Holbrook, M. C., Ed. (2006). Children with visual impairments: A parents' guide, 2nd ed. Bethesda, MD: Woodbine House.
3. Humphreys, G. W. (Ed.). (1999). Case Studies in the Neuropsychology of Vision. East Sussex, UK: Psychology Press, Ltd.
4. Jose, R. T. (Ed.). (1983). Understanding Low Vision. New York, NY: American Foundation for the Blind, Inc.
5. Langley, M.B. (1998). ISAVE: Individualized, Systematic Assessment of Visual Efficiency (Vol. 1). Louisville, KY: American Printing House for the Blind, Inc.
6. Levack, N., Stone, G., Bishop, V. (1991). Low Vision: A resource guide with adaptations for students with visual impairments. Austin, TX: Texas School for the Blind and Visually Impaired.
7. Lueck, A. H. (Ed.). (2004). Functional Vision: A Practitioner's Guide to Evaluation and Intervention. New York, NY: American Foundation for the Blind, Inc.
8. Lueck, A. H., Chen, D., Kekelis, L. S. (1997). Developmental Guidelines for Infants with Visual Impairment: A Manual for Early Intervention. Louisville, KY: American Printing House for the Blind, Inc.
9. McLean, M., Wolery, M., Bailey, D., Assessing Infants and Preschoolers with Special Needs, 3rd Ed., Upper Saddle River, NJ: Pearson.
10. Rapp, B. (Ed.). (2001). The Handbook of Cognitive Neuropsychology: What Deficits Reveal About the Human Mind. Philadelphia, PA: Psychology Press, Ltd.
11. Scholl, G. T. (Ed.). (1986). Foundations of Education for Blind and Visually Handicapped Children and Youth: Theory and Practice. New York, NY: American Foundation for the Blind, Inc.
12. South Carolina Department of Education. (1992). South Carolina Functional Vision Assessment. Columbia, SC: South Carolina Department of Education.
13. Smith, M., Sensory Learning Kit Routines (2005). Louisville, KY: American Printing House for the Blind, Inc.
14. Stillman, T., Battle, C., Callier-Azusa Scale (H): Scales for the Assessment of Communicative Abilities. Dallas, TX: University of Texas.