Tips to address Empty Language for Children with Cortical
Visual Impairment or other types of Visual Impairment
Child with hands over his ears
Recently I had yet another conversation with a distraught parent from another
state, who was upset that her child who has Cortical Visual Impairment (CVI) was
not being included in the story/circle time at preschool. “He doesn’t need to
see the pictures,” the parent was told.
As a Teacher of the Visually Impaired (TVI), it is my job to help educational
teams find ways to make all activities accessible, as well as educate everyone
about why it is SO critically important that children with CVI or other visual
impairments, be fully included and have access to these very important, daily
activities in the classroom.
When was the last time you read a story to a 4 year old child? If you imagine
that scenario, it likely includes a picture book. Now imagine reading a book to
a 4 year old and refusing to allow him or her to look at the pictures as you
read. This would surely be a short-lived activity!
Why do young children need these illustrations to stay focused and interested in
the story? Why is it that books for young children are so richly illustrated?
For young children, words are important, of course, but the real world (or a
representation of it through pictures) is what they crave, because real world
interaction is what they need to grow, learn and develop vocabularies rooted in
meaning. Stripping away pictures from their books demonstrates very quickly how
much young children need the pictures to anchor them to the words being read.
Children who have CVI or other visual impairments have a much greater chance of
developing “empty language” than their sighted peers; that is, vocabularies that
are not rooted in meaning. “Empty language refers to a situation of confusion
where the blind or visually impaired child has words to talk about something,
but incorrect or no ideas to attach to the words.” (Anne McComiskey, Family
Connect, American Foundation for the Blind). With less visual input, reduced
shared visual attention, and fewer chances to interact with their environment,
they may have poorer vocabularies and use “empty words.”
Consider this story to illustrate empty (or incorrect) language:
Carlos is a four year old, who has been blind from birth. He attends a preschool
program located within a public school building and fire drills are a common
occurrence. The shrieking siren is extremely loud. Carlos’s team tells me he
absolutely hates fire drills, covers his ears and cries throughout them. They
have a hard time calming him down afterward.
One day, I was visiting him on a fire drill day. I tried to prepare Carlos in
advance, by talking to him about it and warning him that one was coming soon. It
did not help. He covered his ears, burst into tears and was inconsolable for
some time after it was over.
When he calmed down a bit, and I could talk with him, I asked him about the fire
drill, hoping to get him to express his thoughts and feelings. “I HATE fire!” he
told me, through jagged breaths.
Then, it struck me. Empty language?
I asked him, “Carlos, what is fire?”
He put his hands to his ears and told me “Fire is so loud.”
Carlos had assumed that the siren sound itself was “fire.” Due to his vision
loss, he had no direct experience with fire and had assumed (with good reason)
that fire was the obnoxious sound. Think about it from his perspective: every
time that horribly loud noise came blaring through the school speakers, the word
he always heard associated with it was “fire.”
Sadly, I did not have any magic strategies to help him cope with the drills, but
we could at least help him learn the difference between fire and the fire drill
With empty language, children can frequently ‘talk a good game.’ Telling us that
he hated fire sounded perfectly reasonable from a four year old perspective. But
it was only though probing his thinking that we could discern his “empty” or
In children with CVI, empty language is also common. They may look at images or
scenes but not be able to decipher or make sense of what they see. Meanwhile
they hear language swirling around them. When the two don’t connect, the
situation is ripe for the development of empty language.
Strategies: What can we do to prevent empty language?
Name the item that the child is looking at – keep it simple at first! “Cat,
you see the kitty cat!”
Repetition is how all children learn language. Children with vision
impairment including CVI need repetition as well, probably even more, due to
processing delays and lack of experience. An adult may feel they repeat things
millions of times, but it is not wasted effort.
Story time: Too often, children with CVI are plopped down to listen to
stories in preschool programs, while their sighted peers have the benefit of
seeing the pictures. We are doing a double disservice to these young children if
we do not make the pictures accessible and available to them.
- Bring one or two of the central themes to the child. For example, for a book
about a little girl and a pumpkin, bring a real pumpkin and a life like doll to
the child. Support as they explore the objects with hands and eyes as the story
- Use an iPad. For children who are able to understand and process pictures,
take pictures of the book’s contents before the story is read. Show the child
the pictures using back lighting, zoom in to reduce visual complexity, and
expand function to their benefit.
- If the pictures from the book are too complex, showing these to a child who
cannot process them is not helpful. If the story is about a cow, and the child
has shown the ability to understand simple clear photographs, call up a simple
picture of a cow and use that instead of the pictures from the book.