Vision Nanny

Cerebral Visual Impairment (CVI) is a condition that results in decreased visual response due to neurological damage. As a result, affected children struggle to interpret what they are seeing through their eyes, which makes it a leading cause of childhood blindness globally. With an estimated 36 million children affected by CVI, it is increasingly becoming prevalent with premature births. Studies suggest that CVI occurs in 50-75% of children with autism or Cerebral Palsy, and the prevalence can range from 4 to 82% among children with developmental delay, depending on the geographic region.

Early intervention is crucial for children affected by CVI, especially before the age of five when the brain's adaptability or neuroplasticity is at its maximum. However, interventions for CVI are often limited to urban areas and can be prohibitively expensive. Moreover, the lack of expertise in diagnosing CVI in many low-income countries means that many children with CVI go undiagnosed and untreated. In emergency situations, such as immigration and disasters, children with disabilities, including CVI, are at a higher risk of neglect. Shockingly, 40-50% of persons with disabilities get killed due to neglected needs in emergency situations, despite accounting for only 15% of the global population. The neglect of intervention during the child’s developmental age can hugely impair their overall development, thereby drastically increasing the number of blind years. 

Therefore, it is imperative to provide timely diagnosis and intervention for children affected by CVI to improve their quality of life. However, accessibility to assessment and intervention services can be a challenge for many families, particularly in low-income areas, especially in emergencies.

To address this challenge, Vision Nanny offers a novel solution by simplifying the clinic-based intervention into fun-loving and smart activities that can be easily accessible by any local healthcare provider. The interface is user-friendly and can be easily adapted by community workers to screen for CVI and provide them with consistent therapy sessions.  This innovative approach can enable more children with CVI to receive much-needed support and interventions, which can enhance their development and well-being

Vision Nanny is a web application that provides a comprehensive solution to both the assessment and intervention of Cerebral Visual Impairment (CVI). Vision Nanny is device agnostic, making it convenient for use on various smart devices such as smart TVs or tablets. The application consists of screening tools that help assess a child for CVI. These screening tools comprise questionnaires in simple language that can be easily adopted by community workers with minimal training.

In addition, Vision Nanny has a library of activities that are specifically designed to address various visual skills. Each activity comes with a customisation panel that can cater to the needs of individual children. The activities are interactive and have minimal distractions to encourage engagement with the child. These activities are backed by research and have been clinically tested for their effectiveness in providing therapy. The design of each activity also considers the transition of skills from controlled environments to real-life settings.

Currently, Vision Nanny has approximately 10 activities with different modules under each activity.  Each activity has a simple customisation panel, where the size or colour of the object, and background displayed can easily be changed. Since each child with CVI would have different characteristics, this panel allows crafting the activity to the needs of the child. These activities are designed to address a range of CVI conditions, from severe to mild, and can benefit children aged between 6 months and 16 years old. The activities are easily categorised based on age, the severity of the condition and the skills required to improve.

The user interface of Vision Nanny is simple and does not require extensive training or expertise to understand the therapeutic intervention. This makes it easy to adopt in any primary healthcare centre to provide intervention. Moreover, the simplicity of the app also allows parents and volunteers to provide therapy sessions to children with CVI.

Vision Nanny addresses the 2 crucial needs of children with CVI. 

1. Assessment: Many children with CVI miss on timely diagnosis due to limited professionals equipped with the knowledge on CVI. It is estimated that 40% of children with learning disabilities and 90% of children with Down’s syndrome might have CVI. The array of diagnoses required for CVI also makes it difficult for the parents. It becomes even more difficult for children affected by emergencies. Since CVI happens to be a hidden disability, the identification becomes even more difficult for caregivers in stressful conditions and often goes neglected. With Vision Nanny, the local community worker can easily screen for CVI using the set of assessment tools. This early diagnosis can aid in providing the intervention in the critical window of neuroplasticity i.e., the first 5 years of their lives. Thereby, increasing the chances of improving the vision. 

2. Intervention: Vision Nanny equips the caregivers of children with CVI in providing timely and affordable intervention. A sample study at an Eye Institute in South India shows that 80% of the children diagnosed with CVI cannot avail of the therapy either due to its affordability or unavailability of the services in their locality. Thus, Vision Nanny provides digital intervention services where the parents or the community health workers can easily operate and provide therapy sessions. The simplicity of the setup on any tablet forgoes the need for a huge infrastructure and can provide therapy from anywhere. Thus, it can also be easily adopted in refugee camps where the needs of children with disabilities are often neglected. Since the migration and the settlement can even take years, missing out on intervention during this crucial age can severely impact the child’s development.

Our team comprises four young professionals from diverse backgrounds, united by a common goal to provide affordable and accessible solutions for the visually impaired. Vivian Manohar is an engineer with a master's degree in Energy Systems. He leads the Technical work at development.  He has a passion for volunteering and teaching music to children with neurological disorders during his leisure time. His previous work with the Centre of Innovation at LV Prasad Eye Institute, where he was involved in a project to screen for refractive errors in children, provided him with valuable experience working closely with children and healthcare providers.

Prathyusha Potharaju is the research head of our team, where she is responsible for designing and testing the screening tools, developing content for the platform, and designing pilots for testing. As a biotechnologist, she has a keen interest in understanding visual perception and the role of neuroplasticity in improving skills, which is reflected in her activity design. She has previously volunteered for over two years at the Early Intervention Unit at LV Prasad Eye Institute, where she was involved in various research projects such as case studies on improving vision in children with CVI and analyzing the application of existing assessments to CVI. Currently, she is receiving formal training in Montessori and teaching methods for children with special needs, which has aided her in understanding the world of children with CVI more closely. 

Both Vivian and Prathyusha worked as Social Innovation fellows for child healthcare. Their experience working with indigenous communities in Northern India has also influenced the design of the Vision Nanny platform, keeping in mind the convenience of ASHA workers in adopting the application.

Nivedha Christabel is our product and outreach lead, bringing her expertise as a pediatric optometrist to the content development process. As a mother of a 3-year-old, she has a deep understanding of the psychology and developmental needs of children. Her perspective as a mother helps to design the platform to be more child-friendly, ensuring that the needs of our customers are met.

Keerthi is our customer relations specialist, and she takes care of the journey of parents and therapists from onboarding on the app to regular usage, supporting them with any assistance if required. Being visually impaired herself, she has a unique understanding of the concerns of parents and is able to provide empathetic support to them.

Our team is driven by a passion to provide affordable and accessible solutions to the visually impaired. With our diverse backgrounds and experiences, we are committed to providing a holistic solution to both assessment and intervention for CVI through the Vision Nanny platform. Our team believes that technology can play a vital role in improving the lives of visually impaired children globally, and we are proud to be a part of this mission.

Currently Vision Nanny has 1300+ users throughout the world with a major population from India and USA and 10 more countries throughout the world.We also have organisations from Kenya and Nigeria adopting our solution. We are currently working with CSRs to pilot Vision Nanny for providing intervention to children in rural areas and tribal communities.

Through Solve we look forward to seeking the help in terms of:

1. Technical expertise: Working close to children with CVI, we clearly understand the requirements and can envision the roadmap of the development, but we often encounter a lot of hiccups in technical areas. We need mentorship from AI/ML experts in working toward the automation of activity suggestions based on the child’s responses.

2. Mentorship on Pilot Designs: To expand the usage of Vision Nanny to wider geographical regions, we need advice on designing the pilots in preliminary testing of the product in adapting to a new culturally diverse population.

3. Hiring human resources: Vision Nanny requires many web developers and designers in its journey of development. Getting the right people who have the expertise and share our passion for the cause often becomes difficult. We would to reach young students and graduates who are enthusiastic about the problem through Solve community.

4. Expanding our market: Solve community is immensely known for its global network. Thus, we would require help in connecting to the organisations working with Children with special needs and governments to collaborate and set up community-based early intervention clinics.

5. Funding: We look forward to automating the activity suggestion, integrating more activities and report generation system. Thus, we require funding in the hiring of the talent pool

1. Vision Nanny, an innovative digital intervention service for children with CVI, emphasizes the product's groundbreaking approach to democratizing access to therapy services in developing countries. Traditionally, therapy services have been restricted to professionals and clinic-based experts who are typically limited to metropolitan areas. However, Vision Nanny is an inclusive and device-agnostic application that enables even ground workers to provide therapy to children with CVI in remote and underserved regions.

2. The digital interface provided by Vision Nanny is highly interactive and engaging to children. Furthermore, the platform's customization panel is tailored to meet the specific needs of children with CVI, resulting in a highly effective intervention. Unlike other applications designed to be operated by experts, Vision Nanny's simple interface is designed with caregivers with minimal schooling in mind, increasing the accessibility of the platform to a broader population.

3. Vision Nanny is the first application of its kind to provide assessment tools for CVI, enabling healthcare professionals to screen children effectively. This groundbreaking feature sets Vision Nanny apart from other therapy applications in the market and highlights its commitment to providing comprehensive care to children with CVI.

Thus, Vision Nanny's innovative approach to providing digital intervention services for children with CVI has the potential to revolutionize access to therapy services in developing countries. Its device-agnostic design and simplified interface make it accessible to ground workers and caregivers, enabling them to provide therapy to children with CVI in remote and underserved regions.

Goals:

In 1year : Provide therapy through Vision Nanny to at least 2500 children by next year in India, where 50% of the children come from urban slums and immigrants.

1-Year Plan:

• Identify Primary Healthcare and Anganwadi centres in urban slums and immigrant areas in India where Vision Nanny therapy can be provided.

• Collaborate with CSRs (Corporate Social Responsibility) of companies operating in these areas to fund the early intervention therapy sessions.

• Hire and train dedicated community health workers to operate the Vision Nanny platform and provide therapy sessions to children in these centers.

• Develop a monitoring and evaluation framework to assess the impact of the therapy sessions on the children's vision and learning outcomes.

• Conduct periodic assessments of the children's vision and learning outcomes every 6 months to track their progress.

In 5-Years: Expand the reach of Vision Nanny therapy to 7000 children affected by immigration in countries like Germany, Turkey, and Sweden.

 Plan:

• Identify refugee camps in these countries and set up  early intervention units equipped with Vision Nanny and trained community health workers.

• Collaborate with international aid organizations and local NGOs to fund and support the setup and operation of these units.

• Develop a culturally sensitive and customized version of Vision Nanny for each of these countries, keeping in mind the specific needs of the refugee population.

• Train the community health workers on the customized platform and ensure that they can provide therapy sessions effectively.

• Conduct periodic assessments of the children's vision and learning outcomes every 6 months to track their progress and adapt the therapy sessions accordingly.

Goal 2: Measure the impact of Vision Nanny intervention on the children's vision and learning outcomes in India and refugee camps in Germany, Turkey, and Sweden.

1-Year Plan:

• Conduct periodic assessments of the children's vision and learning outcomes every 6 months in India and refugee camps in Germany, Turkey, and Sweden.

• Analyze the assessment results to identify the areas where the intervention is having the most impact and the areas where it needs to be improved.

• Use the assessment results to refine and improve the Vision Nanny intervention to maximize its impact on the children's vision and learning outcomes.

5-Year Plan:

• Continue conducting periodic assessments of the children's vision and learning outcomes every 6 months in India and refugee camps in Germany, Turkey, and Sweden.

• Analyze the assessment results to identify the long-term impact of the Vision Nanny intervention on the children's vision and learning outcomes.

• Publish research papers and reports on the impact of the Vision Nanny intervention, highlighting its effectiveness in improving the vision and learning outcomes of children with CVI.

• Use the research findings to advocate for greater investment in early intervention services for children with CVI among the immigration-affected population.

Vision Nanny aims to equip the local communities to become self reliant in screening and providing the intervention to the children with CVI. Through which we assist the children with CVI in improving their vision

Activities:

1. Training the local community workers in usage of Vision Nanny

2. Screening the children for CVI

3. Providing the intervention to children diagnosed with CVI

We aim to have the following outputs for the activities performed:

1. Setting up an intervention unit at every Primary Healthcare centre or refugee camp.

2. Timely assessment of CVI in high-risk children 

3. Providing consistent and timely therapy sessions to children diagnosed

We envision the following outcomes for the implementation:

Short-term:

1. Providing timely local early intervention support to the children with CVI

2. Encouraging the child for availing intervention

3. --Engaging sessions for children providing their happy time.

    --Joyful and meaningful learning of the concepts

Lon term:

1.  Increasing the self-reliance of the local communities

2. -- Improving the visual skills in children

-- the development of cognitive and daily living skills 

Thus, the overall impact of the improved vision and cognitive development hugely impacts the independence by improving the ability of the child to perform the daily activities and avail the education and skills.

Vision Nanny is a Software as a Service (SaaS) Progressive Web App (PWA). The activities are developed using the latest frameworks and back-ends like HTML5, VueJS, Canvas, WebGL, Firebase, and Google Cloud. The team is currently working on integrating client-side ML algorithms to track the child's gaze and behaviour. This would further help to understand the needs of the child better and auto-recommend activities with more precision.

Our current efforts:

1. 3 out of 4 members of the leadership team are women.

2. The project leads, Prathyusha and Vivian, have travelled to the remotest corners of India to study and experience the pain points of marginalized and impoverished people. They have worked closely with tribal communities for more than 3 months to understand how to make Vision Nanny more affordable, intuitive, and culturally appropriate.

3. All of our team members are part-time volunteers at a rehabilitation center for persons with disabilities. Therefore, we understand the importance of making our solution and the work environment accessible.

4. 60% of our team consists of persons with visual impairment. Keerthi, our customer relations specialist is visual impaired and is very weel sensitized in talking to our clients. One of our advisors, Aishwarya, is a Visually Impaired tactile artist. She helps us with digital accessibility testing.

5. Our company is open to flexible timings of work for young mothers to accommodate their needs. Nivedha, our product lead and mother of a 3year old, has been working for past 2years adjusting her schedule to baby’s sleep and feeding patterns. 

Some of our near-future goals:

1. Bring a qualified person with CVI to the leadership team.

2. Provide employment opportunities to single mothers of children with CVI.

3. Allocate special resources to support the educational needs of the tribal children with CVI in India

4. Make the Vision Nanny interface, user guides, training materials, and promotional content available in multiple languages and accessible formats, including Braille and ASL (American Sign Language).

There is a growing global market for CVI intervention. We are working towards impacting 1.7 million children in the next 5 years and gain a potential revenue of 67 million dollars. According to our financial projections, at a growth rate of 15%, Vision Nanny could become profitable just in a year's time.

Pricing Model: 

B2C and B2B2C Freemium subscription model

Customer segments:

1. Parents of children with CVI who are looking for affordable home-based intervention solutions

2. Therapists of children with CVI who need customizable tools for providing intervention to multiple children at the clinics

Market Potential:

TAM: $3 Bn (36 million children with CVI x $84/Year)

SAM: $190 Mn (36 million users x 63% internet penetration x 10% affordability x $84/Year)

SOM: $67 Mn Revenue in 5 years (At 15% growth rate & 5% churn)

Go-to-market Strategy:

Channel 1 - Partnering with the vision rehabilitation centres, where the therapists will introduce the product to the parents who are visiting them.

Channel 2 - Social media channels where currently a large number of potential users are actively looking for solutions that address CVI.

Vision Nanny operates on an annual subscription basis.  We would majorly operate on free to service model where we tie up with CSRs and Not-for-profit organisations in providing services to a large number of children across destitute communities across urban settlements as well as rural areas. We are also in talks with state governments in India to integrate Vision Nanny in their intervention programme in government-run Early intervention units where we work with the government on contractual to provide the claimed subscriptions. Soon, we would be expanding this model to counties in the USA where our current 2nd largest customer base is located. We also plan to expand to plan to operate both as B2B and B2C models when selling our services directly to customers. We aim to approach private organisations like Eye hospitals, and intervention units working with children with CVI and provide annual licences depending upon the number of children. We would also operate on a B2C basis directly approaching parents of children with CVI.

Vision Nanny received support in terms of product development and piloting: 

1. Currently we are part of Optum Startup Studio India (OSSI), where we received a funding of $24000. OSSI is hosted by Optum, an integral company of United Health Group. The funding we received helps us sustain ourselves in terms of Human resources for technical development and marketing.

2. Vision Nanny was awarded a grant of  $ 8500 from the Dept of Science and Technology, Government of India. Vision Nanny has also received a seed grant of $13,800 from the Biotechnology Industry Research Assistance Council (BIRAC), Dept of Biotechnology, India, during the initial months of prototyping. These grants were utilised for the activity development and running of the pilots.