CORTICAL VISUAL IMPAIRMENT
By: Carmen Willings
Updated March 11, 2018
Cortical Visual Impairment (CVI) is now the most common cause of visual impairment in children in the United States according to the American Printing House for the Blind's CVI page. CVI is caused by damage, injury, or trauma to the brain, rather than to abnormalities of the eye.
Christine Roman-Lantzy has done much research in the area of Cortical Visual Impairment. In her book, "Cortical Visual Impairment: An Approach to Assessment and Intervention", she identifies the cause of CVI can generally be thought of as conditions that affect the visual pathways or visual processing centers of the brain. It is a condition in which children have reduced visual acuity as a result of damage to posterior visual pathways. In most cases, the eyes of such children are structurally normal, yet they have diminished visual capacity. She indicates that the most common conditions associated with a diagnosis of CVI are asphyxia, perinatal hypoxic-ischemic encephalopathy, intraventricular hemorrhage, periventricular leukomalacia, cerebral vascular accident, central nervous system infection, structural abnormalities, and trauma.
She further states that the occipital lobes of the cerebral cortex at the back of the brain are primarily concerned with vision; the visual messages from the eye traveling along the optic nerve pathway in the form of electrical signals are routed to this location. The child may have an abnormal MRI or CAT scan that shows damage to parts of the brain such as the visual cortex or optic radiations. When attempting to determine the cause of a child’s visual disability, CVI should be considered when the child has:
If you discover that the student has a history of seizures, be very cautious in using any flashing lights as this may trigger a seizure.
CVI is frequently seen in children who were born prematurely, have neurological disorders, or have acquired brain injury. When CVI is suspected, a review of medical and other records is needed. The presence of CVI is indicated when these three criteria are met. Dr. Roman-Lantzy has identified the following characteristics of CVI:
Overall, children who exhibit any of these characteristics or visual behaviors are usually unable to use their vision consistently in what might be thought of as a “normal” way. In general, the greater the severity of CVI, the greater the number of CVI characteristics present. However, these characteristics may change or improve. For more information on CVI and strategies from Christine Roman, visit the APH.
Additional CVI Resources...
Roman-Lantz, Christine. Cortical Visual Impairment: An Approach to Assessment and Intervention. American Foundation for the Blind, 2007. This resource book includes the unique assessment tool developed by Christine Roman-Lantzy and systematic, targeted principles to help students with cortical visual impairment. Includes a framework with which to understand working with CVI and concrete strategies in working with these students.
Roman-Lantz, Christine. Cortical Visual Impairment: An Approach to Assessment and Intervention, 2nd edition. American Foundation for the Blind, 2018. The new and revised content in this second edition brings the book up-to-date with new research and insights into CVI, its development and progression, and the best approaches to assessment and intervention with children affected by this condition. As in the previous edition, assessment forms, including the CVI Range and CVI Progress Chart, provide a comprehensive method for evaluating the functional vision status of, and program planning for, children with CVI.
The American Printing House for the Blind has a great CVI website with information on Cortical Visual Impairment. Information includes articles, videos, stories, as well as supports, strategies and resources.
The Texas School for the Blind has a comprehensive article on Cortical Visual Impairment that was featured in their See Hear Newsletter.
Little Bear Sees is a website dedicated to raising awareness about cortical visual impairments. It is designed to provide the information and tools necessary for helping children with CVI learn how to see.
Eduplanet21 is offering an online Introduction to Students with CVI course through Strafford Learning center. The Learning Path was designed to give you a greater understanding of your students with visual impairments and how to best work with them.
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TVI's Guide to Teaching the ECC: An Activities Based Curriculum for Teaching Students who are Blind or Visually Impaired
Written specifically for fellow itinerant Teachers of Students with Visual Impairments (TVI’s), this book consists of over 400 activities and topic areas of discussion for instructing students in the Expanded Core Curriculum. The activities are age-neutral and multi-sensory and therefore can meet the needs of the broad range of students served on an itinerant caseload serving. The activities can be individualized to the students various learning modalities and scaffold in order to challenge students but ensure success. Select those activities that align with the student’s learning objects based on the student’s unique visual needs and academic and developmental level.
The core activities listed in the Activity section can be adapted to each thematic unit. These include:
In addition to the core activity areas, each of the 32 Thematic Units incorporates additional unique ECC concepts and skills providing you with a years’ worth of activities. These units are cyclical and can be used repeatedly to help students build on prior knowledge and develop a deeper understanding of concepts. Each unit includes suggestions for activity adaptation associated with the unit. These include lists of objects, possible community based experiences, environmental print, poems, children & young reader books, children's songs, pop culture songs, movies, and websites.
Unique Concepts within the Units include:
Although the intended audience of this resource is fellow Teachers of Students with Visual Impairments, special education teachers may find these activities beneficial to the students in their classrooms as the activities are multisensory and include life skills and concepts needed by all students. This resource, however, is not intended to take the place of a Teacher of Students with Visual Impairments (TVI). Readers are advised to consult their own TVI’s regarding instruction in the ECC and the unique visual needs of the student’s served in their programs.
Note: This curriculum is a digital pdf download. Once you make your purchase you will be directed to an order confirmation page where you will find the download link. This download will also be included on the receipt sent to the email address you provide. The pdf download can be found directly under the order number.
Each download is intended for single instructor use per copyright. Thank you for helping me preserve the content and not distributing copies to third parties.
Digital pdf download: 364 pages (11 pt font)
Publisher: Teaching Students with Visual Impairments
Author: Carmen Willings
Visual Efficiency & Magnifier Fluency Grab & Go ECC Supplements
This workbook is a pdf download that can be printed on demand for use with students. It contains five different types of worksheets for developing visual motor skills and near magnifier fluency skills particularly with the use of a video magnifier. As a supplement to the TVI’s Guide to the ECC, the worksheets correspond to each of the 32 ECC Thematic units. The worksheets, along with a list of environmental print for each thematic unit, are designed to help students refine their visual motor skills while reinforcing ECC concepts presented in the thematic units.
Visual Efficiency & Near Magnifier Fluency Worksheet Details:
Digital pdf download: 210 pages
Publisher: Teaching Students with Visual Impairments
Author: Carmen Willings