Cortical Visual Impairments
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.
By: Carmen Willings
Updated March 11, 2018
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.
CVI Book 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.
Lueck, Amanda Hall. Vision and the Brain: Understanding Cerebral Visual Impairment in Children. American Foundation for the Blind, 2015. Cerebral visual impairment, also known as cortical visual impairment, or CVI, has become the most common cause of visual impairment in children in the United States and the developed world. Vision and the Brain is a unique and comprehensive sourcebook of current knowledge about CVI and best practices for working with children. Expert contributors from many countries illuminate the complexities of vision loss related to brain injury and neurological causes and provide readers with approaches to assessment and intervention.
Sheline, Diane. Strategy to See. VeriNova LLC, 2016. Strategy To See is a resource book for parents/caretakers, educators and medical personnel (including but not limited to TVIs, COMS, PTs, OTs, Speech Therapists, Music Therapists, ophthalmologists, optometrists, low vision specialists and Special Education Teachers) of students from birth to 22 years who have a diagnosis of Cerebral/Cortical Visual Impairment or C/CVI. It offers specific strategies and discusses topics including brain plasticity, the importance of early intervention, the use of the CVI Skills, development of IEP Goals and Objectives and several printable handouts are provided.
Online CVI Resources
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 American Foundation for the Blind provides useful articles on Cortical/Cerebral Visual Impairment:
CVI Scotland is devoted to helping people understand cerebral visual impairments, and together work towards developing the understanding of this complex condition. They have created a free reading tool named "Look," a reading tool, with multiple functions and settings, designed to make reading easier for people with CVI.
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.
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On My Way File Folder Cards
Print and use these cards to represent locations the student may visit that are related to the current thematic unit. Use these with the On My Way File Folder Game outlined in the TVI's Guide to Teaching the ECC p. 27.
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