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Cortical Visual Impairments

By: Carmen Willings
teachingvisuallyimpaired.com
​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:

  1. A normal or near normal eye exam that cannot explain the child's impaired vision.
  2. A history or presence of neurological problems.
  3. The presence of behavioral responses to visual stimuli that are unique to CVI.
 
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:

  1. strong color preference, especially for red or yellow
  2. need for movement to elicit or sustain visual attention; either the viewer or the object viewed needs to be moving to maximize the viewer's ability to view the object
  3. visual latency - delayed responses in looking at objects
  4. visual field preferences - the presence of unusual field locations in addition to loss of visual field.
  5. difficulties with visual complexity - difficulty when an object itself presents a complex display when an object is viewed within an environment that presents a complex display, or when an object is viewed at the same time that other sensory input is competing for the viewer's attention and ability to manage sensory stimuli.
  6. light-gazing and non-purposeful gaze
  7. difficulty with distance viewing
  8. absent or atypical visual reflexes - the reflex to blink in response to an approaching object is impaired
  9. difficulty with visual novelty - a preference for viewing familiar objects is shown
  10. absence of visually guided reach - the ability to look at and touch an object at the same time is not displayed, and these two actions are performed separately.

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

Cover of Vision and the Brain
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.
book cover
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.
Picture
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.
Picture
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.

More 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.  
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.
Perkins offers a CVI hub that includes custom CVI training, tailored for your district’s needs. They also promote the Perkins-Roman CVI Endorsement. The endorsement recognizes those who master the techniques of the CVI Range©, the assessment tool created by Christine Roman, to evaluate a child’s use of vision and track progress.
The Texas School for the Blind has a comprehensive article on Cortical Visual Impairment that was featured in their See Hear Newsletter.

Strategies & Activities for Students with Severe & Profound Disabilities (SIDPID) Recorded Presentation

$25.00

This presentation provides instructional and communication strategies for working with students with severe and profound disabilities (SIDPID) who are functioning between a birth to two-year-old level. It also provides suggestions for setting up sensory environments and creating adapted materials, so the student has activities to interact with no matter what position or area of the room they are in. I share lightbox activities and how to use iPads and computers as instructional tools. Finally, I share functional literacy activities that embed sensory experiences that you can create with your students. The activities are appropriate for the classroom but can also be used during distance learning. This presentation is packed full of activities you can begin using immediately with your students! 


Objectives:



  • Instructional & communication strategies for teaching SIDPID
  • How to create sensory stations and active learning spaces for students
  • Adapted materials for students with severe and profound disabilities
  • Lightbox activities for students
  • Using iPads as instructional tools
  • Using computers as instructional tools
  • Functional literacy activities


Includes:



  • Recorded Video Presentation
  • Transcript
  • Presentation handout for note taking


Request a Certificate of Completion

To receive a certificate of completion for 1 contact hour, complete the short survey on Google Forms. If you have any accessibility issues with the form, please don't hesitate to let me know and we can make other arrangements.  ​


System Requirements:

Presentations are recorded PowerPoint presentations in an MP4 file. Please note that the presentation pages are closed member pages available to individuals who have purchase access to the presentation. 
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Simplify Roman Bubble Font T-Shirt

$20.00

This T-Shirt is in black with the word "simplify" in Roman Bubble Font. The text is white and the bubble is bright yellow on the black background.


Each shirt design is custom made and hand pressed. The shirt is incredibly soft and slightly stretchy. Order a size up if you like a looser fit.


The shirt is a Bella+Canvas short sleeve t-shirt made with side seams for added structure & fit unisex sizing, and shoulder taping. It is 100% combed ring-spun cotton with unisex style and is super soft and comfortable! It features a tear-away label if you prefer label-free shirts and it is pre-shrunk. The vinyl decorations are in white and yellow.


If the size you need is sold out, please contact me so I can email you when the size you would like is available, or check back soon for availability. Also, contact me if you need me to create an order for your team.


-------CARE INSTRUCTIONS-------

Turn inside out. Machine wash cold. Tumble dry low. Do not bleach. Do not iron directly on the design.


Note: I do not retain stock of 2XL-4XL shirts, but I can order them and custom create it for you at a slightly higher price dependent on supplier's fees for larger sizes. Contact me directly for current pricing.
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Small Simplify Black Canvas Pouch

$8.50

Express your love of all things related to visual impairments with these 8.3 x 4.7-inch canvas zipper pouch/pen pouch. The "Simplify" pouch features Roman font high contrast lettering with bright yellow and white on a black canvas pouch.


The pencil case is made from high-quality thick cotton canvas, which is lightweight and durable.. The zipper works smoothly and the seams are properly sewn. It will keep your item safe and tidy. The size is 8.3" X 4.7”, and a small body will keep many contents.


Lettering and images are high-quality heat transfer vinyl.


It can be used for organizing little things in travel and daily life orderly. Such as your cosmetics, keys, coins, and other small accessories. They can be regarded as pencil bags, cosmetic bags, clutch bags well as gift bags.
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