Cortical Visual ImpairmentsLearn more about the vision examinations, the differences between medical professionals, tests and tools used, and how to read an eye report including understanding visual diagnosis implications, visual fields and neurological visual impairments.
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By: Carmen Willings
teachingvisuallyimpaired.com 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. 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.
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 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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TVI's Guide Complete Set Bundle + BONUS Resources
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Buy together at a reduced price and get BONUS resources! TVI’s Guide to Teaching the ECC: An Activities Based Curriculum for Teaching Students who are Blind or Visually Impaired The TVI’s Guide to Teaching the ECC is a digital pdf available for download. It is designed specifically for fellow itinerant Teachers of Students with Visual Impairments (TVI’s), and 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. 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. In addition to the book, the following two supplements are included: ·      TVI’s Guide to the ECC Concept Checklist ·      TVI’s Guide to the ECC Activities Checklist For complete product details and additional images, visit the TVI's Guide product page. TVI's Guide to the ECC Product details ·      Digital pdf download: 346 pages (11 pt font) ·      Publisher: Teaching Students with Visual Impairments ·      Author: Carmen Willings ·      Language: English Visual Efficiency & Near Magnifier Fluency Worksheets: TVI's Guide to the ECC Grab and Go Supplements The Near Magnifier Fluency Worksheets is a Grab and Go supplement to the TVI's Guide to Teaching the ECC. 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 companion 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.  For complete product details and additional images, visit the Visual Efficiency & Near Magnifier Product Page. Visual Efficiency & Near Magnifier Fluency Worksheet Details: ·      Digital pdf download: 210 pages ·      Publisher: Teaching Students with Visual Impairments ·      Author: Carmen Willings ·      Language: English Thematic Keyboarding & Braille Fluency and Maintenance Worksheets: A TVI’s Guide to Teaching the ECC Grab & go Supplement The Thematic Keyboarding & Braille Fluency and Maintenance Grab and Go ECC worksheet packet is a print on demand workbook that contains worksheets in print and simulated braille to use for data collection. Present the student with a hard braille copy and use the worksheets to document accuracy and fluency in reading braille. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to the ECC Thematic activities presented in the curriculum guide. These word lists and sentences will help the student refine their keyboarding or braille reading skills while bridging ECC concepts presented in the thematic units. Although the lists and passages can be produced using a manual braillewriter, you may also copy and paste the passages into any braille translation software for quick production on an embosser. They may also be entered into a typing program such as APH’s Talking Typer to build keyboarding fluency. For complete product details and additional images, visit the Thematic Keyboarding & Braille Fluency & Maintenance Product Page Thematic Keyboarding & Braille Fluency Worksheet Details: ·      Digital pdf download: 338-page print and simulated braille worksheets ·      Publisher: Teaching Students with Visual Impairments ·      Author: Carmen Willings ·      Language: English Thematic Vocabulary Cards and Checklists: Grab & Go ECC Supplement The Thematic Vocabulary Cards and Checklists Grab and Go ECC supplement is a 446 page pdf downloadable print on demand workbook that includes 2940 vocabulary card on 3 1/2" x 2" templates divided by each of the 32 Thematic Units along with a checklist of each unit words in print and simulated braille. As a companion to the TVI's Guide to the ECC, the vocabulary cards correspond to the ECC Thematic activities presented in the curriculum guide. Additional Use: Teachers of Students with Visual Impairments can have a extremely varied caseloads. It is possible to go several years without having a student on your caseload who requires braille instruction. Like other skills, if you do not practice your braille regularly, it is easy to lose those skills. Use these checklists and cards to maintain your braille skills. Fold the checklist along the line dividing the print from the braille. Choose to either read the print and produce the word in braille using a braillewriter or read the simulated braille and decode it. Finally, these vocabulary cards and checklists may be used with family members or peers who are interested in learning and practicing the braille code. For complete product details and additional images, visit the Thematic Vocabulary Cards & Checklists Product Page Thematic Vocabulary Cards and Checklists Details: ·      Digital pdf download: 446-page print on demand resource ·      Publisher: Teaching Students with Visual Impairments ·      Author: Carmen Willings ·      Language: English BONUS! Lotto Cards The LOTTO Cards Grab and Go Supplement includes 37 theme related unit cards along with activity suggestions that support activities within the TVI's Guide to Teaching the ECC. 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. NEW! Access to TVI's Guide Bonus Membership Pages Note: All products are digital pdf downloads. 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. If you encounter any difficulty, please let me know and I can assist you. *Please contact me if you need to purchase using a purchase order. 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