To piggyback on what Megan mentioned about sharing resources or making connections to “see” the CVI profiles, I have found it effective to overlap sessions with PT, OT, and Speech to highlight a students need as it specifically relates to each of those areas.
I agree. I have a student with CVI that both the OT and PT thought issues were “just her vision”. Eliminating clutter on the table for the OT and adding verbal cues for the PT made a huge difference. I only had to model the idea once and the child responded so much better it was hard to blame the “vision” any more.
Throughout my career as a TVI, I’ve worked with many special education teachers, speech-language pathologists, occupational therapists, and physical therapists who were unfamiliar with CVI. Professionals and classroom staff working with a student with CVI may not fully understand the condition’s complexities and subtle variations.
After a few sessions with the student, I typically reach out to the related service providers and the classroom teacher to discuss how we can best support the student’s visual needs. This often includes strategies such as reducing visual clutter in the workspace, using high-contrast materials and backgrounds, and considering the student’s color preferences.
I frequently offer to observe their sessions and provide suggestions for visual adaptations they can incorporate into their work. I also invite them to observe my vision sessions so they can see firsthand how materials are presented, how response times are adjusted, and how to optimize the student’s access to visual information.
Ongoing collaboration among classroom teachers, related service providers, and families is essential. It allows for the sharing of ideas and helps build a more cohesive, supportive approach to meeting the student’s unique needs.
1 Like
Hi Barbara,
I definitely am on board with you on having overlapping sesisons with other related service providers. It has made a huge difference in how each of those service providers present materials and work with the students. Even simple adjustments such as a longer response time has enabled the providers to see an increase in interaction.
Hi Robyn! I love that you have a mission to educate others about CVI. I do also find that many professionals are unaware of CVI and have never heard of it at all. I do my best with providing sites and handouts that have been helpful to me to help educate other professionals and families about CVI.
“Consider how has the use of different terms to describe CVI (e.g., CVI, cerebral visual impairment, neurological visual impairment) may affect collaboration with other professionals. Has inconsistent language ever caused confusion or misalignment? What helped clarify communication across teams or settings? How do you navigate terminology in your own practice?”
I’ve been reflecting on this question for quite some time—especially with the introduction of the Perkins CVI Protocol. Inconsistent language often causes professionals, including Teachers of the Visually Impaired (TVIs), to question what they know or whether their understanding aligns with current best practices.
After participating in the Identifying Effects of CVI course on the Hive, I found that even more perspectives, terminology, and conceptual frameworks were introduced, which both deepened my understanding and expanded the complexity of the conversation.
This past school year, a colleague and I—who had the opportunity to attend the Perkins CVI Conference—led a ‘walkthrough’ activity for our TVI team. Our goal was to show that, while the Perkins CVI Protocol and the CVI Range appear different on the surface, the same core visual behaviors are addressed in both tools. This hands-on comparison helped clarify perceived differences and generated a lot of excitement within our group. It also opened the door for a meaningful discussion about what we know, what we’re still learning, and how we can grow together as a team.
CVI is already a challenging diagnosis for many professionals to fully grasp. The additional layer of inconsistent terminology and varying assessment approaches can make it even harder to build shared understanding. For me, navigating this complexity involves focusing on the core visual behaviors and the student’s functional vision, rather than becoming stuck in labels. Open collaboration and continued professional learning have been key to bridging those language gaps across settings and teams.
1 Like
Barb and Megan,
I agree that we need to be more collaborative with other educational team members. I recommend creating a presentation about the student, one that demonstrates what the student might be experiencing throughout the school day. I did this for a student who was experiencing CVI meltdowns. Her reaction was highly impacted by the over stimulating sensory input within her special ed classroom. I used examples similar to Matt Teigen’s ‘What’s the Complexity’ seminar, I took pictures from the student’s vantage point (things might not seem over stimulating from an adult’s point of view).
It is important to share what we know and be available to consult with others across the whole educational environment not just in the Vision room for a 30 minute session.
Robin,
I would add that another layer to this issue is the similarity between CVI characteristics/behaviors and Autism. Often team members fall back on acuity or their own observation that the student can see. It takes education and effort on our part to inform about CVI. This can be complicated when/if we ourselves don’t feel confident in our own understanding of CVI. I applaud your focus on educating others. We need to be advocates for our students.
Hello!
I am responding to question #3.
I had a student this past school year who was in first grade and has CVI. He also has a significant communication piece as he had a trach for his first 6 1/2 years. Though speech is coming along and he’s trying really hard to use his voice, he is very hard to understand his academic progress has been tough to address. In kindergarten he used a talker, being an iPad with proloquo2go. He was able to use this to speak in group and individual lessons as well show some of his academic skills. Though there were many academic pieces that were not able to be assessed, it was felt by his teachers that he was very capable of grade level work.
His first grade year was another story and this is where the impacts of his CVI related to sensory complexity, attention and environment are clearly identified as hinderances to his success. This student participates in an inclusion program and this past school year many of the classrooms had students whose needs could not be supported in those settings. His classroom had daily disruptions and explosions by students causing for classroom evacuations and “field trips” around the school while that student’s needs were addressed. The classroom was often loud with constant motion making it a significant challenge for my student to participate. He refused to use his talker throughout the year and part of this is he has found his voice but is still highly unintelligible. The SLP who works with him on the talker spent some 1:1 time with him toward the end of the school year and he soared. This, to me, indicates that the cannot visually access this tool in that classroom.
In addition, access to many instructional components were impacted as he could not visually attend to the instruction. He would become disruptive at times and demand attention from his 1:1 para. That posed additional issues as his para was not a good match for him.
The only strategies that made a difference was having him move to a more individual space to complete some tasks but this too was a challenge as the school he is in has no additional rooms or work space. He was at a table in the hallway which was often not quiet as other classrooms had students who were highly disruptive and loud. However, with specific guidance to the para and accessible materials, the student did demonstrate some success when the conditions were optimal.
The only other strategy I have at this time is to change his placement. The team is working hard on this and we hope to have another school within our district that will better meet his needs as the cohort of students in the school he is in will not be changing.
1 Like
Hello Amy!
I completely agree with you as I have had the same experiences. I have had students for whom the CVI Range determines they cannot access 2D materials yet the teacher will provide these materials and take data on the student’s progress. I have also had academic students who teachers feel have unidentified additional learning needs and behavioral issues that are labeled as defiant as their many pieces of their educational world are inaccessible. I had one student who I picked up in kindergarten who just completed her 3rd grade year. Throughout I have stated she is brilliant and if her world were accessible she’d shine. All have felt she has additional learning needs, possibly specific learning disabilities, and many have called her stubborn and defiant as she will shut down. She was recently evaluated by a neuropsychologist and I had the privilege of meeting with him prior to hear eval to provide information on her CVI and also attend the follow up meeting to review his findings. He stated, “There are not additional learning needs! Her issues are all related to visual processing!” I was so thrilled to hear this for this student as she truly is a star!
HI Megan!
I couldn’t agree more with your thoughts on this collaboration. The challenge can be helping parents fully understand the complexities of CVI and how its impacts can cause specific behaviors viewed at home. It’s a lot of work and requires time. This is a challenge in and of itself but is so important.
I have 2 families I work with whose cultural components also add to mix. One of my students would spend 7 hours in school then go home to an additional 4 hours of highly structured academics. Her mom would meet with me and state she didn’t understand why she would cry over nothing. In addition, the morning routine of getting ready for school was hard for her and them as a family. I was invited into the home an hour and a half before school to assist with the routines. This helped some but there is still a lot of work to do.
In all my years as a TVI/COMS I have found this collaboration with families critical to a student’s success, regardless of the visual impairment. For our students with CVI, this is even more important.
PaTTON: Different CVI Terminology
6. What are the key similarities and differences among the three sets of terminology (Visual Behaviors, Characteristics, and Manifestations) used to describe CVI, and how might these differences impact a team’s understanding of CVI and its impact on a student?
All three have common themes that address a student’s visual functioning with CVI. But their wording of Behaviors, Characteristics, and Manifestations elicit different constructs and meanings especially for other educators. Some key similarities grouped together are: Visual attention & recognition; Visual-motor coordination; Visual clutter/complexity; Field of vision & eye movement; Color, lighting, Motion; Processing time; Sensory integration. The differences in terminology might impact a team’s understanding of how CVI impacts a student. Behaviors are actions that can be observed. These are what you can see a student doing, such as: eccentric viewing; hesitating when navigating unfamiliar environments. Manifestations are the specific ways the visual impairment presents itself. For example, they look away from an object when they are visually fatigued. However, visual fatigue may not be the only reason a student would look away, they may have been distracted or not interested. Characteristics are traits often associated with students with visual impairments, though they may vary. Not all students with the same diagnosis are identical. Such as a need for light or movement.
1 Like
[quote=“amydicampbell, post:1, topic:2310”]
CVI Scotland: Dr. Amanda Lueck’s Guest Blog
- Compare and contrast the roles of parents and professionals in interpreting a child’s behavior. How can these perspectives complement one another?
**Parents and professionals each bring unique and valuable perspectives to understanding a child’s visual behavior. Parents have the advantage of knowing their child across a wide range of environments, both familiar and unfamiliar. They are often the first to observe how their child responds to various sensory inputs, routines, and social situations. On the other hand, professionals and educators bring a knowledge base grounded in visual functioning, development, practices, and theory. They observe the child within structured learning environments and can identify how the child responds to academic and peer-related challenges. When these perspectives are shared and most importantly when collaboration occurs they create a more complete understanding of the child. Educators can apply insights from parents to adjust supports and strategies in the classroom, while parents can benefit from professional observations to reinforce learning and behavior strategies at home. As reflected in the blog there was no mention of the students left to right tracking despite reading interventions or how the corpus colosseum played an integral role in that ability to cross the midline. This child may have been able to gain more access if materials were accessible in a vertical format such as with Chinese script. Together, this collaborative approach leads to better outcomes for the child.
2 Likes
Yes collaboration and understanding across domaines is essential. I found that one of my most successful experiences was when myself as the TVI, the OT & PT all joined for a combined session to support all of the student’s needs was one of the most rewarding and beneficial. We could clearly see and replicate what the other was doing and what we were all supporting for the student.
I think all too often the vision is cited as the cause but it is not the root cause and some simple accommodations such as you mentioned of eliminating clutter can make a huge difference. I did a PD sessions with the teachers and all related service personnel to review information the TVI had gathered on the students visual functioning based on data collected and how they could apply it in their sessions. This was amazing for them and most importantly for the students.
Question #4: To what extent do existing professional preparation programs (across fields) equip practitioners to understand and serve students with CVI?
Teachers of Students with Visual Impairments (TSVIs) and Orientation & Mobility (O&M) Specialists typically receive comprehensive training in visual impairments, which includes some content on CVI.
Most university-based personnel preparation programs include coursework on the causes and characteristics of visual impairments; the depth of CVI-specific training varies by institution and is not always extensive.
Currently, Perkins School for the Blind offers a four-course CVI certificate program, and UMass Boston’s certificate in cortical/cerebral visual impairment is five courses. Many professional organizations have available continuing education workshops and online courses for practitioners across the field that are typically optional and not universally required for initial TSVI/O&M preparation or licensure/certification. Therefore, there is a high variability in understanding promising/best practices for serving students with CVI across the field. Personnel preparation programs for general special education teachers, occupational and physical therapists, and speech-language pathologists rarely include in-depth CVI content as part of their core curriculum.
While the extent of CVI-related content coverage is inconsistent at best, an additional systemic gap in serving students with CVI is the lack of training in a collaborative model, which is necessary for developing effective services for students with CVI.
1 Like
Hi Rebecca,
Thank you for sharing this example–and the comprehensive programming, observations, commitment, and time which is required for effective service delivery. I answered the question about personnel preparation, and the need for training in a collaborative model… your example is a testament to the dire need for collaboration!
I agree with your sentiments about a switch not always being the answer… I’ve talked a lot about this with Stacey Chambers and her work on “Sensing and Learning” and developing programming for our sensorimotor stage learners, many of which also have CVI.
I have worked with several students over the years similar to your sample student. Thanks for sharing your successes and roadblocks! ~Lacey
1 Like
Hi William,
I agree that an inservice at the beginning of the school year is critical for getting team members on the same page. When I include a student’s diagnosis in the present level of the IEP, I always try to describe the characteristics of the condition and impact in parent-friendly language.
One article that we were asked to read defined the term as “central visual impairment”, which I had never heard before. I agree that focusing on outcomes and taking a multi-pronged approach is best. Thanks for your insights. ~Lacey
Hi, Laura! I think you hit the nail on the head when you said, “As much as I would like to build sensory corners…giving staff tools they can use throughout the educational day has worked for me the best.” For as many workshops and webinars we attend and listen to all the great resources and adaptations we can do/make/instill, I have to agree with you that the best “tools” we can provide are ones that can be utilized by everyone - the student, the school staff (teachers and all the support personnel), parents, etc. on any given day at any given time - which can be accessed by the student for when they need it. I do find that much of my “training” comes more into effect with working with the staff to be able to identify little nuances the student may show throughout their day (when I am not present/in the building), such as preference between one object or another, accessibility of presented (adapted) activities (which may/may not need to continue to be adapted), and/or signs of visual fatigue/complexity “shut-down” when presented with new activities/manipulatives which may not be appropriately adapted for the student to access on their current visual level. I definitely do NOT want to add any one thing too complicated/overwhelming for the teacher/staff members to use/do, as I understand that they are also trying/doing their best for our student(s).
- Compare and contrast the roles of parents and professionals in interpreting a child’s behavior. How can these perspectives complement one another?
Parent perspectives and observations are crucial in understanding the full picture of how a child uses their vision. Parents spend the most time with their children across many different environments and times of day. As vision professionals, we try to observe children in different settings at different times of the day, but ultimately our observation windows are limited by our work hours and caseload numbers.
Parents are the experts on their child’s behaviors across multiple settings, but we are the experts in figuring out what those behaviors are telling us about how they use their vision. As TSVI’s we look at behaviors through a different lens. It’s our job to notice the little things, like not reaching across midline or turning the tablet from the text example, that parents may not notice or realize are vision related. By sharing our observations with parents, they often will recall other instances or similar things they have noticed. Professional insights can help parents have a better understanding of why their child exhibits some behaviors.
The thing I love most about working in early intervention is that I am able to work so closely with parents. At every visit, we’re sharing observations and brainstorming about how the child is using their vision and how CVI may be impacting them in various ways. I try to do a lot of education, so that they have the understanding and terminology they will need to advocate effectively when the child enters school. The amount of parent input in EI is a stark contrast to when I worked in public schools and often only had the opportunity to get parent input when doing the interview portion of a CVI assessment or during an IEP meeting.
1 Like