Robyn,
I appreciated your discussion about pushing into classrooms and embed myself into the student’s routines. I find it provides opportunities for orientation and mobility instruction to occur organically within the activities occurring at that time. This also provides the opportunity to observe the student’s ability to navigate the environment outside of our O&M sessions.
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- Think of a student with CVI you’ve supported. How did sensory complexity, attention, or the environment impact their ability to access instruction? What helped or hindered their visual attention? What strategies made a difference?
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There is a student that comes to mind, new to my caseload this past year, where I came in to observe and assess the student. I found the teaching team was quite nervous about how to provide educational programming, as the student was quite medically fragile with ongoing seizures (not related to lights). When in the life skills classroom, the student was mostly sleeping or keeping their eyes closed. There was minimal engagement with the support staff and I really had to advocate for this student and explain/teach about how CVI and the surrounding environment can affect how the student can access learning. The room was noisy with overhead lights and any toys/visual targets presented to the student in the regular classroom was not regarded by the student. We moved the student to a quieter room, with overhead lights off and I presented items on a light box, the student began to open his eyes, looking at coloured overlays, added movement by moving bright red and yellow objects or objects that had shiny movement like properties on them. The student began to show visual attention for brief moments and then would look away. This was a starting point for the student and with goals and trackers created, the teaching team started to present materials to the student in the quiet dark room. These same strategies would not be as effective in the regular classroom with all the noise and overhead lights. So being aware of the manifestations of CVI and the behavioural characteristics of CVI really helped the team to understand how to open the window for access to looking for this student.
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That is an excellent case study of how important it is to consider and take into effect all of the external conditions that our students can be faced with. While reading about your student, I wondered if learning braille was ever a consideration for your student? But as his vision improved and with the FM system, it appears that he is now able to read at grade level and vision fatigue is not an issue for him? You made excellent points about taking into consideration the hearing of the student and often as VITs we assume the hearing has been tested. But with CVI, both visual and auditory processing can be affected.
Hi Lacey, thank you for sharing the different programs that are available for additional CVI training in the States. I live in Ontario, Canada, so we don’t have any specific CVI training, except for the 3 part courses we take as AQ’s (Additional Qualification Courses) to get our Specialist as TVIs. I do wish there were more courses we could take and even more training to better serve students who are Deafblind. I agree with you that there is a lack of training for all different paraprofessionals on CVI in a collaborative model. I often find it’s a struggle to work with SLPs who want to provide communication programming by using 2D symbols or pictures when the student can only interact with and somewhat look at actual objects. Trying to explain that pictures are not accessible for the student has been an ongoing learning journey and I often think about how important it would be if more team players understood the various visual characteristics of CVI and how much better it would be for programming for our students.
If the FM system had not solved his reading deficit I would have suggested Braille.
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Question 2: 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 offer different but equally important perspectives into a child with CVI. Parents observe their child across daily routines and can detect subtle patterns or responses—such as visual field preferences—that professionals may miss during brief assessments. Professionals bring clinical knowledge, structured tools, and experience with CVI to interpret these behaviors in a broader developmental context.
Dr. Amanda Lueck’s blog highlights the value of combining these perspectives. She emphasizes that parents’ observations are not just anecdotal—they provide crucial context for understanding visual behaviors. When professionals listen to and incorporate this input, and parents understand the implications of clinical findings, the result is a more complete and effective intervention plan.
Collaboration between parents and professionals ensures that both everyday observations and expert analysis inform decisions, leading to more individualized and meaningful support for the child.
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I responded to the same question (#2). I completely agree that parents are the true experts on their child’s day-to-day behaviors, and it’s our job to help interpret those behaviors through the lens of vision. I’ve had similar experiences where a small observation during a session, like how a child turns their head or avoids certain lighting, sparks a conversation with the parent who then shares more examples that help complete the picture.
What you said about early intervention resonated with me too. That close partnership with families is one of the most rewarding parts of the job. It’s such a contrast to working in the school system, where we often only get limited windows to connect with parents. Your comment made me think about how we could bring more of that collaborative spirit into school settings—maybe through more regular check-ins or sharing quick observations more informally. Thanks for sharing your perspective!
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Crystal-You made some excellent points about how collaboration truly deepens our understanding of a child’s visual behavior and how you emphasized that parents observe their child across many environments and can notice patterns professionals might miss in more structured settings. Your example about left-to-right tracking and how the corpus callosum may impact midline crossing really stuck with me—it’s such a great reminder that neurological differences can affect visual access in unexpected ways.
I also appreciated your suggestion about presenting materials vertically, like Chinese script. It’s a creative and individualized strategy that shows how much potential there is when we combine insights from both home and school environments. I have done this as well and it really made a difference for my student! Your post is a great reminder of why we need to keep these lines of communication open—when we collaborate fully, we can think more flexibly and meet the child where they are.
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I am thinking about the O&M questions that I ask parents, and routines are not part of it. Long- and short-term goals are often emphasized in vision, but not O&M. I think the questions are more broadly asked. I have sent cane technique videos to parents. Most of my parents of children with multiple impairments are not as interested in O&M as they are with PT and OT. Thank you the inspiration and helping me out of a “rut”.
How did you convince the team about a quiet setting? Your student is lucky that there was a quiet space to go to. I have students similar to yours in that they have their eyes closed. The classroom sizes are small, but noisy.
Compare and contrast the roles of parents and professionals in interpreting a child’s behavior. How can these perspectives complement one another?
I think Dr. Lueck’s blog provides some nice examples of how parents and professionals need to work together to share knowledge in order to gain a better understanding of how a child uses their vision. A parent is with their child 24/7 so they are able to quickly explain what motivates a child, what their strengths and weaknesses are, and where the child struggles. When these insights are shared with the professional, they can serve as guidance during the observation process.
Parents are naturally very intuitive about their children so they are able to give additional information that may not necessarily be gained during a typical observation.
I think the professional needs to help the parent feel comfortable in order for them to share pertinent information about their child. The parent needs to learn to trust the professional in order to share relevant insights. The more details that they are able to share can lead to a more thorough evaluation since observations can be so short. It is the professional’s role to stay open minded and not have any preconceived notions in order to gain a true understanding of a child’s vision. The parent is able to offer valuable insights that when combined with a professional’s observation can lead to a better understanding of how the child is experiencing the world.
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I too have had similar experiences working with students with multiple disabilities and CVI. The effects of the environment are profound and overstimulation from extra noise or bright lights can almost make it seem like I am working with a different child. Providing a good environment to work on iep goals is important as I too often see avoidance behaviors of closing eyes or light gazing.
Hi Tammy, good point about the contrast of information received from parents in EI and school age. I find that when working with school age students I tend to looks towards other members of the team such as an aide or therapist to gain a different perspective.
Yes, we were lucky to find a small quiet room to use for the vision work. In older schools I find there is more space available and we need to be creative and flexible with what is available. I explained to the team that we can get more interaction with the student if we control the external stimuli such as light and noise and was then able to demonstrate it to them with success.
- Think of a student with CVI you’ve supported. How did sensory complexity, attention, or the environment impact their ability to access instruction? What helped or hindered their visual attention? What strategies made a difference?
When supporting a student with CVI, I saw how sensory complexity and environmental distractions directly impacted their ability to access instruction. The student’s visual attention was fragile and easily disrupted by cluttered visuals, background noise, or multiple competing stimuli. Presenting more than one item at a time or using low-contrast materials often caused them to disengage.
What helped most was using high-contrast objects(especially red or silver), presented on a black background within 6–12 inches of their face. Providing wait time for visual processing and minimizing distractions in the environment improved engagement. Predictable routines, tactile cues, and a simplified setup allowed the student to better use their vision and remain focused. Reducing sensory complexity and creating consistency made the biggest difference in supporting their visual access.
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PaTTAN: Examples of Different CVI Terminology
5.) Inconsistent language can absolutely impact collaboration with other team members. For example, I’ve been mistakenly referred to as a Vision Therapist during meetings. In those instances, I’ve had to be direct and clarify that I am a Teacher of the Visually Impaired. Our roles are very different and this type of confusion can lead to misaligned expectations and strategies for the student. Regarding CVI, I personally refer to it as Cortical Visual Impairment. However, I’ve noticed that the term Cerebral Visual Impairment is becoming more popular, while Neurological Visual Impairment is less so. Naturally, if an outside team member hears multiple terms being used interchangeably during a meeting, it can lead to confusion and misunderstandings. I’ve found that being proactive about this potential confusion is very important, just like the TVI vs. VT discussion. Taking a moment to clearly define what I mean when I say CVI helps ensure that everyone on the team is working from a shared understanding and can support the student as best as possible.
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- Think of a student with CVI you’ve supported. How did sensory complexity, attention, or the environment impact their ability to access instruction? What helped or hindered their visual attention? What strategies made a difference?
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One student with CVI that I supported was in the very early stages of visual development, primarily working on improving their ability to look at and attend to objects. Through this experience, I quickly realized how significantly sensory complexity and environmental factors impacted their ability to access instruction.
The environment was one of the first and most important areas to consider. Visually, background clutter made it difficult for the student to distinguish target items. Auditorily, even moderate classroom noise—such as staff talking or other students moving around—often prevented the student from visually engaging. Many times, well-meaning staff would speak to the student while encouraging them to look, not realizing this divided the student’s attention and reduced their ability to use vision effectively.
What truly made a difference was creating a highly controlled, low-complexity environment. I worked closely with the classroom team to minimize distractions—reducing visual clutter, limiting unnecessary noise, and establishing quiet, focused moments for visual tasks. Initially, it took time and effort to get everyone on board, as the process can be tedious. However, once staff saw the student respond when these strategies were in place—and experienced the success themselves—they were much more inclined to continue.
For students with multiple disabilities and CVI, controlling the sensory and physical environment is often key to helping them begin to use their vision more purposefully and meaningfully.
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Hi William,
I totally agree with your point about the importance of scheduling an in-service meeting at the beginning of the year! They are so helpful for the team to make sure everyone is on the same page, are able to ask clarifying questions and can discuss how the student’s vision can impact them in the classroom.
Hi, Crystal.
I agree that parents and professionals each bring valuable and different perspectives when it comes to understanding a child’s visual behavior. In my 23 years of working with students, I’ve consistently observed that children often behave differently at home than they do in school, and this holds especially true for students with low vision. Parents may notice certain visual behaviors in everyday settings like at home, in restaurants, or at stores; contexts that educators typically don’t observe. Meanwhile, professionals often only see the student within the structured environment of a classroom, which may limit the full picture of the student’s functional vision. That’s why professional development focused on visual functioning is so important. It raises awareness, expands knowledge, and helps educators better understand how a student accesses their learning environment visually across different settings. Great Post!
- Think of a student with CVI you’ve supported. How did sensory complexity, attention, or the environment impact their ability to access instruction? What helped or hindered their visual attention? What strategies made a difference?
I once had a high school student in high-level academic classes who had CVI. The sensory complexity and environment of situations would impact her ability to visually access information in her classes.
For instance, as a demonstration of how her vision worked, a small red ball was placed on the dark brown table and she was asked to reach out and pick it up. She did this directly and without hesitation or error. Then, other common items were added to the array on the table (keys, pen, cup, whatever was handy, not as nice of contrast as the red ball on the brown table) and she was again asked to pick up the ball by using her vision. She scanned, searched, moved in closer, backed up, and could not locate the ball in the array until allowed to touch each object.
In her classes, it was necessary for objects to be presented to her individually and she needed additional time to respond.
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