These are all good examples of what may be useful to a student with CVI. I have seen the scenes you describe often; cluttered work areas and work tasks along with assumptions the student cannot do them. With appropriate accommodations, the opposite may be true.
Hi Patricia,
I answered the same question and completely agree with you, using inconsistent terminology definitely adds another layer of difficulty when trying to create a shared understanding among team members. Personally, I think in-service meetings at the beginning of the school year are a very helpful way to ensure the team is on the same page and help clarify any confusion a team member may have to ensure that the student is supported functionally for the whole school year.
I also liked from Dr Lueckâs blog the idea of setting aside any mindset colored by âhow things should beâ, that clearing any preconceived notions from our thinking allows us to learn from the child.
Great post! I truly felt your passion and almost shed a tear reading how you advocated for this student. Even though the student is medically fragile, Iâm sure they appreciate the support youâve provided in the classroom. Many educators twho havenât had experience working with students with CVI often donât know where to begin or how to recognize the manifestations and characteristics of CVI. Thatâs where the TSVI plays such a vital role; helping educators understand the condition and implement appropriate strategies. Youâre doing an amazing job supporting your students, and I thank you for sharing your experience. I can relate; I currently work with a student who shows limited visual attention, and your post inspired me to try adjusting the environment by removing overhead lighting and using a darker space to see if it increases her visual engagement.
- Compare and contrast the roles of parents and professionals in interpreting a childâs behavior. How can these perspectives complement one another?
When I started my M.Ed. program in special education over a decade ago, I was taught that parents are their childâs first teacher. Having moved into the TVI role since then, and becoming a parent myself, I find that the role of teachers and parents requires a collaborative approach in interpreting a childâs behavior.
Dr. Lueckâs blog resonated with me, especially this paragraph â âSetting aside a mindset colored by âhow things should beâ or âexpected steps in a learning sequenceâ are part of this process. Parents are really good at this. They are with their children 24/7 and quickly learn to follow their childrenâs leads. It is so important for parents to trust what they have learned from their children and to communicate this to professionals.â
As teachers, we are with students for a small part of their day â around 1/3 of the day. In that time, we work with our students and learn about them not only as students, but as people. It is imperative to work with parents and caregivers to âfill inâ the missing pieces of the childâs day â the other 2/3 of the day. Parents/caregivers are an invaluable resource in being able to share what their childâs likes and dislikes are, as well as specific tendencies and what the child is like on weekends versus the school week.
As a TVI, Dr. Lueckâs sentence â âObserving children and being open to what they are telling us by their actions and words teaches us how they operate in the world and how they experience it.â resonated with me. Instead of going into a new school year or vision session with preconceived notions, I need to learn to be more open to learning from the student based on how they are acting or feeling in that particular moment.
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I completely agree with your statement. Parents can offer incredibly valuable insights into their childâs visual behavior and overall development. In my experience, many parents donât always realize just how much they know or how meaningful their observations can be to the evaluation process. Iâve found that asking specific, targeted questions often helps them recall details they may not have considered important. Even seemingly small pieces of information can provide critical context and contribute to a more accurate and comprehensive understanding of how the child is using their vision in everyday settings.
Your experience is the definition of what collaborative teaching is. I too have had the pleasure of working with other therapists to develop a multisensory learning experience for our student. I think it is so important that we as TVIs create rigorous but attainable goals for our students even though others may think it is unattainable. In cases like that, I work to integrate the teachers into my lessons and explain how to break the goals into smaller pieces and watch the students practice each part to eventually meet the larger goal. Thank you so much for your thoughtful input!
When I was a newer TVI (over a decade ago), I found myself being overwhelmed by the thought of what was best for my VI students and how to best support them. Sometimes I found myself cornered in meetings asked to do too much with a student or not enough, per the preconceived notions of the other team members. As I have grown into my role as a TVI and more recently, a COMS, I am more confident in my knowledge of visual impairments and am able to share my expertise. I felt I was more timid in sharing what I knew, for fear of messing up but now I seek out those who have questions and am more confident in answering them and/or saying I donât know the answer and looking up resources.
I had a very similar experience with one of our students who was fairly independent navigating the school building with minimal supervision. The classroom team was puzzled as to why she often struggled to locate familiar items, even though she clearly knew what they were and how to use them.
To better understand what was happening, I demonstrated how she could easily find these items when they were placed on a blank surface with high contrast. She located them visually without difficulty. However, when the same item was placed on a visually busy background, she was unable to find it. I also tested placing the item back on the high-contrast surface but added several other similarly sized objects. This time, she had difficulty againâgetting very close to the items and relying heavily on touch to identify them.
This demonstration helped the classroom staff see how environmental complexity directly impacted her visual access. It reinforced the importance of simplifying the visual field and being intentional about contrast. Sometimes just a small change can make a significant difference, and I always encourage teams not to be afraid to try different approaches to see what works best for each student.
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Diane,
I appreciate Dr Lueckâs idea as well. However, with that being said it is difficult to get some people to think beyond the range. Within our field we need to be open to new ideas and new ways of thinking.
100% agree with you that many professionals and classroom staff do not have a strong understanding of all the variances associated with CVI. Our students are all so different and sometimes it takes time to figure out what works for them. I also become so frustrated when I make suggestions without follow-thru or with a response that the teacher has so many students in her classroom and cannot always diversify lessons to meet just one studentâs needs. I repeatedly advocate on behalf of my student for increased paraprofessional material prep time in these cases but without school staff having a strong background in CVI I often feel my repeated pleas fall on deaf ears. This another reason our students often miss out and fall behind.
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As an itinerant TSVI of 26 years, my professional preparation program (no longer in existence) did not include much training for working with students diagnosed with CVI. In reading through this document and the CEC standards which existing personnel prep programs throughout Pennsylvania currently adhere to, I cannot help but wonder how having a national set of standards for programs to follow would have been so helpful. At the time I went through my training, CVI was just starting to gain more momentum in our professional vision world, in that more doctors were identifying/diagnosing CVI as additional information became known from numerous medical studies. In as much, more teacher prep programs added more in-depth classes/lessons to their programs and conference workshops were beginning to catch on to the latest buzz surrounding CVI. However, despite all the developed knowledge about CVI which has led to additional studies, more widely-known adaptations, numerous workshops/trainings, etc., I feel serving students with CVI remains to be somewhat difficult to pinpoint tried-and-true adaptations â as each student diagnosed with CVI is solely unique in what may work best for the student in their own individual circumstantial situations. In talking with school teams (especially ones who may have not ever worked with a student with CVI previously), I try to convey to them as best I can that every student (regardless of their visual diagnosis) presents uniquely and we as a team need to determine how best to do that, with the student and their social/academic/ functional successes being our overall goal(s) to work on together. That being said, while I do feel having a national set of standards to base professional preparation programs on, I continue to feel that much of our learning to understand and service students with CVI continues to depend highly on actual direct service with each student to find out what works best.
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Hi, Angela! I also agree with you in that parents and teachers should have a collaborative approach in education. While we (as educators/educational staff) have access to our students for ~180 days a year (in a traditional school setting) for 6.5-8 hours a day, parent input is undeniably a key component in understanding and learning how best a student may learn in the educational setting. I like that you included Dr. Lueckâs sentence, âObserving children and being open to what they are telling usâŚteaches us how they operate in the world and how they experience it.â, as I feel that encompassing thought really resonated with me in looking back at how I typically approach evaluating new students over the entirety of my professional career (to this day). One of the first things I try to do when evaluating potential new students and/or working with current students on my caseload every school year is to observe them in their natural classroom/educational environmental setting. I find this observation not only affords me the opportunity to see what the student is already capable of doing, but it may also give me some idea of what the student is struggling with doing within the classroom/educational setting confines. I feel being open to learning from students and/or their parents is key to being able to establish a solid communication relationship from the get-go.
- Reflect on a time when assumptions about development or vision influenced how a student with CVI was understood or supported. What assumptions did you or others bring to the situation? How did those assumptions affect the approach or expectations? What helped shift your perspective?
I had a young man that was three at the time just coming into the ECSE program in my district. He had a TBI and CVI. It was a new combination for the teacher/para/PT/OT/SLP and myself as the TSVI. I know for me I was a novice and trying to find the best approach to the situation. There was still not a lot known and we were not just working with a child with CVI his TBI brought in behaviors that at times made it a struggle to do what we assumed was going to help him in the classroom socially and academically. The teacher did research on CVI and came to the table with a lot of good ideas of things to use with the student. The PT and the OT would ask about his vision to help him to navigate and utilize tools. For me in that situation I asked them to observe and see where areas might be difficult: up and down stairs, playground equipment, and even how he maneuvered in various environments. I know the OT was trying to figure out from the limit information we had on his vision and my FVA that was done at home 6 months prior due to Covid. He had issues with language. He had a some splinter skills. A lot of the assumptions were based on what we knew about a typical preschooler. We knew he could see from a distance as well as up close, and he was struggling with vision in his lower quadrants as well as some peripheral areas. I worked in the classroom more to see if I could help model how to work with a student with CVI/TBI. He was held to the same expectations as the others and at times his behavior got in the way of any learning. The teacher and para kept the room open and free of clutter. What was on the walls didnât seem to distract. I feel what helped to shift my focus was one of two things. We had a FVA done by a more experienced TSVI that I was able to assist in administering and attending a low vision clinic. We were all working towards helping this young man, but with the FVA and LVC we understood his vision better and knew how to help him in the area of vision, but his TBI was an area as a team we needed to have a better understanding of how he could learn. A lot of information, I know that with CVI that each student is different and each approach is going to be different. This was my only student with CVI thus far in my career and I will say there are many things I would do differently and research more how to help those on my team. It was a learning curve for us all.
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I agree totally with your thoughts on collaboration between the TVI and the family. It is invaluable to have the parents prospective and observations when it comes to working with their child. I know that being on the same page can be invaluable when helping the child. It also gives a strong understanding to how they will assimilate into the school environment and be successful.
This I agree is a powerful quote. I know I need to be more aware of this when working with my students
I agree what you said: [quote=âpatricia.dascenzo, post:28, topic:2310â]
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 studentâs 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.
I think that is very powerful. I know as a special education teacher/TVI I work with many related services and they all want to understand how to work with the student. I also love the statement of how to learn to grow as a team. I understand that statement. I know it has taken my several years in special education and as a TVI that we must work as one to help the student learn. Thank you again for sharing.
I agree that CVI related course work in university programming is inconsistent and very much lacking. It has been 12 years since I completed my program at University of Northern Colorado, so things hopefully have changed in that time. I remember that learning about CVI was part of another course and we basically just went over how to complete the CVI Range assessment. As a beginning TSVI I felt woefully prepared when half of my caseload included children with CVI. Because of this, I took it upon myself to seek out more education on CVI through various courses, such as the ones you mentioned from Perkins so that I could better serve my students.
I also agree that more emphasis needs to be placed on learning how to use a collaborative model when serving children with CVI. As you stated, working together as a team is vital to providing consistent and effective services and the training in that area is virtually non-existent as far as I am aware.
- Reflect on a time when assumptions about development or vision influenced how a student with CVI was understood or supported. What assumptions did you or others bring to the situation? How did those assumptions affect the approach or expectations? What helped shift your perspective?
I remember a time when assumptions about vision influenced how a student with CVI was understood. I had a student who was in pre-K. She was in phase 3 on the Roman-Lantzy scale and seemed to have a lot of functional vision. She used her vision quite a bit. She was in a class with students who were blind, sighted, and who had low vision. It was often assumed that she didnât need as many supports as she really did need to be successful. Sometimes, she would repeat responses given by her peers and other staff would assume that she was able to see as well as them. Those assumptions affected her accessibility to education at times when staff werenât sure how close she should be allowed to sit to instruction, didnât give her high-contrast worksheets, or showed her cartoon symbols instead of objects or large real-life images. What helped shift my own perspective toward necessary advocacy was seeing the results of a Functional Vision Assessment and the data generated from a Learning Media Assessment. Some of this included collaborating with a more experienced TVI who helped me see this studentsâ vision in a new lens.
- Compare and contrast the roles of parents and professionals in interpreting a childâs behavior. How can these perspectives complement one another?
The role of parents in interpreting a childâs behavior is the most valuable. Parents tend to be the biggest experts on their children. Professionals have the role of observing, instructing, data collection, and interpretation. These perspectives complement each other by communication, collaboration, and forming relationship.
3. Think of a student with CVI youâve 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?
Sensory complexity impacted my studentsâ ability to access instruction by needing less extraneous sensory input, needing high contrast images, and staying mindful to only present information by one sensory mode at a time. The student needed auditory cues to access attention. It was challenging for the student to access instruction in a busier and noisier environment. Some strategies that made a difference were to optimal seating, auditory cues, and an individual schedule.
- To what extent do existing professional preparation programs (across fields) equip practitioners to understand and serve students with CVI?
Existing preparation programs only equip practitioners to understand and serve students with CVI in a program for teachers of students with vision impairments. The preparation in other programs appear to be minimal at best.
5. 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?
In my experience, the different terms havenât had an affect on the collaboration with other professionals. I understand inconsistent language may have caused some confusion in other areas, but this hasnât been my experience. Use of data and professional reporting help to clarify communication across settings. In my own practice, I navigate terminology by communication data collection.
- 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 teamâs understanding of CVI and its impact on a student?
Some of the similarities between the three sets of terms are the way they are written. The differences are that the behaviors are what students might do, the characteristics are areas of concern to monitor, and the manifestations are how the students display the characteristics of CVI. The differences could impact a teamsâ understanding by communicating the effects on instruction and the studentsâ need for accessibility. The differences could also impact a student by helping parents and professionals to understand a studentsâ accessibility needs specific to their vision.
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I completely agree that, while a set of standards could have value, it could be challenging to develop with each child being so unique. The standards would have to be fluid in nature and open to change over time with added research and development. Also, the standards should vary based on assessed cognitive levels of students.