When we spend time listening to the experiences our families have with their child we can learn so much. They already know the likes, dislikes, and hopefully some motivating toys or activities. Conversely, families may also need a sounding board. That information can also help us understand our students needs and behaviors. And while we can’t support the child in the home, we can provide suggestions of what could be a contributing factor or suggest resources/community supports.
I have a great PT that works with my complex students and handles the posture and its affect on learning for me. He is retiring soon and I am really going to miss him!
- 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?
The use of different terms to describe CVI, such as cortical visual impairment, cerebral visual impairment, and neurological visual impairment, can impact collaboration among professionals. Inconsistent terminology can create confusion, especially for team members (families/caregivers, teachers, paraeducators, and therapists) that have not been exposed to or have specific knowledge of the condition, or if different terms imply different treatment approaches.
Yes, inconsistent language has caused misalignment in practice. The inconsistency has allowed for a spectrum of views and varying degrees of understanding and treatment approaches across the board. For example, a professional who consistently practices using the term “cerebral visual impairment” is hopefully more likely to comprehensively treat a person than one who uses the term “cortical visual impairment”. Unfortunately, it seems that those who only view CVI as visual impairment miss opportunities for comprehensive strategies for appropriate interventions of the brain-based disorder.
What has helped clarify communication across settings is the intentional use of shared definitions. This is accomplished by referencing the CVI Range (Roman-Lantzy), the CVI protocol (Perkins), as well as research groups and advocacy organizations. Interdisciplinary training sessions, shared resources, and parent education tools have also played a key role in aligning perspectives.
In my practice, I navigate terminology by:
• I consistently use the term CVI. When I see that people are struggling to understand the multifaceted impairment, I usually ask the audience to think of it as brain-based visual impairment.
• Before proceeding, I make every effort to ensure that the team is on the same page. Remembering to address that terms may be used interchangeably. This solidifies the relevance of understanding the same underlying condition.
• In remaining consistent with term use, I honor a space for questions or clarifications.
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Hi Yolanda -
I found your post very interesting. You really got my gears turning. I really think that you have something referencing silver. Many people say use red and yellow. To be honest, I have never heard or seen anyone adapt/modify with silver. But it makes perfect sense. Do think that it is something to do with not only the contrast but the reflectivity of the properties of silver. I work with multiple student with CVI that really respond to metal manipulatives or fidgets. I always attributed that to the hardness and cool feeling that metal has. You have made me think to now include the visual contrast as well. Thank you for teaching this old dog a new trick.
Your post was so refreshing to read. Could you share some more about your program? I have been considering obtaining my TVI licensure. Even though I am a licensed teacher in Maryland and ATP, I cannot be TVI credentialed without completing an approved academic program. Most people who share their education with me tell me that their education did not prepare them to serve their population of learners adequately. Much appreciated - Kelly
3. 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 I reflect on my experiences working with students with CVI, one of the first ones who comes to mind is one of the first kiddos I worked with as a Full Time Itinerant TVI right out of college. Some providers were not comfortable working with this student because this was right around pre-covid times and they had a stim where they would put both of their hands very deep into their mouth, which meant there was lots of spit involved when it came to working with them. I was fortunate to have a vision para who was very receptive to working with my student and wanted to learn more about supporting our student daily. I knew what ever interventions were implemented would be reinforced which is one of the best feelings.
This student especially struggled with using their arms to explore objects. They preferred to keep their hands up close near their mouth and did not like to reach out to explore objects. I found some reflective rhinestone ribbon at the craft store and made bracelets that the student could wear on their arms. Through this the student was able to locate their arms in space and we saw more exploration with hands and vision increasing their sensory input. We also presented simplified objects over a lightboard and incorporated items with light or movement into instruction. One activity the student really enjoyed towards the end of the year was tie dying a t-shirt in the light box. I tried making reflective bracelets for another student to encourage hand movement and they hated it! Another attestation to each kid and case being unique.
Some other strategies we used but did not have enough time to see success with before we went on summer break were placing lights or moving items in landmarks around the classroom to encourage independent navigation of the classroom.
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Hi Rachael,
I really connected with your post! The first district I served included a lot of students that were HH where I had to travel to their home and I had a lot of students of Hispanic migrant workers. I always make sure to push for my Spanish speaking families, especially with translators, because I felt that they are sometimes the ones that can be lost through assumptions of them not understanding or that they do not care about their children when that is not the case at all! I also found that sometimes they were not told information or included in the IEP process in the same manners as other families because of the language barrier. Advocating for my parents and making sure they are informed on their child’s education is so important to me, even if that means I need to personally buy supplies to help my kids create experiences. Another way I like to shift my personal perspective with these families is by being open to their culture and wishes and participating with them whenever possible. I hope to continue to bring those small positive interactions to my work like you mentioned, whether through a milestone celebration or through a daily check in to see how families are doing.
- 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?
When discussing and describing CVI, the article written by PaTTAN cites the three sets of terminology are used. The key similarities among the three sets of terminology are they are both used to describe the characteristics of CVI; which is unique in each student. One key difference that I noticed is the Perkins and Manifestation have 16 key components that seem to focus on how the individual uses their vision to function and the responses. The CVI Range, which is 10 specific characteristics, specifically states that there is “difficulty” or “need for” for the individual with CVI. I could see this causing confusion because the team might rely on the defined characteristics and how they are affecting an individual separately, instead of as a whole. The similarities between the three sets are that many of the visual aspects such as: color, visual field, light/illumination, and visual complexity/facial features, and movement are used in the three sets.
Since there isn’t a standard common language that is used to discuss CVI, it can be confusing for individuals on a team to understand what the characteristics look like. It can also cause confusion and frustration because if a definition is too precise the individuals on the team might only look for those characteristics when working with a student. Also, a team might become more confused if they are using the three different terminologies at the same time. It would be beneficial for the team to determine which they would use, and define the information needed as so. That way there isn’t as much confusion.
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It’s great to have a good working relationship with the other service providers our student’s see. They are more willing to ask questions and work with you to properly support the students in the classroom. I like that you invite them to observe the vision sessions! That’s a great way to make them feel more comfortable with how to work with the studend, and it also helps to keep the vocabulary and teaching strategies consistent.
Hello 
I agree with you that all of my CVI students have had multiple disabilities and have needed support from a few services, I have not had a student with CVI who has not had this case. I feel very fortunate to have worked at a Exceptional Center for a little while when I first started teaching. Being on campus with other providers who were working with the kids was a game changer to understanding all roles the disciplines play when interacting with students. When collaborating with the SLP to develop an accessible communication system for some of my students, it really drove home the important role vision can play for students who need alternate methods of communication amongst other things. We have so many facets that can help contribute to interventions including our visual, auditory, and tactile knowledge. Vision continuously overlaps with other areas, like fine and gross motor skills, and we can definitely provide solid interventions when we collaborate with other providers. We also always hope that when others see the positive impact of routines and interventions, they will choose to follow in suit when interacting with the student.
I agree, there is not as much indepth training at the Univeristy level with focus on CVI. However, I think it’s important to focus on all the different visual impairments and once out in the field, the focus can be more on a specific topic. Alot of the teaching strategies I use are the same with students with other visual impairments as with CVI.
I think in general the lack of training in a collaborative model is a struggle. As TVI/COMS it’s important that we are collaborating with our team and making sure that the students are able to access across the curriculum. This is harder when you are an itinerant because you can’t just “pop in” to check on a student. Also, if the other subjects/services aren’t aware of what you do, it is hard to keep the line of communication and collaboration open.
Compare and contrast the roles of parents and professionals in interpreting a child’s behavior. How can these perspectives complement one another?
The parents’ perspective provides information that can provide the TVI information and insight into the assessment that aids in setting up programming for learning, clues as to the right environment or setting that is conducive to learning. It also provides the support and strategies needed to ensure the student is comfortable in their environment. Similarly, the TVI, parent and some of the Individualized Educational Plan team members are advocates. Some professionals or team members may have differences in opinions when learning differences are seen as learning disabilities, CVI meltdowns are viewed as Behavior problems, Visual behaviors of placing the head down or laying down that is associated with visual fatigue and sensory overload is viewed by the differing team members as laziness or a refusal to work.
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I think it is unprofessional to use a term or condition in a team environment without defining it. Each area of expertise is represented based on or because of their expertise.
Faye Thomas
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I agree about parents being the experts. In my case it seems to be the full time nurse that works with the student rather than the parent. Many of our students are low income and the parents are not able to be home during the sessions. The nurse is able to provide valuable information and share with the parent. I always love to go back the next week and hear the excitement when they have seen improvement by trying new thing that were suggested.
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The graduate program that I attended presented information on CVI. I remember thinking it was a lot at the time. However, once I graduated and had new students with CVI on my caseload, I was grateful to be in an area that provided me with access to more information. There is so much to learn about teaching in the VI area. I think having a base of information in several different areas going into a teaching role and then being open to researching and learning on your own is an important part of being a special education teacher.
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I like the idea of using the reflective rhinestone ribbon to help them locate their arms in space. I have a 4 year old I will try that with. I think we all have so many different ideas but you are correct, they do not work for all kids.
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? I found this very interesting. All three sets of terminology describe how a child with CVI uses vision in real life. They cover important factors like clutter, movement, color, lighting, visual field issues, and the ability to recognize or locate objects. Each set, though, seems to come from a slightly different angle.
Roman’s Characteristics focus on diagnosis and help explain the brain-based reasons behind a child’s visual difficulties. The Manifestations seem to go a step further, highlighting how these challenges show up in a child’s everyday learning, attention, movement, and social interactions. Visual Behaviors, in contrast, seem to focus more on how we can adjust educational strategies to make visual information more accessible to the child.
When I look at all three—diagnosis, how the child functions day-to-day, and classroom strategies, it really helps everything make sense. It shows how the child sees the world, what they struggle with, and how we can support them at school.
If a team only focuses on one part, it’s easy to miss important details. For example, a teacher might set up the classroom in a helpful way but not realize the child has a hard time with new things or using their vision to move around. Or someone might notice the child is slow to look at things (visual latency) but not connect that to how the child has trouble keeping up during group activities.
Looking at the whole picture helps us create the right kind of support for that specific child.
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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?
One student I supported who had a diagnosis of Cortical Visual Impairment (CVI) stands out in my memory. He was diagnosed at an early age, and it quickly became clear that sensory complexity (especially visual and auditory clutter) significantly impacted his ability to access instruction. In busy or noisy environments, he struggled to focus, communicate, and process visual information. The presence of multiple competing stimuli made it difficult for him to engage with tasks or respond meaningfully.
What made a noticeable difference was minimizing distractions for him. When we worked in a quiet, less stimulating environment, his attention improved significantly. He was able to concentrate and engage with materials more effectively when visual clutter was reduced. We also found that using high-contrast visuals, particularly placing images or learning materials against a dark background, helped make the content more visually accessible for him. This contrast allowed key elements to “pop out” more clearly and reduced the visual complexity he had to process.
Other effective strategies included presenting one visual element at a time, using movement (when appropriate) to attract attention, and allowing extra time for visual processing. These adaptations not only supported his visual attention but also reduced frustration and increased his participation in instruction. Overall, thoughtful environmental adjustments and individualized supports were key to his success.
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Hi Kelly-
My undergrad is not in education. While I was working towards my graduate degree I felt that so much of what I was learning was abstract and difficult to connect with. However, once I started my student teaching I felt more prepared than I thought I was. Maybe that was more related to my confidence than the prep program.
The greatest hurdle for me was the report writing. Everyone has their own style. I am a district based TVI not an IU contracted TVI like many of the districts in PA. I didn’t have a team of TVIs to consult when I first started teaching. Now I have a fantastic partner (TVI) in our consortium and have gotten to know and work with the local IU (TVIs and O&M) to collaborate and build consistency in our area. It has taken time to build what we have but it is so important since we are often working in isolation. As important as the teacher prep programs are, what you do after graduation and who you connect with can make a world of a difference.
Hello Jennifer- I agree with you. I think that the manifistations go into more detail than Roman does. I also like how you summed up the Characteristics, Manifestations, and Behaviors to be how the child sees the world, what they struggle with, and how we can support them at school. It is important to look at the whole picture because if we don’t, we are sure to miss something.
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