I think that your team’s initial programming is very common. I almost shudder when I think about how many children are considered disinterested, lazy, or unable to learn, when it’s actually their vision getting in the way. It sounds like you have a great team approach with team members to think out of the box. I also wonder how some of the modifications that you made may help some other students that do not have a diagnosis at all, but are distracted by the complexity of the environment and can’t keep up with the speed of presentations.
Hi Deb-
I think the training, or at least exposure to information, on CVI has increased over the last several years. I was very fortunate to work with a Physical and Other Health Disabilities teacher when I had my own DCD classroom that taught me a great deal. This was almost 20 years ago. She even arranged to have Christine Roman come and teach about CVI and demonstrate an evaluation in the Region 4 office (MN). It fascinated me and I began working with the TBVI to learn more. Without that, I would have known very little about it before becoming a TBVI myself. I love all of the new information coming out.
Hi Diane- This is such a great example. So often I think of students with multiple needs when I think of CVI, but it certainly includes students of all levels. Your post reminded me of a student I had when I first started as a TBVI (2015 or so). He was a 4th grader with CVI due to brain trauma as an infant. He spent most of his day in the general education classroom. Teachers would talk about his outbursts and inappropriate language. His paperwork reported his CVI was not impacting his school performance. The classroom he was in was very busy with decorations, displayed work, and quiet music in the background. Once the teacher understood what CVI is, she began to minimize the external stimulation and provided the student with a more consistent schedule. We also made sure he had quick access to tools that helped him block out unwanted text or pictures in his books. Once all of that was done, his school days went much smoother.
Response to question 3:
As a TVI who works with students from when they are in preschool until they graduate, I have enjoyed the opportunity to work with the same students through the years and observe how they grow and develop. I have observed how sensory complexity, attention, and the environment can impact the ability of a child with CVI to access instruction. This student uses an eye gaze device to communicate. He had more difficulty with this when the images were small and visually complex. The SLP and I worked together to remove the background from the images and make them an appropriate size for the student based on the results of his Functional Vision and Learning Media Assessments.
In addition to making sure the images on the eye gaze communication device are appropriate for the student’s vision, I have noticed that he is more likely to respond appropriately with eye gaze when allowed wait time and in a quiet environment. When there is auditory or tactile stimuli, he is more likely to close his eyes or look away from the visual target. Another strategy that made a difference in reducing visual clutter is using a black tri-fold board behind the items the student is viewing. I have shared information about CVI and techniques to help with the parents, classroom teacher, OT, PT, and SLP. They have been great at implementing these strategies. Using appropriate vision strategies is important throughout the day, not just when the TVI is there.
I have worked with this student for several years. There is a noticable difference in how this student functions when the CVI-related strategies appropriate for him are utilized.
1 Like
Great post, Amy,
I have seen similar characteristics in several of my students with CVI as well. Like Abe, they tend to engage more effectively when environmental distractions—especially visual and auditory—are minimized. I’ve found that creating a quiet space and using simplified visual materials really supports their ability to process and attend. It’s always interesting to see how their needs shift depending on their energy level or overall wellness, just as you described. Your approach to gradually adjusting modifications based on the student’s responses is such a valuable reminder to stay flexible and observant.
This reminds me of some of my students who have CVI. What a difference reducing sensory complexity can make! One of the classrooms I go to is actually a suite that includes adjacent areas. My students with CVI spend much of their time in the main part of the classroom with the other students. However, they also have brief periods of time during the day when they work in an adjacent area that is away from auditory and visual distractions. The walls in this area are painted a matte black, and there is a black blackout curtain that separates that part of the room. When the overhead light is off in that area, I have observed students looking at images on the light box or other items that illuminate. This is a change for some of the students who either keep their eyes closed or do not look at visual stimuli when in a brighter, noisier environment. Another benefit of the black walls and curtain is that they provide a good background for colorful items. I also have observed the benefits of using extra time for visual processing and movement to attract attention.
I have also been mistakenly referred to as a Vision Therapist instead of a Teacher of Students with Visual Impairments. Each time, I explain the difference. I also refer to CVI as Cortical Visual Impairment, but I have seen more doctor reports with Cerebral Visual Impairment or even Cortical/Cerebral Visual Impairment. It makes me wonder if the medical field also has issues with terminology. I do think it is important that we define the terms we use when talking with parents and service providers so that we communicate clearly.
Great Post Melissa,
Thank you for sharing your understanding on the different terminology sets used to describe CVI. I agree with your observation that while each framework—Perkins, Manifestations, and the CVI Range—offers valuable perspectives, the differences in language and focus can be confusing for teams supporting a student with CVI. Your point about the Perkins and Manifestations sets focusing more on functional vision and responses, while the CVI Range emphasizes areas of need or difficulty, is especially important.
The lack of a standardized language is a challenge. As you mentioned, when teams aren’t aligned on which framework they’re using—or if they’re using multiple sets simultaneously—it can lead to misunderstandings or fragmented approaches. I think your suggestion that teams choose one set of terminology and define their terms is an awesome strategy. It can help ensure that everyone on the team has a shared understanding and is working toward consistent goals when supporting a student with CVI.
Have you found a particular set of terminology to be more helpful in your work with students?
Hello,
I agree with the old assumptions regarding CVI with the red and yellow colors/objects. I have had students (I work with those 0-3 years of age) who preferred the colors aqua and green. One of my favorite little students (who passed away in April from the rare genetic condition she had) was visually drawn to the color hot pink! We built on this and used that as our guiding color with hot pink scarves, visor, garlands, etc. I am so glad a favorite color was discerned in order to make her short time on this earth a bit better and more colorful!
CVI presents a constantly changing landscape that requires ongoing knowledge and training for both the professional and the teams we educate.
Hello,
I work with children 0-3 years old in their home. I use this opportunity to educate parents about how to modify their home environment in order to best support their child with CVI. I buy black cardboard trifiolds for Hobby Lobby to give to parents. This and a darker/black colored blanket/towel, etc. provide an excellent area for their children to start building visual skills.
I’ll show parents how to place the trifold where light from a window or lamp will illuminate the area. Working on this in the home environment then transitions nicely when the time comes for transitioning from Part C to Part B. Giving parents the knowledge, terminology and knowing what is best for their child enables them to be excellent advocates when they transition to the school setting.
In addition, non-cluttered places is not only good for kids with CVI but for children in general. This is an excellent article that speaks to that point.
I had a student with CVI starting in preschool. He was able to memorize numbers, letters, and songs like one one else that I had know. Each year his classroom teacher and myself tried to continue to push him to learn more. He was said to be performing higher than some of his classmates. It became evident that CVI had more of an impact during his 3rd grade year. I would take him into the classroom for reading rotations. The room was a little bit of chaos. There were many rotations going on around the room. We provided the student with activities that he could do while in that environment that was loud and people moving. We provided him with sight words and familiar books. He was placed in a reading group, which I thought was amazing. But I soon learned that this environment wasn’t the best for him to learn in. He often times wasn’t listening to other students who were reading so that he could answer questions.
So what I learned more about this environment was that we didn’t expect him to learn, but he could do things that he was familiar with. We would teach him in a more controlled setting instead of with his peers.
1 Like
This is great to know and share for I work with infant/toddlers as well. I find that parents usually put their children in front of windows so that they can just gaze outside. A black tri fold would be a cheap way to fix the issue or have more control over the environment. Thanks for sharing.
What a great observation, Melanie! It is great that you are seeing that your child is responding better in certain environments.
I had the same experience with a few of my CVI students when I was teaching in the school system.
It is hard sometimes to explain that the parent (or teacher or peer) that they need to only ask the question one time and give the child plenty of time to respond. I try to explain to some service providers that if you keep asking the question over and over again, the child has to start over and over again because the question interrupted their processing.
You’re correct, Renee, we often consider this as an attribute of our students with complex needs, though it can be a consideration for any of our students.
Question #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?
As I’m learning more and more about visual impairments and the various manifestations - it becomes clearer to me how little I know. Not necessarily cause for alarm but it does guide me in how I need to be able to ask questions to get the “right” answers for my own understanding. For example, Luecheck, Checn and Harman (2021) utilize the vocabulary of “response time” while Roman (2018) uses “visual latency” and Perkins (2024) uses “visual attention”. Again, which IF I’m understanding correct (big IF there, y’all) could potentially mean the same thing. Good thing is that I work with some of the best people who are super willing to sit with me and answer questions like “what does that mean for X student?” and “how would I be able to support that skill development?” Asking a lot of questions (probably to the point of annoyance) helps me navigate my own understanding but, more importantly, how each student’s manifestations of CVI are complex and very individualized
SMG.
1 Like
@tchaney
It’s definitely amazing how much visual clutter can affect students with CVI and lots of other neurodiverse kids. While totally not the same, I’ve always had a slight mini panic about restaurant tables having too much stuff on them. I’ve grown to hate “having too many plates” and that’s because I’m fully able to (1) stack plates for pickup and (2) ask a server to remove the extra plates. I can only IMAGINE how difficult it must be for students who are learning to navigate their own needs and self advocacy skills.
@Melanie_Weldon
It amazes me how much collaboration is always needed to best support students across all areas. Truly love seeing how you’ve advocated for your student with the SLP to assess the students needs based on the FVA and LMA. Then taking it a step further to share with every service provider for that student. Working collaboratively to support in a well rounded way is always the best practice and I love to see it.
That is awesome that you realized in a restaurant. I hadn’t thought of the pates providing clutter and that we can control that. Thank you for sharing!
- Compare and contrast the roles of parents and professionals in interpreting a child’s behavior. How can these perspectives complement one another?
The roles of the parents and professionals are pretty intermingled in my opinion. The parents are the ones that know their child the best. The have the most knowledge regarding how their child functions in a familiar environment like their home and then out in the community especially when having to approach a new situation. The are a wealth of knowledge of which the professional must tap into. The professional has varying roles in assessing and instructing the child. Firstly they see the child as a learner in a structured academic environment. Most parents do not have opportunities to observe or even grasp how instruction in provided in the school setting. The professional also brings understanding of CVI as well as application of the current trends, research and accommodations that may be useful within the school and home environments. I’ve found their needs to be a close, joint, working relationship between the parents and professional to meet the needs of our CVI students. Professionals need to be open to receiving information and observations from the parents while the parents also need to understand that their child may behave or learn in ways that differ from other children and that’s ok.
1 Like
I stated something similar in my post - that parents are the experts on their children’s behavior. I also forgot to mention that within the academic environment it is often the paraeducator (assuming the child has one) that is the expert on the child. I find that information solicited from the paraeducator is often forgotten or overlooked. They are a WEALTH of knowledge when it comes to completing an assessment. They may not always understand the behaviors they are seeing and often attribute them to something else, but when asked the right questions, I find I usually get the answers I’m looking for. It is for this very reason that our role as the professional is to continue to teach and educate not only our students but the staff with whom they interact on a daily basis. Providing them with knowledge and resources helps them understand why materials may need to be adapted as well as how they are delivered.