- Analyze the role of family narratives and lived experiences in shaping intervention priorities. How should these narratives be integrated into professional practice without compromising assessment findings?
Utilizing family narratives and lived experiences can be integrated into professional practice by considering what manifestation their reporting may be connected to in order to provide support. The families may not connect a behavior or action to CVI. They may not be sure who to discuss the concern with. If we are open to discussion, we may find that their is a connection. It will not compromise assessment findings because parent/family interview is part of assessment; assessment is on going formally and informally. As new information is available it can be used to shape interventions. Families may also report successes and techniques that can be integrated across multiple setting.
I have found that language can be a barrier as well. More so the cultural norms and expectations especially when is comes to disabilities and blindness. Iāve consulted with our ELL teachers in some cases to gain a better understanding.
A majority of my students with CVI also have complex bodies. They are in more of a self contained classroom where the teacher is doing a lot of communicating with families. I have found it difficult to connect with some of the families. For some they are overwhelmed with multiple service providers and find it easier to communicate with the teacher. For other families, vision isnāt their greatest concern, therefore they communicate more regularly with the provider they feel they āneedā more. The good thing is that the teacher in this classroom is great at fostering collaboration and team decision making.
This is a great bulleted list. Iāve shared many of these same things with different teams Iāve worked with. Iām always excited when I overhear a team member share these tidbits with another staff member. Itās also exciting when I walk into a classroom and staff reports that the student is having a āgood visionā day or not. I know that there is understanding and realistic expectations of the studentās ability to use their vision. They understand the unpredictable nature of CVI.
Question #2. Evaluate your systemās or regionās readiness to support students with CVI using the recommendations in this guide. What infrastructure (e.g., training, assessments, funding) exists, and where are the gaps?
During one of the very first conferences that I attended in the field over 15 years ago, Dr. Roman-Lantzy was scheduled to be a keynote speaker. Unfortunately, her flight was delayed, and the conference planners had to pivot; however, I have found CVI training in the Dakotas (specifically through the Dakotas AER Chapter) to be a strength of our region. Generally, a CVI-related topic is included during the conference every year. Many school-based TSVIs, NDVS/SB Outreach staff, and SDSBVI staff have attended training to better support our students with CVI.
Now that I have been working at the ND Department of Public Instruction, NVI/CVI is included in our stateās special education eligibility guidance (page 7): https://www.nd.gov/dpi/sites/www/files/documents/SpeEd/Guidelines/VI%20Document%202022.pdf
I would consider assessments and funding to be areas of need in the region. There are no state regulations to require certain assessments, like ECC or FVLMA, let alone any assessments specific to CVI.
Both North Dakota and South Dakota do offer university personnel preparation programs (at the University of North Dakota and Northern State University, respectively), and both program coordinators have indicated that several courses integrate CVI-specific content.
UND: Visual Impairment Specialization in Special Education | University of North Dakota
Northern State: https://northern.edu/teachers-visually-impaired
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Hi Tammy,
Thank you for sharing this! It feels very similar to what is available in the Dakotas. I answered the same initial question, but I failed to mention in my post the lack of medical professionals in our area, too. North Dakota has one pediatric ophthalmologist (Dr. Ahmed Kassem, MD, located in Fargo, ND) on the eastern side of the state. The western (more rural) side of the state is very much lacking in resources and services. Many of our students and families travel 6-10 hours to the Twin Cities (Gillette Childrenās Hospital in MN) for more comprehensive care.
I would love to attend your statewide CVI training in Marchāmake sure to advertise for those across the Midwest. ~Lacey
It really requires the whole team. The SLP has taken the lead and I am lucky that she is receptive to visual options that may be helpful. The OT has been really helpful with what is realistic when she is experience eye fatigue and can no longer use the eye gaze. It is definitely not something for those that want a quick fix, but I am happy with the progress this nonverbal student is achieving with the device.
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I completely agree that we have to āsellā the specifics and needs for each student.
We have a full day PD in our area in November. I have presented for the past 4 years and have added the CVI components as I go along. Last year I had 2 teachers in the school this student is in and they tried one of the simulations and said, āNow I know why she has such difficulty with these types of tasks!ā The principal then had me present to support staff and in that group I had a staff member who had her in kindergarten. She said, āI canāt believe all the things we made her do!ā I know simulations are never exact but they do provide meaningful experiences and allow all to get a feel for what it may be like.
Some strategies I have found effective in helping general education staff understand are sharing the information and characteristics and providing examples with individual students known to them. For students in a certain class, after providing information either by a website, written, and/or talking in a meeting, I may give some examples of how the student the staff is familiar with shows the characteristic. For example, if a certain student seems to be using their peripheral vision most, I may give some examples of said student doing a part of their regular school routine using their peripheral vision more and accessing their environment that way. It can be helpful and effective for staff to see what they learn in action. One misunderstanding that often persists is, ābut the child can seeā. Staff may notice the student reacting to and accessing their environment visually and make the assumption that supports and accommodations are unnecessary and excessive. This is why proper information and training is essential for our students with CVI.
I have been in different systems and regions. I have noticed TVIās attempting to provide training with some challenges. The biggest challenge is time. With a full caseload, it can be a challenge to find the time to do a staff-wide training on CVI. I think TVIās do attempt to share information with staff assigned to students (support staff, gen. Ed. teacher, special ed. Teacher, SLP, OT, PT, etc.) I have found schools specifically for blind students seem to have more funding for full training programs than public school systems. I have found that preferences, environmental complexities, task complexities, and peer interaction often are addressed in assessments, or, at least, they often are. The source is a good example of guiding questions to include in an assessment providing data to support instructional accommodations.
Some effective classroom adaptations Iāve used are high contrast dark boards for a background, removing clutter from workspaces, backlighting or lighting on a task, and placing a workspace optimally in a viewing space. One that is often misapplied is lighting. Often, lights are placed where students can easily begin to gaze at the light, distracting from work and potentially unsafe. I think removing clutter is sometimes underused or forgotten about because there are so many materials that are needed and we like to make things look nice. I wish optimal viewing spaces were used more often because this is helpful for accessibility to instruction and task orientation. This also allows for independence for a student to set up their work in their viewing space and work optimally.
Cross-setting collaboration builds compensatory access skills effectively because of the consistency. For example, students can practice zipping their own backpack at home and at school; it becomes apart of routine and the child stops expecting to always be helped right away. Use of bump dots or other tactile labels around the house reinforces the instruction received at school and reinforces tactile skills. Some practices that support authentic carry over include home-school communication between teacher and parent. Itās very important for the teachers and service providers working directly with the student to communicate with the parent. Another that works is for a teacher to send some materials home. Teachers could send home choice boards for the students to select what to listen to or watch as well. Sending home a choice board would show the parents something that has been working at school and could inspire parents to make something similar. One barrier can be parentsā willingness to participate at home. Parents want the best for their kids and, sometimes, they think that means helping too much and doing things for their kids instead of taking the time to help their kids learn for themselves or the parents may feel they donāt have the time.
The potential risk of applying an intervention such as having objects in motion to the field of vision is that the students may not be able to access their instructional materials in the proper visual field. These risks could be mitigated by proper training, data collection, and getting to know the student.
The role of family narratives and lived experiences in shaping should have a prominent role in shaping intervention priorities. These narratives should be integrated into professional practice by being considered as part of assessment findings. When collecting data for assessments, the intervention priorities from family narratives and lived experiences should be considered and evaluated for effectiveness; that way it wonāt compromise the assessment findings.
Existing preparation programs are currently lacking research, data, and analysis. There are many known interventions for CVI, but what is lacking is research and data reports on the efficacy of each intervention. Some interventions are still new and in the trial process. One challenge is having a control group for a research study. Another challenge is that each person with CVI is different with varying degrees of the different characteristics of CVI. This presents a challenge in collecting and analysing comparative data. Preparation programs may only be partially accurate at this time, although I do think ongoing training and experience are needed for one to continue to prepare oneself for supporting someone with CVI. What I may propose is conducting a research study with some students of varying chronological ages and cognitive ages taking data on 2 interventions at a time.
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Yes, Family interviews should always be apart of the assessment process and not compromise findings. One of the best supports for students is a strong parent-school relationship in which suggestions, ideas, and strategies can be shared across environments.
It sounds like you have good educational support in Kansas, which is phenomenal. In Maryland, we have some select TVIās that know more about CVI and share information where they can. I think efforts are in effect, but there usually doesnāt seem to be enough time for the amount of professional development we could really use.
- What tools or strategies have you found most effective in helping general education staff understand the nuances of CVI-related behaviors? What misunderstandings have been most persistent?
An in-service meeting is a great opportunity to educate a studentās team about CVI-related behaviors, the studentās functional vision, and ways the team can support the student during the school day. Pushing into the classroom to observe the student frequently at different points in their school day also can help provide practical suggestions for specific activities they are completing. Staying open to new tools and strategies is also essential, since CVI is often misunderstood. Iāve had to explain the importance and reasoning behind my recommendations to teams, especially when a team member may assume support isnāt needed because the student is presenting with more useful vision than they can functionally use. Clear communication and education helps ensure consistent, effective support for the student among all team members.
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I totally agree with your point about strategies that work for our students can also work for other students in the class. Increased line spacing for example can help the entire class as they are completing printed work, so if the teacher creates her documents that way our student can be supported visually and their classmates can benefit from reduced visual clutter as well.
This is a very helpful list! I agree with your last misunderstanding point about vision fluctuating from day-to-day. I often explain to teams that while the accommodations I recommend may not always seem necessary, they are essential for supporting the student on days when their visual functioning is more limited.
What a great point! Itās so important for staff to remember that our students have likes and dislikes, just like everyone else. I know many people who automatically dislike a task if it feels too hard (myself included) and will avoid or fight even trying to do it. Sometimes itās not that the student canāt do the task, itās that the task is inaccessible for them. I have also encountered teachers that donāt seem to get that implementing CVI modifications is not simply a personal preference for the child, but a necessity if we want them to be able to have access to the task. This has been especially true with complexity. They give them a visually busy worksheet filled with cartoon line drawing pictures to identify in a noisy classroom and then wonder why the child disengages in the task.
I find that complexity and clutter seem to be the biggest factors that impact my studentsā abilities to complete tasks. Your suggestion of masking has been so helpful for many of my students. I love your idea of taking a task that the child can do successfully and explaining to staff why they can do this task and not others. Also, I agree that making the adaptations easy to implement is so important. If it is difficult, it wonāt get done.
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Considerations for Educating Students With CVI: The Learning Environment
- What tools or strategies have you found most effective in helping general education staff understand the nuances of CVI-related behaviors? What misunderstandings have been most persistent?
I have developed a short general overview of what it is and how it impacts. I have then had the teachers and teams work together to analysis one of their students to understand more of the impact and the need for interventions into daily routines as opposed to isolated instruction. I think the greatest but not often admitted misconception is the TVI is the only one who can provide the intervention, accommodation, or teach the skill. This needs to be a whole team approach in everything the student does to allow more visual access to gain visual meaning and functioning. I find I often have to reiterate students are not just visually impaired 30 minutes twice a week, when the VI Teacher is in the room.
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Yes the family narratives are so important. And all children are different in different environments and different with others. A child may feel more safe and secure or may feel the need for flight or fight in different situations and environments. The role the senses and especially the lack of vision have on a child is often astounding to others to even comprehend. For students in classes with other students with significant needs often the sounds can be a huge trigger to elicit a behavioral response.
I agree with someone else the bulleted list is a great resource to share for this example as well as for classroom/ general education teachers/ families and caregivers. Often writing narratives is essential but expecting everyone to read and fully grasp and implement what was intended is another beast. The list can also help narrow down what may be most essential for them to learn at a given time. While pintrest is pretty it offers a lot of visual clutter and confusion for students with visual impairments, but we donāt want neglect the visual learners that it is essential and pleasing to as well. There is a fine line where collaboration can be the bridge.
- Think about the classroom adaptations youāve used for students with CVI. Which have been most effective, and which seem underused or misapplied? Are there tools or approaches you wish were used more often?
When I think about classroom adaptations for students with CVI or any of my students, I try to step into the studentās perspectiveāsometimes even sitting in their seat to better understand what they see and experience. One of the most effective strategies Iāve used is simplicity in the classroom environment. We begin by reducing visual clutterāremoving unnecessary materials from desks and minimizing overly stimulating or distracting visuals on the walls. This aligns with strategies outlined in the CVI Range framework, which emphasizes the importance of limiting complexity to support visual access.
I also consider auditory distractions. For some students, reducing background noise by placing them in quieter areas of the room, a different room, or using noise-canceling headphones (for those who can tolerate them) has made a noticeable difference in their ability to visually focus.
Another crucial adaptation is lighting and contrast. I make sure lighting is appropriateānot too low or overly bright āand present materials against darker or solid backgrounds to enhance contrast. For example, we would use a black mat under a yellow ball to help the object āpop,ā making it easier for students to locate and identify the objects.
Despite these effective practices, Iāve noticed that some adaptations are underused or misunderstood. For instance, the use of movement to attract visual attention (like slightly shaking an object), I have to remind myself of this as well. Likewise, the integration of primary visual targets in teaching materials sometimes seems inconsistent to me as well, which I can now see how confusing this can be for the student.
I am not sure exactly how other classrooms use individualized visual targets and incorporate CVI-specific accommodations into daily routines but I know on our campus we are trained on how to be more aware of what to look for in our students.
Reflecting on these strategies reminds me how important it is to treat CVI as a visual impairment that requires specialized and intentional approachesājust like any other sensory impairment. Our classrooms must be adaptable, consistent, and informed by ongoing assessment and collaboration with the studentās team.