Unveiling the Impact of CVI Characteristics: A Systematic Approach with CViConnect

A systematic approach is crucial when assessing the impact of characteristics on learners with cortical visual impairment (CVI). Teachers need to uncover how each characteristic impacts a learner’s functional vision. Teachers can do this by changing only one element at a time. This focused methodology, combined with the support of CViConnect, empowers educators to gain a comprehensive understanding of how CVI characteristics impact learners and tailor interventions accordingly.

The Importance of Changing One Element at a Time

According to Dr. Christine Roman-Lantzy, CVI encompasses ten distinct characteristics, each with its own potential impact on a learner’s visual perception and attention. Changing one element at a time allows teachers to isolate variables and observe the individual effects of each characteristic. By systematically altering one factor, educators can accurately assess its contribution to visual engagement, leading to more precise evaluations and interventions.

For instance, consider a scenario where a child is sitting in their wheelchair in the classroom, with the iPad positioned in their central field while engaging with a red activity. In the next session, the team should change only one element, such as moving the iPad slightly to the right of center. By focusing on altering a single variable, we can compare the child’s visual attention and gain valuable insights into the significance of the visual field for their visual engagement. If we were to change multiple factors like visual field, activity color, and environmental complexity simultaneously, it would be impossible to determine the independent impact of each element on the learner’s ability to utilize their vision effectively.

CViConnect: Supporting Teachers in the Process

CViConnect is a powerful tool that supports the systematic collection and analysis of data related to learners with CVI. With features such as the forward-facing camera, screen recording, and microphone, CViConnect enables educators to gather valuable data while learners engage with activities within the app. Here’s how CViConnect can support teachers in the process of changing one element at a time:

  • Data Collection: CViConnect’s data collection capabilities provide teachers with detailed insights into learners’ visual behaviors. The app captures session length, title, look times, and other relevant information, enabling educators to track and analyze visual engagement over time. This rich data serves as a foundation for assessing the impact of individual characteristics on learners.
  • Data Analysis: CViConnect’s web-based dashboard offers a user-friendly interface for data analysis. Teachers can review session results, analyze timeline graphs, and examine heat maps to understand the learners’ visual attention and preferences. These visual representations provide valuable insights that inform decision-making and interventions.
  • Assessing Specific Characteristics: Within CViConnect, teachers assess the impact of specific CVI Characteristics. Teachers can utilize the Activity designer to change one element at a time. For example, educators can modify the color of an activity or adjust the level of movement while collecting data on learners’ visual engagement. The data collected through CViConnect allows teachers to evaluate the influence of these individual characteristics and make informed decisions about interventions.
  • Tailoring Interventions: CViConnect’s data-driven approach enables teachers to tailor interventions to meet learners’ unique needs. By analyzing the impact of specific characteristics, educators can design interventions that target the identified areas of improvement. This personalized approach ensures learners receive the optimal visual environment and support to enhance their visual abilities.
  • Monitoring Progress: With CViConnect, teachers can monitor learners’ progress over time. By collecting and analyzing data regularly, educators can track changes in visual engagement, identify trends, and refine interventions accordingly. CViConnect’s video recordings of sessions further enhance the accuracy of progress monitoring, allowing for a more nuanced assessment of learners’ visual behaviors.

Changing one element at a time is paramount to understanding how specific characteristics impact learners’ visual abilities. CViConnect can be an invaluable resource, supporting teachers in this process by enabling systematic data collection and analysis. With CViConnect’s features, educators can gather comprehensive data, assess the impact of individual characteristics, tailor interventions, and monitor progress over time. By utilizing CViConnect with the one-element-at-a-time approach, teachers can unlock the potential of learners with CVI, providing them with targeted support and maximizing their visual development.

Guidelines for Determining the Frequency of Services to Support Learners with CVI

As an educator supporting children with cortical visual impairment (CVI), you are aware of the unique challenges that come with providing appropriate interventions and services to meet their needs. One of the key considerations in supporting children with CVI is determining the appropriate frequency of services. This can be a complex task, as it requires a thorough understanding of the child’s visual functioning, as well as their overall development.

CViConnect’s Stephanie Steffer and TVI Chaesa MacWilliams, have released The Guidelines for Determining the Frequency of Services to Support Learners with CVI, to support educators in this task. This document provides a comprehensive overview of the factors that should be considered when determining the appropriate frequency of services for children with CVI.

The guidelines are based on the principles of the CVI Range, which is a comprehensive tool used to assess and support the visual functioning of children with CVI. The document outlines the various stages of the CVI Range, and provides specific recommendations for frequency of services based on the child’s stage of visual functioning.

The tool requires professionals to use the data they have collected about their students and their professional judgment to determine how the services should look, and what needs will be addressed during these service times. It was designed as a guideline, to assist Individualized Educational Programming (IEP) teams. At each IEP meeting, service time and delivery is ultimately the IEP team’s decision.

Overall, Guidelines for Determining the Frequency of Services to Support Learners with CVI is a valuable resource for educators who are looking to provide effective support for children with CVI. By taking into account the unique needs and abilities of each child, and using the principles outlined in this document, educators can provide meaningful interventions and services that help children with CVI to thrive.

Considering Light When Utilizing Technology

What was once thought as non-purposeful gazing at light has now shown to be an important element in CVIers’ daily routines. Light can still be a distractor for our learners, but it also has a purpose. Learners with CVI have shown an ability to utilize light to access their functional vision. In either case, light will remain an important element for learners with CVI. 

Dr. Christine Roman Lantzy’s CVI Range score places students in what she refers to as one of the three Phases of CVI; Phase I, II, or III. Light can be used differently across these three phases. Light as a distractor can easily be forgotten after a learner is out of Phase I. Whether it be a bright light in the room, the sun shining in through the window, or a bright toy across the room, IEP teams should be mindful of various light sources. Consider where the lights are and observe how and if the lights impact the learner’s ability to locate/interact with visual targets.

One of our low tech options to support a learner’s need for light can be a light box or a flashlight. Visual targets can be placed on a light box with an occluder to block unnecessary light. Flashlights can be used by shining the light from behind the student on to the visual target.

Using Technology to Help Learners

More often, we are using technology to help our learners gain access to their curriculum. Various tablets and computers are backlit and offer a natural way to utilize light within technology to support your learner. The backlighting acts similar to the use of a light box. Unlike a lightbox, with technology, IEP teams are able to customize so many more details of the target to ensure it meets their learner’s needs.

Educators have many options to create accessible content; CViConnect, BoomCards, or presentations (Google Slides, Powerpoint, Keynote), etc. In addition to adding photographic images, teams can use these programs, or other similar options, to add special effects to utilize light. Effects such as fireworks and sparklers can utilize light, color, and movement. 

Using Special Effects and Background

By adding special effects when the screen is touched, light can be used to increase a learner’s hand eye coordination. For our learners in Phase I, these light effects can also be used during instruction to gain and maintain visual attention. Adding special effects briefly to a presentation for a learner in Phase II or III can be used to draw our learner’s attention to a specific part of the screen or a salient feature on a target. 

Teams should consider the background when truly making sure to utilize light. When considering backgrounds, we typically only think of the color that offers the most high contrast. While this is still very important, we also have to balance the amount of light coming from the background. A white background will emit more light than a black background. We want to offer a visible target, but be mindful that our learner could potentially be distracted by a bright white light too.  

When it comes to all accommodations, there isn’t a simple yes or no answer.  Each of these edits must be considered on an individual basis for what each learner needs.

Using Neural Networks to Assist Educators, Caregivers, and Parents to Better Understand What Their Child With a Visual Impairment Sees

While at the Pediatric Cortical Visual Impairment Society’s conference in Omaha, Nebraska covering the current research in the field, I was speaking with a parent who has a child diagnosed with CVI. She spoke about how her child got a fishing pole this summer and caught his first fish.

He also had the opportunity to do a rope course that was designed for those with difficulty walking and or seeing. She went from storytelling to utmost pride when reflecting on how these opportunities had opened her child’s perception of what is possible in the world. This Brave New World sort of talk.

We also spoke about how unique of a sensorial experience it would be to feel a fish biting and pulling on a fishing line, or the sensation for him of falling through the air guided by a rope. One could only imagine how a child’s brain, if being analyzed by one of the very many doctors at this conference using MRI, would light up like a Christmas tree with unique patterns and communication pathways to interpret what in the world just happened.

“You know what is funny?” she said.

“We were walking at an event that was in a cornfield and we passed a porta-potty. My son immediately says, “What is a vending machine doing in a corn field?” Isn’t it amazing what he can see and how he sees it!?”

It really is. As she said this, I immediately thought to myself, if I was not paying attention to my surroundings, and quickly passed a porta-potty, I too could easily associate that visual outline as a vending machine. Having 20/20 vision and healthy visual pathways, my life’s experiences do not associate a corn field as having a vending machine, my brain would probably have never conjured the association.

BUT, what could make this association? What is not trained to omit certain possibilities, like my brain? 

Text to image neural networks can do just this.

Here is a potential example of how this parent’s child saw the cornfield via an image rendered by a neural network given the following instructions: “a blurred image of a vending machine in a corn field as seen by someone with poor vision.”

CVI child sees vending machine in cornfield CVI child sees vending machine in cornfield CVI child sees vending machine in cornfield

Over time, once the child is taught to recognize the context and associations of a porta-potty, this is potentially what they could see via an image rendered by a neural network given the following instructions: “a foggy image of a porta-potty in a corn field as seen by someone with poor vision.”

CVI child sees vending machine in cornfield CVI child sees vending machine in cornfield c

Then, hopefully with even more training and life experiences with a porta-potty, the sharpness and clarity could improve to something like this via an image rendered by a neural network given the following instructions: “a realistic photo of a blue porta-potty in a cornfield.”

porta-potty in cornfield porta-potty in cornfield porta-potty in cornfield

The potential here is having a tool that could, for the first time, create images for parents, caregivers, and educators to better visualize the world that a child with cortical visual impairment lives in. Each child is unique, and each experiences their own representation of the world. One that is often beyond our grasp.

The better we understand that world view representation, the more accurately we can work with children with CVI to make bridges to the generally accepted societal world. Having a better understanding of the world, as the general society experiences it, helps make every day independent living safer for the child.

Consider Novelty when Utilizing Technology

According to Dr. Christine Roman-Lantzy, there are ten unique visual and behavioral characteristics of CVI. One of these is the characteristic of novelty, or how new a visual target is to the learner.

Learners with CVI show preference to targets they are familiar with or those that share visually familiar characteristics.  Depending on what Phase of CVI the learner is in, your accommodations to support this characteristic will likely vary greatly.   

One difficult, but huge progression is when learners with CVI can move from three dimensional visual targets to two dimensional targets. We are told to utilize realistic photographs of these familiar targets.  Unfortunately, for some of our learners, it isn’t as easy as taking a picture with our phones.  You must still consider the needs of other characteristics. Complexity of the array?; What is behind the target? Distance? How far away did you take the picture? 

I have found a few ways to take and edit images for my learners.  The first thing I try is a Google Image search with ‘PNG.’  PNG is an image file type like jpeg or bmp. PNG files are important to us because they have transparent backgrounds.  This means the image should already be clear of any competing visual stimuli in the background of your target.

If I want the visual target to be my student’s blue spoon. I might search for ‘blue children’s spoon png.’ 

CVI Biog Blue Spoons

Once I find the target that meets my needs, I left-click on the image.  This selects the image and opens it into a window on the side of my screen.  Next, I right-click and either select ‘Save Image As’ to save to my device or ‘Copy Image’ and paste the image directly to my project.

CVI Blog Saving Blue Spoon Image

If I cannot find the image I want doing this search, I might take a picture of the real item. To do this, try to place the image on a solid colored background.  Often, we will see people using black as the background.  Black is light absorbing allowing the target to typically stand out more.

If I find a realistic photograph I like, or one I have taken on my own, there are a few options to remove the background.  One of my favorites is remove.bg.  This website allows users to upload any image from their device (computer, tablet, etc.)  The website will automatically identify the focus of the image and remove any background information.

Remove BG website

Lastly, there are a few places you can manually remove the background or unnecessary information from your image.  One option on a tablet or phone is to use a background eraser app. There are several available in the app store.  Also, PowerPoint has a Remove Background option.  Once you click ‘Remove Background’, the image will show the background that will be removed in bright pink.  Users can further edit the image; add more areas to remove or mark areas to keep.

Are you using other resources to remove the backgrounds of images and support your learners?  What else can we be doing to support our learner’s needs for complexity of the array and novelty?

Intentional Access to Vision Throughout Daily Routines

“I am a teacher, I was never trained in vision therapy.”

Luckily, for learners with a Cortical Visual Impairment (CVI), no one is suggesting vision therapy. Instead, in order to see improved use of functional vision, individuals with CVI require a balance of intentional access to vision throughout daily routines.

According to Dr. Christine Roman-Lantzy, CVI is a disability of access. These individuals, much like our students with ocular visual impairments, seek access to their education.

For a moment, ignore the label of CVI. You are presented with a new student who demonstrates use of functional vision when given certain targets. We are taught to help the child advocate for when their vision is usable, and when they need alternative forms of access (ie. tactile or auditory inputs).

Now add the label of CVI back into the picture. Armed with this information, you can now gather more specifics about the targets that elicit visual attention. As educators, we can rely on the information gathered during a CVI Range (functional vision evaluation) to guide us in selecting visual targets and environments. Further, when educating the child to advocate for their needs, we can help them identify the why and/or when to use alternative accessibility options (ie. tactile or auditory inputs).

Dr. Christine Roman-Lantzy has provided us with the CVI Range. Further, she indicates that the results of this assessment, place a child in Phase I, Phase II, or Phase III. Each of these CVI Phases, subsequently, have a goal.

Learners who have a CVI Range score between zero and three are placed in Phase I. During this Phase, the goal is to build consistent visual behavior. Learners who score above a three to a seven, are in Phase II. The goal of Phase II is to integrate vision with function. For learners who score anything above a seven, they are considered to be in Phase III. At this point, the goal is to facilitate refinement of the characteristics.

Why bother explaining these goals? For me, they are crucial in comparing vision therapy and accessibility. It is important that we align visual opportunities with the goal of the Phase the learner is presently in. Educational teams must understand this in order to ensure access for their learners. We cannot provide an Activity designed for Phase I to a learner who is actually in Phase II and think this is accessible.

In addition, learners move through these Phases sequentially. During Phase I, it is important for teams to learn what elicits visual attention. These characteristics then transfer into Phase II, when the learner is able to begin using vision with daily tasks. In Phase I, let’s say a child was able to sustain visual attention on targets with red mylar. Now in Phase II, we might adhere red mylar to a student’s spoon, switch, or locker to help them visually locate the target while completing daily routines.

Let’s revisit this child who doesn’t have a diagnosis of CVI. Based on the results of a learning media assessment, it is determined the tactile input is the learner’s primary learning modality. Does the school have Braille materials delivered with expectations the child can interpret the contents? No, we create a plan. We determine who is responsible for creating accessible content, and we begin explicit Braille instruction.

Return to our learner with Cortical Visual Impairment. Based on the results of a learning media assessment with consideration of the ten visual and behavioral characteristics of CVI, it is determined when the learner can access information visually, tactually, and auditorily. Not selecting a primary and secondary, but an outline for when each is appropriate. Still, does the school have print, tactile, and recorded materials delivered with expectations the child can interpret these contents? Sadly, I hear stories of this happening all too often. We must create a plan for these learners too. Who is responsible for creating the accessible content? Who will provide the explicit instruction to learn how to interpret the materials?

We wouldn’t label a student’s locker with Braille without explanation. Similarly, we cannot adhere red mylar material to a child’s locker without explaining this to a learner.

Most educators have no training in vision therapy, but they do have training in accessibility.

Make education accessible for all learners.

The Future of Look Detection Is Here

The future of look detection is here for children with Cortical Visual Impairment (CVI). At this year’s ATiA annual conference, CViConnect’s Stephanie Steffer and Travis Spire-Sweets shared their newest vision for the field.  

Currently, while a learner utilizes the activities within the CViConnect iPad application, the system makes use of the forward facing camera to detect if the learner is looking or looking away from the iPad.  Teams are currently using this information from session to session to analyze what is impacting their learners ability to initiate and maintain visual attention.  No longer are teams guessing if the child is looking at the presented target.

For example, we might run the exact same activity in different positions, once in a stander and once while lying in supine position on a mat.  While in the stander, the look detection data indicates the user is experiencing frequent ‘look, look away’ behavior. Meanwhile, when laying in the supine position, the look detection data indicates the user has some ‘look, look away’ behaviors followed by sustained visual attention. 

This tells us the activity we selected may be a good fit, if the child is in the correct position.  Being positioned in a stander is appearing to add an increased environmental complexity.  If vision is expected while the student is in a stander, education teams will likely need to provide visual targets that are considered more comfortable to balance the complexity of the child’s position.

While this data is still available and truly meaningful for teams, the CViConnect team wanted to provide educational teams with even more.  This release will allow educational teams to make data based decisions by knowing where the learner is looking on the screen.  

With this new data, educators can provide their explicit instruction on salient features and comparative thought.  Educators can then review the data to determine if the student was in fact making eye to object contact on the salient features as they were being discussed.

Does the child tend to look off the screen during the instruction and look after the educator has finished speaking? Are you expecting the child to touch or draw the salient features?  With this data, you can now analyze if the child is utilizing look and reach at the same time or if these are being completed separately.  

As an educator for individuals with cortical visual impairment, this is a big game changer.

It doesn’t end here either.  With our CViConnect Activity designer, the intent is you may begin to take advantage of our event action blocks to build in scenarios such as ‘if looked at,’ ‘then say.’  

Participants during the ATiA session have expressed enthusiasm for understanding the learners use of vision in this way for a variety of scenarios.  One idea was to utilize this data when making additional assistive technology decisions.  However you see this best fit for your learners, we are excited to be a part of your journey to support learners with CVI.

Want to learn more?  ‘The Future of Look Detection For A Learner With CVI, is Here’ is a FREE recorded session available to all and is part of an ATIA 2022 Registration Package.


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“Expect Progress” in the CVI Range Assessment – What Does That Mean?

Recently, I had a great conversation with a teacher and mother of a child with cortical visual impairment. The team recently completed a new CVI Range assessment, but the results left them feeling disheartened. 

Over the last year, this almost three year old little girl had made tremendous progress.  Everyone on the team agreed.  Despite the chaos the world was feeling throughout the pandemic, this little girl was making visible progress.

So why would that much progress leave the team feeling down?

The team completed The CVI Range, as they do each fall. From previous years, they had anticipated about a one point difference from the previous year. After all, this little one progressed through Phase I within a year and a half. 

A year ago, she was scoring at a 6 to 6.25.  Now, her score came out as a 6+ to 6.75.  Her score reflects progress, but not the progress the team had grown to expect.  Mostly, they felt the improvement she was displaying was worthy of a significant increase from the previous CVI Range score.

Why weren’t the scores reflecting the progress they felt they were seeing in their day to day observations?

What Does Progress Look Like From Phase I, to Phase II, to Phase III?

It is not uncommon for a situation like this to occur.  As a child moves higher through The CVI Range, the progress will slow.  

Throughout the progression from Phase II to Phase III, the child uses their vision more and more throughout their day. The child is now able to access visual materials beyond their near space. Additionally, the child is required to show not only fixations and discrimination, but now identification of these targets.  As we make this transition, there are a lot more demands on the learner with CVI. It is not only okay, but well documented, that progress will slow down.  

What Should We Do?  

Celebrate those victories!  When your child, or a child you are working with, demonstrates new skills, celebrate each and every one. 

The data captured from the CVI Range is extremely valuable for educational teams. But remember, it does not hold the ultimate value. This child with CVI is more than a number on a scale. This person has numerous adjectives to describe them: strong, relentless, resilient, and so much more. The individual is what matters. When you observe those moments of achievement, celebrate them.  Don’t wait for the score to validate it. 

Have questions, or want to learn how CVIConnect can be a solution for your child or student. Contact us at info@cviconnect.co.

CVI Awareness. Diagnosing and Knowing Your CVI Learner

Cortical Visual Impairment (CVI) is the leading cause of visual impairments in the United States. Uniquely, the number of people with this vision impairment will continue to increase as medical advancements are better able to assess and treat individuals with neurological diagnosis.  

Historically, individuals with CVI have had a hard time getting this diagnosis.  Since this is a brain-based visual impairment, an individual may have perfectly healthy eyes.  Imagine for a moment that you have concerns regarding your child’s vision, but every time you get their eyes checked, you get a clean bill of health.  In your gut, you feel something isn’t right.

Diagnosing CVI

According to Christine Roman-Lantzy, Ph.D, a diagnosis of CVI includes three parts.  

First, a child with CVI has an eye exam that does not explain their present level of vision.  This means that even if the ophthalmologist indicates the child has nystagmus (involuntary shaking of the eye), this would not explain why the child is not able to recognize faces of those most familiar to the child.

Second, a child would have a history of a brain condition, trauma, or damage associated with CVI.  Some of the common conditions we may see are asphyxia, encephalopathy, periventricular leukomalacia (PVL), seizure disorders, intraventricular hemorrhage (IVH), or a traumatic brain injury (TBI).  

This does not mean every one with one of these conditions or other structural brain abnormalities also has CVI.  Simply, these individuals could be considered at risk and should be monitored if there are vision concerns.  Remember, this is one of the three elements necessary for identifying CVI.

Lastly, we look for the ten visual and behavioral characteristics as outlined by Dr. Christine Roman-Lantzy.

  • Color preference
  • Need for movement
  • Visual latency
  • Visual field preference
  • Difficulty with visual complexity
  • Need for light
  • Difficulty with distance viewing
  • Atypical visual reflexes
  • Difficulty with visual novelty
  • Absence of visually guided reach

So, if it is so hard to diagnose, how do we know it is the leading cause of visual impairments?  Sadly, although the diagnosis is hard to obtain officially, it is still the most prevalent diagnosis.  Can you imagine if we had a better system to ensure no children fell through the cracks?  How many children are potentially impacted by this and have yet to receive proper medical and educational support to accomodate for their vision loss?

The good news is that the functional vision of children with CVI can and should be expected to improve.  Unlike with an ocular loss, which typically maintains or declines,  when individuals with CVI are provided with regular meaningful interventions, they can develop their functional use of vision.

CVI meltdowns are not tantrums  

Have you ever heard or witnessed a CVI meltdown?  While they might look like a child throwing a tantrum, they are not.  You might observe an individual screaming and lying on the floor, refusing to stand or walk, physical aggression toward themselves or others, or even them trying to escape.  Much like everything that surrounds Cortical Visual Impairment (CVI), no two learners with CVI look alike. This includes their meltdowns.

Overwhelmed BucketUnlike a tantrum, CVI meltdowns usually occur due to an overwhelming amount of sensory input.  Picture this: we all have an ‘overwhelm bucket.’  Throughout our day, things will fall into our bucket.  These may not be the same each day either.  These stimuli that add to our buckets could be lights, background noise, smells, physical touch, unpredictability, novelty, speed of stimuli, movements, and the list goes on.  Sometimes, things we enjoy can also add to our ‘overwhelm bucket’.   

There is good news! While not always, usually a CVI meltdown can be avoided.  Matt Tiejen has taught us that when we do not have a balance between the complexity of the visual target and the complexity of the environment, what Matt refers to as the visual battery is being depleted.  In this example, when we do not have a balance, we are putting too many drops into the ‘overwhelm’ bucket.

By finding a balance, we are trying to control how often a drop is put into the bucket at a manageable rate.  Still, we need to give the bucket a way to drain throughout the day.  For a learner with CVI, this means a time when we are giving them a break from needing to use their vision.  A calming activity, some time alone, or maybe a preferred activity could be what your learner needs to help empty their bucket before it overflows.  Providing a well balanced day with plenty of opportunities to slowly drain the bucket, before it becomes too full, is essential for avoiding the CVI meltdown

Know Your CVI Learner

Knowing your learner and their signs will always be the best tool you can have.  Even if you think you have done your best to balance the day, when you see the child beginning to exhibit those warning signs, the team should know the child is trying to communicate to you.  The learner is telling you they are hitting their threshold and they need a chance to re-charge.  

This is not a power struggle.  This is not a behavior that needs redirection or consequences.  It is at this time the team should give the child a chance to re-charge.  Additionally, the team should look at what is next in the routine to determine if any other additional accessibility changes need to be made.  That means if math is next and typically the child participates visually, the complexity of the visual task and environment need to be modified in order for the child to use their vision again. OR, and this is big, maybe they need to participate using a different modality all together.  Vision may not always be the best learning modality.

Have questions, or want to learn how CVIConnect can be a solution for your child or student. Contact us at info@cviconnect.co.

Back to School for a Learner with CVI

It’s that time of year.  Many teachers and students are returning to their school year routines.  For your learner, this might bring on stress, worry, and fears.  Parents might begin to have questions about the upcoming year and what their child can expect.  Professionals may begin sending home welcome letters, introducing themselves to the family.

For your learner with Cortical Visual Impairment (CVI), these things could be helpful, but will they be enough for all the novelty and complexity they might encounter?  Is there anything else that can be done to help prepare a learner with CVI?

We have compiled some ideas for the entire Individualized Education Plan (IEP) team to consider. 

I. First, begin by reviewing what is already known about our learner.  Take the time to review the latest IEP.  Remind yourself, and each other, what is needed for your learner’s success.  For team members who are familiar to the learner, re-read the learner’s present level of performance that was written in the last IEP.  Is this information still accurate?  In order to ensure you are providing the best intervention strategies, we have to work from quality data.  Does anything within this document need to be updated?  Is any additional data needed to make any of these decisions?  

Remember some changes to an IEP can be made with an addendum; meaning an entirely new IEP is not necessarily required if changes need to be made.  This includes any medical changes that may have occurred since the team last met.  If the child has had any recent diet, sleep, or medicine changes that will impact their education, it should be documented in the IEP.

II. While you’re looking at the IEP, take a close look at the child’s last CVI Range assessment.  Children with CVI are expected to make progress.  Is the information from this assessment still accurate?  Depending on when the last assessment was completed, your team may need to update this valuable information.  As a team, determine if a new CVI Range needs to be completed.

III. As you look at this important baseline for your learner, consider which staff will be working with your learner this year.  Are there any new team members?  In education, it is always important for team members to understand the needs of the whole child.  A learner with CVI brings additional elements of concern.  Most professionals have never received formal training about cortical visual impairment.

Dr. Christine Roman-LantzyDr. Christine Roman-Lantzy has identified ten visual and behavioral characteristics that can be observed in a child with a cortical visual impairment.  Staff may need training to understand these characteristics. Additionally, Christopher Russell created this great fact sheet as a resource for families and professionals.  However, it is important to remember each of these characteristics impact every learner uniquely.  

Even team members who know what CVI is, still need additional training to fully understand how each of the characteristics uniquely impact your learner’s functional vision.  Creating some cheat sheets may help new team members to recall the characteristics and their impact.  Go through each of the characteristics and describe how it can negatively and positively impact the child.  Here is a template that might help.

IV. We are living in uncertain times.  New data is being shared about COVID-19.  Decisions about where your child will attend the 2021-22 school year is difficult for many parents, but is compounded when you have a child with complicated medical needs.  Families should work closely with the child’s medical professionals and school staff throughout their decision-making process regarding return to school options, whether in person, blended, or remote.  

Would the family like some therapists to come into the home?  Will the school allow therapists to enter the home?  I am a planner and visual learner.  For me, I would need to create a chart and compare what both environments would look like; therapies, accessibility, medical risks, social risks, etc.

Once you’ve made your decision, be sure to understand the protocol for your school’s personal protective equipment (PPE).  Your child may need to practice wearing a mask or other PPE.  Additionally, since faces are already difficult for children with CVI, masks on a person’s face will make this even more difficult.  

Difficulty recognizing faces can have a negative impact on social interactions with peers, if the learner with CVI isn’t supported.  Incorporate how your child will recognize familiar peers and staff if they are wearing PPE.  You could take a picture of a few familiar classmates/staff with and without their masks.  This could become a fun matching game for the whole class.  Show a picture of a classmate with their mask on.  

Give some other information about this student as a getting to know you game.  If your learner is not ready for two dimensional images, the clues could be recorded by the peer themselves ahead of time, so that the learner with CVI can begin matching the voice with their peer.  

After the clues are given, have the class try to match which child matches the image and description.  I would give my learner access to the images before and after the experience, if it would be helpful.

V. Now that you know where your child will be attending school, consider how they will get around this physical space.  

Knowledge from the learner’s physical therapist can provide input regarding their gross motor skills, the teacher for the visually impaired provides their functional vision, and the orientation and mobility specialist provides safety of travel input.  If your team is moving to an interdisciplinary model similar to that supported by CViConnect, all of your teammates have access and are familiar with these various levels and are ready to meet the learner’s mobility needs.

The natural instinct for most professionals, when CVI is first taught, is to make everything the child’s favorite color, or attach lights to everything.  Unfortunately, if we do this, we’ve made all these points meaningless.  This is another great example of the importance of a more interdisciplinary approach and understanding the needs of your learner outside your sole area of expertise.

When we come from a whole child approach, the team is able to better understand the need to carefully select the information that your learner needs visually, and highlight these landmarks.  Meaning, not every teacher’s door needs red tape around their door frame.  Additionally, these well meaning modifications won’t mean anything unless they are explicitly taught to the learner. 

Reach out to the school to see if the child can get into the building before school starts to begin practicing their routes.  Further, maybe the learner’s orientation and mobility specialist can meet you there and begin some of their route training before the school year.  (*Note, some district contracts may not allow this, but it is worth asking to see if anyone from the team could provide additional support).  

This early visit will allow your learner to see the building before other students are there.  While you are there, take pictures and/or video of various locations your learner will need to be familiar with.  Use these images and videos at home to review the routes you practiced.  Remember, it is OKAY to teach other methods to learn routes, for example, relying on tactile input from a white cane or sounds you might hear. 

If your child is staying home this school year, you can still work on routes within your home that your child needs support with.  If your child is very comfortable moving around their home as independently as possible, begin working on routes in your neighborhood.  Again, consulting with your learner’s orientation and mobility specialist may provide you with some guidance and valuable routes to practice.

VI. Show off your new school supplies.  Parents might find themselves buying new backpacks, lunch boxes, clothes etc. Your child may even help pick out their new materials.  For your child with CVI, you may need to use this time to expose them to the new ‘back to school’ purchases you made.  What does their new backpack or lunch box look like?  Do you need to add something to their materials so it stands out easily? 

Just as you may add something to your suitcase to help make your luggage stand out at baggage claim in an airport, teams can add something to the child’s bag that is unique and easy to spot among other backpacks. In the past, I have encouraged families to tie a mylar ribbon around the handles of their student’s materials or add a fabric swatch.  Whatever you choose, make sure you spend time teaching this to the learner with CVI in order for it to be effective.  

VII. Create a space that meets the learner’s needs.  A distraction free, visually accessible,TVI using the CViConnect PRO app to teach a student independent work space looks different for every learner.  Regardless if they are attending school virtually or with in person instruction, it may be valuable for both in-school and at-home learners.  You may even find your learner has a variety of learning spaces throughout their home and school settings.  These workspaces will also look different depending on the task and environment placed upon the learner.  

When creating this space, think through CVI Characteristics.  How can they help the learner and how could they potentially distract the learner.  Every work space needs a good source of light to ensure materials are illuminated, but the angle of the light or light from a window could become a distraction.  Noise cancelling headphones have been used by some learners to help reduce the distracting sounds, but a system is needed to ensure the student still has access to the staff’s verbal cues/directions.  Does your learner need a space with reduced visual complexity?  Some have used trifold boards or fabric to help cover unnecessary information, but if this blocks their view of notes on the board or other resources, ensure your learner has another way to access these with electronic or desk copies.

VIII. This one seems obvious, but often is where teams get stuck.  Agree on a system early on for how the learner will  access their work?  It is unlikely that your schedule will be rigid such that the learner uses their vision during ‘Morning Meeting’ from 9:00 AM- 9:30 AM and tactile access for science from 9:30 AM- 10:15 AM.  Instead, teams will need to be flexible.  Give examples of the types of tasks the learner can complete visually and with what environmental expectations.  

Dr. Roman-Lantzy and Matt Teitjen released the “Sensory Balance” text in 2020.  This is a great tool if you are unsure how to complete a functional media assessment of the 10 visual and behavioral characteristics defining Cortical Visual Impairment.  A teacher for the visually impaired likely has a few ideas of how materials can be made accessible via tactile or auditory input.  Be prepared to utilize these when vision has become too much or is no longer appropriate.

This question also comes up when discussing the best input for our learners.  How much do they understand receptively?  Hopefully, your team is working on a variety of ways for your learner’s wants and needs to be expressed and interpreted by the communication partner.  Regardless of their expressive language modality, when unsure of your learners potential, assume they are capable.  One thing I was fortunate to learn early in my career was to never limit a child’s potential.  See the child, see their future, see their potential.  

IX. This leads me to another really important tip for teams.  Be aware of what your learner’s visual fatigue looks like.  Watch for these cues from the learner and respect their limitations.  Find a way for them to request a break, and select a few activities that are a good fit for your learner to engage in during a visual break.  These are typically things that are low visually demanding tasks in a minimally complex environment according to Matt Teitjen’s ‘What’s the Complexity Framework’.

Include your learner in these conversations as much as possible.  Ask something like ‘what will we want to do if your eyes begin to feel tired?’  You might be surprised to hear their answer and what they prefer to do during this necessary visual break.  Let them know how to communicate that they need a visual break and that needing a break is okay.  We all need to step away at times.  Working adults might text a loved one during a break, go for a walk on our lunch, or read a book they enjoy.  Breaks look different for everyone.

Often my learners with CVI had very large IEP teams, meaning the child was with a large number of staff throughout their day.  Communicate with each other to ensure you aren’t pushing the child beyond their limits.  If you are using the CViConnect PRO system, the messages platform is a great place to make note of these observations.  Teams can quickly glance at notes from the day prior when working with the child.

X. Naturally, after determining your student’s learning media, your team needs to have a plan for how the learner will get their learning materials.  This is where teamwork and communication really comes into action.  If the team decided that learning to read will be visual, who makes these materials accessible?  Can the learner access this technology independently or does a CVI moderator.  Unfortunately, we do not have an answer for this, as each IEP team operates uniquely for the individual child’s needs.   Instead, I can give you a few questions for you and the rest of the team to consider:

  • Who is responsible for creating learning materials in the preferred learning modality?  Is each provider creating their own content or is a member assigned to this responsibility?
  • If one member is creating content for other service providers, how will materials that need to be accommodated be shared with the individual who needs to modify them? Do you have a timeline in place for when lesson plan materials will be provided ahead of time?  
  • Does the team have access to existing content that meets the individual’s needs? 
  • Are there any additional supports or instructions needed, once the learner has the accessible materials?  Do they need instruction on salient features of visual targets?  Can they independently utilize the technology to access their materials?
  • How will the learner communicate their answer?  The team will need to know how the child communicates expressively. 

Your IEP Toolbox. Use Tools When Needed

Your IEP team may not benefit from all of these ideas.  Also, if you have never done any of these, do not feel you need to start with all of them this year.  Pick a few that might work best for your learner to start.  Maybe you can come back and revisit a couple later in the year, or build them into next year’s expectations.  Doing what’s best for kids does not always mean they need top of the line devices, but they deserve the best of you.  Do what you can to best serve these individuals and know you’ve done what you can.  

If you are  still reading this blog, it tells me you care deeply about your learners and have their best interest in your heart.  Good job team.  When the educational team comes together and considers the learner’s needs before they even enter the building, we have a better chance this child can start off on the right foot.

Believe it or not, but the best big changes happen when you start small and make incremental changes to our behaviors and routines.  

Have questions, or want to learn how CVIConnect can be a solution for your child or student. Contact us at info@cviconnect.co.