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.