Day: March 10, 2014

Dr. Christine Roman’s 10 Characteristics of Cortical Visual Impairment

CVI stands for cortical visual impairment, a brain based visual impairment.  The condition has the great possibility for improvements when a child has carefully crafted environmental and learning strategies to support increased vision use and discrimination.

CVI Phases

Dr. Roman-Lantzy uses the CVI Range to assess children.  The skills are measured on a scale from 1-10 around each of the characteristics:

  1. Color
  2. Movement
  3. Latency
  4. Visual fields
  5. Complexity
  6. Light gazing/non purposeful gaze
  7. Distance Viewing
  8. Visual Reflexive Responses
  9. Visual Novelty
  10. Visual Motor

Depending on the assessment, the child is categorized as:

Phase I

Phase II

Phase III

Each Phase has unique instructional goals and environmental supports needed.

 Phase I:  Goal: Building Visual Behaviors. Getting the child to look

  • The child has a favorite color and will only look at simple one colored items. (Color)
  • The child looks at movement or shiny items but does not seem interested in stable objects. (Movement)
  • There is no or little reaction to visual threat or touch between the eyes. (Visual Reflexive Responses)
  • The child fixates briefly but likes light, ceiling fans and movement. (Light gazing and Movement)
  • The child sees things in the peripheral fields but does not react to items in central vision positions. (Visual Fields)
  • There is visual attention in near space only within 2 feet. (Distance and Complexity)
  • The child rarely looks to faces (Complexity).
  • The child sees best in uncluttered, quiet places. (Complexity)
  • The child only looks at familiar and favorite toys. (Novelty)
  • The child has a long delay before they turn to look. (Latency)

 Phase II:  Goal: Integrating Vision with function.  Be aware of environmental adaptations the child requires.

  • Objects can be 2-3 colors but the child likes the favorite color included. (Color)
  • The child can look at patterns. (Complexity)
  • Light does not always distract the child. (Light Gazing)
  • The child takes a while to look but mostly only when sick or tired. (Latency)
  • The child still needs items to move to draw visual attention. (Movement)
  • Some noise in the room is tolerated. (Complexity)
  • The child will blink when you touch them between the eyes. (Visual Reflexive Responses)
  • Sometimes the child blinks to visual threat. (Visual Reflexive Responses)
  • The child sees things 4-6 feet away. (Distance and Complexity)
  • The child looks to faces if the person is not talking. (Complexity)
  • The child can look and reach to a very familiar object. (Visual Motor and Novelty)
  • The child can look at simple pictures. (Complexity)
  • The child can look at musical toys. (Complexity)

Phase III:  Goal: Resolving Characteristics

  • The child looks at all kinds of items, familiar and unfamiliar, colorful or not. (Color, Complexity and Novelty)
  • The child can tolerate most kinds of sensory input and maintain visual gaze. (Complexity)
  • Blink and touch reflexive responses are always present. (Visual Reflexive Responses)
  • The child does not take extended extra time to look. (Latency)
  • The child looks beyond 10- 20 feet for moving items. (Movement, Complexity and Distance)  Distance is often one of the last areas to resolve.
  • The child looks at near items that are not moving. (Movement and Complexity)
  • The child smiles at familiar and unfamiliar faces.  Facial recognition is often one of the last areas to resolve. (Novelty and Complexity)
  • The child will looks at themselves in a mirror. Real eye to eye contact not just looking at the reflected light or the movement in the mirror. (Complexity and Novelty)
  • The child will look at pages in a book or pictures.  Really looking at the pages not just enjoying the movement of the turning page. (Complexity and Novelty)
  • The child imitates the visual action. (Distance from the model may still be an area of concern.)
  • The child sees a visual item and understands the implications. (Sees people getting their coats looks for theirs, Sees someone approaching with arms outstretched and puts their arms up to be picked up). (Complexity and Distance Viewing)
  • Sees a group of parents and sorts out their parent from the others visually with no voice cues.  Smiles to favorite people not at strangers. Facial recognition is often one of the last areas to resolve. (Complexity)
  • The child sees in all visual fields. (Visual Fields)
  • The child looks and reaches to items to play and plays while looking. (Visual Motor)