Month: June 2014

Another Solution for Accurate Visual Motor



This picture shows a solution for a student who was struggling to place objects by shape into a container for recycling.  Just adding red color highlighting to the edges of openings allows the child to more accurately visually locate the hole and accurately sort each recycled object.

What is important to remember is that this is the needed support until the child has success.  Once the child is completing the task, we want to remove the supports gradually by cutting back the red tape to a thinner and thinner border with each increasing success.

Put supports in place after assessment and remove them carefully as you measure achievement.

Showing Their Stuff!


This young boy with CVI could not show his cognitive skills for sorting like items (yellow circles, red cylinder and green cupcake).  He would just place pictures in any of the three containers randomly.  It looked as if he didn’t understand.

When we provided a black background, highlighted the pictures and containers in red, and moved to a quieter, less visually complex part of the room, this boy immediately placed each one correctly and accurately.  Issues of CVI completely masked cognitive abilities.  Providing this boy with strategies matched to his CVI assessment will improve access to learning but also allow children to show us their true abilities!

Children Creating Their Own Movement Strategy

Seeing better with movement is a visual behavior of children with CVI.

Children with CVI will do interesting things to stimulate their brains and to discover the strategies they can use to see better. Head movement or full body movements are often two types of strategies that children come up with on their own. They often want to be in motion rather than to sit.

The puzzle for us is to figure out when they create movement.  If we determine when, we can adapt the environment for better visual regard.

Some questions:

  • Are they moving their heads when looking at things at near? Near items can be viewed against plainer backgrounds: floor or presentation board, and we see the movement stop or lessen.
  • Is there movement when trying to see familiar objects?
  • Is there more movement when looking at unfamiliar things?
  • Is there more movement when trying to discriminate pictures or 2D symbols?
  • Is there more movement against more complex backgrounds. I often see head movements or rocking as the background complexity increases.
  • Is there more movement while walking through the environment? I have one child that moves 4-6 feet forward and turns around to the right. I believe she is creating movement to understand the environment. With the help of the movement she created, she can feel safer moving forward further.
  • Is there less movement with the benefit of a backlighted surface (iPad, computer or TV).
  • Does the child “grow out of” the need for movement? I have many babies with CVI that stop self-created movement when their vision improves. (CVI improves as the child begins to understand their visual world!)
  • Do they make things move to see them better? I have several children that bang the table, make the items “jump” then reach to get them. So smart!

We need to see this movement as a strategy and don’t try and stop it.

  • I evaluated a child that stood up quickly all through mealtime. He stood quickly while looking at his plate then sat and reached accurately for the food. When the staff tried to stop this “behavior”, he could only find his food tactilely and ate like a blind child using only his sense of touch.



Compare Ocular to Cortical/Cerebral Visual Impairments

I found this nice comparison chart for ocular vs cortical/cerebral:


                                                            Ocular                                      Cortical/Cerebral disorder

Eye examination                                         Usually abnormal                           Perhaps Normal

Visual function                                        Consistent                                         Highly variable

Visual attention span                                  Usually normal                                  Markedly short

Nystagmus                                       Present when congenital /early onset      Sometimes present

Coordination:eye movements   Present when congenital/early onset            Sometimes present

Rapid horizontal head shaking                Occasionally                                   Sometimes present

Compulsive light gazing                       Sometimes present                                   Common early

Light sensitivity                            Dependent on the eye disorder                 A third of the cases

Eye pressing                                Especially in congenital retinal disorders              Not common

Close viewing                   Common, for magnification                 Common: complexity, crowding

Color perception                   Dependent on the eye disorder                     Sometimes Preserved

Appearance                                        Appears to be vision impaired                    Usually normal

Peripheral field difference                                  Occasionally                              Nearly always

Additional neurological handicaps       Fairly common                                        Nearly always