Perkins-Roman CVI Range© Endorsement: Exploring a Myth

The issue of competency for TVI’s serving students with CVI is such an important issue in the field of service to students with visual impairments caused by CVI. There is little coordinated education provided in teacher training programs for TVIs, O&M Specialist and Vision Rehabilitation Specialist. There is no way for parents and school systems to understand whether vision professionals have the extensive education about the visual brain, how the visual system operates, how to assess the unique visual behaviors of students with CVI and how to support the educational teams to create accessible instruction that lead to visual improvements.

One step taken by Perkins School for the Blind and Dr. Christine Roman-Lantzy is to create the Perkins-Roman CVI Range© Endorsement. It requires vision professionals to show basic understanding of CVI: history of the building understanding of CVI, definition of CVI, medical causes, and the visual behavioral characteristics.It also asks applicants to prove competence in using the CVI Range, a widely used tool for assessment.

Christine Roman-Lantzy is the creator of the CVI Range and has determined that it is being used widely but incorrectly leading to incorrect scoring. These incorrect scores lead to lack of identification of students, dismissal of students from service, incorrect goals and objectives and ineffective environmental and learning strategies to support visual access and visual improvements.

A frequently heard myth:

“There is a great deal of money being made by Dr. Roman and Perkins School for the Blind”

I contacted Mary Zatta of Perkins elearning to ask her about this issue. She explained that this is not an automated process and that the administrative fee of $125.00 barely covered the expense of awarding the CVI Endorsement. She outlined the intense staffing and man-hours required by 3 full time staff members to review applications, to review recommendation letters, to contact the source of the recommendations, to monitor progress of the written test, to prepare and provide 2 video case studies per applicant, review those submitted CVI Range scores for accuracy, to ensure the applicant is within the margin or error, to provide feedback, to monitor and answer questions, and to provide unlimited live office hours for questions.

Dr. Roman Lantzy receives no money from the Endorsements.

Given that, $125.00 seems appropriate and reasonable!


Understanding What is Seen

For students with CVI, understanding what is seen is based on previous knowledge and the expanded understanding of salient visual features (Roman-Lantzy).

This wonderful example is from Judy Endicott who has a family member with CVI.

Judy shares this experience:

I asked Johnny (now 8), in grade 2 and 6.5 on The CVI Range, “What do you see?”

Note: (Johnny is not “into” football, and doesn’t recognize the Eagles logo, but Judy is always showing him different newspaper or magazine pictures to gain insight into his visual world, and help him use salient features to identify the image.)

Judy asks: “Johnny, what do you see?

Johnny replies: “A guy in jail.” (Johnny connects the helmet bars with the mistaken salient feature of “jail” that is known to him.)

Judy says: “Point to his head.”  (Johnny does this)

Judy asks “What’s on his head?”

Johnny says: “a helmet” (Johnny understands only part of the image).


Then Judy showed him the whole picture:

Judy discussed all the salient visual information more fully.

She talked about body parts, football, uniforms, etc.

Johnny could label all of the parts correctly when Judy pointed to them, but didn’t connect them initially to help him identify a football player wearing a helmet when Judy initially asked, “What do you see?”

The type of questioning that Judy used: “What do you see?”  insured that Johnny truly had access to the visual images and concepts. When it was clear that he truly didn’t have access, Judy knew this was the critical place for more instruction.

Phase I: Visual Affects

The child in Phase I may act like a child with total blindness. They might not locate or visually attend to much in their environment. This is not due to visual acuity but to the overwhelming complexity of the environment. They just can’t handle the confusing swirl of kaleidoscopic color and movement.  Because they behave as if they are ocularly blind, they are treated as ocularly blind. Their vision is never considered, assessed or programmed for. With this lack of visual challenge, they go on to develop auditory and tactile compensatory skills and visual skills lag behind.

One student I assessed in the past at age 11, acted in such a way. She felt for objects rather than looking for them. Once assessed using the CVI Range (Roman-Lantzy 2007), it was clear that presented with materials, given 20+ seconds, on the left visual field at eye level, with bright saturated colors against a non-complex background, this student did, indeed have useable vision. The educational team was present for the assessment and films shared with her parents. From that day forward, visual skills were considered, visual expectations appeared on her IEP, and visual skills improved even in two short weeks. She gained the gift of visual access!

Functional visual assessment using the CVI Range would have identified this sooner. She had only ever had an ocular functional visual assessment even though there was nothing wrong with this student’s eyes. The wrong assessment tool led to the wrong conclusion.

When you act visual impaired and are not assessed using the correct assessment tool, you will never gain visual access..

Scoring the CVI Range Reliability Workshop

This face to face workshop with Dr. Sandra Newcomb is a wonderful and rare opportunity for parents and professionals to practice assessment using the CVI Range (Christine Roman-Lantzy)

The bedrock of service to students with CVI is the accurate assessment of their functional vision using the CVI Range.

This workshop will be held at Perkins School for the Blind in Watertown, Massachusetts on November 3rd and 4th, 2017.

I know when I was learning about CVI, the hands-on practice with other professionals increased my assessment skills and therefore improved the reliability of the results of that assessment of my student’s functional vision. I could be confident that I was scoring it correctly, identifying the correct needs and then providing the correct interventions.

The What’s the Complexity Framework: Designing a Visually Accessible School Day for the Child with CVI

This is an online CVI related class through Perkins elearning conducted by Matt Tietjen.

October 23rd to December 10th, 2017

It provides educators with 35 ACVREPs, 35 PDPs, 35 CEs, or 3 Graduate Credits

Matt is a passionate and gifted practitioner serving students with CVI in all Phases (Roman-Lantzy). He recently developed this framework to help teachers, TVIs, therapists and parents assess the complexity of visual presentations, learning activities and learning environments for students with CVI. I signed up to learn more about this important new tool for my work with students.

Here it the description:

“We will study the characteristic “Difficulty with Visual Complexity” in-depth, explore its central relationship to the other characteristics, and examine the ways in which it can impact behavior and access to education for a child with CVI. Our study of visual complexity will integrate the literature on cortical and cerebral visual impairment.

Participants will learn how to use The What’s the Complexity Framework in order to evaluate the complexity of school environments, tasks and materials and to guide educational teams in creating more visually accessible, appropriate learning activities for children with CVI.

In addition to learning how to rate the complexity level of a particular environment or education task, we will also emphasize the importance of balancing the complexity of the environment and task in each activity, managing cumulative complexity and visual fatigue throughout the school day, assessing interpretation of two-dimensional images, and providing direct instruction in salient features.”

Rebecca Davis: Parent blog

Please check out the latest parent blog: CVI Momifesto at

The subtext of the blog is “Building a Community of Parents of Children with CVI”

Historically, it is the work of parents, organizing and advocating that causes changes in the service to children. I think of the work of parents of children with autism as they organized and advocated for better research, better identification, better funding and more paid services for their children. The parents of children affected with RETT syndrome and related disorders are another wonderful model group for parent advocacy. They came together to advocate for awareness of RETT syndrome, RETT research and funding and they created assessment centers all over the country to serve their children.

Parents with children affected by CVI need to do the same. They need to come together with one voice that will bring the topic of CVI to the forefront. I monitor many Facebook pages that parents have created. They share heartbreaking stories of navigating the misinformation from medical professionals and educators as they seek the best services for their child.

The information about CVI is now decades old and building everyday. Why does it fall on the shoulders of parents with the least free time to organize this effort to help medical professionals and educator understand CVI and how CVI affects learning?  Professionals who understand CVI are out there but they are not sitting at your child’s IEP. That is where the advocacy must begin.

As parents and professionals who understand CVI, let’s begin to build the documented evidence for the IEP process that fosters the diagnosis of CVI. Let’s make sure the students are assessed using the correct tools such as the CVI Range (Roman-Lantzy). Let’s make the CVI Endorsement (through Perkins School for the Blind) mandatory for professionals working with each child. Let’s make sure there is not “vision time” but consideration of visual needs around the day and across the curriculum.

Check out Rebecca’s blog!


Two Interconnected Expanded Core Curriculum Areas for Children with CVI

As a Teacher of Student with Visual Impairments, I am certainly focused on the improvement of visual skills for my students with CVI. I am also interested in how my students understand everything that is easily understood by their sighted peers due to their incidental learning. These intertwined Expanded Core Curriculum (ECC) areas must be considered for that equal access.

These two important areas of the Expanded Core Curriculum must be considered separately and together. These are:

  1. Sensory efficiency skills
  2. Compensatory Skills, Functional Academic Skills (Including Communication Modes)

Sensory Efficiency Skills: This area is especially important for the child with CVI but in a totally different way than that considered for a child with ocular impairments. We are expecting improvement for student with CVI. Functional visual assessment using the CVI Range (Roman-Lantzy 2007) provides the baseline for functional visual skills and sets the stage for this improvement using strategies and objectives matched to the assessed needs.

Compensatory Skills, Functional Academic Skills: This area must be considered to support the
building functional vision of the student with CVI. Vision is the distance sense that supports what is heard, smelled, felt and tasted.

Think about a classroom where someone drops something. The child with typical visual abilities can turn, look and determine what made the sound and determine that the sound is not a threat. The student with CVI hears the item drop and due to lack of visual location abilities or lack of distance abilities, does not turn, does not understand what made the sound and might remain in a state of stress wondering if this sound is a threat or not. We need to build this understanding of environmental sounds by labeling the sound, bringing the child closer to the sound, bringing the sound to them and allowing them to make the sound themselves for complete understanding. If someone drops a tray in the classroom, I make sure to bring a tray to the child and allow them to see it, feel it and push it off the tray to create the sound. Once understood, the sound will not create stress and allow the child to return to the learning. This approach provides the student with the same access to the visual, auditory, tactile, cognitive/language information enjoyed by their sighted peers.

For functional academics, focus needs to consistently be on ways to create and foster the highest level of independence possible to live and work in the future. These are skills that should be worked on from birth! Think of the value of organizational skills for a child with limited visual abilities. Getting objects from a storage place and returning the item to that store place when completed builds independence and understanding of the student’s environment.

For communication the CVI Range can help us determine whether we provide tactile sign language to the student with deafblindness or just visually presented sign. If the child is only using peripheral vision, they could never see and understand the small, distinct visual-only sign that requires central vision use. If a communication device is used, the CVI Range provides information about the accessibility of pictures, the ability to recognize pictures, the number of items that can be seen and recognized at one time (complexity of array), and what size is needed (due to complexity not acuity!). For literacy and communication, the CVI Range provides information about the unique need for color highlighting, spacing and print size (due to complexity not acuity!)

All students with visual impairments need the ECC considered and provided in their educational programming. Students with CVI have the same educational needs but with consideration that CVI is completely different from ocular impairments.

What Do iPads Support for Students in Phase III

As discussed many, many times, the strategies for CVI must match the assessment results using the CVI Range (Roman-Lantzy 2007). We never can just randomly apply a strategy because it will not fit the functional visual needs of the child. If it does not fit the functional visual needs, it will not provide visual access and will not foster improvement of cognitive and visual skills.

With that reminder, I was asked about ideas for iPad apps for children in Phase III (Roman-Lantzy). Just providing a student with an iPad does not guarantee access. We need to assess the child, think about their visual needs and carefully use the iPad as a tool to provide that access.

What can be some general needs for students in Phase III?

Color: The student might benefit from color highlighting to draw visual attention to salient features of pictures and text. (Roman-Lantzy)

Light: Backlighting helps foster access to materials especially in 2D (pictures and text).

Latency: There is still a need for increased time for full visual exploration and full visual understanding.

Visual Field: Lower visual fields might be affected.

Visual Novelty: Presenting novel materials might requires salient feature and comparative exploration. (Roman-Lantzy)

Complexity: Complexity affects visual understanding in objects, increased arrays, of faces, and of the sensory environment.

Distance: Near information is more accessible. Distance curiosity is not typical so distance information is missed.


How do we want the iPad to support the student in Phase III based on assessed need?


  • Tools for color highlighting help support salient feature discussion in pictures and text.


  • Backlighting helps with understanding and easy of access to prevent fatigue.
  • Moving to 2D: taking pictures of their items in the environment and then providing the 2D on the backlighted iPad.


  • Provides ability to capture images and videos for longer visual access time.
  • Capturing images can be reviewed as long as needed.

Visual Field:

  • iPad placement is flexible matched to child’s best visual field.

Visual Novelty:

  • Expanded understanding: Example: Here is one kind of mouse in the book but these are all the other kinds of mice.


  • Enlargement: for things at distance, for small items in complexity and for literacy
  • Overall ability to use settings and apps to reduce complexity of images.
  • Studying facial expression in photographs and videos: salient language of faces matched to voice (auditory). There can be instruction about facial expressions that match the auditory information.
  • Salient feature discussion in photographs and text.
  • Increasing spacing of words and sentences to reduce complexity of array.
  • Masking: complexity reduction with tools in Photos.


  • Videos on the iPad: to bring information about events and concepts that occur at distance: Example: We are reading about giraffes. I think about providing a child with access to where that animal might live and how they move.
  • Access to distance classroom events: Examples: learning song hand movements for circle time.
  • Community access: taking photographs of signs and environmental materials that can be explored on the backlighted, near placed iPad.

The Expanded Core Curriculum (ECC) for Students with CVI

What is an Expanded Core Curriculum?

Years ago, students with visual impairments were educated in separate schools for the blind. Curriculum needs addressed everything for the student with a visual impairment both academic areas and specialized instruction that provided students with all skills to insure full independence in life. Students often lived at the school and instruction occurred across the day: self-care, moving safely in the environment, using transportation, safety awareness, social skills and recreation opportunities were embedded.

The education model shifted in the 1980s and students with visual impairments increasingly moved to inclusive programs in their communities. These inclusive programs could address the academic needs of students with visual impairments when adapted by a teacher of students with visual impairments. Something was missing. At the inclusive setting, inclusive schools were unprepared to address the other important learning needs for children with visual impairments. They never had to address these important areas because students without vision loss learn these skills incidentally by watching.

The Expand Core Curriculum is an essential consideration for all children with visual impairments including children with CVI. The nine areas of the Expanded Core Curriculum, if they are considered at all, are often mistakenly considered only for the academic child with ocular visual impairments.

Inclusive school settings teach the general education curriculum of math, science, English language arts, foreign language, gym, science, social studies and fine arts to their students. For students with visual impairments, the expanded core curriculum provides those essential independence skills needed for living and working. The expanded core curriculum is meant to level the educational playing field by providing instruction specific to the needs of a child with a visual impairment.

The expanded core curriculum, or ECC, should be used as a framework for first assessing students with visual impairments, then for planning individual goals and objectives.

The nine ECC areas that provide this specific instruction include.

  • Compensatory or functional academic skills, including communication modes
  • Orientation and mobility
  • Social interaction skills
  • Independent living skills
  • Recreation and leisure skills
  • Career education
  • Use of assistive technology
  • Sensory efficiency skills
  • Self-determination

Are these considered on your child’s IEP? We will look at each a bit more in-depth in later posts.

“Duckness: How Do We Know?

Look at this series of pictures. (From American Printing House for the Blind website)

How can very young children with intact visual skills understand that these are all ducks?

They understand “Duckness”.

They have a keen understanding of the salient features (Roman-Lantzy literacy) that make up this “Duckness” because of shared visual experiences with others and with access to pictures, TV and movies that feature ducks. This develops effortlessly for children with intact visual skills.  Without direct instruction, they understand that real ducks are different sizes, colors, and ages. They understand that ducks can be seen in different perspectives depending on where and how they are standing. They understand that ducks can be flat in pictures. They understand that ducks can be symbolic in toys, signs, pictures, colored cartoons and in black and white drawings.

Our children with CVI lack this visual access to “duckness”. They lack the expanded and repeated knowledge about ducks. If they have seen a duck, their idea of “duckness” is limited to that one duck. Due to reduced eye contact with people and with reduced eye to object abilities, adults do not explain the shared salient features that all ducks share.

As adults serving children with CVI, we should be aware of this limited access and limited understanding that can occur in 3D and 2D. We must create opportunities to expand children’s access matched to their assessed functional visual skills measured with the CVI Range (Roman-Lantzy 2007). We must evaluate all our materials with this visual access limitation considered. We must adjust our own interactions and instructions to include salient feature, comparative language (Roman-Lantzy).