medical background information

Perkins School for the Blind CVI Symposium April 7, 2017

Spread the word about this important event! It filled very quickly last year so sign up if you are interested.

CVI Symposium: Best Practices and Current Research presented by experts in CVI

Held at Perkins School for the Blind in Watertown, Massachusetts

Friday, April 7, 2017 8:30 sign-in, presentations 9:00-4:30 

$100.

6.5 ACVREPs, 6.5 PDPs, 6.5 CEs

There will be discussion about current research and best practice related to brain-based visual impairments.

From the website:

Topics and Presenters include: (with more to be confirmed)

  • Visual Processing and the Impact of Damage: What We Know and How We Know

Lotfi Merabet, O.D., Ph.D., MPH

Presenter TBD

  • Collaborative/Coordinate Care – The Importance of an Effective Team

Anne Fulton, Ophthalmologist

Rebecca Davis, parent

Ellen Mazel, Ed., CTVI

  • Literacy and O&M from Phase I to Phase III

Christine Roman-Lantzy, D.

Matt Tietjen, M.Ed., CTVI

Find out more at:

http://www.perkinselearning.org/earn-credits/onsite-training/cvi-best-practices-current-research

I believe this will also be available to watch after the symposium.

Understanding Color in the Brain

I always find it so exciting and encouraging when brain research about the visual system continues to unwrap the great mysteries of the brain. This understanding can only move us forward in understanding CVI and in assessing whether interventions are working. I am deeply interested in why my children behave the way they do. Here is a recent article from Spectrum MIT, a publication from Massachusetts Institute of Technology: http://spectrum.mit.edu/fall-2016/color-decoder.

A Primer on Cortical Visual Impairment

This is a great article about CVI written by Sharon S. Lehman, MD, Wilmington, Delaware.

I am so pleased to see this in a medical magazine, “Review of Ophthalmology”!

This is the subtitle:

“We owe the parents of children with CVI a better explanation of their child’s condition. Here’s a look at how to start providing one”.

For too long, the ophthalmologists have not “owned” CVI. They have focused on the ocular system and completely disregarded the obvious lack of visual skills in the child sitting before them. They have referred their small patients to the neurologists where the families still found no answers. Most upsetting to me it’s the lack of referrals for these children to teachers of students with visual impairments. So much of learning is visual so help from a knowledgeable TVI is key to visual improvements and visual access.

Take a look: https://www.reviewofophthalmology.com/article/a-primer-on-cortical-visual-impairment-42791

Youtube Lecture: Recovered Sight: Michael May

Understanding Blindness and the Brain (Brian Wandell, Stanford University)

I think you might find this one fascinating! Michael May lost vision as a child and regained it in his 40s. As he regains sight, there are so many CVI characteristics he experiences!

https://www.youtube.com/watch?v=VVgfC_FV2hI

From Frontiers in Systems Neuroscience

My head is once again spinning after the March 7th Perkins School for the Blind CVI conference.  Fantastic new research about CVI is being conducted by Dr. Roman-Lantzy and Dr. Lofti Merabet.  How does it related to my work with children? I need to understand as much as I can about the “why” children present with certain behaviors.

“New publication from the lab showing mapping of brain anatomy and visual activity in response to visual field deficits in CVI”.

http://journal.frontiersin.org/…/10.3…/fnsys.2016.00013/full

JOURNAL.FRONTIERSIN.ORG

 

 

 

No Diagnosis of CVI?

I am not a doctor and would never assume to be qualified to give a diagnosis of CVI for any child in my care. I do observe children’s visual behavior and suspect cortical visual impairment.  I try to steer the families to ophthalmologists that understand CVI and make sure I provide the doctor with detailed observations and assessment results I obtained using the CVI Range (Christine Roman-Lantzy 2007).  I do this in the hopes that the diagnosis of CVI will be made. But I can not wait for a diagnosis. I must conduct this assessment of visual factors that greatly influence child’s ability to learn. It is my job as a teacher to students with visual impairments to provide detailed functional vision assessments. The CVI Range is that detailed functional visual assessment.

In my functional vision report, here is the language that I use:

“Given the assessed ocular health of XXX’s eyes, the positive history of brain involvement, complex visual developmental history and reduced functional vision for learning and accessing the environment, XXX was educationally assessed using Christine Roman-Lantzy’s CVI Range (Christine Roman-Lantzy 2007).  Functional vision observations focused on the these recognized characteristics of brain based visual impairment: color preference, reaction to environmental movement, attention to light, reduced visual reflexes to touch and threat, reduced distance attention, increased latency for looking or understanding what is seen, difficulties with sensory complexity, reduced visual motor skills, non-purposeful gaze, difficulties with visual novelty, and visual field preference. (Cortical Visual Impairment: An Approach to Assessment and Intervention by Christine Roman-Lantzy 2007) This is not meant to serve as a diagnosis, only as educational observations that will lead to increased access to visual learning and to the creation of strategies and environmental supports to build vision use”.

 

Understanding Medical Information

It is important to understand the medical history of all conditions affecting the children you serve.  It deepens your knowledge of symptoms, learning profiles and places behaviors in context.

For children with CVI, increasing your own understanding of the causes of brain based CVI exposes you to information and terminology about the brain structures and function.  You should understand the structures of the brain as well as you know the structures of the eye.  This is where CVI abnormalities and difficulties are located. I want to learn about the unique brain based damage and the location of those problems.  I hope in the future with increasing understanding of the brain through newer imaging methodologies, I will be ready to understand how damage exactly affects learning.  I’m getting ready!

I always ask for eye reports and neurology reports from parents. These are equally important to understand whether the eye is healthy and providing the information to the brain and whether the brain is healthy enough to receive it. Keeping the brain as a focus of my discussions with teams and parents help drive home the location of the visual problem (the brain), the possibility of improvement, importance of assessment and the importance of targeted interventions to increase access and provide a learning platform for visual skills to grow for children with CVI.

If I understand, I can explain.  If I explain well to parents and teams, they become my partner in the assessment and interventions for children. This is the primary job of a TVI.  Teams and parents that can observe the CVI characteristics they see everyday and understand the functioning are better ready to create and provide accurate environmental supports for learning and for charting progress.