VISN 648: Cortical/Cerebral Visual Impairment
Class #: 14819
Instructor: Ellen Mazel
Course Description: This course provides an in-depth study of CVI and resources available for assessment and instructional strategies. Participants will further examine and explore the unique educational needs of children with CVI and the skills related to teaching these children in a full array of educational settings; Pre-K through grade 12. Topics include teaching strategies in the core and expanded core curriculums, such as: literacy, career-vocational skills, visual efficiency and compensatory auditory strategies. Instruction will also address material modifications and accommodations.
- Cortical Vision Impairment: An Approach to Assessment and Intervention
- Author: Christine Roman-Lantzy
- Copyright: 2007
- Available from: www.afb.org
In preparing my materials for the upcoming onsite workshop March 7th at Perkins School for the Blind, I am once again reminded of the great debt owed to Dr. Christine Roman-Lantzy in the field of cortical visual impairment. There was literally not one slide I prepared that did not contain information she gathered and researched or terminology she created and shared widely. These concepts have become common terms we use in our everyday descriptions of our children with CVI, and our CVI assessments, observations and strategies.
Here’s just a few:
- CVI Range
- CVI Characteristics
- 10 terms as related to CVI: Color, Movement, Latency, Visual Field, Complexity, Lightgazing/Non-Purposeful Gaze, Visual Novelty, Visual Reflexes, Visual Motor, Distance
- Phase I
- Phase II
- Phase III
- Salient features
- Color highlighting
- Comparative thought
- Scoring: Resolved
- Scoring: +
- Scoring: +/-
- Scoring: –
A huge thank you, Dr. Roman Lantzy! What would we do without this common vocabulary to describe our children?
Although this onsite workshop is currently full, it will be recorded and made available by Perkins School for the Blind at some later date online.
Examining Some Perspectives on CVI: Conversations with Experts
|Presented by Barry S. Kran, Darick W. Wright, Luisa Mayer, Christine Roman-Lantzy, Tracy Luiselli, Lotfi Merabet, Corinna Bauer, and Ellen Mazel
I found this lecture so interesting! It is one hour long but worth the time.
Looking Inside the Adaptive Brain of the Blind
Dr. Merabet speaks at the National Institutes of Health in Washington DC about the team’s work on plasticity, ocular blindness, and CVI. As usual I have more questions!
Where are the child’s hands naturally? For the child whose hands are near their body, create a sensory vest. This is a purchased child’s cobbler apron. I sewed white curtain circles in various places under where the hands rest. I attached red bells on elastic cord. The child begins by accidentally touching then purposefully exploring to create the noise. Because the bells are attached with elastic, it can be pulled into view. Great practice for fine motor skills, tactile and visual skills. I like to make sure I create exposure to all kinds, sizes, weights and materials (wood, plastic, metal). This is active learning! The child can wear this an stimulate all the senses. True learning!
Literacy comes in all forms and all kids deserve literacy in their lives!
Check out this great app that is described in this Youtube Video:
My Talking Picture Board: http://www.youtube.com/watch?v=2I4VBMeC0ww
I love using shiny mylar balloons as visual targets. They hang in a child’s best visual field for as long as needed to allow the child to location using peripheral vision and turn to look. I can pick the child’s best color to support looking. The balloon waves gently all the time giving movement. I can make sure it hangs at the correct distance for optimal viewing. I have tried tying the string onto the child’s arm or leg where the child’s own movements create a great visual event. Kids figure out pretty quickly how to get the balloon to move! If they struggle, you can provide hand under hand assistance to demonstrate.
Look at that! One simple balloon addresses the CVI Characteristics of Movement (gentle movement and shiny that looks like movement), Latency (hangs as long as needed), Visual Field (can be placed where the child sees best), Color (chose the one the child finds fastest), Distance (the string can be adjusted to any distance from the child’s eyes), and Visual Motor (the child’s actions cause a visual event: eye hand skills).
Great investment for a few dollars! One classroom bought a tank to refill because they are so popular.
Wait time or allowing extra response time is so important for children with CVI due to the characteristic of Latency. The world can be such a fast moving place that children never have the opportunity to visually locate anything.
The educational team including the parents felt that six year old Amy did not understand her name. I was able to take a video of Amy to prove that wait time must be allowed so she can hear her name then turn to locate the person calling her. I stood six feet away on her right side and called her name.
It appeared as if this little child was totally unaware of my interaction.
I called again.
It took Amy 32 seconds to turn towards me but she was still looking only using peripheral viewing. (I want central viewing because this is the only way a child sees details or my face. Peripheral viewing only gives the child a general shape, movement and color.)
Eight seconds later, Amy was able to look using her central vision! She continued to look at me for 9 more seconds.
I love capturing moments like this to share. A video is clear evidence of Amy’s skills. Now the team including parents, consistently give little Amy the time she needs. Because Amy is building this skill, 8 months later she turns to find people who call her name within 5 seconds at 9+ feet on the left and right! I even see her tracking people moving in the room. Fantastic and very exciting! These improvements are happening within many characteristics: Latency, Visual Fields, Distance and Movement.
If wait time is not allowed for children with CVI, they will not build skills and begin to improve vision use.
We worked with a parent who really wanted their child to respond to other people when he was greeted. Because the child was nonverbal we decided as a team to work on the “high five” (when a person greets you with a raised hand, you touch return the greeting by touching their hand).
We brainstormed and created this strategy to address this important parent generated goal. We greeted this young boy with a “Hi Jimmy” and showed him our hand in a red glove with shiny dots on each finger tip. This strategy supported Jimmy’s visual need under the CVI characteristics of Color (he looked at red) and Movement (the glove would move and the shiny made it look like even more movement). Soon Jimmy began visually locating the glove. A bit later, with hand under hand support at first, Jimmy would look and reach to the glove to “high five”.
Mission Accomplished but wait…When children show improvements in skills with CVI, we want to remove the supports carefully. We would remove the shiny fingertip dots and make sure skills remain. Later we would remove the fingers of the glove and finally remove the glove all together.
Assess improvements the child is showing and remove the supports carefully to move this child’s visual and visual motor skills to the next level.
For those of you still searching your visual brain for recognition of this picture, I will give your brain some clues.
First I will orient it the correct way it appears in the world. I will tell you to look for the “cow”. Now you can limit your vision search to what you know about “cowness”. Can you now see the cow looking at you? There are two dark ears near the top left and a dark nose near the bottom middle of the picture. Because you know that the eyes are near the ears, you can easily see these. You have the benefit of visual memory.. You have seen thousands of pictures of cows and real cows too. Children with CVI can build these skills by exploring real items and then linking what they now know to what is seen. The hallmark idea: CVI Improves! With careful assessment of the 10 characteristics, you create strategies and environmental supports to build vision. We don’t just hope for, we expect improvement!
(Click to enlarge)
It can be so hard to explain what children with CVI see. This picture is a good way to explain how the world looks to a child with CVI. You see all the colors. You see each line and shading but your brain is searching its visual memory for what this image represents. You can feel several CVI characteristics:
You are experiencing Latency: its taking you a long time to understand this.
This is visually complex (Visual Complexity).
If you were in a loud environment, it would take you longer to find meaning (Auditory Complexity).
If I asked you to look at this while balancing on a thin balance beam, you would take longer to understand the picture (Positional Complexity).
You want to hold this closer to your face to understand what it represents (Distance).
You have never seen this before so it is new to you. Once you have understood it the first time. It will take you less time to find it the next time. (Novelty)