Dr. Christine Roman

How to Learn to do the CVI Range

The only way to get comfortable using the CVI Range is to get more training in its exact use.  This can’t happen in one lecture or one conference workshop.  Many people attend one lecture, get a copy of the CVI Range and complete it incorrectly. If the assessment is done incorrectly, you have no firm idea of the child’s functional vision.  You will struggle to create strategies, environmental supports or goals and objectives without this defined functional vision.

The Roman-Lantzy book Cortical Visual Impairment: An Approach to Assessment and Intervention provides an in depth exploration of the entire topic of CVI including how to use the CVI Range. The text should be considered the CVI Range operating manual.

Taking a class in CVI would also be helpful to build assessment skills.  Completing the Range in a group of professionals, all of whom understand the CVI Range and CVI, was so valuable for my CVI assessment competence. Practice, practice, practice!

Professionals are, many times, unaware of the importance of the parent interview, the observation and the direct assessment as three distinct but interwoven parts of the full CVI Range assessment. Each information-gathering component is essential to a good functional vision CVI evaluation.  The parent interview gives us important history of visual skills over time and medical background. It also describes functioning outside the school, at different times of day and across contexts. It frames observations and focuses those observations.  The observation can give me a vast amount of information.  The observations allow me to understand what materials I need for my direct assessment. There is no one assessment kit for CVI. You make observations and bring the tools you need to answer or confirm skills.  The direct assessment answers those final questions about functioning in each characteristic.

Working in schools, it can be difficult to get every parent interview but I do try very hard.  I have to be willing to make the phone call after my workday or on the weekend so it is convenient for the parent.  As a matter of course, I conduct a teacher interview as well.  It establishes a collaborative atmosphere around the assessment and begins to help the teacher understand what I am looking for (the characteristics).

The most challenging part of the CVI Range for me was completing Rating II.  Without a scoring guide to remind me of the definition for each score 0, .25, .5, .75 or 1, I never felt completely confident in my scoring. With explanations, I do understanding it better but I look forward to a scoring guide for Rating II in Dr. Roman’s upcoming book.

 

Common Terms for CVI

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

 

Guiding Principles

I just love Dr. Roman-Lantzy’s Guiding Principles for working with children with CVI!  They highlight professional practice, the need for assessment, the need to have the highest expectation for improvement, the need for precise planning and the ultimate respect for children!

Precision:

  • You must use the CVI assessment to accurately  provide the environmental and learning supports to build visual skills.

Intentionality

  • With assessment you must understand where the student is functioning and where you expect them to function next.  Dr. Roman says not understanding where you are going with your instruction is like a couple of people lost while driving: “Yes, we are lost but we’re making good time”.

Reciprocity

  • Observation is of the ultimate importance. You must respond to the child’s cues.  Put yourself in the child’s shoes and always consider the environment.  When a child is unable to use their vision ask: How is the environment effecting this child’s visual functioning.

Expectation of Change

  • CVI skills improve.  This is a central concept to your teaching.  Assessment must be accurate, interventions must match to the CVI assessment and the environment must support vision use.  As you reassess, make changes to encourage further building of vision skills.

Attention to the Total Environment

  • Complexity of the environment is the major reason that visual skills are poor.  Provide the needed support so the child has access to the instruction at all times.

 

Understand and Use the CVI Range!

I run into many parents, classroom teachers or teacher of students with visual impairments who ask me for ideas about strategies for their children with CVI. The very first question is “Has the Christine Roman CVI Range Assessment been completed?” Again and again the answer is “no”. Random strategies are being used with children with no assessment, no planning and no focus.

This CVI Range Assessment is the only current assessment for the visual skills in children with CVI.

I continue to find it amazing and very disappointing that teachers of students with visual impairments are serving children without completing this assessment. Would a TVI serve a child with visual impairment without a functional vision assessment? Never! How can you possibly make suggestions for strategies when you don’t understand the child’s visual skills. How could you ever chart improvements? How could you ever create appropriate interventions? How can you waste this child’s precious time to build visual skills?

Worse perhaps are the assessments completed without true understanding of CVI or of how to use the CVI Range.  This only serves to give false information to the team and false information about the child’s visual skills.

If you are a TVI and you don’t understand how to do the CVI Range, find out! I am teaching an online class at UMASS Boston this fall 2014 about CVI and using the CVI Range. At the very least purchase the book : Cortical Visual Impairment: An Approach to Assessment and Intervention by Christine Roman-Lantzy.
If you are a parent or classroom teacher, ask the TVI if they have training to complete the CVI Range. Ask to see the assessment. Read the Roman book. Its very team and parent friendly.
Here the article about the reliability of the CVI Range: The Reliability of the CVI Range: A Functional Vision Assessment for Children with Cortical Visual Impairment, by Sandra Newcomb, Journal of Visual Impairment & Blindness, October 2010, © 2010 AFB.

Dr. Gordon Dutton has a parent interview that looks at some CVI skills.  While this is helpful, it is not an assessment. http://biomed.science.ulster.ac.uk/vision/sites/vision/IMG/pdf/visual_skills_inventory_younger_child_4-8yrs.pdf