Educators and Therapists

CVI and Learning

Cortical visual impairment (CVI) has been known within the medical field for decades. Yet, the impact of CVI has not fully filtered through the fields of education and related services. Whereas CVI affects children of all abilities, across individual and multiple disabilities, the deaf-blind community was the first to embrace the realization that CVI has a profound impact on a child’s ability to learn. 

“Cortical visual impairment (CVI) has been identified as the leading cause of visual impairment in children in the Western world (Jan, Good, and Hoyt, 2004). As increasing numbers of children are diagnosed with this condition... the importance of understanding CVI and its implications and the development of effective educational approaches have become paramount.” 

National Center on Deaf-Blindness

Deaf-Blind Perspectives, Spring 2006, Vol. 13, Issue 3

Traditional assessments fail to accurately gauge the ability and understanding possessed by a child with CVI. However, through the use of an intentional, systematic approach and methodology, children with CVI, across varying levels of abilities, can learn to understand the world around them and achieve academically, thrive socially, and acquire independent life skills.

Understanding the CVI Range© Assessment

The CVI Range is the only educational tool to assess the degree of impact on the visual functioning of a child with CVI. Developed by Christine Roman-Lantzy, PhD, specifically for those with CVI, the CVI Range was an outgrowth of the system she used as a TVI/O&M to teach children who had been dismissed as unteachable. Based on information gathered during an interview with parents or caregivers, observation, and direct assessment, the CVI Range evaluates the overall extent to which the visual and behavioral characteristics associated with CVI interfere with the child's use of vision and the degree to which each of the characteristics affects the child.1 (85-92) 

The CVI Range© is a reliable and valid instrument for measuring the level of CVI experienced by an individual, defined by number values and three distinct  phases (Phase I, Phase II, and Phase III). The results provide a framework for describing the functional vision of a person with CVI and determining appropriate adaptations and interventions. It is a common language for parents and service providers who work with a diverse population of individuals with CVI.2 (89)

Expectation of Improvement

The term “range indicates that functional vision of a child with CVI is measured on a continuum, and that the functional vision can be improved with systematic and tailored interventions.3 (83) The scoring system uses a scale of 0 – 10, with 0 recording no detectable functional vision and a score of 10 reflecting functional vision of that of a typical child of the same age.4 (92) A child with CVI would not be able to score a 10 as that would indicate no evidence of CVI.

CVI does not fully resolve. A score of 9 is also extremely rare and practitioners should be wary of a child with a Range score of 9 or above.

Through the use of an intentional, systematic approach and methodology, the child’s functional vision will begin to develop. As this occurs, the child will move from dorsal stream vision, the “where” system, which relies heavily on movement, form, and light, into the higher functioning central/ventral stream vision, the “what” system, which provides visual recognition.5 (14-15) The development of these streams of vision can be measured through the use of Roman-Lantzy's CVI Range assessment, and scored in one of the three Phases she identifies on the continuum of functional vision development for children with CVI.

In Phase I, the goal is to build consistent visual behavior.

In Phase II, the goal is to integrate vision with function.

In Phase III, the goal is to facilitate refinement of the characteristics.

Want to learn more about CVI and how to better serve your students?

1 Read Cortical Visual Impairment: An Approach to Assessment and Intervention (Roman-Lantzy, 2007, 2018) and Cortical Visual Impairment: Advanced Principles (Roman-Lantzy, 2019).

2 Participate in ongoing professional development in CVI best practices from Perkins School for the Blind.

3 Learn more about the What's the Complexity? Framework, created by Matt Tietjen. 

4 Seek your Perkins-Roman CVI Range Endorsement© to demonstrate your expertise in conducting the CVI Range.

5 Become a mentor to fellow professionals.

6 Join PCVIS and attend our Annual Meeting!

The CVI Range allows educators and related service providers the opportunity to draw directly from the scoring statements to identify Present Levels of Performance and guide descriptions of accommodations and adaptations to support visual functioning for a student's Individualized Education Program (IEP) or Individual Family Service Plan (IFSP), if the child is younger than three years old.

Statements in Rating I of the Range with a score of “+ are the child’s Present Levels and can be incorporated into the IEP. For example: Sally is able to demonstrate eye-to-object contact or visual fixation when the environment is controlled for sound and visual clutter.  

Scores from Rating II can be used to identify accommodations and adaptations for areas which scored less than a “1. Visual complexity, visual array (score .25): Jack’s workspace should be free of clutter and he should be facing a gray or black background. Adults should wear either neutral color clothing or place a black work apron over their patterned clothing while working with Jack on activities designed to incorporate use of vision.

The Impact of CVI Beyond Learning

CVI affects a child’s ability to engage socially, to interpret the meaning of an object or activity, or identify a place or a person, even his own mother. Without the advantage of incidental learning through visual observation, spoken words may be void of meaning for a child with CVI. For more information on CVI and the development of social skills, read Chapter 5 of Cortical Visual Impairment: Advanced Principles.

 

Advanced Principles

1, 2, 3, 4, 5 Roman-Lantzy, C. (2018) Cortical Visual Impairment: An Approach to Assessment and Intervention. 2nd ed. New York, NY: AFB Press.

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