Educators and Therapists

Teaching and Learning in Phase I CVI1

Published with permission from author, Dr. Christine Roman-Lantzy.

In Phase I CVI, the goal is building consistent visual behavior for children to use their vision. This can occur only when the environment and materials are highly controlled. Individuals in Phase I will only have access to their dorsal stream, also known as the “where” system, of visual processing.  It is rare for an individual in Phase I to have direct eye-to-object (directly looking at a visual target) visual skills. Rather a “look, look away” pattern can be observed when an individual in Phase I uses his or her vision. (186)

In Phase I, a strong color preference is observed. Children will visually attend to objects of a single color and objects that move or have movement properties (shiny or reflective). Items with patterns or multiple colors or items presented against a patterned or complex background will not elicit visual attention or engagement. Visual latency, a delayed response between the time a target is presented and the time an individual first notices it, must be expected. A child with CVI needs enough time to process visual information, particularly with new or novel objects and when the environment is less familiar or complex. This is especially important with new or novel objects and in a less familiar or complex environment. (186)

Intervention Strategies for Phase I CVI

Students in Phase I typically show inconsistent attention to visual targets. In order to provide an opportunity for an individual in Phase I to use vision, the environment and the objects presented must be void of complexity (sound and appearance), be familiar, have movement or the illusion of movement (for example, shiny/light reflecting material, or surface) and be of a single, preferred color. (199)

In designing interventions, it's important to incorporate activities into the child's daily routines—for example, during mealtimes, leisure-time activities, self-care routines, academic tasks, fine motor skills practice, gross motor skills practice, speech and language, and O&M routines. (199) 

Materials should be thoughtfully considered and adapted to be used in a meaningful way as the individual progresses through the upper phases. Light can elicit the use of vision and draw attention to the objects being presented, but the use of light should be purposeful and intentional. (199) 

Be mindful of the individual's positioning. Standing, sitting up, or other physical activities require additional skill sets which may interfere with the child's ability to use her vision. Be sure to work with related service providers to ensure the child is comfortably positioned and supported, and be mindful of signs of stress and fatigue such as hiccuping, yawning, task avoidance, light gazing, extended periods of closed eyes and frequent sleeping, as well as grimacing and reflexive or high-pitched vocalizations. (201)

CVI and the IFSP/IEP

1Roman-Lantzy, C. (2018) Cortical Visual Impairment: An Approach to Assessment and Intervention. 2nd ed. pp. 186-201. New York, NY: AFB Press.

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