The Pediatric Cortical Visual Impairment Society (PCVIS), in response to the recent decision to discontinue the Perkins-Roman CVI Range Endorsement, wishes to acknowledge the purpose of the CVI Range Endorsement, its role in fueling momentum toward training and education in CVI-specific assessment and intervention, and the value in creating professionals who can reliably administer the CVI Range. PCVIS Icon brain with neural networks

The CVI Range Endorsement has served many purposes since its launch 6 years ago and it has held value for different people in the community—parents, professionals, therapists, medical doctors, educational teams, and students—for different reasons. We’d like to honor what it meant for each branch of our community, and we’d like to acknowledge that the Endorsement, for each branch, was a step in the right direction. It represented a collective “yes” to embark on a long journey toward creating a community of trained, motivated professionals, with the knowledge base, skills, and acquired experience that would allow them to understand the students and children living each day with CVI. It was a nationwide (even international) acknowledgment that we, as a community of service providers, were committed to providing children with CVI the appropriate assessment and intervention they were entitled to, by law.

 

Looking Back 

The installment of the CVI Range Endorsement placed high value on having at least one individual on a child’s team—a Teacher of the Visually Impaired (TVI), Occupational Therapist (OT), Speech and Language Pathologist (SLP), general education teacher—trained and confident in administering a reliable CVI Range Assessment. This came after an unfortunate legacy of  scenarios in which complaints of inappropriate administration of The CVI Range and insufficient assessment procedures for children with CVI were filed. Recognizing a need to ensure the reliability of The CVI Range, Dr. Christine Roman-Lantzy took a step forward. A collaboration between the Dr. Roman-Lantzy and the Perkins School for the Blind’s eLearning program emerged. Courses were designed to not only teach the fundamentals of The CVI Range, but also provide training on how to reliably administer, score, and design interventions based on results of the CVI Range Assessment.

Identifying a Problem, Designing a Solution  

Assessment drives instruction. Poor or unreliable assessment, can at best, create confusion and inadequate service. In the worst-case scenarios, it can create frustration, setbacks, and inaccessible educational scenarios for the child with CVI. Reliable and appropriate assessment of functional vision is paramount. If it’s the first time the child with CVI is being assessed, it’s even more critical that it’s done correctly and that a reliable score is attained.

As universities across the nation and graduate programs for vision professionals were not managing to provide adequate training in CVI or address the unique functional vision assessment and intervention strategies for children with CVI, the training offered by Perkins was a “parting of the waters moment.” Together with Dr. Roman’s CVI Range and Dr. Sandra Newcomb’s Reliability of the CVI Range study, Perkins School for the Blind stepped up to value the importance of this Endorsement. Perkins became a hub for training professionals in the fundamentals of CVI as well as providing prerequisite courses and micro-credentials in reliable scoring of the CVI Range. Individuals motivated and prepared by their daily experiences and their prior investment in CVI Assessment and Intervention would move forward to obtain the Perkins-Roman CVI Range Endorsement.

And again, this was just the first step. Training in administering a reliable CVI Range Assessment was the first collective, streamlined training opportunity for TVIs, O&Ms, SLPs, OTs, PTs, etc, otherwise unequipped to serve the children with CVI on their caseloads. It was a first step in developing a common language of terminology regarding the characteristics and visual behaviors demonstrated by our students with CVI. It was the first step in widespread acceptance that these students had separate needs from their peers with ocular impairments. Serving individuals with CVI, would require a specialized functional vision assessment, administered correctly. Most of all, it was a first step that gave parents a voice when requesting appropriate services for their child with CVI.

 

Giving Parents a Voice and a Long-awaited Standard 

For parents, the CVI Range Endorsement was an act of advocacy and again, a first step in creating reliable teams of teachers of the visually impaired, and other therapists treating their children. It provided a baseline from which the child’s team could understand CVI and then build on that foundation each day. The Endorsement gave parents a standard to start from to ensure service providers were prepared to serve their child. Parents could now ask if any members on the child’s IEP team were or could be trained in CVI-appropriate assessment or instruction. Having the means to request a CVI Range Endorsed teacher or therapist on their child's team, meant that at least one member of their team had training in the services, appropriate for a student with CVI. The CVI Range Endorsement gave parents something tangible to embrace to build confidence. It ensured that daily instruction and CVI accommodations would be more reliable and visually accessible.

For Professionals, Protocol and Standard of Care

For professionals, the CVI Range Endorsement provided an equally important series of first steps. For professionals feeling that they had not been adequately prepared for the caseloads presented after completing graduate school, it provided relief. It was the first source of formal training and instruction available, intentionally preparing professionals for the large number of children with CVI that would need served. For professionals who had seen The CVI Range, and been asked to administer it without proper training, the Endorsement and Reliable Scoring Micro-credential provided confidence. These professionals who invested their time and energy in receiving The CVI Range Endorsement advocated for their children and took responsibility to push for their own professional development on behalf of their students.Girl reaching for a red fork

 

For Medical Professionals, A Partner in Treatment Planning 

For medical professionals—optometrists, ophthalmologists, low vision specialists, neurologists, neuro ophthalmologists, pediatricians, and others serving the population of individuals with CVI—the CVI Range Endorsement was a key component of recommendations after the exam. As it was mentioned in July’s conference on Pediatric Brain-Based Visual Impairment, “without establishing a partnership between the physician and someone that knows how to teach a child with CVI, there really is no treatment plan; there’s simply a diagnosis” (Roman-Lantzy). As critical as the initial diagnosis of CVI is, the intervention plan is used to create actual change in that child’s access to learning. 

Dr. Sharon Lehman, Ophthalmologist at Nemours Alfred I. duPont Hospital for Children, has been a strong advocate for creating these partnerships with the TVI and educational team for her patients with CVI. Creating these relationships requires that we all speak the same language, and that can only come from training and professional development. Doctors aware of the CVI Endorsement had comfort in knowing that there was an education team or, at least one provider on that team, that understood the interventions that would benefit that patient.

For Students, a Chance toward Evidence Based Success

The CVI Range Endorsement meant something less tangible and far more valuable for the students with CVI. With their parents now able to advocate for a trained professional, this meant a team of educators starting from a place of confidence and commitment. In a word, this meant hope. Hopefully, they’d have a range score that could follow them throughout their academic journey, demonstrating progress and improvement in visual function. Hopefully, their CVI Range Assessment and report would spark curiosity in their educational team, clarifying how does “student X” see? How can we, the team, make small changes throughout the day to improve “student Y’s access to materials and curricula?

Boy pointing to a picture of a bear on the screen

Hopefully, for the student, this meant that the proverbial domino effect may be set into action, paving a path toward more understanding and knowledge-based practice for their elementary, secondary and higher educational careers. Hopefully, when the student with CVI was old enough to self-advocate, they, too, could voice the importance of receiving services from a teacher with credentialed training.

Looking Forward

In our ongoing commitment to advocate for the best educational outcomes for all children with CVI and their families, PCVIS considers the CVI Range and the CVI Range Endorsement a critical tool for every educator, professional, and service provider working with children with CVI. To date, the training has created over 250 endorsed professionals, internationally, with roughly another 200 professionals enrolled to receive the Endorsement. The need for more trained professionals working with children with CVI and for mentoring professionals new to CVI is immense. 

As the replication study of the reliability of the CVI Range (Borchert, M. & Roman Lantzy) is underway, PCVIS is confident that it will remain a valid, reliable assessment for children with CVI. In fact, at this time, it is the only reliable assessment available to professionals serving these children. As with every educational training program, it will be revised and improved as needed, ensuring that professionals are best prepared to serve their students. 

Lastly, PCVIS is confident that the CVI Range Endorsement program will find a new home.  PCVIS will keep its members apprised on any new developments.

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