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Everything You Need to Know about Teaching a Child with Cortical Visual Impairment

October 29, 2023 No Comments

Everything You Need to Know about Teaching a Child with Cortical Visual Impairment

Cortical Visual Impairment (CVI) is a unique form of visual impairment, which affects the interpretation of visual information. 

According to current research, up to 1 in 30 kids have CVI-related difficulties. This means that there is a good chance that we have student(s) with CVI in our classrooms and therapy rooms, whether we know it or not. Hopefully, this also means that research will continue to grow and expand, as will resources.

It can be tricky to decipher the medical terminology and jargon surrounding CVI, so in this article, I’ll break it down into quick facts to help you understand. Whether you’re a parent or an educator, this blog post is your go-to guide for a clear and concise understanding of the characteristics, causes, management strategies, behaviors, and classroom support for children with Cortical Visual Impairment.

 

What Causes Cortical Visual Impairment (CVI)?

CVI is often a result of brain injury affecting the visual centers. Common causes include hypoxic-ischemic encephalopathy (HIE), periventricular leukomalacia (PVL), traumatic brain injury, infections, metabolic disorders, and other developmental defects. Accompanying features may include cerebral palsy and developmental delays.

 

A blind woman walks outdoors using a cane along a tactile yellow tile

 

What are the Most Common Characteristics of Cortical Visual Impairment (CVI)?

CVI is characterized by various visual behaviors and responses that differ from ocular visual impairments. 

Let’s explore some of the characteristics of Cortical Visual Impairment (CVI) and how they can impact children’s visual experiences:

  • Color preferences: Children with CVI often show a strong preference for bright and saturated colors, such as red or yellow. They might gravitate towards objects that have these vibrant hues, finding them visually appealing and engaging.

 

  • Need for movement: Children with CVI may require movement to capture their attention. This explains why children with CVI are drawn to toys that move and light up. It also explains why students like objects that appear to move, such as shiny or reflective objects.
    • Some common objects that move or appear to move are mirrors, pom poms, fans or flags, spinner toys, pinwheels, cause-and-effect toys, sensory bottles, and spinner toys.

 

  • Visual latency: Children with CVI may have a delayed response when looking at objects. It’s important to give them sufficient time to process the visual information before expecting a reaction. Their brains need a little extra processing time!

 

  • Difficulty with visual complexity: CVI can make it challenging for children to process visually complex stimuli. Providing them with simple and uncluttered visual materials, such as objects with single colors, can help reduce visual distractions and enhance their ability to focus.

 

  • Light-gazing and non-purposeful gazing: Children with CVI may show a fascination with light sources and may appear to gaze at things without a specific intent. They might spend time looking at sun streaming through a window or be captivated by the play of light and shadows.

 

  • Visual field preferences: Many children with CVI have specific visual field preferences. They may prefer looking at objects in a particular direction, such as in their periphery or by turning their head. Understanding their visual field preferences can help create optimal visual experiences. (See teaching strategies below!)

 

  • Distance vision impaired: CVI can affect a child’s ability to see objects far away, particularly when there are complex backgrounds. If objects in the distance are crowded or complex (such as in a hallway at school), a child may have difficulty with distance viewing. 
    • Using larger and high-contrast visual aids, as well as positioning the child closer to instructional materials, can improve their visual access.

 

  • Visual blink reflex impaired: Children with CVI may not blink as quickly or react as fast when things get too close to their eyes. It’s important to be mindful of their proximity to objects and ensure their safety during visually-guided activities.

 

  • Preference for familiar objects: Children with CVI often find comfort in familiar objects that their brains easily recognize. These objects provide a sense of familiarity and can help them feel more secure in their visual environment.
    • Familiar objects put their mind at ease. So, bring on the cherished items—they’re like little security blankets for a child with CVI’s visual world.

 

  • Impaired visually guided reach: When it comes to grabbing objects, kids with CVI might struggle to look and reach at the same time. Verbal guidance and gentle touch can be super helpful.

Understanding these characteristics of CVI can guide parents and teachers in creating supportive environments and implementing strategies that promote optimal visual experiences for children with CVI. By recognizing and addressing their unique visual needs, we can help them navigate the world with greater confidence and success.

Human dark brown eyes close-up. Side look

 

What are the Behaviors Associated with Cortical Visual Impairment (CVI)?

Children with CVI may exhibit various behaviors that are indicative of their visual impairment. 

Let’s explore the behaviors children with CVI might display through examples:

Abnormal light responses: Students may squint and turn away from bright lights, indicating sensitivity to light.

 

Avoidance of eye contact and social gaze: A student may struggle to establish eye contact during social interactions, often looking away or focusing on peripheral objects.

 

Fatigue from visual tasks: Students may show signs of tiredness and decreased visual engagement after prolonged periods of visual stimulation.

 

Difficulty with visual stimuli in complex backgrounds: Some individuals with CVI may find it challenging to visually locate and attend to objects in busy and visually cluttered environments. You may observe students with CVI bringing objects to toys right up to their nose.

 

Difficulty with visual field: Visual field loss is common in kids with CVI, especially in their lower field. This means they may have difficulty walking around obstacles, difficulty descending the stairs, difficulty seeing things flat on a surface in front of them, etc.

 

Meltdowns in the presence of sensory overwhelm: A meltdown is how a child with CVI might respond to sensory overload.

  • Some things that might trigger a CVI meltdown are: visual clutter, the unknown, busy places, loud noises and unfamiliar places.
  • A meltdown could look like the child screaming or crying, flopping to the floor, trying to leave the location, or aggressive behavior. The CVI meltdown isn’t the individual’s fault. The CVI meltdown isn’t your fault. Try to find a quiet place for the child to go if a meltdown occurs or is about to occur. Give the child time to calm down and to feel safe again.
  • Be sure to watch for signs of overwhelm or exhaustion. This may mean it’s time to leave or take a break.

 

Red balloon floating out from blue balloons that are tied on blue background , Performance outstanding from crowd for different thinking , disruption and leadership by 3D rendering.

 

What are Some Strategies for Managing CVI?

Supporting children with CVI requires adopting appropriate intervention strategies. 

Here are some effective management strategies for educators who are working with a child with CVI:

 

  • Set the stage: Minimize visual clutter on walls by removing posters, artwork, and decorations. Keep things simple and visually organized to help the student focus. Provide a quiet, non-cluttered break space or corner, if possible.

 

  • Contrast is key: Use materials with high contrast and clear images to enhance visual recognition and understanding. Bold colors and sharp contrasts can make a big difference for students with CVI. A child may be able to see things that are a little further away if they are large or are against a solid background.

 

  • Light up their world: Light can be used to gain a child’s attention. A lightbox can be a common tool to use with children with CVI.  A few other ways to incorporate light are through windows/natural light, lamps, light-up toys, iPad/tablet, or a flashlight.

 

  • Balance multisensory exposure: Make sure that you also allow a child to explore new items without noise. This is because some children with CVI have a hard time using their vision when there is competing auditory information.

 

  • Adapt learning materials: When you adapt picture books for students with CVI, you can control many characteristics of the book. 

Try these strategies to adapt a book for a student with CVI:

  • Add black/solid background
  • Add bubbled or enlarged font
  • Highlight the important concepts
  • Add tactile components

You can easily get started by trying my CVI Series: Adapted Books Starter Pack. These CVI-friendly adapted books introduce students to letters, numbers, and shapes.

There are three skills (beginning letter sounds, counting, and shapes) focused on within my CVI Series: Starter Pack Adapted Books Bundle. This bundle is perfect for students with CVI, students with other visual impairments, students with autism, or students who need a multisensory approach:

    • Each page within these books utilizes a black background and brightly colored, high-contrast images. 
    • There are multiple versions of each book included, so you can use the level that your student needs!

 

  • Team up with specialists: Collaboration is key! Work closely with a team of specialists to develop an individualized plan that addresses the specific visual needs of the child. These specialists might include ophthalmologists and occupational therapists.

 

  • Use tools: Explore adaptive technologies and visual supports that can assist the child in accessing educational materials. Use slant boards and black felt boards to make sure that materials are in the child’s preferred visual field.

 

  • Stick to the plan: Create consistent and predictable routines with visual schedules. Using visual schedules with large, simple icons helps the student anticipate and transition between activities, promoting independence and reducing anxiety.

 

  • Light it right: Optimize lighting conditions in the classroom. Adjust the lighting to reduce glare and enhance visibility, making it easier for the child to perceive and attend to visual stimuli.

 

  • Provide extra wait time: Providing wait time is essential. Once presenting an item to a child with CVI, allow them time to process the item. Wait time can be hard and can feel uncomfortable. Here’s a tip to help: Just when you think you have provided enough time, wait longer!

 

Remember, every child with CVI is unique, so it’s important to customize interventions based on their individual needs and preferences. By implementing these strategies, educators can create an inclusive and supportive learning environment for children with CVI.

Cortical visual impairment (CVI) is a complex condition that requires a comprehensive understanding of its characteristics, causes, management strategies, behaviors, and classroom support. 

By recognizing and addressing the unique needs of children with CVI, we can create inclusive environments that foster their visual development and overall well-being. Through the implementation of appropriate strategies and supports, we can help children with CVI thrive and reach their full potential.

 

Check Out Some Other Posts About CVI:

Schedules and CVI: Visually Appropriate Schedules for Children with Cortical Visual Impairment 

Morning Routines and CVI: How to Make Mornings Successful

What are 5 CVI Teacher Materials that I Need for my Classroom?

 

Sources:

Title: Cortical Visual Impairment

Website: Children’s Hospital

URL: https://www.childrenshospital.org/conditions/cortical-visual-impairment

 

Title: Cortical Visual Impairment (CVI) Fact Sheet for Families & Professionals

Website: Paths to Literacy

URL: https://www.pathstoliteracy.org/resource/cortical-visual-impairment-cvi-fact-sheet-families-professionals/

 

Title: What is CVI?

Website: Little Bear Sees

URL: https://littlebearsees.org/what-is-cvi/

Melissa

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