Transcript Cortical Visual Impairment

What is it?
How do we Adapt?
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According to the American Printing House, aph.org, the definition for
medical purposes: Cortical visual impairment (CVI) may be defined as
bilaterally diminished visual acuity caused by damage to the occipital lobes
and or to the geniculostriate visual pathway. CVI is almost invariably
associated with an inefficient, disturbed visual sense because of the
widespread brain disturbance
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According to the American Printing House, aph.org, the definition for
educational purposes: Cortical visual Impairment (CVI) is a neurological
disorder, which results in unique visual responses to people, educational
materials, and to the environment. When students with these
visual/behavioral characteristics are shown to have loss of acuity or judged
by their performance to be visually impaired, they are considered to have
CVI.
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There are 30 areas of the brain that processes vision and 10 areas of the
brain stem - In children with CVI, information must be channeled to these
areas of the brain rather than the affected primary area
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Cortical visual impairment is the leading
cause of visual impairment in children in the
US
Optic Nerve Hypoplasia is the second leading
cause of visual impairment in children in the
US
Retinopathy of Prematurity the third leading
cause of visual impairment in children in the
US
 Can
be congenital
 Can
be acquired
 May
also exist with other visual
conditions such as: optic nerve
atrophy, hypoplasia, dysplasia, or
retinopathy of prematurity
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Asphyxia
Hydrocephalus
Cytomegalovirus
Premature Birth
Metabolic disorder
Periventricular Leukomalacia
Seizure Disorder
Brain Bleeds
Trauma
Shaken Baby Syndromes
Exposure to toxins & drugs
ETC.
Common
Characteristics
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Normal optical structure
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Normal coordinated eye movements with the
possible exception of the presence of eye
movement that is similar to nystagmus
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Normal color perception
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Novelty:
Objects that the child are not familiar with
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More able to notice objects that are familiar to
them
Example: Toys they have played with or
educational tools they have used over a period
of time
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Too much visual, auditory, and/or tactile
information at one time
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Low Complexity
High Complexity
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Environmental complexity include classroom
noise, people talking, visual clutter, etc.
• Headphones, ear plugs or sock caps, project boards can
be used to eliminate or lessen background noise
• Drapes/sheets, project boards, carousels, may be used
to limit or lessen visual clutter
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Educational materials include, worksheets,
whiteboard presentations, board work, etc
• Different sizes of typoscopes (reading windows) can be
used to decrease the amount of visual clutter on a page
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Most typical color preferences are Red or Yellow
(because there are more red cones in the retina
than any other color)
Speech Pathologist can wear
Red Lipstick so the child’s
vision will be directed toward
their lips
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Loss of vision in area(s) of sight
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90% have visual field deficits
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Lesions in temporal fibers; upper field loss
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Lesions in parietal fibers; lower field loss
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Lesions in one hemisphere; field loss in
opposite half of each eye
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Child’s eyes are focused on something/someone
but it appears he is looking through it
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Child likes to look at lights
The child continuously looks at ceiling fans when there is a
source of light
The child will move into a sunny area or area with direct
light
Note: Some children with CVI demonstrate light sensitivity
particularly in the early stages of CVI
Light Gazing
Child sees many service providers
in a day. Take pictures of them,
put them on transparency, and
put them on a light box as a way
of letting the child know they will
be seeing them next. Starts to recognize
the picture and the person are the
same.
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Child takes time to react to something to which
he is visually attending
It make take several seconds or minutes for him
to “notice” and respond
Visual Latency
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Child sees items that have a movement
characteristic. The item may not actually be
moving
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Child does not respond to visual threats, such
as when an open hand is brought quickly toward
the face
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Brings object close to block out irrelevant
background / visual clutter (the effects of figure
ground)
As child resolves difficulties with distant viewing, he is able to see objects
further and further away
Child focuses on a person or object
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The computer or iPad are an excellent tool to use with
children who have CVI. It provides high contrast, two
dimensions and fills the child's visual fields to eliminate
the effects of figure-ground
 There are excellent children’s computer programs that
are simple and educational that use bright colors and
eliminates visual clutter. Examples: Creature Capers,
Creature Cartoons, Creature Antics, Creature features,
Creature Magic (from Laureate Learning Systems),
Senswitcher.com
 Make your own interactive books/games using Microsoft
Power Point
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Scroll n Roll – scrolls print across the screen thus child may be able to
read
Tap and See Little Bear Sees
Fluidity
See Wonderbaby.com for a list of recommended apps for visual
impairment and CVI
Shapes
Baby Finger
Findit
Rattle
Touch Free
Tail Toes
Match It Up
Speak up: When children speak loud enough, colors and shapes
appear
iMeba: Cause and effect
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To promote reading use different fonts, colors, and
sizes
Dog
 Cat
 Bird
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Lighting
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Electronic Magnification
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Dollar Tree or Dollar store: tap and light up,
spinner lights, beads, bows, mini strands of lights,
solar toys, etc
APH.org
Bubble lights purchased at Cracker Barrel Stores
when in stock or Google LED bubble gun for a
variety of sources
Garage sells
Purchase materials cheaper the day after a
holiday
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Renee Miller, CTVI at OSB
Tonya Givens, Secretary, OSB
Pam Cox, Special Education Teacher, Union
Schools
Abi McClain Student, Union Schools
Miss Madge and her students, Union Schools
Students at OSB
Dr. David Lewerenze, Northeastern State
University College of Optometry
Dr. Christine Roman-Lantzy