Understanding Cortical Vision Impairment (CVI) and the Importance of Early Detection for Children with Disabilities

What Is Cortical Vision Impairment?

Cortical Vision Impairment (CVI) is a neurological disorder where the brain has difficulty processing visual information, even though the eyes may be healthy. CVI is one of the most common visual impairments among children with disabilities, but it is also one of the least understood. This condition can present challenges to a child’s development, education, and social engagement. Understanding CVI, recognizing its signs, and accessing early intervention can significantly impact a child’s growth and quality of life. It is common among children with conditions such as cerebral palsy, autism, or prematurity. Because CVI is often undiagnosed due to reliance on standard eye exams, which do not capture brain-based processing issues, early detection and targeted interventions can transform developmental and educational outcomes​. CVI differs from other visual impairments in that it originates in the brain rather than the eyes. The brain’s visual pathways do not process visual information effectively, causing difficulty with recognizing faces, perceiving movement, or focusing on objects.

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Recognizing CVI with 10 Behavioral Characteristics

Dr. Christine Roman-Lantzy identified 10 behavioral characteristics that can help families and professionals recognize CVI early. Children with CVI may show:

1. Color Preference

2. Need for Movement

3. Visual Latency

4. Visual Field Preferences

5. Difficulty with Visual Complexity

6. Light Gazing and Non-purposeful Gaze

7. Difficulty with Distance Viewing

8. Atypical Visual Reflexes

9. Preference for Familiarity

10. Difficulty with Visual Novelty

Recognizing these signs helps families seek timely support, ensuring that children with CVI access the interventions they need​.

Why Early Detection and Intervention Matter

The brain’s plasticity, especially in young children, is a remarkable asset in overcoming some of the challenges associated with CVI. When CVI is detected early, children have a greater opportunity to build compensatory skills that can enhance their visual processing abilities. Early intervention can help a child develop strategies to interpret visual information better, which positively impacts all other developmental areas, such as motor skills, communication, and social interactions. The brain’s adaptability in early childhood makes prompt intervention essential for children with CVI. Early interventions can foster global improvements in sensory, motor, communication, and social skills, significantly impacting a child’s overall development and quality of life.

Steps for Early Detection and Intervention

1. Get A Comprehensive Evaluation: Families noticing CVI signs should consult a pediatric ophthalmologist or developmental optometrist who understands CVI.

2. Building an Intervention Team: In Texas, Part C of IDEA requires local education agencies (LEAs) to conduct FVAs and LMAs from birth for children with CVI. Teachers of the Visually Impaired (TVIs) and Certified Orientation and Mobility Specialists (COMS) trained in CVI conduct these assessments, essential for determining the developmental, educational, and sensory supports each child needs.

3. Multi-Disciplinary Intervention Team: Children with CVI often have complex developmental needs requiring a multi-disciplinary team that includes occupational therapists, CVI-trained TVIs and COMS, speech pathologists, and special education teachers. It is essential that each team member fully understands the pervasive impact of CVI on the child’s life within their discipline. For example, orientation and mobility experts must adapt techniques for CVI, while speech therapists may need to modify communication strategies for children with CVI-specific processing challenges.

4. Expanded Core Curriculum (ECC): For children with CVI, explicit instruction in all nine areas of the ECC may be necessary. These areas include orientation and mobility, sensory efficiency, social skills, independent living, assistive technology, and more, equipping children with the life skills they need to navigate their environments and develop independence​

5. .Environmental and Home Adaptations: Creating a visually accessible environment at home can make a big difference. This could mean using high-contrast colors, introducing materials with different textures, and using slow-moving or brightly colored objects to encourage visual engagement and promote incidental learning.

6. Assistive Technology: Accessible apps and assistive technology tools aid children in navigating educational and daily activities, supporting both learning and engagement. Assistive devices, such as tablets, can promote interactive learning and visual exploration. Many tools are now available to help children with CVI navigate both daily activities and academic tasks more effectively.

7. Monitor and Adjust Interventions Over Time: CVI interventions are not one-size-fits-all, and as your child grows, their needs and responses to interventions may change. Regular check-ins with the intervention team can help ensure that the strategies evolve with your child’s progress.

Advocating for Educational Services

Finally, it’s essential to advocate for your child’s rights within the education system. Under IDEA, children with CVI are eligible for special education services and cannot be excluded from vision eligibility if CVI adversely impacts their education. Effective advocacy includes collaborating with the school to develop an Individualized Education Program (IEP) that incorporates CVI-specific adaptations and techniques in the classroom and other learning environments, ensuring the child’s unique learning needs are fully supported.

Building a Support Network

If your child has CVI, you’re not alone. Many families are navigating similar challenges. Local or online support groups can offer guidance, share resources, and provide emotional support. Joining networks of families and advocates who understand CVI can help you access the best resources and advice. For families navigating CVI, connecting with reputable organizations can provide that support:

• The Pediatric Cortical Visual Impairment Society (PCVIS): PCVIS offers extensive resources and information on CVI for families, educators, and medical professionals. Visit PCVIS​

• Perkins School for the Blind’s CVI Now: A valuable resource offering comprehensive information and an online community for connecting with other families and professionals navigating CVI. Visit CVI Now​

Conclusion

Early diagnosis and intervention for CVI can lead to significant developmental progress for children. By understanding Dr. Roman’s 10 characteristics, working with an informed multi-disciplinary team, and advocating for specialized educational services, families can help children with CVI thrive in every area of life. With the right resources and support, children with CVI can reach their full potential.