What to do for children with cortical visual impairment (CVI)Opportunities to use vision should be incorporated into your child’s everyday life. For example, you might use a red bowl or plate for each meal. Adding a red ribbon to a bottle for younger children works well. You could also place a red object on or near the diaper changing table, car seat or wheelchair. The key is to place opportunities for the child to see throughout their daily routine. It becomes easier and easier for kids with cortical visual impairment (CVI) to see these objects as they become familiar with them. It can also be helpful to keep one familiar object with your child throughout the day. This allows the child to learn to recognize the object in different environments. Furthermore, children with CVI may tire easily when engaged in visual tasks, which is another reason to keep vision sessions short and frequent throughout the day.
In order to maximize your child’s ability to use vision throughout the day it is important to provide spaces that are free of distractions and visual clutter. Learning to see can be very taxing and difficult for a child with CVI. If the environment is too visually complex or contains competing sensory input it can be difficult for the child to focus on visual clues. You can reduce visual clutter by providing an all black background against which the shiny, bright, highly saturated colored objects can be placed. Try to eliminate noise to give your child the ability to simply focus on seeing.
Because latency is a common characteristic of CVI, children often need a lot of time to respond visually. When presenting an object remember that you may need to wait several minutes before seeing a response. This is especially true of unfamiliar objects. When we first started working with Little Bear he would look at objects for only a second at a time before looking away. What was important was that he would return to the object repeatedly.
It’s key to keep it simple when introducing objects to CVI children. Initially, objects should be only one highly saturated color, like fire engine red. Moving objects are easier to see, and shiny objects can approximate movement. For many children with CVI the use of light is also helpful. For example, shining a flashlight on the target object can draw a child’s attention to it. Over time, you can introduce two familiar colors at the same time, then simple patterns with those colors and so forth.
It is also important to remember that it will be much easier for your child to see if your child is properly positioned. This means giving a child as much support as possible. For example, a child who has to work to hold up his or her head will be less able to focus on using his or her vision. Little Bear seems to use his vision best when lying on his back or being held in a sitting position.
Learn as much as you can about CVI. There is not a lot written for caregivers or families, but there are books and papers written for academics, ophthalmologists and vision specialists. A book we recommend is Cortical Visual Impairment: An Approach to Assessment and Intervention by Christine Roman-Lantzy. There is also an online class offered by Gordon Dutton, M.D., a pediatric ophthalmologist from Glasgow, Scotland. The American Printing House for the Blind offers research papers on CVI. For links to these and other resources, check out our CVI resources page.
We recommend you find a vision specialist who is familiar with CVI. Often this can be accomplished through Early Intervention, your school system or your local government programs. Regular visits to provide information, education and further intervention ideas are very helpful.