Trying to explain CVI has been a bit challenging for me in my career. Many children I work with have brain injuries and with that many times also have something called Cortical Vision Impairment (CVI). I try to explain it to parents using a metaphor from the book Where is Waldo. In the book there are so many look-alikes before you actually can find Waldo. This is where we use our visual processing skills try to eliminate certain characteristics to find Waldo. A lot of kids with cortical vision impairment struggle from this concept of finding things in a crowded visual space, called “visual discrimination”. However, CVI is much more than just visual discrimination. Some children can’t process certain colors. Some have struggles with perception and some have challenges visual acuity.
The range of the severity of the cortical vision impairment goes from visual impairment to complete blindness. There’s list of visual elements assed during a vision test. A teacher of the visually impaired (TVI) uses a scale to measure the severity of the cortical visual impairment.
The most incredible part of CVI, is that overtime I’ve seen the severity of a child’s CVI improve as a child receives vision services. Because many of the children do not have damage to their optic nerve, the damage resides in the areas of the brain responsible for vision (posterior visual pathways and/or the occipital lobes of the brain). With therapy (I have seen with my own eyes) improvement in their “vision”. How incredible is that?
As a speech pathologist it is imperative I overlap what I am doing with what the vision teacher is doing in order to understand how the child’s vision impacts their communication. For example, If a child can’t yet process faces, how can I expect them to pick their mom in a field of two for a receptive language test? They can “see” but can they process what it is? We then brainstorm on other communication strategies to find something that is dynamic and created for the child that works for them and with them overtime.