Introduction to CVI
CVI: A Brief Introduction
Since over 40 percent of the brain is estimated to be devoted to visual functioning anything that damages the parts of the brain used for vision will have serious consequences.
Cerebral visual impairment (CVI) is a complex condition in which parts of the brain associated with producing vision have suffered damage. This damage results in deficient visual functioning, stretching from blindness to relatively minor – but still serious – vision perception impairments. We now know that not alone is CVI the Western World’s most common cause of blindness and severe visual impairment among children, but it is also associated with a range of visual perception problems in childhood. Typically a child with CVI will have eyes which function normally, meaning that the problem is not with gathering visual information but, rather, with interpreting it. As Dutton phrases it:
“Disorders of the eye and optic nerve impair vision in a limited range of predictable ways but when vision is affected by damage to the brain the range of possible outcomes is
wider and the resulting nature of each affected child’s vision and visual behaviour is
arguably unique.” [1]
CVI hasn’t one cause but a myriad of causes, including head trauma, meningitis, encephalitis, intraventicular hemorrhage, metabolic problems, hypoxic brain damage, encephalopathy and structural abnormalities.
Sometimes called cortical visual impairment or neurological visual impairment or, less precisely, cortical blindness, CVI impacts negatively on child’s ability to perform visual tasks and, often, has significant implications for a child’s learning. For example, CVI can cause depth perception problems, resulting in serious difficulties in accommodating to a three dimensional world. CVI may result in problems in tracking movement and in the recognition and locating of objects. The condition may cause visual fatigue, leading to vision related tasks being performed less well at some times rather than at other times, perhaps exposing the child to adult claims of truculence or wilful bad behaviour or, even, laziness. CVI may also present as producing what may appear to be intermittent blindness (although it really isn’t) and in children CVI is commonly associated with orientation and mobility anxieties, poor social and self-care skills, poor reading skills and diminished school performance.
Problems with analysing complex visual scenes may, for example, make it difficult to recognise friends or loved ones in a crowd or to see numbers in columns and rows. CVI may be particularly difficult to diagnose in young children or in children who have additional disabilities, particularly additional cognitive disabilities.
TEACH CVI: OUR PROJECT
The real world problems which result in the lives of children with CVI are many and diverse. However, precisely because the eye itself and its physical structures may be perfect the child with CVI is often misdiagnosed and misunderstood. Children with CVI are sometimes considered lazy, disruptive or disinterested in learning, with teachers and parents confused about the condition or unaware of its existence.
According to Dutton and Lueck [2] children with CVI can be divided into three broad groups:
• those with profound visual impairment
• those who have some useful functional vision albeit alongside additional cognitive
and/or other disabilities
• those who despite impaired vision have enough useful vision – and the ability to use
it – to work at or near expected norms
TEACH CVI is aims to improve awareness of CVI among teachers and social pedagogues across Europe, the purpose being to design, test and implement practical strategies to enhance the literacy attainments of children in each of these three categories.
The project will harness the cross-cultural, multi-professional insights of partner participants to design, assess and deliver a comprehensive, cohesive training package to teachers, social pedagogues, parents and interested others within Europe. The emphasis on literacy recognises an emerging appreciation of the plasticity of the young brain and of the way literacy can be explored as an area of commonality, notwithstanding the wide variations in presenting features from child to child which CVI will involve and the different socio-cultural contexts in which different children live.
Choosing literacy as the project focus recognises that intervention with CVI children is, essentially, educational and environmental rather than medical and, therefore, is rooted in the social paradigm of disability thinking.
More, choosing literacy as the project focus recognises that, pedagogically, reading the word is also, in Paulo Friere’s phrase a reading of the world, creating a dialogical space between teachers and students, between adults and children, that allows us all learn from each other in open and respectful ways. Given that CVI is so often misdiagnosed and misunderstood, the creation of this space through utilising a new and creative approach to literacy – a reading of the world – opens up the potential for exciting new ways of working with children with CVI, both in traditional school settings and wider family and social contexts.
[1] Gordon N.Dutton (2015), Disorders of the Brain and How They Can Affect Vision in Amanda Hall Lueck and Gordon N. Dutton (eds) Vision and the Brain: Understanding Cerebral Visual Impairment in Children, AFB Press, New York at 39.
[2] Gordon N Dutton and Amanda Hall Lueck Impairment of Vision Due to Damage to the Brain in Amanda Hall Lueck and Gordon N. Dutton (eds) Vision and the Brain: Understanding Cerebral Visual Impairment in Children, AFB Press, New York