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By Sara Kitchen, TSBVI Educational Specialist and Ann Rash, TSBVI Early Childhood Specialist

Abstract: The authors describe a demonstration assessment clinic event for young children with cortical visual impairment.

Keywords: cortical/cerebral visual impairment (CVI), blind, visually impaired, visual functioning, CVI Clinic, TSBVI, Educational Service Centers (ESC)

When children who have cortical or cerebral visual impairment (CVI) receive intervention at an early age, they not only progress quickly, but can get a head start on learning to use their vision to the best of their ability before they enter elementary school. The key to successful intervention is to start with a thorough assessment of the student's visual functioning, and identify intervention that is appropriate for that child at their current level of visual development. TSBVI Outreach and Diane Sheline paired for the second time in 2016 with a regional educational service center (ESC) to provide a CVI Assessment Clinic for young children. This clinic was conducted in Fort Worth, ESC Region 11. Vision teachers left the clinic with a completed CVI assessment report, including strategies, adaptations, and programming suggestions that provided support to their students' continued progress in using their vision. During this year's clinic, vision teachers were encouraged to identify goals for next year.

This clinic can also happen in your ESC regional area! We plan to continue with additional CVI Assessment clinics in regions throughout Texas. If you are a vision teacher, parent, or agency serving young children with visual impairment and are interested in this coming to your area, please talk to your local regional ESC VI consultant.

Teachers shared the following comments: "Excellent clinic, lots of useful information, could strongly relate to my caseload. Would like an extension clinic of a "'make and take' for materials to be used," and, "We are learning each time we do this process. Thank you for making this happen for Region 11 TVIs and their young students with CVI!"

The CVI Clinic was an intensive process for vision teachers, requiring a time commitment throughout the entire 2015-2016 school year. The process was divided into small, manageable steps. 19 Hours of continuing education credits were given.  For the first step, vision teachers were asked to complete a parent interview. The parent interview conversation is integral in gathering information, as parents have a wealth of knowledge on their own child and how their vision has changed over time. This conversation functions to build awareness of CVI characteristics for the parent and the TVI, giving them the base knowledge of CVI necessary to be able to apply information from the CVI clinic report. One parent shared, "I would most definitely recommend parents and students participating in the program [clinic]. For me, I always appreciate any time that I can be in a room full of individuals that know or want to better understand CVI. Even after almost 2 years, it can be an overwhelming diagnosis, so I love to get ideas and feedback."

The second step for vision teachers was to gather observation videos. These videos were submitted to help facilitators become familiar with the children's CVI characteristics that were evident within everyday activities, environments and with familiar objects.

Photo of a baby looking at brightly colored toys.The first two steps were paired with hour-long conversations, via webinar, between facilitators and TVIs to discuss and explore the details. Facilitators and TVIs then used approximately three hours to compile information from parent interviews and observation videos to complete those sections of Roman-Lantzy's CVI Range, Rating 1. This process helped to plan the direct assessment, which took place in person the day of the CVI Clinic.

Student assessments were scheduled in two-hour increments with short breaks between evaluation sessions on the day of the CVI Clinic. The parents brought their children and the child's familiar toys and snacks for their two-hour slot. The TVIs stayed all day to observe all students participating in the clinic. TVIs came for a half day the second day and worked on student specific reports with assistance from facilitators. Additional teachers of the visually impaired were given the opportunity to register as observers of any number of assessments on the day of the clinic, even though they did not have a student who was being assessed at that time, and were given continuing education credit accordingly.

Teachers and parents have reported a month later that they are using and/or planning to purchase items discussed in CVI reports that were written by the TVIs.  Students are responding more consistently to visual stimuli and parents and teachers are putting into place recommended materials and interventions. From the ESC VI Specialist, Stephanie Walker: " The CVI Clinic was wonderful!! Thank you for coming to ESC region 11. Thanks to all the teachers that participated."