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CVI: Visual recognition

Learn how difficulty with visual recognition is a big part of CVI, explore some observable behaviors and compensatory skills, general ideas for accommodations, and current research.

Access the video transcript.

At Perkins, we are a gathering place of ideas. The CVI visual behaviors synthesize current research and build on the work of leading theorists in the field. CVI is a lifelong disability and we want to ensure that all individuals with CVI are fully understood. The CVI visual behaviors are an ongoing need, they can change and they can improve for some, but the need never goes away. No one area is separated from the other—the CVI visual behaviors are highly connected and all can impact the individual with CVI at any time.

What is visual recognition?

Visual recognition is perceiving an item, animal, or person and knowing what is because you have seen it before or seen something similar. When we recognize something, we compare something in view to the huge library in our visual memory. We have a visual template that we are consistently using to match what we see. We make connections between what we are seeing and what we have known before based on shape & size, function, context, language, feel, sound, and other senses. Each time we see an object and interact with it in a meaningful way, our visual reference library is strengthened. Recognition relies on stored information and the ability to retain and recall that information.

The act of visual recognition requires perception (being able to detect and see something), prior knowledge (having seen that something before), and linking the perception to that stored memory of the perceived item–being able to access your memory bank and pull out the relevant information.

Dr. Corinna Bauer, Ventral Stream Functions in CVI: Object and Face Perception.

Difficulty with visual recognition is a big part of CVI. People with CVI may have difficulty recognizing objects, animals, visual scenes, environmental targets, people, faces, and many other facets of our visual world. Without recognition, the world becomes a barrage of meaningless visual input. CVI has diverse manifestations, and visual recognition skills fall on a spectrum. Some with CVI may read print and chapter books and recognize a wide variety of objects, but they have trouble walking down a hallway or navigating a new, unrecognizable environment. While others with CVI may have difficulty recognizing objects they’ve seen before or processing 2D materials, such as pictures and print text. 

People with CVI may not recognize something because it can’t be seen well (difficulty with input), it’s not known (no prior experience), or both—when the visual input is unclear and they may not have prior knowledge of it (Bauer, 2021). It’s important to remember that many factors may cause a person with CVI not to see well (even if the person has normal/near-to-normal acuity): fatigue, competing sensory inputs, stress, illness, visual field loss, co-occurring physical or neurological conditions, or new places and tasks. And to layer on that, many with CVI also have eye conditions, which can compound an already complex visual impairment. If something is not perceived because it’s not seen well, it can’t be recognized. 

For sighted people, seeing something once or a few times, whether through incidental passive observation or direct interaction, is enough to create a visual memory that can then be used to recognize an object, even if the position, size, angle, perspective, shape, lighting, or color changes (also known as perceptual or form constancy). For example, a child sees a duck walking by a pond and the parent says, “Oh look at that duck!” During nighttime read-aloud, there are pictures of ducks in the story that the child immediately recognizes. These experiences build the memory of the visual attributes of ducks, which can then be applied to many iterations: actual ducks in the real world, pictures, and abstract drawings in different sizes, colors, and angles. 

The child has “duckness,” a term that Ellen Mazel, a leader in the CVI field, discusses a lot: “Our children with CVI lack this visual access to ‘duckness.’ They lack the expanded and repeated knowledge about ducks. If they have seen a duck, their idea of ‘duckness’ is limited to that one duck.” 

The way we see the world is heavily influenced by what we expect to see.

Dr. Lotfi Merabet

For many with CVI, the brain has difficulty building a robust visual library. Even when the brain can add an item to the visual library, applying that visual memory to unfamiliar versions of a well-known object can be extremely challenging, this is why repetition and familiarity are important foundations for instruction and learning.

People with CVI may have difficulty building a robust library of visual memories because

People with CVI may rely on compensatory skills to help track an unrecognizable visual world (listen, touch, color, context, prediction, memory). As sighted individuals, we can take for granted the amount of information we acquire visually. For example, we know that an unsanded piece of wood will be rough just from looking at it.

Some with CVI may recognize:

Remember looking is not understanding. Ask an individual what they see and experience. The establishment of relationships and parent/caregiver knowledge is essential. Comprehensive CVI assessment must go beyond eye-to-object fixation and deeply evaluate visual recognition and all the strategies a person with CVI uses to figure out what something is. For an evaluator to know there is visual recognition, a reliable response from the individual with CVI is required, whether that be vocalizations, speech, facial expressions and body language, sign language, and other manual gestures for example. To the extent possible, having the person with CVI participate in their interview for their assessment is another way to document recognition and related strategies.

I can recognize things only if they are highly familiar and if I use them frequently. I use my Mickey Mouse mug every day. I can recognize it in any setting, but it would be harder for me if it was mixed in among several different objects.

Micah, a young adult with CVI 

What are some compensatory strategies related to visual recognition?

People with CVI have strategies and workarounds for so much in their daily lives, and compensatory skills to help track and make sense of an unreliable visual world. At times, recognition may be solely dependent on compensatory strategies.

As for objects? Now, that’s where things got dicey. I would try to identify objects and would fail, often hilariously. I guess this is what the scientists call visual agnosia. I remember seeing a patch of gray against a yellow background at home once. I knew our couch was yellow, and I knew my cat was a gray tabby. I excitedly got on the couch and curled up next to my sweet baby, looking forward to his warm soft fur, only to find that my “sweet baby” was actually a rough, cold, stiff blanket. 

Nai Damato, adult with CVI, The CVI Perspective

What are some look fors/questions when observing your child with CVI?

These days, I marvel at all the compensatory strategies my kid uses to make it through an unrecognizable visual world. He’ll rummage through the snack cabinet, shake the boxes of cereal and crackers, until he finds the one that sounds just right. He’ll ask who just sat down at the table or pull out something from the fridge and ask, “What is this?” He’ll touch all of the food on his plate until he knows everything that is there.

CVI parent

What are some examples of adaptations and accommodations? 

All accommodations must be based on individual assessment. The following are meant to inspire and provide a general idea. Accommodations and instructional approaches must be student-specific. Access is individual. 

The main goal of accommodations and adaptations for CVI is access to learning. Recognition equals learning, and learning is not only accomplished visually. But it can be incredibly fatiguing for people with CVI trying to figure out unrecognizable items or environments without the necessary adaptations and supports. Many with CVI need strategic teaching methodologies, visual adaptations, and opportunities to use other sensory channels (auditory, kinesthetic, and/or tactile) to support understanding and concept development.

Remember, vision is not reliable 24/7, so what accommodations and adaptations are required for the student with CVI to access their learning throughout the entire day? Supports are also not a hierarchy, meaning visual accommodations are not the be-all-end-all for some with CVI, sometimes tactile and auditory supports need to take the lead. It’s about balance and what works best for the individualized needs of the person with CVI.

Adapt the learning environment

Adapt the learning task

Full access to learning (because vision is not reliable 24/7)

Find more examples from a guide to common CVI IEP accommodations in the CVI Now IEP Guide. 

You don’t perceive objects as they are. You perceive them as you are.

David Eagleman, Livewired: The Inside Story of the Ever-Changing Brain 

Following the science

Connecting current research of the brain, our visual system, and CVI to better understand the CVI visual behaviors.


References

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