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Promising practices and CVI

Until we have more research, many interventions used for kids with CVI are known as promising practices. Here's how to think about what works.

A young girl painting

As the parent of a child with Cortical Visual Impairment/Cerebral Visual Impairment (CVI), you know that time is of the essence: What’s the best way for my kid to access his learning? What needs to be in place immediately to ensure progress? What are some quick tips and strategies? And which evaluations, assessments, and interventions work best for my child with CVI?

But when it comes to CVI, parents and educators have a challenge. We’re learning new things about CVI all the time. We don’t have a long history of best practices, bolstered by years of evidence. There are lots of strategies and approaches, but we don’t yet fully know why they work and who benefits most. We need more research.

This is partly because every child with CVI is so unique. No two experiences are exactly alike. You may see strategy suggestions, programs, CVI iPad applications, or YouTube videos shared for children with CVI, but do they match your child’s individual skills and needs? They might not.

We know that for kids with CVI, it’s all about access. At every turn, professionals need to consider the environment, physical positioning, materials, presentation, and instructional methodologies that match each child’s unique visual profile.

Just the same, there are some strategies that work for many kids with CVI; for example, reducing the complexity and clutter in the environment or using familiar items to support the development of concepts. But it’s also important to know that there’s no one-size-fits-all solution. A literacy intervention that might work with one kid might not work with another. CVI professionals are constantly iterating and innovating.

In education, you often hear about evidence-based practices. These are practices that are supported by robust, well-designed, and peer-reviewed research studies. At the moment, many interventions used for kids with CVI are known as promising practices instead. These practices need to be applied carefully, with their effectiveness determined through measurable results and successful outcomes, as supported through data collection. For some of those promising practices—even if not bolstered by a wide swath of research evidence—the effectiveness can be extrapolated and generalized across the CVI population. Here’s what we do know:

For CVI, a promising practice should be:
  • Well-understood. Who created this promising practice, and what research is it based on? Why was it chosen? For whom did it work? How was data on efficacy gathered? Were certain environments needed for success? Were certain materials needed for success? Was there an optimal time of day for this programming to be the most effective?
  • Well-executed and meet clearly defined goals, such as Individualized Education Plan (IEP) goals and objectives.
  • Scaffolded, which means that learning is based on a solid foundation and that next steps are well thought out. The goal of scaffolding is to carefully progress toward stronger understanding and independence in skills. It should be sustainable and integrated into your child’s educational programming.
  • Collaborative among team members. Does the practice consider a whole-child approach? Does your child have the skills across the board to access the recommended practice?
  • Data-driven, based off of clearly written and measurable educational goals and objectives in the IEP to determine improvements in skills.
And there are certain areas where we can apply promising practices across the board. They include:
  • Developing an IEP: A good IEP should truly reflect your child’s needs, based on a clear assessment with the right form of service delivery.
  • Addressing broader educational goals: The Expanded Core Curriculum (ECC) includes things like concept development, social skills, active learning, advocacy, compensatory skills, independence, and incidental learning. Visual impairments of all kinds require the team to “fill the holes” in learning that are missed by any child with visual impairments.
  • Understanding access to literacy: For kids with CVI, understanding an approach to symbols literacy—for example, when learning math, accessing a communication device, or reading print or Braille—is critical.
  • Adapting the environment based on results of your child’s functional vision and environment assessments: For example, when engaged in challenging visual processing tasks, your child most likely requires an environment with reduced visual clutter, noise, distracting light, and movement. Learn more about designing an accessible school day from Matt Tietjen’s webinar about his “What’s the Complexity?” Framework.
  • Using specific materials and presentation methods based on the results of your child’s functional vision and learning media assessments: For example, your child most likely benefits from reducing the amount of items presented and adding space between visual targets (objects, symbols, pictures, letters, words, sentences). Learn more about promising practices for CVI and Literacy from Judy Endicott, a reading specialist and CVI grandmother.
  • Evaluating and addressing visual overload at all times, and proactively building in visual breaks to avoid cumulative visual fatigue.
  • Adjusting and adapting for visual field loss, and understanding its effect on access to learning.
  • Providing increased time for tasks such as visual attention and visual recognition.

It’s important to consider the range of promising practices being explored for children with CVI. There are no blanket solutions. Among many things, your teacher of the visually impared (TVI) should think about:

  • How your child’s assessments and evaluations inform learning strategies
  • Your child’s unique visual behaviors
  • How to evaluate a strategy’s effectiveness using pertinent data
  • Whether the strategy is backed by scientific research or, if not, if it’s a promising practice that could be tried, applied, and carefully monitored for success
  • How to use certain practices selectively and monitor them appropriately
  • Collaboration partners who can help execute the practice (for instance, a reading or occupational specialist and parents, who carry over this practice to home and community)

To that end, it’s important to regularly check in with your TVI or additional team members to discuss the rationale behind their strategies. Don’t be afraid. There’s nothing wrong with advocating for your child.

When meeting with your TVI, make sure to discuss:

  • How he or she is measuring success
  • When to shift gears if something isn’t working
  • What evidence and research they’re using to determine your child’s plan

Most of all, it’s important to collaborate with your team on promising practices. Here’s how.

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