The CVI Assessment Range by Dr Christine Roman-Lantzy is a well-known tool used amongst CVI professionals and parents. I devoured her book, ‘Cortical Visual Impairment: An Approach to Assessment and Intervention’ (https://tinyurl.com/y75ukm94) when I first came across it a few months after Eva’s diagnosis. Dr Roman-Lantzy has created a framework to help parents/professionals perform accurate assessments of a child’s functional vision, called the CVI Range. The assessment includes understanding ten visual functions in a child:
- Colour Preference
- Need for Movement
- Visual Latency
- Visual Field Preferences
- Difficulties with visual complexity
- Light-gazing and non-purposeful gaze
- Difficulty with distance viewing
- Atypical visual reflexes
- Difficulty with visual novelty
- Absence of visually guided reach
A word of caution if you are ‘a dog with bone’ (i.e. me): I became obsessed with assessing Eva – it became a monthly assessment that had consumed me. I don’t think it was very healthy for me to do it so often as Eva’s improvement was not occurring monthly. If I had my time again I would not have done this as often; I went through many moments wondering what the hell was I doing and was it worth it as the results were the same for several months at a time (I did become quite good at observing her though!). A big lesson here is that it very easy to get caught up in assessing your child, which can then turn into a negative experience leading to all sorts of downward spiraling feelings. This is when you need to walk away from it all for a while, which is what I did. From memory I was assessing Eva every month for almost a year until I had to force myself to pack all the paperwork away and take a break. Don’t be afraid to walk away from it all for a while because your sanity is just as important as assessing your child’s vision. I now assess Eva using the scale maybe every 6 months. I don’t put so much pressure on myself because it can make me feel like I am not doing enough for her. Anyway, I digress…
The assessment tool is a great way to work out what areas of vision your CVI kiddo is struggling with, which is then a good starting point when trying to engage them. For example, I found out that Eva had a delayed visual latency of about 10 seconds so whenever presenting items to her, I had to move it in front of her for at least 10 seconds before I knew she would connect with that item visually. I also keep ALL the assessments I have done so I can look back and see what she has improved on, even if it is an ever so slight improvement. Adding notes to the assessment forms is crucial in my opinion, its those little notes that you write are usually the ones that help you work out which little techniques were successful and which were not.
The book is a fantastic starting point if you are looking to assess your child and see how much functional vision they have. It also has a great introduction on CVI and the brain. I personally don’t feel it is written in a difficult language that parents who do not have a medical degree cannot understand (i.e. me). There are a great deal of charts and forms for you to fill in to accurately assess your CVI kiddo, whilst further along in the book there are intervention strategies. The strategies for Phases I and II offer great insight into how to help gain visual attention, such simple but effective exercises that do work.
Have you taken a look at this book? Has it worked for you? There is another fantastic read that I will be posting about soon by Professor Gordon Dutton, a now retired Pediatric Ophthalmologist for over 20 years at the Royal Hospital for Sick Children in Glasgow…stay tuned!