a blog about raising a daughter with cerebral palsy and learning unexpected lessons along the way

Friday, February 10, 2012

CVI and Visual Clutter

I recently met with the new vision specialist that services Oia's school. She is different than the specialist who assessed Oia last year and thankfully so. This recent meeting has shed some light on things that were going unnoticed by both myself and Oia's teachers. Namely, visual clutter and the behaviors that stem from it.
If you Google the term "visual clutter", you'll get all sorts of articles pertaining to messy desks and unorganized spaces. Refine your search to something pertaining to clutter and visual impairments and you get more than enough on CVI, Cortical Visual Impairment. Those with CVI can have normal eye capacity (healthy eyes) but once the image reaches the brain, it is often difficult to interpret or process correctly, usually due to an interruption of information as the result of a severe injury to the brain or a brain malformation. Focus and concentration are not amoung the easiest of things to do when the brain doesn't play nicely with the eyes. Is this why my child never stops to sit for long, or at all most days, not even to eat? Anyways, I digress...
Oddly, until now, CVI has never been mentioned to Rob or I by neither a neurologist or an ophthalmologist... and remember, Oia has a significant congenital brain malformation. Because the term has never been bounced in our direction, we assumed Oia wasn't effected by it and therefor we've spent no time researching it or living life as though she has it. But after doing the smallest amount of research on CVI since our meeting, it seems like CVI is almost a given when brain injury or malformations are present. The vision specialist noted that many of the behaviors she observed while working with Oia were classic behaviors for kiddos with CVI. For example, Oia gets "lost" before some activities even begin if the activity involves multiple objects/materials. Objects must be sequenced, and introduced one at a time in an uncluttered environment to increase Oia's ability to focus. If her sweet brain is trying to channel and process too much at once, she's over the task before it even gets started.
Another example, the specialist noted that Oia looked at an object on the table in front of her, glanced away from the object, then while looking away, reached and picked up the object with accuracy. For reasons that are unexplained, seeing objects is sometimes easier for CVI folks when not looking directly at them. Think about trying to walk around your house in the dark... ever turn your head slightly and look away from the direction you are trying to head to find that you can see your destination a little better? Perhaps this is the same concept for Oia in the daytime. And is this why she so reluctantly looks at our faces, or makes eye contact when speaking or being spoken to, especially during speech therapy? She will and can look at someone when asked to but quickly chooses to look away... hmmmmm.
I realize a vision specialist is by no means a doctor but her input is definately something to think about. We will just continue with the visual accommodations we have been using and be more mindful of and implement the visual strategies I've found in my searches that are helpful for kids with CVI. I'll be adamant that Oia's teachers are mindful as well. CVI or not, Oia is amoung the visually impaired population and these strategies can't hurt her. The vision specialist will schedule with Oia's teacher once per grading period for 30 minutes to offer suggestions that will hopefully enhance Oia's learning environment by avoiding the visual clutter. One of the comments on Oia's most recent IEP report stated that "Oia is interested in learning new concepts however her vision is a major obstacle to her learning at this time." Reading that sucked and it was the first time vision difficulties have ever been noted on her report. But it is what it is. Visual accommodations are a must for our preschooler now more than ever. Bolder prints, larger fonts, contrasting objects, simple generalizations, minimal "clutter", realistic pictures, and whatever else we need, we'll do... all for a girl who deserves to see and learn the world like anyone else.


  1. Oia is looking so grown up! I love her hair! This post was so informative and helpful. Definitely something I will watch for with Sebastian, especially in regards to learning. You are awesome.

  2. My Emma, who also has CP, has CVI. So much of what you are descibing sounds like what I see in Emma, especially the lack of prolonged eye contact and looking away with a reach. I definitely think you will see some big improvements with schooling/focus/mood when you implement the changes. I am glad that you got vision specialist/therapist that took the time to see the signs. Glad you got this information early in Oia's educational journey.

  3. My daughter, Olivia, also has CVI. Her progress in all sorts of areas of development have taken off since we have been working with a vision teacher. She actually attends a preschool for visually impaired children and the difference it has made for her is incredible. Oia, by the way, is adorable!

  4. Thanks for posting this beautiful girl's pictures today!