CVI Momifesto

Adventures in Advocacy / DC + MD AER Conference

April 3, 2018April 3, 2018 CVI MomifestoLeave a comment

It’s been a busy couple of weeks here at CVI Momifesto. Spring is conference season. Time for the experts in everything to get together in quaint or exotic places to compare notes, to share their research, and, maybe to learn a new trick or two.

It’s been a great conference season in terms of building momentum and raising awareness about the learning needs of children with CVI. Needs that continue to be unmet in most educational settings across the country.

(Then, it’s Spring Break, and all bets are off for writing any blog posts as your children run amok in your house demanding to be fed, nurtured, and challenged at board games. But I digress.)

So far this year, CVI was a hot topic at the American Association for Pediatric Ophthalmology and Strabismus. Also, several AER conferences admitted presentations by educators and parents about Cortical Visual Impairment. The Northeast AER conference included presentations on CVI (from Dr. Christine Roman-Lantzy, Ellen Mazel, and Peg Palmer among others) in each slot in their schedule. Virginia AER had several presentations including a parent’s perspective on the challenges of getting a Free and Appropriate Public Education (FAPE) for a child with CVI.

At the Pacific Northwest AER conference, MaryAnne Roberto, a CVI Endorsed Teacher of the Visually Impaired (Envision CVI Consulting), presented on Current Trends in CVI to standing room only crowds.

On March 15th, this CVI mom drove to St. Michael’s in Maryland for the DC / Maryland AER Conference to reach out to Teachers of the Visually Impaired and Certified Orientation and Mobility Specialists. Thanks to Karen Frank and the AER folks who allowed me the chance to talk up the urgent need for educators to get more training to help children with CVI build functional vision.

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Image: Rob Hair, Michelle Horseman, and Karen Frank from the Maryland School for the Blind

Image: Dr. Michael Bina from the Maryland School for the Blind and Rebecca Davis

The Executive Director of AER, Lou Tutt, attended this conference and sat in on my presentation. When I suggested to the audience of teachers that they contact AER to tell them they support more training for TVI in Cortical Visual Impairment, I didn’t have to give Mr. Tutt’s email address. I just said, “There he is.” He was a great sport about it.

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Image: Lou Tutt and Rebecca Davis

If you have any luck sharing your stories at a conference or a meeting of educators or doctors (or legislators… or anyone who will listen), send us your story! CVI Momifesto would love to expand the scope of both personal stories and adventures in advocacy.

Moms on Monday # 18 / Lacey from MA

April 2, 2018April 2, 2018 CVI MomifestoLeave a comment

Good morning fellow families of delicate chubby cheeked children who happen to have Cortical Visual Impairment,

This morning’s Mom on Monday is Savannah’s mom, Lacey. Savannah is leading her mom on a journey of joy, challenges, and education.

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Sweet Savannah Mae is my little six year old blessing. Oh, how I love everything about her. My journey in life is led by a little girl. She is paving the way. She is my tiny little teacher.

savannah

Image: A smiling young girl in glasses

It’s been six years since Savannah was diagnosed with cortical visual impairment. That day will forever be stamped in my heart. Savannah was diagnosed with cortical visual impairment at 8 months old. Before the diagnosis, I will never forget her six month appointment at our local ophthalmologist. We had been referred by Early Intervention because as our early interventionist put it, “It’s like the lights are on and nobody is home.” Yikes!! I’ll tell you I’m a lot stronger now and I would never stand for that insensitivity, ever. That was a different time and a fragile place so I just went along with the referral.

Our local ophthalmologist had real vision concerns and wanted to refer her to a specialist in Boston. Savannah had a normal eye exam but he thought she might be blind. But wait, she sees her spoon coming and opens her mouth for food and she loves to look at the mirror above her infant swing. She can see. She loves to look at the overhead lights and she knows exactly where they are, even if the lights are off. It went as far as her dad and me calling our overhead lights, “her friends”. Due to her hydrocephalus, I always thought her eyes were just a bit different. They were aligned by this age, at least mostly, and not in the sun setting position due to hydrocephalus. Little did I know at that time.

It had already been a busy eight months, six weeks spent in the NICU and the appointments that followed, all while try to juggle work as a “medical mama”. My little warrior girl had brain surgery at one day shy of one month. Our schedule was filled with appointments, follow up, and just maintaining her overall care. On February 1st, 2012, her dad and I arrived at Boston Children’s Hospital. When our appointment started, Savannah was brought into a room for a preferential looking test (PLT). This is a visual acuity test for young or nonverbal children. Black and white stripes are presented and as they get thinner, an evaluator will determine if the child is looking towards the striped pattern. They use the stripes as an acuity measure which is calculated based on the size of the stripes the child can locate.

Next was a VEP, also known as a visually evoked potential. This test records electrical activity in the vision portion of the brain. The patient is positioned in front of a computer screen with electrodes strategically placed on the patient’s head. The computer screen is a black and white checkerboard pattern. This test evaluates vision functioning in the retina-to-brain nerve pathway. Ophthalmologists might use this as a tool when considering the diagnosis of Cortical Visual Impairment (CVI). Not all children with suspected CVI have this as an option but we are fortunate enough to live in an area with advanced medical care.

Following testing, we met with a highly recommended ophthalmologist. She told us that our daughter was legally blind. She has “cortical visual impairment.” She told us, “We will register with Massachusetts Commission for the Blind and with Perkins School for the Blind.” I tried listening but all I heard was BLIND, not truly knowing the definition, not truly understanding how this could be. She had already been through so much in her short life.

The visit concluded with a prescription for glasses. Savannah was prescribed glasses due to her astigmatism and because she was farsighted. She was getting glasses!! At eight months!! I couldn’t decide to dance in excitement with the thrill of a new accessory or cry because she was a baby and I didn’t know a single baby that wore glasses. I do have to admit she looked adorable in her first frames that were entirely too large for her delicate chubby face.

sav baby

Image: An infant wearing glasses

The ride home was rough and filled with tears. Mark drove, as I couldn’t contain my tears. I called my mom to tell her and I couldn’t even get out a word because I was crying so hard. As we pulled into our narrow drive, Mark’s emotions were also evident as he hit the side of the neighbor’s house. It was devastating for both of us to get this type of news. The tears continued for a week. And then suddenly, I decided to embrace my journey.

A little more about my sweet little girl. My love for her is something fierce. We share a special bond. She has defined me into who I am today. She is a happy but feisty little girl. She smiles with her entire body, especially to the tune of a xylophone. She fills every crevice of my human body with joy.
My life with Savannah has always seemed complex but normal. It’s my normal. It’s everything I know about motherhood. It is 100% normal to us, even when it might not seem normal to others.

At birth, Savannah suffered a grade 4 brain bleed, periventricular leukomalacia suggestive of hypoxic ischemic injury. Savannah has a diagnosis of hydrocephalus and had a VP shunt placed one day shy of a month old. At almost five years of age, Savannah was diagnosed with Ogden Syndrome, an extremely rare syndrome also known as a Naa10 mutation. I mean, she is a diamond in the rough. And this kid sparkles. Savannah is one of 18 in the world with her exact mutation and 1 of 29 with a variation of the Naa10 mutation at this current time.

But let’s get back to her vision. I remember reading Little Bear Sees, which I highly recommend to any parent of a child with CVI. I remember thinking by her current age she would have near normal vision. We are part of the CVI endorsement so I can’t talk about phases and scores but I can tell you, any child with CVI faces many obstacles. Her vision is anything but typical, but it is what she knows and what we know for her. We are working hard to help decrease the frustration that comes with low vision and nonverbal communication. Along with her vision, Savannah is equally as complex. At this current time, she is not sitting, walking, or talking.

She is happy and loved fiercely.
That is what matters most to me as her mommy.

As a mom, I’m hopeful. I TRY to put the best interventions in place. Savannah continues to make visual progress, especially if food and beverage are involved. She is great at locating objects in her environment using her peripheral fields. I am working hard, as her mom and her advocate, to help her start using her central vision. Her team at school is also working toward this goal. Savannah knows some routines, and she continues to make strides in every area of development. She is an amazing little girl and I am so blessed to be on this journey in life with my sweet Savannah Mae.

sav with blocks

Image: A little girl in glasses playing with yellow blocks on a lightbox

Savannah has really inspired me to be the best I can be for her. This journey we are on led me to graduate school. I completed my Masters in Education and I now work as a TVI with the youngest children. I am also very close to becoming CVI endorsed. I absolutely love helping children learn to use their vision but also supporting their families during this fragile time.

Savannah has improved in every aspect of her life but she is on her own chart, in every single way. I once read from a blog I follow of another child with CVI, “she is just inching along”. This is a phrase I like to use now. Milestones are just so big and inchstones are much more appropriate.

Another mom in my Naa10 group wrote an article and hands down my favorite quote, “It’s like raising a giant question mark!” Yes, it totally is!!!

Thank you Lacey and Savannah Mae, this beautiful one-in-a-million girl! Your journey together is helping other families who face similar challenges.

Moms on Monday #17 / Maggie from PA

March 26, 2018March 26, 2018 CVI Momifesto4 Comments

Good morning!

Today’s Mom on Monday is Will’s mom, Maggie. Will has a smile that will brighten your day. Maggie has experience, wisdom to share and a “can-do” spirit that has taken them all over the country.

Introduction: Maggie, mom of Will, age 9. We live in Feasterville, Bucks County, a suburb of northeast Philadelphia, Pennsylvania.

What does Will like to do? What makes him laugh? What are his favorite activities? What do you do as a family?

Will is a very happy, very social, very adorable redhead who has a smile that makes you smile when you see it. If you get him giggling you are certain to laugh, too. He has always loved music. I remember him lying on the hospital bed the day after he was born, all bundled and ready to make our journey home. Only his face was exposed. I put my face close to him and quietly sang “Somewhere over the Rainbow” to him. He quieted and just “stared” at me while I sang. From then, whenever he is fussing or restless, he will still quiet, or calm, when I sing to him.
We also loves water. He is very discerning though because the water must be warm. He wears his life jacket and we put ankle weights on, which allows him to bob in the water upright. He loves the freedom of kicking and moving in the water.

will in pool

Image: Will in a life jacket with his dad in a pool

Another activity we do is traveling! This boy is very well-traveled. We estimate that he has visited 16 states and DC. He has traveled coast to coast and north to south on around 2 dozen flights in his action-packed 9 years. We decided early on that we would not let his challenges keep him from experiencing his world. He is a great traveler both by car or plane.

Image: Will, a smiling red haired boy

We travel with Will’s stuffed friend, Cordy Roy, who gets a photo shoot at every location we travel to.

Image: Will’s stuffed toy, Cordy Roy, next to a Bedford County sign

will in van

Image: Smiling Will in a wheelchair in a van

When did you first learn about CVI? How were you given the diagnosis?

We knew something was wrong when Will was about 1-month-old. He wasn’t tracking us with his eyes and he wasn’t smiling in response to our facial expressions. He had an unfocused stare. Not long after, we began our journey of discovery. After several tests, we found ourselves at the neuro-ophthalmologist at CHOP who gave us the official diagnosis of CVI. We were fortunate that he was diagnosed very early without any resistance from our neuro-ophthalmologist.

We began consulting with Dr. Roman early. We started seeing her every 6 months for a few years. Now we visit her annually. So, we were luckier than many and have known about CVI for a long time.

How was Will’s early intervention experience with regard to CVI?

We already had begun learning about what CVI meant through our early intervention TVI, MaryAnne Roberto. We were so fortunate that she was assigned to Will and had a lot of knowledge about CVI. She pointed out Will’s behaviors that supported the diagnosis. She helped us create an environment that accessed Will’s vision. She was also instrumental in linking us to Dr. Roman in Pittsburgh. We started seeing her every 6 months for a few years. Now we visit her annually. With our neuro-ophthalmologist, MaryAnne, and Dr. Roman, our knowledge of CVI and the world of accommodations began.

will with rl

Image: Will with Dr. Roman-Lantzy and his dad

Does Will have other diagnoses you’d like to mention?

Will lived in the land of “undiagnosed” for the first 5 years. We had many diagnoses – global developmental delay, seizure disorder, failure to thrive requiring a feeding tube, non-verbal, non-ambulatory, CVI, hypotonia, microcephaly, cataracts – but no overarching name of the cause.

Genetic testing in first year was inconclusive. When he was 5, we decided to revisit genetic testing. In March of 2014, we received the call that our son has a rare genetic disorder called FOXG1syndrome.

FOXG1 syndrome is a spontaneous genetic mutation that affects approximately 300 children in the world. Neither Will’s father nor I have this error, but when we looked at the characteristics of the syndrome – love of water, love of music, CVI, feeding issues, seizures – Will’s picture could have been posted next to the definition. A diagnosis at last!

It did not change our interventions, but it did give us a group of parents who are also living with the consequences of FOXG1.

How is CVI being addressed in Will’s school setting?

CVI in school has been a different story from our early intervention experience. Our early intervention team embraced the CVI interventions that MaryAnne shared so generously. It hasn’t been so easy in school. The vision team is not educated in CVI. They have been resistant to learning about it and adapting Will’s materials. After 2 years with few adaptations and the purchase of a communication device by the school district, we have finally put our feet down and said enough is enough. They cannot continue to work without making vision a priority. So this year’s IEP reflects a lot of changes. With the assistance of an advocate, we had a CVI endorsed TVI come in and complete a new CVI Range. The score on the range revealed a loss of visual literacy. That led to new goals and a significant increase in vision service time. Sadly, the vision team still does not share my sense of urgency. This is an ongoing source of friction. It’s heartbreaking since we really want to have a better relationship with our TVI and Will’s vision team.

What would you tell a mother whose child has just been identified with CVI?

I would say two things to other moms.

First, do not give up. Do not despair. Your child knows your voice and your touch. He/she knows you even though they don’t seem to acknowledge you. With time and training, your child WILL see you.

It was a momentous day when Will looked at me and “saw” me! He now has more than 12 feet of functional vision and can most likely see farther.

The second thing I want parents to remember is to presume competence! I have found over and over that Will surprises me with what he knows and can do! Set the bar high, work hard, and be amazed with what your child will do!!!

What would you like for people who have never heard of CVI to know?

Other people should know that CVI is a vision impairment that is neurologic in nature. With time, patience, and specific interventions and accommodations, vision can be improved! If a child can achieve a certain place on the CVI Range, he/she may sight read. If that is achieved anything is possible for that child!

What are your hopes and dreams for Will?

Our goal for Will is to be the best Will he can be! We don’t know what that is yet, but he is still full of possibilities! We will continue to work and help him achieve his greatness!!!

Image: Smiling Will wearing a Start Seeing CVI t-shirt

Thank you Maggie for sharing your journey with your handsome, red haired, well traveled young man! He IS full of possibilities!

AAPOS 2018 / Champions and Challenges

March 24, 2018June 28, 2018 CVI Momifesto1 Comment

The annual conference for Pediatric Ophthalmologists from all over America and around the world has ended. From one mother’s perspective, volunteering at the conference was an education in itself.

CHAMPIONS

For the first time, the Pediatric Cortical Visual Impairment Society had a table in the AAPOS (American Association for Pediatric Ophthalmology and Strabismus) exhibit hall.

The Pediatric CVI Society is the one organization in America focusing on raising awareness about CVI and advocating for improvement in medical and educational outcomes for children with CVI. It is a 501 c3 non-profit organization driven by membership and donor funding. HINT HINT (www.pediatriccvisociety.org)

The PCVI table was around the corner from the Perkins School for the Blind table. Perkins has become a leader in moving education about CVI forward for providers and families. (www.perkinselearning.org/cvi)

Carol Kinlan from Perkins and I referred interested doctors to each other’s tables. It was very encouraging to have another champion for children with CVI in the exhibit hall. Not only is there strength in numbers, there is momentum in numbers.

And, there was yet another champion for children with CVI raising awareness and creating traffic at the PCVI and Perkins exhibit tables.

Dr. Sharon Lehman, a Pediatric Ophthalmologist from Nemours Hospital in Delaware, generated interest among the attendees with her scientific poster presentation on a survey she sent out to pediatric ophthalmologists and teachers of visually impaired.

Here is some of the information from this poster presentation. CVI families may find this particularly interesting.

Attitudes Concerning Cortical Visual Impairment Among Pediatric Ophthalmologists and Teachers of the Visually Impaired.

METHODS

An email study was distributed to the 2 groups via their two respective national organizations (AAPOS and AER). The survey contained questions about the following:

Frequency of seeing children with CVI

Adequacy of education about CVI during training

Comfort with making diagnosis

Adequacy of communication from the pediatric ophthalmologist

Comfort with making recommendations

Referral of patients for services

Interest in receiving further education about CVI

RESULTS

The response rate for pediatric ophthalmologists was 8.0%.

The response rate for TVI was 14.8%.

A significant gap was identified in opinion of the adequacy of communication from the pediatric ophthalmologist to the care team.

Communication was deemed adequate by 61.9% of pediatric ophthalmologist respondents while it was considered not adequate by 68.4% of TVI respondents.

The majority of respondents of both groups (80.5% of pediatric ophthalmologists and 85.8% of TVI) wished to learn more about CVI.

DISCUSSION

The survey highlights gaps in knowledge and attitudes concerning the care of patients with CVI that limit the effectiveness of the team’s patient care. The strong desire to learn more about CVI is a positive finding that bodes well for patients.

The relatively low response rate (8.0% of pediatric ophthalmologists and 14.8% of TVI) is a limitation. It may indicate that there is a core section of individuals within both provider groups interested in CVI who could develop expertise in providing services for children with CVI. The attitudes of the nonrespondents is unknown and could be valuable in interpreting the data.

CONCLUSION

Lack of standardized methods for evaluation and diagnosis and for providing recommendations for children with CVI create challenges for the care team. Improved clinical education of pediatric ophthalmologists and TVI and development of standardized tools that can provide the patient’s team with necessary information are practical ways to approach this problem.

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It was heartening to see research about CVI discussed by the medical community. We need our pediatric ophthalmologists to acknowledge CVI and to learn what to do when they identify a child with CVI. Dr. Lehman’s work is having a positive impact.

Challenges remain.

Here is what I heard from the majority of doctors who came to the PCVI Society table to get more information and resources for their patients and to join the email list.

“I see so many of these kids in my office.

I get so many of these kids.

I don’t know where to send them.

I don’t know what to give them.

CVI is scary.

I don’t know what to do with it.”

I am glad these doctors were willing to approach the PCVI Society table, and to admit that they need more information. I am glad that this year these doctors left with a list of resources and take away information about how to diagnose CVI.

Bravo to the doctors who are seeking out new information and who are not afraid to admit that they have more to learn. Bravo to the doctors who are seeking out a community for their patients. They are championing children with CVI as well. Someone should bake pies for these people!

Encouraging education and debate about Cortical Visual Impairment (Cerebral Visual Impairment, Neurological Visual Impairment, Rumplestiltskin – whatever term we are using today) is critical to the common goal of getting our children diagnosed more quickly and accurately.

To this mother’s untrained eye, it seems as though, until recently, when conversation about CVI turned into debate about which word follows the “C” – Cortical or Cerebral – the debate stopped. The opposing sides retreated to their camps and dug in until further notice.

This unyielding approach (from the jaded and sleep deprived eye of a mother who sat through too many hours of unsuccessful IEP meetings, so consider the source) does a disservice to doctors, teachers, families, and most importantly, children.

This approach has left many children sitting in classrooms without access to their educational environments. This approach has left many confused parents piecing together information from competing (?) sources in their individual attempts to educate the uninformed doctors and teachers in their child’s life. This “approach” is not an approach at all. It is static and unproductive.

Now on many fronts there is a willingness for an open exchange of ideas and research. Much of this openness has been fueled by the urgency of families who will wait no longer.

Every presentation, every poster, every question asked at an exhibit table brings us closer to our common goal.

Let’s keep our lines of communication open with our pediatric ophthalmologists and pediatric neuro-ophthalmologists. Next time you see your child’s doctor, you can mention the AAPOS conference. You can tell your doctor that CVI is becoming a hot topic and – just a thought – that you’d like your doctor to participate in the conversation. Even better, you two can have your own conversation.

lehman pcvi

Image: Dr. Sharon Lehman and Rebecca Davis standing in front of the exhibit table for the PCVI Society at AAPOS 2018

P.S. The conference hall NEVER got warmer or brighter. I decided the architect of the Washington Hilton was just a huge science fiction fan. (It is possible I had some time on my hands for random speculation while sitting and freezing at the table.)

Adventure in Advocacy / AAPOS 2018

March 19, 2018 CVI Momifesto2 Comments

Good morning fellow families of wonderful children who happen to have Cortical Visual Impairment,

I’m sitting in the Cabinet room which is technically a conference hall of the Washington Hilton Hotel. I am the responsible adult for the Pediatric CVI Society’s very first exhibit table.

How fitting that this event should occur at the annual conference of the American Academy of Pediatric Ophthalmology and Strabismus.

Pediatric Ophthalmologists! Maybe there’s a Pediatric Neuro-Ophthalmologist thrown in here somewhere. I’ll have to ask.

This is important because it remains difficult for families of children newly identified with Cortical Visual Impairment to receive an actual diagnosis of CVI.

This is important because even if a doctor does diagnose CVI, she or he may not realize that CVI can improve with the appropriate interventions. She or he may not realize that education – for children, parents, caregivers, therapists, and teachers – is the key to improving a child’s functional vision.

They can’t fix CVI. So, many of them don’t address it. They are not SEEING CVI. (That one’s for you, Brenda Biernat. I’m wearing the shirt!)

This is the year, the PCVI Society begins to change the landscape of CVI in the medical community.

We have actual conference materials.

pcvi table.png

Image; An exhibit table covered by a black tablecloth and white drape with PCVI in large letters. Other exhibit materials promoting the PCVI Society.

Image: A low lit ceiling which may also be the inside of a alien ship. I just report ’em like I see ’em.

I have to mention that when CVI Mom Rachel and I were setting up yesterday, it was weirdly dark in here. There’s an alien/cave vibe happening. I thought for sure they’d turn up the lights for the actual conference. Not yet. We may take off any moment now for the general cosmos.

We have swag – Diagnosis cards and hard candy. (If that wasn’t the name of a punk band in the late 70’s, it should have been.)

hard candy

Image: A gift box with candy spilling out on to a table covered by a black tablecloth.

We will see how I do here after 3 days. Maybe the low lighting is a deliberate move to calm the well documented frantic energy of pediatric ophthalmologists.

Carol Kinlan of the Perkins School for the Blind just came over to say hi.

Will keep you posted.

Adventures in Advocacy / AFB’s Advocacy Call to Improve Special Education for Children with CVI

March 15, 2018March 16, 2018 CVI Momifesto2 Comments

It happened! History was made!

Yesterday evening, March 14th, at 8:30, the American Foundation for the Blind hosted a panel of parents, educators, TVI, administrators of teacher training programs, and advocates to engage in a “spirited” national conversation concerning Special Education of Children & Youth with CVI. (I am deliberately using the initials CVI since AFB referred to the diagnosis as “Cortical Visual Impairment – what others refer to as cerebral visual impairment, and still others describe as neurological visual impairment.”)

Our moderator, Mark Richert, Esq., diplomatically came up with the following title for the call:

CVI = Consensus, Vision, and Initiative

As a parent, I have said before and I will say it again. I do not care what you call this diagnosis. You can call it, “Harold,” or “Pearl,” or “Jeff.” This attitude may seem flippant to researchers and educators and it is. CVI has lorded over our lives for over a decade and I’m not great with authority figures.

I care about finding the teaching methods that give my daughter (what?….Say it with me, folks!) ACCESS to her environment.

Image: A child wearing a backpack climbs on a school bus

My dream is that one day my daughter will get on a bus and go to a school where the teachers know more about CVI than I do. My dream is that one day I won’t have to worry about what is happening at school all day.

Is this likely to happen anytime soon? No, it is not likely to happen anytime soon.

But, I have to try. For Eliza. For every other child. For every other mom. I believe I can say the same for the other parents who are advocating in their personal lives and the parents who participated in last night’s call whether as a panelist or a caller.

Mark Richert gave each panelist a chance to speak. He made every effort to give callers a chance to comment or ask questions. This turned out to be a bigger task than expected as AFB had nearly 200 people call in. I don’t have the exact numbers but at last count we heard the AFB folks say 175 people wanted to participate in the call, both panelists and callers.

The panelists included:

Brenda Biernat – CVI Parent, Advocate, and Founder of StartSeeingCVI.com (and the mom who reached out to AFB to make this call happen. Bravo!)

Rebecca Davis – CVI Parent, Advocate, Member of the Pediatric Cortical Visual Impairment Society & Blogger at CVI Momifesto

Sandra Lewis, Ed.D – Coordinator and Professor, Visual Disabilities Program, Florida State University

Amanda Lueck, Ph.D – Professor Emerita in Special Education, San Francisco State University

Rona Pogrund, Ph.D – Professor and Coordinator of Programs for Teachers of Students with Visual Impairments, Texas Tech University

Dorinda Rife, CLVT, COMS – Vice President, Educational Services and Product Development, American Printing House for the Blind

Christine Roman-Lantzy, Ph.D – Director, Pediatric View Program, Western Pennsylvania Hospital

Diane Sheline, TVI, CLVT – Independent Consultant for Students with Cerebral/Cortical Visual Impairment

Alisha Waugh, COMS – CVI Parent and Physical Therapist

It was a passionate conversation. I, for one, appreciated the fact that the professionals in the field of educating children who are blind or visually impaired were willing to listen to us and to each other.

Listening is an important first step.

We parents do have a lot to say. We have been waiting a long time for Cortical Visual Impairment to be taken seriously in the educational community. Many of us have stories about the CVI Range. We have stories about what we have learned by studying the work of Dr. Christine Roman-Lantzy and how it has changed our children’s lives for the better. We have stories of daily struggles and challenges, confusion and tears, low expectations for our children’s cognitive abilities, and lack of access to visual information being interpreted as “behavior issues.”

It is still hard for me to believe that despite Cortical Visual Impairment being the #1 pediatric visual impairment in first world countries, there remains so little consensus on how to educate these children.

It is time for things to change.

If, as Mark Richert and AFB have stated –

“Successful advocacy requires at least 3 key elements:

consensus about the problems and solutions,

a shared vision among stakeholders regarding the desired outcome,

and initiative on the part of committed change agents who are willing to play a long game while achieving milestones along the way” –

Then, yesterday’s conversation revealed a common concern for the education of children with CVI and parents revealed themselves as committed change agents extraordinaire.

What a great t-shirt idea! (AFB, I get 10% of net sales.)

I’m in for the long game, just don’t tell my daughter or she will make me play Monopoly. No one deserves that.

Stay tuned!

Moms on Monday #16 / Dixie from KY

March 12, 2018March 12, 2018 CVI MomifestoLeave a comment

Good morning fellow families of lovable children who have Cortical Visual Impairment!

This morning’s Mom on Monday is Olivia’s mom, Dixie, from Kentucky. Dixie is a Teacher of the Visually Impaired for Visually Impaired Preschool Services (VIPS) in Kentucky. She provides early intervention to infants and toddlers with ocular visual impairments or Cortical Visual Impairment. She also provides support to their families who often struggle to understand their children’s diagnoses. Dixie has the unique perspective of experiencing a CVI diagnosis as a mother and of guiding other parents through their CVI experiences as an educator. She was kind enough to take time out of her schedule to speak to me while driving home from vacation.

Image: A smiling young girl and a woman in glasses.

What does Olivia like to do? What makes her laugh? What are some of her favorite things? Olivia is almost 14 years old and enjoys the things most teenagers enjoy. She loves watching movies and TV. Her favorite foods include hamburgers and spaghetti. She is not a fan of fruits or vegetables. Olivia loves gymnastics and tumbling. She loves playing outside. She loves her dog. She has a huge sense of humor. She is always smiling or giggling about something. IMG_20170904_153045146

When did Olivia join your family? I had started providing foster care and was working as a Developmental Interventionist for First Steps (Kentucky’s early intervention system). Olivia’s biological mother was a drug addict. At 2 months old, Olivia had been rushed to the ER because of malfunctioning valves in her heart. She was pronounced dead at the hospital, but was resuscitated. She experienced oxygen deprivation during all of this. Afterward, Olivia entered foster care and was staying with a foster parent who was a friend of mine. They were waiting until Olivia was 6 months old to be able to perform surgery to fix the valves. My mentor kept telling me, “Your daughter is down the street.” I met her 10 days before surgery and fell in love with her. The adoption was finalized when she was 9 months old.

How was Olivia’s early intervention experience? We knew there was some brain damage because of her other diagnoses, Down syndrome and Fetal Alcohol Syndrome, and heart failure. We did not know the impact it would have. Olivia rolled over at a typical age of 3 months, but she lost skills as a result of the surgery. At 9 months old, we started over. She essentially lost a year of her life at the beginning. She had developmental intervention, speech therapy, and occupational therapy. Olivia always loved to look at books in her developmental therapy. When she was a baby, she would watch Baby Einstein videos. CVI did not occur to me.

When did you first learn about CVI? I knew her vision was off. Over the years, we went to 3 or 4 different eye doctors. When she started kindergarten, they said she was a little farsighted. They said Olivia needed glasses, that all children with Down syndrome need glasses. Then, they said she needed bifocals, but she just kept looking over the top of them.

By this time, I was working as a Teacher of the Visually Impaired for VIPS. I asked for a Functional Vision Assessment at school. The school refused saying there was no diagnosis of legal blindness.

We went to Cincinnati Children’s Hospital and saw Dr. Robert North. He referred us to the Cincinnati Association of the Blind to do a Functional Vision Assessment. When they began testing, they started making modifications for CVI without explaining what the modifications were for. I recognized what they were doing, watched her respond, and realized that she had CVI.

Then, the lightbulbs started going off. I started to think about times when she was smaller and behaviors I did not understand.

Olivia had bad nystagmus as a baby. She never crawled outside of the living room except for one time when I was vacuuming. She ventured out to follow the vacuum all over the house. Until then, she would not go out of the living room – the familiar environment she knew.

How were you given the diagnosis? The Cincinnati Association of the Blind sent their report to Dr. North at Cincinnati Children’s Hospital. He gave us the diagnosis. He was the first doctor we had seen who took the time to look at Olivia’s history and not blow us off.

How has CVI been addressed in Olivia’s school setting? When we came back with Dr. North’s diagnosis of CVI, she automatically qualified for vision services and federal quota funding.

Despite our trip to Cincinnati Children’s Hospital and our prescription from Dr. North, the school’s TVI informed me that Olivia didn’t have CVI. The TVI announced that Olivia was colorblind.

I told her, “You’re not an eye doctor.”

I had not told the school system that I was a Teacher of the Visually Impaired and that I was aware of the laws that regulated education for children with visual impairments.

I provided the first lightbox to Olivia’s school. I borrowed it from VIPS. As soon as they figured out it was working, they ordered one for their school.

It had taken a year to get the CVI diagnosis and to get the school system to recognize that Olivia was visually impaired. By the first day of school in 1st grade, she qualified for “vision services,” but I don’t know how much vision support she got.

We eventually went to see Dr. Roman because Olivia was in Phase III and folks didn’t know what to do with the higher levels of CVI. Dr. Roman helped me realize that some of Olivia’s communication delays were really related to CVI. She would often mix up the pronouns “him” and “her.” Olivia would sometimes look at a girl with short hair and say “him.” Dr. Roman explained that it is hard for children with CVI to figure out the details that define people and their gender.

Her school experience at the time was frustrating. For 2 years, she had the same list of 15 sight words because she wasn’t learning all of them. We lost a lot of time with this because the school didn’t realize that a word has to have meaning to Olivia for her to learn and to recognize them.

She learned words like “mom” and “dog” because she has a mom and a dog in her life.

Little words like “a,” “an,” and “the” don’t have meaning. “It” was on the list. How do you define “it”? “This?” How do you explain the word “This?” And, you don’t really need the word “The.”

The longest word on the list, “friend,” was the one she learned because it had meaning for her. It had a clear definition she could understand.

In teaching reading, I started to realize that the little sight words also create visual clutter. We started using a curriculum for whole word learning which has a lot of similarity to how Dr. Roman uses highlighting and bubbling words. (EdMark Reading Program)

What would you tell a mom whose child has just been identified with Cortical Visual Impairment?

Cortical Visual Impairment doesn’t stand alone. The children with this diagnosis usually have other diagnoses. Many of the families I work with don’t know what CVI is. They just hear “blind.” They don’t know CVI can improve. When the vision of a child with CVI does improve, I get the joy of seeing their families experience moments that other parents would just take for granted.

Also, trust your mother instinct. If something doesn’t seem right to you, keep asking. Keep advocating.

My mom often tells me that everything has a season. Both good or bad. When something seems really bad, it will not last forever. Everything has a season.

It has been so important for me to have that village of people you trust and who know and understand your child. You need a village.

What do you know now that you wish you had known?

I definitely wish she had gotten the CVI diagnosis sooner. We wasted a lot of time not knowing about her vision.

What would you like people who’ve never heard of CVI to know? That visual clutter is everywhere. Complexity will never go away 100%. I educate people on that everyday in my job. And Phase III is hard for people to understand. People don’t realize Olivia is visually impaired.

Every child with CVI is different. IMG_20171224_150802713

Hopes and dreams? I just want her to do something that allows her to be a functioning member of society. She loves babies and animals. I hope she can eventually get a job doing something she loves. I want her to be happy.

Thank you Dixie for sharing your experience! Thank you for serving families like ours. Thank you lovely Olivia for sharing your mom with us.

Adventures in Advocacy / Sometimes All You Have To Do Is Ask – A CVI Advocacy Win

March 11, 2018March 12, 2018 CVI MomifestoLeave a comment

Kathryne, mother of “Little C,” (Moms on Monday #6) is changing how children with CVI are being educated in Louisiana. BRAVO!

Image: A little boy sitting on a black floor and surrounded by black walls. He wears glasses. He is leaning forward looking at a light source with many strands of shiny red beads hanging over it.

When I asked my local university VI graduate program why their curriculum did not address CVI and how they could add education opportunities on CVI to their VI curriculum I received the response, “it is almost impossible to provide all things to all people for all purposes.” CVI is the #1 pediatric visual impairment in the US. This was followed up with how Dr. Roman’s methods are “far from accepted as the preferred model” and there are a “diversity of opinions on how these youth are best served by educational systems.” Dr. Roman has provided the only educational model.

This happened a few weeks before the NE AER Conference. The November 22 post on CVI Momifesto provided the link to AER’s website to look up our state chapters. CVI Momifesto suggested that we contact our AER Presidents and ask how we as parents can support TVI training in CVI.

Even though I found no contact information, website, or conference for my local chapter I decided to pay the dues and see where this rabbit hole led.

After joining AER I reached out to my son’s outreach therapist that Louisiana School for the Visually Impaired (LSVI) is sending out twice a month. I asked if she knew if LA AER had any workshops or conferences and how as a parent member I could become involved. I hit the Jackpot. It turns out the head of LSVI’s Outreach Department is the outgoing AER President. She called me soon after full of excitement that a parent wanted to be involved. She was in total agreement that CVI training was needed.

All I had to do was ask to sponsor training. The next month AER approved the workshop. Louisiana will have a CVI work shop October 19, 2018, and I have extended a personal invitation to our local graduate VI program.

If you are in Louisiana and want to attend you can sign up here.

https://docs.google.com/forms/d/e/1FAIpQLSfEe__xP9Kvzow7nApx_eN8jZ6XXM7mUUe1WRrpp3m-MuNv9A/viewform?c=0&w=1&usp=mail_form_link

Adventures in Advocacy / A CVI Mom Goes to Capitol Hill Advocacy Day 2018

March 8, 2018March 10, 2018 CVI Momifesto1 Comment

Last week, I had the chance to join the American Foundation for the Blind (AFB) and CEASD (The Conference of Educational Administrators of Schools and Programs for the Deaf) in their efforts to advocate for the Cogswell-Macy Act. Cogswell-Macy (H.R. 1120, S. 2087) is legislation named after Alice Cogswell, the deaf child who inspired Thomas Gallaudet to introduce deaf education to the United States and Anne Sullivan Macy, Helen Keller’s gifted teacher.

Why We Need the Cogswell-Macy Act

From the AFB Website: Today’s schools are not prepared to help children who are deafblind, deaf or hard of hearing, blind, or visually impaired develop to their full potential. (Magnify this statement times 10 for children with a brain based visual impairment such as Cortical Visual Impairment. See my earlier post titled Lego Trees and the posts under Death by IEP.)

The Cogswell-Macy Act is the most comprehensive special education legislation for students with sensory disabilities to date.

This act seeks to expand the resources available to these students, and their parents and educators, through the Individuals with Disabilities Education Act (IDEA).

The Cogswell-Macy Act would –

ensure specialized instruction specifically for students who are visually impaired, deafblind, or deaf or hard of hearing.
increase the availability of services and resources by ensuring all students who are deaf or hard of hearing, blind, visually impaired, or deafblind are accounted for.
enhance accountability at the state and federal levels.
increase research into best practices for teaching and evaluating students with visual impairments by establishing the Anne Sullivan Macy Center on Visual Disability and Educational Excellence—a collaborative consortium of nonprofits, higher education institutions, and other agencies to provide technical support, research assistance, and professional development.

To learn more: http://www.afb.org/info/get-connected/take-action/12

AFB and CEASD can offer you much more detailed information about this bill.

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What I can do is give you the play by play of the novice parent advocate who lives near D.C. and wants to help.

WEAR COMFORTABLE SHOES. Someone told me this last year. I thought I wanted to look professional so I’ll just wear my most comfortable heels.
THERE ARE NO COMFORTABLE HEELS.

Image: A pair of black shoes with heels and a binder with pictures of a child on the cover

I call this photo “Waiting for Senator Warner 2017.” By this time of day (early afternoon), I was already barefoot in a Senate building and sporting some impressive blisters.

3. DO NOT WEAR HEELS. Did you not hear me the first time? I know, I know. It’s the Capitol and the heart of our democracy, but seriously. Look around, everyone who works there wears tennis shoes or flats to run from building to building. They must keep their uncomfortable grown up shoes in their offices.

4. When you feel smug about how early you got up to drive to the Metro and catch a train to go into D.C., don’t. I got to our local Metro station in ample time to catch a train to be at the Advocacy Training by 8:30 a.m. And, the train was “delayed.” I waited. Annnnnd, after 20 minutes the status of the train was now “suspended.”
And, I ran back to the parking garage (Vienna Metro owes me $5) and drove to D.C. See where the shoes come in?

Image: My view of Northern Virginia traffic from the windshield of my car

Image: The dome of the Capitol building in the distance taken from a side street

5. When you see the Capitol, look for parking. And, keep looking, because the concept of public parking in D.C. is a city version of snipe hunting. Sure, you can drive to D.C. and find easily accessible parking! Sure, there are snipe in them there woods! (My family hails from Kentucky so I get to use phrases like “them there woods.” Although no one in my family has actually used the phrase “them there woods.”)

Image: A line of people standing outside the Rayburn building in DC

6. FYI – When you find parking (snipe!), you will not get even close to the government building you need to be in RIGHT NOW. When you hustle (SHOES!) to get to that building (by now only a half an hour late), there are dozens of people lined up outside the entrance waiting to get through security. What the heck? It was not this hard to get in the building last year.

At least, standing in line, you have time to catch your breath, dab your sweaty forehead with a Kleenex, and curse yourself for not leaving even earlier in the morning.

Then, you get a text from Rebecca Sheffield, Senior Policy Researcher, Ph.D. from the American Foundation of the Blind. (This is just a cool sentence to type.)

The text says, “If you are still on the way can you go over to the Russell building for a meeting with Sen. Tim Kaine’s staff?” Some of the Virginia advocates had not yet checked in. I imagined them sitting on the same metro platform I had been waiting on.

This year, you are wearing good shoes so YES, Rebecca Sheffield!

You ask no less than 3 D.C. policefolk how to get to the Russell building. Normally you could have cut across in front of the Capitol but the Rev. Billy Graham was lying in honor there. There were barricades all around the building and another line of over a hundred people waiting to pay their respects.

You will pass the Supreme Court building. There is a line to get in there as well. D.C. is a just a buzz of activity! You will see Boy Scouts. You see high school students from Oakton, Virginia on a scavenger hunt. You see Americans and tourists of all sizes, ages, and colors. It is a beautiful power walk through D.C. in business attire.

Image: The Supreme Court building

You hoof it to the Russell building, one of several Senate office buildings and location of Sen. Tim Kaine’s office with roughly 8 minutes to spare. Success!

Image: Outside of the Russell building

You have just enough time to dab sweat again, look over the talking points on Cogswell Macy and find Sen. Kaine’s office. This building is a buzz of activity as well. There are groups of teenagers, flower growers from all over America dressed in suits with brightly colored corsages pinned to their lapels, other advocates and lobbyists moving in packs with their affiliations written on badges hanging around their necks. Everyone has folders of talking points and information to leave with staff.

For a brief moment, standing outside the office, you are nervous that you will flub something in your meeting. You walk past well dressed teens joking around in the hallways and wonder how long it took one young man to get his part that straight. You feel a pang of something – not regret – envy? – because you know your own little girl will not have a moment like this. These teenagers take in so much information about this busy place, about each other in a single second because they have normal vision. Because they can learn incidentally.

You think about all of the students throughout the U.S. who are blind, or deaf, or deafblind. You think about all of the children with sensory loss who are misunderstood in their classrooms. Children who lack ACCESS to their environment. You think about your own daughter and her diagnosis of Cortical Visual Impairment – information that inevitably produces the following response: “Huh?” – when you mention it for the first time.

You think about how many times you’ve tried to explain your daughter’s visual impairment. How it seems as though she is not paying attention or that she cannot understand because typically sighted folks do not know what to make of a child who does not look them in the eye and who takes longer to respond.

You think about the national shortage of Teachers of the Visually Impaired and Orientation and Mobility Specialists. You think about the lack of teachers and other providers who know what to do with a child with CVI. There is so much work to be done to give our children a better chance to connect with the world around them, to give us a chance to reach them. Frankly, you feel a tad overwhelmed.

You want to yell, “Oh, Senators, we need co-sponsors for Cogswell-Macy! We need champions for children with sensory loss. We need champions for children with CVI!”

You do not.

Image: Kirk Adams, a tall man with gray hair holding a cane, and Adrianna Montague, a woman in a black dress smile while standing next to a sign that reads Senator Tim Kaine of Virginia

7. You enter the senator’s office to jump into Advocacy Day (and decide to stop numbering your post that has gone on way too long and will be read by no one…).

With a flood of relief, you find Kirk Adams, the president of the American Foundation for the Blind, and Adrianna Montague, the Chief Communications and Marketing Officer for AFB, waiting for the meeting as well.

You meet with one of Sen. Kaine’s staffers, Karishma Merchant, who oversees education and other issues. Ms. Merchant is a willing audience and asks great questions.

AFB recently moved their main office from New York to Arlington, Virginia. Mr. Adams and Ms. Montague take this opportunity to introduce AFB as a resource for Sen. Kaine’s staff and to emphasize the need for legislation like Cogswell Macy. You get to tell her a little about the challenges children with sensory loss face in U.S. school systems.

Ms. Merchant asks your help to advocate against legislation that was introduced in the House to deregulate the Americans with Disabilities Act.

ACTION ITEM: H.R. 620 is what supporters in the House are euphemistically calling the ADA Education and Reform Act (H.R. 620). Don’t believe it for second.

Senator Tammy Duckworth of Illinois is leading the call to ask Senator Chuck Schumer and Senator Mitch McConnell not to bring forward H.R. 620 or any similar bill.

Calls to senators in Florida, Indiana, Maine, Michigan, Minnesota, Nevada, New Mexico, Oregon, Virginia, or Washington will have the most impact. (https://www.senate.gov/senators/contact)

You leave Sen. Kaine’s office hoping that you have earned another co-sponsor for Cogswell-Macy and prepared to help him advocate for all people with disabilities.

Then, you bid Mr. Adams and Ms. Montague adieu and wait for your next appointment with Sen. Mark Warner in the afternoon. You have time to jog back to your car and feed the meter.

Later, at the Hart Senate Office Building, for the meeting with Senator Warner, you will see this sculptural work Mountains and Clouds by Alexander Calder. The Hart building feels different from other senate buildings. Wikipedia tells me its architectural style is Modernist not Neoclassical like the Dirksen and Russell buildings.

Now you know for your next Adventure in Advocacy. If you see this sculpture, you are in the Hart Senate Office Building. Handy!

Image: Large black triangular sculpture that nearly touches the ceiling of the atrium of the Hart building

Image: Woman standing next to a sign that reads Senator Mark R. Warner / Virginia

At some point in the afternoon, you realize you’ve been taking pictures of places but very few pictures of people. You wish you had gotten a picture of the flower growers and their brightly decorated lapels, or the extremely straight part in that young man’s hair.

At Senator Warner’s office, you have a brief meeting with Lauren Marshall, the same staffer you met last year. She is attentive and kind. She promises to reread Cogswell-Macy and to bring it up with Sen. Warner.

That’s really all you can ask.

You walk away from the Hart Building hoping you have made some small connection within the Senate for children who are blind, or deaf, or deafblind. You know that these populations of children do not get a lot of press. You hope you can help spread a sense of urgency about the challenges facing children with sensory loss in the classroom.

You want senators, representatives, and anyone who affects legislation to understand two simple facts. These children matter. Their education matters.

At the end of the day, you hope you have made it easier for the next mom to reach out to her legislator to tell her story. That mom is going to make change happen for her child. She is a force of nature.

P.S. You make it back to your car in time to avoid a ticket. Success!

You see this poster at the Thai restaurant next to your car.

Pretty much sums it up.

Moms On Monday # 15/ Beth from IA

March 5, 2018March 6, 2018 CVI Momifesto2 Comments

Good morning fellow families of miraculous children who happen to have Cortical Visual Impairment,

This morning’s Mom on Monday is Beth from Iowa. Beth is the mother of 3 young men, Matt (24), Pat (22), and Tyson (6). She is a Special Education teacher for the Nebraska Department of Corrections. As Beth says, “I’m an Iowa mom and a Nebraska teacher.”

Matt Pat and Tyson

Image: A smiling young man giving a thumbs up sign and a smiling boy leaning against him. Image: Two smiling young men. One young man is holding the boy in his lap.

She has been a staunch supporter and board member of the Pediatric Cortical Visual Impairment Society (PCVIS).

Beth is wise, fierce and funny with the straight forward, “call ’em like you see ’em” perspective of a mom who has seen a lot and has persevered.

Both Tyson and Pat have been identified as having Cortical Visual Impairment although at markedly different times in their lives. Beth has experienced having one child diagnosed as an infant and one child diagnosed as a young adult.

Tyson came into Beth’s life when he was 4 months old after being neglected, underfed and drugged by his birth mother. In addition to CVI, Tyson has an ocular visual impairment. He is extremely farsighted in one eye (20/400) and wears glasses. He has moderate to severe hearing loss, hypotonia, developmental delays, and “autistic type behaviors”. His dual sensory loss and lack of communication skills qualify him as a deafblind child. Beth adopted Tyson when he was 18 months old.

Tyson was diagnosed with CVI at approximately 12 months old.

It was only when Beth started to learn more about Tyson’s brain based vision loss that she began to see similarities in Pat’s and Tyson’s visual behaviors. This led her to take her older son – by then a young man – to the same Pediatric Ophthalmologist who diagnosed Tyson, Dr. Richard Legge, from Omaha Children’s Hospital. (Dr. Legge is also the current president and one of the founders of the Pediatric Cortical Visual Impairment Society.)

Beth’s older son, Pat, received a CVI diagnosis at the age of 20.

Enduring a traumatic birth and underdeveloped lungs, Pat “was blue when he was born.” He had Periventricular Leukomalacia (PVL), a type of brain injury to white matter and experienced heavy seizure activity before the age of 2. He received early intervention services for speech delays.

As a boy, he wore glasses for 8 or 9 years and often complained that “his eyes were hurting.” Beth continued to take him to pediatric eye doctors who decided that his history of seizures left him with “weak eyes” and a lazy eye. Eventually, Pat stopped wearing glasses when the doctors decided that he had issues that “glasses would not fix.” At that time, Beth explained that she did not know about the specializations for pediatric vision. “I didn’t know there was such a thing as a neuro-ophthalmologist.”

Pat is 22 years old now. His seizure disorder and visual impairment prohibit him from driving. He is employed and takes an Uber or gets a ride from Beth to get where he needs to go.
About Tyson: What does he like to do? What makes him laugh? What are his favorite activities?

Image: A smiling young boy in glasses wearing a Chewbacca Halloween costume

Tyson loves cars, trucks, and all things with wheels. He doesn’t understand the concept of cartoons, but will enjoys Daniel Tiger cartoons and Bob the Builder.

He likes to watch old movies and Westerns like Rawhide and the Lone Ranger. Older shows and movies have music in the background. They are not as flashy as shows today. He likes the music; it helps him understand what is going on.

His favorite colors are neon pink and green, especially pink.

Beth and his teachers to use neon pink to get Tyson’s visual attention. One of his favorite toys is a bright pink sensory ball he received from the Iowa School for the Blind.
When did you first learn about CVI?

The first eye doctor I took him to said he didn’t know why people “brought kids in before the age of 2.”

Beth realized that his multiple diagnoses required more specialized doctors, so she opened the phone book and started calling until she found Dr. Legge at Omaha Children’s Hospital.
How were you given the diagnosis?

Dr. Legge explained Cortical Visual Impairment. He said it would be a long road and how his vision improved would depend on the amount of damage to Tyson’s brain. He thought that since I was a special education teacher it would be easier for me to understand it.
How was your child’s early intervention experience with regard to CVI? Were your providers knowledgeable? Were they open to learning?

In early intervention, Tyson’s first Teacher of the Visually Impaired did not like that he didn’t prefer the color red. What she took from Dr. Roman-Lantzy’s book was that all children with CVI prefer the color red. This is NOT true and not what Dr. Roman-Lantzy wrote.

Children may have color preferences. The choice of color will vary depending on the child. Tyson likes neon pink. When he did not respond to the color she thought he should respond to, she told Beth’s babysitter, “Tyson’s just making retarded choices.”

Even though he was a non-verbal infant who couldn’t crawl, Tyson made his opinion of this TVI very clear. He didn’t crawl, but he could roll. So he rolled over to the front door to close it when he heard her approaching. Sometimes he would roll away and hide under a bed when she came to work with him.

Beth changed to another TVI. In Iowa, TVI cover geographic zones so a child may work with the same teacher from birth to adulthood. Tyson’s 2nd TVI still works with him and his school team.
How is CVI being addressed in your child’s school setting?

The first year he was in school and this year have been great. The first year, everyone was willing to learn. We explained that the stairs needed to have reflective tape on them to help Tyson navigate them safely. The principal said that this accommodation would help everyone. One weekend the principal and other school staff came in to put reflective tape on the stairs – one color for going up and one color for going down.
What do you know now that you wish you had known at the beginning of your journey as your sons’ mom?

That you can switch your providers or services. I assumed you just got who you assigned.
Follow your gut. If something feels wrong, keep looking, keep asking.

What would you tell a mother whose child has just been identified as having CVI?

DO NOT GOOGLE CVI and all the horrible things you might find on the internet until you have spoken to an expert. Find an expert and ask questions. And, keep asking.
If you do research on the internet, look for something research based and at your level. The internet is a wonderful and scary place at the same time. Not everything you read will be true.
It is terrifying enough when you hear initials instead of words. When they said Pat had PVL (Periventricular Leukomalacia), I heard leukemia.
Know that CVI is a spectrum diagnosis. There can be 20 kids in a room with CVI and each one will be different from the next.
Just because someone (even if it’s your parents) gives you advice, you can listen but it might not be what works for you. Take everything you hear with a grain of salt. What’s best for you is not going to work for me. Figure out what works for you and your child and what you have access to.
Don’t be afraid to take advantage of any services you can get – even if it means having a label assigned to your child. Take help where you can get it.
Don’t be so afraid that there is so much more to do. It’s small steps. A little at a time.
Move past the guilt part. Cut that out quick.

What would you like for people who have never heard of CVI to know?

Having a visual impairment is not the end of the world. We all “see” things differently anyway.

There is a huge range within the spectrum of a CVI diagnosis. What they can do at 6 months is not what they can do at 16 years. Let time work.

Hopes and dreams? Anything else you’d like to add?

I’d like them to eventually take care of themselves and/or to express their needs. I’d like them to live a peaceful life.

Tyson has CVI and other diagnoses. He has about 10 words – not full words. He has his own signs. Sometimes the frustration he has is not about vision, it’s communication. When they talk about getting a child to “talk,” use the word communicate. It might not be in the cards for him to talk. And, you can’t let the kids get away with everything because of a diagnosis.

There is a lot of trial and error in this. At the end of the day, if they’re all still alive, it’s ok.

On judgment from strangers: Everyone will have an opinion. Tyson likes pink. Some people have a problem with boys liking pink. Who cares what color your kid likes?

There are people everywhere who will try to give you advice. For example, we were in a toy aisle one day. A woman noticed Tyson and started to tell me all of the things he wasn’t doing. She told me, if he’s not doing this and that, then he needs to be in therapy.

I thought, “I’m so glad I came to the toy section of Walmart to get medical advice.”

And, that, gentle readers, may be my favorite sentence of all time.

Beth, talking to you made my weekend. Thank you for taking the time to share your experience, your wisdom, and your humor. Your young men have a formidable mother.