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What Cerebral Visual Impairment (CVI) is, what pupils with CVI might have problems with and how to help them, CVI and complex needs.
Cerebral Visual Impairment (CVI) is a form of visual impairment caused by the brain not being able to process information from the eyes passing along the visual pathways in the brain. As the pupil grows older, the visual difficulties may slowly improve as they find strategies to use their vision.
What pupils with CVI might have problems with
Pupils with CVI can have problems with:
- recognising faces
- recognising and reaching for objects
- clarity of vision, that is sharpness of vision for both near and distance vision
- seeing movement
- visual field loss, also known as peripheral vision loss
- colour and contrast
- crowding and complexity, for example difficulty seeing detail or one item in a busy scene
- visual fatigue, for example pupils may have periods of good vision and then periods when vision is less good
- controlling eye movements
- moving through the world, for example using stairs, steps and slopes
- orientation and route finding, for example losing their way even in familiar places
How to help pupils with CVI
Some strategies that may be useful:
- pupils who have difficulties in recognizing faces use an identifier, for example always wearing the same coloured item, having a meeting point in the playground, or a buddy
- reducing visual clutter, visually simple and of good contrast
- enlarging print size and increasing the space between words on a line
- using a desk slope bring the text closer and keeps it in central visual field
- using a typoscope (a small window cut into a piece of card) to isolate words and help prevent crowding
- using a child’s preferred colour to engage in activities (red is often preferred)
- avoiding visual clutter in the general environment by keeping storage and signage simple, for example using the end peg or the end drawer for the pupil’s storage
- making sure a pupil is seated appropriately so they can concentrate on seeing, for example at the front of the class
- practicing key routes and using highlight landmarks
- highlighting obstacles, steps and stairs
- keeping objects in the same place to help location, for example coat peg, seating, equipment
CVI and pupils with complex needs
There are a range of characteristics often present in pupils with CVI and complex needs. Being aware of these characteristics can be helpful in setting up invention programmes.
Colour preference
Many pupils with CVI have a colour preference, often red or yellow. This can be used in the resources used to encourage visual attention before introducing 2 or 3 colours and patterns.
Need for movement
Pupils with CVI start by being visually attracted by movement or reflective properties to initiate visual attention. The need for movement may reduce.
Visual latency
Pupils with CVI often need time to make a visual response and to interpret what they see. The time to respond will reduce as visual targets become familiar.
Visual field preference
Pupils with CVI often show a definite visual field preference, for example within the left or right field, or use of peripheral vision.
Difficulty with visual complexity
Pupils with CVI use their vision where the environment is controlled. For example, simple bold targets with reduced visual clutter mounted on a plain background, reduced background noise.
Light gazing and non-purpose gaze
Pupils with CVI can be overly attentive to overhead lights to the detriment of purposeful visual attention. Take care in positioning the pupil and encourage them to look at appropriate targets.
Difficulty with visual distance
Pupils with CVI initially give visual attention to targets nearby. Over time, the pupil may extend the distance of their visual interest.
Difficulty with visual novelty
Pupils with CVI give visual attention to familiar objects. They may not look at novel objects unless they share familiar attributes, for example colour and movement.
Absence of visually guided reach
Pupils with CVI find it difficult to integrate looking and reaching. They may look, and look away before reaching.
Further information
For more information visit:
- the CVI Society, a UK charity that raises awareness of Cerebral Visual Impairment providing education and support to families and healthcare professionals
- the Royal National Institute of Blind People (RNIB) page on cerebral visual impairment
- a 19 minute video of an adult with CVI explaining how it impacts on their life
How to add subtitles to videos for social media, Google Drive, or a film you’re watching on your computer.
Why subtitles are important for equal access
Without subtitles deaf pupils will not have equal access. Subtitles or a transcript need to be provided as a reasonable adjustment.
If music and song is part of the understanding of the story, you need:
- a transcript of the words
- to go through the song words as a class session, to talk about how they relate to the film
This pieces together areas of the film which aren’t fully accessed by a deaf student.
Add subtitles to videos
The National Deaf Children’s Society has:
- a screencastomatic captioning video on YouTube
- tips on adding captions to pre-recorded videos before posting them on social media
You can find instructions on how to:
- add subtitles to Google Drive
- download subtitles onto the computer to go with a film you’re watching
- add subtitles to a movie or video you're watching on VLC
Contact the Sensory Support Service for further support.
Things to try when a radio system has crackling, poor connection, low volume or no connection, troubleshooting OPUS 2, Nucleus 6 and 7, and Sonnet audio processors.
Troubleshooting radio systems
A radio system consists of:
- a transmitter (Tx), worn by the person speaking
- a receiver (Rx), worn by the listener
If there's crackling, poor connection, low volume or no connection in a radio system, try the following:
- fully unwind the external aerial for good signal
- position microphone a pen's length from the mouth, in a central position
- connect the Tx to the Rx when on the hearing device by pressing the connect button on the Tx within 10cms of Rx
- repeat this process for best signal
- check the battery of the Tx is charged
- check the batteries of the hearing device are not flat, give the Rx power
- check all devices are switched on: the switch for the MicroMlxs must be on the two full dots setting
- check paperwork from Sensory Support Service: for FM use, the number in the Tx screen must match the FM channel programmed in the Rx
- check with the Teacher Of the Deaf that the Rx is on the correct setting for the device of children with cochlear implants
- check the gold pins on the Rx are clean: they can be affected by debris and condensation and may look green at the base
- try the system in different parts of the room or building for persistent interference: interference may be caused by metalwork, obstructions in rooms and other equipment
- try system reset by holding down all 4 corner buttons on the Tx: release and the system will reboot
For more advice, contact:
- the Teacher of the Deaf supporting the setting
- the Audiology Technician
Troubleshooting audio processors
You can read troubleshooting guides for:
Information and tips on how to use the Mini Mic and Mic 2+ in the classroom and during group work.
Using the Mini Mic
Using the Mini-Mic brings the teacher's voice direct to the cochlear implant. This makes it easier for the pupil to hear across distance or if there's background noise.
How to use the Mini Mic
The pupil should hand the transmitter to you at the start of each session.
When you have the transmitter:
- attach it so that the microphone is about 10 cm from your mouth
- switch on and check the green light is flashing
- discreetly check the pupil can hear you
- repeat contributions from other pupils in class discussions
- switch the transmitter off when talking to other groups or individuals
- check with pupil before switching it back on
Face the class when using the transmitter. If you turn away, the mini mic’s transmission may be interrupted.
During group discussion, place microphone in horizontal position.
The microphone is very sensitive. Avoid wearing noisy clinking jewellery.
Using the cochlear Mini Mic 2
Wearing the microphone
When you’re wearing the microphone:
- make sure the device is clipped on with the microphone facing outwards and a pens length from your mouth: if it is too far away or too close, it will not pick up speech effectively
- remove lanyards and scarves, so that they do not rub against the microphone: this creates background noise, making it harder for the student to understand speech
- make sure the microphone has a direct line of sight to the processor, otherwise the sound may cut out
- use the mute button when not talking directly to the student: the mute button will flash red when muted, press this again to unmute
Indicator lights
Quick green flashes: turned on.
Yellow flashes: muted.
Continuous yellow flashes: low battery .
Group work
During group work, place the microphone flat on top of a soft cloth in the middle of a table. It will pick up multiple speakers.
Transmit audio directly to the student’s hearing device
To transmit the audio used in class directly to the students’ hearing devices:
- plug an audio lead into the jack at the bottom of the mini mic 2+
- connect it to a computer or tablet
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