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The cerebral visual impairment (CVI) companion guide was developed as an extension to the Developmental Guidelines after it was recognised by the authors that practitioners working in the field of supporting young children who are blind or have low vision needed more information on supporting children with CVI. The authors were also aware that the research around CVI had greatly advanced over the last 10 years and an updated guidebook with this new knowledge was needed. To ensure that the guidebook was relevant for all, the authors conducted focus groups and worked closely with children and caregivers in pre-publication field trials. The book was then reviewed by a number of CVI experts before being published.
The aim of the companion guide is to support practitioners to develop, monitor and address potential effects of CVI. It also provides guidance regarding the types of interventions to consider for young children. The book follows the framework of the developmental domains from the Developmental Guidelines, which include social emotional, communication, cognitive, fine motor and gross motor. The guide also has a whole section on manifestations of CVI that can be addressed in addition to functional vision. The guide has been developed to show the dynamic relationship across domains, where one domain influences another and that learning is an integrated experience. As outlined by Dr Lueck,
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<italic>“the book gives people a tool to use. To monitor children with CVI, understand their CVI and understand the complexity of CVI. It is not a cookbook. It's something that people have to reflect on and use their judgment and their skills and work as a team”.</italic>
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Within each domain, the guide outlines how CVI can impact development in those areas. It also provides a summary and checklists, as a starting point for people working with children with CVI. A real strength of the guide is the tips for practice section, which practitioners can refer to as they explore different ways of supporting children with CVI.
The authors are very clear that the CVI companion guide is not an assessment tool. Instead, it helps bring assessment data together from various formats, any kind of relevant assessment can be used to develop a CVI profile for every child. To help with this, the guide provides a profile form and data can be added to this constantly. This can be from formal and informal assessments and observations in specified environments by teachers and parents. The purpose of the profile is to characterise a child's CVI and to distinguish the root cause of a child's behaviour to guide intervention. For example, it is important not to confuse inability to track due to inefficient saccades with visual field or neglect problems because the interventions are different. When developing the CVI profile, it is important to work with everyone supporting the child, including the medical team and the therapy team, as this will help to ensure a detailed profile is developed and appropriate interventions are infused into meaningful, age-appropriate contexts.
The guide includes interview questions that can be used to help gather the profile data. There are also functional vision development logs, which is a way to monitor early functional vision development and milestones for children with CVI. In addition, there are intervention planning and monitoring forms to help in the design of interventions and analysing data on their effects over time.
An important component of the guide is the section on CVI manifestations. From exploring the literature, talking with people who have CVI and from their own practice experience, the authors identified over 56 potential manifestations of CVI. These have been grouped into 16 manifestation categories. However, the authors make it very clear that each child will have their own unique profile and will not necessarily have manifestations from each of these categories, as it depends on the area of the brain that has been affected. The 16 manifestation categories are:
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<list-item><label>-</label>Clarity of vision</list-item>
<list-item><label>-</label>Area of vision</list-item>
<list-item><label>-</label>Following people or objects visually due to eye movement limitations or visual field restrictions</list-item>
<list-item><label>-</label>Locating people of objects visually / visual search capabilities</list-item>
<list-item><label>-</label>Response to faces</list-item>
<list-item><label>-</label>Recognition of objects or symbols</list-item>
<list-item><label>-</label>Response to movements</list-item>
<list-item><label>-</label>Accuracy of visual motor planning and control</list-item>
<list-item><label>-</label>Imitation and copying</list-item>
<list-item><label>-</label>Colour</list-item>
<list-item><label>-</label>Depth perception</list-item>
<list-item><label>-</label>Illumination</list-item>
<list-item><label>-</label>Response to sound</list-item>
<list-item><label>-</label>Response to environment</list-item>
<list-item><label>-</label>Effects on visual novelty</list-item>
<list-item><label>-</label>Response time</list-item></list>

Once a child's CVI profile has been developed, appropriate interventions can be implemented. This is where the CVI Companion Guide is vital, as the basic premise of the book is routine. Effective and meaningful learning experiences occur within daily routines for little people.
For example, mealtime, coordinates vision, social interaction, cognition, communication, and fine motor. In order to use the guide effectively, it is important to gather information about a child's daily activities, find out what the family's routines are, what works well for them and what is challenging, as this will help with determining learning opportunities. Interventions and the resulting outcomes can integrate multiple developmental domains and progress can be constantly monitored and evaluated.
The CVI Companion Guide is a must have for any practitioner supporting young children with CVI. It effortlessly weaves together the developmental domains, CVI manifestations and functional vision interventions together to provide a straightforward approach to helping this cohort of children. A real strength of the guide is how it highlights the benefits of developing an individual CVI profile for each child, which can then be used to develop personalised, meaningful and purposeful interventions that can be woven into a child's daily routines. The guide also helps to empower parents of children with CVI, as it shows how their knowledge can help inform support.
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The CVI Companion Guide – To the Developmental Guidelines for Infants with Vision Impairment: A guidebook for early intervention (2nd ed.), Amanda Hall Lueck, Deborah Chen, Elizabeth S. Hartmann

Vision Rehabilitation International

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The CVI Companion Guide – To the Developmental Guidelines for Infants with Vision Impairment: A guidebook for early intervention (2 ed.), Amanda Hall Lueck, Deborah Chen, Elizabeth S. Hartmann

The CVI Companion Guide – To the Developmental Guidelines for Infants with Vision Impairment: A guidebook for early intervention (2^nd ed.), Amanda Hall Lueck, Deborah Chen, Elizabeth S. Hartmann

Article Category: Book review

Published Online: Dec 28, 2023

Page range: -

DOI: https://doi.org/10.2478/vri-2024-0005

© 2023 Nicola McDowell, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.