The Reliability of the CVI Range: A Functional Vision Assessment for Children with Cortical Visual Impairment

Abstract

Children identified as visually impaired under the Individuals with Disabilities Education Act (IDEA) need to have a functional vision assessment to determine how the visual impairment affects educational performance. Most current functional vision assessments have been based on the needs of children with ocular visual impairments (children with damage to the eye structures). Children with visual impairment due to brain damage, or cortical visual impairment (CVI), have unique vision characteristics that are often different from children with ocular visual impairments. Given this situation, Roman-Lantzy (2007) developed The CVI Range for conducting a functional vision assessment of children with CVI. The purpose of this study was to examine the reliability of The CVI Range. In this study, 104 children were assessed with The CVI Range. Twenty-seven children were tested by two examiners to determine inter-rater reliability; 20 children were tested on two occasions to determine the test-retest reliability; and 57 children were tested one time by a single examiner. The CVI Range had an internal consistency measure or alpha of .96. The inter-rater reliability coefficient was .98 and the test-retest reliability coefficient was .99. In addition, the CVI Range has two sections that are scored differently and the scores from the two sections were compared to determine if they provided similar scores and therefore similar implications for intervention. Kappa, or the index of agreement, for the two parts of the assessment was .88. Results of this study indicate that The CVI Range is a reliable instrument. Future research needs to focus on training requirements related to administration of The CVI Range as well as training of the many professionals that serve children with CVI. Research is also needed to determine appropriate and effective interventions for children with CVI. The CVI Range can be used to document progress and therefore determine the effectiveness of interventions and further knowledge in the field of evidence-based practices that are appropriate for children with CVI.

10.5937/specedreh13-6827 = Cortical visual impairment: Characteristics and treatment

“…Kortikalno oštećenje vida (Cortical visual impairment -CVI) je posledica oštećenja vizuelnog korteksa, posteriornog vizuelnog puta ili oba zajedno (Boot, et al,2010;Groenveld, 1997;Khetpal & Donahue, 2007;Kozeis, 2010;Matsuba & Jan, 2006;Newcomb, 2009;Shaman, 2009). CVI je uzrokovano neadekvatnim funkcionisanjem vizuelnog sistema, smeštenog posle hijazme (retrohijazmatski deo), pri čemu ne postoji neko oboljenje perfirenog dela (Porro et al, 1998, prema Vučinić, 2014.…”

“…CVI obuhvata širok spektar vizuelnih teškoća koje su posledica nesposobnosti centralnog dela vizuelnog sistema da na odgovarajući način integriše i organizuje vizuelne informacije koje dobija od perifernog dela, koji je uglavnom očuvan (Edmond & Foroozan, 2006;Newcomb, 2009;Shaman, 2009). Većina autora predlaže jednostavnu radnu definiciju CVI koja glasi "Oči su u redu ali nije mozak" jer ova deca imaju tipičan izgled očiju i reakcije zenice na svetlost i neuobičajeno vizuelno ponašanje (Baker-Nobles & Rutherford, 1995; Groenveld, 1997;Newcomb, 2009;Shaman, 2009).…”

“…Njihovo stanje vida obuhvata kontinuum od potpune nemogućnosti viđenja do minimalnih vizuelno perceptivnih teškoća, koje postaju vidljive prilikom rešavanja vizuelnih zadataka, na primer pronalaženje predmeta ili prepoznavanje osoba/prijatelja koji se u datom trenutku nalaze među grupom ljudi (Kozeis, 2010;Khetpal & Donahue, 2007;Palmer, 2003;Shaman, 2009). Neurološka oštećenja, prisutna kod većine dece sa CVI utiču na pojavu teškoća u razvoju govora i jezika, socijalnom i intelektualnom razvoju (Newcomb, 2009). Najučestaliji neurološki nalazi su epilepsija (53-68%), cerebralna paraliza (26-74%), mikrocefalus (15,29%), hemipareza (11,76%), oštećenje sluha (1,76-16%) (Good et al, 2001;Huo et al, 1999;Khetpal & Donahue, 2007).…”

“…Brojni autori ističu da je CVI najčešći uzrok oštećenja vida u razvijenim zemljama (Good, 2001;Good et al, 2001;Khetpal & Donahue;Newcomb, 2010;Ospina, 2009), što može biti povezano sa pretpostavkom da u drugim zemljama ovaj problem nije još ni prepoznat (Vučinić, 2014). Osamdesetih godina prošlog veka u kanadskoj bolnici Britiš Kolumbija (British Columbia) po prvi put je konstatovano da među slepom decom ima oko 10% one kod koje je oštećenje vida posledica CVI.…”

“…Zasniva se na posmatranju ponuđenih vizuelnih stimulusa -da li deca radije gledaju crno-bele linije ili jednobojni stimulus. Sklonost ka vizuelnom stimulusu se uočava na osnovu detetovog pogleda i/ili okretanja glave ka jednom od stimulusa (Malkowicz, Myers & Leisman, 2006;Newcomb, 2009). Oštrina vida kod dece sa CVI se ispituje i pomoću LH simbola i evociranih vidnih potencijala.…”