Skip to main content

The CVI practice framework: An approach for working with children who have cerebral visual impairment in an education or habilitation/rehabilitation context

This series provides advice about a CVI practice framework.
Nicola McDowell

Selecting an option will move you to a different section of the page.

Key Details

Masterclass Series
Course Code

Course Information

Cerebral visual impairment (CVI) is the most common cause of visual impairment affecting children in the economically developed world, with the prediction that numbers will continue to rise with continued advancements in medical care for neonates. Despite this increase, many children are still being supported with approaches that have been developed for children with ocular visual impairments, as there are limited evidence-based approaches for supporting children with CVI. For her doctoral research, Nicola McDowell proposed a CVI practice framework to help meet the specific needs of children with CVI that can be used within an education or habilitation/rehabilitation context. The framework was based on her own experience of developing a successful rehabilitation programme to improve her visual and overall functioning following a late CVI diagnosis. From this programme, Nicola identified three main components that led to the improvements in her quality of life. These included the development of an individual CVI profile, an individualised programme, and empowerment through the attainment of knowledge. To ascertain whether a similar approach could be effective for children with CVI, Nicola conducted a number of different research projects to assess the effectiveness of each individual component and the overall framework. Results from the different research projects show that the CVI practice framework has the potential to be an effective approach for supporting children with CVI.

Session 1

In the first session of the series, Nicola will provide a brief overview of cerebral visual impairment. This will include a background to the history of CVI and introducing the concept that CVI is an umbrella term for a range of different visual issues caused by damage or injury to the visual brain. Nicola will also discuss the continuum of CVI related visual issues, from those with normal or near normal visual acuity and significant visual perceptual issues (issues with the higher visual functions) to those who appear functionally blind. Alongside this, Nicola will discuss the impact these visual issues can have on a child’s visual and overall functioning.

Within this session, Nicola will also describe her personal experience of CVI and how this has led to her conducting research in the field of supporting children with CVI. In particular, the development of the CVI practice framework and how this evolved from creating her own rehabilitation programme she developed after receiving a CVI diagnosis 16 years after she acquired the condition following a brain hemorrhage.

Session 2

In session two, Nicola will focus on the first component of the CVI practice framework, the development of an individualised CVI profile. This will include an exploration of what is needed to develop this CVI profile, including what clinical information and also, what functional vision assessment tools and strategies can be used for children with CVI.

In relation to Nicola’s research, she will introduce the Austin Assessment in this session, which is an assessment tool she developed to identify visual perceptual or higher visual function issues related to CVI. Initial research on the Austin Assessment indicated that this is a very effective tool, and it has since been made into an app for iPads. Nicola is currently conducting research to validate the Austin Assessment.

Session 3

In the third session, Nicola will explore the second component of the CVI practice framework, individualised plans/programmes. This will include a discussion around the importance of supporting not only the visual needs of children with CVI, but also their emotional and behavioural needs. She will then introduce the strategies she used in her research to support the visual, emotional and behavioural needs of children with CVI.

This session will also explore who should be involved in developing and supporting the individualised plan/programme and how to implement it within the child’s home, school and community environments.

Session 4

The fourth session will focus on the third component of the CVI practice framework, the empowerment of the child and their parents and the role the attainment of knowledge plays in this. This component of the framework relates back to Nicola’s own experience and is a vital part of the overall approach for supporting children with CVI. Within this session, Nicola will provide an overview of the research she conducted in this area and how she is continuing to focus on the area of empowerment in her ongoing research and work to support children with CVI.

Session 5

The final session of the series will be focused on bringing it altogether and exploring how the CVI practice framework can be used in practice. Although Nicola’s research focused on supporting children with CVI, the CVI practice framework can also be used with adults with CVI in a rehabilitation context for both acquired and early onset CVI.

In this session, Nicola will also provide an overview of her ongoing work in the area of CVI. This includes research, involvement in CVI working groups, facilitating an adult CVI group and collaborations with other researchers and experts in the field of CVI.

Session 6 The Austin Assessment

The Austin Assessment is a screening app for CVI related visual issues. It has been validated as an effective way of distinguishing between children with typical vision and those with potential brain based visual issues. The Austin Assessment will be launched in January 2024 for both personal and professional use. The personal app is for individuals and families and the professional app is for teachers, vision professionals, therapists, clinicians and researchers. Both apps will be available worldwide.

The Austin Assessment was developed by Dr Nicola McDowell and a not for profit, charitable trust has been established, The Austin McDowell Foundation to run the app.

In this lecture, Dr McDowell will provide an overview of the validation process and how this helped to confirm the effectiveness of the app. She will also outline how to use the app and how to use the results of the app from individual children to support them both from an education and rehabilitation perspective.

This series will contribute 6 PD points towards COMS recertification with ACVREP/OMAA.