Cincinnati Children’s Vision Rehabilitation
Program – Cerebral Palsy (CCVRP-CP):
An interdisciplinary model for serving children
with low vision and physical disabilities
(Formerly CLEAR-CP)
Kelly E. Lusk, Ph.D, CLVT,
Terry Schwartz, M.D., and Rebecca Coakley, M.A., CLVT
Funded in part by a Perlman Center grant from The Ettlinger Trust Fund via United Way
Topics to consider
• What is CCVRP-CP and who are the Key Collaborators?
• What is Low Vision? What is Cortical Visual Impairment
(CVI)?
• What is Cerebral Palsy (CP)?
• How do young children learn and interact with their
environment?
• How does low vision/CVI interact with Cerebral
Palsy(CP)/other physical disabilities?
• Case Studies
• Family Feedback
• Discussion
What is CCVRP-CP?
- Interdisciplinary vs. multidisciplinary
- Vision (Ophthalmology, Education/Rehabilitation)
- Perlman Center (OT/PT, Assistive Technology)
- Instruction and Follow-up
- Family Education Sessions (Guess who gets the
most out of these?)
CCVRP-CP Key Collaborators
Aaron W. Perlman Center
• Linda Wnek, Sr. Director (PI)
• Katherine Eingle, MOT, OTR/L
• Elizabeth McCarty, OTR/L, ATP
• Kihmberly Wilmer, MS, OTR/L
• Patricia Gribben, OTR/L
Pediatric Ophthalmology
• Terry Schwartz, MD
• Becky Coakley, MA, CLVT
• Mel Klayer, COA
Cincinnati Assoc. for the Blind and Visually Impaired (CABVI)
•Anna Ruhmkorff
What is low vision?
• A person with low vision is “a person who has
measurable vision but has difficulty
accomplishing or cannot accomplish visual tasks,
even with prescribed corrective lenses, but can
enhance his or her ability to accomplish these
tasks with the use of compensatory visual
strategies, low vision devices, and environmental
modifications” (Corn & Lusk, 2010, p. 4-5).
• Low vision devices include optical, non-optical,
and electronic devices.
Cortical Visual Impairment (CVI)
(Roman-Lantzy, 2007)
• Other names: Cerebral Visual Impairment,
Neurological Visual Impairment, etc.
• Definition: Visual impairment caused not by ocular
visual impairment, but by damage to the brain or
visual pathways.
• Causes: Prematurity, neurological disorders, acquired
brain injury
• Characteristics
Characteristics of CVI
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Distinct color preference
Attraction to movement
Visual latency
Visual field preferences
Difficulties with visual and environmental complexity
Light-gazing or non-purposeful gaze
Difficulties with distance viewing
Absent or atypical visual reflex responses
Difficulties with visual novelty
Absence of visually guided reach
What is Cerebral Palsy (CP)?
• A number of disorders of the developing brain affecting
body movement, posture and muscle coordination.
• Caused by damage to one or more specific areas of the brain,
usually occurring during fetal development; before, during
or shortly after birth; during infancy; or during early
childhood.
• Not a disease, not progressive, nor communicable.
(From: http://www.ucp.org/uploads/media_items/cerebral-palsy-factsheet.original.pdf United Cerebral Palsy Website)
Children with a Visual Impairment and a
Physical Disability (specifically CVI and CP)
Children with a
visual impairment
Children
without CVI
Children with a
physical disability
Children with
CVI
Children with
CP
Children with CVI
and CP
Children
without CP
How do Young Children Learn
and Interact with Their Environment?
• Primary mode of interaction
– Visual observation
• Secondary modes
– Motor skills (e.g., pointing, reaching, crawling)
– Communication is visual and non-verbal
• Complicating factors:
– Physical disability that inhibits motor control
– Ability/awareness of nonverbal communication
Low Vision/CVI and CP/Physical Disability
• Vision helps to develop motor skills
• Motor skills help to develop visual skills
• How can we as an interdisciplinary team work to
improve outcomes for children with both a visual
impairment and a physical disability?
Case Studies
Family Feedback
- Rate the quality of the evaluation
- Rate the information you received
- What did you like most?
- What did you like least?
- What could we do differently?
- Would you recommend CCVRP-CP to other families?
- Other comments/questions
Discussion
- Feedback on our model
- Your experiences/Similar models?
- Thoughts for the future
References and Resources
Ferrell, K. A. (Spungin, S. J., Ed.) (2011). Reach out and
teach: Helping your child who is visually impaired learn
and grow. New York: AFB Press.
First steps: A handbook for teaching young children who are
visually impaired. (1993). Los Angeles: Blind Childrens
Center.
Hatlen, P. (1996). The core curriculum for blind and visually
impaired students, including those with additional
disabilities. RE:view 28, 25-32.
Holbrook, M. C. (Ed.) (1996). Children with visual
impairments: A parent’s guide. Bethesda,
MD: Woodbine House, Inc.
References and Resources, cont’d
Pogrund, R. L., Fazzi, D. L., & Lampert, J. S. (Eds.)
(1992). Early focus: Working with young blind and
visually impaired children and their families. New York:
AFB Press.
Roman, C. (2010). CVI Complexity Sequences: Guidelines
for use. Louisville: American Printing House for the
Blind.
Roman-Lantzy, C. (2007). Cortical visual impairment: An
approach to assessment and intervention. New York:
AFB Press.
References and Resources, cont’d
Sapp, W. & Hatton, D. (2005).
Communication and Emergent
Literacy: Early intervention
training center for infants and
toddlers with visual impairments.
Chapel Hill, NC: FPG Child
Development Institute.
Questions?
Thank you!
kelly.lusk@cchmc.org