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SARA: The next area we'll talk about is resolution of CVI. We've discussed the definition of CVI, some of its causes, characteristics, and all of it kind of boils down to this. If there has been damage to the brain, because the brain is so plastic, it can rewire itself, bypassing injured areas, to learn how to do the tasks that that damaged area would have done. It's accepted medical practice today that if someone has a stroke and loses the ability to walk, physical therapists probably on day two are getting that person up and practicing relearning how to walk. And they will practice and practice until the ability to walk is regained to varying degrees. And so, by the same token, someone who has lost vision due to brain damage, if they have the opportunity to practice seeing, eventually the brain will rewire itself and they will learn how to see again to varying degrees. In the case of children with congenital CVI, they will have to work harder to build connections that may be easier for those who have had previous experience with having vision. It's not a case of rewiring, it just wiring.

LYNNE: Changes in the brain occur most quickly within the first years of life or the first years after an insult to the brain. However, the brain can and does continue to change throughout a person's lifetime.
The assessment Christine Roman created and that we will be introducing and using within each of our case studies provides information about the student's current visual functioning. It also provides a structured approach to intervention based on this information. These principals are given as guidelines for successful intervention: 

SARA: The first is precision, meaning, random intervention does not work. The reason for such a precise approach is that we must provide intervention AT THE PERSON'S CURRENT LEVEL of functioning, not beyond, or at the very next level, as we do with most assessments. Other kinds of assessment show you where the child is and tell you the next skill to teach. This assessment shows you where the child is, and you support that. The student's behavior determines when to move to the next level. The brain signals it is ready by changing visual behavior. And that is why it is so important to revisit this assessment regularly with your students.
The next point is intentionality: know where you are and where you are going. 
Reciprocity means you watch the child and follow their lead.

LYNNE: Expectation of change: We need to expect improvement-if it is not happening, our programming may be incorrect, and we need to reaasses our own strategies.
The last is attention to the total environment: which is often responsible for changes in visual response. 
These are described further on page 126-127 of Christine Roman's book.
It's not vision stimulation.
SARA: Right. For people with CVI, vision won't get better just by exposure. Christine Roman-Lantzy defined three phases of visual functioning that students with CVI move through: Phase one is learning how to look at something. Those are the students who appear to be the most visually impaired. We want the child to just look. We want to make vision easy, and provide items and environments so that nothing competes with the visual sense. These connections are built through repetition of the same types of activity. This is the phase of building awareness of visual information.
LYNNE: Phase 2, Integrating Vision with Function, is where the person has become aware of visual information and begins to learn that it is useful. This is where the person integrates visual information with the other senses. An individual begins to act upon what they see and in doing so, perceives their own power to impact their environment. So, first you learn how to be able to look, and then you learn about connecting that information with what you have learned about these objects at the same time through other senses. And you have to do it over and over and over again. Near the end of phase 2, at about 6 to 7 on the CVI Range, is when you can explore the introduction of two-dimensional materials by pairing familiar objects with pictures of those objects on an uncluttered background. Before this level, the ability to perceive two-dimensional materials has not yet developed.
And then you move into phase 3. Phase three is defined by decreased interference from CVI characteristics. Two big themes of this phase include being able to handle increasing amounts of background information, which is complexity and distance, and identifying salient features within things, which is also complexity. Phase three can be tricky because the vision begins to look more like that of a sighted person, however almost every characteristic is still interfering with vision to some extent. Typically, a student's vision tops out at approximately 8-9 on the CVI Range, which will be discussed in the next section. These students are visually impaired and will continue to require the expertise of the teacher of the visually impaired throughout their school career. The Phase III extension chart in Roman's book, and further materials for students at this level as they are developed, can be helpful. Christine Roman-Lantzy's upcoming publication, not yet available as of April, 2016, will provide additional guidance.
This quote from the Blind Babies Foundation Fact Sheet is really pertinent to what we have been talking about: "When a child with CVI needs to control his head, use his vision, and perform fine motor tasks, the effort can be compared to a neurologically intact adult learning to knit while walking a tightrope." 
Our goal for teaching a student with CVI is to make information seeable by adapting the environment and to avoid the tightrope scenario.