Research

Citation
Roman-Lantzy, C. (2018). Cortical visual impairment: An approach to assessment and intervention (2nd ed.). New York, NY: AFB Press.

Summary

This foundational text provides a comprehensive framework for understanding, assessing, and supporting individuals with cerebral/cortical visual impairment (CVI). Roman-Lantzy describes CVI as a brain-based visual impairment that affects how visual information is processed and interpreted. The book introduces the CVI Range, an assessment tool used to identify how a child uses vision and to guide individualized educational planning.

The book also outlines ten common behavioral characteristics associated with CVI, including preferences for certain colors, difficulty with visual complexity, challenges with visual novelty, and the impact of movement and light on visual attention. These characteristics help educators and families understand how visual processing differences may influence learning, interaction, and participation in everyday environments.

Roman-Lantzy emphasizes that effective intervention requires carefully designed visual environments, intentional presentation of materials, and individualized supports that align with how each learner uses vision.

Why This Matters for the CVI Book Nook

The CVI Book Nook is grounded in the understanding that learners with CVI often benefit from intentional visual design that reduces complexity and supports visual recognition. Many of the design principles used in CVI Book Nook materials, such as simplified backgrounds, salient visual features, limited visual elements, and predictable presentation, align with the characteristics and intervention strategies described in Roman-Lantzy’s work.

By designing materials that reflect how learners with CVI use vision, CVI Book Nook aims to support visual engagement, recognition, and meaningful participation in shared literacy experiences.

Citation
Roman-Lantzy, C. (2019). An approach to literacy for children with CVI. Pediatric Cortical Visual Impairment Society.
https://pcvis.vision/educators-and-therapists/cvi-and-literacy/

Summary
This article outlines a CVI-specific, developmentally sequenced approach to literacy that differs from traditional literacy instruction used with children who have ocular visual impairments. Literacy learning for children with CVI begins with real objects presented in isolation, paired with intentional language that highlights salient visual features. Instruction progresses from objects to images and then to symbols and words, with careful attention to visual complexity, consistency, and repetition.

The article emphasizes that visual discrimination develops before visual recognition and identification. As learners gain experience recognizing objects, images, and symbols, words become more accessible when they are presented in clear, consistent visual forms that support recognition and meaningful language connections.

Why this matters for the CVI Book Nook
The CVI Book Nook is grounded in this exact framework. Books are intentionally designed to reduce visual complexity, introduce salient features, and support object-to-image-to-symbol learning. Predictable layouts, realistic images, minimal text, and repetition help support visual access, emerging literacy, and shared reading experiences for learners with CVI.

Citation

Dutton, G. N., & Lueck, A. H. (2015). Vision and the brain: Understanding cerebral visual impairment in children. New York: AFB Press 

Summary

This book provides a comprehensive overview of cerebral (cortical) visual impairment (CVI) and explains how differences in brain-based visual processing affect how children perceive and interpret visual information. The authors describe how vision involves complex networks in the brain that support both object recognition (“what” pathway) and spatial processing (“where” pathway).

Children with CVI may experience difficulty with visual recognition, processing complex visual scenes, interpreting movement, and integrating visual information with other sensory inputs. The book emphasizes that visual difficulties in CVI are often related to how the brain processes visual information, rather than problems with the eyes themselves. 

Dutton and Lueck highlight the importance of understanding each child’s unique visual processing profile and adapting learning environments and materials to reduce visual complexity and support meaningful visual engagement.

Why this matters for the CVI Book Nook

Research on CVI shows that many learners experience difficulty processing visual complexity and clutter, which can interfere with recognition and visual attention. Materials designed for learners with CVI often benefit from simplified visuals, reduced background complexity, and direct instruction with salient features.

The design principles used in CVI Book Nook, including single images on simple backgrounds, limited visual elements, and consistent visual representations, align with research suggesting that reducing visual complexity can help support visual processing and recognition for learners with CVI.

Citation

Chokron, S., & Dutton, G. N. (2016). Impact of cerebral visual impairments on motor skills: Implications for developmental coordination disorders. Frontiers in Psychology, 7, Article 1471. https://doi.org/10.3389/fpsyg.2016.01471

Summary

This peer-reviewed article examines how cerebral/cortical visual impairment (CVI) affects motor development, coordination, learning, and functional participation in children. The authors explain that vision is foundational to early development, guiding movement, interaction, and understanding of the environment.

CVI is described as a brain-based visual impairment that can disrupt visual recognition, attention, spatial organization, visual search, and visuomotor coordination, even when visual acuity appears normal. Differences in dorsal and ventral visual processing can impact object and face recognition, navigation, interpretation of complex scenes, and coordination of movement, especially in visually cluttered environments.

The authors also highlight the overlap between CVI and developmental coordination disorder (DCD), noting that motor difficulties are often misattributed. When CVI is unrecognized, it can limit exploration, reduce incidental learning, and impact academic performance, social interaction, and independence.

The article emphasizes the importance of early identification, comprehensive assessment, and accurate diagnosis to ensure appropriate supports are in place.

Why this matters for the CVI Book Nook

This article reinforces the CVI Book Nook’s emphasis on intentional visual access, reduced visual complexity, and thoughtful material design. It highlights that vision supports not only recognition and reading, but also movement, exploration, and engagement with the environment, areas that are often impacted for children with CVI.

CVI Book Nook materials are intentionally designed to minimize clutter, introduce salient features, and reduce unnecessary visual demands so children can use vision more efficiently and comfortably. This research supports the need for predictable layouts, simplified visual scenes, and multisensory supports to reduce visual fatigue, support incidental learning, and promote meaningful participation across daily routines.

Citation
Stockall, N., Villar Cole, C., & Contreras-Vanegas, A. (2020). Behavioral signs of cerebral visual impairment in very low birth weight infants. Journal of Occupational Therapy, Schools, & Early Intervention. https://doi.org/10.1080/19411243.2020.1822258

Summary
This peer-reviewed article examines early behavioral signs of cerebral/cortical visual impairment (CVI) in infants and young children. The authors explain that CVI is frequently under-identified because many children demonstrate typical visual acuity on eye exams, while still experiencing significant challenges with visual processing, attention, movement, and interpreting visual information.

They describe how CVI often shows up through subtle, adaptive behaviors that are frequently misinterpreted as motor delays, sensory differences, anxiety, or behavioral concerns. Examples include avoiding visual clutter, difficulty with stairs or uneven surfaces, reliance on movement or touch to explore space, preference for slower visual input, difficulty recognizing faces, and challenges making sense of complex visual scenes.

The article explains that dorsal stream impairments may affect visual attention, motion processing, depth perception, and navigation, while ventral stream impairments may impact object recognition, facial recognition, and visual memory. Together, these differences can significantly influence motor development, communication, cognition, and social interaction, especially when children have limited opportunities to visually explore their environment.

The authors stress that many behaviors seen in children with CVI are intentional compensatory strategies used to manage visual overload and fatigue. When these behaviors are misunderstood, children may miss out on appropriate supports during critical periods of brain development. To support access and learning, the authors recommend interventions grounded in Universal Design, Universal Design for Learning (UDL), multisensory instruction, and differentiated instruction, with a focus on reducing visual complexity, supporting predictable routines, honoring individual pacing, and adapting environments and materials to align with how children with CVI use vision.

Why this matters for the CVI Book Nook

This article reinforces that many behaviors seen in children with CVI are adaptive responses to visual overload, not lack of interest or ability. It supports the CVI Book Nook’s focus on simple visuals, reduced clutter, predictable layouts, and intentional pacing to support access and reduce visual fatigue. Most importantly, it validates the need for early, visually respectful learning experiences so children’s strengths are recognized and supported from the start.

Citation

Fisher, A. V., Godwin, K. E., & Seltman, H. (2014). Visual environment, attention allocation, and learning in young children: When too much of a good thing may be bad. Psychological Science, 25(7), 1362–1370. https://doi.org/10.1177/0956797614533801

Summary

Fisher et al. (2014) examined how classroom visual environments affect attention and learning in young children. In a controlled study, kindergarten students were taught identical lessons in two settings: one with highly decorated walls and one with minimal visual distractions. The researchers found that children in the decorated classroom spent more time off-task, were more frequently distracted by the surrounding environment, and demonstrated lower learning outcomes. The study highlights how excess visual stimuli can compete for attention and interfere with a child’s ability to focus on instruction.

Why this matters for the CVI Book Nook

This research reinforces the importance of reducing visual clutter to support attention and learning. The CVI Book Nook uses simple, intentional designs, such as plain backgrounds, limited images and text on a page, and intentional spacing, to help direct attention to what matters most. If clutter impacts attention in typically developing children, it can present even greater barriers for children with CVI, who already have difficulty filtering complex visual information. Thoughtful reduction of visual complexity supports sustained attention, improves access to materials, and creates more meaningful learning opportunities.

Citation

Van Hove, C., Damiano, C., & Ben Itzhak, N. (2025). The relation between clutter and visual fatigue in children with cerebral visual impairment. Ophthalmic & Physiological Optics, 45(2), 514–541. https://doi.org/10.1111/opo.13447

Summary

This peer-reviewed study examined the relationship between visual clutter and visual fatigue in children with cerebral/cortical visual impairment (CVI). 

The researchers found a clear association between higher levels of visual clutter and increased signs of visual fatigue. Over 90% of participating children demonstrated observable indicators of visual fatigue, particularly in cluttered environments. The study also highlighted that visual fatigue is influenced not only by visual clutter, but by interacting factors such as lighting, movement, auditory input, and social activity within a space.

Why this matters for the CVI Book Nook

CVI Book Nook materials are designed with careful attention to background simplicity, salient features, reduced clutter and predictable layouts. The findings reinforce the understanding that visually complex environments and materials can increase visual fatigue and reduce a child’s ability to engage, attend, and learn. This study supports the need for materials that prioritize visual access and meaningful interaction for children with CVI.

Related Resource

Perkins School for the Blind. (2025). Research confirms what families know: Clutter causes fatigue in kids with CVI. CVI Now.

This companion article translates the research findings into family- and educator-friendly language and highlights how lived experiences within the CVI community helped shape and inform this study.

Citation

Manley, C. E., Walter, K., Micheletti, S., Tietjen, M., Cantillon, E., Fazzi, E. M., Bex, P. J., & Merabet, L. B. (2023). Object identification in cerebral visual impairment characterized by gaze behavior and image saliency analysis. Vision Research, 213, 108228. https://doi.org/10.1016/j.visres.2023.108228 

Summary

This peer-reviewed study investigated how individuals with cerebral/cortical visual impairment (CVI) identify common objects presented in different visual formats, including abstract line drawings, realistic line drawings, and color photographs. The researchers compared object identification accuracy, reaction time, and visual gaze behavior in 50 individuals with CVI and 50 neurotypical controls using eye-tracking technology.

The study found that individuals with CVI demonstrated lower success rates and longer reaction times when identifying objects, particularly when images were abstract or presented in black and white. Object identification improved as images became more realistic and included color, with performance approaching that of neurotypical controls when color photographs were used. These findings highlight the importance of object form, contours, and color as critical visual cues for recognition in individuals with CVI.

Eye-tracking data revealed that participants with CVI showed larger visual search areas and a greater number of fixations, indicating increased visual effort during object identification. Gaze patterns in the CVI group were also less aligned with the most visually salient features of the images. When objects were incorrectly identified, participants required even more time and visual effort, further illustrating the cognitive and perceptual demands of visual processing in CVI.

The authors conclude that image design plays a significant role in visual accessibility. Abstract, symbolic, or simplified images—commonly used in educational materials—may pose substantial barriers for individuals with CVI, while realistic, color-rich images can better support recognition and reduce visual effort.

Why this matters for the CVI Book Nook

This research directly supports the CVI Book Nook’s emphasis on intentional image selection, realistic visuals, and reduced visual complexity. The findings reinforce that commonly used abstract or symbolic images may not be visually accessible for many learners with CVI, even when those images are designed to be “simple.”

CVI Book Nook materials prioritize realistic images, salient features, meaningful color, and predictable presentation to support object recognition and reduce visual effort. This study provides empirical evidence that thoughtful image design can improve access, support incidental learning, and reduce visual fatigue for individuals with CVI.

Citation

Bennett, R. G., Tibaudo, M. E., Mazel, E. C., & Nai, Y. (2025). Implications of cerebral/cortical visual impairment on life and learning: Insights and strategies from lived experiences. Frontiers in Human Neuroscience, 18, Article 1496153. https://doi.org/10.3389/fnhum.2024.1496153

Summary

This peer-reviewed article examines how cerebral/cortical visual impairment (CVI) impacts learning, navigation, socialization, and overall quality of life through an analysis of lived experiences shared by individuals with CVI. 

The article highlights that visual access for individuals with CVI is often inconsistent and unreliable, particularly in visually complex, cluttered, noisy, or fatiguing environments. Participants described significant challenges with incidental learning, reading, recognizing objects and people, navigating environments, and interpreting social cues. Many individuals reported that using vision requires substantial cognitive effort, often leading to visual fatigue and the need to rely on compensatory sensory strategies.

The authors also describe CVI as a “full-body experience,” emphasizing the impact of CVI on mental and physical health, including anxiety, stress, fatigue, and reduced quality of life. The article underscores the importance of early identification, comprehensive assessment, and individualized, multisensory supports to improve access, participation, and long-term outcomes for individuals with CVI.

Why this matters for the CVI Book Nook

This article directly supports the CVI Book Nook’s emphasis on individual access, reduced visual complexity, and multisensory learning experiences. It reinforces that many foundational concepts typically learned incidentally through vision must be intentionally taught for children with CVI due to fluctuating visual access, fatigue, and environmental demands.

CVI Book Nook materials are designed to reduce visual clutter, support predictable layouts, and pair visual information with meaningful sensory experiences. This research validates the need for materials that prioritize access and participation.

Summary

Contrast sensitivity is an ocular condition, not a brain-based visual processing condition like CVI, although the two often co-exist.

These resources collectively highlight how contrast sensitivity can affect how a person sees, interprets, and uses visual information in real-world environments. 

Good-Lite Company. (n.d.). Lea contrast sensitivity tests. Good-Lite.

The Good-Lite materials reveal visual challenges that may not appear during standard eye exams and are especially valuable for young children and individuals with complex communication needs.

Hemianopsia.net. (n.d.). Contrast sensitivity loss. https://www.hemianopsia.net/contrast-sensitivity-loss/ 

The Hemianopsia.net article explains how contrast sensitivity loss is often a better predictor of everyday visual functioning than visual acuity. It highlights how reduced contrast can make environments appear foggy or indistinct, affecting tasks such as mobility, reading, and object recognition, even when visual acuity appears relatively intact.

Perkins School for the Blind. (n.d.). Solving the low vision equation. https://www.perkins.org/solving-the-low-vision-equation/ 

The Perkins School for the Blind article connects these findings to educational practice, emphasizing that vision is influenced by the interaction between contrast, lighting, task demands, and environment. It reinforces the need to thoughtfully design materials and learning spaces that reduce visual load and support access through intentional contrast.

Why This Matters for CVI Book Nook

Many learners, including those who are blind, have low vision, and those with CVI, benefit from materials that are intentionally designed to support access. Visual information that is clear, well-contrasted, and intentionally presented can make it easier to see, interpret, and engage.

These resources support the CVI Book Nook’s emphasis on:
• high-contrast images
• simple backgrounds and reduced visual competition
• intentional use of color to support visual “pop-out” and recognition

Citation
Ehri, L. C. (2014). Orthographic mapping in the acquisition of sight word reading, spelling memory, and vocabulary learning. Scientific Studies of Reading, 18(1), 5–21. https://doi.org/10.1080/10888438.2013.819356

Summary

This article explains the cognitive process known as orthographic mapping, which allows readers to store written words in memory for quick and effortless recognition. Orthographic mapping occurs when readers form connections between a word’s letters (graphemes), sounds (phonemes), and meaning. Through repeated exposure and practice, these connections become firmly established, allowing words to be recognized instantly rather than decoded each time they are encountered.

Ehri explains that successful word recognition depends on clear perception of visual letter patterns and the ability to connect those visual forms to spoken language. As readers encounter words repeatedly, the brain stores stable visual representations of those words in long-term memory, allowing reading to become faster and more automatic. This process frees cognitive resources so readers can focus on comprehension and meaning rather than decoding each word individually.

Why This Matters for the CVI Book Nook

Orthographic mapping depends on a learner’s ability to perceive and recognize visual forms consistently. For children with cerebral/cortical visual impairment (CVI), visual recognition may require additional support due to differences in how the brain processes visual information.

CVI Book Nook materials are designed to reduce visual complexity and highlight salient visual features so learners can focus on recognizing objects and images more easily. By presenting clear, consistent visual forms and pairing them with meaningful language and experiences, these materials support the development of visual recognition skills that are foundational for later symbol and word recognition.

Image flashcards further support this process by strengthening connections between visual forms, spoken language, and meaning—helping learners build vocabulary and deepen understanding through repeated, meaningful exposure.

This research reinforces the importance of creating visually accessible materials that allow learners with CVI to build stable visual representations, an essential step in supporting emerging literacy and reading development.

Citation
Dunst, C. J., Trivette, C. M., Masiello, T., Roper, N., & Robyak, A. (2006). Framework for developing evidence-based early literacy learning practices. CELLpapers, 1(1), 1–12.

Summary

Dunst et al. (2006) present a framework for identifying and using evidence-based early literacy practices grounded in everyday experiences. The framework emphasizes that young children learn literacy best through meaningful interactions, natural routines, and engaging activities rather than isolated instruction.

The authors organize early literacy into key areas such as oral language, phonological awareness, print awareness, and comprehension, and connect these areas to specific adult behaviors and environmental supports that promote learning.

A central focus of the framework is on:

• Responsive adult–child interactions

• Embedding literacy opportunities into daily routines (play, meals, caregiving)

• Using intentional, research-based strategies to support skill development

The paper highlights that early literacy develops through active participation, repetition, and real-world experiences, with adults playing a critical role in scaffolding learning.

Why This Matters for the CVI Book Nook

This framework reinforces that early literacy develops through meaningful, everyday experiences, not isolated tasks. This directly aligns with the CVI Book Nook’s emphasis on pairing books with real objects, routines, and hands-on exploration to build understanding.

For learners with CVI, literacy is most accessible when it is intentional, repetitive, and grounded in familiar contexts. Embedding literacy into daily routines, such as snack time, play, or shared reading, supports visual recognition, concept development, and language growth.

The CVI Book Nook materials are designed to support these interactions by providing simple, visually accessible images paired with opportunities for multisensory learning and shared engagement. This approach helps move learners from real objects → images → symbols, building a stronger foundation for literacy over time.

Citation
Gough, P. B., & Tunmer, W. E. (1986). Decoding, reading, and reading disability. Remedial and Special Education, 7(1), 6–10.  

Summary

Gough and Tunmer introduced the Simple View of Reading, which explains that reading comprehension is the result of two essential components: word recognition (decoding) and language comprehension. Both components must be present and working together for successful reading to occur.

Language comprehension refers to the ability to understand spoken language, including vocabulary, concepts, and sentence structure. Word recognition involves the ability to accurately and efficiently identify written words. When either component is weak, reading comprehension is impacted.

This model highlights that strong language skills are a critical foundation for literacy development and begin to develop well before formal reading instruction.

Why This Matters for the CVI Book Nook

The Simple View of Reading reinforces that language comprehension is a foundational component of literacy. For learners with cerebral/cortical visual impairment (CVI), building strong language and conceptual understanding is especially important, as access to visual information may be inconsistent.

CVI Book Nook materials are designed to support language development through meaningful experiences, repeated routines, and intentional pairing of words with objects and actions. These experiences help learners build vocabulary and understanding, which are essential for later reading comprehension.

By strengthening language comprehension alongside visual recognition, these materials support both components of the reading process described in the Simple View of Reading.

Citation
Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Harvard University Press.

Summary
Vygotsky’s work emphasizes that learning and development occur through social interaction and meaningful experiences. He proposed that children build understanding through engagement with others, using language as a primary tool for thinking and learning.

A key concept in his work is that learning happens within the context of shared activities, where adults or more experienced partners support a child’s development by connecting language to real-world experiences. Through repeated interactions, children begin to form connections between actions, objects, and words, building a foundation for later learning and literacy.

Why this matters for the CVI Book Nook
Vygotsky’s work reinforces the importance of building language and understanding through meaningful, shared experiences, an approach that is especially critical for learners with cerebral/cortical visual impairment (CVI).

Children with CVI may have reduced access to incidental visual learning, making it more difficult to naturally connect objects, actions, and language. CVI Book Nook materials are designed to provide intentional, structured experiences that pair clear visual information with language, movement, and interaction.

By supporting shared exploration and connecting words to real objects and routines, these materials help learners build understanding and form the foundational connections needed for concept development and early literacy.

This work highlights that language develops through experience, an idea that underlies the design of CVI Book Nook materials.

Citation

Gori, M., Campus, C., Signorini, S., Rivara, E., & Bremner, A. J. (2021). Multisensory spatial perception in visually impaired infants. Current Biology, 31(22), 5093–5101.e5. https://doi.org/10.1016/j.cub.2021.09.011

Summary

This peer-reviewed study explored how infants with severe visual impairment use and integrate auditory and tactile information to understand space and learn. By comparing infants with visual impairment to sighted peers, the researchers examined how early sensory experiences shape spatial perception.

The findings showed that infants with visual impairment rely more heavily on nonvisual sensory channels and use them differently than sighted infants. Importantly, even very young infants demonstrated the ability to integrate auditory and tactile information, highlighting the brain’s early adaptability. The authors emphasize that these findings support the value of early, intentional multisensory experiences that build understanding through touch and sound, rather than relying on vision alone. 

Why this matters for the CVI Book Nook

This research supports the CVI Book Nook’s emphasis on multisensory access as a foundational component of learning for children with CVI and other visual impairments. The findings reinforce that learning does not depend on vision alone and that thoughtfully designed tactile, auditory, and experiential supports can strengthen understanding, memory, and engagement.

CVI Book Nook materials are intentionally designed to invite multisensory exploration, pairing simplified visuals with tactile elements, movement, sound, and real-world experiences, to support access, reduce visual fatigue, and honor the many ways children with CVI learn and make meaning.

Additional Resource

Bennett, R. (2024, May 15). A multisensory approach for children with CVI. Perkins School for the Blind. https://www.perkins.org/a-multisensory-approach-for-children-with-cvi/

This practitioner-focused resource complements the research findings by illustrating what multisensory learning looks like in real educational settings and why it is essential for ensuring full access for children with CVI.

Citation

Morelli, F., Cappagli, G., Gori, M., & Cuppone, A. V. (2020). A multidimensional, multisensory and comprehensive rehabilitation intervention to improve spatial functioning in the visually impaired child: A community case study. Frontiers in Neuroscience, 14, 768. https://doi.org/10.3389/fnins.2020.00768

Summary

This peer-reviewed case study examined a comprehensive, multisensory intervention designed to support spatial understanding and functional skills in a child with visual impairment. The intervention intentionally integrated tactile, auditory, motor, and residual visual input within meaningful, real-world activities, rather than teaching skills in isolation.

Over time, the child demonstrated improvements in spatial awareness, movement, orientation, and the ability to use multiple sensory cues together to understand the environment. Progress was strongest when learning was experiential, consistent, and embedded within everyday routines, allowing sensory information to build context and meaning.

Why this matters for CVI Book Nook

This study supports the CVI Book Nook’s emphasis on multisensory, experience-based learning that goes beyond vision alone. The findings reinforce the importance of pairing simplified visual information with tactile exploration, movement, sound, and real-life context to support understanding and independence.

CVI Book Nook materials are designed to invite multisensory engagement, supporting children as they build concepts through doing, touching, listening, and interacting, while reducing visual fatigue and honoring the diverse ways children with CVI and visual impairment access learning.

Citation

Smyth, C. A. (2019). It’s more than a touch: Early tactual development in infants and toddlers. Visual Impairment and Deafblind Education Quarterly, 64(41).

Summary

In this practice-informed, research-based article, Cathy Smyth emphasizes the critical role of early tactual development for infants and toddlers with visual impairment. Smyth explains that touch is not simply a compensatory sense, but a primary pathway for building concepts, understanding the environment, and supporting cognitive, motor, and language development.

The article outlines how intentional, meaningful tactile experiences, paired with movement, routine, and caregiver interaction, support learning and exploration. Smyth highlights that children with visual impairment need repeated, hands-on opportunities to actively explore objects and environments in order to build accurate mental representations and make sense of the world around them.

Why this matters for CVI Book Nook

This work directly supports the CVI Book Nook’s emphasis on tactile exploration and multisensory learning as essential, not optional, components of access for children with CVI and visual impairment. Smyth’s research reinforces that touch and movement are foundational to concept development, especially when visual input is inconsistent, unreliable, or unavailable.

CVI Book Nook materials intentionally invite children to learn through hands-on interaction, movement, and real-world experiences, pairing tactile input with simplified visuals and meaningful context. This approach aligns with Smyth’s call to move beyond passive exposure and toward active, experiential learning that supports understanding, independence, and engagement.

Citation
Hatton, D. D., Ivy, S. E., & Boyer, C. (2013). Severe visual impairments in infants and toddlers in the United States. Journal of Visual Impairment & Blindness, 107(5), 325–336.

Summary
This large-scale study examined data from nearly 6,000 infants and toddlers with severe visual impairments across the United States. The findings identified cerebral visual impairment (CVI) as the most prevalent cause of severe visual impairment in young children. The study also found that a majority of these children have additional disabilities and that there is often a significant delay between diagnosis and referral to specialized early intervention services.

The authors highlight the importance of early identification, early intervention, and the need for developmentally appropriate materials that support learning from a very young age.

Why this matters for the CVI Book Nook
This research reinforces the need for accessible, inclusive learning materials designed for children with CVI and complex needs. CVI Book Nook resources are created with the understanding that many children with CVI have multiple disabilities and may experience delays in accessing appropriate services. Providing visually accessible books early helps support concept development, communication, and shared learning experiences during critical developmental periods.