How do you greet a child with CVI?

How do you greet a child with CVI?
How do you greet a child with CVI?

We know that one of the ten characteristics of cortical visual impairment (CVI) is difficulty with faces, a component of Complexity (Roman-Lantzy). Knowing this, we should take some time to consider how we greet and interact with a child with CVI, remembering he is not likely to recognize you. This is essential for school teams, especially at the beginning of the school year. With a swirl of new peers, teachers, and classes, how we greet kids with CVI is so important.

Difficulty with faces means many things. First and foremost, it means a child with CVI will do his best to avoid eye contact with you. Faces are visually complex (Roman), expressions are fleeting, distant, and ever changing, making interpretation of those expressions and facial features nearly impossible. When he was in Phase II CVI (Roman), my son would turn his head any way he could, in order to avoid my face each morning when picked up out of his crib. Now, years later and well into Phase III CVI (Roman), it means he may regard my face, briefly, but cannot maintain eye contact. It means most of the time when he is “looking” at me, he is really looking just to the right side of my face.

Every year, teaching school teams about his cortical visual impairment, they are reminded that he cannot recognize faces, not peers, not teachers, not even mom. Not today, not by the time of his next IEP, not by the end of the school year. Children with CVI are smart and, when they can, will compensate and find other ways to recognize the familiar people in their lives.

So what do you say when greeting a child with CVI? Most of the time, “Hi Jasper, it’s Mrs Smith from homeroom” will do. Identifying yourself by name is a great way to start. If you are just getting to know a child or will interact throughout the day, you could also add an identifier or salient feature. “Hi Jasper, it’s Mrs Smith, I’m wearing a purple sweater today.” Unless Mrs Smith lives in purple sweaters, this is not a true salient feature, but more of a visual identifier. When we greet a child with CVI this way, respectfully, it helps others learn something about that child, and how to communicate with him.

When a child with CVI does not recognize faces, what we do not want to do is turn the greeting into a game or quiz. “Hi Jasper, can you guess who I am?” No–he cannot. Let’s always assume that a child with CVI possesses an awareness that he does not recognize others, not even mom. This quizzical approach puts the child in a terrible position, unable to craft a response. Depending on who else is around, it also models an inappropriate greeting for those nearby, both teachers and students. And besides, would you greet a child with ocular blindness this way? Would you play guessing games? No. Exchanges like these make him unlikely to attempt a greeting himself.

A young child with CVI may already be sensitive about his difference – walking down the school hallways, being greeted by name by anonymous peers, unable to respond. Being put on the spot leaves him self conscious, awkward, vulnerable. My son is so sensitive to his inability to recognize peers that, while he is highly social, he will shut down at the oncoming greeting of a familiar friend, calling his name, knowing that he cannot reciprocate. Being unable to recognize faces impacts our children’s self esteem, their self image, their social development; it  interferes with the building blocks of friendship.

That’s no way for a child with CVI to begin school.


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