extending hospital managed care to the home

Cortical Visual Impairment (CVI)

LifeScience Technologies Cortical Visual Impairment System is an effective tool for executing protocols designed to help strengthen the vision of those with Cortical Visual Impairment.

Cortical Visual Impairment is the term used for a brain that misinterprets signals from otherwise healthy eyes. In 2013, Christine Roman-Lantzy, PhD, developed a protocol for improving the vision of kids with CVI that has proven extremely effective in helping them to recover their vision. LifeScience Technologies has augmented our base care system with components that allow a teacher to build lesson plans according to this developed protocol. Our CVI system also has components available for monitoring, managing and improving the treatment program, based on a qualified educator's use of our system's features.

1Lesson Planner

The Lesson Planner allows a CVI educator to create and assign lesson plans that follow the CVI protocol. The lesson plan defines the following:

  • Plan title
  • Plan objectives
  • Session directions
  • Background images used
  • Graphics transitioned
  • The motion and timings of graphics transitioned
  • Events to be captured

2Training Session Manager

The Training Session Manager is capable of interpreting instructions in the lesson plan, for example: "display a black background and move a red box around the background for a count of 'X' seconds" - and displaying elements as specified. The Training Session Manager also offers the following capabilities:

  • Displays any number of moving graphics (we call them sprites) over the top of the backgrounds.
  • Allows for many different movement types including: circular, rectangular, path-based, straight line, random and fades.
  • Varies the display of objects in terms of how rapidly they move, how large or small they are and how long they stay on the display.
  • Automatically captures key events that are then sent back to our back end web server for analysis.
  • Emits audible sounds to indicate to the CVI student what is going on in the training session.
  • Displays any number of backgrounds for any duration of time as the session progresses.
  • Allows the user to vary the brightness of the display.
  • Movies can be played as backgrounds and can be used as "warm up exercises" for students.

3Training Session Monitor

The Training Session Monitor allows an instructor to join in on a training session in order to monitor that session and has the following capabilities:

  • Allows an instructor to record events that are of interest during the lesson plan, based on the information contained in the lesson plan. The lesson plan indicates what events to track while The Training Session Monitor records when these events occur using buttons presented on their workstation.
  • Allows the instructor to see all events that are being recorded, both automatically by the system and individually by the human monitor.
  • Allows any number of monitors to submit events seen during the training session.
  • Emits additional sounds to indicate to the CVI student what is going on in the session.

The system uses audible sounds to provide behavioural feedback to students. If a student looks at the images displayed on the iDevice, a positive reinforcement sound is played. If a student were to look away, a negative reinforcement sound can be played. Sounds are important methods of feedback for CVI kids. As such, our system allows for the sounds to be tailored so that what sounds are played match the desires of the student.


Kalamazoo Gazette

December 26, 2013

'For the first time my child game me eye contact' Kalamazoo RESA visual-impairment specialists create iPad app to aid interventions

Read the Article (PDF)

Fox 4 News Feature

February 10, 2014

Web Services that Support the CVI iPad Application

Our CVI application displays training sessions to the student using an iPad. The orchestration of the training session is managed by our web server and online services.

Defining a Lesson Plan

Defining lesson plans is as easy as selecting web pages that capture what the educator wants the plan to include. There are tools for managing plans and assigning plans to students as well as tools that allow the educator to see how often and how well a particular plan is working.

Reviewing a Training Session

When a training session is progressing, the iPad sends events to the website via our web services. The events are basic units of information about: buttons being pressed, screens being touched and sessions starting and stopping - as well as a new feature on the website that analyzes the results of a training session. It takes all of the basic event information from the iPad and generates interesting facts about what has occurred within a training session. For example, the expert:

  • Counts seconds of actual execution of a plan
  • Counts elapsed/total time from first start to last start
  • Determines the lowest, highest and average brightness used during a session
  • Counts the number of touches on a background
  • Counts the number of touches of a moving sprite
  • Summarizes the areas where sprites are touched
  • Produces a resultant map showing the most effective area for display of graphics to a student
  • Determines the most effective graphic for capturing the students attention
  • Total time a student spends looking at the screen
  • Total time looking away from the screen
  • Number of times the student looks at the screen
  • Number of events captured

All of these expertly-determined facts can then be graphed and analyzed by the educator, in whole or in part, across all training sessions. For example, it is possible to graph the time spent, on average, on training sessions combined with the number of times a sprite is touched, showing ways of measuring improvement in visual acuity as well as allowing a teacher to tailor future lesson plans to better match the needs of the student.

In addition to analyzing favorite and least favorite lessons, the CVI system has the ability to use information from the training sessions to automatically generate new training sessions that are best for the student. As an example, the system can detect highly touched areas of the iPad and where sprites are commonly touched. Using this information, the system can automatically generate new lesson plans that focus the attention specifically on these areas as well as specifically AWAY from these areas to improve acuity. The system can use facts about the lengths of time spent on average by the user on training sessions to tailor the length of time a typical training session should take place.

Integration of Our Web Services with Our Base System

There are a number of ways that these new features integrate and make use of our base system to provide the complete solution for managing CVI student populations.

  • Lesson plans can be assigned to a student or a set of students for execution
  • Lesson plans can be placed on a student’s personal calendar
  • The system reminds a student when it is time to perform a lesson
  • The system captures instances when a student does NOT perform a scheduled lesson
  • The system alerts the teacher when lessons are skipped
  • The system detects goals specific to CVI training such as "Lifetime time spent on training sessions" and "Number of sprites touched lifetime" to provide a goal based system to encourage the students to work towards specified goals.
  • The system allows an educator to place sounds, backgrounds and sprites into a store allowing students with enough points to purchase these items from the store.
  • The system can construct lesson plans that make use of student purchased sounds and graphics as a way of rewarding a student for good behavior.
  • The system rewards points for successful lesson plan accomplishments (such as touch sprites or time spent)
  • The system records "favorites" of graphics and sounds for the user and keeps track of these favorites for use in lesson plans
  • CVI based educational material can be passed down to parent of caregiver for educational purposes
  • At home appointments can be scheduled. These appointments can specify times/dates when the CVI educator will be at the student's house
  • Health journals can be used to record student's mood
  • Health journals can be correlated automatically with training session data to show trends in mood versus training session performance
  • Movies of a training session can be captured and stored with the students information
  • A student notebook is used to track everything about the student and the training sessions
  • Educators can select and revoke iPad applications with a click of a button to add or remove features required by a student
  • Educators can send secure messages to a student population. Messages can be automatically translated and approved before being sent. Messages are delivered based on national language preferences of the recipient
  • The system tracks all "Tasks" completed by the educators and can produce automatic status reports
  • The system allows for an at-home student-to-educator meeting to be held using FaceTime™. The contents of the call can be recorded and logged for later review. The recording is logged or stored in the patient notebook
  • Workload of educators can be balanced by their manager using our dashboard. The dashboard shows student workload and allows for automatic reassignment of work to less busy individuals. The tools allow an administrator to mark an individual as being on vacation and provide a return date. The system moves coordination of students that are assigned to a vacationing educator to another educator and moves them back on return of the vacationer