Guest Editors' Page

Issues related to vision and the brain have been moving to the forefront of medical, educational, and rehabilitation services for children and adults with vision impairment over the past 10 years. In our commentary, covering some 60 years, we address the relatively recent increase in the numbers of children and adults with vision conditions related to brain injury, which parallel developments occurring when our professional field began, and when large numbers of wounded veterans returned blinded from combat during World War II. Then as now, professionals who work with children and adults with new, emerging causes of vision loss needed exposure to curricula containing relevant information. Today the challenge is to provide information and skills relevant to the interplay between the brain and vision to meet the needs of a burgeoning population. A number of faculty have provided perspectives in this issue of the Journal of Visual Impairment & Blindness (JVIB) on the extent to which this material has been included in their programs, and they have highlighted the challenges associated with them. Terminology is also a significant issue that must be considered by the medical, rehabilitation, and special education communities. Terminology affects the identification of conditions and those who experience them, qualification for services, and data collection methods. It can also affect the ways in which education and rehabilitation treatment options and programs are developed, as well as the content of personnel preparation programs and the types of personnel preparation programs that must address issues related to vision and the brain. The commentary by Colenbrander in this issue of the journal addresses terminology. For the remainder of this editorial, we will use the terms CVI/ABI (cerebral visual impairment/acquired brain injury) to refer to visual impairment and visual dysfunction due to brain injury (including traumatic brain injury, TBI) in children and adults. This special issue of JVIB contains articles that address many of the challenges confronting today's practitioner. Lueck's commentary examines changes in our understanding of the nature of CVI in children. The slow emergence of multidisciplinary services that address CVI/ABI has made it difficult for many to find appropriate, comprehensive assistance. The impact of CVI/ABI on families and access to appropriate services comes to the foreground in the article by Jackel and colleagues. Assessment provides the basis for these services, and the article by Newcomb discusses one assessment tool developed to evaluate the traditional hallmarks of cortical visual impairment in children. Changes over time seen in children with cortical visual impairment using this instrument are discussed in the Research Report by Roman Lantzy and Lantzy. Intervention is another major concern for adults and children with CVI/ABI. Lam and his colleagues present a case study that includes intervention recommendations for a child with near-normal visual acuity but whose brain injury still leads to visual processing difficulties that severely affect functional vision. Relevant to adults, Kingston and colleagues present a case study from assessment to intervention that reflects a model program under development at the U.S. Department of Veterans Affairs (VA) medical center in Palo Alto, California. This presentation emphasizes the importance of multidisciplinary teams and the impact of multifaceted forms of assessment and interventions on maximizing outcomes. Now that we have mentioned the range of topics that are included in this special issue, topics that cover a great deal of ground, we would like to discuss areas that have not been covered. We do this to emphasize the broad scope of material that must be addressed as our field develops an evidenced-based body of knowledge that leads to adequate and appropriate services for children and adults with CVI/ABI. …