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Sight Unseen

As shared on the Nishmoseini hotline by Raizy Sander

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Sharing my story isn’t something I ever thought I’d do. It’s way out of my comfort zone, but I’ve chosen to share it because I want to spread awareness, and I hope the information will be of benefit.

My daughter, Faige Malky, is an adorable three-year-old with Down syndrome. When she was around fifteen months old, at the beginning of Covid, we started doing therapy sessions for her on Zoom, as therapists couldn’t make in-person visits. 

During one session, her OT, Lynn, noticed that Faige Malky’s head dropped for a second.

“What was that?” she asked me, concerned.

I explained that recently, Faige Malky had started having this interesting reflex when she was startled — she’d drop her head for a second. Initially, I’d been worried about it, but the pediatrician said it was fine, so I didn’t give it much thought.

“I think you should check with a neurologist,” the therapist said. “I’m concerned it could be a seizure.”

A seizure? No one I’d mentioned it to thought it could be that — seizures are usually longer than a second. But to be on the safe side, I started inquiring about good neurologists and how to get an appointment. The first available appointment was three months later.

When I told the OT, she suggested I speak to another mother, whose child had similar symptoms that were ultimately diagnosed as seizures. 

I followed through, and although this child’s symptoms were different, I heard enough to realize that Faige Malky’s head drops actually could be a seizure disorder. And with seizures, early detection is critical — and we’d already missed that boat.

“Chaim Medical advised us to take our child to the ER when we suspected seizure disorder. Immediate treatment is vital to prevent long-term damage,” the other mother told me.

I called Chaim Medical, and they urged me to take Faige Malky to the ER. We headed to Columbia Hospital, where they placed an EEG along her scalp to detect if there was seizure activity. 

I told them that the seizures often came when she was startled.

“Try to startle her, let’s see what happens,” they said.

I went behind Faige Malky and picked her up without warning. She startled, and her head dropped.

The doctor confirmed that during the head drop, the brain showed seizure-like activity. She was diagnosed with infantile spasms, a form of epilepsy that typically affects babies, and involves brief spells of tensing or jerking.

Seizures of this kind are usually short — one to two seconds — as opposed to other seizure disorders, in which the spells last from thirty seconds to two minutes. 

There are a few standard treatments for infantile spasms, including hormone therapy, steroids, and a medication called vigabatrin. In this case, the doctor suggested the third option, and started Faige Malky on the lowest dose of the medication, instructing us to increase the dosage gradually.

Baruch Hashem, after starting on the lowest dose, the head drops stopped completely. I didn’t want to increase the dosage if it wasn’t necessary, so the day after being discharged from the hospital, the team at Chaim Medical helped me get an appointment with a top neurologist.

Dr. Orrin Devinsky is a neurologist and the director of the NYU Comprehensive Epilepsy Center, and I’m so grateful we were able to see him. When I shared my concerns about increasing the medications, he agreed with me.

“Don’t increase the dose, continue with the dose you’re using now, and we’ll monitor the situation,” he said.

He also told me that, interestingly enough, children with Down syndrome who have infantile spasms often outgrow them quicker than other children do.

“See?” I said. “Down syndrome rocks!”

Baruch Hashem, after six months of Faige Malky being on the lowest dosage of the medication, with EEGs every two months to check for seizure-like activity, we were able to take her off the medication, and that saga was behind us. Chasdei Hashem, it was such a relief to be able to do that.

But if we thought we could finally relax, we were mistaken. Soon, we were thrust into an entirely new challenge — this time, with Faige Malky’s vision issues.

Once again, it was Lynn, her OT, who caught the problem. And this itself was tremendous Hashgachah pratis: Why would Lynn, an OT, have such detailed knowledge in this area? And yet, she did — because several children she worked with had CVI (cortical visual impairment) and she was determined to help them as best she could. Wanting to deepen her expertise, she even paid out of pocket to take a course on the topic, ensuring she could provide them with the support they needed.

She did that training just in time to realize that my daughter had CVI.

It was again during a Zoom session when Lynn realized that Faige Malky wasn’t looking at a toy that was right near her. When Lynn mentioned her concern to me, I felt like my world had come crashing down. Faige Malky was already delayed because of her Down syndrome, we’d finally finished with the infantile spasms — and now this? A lifelong struggle with her vision?

Had I known then how much help was available and how much my daughter could progress in such a short time, I wouldn’t have felt so devastated.

Right away, we began researching CVI. It appeared that because the seizures hadn’t been diagnosed immediately, there was some brain damage affecting the visual pathways, resulting in CVI.

This condition means that while the eyes themselves are structurally fine, the brain doesn’t properly interpret what they see. CVI can have various causes, including lack of oxygen, seizures, infections, or head injuries. 

It’s difficult to diagnose since a standard eye exam typically appears normal, even though the child struggles to see properly. They may perceive colors swirling around them, but without meaning — because the brain isn’t processing visual input correctly.

CVI progresses through different stages, ranging from very limited vision to near-normal eyesight. Faige Malky started at the lowest level — she couldn’t even see the toys around her. As I began researching ways to help her, we learned that children with CVI can be guided through specific phases to improve their vision.

In Phase 1, the goal is to teach the brain to see. We focused on helping Faige Malky look at objects so her brain could learn to process them visually. We discovered that children with CVI respond more easily to metallic objects, movement, and light. Suddenly, it all made sense — was why Faige Malky had always been so captivated by light!

Usually, children with CVI show a preference for a certain color. For Faige Malky, it was red; when her clothing had some red, she would look at it. 

Thus began what we called the “red movement.” We bought everything in red — a red bowl and spoon, a red towel, red metallic items to hang around the house, the works.

We also asked a dayan about getting her an iPad with specific apps that could help improve her vision, and this helped her tremendously — she could look at it for hours, while looking at other things was a struggle.

We were lucky to be able to schedule a Zoom appointment with Dr. Christine Roman-Lantzy, an expert in CVI who has developed materials and treatment plans to help children with this impairment. 

She confirmed the diagnosis, and told us that since Faige Malky was now recognizing and reaching for red objects, she was up to Phase 2 — object functioning, using the abilities she’d developed in Phase 1 to teach her to actually use objects she was seeing. For example, we’d put red tape on the keys of a toy piano to get her to actually play it.

Dr. Roman-Lantzy recommended that we follow up with one of her students, Chris Russell, a CVI specialist. He was incredibly kind and helpful, traveling to our home to conduct a full evaluation of Faige Malky. Afterward, he provided us with a detailed written report outlining his findings and recommendations. With the help and recommendations of these experts in the field, we saw rapid improvement. In just eighteen months, Faige Malky went from having almost no vision to seeing almost everything — so much so that I sometimes forget that she has CVI!

Yes, it’s a lifelong journey, but tremendous improvement is possible. And I’m so grateful to Hashem for sending Lynn at just the right time to catch this and begin working on it, allowing Faige Malky to regain her ability to see.

To understand how unusual this is — most therapists aren’t familiar with CVI, and even some ophthalmologists are unaware of it. When we took Faige Malky to an ophthalmologist after she had reached the second stage of CVI (where she was already able to focus on specific objects), the doctor dismissed the diagnosis, saying, “There is no way this child has CVI. Children with CVI can’t see anything, and there’s nothing that can be done to help.”

That simply isn’t true. I want to urge anyone who suspects their child may have CVI to reach out to an expert — because so much help is available!

Recently, I arranged for Chris Russell to visit our neighborhood and evaluate five children whose parents had concerns about their vision. Two were diagnosed with CVI, while the other three were able to rule it out with confidence and clarity. He has since recorded an extensive explanation of CVI, diagnosis protocol, and treatment guidelines, on the Hamaspik hotline. You can read it here as well.

I’m grateful to be able to pay it forward, to help other families find clarity in the darkness, just as Lynn did for us and for Faige Malky.

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Sensibilidad auditiva

Mi hijo es sensible a los ruidos fuertes
(p. ej., sirenas, aspiradora).

Mi hijo busca sonidos o tipos de música específicos y parece más tranquilo cuando los escucha.

Sensibilidad táctil

A mi hijo le irritan ciertas telas o etiquetas en la ropa.

Mi hijo parece indiferente a las sensaciones que suelen ser dolorosas o a las temperaturas extremas.

Sensibilidad visual

Mi hijo es sensible a las luces brillantes o parpadeantes.

Mi hijo tiende a evitar el contacto visual.

Sensibilidad al gusto y al olfato

Mi hijo prefiere constantemente los alimentos blandos y rechaza los alimentos con sabores o especias fuertes.

Mi hijo busca olores fuertes o inusuales, como oler comida u objetos.

Sensibilidad propioceptiva

Mi hijo prefiere los abrazos fuertes o que lo envuelvan en una manta.

Mi hijo no es consciente de la posición del cuerpo en el espacio (por ejemplo, a menudo choca con cosas).

Sensibilidad social

Mi hijo se pone ansioso o angustiado en espacios abarrotados.

Mi hijo duda o se resiste a las actividades de escalada o equilibrio (por ejemplo, gimnasios en la jungla, balancines).

Sensibilidad al movimiento

A mi hijo no le gustan los movimientos rápidos o giratorios

Sensibilidad vestibular

Mi hijo se pone ansioso o angustiado en espacios abarrotados.

Mi hijo duda o se resiste a las actividades de escalada o equilibrio (por ejemplo, gimnasios en la jungla, balancines).

Please answer all questions before submitting.

Your Child’s Score is

  • 0-15

    Baja sensibilidad sensorial

  • 16-30

    Sensibilidad sensorial moderada

  • 31-45

    Alta sensibilidad sensorial

  • 46-60

    Sensibilidad sensorial muy alta

0-15: Baja sensibilidad sensorial

  • Interpretación: Su hijo presenta niveles bajos de sensibilidad sensorial, que por lo general se encuentran dentro del rango de desarrollo típico.
  • Recomendación: Por lo general, no es motivo de preocupación. Si tienes preocupaciones específicas o notas un cambio repentino de comportamiento, consulta a un profesional de la salud para que te haga una evaluación exhaustiva.
  • 0-15

    Baja sensibilidad sensorial

  • 16-30

    Sensibilidad sensorial moderada

  • 31-45

    Alta sensibilidad sensorial

  • 46-60

    Sensibilidad sensorial muy alta

16-30: Sensibilidad sensorial moderada

  • Interpretación: Su hijo muestra una sensibilidad sensorial moderada, lo que puede justificar la intervención.
  • Recomendación: Considera la posibilidad de realizar actividades que favorezcan los sentidos, los juguetes o la ropa sensorialmente sensibles, como auriculares con cancelación de ruido y mantas pesadas, para mejorar la comodidad. Si los síntomas persisten, consulta a un profesional de la salud.
  • 0-15

    Baja sensibilidad sensorial

  • 16-30

    Sensibilidad sensorial moderada

  • 31-45

    Alta sensibilidad sensorial

  • 46-60

    Sensibilidad sensorial muy alta

31-45: Alta sensibilidad sensorial

  • Interpretación: Su hijo tiene una sensibilidad sensorial superior a la media que puede interferir con su funcionamiento diario.
  • Recomendación: Solicite una evaluación detallada por parte de profesionales de la salud para conocer las opciones de terapia de integración sensorial y las posibles modificaciones ambientales.
  • 0-15

    Baja sensibilidad sensorial

  • 16-30

    Sensibilidad sensorial moderada

  • 31-45

    Alta sensibilidad sensorial

  • 46-60

    Sensibilidad sensorial muy alta

46-60: Sensibilidad sensorial muy alta

  • Interpretación: Su hijo demuestra niveles altos de sensibilidad sensorial que podrían interferir significativamente con la vida diaria.
  • Recomendación: Si su hijo muestra este nivel de sensibilidad sensorial, es muy recomendable que consulte con un profesional de la salud para una evaluación multidisciplinaria. Es probable que te dirijan hacia programas de intervención temprana y apoyo especializado.

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Understanding CVI

Sight Unseen

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Las habilidades secretas del verano

Reconocer los signos tempranos del autismo

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Caminos hacia el potencial, parte 4

Los colores del espectro

La guía esencial para salir con niños con necesidades especiales

Caminos hacia el potencial, parte 3

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Aventuras sensoriales de invierno en interiores

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Habilidades para la vida para personas con discapacidades intelectuales

La guía de regalos de Sensory-Smart

Espina bífida: intervención temprana

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Caminos hacia el potencial, parte 2

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Mi vida en Holanda

Fomentar la independencia en los niños con problemas de carencia de yodo

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¿Qué es la epilepsia?

Definición de los signos de dislexia

Caminos hacia el potencial, parte 1

Comprender el síndrome de Down

Intervención temprana para el síndrome de Down

Nuestro paseo en montaña rusa

Entendiendo la parálisis cerebral

Entender el autismo

Apoyo para el autismo

Prueba de sensibilidad al procesamiento sensorial

Decodificación de pruebas de diagnóstico

La lista de verificación del desarrollo infantil

Potenciando la inteligencia emocional

Cómo manejar los ataques de pánico

Comprender el trastorno de ansiedad social

Enfrentando el trauma infantil

Cómo apoyar a un miembro de la familia con ansiedad

Comprender la ansiedad por separación |

Comprender el trastorno de estrés postraumático (TEPT)

Prevención de trastornos mentales

Combatir la depresión en los ancianos

Entender la depresión

Entender la ansiedad

Plan de acción para el TDAH en adultos

Estrategias de sueño para el niño ansioso

Recognizing CVI: Ten Characteristics

Understanding CVI

Sight Unseen

To Tell or Not to Tell

Gafas de color rosa

Reconocer los signos tempranos del autismo

Espina bífida: intervención temprana

Guía para padres sobre cómo cocinar para niños con alergias alimentarias

Intervención temprana para el síndrome de Down

Comprender el desarrollo del habla y el lenguaje

Estrategias de sueño para el niño ansioso

Prueba de sensibilidad al procesamiento sensorial

Alimentar a su quisquilloso con la comida

Actividades sensoriales sencillas

Decodificación de pruebas de diagnóstico

La lista de verificación del desarrollo infantil

Categorías

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Shortly after the recording went live on Nishmoseini, Raizy called in to record the following update:

It wasn’t easy for me to share my story. I did it for one reason: in the hope that it would benefit others in a similar situation.

And now I want to share two incredible follow-up stories.

Shaindy*, a mother of a nine-month-old baby with special needs, had taken her child to a specialist for an unrelated issue when the doctor raised a new concern — CVI.

“I don’t want to overwhelm you with more information, evaluations, and therapies,” the specialist told her. “But if it is CVI, your child can truly be helped. Do some research, and when you come back for your next appointment in two weeks, we can discuss it further.”

A few days later, Shaindy brought up the possibility with her baby’s neurologist. “Could she have CVI?” she asked.

Given the baby’s history — born prematurely and suffering a stroke — the neurologist acknowledged that it was very possible. However, he explained that he wasn’t able to diagnose it himself.

The baby’s eyes had been given a “clean bill of health,” yet she wasn’t making eye contact or responding visually to her surroundings, both of which are key indicators of CVI.

Two weeks passed, and on the morning of the next appointment, Shaindy was listening to the latest updates on Nishmoseini. One of them was my personal story, and Shaindy couldn’t believe it — here she was, wondering if her child had CVI, and here was a story giving her direction as to who might have the answers! She immediately left me a message asking me to call her back, and then went to her appointment.

“I heard about this CVI expert, Chris Russell,” she told the specialist. “Should I reach out to him about my baby?”

“He’s exactly the one I was going to refer you to!” the specialist said.

As she was leaving the appointment, I returned her call. We arranged for Chris to come and evaluate her baby, and as expected, she was diagnosed with CVI. 

Catching it this early meant that she could start treatment early, teach her brain to see, and baruch Hashem, begin living a sight-filled, functional life.

***

And then there’s another story:

Recently, I attended a Hamaspik Shabbaton, and met a lovely young woman named Esti*. Her beautiful eighteen-month-old son had many medical issues, including having a stroke at two months old. The doctors thought he might have vision problems, so at eight months old, they took him to be checked out.

“His eyes seemed perfect, but he couldn’t see anything,” Esti told me. “At twelve months, he was diagnosed with infantile spasms, and we had another eye exam done — again, it seemed perfect, but he has no vision.”

Now, she shared, her son was doing much better medically. But without vision, she worried for his quality of life and level of functioning.

“Have you looked into whether it might be CVI?” I asked her. I then shared my story.

“I’ve heard of it, and have even heard of Chris Russell, but we never pursued it,” she said. Now, it seemed, was the perfect time.

We contacted Chris, and two weeks later, he came down to conduct an evaluation. We tried to be positive and hopeful about it, but nothing prepared us for the actual outcome.

Chris came in, darkened the room, and closed the shades. Then he shone a flashlight to the right, and Esti’s son — who they thought was completely blind — turned in the direction of the light.

Then he shone it the other way, and the toddler turned to the left!

At first, Esti thought it must be a coincidence. But Chris kept doing more tests, and her son kept looking in the right direction.

It turned out that her son had vision — a lot of vision! He just needed training to process the sights, since he had CVI.

In forty minutes, he progressed from seeing almost nothing to seeing objects — and with the right intervention, b’ezras Hashem, he can progress so much further.

I’ll end by emphasizing once again: Awareness of CVI is so important. With Hashem’s help, the right evaluation by a knowledgeable specialist and early intervention to train the brain to see can make a world of difference. A child can reach incredible milestones — and step into a world filled with sight and light.