Building Strategies Around CVI Phases Ellen Cadigan Mazel, M.Ed., - PowerPoint PPT Presentation

Building Strategies Around CVI Phases Ellen Cadigan Mazel, M.Ed., CTVI CVI Advisor Concord Area Special Education Collaborative: CASE 1

Why Do I Need to Know This? An audience poll 2

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Why Do I Need to Know This?  CVI is the #1 cause of visual impairment in children.  It requires new understanding of brain function.  It requires new understanding for assessment to build strategies. 4

CVI Defined  Damage to the visual cortex.  Damage to the visual pathways  Both 5

Eye and Brain are One 6

Ocular Impairment with CVI:  Any child can have both types of visual impairment.  Gather information  Assess for both  Create strategies for both 7

Ten Characteristics  Color  Movement  Latency  Visual Field  Complexity  Light Gazing  Distance  Visual Reflexive Response  Visual Novelty  Visual Motor 8

Color What colors alert this child ’ s brain to look? • The brain is wired to notice color. • Red and yellow colors seem to alert the brain. 9 9

Movement How does movement affect a child ’ s ability to look?  Movement alerts the brain especially in the periphery.  Movement is a primitive defensive response in all animals. 10 10 10

Movement  Movement should be off to the side, shaking without noise, in a small area.  Shiny items make the brain think it sees movement due to the light ’ s refection. 11 11 11

Latency How long does it take a child to visually locate materials?  Quiets when the object is presented peripherally:  Takes time to turn to use central vision. 12 12 12

Visual Field Does the child seem to see best in some visual fields? Assess:  Left  Right  Upper  Lower 13 13 13

Complexity What level of multisensory presentation is tolerated? Complexity includes three areas:  Visual complexity  Auditory complexity  Positional complexity 14 14 14

Visual Complexity  Background “ busyness ” .  The child needs to see things at a very close.  Lower light levels in the environment reduce the complexity of the room.  Children will sleep to avoid complexity. 15 15 15

Auditory Complexity  Auditory background distractions which draw the child ’ s attention away from seeing.  Children have difficulty fixating on anything in a noisy environment. 16 16 16

Positional Complexity  The child struggles to see in difficult physical positions.  In supported positions children can locate, sustain and look with greater speed. 17 17 17

Light Gazing / Non-purposeful Gaze  How does the child respond to light?  Light perception is a primitive visual ability.  Children will seek out light sources and stare. 18 18 18

Light Gazing / Non-purposeful Gaze  Children will be distracted by light sources  Children will have difficulty re-engaging with materials.  Children perform better when light levels are behind them.  The child stares without looking. 19 19 19

Distance Viewing At what distance can a child:  Look and locate?  Look and recognize?  As children improve, they may be overly attentive to distant movement. 20 20 20

Visual Reflexive Responses How the child react to touch near the eyes or to visual threat?  Immediately  Delayed  Not at all 21 21 21

Visual Novelty What items does the child already look at because they are familiar?  Parents report favorite toys.  Looks at objects always present in their environment. 22 22 22

Visual Motor What is the child ’ s quality of looking and reaching?  Quiets and looks only with peripheral vision.  Locates and looks: no reaching. 23 23 23

Visual Motor  Looks but turns away to reach.  Looks and reaches but looks away as soon as they reach the material.  Looks and reaches together.  Continues to look while playing. 24 24 24

CVI  Child is not looking.  Child is not looking and reaching.  Child is not processing visual information 25 25 25

The child functioning?  Each characteristic: continuum from 1-10.  Assess each characteristic: determine the level of support.  Parent input is essential.  Assess to chart progress  Remove supports 26 26 26

Levels of Severity: Phases of CVI 1. Phase I 2. Phase II 3. Phase III 27 27 27

Spe Speci cific fic Go Goals als fo for Ea r Each ch Ph Phas ase Phase I: Building Visual Behaviors. Getting the child to look. Phase II: Integrating Vision with function. Phase III: Resolving Characteristics 28 28 28

Strategies  Ocular impairment assessment is inappropriate for a child with cortical visual impairment.  Strategies are based on assessment of the ten characteristics. 29 29 29

Phase I: Building Visual Behaviors  Single colored objects (often red, yellow but not always)  Peripheral presentations  Increased response time. 30 30 30

Gently moving visual targets 31 31 31

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Active Learning: Littlerooms Materials that stay at near 38 38 38

Active Learning Attribute trays 39 39 39

Active Learning Attribute trays 40 40 40

Active Learning Vests and materials near hands 41 41 41

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Phase I: Building Visual Behaviors  Use shiny items.  Quiet environments, quiet toys.   Reduced background complexity  Single item presentations 43 43 43

Reducing complexity: single item 44 44 44

Reducing Complexity 45 45 45

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Phase I: Building Visual Behaviors  Well positioned child  Staff should wear plain clothes  Use three dimensional symbols: no pictures!  Control and use light 53 53 53

Phase I: Building Visual Behaviors  No programming for visual reflexes.  Use familiar objects.  Build lateral skills  Targets everywhere at near: Preferential seating 54 54 54

Lateral Skills The child is looking at one kind of item now try different colors 55 55 55

Lateral skills The child looks at one kind of item now try items with similar shapes. 56 56 56

Phase I: Building Visual Behaviors Use large targets. Place items in the best visual field. Challenge the weaker visual field. Register the child with state agencies for children with visual impairments. 57 57 57

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Other Phase 1 Strategies 59 59 59

Phase II: Integrating Vision with Function Reduce complexity: auditory, visual and positional. Use highlighting color as part of visual target. Use embedded symbols 60 60 60

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Embedded Symbols 64 64 64

Phase II: Integrating Vision with Function  Movement to gain visual attention.  Allow for latency.  Familiar items especially with new learning.  Predictable books with salient feature. 65 65 65

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Phase II: Integrating Vision with Function  Backlight materials/control light  Use large print.  Highlight best place to reach. 68 68 68

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Other Phase 11 Strategies Tell us other strategies you use or have used in Phase 11: 83 83 83

Phase III: Resolving Characteristics  Reduce complexity: auditory, visual and positional.  Increase word and letter spacing.  Use color highlighting  Use predictable books/materials. 84 84 84

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Phase III: Resolving Characteristics  Use large print  Use covers and line keepers.  Use backlighted technology  Check facial recognition: Support social skills 89 89 89

Phase III: Resolving Characteristics  Assess using CVI Complexity cards from APH  Move carefully from 3D to 2D.  Assess 2D against levels of complexity. 90 90 90

3D to 2D 91 91 91

Pick a Salient Feature 92 92 92

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