University of Edinburgh

An Introduction to Cerebral Visual Impairment
Professor Gordon Dutton

Questions 6-10 and References - Supporting children with CVI, Strategies for children with Dorsal and Ventral stream dysfunction, Visual stimulation, Eye gaze technology, the 'Bottom Line'

Slide text:

6. What is the first thing adults supporting children or young people with CVI should be aware of?
Each and every strength and limitation (without inferring a disability based model)
How do they build on this?
Using every strength
Working within every limitation and threshold in ‘time’, place/space & person
Making life meaningful, fun, motivating and rewarding
Working consistently to bring about incremental developmental steps
(knowing exactly what the child knows and can do)

7. How can I best understand visually impaired children in my class?
Understanding and working within the profile of each and every known and inferred visual limitation

8. What strategies can class teachers use to best support children with dorsal and ventral stream dysfunction (& those affected by substance abuse?)

9. Is the use of visual stimulation with young people with CVI effective? Where can parents take their children for such training?
Williams et al 2014. How to help children with neurodevelopmental and visual problems: a scoping review. Br J Ophthalmol 98: 6-12.
Children with visual impairment and a condition affecting their neurodevelopment (children with VND) may require extensive and specialised help but evidence on the most effective strategies for visual improvement is lacking. We defined a PICO format (Population, Intervention, Comparator, Outcome) for a scoping review and systematically searched 13 databases. Two reviewers assessed the abstracts for inclusion and a third arbitrated in cases of disagreement. We abstracted data from included studies. We found 4450 abstracts from which we identified 107 papers for inclusion. Of these, 42 related to interventions involving a change in visual input or function: 5 controlled trials, 8 before and after studies and 29 case reports. The strongest evidence supported the provision of spectacles to improve distance or near vision and the use of ultraviolet light as environmental modification for training. Less strong but suggestive evidence supported training/practice routines to improve acuity or oculomotor control. Interventions exist to help children with VND and current recommendations that they are assessed by a vision specialist are supported by the evidence. More information is needed on the effectiveness of training/practice programmes which may promote improved function, and of environmental modifications to facilitate engagement of children with VND with the surroundings.

10. What potential does eye-gaze controlled technology with young people with CVI have? If so what potential does it have for this group?
Switching to make things work
Limited to those who are able and motivated (remembering that for the group who could benefit, vision may be their greatest strength)
This is only a very small group who have paralysis due to brain stem disorders (usually without CVI).

Bottom Line
Find and use strengths and abilities
Within the child’s limitations in
‘Place’ and
With loving support!

Milena Canning
Nicola McDowell
Mel Goodale & Jody Culham