Vision:Supports for Students with Multiple Disabilities and Complex Needs

Lawana Titiryn - Vision Consultant

Jan. 22, 2019

Let’s talk about: ● Why are you here?

● CVI Quick Facts

● Strategies

● Q&A

Causes:

Higher presence of visual disorders in children with developmental disabilities and complex needs:

- Prematurity

- Cerebral Palsy

- Genetic syndromes

- Central nervous system infections

- Encephalopathy

- Structural abnormalities

- Trauma

- … and any other brain related difference

Your student may have a visual impairment if...

- Many of their favourite things are of the same colour; maybe purple, red or yellow?

- They only look at things that are moving or shiny- They turn their head at unusual angles when they seem to be looking at

something- They rarely, if ever, make eye contact or even look at your face - They spend a lot of time looking at lights- They are most likely to look at things when they’re within 24 - 36 inches- Their parents say they see evidence of the child looking at things when they’re

at home- They look away instead of looking at the object they are reaching for- Their vision seems to fluctuate all the time- They put their face really close to books and objects

Cortical Visual Impairment

- Number 1 cause of visual impairment in children- Visual impairment that occurs as a result of damage, injury or insult to the brain- May or may not occur along with ocular issues- Only occurs with neurological damage- We expect there can be improvements in functional vision that can be measured

Diagnosed by a pediatric neuro-ophthalmologist - in Edmonton, Dr. Lewis:

1) Eye exam that does not explain the child’s impaired vision2) History or presence of neurological problems3) Presence of behavioural responses to visual stimuli that are unique to CVI

Characteristics of CVI:

6. Light gazing

7. Near viewing only

8. Atypical Visual Reflexes

9. Preference for familiar items

10. Absence of visually guided reach

1. Need for colour

2. Need for moving/shiny objects

3. Latency-- slow to look

4. Often can see better in

peripheral fields

5. Need reduced complexity

Characteristics of CVI:

6. Light gazing

7. Near viewing only

8. Atypical Visual Reflexes

9. Preference for familiar items

10. Absence of visually guided reach

1. Need for colour

2. Need for moving/shiny objects

3. Latency-- slow to look

4. Often can see better in

peripheral fields

5. Need reduced complexity

Consider:

Assessing vision for a student who may have CVI: using The CVI Range

Targeted interventions, determined by where they score for each characteristic on the CVI Range, will improve their ability to look, use their vision for functional tasks and possibly begin a path to literacy.

The CVI Range

Strategies & Supports

In the classroom: Where do we start?

Presume Competence

Provide the Tools

Create Opportunities

It may start here but this is a lifelong journey that involves the community as a whole!

The Student

Learn about your student:

1. Get information from your student’s caregivers:- Vision- Hearing- Communication

2. Read prior reports on PinPoint:- Inclusive Learning Consultants- Ophthalmology

3. Try previously successful strategies and recommendations

The Environment

Students in Phase I & II need a controlled environment to access their vision

Students in Phase III need the material presentation controlled to access vision

We need to adapt the environment to help students with CVI access their vision.

Complexity

Need to account for factors that will compete with their visual attention:

- Internal

- Colours

- Busy-ness

- Auditory

Find:- Elephant- Bunny- Flower- Letter S

Find:- Elephant- Bunny- Flower- Letter S

Find:- Elephant- Bunny- Flower- Letter S

Adaptation for a student with CVI...

VS

Reduced Complexity

Reducing Complexity: Audio

Providing adequate wait time is crucial

When the task is visual, auditory stimuli may distract/short circuit from the student’s visual attention.

Instead --1) Wait quietly...for up to 1 ½ -2 minutes2) [watch for them to] Fixate3) [then] Talk

Literacy

Considerations for presenting letters/words/images:

- Background- Colour- Outlining / highlighting- Salient features- Readiness for 2D materials

Examples of considerations for presenting letters/words/images

Salient features of a moose: Palmate antlers, dewlap, long face, 4 long legs