Western april 2013
56
University of Western Ontario April 8 th , 2013 Lindsay Hillier Manager, Training and Quality Assurance, BLVEIP Visual Impairments in Young Children
-
Upload
lhillier -
Category
Health & Medicine
-
view
45 -
download
1
description
Transcript of Western april 2013
University of Western OntarioApril 8th, 2013 Lindsay Hillier Manager, Training and Quality Assurance, BLVEIP
Visual Impairments in Young Children
Agenda• Overview of the Ontario Blind – Low Vision Early
Intervention Program• Overview of common childhood visual impairments• Impact of visual impairments on
service providers’ programming/goals• Suggestions for modifying
audiologists’ test procedures for
children with visual issues
Ontario Blind – Low Vision Early Intervention Program• Implemented September 1st, 2007
• 12 Regional Lead Agencies across the province
3
4
Program GoalTo promote an integrated system of services and supports across the province for families with children who are blind or have low vision, promoting:
early identificationinterventionsupport
Ontario BLVEIP Population
5
*Family Centered Service
Components of the Ontario BLVEIP
6
1. Early Childhood Vision Consultants (ECVC)The Child/Parent ConnectionThe Child/Parent Connection
AttachmentRoutine based support
The Child’s Skill DevelopmentThe Child’s Skill Development
The Child’s Ability to Function within The Child’s Ability to Function within his his EnvironmentEnvironment
The Child within his The Child within his CommunityCommunityMany children will have a number of professionals providing service / therapy
Components of the Ontario BLVEIP
7
2. Family Support Workers
3. Provincial BLVEIP Training and
Development Centre• Support to the 12 Regional Programs: individual
ECVCs and BLV Coordinators• Provide the MCYS formal training for new ECVCs.• Work with the Ministry of Children and Youth
Services, Early Learning and Child Development Branch in the development/revisions of the BLV service guidelines and provincial BLV work plans.
Areas Currently Served by Surrey Place Centre’s Blind – Low Vision Early Intervention Program
Early Childhood Vision Consultants:
•Toronto
•Durham
•York
•Peel
•Halton
8
Prevalence of Visual Impairments
• Approximately one child in a thousand
• Approximately 1% of all children with disabilities
• Approximately 50-70% of children with visual impairments have additional disabilities
Defining Visual Impairment
Visual Impairment is defined as an impairment in vision that, even with correction, adversely affects a child’s interaction with his environment and may affect the ability to access early learning opportunities and educational material.
The term includes both low vision and blindness. Visual impairment refers to the abnormality of the eyes, the optic nerve or the visual center for the brain resulting in decreased visual acuity and/or visual perceptual abilities.
•Retinopathy of
Prematurity
•Coloboma
•Leber’s C.A.
•Albinism
•Many Others
Cortical Visual
Impairment
• Optic Nerve Hypoplasia• Optic Atrophy
Visual Impairments Will Affect Vision Differently
?????
‘Seeing’ Requires Visual Input and Memory
VisualVisual InputInput
MemoryMemory
“Seeing”
Sensory experience from the external world can influence how the brain wires itself up after birth.
Visual experience is crucial for a child's vision to develop normally -- a "use it or lose it" situation.
Society for Neuroscience, 2007
15
Babies Count The National Registry for Children With Visual Impairments, Birth to 3 years Deborah Hatton, Ph.D., & Sarah Ivy, M.Ed. Vanderbilt University Burt Boyer, M.A. American Printing House for the Blind
September 2012 US National Data
Early Learning Environments, Materials and Instruction
Cortical Visual Impairment
(CVI) is the leading cause of bilateral visual impairment in children in western countries.
Let’s Talk about Our Brainand Vision!
Fast, Small, Complexes.
Slow, Large,
Simplicity
We should think about our vision and those with CVI in the context of
VISUALVISUAL THRESHOLDSTHRESHOLDS.
Our Brain Operates like a Library
This analogy is more accurate for children with CVI as the image arrives to the brain but the brain has trouble
deciding what to do with it
•Categorizing incoming visual
information•Retrieving stored visual information
Early Visual System
Object Recognition
Face Recognition
The inability to visually recognize familiar faces –
Prosopagnosia
We all went back We all went back to our ‘library’ to to our ‘library’ to find a book that we find a book that we stored. The name stored. The name we gave these ink we gave these ink blots are names of blots are names of previously stored previously stored visual information.visual information.
What is the Foreground and what is the Background??
The Coffee Beans or the Face?
Figure-Ground
The “Primitive and often Unconscious” part of our brain
Registers and causes
a quick response to MOVEMEN
TThis is often still intact for children with CVI.
Common Characteristics of Children with CVI
Program Implications• Face recognition difficulties• Object generalization difficulties• Object invariance difficulties• Light gazing• Visually attentive to colour• Visually attentive to movement• Latency • Visual attention differences based on object placement • Complexity difficulties –
– Targets/Objects– Sensory Environment – Array
• Preference for familiar vs. novel • Visual motor behaviours
Easie
st
Easie
st
Har
der
Har
der
Once a child is
demonstrating visual skills with
lower, easier stimuli,
move move down to down to the next the next
level.level.
Implications for Assessment
Ask for Help
All children with VI in the province should
have an Early Early Childhood Vision Childhood Vision
ConsultantConsultant
Latency DownSlow Down & Wait
There may be a delay in response to presented stimuli.
No Turning to Auditory Stimuli
You may need to look for atypical responses to the auditory stimuli
Example: Some children will consistently roles their eyes in an upward position when listening
Using vision after hearing something occurs because vision is giving more information.Many children with visual impairment are Many children with visual impairment are getting more information from their getting more information from their hearing then their vision therefore will hearing then their vision therefore will not turn to sound.not turn to sound.
Many of the children have physical issues limiting their ability to turn their head.The turning of the head is not The turning of the head is not established for many of the established for many of the children -----children ----- ------ too much work for little ------ too much work for little payout!payout!
Limit Other Distractions
Children with CVI have difficulty using more than one sense at a time.
Keep Stimuli Close
Visual items need to be close.
Many children with CVI have difficulty attending to objects in the distance.
May Need to Repeat
After waiting for a response, you may need to try again. Many children with CVI have difficulty attending to objects in the distance.
Ontario Blind – Low Ontario Blind – Low Vision Vision
Early Intervention Early Intervention ProgramProgram
For specific recommendations and suggestions, please contact your local
EARLY CHILDHOOD VISION EARLY CHILDHOOD VISION CONSULTANTCONSULTANT
Ontario Association of Optometrists’ Initiative
Augmentative Communication Considerations
Communication Systems
Can the child visually access the communication system?
–Visual Motor
–Visual perception / Functionally
–Cognitively
May need to use:
• CONCRETE ITEMS (easiest)• PHOTOGRAPHS (more difficult)• LINE DRAWINGS
(may or may not require both a
higher visual and cognitive ability)
Which Symbol is easier for a child with CVI??
Need to be open to experimenting….. Need to be open to experimenting…..
– – There is no one answer!There is no one answer!
What is the best presentation of communication materials?Vertical or Horizontal Presentation?
Auditory Scanning is often helpful …..
This can allow for single presentation of
communication symbols
Using combinations of different symbol forms may be easier.
• Sufficient space between pictures / symbols
• Expect a consistent response with 2 choices / presentations before increasing.
• Using a consistent colour to anchor the child’s visual focus
• Check for levels of glare on materials
Other Considerations
