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Western april 2013
- 1. University of WesternOntario April 8th , 2013 Lindsay Hillier Manager, Training and Quality Assurance, BLVEIP Visual Impairments in Young Children
- 2. Agenda • Overview ofthe 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
- 3. Ontario Blind –Low Vision Early Intervention Program • Implemented September 1st , 2007 • 12 Regional Lead Agencies across the province 3
- 4. 4 Program Goal To promotean integrated system of services and supports across the province for families with children who are blind or have low vision, promoting: early identification intervention support
- 5. Ontario BLVEIP Population 5 *FamilyCentered Service
- 6. Components of theOntario BLVEIP 6 1. Early Childhood Vision Consultants (ECVC) The Child/Parent ConnectionThe Child/Parent Connection Attachment Routine based support The Child’s Skill DevelopmentThe Child’s Skill Development The Child’s Ability to Function within hisThe Child’s Ability to Function within his EnvironmentEnvironment The Child within hisThe Child within his CommunityCommunity Many children will have a number of professionals providing service / therapy
- 7. Components of theOntario 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.
- 8. Areas Currently Servedby Surrey Place Centre’s Blind – Low Vision Early Intervention Program Early Childhood Vision Consultants: •Toronto •Durham •York •Peel •Halton 8
- 9. Prevalence of VisualImpairments • Approximately one child in a thousand • Approximately 1% of all children with disabilities • Approximately 50-70% of children with visual impairments have additional disabilities
- 10. Defining Visual Impairment VisualImpairment 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.
- 11. •Retinopathy of Prematurity •Coloboma •Leber’s C.A. •Albinism •ManyOthers Cortical Visual Impairment • Optic Nerve Hypoplasia • Optic Atrophy
- 12. Visual Impairments WillAffect Vision Differently ?????
- 13. ‘Seeing’ Requires VisualInput and Memory VisualVisual InputInput MemoryMemory “Seeing”
- 14. Sensory experience fromthe 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. 15 Babies Count The NationalRegistry 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
- 17. Early Learning Environments, Materialsand Instruction
- 18. Cortical Visual Impairment (CVI)istheleading causeof bilateral visual impairment in children in western countries.
- 20. Let’s Talk aboutOur Brain and Vision!
- 21. Fast, Small, Complexes. Slow, Large, Simplicity We shouldthink about our vision and those with CVI in the context of VISUALVISUAL THRESHOLDSTHRESHOLDS.
- 22. Our Brain Operateslike 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
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- 25. Object Recognition Face Recognition The inabilityto visually recognize familiar faces – Prosopagnosia
- 26. We all wentback to ourWe all went back to our ‘library’ to find a book‘library’ to find a book that we stored. Thethat we stored. The name we gave these inkname we gave these ink blots are names ofblots are names of previously stored visualpreviously stored visual information.information.
- 30. What is the Foregroundand what is the Background?? The Coffee Beans or the Face? Figure-Ground
- 31. The “Primitive andoften Unconscious” part of our brain Registers and causes a quick response to MOVEMENT This is often still intact for children with CVI.
- 33. Common Characteristics ofChildren 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
- 35. Easiest Easiest Harder Harder Once a childis demonstrating visual skills with lower, easier stimuli, movemove down to thedown to the next level.next level.
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- 37. Ask for Help Allchildren with VI in the province should have an EarlyEarly Childhood VisionChildhood Vision ConsultantConsultant
- 38. Latency Down &Slow DownWait There may be a delay in response to .presented stimuli
- 39. No Turning toAuditory 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
- 40. Using vision afterhearing something occurs because vision is giving more .information Many children with visual impairment areMany children with visual impairment are getting more information from theirgetting more information from their hearing then their vision therefore will nothearing then their vision therefore will not .turn to sound.turn to sound
- 41. Many of thechildren have physical issues limiting their ability to .turn their head The turning of the head is not establishedThe turning of the head is not established for many of the children -----for many of the children ----- ------ too much work for little payout!------ too much work for little payout!
- 42. Limit Other Distractions Childrenwith CVI have difficulty using more than one sense at a .time
- 43. Keep Stimuli Close .Visualitems need to be close Many children with CVI have difficulty attending to .objects in the distance
- 44. May Need toRepeat After waiting for a ,response you may need to try .again Many children with CVI have difficulty attending to .objects in the distance
- 45. Ontario Blind –LowOntario Blind – Low VisionVision Early InterventionEarly Intervention ProgramProgram For specific recommendations and suggestions, please contact your local EARLY CHILDHOOD VISIONEARLY CHILDHOOD VISION CONSULTANTCONSULTANT
- 46. Ontario Association ofOptometrists’ Initiative
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- 50. Communication Systems Can thechild visually access the communication system? –Visual Motor –Visual perception / Functionally –Cognitively
- 51. May need touse: • CONCRETE ITEMS (easiest) • PHOTOGRAPHS (more difficult) • LINE DRAWINGS (may or may not require both a higher visual and cognitive ability)
- 52. Which Symbol iseasier 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!
- 53. What is thebest presentation of communication materials? Vertical or Horizontal Presentation?
- 54. Auditory Scanning is oftenhelpful ….. This can allow for single presentationof communication symbols
- 55. Using combinations of different symbol formsmay be .easier
- 56. • /Sufficient spacebetween 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