Guidelines for Stables: Cerebral Visual Impairment (CVI) and Horse riding
By Fiona Gorrie, Associate, CVI Scotland
Written for CVI Scotland & CVI Society
What is CVI?
- CVI is the leading cause of visual impairment in children in the developed world.
- CVI is a complex condition that is the result of the brain being unable to process information from the eyes to the rest of its visual pathways.
- Everyone's CVI is unique - some may have perfect 20/20 visual acuity, but be unable to see moving things and/or struggle to recognise faces and/or be unable to see below the midline of their eye gaze (lower visual field impairment). These are only a few aspects of vison that can be affected by someone with CVI - for more detail see the main CVI Scotland's website.
Benefits of riding for a child with CVI
There are thought to be many benefits of horse riding for children with CVI. Many of these revolve around the premise that, on a horse, the level of visual processing that has to be done is considerably reduced, compared to when on the ground. This results in the child being much more relaxed, and able to concentrate on other things. A feature discussing this in more detail, with parental accounts of their child's experience of horse riding, can be found here.
What might help someone with CVI when horse riding?
Each child will be different, but these are some suggestions that may benefit children with CVI whilst horse riding.
- With CVI, a clutter free, empty arena is likely to benefit children during their sessions.
- Individual sessions may be preferable for people with CVI. In group sessions the benefit that comes from being high up on a horse, above much visual clutter is reduced (other people on horses are at your eye level, moving in different directions and need a lot of visual processing).
- Depending on the child, if in group sessions and for example on a walk outdoors, it may be preferable for them to be in the front of the group - to again reduce the visual clutter.
- Movement - if the child is in a group session, where possible, it is best to ensure they are moving in the same direction, at the same speed as the other riders in the group (as this gives them the best chance of seeing clearly). In contrast, if they're moving in one direction and people are coming towards them, moving in the opposite direction to them, this significantly reduces clarity of vision.
- The child may feel more at ease with familiar music playing, or singing and no speaking.
- A predictable routine each week might be beneficial e.g. equipment located in the same place, same horse and same escorts.
- Asking for helmet measurements ahead of time may reduce initial anxiety and stress of a new situation by reducing the need to try on multiple helmets.
CVI Frights and Horse Riding
The following are characteristics of CVI that children may have. They can sometimes result in what we call 'CVI Frights'. These are worth being aware of when the child is on a horse.
Parents and children may not be able to articulate why the child experiences these frights, but may be able to describe the situations they occur in. Getting to know the child over time will help anticipate which situations can result in CVI Frights.
Some children with CVI will have challenges with depth perception and movement can exacerbate these difficulties.
- Associated frights: The child may make unexpected actions when on the horse e.g. they may duck out of the way of objects that are far away in the distance, they may reach for things thinking they're closer than they are.
- Managing frights whilst horse riding: Frequency of occurrences may reduce over time, as the child gets more familiar with the environment.
Some children with CVI may be unable to perceive moving objects e.g. objects may not be seen because the object and/or the child is moving too fast.
- Associated frights: The child may be startled as the object may suddenly appear when they slow down.
- Managing frights whilst horse riding: This may be reduced with individual rather than group sessions.
Visual Field Loss
Some children with CVI may have visual field loss, e.g. on their right side, or in their lower visual field.
- Associated frights: They may again be startled if things suddenly appear as if out of nowhere.
- Managing frights whilst horse riding: If they are unable to perceive objects on their right, approach from the left and vice versa. If they have lower visual field impairment and you tell them to take the reins, they may not be able to see the reins - guide their hands to them.
Reduced visual attention resulting in difficulty perceiving the whole visual scene at once:
- Associated fright: the child may be startled if something or someone unseen suddenly appears.
- Managing frights whilst horse riding: again, individual rather than group sessions will help with this.