In this Level we have introduced different elements of the visual processes that come together to create your visual world.
Separate visual processes that come together.
When any of the visual processes are not working so well, it can have a knock-on effect on the other processes, and make your visual world less accurate.
Where these visual processes are not working too well, they can create cerebral visual impairments. Each visual process has a matching CVI, where it is not working so well.
Mildly Affected By CVI
For some, mildly affected by CVI, the visual world their brain creates may just be a little less accurate than typical, maybe making them seem a little clumsy, possibly...
Severely Affected by CVI
For some, more severely affected, the visual world their brain creates may bear no resemblance to the world as would be seen by a typical person, and is often frightening, possibly because...
In the above examples, for those severely or mildly affected, each suggested reason will have a different helping approach that can work. If the problem is the accuracy of the depth map, there are strategies to help, like reaching for things with your little finger stretched out, to gently touch the object, so as to reach it without knocking it over. This approach can be useful for someone who has inaccurate guidance of reach. Sometimes, when things are not seen because they move too fast, for this person, the optimal visible speed needs to be understood, so that those supporting them can make sure things are not too fast to be seen.
The challenges and difficulties, including the visual behaviours like inaccurate guidance of reach, are not the reason why, someone with CVI has visual difficulties.
Behind the challenges, we need to look at each of the core visual processes and try to figure out where the problems lie.
This can be difficult, and getting to understand is an evolving journey, especially where a person may be affected by many of the different parts of their visual brain not working so well.
To understand how to best support the person with CVI you need to keep asking why?
As the person develops, they will change, and the challenges will change.
Each person with CVI is unique, and understanding them requires a lot of knowledge, including:
1) A full list of the person's individual cerebral visual impairments.
2) The severity of each impairment, from mild, to most challenging, and how each one...
Limits the person's access to their world.
Affects their interpretation of their world
Impacts upon their learning
3) The situations that make each impairment better or worse, which may be:
a. Environmental / External (e.g. somewhere quiet, or somewhere busy, crowded or noisy)
b. Internal (e.g. how they are feeling - happy? bored? in discomfort?)
4) Details of other neurological processing difficulties, for example:
How sound is processed if cerebral auditory impairment is also present. How timing is affected (e.g. overall slow processing that needs to be matched)How motor skills are affected (e.g. impaired visual guidance of movement, or cerebral palsy)
5) An understanding of the resulting behaviours which can include:
Adapting to the difficulties (eg. looking away so as to listen)
Reacting to circumstances (e.g. fear of busy places)
Not respond because of lack of perception
6) An understanding of how their emotional, intellectual and social development may have been affected.
7) An understanding of how these factors have affected their learning to date.
8) An understanding of any difference between the person and how others of a similar age are developing (in terms of their learning, behaviour, independence and social skills).
9) Other medical conditions that affect the person.
10) Whether the CVI was present at birth or soon after, or acquired in childhood or later.
Next, you have to look at the past, present and future...
The past is full of priceless knowledge.
Reflecting - think about times when the person has...
Been most happy
Been most distressed
Really surprised you, doing something you thought was way beyond them
Really focused on something
Seemed most distracted and difficult
And for each of these, think about:
The physical environments they were in
The people they were with
What they were doing
Anything else that seems relevant
See if you can come up with any common themes that explain how the person behaves.
Where the CVI was acquired, also consider the skills the person had before the event, how these have changed, and which are still present.
Your starting point is where the person is now - not where someone else says they should be.
We all exist in the four dimensions of space and time.
With what you know from 1-10 (above)
How much time do you need to allow?
How fast or slow do things need to be moving to be seen?
How big, or small do things need to be, to be seen?*
How are things heard? Is quiet needed to hear? Only one sound?
At what speed do consonants and vowels need to be spoken to be heard?
What environments help the person see, hear and experience the world most clearly?
How many things is the person able to process at once (across all the senses)
How are their other senses affected?
How is their mobility affected?
And how can we make everything perceivable for them.
As well as teaching everyone else make everything perceivable for them.
*This list is by no means comprehensive, once each element of the visual impairment is identified, then the support needs to be matched (see our What Is CVI? sections for more information).
Plans need to be organic, and as a person develops, everything gradually changes, and needs to be reviewed and re-reviewed.
Consider the person's needs, relevant to them, in terms of:
Their learning and education
Their independence, doing more for themselves and taking more control of their life and decisions
Their social relationships and interactions, so they are not isolated nor lonely.
This might seem like a daunting amount to learn, but we know from those who have mastered the subject in relation to someone they support that it quickly becomes second nature. It is also incredibly rewarding. With a greater understanding, you will learn to tune-in to the persons CVI world and experience, and become better at understanding the world from their perspective, and with that understanding, you can make the changes that are needed to help them learn. You will learn to see their world, seeing inside to out (from their perspective, not yours).
In the next levels, we will look at:
Before you move onto the next lesson, please check:
Next lesson: Level 4a Self Referencing - Your World
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At CVI Scotland we are devoted to helping people understand cerebral visual impairments, and together working towards developing the understanding of this complex condition.