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Lessons

9c - The Dynamic Map

Posted by Helen St Clair Tracy in Level 9 - Dorsal (2)
Published: 28/03/2020, 12:12am | Updated: 02/04/2020, 3:02pm

The three lessons in this level (Level 9) have been written from many first-hand accounts shared by people who have a type of CVI where their posterior parietal lobes have been affected. This is therefore more subjective than our other lessons, but it is the subject of ongoing research. As the accounts have been so consistent, we wanted to share them, because the understanding they give us lets us make simple adjustments to help many people, especially those unable to communicate their challenges, as is the case for young children and those with limited communication skills.

Video Link: https://vimeo.com/392458265

In the previous lesson (9b) we explained the challenges faced by some with CVI in terms of the map with fewer, bigger voxels.

This is where it gets complicated, because it does not seem to be fixed.

To explain, let us return to our sliding scale on the bookshelf from the previous lesson (image below)

From many consistent descriptions, rather than a fixed point where the map is consistently reduced at the same level, it varies.

Please take a few minutes to watch the film below, where this is explained with video images. The changing window of how much there is to see is what we are trying to describe here, as the varying, or dynamic effect of this type of CVI.

University of St AndrewsVideo Link: https://vimeo.com/384014482

So this sliding scale moves, not just for different people, but for the same person.

It can vary from moment to moment, so walking down a street, like this (below)...

Can very quickly become like this (below)...

...and often without the person being aware that their vision has altered.

What causes these incredible changes?

From the descriptions we've been given, there are two key areas that directly affect what can be seen and a third that can either help or hinder. These are:

  • 1: Environment. The physical environment they are in at that moment, in terms of how much there is to map visually includes how much detail and how many colours there are to see, as well as how much movement. Noise has an adverse impace. So being in the audience of a crowded music concert is likely to create great challenges, but sitting on a quiet beach is likely to help, by significantly reducing the demands on the creation of the map.
  • 2: How the person is feeling. Being frightened, anxious, stressed or confused, negatively affects their visual processing. As expected, feeling safe, happy, confident and calm all help vision, while feelings of discomfort, like pain, hunger, thirst, and skin irritations have been described as limiting vision. Where an emotion is heightened but positive, for example laughing, we are not sure what happens, as being calm seems key to optimal visual processing.
  • 3: Memory. In general, where prior visual memories are there as support, then vision works better, but prior bad memories can provoke fear leading to constricted visual attention.

What we are describing affects us all to a small degree, but not like this, from one moment to the next (below)

This sliding scale can go both ways, either to improve visual processing or to make it more difficult. To improve visual processing, we should optimise the things that make it easier and try to avoid, eliminate or reduce the things that make it more difficult. This is obvious!

Another strategy, is to borrow processing capacity from other parts of the brain that are working more effectively.

When vision is reduced due to the map, as in the image below...

The area covered with the grey fog represents the area that has not been mapped and therefore does not have visual attention (explained in the video)...unless

  • Something moves - the movement is processed nearby in the brain (MT the middle temporal lobes, lesson 7a)
  • Something stands out as being very bright or a markedly different colour.

Here, we are sort of borrowing from other places in the brain where processing is not affected or less affected.

How to help:

The list below gives a few examples of simple changes that can improve the visual processing of attention, making experiences easier to learn from and more enjoyable.

  • Keep spaces clear. Put away things that aren't being used, in cupboards. Avoid patterned wall coverings, curtains, bedding and other soft furnishing.
  • Give things a place and keep them organised, so where things are kept can be memorised, making them easier to find. (Do this together when you can.)
  • Store things horizontally or vertically so as to search in one direction, in the same way as books on a library shelf.
  • Learn to use prior knowledge to search, for example if in a new shop, to help find the milk, think about what it is next to in other shops.
  • Use movement, colour and brightness to help things stand out, especially where it is not possible to optimise surroundings as much as would be desirable.
  • Use language to label and describe what is being looked at (lesson 2h).
  • Use sounds and touch to supplement vision.
  • Develop searching strategies
  • Address any issues leading to distress, anxiety or discomfort
  • Promote calmness, happiness and a sense of well-being.
  • Ensure the area of the visual field (level 6) with best vision is used.

These are just a few examples, please review the list of what we think is needed to know about each person affected by CVI in lesson 3l.

Each person needs their own detailed specific list.

The Dynamic Map

So this map we are talking about, would appear to be very dynamic. We are used to thinking of the brain as structurally and functionally 'fixed'. This is a mindset that is slowly shifting due to incredible developments in our understanding of neuroplasticity. The brain is constantly active, and it is atypical functioning of this brain activity (lesson 9b) that we think is the reason for this dynamic changing experience.

  • The bad news is that being dynamic, means that the way life is experienced can create major challenges.
  • The good news is that there is a great deal we can all do to ensure optimal experiences and learning (see the to do list above)

Fibres

Where there are fewer fibres to map the surroundings effectively in the posterior parietal lobes, what is happening to cause this dynamic experience, when there are added challenges?

Let us return to thinking of each visual nerve fibre contributing a voxel, with lots of tiny voxels near the centre and fewer bigger ones to the side.

Importantly sound is similarly mapped in the same part of the brain.

What would appear to be happening, from the descriptions we've heard, is that as the demands of the (posterior parietal) mapping systems increase beyond their limited capacity (due to fewer fibres ), the smaller central ones still work, while the larger outer ones become unavailable for use. This leads to the experience of less and less peripheral visual information being available to the mind to 'see', to the point where a person can quickly become practically unable to see or hear anything meaningful.

This is also consistent with the challenges of trying to look and listen at the same time, described by many affected by CVI.

Conclusions

There is a lot of research needed in this area. We need to understand more about the connection between changing emotions and visual processing. Where memories support vision, might this mean more becomes visible. Maybe the familiarity makes the person feel more confident, and that positive emotion supports vision.

Throughout these three lessons we have repeated that we are sharing first-hand accounts. This understanding of the extremely dynamic nature of the map is an area of great interest in the research community, but as yet there are no published results. Our reason for sharing these ideas with you, is to show that the dynamic nature of this condition is something we can potentially have a great deal of control over, making life much easier, or considerably more difficult.

We are confident about the improved outcomes, because, without exception, everyone we've met who has made the changes to 'help' the map, has seen benefits. That is why we have chosen to share this information now, rather than wait for what is likely to be a number of years for the published research.

One last thing...

We started each of these three lessons (9a-c) with a highlighted text box (like this one) referring to those who are 'unable to communicate their challenges'. This presents a diagnostic problem. How can their difficulties be diagnosed, if they can't cooperate with testing?

No harm can come from making things easier. So if the above suggestions work, then it's reasonable to assume that the person helped may well have a less accurate mapping system, because in medical practice, a treatment that works often helps confirm a diagnosis.

Checklist: Before moving on, please check that you have understood:

  • the CVI Map, Voxels and Voxel Sliding Scale are all just illustrations to help understand the map created in the posterior parietal lobes to aid guidance of reach.
  • the CVI Map is dynamic
  • what happens when voxels get bigger and smaller.
  • the CVI Map is affected by the environment and how a person is feeling, and can be supported by memories and other senses.
  • the difference where a person feels anxious / stressed etc if they have a typical map compared with a CVI Map

Next lesson: To follow

Further reading is not necessary to proceed, but if interested you may enjoy the following:

Clutter - page explaining the challenges clutter creates, and how reducing clutter is essential to improve the environmental for those with CVI.

Gordon Dutton's Blog 18 where he explains parallel processing challenges, that relate to the experience when the map is overloaded.

Dorsal Stream Dysfunction CVI Experience - Page explaining the process of making the video (featured in this lesson, above) with a further explanation of the challenges we have described in this lesson.

Cerebral Auditory Impairment - Page looking at the challenges many with CVI report around processing sounds and noise, where reactions can be extremely inconsistent, with a suggested explanation.

Level 9 Full Checklist

You should understand...

  • The part of the brain the map is processed in
  • What a voxel is, as different from a pixel
  • What the map is
  • Things the map enables you to do
  • What the map may affect in terms of other processes
  • Ways the map keeps you safe
  • The map is body centric
  • What we mean when we use the term fibre
  • With CVI the map may have fewer, so bigger voxels
  • What bigger voxels entail in terms of causing difficulties with accurate movement using visual guidance
  • What bigger voxels mean in terms of looking at something or for something
  • The CVI Map, Voxels and Voxel Sliding Scale are all just illustrations to help understand the map created in the posterior parietal lobes to aid guidance of reach.
  • The CVI Map is dynamic
  • What happens when voxels get bigger and smaller.
  • The CVI Map is affected by the environment and how a person is feeling, and can be supported by memories and other senses.
  • The difference where a person feels anxious / stressed etc if they have a typical map compared with a CVI Map

Congratulations on completing Level 9!Congratulations on completing Level 9!

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