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Gordon Dutton’s Blog (10) Acting on probable simultanagnostic vision

  • Following the child’s agenda - not inflicting the adult’s one!
  • clutter does not stimulate children, or help them to develop, it tends to bamboozle and overwhelm them, especially those with simultanagnostic vision!
  • The rewards of bringing about learning when the professionals have said it may not happen, are boundless! 

Hypothesising that a child may have limited (simultanagnostic) vision and doing something about it

This blog follows on directly from Blog 9, so it's worth reading Blog 9 before this one.

If you put your hands over your ears, your fingers are over the part of the brain that makes the 3D map of what you can see, that uses vision to guide your movements.

If this bit of the brain isn't working so well, then fewer things are mapped, and less accurately so.

This means that fewer things are seen, especially when there is clutter. The less accurate mapping may lead to apparent clumsiness, due to less accurate visual guidance of movement.

This is simultanagnostic vision and is what 'Mary' experiences and describes so well on this website.

There are very few papers in the world literature that mention simultanagnosia in children.

Is this because it is rare, or because it is not being recognised?

From my experience of seeing children with cerebral visual impairment over the last 25 years or more, I believe in many cases, it is not being recognised.

But why may this be the case?

There are a number of possible reasons:

  • People with it usually do not know they have got it, because it is due to impairment of the non-conscious brain function of mapping our surroundings.
  • Loss of a non-conscious function is a problem, but it is 'asymptomatic'. One cannot know that one has lost, or one does not have, a non-conscious function, so one can't describe it. This is called anosognosia (not knowing that one does not know!)
  • Simultanagnosia leads to behaviours that are given behavioural labels as if they are diagnoses. Once one has a behavioural label people can stop thinking about what causes the behaviours.
  • Visual disorders are hidden disabilities, and many professions in medicine and professions allied to medicine are afforded only basic training in vision
  • Simultanagnosia has until now needed cooperation from the 'patient' to diagnose it, because making a diagnosis needs those affected to be able to describe what they see. But children who have had any form of low vision from an early age know their vision to be normal. They may also be too young to speak, or can't do so.

So how can simultanagnostic vision be diagnosed if the child cannot describe it?

The answer is 'It can't'.

But

It can be suspected and hypothesised.

How could this help?

It means that the child who cannot find things, and can't cope in cluttered scenes can be parented and taught in a way that takes these difficulties into account.

But could this harm the child?

No, because this approach simply entails making things simple by focussing on, and adding simple information to what the child is attending to and doing (see Blog 9)

Following the child's agenda - not inflicting the adult's one!

Making things uncluttered, matched to experience, singular and simple, is the essence of education and all can benefit!

So, what makes one suspect that a child may have simultanagnosia, so that one can consider this approach?

Children with lack of the lower visual field commonly but by no means always have associated simultanagnosia.

Lack of lower visual field can lead to:

  • Watching TV upside down, so the picture is in the upper visual field
  • Consistently leaving food on the near side of the plate, until the plate is rotated
  • Not opening the mouth to an approaching spoon unless it is moved in from the upper visual field
  • Missing the pictures and text at the bottom of the page
  • The mobile child consistently bumping into low obstacles and often hating it when low furniture is moved (most families will already have removed the low furniture).
  • Having difficulty going down stairs
  • Not seeing the ground ahead and tripping and falling a lot
  • Not wanting to jump off a bench, or into a swimming pool
  • The child choosing to use their upper visual field to go down slides on their tummy

to name but a few behaviours

Lack of lower visual field can lead to..The child choosing to use their upper visual field to go down slides on their tummyLack of lower visual field can lead to..The child choosing to use their upper visual field to go down slides on their tummy

Children with simultanagnostic vision tend to:

  • Get very close to the TV, and focus on parts of the screen
  • Not to be able to see things that are pointed out despite sufficient vision (the further things are away, the more there is to see)
  • Not to be able to find a close relative in a group of people

along with many other behaviours related to not coping with clutter or crowds

Profoundly disabled children with impaired movement of all four limbs, who appear not to see, may start to look around when surrounded by an empty tent.

We have hypothesised that this is due to their having simultanagnosia that is relieved in the novel uncluttered surroundings.

If you are reading this and your child has a number of these difficulties, then it may be worth thinking about simultanagnostic vision as a possibility, and trying out the approaches that are currently being assembled on this website.

If as a result, your child starts to make unanticipated developmental strides, then this provides evidence to support the hypothesis and to carry on!

Using the KISS principle - Keep It Slow and Simple, and matched to what one's child is giving attention to, is exactly what we did for our children when they were young.

KISS: Keep It Slow & Simple

It's not rocket science, but it is so simple and basic that it can be missed in our busy worlds.

Mobile phones and tablets are an enormous visual distraction, so remember to keep them out of sight whilst you enjoy this special contact and time together. Don't expect immediate results. What you teach is not unlikely to come back to you a few days later.

Remember, clutter does not stimulate children, or help them to develop, it tends to bamboozle and overwhelm them, especially those with simultanagnostic vision!

The rewards of bringing about learning when the professionals have said it may not happen, are boundless!

Every child can learn from information they can

  • access
  • pay attention to
  • give meaning to and
  • remember!

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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.