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Gordon Dutton’s Blog 17

Hypothesising that more than one or two things can't be seen at once, checking this idea out and acting on it

For children with cerebral visual impairment, whose communication skills are limited, assessment of vision in children depends on taking a detailed history and carefully observing the way they respond to a range of tests and to their surroundings.

One day I saw a seven year old young man with CVI, who was not able to communicate. History taking and assessment to profile his vision to help plan his future education showed:

  • No responses to any moving targets in his lower visual field below his eyes, (explaining why he did not appear to see anything below his eyes).
  • Inaccurate reach in his intact upper visual field
  • Inability to look round the room. Instead focussing upon single items until he lost interest, then randomly looking at the next item and taking interest in it.

In the medical literature these three features occur in a cluster, along with lack of ability to see more than one or two things at once, so I suggested to the child's mother that it would be worth keeping things simple and uncluttered.

Here is the outcome some time later reported by his mother:

I though you might like to know some of the things Jeremy is doing at home - the place made most accessible on every level for him - proper visual search!!! If Jeremy needed me he used to yell, now he comes looking for me, and properly looks for me, if he doesn't find me in the study he looks for me in the kitchen. He has also discovered a whole new room belonging to his sister with a spinning chair. His world keeps betting bigger and bigger as he is able to navigate effectively through this maze of wonder (it has also forced my daughter to keep her room tidy because he trips over things on the floor!)

Also, to further confirm the hypothesis of presumed simultanagnostic vision - I think I mentioned I slowly replaced all the patterns in the house with plain decoration, and one area was my bed which had lots of coloured cushions and a checked blanket, and is now all white. Jeremy now spends ages in my room, but will not tolerate anyone putting anything on the pure white bed - he just throws it onto the floor; to me clearly demonstrating that he wants the new single colour to be left as it is, because this is not only easier for him to see the important things (like me) but I think it makes the space much more calm and relaxing. He sometimes comes in just to roll on the bed.

  • School rooms without clutter have been shown to enhance learning.
  • Good building design recognises the need for elegance and simplicity.
  • Museums long ago recognised that elimination of clutter enhances attention and learning.

Lets all try to follow their example, particularly for children with CVI.

No harm can come from doing this, only benefit!

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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.