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CVI

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CVI

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  1. Orientation and lenght of lines CVI Refraction and motor functions Picture perception&recognition General Features & SYMPTOMS Motion perception and VField

  2. OUR GOAL to understand each child’s visual functioning

  3. Children with CVI OUR GOAL: to understand • the quality of the image • the use of information in higher visual functions • the role of vision in development and education

  4. The effect of visual impairment varies in different tasks. Visual disability is task dependent.

  5. Visual Impairment affects four main areas: • Communication • Orientation & movement • ADL, daily living skills • Sustained near vision tasks

  6. Four-leafed clover ofVISION

  7. Visual Impairment Basic questions: How does vision affect this function? How is vision going to affect development of this function? Does the child have compensatory techniques? How do I teach them?

  8. Visual Impairment Basic questions: How does vision affect this function? How is vision loss going to affect development of this function? Does the child have compensatory techniques? How do I teach them? How do I help the child to develop compensatory techniques?

  9. Orientation and lenght of lines Refraction and motor functions Picture perception&recognition CVI Motion perception and VField

  10. Visual cortex V1 & V2

  11. Visual cortex V1 & V2

  12. Visual cortices posterior parietal eye-hand coordination spatial awareness frontal recognition inferotemporal

  13. CVI Often a part of larger brain damage >> thus Cerebral visual impairment or Brain damage related visual impairment

  14. Brain damage related VI Caused by: - lesions in visual pathways - cortical lesions, visual and other - subcortical lesions - leads touneven profileof visual functions, some good, some poor important in assessment of children with intellectual disabilities

  15. CVI - Behaviours - VARIATION in visual behaviour - effect of basic disorder - effect of medication, wakefulness - misunderstanding the functions easy to us, difficult to the child

  16. CVI - Behaviours - VARIATION in visual behaviour - speech as compensatory function

  17. CVI - Behaviours - VARIATION in visual behaviour - speech as compensatory function - plays with adults, not with children

  18. CVI - Behaviours - VARIATION in visual behaviour - speech as compensatory function - plays with adults, not with children - clings to parents in crowded places

  19. CVI - Behaviours - VARIATION in visual behaviour - speech as compensatory function - plays with adults, not with children - clings to parents in crowded places - uses colours for recognition

  20. CVI - Behaviours - VARIATION in visual behaviour - speech as compensatory function - plays with adults, not with children - clings to parents in crowded places - uses colours for recognition - may learn letters early, only short words

  21. CVI - Behaviours - VARIATION in visual behaviour - speech as compensatory function - plays with adults, not with children - clings to parents in crowded places - uses colours for recognition - may learn letters early, only short words - starts drawing late or never

  22. CVI – Behaviours 2 - stops at thresholds and shadows - depth perception - perception of surface qualities

  23. CVI – Behaviours 2 - stops at thresholds and shadows - does not look at, ”avoids eye-contact”

  24. CVI – Behaviours 2 - stops at thresholds and shadows - does not look at, ”avoids eye-contact” - peripheral vision better, central scotoma

  25. CVI – Behaviours 2 - stops at thresholds and shadows - does not look at, ”avoids eye-contact” - peripheral vision better, central scotoma - gets lost in familiar places

  26. CVI – Behaviours 2 - stops at thresholds and shadows - does not look at, ”avoids eye-contact” - peripheral vision better, central scotoma - gets lost in familiar places - gets angry if objects are moved

  27. CVI – Behaviours 2 - stops at thresholds and shadows - does not look at, ”avoids eye-contact” - peripheral vision better, central scotoma - gets lost in familiar places - gets angry if objects are moved - uses siblings and adults for help

  28. CVI A list of typical behaviours does NOT help us to understand a child.

  29. When a child has an unusual behaviour, describing it is not enough.

  30. When a child has an unusual behaviour, describing it is not enough. Try to find out WHY the child has that behaviour. Consider other impairments. Consider the situation.

  31. Fixation & accommodation

  32. Length & parallel lines

  33. Angle & cross Pen and spasticity

  34. Parallel v. crossing lines

  35. Eye-hand coordination

  36. Cognitive visual functions Discrimination of orientation of lines Discrimination of size/length of lines Detection & discrimination of movement Perception of texture, surface qualities Object / background, Depth Recognition of faces, expressions Recognition of geometric forms Perception of pictures Spatial awareness, eye-hand coordination

  37. CVI Diagnose and therapy: - team, transdisciplinary - tests are used by everyone - observation - structured play situations - repeated assessment

  38. Transdisciplinary Diagnose In the assessment of children with brain damage related vision loss: - ophtalmologist: anatomy, refraction - teacher, therapist: observations, testing - neurologist: dg, neurologic impairements - neuropsychologist: cognitive vision video documentation

  39. Assessment of functional vision - basic information from the eye hospital structure of the pathways, refraction, glasses (under- or overcorrection?) VA, VF, CS, CV, VAd, motor functions

  40. Assessment of functional vision - basic information from the eye hospital structure of the pathways, refraction, glasses (under- or overcorrection?) VA, VF, CS, CV, VAd, motor functions - testing of all visual functions in play and teaching situations, effect of other impairments and disorders

  41. Transdisciplinary assessment

  42. School assistant

  43. Assessment of functional vision - basic information from the eye hospital structure of the pathways, refraction, glasses (under- or overcorrection?) VA, VF, CS, CV, motor functions - testing of all visual functions in play and teaching situations, other impairments - effect of posture and facilitation in children with severe motor problems

  44. Influencing factors

  45. Four children • Prematurely born girl with problems in recognition of faces + other impairments • Boy with severe CP, poor head control and poor oculomotor functions, good VA, CS,VF • Girl with extreme hypotonia, insufficient accommodation, slow hand movements • Boy with deletion syndrome, central scotoma, hearing problems, delayed development

  46. Recognition of faces Re-cognition: - the facial features are seen - a template is formed in memory - the face is seen again - template is found and matched

  47. Periventricular leukomalasiaNext to ventricle loss of white matter PVL

  48. Matching pictures