Eye Contact in Children with CVI

Children with CVI, even into Phase III, can struggle with reduced or no eye contact. I always struggle with behavior-based teams as I try to explain that eye contact is impossible for some children due to CVI. Eye contact can sometimes feel like the only focus for a child’s education in these behavior-based programs. These children with CVI are visually impaired and CAN’T look at the complexity of the noisy, moving, ever changing face.

We would never demand “looking” from a blind child yet it appears again and again on IEPs for children with CVI, a poor and impossible goal. There are so many other things to work towards!  Eye contact is a skill we want to develop but it comes after visual skills are solid for less complex targets.

I see eye contact develop when the child is accessing materials in the world visually. Then I begin to see “face contact” where a child looks towards people’s faces but not necessarily in the eyes. I do encourage children to face the speakers and remind them to point “nose to nose”. If they begin to orient towards the speaker’s voice using their auditory skills this is seen as more typical for socialization.

Eye contact does develop with support and understanding of the impact of complexity. Eye contact skills are first seen in familiar, quiet environments but as soon as the speaker begins to deliver a message, the eye contact disengages (auditory complexity characteristic). The child clearly can’t listen and look to the complex face at the same time (complexity) as eye contact skills build. Children might also need to look away from faces when delivering a message themselves. Children might then develop the ability to look at familiar faces but not at unfamiliar ones (visual novelty characteristic) or have eye contact abilities when the speaker is calm with a softer voice (auditory complexity).

Lack of eye contact in children with CVI is not a social breakdown such as that seen in children with autism. It is a complexity issue for the child with CVI. The eye contact visual skills must be developed not demanded.

 

One comment

  1. Thanks for your insights. I really enjoy your blogs – they are incredible useful. I have shared a link to your blog on the Facebook group for kids with CDKL5 disorder (inc. CVI) many times. Thought you should know!

    Like

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