It is very important to determine the exact number of items in a presentation that a child can look at and recognize. I need to always be sure a child can discriminate one item from others as a visual skill before I use larger arrays for teaching. To begin to assess this, I use that child’s very favorite item in a decreasing number of dissimilar items. I present that favorite item in an display of 6 items, then 5 items, then 4 items, then 3 items and finally 2 items until I see the child look towards and recognize their favorite. I conduct this assessment over a series of days, taking data on the attributes of the presented items (in the same environment), the number of items and the time the child needed to find their favorite one. If they have the ability to reach, I look at the quality of reaching (direct reach while looking, direct reach while looking away, sweeping reach while looking or sweeping reach while looking away). Once I have data about the child’s abilities with increasing displays, I can make recommendations to the team about the number of items that can be visually tolerated for recognition to occur.
Finally, I would want to test this display tolerance with items that are similar to one another as well but if I am testing this at all, it means I am concerned about this tolerance of array. The recommendation for dissimilar materials is always in place for ease of discrimination in all situations with all alert states and in all environments.
Throughout this testing, I use dissimilar materials; all different from one another in color, shape and size. Recommendations to the team must include a suggestion for any array, especially with symbol systems, to highlight the need for items used to be of great dissimilarity.
Children with CVI 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. The child clearly can’t listen and look to the complex face at the same time 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 or have eye contact abilities when the speaker is calm with a softer voice.
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.