In this video, Ellen Mazel talks about how complexity affects children in phase 1 of Cortical Visual Impairment, as measured on Christine Roman's CVI range.
Mazel look at the different kinds of levels of complexity: complexity of the object, complexity of array, complexity of the sensory environment, and the complexity of faces.
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MAZEL: Hi, My name is Ellen Cadigan Mazel, and I'm a teacher of students with visual impairments, a deafblind specialist, and a CVI adviser.
We're here today to talk about how complexity affects children in phase 1 of Cortical Visual Impairment, as measured on Christine Roman's CVI range.
Certainly, children in phase 1 are affected by every single one of the 10 characteristics. They have a greater attention to certain colors. They are attracted to movement in the environment and don't really like to look at things that are not moving. They have latency for looking when they do look. They have visual field preferences, greater attention to light sources. They have limited or absent visual-motor skills.
They have visual novelty differences. They have to really have a firm visual memory of something to find it and recognize it. The visual reflexes are absent or delayed. They have difficulty with distance viewing and tend to be very close lookers, and certainly have great needs around the issue of complexity. It's a huge factor for all children in all three phases of CVI, but certainly for children in phase 1.
So we want to look at the different kinds of levels of complexity. We have complexity of the object, and typically children with Cortical Visual Impairment will only look at items that are one simple color. The complexity of array — they only can look at things that are presented separately. The complexity of the sensory environment — this certainly affects children. They are really unable to look at anything with the input to other senses, whether it be tactile or sound or being handled. And the complexity of faces — children in phase 1 just do not make eye contact. They do not have facial regard.
For the complexity of objects, they have the highest needs for environmental supports in this area. And they may need several supports at the same time. So maybe they need to look at the slinky against a black background, but then need the input of movement and light in order to draw their visual attention-- so really, a combination of supports together to ensure that the complexity of the item is understood.
The children in phase 1 have strong color preferences, as well, and they'll only look at these single one colors at a time. These favorite colors are often red or yellow, but not always. Sometimes, the color can be a strange color like green. I had one child whose parent reported that their favorite color was green. And, in fact, he had a kelly green bear in the corner of his crib since his birth, so he had a very firm visual memory of that color. And indeed, that was the color that was the anchor for all of his looking. Parents are great reporters of children's favorite colors.
When you determine the color, as you can see, many times, they are strong, saturated primary colors. Favorite items might need to be a certain color, but they need the extra-environmental support of the shininess. Something that's shiny gives the illusion of movement and reflects the light — two other environmental supports that match with complexity that we need to add for children to be able to look.
With reductions in the complexity of the environment, the children will still have latency, but it will shorten the latency. Children will find things faster and be able to look at things longer when they're placed up against non-complex backgrounds like this board here.
Children with Cortical Visual Impairment in phase 1 cannot access pictures at all. They're completely inaccessible for children. All the items that they see have to be the non-complex, three-dimensional materials in order for them to locate them.
If a child with CVI in phase 1 can fixate, it's only very briefly. And again, by using non-complex boards and thinking about complexity of environment will allow these children to find things faster and sustain their gaze longer. When you can sustain your gaze longer, you can begin to understand materials better than a quick glance can give you.
That fixation may only also be to a very, very small number of familiar materials. And again, parents are very good reporters of what things their children will look at. It may be very, very hard to do an assessment without that parent input to what the child will look at in their environment. And again, against a background is very, very important. That complexity of the background has to be completely eliminated.
Children with Cortical Visual Impairment really like light. It's the easiest, most non-complex visual target. You will find that children with CVI in phase 1 will need to have things within 2 feet of their face in order to see them. And that has to do with complexity. The further away something is, the more of the world that they have to look at.
I really encourage people, when they're thinking about complexity with children, to get down right at the child's level. Get right next to their head to see what is the complexity that we're asking them to look at. I think often we think we're reducing the complexity. But when we take a child's eye view of the world, we realize that's still a very complex scene.
Often, children will lean forward in order to fill their visual field with more of the object. That reduces the complexity, again, because they're not having to look with all that background information. And again, this is not to be confused with a child with an ocular impairment that will lean forward due to issues of acuity.
Children with CVI in phase 1 might really depend on reductions of complexity in a room by turning the lights down. It seems so counter-intuitive, but the dimmer the room is, the less the other items in the room really stand out. And just dimming the room can really reduce the complexity for a child in phase 1.
It's important to always think about all your backgrounds for children. And again, this is not to be considered in the same vein as providing contrast for a child with an ocular impairment. We're really thinking about non-complexity. We're thinking about reducing the complexity.
And I have several types of backgrounds here. I have this background here which is covered with Veltex. Very easy to attach a strip of Velcro at the top and hang toys from this or present materials against this-- any kind of reading materials against this.
I have an APH slant board which has, again, this nice Veltex on one side to stick things on, and some nice, clear, non-complex white on the back.
I have a nice shelf here, where I can stand materials against a non-complex background-- again, very, very important to make sure we're down at kids' eye level and making sure that these kinds of boards fill the child's visual fields enough and block the complexity from the rest of the room.
I also have a calendar system here that I'll use for some of my children with Cortical Visual Impairment in phase 1. This allows me to show one item at a time. You're going to go to circle time. You're going to go to work group. So a child will be able to access their day in three dimensions against a non-complex background, as a calendar system for their day.
So say they're going to go to work. They take the item off, travel to the area. And this is my complexity reduction for the area — the learning area, the work group area — that they'll be traveling to.
And again, it's important to think about spacing, because the further things are away from one another, the less complexity there is. If they're too close together, that complexity of array, they can't sort one item from another.
It's very important to think about non-complex shirts, for instance. The shirt I have on today is very non-complex. These are the sorts of shirts I wear every day, or I'll have a smock. Just imagine trying to learn against a background that looks like this-- just too patterned. You are a background for your children with Cortical Visual Impairment.
Complexity of sensory input is also very important. We want to completely eliminate all other kinds of input coming in to a child who's trying — struggling, really — to look, to look to things in their environment. So we want to think about very strict controls against our multi-sensory learning.
Because they're very visually impaired when you're in phase 1, it's important to have a multi-sensory curriculum. But we want one sense challenged at a time. We really have to slow down learning in order to let them look and listen and touch as three separate and distinct events.
So controlling the auditory complexity, the visual complexity, taking all the sound that we can out of toys, supporting them while they're seated, limit the touching of children while they're trying to look — that's tactile complexity for children. Limiting fast movements, because the faster something moves, the more complex it is.
We want to carefully look across that day again and make sure that we do have a multi-sensory curriculum, but that we've challenged only one sense at a time, that we think very distinctly about which sense we want the child to use in a sequence, rather than totally together.
When we think about complexity of faces, faces are really inaccessible for children with Cortical Visual Impairment in phase 1. They may have some success looking at the edge of your hairline or at your moving mouth. They may have a little bit more success looking at a parent's — looking towards a parent's face. But basically, faces are inaccessible.
So it's really up to us to look for other ways that we know we have children's attention. Greeting them by name to deliver a message, introducing ourselves — all very important so the child understands who I am and what I might be doing with them.
I want to be very, very careful with children around changing needs around complexity. Every classroom is constantly changing. So if the child is struggling to look, if I do not see them able to look, I want to really assess my environment and reduce the complexity. So if there's added sound, added new sound in the room, I want to wait until that sound has stopped or get the child away from that sound in order for them to access the materials.
They can lose visual skills due to fatigue, illness, poor positioning — any of those things can be changes in the environment that need us to readjust our ideas around what's complex right now for a child's learning and to really heighten our awareness of the changing complexity of the environment.
So after assessment using the Christine Roman CVI range, we should be able to determine what level of complexity children can tolerate. And we do want to know what that level is so that we can put supports in place and then carefully reduce them when the child's visual skills start to build.
Each child in phase 1 may be measured as the same as being in phase 1, but they operate very, very differently. They each have very, very unique needs around each one of the levels of complexity.
Thank you so much.
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