Positioning for comfort and ease is essential to begin to support the exploration of movement and touch combined with vision.
An important part of the child's sensory, cognitive and communication development is the integration of therapies and team work with the physiotherapist, occupational therapist and speech therapist in order to plan an optimal learning experience. This team work can involve planning based upon observation of how to combine the use of other senses in learning without sensory overload.
This could include the use of :
Touch awareness (processing levels as for vision)
Providing physical support to enable the child to reach out to visually stimulating objects which reflect light.
Combining light and colour (for example a light reflection on a silver space blanket) with reaching out.
Auditory awareness and a communication programme can be built upon the anticipation cues used for visual recognition and understanding and for intensive interaction methods. Introducing new sensory experiences must always be undertaken one at a time because children with severe CVIs cannot process a visual stimulus or combine a sensory experience when there are other distractions.
Changes which appear to indicate some extension to purposeful use of vision were observed with Ali when she was taken to a garden centre during a Christmas period. She was placed next to a Christmas tree with many multicoloured lights and she turned her head to gaze and fix her vision on the lights. This was a first time response to a visual stimulus outside of a colour tent that followed a period of around three to four years of consistent tent work. She also began using her visual locating of moving colour and light sources in the darkened Multi sensory room which was a new visual response. Leading on from this, Ali began to socially interact with the use of her vocalisations and clapping as part of her communication programme.
Ali appears to have more energy and calmness for social interaction if she has quiet times in her day to just 'be' in the tent with no other stimulus. This quiet calm space has enabled her to enjoy learning at her own pace and engage with interaction on a 1-to-1 basis. It also appears to increase Ali's ability to be a part of some larger group settings and other social events without distress.
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