Examining the Effect of Eye Gaze Technology on Children With Cortical Visual Impairment & Its Impact on Occupational Performance

PURPOSE: Cortical visual impairment (CVI) is one of the leading causes of bilateral visual disability amongst children, affecting as many as 72 per 100,000 children (Cohen-Maitre & Haerich, 2005). While an eye examination would appear typical, CVI represents difficulty processing and interpreting visual information in the visual cortex; the eye receives pictures of the objects that are being viewed and sends the message to the brain, but the brain cannot process what it’s seeing (Abd El-Maksoud et al., 2016). About 30-40% of children with a visual impairment are diagnosed with CVI (Roman et al, 2018). Although eye gaze technology is used with many individuals to access computers and communication devices, there is a lack of research to support practice using eye gaze technology as an intervention for children with Cortical Visual Impairment. The purpose of this study is to determine if the use of eye gaze technology will improve the functional vision of children 2-6 years of age who have cortical visual impairment, and to recognize how the use of eye-gaze technology may impact their occupational performance.

DESIGN: This was a mixed-method, case series design. Qualitative data was collected through a descriptive case series, and quantitative data was collected through a pre-experimental pre-post design. Data was collected in a classroom at a local school for the blind and visually impaired and interview of the parent via Zoom. The participants consisted of five children aged 2-6 years of age who attended a school for the blind and visually impaired. Inclusion criteria consisted of having a CVI diagnosis and a caregiver available to participate in the study. Children with only an ocular vision diagnosis were excluded from the study.

METHOD: Eye gaze cameras using Insight and Learning Curve software were used daily for 20-30 minutes for 3 weeks. Pre and posttest data on visual attention and noticing images subtests was collected using eye gaze technology, Canadian Occupational Performance Measurement (COPM), and CVI Range for each participant.

RESULTS: Results showed statistical significance of <.05 for the CVI Range and visual attention subtest on the eye gaze technology. Noticing images subtest was approaching significance, and the COPM was not statistically significant.

CONCLUSIONS: Children with cortical visual impairment have unique vision and occupational performance. This study provides evidence for use of eye gaze technology for evaluation and intervention with children who have cortical visual impairment. Eye gaze technology shows promise as a measurement and intervention to improve functional vision and in turn occupational performance of children with cortical visual impairment.

References

Abd El-Maksoud, G. M., Mohammed Gharib, N. M., & Diab, R. H. (2016). Visual-based training program for motor functions in cerebral palsied children with cortical visual impairment. International Journal of Therapies & Rehabilitation Research, 5(4), 265–277.

Cohen-Maitre, S. A. & Haerich, P. (2005). Visual attention to movement and color in children with cortical visual impairment. Journal of Visual Impairment & Blindness, 99(7), 1–20.

Karlsson, P., Allsop, A., Dee-Price, B.-J., & Wallen, M. (2018). Eye-gaze control technology for children, adolescents and adults with cerebral palsy with significant physical disability: Findings from a systematic review. Developmental Neurorehabilitation, 21(8), 497–505. https://doi-org.lib.rockhurst.edu/10.1080/17518423.2017.1362057

Roman-Lantzy, C. (2018). Cortical Visual Impairment: An Approach to Assessment and Intervention 2nd ed. Edition, AFB Press.