skills of the participants. The software recorded eye gaze data during the intervention. Although the Insight software records many eye gaze variables, this study only focused on activities of “Visual Attention” and “Noticing Images” provided by the software. Researcher observations were also collected during the intervention using the Eye Gaze in the Classroom Data Sheet. An eye gaze post-test was completed the final week of the intervention, and the COPM and CVI range were performed again a week following the intervention to determine if the intervention was effective in improving the visual skills, occupational performance, and performance satisfaction of the participants. The descriptive portion of the study contributes to a greater understanding of how CVI impacts the lives of children. The participants had difficulty with many daily activities. All of the children’s parents reported that their child had difficulties with communication/social interaction, self-care, learning/literacy and mobility. Other difficulties in daily occupations reported by participants included feeding, play, riding in the car and fine motor activities like crafting. Each child showed difficulty with participation in typical daily routines, occupations, and activities compared to other children their age. Though there were some similarities among participants, each child in the study was also unique in their strengths, abilities, and struggles, such as one child’s difficulty with tactile tolerance and another having excellent tactile skills. CVI has affected each child’s performance in a unique way, and this should be taken into consideration when implementing interventions for this population through individualization of interventions. Data analysis of the information obtained during the study indicates an improvement in visual skills and occupational performance following the intervention (See Table 1). This supports the use of eye gaze technology as an effective intervention to improve visual skills and occupational performance in children with CVI. The improvement of means in most of the eye gaze variables shows the technology has an effect and may be used to assess the visual skills of children with CVI in the future. The lack of improvement in visual consistency can possibly be explained by the known inconsistent visual performance of children with CVI (possibly due to environmental changes or internal sensory processing) and changes in the eye gaze intervention activities to higher level activities as the child improved their visual skills on the software. These results correspond with previous studies which have found that eye gaze technology is an effective intervention for improving visual field awareness (Atasavun & Duger, 2012) and occupational performance (Borgestig, et al., 2017). Although there have been studies on a few interventions and assessments there is limited information about how CVI presents in children in relation to the impact of CVI on occupational performance.
This study shows promise for this type of intervention although it involved a relatively small sample, no randomization or blinding of researchers or participants, possible co-intervention and a single location. These limitations could impact the generalizability; however, due to the new direction of this research, this level of evidence is important to establish and justify further research. The final limitation of the study was the lack of standardization in the amount or frequency of intervention provided to each participant due to the COVID-19 pandemic and mandated precautions, which caused some scheduling difficulties. Children who had more frequent intervention did show more progress in visual skills as shown in Table 1. Statistically insignificant findings can potentially be explained by these limitations mentioned above. A larger sample size and more intervention sessions for the participants could have helped with even greater increases in skills, helping the data reach statistical significance. See Table 1 for results of the study and eye gaze activities.
David Jessica Abby Landon
Number of sessions Average number of Insight trials / session Total Insight Software trials COPM Performance scores COPM Satisfaction scores CVI Score 1
9
6
9
11
4.45
4.22
2.5
3.66
33
49
38
15
PRE: 4.4 POST: 5.6
PRE: 2.8 POST: 5
PRE: 2.7 POST: 3.2
PRE: 3.8 POST: 5
PRE: 4 POST: 4.6
PRE: 3.6 POST: 5.6
PRE: 5 POST: 5.8
PRE: 1.8 POST: 2.4
PRE: 5 POST: 8
PRE: 2 POST: 4
PRE: 3 POST: 6
PRE: 4 POST: 8
CVI Score 2
PRE: 6.75 POST: 8
PRE: 2.25 POST: 5.75
PRE: 3.75 POST: 6
PRE: 3.5 POST: 5.75
Table 1:Testing Scores
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