This post is part of a mini blog series documenting four weeks of Constraint-induced Movement Therapy (CIMT).
The cast has been on my daughter’s arm for a full day and night. I’ve noticed her starting to bring her left hand to her mouth and even suck on her thumb. It’s a great improvement considering she generally ignores it. She woke up many times throughout the night but it’s not unusual and I don’t necessarily blame the cast. That said, she does seem tired but surely her brain is working extra hard at creating new neural pathways and connections. Imagine how much energy that uses up!
Today is a big day for us. Dr. Christine Roman has very generously offered to speak with Ruth and Fetullah, my daughter’s physiotherapists in this Constraint-induced Movement Therapy (CIMT) program. We’ll be discussing ways to adapt the environment and activities to provide better accessibility for her Cortical Visual Impairment (CVI).
Our call with Dr. Christine Roman
We start the video call and Dr. Christine Roman provides a wealth of very helpful information about adapting the daily activities for Cortical Visual Impairment. The key takeaway is that whenever possible, vision should precede auditory and tactile. So, if the activity is to stimulate my daughter’s hand with a fabric swatch, we should show it to her first (in silence) and only when she looks should we let her feel it. Even better is if what we are showing her is a bright or fluorescent color. If vision always precedes auditory and tactile, then as a consequence, we will easily increase the frequency of looking opportunities we give her throughout the day. Building visual behavior is key for helping a child move from Phase 1 to Phase to 2 in Cortical Visual Impairment (CVI). My daughter is currently in Phase 1.
We give Dr. Christine Roman a short tour of the large therapy room and she suggests we dim the lights so my daughter doesn’t have to work too hard at looking. She also suggests some adaptations to toys we’re using, such as the one in the photo below. This toy had a lot of colours and drawings but we simplified it by adding bright red tape to it.
When adapting toys and objects, I specifically choose the colors red or yellow (shiny, if possible) because I know they’re the ones my daughter prefers. They signal to her brain that there’s something to look at. As it turns out, red is often the color that kids with CVI prefer. Interestingly, you could not have a visual cortex and still see the color red. How fascinating?
Tomorrow, we’ll be starting the CIMT session fresh using all of Dr. Christine Roman’s tips and recommendations. It’s not easy to think about both hemiplegia rehabilitation and adaptations for Cortical Visual Impairment (CVI) in one go, but I know it will all be worthwhile in the end. I’m grateful that the CIMT team is on board with making the adaptations needed.
On our stroll home, the beauty of today’s autumn day in Manchester doesn’t escape me. I can’t help but wish my daughter could see it too.
Fun fact: my daughter has discovered the cast and her new favourite sport is banging things with it—my face included!
Click here to go to day 3 in this mini blog series.
Cindy has a deep interest in Cortical Visual Impairment (CVI) and is currently studying Early Childhood Education. She focuses most of her time on her energetic daughter: playing, cuddling and helping to make her world visually accessible. Cindy holds a degree in Marketing and has worked in the not-for-profit sector for many years.