An individualized and adaptive game-based therapy for cerebral visual impairment: Design, development, and evaluation

Itzhak, Nofar Ben; Franki, Inge; Jansen, B.; Kostkova, Katarina; Wagemans, Johan; Ortibus, Els

doi:10.1016/j.ijcci.2021.100437

Cited by 10 publications

(3 citation statements)

References 63 publications

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“…In conclusion, there is a high prevalence of cases of children with CVI, particularly in low-income countries (Sahli et al, 2022). This is an important problem for which a satisfactory solution has not been found (Ben Itzhak et al, 2022). Our results suggest that one aspect of rehabilitation could be training with complex motion stimuli, which, for the patient in this study, promoted fast, robust, and durable recovery.…”

Section: Discussionmentioning

confidence: 60%

Rapid recovery from cortical visual impairment in a pediatric patient following vision training: A case study

Pandey

Neupane

Vaidya

et al. 2022

Preprint

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Background. Cortical visual impairment (CVI) is a severe loss of visual function caused by damage to the visual cortex or its afferents, usually as a consequence of stroke or hypoxic insult. It is one of the leading causes of vision loss in children. Objective. Several studies have demonstrated limited vision restoration in adult CVI patients who trained on well-controlled psychophysical tasks involving complex motion stimuli. Given the greater potential for plasticity in the young brain, we hypothesized that similar vision training would be more effective in young patients. Methods. To test this hypothesis, we conducted a proof-of-principle study in one young CVI patient (age 18), to test the training speed, efficacy and generalizability of vision rehabilitation using complex motion stimuli. The patient trained at home and in the laboratory, on a psychophysical task that required discrimination of motion stimuli presented in the blind field. Visual function was assessed before and after training, using perimetric measures, as well as a battery of psychophysical tests. Results. The patient showed rapid improvements on the training task, with performance going from chance to 80% correct over the span of 11 sessions. With further training, improved vision was found for untrained stimuli and for perimetric measures of visual sensitivity. Some, but not all, of these performance gains were retained upon retesting after one year. Conclusion. These results suggest that existing vision rehabilitation programs can be highly effective in pediatric patients. Validation with a large sample size is critical, and future work should also focus on improving the usability and accessibility of these programs for young patients.

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Section: Discussionmentioning

confidence: 60%

Rapid recovery from cortical visual impairment in a pediatric patient following vision training: A case study

Pandey

Neupane

Vaidya

et al. 2022

Preprint

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Section: Discussionmentioning

confidence: 61%

Cortical visual impairment at birth can be improved rapidly by vision training in adulthood: A case study

Pandey

Neupane

Vaidya

et al. 2023

Preprint

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Background. Cortical visual impairment (CVI) is a severe loss of visual function caused by damage to the visual cortex or its afferents, usually as a consequence of hypoxic insults during birth. It is one of the leading causes of vision loss in children, and it is most often permanent. Objective. Several studies have demonstrated limited vision restoration in adults who trained on well-controlled psychophysical tasks, after acquiring CVI late in life. Other studies have shown improvements in children who underwent vision training. However, little is known about the prospects for the large number of patients who acquired CVI at birth but received no formal therapy as children. Methods. We therefore conducted a proof-of-principle study in one CVI patient long after the onset of cortical damage (age 18), to test the training speed, efficacy and generalizability of vision rehabilitation using protocols that had previously proven successful in adults. The patient trained at home and in the laboratory, on a psychophysical task that required discrimination of complex motion stimuli presented in the blind field. Visual function was assessed before and after training, using perimetric measures, as well as a battery of psychophysical tests. Results. The patient showed remarkably rapid improvements on the training task, with performance going from chance to 80% correct over the span of 11 sessions. With further training, improved vision was found for untrained stimuli and for perimetric measures of visual sensitivity. Some, but not all, of these performance gains were retained upon retesting after one year. Conclusion. These results suggest that existing vision rehabilitation programs can be highly effective in adult patients who acquired CVI at a young age. Validation with a large sample size is critical, and future work should also focus on improving the usability and accessibility of these programs for younger patients.

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“…These disturbances are not explained by any (possibly co-occurring) eye-damage (Sakki et al, 2018). With the same diagnosis, different children with CVI can vary widely in what they can see (Ben Itzhak et al, 2022). In addition, their vision may vary depending on the circumstances of the child (e.g., tiredness) or the surroundings (e.g., level of illumination) (Roza et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

A mixed-methods study into the effect of a psycho-educational programme for children with cerebral visual impairment (CVI)

Overbeek

Stokla-Wulfse²,

Lievense³

et al. 2022

British Journal of Visual Impairment

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Cerebral visual impairment (CVI) is one of the most common causes of visual impairment in children. CVI is a complex visual disorder to understand and explain to others. Understanding one’s diagnosis and being able to explain it to others may facilitate adaptive functioning. To educate children and young people on their CVI and accompanying needs, the computerized psycho-educational programme ‘My CVI’ has been developed. A mixed-methods study was conducted to evaluate the effect of this programme. The aims of the programme are to increase participants’ knowledge of CVI, as well as self-esteem (SDQ), adaptive coping (SCQ), and well-being (Cantril, PERIK, HRQoL). Thirty-nine children (aged 7–16 years; 51% boys) participated in a pre-test, post-test, and follow-up assessment. Qualitative interviews were conducted for a subjective evaluation of the programme. Participation in the psycho-educational programme resulted in increased knowledge of CVI, as well as a better teacher-reported social and academic self-concept and less self-reported feelings of social exclusion. No effects of participation were found on self-reported self-esteem, coping or other measures for well-being. An increase in knowledge of CVI was not associated with changes in psychosocial functioning. Qualitative data revealed that children enjoyed participating in the programme; they learned there are others with CVI, and gained more knowledge and practical tools on how to deal with their CVI. The results provide preliminary evidence that participation in the psycho-educational programme ‘My CVI’ increases children’s knowledge of their visual impairment as well as improves social outcomes and feelings of inclusion. The highest gains may be achieved through a personalized approach, depending on a child’s (developmental) age and parental involvement.

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An individualized and adaptive game-based therapy for cerebral visual impairment: Design, development, and evaluation

Cited by 10 publications

References 63 publications

Rapid recovery from cortical visual impairment in a pediatric patient following vision training: A case study

Rapid recovery from cortical visual impairment in a pediatric patient following vision training: A case study

Cortical visual impairment at birth can be improved rapidly by vision training in adulthood: A case study

A mixed-methods study into the effect of a psycho-educational programme for children with cerebral visual impairment (CVI)

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