Why are cluttered environments so challenging for children with brain-related visual impairment?

Brief Lay Background

When children have a brain injury around birth (e.g. lack of oxygen, epilepsy), parts of the brain that are responsible for vision can be damaged. These children will have problems with finding their toys, recognising their parents' faces, or dealing with busy classrooms. This is called Cerebral Visual Impairment or CVI.

For about 80 percent of children with CVI, cluttered spaces are particularly difficult. Classrooms, bedrooms, playgrounds, and children’s parties all have an overwhelming amount of visual information which their brains cannot process as quickly and automatically as most of us can do.

So, these children get distressed and cannot concentrate on tasks like learning, playing, or listening. Studies have shown that these children are slower in learning to read, and their behaviour and learning improve when classrooms are decluttered.

What problem/knowledge gap does it help address?

Despite clutter being such an important challenge for children with CVI, we have little understanding of what is causing these difficulties. Neuropsychological research with adults suggests there are two possible explanations:

1. They have difficulties combining visual elements like colours and shapes that belong to one object (apperceptive agnosia). With a lot of clutter, for instance, a full breakfast table, a yellow splash of colour can be part of a banana, a cereal box or orange juice. With little clutter, for instance, a glass of juice on an empty table is much easier to process.
2. They can only see one object at a time (simultanagnosia). Imagine pouring a drink but you can either only see your glass or the water, but never both at the same time.

Knowing why children have difficulties with clutter is important to give children and their parents the right advice and support.

Aim of the research project

To understand why children with Cerebral Visual Impairment (CVI) have difficulties with clutter.

Key procedures/objectives

1. Using answers to a questionnaire completed by parents of children with and without CVI, investigate how common difficulties with clutter are for children with CVI.
2. Explore symptoms and strategies with parents of children with CVI and categorise these into apperceptive agnosia and simultanagnosia.
3. Recruit a group of children with CVI and difficulties with clutter to complete three tasks: counting dots, naming shapes, and finding an object in a photograph of a real-world environment (visual search) while their eye movements are recorded. 
4. Carry out analyses to determine whether the children make the type of mistakes expected from someone with difficulties in combining visual elements or from someone who can only see one object at the time.

Potential impact on people with sight loss

Children with CVI cannot use their vision in the way most of us can. This is called functional vision loss and severely limits children’s daily life and education.

The project will provide free webtools for parents and professionals who support a child with CVI with difficulties in cluttered environments: a mini-questionnaire and mini-tasks. The webtools will help them to understand their child’s vision (e.g. your child can probably see only one object at a time) and provide them with personalised advice for management (e.g. remove unnecessary stationary when doing concentrated work).