Individuals with CVI show fatigue in a myriad of ways. The medical and educational teams for each child with CVI must understand the compounding effects of visual fatigue and implement strategies and supports to reduce visual fatigue and increase access. There is a neurological and physiological reason why individuals with CVI develop fatigue. Read the first part in this series: The science behind visual fatigue and CVI.
It’s imperative to understand the signs of fatigue specific to each individual with CVI. Parents have the most observational data of their child with CVI and know what fatigue looks like.
In the CVI Now Parents group, we asked “What are your child’s signs of visual fatigue and fatigue in general?” Here are some of the responses:
“Visual fatigue occurs most often for my son with multi-sensory input; for example, as he’s physically exerting himself, the school gym is loud with lots of people and items moving quickly. His vision essentially turns off for a period of time.”
“My son’s fatigues visually very quickly on the computer. His eyes water, he starts yawning, and he gets very difficult to redirect to the task.”
“My son just puts his head down and goes to sleep when visually overwhelmed and tired.”
“Learning has to happen in 10-15 minute bursts. Anything more than that and my daughter can’t physically hold herself together. If she has an intense session of physical activity (PT, swimming, horseback riding) that may be all she is able to do in a day because it takes ALL of her energy and effort to do that major physical activity.”
“My daughter’s visual fatigue presents as instant regression. She puts her head down on her desk and when she pops back up it’s like she forgot what she was doing. We had her teacher conference today, and I took the opportunity to reiterate that she isn’t ‘misbehaving’ when she doesn’t look at the screen or the teacher, or needs a break to get up.”
“My daughter will cover her eyes with her fists when she needs a break. She usually wants to go to bed about 7 o’clock and will sleep until six in the morning.”
“My son will quit activities that require hand/eye coordination such as coloring when visually fatigued.”
“My son closes his eyes or keeps them open just a small amount. He’ll still respond to questions, follow some directions but just doesn’t really use his vision if he’s fatigued.”
“My 8-yr-old son still needs 12 hours of sleep a night and a daytime nap to be able to get through his day in a positive and productive way. When I pick him up from school, he doesn’t want to talk, he just doesn’t have the energy to talk about his day or respond to me. I can tell when he’s tired his nystagmus is going wild more than usual. His fatigue accumulates throughout the week, so by Thursday or Friday he has a hard time with those challenging tasks at school or even meals at home.”
“My daughter’s fatigue always shows as behaviors—meltdowns and aggression. She will also look away from everything and often puts blankets on top of her head.”
Some other examples of signs of fatigue can include: resting head in hands, pushing all items out of view, asking for a snack or preferred activity, running away, walking to the corner of the room, looking away, closing eyes and appear to be sleeping, head down, talks, sings, or tells jokes to change the interaction to an auditory event, fidgets and plays with objects in near, yells, grabs, or shows other outward behaviors.
Behavior is communication. Fatigue is a key contributor to visual difficulties associated with CVI. Ellen Mazel wrote a blog post, Beyond the CVI Meltdown, that discussed what certain behaviors from students with CVI might be communicating. Mazel wrote, “if teams understood CVI, they would understand these behaviors as communication. They would know why these children were distracting and avoiding.”