Increasing independence in activities of daily living for adolescents with cortical visual impairment: a staff training program
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INTRODUCTION: Cortical Visual Impairment (CVI) is a complex, brain-based vision impairment that is emerging as one of the leading causes of pediatric visual impairment in the world. Evidence suggests that individuals with CVI can experience improvement in their functional vision use with appropriate intervention, primarily centered around environmental modification, which may contribute to increased participation and independence within daily living skills. THEORETICAL PERSPECTIVE: Under the umbrella of the Knowledge to Action Framework, the program is guided by the Ecology of Human Performance model, and an Active Support approach to staff training. PROJECT DESCRIPTION: The project includes a needs assessment of barriers to staff ability to support students with CVI in developing their independent living skills, followed by a knowledge-based group training for residential staff supervisors. In the context of this training, staff and occupational therapists developed an individualized plan designed to support specific student CVI needs, primarily around environmental modification. Staff were encouraged to use the least restrictive level of assistance when supporting a student in completing an independent living skill. This was reinforced during an interactive training between staff and the occupational therapist, who was be present while staff supported a student in an independent living task, and provide in situ feedback to the staff member. OUTCOMES: Staff demonstrated increased knowledge of CVI and the environmental needs of individuals with CVI, as well as increased confidence in supporting individuals with CVI in the residence. Staff also demonstrated marked changes in prompting styles, and implemented less restrictive levels of prompting while supporting students during independent living skill performance.