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A Publication about Visual Impairments and Deafblindness for Families and Professionals

TX SenseAbilities - Spring 2018

By Sara Kitchen, with assistance from Kate Hurst and Lynne McAlister, TSBVI Outreach

Abstract: Anat Baniel is trained as a clinical psychologist, and as a dancer, and was a close professional associate of Dr. Moshe Feldenkrais for over a decade. She is the founder of the Anat Baniel Method© out of San Rafael, CA, and Author of “Kids Beyond Limits” and other books. She developed an approach that uses movement to impact brain function. This approach is based heavily on current research related to learning and neuroplasticity, the brain’s ability to form new neural connections and “rewire” itself throughout a person’s life.

Dr. Christine Roman-Lantzy, author of Cortical Visual Impairment: An Approach to Assessment and Intervention” and director of the Pediatric VIEW Program in Allison Park, PA, is a leading expert in the study of Cortical Visual Impairment (CVI) in the United States. Cortical Visual Impairment occurs as a result of damage to the area of the brain that processes visual information. 

Patty Obrzut is an Occupational Therapist and Assistant Director of Penrickton Center for Blind Children in Michigan. Penrickton utilizes an approach developed by psychologist and educator Dr. Lilli Nielsen of Denmark known as “Active Learning”. The foundation of this approach is that all human beings learn through doing, especially in the earliest stages of learning. Obrzut trained extensively with Dr. Nielsen and was authorized to provide training as an expert on Active Learning.

This article discusses some of the many parallels within each of the three presenters' body of knowledge and work.

Key Words: Anat Baniel, ABM, Neuromovement®, brain plasticity, nine essentials, attention, movement, neuroscience, Christine Roman-Lantzy, Christine Roman, CVI, Comparative Language, Salient Features, Cortical Visual Impairment, Patty Obrzut, Active Learning, Dynamic Learning Circle, Discrimination, Differentiation, Integration.

Anat Baniel, Christine Roman, and Patty Obrzut were presenters at the recent Texas Focus Conference in Austin in March, 2018. During the time they spent in Texas they had opportunities to visit with each other and they shared some of their perceptions of each other’s work with conference organizers. We’d like to explore some of the points raised by Anat Baniel and explain how they relate to what we know about other techniques that successfully and methodically target neuroplasticity, as explained by Patty Obrzut and Christine Roman.

Anat Baniel has described very thoughtfully what our children have been teaching us for years. Lilli Nielsen, Jan van Dijk, Barbara Miles, Christine Roman, and many other great minds within the field of visual impairment have spoken of and written about these ideas using different language, and all come back to consideration of and working within the perspective of the individual student. Anat Baniel’s work with Michael Merzenich, the “father of neuroplasticity”, validates these tools even more. Our traditional approach to learning in public education may eventually change and catch up. In the field of visual impairment, we may add to our toolbox or continue to use these “cutting-edge” strategies that are backed by prominent neuroscientists. We can feel reassured that at least within our community, we are providing the best learning situations for growing and developing the mind of each child, and can explain what we are doing and why, knowing we are backed up by the latest research on learning. 

Brain friendly learning takes advantage of neuroplasticity and can be provided in any situation by applying what Anat Baniel has dubbed the “Nine Essentials.” For more information on the nine essentials, please go to

https://www.anatbanielmethod.com/about-abm/the-nine-essentials and/or watch https://www.youtube.com/watch?v=u6pI6BiKvAM and https://www.youtube.com/watch?v=m56hA6fTVcc.

Anat Baniel offering information at Texas Focus 2018
Anat Baniel offering information at Texas Focus 2018

 

The Job of the Brain

“The ‘job’ of the brain is to put order into the disorder, to make sense of the nonsense.”

-Anat Baniel

In the field of visual impairment, we understand that many of our children have experienced barriers to accessing perceivable, relevant information. A lack of sensory input does not give the brain enough information to organize and create a comprehensive whole. Information is fragmented and the brain has few opportunities to make sense of what it does receive. 

The brain will get good at things it does often. When neurological connections are not reinforced by repetition they will wither and disappear. This occurs naturally in all humans during the first few years of life when thousands of connections are made and then pruned away as the child establishes greater understanding of the world and how it works. 

Our task as educators and parents is to ensure a child is provided with information frequently enough that organization (creation of neural networks) can occur. This information must be provided through whatever senses are available to the child. A child needs many opportunities to use and strengthen neurological connections. Anat Baniel brings this about through facilitation of slow, thoughtful movements.

In Active Learning, we bring instructive materials close to the child and allow them to act upon them in whatever way they are able. In order to be perceived, objects are often in direct contact with the child’s body. Each time a child acts upon an object and then notices the sensory information they get in response (a sight, sound, vibration, weight, etc.) they are able to build connections and “make sense of the nonsense.”

A child with CVI may have difficulty discriminating what visual information is relevant and useful. She may not have the visual memory it takes to make any association with visual input. Modifying this child’s environments to maximize vision within the correct range of visual functioning is another way to help the child ‘make sense of the nonsense’. 

The Underlying Process of Learning

“The underlying process of learning: Discrimination, Differentiation, Integration.”

Anat Baniel

The process of learning has been presented in stages by each of these three experts. Mirrored in each other’s work are divisions referred to as stages, levels, phases, etc., and are all necessary aspects of the process of learning. Though these stages are linear in appearance, all humans cycle through them when they begin learning something new or relearning how to do something old.

Discrimination

Information equals the perception of a difference (signal to noise ratio).

Anat Baniel

According to Wikipedia, the signal-to-noise ratio is defined as “the ratio of the power of a signal (meaningful information) and the power of background noise (unwanted signal).” In other words, the signal must be significantly greater than the noise. 

Perception is a key word. If something is not perceived, it does not exist for an individual. Huge chunks of information are absent in the world of the child with visual impairments, especially if they have additional disabilities. Even with some vision the quality, depth, and breadth of perceptual information is missing in every concept area.

Anat Baniel uses slow movement to give the brain time to perceive both the movement and the effect it has on the rest of the body - the difference. She referred to this as “movement with attention.” When we try to do something quickly or faster, we will do whatever we already know and will not learn anything new because we can’t perceive any difference at that rate. We have to slow down and attend to subtle information.

In Active Learning we teach basic concepts of how the world works by creating activities and environments that interest the child. Through close observation we can begin to understand what qualities the child perceives and finds interesting such as taste, weight, temperature, sound, and movement. We share many things and activities that are similar to the experience which caught the child’s attention, hoping the child will perceive the differences. If there is no interest, perception of the difference is unlikely because humans tend to ignore what isn’t interesting.

The discrimination phase of the Active Learning approach relates to Stage One of the Dynamic Learning Circle: the learner becomes aware and interested. (See on the Active Learning Space website http://activelearningspace.org/dynamic-learning-circle.) The learner becomes aware that something is there.

In the case of CVI intervention, our students spend a great deal of time learning to see. Initially the child may only notice visual qualities like movement and light and then over time may begin to notice very familiar items. Initially, visual items must stand out from the environment and distractions must be extremely reduced if not eliminated entirely. In CVI Phase I, “building visual behavior,” the learner becomes aware of visual information by the reduction or elimination of all other competing sensory information. The learner finds out that visual information isn’t just more nonsensical visual noise and so becomes aware of what he sees. For this to happen for someone functioning in Phase I of CVI, visual clutter, auditory clutter, and positioning must be considered (among other things). Examples of adaptations include turning the lights low or off and lighting a single target, using a CVI Den (https://strategytosee.com/diy-projects/cvi-den/) in which one target is visible, turning off televisions and radios, and reducing or eliminating background chatter. 

Often, when we do not approach instruction from the child’s perception of a difference, we may find that our efforts fail. If the child experiences failure over and over again, this may become ingrained in the child’s self-perception and shut down learning.

Differentiation

“Perception of differences leads to differentiation, i.e., creation of new connections which open the opportunity for integration of new patterns.”

Anat Baniel

Anat Baniel notes that two repetitions of a random movement that creates an awareness of a ‘difference’ for the child will result in the child making a purposeful third movement. From the literature on Active Learning, once a child can begin to compare how one activity/object is different from another, she can begin to hypothesize about items. This leads to categorization of information or building the internal scaffolding on which the child can hang new information.

The differentiation phase within Active Learning relates to Stage 2 of the Dynamic Learning Circle: the learner is curious and active. By repeating an action over and over on an object the child learns what it will do, how it feels, and so forth. This experience can be compared with other similar experiences to see what is “the same” and what is “different”. A child then tries to act on a new object in an old way and he learns it responds differently from other objects he has experienced before. So the child employs a slightly different pattern of movement to get additional or new information. The child builds a new pattern that can be used with a new object to get different information. For example, a child with a visual impairment may play with an object placed on either side of his body by batting it. He may experiment with batting this way and that way for quite some time or may pause in his play with his hand on the object. The child could be unaware that the activity on his right side and that on his left side can ever be related, since he has no visual information to confirm this. 

If at some point, while his hand rests on an object to his right, he bats the object on his left causing the object to touch his right hand, he may experience a great surprise! The child may stop and think about what just happened, and try to make this new and different thing happen again. This experience if repeated enough could lead to two-handed exploration at midline, a skill that is integral to many functional activities.

At the moment we see a child make a new connection both Lilli Nielsen and Anat Baniel tell us not to interrupt the learning by saying something like, “Good job!” We mean well, but it takes the attention away from what is being learned and puts the focus on the relationship the child has with us. Children’s learning is not about trying to please an adult! We have to retrain ourselves to express our excitement by calmly describing what the learner did when they are ready to talk about it. It is exciting to see connections being made, but too much emphasis on the adult’s feelings can take the success away from the child. 

Patty Obrzut points out important aspects of movement for Active Learners at Texas Focus 2018
Patty Obrzut points out important aspects of movement for Active Learners at Texas Focus 2018

 

Differentiation within CVI can be characterized during Phase II, “Integrating Vision with Function,” when the learner begins to meld the visual information they are now aware of with other sensory information. This is a situation in which a CVI den can be very beneficial for moving from Phase I to Phase II, when the learner realizes her movements affect the visual information she has begun discriminating. Not only can items be seen, but those same items can be touched, moved, and can make a sound when the learner acts upon them. In a CVI den made from a tent with an attached bottom layer, even the learner using his legs to kick can create the noticing of a difference, as the items will move when the tent is moved.

Intervention regarding CVI tells us that once familiar items are perceived consistently, the teacher or parent can begin to draw the child’s interest to the qualities that make these things different or the same from one another. Visual attention must be drawn to a difference (or a likeness) for children with CVI based on what the child finds interesting. Otherwise the child might overlook that difference and only focus on the familiar aspects of the objects.

Comparative language can be used to highlight salient features, such as pointing out similar and dissimilar visual qualities between different breeds of dogs. (For example, this dog has long, black, hair and this dog has short, white hair.) If the child is interested or curious about the dogs’ hair and we take the time to discuss it with him, we can awaken and/or reinforce visual curiosity. We should mention this is not a time to quiz or test. It is a time to interact and enjoy the discussion using the child’s interests, language, and pace.

Integration

Anat Baniel describes integration as a process that can be refined when increasingly smaller, more subtle bits of information have been compiled through differentiation.

In Stage 3 of the Dynamic Learning Circle in Active Learning the learner completes learning from his repeated action. The formerly new action becomes a natural part of the way he gets information about other objects in the world, even those that are already familiar. This opens up a whole new set of possibilities for the learner. Instead of just having one way to explore, he now has two ways to learn about his world. 

In Stage 4 of the Dynamic Learning Circle, the learner becomes ready for new challenges and the process starts over with a new item or quality of an item. The learner becomes aware of something and gains a more complex understanding of the object or its qualities. The old and new information is connected or integrated in the child’s understanding. As more exploration schemes are added by the learner, the more subtle and refined elements of objects can be integrated into a more representative holistic concept of the object. The function of the object may now be introduced.

During Phase II of CVI, familiar items are presented in an environment in which visual information can be accessed and then acted upon. This happens repeatedly enough that the child can begin to visually recognize the item before acting upon it. Once an item is so familiar that it can be viewed easily, the child may become interested in and curious about the visual details. The child is so good at using his vision in this instance that he is not working so hard just to see, rather he is using his vision easily and naturally along with other senses, like someone with more typical connections between their eyes and brain. The pleasure associated with the ease of looking at something may serve as motivation to find other situations in which looking is easy, if the child is able to control some aspects of his own environment. Proper intervention allows multiple opportunities to build and strengthen these connections.

In Phase III of CVI, the learner also starts over with the process, learning to discriminate, differentiate, and integrate increasingly smaller and subtler types of visual information. This fine-tunes the brain’s ability to quickly identify visual information paired with the associated concepts, and strengthens visual memory.

Through environmental modifications and guided learning, the learner’s ability to discriminate, differentiate, and finally integrate visual information allows for “seeing to learn” as opposed to learning to see. Throughout life individuals with CVI face challenges when novel items and environments are experienced. This is why even though an individual’s vison appears much more typical, the learner and educational team need guidance and strategies provided by a knowledgeable professional in CVI throughout their educational career.

Dr. Christine Roman-Lantzy stresses the importance of using brain-friendly CVI strategies at Texas Focus 2018
Dr. Christine Roman-Lantzy stresses the importance of using brain-friendly CVI strategies at Texas Focus 2018

 

Connecting

“We can only integrate elements into new neural networks (skills) with the current achieved level of differentiation.” Anat Baniel

Anat Baniel suggested a paradigm shift for educational staff and caregivers; we need to move away from the idea of “fixing” the child and move toward the idea of “connecting” with the child. When we move from fixing to connecting, we let the child teach us what it is that they are ready to learn. We gain this knowledge by observing them intensely.

Baniel stressed that if a child could do what is being requested by her teacher, she would do it. We must provide the information and environment their brains need to make the connections in order to learn the skills we want them to have. The brain will get there if the correct information is provided.

This is why intensive observational assessment is a first and necessary step. We must first determine where the child is right now. What movement skills have already been achieved and what skills are not yet present? When we provide more practice in strengthening neural pathways and networks at the current level, the brain becomes ready for what comes next. When we push a learner to do something without first helping them build a framework to store the information this ability may not be generalized to other environments or materials. This is training not learning.

When the brain has had enough discriminable and differential information with enough experience to integrate the information, new interests will begin to emerge. Children show us that they are ready for a new step by changes in their behavior. In Active Learning, we examine fine and gross motor skills and fine-tune our activity using other areas of assessment, such as spatial relations and emotional skills, to provide appropriate learning environments. We then reassess to make sure what we are providing continues to interest the learner and document new skills that are achieved. For Cortical Visual Impairment, we use the CVI Range to gather information about how a child uses their vision in various environments. We then provide appropriate learning environments based upon that information and reassess as the child changes her use of vision.

A New Paradigm

“Discrimination and Differentiation seem to be the ‘orphans’ of the process in many of the clinical and theoretical frame works.” Anat Baniel

When we begin to consider discrimination and differentiation while providing intervention for children, we will automatically change our way of thinking. Consideration of what is perceivable and interesting to a child shifts our focus from a system-centered to an individual-centered approach. This frees us up to truly know and connect with the children we serve and let go of what has not been successful. The techniques described by Christine Roman, Anat Baniel, and Patty Obrzut each provide us with a structure and method that allows freedom to be individual-centered, are backed by current research in neuroscience, and are validated by the children who teach us what does and doesn’t work.