An In-Depth Case Description of Gaze Patterns of an Individual With Cortical Visual Impairment to Stimuli of Varying Complexity: Implications for Augmentative and Alternative Communication Design

Abstract

Purpose: Many individuals with cortical visual impairment (CVI) are unable to meet their daily communication needs through natural speech. Augmentative and alternative communication (AAC) provides supports for individuals with complex communication needs, including those with CVI. However, many forms of AAC involve access via a visual modality. This presents specific challenges for assessment and intervention of individuals with CVI using AAC. Method: This study used an automated eye tracking technology to analyze the gaze patterns of one individual with CVI to stimuli of varying complexity. The automated eye tracking technology captured the point of gaze of the participant every 16 ms (60 Hz), allowing for a detailed evaluation of what captured the participant's attention. Results: Variations in stimulus complexity resulted in changes in visual attention. Overall, the participant engaged significantly faster to and longer with simpler images both when presented one at a time and also during a preferential looking task when two stimuli were presented. Additionally, one stimulus displayed a teddy bear, with an animated face. The participant gazed at the face for the majority of her looking time to that stimulus, rather than the colorful foot pads. Conclusions: The participant demonstrated clear patterns of quicker response times and longer gaze times when the stimuli were simpler in design. This has implications for AAC interventions and choice of symbols. Additionally, the participant's ability to engage with the face of the teddy bear image suggests her visual processing was consistent with the score she received on the CVI Range, an assessment tool that describes functional vision in individuals with CVI.