The BIOS SEN CAG meeting was held on Tuesday January 26th with a focus on the provision of evidence-based care for patients with SEN. This years meeting was presented virtually due to COVID-19. However, it was a delight to see over 70 attendees and so many people coming together given current pressures and demands on clinics.
There were two fantastic and enlightening presentations from Professor Rachel Pilling (Consultant Ophthalmologist at Bradford Teaching Hospitals) and Richard Bowman (Consultant Ophthalmologist, Great Ormond Street Hospital and ICEH). These were available to view prior to the meeting with the opportunity for attendees to send in questions for both speakers to be put forward on the day during an interactive Q&A session. In addition, there was an introduction to a UK national framework for supporting children with CVI/ Brain based visual difficulties (BBVD) and Doctor Anna O’Connor presented a fantastic interactive session on evidence based practice. The meeting was closed with an update from the SEN CAG chair.
Professor Rachel Pilling gave an excellent talk about Visual behaviours in autistic spectrum disorder (ASD) and a fascinating insight into models of visual perception in ASD. Included in this were the different types of processing that patients with ASD may exhibit, which provoked some great questions and discussions on testing techniques and environments for these types of patients. One of the key take home messages for these patients is we can gain a huge amount of detail and information from simply observing. In current times with new ways of constructing clinics and pressures of waiting lists coupled with issues of social distancing it was discussed that perhaps a video consultation with the parents/ carers (potentially with observation of the child also) would be beneficial to gain an insight into the patients visual behaviour without the stress of coming to clinic.
Richard Bowman provided and outstanding talk on Cerebral visual impairment in children, covering causes of CVI, how we can assess these patients and how we can help children with CVI. It was interesting to note from previous research based on certification data in the UK that cerebral visual impairment appears to be increasing, a potential reason being more babies being saved from extreme prematurity or perinatal hypoxia and increased recognition of CVI. Additional tests which could be beneficial in the assessment of these patients include measuring pattern VEPS in babies and the inclusion of a questionnaire (similar to the one produced by Gordon Dutton) to aid differentiation in whether there is damage to dorsal or ventral streams. We can try to make a difference to these patients by maximising visual functioning, addressing visual perceptual problems and maximising the use of residual vision offering specific coping strategies. Furthermore, gaining feedback from parents / careers on the impact of these strategies.
Following the Q&A session Professor Rachel Pilling gave a live presentation. She is part of a wider group of education and eye health professionals working together to create a UK national framework for supporting children with CVI/ Brain based visual difficulties (BBVD). The presentation outlined the importance of such a framework and the aim to proactively identify children at risk or displaying visual behaviours consistent with CVI. There is currently an unmet need of known and unknown children with CVI/BBVD and few NHS specialist services to support children and their families. The key aims of the framework are to determine how we detect these children, how we make a diagnosis, how we offer support to families and how this is accessed and to monitor and evaluate the system. Contributions to the scoping document are welcome which can be found on the BIOS SEN CAG page.
Dr Anna O’Connor hosted the penultimate session of the afternoon with an interactive talk looking at evidence based practice in the care of Orthoptic patients of SEN. The key themes were exploring Orthoptists views, identifying issues and sharing good practice. It was fascinating to learn of the different and varying methods we are all using to obtain an evidence base and to be able to share this with each other using such platforms as social media and the SEN CAG discussion board. This also created discussion about auditing Orthoptic services for patients with SEN with a view to publishing results.
Louise Allen co-chair of SEN CAG closed the meeting with an update from the SEN CAG which can be found on the Events and CAG page of the BIOS website. The impact of COVID-19 on assessment in special schools was discussed including the NHS England Special School Eye Service. Updates on research were given with the literature review ongoing and study looking into parental stress of SEN patients to hopefully commence soon. Continuation of evidence based practice and collaborative sharing is important in continuing to strive to provide excellent care and service for these patients. There are current vacancies on the steering group and so any additional contributions would be most welcome.
All presentations and Q&A session are available to view on the BIOS website.
Finally, a big thank you to all who joined our first virtual SEN CAG, it was a brilliant and informative meeting and feedback received has been extremely positive. We hope to be able to host more virtual meetings with a variety of speakers in the future and look forward to welcoming you then.
Best Wishes
Rachel Clarke
SEN CAG member
