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Introduction Rehabilitation can improve visual outcomes for adults with acquired homonymous visual field loss. It is unclear, however, whether rehabilitation improves visual outcomes for children because previous training schedules have been tiresome, uninteresting, and have failed to keep them engaged. In this study, we assessed whether children and young people with homonymous visual field loss would adhere to six weeks of unsupervised compensatory training using a specialized video game. Methods Participants aged between 7 and 25 years with homonymous visual field loss completed tabletop assessments of visual search across four site visits. Two baseline assessments separated by four weeks evaluated spontaneous improvements before training began. Participants were then given a copy of the video game to use unsupervised at home for six weeks. Two follow-up assessments separated by four weeks were then conducted to evaluate immediate and acutely maintained effects of training. Results Fifteen candidates met the inclusion-exclusion criteria, nine participated, and eight completed the study. Participants completed an average of 5.6 hours of unsupervised training over the six weeks. Improvements on in-game metrics plateaued during week three of training. The time taken to find objects during tabletop activities improved by an average of 24%–95% CI (2%, 46%)—after training. Discussion The findings demonstrate that children and young people with homonymous visual field loss will engage with gamified compensatory training, and it can improve visual outcomes with less of a time commitment than has been required of adults participating in non-gamified training in previous studies. Appropriately powered, randomized controlled trials are required to evaluate the validity and generalizability of observed training effects. Implications for practitioners Rehabilitation specialists can use specialist video games and gamification technique to engage children and young people with homonymous visual field loss in long-term unsupervised training schedules.

The following article discusses the importance of mobility training for children and describes the comprehensive programme employed at The West of England School, Exeter. It brings out the present inadequacy of mobility provision in some mainstream schools and emphasises the need for more mobility officers trained to work with children.Visually impaired children need the support of a programmed course of mobility instruction throughout their school years in order to develop as competent independent travellers and interpreters of their environment. This is not to suggest that they will require regular mobility sessions from the time they start school to the day they leave -that would be impracticable and unnecessary.Mobility training for an adult can usually be packaged into a time period which suits both client and instructor. During this period of training adult learners will, in most cases, be able to assimilate all of the skills that are required in order to meet their own personal objectives. This scenario is incompatible, however, with the nature of mobility training for children. It would be impossible to teach visually impaired children the full range of available mobility skills and techniques at any one point in their development. Children must be introduced to and trained in skills that are appropriate to their maturity, ability and needs at various developmental stages. A mobility programme for children will not then have a clearly defined starting or finishing point. Instead, it should be seen as an ongoing process of assessment, appropriate training, monitoring and evaluation.The other main characteristic of a mobility programme for children is that it should be skills-orientated and not designed merely in response to specific personal requirements. Doris Tooze (1981) cites an example that demonstrates the difference between the route-learning approach frequently used in the teaching of adults and the skillsbased approach that is so valuable and necessary when working with children. She describes mobility lessons given at a railway station. These sessions for an adult will be primarily a preparation for a future independent journey by train. For a child this same setting can be used to teach and reinforce a whole range of mobility, sensory and social skills regardless of whether or not the child will ever reach a high level of independent mobility. There is always a danger, especially with children, that the skills and techniques taught will be associated exclusively with the context in which they were learned, hence the limitation of a route-learning based programme.It t is important that children are encouraged to see their skills as tools which when employed appropriately will give them safe access to the world around them. The ability to transfer skills from one setting to another is fundamental to successful independent mobility.There are many factors involved in the debate concerning the education of visually impaired children in a special school, but with regard to mobility training a special ...