University of Edinburgh

Early Years: Working with visually impaired children

Presented on Wednesday 2 December 2009

Visual Impairment, early years
Gathering information by assessment of functional vision

Alison Duthie

General developmental milestones

Vision for what? For Doing.

"Vision for Doing" (Aitken and Buultjens) Stages of visual function:

  • Awareness,
  • attention,
  • localising,
  • recognising,
  • understanding.  ("Vision for Doing" pp39-43)


  • Blinds open/shut. Lights on/off  Torches.  
  • Signs of awareness; agitation stilling?
  • Stimulation of vision and maturation of vision


Attention: still a subjective judgement "You know it when you see it"

  • increased stilling or raising of limbs.
  • Vocalisation.

"Little Room"

little room


  • Localising: turning to stimulus? Reaching? Dark room with light stimulation, therefore difficult to film.  
  • Blind child may not turn.  Why would they?
  • Importance of development of swiping to reaching.
  • Binocular function and 3D vision


  • Begin to involve the 'library' of images in the ventral stream.
  • Comparing and discarding images.


  • Understanding: concept formation over prolonged period.
  • Repetition of experience.
  • Reduced incidental learning: implications for carers. (DLA applications)

Vision for...

1. Bonding:

Can baby see his mother's smile?

  • Contrast sensitivity
  • Distance acuity: masks, make up

Can he see to imitate her expression or movements? How far away? (long sight in babies)

2. Movement

Can he see things beyond his reach? If not, how will you motivate him to want to move?

Can he see

  • Moving things
  • Stationary things when he is moving?
  • Assessment strategies: bubbles, cars, fixing and tracking toys, observation of him watching mother/cat?

Working with the physiotherapist

  • On tummy, head up
  • Rolling
  • Crawling

Getting going:

  • Confidence
  • Judging slopes and steps
  • Speed and distance
  • Vision in poor light
  • Assessment may then be mostly by observation and report from family

Edges of doors: acuity/contrast/3D vision

3. Communication

  • Can he wave to Granny as she approaches the house? 
    Tinsel wig, mask, silly faces
  • See your mouth as you speak?
  • Hear distinct sounds?
  • Share a story book? 
    Observation, attention
  • Imitate?

4. Shared gaze

Importance of shared gaze for

  • Bonding,
  • Language
  • Concept formation
    Distance/close vision
  • If his world exists only within his reach, what are the implications?

5. Life skills

  • Feeding
    Fields of vision
  • Feeding bottle in sparkly wrapping
  • White tray, coloured plate, contrast with food

Assessment tools

See additional sheet


S Aitken and M Buultjens, 1992  "Vision for Doing" Moray House Publications

Sonksen and Stiff "Show me what my friends can see" 1999  Institute of Child Health

Developmental Journal DfES 2007

The Oregon Project Jackson County Education 1978 (available form JAG Enterprises ltd.)