University of Edinburgh

Prematurity and Vision

Friday 3 March 2006

Mairi Graham, VTSS Edinburgh

Two Case Studies

Case Study 1
S, aged 12, born prematurely at 26 weeks has a visual impairment, retinopathy of prematurity and amblyopia.  His difficulties are related to early developmental delay. Aged 8 he performed most of the assessment tasks at a 4-5 year-old level indicating considerable social and emotional immaturity and a short attention span.  His speech patterns were also very immature. His fine motor control was also underdeveloped.

S has benefited from considerable support for his maths and language also has had motor skills development over several years too. Speech therapists also worked with him in the infant school to great effect.

He is a friendly, happy and sociable boy no longer showing any of the signs of previous speech delay and he is now included in the work of his mainstream class apart from maths and language work which he works at in the learning base. His language and maths remains significantly behind that of most of his peers as he is operating at level A.

His visual impairment does not significantly impact on his learning and as a result VTVI involvement has been recently minimal with the Support for Learning approaches demonstrating what we would consider best practice common to both Visual Impairment and Specific Learning Difficulties.

A recent report highlights his insecurity in unfamiliar surroundings and he appears to have little sense of danger and wanders away when on school outings.

He is about to go to secondary school.

What are the next steps?

Case Study 2

C is now in her final year at Secondary school.

Due to extreme prematurity and a very complicated neonatal period, she started school attending only 2 hours a day. She has reduced vision and nystagmus and has learning difficulties.

Against all the odds she began to thrive and before leaving Primary school she was a fluent reader achieving level B reading and writing. Her fine motor control and handwriting were good. Maths concepts however were and remain a challenge.

The main difficulty lies with her distance vision and she became quite disorientated out in the playground. Although living less than 150 metres from the school, C had never been able to come to school alone. It was difficult to establish whether this was due to an overprotective family group or after intensive mobility training; whether this was rather the result of some kind of topographical agnosia. The techniques of repetition and rote learning, successful in literacy, were also applied here with more limited success. This became the major challenge as she moved to a mainstream secondary where she has slowly learned to find her way from class to class. She is still unable to make the decision for herself to cross the road. She is unable also to make the decision to finish a task and will seldom initiate conversations.

At Secondary school she has made some strong friendships, achieved several National Assessment Awards and spent much of the past two years working through a life skills programme.

C has just completed a very successful work placement as a waitress and is now considering college.

What are the next steps?