University of Edinburgh

Development and Supportive Interventions for Babies and Young Children with Visual Impairment

Presented on Thursday, 11 November 2010

Impact of Vision on Development

Janis Sugden

The Human Eye

With the person sitting next to you fill in the diagram of the eye that you will find in your pack.

Notes: Take diagram of the eye and ask  the participants to complete this. 5 minutes
When this activity has been done. Show the participants completed diagram and then tell participants that we will come back to this.

What do we use vision for?

  • Gaining Information
  • Communication
  • Moving around

Notes: Think about this from your own perspective? Share your thoughts with the person next to you.
Now we will look at how a baby uses his /her vision. Think back to the presentation earlier this morning.
Vision is used to guide motor behaviour like catching a ball, picking uo a pencil etc.
To interpret space and time.
To integrate information from out other senses.
Vision allows us to see and process light information so we can identify what we see by where it is, how far away it is how big it is how fast it is moving what texture it is etc. We store this information for future retrieval to use again.

Awareness of the world, people and himself

"Interest in the world and in people is usually awakened through the eyes of a newborn baby and is reinforced by the visible joy of his parents in his responsiveness to them and his surroundings." page 1 "Show me what my friends can see" Patricia Sonsken and Blanche Stiff 1991


Blind and Visually impaired children can grow up to be productive fully functioning independent members of society.

We should have:

  • Normal expectations for their development
  • Exposure to healthy, positive attitudes
  • High quality training in the skills of blindness

A Skills definition of Blindness

Blindness means using alternative skills, methods and tools to get the job done

Notes: The key is skills. With the alternative skills of blindness, a child will be able to accomplish tasks without frustration and with success.

Effects of visual impairment on early development

  1. Cognitive development
  2. Language development
  3. Fine and gross motor development
  4. Social and emotional development
  5. Self-help and independence skills.

1. Cognitive Development

  • Cognitive development involves the development of thinking skills related to concepts, abstracts and mental representations
  • Early measures of cognitive development reflect the progression of motor skills sequences

3. Motor skills

  • Many motor skills are learned from imitation and visual stimulation to motivate activity
  • By three months vision is the lead modality
  • A child with little or no vision must learn to use other sensory modalities.

Notes: These range from simple to complex: from head to toe, from parts of the body towards the trunk, from parts of the body away from the trunk. From gross motor to fine motor

What can go wrong?

  • Ocular: Loss of visual acuity
  • Visual Field Loss
  • Cerebral or cortical visual impairment (CVI)

A visual problem can give rise to:

  • Less information coming in
  • Fewer facts on which to base judgement
  • Poorer quality information
  • Distorted picture of the world
  • Restriction on incidental learning
  • Risk of passivity
  • Need for intervention to ensure learner reaches their optimum potential.

Auditory Sense

  • The auditory sense is commonly considered the compensatory modality
  • The auditory system develops more slowly, so the blind child has a slower development scale to follow for learning about the environment.
  • But... in order to attend to a sensory input meaning must be assigned to it.

Notes: Blind children receive much auditory stimulation that is meaningless to them

Auditory Development

  • Reflexive responses to auditory development
  • Attention to auditory stimuli
  • Localisation of auditory stimuli
  • Discrimination of sounds (the child analyses and categorises)
  • Recognition of auditory stimuli (the child obtains meaning and associates)
  • Comprehension of auditory stimuli (The child understands verbalisations)
  • Hearing without vision provides incomplete information
  • Sound can motivate a child to move, can reinforce reaching and encourage them to keep trying
  • Auditory cues do not give substance to an object because there is no information that unites the tactile experience of touching the object to the sound

Tactile Sense

  • Tactile input is another compensatory modality
  • Tactile exploration takes longer because the learner often needs to feel an object repeatedly to obtain an accurate idea of what it is like. ( Even then minor details may be lost)

Notes: It should be stressed that this is very different to visual learning

Developing hand skills

  • Babies are able to grasp and manipulate objects; This helps them to develop ideas about objects, actions and three dimensional space
  • Blind children do not follow the same developmental sequence of manual activity as sighted children.
  • Visually impaired children generally maintain fisted hands when at rest
  • The mouth remains the primary organ of perception until well into the second year

Notes: Hands only give limited information about the world
Tactile exploration lacks a high degree of intentionality (Mike McClinden and Steve McCall Birmingham University) Appropriate intervention limits the risk of self stimulatory behaviour developing. Teaching systematic scanning of objects is one way of approaching this.

Object Permanence

  • "The basic understanding that an object exists whether it is seen or not"
  • Blind children usually lag behind sighted children by about a year; in sighted children it is normally fully developed by about 18 months

Notes: Visually impaired children should be encouraged to search for something that has been dropped. Auditory cueing can assist the child to develop object permanence but the child must be able to determine that the sound signifies that something exists with both tactile and acoustical properties.

Abstract thinking

  • Abstract thinking and the development of other complex concepts are observed in the pre-schooler.
  • In blind children there is generally a substantial delay in the formation of inner representational system that includes independent action and the behaviours of others.

Gathering information

  • Blind children often gather information from people in an attempt to substitute it for information that they cannot obtain visually.
  • Concepts are formed by the organisation of information into generalisations eg; all four-legged animals are dogs.
  • Visually impaired children's concepts are often based on non-visual sources.

Notes: eg; classifications occur when groups of objects are defined on the basis of similarities or differences Classifications for the blind child may be based on different modalities. This could lead the child to make inaccurate or limited categorisations.

What do blind children require?

  • Lots of hands on experience and verbal information to compensate
  • Mary Dallas will be talking about strategies that we can use in greater detail this afternoon.

Close by reading Page 9 of 'A Parent's Guide to Special Education for Children with Visual Impairments' edited by Susan LaVenture