University of Edinburgh
 

Visual Impairment Scotland Research

Low Vision Aid use in Children

Blaikie AJ, Ravenscroft J, Buultjens M, Dutton GN, Visual Impairment Scotland Research Group

Royal College of Ophthalmologists Congress
Birmingham, May 2003

Purpose

The developmental and educational benefits of low vision aid (LVA) use in childhood are great(1). There is however no coherent national framework for the funding and provision of low vision aids to children in Scotland(2,3). Policy and practice varies from area to area. For parents and policy makers alike it can be unclear whether health, education, social services, voluntary organisations or high street optometrists are responsible for provision. As a consequence LVA service provision can be fragmented and haphazard(4).

Methods

The electronic database of Visual Impairment Scotland’s (VIS) childhood notification system (5) was analysed. Information on the education and health of children was acquired from parents, educational institutions and health professionals.

Results

Frequency of LVA Use

table1

Less than half the children with significant visual impairment were reported to use a LVA by either their parents (40%) or teacher (42%).

figure1

Some children’s (12%) parents reported they were using a LVA where their teacher did not. Similarly there were a few (9%) reported by their teacher to be using a LVA at school but seemingly not at home.

Age Group

Figure 2 describes the percentage of children reported to be using LVAs by their parents by age group.

Only one preschool child was reported to be using a LVA. Throughout primary school years LVA use rises steeply peaking at 74% (14/19) of children between 9 and 10 years of age. Use then drops during transition to secondary school period dipping to 33% of the 11 to 12 year olds. The percentage of children using LVAs then rises steeply again and plateaus at an average of 72% (23/32) between the ages of 13 to 16 years.

Visual Acuity Groups

As visual acuity becomes poorer a greater percentage of children are reported to use LVAs. This trend dips in the poorest visual acuity group.

figure3

Additional Disabilities

Children with no additional disabilities are more likely (58%) to be reported to be using a LVA compared to children with additional disabilities (21%).

table2

It is surprising that 42% of children with visual impairment and no additional disabilities are not using a LVA.

Educational Placement

Only one preschool child and two children in special schools were reported to be using using a LVA.

table3

Only 56% of children in mainstream education with visual impairment were reported by their teachers to be using a LVA.

Types of LVAs used as Reported by Teachers

A wide variety of LVAs were employed in school. The most common was a hand held magnifier (81%). Other forms of ‘near sphere’ LVAs were employed such as CCTV (30%), desktop magnifiers (17%) and spectacle mounted magnifiers (8%). These other forms of LVA were however much less commonly used compared to hand held devices.

figure4

Only a minority of children were reported to be using distance aids in school, such as telescopes (27%) and binoculars (5%).

Conclusions

The overall use of LVAs amongst mainstream school age children on the VIS database is surprisingly low (56%). There is also evidence of inconsistent use between home and school and during transition from primary to secondary school. Children of a developmental age of 2 to 3 years can be effectively taught to use LVAs(6) however only 1 of 31 pre-school children use one. LVA use is also uncommon (21%) in children with additional disabilities despite the development of effective practice guidelines(7,8). Distance LVAs are as important to the developmental and educational needs of children as near devices (9,10). The use of distance devices was however relatively uncommon (27%) compared to near aids (81%).

Cross-discipline VI assessment teams (11) with integrated budgets and coherent service delivery are recommended to improve LVA use in the the key groups of children identified in this study.

References:

1. Wilkinson ME, Stewart IW, Trantham CS Iowa's pediatric low-vision services J Am Optom Assoc 2000 Jan;71(1):40-8
2. Social Work Inspectorate ‘Sensing Progress’, Social Work Services for People with a Sensory Impairment The Scottish Office: September 1999
3. Certification and Registration Working Group Social Work Services for People with a Sensory Impairment The Scottish Office: May 2001
4. Mason, HL The Use of Low Vision Aids in Mainstream Schools by Pupils with a Visual Impairment, Report to the Viscount Nuffield Auxilliary Fund University of Birmingham, 1998
5. http://www.viscotland.org.uk/ (now defunct)
6. Sonksen PM, Petrie A, Drew KJ. Promotion of visual development of severely visually impaired babies: evaluation of a developmentally based programme. Dev Med Child Neurol Apr 1991;33(4):320-35
7. McLinden, M., Douglas, G., Arter, C., McCall, S. (2001). Developing effective practice in the use of low vision aids for children with multiple disabilities and a visual impairment. Final Report to the Viscount Nuffield Auxiliary Fund. Birmingham: University of Birmingham
8. Mason, HL (1998) Guidelines for teachers and parents of young people with a visual impairment using LVAs. University of Birmingham.
9. H Minto Use Of Low Cost Telescopes In Visual Rehabilitation In Children, The 7th International Conference on Low Vision Activity and Participation July 2002, Göteborg, Sweden
10. D J Lapolice The Use Of Telescopic Devices With Young Visually Impaired Children The 7th International Conference on Low Vision Activity and Participation, July 2002, Göteborg, Sweden
11. A J Blaikie, M Campbell, G Coyle, E Lymburn, M Comerford, M Buultjens, GN Dutton Introduction of a multi-disciplinary community vision assessment team The 7th International Conference on Low Vision Activity and Participation July 2002, Göteborg, Sweden

John Ravenscroft
Manager
VI Scotland, SSC