Children with visual impairments

Question 1

Typical visual development

Answer 1

3 months
-lying supine
-bringing hands to midline
-beginning of color vision

6 months
-rolling
-reaching
-grasping
-close to normal adult vision

-increase in color and depth perception over time
-able to see increase in visual delay at 3 month mark and widening of delay at 6 months

Question 2

Role of vision in early development

Answer 2

Vision is the primary driver of movement

Lack of vision results in limited self- initiated movement

Limited integration and calibration of other sensory systems

Absence or impairment of vision can lead to delays in motor skill
development that persists into childhood

Question 3

Causes of VI in children

Answer 3

-75% of those with VI also have neuro or developmental disability

-cortical visual impairment (18%)
-optic nerve hypoplasia 15%
-retinopathy of prematurity (ROP)

Question 4

Cortical visual impairment

Answer 4

-brain can’t interpret what’s being seen

-neurologic insult with visual impairment and *normal ocular exam

-variable level of visual impairment with potential for improvement

Question 5

Optic nerve hypoplasia

Answer 5

-diminished axons within the optic nerve

-associated with neuro and endocrine disorders

-variable level of visual impairment, stable and non-progressive

-underdeveloped optic nerve –> depressed visual field, cetnral, or peripheral vision

Question 6

Retinopathy of prematurity

Answer 6

• Retina converts visual
  information to electrical signals
  for the brain to interpret

-associated with prematurity and low birth weight (underdeveloped countries)

-variable level of visual impairments with several medical management options to treat

-often limited central vision and depth perception

-scar tissue around or detachment of the retina (scar tissue due to hemorrhage or ischemia)

** surgery possible

Question 7

Team for children with VI

Answer 7

opthalmologist

optometrist

orientation and mobility specialists and/or certified low-vision therapist
–> how to navigate cross walk or board a bus (often teachers)

occupational therapist

Question 8

Visual strategies

Answer 8

Environmental
-reduce distraction
-try a private room
-simple colors
-shrink space

Lighting
-dim
-change the light source to encourage movement

Positioning
-place things in the periphery (often have better peripheral vision)
-see where they are turning their head

Toys/Tasks
-try things that incorporate multiple senses
-brightly colored and highly contrasted with a background
-encourage play/motivation

Timing
-increase timing, allow time for visual latency
-increase repetition
-balance of success and failure

Question 9

Sensory and movement strategies for children with visual impairment

Answer 9

-incorporate multiple senses/sensory systems –> Increase sensory input

-be mindful of other sensory systems involved in the task/environment
–> put your hand under their hand when exploring new environments to reduce anxiety

-supportive positioning
–> Decrease cognitive energy needed to maintain an upright posture