Following are a number of commonly encountered developmental areas concerning visually impaired pre-schoolers. Not every child will experience them and some also to a lesser degree than others. They are nevertheless worthy of note.

INFORMATION ACCESSED THROUGH SIGHT

It is estimated that a very high percentage of information is accessed through sight. A huge amount is also learned through incidental learning via sight. Incidental learning represents an important foundation for more formal learning later.

Through sight, your child is informed about,

• Her or him self
• The environment
• Relationship to the environment
• Others

FULLY SIGHTED COMPARED TO CHILDREN VISUALLY IMPAIRED

When comparing a fully sighted child with one visually impaired four developmental areas are highlighted,

• Social and emotional development
• Language development
• Cognitive development

And, the development of,

• Independent travel skills (movement, mobility and orientation)

Singly or in combination they will impact on your child’s potential to learn. Development in these areas should therefore be monitored and where necessary addressed. Here your child’s low vision may require support.

Following are a few examples about where professional advice and intervention may be necessary in relation to the four bullet points above.

CHILD PARENT RELATIONSHIP

The child parent relationship may be affected through misunderstanding the visual impairment and its effects. The behaviour of a sighted baby acts as a trigger for an affectionate response. This may be missing in a visually impaired baby; for example, parents may misinterpret a blind baby’s expressionless face as reflecting,

• Rejection
• Lack of interest

It may be necessary therefore to point out that the child communicates in different ways.

IGNORED IN A PLAYGROUP

Children learn to cooperate partly by observing each other’s play and making eye contact. Through not engaging in eye contact or unable to see what other children are doing the visually impaired child might be ignored and not invited in. This cooperation must therefore be staged and managed by a specialist who knows about the child’s needs.

TURN TAKING

When children play together it often involves turn taking with toys. However, a child with low vision may not appreciate that a toy continues to exist when it leaves her or his hand. Consequently, a verbal commentary will be necessary to enable the child to make sense of what is happening.

SUSTAINING SOCIAL RELATIONSHIPS

As a child becomes older s/he needs the skills to initiate and sustain social relationships. If body language for example doesn’t conform to that of peers s/he might find socialising difficult.

The very fine nuances of body language which are observed and interpreted by children with sight may contrast significantly with the body language of some visually impaired children.

MANERISMS AND LOW VISION

Some children find it very difficult losing mannerisms started in early childhood; for example,

• Hand flapping
• Eye pocking
• Rocking

Input from a specialist in low vision can help diminish these mannerisms. The need to constantly shout ‘don’t do that’ for example, can be avoided by,

• Behaviour modification
• Positive reinforcement of good behaviour

LANGUAGE DEVELOPMENT

There is evidence of differences in the language development in those with low vision. Like the fully sighted child the severely sight impaired child without other disabilities begins (these are approximates),

• Vocalising at eight weeks
• Squeals with pleasure and ‘talks’ when spoken to at twelve weeks
• Says syllables ‘ba/ka/da’ at twenty eight weeks
• May say one word with meaning and imitate sounds at forty eight weeks
• May have two or three meaningful words by one year

After this stage the severely visually impaired child’s language development slows. This occurs with other developmental stages delayed too.

Fully sighted children along with the child with low vision may frequently repeat the first words without understanding them. However, this may happen in a visually impaired child for longer.

Along with fully sighed children the severely sight impaired child learns at an early age to distinguish voices. However, a voice from an unfamiliar person may come from the unknown and return to the unknown. This can mean the blind child remaining dependent on the initiative of others. Consequently, specific strategies to encourage and consolidate interaction may once again be required.

COGNITIVE DEVELOPMENT

Low vision can impose limitations on the development of cognitive skills. This might occur through a limited,

• Range and variety of experiences
• Ability to move about
• Opportunity to interact with the environment

Because the other senses cannot process information as efficiently as vision facts about someone or something are missed. There is no other sense that provides so much as quickly. This can lead to reduced cognitive skills.

However, there is no firm evidence indicating limitations will necessarily restrict potential. Research suggests that in general, average IQ scores do not differ significantly between severely sight impaired and fully sighted children.

MOTOR DEVELOPMENT, MOBILITY AND ORIENTATION

The development of orientation and mobility skills are inextricably linked to the early development of movement. Severely sight impaired children who have not been given adequate opportunities are often delayed in the development of motor skills. They may for example,

• Be poorly coordinated

And,

• Walk in an insecure and idiosyncratic way

Children with low vision cannot easily monitor their movement. They may have difficulty understanding what happens when,

• Moving
• Stretching
• Bending
• Rolling-over

If unable to clearly see others they will have fewer terms of reference and may not for example realise what sitting up means.

With low vision children may experience difficulty when creating a mental map of their world too. Without appropriate support s/he may not know,

• In which direction to go
• How to find her or his way
• Avoid obstacles

Uncertainties about surrounds may also undermine confidence and with it a desire to explore.

Low vision may as a consequence reduce motivation; for example, why attempt to crawl across a room without being able to see a reason for moving?

Children visually impaired typically show delay in motor development and movement. It has been established that this begins at about six to eight months and continues throughout pre-school years. Then, at the age of five research further indicates a child visually impaired is on average twelve months behind fully sighted peers.

In order to develop independent travel techniques children with low vision therefore need specialist intervention from a very early age. This is necessary to promote,

• Motor development
• Coordinated and purposeful movement

As the child develops s/he will then require a specific, quantifiable and structured programme to teach independent travel techniques.

MAXIMISING VISION

The maximising ofvision may also require specialist advice. Depending on the type and severity of impairment a child may have difficulty developing visual skills such as,

• Fixation
• Tracking
• Focusing
• Accommodation
• Convergence

AGE APPROPRIATE INDEPENDENCE AND SELF-HELP SKILLS

Parents may also require advice in relation to low vision and,

• Toilet training
• Sleep
• Dressing
• Eating
• The use of precise language when talking to the child
• Adaptations to the home environment

Too often professional advice and developmental support during early years is unavailable. The author is aware of this. Consequently, along with MANAGING THE NOISE, from which this extract is taken, two other books in a trilogy, INNOCENCE AND EXPERIENCE and PITTER PATTER address this crucial area extensively. They are written in accessible language and offer practical exercises and strategies to help you deliver learning.