This powerpoint has been created as part of my Postgraduate Diploma in Specialist Teaching. It summarises my research into the impact of vision impairment on children's sensory, motor, communication and cognitive development.
The Impact of a Vision Impairment on sensory, motor, communication and congitive development
The key impacts of visionimpairment on sensory, cognitiveand communication skillsdevelopment.
“All children are unique andchildren with visualimpairments are no differentin their…need for lovinghome environments that areboth stimulating andsupportive. However,perhaps more than any otherdisability, visual impairmenthas the potential to influencedramatically how childrendevelop.Whether it does and howmuch it does depends onparents‟ and teachers‟knowledge andunderstanding of thepotential impact of thePeterken, A (2011) Kaia,Auckland.
Development Theory & ResearchHistorically children with visual impairments were compared tosighted children who were developing typically. Prior to the1980s, it was felt that vision impaired children followed asimilar sequence of development as sighted children, jut at aslower pace and needed more assistance/time to develop skills(Cass, 1996).“More alike than different”Fraiberg‟s research (1960s/70s) concluded that VIchildren demonstrated developmental delays in that were“dependent or greatly influenced by vision such as motorskills, perception, concept development, spatialrelationships, auditory skills, tactile exploration and egodevelopment” (Ferrall, 2000, pp.120-121)
D.H. Warren disagreed with Fraiberg‟s „More alike thandifferent‟ theory and felt comparative studies were basedon faulty compatibility. Warren stated that they viewedthe child as “structurally incomplete” therefore educationwas also a “remedial therapy” that would replace themissing ability/aspect. Warren also states “It occurs butto few that a blind child is a complete mental andphysical whole, organised to function perfectly upon hislevel of sensory equipment (1984, p.50)More empirical evidence has been collected since then, toinform our understanding of the best way to optimise visuallyimpaired children‟s developmental sequence, rather than tryto force them to meet sighted milestones at the same paceand in the same order. The latest of this research is known as„Project Prism‟.
ProjectPrismAn American study, led by Kay Ferrell focusing on thequestion “Are there differences in the rate and sequence ofdevelopment of young children with visual impairments?”.Summary of Findings: Out of a total of 19 possiblemilestones, for VI children: 2 milestones delayed 5 milestones within the range of typical acquisition 2 milestones acquired early 7 milestones acquired in a different sequence 3 acquired later:– Searching for dropped object– Feeding bite‐size pieces– Crawling 3 or more feet
Overall outcome:Children without an additional disability develop within thenormal range of their sighted peers BUT they seem to belosing 1/10th of a month per month – theerefore reachingmilestones noticeably later after 2 years old.
NLP: No light perception (blind) LP: Light perceptionSLV: Severe low vision MLV: Moderate low vision
Sensory: (sen.so.ry)Adj. of or pertaining to the senses orsensationA sense is any ability that enables us toaccess stimuli from outside(exteroception) or inside our body(interoception).Impact on Sensory Development
Impact on Sensory DevelopmentFerrell states that children with a vision impairment learndifferently because they cannot rely on their visualinformation, therefore the information they obtain is from othersenses which may be:• inconsistent - things don‟t always make a noise or odour• fragmented - comes in bits and pieces• passive -not under the child‟s control). It takes practice,training and time to sort this out (2000, p.122)That being said, the ability to utilise other senses in a moreefficient way, may cause cortical reorganisation, wherebycertain brain structures which could be left otherwise „unused‟because of lack of visual input, become recruited to processauditory/tactual information. In this way, blind/VI childrenreally do „think‟ differently to their sighted peers.
Auditory SensesHearing is the only distance sense available to a blind infant,but the child has no control over the presence/absence ofsound.Dottie Bridge from the Blind Babies Foundation states thatblind babies rely on their auditory information, if you speak tothem, they don‟t reach for you – they “get quiet and still, theyreach for you with their ears, not their hands until you teachthem otherwise” (CNIB, n.d). It is not until a blind child isaround 12 months that they will reach for an object based ona sound cue alone (Strickling, 2010 )The auditory sense is commonly considered the maincompensatory modality for vision loss. The auditory systemdevelops more slowly than vision, therefore, the blind childhas a slower development scale to follow for learning about
Sound only acquires meaning after much tactual, motor andauditory interaction – only then can sound provide informationabout location , cause or source. See the clip of Lucas below,to witness how sound can be harnessed for navigation andidentification purposes („echolocation‟).
TactileSenses:Tactile explorationis anothercompensatorymodality whichtakes longer todevelop thanvision. This isbecause thelearner oftenneeds to feel anobject repeatedlyto obtain anaccurate idea ofwhat it is like.Certain objects will be inevitably inaccessible for Blindchildren as they need to be „observed‟, such as the sun ormoon; others are too big to perceive in full such mountains ortoo small such as fleas. Some are simply too fragile to touchsuch as soap bubbles. These need to be taught conceptually
Learning about the Moon – usingtactile imageryThe sense of the enormity,texture and distance is difficult(near impossible) to conveywhen using tactile imagery tolearn about the Moon.
Cognitive: (cog.ni.tive)Adj. of or pertaining to the act or processof knowing, perceiving, remembering etcImpact on Cognitive Development
Impact on CognitiveDevelopment Vision facilitates cognitive development – “vision is relatedto the development of concepts, abstractions and mentalrepresentations that are difficult to form without visualmemory” (Ferrell, 2000,p.129) Ferrall states that “cognitive-transactional theory holds thatdevelopment occurs through a combination of forces:biological maturation, physical experiences and socialinteraction” (2000, p.113). This is particularly true in visionimpaired children, who need time, physical experiences andoften direct teaching to understand the world around them.
• Blind children often cannotgrasp the concept of objectpermanence until they are ableto reach for objects based onsound cues alone (after theage of 12 months).• They also find it difficult tounderstand the concept ofcausality, as they cannot seethe results of their actions.• Classification is equallydifficult for blind children –they have limited opportunitiesto explore objects and look forsimilarities/differences whichare not based on size ortexture (Strickling, 2010)An egg byany othername…Blindchildrenneed to betaught thatthe imagesleft are all„eggs‟,despitetheirdifferenttexture,size,sound etc.
Therefore, when teaching blind or visually impairedstudents, it is important to consider the following:• Concepts must build upon each other, and begin bybeing based upon something tangible, that a child cantouch/smell/taste/hear etc.• Repeated experiences are best for teaching concepts e.gturn taking• It is important to remember that self-concepts and socialconcepts need direct experiential teaching just the sameas maths/science concepts do.• Relate concepts to day to day activities/daily life to makeit meaningful and allow links/comparisons to occur andbe reinforced.
"What colour is the wind?”, “Does a stone look the way itfeels?”, “I know how fish swim, but how do they walk?”, “I thinkI know what it’s like to see: It’s like telling the future becauseyou know now that there will be a tree and I will know later,when I come up to it and touch it” – all of these questions andremarks strike a sighted person as unusual. But for blindchildren they are a normal way of expressing interest in theinvisible world which surrounds them…These questions andcomments are also an attempt to place that vast outer spacestretching beyond the fingertips, within some logical,manageable structure which could help understand suchmysteries as the fact that a toy released from one’s grip doesnot disappear for ever but continues to exist; that a child canresemble an adult, even an old person with a wrinkled face andrough hands; that a sighted person canrecognise friends on a smooth, slipperypiece of paper called “a photograph”, andthat sighted people can see tall trees,houses and mountains through a small
Chart showingrecommendedcognitivedevelopment forblind and visuallyimpaired babies andchildren – note thatitems which wouldbe assisted heavilyby vision (egmatches objects)occur at a later agethan for the averagesighted child.(Bobnar, 2012)
Communication: (com.mu.ni.ca.tion)Noun. 1. The act or process ofcommunicating2. The imparting, or interchange of thoughts,opinions, or information by speech, writing orsigns.Impact onCommunication/LanguageDevelopment
We learn to communicate by making associations betweenone thing and another. One of the “most seriousconsequences of sensory deprivation in the young child isthat of communication” (Pagliano, 2013). The frequency oflanguage disorders amongst pre-schoolers who are visuallyimpaired has been reported to be over 80% compared to lessthan 25% among sighted peers. This is possible because blindchildren must depend on accoustic imitation to learn speechbecause they cannot observe the muscular movements thataccompany articulation.Vision provides an incentive for communication - Fraibergfound that vision impaired babies lacked the “exclusive smilefor their parents which is characteristic of normally developingsighted infants. However they did exhibit an „alternative‟preferential behaviour which is not part of the repertoire ofsighted babies, namely frequent manual exploration ofparent‟s faces.” (Cass, 1996)
Dunlea suggests that a blind child may jabber/imitate soonerthan a sighted child, but may show delay when combiningwords to make its wants known – this is because they may notgrasp the meaning of the words or repeat memorisedphrases/words out of context („echolalia‟) (1989, p.14).Strickland states “the early language of the blind child doesnot seem to mirror his developing knowledge of the world, butrather his knowledge of the language of others (2010). Thebest example of this is the uses of „verbalisms‟, e.g studentstalking of „red‟ roses or „twinkling‟ stars to describe things thatthey cannot see (Dunlea, 1989, p.15).
A lot of communication is non-linguistic, but shownthrough facial expressions and body language.Congenitally blind children are not aware of thereactions from others to their own body languageunless they are specificially taught.Visually impaired children may instead, be moreaware of auditory clues in conversations (much likesighted people reading body language), however,may are not able to correctly identify the impliedmeaning, without life experience and an ability toplace it within a holistic context (Gunaratne, 2002)
Motor (Mo.tor)adj. 1. Causing or producing motion2. Of or being nerves that carry impulsesform the nerve centers to the muscles3. Involving or relating to movements ofmusclesImpact on Motor Development
Impact on Fine & Gross MotorDevelopment“Blind children can learn to walk just as soon as seeing ones, only theyhave to be led around in the beginning more frequently than the others”– Kleig 1836 (Ferrell, 2013).“For the blind child…it is important that he/she can feel safe whenmoving around. Then the child dares to be more active and by thatlearn more” – Schneekloth 1989 (Fjeldsenden, 2000)“[Blind] children experienced extreme developmental delays in theacquisition of manual skills and a high degree of variability indevelopmental delays within and across six categories of fine-motorskills (Brambing, 2007, p.212)
Impact on Motor DevelopmentVision (and perception of colours/patterns/shapes) givesreason for movement – usually children see somethinginteresting and move towards it, this is not a motivator forvisually impaired children.Vision gives an estimation of space, locating obstacles withoutmoving. This is not an option for children with a visionimpairment, therefore they find moving into the unknown muchmore scary/daunting. This results in a longer delay betweencrawling and walking.Vision stimulates co-ordination and control. Infant‟s vision isinitially reflexive but over time vision allows infants to monitorand co-ordinate their movements, becoming more aware oftheir body parts from visual cues given when watchingparents/siblings move. Blind children often develop awide/awkward gait with poor posture. They need to be taught
Vision gives meaning to movement – when they reach for a toy,vision allows them to learn how far and what direction to extendtheir arms and make adjustments.VI and blind children may have lowmuscle tone, decreased movementtolerance and poor balance. Even at 5months and onwards, many childrenmaintain fisted hands, held atshoulder height when at rest and willuse their feet as an additional sensorytool for a protracted period whichaffects walking/movement. The mouth remainsthe primary organ of perception until well intotheir second year (Sugden, 2010).
Blind children often do not follow the same developmentsequence of manual activity as sighted children. They mayneed specific assistance to develop prehensile patterns(grasp, reach, release, carry, support etc.) rather than theirpreference for non-prehensile movements (tap, push, pat,shake etc.)Impacts on functional use as the child grows• Without vision, the hand and eye do not work together;instead ear-hand co-ordination must occur. This onlyhappens after lots of experience and is achieved later in life.This has implications on playing physical games with otherchildren, completing both gross and motor skills tasks andmore.
Cane holding andusage may becomeawkward due toweaker wristextension, poorwrist rotation andreduced ability tomaintain a strong,effective grasp ofthe cane (Andrew,2013).Of course itdoesn‟t have to beall doom andgloom, there are many examples of visually impaired studentswho can go on to achieve fantastic things, such as Americangymnast Aimee Walker Pond .
Works Cited:Andrew, J. and Ritzema, G. (2013) Underneath the Arches: The importance ofweight bearing through hands and feet for blind children [powerpoint slides].Paper presented at „Weaving the mat: Strength through connection‟ 2013Biennial Conference of the South Pacific Educations in Vision Impairment, 13-18 January. Rendezvous Hotel, Auckland NZ.Bobnar, A. (2012) Development Charts for Blind and Visually Impaired Babiesand Children. Retrieved on 24.04.13 fromhttp://www.wonderbaby.org/articles/development-charts#cognitive.Brambring, M. (2007) Divergent Divelopment f Manual Skills in Children whoare Blind or Sighted. Journal of Visual Impariment * Blindness, April 2007,101(4), 212-225. Retrieved fromhttp://web.ebscohost.com.ezproxy.massey.ac.nz/ehost/detail?sid=064e73b8-4618-4563-a55a-ffd0e2e69339%40sessionmgr104&vid=1&hid=123&bdata=JkF1dGhUeXBlPWlwLGNvb2tpZSx1cmwsdWlkJnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=aph&AN=25057007Canadian National Institute for the Blind (n.d) The Impact of Vision Loss on theDevelopment of Children from Birth to 12 years: A Literature Review. Retrievedon 24.04.13 from
Cass, H. (1996, March 27). Visual Impairment and Autism - What we knowabout causation and early identification. Retrieved April 02, 2013, fromScottish Sensory Center:http://www.ssc.education.ed.ac.uk/resources/vi&multi/hcass96.htmlDunlea, A. (1989) Vision and the Emergence of Meaning: Blind and SightedChildren‟s Early Language, Cambridge, England, Cambridge University PressFjeldsenden, B., (2000) Blindness and Cognitive Structures. Retrieved on23.04.13 fromhttp://www.sv.ntnu.no/psy/bjarne.fjeldsenden/Articles/CognitionandBlindness.htmFerrell, K.A (2000) Growth and Development of Young Children, in HolbrookM.C and Koenig, A.J. (2000) Foundations of Education. Volume 1 History andtheory of Teaching Children and Youths with Visual Impairments, New York,AFB Press.Ferrell, K. A (2013 January).Weaving the Mat: Longitutdinal Study ofDevelopment of Children with Visual Impairment [Powerpoint slides]. Paperpresented at „Weaving the mat: Strength through connection‟ 2013 BiennialConference of the South Pacific Educators in Vision Impairment, 13-18January, 2013. Rendezvous Hotel, Auckland, NZ.
Gunaratne, L.A. (2002) Visual Impairment: Its effect on cognitive development andbehaviour. Retrieved from Understanding Intellectual Disability and Health on24.04.13. http://www.intellectualdisability.info/physical-health/visual-impairment-its-effect-on-cognitive-development-and-behaviour.LandisCom (2009) Blind Babies Foundation – KGO TV [video file]. Retrieved on24.04.13 from http://www.youtube.com/watch?v=kmvWwRTwNpQMarek, B (2000) Does a stone look the way it feels. Introducing tactile graphics,spatial relations and visual concepts ot congenitaly blind children. Paperpresented at the European ICEVI Conference, Cracow 9-13 July 2000. Retrievedfrom http://www.hungryfingers.com/stone.htmlPagliano, P. (2013 January). Strength through connection: Multisensorystimulation as communication. Paper presented at „Weaving the mat: Strengththrough connection‟ 2013 Biennial Conference of the South Pacific Educators inVision Impairment, 13-18 January, 2013. Rendezvous Hotel, Auckland, NZ.Strickling , C. (Oct 2010) Impact of Visual Impairment on Development. Retrievedfrom Texas School For the Blind on 22.04.13 http://www.tsbvi.edu/infants/3293-the-impact-of-visual-impairment-on-develop
Sugden, J. (Nov 2010) Development and Supportive Interventions forBabies and Young Children with Visual Impairment. Retrieved on 24.04.13from http://www.ssc.education.ed.ac.uk/courses/vi&multi/vnov10ii.html.Pagliano, P. (2013 January). Strength through connection: Multisensorystimulation as communication. Paper presented at „Weaving the mat:Strength through connection‟ 2013 Biennial Conference of the South PacificEducators in Vision Impairment, 13-18 January, 2013. Rendezvous Hotel,Auckland, NZ.Warren, D.H., (1984) Blindness and children: An individual differencesapproach, Cambridge, England, Cambridge University Press.