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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 6, Lesson 3

Prevalence

The number of young children with visual impairments is relatively small. There are approximately 0.108 % of young children diagnosed with visual impairments. Of these, 3.5 % are unable to perform age appropriate activities. Children with unilateral blindness have vision in one eye, but must adjust their orientation and mobility to accommodate the loss of vision in one eye. This includes the loss of depth perception, as a bilateral visual system is needed for this. Infants and toddlers with severe visual impairment usually have other co-morbidities with other neurological conditions that will require a team approach to plan intervention and support with the family.

Causes

premature baby sleepingEmbryological causes of visual impairment can result in a coloboma (a cleft or defect in the normal continuity of a part of the eye) to major malformations or anophthalmia (absence of the eyes). Developmental interruptions in the fetal stage result in minor malformations. Infections during this period can cause cataracts, glaucoma, and/or chorioretinitis.

Vision can be affected by a premature birth. Retinopathy of prematurity or damage to the small blood vessels in the retina can result from the combination of prematurity and exposure to oxygen. The visual system is prone to imbalance during the early years and can be affected by muscle or cortical preference that can result in loss of visual function.

Problems such as that seen with amblyopia, (an asymmetric loss of vision due to the visual cortex not using the weaker eye as much as the dominant eye for vision), are seen in the first years of life. If amblyopia, sometimes called "lazy eye", is left untreated it can result in some field loss, poor or absent depth perception and possible blindness in the weak eye (Harrell, 1992; Levack, 1994).

Issues

mother and little girl playingAs noted in Lesson One and the opening vignette, families must cope with the loss of the dream of a perfectly developed infant and then plan for major life changes at the same time. When a child cannot see or has less than perfect vision, the family, as well as the child must learn and achieve coping skills. The ITDS should provide support accordingly. In addition, the infant and toddler must learn and achieve coping skills related to his or her developmental level. Plans of Care must always include emotional support as well as community supports that will build the future for the child. This can include services from a local Family Resource Specialist (FRS) through Early Steps and/or counseling services if requested.

Interventions

Treatment of eye problems may be medical and/or educational. Examples of medical treatment include medications, corrective lenses or eye patches. Surgery may also be required. Glaucoma may be treated both medically and surgically. Cataracts require surgical removal. The treatments for strabismus or muscle weakness include the conservative measures of patching the stronger eye and corrective glasses. Sometimes a more aggressive approach includes surgical correction. Retinopathy of prematurity requires frequent eye examinations. If retinal detachment is a risk then laser surgery is usually performed.

baby with glassesEducational treatment is a federal entitlement for all persons identified as blind or visually impaired. Services in the State of Florida are provided from birth or upon diagnosis. Infants and toddlers who have visual impairment will usually have slower motor skills attainment. If there is some vision, visual perceptual differences still remain. Language differences and an alteration in the development of social skills are also a concern.

 

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