Visual Impairment in Children: Identifying Causes, Signs & Symptoms and Learning How To Support Them
Visual impairment in children is a term used to describe a functional loss of vision either fully or partially. With a partial vision, the child may not have lost their sight completely but it so bad that they have to stand very close to an object to see while someone else with perfect vision can stand afar off and see it.
Children with visual impairment or eye health problems may experience challenges in various aspects of their life and can affect areas such as learning at school, being able to do things themselves and even exclusion in various social activities with other children.
Studies have shown that between 5 -25% of preschoolers and school-aged children have vision problems. Detecting a child's vision defects early can be crucial because children respond to treatment more when problems are diagnosed early.
Common Types of Visual Impairment in Children
There are various conditions that lead to visual impairments in children, some are inherited while others are developed as the child grows.
Although some of these conditions have no cure and may be untreatable, as a result of damage to one or more parts of the eye or brain that need to process images, others may be treated through surgery or with the use of corrective lenses like glasses or contacts.
Simple refractive errors are the most common types of visual impairment in children. This is a condition whereby the eye can not properly bend light to create a clear image.
This condition is divided into 3 categories
Myopia (nearsightedness) - This is as a result of the elongation of the eyeball which causes an image to fall in front of the retina instead of on its surface. This condition only allows the child to see objects right in front of them, but have difficulty seeing objects farther off, the objects just appear blurred.
Hyperopia (farsightedness) - This is caused by a slightly shortened eyeball that causes images to focus slightly behind the retina making it difficulty for the child to see objects that are close up. More like the opposite of myopia. The child can not focus or clearly see an object that is right in front of them.
Astigmatism - This is a condition that keeps light rays from focusing properly in one area of the retina. This results in the child's inability to focus on objects that are either far or near.
Luckily, these kinds of visual impairment are easily treated with the use of corrective lenses.
Cortical Visual Impairment
This condition occurs when there is a damage to the visual pathways to the brain which results in the brain not adequately receiving or interpreting visual information.
Children with this condition often always have celebral palsy, seizure disorder or even developmental delays as a result of this damage.
A common symptom of this condition is that the affected children would prefer to touch rather than look when exploring objects that are placed close together or in front of them. Vision may fluctuate during the day, depending on the health, mood of the child, or their environment.
Cataracts is a condition that prevents light from passing easily through the lens, causing loss of vision. Even though they often form slowly and usually affect people in their 60s and 70s, some children are born with congenital cataracts.
Symptoms include double vision, cloudy or blurry vision, difficulty seeing in poorly lit spaces, and colors that seem faded.
This condition is also known as lazy eye and has been identified as the most common form of visual impairment in children. It starts out during infancy and early childhood. In most cases, only one eye is affected.
This condition occurs when the brain, for some reason, does not fully acknowledge the images seen by the weaker eye. The child’s brain naturally tries to fix this problem by blocking out the picture from the weaker one and putting more strain on the stronger one. If the problem is not fixed when the child is young, the child’s brain will always ignore pictures from the weak eye.
A lazy eye can visibly turn in or out, but sometimes there is no outward sign. The treatment is commonly a patch over the normal eye thus making the lazy eye to work harder. Surgery can be used to correct this condition.
Some children are visually impaired at birth. This can be caused by an injury that happened to the mother during childbirth or can be inherited because of an infection (like German measles) a mother developed and transmitted to the developing fetus while pregnant.
Signs A Child is Visually impaired
A child may not be able to tell you if he has an eye health problem, very often problems with a child's vision are not detected until the child begins to go to school, but as a parent or carer, you can recognize the signs.
Intervention can be very effective when visual impairment is detected early on in the child's life. If you notice any of these characteristics, be sure to see an optometrist.
Some of the common behaviors that often show that a child is experiencing challenges with his vision are
- Droopy eyelids
- Crossed Eye
- Often sits very close to the television
- The eye lids do not cover the eyes completely when the child closes them.
- The child does not look at your eyes (after 3 months from birth).
- Watery eyes all the time
- The child has a clear squint.
- The child always reaches beyond or in front of the object she wants (after 6 months).
- The eye movements are jerky.
- The eyes do not move together (after 8 months from birth).
- The child always holds objects very close or very far to see them.
- The child searches for a dropped object by feeling on the ground rather than looking with her eyes.
Other Signs that become noticeable when the child begins school
- Clumsiness (overly clumsy) - when the child is constantly running into things
Poor Eye-Hand Coordination - identified during child's play especially when he can not throw or catch a ball, tie his own shoe laces
- Loss of attention and concentration
- Difficulties respecting other children’s personal territory
- Blurring during and/or after reading
- Constant Headaches
- Poor handwriting
- Lack of retention with reading and learning resulting in poor performance
Supporting a Visually Impaired Child
Visual impairment in children can affect most aspect of their lives especially developmentally (since they struggle to learn), it is important to understand how one can support them.
As a Parent/Carer
Get the child to be independent - For a visually impaired child, there is the tendency to always want to do regular everyday things for them, rather you should encourage the child to act independently. When a child is unable to see a desired object or toy, there is no motivation to try to reach it, so a child is less interested in learning to move independently. Engage their other senses to get them to act. For instance, by activating a musical toy a child can use their hearing senses to find it.
When playing - Use high contrast objects or toys that are shiny or reflect light to stimulate their visual senses. Vary the distance which you present objects, this can help you determine at what distance your child best responds. Organize games and play that stimulate their thinking and creativity.
Help them develop their other senses - Unlike 'normal' children the touch and nose senses of a visually impaired child are well developed. Help your child discover and explore by giving them a wide variety of touch and feel experiences. Use objects with different textures all over your house: like soft and textured squeak toys, rough scrub brushes, and even playing with food, this can be messy but a very essential experience for them. Take part in their experience by closing your eyes and trying to imagine how an activity feels or sounds to your child.
Be patient with them -Every child develops differently especially children with special needs. Rather than compare their development with other 'normal' children of their age, focus instead on the progress they have made and always challenge the child to move a little further toward achieving a set goal. Take each day as it comes with patience.
Communication - A child with an impaired vision is usually a good listener, but the sounds, voices, and language that he hears has to be meaningful. It is very common place to speak loudly or shout when talking to a visually impaired child as a form of 'compensation' for their condition. There is no need for this, if you want his attention call him by his name.
In a Learning Environment
- From the first day build a rapport with the child and understand the extent of the child's visual impairment. Give him a tour and a proper description of the classroom to help him gain a sense of spatial position. Announce your entrance or exit from the room and If you have to move the position of things like furniture, equipment or materials make sure to inform the child of any changes.
- Seat the child preferably in front of the room and away from glaring lights particularly by the window. Make sure the child is in a comfortable position before starting any visual activities. It is difficult for a child to look when he is working on balance and motor control.
- Speak clearly and use descriptive words, when speaking to him. When giving directions, be specific and avoid the use of vague terms, such as "over there," "this,"''that,'' or "here." Refrain from using gestures and avoid the use of vague terms when speaking. Offer to read written information when appropriate. Give all assignments orally . Spell out new words or technical terms that are not easily understood.
- A tape recorder can be used to record a class session or text readings to allow the child to go over what has been taught. Use a "buddy system" by pairing him with a sighted child. Ask the non-impaired child to describe activities as they are observed.
- In the case of a complete loss of vision, Include learning to read and write in Braille, how to use different types of canes, how to turn toward a person when speaking to him, and how to use special computer equipment. Use textbooks and other printed work in large, prints or Braille. Order instructional equipment and other low vision aids, such as electronic white boards, audible screen readers and books with tactile illustrations, which the student can use for learning.
- It is never too early to discuss the types of jobs that the child might find interesting, they should be encouraged to begin thinking about career preferences and skills while in grade school. Explore career options and develop work skills.
Make sure to take your child for their first comprehensive eye exam at 6 months from birth, another at the age of 3 and again before they are enrolled in school at the age of 5. So that if there are any problems they can be easily detected and treated.
Having a child who was born blind or developed an impairment as he grows can be a challenge. Visually impaired children are unique but can be taught just the same way you teach other children only with a little extra patience. Always remember that simple is best.
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