A scoping review of longitudinal studies of children with vision impairment

In past comparative studies, children with vision impairment were often shown a developmental delay compared to sighted children in several developmental domains. Medical treatments of vision impairments and societal attitudes toward disabilities changed considerably. Besides, within the rehabilitation practices, a stronger integration of multiple perspectives and increased focus on social inclusion and participation in society is present. The main goal of this scoping review was to investigate what is known about the development in cognition, language and communication, motor, social–emotional, and adaptive skills development of children with vision impairment by longitudinal studies. Besides, the results of the past studies were related to a contemporary view on disability, the participation concept. This was done by applying the family of participation-related constructs (fPRC) framework to examine which factors were covered and which not. A systematic literature search was performed in Web of Science, PsycInfo, ERIC, and Medline. Studies were included if they have been published in peer-reviewed journals between 1994 and 2020 had a longitudinal design and examined the development of children with vision impairment with no additional impairments up to 18 years of age. From the 2698 identified studies, 32 studies were included. The most commonly assessed variables concerned cognition and language and communication development. To a lesser extent, studies examined adaptive skills, motor, and social–emotional development. The majority used vision status as a predictor variable for developmental outcomes. In terms of the fPRC framework, most studies included variables related to the factor activity competences. The factors preferences, sense of self, environment, and involvement were studied far less often. The review suggested a positive impact on developmental outcomes for including variables that can mediate the relation between vision status and developmental outcomes and variables that are related to the fPRC factors environment, sense of self, and preferences.

Standardized and Experimental Tools to Assess Spatial Cognition in Visually Impaired Children: A Mini-Review

The acquisition of spatial cognition is essential for both everyday functioning (e.g., navigation) and more specific goals (e.g., mathematics), therefore being able to assess and monitor spatial cognition from the first years of life would be essential to predict developmental outcomes and timely intervene whenever spatial development is compromised. Several shreds of evidence have indicated that spatial development can be compromised in the case of development with atypical sensory experience such as blindness. Despite the massive importance of spatial abilities for the development of psychomotor competencies across childhood, only a few standardized and experimental methods have been developed to assess them in visually impaired children. In this review, we will give a short overview of current formal (standardized) and informal (experimental) methods to assess spatial cognition in visually impaired children, demonstrating that very few validated tools have been proposed to date. The main contribution of this current work is to highlight the need of ad hoc studies to create and validate clinical measures to assess spatial cognition in visually impaired individuals and address potential future developments in this area of research.

The use of augmented toys to facilitate play in school-aged children with visual impairments

BACKGROUND

Children with visual impairments (VIs) face challenges in social play activities, which limits their opportunities to practice social skills.

AIMS

We investigated whether augmented toys were effective to facilitate play in 52 children with VIs who attended special schools for students with visual impairments and blindness.

METHODS AND PROCEDURES

52 children with VIs (mean age: 9.22 years, SD = 2.07) played three times with both an augmented and a non-augmented toy. A Playmobil® knight's castle was augmented with Radio Frequency Identification (RFID) technology, such that each play figure produced audio feedback during play. The RFID-technology could be activated and deactivated. Social and cognitive aspects of play were coded from video and data were analyzed using multilevel logistics.

OUTCOMES AND RESULTS

Children showed less disengagement and more parallel play, but less cooperative play when they used the augmented versus the non-augmented castle. This pattern persisted after repeated play sessions with both toys.

CONCLUSIONS

The addition of sounds to physical toys increased shared attention between children with VIs during the exploration of play materials, yet it interfered with social interaction during peer play.

Pilot study: Sensory integration processing disorders in children with optic nerve hypoplasia spectrum

This study aimed to explore the sensory processing profiles of children with the spectrum of optic nerve hypoplasia (ONH). Caregivers completed the Short Sensory Profile (SSP), the Social Communication Questionnaire (SCQ), and the Vineland Adaptive Behaviour Scale (VABS) interview. The study demonstrated that children with ONH present with sensory integration dysfunction (SID), in their intact senses, and that autistic spectrum condition (ASC) was the best predictor of SID, rather than visual loss, or level of intellectual disability in these children. The results indicate that assessment and monitoring of SID in children with ONH is crucial.

Development of an Age Band on the ManuVis for 3-Year-Old Children with Visual Impairments

AIM

To compare fine motor performance of 3-year-old children with visual impairment with peers having normal vision, to provide reference scores for 3-year-old children with visual impairment on the ManuVis, and to assess inter-rater reliability.

METHOD

26 children with visual impairment (mean age: 3 years 7 months (SD 3 months); 17 boys) and 28 children with normal vision (mean age: 3 years 7 months (SD 4 months); 14 boys) participated in the study. The ManuVis age band for 3-year-old children comprised two one-handed tasks, two two-handed tasks, and a pre-writing task.

RESULTS

Children with visual impairment needed more time on all tasks (p < .01) and performed the pre-writing task less accurately than children with normal vision (p < .001). Children aged 42-47 months performed significantly faster on two tasks and had better total scores than children aged 36-41 months (p < .05). Inter-rater reliability was excellent (Intra-class Correlation Coefficient = 0.96-0.99).

CONCLUSIONS

The ManuVis age band for 3-year-old children is appropriate to assess fine motor skills, and is sensitive to differences between children with visual impairment and normal vision and between half-year age groups. Reference scores are provided for 3-year-old children with visual impairment to identify delayed fine motor development.

A Systematic Review of the Literature on Parenting of Young Children with Visual Impairments and the Adaptions for Video-Feedback Intervention to Promote Positive Parenting (VIPP)

Secure parent-child attachment may help children to overcome the challenges of growing up with a visual or visual-and-intellectual impairment. A large literature exists that provides a blueprint for interventions that promote parental sensitivity and secure attachment. The Video-feedback Intervention to promote Positive Parenting (VIPP) is based on that blueprint. While it has been adapted to several specific at risk populations, children with visual impairment may require additional adjustments. This study aimed to identify the themes that should be addressed in adapting VIPP and similar interventions. A Delphi-consultation was conducted with 13 professionals in the field of visual impairment to select the themes for relationship-focused intervention. These themes informed a systematic literature search. Interaction, intersubjectivity, joint attention, exploration, play and specific behavior were the themes mentioned in the Delphi-group. Paired with visual impairment or vision disorders, infants or young children (and their parents) the search yielded 74 articles, making the six themes for intervention adaptation more specific and concrete. The rich literature on six visual impairment specific themes was dominated by the themes interaction, intersubjectivity, and joint attention. These themes need to be addressed in adapting intervention programs developed for other populations, such as VIPP which currently focuses on higher order constructs of sensitivity and attachment.

Attentional processes in young children with congenital visual impairment

The study investigated attentional processes of 32 preschool children with congenital visual impairment (VI). Children with profound visual impairment (PVI) and severe visual impairment (SVI) were compared to a group of typically developing sighted children in their ability to respond to adult directed attention in terms of establishing, maintaining, and shifting attention on toys. The measures of children's sensory-motor understanding (SMU) and language ability were obtained using the Reynell-Zinkin scales of mental development. The videorecordings of these play-based assessments were coded for three categories of behavioural responses (Establish, Maintain, and Shift). The three groups were matched on verbal comprehension (VC), but differed significantly in their SMU and their chronological age. The groups of children with PVI and SVI were found to be comparable in their ability to establish and maintain attention on objects. Despite a relatively good performance overall both groups scored significantly lower on those skills than children who were sighted. However, with regards to attention shifting, children with PVI showed significantly lower performance than both the children with SVI and the sighted children who were similar on this component. Ability to maintain and shift attention was significantly related to the cognitive ability of children with PVI; however the poorer attentional responses were not confined only to the children with low IQ. The results are discussed in relation to the role of vision, cognitive ability and executive function in attentional processes in children with congenital VI.

The parent-infant dyad and the construction of the subjective self

Developmental psychology and psychopathology has in the past been more concerned with the quality of self-representation than with the development of the subjective agency which underpins our experience of feeling, thought and action, a key function of mentalisation. This review begins by contrasting a Cartesian view of pre-wired introspective subjectivity with a constructionist model based on the assumption of an innate contingency detector which orients the infant towards aspects of the social world that react congruently and in a specifically cued informative manner that expresses and facilitates the assimilation of cultural knowledge. Research on the neural mechanisms associated with mentalisation and social influences on its development are reviewed. It is suggested that the infant focuses on the attachment figure as a source of reliable information about the world. The construction of the sense of a subjective self is then an aspect of acquiring knowledge about the world through the caregiver's pedagogical communicative displays which in this context focuses on the child's thoughts and feelings. We argue that a number of possible mechanisms, including complementary activation of attachment and mentalisation, the disruptive effect of maltreatment on parent-child communication, the biobehavioural overlap of cues for learning and cues for attachment, may have a role in ensuring that the quality of relationship with the caregiver influences the development of the child's experience of thoughts and feelings.

As relações entre deficiência visual congênita, condutas do espectro do autismo e estilo materno de interação

Este trabalho examina a possível ocorrência das condutas do espectro do autismo em crianças portadoras de deficiência visual congênita e focaliza os comprometimentos da habilidade de atenção compartilhada, da capacidade simbólica e de estereotipias motoras, além de investigar o estilo diretivo de interação das mães ao tentar engajar os seus filhos em brincadeiras. Participaram do estudo oito díades mãe-criança distribuídas em dois grupos: quatro com deficiência visual congênita e quatro com desenvolvimento típico. Realizou-se uma entrevista sociodemográfica e de desenvolvimento da criança com as mães e uma sessão de vídeo da interação mãe-criança em laboratório. Os resultados mostraram que duas das crianças com deficiência visual congênita apresentaram uma freqüência maior de comprometimentos de habilidade de atenção compartilhada comparadas às crianças com desenvolvimento típico, e duas crianças com deficiência visual congênita apresentaram estereotipias motoras, porém com baixa freqüência. Apenas uma das mães das crianças com deficiência visual congênita apresentou maior freqüência de diretividade materna comparada à mãe da criança com desenvolvimento típico, contrariando a expectativa inicial. Observou-se a ocorrência de brinquedo simbólico no grupo das crianças com deficiência visual congênita. Esses resultados contrariam algumas das expectativas da literatura. Conclui-se que as crianças com deficiência visual congênita não estão necessariamente em risco para desenvolver condutas do espectro do autismo.

Divergente Entwicklung blinder und sehender Kinder in vier Entwicklungsbereichen

Zusammenfassung. In der Längsschnittstudie werden die durchschnittlichen Erwerbszeitpunkte für 107 Einzelfertigkeiten von vier blind geborenen Kindern in der Altersspanne von 10 bis 60 Monaten mit den Altersnormwerten sehender Kinder verglichen. Nach den medizinischen und psychologischen Erhebungen handelte es sich bei den blinden Kindern nachweislich um Kinder ohne weitere Beeinträchtigungen und mit gut durchschnittlicher Intelligenz. Die 107 Entwicklungsfertigkeiten lassen sich inhaltlich vier Entwicklungsbereichen - manuell-lebenspraktisch, grobmotorisch, sozial-interaktiv und sprachlich - zuordnen. Mittels dreier Rechenmethoden (kategorial, relativ, regressionsanalytisch) wird nachgewiesen, dass in den vier Entwicklungsbereichen bei blinden und sehenden Kindern kein paralleler, sondern ein divergenter Entwicklungsverlauf beobachtbar ist. Große Entwicklungsunterschiede zwischen blinden und sehenden Kindern ergeben sich bei den manuell-lebenspraktischen, geringe Unterschiede bei den sprachlichen Fertigkeiten.

Symbolic play in congenitally blind children

There is controversy over the existence and nature of blind children's limitations in symbolic play. In this study we tested 13 5- to 9-year-old congenitally blind children for the ability to symbolize when an adult provided scaffolding for their play. The blind children were selected on the basis that they did not have the syndrome of autism, and they comprised two groups matched for age (MA) and verbal ability on the Wechsler Intelligence Scale for Children who contrasted in their ability to engage in social relations. We also tested a group of sighted children who were MA matched with the more socially able blind children. On the basis of an hypothesis about the social-developmental sources of symbolic play deficits in congenitally blind children, we predicted differences between the socially able and socially impaired groups of blind children in the following respects: the attribution of symbolic meanings to play materials, the ascription of individual roles to play figures, and the anchorage of play in the scenario as presented by the adult. The results accorded with these predictions. Whereas the more socially able blind children showed symbolic play that was very similar to that of sighted children, the MA- and IQ-matched socially impaired blind children were limited in the three aspects of their play. On the other hand, even the socially impaired children showed instances of symbolizing. The findings suggest a way to reconcile conflicting reports of symbolic play deficits in young blind children, and may be relevant for explaining the association between autism and congenital blindness.