In the Early Months of Life, the Infants Visual System Is Still Maturing and It Is Not

Look What my Hands Can See!

By Sherry Lovelace, OTR New Mexico School for the Blind and Visually Impaired

In the early months of life, the infants’ visual system is still maturing and it is not fully developed even at birth. As the infant matures, the normal visual system develops specific functions and abilities. The infant’s early development depends on vision, since all of the body systems require visual feedback for practice and refinement. Vision happens in the brain, not the eyes. The visual system is made up of an ocular system (the eyes and eye muscles) connected to a perceptual (understanding) system, the brain. It takes both the eyes and the brain for vision to occur and if either system is dysfunctional, the visual system cannot provide adequate visual information and the brain damage will impact visual function while ocular defects can impact on all other areas of development. Every other body system may be delayed in development when vision is impaired or delayed.

Knowledge of normal visual development provides the foundation to facilitating skills with young children who have visual impairments. Visual impairments that exist at birth or early on, are more likely to cause delays in development than visual problems that occur when the child is older. Typical development occurs in a generally predictable pattern with body systems maturing parallel to developmental milestones. The eyes and hands become coordinated for reaching; neck and trunk muscles strengthen in coordination with arms for rolling to progress into sitting; large muscle coordination with visual acuity develop in conjunction with creeping and crawling. Developmental is generally sequential though the timing at which the skills are acquired for young children with visual impairments is longer.

Infants initially begin to experience their world around them by what comes in contact with their body such as the receiving blanket, lotion, and the touch or their caregivers. As the infant gains more head, trunk and arm coordination, they initiate movement coming into contact with what is in close proximity to their body. For an infant/young child with a visual impairment, the feedback from their vision may not be a motivator or reinforcement to move. “Because an estimated 85% of early learning is visual, the child with a visual impairment learns differently, and requires teaching strategies, activities and environments that support and encourage developmental progress for each individual child” Bernas-Pierce, J and Miller, T; 2003).

Learning Activities: When the infant is on the floor or in the crib, place items that make music/noise and/or lights in close proximity to the baby’s body so that any contact with the items provide immediate feedback. Auditory learning is paired with tactual learning to increase the amount of information available to the infant about their world. Place high contrast items around the crib or in front of the baby while on the floor.

Generally infants then begins to move their arms away from their body with a random reach developing into a more intentional reach and into a functional skill adding more awareness and perception of their immediate environment. Young children with visual impairments need to develop the ability to use their hands for touch to learn about and explore their world and importantly to develop functional skills. For visually impaired young children their hands become windows to their world. The blind baby may not have the motivation or a reason to reach unless a tactual approach is used to support active learning. Tactual exploration and discrimination become primary learning modalities for young children with visual impairments.

Learning Activities: Materials and items that promote tactual exploration, touching, grasping, searching and reaching need to be accessible to the infant with visual impairments at the appropriate motoric developmental stages.

For developing infants, it is necessary to incorporate meaningful exploration of objects into daily routines within their natural environment (Lueck, Chen, Kekelis; Developmental Guidelines for Infants with Visual Impairments). As arm and hand coordination progress, purposeful reach and grasp develops where the hand moves to obtain an object that comes into the path of the hand. Motor skills progress with the manipulation of an object by moving the arm away from the body and hand comes across an object getting tactual information about the object through fingers and the palm of the hand.

Learning Activities: Promote arm and hand strength and coordination with lots of tummy time on the floor with numerous kinds of toys, objects, which are different in texture, size, and form producing music/noise and/or lights when contacted.

The visually impaired infant/toddler need ongoing opportunities for early tactual exploration and discrimination experiences through activities that require two hands together to manipulate objects; promote hand and finger strength, dexterity, and coordination. These skills are essential in the development of tactual kinesthetic perception for increasing their awareness of and attention to differences in characteristics to textures, form, and shape for Braille reading.

Learning Activities: Play activities that encourage the use of both hands to do perform the task such as scooping and filling containers with different textures; squeezing sponges at bath-time, or toys with moveable parts. References

Bernas-Pierce, Julie and Miller, Tom (2003) Position Paper on Services to Young Children with Visual Impairments in Natural Environments; AER conference, Orlando, FL 2004

Lueck, A., Chen, D., Kekelis, L. (1997). Developmental Guidelines for Infants with Visual Impairments, A Manual for Early Intervention). Louisville, KY: American Printing House For the Blind.

Smith, M. and Toy, R. (2004). Feel’in Groovy: Functional Tactual Skills. Austin, TX: Texas School for the Blind and Visually Impaired website.

Bishop, V. (1998). Infants and Toddlers with Visual Impairments. Austin, TX: TSBVI website.

Sanspree, M. J., Early Literacy: Braille and the Young Child. See/Hear, A Quarterly Newsletter for Families and Professionals on Visual Impairments and Deafblindness. Summer 1998, Vol. 3, Number 3. Austin, TX

Sherry Lovelace is originally from Wisconsin. She fell in love with the southwest on a camping trip to Utah with my 2 little children. Upon college graduation, she packed up the U-Haul, the 2 children and the cat and headed for New Mexico where she has been an Occupational Therapist for over 20 years. Early childhood has been her focus, and exploring the unique rural state of New Mexico continues to be a thrill. Working for the University of New Mexico in the Indian Children's Program, she had the privilege to work closely with the Native American people, providing OT services throughout New Mexico, eastern Arizona and southern Utah. Her desire to learn more about visual impairments, especially in young children, came from working as an OT with TVIs from the New Mexico School for the Blind and Visually Impaired where she soon became an employee. She is currently finishing her TVI certification through New Mexico State University and pursuing a Masters in Special Education.