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Home-based early intervention in infants and young children with visual impairment using the Developmental Journal:
Naomi J Dale1,2, Elena Sakkalou2, Michelle A O'Reilly2
1Neurodisability Service, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
Insights
Home-based early intervention using the Developmental Journal for babies and young children with visual impairment (DJVI) improved outcomes for children with severe visual impairment (SVI). The DJVI approach enhanced child development, behavior, and reduced parenting stress compared to other interventions.
Area of Science:
- Pediatric Ophthalmology
- Developmental Psychology
- Early Intervention Services
Background:
- Severe visual impairment (SVI) in infants presents significant developmental challenges.
- Early intervention is crucial for optimizing outcomes in visually impaired children.
- The Developmental Journal for babies and young children with visual impairment (DJVI) offers a structured home-based approach.
Purpose of the Study:
- To evaluate the effectiveness of the DJVI home-based early intervention for infants with congenital disorders of the peripheral visual system (CDPVS) and SVI.
- To compare developmental and psychosocial outcomes between children receiving DJVI and those receiving 'Other Support'.
Main Methods:
- A longitudinal observational study (OPTIMUM cohort) of infants with CDPVS and SVI.
- Intervention group received DJVI; control group received 'Other Support' for 12 months.
- Outcome measures included cognition, language, behavior, parenting stress, and parent-practitioner partnership.
Main Results:
- Children receiving DJVI showed accelerated sensorimotor understanding and expressive language, particularly in the 'simple' CDPVS subsample.
- DJVI intervention was associated with reduced behavioral withdrawal and parenting stress.
- Improved perceived practitioner-parent relationships were noted in the DJVI group.
Conclusions:
- Home-based early intervention using the DJVI is associated with enhanced developmental outcomes in infants with SVI.
- The DJVI approach positively impacts child behavior, parenting stress, and the parent-practitioner relationship.
- Visual impairment characteristics influence intervention outcomes.
Aim:
To investigate the effects of home-based early intervention in children with severe visual impairment (SVI) using the Developmental Journal for babies and young children with visual impairment (DJVI).
Method:
A longitudinal observational study was undertaken with a national cohort (OPTIMUM) of infants with congenital disorders of the peripheral visual system (CDPVS) and profound-SVI; and followed up after 12 months and 24 months. Intervention was categorized according to the practitioner diary records of their usual practice over 12 months from baseline comparing those receiving the DJVI and those receiving 'Other Support'. Outcome measures of cognition and language, behaviour difficulties, parenting stress, and satisfaction with parent-practitioner partnership were collected.
Results:
In the 54 children (26 males, 28 females, baseline mean age 13.5mo, SD 2.3mo, range 8-17mo) with 'total' CDPVS (including 16 'complex' and 38 'simple' with or without known brain disorder respectively), linear mixed effects pointed towards acceleration in sensorimotor understanding and expressive language especially in the 'simple' subsample (11.72 developmental quotient, 95% confidence interval -1.17 to 24.61, p>0.05) in those receiving the DJVI. Vision level also predicted outcomes (p<0.05). The DJVI group showed improvements in behavioural withdrawal (η2 =0.20, p=0.02, 'simple') and parenting stress (d=0.78, d=0.92, p=0.02 total and 'simple' respectively) and perceived practitioner-parent relationship (η2 =0.16, p=0.01).
Interpretation:
Infants and young children with visual impairment receiving home-based early intervention using the DJVI with a structured developmental approach had better outcomes than those receiving 'other' home-based early interventions. Moderate to large effect improvements were found in child cognition and language, behaviour and parenting stress and the perceived practitioner-parent relationship, although cognition did not reach 5% significance level.
What This Paper Adds:
Early intervention using the Developmental Journal for babies and young children with visual impairment was associated with enhanced developmental outcomes compared to other approaches. Improvements were also found in child behaviour, parenting stress, and perceived parent practitioner outcomes. Type and complexity of visual impairment also influenced outcomes.
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