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Effect of vision on development of multiply handicapped children
Insights
Early cataract surgery is crucial for rubella children, as vision significantly impacts development more than hearing or birth weight. Post-surgery, visually stimulating environments and sensory interactions are recommended to foster development.
Area of Science:
- Developmental Pediatrics
- Ophthalmology
- Child Psychology
Background:
- Congenital rubella syndrome can cause visual and hearing impairments.
- Visual impairment significantly affects the development and behavior of affected children.
- The impact of vision loss may outweigh other developmental factors like hearing impairment or low birth weight.
Purpose of the Study:
- To investigate the profound effect of vision on the abnormal development of children with congenital rubella.
- To emphasize the critical role of early intervention, specifically cataract surgery, in mitigating developmental delays.
- To provide recommendations for environmental and sensory management post-surgery to optimize developmental outcomes.
Main Methods:
- Study included 81 children with visual and/or hearing impairments due to rubella.
- Subgroups analyzed included those with bilateral cataracts (operated 2-18 months), unilateral cataracts, and clear media.
- Behavioral observations and developmental assessments were implicitly considered.
Main Results:
- Visual impairment has an enormous impact on the abnormal behavior and development of these children.
- Vision's influence on development is greater than hearing impairment or prenatal factors like low birth weight.
- Early cataract surgery is strongly supported by the findings.
Conclusions:
- Cataract surgery should be performed as early as possible in visually impaired rubella children.
- Post-operative management should include visually stimulating environments to prevent abnormal visual behaviors (e.g., Hand Before Eyes).
- Addressing stimulus deprivation through enriched sensory and social interactions is vital for promoting orientation reflexes and learning.
Abstract:
The effect of vision on (abnormal) development was studied in a group of 81 visually and/or hearing impaired rubella children, 18 of whom had bi-lateral cataracts operated between 2-18 months, 3 children had uni-lateral cataract, and 60 children had clear media. In this group of children the effect of visual impairment on (abnormal) behaviour is enormous. Vision has in these children a greater impact on their development than hearing impairment or prenatal variables such as low birthweight. This justifies the conclusion of cataract surgery as early as possible. After surgery the environment should be manipulated in such a way, that it becomes visually attractive for the child. This might prevent strong light-gazing and/or exhibiting the phenomenon of HBE (Hand Before the Eyes). The desire for rocking and jumping should be seen in connection with stimulus deprivation, especially social ones. It is therefore recommended that these children should be offered ample experience and interaction with the environment, such as giving the child proprioceptive stimuli, rocking him in the crib or on the lap. The interest in the world outside his own body should be encouraged by manipulating the children's special interest (such as changing the objects for light gazing). The purpose for this kind of management is to develop orientation reflex, in other words to stimulate the child to give attention to the world around him and therefore learn from it. When this sort of early stimulation is provided the child's development may be not so retarded as without appropriate intervention.