Children with low vision can engage in activities that allow them to control their environment. Encourage your child to hold objects at different distances or angles to determine how she can see the items best. Read picture books with big, colorful, simple pictures to encourage her ability to distinguish and discriminate images. Telescope and microscope play can enable children to examine things from a closer perspective.
Promote your child’s ability to discriminate objects and textures with tactile activities that encourage kids to explore with their hands. Arts and crafts activities with finger paint and clay enable visually-impaired children to experience and create art with their fingers. Read textured books to a young child and encourage him to run his hands across the fabrics and materials to promote comprehension. Stack blocks and complete simple jigsaw puzzles with your child to promote his understanding of concepts such as dimension and spatial relationships through touch.
Learning to Listen
Auditory cues from the environment enable visually-impaired children to “see” what’s going on around them, says the Texas School for the Blind and Visually Impaired. Help your child develop her ability to listen for, identify and localize auditory cues by playing games such as “I Hear with My Little Ear." The game is similar to the classic “I Spy with My Little Eye” children’s game, but this one uses sounds instead of sights. Tell your child, “I hear with my little ear, a sound that’s far away.” Your child must then listen for the sound you might’ve heard and identify it. Provide your child with auditory toys to promote her ability to perceive, infer and process meanings from sound.
Since children with poor or no vision can’t learn by watching others, the best learning lessons are ones that provide visually-impaired children with opportunities for discovering concepts through direct interaction and active involvement. Take your child to a museum, zoo or other place of learning where she can explore and interact with the environment through her other senses. Encourage her to listen for the sounds the monkeys make, or to reach out and stroke an animal’s fur at the petting section of the zoo. Provide her with real objects to help facilitate her understanding of concepts. Give her a toy car to play with and explore with her hands while encouraging her to envision the shape of the wheels or to describe what happens when she rolls the car across a table.
AskDrSears points out that children need visual stimulation for their brains to develop. Infants develop peripheral vision first, followed by their macular, or central vision. Sensory input causes nerve cells in the brain to form connections with other nerve cells. This continuous visual input to the eyes is what develops the visual center in the brain. Sensory deprivations, particularly the lack of visual stimulation, interfere with a baby’s brain development. According to the National Association for Child Development, vision dysfunction -- including undeveloped central vision -- is common in many children with autism spectrum disorders, some of whom are unable to process visual and auditory information at the same.
Developmentally delayed or visually impaired children might engage in stimming behaviors to compensate for undeveloped vision or other problems with vision function. Stimming behaviors send messages that stimulate the senses and are common in children with autism spectrum disorders. Autistic children who have problems with visual function often engage in repetitive behaviors that continue to strengthen their peripheral vision while their central vision fails to develop normally, according to the NACD.
Visual Stimming Behaviors
The North Shore Pediatric Therapy website lists visual stimming behaviors such as hand-flapping, staring at lights or ceiling fans and repetitive blinking as common stereotypical behaviors children with autism rely on to stimulate the senses. Some children use stimming behaviors such as looking out of the corners of their eyes, moving their fingers in front of their eyes, staring at an object or watching it spin. Stimming behaviors help to stimulate the brain, particularly for a child who needs more sensory input.
Reasons for Stimming Behaviors
Stereotypical behaviors generally associated with autism include not making eye contact or looking from the side of the eye. Stimming is another common characteristic of autism that is often related to vision problems. Whatever form stimming takes, a child has a reason for engaging in the behavior. Dr. Melvin Kaplan, an expert in the field of visual management training, points out at Autism-help.org that an autistic individual might flick her fingers in front of her eyes or rock back and forth to create depth perception. Similarly, rocking from side to side can be a sign that a child has trouble paying visual attention.
Inherited genetic disorders cause poor vision in 60 percent of infants with vision problems, according to the Cleveland Clinic. As many as 40 percent of babies with strabismus -- meaning that one eye (or both) deviates either inward, toward the nose, or outward -- inherit their disorder. Congenital cataracts, a clouding of the lens in the eye or congenital glaucoma, higher than normal pressure within the eye, can be inherited traits, although they can also have non-genetic causes. Vision deviations such as astigmatism myopia, or nearsightedness and hyperopia, or far-sightedness, commonly pass from parent to child in the genes. In addition, as many as 33 percent of children with an inherited medical condition also have eye problems, the Cleveland Clinic reports.
Congenital vision problems and genetic problems aren't necessarily the same thing. While inherited disorders are carried on certain genes, congenital defects can occur during pregnancy from errors in development or toxin exposure. Optic nerve defects, malformations of parts of the eye such as the lens, iris or cornea, or maternal infections during pregnancy such as German measles can cause eye damage that's present from birth. Retinoblastoma, a type of tumor that forms in the eye, can be present as a congenital condition.
Infection and traumatic injury can cause infant vision loss. A common cause of vision loss in premature babies, retinopathy of prematurity, or ROP, affects as many as 40 percent of babies born weighing less than 2 pounds, according to the University of Michigan Kellogg Eye Center and around 5 percent of those weighing around 3 pounds. Supplemental oxygen, once thought to be the primary cause of ROP, is now considered to be a factor but not the entire cause. Poor oxygenation to the retina after birth causes the proliferation of abnormal blood vessel growth; the blood vessels bleed and scar, causing vision loss. Birth trauma, infection acquired from sexually transmitted diseases when passing through the birth canal, poor oxygenation during pregnancy or at delivery as well as physical trauma during infancy can also cause vision loss.
Sometimes the problem that causes vision loss isn't in the eye itself but in the nerve pathways and areas of the brain that "tell" the eye to see. Infections such as meningitis, traumatic head injuries, strokes or brain tumors can all affect the parts of the brain needed for vision. Because the problem isn't within the eye, glasses often won't help these types of vision losses, the Better Health Channel reports.
According to BabyCenter, a baby typically gains full head control around the age of 4 months. Visually impaired infants often have delayed motor skills. Help your baby develop head control by placing him on his back on your lap while supporting him with both hands behind his shoulders so his head does not fall back, then raising him slowly into a sitting position. When he is able to bring his own head forward, hold his hands to ease him into a sitting position. Shaking a rattle or playing a musical toy at the side of his head will also encourage him to turn his head.
Interaction and Communication
Early Intervention Support recommends simple strategies to develop interaction and communication. Keep your hairstyle and makeup the same to encourage visual interaction. While you are feeding your baby, whether by breast or bottle, humming will encourage her to look up at your face. Alternate sides when feeding, even if bottle feeding. Keeping your face no more than 10 inches away from her face and forming lots of different facial expressions will make communication productive. Black and white toys stimulate a newborn baby's retina development, but beware of causing sensory overload. Introduce bright colors with lots of contrasting shapes for toys, nursery bedding and wall decorations as your baby gets older.
Encouraging a visually impaired child to touch his legs and feet each time he is dressed helps him accept them as part of his body and learn to move them intentionally. Pediatric ophthalmologist Dr. Lea recommends helping him bring his toes up to his mouth and clap his cheeks with his feet. Dangling a large ball or similar object directly above him will trigger his desire to grab it with his hands and feet, developing his concept of space.
A visually impaired infant finds it harder to identify objects than a child with normal vision, who can look at an object from different angles and process the visual information alongside his sense of touch, says Dr. Lea. Help your child touch the entire surface of an object with her hands. If she drops an object, help her to pick it up again. If you pick it up yourself and hand it back to her, she will think of the object as an extension of your body and not a separate entity.
Step up the visual stimulation. Since eye muscles strengthen and nerve connections multiply constantly throughout childhood, it's important to provide your toddler with plenty of interesting visual stimuli. Invest in toys that contain moving patterns, such as pinwheels, or create patterns together with objects like wooden blocks or toddler-safe plastic interlocking blocks.
Read together. Point out pictures as you read the words or ask your toddler to point to the pictures as you read the story. By searching for the illustrations throughout the book, your child will not only exercise her eye muscles but will also improve her hearing and vision coordination.
Play games, lots of games. Any game that requires your tot to move his eyes in search of something can make his eyes stronger. Activities like coloring, assembling puzzles, tossing a ball back and forth, or engaging in a few rounds of "I Spy" can boost eye health.
Sneak nutrient rich foods into her diet. Though a balanced diet is critical for healthy eye development, toddlers should eat foods rich in antioxidants like vitamins A, C, and E, as well as lutein and omega-3 fatty acids to boost eye health and help to strengthen eyesight. Add veggies like carrots, broccoli, spinach, yams and red bell peppers to your tot's dinner plate, along with fruits such as cantaloupe, oranges, mango, strawberries and raspberries, to increase her intake of vitamins A, C and lutein. Peanuts, almonds, sunflower seeds and hazelnuts are excellent sources of vitamin E. For picky eaters, disguise veggies by mixing them into spaghetti sauce, blending leafy greens in smoothies or adding shredded veggies to baked desserts.
Schedule regular eye examinations. An eye and vision examination at 6 months of age is the best approach for early detection and prevention of eye and vision problems in toddlers, according to the American Optometric Association. Avoid future academic struggles and low self-esteem common to many children with poor vision by visiting a pediatric ophthalmologist at regular intervals: 6 months old, 3 years old, before he starts first grade and every 2 years after.
Contact your eye doctor if you notice any unusual eye problems in your toddler like crossing, drooping eyelids, pink or red eyes, milky white covering the pupil or vibrating eyes.
An untreated eye condition can worsen over time and possibly even lead to blindness.