The term ‘visually impaired’ is used to describe a child who has sight problems severe enough to interfere with their learning. The majority of children with a visual impairment still have some vision – only five per cent are totally blind. Most blind or partially sighted children have their sight problem from birth, though a small number lose their sight later in life following illness or an accident.
Visual impairment refers to a significant loss of vision, even though the child may wear corrective lenses. The nature and degree of visual impairment may vary significantly, so each child may require individual adaptations to instructional
practices and materials in order to learn effectively. Visual impairment includes two main categories: blindness and low vision.
Legal Blindness – ranges from a visual acuity of 20/200 in the better eye after correction, to having no usable vision or a field of vision reduced to an angle of 20
degrees. Visual acuity of 20/200 means that the individual sees at 20 feet what is
normally seen at 200 feet. A reduced field of vision means that the individual has
tunnel vision with limited peripheral vision.
Blindness – ranges from being totally without sight to unreliable vision and primary
reliance on other senses. A child with blindness usually uses braille as a reading
and writing medium.
Low Vision – is reduced central acuity of 20/70 or less in the better eye after
correction. Most children with visual impairments have low vision. These children should be encouraged to use their residual (remaining) vision, when appropriate, using the necessary optical aids and adaptations. children who are described as blind may have some usable vision.
Visual impairments are further classified as congenital or adventitious.
Congenital refers to loss of vision present at birth. Some of the more common causes of congenital visual impairment are:
Adventitious refers to loss of vision acquired after birth as a result of illness or accident. The age and level of development of the child before the onset of the visual impairment influences the child’s ability to acquire skills and concepts. children with congenital blindness may have difficulty acquiring concepts, while children with adventitious blindness may retain sufficient visual memory to benefit from visual descriptions.
Although two children may be medically assessed as having the same diagnosis and
visual acuity, they may each learn and function in different ways. A childs vision
may fluctuate or may be temporarily influenced by such factors as:
Most children with a marked visual impairment will arrive in nursery with their condition already diagnosed. Early years practitioners’ observations can still contribute to the ongoing assessment of the child’s functional use of vision, linking with the Qualified Teacher of Visually Impaired children (QTVI).
Practitioners will look out for signs of impaired vision in children by noticing the child who:
• displays undue sensitivity to light; closes or covers one eye when attempting visual tasks;
• often trips or bumps into things;
• holds books unusually close to their face;
• tilts their head to an unusual angle when trying to focus.
Since 80 per cent of communication is nonverbal, a young child with impaired vision is at a huge disadvantage when developing interpersonal skills. Unable to discern the facial expressions of others, they cannot ‘read’ reactions to things they say and find verbal turn-taking very difficult. These children cannot learn by watching, only by doing.
Restricted vision also leads to restricted mobility. In a typically developing child, vision is a huge motivator: seeing a desired toy just out of reach prompts the child to stretch for it or crawl towards it; a visually impaired child doesn’t know the toy exists.
The development of play – leading to concepts such as conservation, classification and one-to-one correspondence – is also negatively affected by visual impairment. When a child cannot observe others at play, it limits their own skills.
Finally, independence and self-help skills are significantly delayed in a child with sight problems.
How can we help?
Close links with parents and specialist professionals is vital. Additionally, practitioners will help the young child with a visual impairment by:
• making wall displays colourful, clear and uncluttered;
• offering toys with good colour contrast and books with simple illustrations;
• offering activities which draw upon all the senses;
• saying the child’s name before giving instructions;
• giving individual demonstrations of tasks; warning of changes in routine;
• giving the child longer to explore new toys and activities;
• consider providing a secure, familiar place to play;
• if a toy rolls out of reach, leading the child towards it to encourage independent exploration;
• describing the things you or others do, to the child;
• helping the child connect with others and to link present with past experiences;
• encouraging other children to approach the child;
• taking care not to overprotect the child, becoming a barrier between them and others.
LOOK UP: www.look-up.org.uk
National Blind Childrens Society: www.nbcs.org.uk
Royal National Institute of Deaf People: www.mid.org.uk