Taking our sight for granted comes naturally to those of us who can see. But what about those who are born without this innate ability? How do they learn to find their way in a visual world?

Deborah Hatton, an investigator at UNC-CH's Frank Porter Graham Child Development Center who studies the development of children with visual impairments, says, "If you're not exposed to children who are visually impaired, it doesn't occur to you that development would be all that different for children who can't see."

But a recent study led by Hatton found that the amount of a vision a child has does make a difference, even when the child has another disability in addition to the visual impairment.

Hatton conducted a comprehensive, long-term study to determine the level of vision impairment that really begins to affect a child's development. Because there are so few children with disabilities in any one area, Hatton had to do some clever maneuvering to acquire the data she needed. Fortunately, she could draw on data she had collected while working with the Governor Morehead Preschool, which serves North Carolina children who are blind. She further tapped into a long-term study already under way at the University of Northern Colorado. Over time, she acquired multiple assessments of 186 children with visual impairments between the ages of 12 and 73 months. Of these children, 40 percent also had mental retardation or developmental delay. The children were measured in terms of several skills—personal-social, adaptive, motor, communication, and cognitive. Their levels of vision were also measured.

The study found that development for children whose vision was worse than 20/800 (they have to be 20 feet away to see what a normal eye can see from 800 feet) was very different from children with higher vision levels. Hatton discovered that amount of vision had a similar affect on children with and without mental retardation or developmental delay, showing that both visual acuity and mental retardation make unique contributions to development.

Motor and personal-social skills appeared to be most affected by amount of vision. Children without vision are probably not as aware of their environment as other children. Hatton says, "If a child can't see interesting things, there is not much motivation to move or reach toward them."

And, since they can't establish eye contact, these children often don't bond as well with their parents, causing them to feel less secure in exploring their environment. This is important because when children with sight first start to investigate their surroundings, they tend to move out a little, look back at their mother for approval, and then continue moving. "Children who cannot see," Hatton says, "may lack that kind of security and relationship with the parent."

Another critical factor that affects motor skills as well as personal-social skills is the inability for children without sight to imitate those around them. Children learn by watching others, so those who cannot see are definitely at a disadvantage from the start. "This is why," Hatton says, "it's important to have intervention early on with babies who have disabilities, especially blindness."

As they get older and begin to associate with peers who can see, they can't hang around a group of children, watching for an opportunity to join the action, Hatton says. They have to ask, "What are you doing and can I play?" As a result, Hatton says, "They just don't jive with what's happening with children who have vision."

Considering the obstacles children with visual impairments must overcome, Hatton says, "It is amazing that some children do so well developmentally without sight."

In the right environment, however, children without sight can and do learn to get along in a visual world. An insightful teacher, for example, can make all the difference. Let's say there is a group of children playing with blocks in one corner of the classroom, and not far off a child without vision trying to work his way into the group. The teacher could take the boy by the hand and say, "Stephen, they are building blocks, why don't you come on over," and then find someone in the group to get Stephen started. Unless the teacher makes a conscious effort to help children interact, it probably won't happen, Hatton says.

The next step for Hatton is to design some intervention studies to test possible methods of enhancing development. First, Hatton wants to talk to teachers and parents of the children, as well as adults who have been blind from birth, to find out what they think helps. As Hatton says, "The bottom line is to try to figure out what's affecting development, so that we can decide what we can do to make it more optimal."

Other researchers in the study are Don Bailey, director of FPG, Margaret Burchinal, also at FPG, and Kay Ferrell at the University of Northern Colorado. The study was published in Child Development, October 1997.

Article by Catherine House.
© Copyright 1998 Endeavors magazine. All rights reserved.

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