Developmental Disabilities

Vision/Hearing » Vision


Uri 26 Months - Cortical Vision Impairment

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Description: Uri is a 26 month-old-toddler whose mother and grandmother accompany him along with a six month-old infant. Uri busies himself in play; exploring his surroundings, then suddenly retreating to his mother’s side. He finds activities that interest him, but his gaze shifts and his head turns to see rather than rotating his head and eyes. He has difficulty moving toward targets. Uri ventures toward the pool of balls, pushes riding toys with other children. He smiles but now it seems he is delayed in the time it takes to smile. He seems distracted.

His mother and grandmother expressed concern that other children and adults have begun to treat Uri as if he is blind. According to mother’s report, he has no visual problems and inherits this condition which will be corrected by surgery at age of five or six. According to parent report, Uri’s grandmother has been especially helpful to him, helping him to do strengthening exercises. Uri wobbled and rocked sideways, unable to balance on his feet and legs when the observer visited him at home.

Uri swims and takes art lessons. Mother reports that art lessons are good therapy for her son’s cortical vision impairment. Uri’s mother comments that he sees clearly in spite of this condition; the observer feels others do not consider him blind, but that his eye condition apparently now makes him somewhat uncomfortable in the bright light of the classroom.

Assessment: The observer notes some signs of slowness in Uri’s movements and his social contacts with other children that were not noticed previously. Uri is not shy or cautious, but he seems unsure of how to play with several familiar toys. The observer takes Uri to the tent and puts a blanket over the top of the tent to decrease the brightness in the room. Uri settled down and seemed more comfortable in a darker place and stays there for some time. In the big room, Uri was less productive and stable.

Recommendations: The observer suggests Uri’s mother make a place at home where he can have less light and darker space in which to play. Uri does not seem interested as he did six months ago in make-believe games; he does not seem eager to participate with other children in the floor play games.

Uri moves across the floor in all directions, crawling and standing to get toys; Uri grasps, inserts toys into containers, removed objects from boxes, pulls strings to get objects, throws toys and escapes his mother’s arms to play with toys.

Uri does not use many words or show changes of expression when he makes sounds. The most important activity for him right now is to talk talk talk. Uri’s mother and grandmother need to work very hard on language development by talking and singing to him and by repeating sounds he makes and making them into words; for singing to him and by repeating sounds he makes and making them into words; for example, if he says “eeaya,” his mother says, “Uri, eat, eat, eat!”

Encourage his standing and walking by pushing heavy household items around the apartment, saying, “Stand up and push the box to me.” Help Uri to move his body anyway he can toward other children so he becomes aware of other children and starts to make friends. Play hide and seek with Uri. Encourage him to touch and make contact with other children.

When the observer visited Uri last his mother confided to the observer that she wants to talk to her child about his eyes and his vision; she wants advice about what to say. The observer notes that it is time for Uri’s mother to talk to him every week or so about what he sees and keeps a journal of what he says. He may needs more sensory integration activities to do at home due to the changes the observer sees this time. It may also be that having a new brother and changes in the household are causing the differences that the observer notices.

Uri needs to do as much small muscle play as possible, and the art classes are the best thing to do at this point. It is vital that Uri’s eyes, hands and feet work together as much as possibility! The observer suggests grandmother and mother allow Uri to help at home with small jobs and helpful activities. He is at the stage where he needs to feel important and special. With a new brother getting attention, Uri may not feel important, so encourage him to help in the kitchen with stirring or mixing activities and other tasks that allow him to observe and focus his vision on one object at a time.

If his mother and grandmother take time to enrich his imagination by reading to him daily, telling family stories and engaging him in make-believe play, Uri will continue to develop his mental and motor skills and continue to be a curious, eager and happy toddler. Make pretend play and reading essential parts of Uri’s daily routine. 

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