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Techniques for Infants and Toddlers with Visual Impairment - Developmental Research

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Developmental Research

by Alycyn Ferrell and Sharon A. Raver

Four major research efforts provide interventionists with general guidelines to the more significant developmental hurdles infants with visual impairment are likely to face. For example, Norris, Spaulding and Brodie (1957) attempted to establish developmental norms for visually impaired children by administering the Cattell Infant Intelligence Scale (Cattell, 1940) to 66 children born between 1945 and 1952. Eighty-five percent of the sample experienced a preterm birth and subsequently developed retrolental fibroplasia (RLF, now known as ROP, retinopathy of prematurity). None of the subjects was identified as multi-handicapped. The degree of visual functioning was not reported. These researchers concluded that the delays in developmental milestones noted in their blind sample were due primarily to the lack of experience, rather than to the visual impairment. Further, they stated that developmental delay increased geometrically with age, pointing out that the more time that passed between when the child was ready to learn and when the opportunity to learn was actually provided, the greater the time delay before the child actually acquired the skill.

The same year Maxfield and Buchholz (1957) attempted to adapt the Vineland Social Maturity Scale (Doll, 1953) by norming the test on a group of 308 visually impaired children ranging in age from 5 months to 5 years, 11 months. This work resulted in the publication of the Social Maturity Scale for Blind Preschool Children. Again, the majority of this sample was premature with subsequent ROP, and neither the degree of visual functioning nor the presence of additional handicapping conditions were reported.

Perhaps the best known of the developmental studies, Fraiberg’s work (1977) with her colleagues at the University of Michigan is widely cited as evidence of the significant delays caused by visual impairment. Only 10 children were studied intensively, none of whom were reported to be multi-handicapped, and only 3 of whom had ROP. All were involved in what Fraiberg called a home-based education and guidance program, until the age  2-1/2 years. Fraiberg concluded.

Blindness as an impediment to adaptation was clearly discerned in each of the areas of development in this study, even when we employed our knowledge to facilitate development and helped the child and his parents find adaptive solutions. (1977, p. 272)

Finally, Reynell (1983) studied visually handicapped children to develop the mental development portion of he Reynell Zinkin Scales. Reynell studied 109 partially seeing and blind children, about one fourth of whom had additional handicapping conditions. Like the other major studies, Reynell found delays in mental development, with blind children experiencing greater delays than the partially seeing children.

Developmental Research in Progress

The Visually Impaired Infants Research Consortium (VHRC) has developed a database for tracking the development of infants with visual impairment and is gathering information on demographic and birth information, as well as the age of acquisition of 21 milestones selected by VHRC as indices of developmental progress (Ferrell et al., in press). The consortium has arrived at the following conclusions:

  1. Infants with visual impairment and no additional handicapping conditions, in many cases, achieve selected developmental milestones within the range of acquisition demonstrated by sighted infants.
  2. Infants with visual impairment who also have additional handicapping conditions, in most cases, acquire these same milestones at a later chronological age.
  3. The sequence of acquisition differs in both groups that demonstrated by sighted infants.
  4. The greatest delays in development are in the fine motor domain.

Although this study is limited by its reliance on informants and its lack of specificity on the degree of functional vision, it offers insight into the developmental problems of infants with visual impairment.


In 1989, Dr. Turben received funding that enabled the Cleveland Sight Center to initiate the first large-scale, family-centered Children's Services Program in Cleveland, Ohio. Dr. Turben worked for Lake County Early Intervention Collaborative Group in 1988-89 as the consultant who prepared the County Needs Assessment and assisted the collaborative in the preparation of the 1988-89 Lake County Early Intervention Collaborative Plan, which launched family collaboratives as a network of families with children who had disabilities.
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