How Impaired Vision Affects Childhood Occupations

Vision is the primary sensory system used to gather information about our surroundings. Foundational skills control voluntary eye movements, whereas higher-level skills help the brain to make sense of what is seen. Functional vision is dependent on the collaboration between all visual-perceptual skills. Dysfunction at any level impacts function at all levels.

Underlying visual deficits inhibit a child’s ability to learn. Unlike adults, children are unable to compensate for visual impairment using the remaining senses because they are still in the process of making sensory associations, which affects the developing brain. Children learn to form perceptions through experience, practice, and play.

Functional Implications of Visual Impairment

When left untreated, visual impairments negatively impact participation in common childhood occupations, including education, social participation, and play.

Education

About 80-90% of learning is visual.1

  • Spelling is founded on visual imagery.
  • Vocabulary development follows a visual-perceptual lead.
  • Literacy depends on functioning vision.

Social Participation

Vision facilitates social-emotional development:2

  • Infants communicate through social eye-gaze.
  • Children learn to communicate emotion through facial expression.
  • All ages use mutual gaze to build social and emotional bonds.

Play

Children use vision to learn from, model for, and reinforce each other during play:3

  • Pretend play involves imitation of real life events and occupations.
  • Play often requires translation of visual input into a motor response.
  • Children often demonstrate motor skills consistent with their stage of visual development.4

Building Functional Vision

Vision is critical to a child’s overall development. When working with children, visual-perceptual deficits are addressed through specific experiences, practice, and play. Embedding treatment into play enhances visual development while at the same time taps into the child’s intrinsic motivation. Additional strategies include utilizing tasks of graded complexity and providing “just-right” challenges to avoid frustration and make learning easier.

References
  1. Warren, M. (1990). Identification of visual scanning deficits in adults after CVA. American Journal of Occupational Therapy, 44, 391-399.
  2. Muir, D. W., & Nadel, J. (1998). Infant social perception. In A. Slater (Ed.), Perceptual development: Visual, auditory, and speech perception in infancy (pp.247-286). East Sussex, UK: Psychology Press.
  3. Case-Smith, J., & O’Brien, J.C. (2010). Occupational Therapy for Children (6th Ed). Maryland Heights, MO: Elsevier.
  4. Bonifacci, P. (2004). Children with low motor ability have lower visual-motor ability but unaffected perceptual skills. Human Movement Skills, 23(2), 157-168.