This powerpoint has been created as part of my Postgraduate Diploma in Specialist Teaching. It summarises my research into the impact of vision impairment on children's sensory, motor, communication and cognitive development.

1. The key impacts of vision
impairment on sensory, cognitive
and communication skills
development.

2. “All children are unique and
children with visual
impairments are no different
in their…need for loving
home environments that are
both stimulating and
supportive. However,
perhaps more than any other
disability, visual impairment
has the potential to influence
dramatically how children
develop.
Whether it does and how
much it does depends on
parents‟ and teachers‟
knowledge and
understanding of the
potential impact of the
Peterken, A (2011) Kaia,
Auckland.

3. Development Theory & Research
Historically children with visual impairments were compared to
sighted children who were developing typically. Prior to the
1980s, it was felt that vision impaired children followed a
similar sequence of development as sighted children, jut at a
slower pace and needed more assistance/time to develop skills
(Cass, 1996).
“More alike than different”
Fraiberg‟s research (1960s/70s) concluded that VI
children demonstrated developmental delays in that were
“dependent or greatly influenced by vision such as motor
skills, perception, concept development, spatial
relationships, auditory skills, tactile exploration and ego
development” (Ferrall, 2000, pp.120-121)

4. D.H. Warren disagreed with Fraiberg‟s „More alike than
different‟ theory and felt comparative studies were based
on faulty compatibility. Warren stated that they viewed
the child as “structurally incomplete” therefore education
was also a “remedial therapy” that would replace the
missing ability/aspect. Warren also states “It occurs but
to few that a blind child is a complete mental and
physical whole, organised to function perfectly upon his
level of sensory equipment (1984, p.50)
More empirical evidence has been collected since then, to
inform our understanding of the best way to optimise visually
impaired children‟s developmental sequence, rather than try
to force them to meet sighted milestones at the same pace
and in the same order. The latest of this research is known as
„Project Prism‟.

5. Project
Prism
An American study, led by Kay Ferrell focusing on the
question “Are there differences in the rate and sequence of
development of young children with visual impairments?”.
Summary of Findings: Out of a total of 19 possible
milestones, for VI children:
 2 milestones delayed
 5 milestones within the range of typical acquisition
 2 milestones acquired early
 7 milestones acquired in a different sequence
 3 acquired later:
– Searching for dropped object
– Feeding bite‐size pieces
– Crawling 3 or more feet

6. Overall outcome:
Children without an additional disability develop within the
normal range of their sighted peers BUT they seem to be
losing 1/10th of a month per month – theerefore reaching
milestones noticeably later after 2 years old.

7. NLP: No light perception (blind) LP: Light perception
SLV: Severe low vision MLV: Moderate low vision

8. Sensory: (sen.so.ry)
Adj. of or pertaining to the senses or
sensation
A sense is any ability that enables us to
access stimuli from outside
(exteroception) or inside our body
(interoception).
Impact on Sensory Development

9. Impact on Sensory Development
Ferrell states that children with a vision impairment learn
differently because they cannot rely on their visual
information, therefore the information they obtain is from other
senses which may be:
• inconsistent - things don‟t always make a noise or odour
• fragmented - comes in bits and pieces
• passive -not under the child‟s control). It takes practice,
training and time to sort this out (2000, p.122)
That being said, the ability to utilise other senses in a more
efficient way, may cause cortical reorganisation, whereby
certain brain structures which could be left otherwise „unused‟
because of lack of visual input, become recruited to process
auditory/tactual information. In this way, blind/VI children
really do „think‟ differently to their sighted peers.

10. Auditory Senses
Hearing is the only distance sense available to a blind infant,
but the child has no control over the presence/absence of
sound.
Dottie Bridge from the Blind Babies Foundation states that
blind babies rely on their auditory information, if you speak to
them, they don‟t reach for you – they “get quiet and still, they
reach for you with their ears, not their hands until you teach
them otherwise” (CNIB, n.d). It is not until a blind child is
around 12 months that they will reach for an object based on
a sound cue alone (Strickling, 2010 )
The auditory sense is commonly considered the main
compensatory modality for vision loss. The auditory system
develops more slowly than vision, therefore, the blind child
has a slower development scale to follow for learning about

11. Sound only acquires meaning after much tactual, motor and
auditory interaction – only then can sound provide information
about location , cause or source. See the clip of Lucas below,
to witness how sound can be harnessed for navigation and
identification purposes („echolocation‟).

12. Tactile
Senses:
Tactile exploration
is another
compensatory
modality which
takes longer to
develop than
vision. This is
because the
learner often
needs to feel an
object repeatedly
to obtain an
accurate idea of
what it is like.
Certain objects will be inevitably inaccessible for Blind
children as they need to be „observed‟, such as the sun or
moon; others are too big to perceive in full such mountains or
too small such as fleas. Some are simply too fragile to touch
such as soap bubbles. These need to be taught conceptually

13. Learning about the Moon – using
tactile imagery
The sense of the enormity,
texture and distance is difficult
(near impossible) to convey
when using tactile imagery to
learn about the Moon.

14. Cognitive: (cog.ni.tive)
Adj. of or pertaining to the act or process
of knowing, perceiving, remembering etc
Impact on Cognitive Development

15. Impact on Cognitive
Development
 Vision facilitates cognitive development – “vision is related
to the development of concepts, abstractions and mental
representations that are difficult to form without visual
memory” (Ferrell, 2000,p.129)
 Ferrall states that “cognitive-transactional theory holds that
development occurs through a combination of forces:
biological maturation, physical experiences and social
interaction” (2000, p.113). This is particularly true in vision
impaired children, who need time, physical experiences and
often direct teaching to understand the world around them.

16. • Blind children often cannot
grasp the concept of object
permanence until they are able
to reach for objects based on
sound cues alone (after the
age of 12 months).
• They also find it difficult to
understand the concept of
causality, as they cannot see
the results of their actions.
• Classification is equally
difficult for blind children –
they have limited opportunities
to explore objects and look for
similarities/differences which
are not based on size or
texture (Strickling, 2010)
An egg by
any other
name…
Blind
children
need to be
taught that
the images
left are all
„eggs‟,
despite
their
different
texture,
size,
sound etc.

17. Therefore, when teaching blind or visually impaired
students, it is important to consider the following:
• Concepts must build upon each other, and begin by
being based upon something tangible, that a child can
touch/smell/taste/hear etc.
• Repeated experiences are best for teaching concepts e.g
turn taking
• It is important to remember that self-concepts and social
concepts need direct experiential teaching just the same
as maths/science concepts do.
• Relate concepts to day to day activities/daily life to make
it meaningful and allow links/comparisons to occur and
be reinforced.

18. "What colour is the wind?”, “Does a stone look the way it
feels?”, “I know how fish swim, but how do they walk?”, “I think
I know what it’s like to see: It’s like telling the future because
you know now that there will be a tree and I will know later,
when I come up to it and touch it” – all of these questions and
remarks strike a sighted person as unusual. But for blind
children they are a normal way of expressing interest in the
invisible world which surrounds them…These questions and
comments are also an attempt to place that vast outer space
stretching beyond the fingertips, within some logical,
manageable structure which could help understand such
mysteries as the fact that a toy released from one’s grip does
not disappear for ever but continues to exist; that a child can
resemble an adult, even an old person with a wrinkled face and
rough hands; that a sighted person can
recognise friends on a smooth, slippery
piece of paper called “a photograph”, and
that sighted people can see tall trees,
houses and mountains through a small

19. Chart showing
recommended
cognitive
development for
blind and visually
impaired babies and
children – note that
items which would
be assisted heavily
by vision (eg
matches objects)
occur at a later age
than for the average
sighted child.
(Bobnar, 2012)

20. Communication: (com.mu.ni.ca.tion)
Noun. 1. The act or process of
communicating
2. The imparting, or interchange of thoughts,
opinions, or information by speech, writing or
signs.
Impact on
Communication/Language
Development

21. We learn to communicate by making associations between
one thing and another. One of the “most serious
consequences of sensory deprivation in the young child is
that of communication” (Pagliano, 2013). The frequency of
language disorders amongst pre-schoolers who are visually
impaired has been reported to be over 80% compared to less
than 25% among sighted peers. This is possible because blind
children must depend on accoustic imitation to learn speech
because they cannot observe the muscular movements that
accompany articulation.
Vision provides an incentive for communication - Fraiberg
found that vision impaired babies lacked the “exclusive smile
for their parents which is characteristic of normally developing
sighted infants. However they did exhibit an „alternative‟
preferential behaviour which is not part of the repertoire of
sighted babies, namely frequent manual exploration of
parent‟s faces.” (Cass, 1996)

22. Dunlea suggests that a blind child may jabber/imitate sooner
than a sighted child, but may show delay when combining
words to make its wants known – this is because they may not
grasp the meaning of the words or repeat memorised
phrases/words out of context („echolalia‟) (1989, p.14).
Strickland states “the early language of the blind child does
not seem to mirror his developing knowledge of the world, but
rather his knowledge of the language of others (2010). The
best example of this is the uses of „verbalisms‟, e.g students
talking of „red‟ roses or „twinkling‟ stars to describe things that
they cannot see (Dunlea, 1989, p.15).

23. A lot of communication is non-linguistic, but shown
through facial expressions and body language.
Congenitally blind children are not aware of the
reactions from others to their own body language
unless they are specificially taught.
Visually impaired children may instead, be more
aware of auditory clues in conversations (much like
sighted people reading body language), however,
may are not able to correctly identify the implied
meaning, without life experience and an ability to
place it within a holistic context (Gunaratne, 2002)

24. Chart
showing
recommende
d
communicati
on
development
for blind and
visually
impaired
babies and
children
(Bobnar,
2012)

25. Motor (Mo.tor)
adj. 1. Causing or producing motion
2. Of or being nerves that carry impulses
form the nerve centers to the muscles
3. Involving or relating to movements of
muscles
Impact on Motor Development

26. Impact on Fine & Gross Motor
Development
“Blind children can learn to walk just as soon as seeing ones, only they
have to be led around in the beginning more frequently than the others”
– Kleig 1836 (Ferrell, 2013).
“For the blind child…it is important that he/she can feel safe when
moving around. Then the child dares to be more active and by that
learn more” – Schneekloth 1989 (Fjeldsenden, 2000)
“[Blind] children experienced extreme developmental delays in the
acquisition of manual skills and a high degree of variability in
developmental delays within and across six categories of fine-motor
skills (Brambing, 2007, p.212)

27. Impact on Motor Development
Vision (and perception of colours/patterns/shapes) gives
reason for movement – usually children see something
interesting and move towards it, this is not a motivator for
visually impaired children.
Vision gives an estimation of space, locating obstacles without
moving. This is not an option for children with a vision
impairment, therefore they find moving into the unknown much
more scary/daunting. This results in a longer delay between
crawling and walking.
Vision stimulates co-ordination and control. Infant‟s vision is
initially reflexive but over time vision allows infants to monitor
and co-ordinate their movements, becoming more aware of
their body parts from visual cues given when watching
parents/siblings move. Blind children often develop a
wide/awkward gait with poor posture. They need to be taught

28. Vision gives meaning to movement – when they reach for a toy,
vision allows them to learn how far and what direction to extend
their arms and make adjustments.
VI and blind children may have low
muscle tone, decreased movement
tolerance and poor balance. Even at 5
months and onwards, many children
maintain fisted hands, held at
shoulder height when at rest and will
use their feet as an additional sensory
tool for a protracted period which
affects walking/movement. The mouth remains
the primary organ of perception until well into
their second year (Sugden, 2010).

29. Blind children often do not follow the same development
sequence of manual activity as sighted children. They may
need specific assistance to develop prehensile patterns
(grasp, reach, release, carry, support etc.) rather than their
preference for non-prehensile movements (tap, push, pat,
shake etc.)
Impacts on functional use as the child grows
• Without vision, the hand and eye do not work together;
instead ear-hand co-ordination must occur. This only
happens after lots of experience and is achieved later in life.
This has implications on playing physical games with other
children, completing both gross and motor skills tasks and
more.

30. Cane holding and
usage may become
awkward due to
weaker wrist
extension, poor
wrist rotation and
reduced ability to
maintain a strong,
effective grasp of
the cane (Andrew,
2013).
Of course it
doesn‟t have to be
all doom and
gloom, there are many examples of visually impaired students
who can go on to achieve fantastic things, such as American
gymnast Aimee Walker Pond .

31. „Raising the bar‟…

32. Works Cited:
Andrew, J. and Ritzema, G. (2013) Underneath the Arches: The importance of
weight bearing through hands and feet for blind children [powerpoint slides].
Paper presented at „Weaving the mat: Strength through connection‟ 2013
Biennial Conference of the South Pacific Educations in Vision Impairment, 13-
18 January. Rendezvous Hotel, Auckland NZ.
Bobnar, A. (2012) Development Charts for Blind and Visually Impaired Babies
and Children. Retrieved on 24.04.13 from
http://www.wonderbaby.org/articles/development-charts#cognitive.
Brambring, M. (2007) Divergent Divelopment f Manual Skills in Children who
are Blind or Sighted. Journal of Visual Impariment * Blindness, April 2007,
101(4), 212-225. Retrieved from
http://web.ebscohost.com.ezproxy.massey.ac.nz/ehost/detail?sid=064e73b8-
4618-4563-a55a-
ffd0e2e69339%40sessionmgr104&vid=1&hid=123&bdata=JkF1dGhUeXBlPWl
wLGNvb2tpZSx1cmwsdWlkJnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#d
b=aph&AN=25057007
Canadian National Institute for the Blind (n.d) The Impact of Vision Loss on the
Development of Children from Birth to 12 years: A Literature Review. Retrieved
on 24.04.13 from

33. Cass, H. (1996, March 27). Visual Impairment and Autism - What we know
about causation and early identification. Retrieved April 02, 2013, from
Scottish Sensory Center:
http://www.ssc.education.ed.ac.uk/resources/vi&multi/hcass96.html
Dunlea, A. (1989) Vision and the Emergence of Meaning: Blind and Sighted
Children‟s Early Language, Cambridge, England, Cambridge University Press
Fjeldsenden, B., (2000) Blindness and Cognitive Structures. Retrieved on
23.04.13 from
http://www.sv.ntnu.no/psy/bjarne.fjeldsenden/Articles/CognitionandBlindness.h
tm
Ferrell, K.A (2000) Growth and Development of Young Children, in Holbrook
M.C and Koenig, A.J. (2000) Foundations of Education. Volume 1 History and
theory of Teaching Children and Youths with Visual Impairments, New York,
AFB Press.
Ferrell, K. A (2013 January).Weaving the Mat: Longitutdinal Study of
Development of Children with Visual Impairment [Powerpoint slides]. Paper
presented at „Weaving the mat: Strength through connection‟ 2013 Biennial
Conference of the South Pacific Educators in Vision Impairment, 13-18
January, 2013. Rendezvous Hotel, Auckland, NZ.

34. Gunaratne, L.A. (2002) Visual Impairment: Its effect on cognitive development and
behaviour. Retrieved from Understanding Intellectual Disability and Health on
24.04.13. http://www.intellectualdisability.info/physical-health/visual-impairment-
its-effect-on-cognitive-development-and-behaviour.
LandisCom (2009) Blind Babies Foundation – KGO TV [video file]. Retrieved on
24.04.13 from http://www.youtube.com/watch?v=kmvWwRTwNpQ
Marek, B (2000) Does a stone look the way it feels. Introducing tactile graphics,
spatial relations and visual concepts ot congenitaly blind children. Paper
presented at the European ICEVI Conference, Cracow 9-13 July 2000. Retrieved
from http://www.hungryfingers.com/stone.html
Pagliano, P. (2013 January). Strength through connection: Multisensory
stimulation as communication. Paper presented at „Weaving the mat: Strength
through connection‟ 2013 Biennial Conference of the South Pacific Educators in
Vision Impairment, 13-18 January, 2013. Rendezvous Hotel, Auckland, NZ.
Strickling , C. (Oct 2010) Impact of Visual Impairment on Development. Retrieved
from Texas School For the Blind on 22.04.13 http://www.tsbvi.edu/infants/3293-
the-impact-of-visual-impairment-on-develop

35. Sugden, J. (Nov 2010) Development and Supportive Interventions for
Babies and Young Children with Visual Impairment. Retrieved on 24.04.13
from http://www.ssc.education.ed.ac.uk/courses/vi&multi/vnov10ii.html.
Pagliano, P. (2013 January). Strength through connection: Multisensory
stimulation as communication. Paper presented at „Weaving the mat:
Strength through connection‟ 2013 Biennial Conference of the South Pacific
Educators in Vision Impairment, 13-18 January, 2013. Rendezvous Hotel,
Auckland, NZ.
Warren, D.H., (1984) Blindness and children: An individual differences
approach, Cambridge, England, Cambridge University Press.