Effect of vision on development of multiply handicapped children.

The effect of vision on (abnormal) development was studied in a group of 81 visually and/or hearing impaired rubella children, 18 of whom had bi-lateral cataracts operated between 2-18 months, 3 children had uni-lateral cataract, and 60 children had clear media. In this group of children the effect of visual impairment on (abnormal) behaviour is enormous. Vision has in these children a greater impact on their development than hearing impairment or prenatal variables such as low birthweight. This justifies the conclusion of cataract surgery as early as possible. After surgery the environment should be manipulated in such a way, that it becomes visually attractive for the child. This might prevent strong light-gazing and/or exhibiting the phenomenon of HBE (Hand Before the Eyes). The desire for rocking and jumping should be seen in connection with stimulus deprivation, especially social ones. It is therefore recommended that these children should be offered ample experience and interaction with the environment, such as giving the child proprioceptive stimuli, rocking him in the crib or on the lap. The interest in the world outside his own body should be encouraged by manipulating the children's special interest (such as changing the objects for light gazing). The purpose for this kind of management is to develop orientation reflex, in other words to stimulate the child to give attention to the world around him and therefore learn from it. When this sort of early stimulation is provided the child's development may be not so retarded as without appropriate intervention.