Development - Emotional Status and Development in Children Who Are Visually Impaired - August 2005

This study examined the developmental attainments of children with visual impairments, aged 6–59 months, with and without emotional deficits, behavioral deficits, or both. It found that an emotional or behavioral deficit was significantly related to gross motor and visual motor integration, expressive and receptive language, and social or personal development, and that there was an interaction between the effect of the mother's education and the child's age on the child's perception of language. The authors are indebted to the children and families who participated in the study and to Rivka Abiry for her help in preparing this manuscript. To date, studies on the development of children who are visually impaired (that is, those who are blind or have low vision) have focused mainly on the relationship among the children's levels of vision, comorbidities and gestational age, and developmental attainments (Hatton, Bailey, Burchinal, & Ferrell, 1997; Tröster & Brambring, 1992). The possible effect of visual impairment on attachment and socialization has also been suggested (Fraiberg, 1977; Preisler, 1991), and the increased prevalence of specific emotional and behavioral problems, as well as developmental delays, among visually impaired children has been established http://www.afb.org/jvib/jvib990804.asp (1 of 14)8/24/2005 2:32:46 PM Development Emotional Status and Development in Children Who Are Visually Impaired August 2005 (Rudd, 1982; Tirosh, Schnitzer, Davidovitch, & Cohen, 1998). Therefore, the mutual effect of emotional problems on the development of visually impaired children, and vice versa, is of great importance. Such an understanding may influence treatment strategies that are related to development at different ages, particularly among infants and young children. Yet the research methodology that is needed to assess the mutual relationship between developmental attainments and emotional status is extremely complicated. It has been proposed that different emotional and behavioral deficits are specifically related to visual impairment in early childhood (Jan, Freeman, & Scott, 1977; Tirosh et al., 1998). The effects of mothers' behavioral characteristics and emotional status and children's development and visual impairment on the development of children who are visually impaired have been reported (Hughes, Dote-Kwan, & Dolendo, 1999). However, to our knowledge, only one study analyzed the relationship between children's emotional or behavioral status and development (Tröster & Brambring, 1992). This study included infants aged 9 months and 12 months who were compared to age-matched fullterm sighted infants. The authors found a significant correlation between motor development and social and emotional development but did not examine the relationship between developmental attainments and emotional and behavioral status. As Tröster and Brambring (1992) acknowledged, a comparison of both the developmental attainments and social and emotional status of children who are sighted and blind, using the same scales, is difficult, as is the assessment of the additional risks of prematurity for both the emotional status and the development of children who are blind. It has been suggested that the comparison of a group of children who are blind to their sighted peers may result in false labeling of problem areas that are specific to the http://www.afb.org/jvib/jvib990804.asp (2 of 14)8/24/2005 2:32:46 PM Development Emotional Status and Development in Children Who Are Visually Impaired August 2005 sensory impairment (Groenveld, 1998). Thus, it appears that investigating a within-group difference in children who are visually impaired who have no other developmental risk could be a methodologically acceptable approach to identifying the relationship between development and emotional status. The purpose of the present study was to identify a group of children with visual impairments and emotional or behavioral deficits and to compare their development with that of visually impaired children with no emotional or behavioral deficit as related to age. The hypothesis for this study was that there will be a significant delay in the social and language development and a less significant delay in the fine and gross motor functions of children who are visually impaired and have emotional or behavioral deficits. It has been shown that the emotional status of infants who are blind changes at least in early infancy (Tröster & Brambring, 1992). We therefore further hypothesized that such a relationship will increase with age.