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AFBAmerican Foundation®
for the Blind

Expanding possibilities for people with vision loss

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Many young children with visual impairments do not know they see differently from everyone else so they can't tell you about it. As a parent, you may have suspected that your child had a vision problem within the first few months after birth. You might know, for example, that if a child's eyes don't appear to be aligned at age two or three months, it's not cause for worry because ocular muscles take several months to become fully coordinated. But at what age should that continuing condition be considered a possible danger signal? That is something only an eye specialist can tell you.

Assessment

The earlier vision impairment is diagnosed, and functional vision is assessed, the sooner treatment and training can begin. So as soon as you have any reason for concern it is essential to bring your child to an eye specialist, who can advise you about next steps. At that point, he or she will probably refer you to a vision evaluator for a functional vision assessment of your child.

In evaluating functional vision, the evaluator will observe your infant's or toddler's reactions to various situations:

  • Does the child react to light? If so, how?
  • Does the child react to black-and-white designs (such as a bull's eye, checkerboard pattern, wide diagonal, or jagged lines)? If so, how and at what distance?
  • Does the child react to silent human faces? If so, how, and at what distance?
  • Does the child make any attempt to maintain a gaze at silent people or silent objects? If so, at what distance?
  • What size and color of silent objects does the child try to look at, at what distance, and under what lighting conditions?

The evaluator also notes behaviors that are related to or monitored by vision, such as these:

  • Ability to hold the head erect and steady, allowing the visual system to operate at whatever level it is able
  • Interest in people, their facial expressions, and body movements;
  • Interest in objects and attempts to grab them
  • Ability to reach accurately for objects and people
  • Ability to imitate facial expressions (such as sticking out the tongue, opening the mouth wide, making a silly face) or gestures (like finger wiggling and playing peek-a-boo).

The results of these observations are indicative of how the child uses whatever vision is available to him or her.

Your Rights to Services

High-quality intervention and appropriate educational and family services during the early childhood years help ensure that a child with a visual impairment will enter kindergarten or first grade with the necessary skills to be successful.

In 1997, amendments to the Individuals with Disabilities Education Act (IDEA) shifted the Early Intervention Program for Infants and Toddlers with Disabilities to Part C of IDEA, and early intervention programs are sometimes referred to as Part C programs. Under Part C program regulations, children under age 3 who have developmental delays or any physical or mental conditions that are likely to cause developmental delays are entitled to receive early intervention services.

These services require an Individual Family Service Plan (IFSP) that clearly outlines why intervention is needed; what kind of intervention it will be; who will provide it and how often; and in what environment it will be provided. A service coordinator must be designated, who will ensure that the plan is implemented and coordinate the participation of all agencies involved.

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