Visual Problems FInal

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Visual Problems FInal
2010-03-24 22:21:35
Lecture # 1 Developmental Final

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  1. What are the most prevalent visual impairments
    • Cortical visual impairment
    • ROP
    • optic nerve hypoplasia
    • structural abnormalities
    • albinism
  2. Most prevalent visual condition in young children
    cortical visual impairment
  3. What is the cause of cortical vision impairment
    • injury to brain or visual pathways in the brain rather than abnormal structures of the eyes
    • From O2 deprivation, prematurity, PVL, trauma, meningitis
  4. What other health conditions occur with cortical vision impairment
    • Many children with CVI (and ROP) have co-occurring health conditions
    • Infants and toddlers with CVI and ROP who depend on technology may have unique medical needs that effect early intervention
    • Common conditions: legally blind, developmental delays, seizures, eating disorders, dependent on technology (trach, GT),
    • respiratory problems
  5. How does cortical vision impairment vary
    • severity varies from child to child and from environment to environment
    • these kids may experience improvement in visual function
  6. What are the visual behaviors of cortical visual impairment
    • neuro abnormalities in addition to other ocular disorders
    • vision fluctuates with fatigue and levels of sensory input
    • may have limited or no eye contact because peoples faces look different at different times
    • vision generally improves overtime but does not extend to typical levels of vision
  7. Why has incidence of ROP increased
    improved technology that allows for smaller and younger infants to survive
  8. What is the incidence of blindness from ROP
    500-550 per year
  9. Who is at risk for ROP
    • more complicated hospital stays
    • RDS
    • pneumothorax
    • PDA
    • IVH
    • sepsis
    • other complications from prematurity
  10. Considered to most prevalent congenital optic disorder found in young children with severe visual impairment
    optic nerve hypopasia
  11. When does optic nerve hypoplasia develop
    present at birth from the abnormal development of nerve fibers that make uo the optic nerve
  12. What are the risk factors of optic nerve hypoplasia
    • young mother
    • 1st pregnancy or >4th
    • smoking
    • premature birth
    • SGA
    • LBW
  13. Why is vision an integrating sense
    • enables infants to learn about people, objects, and events
    • encourages play behaviors, visual imitation skills and activities
    • facilitates social development and self-help activities
    • plays a critical role in attention and cognitive development
    • motivates infants and toddlers to stay awake, alert and attentive to people, objects and events
  14. What are the red flags for visual impairments
    • squinting, closing or covering one eye
    • holding objects close to the face
    • excessive clumsiness
    • tilting head to one side
    • over/under reaching for objects
    • rubbing or pressing eyes repeatedly
    • drooping eyelids
    • watery eyes constantly
    • jerky eyes that dont move together
    • child doesnt look at your eyes (after 3 months of age)
    • doesnt look directly at the object, looks above, below or off to one side
    • trouble seeing at night
    • searches for things on ground by feeling
  15. Why is dx and referral important
    • structural abnormalities may be dx at birth or very early but many are not
    • lag time bw dx and referral suggests that closer collaboration with eye specialists is needed
    • earlier referral could lead to more immediate supports for the family and facilitate optimal development
  16. What children are eligible for services
    • Corrected visual acuity of 20/70 or worse in the better eye &/or
    • remaining visual field of 20 degrees or less in the better eye &/or
    • state from an ophthalmologist that a child would benefit from services provided by a teacher or visually impaired
  17. What type of services are available for visually impaired
    • Functional vision assessments
    • Visual efficiency & low vision training
    • orientation and mobility
    • assessment and intervention
    • emergent braille and braille instruction
    • Family support services and activities
    • developmental assessments
    • IFSP & IEP
    • service coordination
    • staff development opportunities
  18. What is the IFSP & IEP
  19. Why is time important with visually impaired children
    • Slow is not a behavior but a need for processing
    • children with VI may need additional time to process visual impairments
  20. Why is contrast important for VI
    The differences in light and dark create clear edges, boundaries and patterns
  21. Why is size and form important for VI
    • Selection of sizes and forms of objects are determined by degree of the visual field and accuity
    • Ex: if have poor visual acuity then bigger is better but if have poor visual fields bigger is not better they need smaller
    • Shapes such as pentagons are sharp and easier to see versus oval or circle
  22. Why is movement important in children with VI
    • Movement is one of the most motivating intervention strategies
    • the visual system is sensitive to direction, orientation and speed of movement in central and peripheral fields
    • A slinky is very good at movement
  23. What additional disabilities accompany ROP?
    About 70% of children with ROP have additional disabilities including MR, CP, behavioral problems, deafness/hard of hearing
  24. What type of problems do premature infants usually have?
    • More Myopic (near-sighted) at birth when ROP is present
    • Have small papillary aperture so the response to light may vary depending on the degree of prematurity
    • Visual skills may emerge at a slower rate
  25. Which eye does Optic nerve hypoplasia effect
    May effect one or both eyes
  26. What type of impairment does a child have with optic nerve hypoplasia
    Visual function ranges from normal to total blindness
  27. How is optic nerve hypoplasia related to congenital hypopituitarism
    • Hypopituitarism is associated with impaired growth, hypoglycemia, developmental delay, seizures, and death
    • When combined with optic nerve hypoplasia �condition icalled septo-optic dysplasia is usually present
  28. What is Septo-optic dysplasia?
    • Associated with the absence of the septum pelucidum and a thinning of the corpus callosum accompanied by small optic nerves
    • These children usually have hypopituitarism and may exhibit clinical signs that are similar to those children with ONH alone
  29. What are the two most common problems associated with septo-optic defect
    • Vision loss
    • Hypopituitarism
  30. What is an IFSP
    • A plan for families and the child
    • Used in early intervention
  31. What is an IEP
    Educational plan for the child when he enters school
  32. When does the child leave early intervention
    At age 4
  33. What is the advantage of teacher of visual impaired (TVI)
    • Located in all 100 counties in NC
    • Serve children birth-5 regardless of the impairment
    • Services are provided in the childs natural environment
    • Collaborate with other professionals to benefit the child
    • NC is the only state to provide full services until age 5
  34. What is needed to provide a visual for eye services at the governor morehead preschool
    • Copy of an eye report that is current within one year
    • Referrel form completed by the parent, ophthalmologist or other care providers
  35. Why is time important for children who are visually impaired
    They need additional time to process visual information
  36. Why is contrast good for visually impaired children
    The differences in light and dark create clear edges , boundaries and patterns
  37. How is size and form important to visually impaired children
    Selection of sizes and forms of objects is determined by the degree of the visual field and/or acuity
  38. How is movement important to vision
    The visual system is sensitive to direction, orientation and speed of movement in central and peripheral fields
  39. How is the auditory system important to vision
    • hearing is our only other distance sense
    • when residual vision alone has not gained a response add sound
  40. How is tactile important to vision
    Childrens manipulation of objects contributes to a knowing of the edges and patterns which reinforces what their brain interprets visually