Teams in Vision Screening and Early Intervention

Dear Doctor/Nurse Practitioner/Teacher/Therapist/Administrator

As a paediatrician, paediatric nurse or nurse practitioner, teacher at school or preschool or an administrator in charge of services for children, each of you has an important role in the prevention of visual impairment, both binocular and monocular. If you see to that an infant or child is referred for examination and treatment without delay when the symptoms and signs are noticed, the functional results are better than after "wait and see"-periods. We can all make this as an integral part of our routine work by observing and reporting in time.

In the care of visually impaired children the needs of the family are greatest when the diagnosis is made so the counselling and early intervention should be started at the time of diagnosis. This does not always happen at the big hospitals where the child may be seen only once, "because there is nothing to be done" when there is no surgical treatment and the hospital has outsourced rehabilitation to another service. There is always a lot to be immediately done and more to be planned for the future at the local level.

In Finland we have rewritten the recommendation for the follow-up of development of children. Some of the materials related to vision screening and early intervention are now placed on this homepage, also in its English part of the medical and educational questions. They might interest your teams for vision screening and early intervention. More materials are in the sections Assessment of Vision and Info for Parents, and on the LEA tests in the Instructions.

The important feature in the follow-up of the development of vision is to standardize the content of observations and test situations for testing of the different groups of children: healthy infants, infants with special needs; healthy toddlers and toddlers who need to train for test situations; healthy preschool and school children and children who need to be tested in special ways due to their basic health problems. As in any diagnostic work, we need to know what we are looking for and which other findings may be possible. The follow-up of children with special needs is not adequate in any country. Both detection of visual problems, early intervention and the special education of children with special needs requires much work to meet the standards of inclusive education in the 21st millennium.

The transdisciplinary approach combining observations of all workers in health services and day care of children requires further education in each training program. If further training in vision and vision related questions are included in the basic training programs, development of infants and children will be better understood and their problems and strengths are recognized and included in the medical care and in their education.  

I will be looking forward to your comments and suggestions. Feed-back is very welcome to lea.hyvarinen(at)
  1. Follow-up of vision development, videos, typically developing healthy children. The routine observations on the abnormalities, like congenital cataract, constant strabismus, and structural abnormalities of the eyes are covered in the texts and lectures # 2 to 7.

  2. Important First and Preschool Years in the Development of Vision

  3. Routine observations in vision screening, the 1st year (pdf-file)

  4. How to detect impaired vision in infants and children early?

  5. Testing vision of a 23 months old child - Videos

  6. Training for testing of visual acuity

  7. Testing visual acuity of a child with Down syndrome, videos

  8. Do we find all infants at risk? Slides of a lecture given in February 2012 in Montreal.

    You might also want to know about the Assessment of Visual Functioning by ophthalmologists, paediatric neurologists, orthoptists, rehabilitation optometrists, special teachers of the child, therapists, parents and many other persons:

  9. Assessment of Visual Functioning of Disabled Infants and Children as Transdisciplinary Team Work

    In a workshop, an older text with the same content on 6 pages may be easier to begin with:

  10. Assessment of Vision in Infants and Children for Early Intervention and Education

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