Motor Development

Impaired vision affects both oculomotor and general motor development. The childmay not develop normal fixation but has nystagmus (=rythmic movements usually inhorizontal direction) or slowly roving eye movements, if vision is really poor. Tracking,following an object with eye movements may be irregular and accommodation insufficientor lacking.

In general motor development the effect is clearly seen in the development ofhead lift, hand regard, and bringing hands to the midline.

19. The difference in the behaviour of the two twinsis demonstrative: the visually impaired infant to the left, when brought towarda surface, does not reach with his hands toward it and his head hangs low, whereasthe sighted twin reaches for the surface and his head control is good (Dr.PatriciaSonksen's slide).

20. Head lift can be trained in many ways as a partof physiotherapy. Strong visual stimuli can be used throughout the infancy andeven later to motivate the child to train head control. This little light box teachesthe infant also another important function, making decisions. The child can him/herselfturn the light of and on. When the infant learns to make a decision in such a simplesituation, he/she may be able to make up his/her mind later in more difficult situations.

21. Normally sighted infants start to watch their handsat the age of three months and spend hours in admiring them. Visually impaired infantsmay see details of their hands only by placing the hands on a light box.

22. This infant has spontaneously crawled to the lightbox and is watching her fingers when she lifts them one at a time. This way she canget visual information about fine motor control.

23. If an infant does not start looking at his/her handswe can create a play situation to make the infant aware of them by using a simplevisuotactile picture on the light box.

24. When the fingers happen to touch the raised lineof the figure, the infant looks at his hand for the first time. As we can see fromthe wrinkles on the little forehead, it is very difficult to understand what youare looking at when you see your hand for the first time.

25. In such a situation the only sensible thing to dois to put that something in your mouth to get more understandable information.This play situation creates a very useful learning situation: the child sees somethingand puts it in his mouth to combine visual and tactile information.

26. In baby gymnastics, several motor functions canbe trained at the same time: head control, looking at an object and reaching forit (Photo A.M Hartman 1983).

27. When we see a visually impaired infant bringingan object closer to the eyes to watch it more carefully, we know that the child haslearned to use vision to study the environment and is training eye-hand co-ordination.

28. If a neurologically normal, nearly blind or blindinfant does not have early physiotherapy, development of gross motor functions maybe delayed. The static motor functions like sitting may be well developed.

29. When the infant is pulled up on her feet, standingis quite stable.

30. However, when the child is turned on her stomach,head control of this six-month-old, severely visually impaired infant is worse thanthe head control of a normally sighted two-month-old infant (Painting by M.Törmibased on a black and white photograph).

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