Object Permanence

Severely visually impaired infants experience such a limited space that toys andother things regularly disappear from it. Therefore they see their toys and the surroundingsonly short times now and then and are unaware of the fact that these objects do existnot far from them at the time they are out of reach. This obviously makes it difficultto develop the concept of object permanence and also to get forewarnings, both positiveand negative ones.

If the child has normal hearing, we can use auditory information to make the childaware of that things do exist outside the visual sphere and can be recognised becauseof their auditory features. If the child uses a bottle, the sound of the bottle isa good auditory stimulus in this training. When the bottle is shown to the childwithin his/her visual sphere with simultaneously moving it to make it sound, thechild can learn the connection between the visual structure of the milk bottle andthe sound of the milk bottle. Then one can move the bottle further and further awayfrom the infant while letting the bottle sound and then come back closer to the infantuntil the child can also see the bottle. All interesting objects that have a soundcan be shown this way. Similarly people's voices are effective in reassuring theinfant that the family members do not disappear in thin air when they are invisible.

57. Normally sighted infants usually have some playthings hanging from a rod across their crib. For the visually impaired infant itis so important to get objects in the mouth that the play things should be fastenedon a heavy duty rubber band so that the child can pull them into the mouth. Whenhe/she then lets them go they stay hanging on the same place where they were foundpreviously.

59. Carrying the infant around in the rooms and studyingdifferent objects with him/her, especially lamps, is a good training in orientationand in object permanence.

Vision allows a sighted infant to observe activities around him/herself. Objectsare recognized at longer and longer distances and the infant/child gets a forwarningof what is going to happen. A normally sighted infant can see for example a syringewith a needle in the hand of a nurse at a distance of more than a meter and get aforewarning before it is stuck in his/her skin. A severely visually impaired infantdoes not get this information, the shot then comes without any forewarning and maybe a very traumatic experience. It is important to inform new nurses taking careof the infant to make sure that the infant has seen as much as possible of the instrumentationand that the nurse explaines the infant/child with a few simple words and by touchingthe relevant body part, what is going to happen. The frases used need to be the sameby everybody. Then the auditory code will function as the forewarning and the infantwill not be unnecessarily startled. Sighted people who are not often in contact withvisually impaired infants and children may find it very difficult to remember thatthese children have such a limited world and that their concepts of objects and theirexistence do not have the same character that normal sight gives to sighted people.

When visually impaired infants and children stay at different wards at the hospitals,it has been beneficial to have with them a small children's suitcase with their favouriteplay things and an explanation on the inside of the suitcase about how to warn thechild and how to approach the child, what the child is afraid of and what he/shelikes especially much. I also recommend hanging a sign at the crib or bed of thevisually impaired child "I do not see who you are so tell me and come close".

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