Understanding of Objects/Relationships between objects: child with visual impairments, including CVI, are aware of fewer possible objects in the environment with which to interact. Those that are touched and experienced are often misunderstood with fragmented and limited conceptual understanding. Interactions between objects and events are inaccessible without tactile and auditory support.
Object Permanence: Objects must be tactilely explored to even know of their existence. Object permanence develops later for children with visual impairments including CVI. Without vision, there are just fewer opportunities to build learn this concept.
Cause and Effect: Objects must be touched to create a reaction and the reaction must be tactile or auditory.
Spatial relations: Visual relationships between items are limited. Comparisons of attributes (size, shape, color, relative size etc.) are limited. Positions between and among objects must be explored tactilely and through auditory channels.
Concept development: The child must directly explore real items in the real situations in the real world to gain more complete understanding. Incidental learning is missed and concepts reinforced more often.
Communication: Children lack complete access to the facial expressions, body language, gestures, and referenced pointing, all of which build language concepts. They might have limited or no eye contact to promote social interactions. Children with limited eye contacted are addressed and communicated with less often and for shorter period of time. Because they are listening, they are often described as “good babies”. Because they are quiet, people leave them alone more often. They might have reduced language tied to concepts due to limited object and interaction experience. (dogs, puppies, Collies, Golden Retrievers are all dogs). Pronouns are confused due to lack of a visual reference. Play is often are self focused play (tactile, movement or auditory play) rather than outwardly focused on materials in the world. Children often imitate parts of language heard echoing language.
Gross Motor Development
Children with visual impairments may seem passive and need intervention to purposefully explore and know what there is to explore. The developmental milestones occur with some fragmented sequences (limited lifting head while on the stomach, delayed sitting, standing, and walking). These all benefit from compensatory skills use to build motor skills. (let children crawl to sounds rather than handing toys to them all the time, placing sound making toys up on surfaces to encourage pulling to stand and cruising). With less movement there is often low muscle tone in the truck and arms. With less experience and without vision there is delayed or poor protective and balancing skills.
Fine Motor Development
Mouthing remains a primary tactile sensory organ for a longer period of time. This is seen as rolling items on the lips and tongue rather than biting items.
With poor experiences using the arms and hands, there is overall weakness. This impacts Braille learning. Tactile defensiveness may develop as people grab their hands to exploration items. The child had no idea what their hands with encounter and they begin to resist this interaction. This lessens reaching to explore. Parents and teachers should use hand under hand exploration to allow children the option of disengaging. Without direct teaching there are delays in activities of daily living such as hair brushing, tooth care etc.
Bonding is often impacted due to lack of eye contact. Parents and teachers need to look for non-visual cues to a babies needs and interactions. Children are dependent upon parents and teachers to introduce and provide explorations of the environment. Children often have the “good fairy” syndrome. Things appear and disappear in their world. Overall independent must be supported.