Problemi u vizualnom funkcioniranju djece s inetelektualnim teškoćama

Problems in visual functioning are one of the most common additional problems in children with intellectual disabilities. Nevertheless, they often remain undetected in children with intellectual disabilities, yet they affect development and learning. Therefore, to examine the prevalence and the kind of visual problems in children with intellectual disability we tested visual functions (visual acuity, contrast sensitivity, stereoacuity, oculomotor functions) in 25 children. All children had mild to moderate intellectual disabilities, and were between 7 and 13 years old. They all attended schools for children with intellectual disabilities. Results show that visual functions in most children were less developed than expected for their age, especially stereovision. Almost half of them had uncorrected refractive errors. We found some degree of low vision in seven children, according to results of visual acuity. The results of this study indicate that functional vision assessment should be mandatory for children with intellectual disabilities, to detect visual problems, and provide timely intervention and adaptation of materials and methods.Problemi u vizualnom funkcioniranju među najčešćim su dodatnim poteškoćama u djece s intelektualnim teškoćama. Ipak, ovi problemi često ostaju neprepoznati i neotkriveni, a uvelike utječu na razvoj i učenje. Kako bismo ispitali učestalost i vrste problema u vizualnom funkcioniranju djece s intelektualnim teškoćama, procijenili smo vidne funkcije (oštrina vida, osjetljivost na kontraste, stereovid i okulomotoričke funkcije) u 25-ero djece s blagim i umjerenim stupnjem intelektualnih teškoća, kronološke dobi od 7 do 13 godina, polaznika škole za djecu s intelektualnim teškoćama. Rezultati su pokazali da su vidne funkcije većine djece razvijene ispod očekivanih rezultata u odnosu na njihovu dob, osobito stereovid. Gotovo polovina djece imala je refrakcijske greške koje nisu korigirane. Rezultati čak sedmero djece na testovima oštrine vida ukazuju na slabovidnost. Procjena funkcionalnog vida mora postati obavezna za svu djecu s intelektualnim teškoćama, kako bi se na vrijeme prepoznale poteškoće u vizualnom funkcioniranju, osigurala pravovremena intervencija i učinila prilagodba nastavnih sredstava i metoda

Povezanost stereovida i motoričkih vještina u djece s intelektualnim teškoćama

The goal of this study was to determine the relationship between stereoacuity and proficiency in fine and gross motor skills. Stereovision is one of the information sources for accurate perception of objects in depth, and it is related to performance on motor skills tasks. Studies have shown that children of primary school age with mild intellectual disabilities perform worse than typically developing children on specific fine and gross motor skills. Also, problems in visual functioning, including impaired binocular vision (stereovision), are common in children with intellectual disability. We tested 27 children with intellectual disabilities but without any motor skills deficiency. Research was conducted at the Centre for Education "Velika Gorica" and Elementary School "Nad lipom". For this research, we constructed a Likert-type scale to assess fine and gross motor proficiency. We also tested stereoacuity using the Random Dot 2 Acuity Test with Lea Symbols®. Our results show a relationship between the degree of stereovision and level of proficiency in fine and gross motor skills. Since stereovision develops during preschool years and is related to other skills, we need to provide timely assessment of visual functioning and create specific program adaptations for children with intellectual disabilities.Cilj ovog istraživanja bio je utvrditi postoji li povezanost između stupnja razvoja stereovida i spretnosti u gruboj te finoj motorici. Stereovid je jedan od izvora informacija za točnu procjenu percepcije objekata u dubini i povezan je s izvođenjem motoričkih aktivnosti. Rezultati istraživanja pokazali su da su djeca s lakim intelektualnim teškoćama osnovnoškolske dobi lošija u izvođenju motoričkih aktivnosti nego djeca tipičnog razvoja. Također, vizualna odstupanja učestala su kod djece s intelektualnim teškoćama, uključujući i oslabljen binokularni vid (stereovid). Testirali smo 27-ero djece s intelektualnim teškoćama, bez motoričkih teškoća. Istraživanje je provedeno u Centru za odgoj i obrazovanje "Velika Gorica" i Osnovnoj školi "Nad lipom". Za potrebe ovog istraživanja, konstruirali smo skalu Likertovog tipa za procjenu spretnosti u finoj te gruboj motorici. Također, testirali smo i stereovid koristeći stereotest Random Dot 2 Acuity Test with Lea Symbols®. Rezultati su pokazali postojanje povezanosti između stupnja razvoja stereovida i spretnosti u finoj te gruboj motorici. Budući da se stereovid razvija u predškolskoj dobi i povezan je s razvojem drugih vještina, nužno je osigurati pravovremenu procjenu vizualnog funkcioniranja i u skladu s tim, kreirati specifične programe za djecu s intelektualnim teškoćama

Povezanost stereovida i motoričkih vještina u djece s intelektualnim teškoćama

The goal of this study was to determine the relationship between stereoacuity and proficiency in fine and gross motor skills. Stereovision is one of the information sources for accurate perception of objects in depth, and it is related to performance on motor skills tasks. Studies have shown that children of primary school age with mild intellectual disabilities perform worse than typically developing children on specific fine and gross motor skills. Also, problems in visual functioning, including impaired binocular vision (stereovision), are common in children with intellectual disability. We tested 27 children with intellectual disabilities but without any motor skills deficiency. Research was conducted at the Centre for Education "Velika Gorica" and Elementary School "Nad lipom". For this research, we constructed a Likert-type scale to assess fine and gross motor proficiency. We also tested stereoacuity using the Random Dot 2 Acuity Test with Lea Symbols®. Our results show a relationship between the degree of stereovision and level of proficiency in fine and gross motor skills. Since stereovision develops during preschool years and is related to other skills, we need to provide timely assessment of visual functioning and create specific program adaptations for children with intellectual disabilities.Cilj ovog istraživanja bio je utvrditi postoji li povezanost između stupnja razvoja stereovida i spretnosti u gruboj te finoj motorici. Stereovid je jedan od izvora informacija za točnu procjenu percepcije objekata u dubini i povezan je s izvođenjem motoričkih aktivnosti. Rezultati istraživanja pokazali su da su djeca s lakim intelektualnim teškoćama osnovnoškolske dobi lošija u izvođenju motoričkih aktivnosti nego djeca tipičnog razvoja. Također, vizualna odstupanja učestala su kod djece s intelektualnim teškoćama, uključujući i oslabljen binokularni vid (stereovid). Testirali smo 27-ero djece s intelektualnim teškoćama, bez motoričkih teškoća. Istraživanje je provedeno u Centru za odgoj i obrazovanje "Velika Gorica" i Osnovnoj školi "Nad lipom". Za potrebe ovog istraživanja, konstruirali smo skalu Likertovog tipa za procjenu spretnosti u finoj te gruboj motorici. Također, testirali smo i stereovid koristeći stereotest Random Dot 2 Acuity Test with Lea Symbols®. Rezultati su pokazali postojanje povezanosti između stupnja razvoja stereovida i spretnosti u finoj te gruboj motorici. Budući da se stereovid razvija u predškolskoj dobi i povezan je s razvojem drugih vještina, nužno je osigurati pravovremenu procjenu vizualnog funkcioniranja i u skladu s tim, kreirati specifične programe za djecu s intelektualnim teškoćama

Stimulation of Functional Vision in Children with Perinatal Brain Damage

Cerebral visual impairment (CVI) is one of the most common causes of bilateral visual loss, which frequently occurs due to perinatal brain injury. Vision in early life has great impact on acquisition of basic comprehensions which are fundamental for further development. Therefore, early detection of visual problems and early intervention is necessary. The aim of the present study is to determine specific visual functioning of children with perinatal brain damage and the influence of visual stimulation on development of functional vision at early age of life. We initially assessed 30 children with perinatal brain damage up to 3 years of age, who were reffered to our pediatric low vision cabinet in »Little house« from child neurologists, ophthalmologists Type and degree of visual impairment was determined according to functional vision assessment of each child. On the bases of those assessments different kind of visual stimulations were carried out with children who have been identified to have a certain visual impairment. Through visual stimulation program some of the children were stimulated with light stimulus, some with different materials under the ultraviolet (UV) light, and some with bright color and high contrast materials. Children were also involved in program of early stimulation of overall sensory motor development. Goals and methods of therapy were determined individually, based on observation of child’s possibilities and need. After one year of program, reassessment was done. Results for visual functions and functional vision were compared to evaluate the improvement of the vision development. These results have shown that there was significant improvement in functional vision, especially in visual attention and visual communication

Povezanost socijalnih vještina i problema u ponašanju kod djece oštećenog vida

Previous research has indicated that there is a significant correlation between social skills and problem behaviors. Children with poor social skills usually show some kind of problem behavior. Both poor social skills and problem behaviors negatively influence psychosocial functioning as well as academic achievement. Children with visual impairment often have problems in social functioning throughout their whole life as a consequence of impaired vision, but also as a consequence of insufficient and adverse social experiences. The most common problem behaviors these children experience are social withdrawal and aggression. The goal of this study was to define the relationship between social skills performance and behavioral problems in students with visual impairment. The study was comprised of 39 parents of teenage children with visual impairment (13–17 years old). The children attended regular state schools and a school for the blind in the Republic of Croatia. The data were collected using the Social Skills Rating System (SSRS) developed by Gresham and Elliott (1990) and were analyzed by quasi-canonical correlation analysis using ROBKAN software. The obtained results confirmed the correlation between social skills and problem behaviors in children with visual impairment. Children with poorer social skills had more problems with behavior. The correlation was particularly evident in the domain of cooperation, as more responsible and more cooperative children had significantly less problems with behavior.Socijalne vještine i problemi u ponašanju povezani su. Djeca koja imaju slabije razvijene socijalne vještine redovito manifestiraju neki od oblika problema u ponašanju. Slabije socijalne vještine kao i problemi u ponašanju negativno utječu na psihosocijalno funkcioniranje i na akademska postignuća. Djeca oštećenog vida, zbog samog oštećenja ali i zbog nedovoljnih i nepovoljnih socijalnih iskustava, često imaju poteškoće u socijalnom funkcioniranju, koje ostaju prisutne tijekom cijelog života. Od problema u ponašanju u ove djece najčešće se javljaju socijalna povučenost i agresija. Cilj ovog rada bio je ispitati povezanost socijalnih vještina i problema u ponašanju djece oštećena vida. Ispitivanjem su obuhvaćeni roditelji tridesetdevetoro (N=39) djece oštećenog vida kronološke dobi od13 do 17 godina. Djeca su pohađala redovne osnovne škole u RH i specijaliziranu ustanovu za odgoj, obrazovanje i rehabilitaciju učenika oštećenog vida. Podatci su prikupljeni primjenom instrumenta SSRS – Social Skills Rating System (gresham i Elliot, 1990.) a obrađeni su kvazikanoničkom korelacijskom analizom pomoću programa ROBKAN. Podatci dobiveni istraživanjem potvrđuju povezanost socijalnih vještina i problema u ponašanju kod djece oštećena vida. Djeca oštećenog vida koja imaju slabije socijalne vještine manifestiraju veći broj problema u ponašanju. Osobito je ta povezanost vidljiva u području odgovornosti i kooperativnosti: odgovornija i kooperativnija djeca manifestiraju značajno manji broj problema u ponašanju

Cerebralno oštećenje vida - dijagnostički kriterijumi i elementi tretmana

Cortical visual impairment is a leading cause of difficulties in visual functioning in premature children and children with cerebral palsy. Bearing in mind that a large part of the brain is involved in regulating visual-perceptive activities, the factors which influence its structure and functioning are a common cause of visual impairment. Complex neurological and neuro-ophthalmological basis of cortical visual impairment requires a transdisciplinary approach, as the most effective one for making accurate diagnosis and planning treatment. Introducing a separate code for cortical visual impairment in the International Classification of Diseases can simplify the diagnostics, formation of uniform diagnostic criteria, and provide evidence-based treatment involvement. Determining the presence of neurological impairment and a detailed assessment of visual functioning facilitate the creation of intervention programs and a "friendly environment" for working and daily functioning, based on individual needs of a child.Cerebralno oštećenje vida predstavlja vodeći uzrok teškoća u vizuelnom funkcionisanju kod prevremeno rođene dece i dece s cerebralnom paralizom. Imajući u vidu da je veliki deo mozga uključen u regulaciju vizuelno-perceptivnih aktivnosti, činioci koji utiču na njegovu strukturu i funkcionisanje su čest uzrok oštećenja vida. Složena neurološka i neuroofalmološka osnova cerebralnog oštećenja vida zahteva transdisciplinarni pristup, kao najefektivniji za postavljanje precizne dijagnoze i planiranje tretmana. Uvođenje posebnog koda za cerebralno oštećenje vida u Međunarodnu klasifikaciju oboljenja može da pojednostavi dijagnostiku, formiranje jedinstvenih dijagnostičkih kriterijuma i obezbedi, na dokazima zasnovano, uključivanje u tretman. Utvrđivanje prisustva neurološkog oštećenja i detaljna procena vizuelnog funkcionisanja olakšavaju kreiranje programa intervencije i "prijateljskog okruženja" za rad i svakodnevno funkcionisanje, zasnovanog na individualnim potrebama deteta

Visual Impairments in Children with Cerebral Palsy

Cerebral palsy (CP) is the neurological developmental disorder mainly affecting motor abilities. Considering the high rate of associated impairments even the definition of CP is revised and changed. Visual impairment is one of the most common associated impairment. Unfortunately, it is often unrecognized and considered to be a normal consequence of motor problems. Sense of sight is most important for early child development, motivation, learning through imitation. It is, therefore, indispensable to know about visual problems of children with CP and possibilities of facilitating visual functioning in different situations. Early comprehensive, multidisciplinary assessment must be done whenever the child is at risk for developing neurological dysfunction. This review gives informations about incidence and kind of visual problems in children with cerebral palsy

Visual Impairments in Children with Cerebral Palsy

Cerebral palsy (CP) is the neurological developmental disorder mainly affecting motor abilities. Considering the high rate of associated impairments even the definition of CP is revised and changed. Visual impairment is one of the most common associated impairment. Unfortunately, it is often unrecognized and considered to be a normal consequence of motor problems. Sense of sight is most important for early child development, motivation, learning through imitation. It is, therefore, indispensable to know about visual problems of children with CP and possibilities of facilitating visual functioning in different situations. Early comprehensive, multidisciplinary assessment must be done whenever the child is at risk for developing neurological dysfunction. This review gives informations about incidence and kind of visual problems in children with cerebral palsy

Razvoj funkcionalnog vida kod djece s perinatalnim oštećenjem mozga

Development of visual functions is a result of cortical circuits development. From different researches it is known that early stimulation affects those cortical circuits development and encourage development of the function. Nevertheless there are no data about critical period for visual function habilitation, esspecially in children with perinatal brain damage. Our hipotesis was that the critical period for stimulating visual functions and functional vision in children with perinatal brain damage is within the first year of life. We tested this hipotesis by comparison of visual function and functional vision improvement during visual stimulation program between children who were included in (re)habilitation within the first and the children included within the second and the third year of life. Our aim was, also, to compare differences in vision function and functional vision development in relation to the type and degree of perinatal brain damage. And to define which perinatal brain damage type is the most common cause of impaired vision. Results have shown that children with perinatal brain damage who were included in visual stimulation program within the first year of life, and esspecially those who were included within the first six moths of life, tend to achieve better improvement in visual functioning in comparison to children who were included in the program within the second and the third year of life. The children had the best improvement in fixation point, pursuit eye movements, eye convergence, contrast sensitivity, visual attention and eye-hand coordination. Hence, for the optimal development of these functions timely intervention is a crucial factor. According to our data, the most problems in visual functioning children with perinatal brain damage have in oculomotor functions (fixation, tracking) and visual attention, visual communication and eye hand coordination, alhough, all visual functions improve during the visual stimulation program. Preferential visual acuity is a function that is the least developed during the visual stimulation program in all children included in the study. Results have, also, showed that children with periventricular leucomalacia have more problems in all the visual functions and visual functioning indicators than children with hypoxic ischemic encelophaty and intraventricular hemorrhage. These differences in visual functioning problems between children in relation to type of perinatal brain damage are noticed on both assessmetns. Nevertheless, the type of perinatal brain damage does not significantly affect the outcome of visual stimulation program

Early functional vision habilitation outcome in children with perinatal brain damage

Cerebralno oštećenje vida je najčešći uzrok slabovidnosti, odnosno sljepoće u razvijenim zemljama. U dječjoj dobi najčešće je uzrokovano perinatalnim ozljedama mozga. Teorijski model rane intervencije bazira se na spoznaji o plastičnosti mozga. Tako autori tvrde kako je rana dob djeteta najbolje razdoblje za poticanje razvoja vidnih funkcija u djece s cerebralnim oštećenjem vida. Cilj istraživanja je bio utvrditi postoji li značajno poboljšanje funkcionalnog vida (korištenje vida u svakodnevnim situacijama) u djece s perinatalnim ozljedama mozga nakon provedenog programa vidnih stimulacija. Procjena funkcionalnog vida učinjena je na uzorku od 100 djece s perinatalnim ozljedama mozga prije i poslije provođenja programa vidnih stimulacija. Rezultati su pokazali kako djeca značajno bolje koriste vid nakon provedene habilitacije, a najveće poboljšanje zabilježeno je u sposobnosti zadržavanja vidne pažnje.Cerebral visual impairment is the most common cause of low vision and blindness in developed countries. In childhood, it is mostly caused by perinatal brain damage. Theoretical model of early intervention is based on our knowledge of brain plasticity. Most of the authors claim that early infancy is the best age for stimulating visual functions development in children with cerebral visual impairment. The aim of the study was to investigate the improvement of visual functioning (using vision in everyday activities) in children with perinatal brain damage after the visual stimulation program. We assessed 100 children and compared results of assessments before and after visual stimulations. Results show that children improved their visual functioning in all situations, and the best improvement was in keeping visual attention