Early Identification

EARLY IDENTIFICATION

All children deserve and are entitled to a strong foundation, and for a child who is deaf-blind, the early response of the health community, families, and individual adapted learning experiences can greatly impact his/her future. All areas of development are impacted when one has a dual sensory loss.  

The Story of Max–  

  • Nearly two-thirds of children with vision impairment also have at least one other developmental disability, such as intellectual disabilities, cerebral palsy, hearing loss, or epilepsy.

Vision Loss in Children 

Nearly two-thirds of children with vision impairment also have at least one other developmental disability, such as intellectual disabilities, cerebral palsy, hearing loss, or epilepsy.

Vision Loss in Infants

Hearing Loss – 24.2 (1993) million children under 3 with hearing loss in US – 

1 to 6 per 1000 newborns have congenital hearing loss

Motor Skills: Motor fluency can be difficult. In a young child the motivation to move is most often triggered by something they see or hear. For anyone, movement that is challenging can bring about feelings of insecurity.  Walking with Max

Cognitive Skills: Concept development is compromised. Incidental learning is limited. 

Social-Emotional Skills: Social cues are missed resulting in difficulties learning how and when to interact with others.  https://www.zerotothree.org/resources/series/developing-social-emotional-skills

https://www.virtuallabschool.org/infants-toddlers/social-emotional/lesson-4

Communication Skills: Learning to engage in interactions and participate in language opportunities is difficult. Other people make language accessible to persons who are deaf blind.

 

Adaptive Skills: Learning how to meet one’s own needs for self-care and independence can be challenging.  http://www.guidedogsofamerica.org/1/about-us/financial-information/

Click article for help understanding Common Visual Impairments in Young Children.

Want to know what happens in the first 2000 days of your child’s life?  Click below on link to explore those days.

North Carolina Early Childhood Foundation First 2000 Days Resource

Risk Factors for Dual Sensory Impairments

Prematurity

Associated Vision Loss

  • 4.3% of the premature infants have serious visual defects
  • Optic atrophy, refractive errors and cataracts
  • Optic atrophy associated with severe cerebral palsy

Associated Hearing Loss

  • Sensorineural deafness from hypoxia and hyperbilirubinemia
Direct Trauma to the Eye and Ear

Associated Vision Loss

  • Retinal detachment from an accident
  • Cataracts and glaucoma
  • Scotomas (blind spots in the field of vision)

Associated Hearing Loss

  • Displaced ossicular chain
  • Perforation of the eardrum
  • Temporal bone fracture from a severe blow to the ear or head

 

Severe Head Injury

Associated Vision Loss

  • Visual perceptual deficits; Field cuts; Nystagmus
  • Blindness; Decreased acuity; Scotoma
  • Optic nerve atrophy
  • Retinal detachment

Associated Hearing Loss

  • Tears in the eardrum/displacement of the bones in the middle ear
  • Damage to the inner ear
  • Damage to the auditory nerve or portion of the brain which receives/interprets messages

 

Intraventricular Hemorrage (IVH)

Associated Vision Loss

  • Cortical Visual Impairment

Associated Hearing Loss

  • Central Auditory Processing Disorder

 

Asphyxia

Associated Vision Loss

  • Cortical Visual Impairment

Associated Hearing Loss

  • Central Auditory Processing Disorder

 

Periventricular Leukomalacia (PVL)

Associated Vision Loss

  • Cortical Visual Impairment

Associated Hearing Loss

  • Central Auditory Processing Disorder

 

Tumors

Associated Vision Loss

  • Retinoblastoma is a cancerous (malignant) tumor which develops from an immature retina

Associated Hearing Loss

  • Tumors may also result in conductive or sensorineural hearing losses

 

Post Hemorrhagic Hydrocephalus (PHH)

Associated Vision Loss

  • Cortical Visual Impairment
  • 50% moderate or severe impairment by age 5

Associated Hearing Loss

  • Central Auditory Processing Disorder
  • 50% moderate or severe impairment by age 5

 

Meningitis

Associated Vision Loss

  • Cortical Vision Impairment

Associated Hearing Loss

  • Hearing loss occurs in approximately 10% of bacterial meningitis
  • Hearing loss may be present in one or both ears
  • Damage to the eighth cranial nerve
  • Deafness may occur

 

Encephalitis

Associated Vision Loss

  • Blindness and visual impairments

Associated Hearing Loss

  • Sensorineural loss may result

 

Syphilis

Associated Vision Loss

  • Astigmatism
  • Chorioretinitis (an inflammation of the retina and choroids area)
  • Iridocyclitis (inflammation of the iris and ciliary body)
  • Glaucoma
  • Optic atrophy may be present

Associated Hearing Loss

  • Sensorineural

 

Toxoplasmosis

Associated Vision Loss

  • Mild vision loss to blindness
  • Chorioretinitis (an inflammation of the retina and choroids area)
  • Retinal detachment
  • Cataracts
  • Retinal necrosis

Associated Hearing Loss

  • Sensorineural present at birth or develops later
  • Degree of hearing loss varies including profound hearing loss

 

Rubella

Associated Vision Loss

  • Cataracts
  • Abnormalities to the cornea, iris, ciliary body and retina
  • Glaucoma
  • Microphthalmus (small eyes)
  • Ocular Motor disorders
  • Severe refraction errors, especially myopia
  • Common to have acuity worse than 20/200
  • Sensorineural loss is the most common long term problem

Associated Hearing Loss

  • May involve only one ear
  • Degree of hearing impairment varies
  • Hearing loss may develop over time and be progressive

 

Herpes

Associated Vision Loss

  • Optic nerve atrophy (wasting away of the optic nerve)
  • Retinitis (inflammation of the retina)
  • Inflammation, lesions, and cloudiness of the cornea (keratitis)
  • Retinal detachment
  • Cataracts
  • Strabismus
  • Visual Field Deficits

Associated Hearing Loss

  • High risk for hearing loss

 

Cytomegalovirus (CMV)

Associated Vision Loss

  • Retinitis (inflammation of the retina)
  • Optic atrophy
  • Anophthalmia (absence of the eyeball)
  • Coloboma
  • Iridocyclitis
  • Photophobia (intolerance of light)

Associated Hearing Loss

  • Sensorineural
  • Hearing loss ranges from mild to profound
  • Occurs in both ears and may be progressive

 

Down Syndrome

Associated Vision Loss

  • Problems in visual acuity (nearsightedness and farsightedness)
  • Strabismus (crossed eyes)
  • Keratoconus (cone shaped cornea)

Associated Hearing Loss

  • Moderate hearing loss
  • Conductive hearing losses from recurrent middle ear infections

 

Trisomy 13

Associated Vision Loss

  • Microphthalmia (abnormally small eyes)
  • Colobomas (fissures) of the iris
  • Retinal dysplasia (abnormal development of retinal tissue)
  • Cataracts

Associated Hearing Loss

  • Varying degree of loss

 

Usher Syndrome

Associated Vision Loss

  • Retinitis Pigmentosa
  • Night blindness
  • Visual loss in the peripheral fields
  • Blindness may not occur until middle or late adult life

Associated Hearing Loss

  • Congenital hearing loss
  • Severe to moderate loss in both ears
  • High frequency loss is typical

 

Alstrom Syndrome

Associated Vision Loss

  • Nystagmus with sensitivity to light
  • Blindness from retinitis pigmentosa
  • Progressive vision loss by age seven nearing total blindness
  • Mild to moderate cataracts in the teen years
  • Glaucoma and dislocated lens

Associated Hearing Loss

  • Mild sensorineural hearing loss occurs in both ears around seven to ten years
  • Progressive loss occurs later in life

 

Charge Syndrome

Associated Vision Loss

  • Coloboma
  • Visual field and acuity losses (often occurring in the upper field of vision)
  • Total loss of vision will be present if anophthalmos (absence of the eyeball) occurs
  • Microphthalmus (small eyes)
  • Optic nerve hypoplasia (defective development of optic nerve)
  • Cataract, retinal detachment, nystagmus
  • Disorders of refraction and ocular movement

Associated Hearing Loss

  • Sensorineural loss and structural deformities in the outer ear
  • External ear abnormalities
  • Chronic otitis media (middle ear infection)
  • Varying degree of loss

 

Goldenhar Syndrome

Associated Vision Loss

  • Stigmatism
  • Coloboma of the eyelid, iris or choroids
  • Cataracts, nystagmus, strabismus, and retinal detachment
  • Central visual pathway abnormalities

Associated Hearing Loss

  • Physical malformation of the ear
  • External ear canal absent or narrowed
  • Abnormalities in the middle ear
  • Abnormalities in the inner ear
  • A mixed loss may be present as well
  • Hearing loss in one ear

 Resources

Videos

 

Series of Training Videos:

 

Articles