CHILDREN WHO ARE DEAF-BLIND
EARLY IDENTIFICATION
The Story of Max– Take a few minutes to view 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.
https://www.dailymotion.com/video/x2nn5u0
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
- Beginner Sign Language inEmergency – 25 Beginner Signs
- Beginner Sign
- Beginner Sign 2
- Switched at BirthCast use favorite words
- Sign for Stores, Eatery
- Fingerspelling for Beginners
- Foundations for Inclusion Birth to 5 Inclusion
- Early Intervention – Helping babies with visual impairments
- Teaching Students with visual impairments (Video)
- Kathleen Consadine, Akron Children’s Hospital, level 1 introduction, typical language (Video) – signs of speech/language delay
- Dr. James Dean, University of Arizona Series of trainings developed and funded by the Arizona Department of Health Services (Video)
- What happens after a child is referred from the Newborn Screening? (Video) – Linda Norax, University of Arizona
- What are the steps for early intervention? IFSP process, and the communication needs (Video) – Julie Peterson University of Arizona
- Sign language for all children (Video)
- Identifying and Treating Speech and Language Delays (Video)
- Early Language and the Brain – The Economist (Video)
- Cortical Vision Impairment: Assessment and Intervention (Video)
- Autism and Visual Impairment: The Better Together Curriculum (Video)
Series of Training Videos:
- Early childhood hearing and vision loss videos
- What is Vision Impairment? (Video)
- Blind Children’s Learning Center (Video)
- Your Child’s Senses: Why You Need His or Her Hearing (Video)
- Early Learning Coalition – Hearing & Vision Screening (Video)
- Assistive Technologies for Vision and Hearing Impaired (Video)
Articles
- Hearing Impairment article with adaptations
- Prevalence, definitions and characteristics
- American Family Physician – Speech and Language Delay in Children – Discusses typical and atypical development