Because it is difficult for a blind child to observe the results of his or her own actions, it is often difficult for them to comprehend causal relationships in the world around them. Consequently, the motivation to act can be absent or delayed compared to the development of sighted children. It important that blind children have toys that assist them in better understanding the role that they themselves play in influencing, manipulating, and controlling their environment. We recommend noisy rattles or learning tables.

Since usual incentives for environmental exploration (color, pattern, shape, and location of visual cues) are unavailable to a blind infant, they may experience significant developmental delays in the usual milestones: reaching, rolling over, and crawling. Infants with visual impairment require sensory stimulation through other channels to make up for the visual input they are lacking; only then can they begin to understand the complex external world and the effect of their own actions upon it. Toys that help the child understand spatial relationships, such as stacking cups (bigger, smaller, inside, outside, etc.) are particularly useful.

Social interaction may also be more difficult for blind or visually impaired children since subtle visual cues and facial expressions are unavailable. Blind children may need additional focus in this area to preserve and promote future development of attachment, recognition, and communication in their interpersonal relationships. Braille playing cards and braille dominoes are a great place to start.

The blind child may be unwilling to explore his or her surroundings due to a fear of the unknown. It is therefore vital to encourage exploration in a manner that is safe (without being overprotective), as a child will be unable to develop meaningful constructs or the ability to describe or think about them without concrete experiences. Play yards and push-along toys are great for this.

Children that have limited vision may benefit from stimulation from high-contrast mobiles or arches. Research indicates that red, white, and black are the easiest colors for developing eyes to see. Also never forget that holding, cuddling, rocking, carrying, touching, and talking to a visually impaired infant or child is equally as important as any other toy or resource!

Tips for helping partially sighted infants see

Visually impaired babies and children have a unique set of requirements for furthering their development. Below we discuss some of the common causes of vision impairment in children and some of the methods parents, doctors, and visual therapists have used to help improve their vision.

Common vision problems in babies and children

CVI – Cortical Vision Impairment: A visual impairment resulting from a brain injury. Unlike vision problems that arise due to physical problems with the eyes, CVI is a failure of the eyes and brain to communicate properly. Consequently, it can be hard to diagnose as the structure of the eye and optic nerves may initially seem to be normal, although they are not functioning properly. This condition is sometimes referred to as neurological visual impairment or cortical blindness, but will hereafter be referred to as cortical vision impairment or CVI within this article. Depending on the study, between 3.6 and 21% of children with vision impairments have a cortical vision impairment, making it the leading cause of vision impairment in children.

Characteristic features of cortical vision impairment include preference for a certain color (usually, but not always, red and yellow), delayed recognition of an object, a preference to look at moving objects or familiar objects, trouble looking at visually complex objects, staring or non-purposeful gazing (particularly at light), nearsightedness, absent blink reflex, and trouble reaching for objects. Luckily, recent research indicates that with appropriate intervention 97% of highly motivated parents helped their child with cortical vision impairment reach near-normal vision in an average of 3.7 years.

Read about one parent’s journey with a child with infantile spasms and cortical vision impairment here.

DVM – Delayed Visual Maturation: substandard visual attentiveness in early infancy, but with a possibility for subsequent improvement in vision as the child ages. The child will present with a normal eye exam but abnormal visual behavior. With proper intervention, substantial improvement in visual acuity and visual behavior can be achieved. Characteristics include nystagmus (repetitive, uncontrolled movements of the eyes, often in a back and forth pattern), visual inattentiveness, and poor visual fixation. It may present with diverse ocular symptoms, but there is usually no observable damage to the eye or nerves.

DVM may simply be related to a delay in the infant’s cortical maturation. According to the reports of many parents, children afflicted with delayed visual maturation sometimes behave as if “a switch is turned on”, and vision, attentiveness, and responsiveness rapidly improve without warning; however, some improve much more gradually. Research varies on the subject, although anecdotal evidence suggests that a child is more likely to improve more quickly if they are continuously exposed to visual stimuli, particularly those that make sounds and that the infant is able to easily hold.

ROP – Retinopathy of Prematurity: immature vasculature in the eyes, with mild or no visual defects, most commonly seen in premature babies. There is a risk of neovascularization (new blood vessels forming), which can turn into retinal detachment or blindness. An ophthalmology consultation is necessary for diagnosis, and depending on the degree of retinal findings, cases may resolve on their own, or require extensive medical or surgical intervention.

Intravitreal bevacizumab, cryotherapy, laser photocoagulation, or other surgeries may be used to treat ROP. Regular eye exams and periodic evaluation by an ophthalmologist are necessary. It is unclear the extent to which the child benefits from increased attention to visual stimulation.

ONH – Optic Nerve Hypoplasia: a congenital condition that presents as damage, immaturity, or complete absence of the optic nerve; often in conjunction with possible cerebral and endocrine abnormalities. ONH may be referred to as Septo-Optic Dysplasia or DeMorsier’s Syndrome, and is typically diagnosed by the discovery of small or particularly pale optic nerves during the ophthalmologist’s ocular examination. Often, there is no obvious identifiable cause. Characteristics include vision impairment, which can range from mild to very severe, nystagmus (repetitive, uncontrolled movements of the eyes, often in a back and forth pattern), and sometimes strabismus (inward or outward misalignment of the eyes).

Kids with optic nerve hypoplasia may be at increased risk for seizure disorders, developmental delays, and hormone deficiencies, and will typically be evaluated by an MRI (a brain scan using magnetic resonance imaging) and have a consultation with an endocrinologist. While there is no medical or surgical treatment for ONH, early supportive intervention by vision therapists and special attention from the parents may be correlated with optimal outcomes in terms of vision improvement.

*This is not a complete list, merely an overview of some of the conditions causing blindness or vision impairment in children. If you suspect that your child has vision problems, please seek out a pediatric ophthalmologist or ask your regular pediatrician to refer you to one.

Children with some (but not all) vision problems can benefit greatly from early intervention, and the results are often much more positive the earlier treatment begins. Below we have included some tips and resources for helping partially sighted or visually impaired infants learn to improve their vision.

Toys to help develop baby’s vision
With appropriate and early intervention, dramatic improvement can be possible for some, but not all vision conditions. Every child’s circumstance is unique, but we strongly believe that it is the responsibility of the parent to attempt every possible method of improving the child’s vision. If opportunities to improve a child’s vision are incorporated into their daily life, the chances of their vision improving may be greatly increased. While you should always consult with your pediatrician and ophthalmologist, below we have included some suggestions for toys that have been reported to be effective in helping to improve the vision of partially blind infants with certain conditions.

Check out our favorite toys for visually impaired kids:
Toys for vision improvement in children with cortical vision impairment
Babies with cortical vision impairment, in particular, can benefit from simplicity and repetition. Visually complex items are initially confusing to an infant with CVI. They are much more likely to respond to a simple, familiar item. Using trial and error, determine if your child has a color preference (often red or yellow, but sometimes bright blue, green, or pink), and find a simple, single colored toy in that color. A ball, LED light-up balloon (with supervision only!), or single colored stuffed animal are fantastic toys for cortical vision impairment. For contrast, it may help the baby focus to put a solid black sheet of paper behind the item, which helps to reduce the clutter and visual noise around it.

Remember :

• Visual latency means that a child may have a delayed response when looking at objects. They are also more likely to look away from a toy and return their gaze, rather than gaze continuously. Be sure to give your child plenty of time to look at and recognize the toy, even if it takes longer or they look away at first.
• The best toys for cortical vision impairment are toys that are easily recognized by the child. Keep a familiar object with your child throughout the day.
  -Determine a position in which your child can comfortably look at the object. If they tire themselves from holding the position, they have less energy to spend on focusing their gaze.
• Introduce shiny, bright, and highly saturated toys. A pinwheel, miniature disco ball, bubbles, or a baby mirror can be a good way to stimulate vision in kids with CVI.

In addition, for every Quiet Book sold, Piqipi donates books and money to partner organizations across Africa which help children to make the most of their potential, no matter their circumstances. Click to buy

Ideas for activities for visually impaired infants – Simple play activities that visually stimulate a low vision infant can not only encourage their eye development but promote speech, balance, motor skills, social skills, and more.