Neuropsychological presentation and adaptive skills in high-functioning adolescents with visual impairment: A preliminary investigation

Patient- and parent-reported outcome measures of developmental adaptive abilities in visually impaired children: The Visual Impairment Developmental Autonomy (VIDA) scale

In the pediatric context, parents' and patients' engagement in the care process is strongly recommended and could be pursued using patient-reported outcome measures (PROMs), which therefore become useful for planning and monitoring treatments. Nevertheless, few data are available from families of children with neurodevelopmental disorders such as visual impairment (VI). The Visual Impairment Developmental Autonomy (VIDA) project aims to develop and validate a patient- and parent-reported tool to measure the most relevant aspects concerning everyday adaptive abilities in children and adolescents with visual impairment: the VIDA scale. The present paper illustrates the Delphi process of item generation engaging parents and patients and presents a protocol for the validation of this new co-designed tool in an Italian visually impaired pediatric population. Twenty-three families and five adolescents provided a list of 192 items and assessed their relevance. Items were categorized in 5 areas of adaptive abilities (i.e., table manners, clothing, personal hygiene, orientation and mobility, and socio-affectivity) and into three age ranges based on the patient's age. The final 102-item Vida Scale will be administered to a minimum of 300 visually impaired children together with measures of quality of life and child adjustment to investigate its psychometric properties.

Emotional and Behavioral Assessment of Youths With Visual Impairments Utilizing the BASC-2

Introduction: Few studies have examined the psychological and mental health effects of visual impairments (i.e., blindness and low vision) on youths. Our objectives were to describe the behavioral and emotional profile of students with visual impairments, compare the BASC-2 composite scores for youths with visual impairments with the normative data to determine if significant differences exist, and compare the BASC-2 scores of students categorized as having low vision with students categorized as being totally blind. Methods: A total of 63 students with visual impairments entering a state school for the deaf and blind between 2012 and 2017 had a parent complete the BASC-2 Parent Rating Scale as part of the intake procedure. A retrospective study was conducted to determine patterns of emotional and behavioral strengths and weaknesses in students with low vision and blindness. A Multivariate Analysis of Covariance (MANCOVA) and Wilcoxon Rank Sums test were performed to test for differences between children who are blind and children with low vision. Results: Students with visual impairments showed higher levels of clinical symptoms such as anxiety and withdrawal. Statistically significant higher deficits were detected for the students with visual impairments on the Behavioral Symptoms Index and Internalizing Problems composites and significant lower differences for the Adaptive Skills and Externalizing Problems composites compared to the BASC-2 normative sample. When compared with youths with low vision, students who are blind had statistically significant scores (i.e., deficits) for adaptive skills and resiliency. Discussion: Our results suggest that a substantial proportion of students with visual impairments may experience more emotional and behavioral difficulties than the average youth while lacking the adaptive skills to manage their conduct adequately. Implications for practitioners: Professionals working with youths with visual impairments face a number of daunting challenges, since the conditions under the visually impaired umbrella are heterogeneous, and variation exists within a statistically low-incidence disability category. Therefore, those who work with youths with visual impairments have to apply various and unique methods to understand, train, teach, rehabilitate, or counsel these youths.

Adaptive behaviour and quality of life in school-age children with congenital visual disorders and different levels of visual impairment

BACKGROUND

Adaptive behaviours are vital skills that allow individuals to function independently and are potentially amenable to behavioural interventions. Previous research indicated that adaptive behaviours are reduced in children and adolescents with severe to profound VI, but it was unclear if this was also the case for children with mild to moderate VI.

AIM

The aim of the study was to assess differences in adaptive behaviour in children with congenital visual disorders and different levels of visual impairment and their influence on quality of life and everyday strengths and difficulties.

METHODS AND PROCEDURES

Questionnaires about adaptive behaviour, strengths and difficulties, and quality of life were completed by parents of school-age children with severe-to-profound VI (S/PVI, n = 9, 0.9 logMAR - light perception only), mild-to-moderate VI (MVI, n = 9, 0.1-0.7 logMAR), or typical sight (control, n = 18, -0.3 to 0.1 logMAR). Differences in questionnaire domains by the severity of VI and relationships between adaptive behaviour and quality of life were analysed in general linear models.

OUTCOMES AND RESULTS

The questionnaire ratings indicated reduced adaptive behaviour, more difficulties, and reduced quality of life in children with S/PVI compared to typically-sighted peers. Effects were smaller for children with MVI, but indicated a significant reduction in quality of life compared to typically-sighted children. The effect of visual impairment on quality of life in school was partially mediated by adaptive behaviour.

CONCLUSION AND IMPLICATION

Severe congenital visual impairment affects adaptive behaviour in children with verbal abilities in the typical range. This effect is less pronounced in children with mild-to-moderate VI, but still impacts on quality of life, particularly in school.

Event-related potential response to auditory social stimuli, parent-reported social communicative deficits and autism risk in school-aged children with congenital visual impairment

Communication with visual signals, like facial expression, is important in early social development, but the question if these signals are necessary for typical social development remains to be addressed. The potential impact on social development of being born with no or very low levels of vision is therefore of high theoretical and clinical interest. The current study investigated event-related potential responses to basic social stimuli in a rare group of school-aged children with congenital visual disorders of the anterior visual system (globe of the eye, retina, anterior optic nerve). Early-latency event-related potential responses showed no difference between the VI and control group, suggesting similar initial auditory processing. However, the mean amplitude over central and right frontal channels between 280 and 320 ms was reduced in response to own-name stimuli, but not control stimuli, in children with VI suggesting differences in social processing. Children with VI also showed an increased rate of autistic-related behaviours, pragmatic language deficits, as well as peer relationship and emotional problems on standard parent questionnaires. These findings suggest that vision may be necessary for the typical development of social processing across modalities.