The dilemma of assessing the visually impaired child

24-H movement behaviors and visual impairment among Chinese adolescents with and without obesity

BACKGROUND

Previous studies have identified obesity, sleep patterns, screen time, and physical activity as independent risk factors for the visual health of adolescents. However, our understanding of how these factors interact and contribute to visual impairment remains limited. This study aimed to investigate the relationship between adherence to the 24-h movement guidelines (24-HMG) and visual impairment in adolescents with and without obesity.

METHODS

We analyzed data from the 2014-2015 China Education Panel Survey. Participants provided self-reported information on their screen time, sleep duration, and physical activity levels. The data on weight, height, and visual acuity were obtained from school health examination reports. Logistic regression analysis was conducted to assess the association between 24-h movement behaviors and visual impairment, reported as odds ratios (ORs) with a 95 % confidence interval (CI).

RESULTS

After controlling for covariates such as sex and age, it was found that adolescents with obesity who adhered to the sleep guidelines had a lower risk of visual impairment compared with adolescents without obesity who did not adhere to the 24-HMG (OR = 0.84, 95 % CI: 0.75-0.94, P = 0.003). Additionally, adolescents who adhered to both the physical activity and sleep guidelines had an even lower risk of visual impairment (OR = 0.58, 95 % CI: 0.42-0.79, P = 0.001).

CONCLUSIONS

Adhering to the Sleep and physical activity + Sleep recommendations in the 24-HMG could significantly reduce the risk of visual impairment in adolescents without obesity. No significant relationship was observed between adherence to 24-HMG and the risk of visual impairment in adolescents with obesity.

Effects of aerobic exercise on balance and mobility in individuals with visual impairment: a systematic review

BACKGROUND

This meta-analysis aimed to assess the impact of aerobic exercise on the balance and mobility of visually impaired individuals and identify potential factors affecting these outcomes.

METHODS

A systematic review was conducted following PRISMA guidelines. The eligibility criteria for the study included visual impairment in the participant population, type of visual impairment, aerobic exercise intervention, controlled trials, age, design, and outcomes. Data were extracted based on these seven questions, and a narrative synthesis approach was employed for analysis. A comprehensive search of the database yielded 1987 articles, and ultimately, 14 randomized controlled trials involving 685 participants were selected for inclusion.

RESULTS

The study findings indicate that aerobic exercise can greatly enhance the static balance ability [SMD = 1.23, 95%CI 0.80-1.66, p < 0.00001] and dynamic balance ability [SMD = 1.04, 95% CI 0.09-1.99, p = 0.03] of individuals with visual impairment. However, it appeared that mobility did not exhibit significant improvement [SMD = -0.49, 95% CI -1.06 to 0.09, p = 0.10]. Through subgroup analysis, it was found that exercise frequency, age, and degree of visual impairment significantly affect static balance.

CONCLUSIONS

Engaging in aerobic exercise 3-6 times per week, with each session lasting between 30 and 60 min, and continuing for a cycle of 8-16 weeks has been shown to enhance both dynamic and static balance in individuals with visual impairments.

Intelligence Profiles of Low Vision and Blind Children

This article reports on an analysis of the WISC-R and WPPSI profiles of 118 visually impaired children without additional neurological problems. A consistent response pattern on the Wechsler batteries emerged, suggesting that the verbal as well as the performance tests can provide useful assessment information.

Accommodating the Bayley-III for motor and/or visual impairment: a comparative pilot study

PURPOSE

This study assessed the validity and usefulness of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) Low Motor/Vision accommodated version. Accommodations are adaptations to minimize impairment bias, without altering what the test measures. Of the items, 66% have Low Motor accommodations like enlarged materials; 62% have Low Vision accommodations.

METHODS

Using a within-subject design, we tested 19 children with the accommodated and standard Bayley-III, in a randomly counterbalanced order. The children had motor and/or visual impairment and a chronological age between 22 and 90 months. The test administrators completed an evaluation form.

RESULTS

A subgroup of children benefited from the accommodations; 2 children obtained a large raw score difference. Test administrators considered the accommodations as practical, and advantageous for most children.

CONCLUSION

The Low Motor/Vision accommodated version seems to validly assess the development of this population. Future, larger-scale research should study whether the accommodations improve the construct validity of the Bayley-III.

Adaptive assessment of young children with visual impairment

The aim of this study was to assess the effect of adaptations for children with low vision of the Bayley Scales, a standardized developmental instrument widely used to assess development in young children. Low vision adaptations were made to the procedures, item instructions and play material of the Dutch version of the Bayley Scales of Infant Development — Second Edition (BSID-II), and the Original and Low Vision versions were administered to children with visual impairment over an interval of two weeks. Although quantitative analysis revealed no significant differences between the Original and Low Vision versions of the test in children’s scores, feedback from test administrators indicates that the Low Vision materials make the test easier to administer and more engaging for children.

Training motor skills of children with low vision

The aim of this study was to study the effectiveness of a motor training program for visually impaired children. 40 children with low vision took part in the study. 20 children (10 boys, 10 girls), mean age 8:9 yr.:mo. (SD= 1:6), were in a Training group and 20 children (10 boys, 10 girls), mean age 8:10 yr.:mo. (SD= 1:65), were in a Home Training group. The Snellen Chart and Bruininks Oseretsky Motor Proficiency Test were used for assessment. Training program included training balance, coordination, strength, visuomotor control, and finger dexterity. Significant differences were found on all skills after training in the Training group, but no significant differences were observed, other than visual motor control, in the Home Training group. Children with low vision have some useable vision and learning to use the available vision depends on proper rehabilitation.

Multihandicapped blind and partially sighted children in south Germany. II: Aetiology and pathogenesis

The results of a classification of the aetiology of visual impairment and mental retardation in a series of 239 multihandicapped blind and partially sighted children are reported. These children had been born between 1981 and 1987 and were examined in a population-based study in South Germany. There was marked aetiological heterogeneity. Most prominent were causes related to the perinatal period and late gestation which were found in 41% of the children. Among these, lesions of the visual pathways in preterm children were especially frequent and could be explained by periventricular leukomalacia in a large proportion. The distribution of the major aetiologic groups is different from populations with isolated mental retardation and populations with isolated visual impairment but similar to a Swedish population with spastic quadriplegia. The implications for the prevention of severe multiple impairments in children are discussed.

Visual impairment in preterm children with periventricular leukomalacia--visual, cognitive and neuropaediatric characteristics related to cerebral imaging

Thirteen preterm children, aged 4 to 14 years, with visual impairment due to periventricular leukomalacia (PVL) were evaluated for visual function, intellectual level, cognitive profile and motor function. Their visual impairment was characterized by low acuity, crowding, visual field defects and ocular motility disturbances. Their cognitive profile was uneven, often with considerably higher scores on verbal than on visual-spatial tasks. Nine children had normal intelligence, three had mild mental retardation and one had severe mental retardation. In all the children, visual impairment was complicated by visual perceptual difficulties, accounting for their greater visual handicap than would be expected from their visual acuities and strabismus alone. Though CT or MRI revealed bilateral PVL in all the children, six had no motor impairment consistent with cerebral palsy, which is an unexpected finding.

Cortical visual impairment in children

Cortical visual impairment (CVI) in children is most commonly caused by peri- or post-natal hypoxia-ischemia, but may also occur following other insults, e.g., trauma, epilepsy, infections, drugs or poisons, and certain neurologic diseases. The disorder differs considerably in etiology, physical findings, and, perhaps, prognosis, from the cortical blindness seen in adults. The same event that causes CVI by damaging the geniculate and/or extrageniculate visual pathways may also damage other areas of the brain, or the retina, optic nerves, or chiasm. Thus, children with CVI often have other neurological problems. Diagnosis may require the participation of a multidisciplinary team and the use of special visual testing techniques. Due to the uncertainty concerning the prognosis in CVI, clinicians should remain optimistic about the child's potential for some vision recovery.