How can you tell if your child is showing early signs of blindness? Here is a quick guide on early childhood indicators of blindness.
by Anneliese Knop | Anneliese is an Associate Licensed Counselor, freelance writer, and self-proclaimed “blindfluencer”. She uses her blog to promote accessibility, for the blind and service dog users, in her community. She loves to travel, read, hike, and plan adventures for her friends. You can follow her on Twitter @AnnelieseM_DK and visit her blog Look On The Dark Side.
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“Have you ever been tested for autism?”
“Why do you ask?” I inquired carefully. I was in the office of Disabled Student Services at my university, setting up accommodations for the next semester. Earlier that week, I was asked if I had anorexia. I was having a bizarre week.
“Well, you’re very logic-oriented,” the DSS coordinator said, “and pair that with your lack of facial expressions, it made me wonder.”
She had noticed my resting bitch face. Women are supposed to smile all the time, and I do not. In fact, I don’t make a lot of facial expressions unless there is a good reason. And then it’s a conscious choice, not instinctive.
I learned later that this particular DSS coordinator was a specialist in the Autism Spectrum Disorder. She had no experience at all, with blindness, so she only saw one explanation for a flat facial affect.
The actual explanation was that I did not learn facial expressions as a baby because I could not see them. To this day, I have to remind myself to use my face when I’m with the sighted, or as I like to call them, light-dependent people. Babies with vision loss or who are totally blind can often miss crucial developmental milestones. They can experience delays in incidental learning because of it.
Today, I’m going to share with you some common behavioral indicators of vision loss in young children.
Newborn and Early Childhood Vision screenings
The most common vision test for newborns is the red reflex test. This is when a light is flashed into a newborn’s eyes to see how the eye responds to light. A lack of response, an abnormal response, or visual signs of damage or distress around the eye may prompt your doctor, midwife, doula, or another birthing professional to recommend additional tests or refer you and your baby to an ophthalmologist (eye specialist).
Up until the last 10 years or so, most doctors, nurses, midwives, and other birthing professionals were trained primarily to identify total blindness or obvious outward indicators of eye damage. Additional testing would be ordered if the family history contained genetic risk factors, or if behavioral or environmental risk factors were known. Preemies also got more testing because of the common condition known as Retinopathy of Prematurity (ROP).
However, checking a newborn’s eyes is a complicated business. Apart from the fact that a lack of verbal skills makes it hard to accurately assess what they can see, babies are not usually very keen on having their eyes open for long periods. Their eyes are small and hard to peer into, and their primary indicator of distress–screaming–could mean any number of things.
And with the bias toward partial blindness being a geriatric condition, it wasn’t until recently that new technologies and techniques have been pioneered to help doctors identify a wider range of vision loss issues in newborns and babies younger than 3 years old.
But what if you are concerned, and the doctor is not? Or, what if you don’t have access to regular early infant vision screenings? Will you have to wait until your child is struggling at school to find out if they need glasses, to learn Braille, or use a cane?
Behavioral Indicators of Vision loss in Early Childhood
How often have you wished for a parenting guide with a searchable index? “Toddler trips on younger sibling…color of blanket and clothes similar…oh, a toddler may have trouble distinguishing color in poor lighting. See the doctor for recommendations.” Yes, I tripped on my baby sister alot until we figured that one out. She’s forgiven me, thankfully, but it brings up an interesting point.
How are parents supposed to know the difference between normal baby clumsiness and signs of a problem?
The good news is there are plenty of bloggers like me who are happy to shout our accumulated experience and expertise into the internet for you to find.
Vision loss can occur in young children even if they aren’t born blind or visually impaired. Accidents, chemical exposure, cancer, and other things can damage a young child’s eyes. But in most cases, vision loss in young children is congenital (they were born with it), and it just got missed in newborn and well-baby checkups.
My parents first noticed something was a little off when I failed to find my dad’s silly faces amusing. He could make silly noises, and I would laugh. He could toss me playfully into the air, and I reacted with delight. But scrunching up his face just didn’t do it for me.
I had just enough vision that it did not prevent me from achieving regular movement milestones. But many children with low vision experience delays in learning behaviors like rolling over, crawling, or walking. If their world consists of what they can touch, then there is no reason to reach for more, right?
This article can provide a good summary of some basic behavioral indicators that your young child might not see the world how you do. Though these indicators are obviously red flags, I would like to share with you some subtler clues.
There is no coffee table or free-standing furniture in my house because I cannot see below the level of my eyes (no peripheral vision). My parents first observed this when I could not find the toy they pointed at–it was at the base of my feet, just to my left or right. It was almost touching me, but as far as I was concerned, it did not exist. Of course, I couldn’t see the slender pointing, either. Just the thicker arm in the brightly colored sweater.
Does your child reach for a crayon on the table but miss it by a few inches? Do you see them often sweep their arms across the floor or table in a search pattern for the desired toy? This kind of procedural flailing may indicate difficulty with depth perception. Yet, you will notice how your child even before a year old, can learn to compensate. Such adaptability exists in a child before they know that blindness is a hardship.
My parents theorized that my rejection of naps, bedtime, and other sleep-related behavior was due to my disliking the utter darkness. Utter because a nightlight barely registered for me. Of course, different children have different temperaments. No singular behavior like poor sleep can diagnose vision loss. But as you become intimately familiar with your baby, little clues can add up.
Babysitters, nannies, and daycare workers reporting on children’s cooperativeness, facial expressions, dislike of the dark, tendency to try stimulating their own eyes, trouble distinguishing distance from things or recognizing people, use those indicators as vital clues to what is or isn’t penetrating to your baby’s developing brain.
The Aftermath of the Diagnosis
You’ve seen the signs, you have collected notes, and talked to a doctor. Your suspicions were right; your child can’t see the way you do. Glasses, canes, Braille? What’s next?
I remember my mother paying for private Braille lessons so she could learn alongside me. I remember her spending hours on the phone with insurance people, doctors, occupational therapists, school district officials and teachers, and activity coordinators for summer camps. Your child will remember how you broke down barriers for them, assuming they could keep up with everyone else, given the chance.
What comes next is you deciding how you want your child to experience life. You want them to feel confident, unique, capable, lovable, and precious. Whether your child can see it or not, this doesn’t change. It’s this desire that informs each late night spent researching, each phone call insisting on accommodations so your child has the chance to make the same choices as every other child. Each fight won or lost is one your child sees you suiting up for, showing them they matter, no matter what.
Your favorite blindfluencer would like you to know that a blind child can show you the world if you have enough vision to see her needs.