Abstract
In recent years, there has been growing evidence in literature reporting the impact visual impairment has on the everyday functioning skills of children with cerebral palsy.
Visual impairment may indeed be present at different levels of severity, and its addition compromises significantly the child’s neurodevelopment. A recent systematic review indicated that, according to the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (ICD-10), one child in ten with cerebral palsy has some form of severe visual impairment or blindness.
The central role of vision in the child’s growth is highlighted here as well as the definition of visual impairment and its main characteristics in the child with cerebral palsy.
The peculiarities of children with cerebral palsy and visual impairment are considered here in order to determine how the therapist may contribute significantly to their development and the quality of their daily life when a comprehensive and nurturing approach is adopted.
Steps from assessment to care and intervention are illustrated, always emphasizing the distinctiveness of each and every child and the importance of a relational approach and of continuous attention to the child and to the family. Furthermore, the role of an enriched and visually facilitating environment is discussed as well as the importance of posture in promoting visual function. An overview on rehabilitative tools is finally considered, focusing on their application in the support and rehabilitation of children with visual impairment and multiple disabilities.
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- 1.
Robert Hollman Foundation, (IT), http://www.fondazioneroberthollman.it/home-english.html
References
Alimovic S (2012) Visual impairments in children with cerebral palsy. Hrvatska Revija Za Rehabilitacijska Istrazivanja 48(1):96–103
Baranello G, Signorini S, Tinelli F, Guzzetta A, Pagliano E, Rossi A, Foscan M, Tramacere I, Romeo DMM, Ricci D (2020) Visual Function Classification System for children with cerebral palsy: development and validation. Dev. Med. Child Neurology, 62:104–110. https://doi.org/10.1111/dmcn.14270
Bathelt J, de Haan M, Dale NJ (2019) Adaptive behaviour and quality of life in school-age children with congenital visual disorders and different levels of visual impairment. Res Dev Disabil 85:154–162. https://doi.org/10.1016/j.ridd.2018.12.003
Battistin T, Lanners J, Vinciati M, Pinello L, Caldironi P (2005) Visual assessment in multidisabled children. ICS Elsevier 1282C:21–25. https://doi.org/10.1016/j.ics.2005.04.033
Bedny M, Pascual-Leone A, Saxe RR (2009) Growing up blind does not change the neural bases of Theory of Mind. Proc Natl Acad Sci U S A 106(27):11312–11317. https://doi.org/10.1073/pnas.0900010106
Berry KP, Nedivi E (2016) Experience-dependent structural plasticity in the visual system. Annu Rev Vis Sci 2:17–35. https://doi.org/10.1146/annurev-vision-111815-114638
Braddick O, Atkinson J (2013) Visual control of manual actions: brain mechanisms in typical development and developmental disorders. Dev Med Child Neurol 55(Suppl 4):13–18. https://doi.org/10.1111/dmcn.12300
Brazelton TB, Sparrow J (2007) The Touchpoints TM model of development. Brazelton Touchpoints Center, pp 1–10. https://www.touchpoints.org
Chokron S, Dutton GN (2016) Impact of Cerebral Visual Impairments on motor skills: implications for developmental coordination disorders. Front Psychol 7:1471. https://doi.org/10.3389/fpsyg.2016.01471
Consorti A, Sansevero G, Torelli C, Berardi N Sale A (2019) From basic visual science to neurodevelopmental disorders: the voyage of environmental enrichment-like stimulation. Neural Plast ID 5653180, 1–9. https://doi.org/10.1155/2019/5653180
Dale NJ, Sakkalou E, O’Reilly MA et al (2019) Home-based early intervention in infants and young children with visual impairment using the Developmental Journal: longitudinal cohort study. Dev Med Child Neurol 61(6):697–709. https://doi.org/10.1111/dmcn.14081
Di Pellegrino G, Fadiga L, Fogassi L, Gallese V, Rizzolatti G (1992) Understanding motor events: a neurophysiological study. Exp Brain Res 91:176–180. https://doi.org/10.1007/BF00230027
Drenser KA, Trese MT, Capone A (2010) Aggressive posterior retinopathy of prematurity. Retina 30(4 Suppl):S37–S40. https://doi.org/10.1097/IAE.0b013e3181cb6151
Ellis R, Tucker M (2000) Micro-affordance: the potentiation of components of action by seen objects. Br J Psychol 91:451–471. https://doi.org/10.1348/000712600161934
Fagerholm R, Vesti E (2017) Retinopathy of prematurity—from recognition of risk factors to treatment recommendations. Duodecim 133(4):337–344. PMID: 29205980
Fantz RL (1961) The origin of form perception. Sci Am 204:66–72. https://doi.org/10.1038/scientificamerican0561-66
Fazzi E, Signorini SG, Lanners J (2010a) The effect of impaired vision on development. In: Dutton GN, Bax M (eds) Visual Impairment in children due to damage to the brain. MacKeith Press, London, pp 162–173
Fazzi E, Signorini SG, Bianchi PE (2010b) Visual impairment in cerebral palsy. In: Dutton GN, Bax M (eds) Visual impairment in children due to damage to the brain. MacKeith Press, London, pp 194–204
Fazzi E, Signorini SG, LA Piana R et al (2012) Neuro-ophthalmological disorders in cerebral palsy: ophthalmological, oculomotor, and visual aspects. Dev Med Child Neurol 54(8):730–736. https://doi.org/10.1111/j.1469-8749.2012.04324.x
Fraiberg S (1977) Insights for the blind: comparative studies of blind and sighted infants. Plenum Press, New York
Geldof CJ, van Wassenaer-Leemhuis AG, Dik M, Kok JH, Oosterlaan J (2015) A functional approach to cerebral visual impairments in very preterm/very-low-birth-weight children. Pediatr Res 78(2):190–197. https://doi.org/10.1038/pr.2015.83
Gibson EJ, Walker AS (1984) Development of knowledge of visual-tactual affordances of substance. Child Dev 55(2):453–460. https://doi.org/10.2307/1129956
Good W, Jan J, DeSa L, Barkovich J, Groenveld M, Hoyt C (1994) Cortical visual impairment in children. Surv Ophthalmol 38:351–364. https://doi.org/10.1016/0039-6257(94)90073-6
Hadders-Algra M (2014) Early diagnosis and early intervention in cerebral palsy. Front Neurol 5:185. https://doi.org/10.3389/fneur.2014.00185
Hafström M, Källén K, Serenius F et al (2018) Cerebral palsy in extremely preterm infants. Pediatrics 141(1):e20171433. https://doi.org/10.1542/peds.2017-1433
Hallemans A, Ortibus E, Truijen S, Meire F (2011) Development of independent locomotion in children with a severe visual impairment. Res Dev Disabil 32:2069–2074. https://doi.org/10.1016/j.ridd.2011.08.017
Haupt C, Huber AB (2008) How axons see their way—axonal guidance in the visual system. Front Biosci 13:3136–3149. https://doi.org/10.2741/2915
Himmelmann K, Beckung E, Hagberg G, Uvebrant P (2006) Gross and fine motor function and accompanying impairments in cerebral palsy. Dev Med Child Neurol 48:417–423. https://doi.org/10.1017/S0012162206000922
Hotz GA, Castelblanco A, Lara IM, Weiss AD, Duncan R, Kuluz JW (2006) Snoezelen: a controlled multi-sensory stimulation therapy for children recovering from severe brain injury. Brain Inj 20:879–888. https://doi.org/10.1080/02699050600832635
Huurneman B, Boonstra FN (2016) Assessment of near visual acuity in 0-13 year olds with normal and low vision: a systematic review. BMC Ophthalmol [Internet] 16(1):1–15. https://doi.org/10.1186/s12886-016-0386-y
Hyvärinen L, Walthes R, Jacob N, Chaplin KN, Leonhardt M (2014) Current understanding of what infants see. Curr Ophthalmol Rep 2(4):142–149. https://doi.org/10.1007/s40135-014-0056-2
ICCRP (International Committee for the Classification of Retinopathy of Prematurity) (2005) The international classification of retinopathy of prematurity revisited. Arch Ophthalmol 123(7):991–999. https://doi.org/10.1001/archopht.123.7.991
Ishihara S (1972) The series of plates designed as tests for colour-blindness. Kanehara Shuppan Co. Ltd, Tokyo
Jan J, Lyons C, Heaven R, Matsuba C (2001) Visual impairment due to a dyskinetic eye movement disorder in children with dyskinetic cerebral palsy. Dev Med Child Neurol 43(2):108–112. https://doi.org/10.1017/S0012162201000184
Kitchel E (2000) The effects of blue light on ocular health. J Vis Impair Blindness 94(6):399–403. https://doi.org/10.1177/0145482.X0009400606
Klinge C, Röder B, Büchel C (2010) Increased amygdala activation to emotional auditory stimuli in the blind. Brain 133:1729–1736. https://doi.org/10.1093/brain/awq102
Koenraads Y, Braun KP, van der Linden DC, Imhof SM, Porro GL (2015) Perimetry in young and neurologically impaired children: the Behavioral Visual Field (BEFIE) Screening Test revisited. JAMA Ophthalmol 133(3):319–325. https://doi.org/10.1001/jamaophthalmol.2014.5257
Lang J (1983) A new stereotest. J Pediatr Ophthalmol Strabismus 20(2):72–74
Lanners J, Salvo R (2000) Un bambino da incontrare. Fondazione Robert Hollman
Lanners J, Goergen E (2001) Functional evaluation and rehabilitation of severely visually impaired children (0-4 years). Vis Impair Res 3(1):1–5. https://doi.org/10.1076/vimr.3.1.1.4416
Lanners J, Piccioni A, Fea F, Goergen E (1999) Early intervention for children with cerebral visual impairment: preliminary results. J Intellect Disabil Res 43(Part 1):1–12. https://doi.org/10.1046/j.1365-2788.1999.43120106.x
Lanners J, Battistin T, Del Negro E, Segnacasi S, Caldironi P (2005) Early rehabilitation in ROP children. Int Congr Ser 1282(1):191–195. https://doi.org/10.1016/j.ics.2005.05.095
Lueck AH, Dutton GN, Ophth FRC, Chokron S (2019) Profiling children with Cerebral Visual Impairment using multiple methods of assessment to aid in differential diagnosis. Semin Pediatr Neurol 31:5–14. Elsevier Inc. https://doi.org/10.1016/j.spen.2019.05.003
Marret S, Marchand-Martin L, Picaud JC et al (2013) Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study. PLoS One 8(5):e62683. https://doi.org/10.1371/journal.pone.0062683
Meeus L (1994) Stimulation of the visual possibilities in the Dark Room by means of black light and other light sources. Series Studies in Health Technology and Informatics, vol 11, Low vision: 320–322. https://doi.org/10.3233/978-1-60750-855-7-320
Mercuriali E, Battistin T, Schoch V, Di Maggio I, Suppiej A (2016) L’importanza del counseling precoce alla famiglia: L’esperienza presso la Fondazione Robert Hollman. Il counselling in Italia. Funzioni, criticità, prospettive e applicazioni, Ed. Cleup, pp 501–516
Novak I, Hines M, Goldsmith S, Barclay R (2012) Clinical prognostic messages from a systematic review on cerebral palsy. Pediatrics 130:e1285. https://doi.org/10.1542/peds.2012-0924
Orban GA, Van Essen D, Vanduffel W (2004) Comparative mapping of higher visual areas in monkeys and humans. Trends Cogn Sci 8(7):315–324. https://doi.org/10.1016/j.tics.2004.05.009
Parisi MA (2019) The molecular genetics of Joubert syndrome and related ciliopathies: the challenges of genetic and phenotypic heterogeneity. Transl Sci Rare Dis 4(1–2):25–49. https://doi.org/10.3233/TRD-190041
Pavone P et al (2017) Ataxia in children: early recognition and clinical evaluation. Ital J Pediatr 43:6. https://doi.org/10.1186/s13052-016-0325-9
Pereins G, Ortibus E (2016) Concept and overview of cerebral visual impairment: a clinical perspective. In: Visual impairment and Neurodevelopmental disorders: from diagnosis to rehabilitation. John Libbey Eurotext, pp 71–84
Philip SS, Dutton GN (2014) Identifying and characterising cerebral visual impairment in children: a review. Clin Exp Optom 97:196–208. https://doi.org/10.1111/cxo.12155
Philip SS, Guzzetta A, Chorna O, Gole G, Boyd RN (2020) Relationship between brain structure and Cerebral Visual Impairment in children with Cerebral Palsy: a systematic review. Res Dev Disabil 99, 1–16, 103580. https://doi.org/10.1016/j.ridd.2020.103580
Pietrini P, Furey ML, Ricciardi E et al (2004) Beyond sensory images: object-based representation in the human ventral pathway. Proc Natl Acad Sci U S A 101(15):5658–5663. https://doi.org/10.1073/pnas.0400707101
Porro G, Dekker EM, Van Nieuwenhuizen O et al (1998) Visual behaviours of neurologically impaired children with cerebral visual impairment: an ethological study. Br J Ophthalmol 82(11):1231–1235. https://doi.org/10.1136/bjo.82.11.1231
Prechtl HF, Cioni G, Einspieler C, Bos AF, Ferrari F (2001) Role of vision on early motor development: lessons from the blind. Dev Med Child Neurol 43(3):198–201. https://doi.org/10.1111/j.1469-8749.2001.tb00187.x
Preston KL, McDonald M, Sebris SL, Dobson V, Teller DY (1987) Validation of the acuity card procedure for assessment of infants with ocular disorders. Ophthalmology [Internet] 94(6):644–653. https://doi.org/10.1016/S0161-6420(87)33398-6
Provenzi L, Rosa E, Visintin E, Mascheroni E, Guida E, Cavallini A, Montirosso R (2020) Understanding the role and function of maternal touch in children with neurodevelopmental disabilities. Infant Behav Dev 58:101420. https://doi.org/10.1016/j.infbeh.2020.101420
Purpura G, Tinelli F (2020) The development of vision between nature and nurture: clinical implications from visual neuroscience. Childs Nerv Syst 36:911–917. https://doi.org/10.1007/s00381-020-04554-1
Ricciardi E, Bonino D, Pellegrini S, Pietrini P (2014) Mind the blind brain to understand the sighted one! Is there a supramodal cortical functional architecture? Neurosci Biobehav Rev 41:64–77. https://doi.org/10.1016/j.neubiorev.2013.10.006
Roman-Lantzy C (2018) Cortical visual impairment: an approach to assessment and intervention, 2nd edn. AFB Press, New York
Romani M, Micalizzi A, Valente EM (2013) Joubert Syndrome: congenital cerebellar ataxia with the molar tooth. Lancet Neurol 12(9):894–905. https://doi.org/10.1016/S1474-4422(13)70136-4
Rosenbaum P, Paneth N, Leviton A, et al. (2007) A report: the definition and classification of cerebral palsy. April 2006. Dev Med Child Neurol Suppl 109:8–14. Erratum in: Dev Med Child Neurol (2007) 49(6):480. https://doi.org/10.1111/j.1469-8749.2007.00001.x
Sanghi G, Dogra MR, Katoch D, Gupta A (2014) Aggressive posterior retinopathy of prematurity in infants ≥1500 g birth weight. Indian J Ophthalmol 62(2):254–257. https://doi.org/10.4103/0301-4738.128639
Saunders KJ, Little JA, Mc Clelland J, Jackson AJ (2010) Profile of refractive errors in cerebral palsy: impact of severity of motor impairment (GMFCS) and CP subtype on refractive outcome. Invest Ophthalmol Vis Sci 51(6):2885–2890. https://doi.org/10.1167/iovs.09-4670
Siatkowski RM, Good WV, Summers CG, Quinn GE, Tung B (2013) Clinical characteristics of children with severe visual impairment but favorable retinal structural outcomes from the Early Treatment for Retinopathy of Prematurity (ETROP) study. J AAPOS 17(2):129–134. https://doi.org/10.1016/j.jaapos.2012.10.022
Signorini SG, Fedeli C, Luparia A et al (2016) A multidisciplinary and multidimensional approach to visual function in childhood: from neurovisual disorders to strategies of intervention for promoting neuropsychomotor development. In: Fazzi E, Bianchi PE (eds) Visual impairment and neurodevelopmental disorders—from diagnosis to rehabilitation. John Libbey Eurotext, London-Paris, pp 155–170
Solebo AL, Teoh L, Rahi J (2017) Epidemiology of blindness in children. Arch Dis Child 102(9):853–857. https://doi.org/10.1136/archdischild-2016-310532
Sonksen PM, Dale N (2002) Visual impairment in infancy: impact on neurodevelopmental and neurobiological processes. Dev Med Child Neurol 44:782–791. https://doi.org/10.1111/j.1469-8749.2002.tb00287.x
Stern DN (1985) The interpersonal world of the infant. Basic Books, New York
Surman G, Hemming K, Platt MJ, Parkes J, Green A, Hutton J, Kurinczuk JJ (2009) Children with cerebral palsy: severity and trends over time. Paediatr Perinat Epidemiol 23(6):513–521. https://doi.org/10.1111/j.1365-3016.2009.01060.x
Tierney AL, Nelson CA 3rd. (2009) Brain development and the role of experience in the early years. Zero Three 30(2):9–13
Trevarthen C, Aitken KJ (2001) Infant intersubjectivity: research, theory, and clinical applications. J Child Psychol Psychiatry 42(1):3–48. https://doi.org/10.1017/S0021963001006552
Umiltà MA, Kohler E, Gallese V, Fogassi L, Fadiga L, Keysers C, Rizzolatti G (2001) I know what you are doing: a neurophysiological study. Neuron 31(1):155–165. https://doi.org/10.1016/S0896-6273(01)00337-3
Vaglio S, Battistin T, Lanners J, Lodigiani S, Panizzolo L, Segnacasi S, Zaccheo D, Schoch V (2018) Caratteristiche e comportamenti visivi nei bambini ipovedenti con danno neurologico associato. Oftalmol Soc 3:29–36
Vincer MJ, Allen AC, Joseph KS, Stinson DA, Scott H, Wood E (2006) Increasing prevalence of cerebral palsy among very preterm infants: a population-based study. Pediatrics 118(6):e1621–e1626. https://doi.org/10.1542/peds.2006-1522
Wang SF, Kowal TJ, Ning K, Koo EB, Wu AY, Mahajan VB, Sun Y (2018) Review of ocular manifestations of Joubert Syndrome. Genes (Basel) 9(12):605. https://doi.org/10.3390/genes9120605
Wente S, Schröder S, Buckard J, Büttel HM, von Deimling F, Diener W, Häussler M, Hübschle S et al (2016) Nosological delineation of congenital ocular motor apraxia type Cogan: an observational study. Orphanet J Rare Dis 11(1):104. https://doi.org/10.1186/s13023-016-0486-z
WHO (2019a) World Health Organization. International Statistical Classification of Diseases and Related Health Problem. 10th Revision, https://icd.who.int/browse10/2019/en#/H53-H54
WHO (2019b) World Health Organization. International Statistical Classification of Diseases and Related Health Problem. 11th Revision https://icd.who.int/browse11/l-m/en
WHO (2019c) World report on vision. https://www.who.int/publications/i/item/world-report-on-vision
WHO (2020) Blindness and vision impairment prevention. https://www.who.int/blindness/causes/priority/en/index1.html
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Baiardi, V., Battistin, T. (2022). The Child with Cerebral Palsy and Visual Impairment. In: Giannoni, P., Zerbino, L. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-030-85619-9_11
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