12 Physical, Motor and Sensory Development

Impacts on early physical and motor development

Vision plays a critical role in providing the motivation for the development of early motor skills. Much of the interest in acquiring mobility is based upon an infant’s ability to visually scan their environment and move toward objects of interest. Without this stimulation or with modified degrees of stimulation, a key factor of motivation is often impacted. Many blind and low vision students will develop motor skills at a later date compared to their sighted peers. Delays may be slightly or extremely delayed based on the degree of vision loss and early intervention. Bakke and colleagues (2019) found that challenges and impacts on gait acquisition, posture, spatial orientation and timing, perceptual information coordination, environmental perception, understanding of one’s own body and position in space, and development of functional daily living skills. Extreme delays, such as not walking until the age of four years, should always be considered as possible indicators of other difficulties.

Effects on later physical and motor development

Even as the blind and low vision student becomes older, differences in physical development are often noted. The blind and low vision student may have few opportunities for age-appropriate physical movement without support and intervention. Opportunities to play outside or participate in sports, dance, or other activities may require special arrangements. As a result, movement may be minimized. Passivity may become an issue. The blind and low vision child may have less interest and take less action in participating in physical movement. Specific encouragement and intervention are often required to maintain healthy physical activity levels.

Orientation and mobility

Blind and low vision children need conceptual understanding, skills, and tools to understand and move through their environment at home, at school, and in the community. Orientation and mobility (“O&M” for short) skills involve knowing where one is in relation to other objects and people in the environment (orientation) and knowing how to navigate to the desired destination using mobility skills and devices (mobility). Orientation and mobility instruction, provided by a trained orientation and mobility specialist, may encompass concept development, use of mobility devices, techniques for moving safely through the environment, and understanding when and how to seek additional information or assistance. Ultimately, the goal of O&M is to allow a student to travel as independently or interdependently as possible (Fazzi, 2014). Direct instruction in these skills promotes independence and safety.

Examples of Orientation and Mobility Skills

• Using techniques to move safely through one’s home and school environment independently.
• Listening to traffic and other cues to determine the type of intersection and the safest time to cross.
• Learning to ask for assistance and direct a peer or teacher on how to provide help appropriately.
• Utilizing public transportation.

Sensory

Blind and low vision students may be sensitive to sound, touch, or other sensory information. Proprioception is the sense of information about the relative positions of the parts of the body or body awareness and is required to regulate posture and movement. Proprioception is connected to the tactile and vestibular systems. Tactile defensiveness is when an individual reacts aversively to touch. Be conscious of the amount of sensory stimuli in the environment, especially with young children and children with cortical/cerebral visual impairment or multiple disabilities, as it can be difficult for them to focus when there are various competing stimuli in the environment at the same time. Blind and low vision students often seek additional sensory input to help regulate themselves. When sensory processing needs are not addressed, students may experience difficulties engaging in functional or academic tasks.

Self-stimulatory behavior

A special issue in physical development is that of self-stimulatory behaviors. Self-stimulatory behaviors (e.g., eye pressing, body rocking, and eye rubbing) may be observed in blind and low vision students (Houwen et al., 2022). Youth, particularly those with blindness or severe visual conditions, often develop self-stimulatory behaviors similar to those seen in students with autism spectrum disorder. The reason for this pattern is unclear. Most experts hypothesize that it is an attempt to bring stimulation to senses that may be deprived of other sensory experiences.

Self-stimulatory behaviors can be a number of different behaviors. They are typically repetitive behaviors without any clear function but may include behaviors as diverse as spinning, flapping hands, poking eyes, loud vocalizations, hitting of the face, shaking the head or other body parts, or jumping. Although not all blind and low vision children will develop these behaviors, a large percentage of those with severe visual impairment will have some type of self-stimulatory behavior as a young child.

For more information, review “Occupational Therapy and Sensory Integration for Children with Visual Impairment” (Ricketts, 2008).

Recreation and leisure

For blind and low vision children, learning about opportunities for recreation and leisure is important. While sighted students observe people in their communities at work and play, blind and low vision students might miss this information if their attention is not drawn to it. Providing blind and low vision children several opportunities to try a variety of different leisure activities in a safe environment will help them get a sense of what they enjoy and encourage them to become proficient, allowing them to dive deeper into the experience.

References

Bakke, H. A., Cavalcante, W. A., Oliveria, I. S., Sarinho, S. W., & Cattuzzo, M. T. (2019). Assessment of motor skills in children with visual impairment: A systematic and integrative review. Clinical Medicine Insights: Pediatrics, 13., 1179556519838287. https://doi.org/10.1177/1179556519838287

Fazzi, D. L. (2014). Orientation and mobility. In C. B. Allman, C. B. & S. Lewis. (Eds.). ECC essentials: Teaching the expanded core curriculum to students with visual impairments (pp. 248-282). AFB Press. https://www.aph.org/product/ecc-essentials-teaching-the-expanded-core-curriculum-to-students-with-visual-impairments/

Houwen, S., Cox, R. F. A., Roza, M., Oude Lansink, F., van Wolferen, J., & Rietman, A. B. (2022). Sensory processing in young children with visual impairments: Use and extension of the Sensory Profile. Research in Developmental Disabilities, 127, 104251. https://doi.org/10.1016/j.ridd.2022.104251

Ricketts, L. (2008). Occupational therapy and sensory integration for children with visual impairment. Paths to Literacy. https://www.pathstoliteracy.org/occupational-therapy-and-sensory-integration-for-children-with-visual-impairment/