Eye Poking: Review of Literature

By: BJ LeJune (via email, 9/6/2006)

Recently we submitted a grant application for reducing some selected rocking blindisms in congentially blind children. In our literature review I thought it was interesting that there is not full agreement about the causes, which would certainly impact on treatment options and interventions. Usually we observe these self stimulation behaviors when the child is frustrated, bored, happy, angry or anxious. They very quickly become habitual.

Theories we discovered included:

1. Physical need for kinesthetic, proprioceptive or vestibular stimulation
2. Emotional needs as it appears during times of emotional stress or elation.
3. Spiritual/psyche imbalance - one indication of the elimination of this behavior in a pre-adolescent teen after one session with someone practicing alternative wholistic counseling.
4. Reaction to a stressful incident in early life - perhaps birth trauma.
5. Possible connection to autism and brain activity
6. Chemical imbalance in the body - prehaps related to absorption of melatonim, calcium, or vitamin d into the body.

Interventions that proved effective were:

1. Redirection
2. Unsolicited and often inappropriate harrassment and ridicule of older siblings (not recommended but effective)
3. Various behavior modification interventions
4. Other opportunities for kinesthetic, proprioceptive or vestibular stimulation
5. As the child becomes older, cognitive therapy
6. Vitamin supplements

It was generally felt that the longer it goes uncorrected, the harder it is to emliminate.

Here are a few other articles on eye poking and interventions you might find useful:

Sarah Blake has a very interesting and self declosing article

Functional analysis and treatment of eye poking.

Early Development of Stereotyped and Self-Injurious Behaviors: II. Age Trends

Pediatric Visual Diagnosis Fact Sheet TM RETINAL DISEASES

Understanding and Treating Self-Injurious Behavior
This article is addressing the concerns of autistic children but I think it is interesting that calcium supplements were regarded as a treatment.

Selected Articles from Literature Review at http://www.fpg.unc.edu/~edin/refbytopic.cfm?topic=3

• Cass, H. D., Sonksen, P. M., & McConachie, H. R. (1994). Developmental setback in severe visual impairment. Archives of Disease in Childhood, 70, 192-196.
• Ferrell, K., Trief, E., Deitz, S., Bonner, M. A., Cruz, D., & Stratton, J. M. (1990). The visually impaired infants research consortium: First year results. Journal of Visual Impairment and Blindness, 84(8), 404-410.
• Good, W. V., Jan, J. E., De Sa, L., Barkovich, A. J., Groenveld, M., & Hoyt, C.S. (1994). Cortical visual impairment in children. Survey of Ophthalmology, 38, 351-364.
• Hatton, D., & Model Registry of Early Childhood Visual Impairment Collaborative Group. (2001). Model registry of early childhood visual impairment: First year results. Journal of Visual Impairment and Blindness, 95(7), 418-433.
• Jan, J. E. & Freeman R.D. (1998). Who is a visually impaired child? Developmental Medicine & Child Neurology, 40, 65-67.
• Jan, J. E. & O'Donnell, M.E. (1996). Use of melatonin in the treatment of pediatric sleep disorders. Journal of Pineal Research, 21, 193-199.
• Jan, J. E. (1991). Head movements of visually impaired children. Developmental Medicine & Child Neurology, 33, 645-647.
• Jan, J. E., Carruthers, J.D., & Tillson, G. (1992). Neurodevelopmental criteria in the classification of congenital motor nystagmus. Canadian Journal of Neurological Sciences, 19, 76-79.
• Jan, J. E., Farrell, K., Wong, P.K., & McCormick A.Q. (1986). Eye and head movements of visually impaired children. Developmental Medicine & Child Neurology, 28, 285-293.
• Jan, J. E., Freeman, R.D., & Fast, D.K. (1999). Melatonin treatment of sleep-wake cycle disorders in children and adolescents. Developmental Medicine & Child Neurology, 41, 491-500.
• Jan, J. E., Freeman, R.D., McCormick, A.Q., Scott, E.P., Robertson, W.D., & Newman, D.E. (1983). Eye-pressing by visually impaired children. Developmental Medicine & Child Neurology, 25, 755-762.
• Jan, J. E., Good, W.V., Freeman, R.D., & Espezel, H. (1994). Eye-poking. Developmental Medicine & Child Neurology, 36, 321-325.
• Jan, J. E., Groenveld, M., & Anderson, D.P. (1993). Photophobia and cortical visual impairment. Developmental Medicine & Child Neurology, 35, 473-477.
• Jan, J. E., Groenveld, M., & Sykanda, A.M. (1990a). Light-gazing by visually impaired children. Developmental Medicine & Child Neurology, 32, 755-759.
• Jan, J. E., Groenveld, M., Sykanda, A. M., & Hoyt, C.S. (1987). Behavioural characteristics of children with permanent cortical visual impairment. Developmental Medicine & Child Neurology, 29, 571-576.
• Jan, J. E., Robinson, G. C., Scott, E., & Kinnis, C. (1975). Hypotonia in the blind child. Developmental Medicine and Child Neurology, 17, 35-40.
• Moore, V., & McConachie, H. (1994). Communication between blind and severely visually impaired children and their parents. British Journal of Developmental Psychology, 12, 491-502.
• Sonksen, P. M. (1993). The assessment of vision in the preschool child. Archives of Disease in Children, 68, 513-516.
• Sonksen, P. M., Petrie, A., & Drew, K. (1991). Promotion of visual development of severely visually impaired babies: Evaluation of a developmentally based program. Developmental Medicine and Child Neurology, 33, 320-335.

B. J. LeJeune, CRC, CVRT
Director of Deafblind Programs
RRTC on Blindness and Low Vision
Mississippi State University
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662-325-2001