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Young children are difficult to test in any way, because they have the capacity to ignore the evaluator or to choose not to cooperate. When multiple disabilities are present, the process is even more difficult, because the child may be non-verbal or non-communicative. For these reasons, there are a few guidelines for those who would do vision screening with young children.

1. Speed is essential! A young child will not wait for the examiner to "get his act together." Young children also have a very short attention span, and lose interest quickly in repetitive activities. The secret is to keep testing activities short, fast, and interesting. It may be necessary to spend several sessions in completing tasks; 10- 15 minute sessions are as much as many young children can endure.

2. Learn to observe. Watch how the child approaches activities and how vision is used. Look for unusual visual behaviors (head turns or head tilts; holding materials very close or very far away, or at unusual angles; closing or covering one eye). Look at the child's eyes; are they moving together? Steady? Jumping or "jiggling?" Don't be concerned if a child needs to turn his/her head as well as his/her eyes: the ability to use eyes independent of head turning is a maturity factor, and some 5 year olds can't yet do it! Watch how a child walks around; is it a hesitating, careful stepping because he/she is not sure what obstacles are in the way? Are the child's hands used as "probes" to feel what's ahead?Does the child bump into things alot? Is hesitancy or an awkward gait a physical (motor) problem, or is it because the child doesn't see well? Look for My unusual behavior that might be related to poor vision

3. Let your plan evolve with the child. Take your cues from the child -whether he/she wants to "play,"work," or be entertained; what things interest him/her; whether the child has recently had medication (or is about to receive it), is hungry or sleepy, is well or ill, is rested or cranky. Not observing a child's cues can sabotage the best plan for assessment, and you'll get nothing.

With these general guidelines in mind, a plan for screening vision can be developed.

  1. Grouping similar tasks can save time
  2. Having someone else record responses can also save time, but if the examiner is alone, have a check list on which to make notes or record responses.
  3. Have materials ready and operational. (If you plan to use a penlight, make sure it is in working order ahead of time!)
  4. Use a relaxed approach (children sense when you're unsure of what you're doing).
  5. Enjoy the experience, and enjoy the child!

Back to Main Page of Infants and Toddlers with Visual Impairments by Virginia Bishop