Blindism

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Blindisms, [1] [2] also known as restricted or repetitive behavior (RRB) in visually impaired children, [3] and stereotyped behaviors in blind children [4] are a set of stereotypies (stereotyped, habitual and characteristic movements) in visually impaired children. These appear most often in those who are congenitally blind. Frequent movements include body rocking, repetitive handling of objects, hand and finger movements, eye poking, pressing and rubbing. [4] [1] Causes are not well understood, and treatment outcomes tend to be highly variable but generally positive. [3]

Contents

Symptoms and presentation

RRBs in visually impaired children are categorised into mannerisms and motor stereotypes. Mannerisms include eye poking, pressing and rubbing, gazing at lights and staring. Motor stereotypes include repetitive head/body rocking, thumb sucking, jumping, swirling, and repetitive hand/finger movements. [1]

Blindism behaviors overlap with stereotypies observed in autistic people, and as some diagnostic criteria of autism depend on vision, it is particularly difficult to diagnose autism among the visually impaired, often based on a subjective clinical impression. [1] [5]

Children displaying blindism behaviors may experience teasing or social isolation by other children. Additionally, in the case of eye pressing, poking and rubbing which are generally exclusive stereotypies to visually impaired children, the skin around the eye may discolor and become calloused, along with a risk of eye infection, keratoconus, and corneal scarring. [1] [6]

Causes

The causes of RRBs in visually impaired children are not well understood. Two distinct theories for causes are that it is compensation for sensory and/or social deprivation, and that it is a regulatory function in response to overstimulation and/or anxiety. However, as of 2021 such theories do not have empirical support. [3] The lack of visual sensory feedback in blind people is known to affect the calibration process for body movement. [7] It is also suspected that reinforcement of behavior plays a role in the development of RRBs. [1] There are a variety of other theories drawing from neuroscience. [1]

Treatment

Early intervention is often helpful in preventing children from displaying blindism behaviors. In most cases, a qualified teacher arranges an early education program to help develop accurate and effective use of the child's senses. The parents are often included in such programs alongside their visually impaired children. [3] [6]

Overall success rates for treatment ranges from 88.9% to 68.4% depending on risk factors. However, these results have questionable reliability due to the lack of recent treatment studies for RRBs in visually impaired children, and many such past studies using punishment as opposed to reinforcement which featured highly variable efficacy. [3]

Prevalence

Autism has a high co-occurrence rate with visual impairment. [1] As of 2022, prevalence of blindisms is largely inconclusive. with estimates ranging from 2% to 50% in autistic people. The prevalence of autism in children with visual impairment ranges from 20% to 38%, with a risk factor including the presence of other neurological conditions. [1]

See also

Related Research Articles

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<span class="mw-page-title-main">Echolalia</span> Speech disorder

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Amaurosis is vision loss or weakness that occurs without an apparent lesion affecting the eye. It may result from either a medical condition or excess acceleration, as in flight. The term is the same as the Latin gutta serena, which means, in Latin, clear drop. Gutta serena is a condition of partial or complete blindness with a transparent, clear pupil. This term contrasts with suffusio nigra which means, in Latin, dark suffusion, indicating partial or complete blindness with a dark pupil, e.g., a cataract. Milton, already totally blind for twelve years by the time he published Paradise Lost, refers to these terms in Book 3, lines 25–26.

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<span class="mw-page-title-main">Visual impairment</span> Decreased ability to see

Visual or vision impairment is the partial or total inability of visual perception. In the absence of treatment such as corrective eyewear, assistive devices, and medical treatment, visual impairment may cause the individual difficulties with normal daily tasks, including reading and walking. The terms low vision and blindness are often used for levels of impairment which are difficult or impossible to correct and significantly impact daily life. In addition to the various permanent conditions, fleeting temporary vision impairment, amaurosis fugax, may occur, and may indicate serious medical problems.

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<span class="mw-page-title-main">Stimming</span> Repetitive self-stimulatory behaviour common in neurodevelopmental disorders

Self-stimulatory behavior, also known as "stimming" and self-stimulation, is the repetition of physical movements, sounds, words, moving objects, or other behaviors. Such behaviors are found to some degree in all people, especially those with developmental disabilities such as attention deficit hyperactivity disorder (ADHD) and autism. People diagnosed with sensory processing disorder are also known to potentially exhibit stimming behaviors.

<span class="mw-page-title-main">Classic autism</span> Former neurodevelopmental disorder now classified under autism spectrum disorder

Classic autism, also known as childhood autism, autistic disorder, (early) infantile autism, infantile psychosis, Kanner's autism, Kanner's syndrome, or (formerly) just autism, is a neurodevelopmental condition first described by Leo Kanner in 1943. It is characterized by atypical and impaired development in social interaction and communication as well as restricted, repetitive behaviors, activities, and interests. These symptoms first appear in early childhood and persist throughout life.

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<span class="mw-page-title-main">Hand clasping</span> Joining ones hands with fingers interlaced

Hand clasping or hand folding is the interlocking of the fingers of one hand with the fingers of another. It is commonly used to express authority above or respect for others. It is also common to clasp the hands during prayer.

Sex and gender differences in autism exist regarding prevalence, presentation, and diagnosis.

Nonverbal autism, also called nonspeaking autism, is a subset of autism spectrum disorder (ASD) where the person does not learn how to speak. One study has shown that 64% of autistic children who are nonverbal at age 5 are still nonverbal 10 years later.

Social (pragmatic) communication disorder (SPCD), also known as pragmatic language impairment (PLI), is a neurodevelopmental disorder characterized by difficulties in the social use of verbal and nonverbal communication. Individuals who are defined by the acronym "SPCD" struggle to effectively indulge in social interactions, interpret social cues, and may struggle to use words appropriately in social contexts.

Deaf and hard of hearing individuals with additional disabilities are referred to as "Deaf Plus" or "Deaf+". Deaf children with one or more co-occurring disabilities could also be referred to as hearing loss plus additional disabilities or Deafness and Diversity (D.A.D.). About 40–50% of deaf children experience one or more additional disabilities, with learning disabilities, intellectual disabilities, autism spectrum disorder (ASD), and visual impairments being the four most concomitant disabilities. Approximately 7–8% of deaf children have a learning disability. Deaf plus individuals utilize various language modalities to best fit their communication needs.

References

  1. 1 2 3 4 5 6 7 8 9 Molinaro, Anna; Micheletti, Serena; Rossi, Andrea; Gitti, Filippo; Galli, Jessica; Merabet, Lotfi B.; Fazzi, Elisa Maria (2020-08-01). "Autistic-Like Features in Visually Impaired Children: A Review of Literature and Directions for Future Research". Brain Sciences. 10 (8): 507. doi: 10.3390/brainsci10080507 . ISSN   2076-3425. PMC   7465914 . PMID   32752249.
  2. ↑ Gwenb (2011-04-27). "Gwen's Things Unseen: Blindisms - what they are and why we need our children not to do them!". Gwen's Things Unseen. Retrieved 2022-04-29.
  3. 1 2 3 4 5 Ivy, Sarah E.; Ledford, Jennifer R. (2021-01-12). "A Systematic Review of Behavioral Interventions to Reduce Restricted or Repetitive Behavior of Individuals with Visual Impairment". Journal of Behavioral Education. 31 (1): 94–122. doi:10.1007/s10864-020-09418-x. ISSN   1053-0819. S2CID   231822632.
  4. 1 2 Fazzi, Elisa; Lanners, Josè; Danova, Simona; Ferrarri-Ginevra, Oreste; Gheza, Chiara; Luparia, Antonella; Balottin, Umberto; Lanzi, Giovanni (December 1999). "Stereotyped behaviours in blind children". Brain and Development. 21 (8): 522–528. doi:10.1016/s0387-7604(99)00059-5. ISSN   0387-7604. PMID   10598052. S2CID   34501322.
  5. ↑ Cass H (1998). "Visual impairment and autism: current questions and future research". Autism. 2 (2): 117–38. doi:10.1177/1362361398022002. S2CID   146237979.
  6. 1 2 "Blindisms–What are they? What can be Done to Correct Them?" (PDF). Parent to Parent. Kentucky School for the Blind. Summer 2007. Archived from the original (PDF) on July 17, 2011.
  7. ↑ Finocchietti, S.; Cappagli, G.; Gori, M. (2017). "Corrigendum: Auditory Spatial Recalibration in Congenital Blind Individuals". Frontiers in Neuroscience. 11: 268. doi: 10.3389/fnins.2017.00268 . ISSN   1662-453X. PMC   5422422 . PMID   28491022.
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