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The use of low vision aids by pre-school children. Training with a magnifier


Loepspel voor slechtziende kleuters
Kleine kinderen met visuele problemen zijn het niet gewend om iets van dichtbij te bekijken. Dit belemmert hen later ook in hun ontwikkeling in leren lezen. Ze zijn het niet gewend om hiervoor hulpmiddelen te gebruiken. Ook zijn er weinig richtlijnen voor het gebruik van hulpmiddelen voor jonge visueel beperkte kinderen.

Doel van het project is om meer inzicht te krijgen in het gebruik van een hulpmiddel (een loep) door jonge slechtziende kinderen en om loepspel te ontwikkelen waarmee dit loepgebruik kan worden gestimuleerd en verbeterd. In het vervolgproject is bekendheid gegeven aan het loepspel.

Ruim 40 slechtziende kinderen uit heel Nederland tussen de 3,5 en 6 jaar werden ingedeeld in twee groepen. De ene groep kreeg een training met een loep, de andere groep zonder loep. Om het loepspel te verspreiden zijn onder andere informatiebijeenkomsten georganiseerd.

Instellingen voor visueel beperkte kinderen, scholen. 


Samenvatting van de aanvraag

Up till now there are no clear clinical guidelines for the use of low vision devices for visually impaired pre-school children although the early use of low vision devices may be useful in later life. The purpose of this project is to investigate the visual and motor possibilities of young pre-school children when they have to handle a magnifier and to develop and evaluate a training in handling a magnifier. There are three important questions in this study: Firstly to investigate whether young visually impaired children can learn to handle a magnifier; Secondly, if they can recognize and name more and smaller pictures after a training with the magnifier then before the training. Thirdly we would like to know what the effect of the training is on fine manual skills needed to handle the magnifier, and on some time variables that have been developed in a pilot study with a group of toddlers with normal visual acuity (Boonstra et al. 2003) Young children with a visual impairment need the help of a magnifier to observe small details. Usually they shorten the viewing distance in order to see more details. If they get used to a low vision aid at a very young age and are trained to work with it, they, according to our working hypothesis, may see more details and will develop better skills for handling a magnifier. From Ritchie's work (Ritchie 1989) we know that children with a developmental level of a sighted 2 ½ year-old may be able to use low vision aids. Two pilot studies have been done to prepare this project: I ) The procedure that will be followed has been developed in 2002 in a group of 27 healthy Toddlers with normal visual acuity. This group of Toddlers with normal visual acuity had to study small objects with and without the use of a magnifier. They experienced no difficulty in handling the magnifier and they did not need any additional time for handling the magnifier. The variables to be tested were the use of the magnifier, the size of the pictures and time-variables describing viewing behaviour such as: response time, focussing time and interval time. (These terms are explained in strategy). Motor skills needed to handle a magnifier were recorded on video tapes and an observation scheme to study these motor skills was developed by a thorough analysis of these video tapes. II ) To prepare the training of the fine motor skills of visually impaired children another pilot study was performed in 2003 (Reimer et al. 2004). Participants were 11 visually handicapped children and 12 children with normal visual acuity. This study showed clear differences between children with normal visual acuity and visually impaired children. Visually impaired children needed significantly more time to shift a cylinder on a flat surface, they made significantly more errors than children with normal visual acuity and they had significantly more errors when they had to work without visual feedback. This second pilot illustrates the need to incorporate a training in fine motor skills when young visual impaired children are going to work with a magnifier. Training may be especially useful for visually impaired children with a progressive ocular condition. These children may have only a short time to acquire a visual memory. In the project submitted it is intended to include forty visually impaired children. Their age will be 2,5-4 years. The children should have a stable (non progressive) eye disease, for instance Nystagmus or Albinism. The children will have a complete ophthalmologic examination: Distance vision (LH), near vision (LH, presented singly and in a row), orthoptic examination, colour vision and visual field. Their developmental and motor competencies will be determined by the Dutch version of the Reynell-Zinkin scale (Vervloed, 2000) and the Manuvis test (Smits-Engelsman 2003) respectively. During the pre tests the children will have to discriminate optotypes in a random sequence. They may name or match the optotype with or without magnifier. Items that will be studied are: The amount of optotypes that have been named correctly, the effect of the use of the magnifier, the size of the pictures, the fine motor skills when handling the magnifier and the time variables. The results of the first (pre- training) measurements will also be compared with the group of normal toddlers (Boonstra et al.2003). After the pre test (all the items mentioned above) the group will be split into an experimental and a control group. One group of 20 children (experimental group) will receive specific tasks and will be allowed to use the magnifier. The control group of 20 children will do the same tasks without the magnifier. The training will be given twice a week during six weeks. The training is developed to stimulate the type of movement that appears to be difficult to perform for visually handicapped children and is based on the second pilot study (Reimer et al. 2004). After the training the post tests will be performed, and compared to the pre tests. In the six weeks after the post tests both groups will receive a magnifier which they may use at home. The parents will note spontaneous use of the magnifier in a diary. Spontaneous generalisation of the use of the magnifier as a result of the training can possibly develop in this period.



Looptijd: 100%
Looptijd: 100 %
Onderdeel van programma:
Projectleider en penvoerder:
Dr. F.N. Boonstra
Verantwoordelijke organisatie: