Early Childhood Development and O&M
What should that kid being doing when?
Understanding early movement patterns in visually
impaired children
• Motor development typically occurs in an orderly
sequence from head to trunk to hand to feet, from
midline to extremities, and from gross to fine muscles.
Gross to fine….general to specific!
• With each developmental step, the next skill missed or not fully
mastered will affect children’s abilities to achieve subsequent
skill mastery (Alexander et al., 1993)
• The acquisition of controlled movement or postural control
requires both stability (maintaining posture) and mobility
(moving).
• “Mobility is present before stability…”
• Children are able to maintain a crawl stance before they start to
shift their weight side to side or back and forth.
• Sensory input can increase or decrease arousal and provides motivation to
initiate movement.
• Infants use different senses to stimulate and reinforce motor behaviors
and movement.
• Vision provides motivation for the development of head control.
• Auditory input prompts children to look for the source of sound, to reach
for objects, and explore.
OTs & PTs
• Working with an OT or PT who can analyze and assess atypical
movement is useful to COMS/L and families.
• Therapists can recommend specific motor activities to assist
the child in developing the movements needed to master the
lagging skill (rolling, crawling, walking, etc.)
• These activities can be enhanced with
suggestions from COMS/L and TVIs that
would facilitate awareness of surroundings,
security in moving through space, etc.
• Sighted child
1-2 Months
- begins to lift head against gravity while prone (prone on elbows)
- begins to have a visual interest in objects and actions
• Visually impaired child
- has difficulties being prone on elbows
- the child is interested in play on the body, physical
handling and rhythms.
• Sighted child
3-5 Months
- begins to have symmetry in their movement
- begin visually directed reach, first with one
hand then two
-head control improves and the child begins
• Visually impaired child
- has more symmetry in movement
- typically avoids prone positioning.
to roll.
- Head control improves while sitting (likes to be on
their back).
- Hands tend to be lightly fisted.
• Sighted child
6-8 Months
- sits independently (propped).
- the grasp, release and transfer toys begins
- creeping and crawling begin.
• Visually impaired child
- will be able to sit independently (propped).
- They will begin to hold objects placed in their hand.
they will mouth them and sometimes just release
the item.
- They may begin to move from sitting to lying on their back.
limited crawling.
• Sighted child
Sometimes
- There is
9-11 Months
- will pull to stand with minimal assistance
- can sit to stand and stand to sit.
- Stands alone momentarily and begins walking.
• Visually impaired child
- will pull to stand with minimal assistance.
- child may stand on their toes for several months.
the transitional movements well.
- may start goal-directed movement through space
they are encouraged.
• Sighted child
- manages
if
12-14 Months
- walks with one hand held or independently.
- child will choose to walk or crawl.
- child can also move on and off of furniture.
• Visually impaired child
- will walk indoors with one hand held.
continues and the child may cruise on
furniture.
- some children may skip the crawling as a way to
- crawling
move.
• A sighted child
15-18 Months
- Walks independently on level surfaces
- Begins to negotiate indoor declines and declines,
but still needs help with steps.
- Learning simple routes.
• A Visually Impaired Child
- Walks independently on level surfaces
- Searches with hands
- limited exploration of unfamiliar environments.
•
•
Sighted Child
-
21-24 Months
Manages stairs with little assistance
Running begins
Using push and pull toys
Spinal Posture has developed
Visually Impaired Child
- Manages stairs with assistance
- walks independently – familiar settings
- learns simple routes
36 Months
• Sighted child
- runs, kicks, and jumps
- alternates feet when climbing stairs
• Visually Impaired child
- Travels indoors independently
- not yet running, kicking, or jumping.
How To
• Prior to about 7 months the COMS/L is not very
actively involved with the child’s team.
• Basic play schemes.
• Introduction of “tools”
• Family become familiar with blindness and O&M
outcomes.
The importance of O&M play
• Play provides the opportunity for children to practice
new cognitive, social-emotional, and physical skills.
• Play offers numerous opportunities for children to act
on objects and experience events.
• Babies learn to turn the pages of books and begin to sense a
sequence to the story.
• Play is an active form of learning that unites the mind,
body, and spirit (Levy 1978). Until at least age 9,
children’s learning occurs best when the whole self is
involved.
• Play enables children to use their real experiences to
organize concepts of how the world works/operates.
• Through play, children can see how new experiences are
related to previous learning.
• As they play, blind/VI children can develop a playful
attitude and are open to a variety of problem solutions.
• Art appreciation can develop through tactual play.
When the blind/VI child makes a clay pot, then he is a
potter.
• Play increases a blind/VI child’s curiosity, invention,
staying with the task, and feeling successful.
• Play reduces tension. Often blind/VI children are
pushed to “achieve” or are “needing” to learn. In play,
adults do not interfere.
• Play challenges yet does not punish for mistakes.
• If peers/siblings are involved the child develops skills
for taking in another’s point of view, cooperating,
helping, sharing, and solving problems together. Team
work!
• Children express and work out emotional aspects of
everyday experiences as well as frightening events,
especially through dramatic play.
O&M concepts of motor and supporting
play
• Let child choose their activities. Provide a variety of toys,
activities, and materials, but let the blind/VI child decide
which ones he wants to “explore”.
• Let the child determine length of play time.
• Pushing children to continue with an activity that no longer holds their interest is
likely to lead them to avoid that activity or skill in the future.
• When the COMS/L interrupts play and exploration
prior to the child feeling finished with the activity, it
could interfere with the development of attention span.
Preschoolers need notification that play time will end in
2 mins or 5 mins, so they can finish up.
• Provide activities/materials that challenge various
motor skills and levels.
• Makes sure the physical environment is safe.
• Arranges space so as to minimize interruptions.
• Allows blind/VI children to use objects and try out new
skills in unusual ways and/or as they are intended.
• Challenges the level of play by suggesting more
advanced props (pre-cane materials).
Helping babies play
-birth to 4 months-
• Provide bright, moving objects for the blind baby to see/hear.
• Move objects in/around around the baby. This
will make a different visual/auditory impact. It helps babies judge the
relationship between objects and between themselves and objects.
• Hold babies up to your shoulder and move them around to
provide more sensory input.
• Playfully engage the baby in repetitions.
• Stop between sounds and watch for them to smile or move.
• Sing. Sing-song.
• Dance.
• Play with baby’s hands and
• Feet.
Four to 8 months
• Keep toys safety a primary concern.
• Toys that move or make sound in response to the baby’s
action are best!
• Minimize interruptions to protect babies’ exploration or
new objects.
Eight to 12 months
•
•
•
•
Container play, dump tables, water play, baskets, shoe boxes.
Hide and seek with objects and sounds.
Read a book to them.
Provide toys that challenge the toddlers motor skills. Begin
some riding toys.
• Stretch the toddler’s arms above head… playing Yoga.
Twelve to 18 months
• Provide simple pictures/objects of familiar items for
toddler to name.
• Provide for a safe place to travel (indoors and
outdoors).
• Increase motor opportunities – tunnels, cabinets,
drawers, etc.
• Provide real objects for daily activities such as eating,
bathing, riding, and cleaning. These are also important
toys for “pretend” play.
Eighteen months to 3 years.
• Provide equipment to challenge gross motor skills.
• Provide objects that relate to each other.
• Allow the B/VI child to try it in his own way.
– Push toys, riding toys, rocking the rocking boat, climbing stairs, sliding down short
slides, and crawling through tunnels.
How COMS/Ls play games with children…
• Keeps the focus on fun of playing not on winning. We
are learning new skills, here.
• Does not offer prizes of rewards for learning.
– Sometimes this takes away from the development of self-motivation.
•
•
•
•
Keep the child active.
Introduces new skills or devices.
Stays flexible on rules.
Considers the overall ability of the child.
Other areas incorporated into O&M play.
• Pre-cane skills. Staying on task. Maintaining a route.
Searching for dropped objects. Listening skills. Turntaking. Building relationships.
Conclusion
• O&M play helps the b/VI child integrate into the motor
world. Simply describing what a place will be like or
what will happen is not enough.
• Be sure to enjoy your b/VI student!