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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 6, Lesson 3


As young children are assessed for appropriate intervention it is important for the ITDS to understand the terms that families will hear. Services are based on the amount of support a child will need. The National Dissemination Center for Children with Disabilities (NICHCY) provides the following definitions:

  • Low vision refers to a severe visual impairment and indicates that the person needs adaptive lenses, adaptations in lighting, large print books or Braille books. This refers to a child whose best corrected vision is lower than 20/70 in the better eye.
  • Legally blind means the person has less than 20/200 vision in the better eye or a very limited field of vision.
  • Totally blind refers to a person who has no vision and must learn through non-visual instructional methods including the use of Braille readers.

Note: Definitions of blindness and visual impairment vary depending on the discipline or agency providing services. Additional information on terminology, incidence, characteristics and resources is available through NICHCY.

Strabismus and Amblyopia

Strabismus, which is sometimes referred to as crossed eyes, is a condition in which a person cannot align both of their eyes simultaneously due to an imbalance of the eye muscles. One of the eyes may turn in, out, up, or down. The eyes do not work together to focus the image in a binocular fashion. Strabismus also affects depth perception and eye-hand coordination. If untreated, the brain, rather than being confused with two competing visual signals, quits accepting one signal and vision can be permanently affected. More information on this condition can be found by reading All About Strabismus The ITDS should know that this condition differs from amblyopia.

3 little girls smilingAmblyopia or 'lazy eye' results in reduced vision that is not corrected with glasses or contact lenses and may not be apparent to caregivers. The brain does not fully accept and interpret the image from the amblyopic eye; therefore, it is important that the condition be diagnosed by a thorough eye exam by an eye specialist, especially when the pediatrician suspects the condition during routine well baby checks. Amblyopia is best treated early between the ages of 6 months to 2 years. Additional information can be found through a web resource about amblyopia and Strabismus.

Consider this scenario.

The ITDS is likely to assume responsibility as the Primary Service Provider, for children who are referred with strabismus and are patched by the ophthalmologist with poor vision in the un-patched eye. Vision teachers/specialists do not serve this population. It is critical for parents to receive support in patching the "good eye" so that permanent vision loss will not develop in the "bad eye".

What are strategies the ITDS should follow when working with the young child and the family?


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