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Visual Rehabilitation for Infants, Toddlers, Preteens & Teenagers

The Rainbow Children’s Hospital now provides visual rehabilitation to infants, toddlers, preteens, and teenagers. Our goal is to maximizing the potential of a visually-impaired child. For this, we use early child care intervention followed by vision therapy. The goal of the rehabilitation process is allowing them to learn how to cope with their life. Through rehabilitation, your child will have enhanced confidence to take advantage of the myriad opportunities of life and become independent to the best possible level. Services The following visual Physiotherapy & Rehabilitation services are provided at the Department of Visual rehabilitation: 1. Devoted counseling - A professional hand is needed to help the child and the parents in understanding what is the accurate prognosis of their ocular condition. Also, they help discover and address the different social, functional, and psychological implications that come along with vision loss. We encourage special skills training for visually-impaired children. 2. Early intervention - The importance of early intervention cannot be overstated. With the right assessment and appropriate therapy, we can work on maximizing the milestones of normal development. This also includes utilizing the residual vision. To achieve this, functional vision assessment is done for observing the visual skills in relation to the assessment and management of cognitive, motor, spatial, and perceptual abilities. 3. Training parents - We provide training to the parents, guardians, and caretakers to discover and concentrate on the child’s residual senses that they can use for exploring the world. 4. Finding the Deaf-blind - It is important to identify children with deaf-blindness through early detection and intervention. We use an Otoacoustic emission screener on the newborn for identifying whether they are deaf-blind or not. 5. A comprehensive evaluation of the low vision - We examine and prescribe appropriate low-vision devices to children with residual vision. We also train them to use the devices in a simulated environment. 6. Educational guidance - Based on the prognosis and type of the disorder, we will let you know if neurosurgery is necessary. We will suggest the right learning models (regular, special, inclusive, and integrated) and mode of education (regular print, Brailler, large print, special software, and audio books) to your child. 7. Modification of the environment - We will suggest simple modifications that you can make in the environment to maximize the usage of other senses and residual vision. This includes lighting, tactical clues, contrast, etc. 8. Vocational guidance - We provide support and suggestions for discovering appropriate locations for your child based on their needs and ocular function. 9. Access to technology - We will provide your child with intensive training to use special software designed for helping them access technology driven gadgets like mobile, computer, etc. 10. Guidance for availing supporting benefits - All visually-impaired children are eligible for different government concessions and benefits. This can include disability certificate, monthly pension, job reservation, travel allowances, and education benefits. FAQs 1. Who can benefit from visual rehabilitation? Visual rehabilitation can be beneficial for children with:

Total blindness Deaf-blindness Low vision Multi-disability 2. What is vision therapy? The aim of the vision therapy is not strengthening the eye muscles. They are already incredibly strong. It is different from any self-help, self-directed neurology program of eye exercises. In a vision therapy, an optometric vision care professional supervises you. Also, there are different specialized equipment that you can use in a vision therapy program including the following:

Computer software Electronic targets with timing mechanisms Regulated medical devices (corrective, therapeutic, and prism lenses) Occludes or eye patches Optical filters Vestibular device or balance boards Visual-sensory-motor integration training devices Vision therapy is also for children whose visual acuity is near normal but they still have functional vision problems like impaired contrast, peripheral field loss, etc. This makes it hard for them to perform daily activities. In case of children with multiple disabilities, parents need to make extra efforts to help their children live an independent life.

3. Will my child have to attend specialized schooling or can they attend regular schools? The answer to this depends on the condition of your child and the place where you live. Some of the children with blindness or visual impairment attend regular schools. They are given separate instructions from the teacher. In the case of toddlers aged between three to five years with blindness or visual impairment, you need to enroll them in a daycare or preschool that has teachers with experience in working with students with visual impairments. You can enroll them in early childhood programs and preschool that specializes in visual impairment and blindness.

4. Should I let my child use large print or learn braille? To make the right decision for your child, you need to take the advice from the children’s specialist, teachers, and the education team. There are different forms of learning modalities like tactile, auditory, and visual. In many cases, children with low vision use a combination of the learning modalities to get the best results. For children who are visually impaired, you should try to use standard, regular print with or without any low vision devices, instead of using enlarged print. There are several drawbacks of using large print:

It is not always available. For making your child more independent, you should make them learn a low vision device or a magnifier for reading standard print. Your child might feel uncomfortable using these because they would look different from the ones their classmates are using. Large print books are bulkier,

longer and difficult to carry than the standard ones. As your child grows, it will get increasingly difficult for him to get the book in large materials. Some examples of this include college texts, recreational

reading materials, and workplace reading materials. For easy transition to college and work life, you should help them use standard-print books with or

without an optical design. When the vision of your child reaches a level where optical devices won’t work, you can try brailler and auditory devices for proper educational training and assistance.

5. What will the future be like for my child with visual impairment? Today, there are more options than ever for blind or visually impaired children and you should talk with an adolescent neurologist regarding it. They can work on enhancing their functional vision and using other senses more effectively. There are a number of low vision devices that could help your child see clearly. Also, there are a variety of low vision services that provide assistance in utilizing the existing vision of your child. Through this, you can be rest assured that your child will get through school, college, and work life, and become a self-supporting, independent adult.

Dr. Lokesh Lingappa

Consultant Child and Adolescent Neurologist

Rainbow Children's Hospital, Banjara Hills