Scoping review: quality of life of siblings of children who are deaf and hard of hearing, have a vision or motor impairment.

This study identified the current state of knowledge about the Quality of Life (QoL) of siblings of children who are deaf and hard of hearing (DHH), have a vision impairment (VI) or motor impairment (MI). Additionally, factors associated with individual variation in QoL were examined. A scoping review was performed using PsycInfo, ERIC, Web of Science, and CINAHL. Empirical studies with siblings (age 0-18 years) of children who are DHH, have a VI or MI that investigate the QoL of siblings were included. A total of 1746 studies were identified of which 11 met the inclusion criteria. The results showed that QoL has different interpretations and various measurement tools are used. The findings showed both positive and negative outcomes for the QoL of siblings. For example, family cohesion was found as a positive consequence. A negative consequence could be a higher score on problem behavior. Personal and parental characteristics such as age and parental availability were two main factors related to individual variation in QoL. Insight in the factors related to individual variation may help researchers to consider the research perspective. In addition, healthcare providers can use the information to be either aware or intervene on specific factors that are related to the QoL of the children who are DHH, have a VI or MI and their siblings.

Characteristics of peer play in children with visual impairments.

BACKGROUND: Although many studies report children with vision impairments (VIs) experience play difficulties compared to sighted peers, large variation is present within the population of children with VIs. AIMS: The present study investigated peer play variation in 70 elementary school-aged children with VIs (M age = 8;11 years, SD = 2.25) and associations with specific child characteristics in sub-groups of participants. Also, it was examined how play materials with supportive auditory cues affected social play in children with varying cooperative play skills. METHODS AND PROCEDURES: Play behavior was coded while participants used play materials with and without auditory cues and parents filled in questionnaires about child characteristics. Data were analyzed using binomial logistic regression analyses. OUTCOMES AND RESULTS: Although the profoundness of the VI was not associated to cooperative or symbolic play, age, language ability and gender did predict the demonstration of these play behaviors. Furthermore, auditory cues were particularly facilitative of social play in children with VIs with low cooperative play capabilities. CONCLUSIONS AND IMPLICATIONS: In sum, this emphasizes that child characteristics other than the VI can play a significant role during peer play and interaction, and that individual variation should be considered when providing peer play support.

Interventions to improve functioning, participation, and quality of life in children with visual impairment: a systematic review.

Visual impairment in childhood often has life-long implications. To aim for the highest levels of functioning, participation, and quality of life and to ensure children's well-being, children should be entitled to the most effective rehabilitation programs. We review evidence for the effectiveness of rehabilitation interventions for children with visual impairment to improve skills and behavior, thereby improving participation and quality of life as an ultimate goal. Of the 441 potentially relevant articles identified, 66 studies met our inclusion criteria (i.e., 28 randomized controlled trials, 18 nonrandomized controlled trials, and 20 before-after comparisons). The results suggest that sports camps, prescription and training in the use of low vision devices, and oral hygiene programs might be effective in improving functioning and elements of participation and quality of life in children with visual impairment. Other interventions showed mixed or negative results. The results should be interpreted with caution because of moderate to high risk of bias and suboptimal reporting. Heterogeneity of results and the use of over 50 different outcome measures prevented a meta-analysis. Future studies should focus on promising interventions for which effectiveness is still unclear (e.g., mobility, social skills), with adequately designed methodology.

The use of augmented toys to facilitate play in school-aged children with visual impairments.

BACKGROUND: Children with visual impairments (VIs) face challenges in social play activities, which limits their opportunities to practice social skills. AIMS: We investigated whether augmented toys were effective to facilitate play in 52 children with VIs who attended special schools for students with visual impairments and blindness. METHODS AND PROCEDURES: 52 children with VIs (mean age: 9.22 years, SD = 2.07) played three times with both an augmented and a non-augmented toy. A Playmobil® knight's castle was augmented with Radio Frequency Identification (RFID) technology, such that each play figure produced audio feedback during play. The RFID-technology could be activated and deactivated. Social and cognitive aspects of play were coded from video and data were analyzed using multilevel logistics. OUTCOMES AND RESULTS: Children showed less disengagement and more parallel play, but less cooperative play when they used the augmented versus the non-augmented castle. This pattern persisted after repeated play sessions with both toys. CONCLUSIONS: The addition of sounds to physical toys increased shared attention between children with VIs during the exploration of play materials, yet it interfered with social interaction during peer play.

Assessing Autism Spectrum Disorder in People with Sensory Impairments Combined with Intellectual Disabilities.

People with sensory impairments combined with intellectual disabilities show behaviours that are similar to Autism Spectrum Disorder (ASD). The instrument Observation of Autism in people with Sensory and Intellectual Disabilities (OASID) was developed to diagnose ASD in this target group. The current study focuses on the psychometric properties of OASID. Sixty individuals with intellectual disabilities in combination with visual impairments and/or deafblindness participated in this study. The OASID assessment was administered and rated by three independent observers. By means of expert consensus cut-off scores for OASID were created. To determine the concurrent validity OASID was compared with the Pervasive Developmental Disorder for People with Mental Retardation (PDD-MRS) and the Childhood Autism Rating Scale second edition (CARS-2). The intra-rater reliability, the inter-rater reliability, internal consistency and concurrent validity of OASID were good to excellent. Cut-off scores were established based on criteria from the DSM-5. OASID was able to differentiate between four severity levels of ASD.

Finding friends online: online activities by deaf students and their well-being.

Generally, deaf and hard of hearing (D/HH) children have fewer friends than hearing peers and their friendships are of a lower quality. The research hypothesis was that using the computer to communicate with new online friends through social network sites or playing games with offline friends is associated with D/HH friendship qualities, because it removes certain communication barriers D/HH face in offline communication settings. With online questionnaires the relation between computer use and online, mixed (offline friend who you also speak in online settings), and offline friendship quality of D/HH and hearing students (18-25 years) was compared in both the Netherlands (n = 100) and the United States (n = 122). In addition, the study examined whether the different friendship qualities were related to the participants' well-being. Results showed that, in general, D/HH students' friendship qualities and levels of well-being were similar to their hearing peers. The quality of the mixed friendships was positively related to well-being. Furthermore, the frequency of pc use with both online and offline friends was positively related to friendships qualities in both hearing and D/HH students. A combination of the online and offline friendship seems to be the most important friendship type for both hearing and D/HH students and it is worthwhile to encourage this friendship type.

The use of exploratory procedures by blind and sighted adults and children.

The study examined exploratory procedures (EPs) of congenitally blind and sighted children and adults on a haptic match-to-sample task. The aim was to examine the influence of age, visual status, and familiarity on the use of EPs when people haptically examine the object properties of weight, size, exact shape, and texture. EPs in the first and last of four series of trials were compared. The results showed that all four groups chose the same dominant EP for examining the four different object properties, all of them in agreement with the ones found by Lederman and Klatzky (Cognitive Psychology 19:342-368, 1987). Children were found to use more EPs, rather than using only the most efficient EP, for the dimension under study. Overall, performance was affected more by age than by visual status, and repeating the task led to increased efficiency in all groups. To describe exploratory behaviors in more detail, actions were introduced. Actions are single or sequential hand movements occurring in parallel with the EPs or apart from the EPs. The use of actions explained, in part, individual variation among the participants.

Short term memory and working memory in blind versus sighted children.

There is evidence that blind people may strengthen their memory skills to compensate for absence of vision. However, which aspects of memory are involved is open to debate and a developmental perspective is generally lacking. In the present study, we compared the short term memory (STM) and working memory (WM) of 10-year-old blind children and sighted children. STM was measured using digit span forward, name learning, and word span tasks; WM was measured using listening span and digit span backward tasks. The blind children outperformed their sighted peers on both STM and WM tasks. The enhanced capacity of the blind children on digit span and other STM tasks confirms the results of earlier research; the significantly better performance of the blind children relative to their sighted peers on verbal WM tasks is a new interesting finding. Task characteristics, including the verbal nature of the WM tasks and strategies used to perform these tasks, are discussed.

Attitudes of children and adolescents toward persons who are deaf, blind, paralyzed or intellectually disabled.

This study aimed to explore Dutch students' attitudes toward deaf, blind, paralyzed or intellectually disabled persons and to determine whether age, self-esteem, gender, religion and familiarity with a disabled person have a significant effect on these attitudes. The attitudes of 200 high school and 144 university students were determined with two questionnaires, the CATCH and MAS. Only the CATCH was applicable with all four disabled groups. Two factors were found: behavior-positive affect and cognition-negative affect. With regard to the first factor respondents had more positive attitudes toward deaf, blind and paralyzed persons than toward intellectually disabled persons. The cognition and negative affect factor showed that respondents had more positive attitudes toward deaf and blind persons than toward paralyzed and intellectually disabled persons. Being older and familiarity with a disabled person had a significant positive effect on attitudes, while self-esteem and gender had only a partial effect and having religious beliefs was not a significant predictor in this study.

Pragmatic abilities in children with congenital visual impairment: an exploration of non-literal language and advanced theory of mind understanding.

Children with congenital visual impairment have been reported to be delayed in theory of mind development. So far, research focused on first-order theory of mind, and included mainly blind children, whereas the majority of visually impaired children is not totally blind. The present study set out to explore whether children with a broader range of congenital visual impairments have a delay in more advanced theory of mind understanding, in particular second-order theory of mind (i.e. awareness that other people have beliefs about beliefs) and non-literal language (e.g. irony or figure of speech). Twenty-four children with congenital visual impairment and 24 typically developing sighted children aged between 6 and 13 were included. All children were presented with a series of stories involving understanding of theory of mind and non-literal language. When compared with sighted children of similar age and verbal intelligence, performance of children with congenital visual impairment on advanced theory of mind and non-literal stories was alike. The ability to understand the motivations behind non-literal language was associated with age, verbal intelligence and theory of mind skills, but was not associated with visual ability.

Haptic object matching by blind and sighted adults and children.

The present study describes a tactual object matching task based on the study of Lederman and Klatzky (1987) for the dimensions Exact shape, Weight, Volume and Texture. Participants were congenitally blind children and their sighted classmates, congenitally blind adults and sighted adults. To study a possible effect of familiarity the task was performed four times. Based on Millar's CAPIN (Convergent Active Processes in Interrelated Networks) model of spatial processing (Millar, 1994) it was thought that this manipulation would add redundant information to the experiment from which the children and blind participants could benefit. The results showed that accuracy was affected more by age than visual status, especially for the dimension Exact Shape. With regard to response times, children were in most cases faster than adults, especially the sighted adults. Familiarization had a significant effect on response times for all dimensions. Extra exercise only increased accuracy for the dimension Texture. These results were generally in line with the CAPIN model.

The effects of mothers' past infant-holding preferences on their adult children's face processing lateralisation.

Face processing development is negatively affected when infants have not been exposed to faces for some time because of congenital cataract blocking all vision (Le Grand, Mondloch, Maurer, & Brent, 2001). It is not clear, however, whether more subtle differences in face exposure may also have an influence. The present study looked at the effect of the mother's preferred side of holding an infant, on her adult child's face processing lateralisation. Adults with a mother who had a left-arm preference for holding infants were compared with adults with a mother who had a right-arm holding preference. All participants were right-handed and had been exclusively bottle-fed during infancy. The participants were presented with two chimeric faces tests, one involving emotion and the other one gender. The left-arm held individuals showed a normal left-bias on the chimeric face tests, whereas the right-arm held individuals a significantly decreased left-bias. The results might suggest that reduced exposure to high quality emotional information on faces in infancy results in diminished right-hemisphere lateralisation for face processing.

Young children's use of a visual aid: an experimental study of the effectiveness of training.

We report an experiment concerning the use of a stand magnifier by young children with visual impairments (21 males, 12 females; mean age 4y 8mo [SD 11mo]). Children had a normative developmental level and a visual acuity of 0.4 or less (< or =20/50 in Snellen's notation). To measure magnifier use objectively, we developed a task that closely resembled the dynamics of its real-life (pre-reading) use. Children had to follow trails visually, from a start location to an unseen end location. This could only be done successfully and reliably by proper use of the magnifier. In addition to this, we analyzed the effect of specific training with the magnifier by using a repeated-measures (before and after training) matched-groups (with respect to age and near-visual acuity) design. Results established both the task's efficacy as an instrument for measuring magnifier use in young children and the effectiveness of the training. Improvement in task performance after training was found in both groups, except for the youngest children (<3y 6mo). On average, 1.8 times as many paths were followed in both groups after training (p=0.001). The without-magnifier training group became 2.5 times as good at finding the correct end location, whereas the with-magnifier training group became 4.3 times as good (p=0.05).

Visual rehabilitation of children with visual impairments.

Visual rehabilitation, consisting of visual stimulation and visual training, is a common practice in the education of children with visual impairments. Ferrell and Muir have stated that scientific research into the effects of visual stimulation and training is ambiguous and that therefore stimulation and training should be abandoned. The support for this statement is reviewed by describing the scientific relevance and plausibility of the aims and presuppositions of visual stimulation and training programs as well as the results of 10 empirical intervention studies. The review results are in strong agreement with the claim of Ferrell and Muir to abandon noncontingent visual stimulation. It is hypothesized that it is possibly counterproductive for the adaptive functioning of the brain to show strong visual stimuli in artificial surroundings, which are noncontingent on the behavior of the child. Training of visual functions seems fruitful whenever skills that are ecologically valid and adapted to the individual needs and task demands of the child are trained. However, the empirical evidence is still too sparse to draw convincing conclusions. There is an urgent need for good randomized controlled trials with dependent variables that are relevant to everyday life.

Interaction between the teacher and the congenitally deafblind child.

Empirical data on the development of interaction, communication, and language in deafblind children is very rare. To fill this gap, a case study was conducted in which the interaction between a teacher and a deafblind boy age 3 years 4 months was analyzed. Sequential analysis of their interaction confirmed some general clinical impressions about interaction with deafblind children, and provided the basis for suggestions on how the interaction pattern might be changed.

Benefits of sign language interpreting and text alternatives for deaf students' classroom learning.

Four experiments examined the utility of real-time text in supporting deaf students' learning from lectures in postsecondary (Experiments 1 and 2) and secondary classrooms (Experiments 3 and 4). Experiment 1 compared the effects on learning of sign language interpreting, real-time text (C-Print), and both. Real-time text alone led to significantly higher performance by deaf students than the other two conditions, but performance by deaf students in all conditions was significantly below that of hearing peers who saw lectures without any support services. Experiment 2 compared interpreting and two forms of real-time text, C-Print and Communication Access Real-Time Translation, at immediate testing and after a 1-week delay (with study notes). No significant differences among support services were obtained at either testing. Experiment 3 also failed to reveal significant effects at immediate or delayed testing in a comparison of real-time text, direct (signed) instruction, and both. Experiment 4 found no significant differences between interpreting and interpreting plus real-time text on the learning of either new words or the content of television programs. Alternative accounts of the observed pattern of results are considered, but it is concluded that neither sign language interpreting nor real-time text have any inherent, generalized advantage over the other in supporting deaf students in secondary or postsecondary settings. Providing deaf students with both services simultaneously does not appear to provide any generalized benefit, at least for the kinds of materials utilized here.

CHARGE syndrome: relations between behavioral characteristics and medical conditions.

The behaviors and medical problems in 27 persons with CHARGE syndrome were studied, because it was hypothesized that their behavior might be partly dependent on the heterogeneous medical status. With the exception of more tics, cardiac surgery was associated with positive behaviors: less withdrawn behavior, better mood, and a more easy temperament. Tube feeding was also related to positive behavior, since participants with a history of tube feeding showed less intense behavior. Cerebral deficits were associated with three problem behaviors: more intense and withdrawn behavior and a worse mood. Deaf-blindness was associated with developmental delays in expressive and overall communication level, and recurrent middle ear infections correlated with delays in written language. Of all medical conditions, only the presence or absence of heart defects and cardiac surgery could differentiate between the participants with regard to the number of behavioral problems. Participants with heart surgery especially, had less behavior problems. The number of operations and hospitalizations was not associated with behavior, but the total length of the hospitalizations was. Long hospital stays were associated with less problem behavior, especially internalizing behaviors. Cerebral and heart problems did not result in longer hospital stays, whereas esophageal reflux did. Age effects were reflected in older participants, who showed more internalizing problems. Heart surgery and hospitalization may be protective factors, but the protection might not be the actual surgery or hospital stay, as there may be other variables that are the actual cause, such as reduced vitality or altered parent child interactions after heart surgery. The study could not confirm a significant association between medical conditions and autism found in previous studies.