1 VISION SCREENING Department of Blind and Vision Impaired Created by Carmen Valdes & Lisa Shearman Behavioral Observations Part 1

2 DBVI EDUCATION COORDINATORS Contact List Bristol Regional Office: Richard Fanis (540) Fairfax Regional Office: Vacant Contact: (703) Norfolk Regional Office: Donna Cox (757) Richmond Regional Office: Sue Cobb (804) Roanoke Regional Office: John McHugh (540) Staunton Regional Office: Lisa Shearman (540) Toll Free Number: (800)

3 Overview Welcome from the Department of Blind and Vision Impaired. This training is structured to give information on vision screening for infants and toddlers from 0 to 3 years of age. This is part 1 of a 4 part training which will cover: Behavioral Observations Review of Observations of the Eye Eye and Vision Screening Procedures Resources

4 Behavioral Observations Learning Objectives for Part 1: 1. Developmentally appropriate expectations from 0 to 3 months. 2. Developmentally appropriate expectations at 6 months.

5 Vision Development to 3 Months Babies usually see movement before anything else, as their vision is still evolving. Full-term babies should be able to see their mother's facial expression within a week of birth. Color vision is not yet fully developed at this time. Depth perception will also mature during the first year of life, as long as both of the child's eyes are working as a team. Eye muscle coordination in a newborn, as well as a small child, is also very immature. Babies often exhibit eyes turned in, turned out or not working as a team, this should resolve itself by the age of 3 or 4 months.

6 Examples of Development Birth to 6 weeks of age: Stares at surroundings when awake Momentarily holds gaze on bright light or bright object Blinks at camera flash Eyes and head move together One eye may seem turned in at times

7 Examples of Development 8 weeks to 24 weeks of age: Eyes begin to move more widely with less head movement Eyes begin to follow moving objects or people (8-12 weeks) Watches parent's face when being talked to (10-12 weeks) Begins to watch own hands (12-16 weeks) Eyes move in active inspection of surroundings (18-20 weeks) While sitting, looks at hands, food, bottle (18-24 weeks) Now looking for, and watching more distant objects (20-28 weeks)

8 3 Months Looks at someones face and tracks with head and eyes

9 3 Months Pupil constricts at bright lights

10 3 Months At 3 months the infant will observe different types of movement and light changes. Observes movement in the room.

11 3 Months At 3 months the infant will observe different types of movement and light changes. Watches own hands and feet.

12 3 Months Stares at light source

13 Vision Development at 6 Months Between ages four and six months, a child should start to reach or bat at the mobile or toys you hold in front of him. Swatting a toy will happen by chance at first, then become deliberate as a child's vision, depth perception and understanding grows.

14 Examples of Development 30 weeks to 36 weeks of age: May turn eyes inward while inspecting hands or toy (28-32 weeks) Eyes more mobile and move with little head movement (30-36 weeks) Watches activities around him for longer periods of time (30-36 weeks)

15 6 Months The developmental expectations at 6 months are: Displays smooth- following eye movements in all directions.

16 6 Months Reaches for toys Tracks movement Shifts gaze between objects