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 Visual training methods for visually impaired children aged between 2 and 6 years

Focus: Early Intervention

Topic: New Service Models

Roxana E. Cziker

Early Intervention Worker

School for the Visually Impaired Children

Calea Dorobantilor nr. 31

3400, Cluj-Napoca


Tel. / fax: +40 – 64 – 43 13 46

Email: rcziker@yahoo.com


A number of methods are available for the assessment and functional vision in young visually impaired children. There are also a lot of techniques to assess the visual abilities of these children as: Teller Cards, Hiding Heidi Low Contrast Face test, Lea Gratings Test, Lea Symbols and other tests, which give information about visual acuteness, contrast sensitivity, light sensitivity, chromatic sensitivity, visual fields and sthereoscopique and binocular vision.

Gracefully to these facilities, we can have information about the visual capabilities of young visually impaired children. In this respect, we can use this information to design appropriate educational environment for these youngsters and to develop the programs that improves visual capacity and visual behavior including here the visual stimulation and visual training. When we know a child’s visual capabilities, we can construct en environment in which materials of optimum size contrast, color and so on can be presented for that child.

In 1986 Corn indicated that vision stimulation serves multiple proposes for children:

  1. who have a minimal amount of vision;
  2. who have vision but don’t use the vision for visually orientated behaviors or for incidental learning;
  3. who have vision but not learned to interpret what they see as useful concept.

She makes a distinction between vision stimulation and visual efficiency training and vision utilization instruction.

Harrel and Akeson (1986) emphasized that productive vision stimulation goes beyond presenting a stimulus that is strong enough to assure the physical act of “seeing”.

Goetz and Gee (1987) describe visual stimulation as the noncontingent presentation of visually interesting stimulus items, which is based upon the assumption that visual display will motivate a child to become visually attentive. They have suggested that a student might master visual attention more rapidly provided with an opportunity to experience natural consequences of using vision and that this may facilitate response generalization.

It is necessary to make the differences in emphasis and interpretative of the terms “vision stimulation” and “vision training”. The concept of visual stimulation often implies the selection of or control of the strength of, visual stimuli, to encourage the use of vision and it may or may not involve structured specific training exercises or tasks.

The presentation of visual training methods

I. Images on transparent paper with geometrical shapes in simple and contrasting colors

The materials include eight groups of exercises including a different type of perceptive analysis. The exercises are structured on the following form:

  1. Each item contain a white paper with different shapes named “basic-images”. They can be circles or squares with missing parts inside.
  2. The missing parts are named “missing-images” and they are made on slide/transparent paper.

The exercises follows the simple to complex principle:


  1. to enlarge the visual field of images on row and all sheets through general view analysis;
  2. to develop the contrast sensitivity;
  3. to improve the shape/background discrimination;
  4. to develop the capacity to explore simple or complex images and also to perceive more images on a sheet;
  5. to develop the chromatic sensitivity;
  6. to develop the eye-hand coordination;
  7. to develop the orientation on a sheet;

It is very important to test the cognitive level of the child before using these types of exercises because it is necessary a proper level of mental development for 4 to 6 years old.

The target group is visually impaired children beginning with 4 years old. It is not recommended to use these kinds of materials with albinism children because of the transparency of paper. It should be taken into consideration that in case of nystagma will be used only a few images on a paper (one or two) at the beginning to not be tiresome for visual perception.

Prior to the visual training by “overlapped images” the children has to follow a program with simple exercises, which make easy the perception of geometrical shapes and colors in separate way. In this way the next step in the perceptual process of simple images and combination of colors will not create problems for perceptive analysis.

The therapist will present a sheet with “basic-images” to the child who has to establish the spatial position, the color, the texture and the geometrical shape of the “missing-image”. The “missing-images” are randomly arranged on a white paper to create a good contrast and to be perceived in an easier way.

It is very important to develop the capacity of focussing the eyes only to one image no matter how many images or details are on the sheet. At the beginning the therapist will cover the other images and will let to perceive only two images or the whole row. The child will start to perceive the images always from the left-up side to create a certain order in the visual exploration of an image.

The result of this program with visual training including the “overlapped images on transparent paper” is the increase of the capacity of focussing on an image and later the perception of images on books will improve.

II. “Matrix R” – Slides with simple images and colors

            The slides are based on geometrical shapes in black and white and primary, secondary colors and combinations of colors as well. The items are designed from simple to complex beginning with:

  1. black and white patterns;
  2. simple images in two combinations of colors, which emphasize the visual discrimination between colors;
  3. overlapped images in shades of colors which are based on perceptive discrimination capacity;

Before using this kind of exercises the children has to follow the following steps:

It was improved that the children prefer to look at the high contrast images (especially black/white contrast) and all this images help increase concentration skills, stimulate the creation of synapses (brain cells connection), increase an infant’s attention, enhance curiosity. The more stimulating experience gave to the baby means the more circuitry that built for enhanced learning in the future.

The visual stimulation with this kind of images produce developmental advantages including enhanced curiosity, attentiveness, concentration and the capacity to focus the eyes to a stimuli and to use the minimal amount of vision.

According with the theory that information from the central field is processed to obtain the identification of objects (the “what” system) and the information from peripheral field is processed to obtain the spatial location of object (the “where” system) (Held, 1970; Johnson, 1976; Schneider, 1969; Trevarthen, 1968; Ungerbiter &Mishkin, 1982), it is very important to exercise and to enlarge the visual field that the perception of objects to be optimal. This kind of black/white patterns and colored images on slides create a special environment to perceive the whole.

The following goals should be reached:

For each items the therapist has to realize different exercises:

III. Computer animated images

Barraga says that children with low vision progress more slowly or become stagnated at some lower level. The major implication of this developmental model for practitioners was that child’s actual developmental level should be determines and that the child should be trained to master the next stages in his or her visual development sequentially. That’s why it is necessary to create a proper environment and special programs to improve the modality of using the minimal amount of vision.

The animated images on the computer were designed to stimulate the initiative of children to focus the eyes, to explore and to prepare the visual system to perceive the environment. These images can be use with very young visually impaired children and also with children with motor disabilities to whom the lifting up had is very difficult. To perceive this kind of images, the child’s had is better to be supported by the adult (the child will be based upon the chest of adult). The movement of images keeps the child’s visual attention.

The images are very simple in bright colors, with black and white patterns (vertical and horizontal stripes, combination among black and white little squares). The contrast of colors is very important (black/white, red/black, yellow/black) to be perceive and follow in a better way.

The images are designed to create different effects:

The objectives:


In this paper it was presented a model that describes methods for visual training and visual stimulation for visually impaired children. There are three different kinds of exercises, which can be used separately, ore in association, according to different aspects of child’s development level. To establish a proper set of visual stimulation and training programs it has to be take into consideration:

During the work with visually impaired children with these kinds of exercises it was observed the following improvements:

It is important to draw the conclusion that stimulation during the first month of life and certainly before age 6 is important for preventing visual deprivation. But we have to be careful what kind of stimuli it can be used for each child in accordance with the eye-diagnosis, the visual functioning, the amount of vision, the mental and chronological age.


  1. Belcher C. M., Helms R.N., 1998, Lighting for energy – efficient luminous environment, Prentice Hall, New Jersey.
  2. Cziker, R., 2001, Visual training for visually impaired child, Publisher “Presa Universitara Clujana”, Cluj-Napoca, pp. 61-67.
  3. Hall, A.; Bailey I. L., October 1989, A model for training vision functioning, Journal of visual impairment & blindness, pp. 390-396.
  4. Knowlton, M., UV light: Some consideration for visual stimulation, education of the visually handicapped;
  5. Tavernier, G.G.F., May 1993, The improvement of vision by vision stimulation and training: a review of the literature, Journal of visual impairment & blindness, pp. 143-148.

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