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Caring for the Eyes of Children with Developmental and Intellectual Disabilities

By Zocdoc | Medically reviewed by Dr. Nassim Assefi

Children with intellectual and developmental disabilities (IDDs) can be at a higher risk for a wide range of visual problems, affecting their ability to interact with their environment. These issues can be broad or highly specific, ranging from general vision problems like blurred or double vision to more specialized difficulties like color blindness or structural eye anomalies.

Visual impairments can also affect a child’s motor development, balance, coordination and ability to learn. But they can often be overlooked, and as such, are notoriously unaddressed in vision care. This is a considerable issue as those with IDDs can be particularly vulnerable regarding their visual health. In fact, blindness and low vision are among the nation’s top ten disabilities. 

Unfortunately, many barriers stand in the way of children with IDDs getting the eye care they need. This can range from a lack of access to appropriate services or providers’ limited transportation options and insurance coverage for vision care. In addition, financial, logistical and lack of awareness were shown to be the most common reasons that accessibility to eye care did not occur for children with disabilities. These barriers can lead to delays in diagnosis, late intervention and a lack of proper treatment.

What children are at the highest risk of vision impairment?

The more severe the IDD, the higher the likelihood of visual impairment. Conditions such as cerebral palsy, learning disabilities, down syndrome and brain injuries are linked with an increased risk of developing visual impairments.

For example, children with craniofacial anomalies also have a higher risk of developing developmental visual impairments and physical disabilities. These include difficulties with speech, hearing, breathing and feeding. Individuals with intellectual or developmental disabilities are more likely to develop visual impairments (VI) due partly to the challenges of detecting and diagnosing issues early on. 

As a result, individuals with an IDD are more vulnerable to developing sight-related issues that go undiagnosed for an extended period, leading to further consequences such as difficulty accessing necessary resources or learning materials. In addition, it can be difficult for caregivers and healthcare providers to distinguish between symptoms of visual impairment and other conditions, making early detection and treatment even more of a challenge.

How IDDs exacerbate and conceal visual impairments

The challenges of living with an Intellectual Developmental Disability (IDD) can often act as a mask for symptoms associated with vision impairments. Here are a few examples of how this can happen:

Expressive delay

People with an IDD often have expressive language delays, making it difficult to assess their visual abilities. Since they may not be able to articulate what they are seeing or describe their difficulties, this can lead to a misidentification of the underlying cause of their symptoms.

These challenges can also be compounded by the fact that people with an IDD may not always be able to explain what is happening or how it feels. This can make it difficult for healthcare providers to accurately identify what type of visual issue is present.

Behavioral issues

It is not unusual for people with an IDD to display behaviors, such as aggression or impulsivity. These behaviors can make assessing vision in a clinical setting challenging, especially for providers with minimal experience with children with IDDs. 

This is why it is essential to be aware of how your child’s behavioral problems might affect their vision and be mindful of potential signs of visual impairment. Early detection is necessary to help ensure the best possible outcomes for individuals with an IDD and their families.

Intellectual impairment

Individuals with an IDD tend to have intellectual impairments that make it difficult to understand how their vision works. This can lead to problems with interpreting visual information, contributing to difficulty learning visually-based tasks or making sense of what they see.

In addition, individuals with an IDD may be less likely to access vision care services due to a lack of understanding or insight into the importance of their vision.

Communication barriers

It is also not uncommon for individuals with an IDD to have difficulty with communication, making it even more challenging to assess their vision. The lack of verbal or written communication skills can make understanding how someone interprets the visual world difficult and may lead to further delays in diagnosis and treatment.

Because of these communication barriers and complications that arise from them, patients may be less likely to seek help as a result. Healthcare providers need to be aware of this and make a concerted effort to ensure that individuals with IDD access appropriate vision care services.

Visual attention

Finally, people with an IDD may have difficulty visually focusing on objects or tasks. This could be a sign of visual attention deficit disorder and should be further evaluated by an eye care professional to rule out any underlying causes.

One common cause for visual attention issues could be head traumas sustained at birth, during development or even later in life. It is important to know these potential causes and seek appropriate vision care services if needed.

These difficulties can be compounded by a lack of resources or awareness when providing vision care services for individuals with an IDD. Healthcare providers and caregivers must be aware of the probable impact of visual impairments on people with an IDD and make sure to provide appropriate screening, assessment and follow-up services.

Preparing your child for an eye care visit

If your child has an intellectual developmental disability, they may require additional support to ensure the best possible outcome from their eye care visit. Here are a few tips to help you prepare for a doctor’s visit.

Visit the office before the appointment

Ease anxiety by visiting the office ahead of time. This will help them to become familiar with the environment and staff, helping alleviate potential fear or anxiety.

You can walk them through the optical store and explain what is happening. This can be especially helpful for those who have difficulty with communication, as it allows them to become familiar with their surroundings in a safe, non-threatening environment.

Provide visual supports

If your child struggles with verbal communication, visual supports can be an invaluable tool for explaining the eye care visit. You can use photographs or other visual aids that show an image of the doctor and the office to help them understand what will happen.

You can also provide diagrams of the eye and its various structures. You can also use flashcards to explain concepts such as pupil dilation and refraction. This will make it easier for them to understand the process and feel more comfortable during the appointment.

Count down the days until the visit

You can use a countdown calendar to mark off each day in the days leading up to the appointment. This will help them understand that something is coming up and give them an idea of when it will happen.

You can also use it to review their expectations of the visit and help them feel more prepared. This will make it easier for them to remain calm during the visit and ensure a positive outcome.

Explain the procedure

Before the appointment, ensure your child knows what will happen during the visit. Explain the different tests and procedures that the doctor may use and provide visual supports to make it easier for them to understand.

It is also important to ensure that your child knows what to expect during the eye exam, such as dilating drops or being asked to look through a machine. This will help them feel more comfortable and lessen any fear or anxiety about the visit.

Discuss and plan reward activities

Having a rewarding activity or celebration after the visit can help reinforce positive behavior and make it easier for your child to cooperate. You can use this time to discuss the appointment, review expectations and even plan a fun event, such as going out for ice cream or seeing a movie afterward.

By taking these steps and providing the right resources, you can ensure that your child has a positive experience during their eye care visit. With the proper preparation and support, they will be able to get the care they need and maintain a healthy vision for years to come.

Helping to prepare your doctor

Finding the best ophthalmologist for your child is essential in providing the best care. But before you make an appointment, you should do thorough research on the doctor’s history and discuss the visit with them ahead of time.

By speaking to your potential doctor, you can provide more information about your child’s medical history, abilities, and communication needs, allowing them to better prepare for the appointment. And this will enable you to find an eye doctor who is comfortable, knowledgeable, and experienced in treating your child.

You can also discuss any questions or concerns about the exam and ask the doctor what they think would be most helpful for your child. This can help the doctor understand your child’s needs and create an individualized plan to ensure they get the best care. 

Finally, you should talk to the staff at the office as well. Ask them if they have any experience with treating children or dealing with special needs patients. This will allow them to provide better customer service and help make your child’s appointment more comfortable.

These steps will help to ensure that the eye care visit is a positive experience for your child and allow them to receive the best possible treatment for their condition. With the proper preparation, your child can get the care they need, and the doctor will be better equipped to meet their needs. 

Financial assistance and low-cost care

If cost is a concern, you can explore different options for financial assistance, such as insurance plans or government programs. Many organizations provide low-cost eye care services for those in need.

Eyes of Hope: provides disaster assistance and free eyewear in the most needed locations. They have provided access to more than 3.6 million people in need of free vision care.

New Eyes: Over 10 million people in the United States and worldwide who have faced financial hardships have received clear vision thanks to New Eyes since 1932.

Children’s Eye Foundation of AAPOS: Children who have failed a vision test or have other significant eye issues can receive free, comprehensive eye exams from competent ophthalmologists through their public service program. 

Additional resources for parents of children with special needs

If you are the parent of a child with a disability, many resources are available to help you with your child’s eye care and other medical needs.

Services for children with disabilities information: Visit this site if you require details on your child’s exact diagnosis, early intervention programs, special education services, social security benefits, and more.

Parent to Parent USA: They offer programs in all 50 states that provide hands-on support, training, and technical help, as well as top-notch tools and resources that are viable, sustainable, fully operational, and effective.

PACER: For each person to attain their full potential, PACER Center improves the quality of life and widens opportunities for children, teens and young adults with all types of impairments and their families.

Federation for Children with Special Needs: The Federation equips families with the knowledge and tools they require to care for their children. From infancy until adulthood, they engage with families that have children, offering tailored support, education and assistance in building leadership skills.

Council for Exceptional Children: CEC promotes appropriate governmental policies, establishes professional standards, offers professional development and aids in helping professionals acquire the conditions and tools necessary for efficient, professional activity. For information, tools, and professional development for special educators, contact the CEC.

Roshambo Prescription Glasses: We offer many discounts for the special needs community, so please reach out if you need assistance with your glasses. Our customer reviews speak for themselves!

These are just a few valuable resources available to help you provide your child with the best care possible. With the right preparation and support, you can ensure that your child’s eye care visit is as successful and stress-free as possible.


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