title: Development of social functioning in children with congenital visual impairment
Creators: name: Tadić, Valerija
Publisher: name: Goldsmiths, University of London
Year: 2009

description: Effects of significant visual impairment (VI) in childhood are profound and far-reaching, impacting on most developmental areas. In recent years, there has been a particular emphasis on the effects of VI on social communication and social cognition, with a focus on a potential link with autism. However, the mechanisms underlying specific socio-developmental difficulties and the 'autistic-like' presentation shown by some children with VI, as well as the mechanism by which many children with VI are able to overcome such developmental vulnerabilities, remain poorly understood and require further clarification. The goal of the research reported in the present thesis was to elicit further understanding of the developmental patterns of social functioning in children with VI, and gain a better appreciation of the role that language may play in these processes. The thesis focused on children with severe and profound degrees of congenital vision loss without additional impairments, as learning difficulties have been identified as a confounding factor. Their developmental outcomes were compared to those of a group of typically developing sighted children of similar age and ability. The children were assessed using parental/teacher questionnaires and a battery of developmental and experimental tasks targeting language, social communication, mental state understanding and discourse, and executive functioning. An important finding was a discrepancy between the structural language skills and pragmatic language use in children with VI. Additionally, a substantial proportion of children with VI showed socio-communicative profiles that were consistent with a broader autism phenotype. An investigation of the children's mental state language use, which was also reported, provided a useful context within which socio-pragmatic difficulties seen in children with VI in this research could be considered. A similar contribution was provided by a study of mother-child mentalistic language exchange, which emphasised specific strengths of socio-interactive environment of children with VI that future interventions can capitalise on. Furthermore, the developmental vulnerabilities imposed by VI were found to extend to a broader behavioural presentation in children with VI, including weaknesses in specific executive function domains. Such weaknesses, notably in cognitive shifting, were considered in the context of attentional mechanisms that may be particularly affected by vision loss in early development. A retrospective examination of attentional behaviours in pre-school development of children with VI helped to clarify these issues further, by shedding light on the potential precursors to the vulnerabilities in achieving social competence and adjustment in children with VI at school age. The findings are believed to offer original contribution to understanding the development of social functioning in children with congenital VI, and are hoped to contribute towards the diagnostic considerations and intervention strategies aiming to boost such children's developmental potential.