Neuropediatrics 2019; 50(S 01): S1-S10
DOI: 10.1055/s-0039-1685423
Oral Communications
Georg Thieme Verlag KG Stuttgart · New York

Environmental Adaptation and Early Visual Training to Promote Neurodevelopment in Infants with Visual Impairment: A Pilot Study

E. Fazzi
1   Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italie
2   Unit of Child and Adolescence Neurology and Psychiatry, ASST Spedali Civili of Brescia, Italy–Brescia (Italie)
,
J. Galli
1   Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italie
1   Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italie
,
S. Micheletti
2   Unit of Child and Adolescence Neurology and Psychiatry, ASST Spedali Civili of Brescia, Italy–Brescia (Italie)
,
A. Rossi
2   Unit of Child and Adolescence Neurology and Psychiatry, ASST Spedali Civili of Brescia, Italy–Brescia (Italie)
,
A. Molinaro
1   Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italie
,
A. Alessandrini
2   Unit of Child and Adolescence Neurology and Psychiatry, ASST Spedali Civili of Brescia, Italy–Brescia (Italie)
,
E. Campostrini
1   Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italie
,
E. Fumagalli
1   Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italie
,
S. Calza
3   Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia–Brescia (Italie)
› Author Affiliations
Further Information

Publication History

Publication Date:
20 March 2019 (online)

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Objectives: Systematic reviews on early visual intervention in infants reported promising but inconclusive results due to extreme among programs, lack of control group, and random allocation. Our aim is to evaluate the effects of environmental adaptation and early visual training in visually impaired infants and to test whether this approach leads to changes in the overall neurodevelopment.

Background: Thirty infants (average age: 5.9 months, 16 males) with visual impairment of cerebral and peripheral origin associated with neurological signs/developmental delay received a visual training for a 6 months period based on environmental modification and training on oculomotor functions and hand–eye coordination. Thirty infants (average age 6 months, 18 males) matched by gestational/chronological age, sex, diagnosis, and psychomotor abilities were recruited as control group. Neurovisual abilities were primary outcome measures; developmental quotient and subscales of Griffiths’s ER were secondary ones. Assessments were carried out at baseline and after 6 months of treatment by a child neurologist blind to group assignment.

Methods: At baseline the two groups did no differ on demographic and clinical variables (p > 0.5 for all). After 6 months, oculomotor functions improved in both the groups (fixation, smooth pursuit, and saccades p < 0.01). Improvement in all the oculomotor components was better in the treated group (p < 0.01). Visual acuity and contrast sensitivity ameliorated in both the two groups (p < 0.01). Visual acuity better improved in the treated group (p < 0.01). At Griffiths’s scales hand–eye coordination and performances subquotients (p < 0.01) improved in the treated group. Developmental quotient (p < 0.01), Language (p < 0.01), hand–eye coordination (p = 0.02) and performance (p < 0.01) subquotients decreased in control group.

Conclusion: Environmental adaptation and early visual training seem to influence favorably visual abilities, vision related performances, and the overall neurodevelopment outcome in infants with visual and neurodevelopmental impairments.