Blindisms, also known as restricted or repetitive behavior (RRB) in visually impaired children, and stereotyped behaviors in blind children are a set of

stereotypies A stereotypy (, or ) is a repetitive or ritualistic movement, posture, or utterance. Stereotypies may be simple movements such as body rocking, or complex, such as self-caressing, crossing and uncrossing of legs, and marching in place. They are ...

(

stereotyped In social psychology, a stereotype is a generalized belief about a particular category of people. It is an expectation that people might have about every person of a particular group. The type of expectation can vary; it can be, for example ...

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and characteristic movements) in visually impaired children, appearing most often in those congenitally blind. Frequent movements include body rocking, repetitive handling of objects, hand and finger movements, eye poking, pressing and rubbing. Causes are not well understood, and treatment outcomes tend to be highly variable but generally positive.

Symptoms and presentation

RRBs in visually impaired children are categorised into mannerisms and motor stereotypes. Mannerisms include eye poking, pressing and rubbing, gazing at lights and staring. Motor stereotypes include repetitive head/body rocking, thumb sucking, jumping, swirling, and repetitive hand/finger movements. Blindism behaviors overlap with stereotypies observed in autistic people, and as some diagnostic criteria of autism depend on vision, it is particularly difficult to diagnose autism among the visually impaired, often based on a subjective clinical impression. Children displaying blindism behaviors may experience teasing or social isolation by other children. Additionally, in the case of eye pressing, poking and rubbing which are generally exclusive stereotypies to visually impaired children, the skin around the eye may discolor and become

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, along with a risk of eye infection,

keratoconus Keratoconus (KC) is a disorder of the eye that results in progressive thinning of the cornea. This may result in blurry vision, double vision, nearsightedness, irregular astigmatism, and light sensitivity leading to poor quality-of-life. Usu ...

, and corneal scarring.

Causes

The causes of RRBs in visually impaired children are not well understood. Two distinct theories for causes are that it is compensation for

sensory Sensory may refer to: Biology * Sensory ecology, how organisms obtain information about their environment * Sensory neuron, nerve cell responsible for transmitting information about external stimuli * Sensory perception, the process of acquiri ...

and/or social deprivation, and that it is a regulatory function in response to

overstimulation Stimulation is the encouragement of development or the cause of activity generally. For example, "The press provides stimulation of political discourse." An interesting or fun activity can be described as "stimulating", regardless of its physic ...

and/or anxiety. However, as of 2021 such theories do not have empirical support. The lack of visual sensory feedback in blind people is known to affect the calibration process for body movement. It is also suspected that reinforcement of behavior plays a role in the development of RRBs. There are a variety of other theories drawing from neuroscience.

Treatment

Early intervention is often helpful in preventing children from displaying blindism behaviors. In most cases, a qualified teacher arranges an early education program to help develop accurate and effective use of the child's senses. The parents are often included in such programs together with their visually impaired children. Overall success rates for treatment ranges from 88.9% to 68.4% depending on risk factors, although these results have questionable reliability due to the lack of recent treatment studies for RRBs in visually impaired children, and many such past studies using

punishment Punishment, commonly, is the imposition of an undesirable or unpleasant outcome upon a group or individual, meted out by an authority—in contexts ranging from child discipline to criminal law—as a response and deterrent to a particular acti ...

as opposed to reinforcement which featured highly variable efficacy.

Prevalence

Autism has a high co-occurrence rate with visual impairment. As of 2022, prevalence of blindisms is largely inconclusive. with estimates ranging from 2% to 50% in autistic people. The prevalence of autism in children with visual impairment ranges from 20% to 38%, with a risk factor including the presence of other neurological conditions.

References

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External links