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

visually impaired Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as correctable eyewear, assistive devices, and medical treatment� ...

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 Teasing has multiple meanings and uses. In human interactions, teasing exists in three major forms: ''playful'', ''hurtful'', and ''educative''. Teasing can have a variety of effects, depending on how it is used and its intended effect. When teas ...

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 calloused, along with a risk of eye infection, keratoconus, 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 and/or

social deprivation Social deprivation is the reduction or prevention of culturally normal interaction between an individual and the rest of society. This social deprivation is included in a broad network of correlated factors that contribute to social exclusion; thes ...

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

anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...

. 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 Neuroscience is the scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a multidisciplinary science that combines physiology, anatomy, molecular biology, developme ...

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

sense A sense is a biological system used by an organism for sensation, the process of gathering information about the world through the detection of stimuli. (For example, in the human body, the brain which is part of the central nervous system re ...

s. 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 as opposed to

reinforcement In behavioral psychology, reinforcement is a consequence applied that will strengthen an organism's future behavior whenever that behavior is preceded by a specific antecedent stimulus. This strengthening effect may be measured as a higher fr ...

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