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From the Hospital to Home: Using Early Visual Screening to Support Families

cathy smyth, ph.dCathy Smyth, Ph.D. is excited to share a research project initiated by Robert King, MD, pediatric ophthalmologist, to determine neurological visual status in pre-term infants. Anchor Center for Blind Children and the Neonatal Intensive Care Unit (NICU) at Rocky Mountain Children’s Hospital are collaborating to identify visual function concerns of pre-term infants and to support follow through with ophthalmological services for families and getting connected to early intervention.

Early visual skills in pre-term and full-term infants are the first sensory system to develop to support the infant’s learning potential. The Neonatal Assessment Visual European Grid (NAVEG) is a validated visual screening tool (Rossi, et al., 2017) that indicates neurological risk. After the initial pre-term assessment in the NICU, infants that do not pass the NAVEG screening receive follow-up ophthalmological visits at six months and again at one year. This care is provided at Anchor Center for Blind Children for the families’ convenience, and early intervention vision professionals attend the visits to collaborate with the medical providers.

The initial goals of this research are to (a) train vision professionals in early intervention to reliably perform the NAVEG vision screening on pre-term infants, (b) determine the presence of visual function concerns in pre-term infants, and (c) provide medical follow-up for identified infants for future diagnosis of Cortical/Cerebral Visual Impairment (CVI).

For infants identified with visual concerns, early intervention professionals and caregivers will work together to develop targeted parent education and strategies through routine-based environmental adaptations in natural environments. Research-based protocols and collaborative strategies using assessments and interventions will be collected over the next year to provide evidence of the caregiver’s interactions with the infant to (a) build visual behaviors, and (b) resolve specific CVI characteristics.

Future goals of the research are to (a) create an assessment protocol, including the CVI range when appropriate (Roman-Lantzy, 2019), for identified infants from birth to two years of age to identify specific CVI characteristics, (b) create routines-based resource documents and idea checklists for families to implement strategies in everyday environments, and (c) educate families to advocate for their child with CVI in the transition to preschool.

Teachers of Students with Visual Impairment (TSVI) will create parent education resources based on current knowledge in the field (Lueck & Dutton, 2015) that can be used to address the specific visual needs of each child, guided by the parent within routines. Parent groups will be available to all families at the Center and through tele-outreach to build deeper understanding and advocacy skills around CVI.

As the Director of Research at Anchor Center for Blind Children, Cathy Smyth will oversee the NAVEG study implementation as infants move from the hospital to home environment. Data collected during this study will determine program strategies and evaluate best practices with families. Anyone wishing to know more about this research should contact Cathy Smyth at 303-377-9732 x120.

Lueck, A. H., & Dutton, G. N. (2015). Vision and the brain: Understanding cerebral visual impairment in children. AFB Press, N.Y, N.Y.

Roman-Lantzy, C. (2019). Cortical vision impairment: An approach to assessment and intervention (2nded). APH Press, Louisville, KY.

Rossi, A., Gnesi, M., Montomoli, C., Chirico, G., Malerba, L., Merabet, L.B., NAVEG Study Group, & Fazzi, E. (2017). Neonatal Assessment Visual European Grid (NAVEG): Unveiling neurological risk. Infant Behavior and Development, 49. 21-30.  doi: 10.1016/j.infbeh.2017.06.002


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