Language and communication difficulties of young children with visual impairment (VI) may be ascribed to intellectual disability, multiple disabilities and autism spectrum disorder (ASD) rather than sensory impairment. As a result, the impact of VI on communication development has been underestimated and undertreated. Speech-language therapists should be included on the early intervention team for children with VI. There is a need to review and critically appraise recent peer reviewed research to examine the strength of the evidence and to describe the language and communication developmental characteristics in young children with VI. A literature review regarding the developmental characteristics of children with VI was compiled as a foundation of information. A systematic search of recent literature (2003-2013) was then completed using the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Primary and secondary search phrases were used in three databases and 1661 articles pertaining to language and communication developmental characteristics were identified. Once the inclusion criteria were applied, the level of evidence of the nine remaining publications was determined. Thematic analysis was used to describe the early language and communication characteristics of children with VI. All the studies were from developed countries and participants from seven of the nine articles had congenital VI. Five studies received an evidence level rating of III while four articles were rated as IIb. Two main themes emerged from the studies, 1) early intervention and 2) multiple disabilities and ASD. Language and communication development is affected by VI especially in the early stages of development and speech-language therapists should therefore be included in early intervention for children with VI. Recent evidence on the early language and communication difficulties of children with VI is stronger than in the past where studies were mostly on evidence level IV, i.e. descriptive research and expert opinion. Language and communication difficulties are missed or not prioritized in children with VI due to the co-occurrence of multiple difficulties such as intellectual disability, ASD and multiple disabilities. Six articles attempt to address this problem. The impact of VI itself on communication remains unclear because the effect of VI on language and communication development cannot yet be separated from the primary conditions. Children with VI are a hidden population for speech-language therapists. This systematic review motivated the need for speech-language therapists to become involved in early intervention for children with VI from the perspective of prevention of further delay, intervention for existing delays and advocating for the awareness of the possible communication problems. Children with VI, specifically those in developing countries within Sub-Saharan Africa with acquired VI, need to receive greater focus not only within research but also in clinical practice. The identified language and communication developmental characteristics and early intervention guidelines by ASHA (2008) provide the framework for improved service provision by speech-language therapists to young children with VI.
Dissertation (MComm Path)--University of Pretoria, 2015.