Do you think a 3month old with aniridia should be referred to Early intervention to develop the other senses,and/or stimulate vision?Do you know of any studies showing that early intervention can make a difference in visualy impaired infants?Thank you

Yes, I think this patient should definitely be referred to EI. I would refer to a specific agency, though, to be sure that the generic EI intervention also has vision service from one of the few agencies with experience in this field. (The lighthouse has EI services.)

There are several reasons for a referral, or at least for specialized OT and PT, which doesn't have to come as EI. First, aniridia is not a stable pathology. It is hard to know exactly how compromised the vision is in infancy, but there is associated progressive visual loss from glaucoma and also may be associated developmental difficulties, hard to know about early. More attention to visual learning and also help with compensatory strategies makes sense to me.

You would be hard-pressed to get IRB approval for a study withholding therapy from visually compromised kids, so theory and observations will have to do.

There are two interesting books I would recommend: Selma Fraiberg, who sort of invented the field of infant mental health and the model of family treatment for abuse and neglect, started her career working with blind babies. Her writing about the blind infants she observed documents their developmental progress in the first two or three years. It is fascinating because not only are they late with some obvious things, but they actually acquire some concepts in a sequence that is different from normal children, based on their different physical and sensory experience. Those papers can be found in a fat paperback called the Complete Works of Selma Fraiberg, which is widely available and which I have in my office in PH 508, if you want to take a look or xerox that chapter.

On a more practical level, there are books to guide therapists and parents. I'm sure many are good, and I don't know this literature, but one I would also recommend is "Play it My Way" which gives lots of ideas about teaching/playing with blind babies and toddlers-for example moving them toward and away from a sound to help them learn "near" and "far", an idea easily learned if you can see, before they can navigate physically. This book is put out by the Royal National Institute for the Blind, which does not ship overseas and is very expensive on ebay, but I just ordered it from England and would love to share it with you if you tell me who you are. Yours, Harriet McGurk