Gross motor development and reach on sound as critical tools for the development of the blind child.

The aim of the study was to assess early neuromotor development in 20 congenitally blind or severely visually impaired children, nine without (B) and 11 with associated handicaps (B + H), in order to develop a strategy for early intervention in these subjects. The mean age at first observation was 11.4 months (range: 4-30 months). The mean follow-up duration was 16.9 months (range: 3-36 months). Assessment included developmental history, neurological examination, video-recording of spontaneous activity and administration of the Reynell-Zinkin Scales and neuroradiological and neurophysiological investigations. All B children walked independently (mean age 19.8 months) and 55.5% crawled (mean age 15 months); the B + H subjects displayed absence of almost all neuromotor functions, except one who walked at 20 months. All the B and just one (9%) of the B + H children developed satisfactory fine motor abilities. 'Reach on sound' at distance was achieved by all the B children by the age of 14.2 months while in the B + H group it was achieved by only two subjects at a median age of 19.5 months. We conclude that it is possible to describe the profile of neuromotor development in B and B + H children; strategies to help postural-motor development and 'reach on sound' appear to be fundamental in early intervention in these subjects. Copyright 2002 Elsevier Science B.V.