Aim: To review the literature on visual impairment in children in order to determine which manneristic behaviors are associated with visual impairment, and to establish why these behaviors occur and whether severity of visual impairment influences these behaviors.
Methods: A literature search utilizing PubMed, OVID, Google Scholar, and Web of Knowledge databases was performed. The University of Liverpool ( www.liv.ac.uk/orthoptics/research ) and local library facilities were also searched.
Results: The main manneristic or stereotypic behaviors associated with visual impairment are eye-manipulatory behaviors, such as eye poking and rocking. The degree of visual impairment influences the type of behavior exhibited by visually impaired children. Totally blind children are more likely to adopt body and head movements whereas sight-impaired children tend to adopt eye-manipulatory behaviors and rocking. The mannerisms exhibited most frequently are those that provide a specific stimulation to the child. Theories to explain these behaviors include behavioral, developmental, functional, and neurobiological approaches. Although the precise etiology of these behaviors is unknown, it is recognized that each of the theories is useful in providing some explanation of why certain behaviors may occur. The age at which the frequency of these behaviors decreases is associated with the child's increasing development, thus those visually impaired children with additional disabilities, whose development is impaired, are at an increased risk of developing and maintaining these behaviors. Certain manneristic behaviors of the visually impaired child may also help indicate the cause of visual impairment.
Conclusions: There is a wide range of manneristic behaviors exhibited by visually impaired children. Some of these behaviors appear to be particularly associated with certain causes of visual impairment or severity of visual impairment, thus they may supply the practitioner with useful information. Further research into the prevalence of these behaviors in the visually impaired child is required in order to provide effective management.