VISIBLE: Vision Intervention for Seeing Impaired Babies: Learning through Enrichment

VISIBLE is an early intervention program based on the core principles of optimising infant’s visual experience during the first phases of development. The general principles are activity-dependent learning and environmental enrichment. Parents are essential to environmental enrichment for infant learning success. They provide the environmental cues for both social and physical infant exposure. Utilizing this principle, parents will provide vision-awareness environmental enrichment – adapting the social and physical environment to allow the infant the opportunities to learn by successfully experiencing their enhanced environment. Within the context of parent-child daily goal-oriented interactions, environmental enrichment, as it relates to vision-awareness modifications, will include light, spatial distances, salience, consistency and multimodality of infant’s environment. The program will be lead and supported by multidisciplinary teams at each institution, including Paediatric Neurologists, Ophthalmologists, Paediatric developmental therapists. Between 12-18 fortnightly home or telehealth visits will be conducted over a 6-9 month period concluding at 12 months corrected age dependent on the age at entry, will be undertaken by VISIBLE-trained developmental therapists to contextualise the EI program to the infant’s natural environment. The first home or telehealth visit for the VISIBLE group families will include parent training and information about and demonstration of activities appropriate for their infant. The following visits (90 -120 minutes) will include direct activities with the parents and infant, coaching on advancement of activities to accommodate infant’s emerging skills and parent treatment fidelity checks. Optimising infant’s visual experience: environmental modifications based on the family unit and infant’s individualized goals, such as perceptual adaptation (e.g. lighting and colour contrasts) and organization of the physical environment (e.g. distances, speed of moving objects etc.). We will systematically teach parents the essential aspects of visual awareness modification of the environment and activities to allow their infant successful engagement with their social and physical environment during both play and targeted developmental activities. Social and emotional goals (e.g. reacting to differing facial expressions) are first identified by the parent. The factors for learning to advance performance, with specific focus on visual attention and the adaptation of the physical environment, are identified by the therapist and discussed with the family (e.g. improved lighting and reduced distance). Parents are coached on visual awareness strategies to promote learning, movement and social interaction. Parent-infant interactions are adaptive, supportive, and consistent. Training through developmentally appropriate play is conducted at the limit of the infant’s performance ability with variation and increasing complexity built into the play activities.