Developmental Vision Clinic

The Developmental Vision Clinic at Great Ormond Street Hospital (GOSH) is a specialist clinic for children with visual disorders and impairment.The clinic provides assessment of the child’s functional vision (how the child is able to use their vision in everyday life) and their development, and links this with practical recommendations to help the child at home or school.

We work closely with local services, including Specialist Advisory Teachers for children with visual impairment, to provide advice and support for parents and local professionals in order to promote the child’s full visual and developmental potential.

The team has specialist expertise in understanding and facilitating the development and progress of children with little or no vision. Severe visual impairment does potentially impact on all areas of development.

Specialist help can play an important role in preventing or overcoming difficulties and delays and in enhancing the child’s potential.

The team developed the Developmental Journal for babies and children with visual impairment, which is available to all parents who have a child with visual impairment under the age of three years. Parents' observations as noted in the journal will help inform the team's assessment.

Three main groups of children are referred to the clinic:

Infants whose main problem is severe visual impairment. We aim to see these children as soon as possible after diagnosis to ensure parents and local professionals receive support and advice early to avoid any preventable delays in development.

These children will then be seen at regular intervals (initially every four to six months, and then yearly until five to six years of age) working closely in collaboration with local professionals.Children are generally referred by the hospital Ophthalmologist or the local Paediatrician. Babies less than one year of age will be seen as a priority as soon as possible after receiving the referral. Usually appointments are offered two weeks after receiving a referral.

Older children with severe visual impairment where there is a specific concern about the child’s development, such as delays in learning to talk or read, lack of progress at school, difficulty in forming social relationships, or behaviour difficulties.

Children who have additional disabilities where there are specific questions about their vision or development. These children will be reviewed according to individual need.

After you have received an appointment, your child will be called for an assessment. The appointment lasts up to three hours. Members of the local team are encouraged to attend with the family where appropriate, with the family's permission.

Initially, time is spent talking to parents to learn about the child’s history and current behaviour and to understand their concerns and questions.

The assessment of vision and development will then follow, with the parents closely involved. At the end of the assessment, the team will spend a short time together to consider the findings of the assessment and to devise a plan of guidance.

A full discussion with parents, and local professionals if present, then takes place, and follow-up arrangements are agreed.

Parents are given a brief handwritten summary of the findings and recommendations and, within three weeks, a full report is sent to parents and, with their permission, to an agreed circulation list.

The Developmental Vision Clinic team includes consultant developmental paediatricians, a consultant clinical psychologist, clinical psychologists and, where appropriate, an occupational therapist, a speech and language therapist, and specialist registrars (paediatricians completing specialist training) and trainee clinical psychologists.

A range of assessments are carried out, which aim to find out the child’s level of abilities and to explore any behavioural issues.

This information can also be used to make recommendations to guide education, therapy and behavioural management, and to contribute to additional diagnoses where relevant.

This is our first study looking at the development of children between 8-12 years with visual impairment. The results will tell us more about the progression and strength of children with visual impairment in mid-childhood, and will highlight areas that might need extra help and intervention.

We would like to work with children between 8-12 years with disorders affecting the eye, retina or anterior optic nerve. We are also recruiting a comparison group of children with typical vision in the same age range.

For further details about taking part in the study, please contact Johannes Bathelt at johannes.bathelt.10@ucl.ac.uk or on 020 7905 2749.

Research led by Naomi Dale and Alison Salt aims to learn more about the early development of babies and young children with visual impairment, and also how different methods of early intervention and care might influence this early development.

The research has resulted in the production of the early childhood intervention programme “The Developmental Journal for babies and young children with visual impairment”. A national scientific investigation of its effectiveness has since been completed as part of the Optimum VI project.

You can contact the Developmental Vision Clinic on 020 7405 9200 ext 1142.