Free Health Dissertations - Discuss The Role Of Early Intervention For Children With Visual Impairments
Discuss the role of early intervention for children with visual impairments
An essay
3,000 words
Introduction
The whole area of visual impairment is a complex and difficult field. Children may either be born with a degree of visual impairment or they may acquire visual impairment at some stage after birth. Some defects may be comparatively obvious and easily detectable other may be very subtle and not obvious for some time.
Visual defects may occur as a single lesion or may be part of a larger spectrum of congenital or acquired problems. They can be directly referable to the eye itself, as in the case of infantile cataracts, or may be as a result of more diffuse trauma such as cerebral palsy or perhaps a genetic error of metabolism or even infections such as meningitis. In this essay we intend to consider the role and value of early intervention together with an assessment of the value of screening which is obviously part of the same consideration.
The mechanism of examination of the issue will be by means of a critical review of some of the relevant literature which has been recently published on the subject
Screening
There are many definitions of screening. Perhaps one of the best for our purposes comes from Wald (1)
"The systematic application of a test or enquiry, to identify individuals at sufficient risk to benefit from further investigation or direct preventive action, amongst persons who have not sought medical attention on account of symptoms of that disorder"
Screening is a common practice in many areas of the NHS. Whenever it is discussed, it is usually accompanied by prolonged discussions relating to cost-effectiveness and efficacy. With specific regard to visual impairment, screening for conditions that can produce visual impairment at an early age is utterly essential because of the development in early life of the visual processing pathways in the visual cortex (see below). (2)
There is a window of opportunity for correction, which rapidly closes depending on the nature and severity of the visual impairment. Because of the dire implications for vision in later life, the cost effectiveness of such screening procedures are seldom applied in this area. This does not mean to say that considerations of efficacy are not valid (see below), but simply that it is not possible to put an appropriate value on a person’s sight. (3)
Clearly the purpose of a screening programme is to try to identify those individuals who may be at risk of developing a potentially treatable condition. It is not a diagnostic service. There will usually be both false positives and false negatives. The importance of the National Screening programme is to identify those individuals who would benefit from further specialist assessment.
A good place to start is the paper by Rahi (4).
Dissertations - Free Health Dissertations
