Families of some children with visual impairment discover that their blind or (severely) visually impaired children exhibit repetitive and seemingly purposeless behaviors that are strange to them, but also to the environment. Shaking the head, clapping hands or pressing fingers into the eyes are some examples of these behaviors. Scientists label this stereotypical behavior as ‘blindisms’. The precise causes for these phenomena are not known as of October 2020, but some theories are known. It is important to pick up any socially unacceptable behavior as quickly as possible and then distract the child in a positive way and stimulate it in other ways. For this purpose, parents work best together with all the people in the environment of the blind or visually impaired child.

• Examples of blindisms in blind and visually impaired children

• Shaking your head
• Press into the eye
• Hand clapping
• Looking at the light
• Rocking/wobbling
• Other forms of blindisms

• Causes of repetitive behavior
• Treatment of repetitive movements

• Provide physical activity
• Use repeated movements differently
• Reward child
• Don’t scold
• Treating eye strain
• Talk about normal habits
• Do not encourage self-stimulating behavior

• Prognosis of sometimes socially unacceptable behavior in blind and partially sighted people

Examples of blindisms in blind and visually impaired children

Children exhibit different types of repetitive behavior. Some are harmful and/or socially unacceptable. For some children, the behavior means nothing and they do it for no reason. Others engage in this repetitive behavior to express their feelings, or to express that they are not getting enough exercise and playtime.

Shaking your head

One form of blindism is shaking the head back and forth repeatedly. This does not indicate saying no. Some babies do this especially when they are in their crib or lying on their back on the floor.

Press into the eye

Some visually impaired children repeatedly press their eyes with their hands or fingers. This gives a child security, safety and confidence. Some people initially think that the child is tired and wants to sleep. Only later does the realization come that this may be a form of blindism. It is important that an underlying medical condition is excluded, because a child will sometimes scratch or press in the eyes. In addition, a parent or someone from the environment must distract the child in a timely manner, otherwise eye irritation or even damage to the eye (such as a detached retina) may occur.

Hand clapping

Some blind children clap their hands when they are excited and then stop after a while when they are calmer. This sometimes happens repeatedly for no apparent reason.

Looking at the light

Seeing light is very stimulating for some children with a visual impairment. They enjoy staring at a lamp or sunny window and sometimes also move or wave their fingers in front of their eyes to create light patterns.

Rocking/wobbling

A child sometimes rocks from left to right or back and forth, both sitting and standing. For some children, the behavior increases as they become more excited.

Other forms of blindisms

Some other common repetitive behaviors include:

• pulling or fiddling with the hair
• sniffing or smelling objects in the air or on certain objects
• manipulate the ears, nose and lips
• shrug one’s shoulders
• moving the head and torso back and forth (rocking)
• touching the face
• clapping your hands
• repeat sounds
• waving the arm
• waving hands
• kicking or kicking with the foot
• hitting the head with fists
• throwing objects
• grinding the teeth (bruxism)
• sucking on hands or fingers
• chewing on objects
• pp walk the toes
• spinning around
• crying out of nowhere
• shouting out of nowhere
• pressing fingers into nose or mouth
• putting objects in the mouth
• cradle
• make rubbing or sweeping movements

Causes of repetitive behavior

The precise cause of blindness is not known as of October 2020. This stereotypical behavior also occurs in children with a variety of other functional limitations, such as an autism spectrum disorder (autism: problems with social interaction, communication and behavior). One possible theory is that a blind or visually impaired child may not receive as much stimulation from the environment as a sighted child. A visually impaired child will then seek stimulation from his mind. Another theory is that some visually impaired children do not play with toys or socialize like sighted babies. The behaviors that normal babies occasionally perform then become habits for blind and visually impaired babies. This behavior is very difficult to unlearn or to distract the child. Learning more socially acceptable ways to express excitement or boredom then presents a challenge.

Treatment of repetitive movements

For most blind and visually impaired children, this stereotypical behavior is self-stimulating and they perform blindsights without thinking about it. However, in some visually impaired children, these behaviors are not socially acceptable or even harmful to themselves and/or the environment. People therefore regard blindisms as very unusual; they may even associate it with an intellectual disability. It is helpful to work with the child to replace blindnesses with other more socially acceptable behaviors.

Provide physical activity

Stimulating a visually impaired baby with toys is a way to use the hands and explore toys. This way he gets stimulation and is less likely to put his hands in his eyes or perform other forms of blindness. This causes the parent to turn the stereotypical behavior into a different, enjoyable and stimulating activity. Toys are not the only way to keep a child physically and mentally occupied. This is also possible by singing to a baby or child, tickling a baby or playing other baby or children’s games.

Use repeated movements differently

It is also possible to use repetitive activities differently, for example by letting a child swing on a swing instead of spinning around the house. Shaking your head on a pillow is better than shaking your head on the floor.

Reward child

A visually impaired child who does not perform a blindsight activity when, for example, waiting to pet a pony, deserves a reward from the parent. Giving a big hug or a verbal reward reinforces this positive behavior.

Don’t scold

When a baby or child with a visual impairment shows self-stimulating behavior, the parent or a person from the environment should certainly not scold or punish the baby or child. Negative attention is also attention and that is why a baby or child may show this behavior to get attention. Distracting a child is a better alternative.

Treating eye strain

Pressing the eyes with the fingers can be prevented by wearing glasses with side shields immediately after starting the eye pressure. These glasses prevent a child from damaging their eyes. It is necessary to immediately introduce this aid to the blind or visually impaired child, because otherwise the little fingers quickly go under the edge of the glasses. Because the first signs of eye pressure are usually not noticed by the parents but by others, it is important that people in the environment immediately report abnormalities to the parents. This way they can use ways to promote normal development as quickly as possible.

Talk about normal habits

A slightly older child with blindness may already understand why other children are afraid of him if, for example, he keeps rocking back and forth or waves his arms, if the parent or a person from the environment reports this. This must be done carefully. For example, the parent reports that if the child stops moving back and forth or keeps his hands still, a friend might come and play with him.

Do not encourage self-stimulating behavior

Family members and friends should not encourage self-stimulating behavior in the visually impaired child, as this will make it more difficult to break the habit as the child grows older. Also, others should not scold or tease the child. Distracting the child (involving another activity and playing) is also necessary for them. It is best for parents to report this information to the people in the area who deal with the blind or visually impaired child.

Prognosis of sometimes socially unacceptable behavior in blind and partially sighted people

Breaking blindism often takes a lot of time. In addition, many blind or partially sighted children continue to show repetitive behaviors to a limited extent, even after parents and people from the environment have tried various tips. However, every child is different and the outcomes are therefore variable. It is important to interact positively with every child, including a child who is blind or visually impaired, and to spend a lot of time together. In this way it is possible to stimulate a visually impaired child in other ways so that as few socially unacceptable and harmful behaviors as possible are expressed.