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A preliminary study of haptic and auditory responses in visually impaired infants Sykanda, Ann Marie 1983

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A PRELIMINARY STUDY OF HAPTIC AND AUDITORY RESPONSES IN VISUALLY IMPAIRED INFANTS b y ANN MARIE SYKANDA . S . R . , The Un ivers i ty of B r i t i s h Columbia, 1978 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS IN THE FACULTY OF GRADUATE STUDIES DEPARTMENT OF EDUCATIONAL PSYCHOLOGY AND SPECIAL EDUCATION UNIVERSITY OF BRITISH COLUMBIA We accept th is thes is as conforming to the required standard The U n i v e r s i t y of B r i t i s h Columbia October 1983 ©Ann Marie Sykanda 1983 In presenting t h i s thesis i n p a r t i a l f u l f i l m e n t of the requirements f o r an advanced degree at the University of B r i t i s h Columbia, I agree that the Library s h a l l make i t f r e e l y a v a i l a b l e f o r reference and study. I further agree that permission for extensive copying of t h i s t h e s i s f o r scholarly purposes may be granted by the head of my department or by h i s or her representatives. I t i s understood that copying or publication of t h i s thesis f o r f i n a n c i a l gain s h a l l not be allowed without my written permission. Department of The University of B r i t i s h Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 Date (KLT, DE-6 (3/81) ABSTRACT T h e d e v e l o p m e n t o f t h e f u n c t i o n a l u s e o f t h e h a p t i c a n d a u d i t o r y s e n s o r y s y s t e m s was s t u d i e d i n s i x c o n g e n i t a l l y b l i n d c h i l d r e n . S u b j e c t s c o n s i s t e d o f f o u r b o y s a n d two g i r l s r a n g i n g i n a g e f r o m 5.5 t o 18 m o n t h s o f a g e a t t h e c o m m e n c e m e n t o f t h e s t u d y . T h e y w e r e v i s i t e d i n t h e i r homes t w i c e a m o n t h f o r f i v e m o n t h s , a n d b e h a v i o u r a l o b s e r v a t i o n s a n d i n f o r m a l t e s t i was c a r r i e d o u t i n o r d e r t o d e t e r m i n e t h e s e q u e n t i a l d e v e l o p m e n t o f h a p t i c a n d a u d i t o r y s k i l l s i n e n v i r o n -m e n t a l a n d p e r s o n a l i n t e r a c t i o n . T h e r e s u l t s s u p p o r t t h e o b s e r v a t i o n t h a t t h e h a p t i c s y s t e m i s u s e d f o r t h e l o c a t i o n o f o b j e c t s p r i o r t o t h e u s e o f t h e a u d i t o r y s y s t e m . Some c o n s i s t e n t s e q u e n c e s i n t h e e m e r g e n c e o f s e n s o r i m o t o r s k i l l s a r e n o t e d , a n d i m p l i c a t i o n s f o r e a r l y i n t e r v e n t i o n a n d p a r e n t c o u n s e l l i n g a r e d i s c u s s e d . - I l l -TABLE OF CONTENTS CHAPTER I - I n t r o d u c t i o n CHAPTER II - Review of the L i t e r a t u r e A. The Hap t ic and A u d i t o r y Sensory Systems . . . . i . The H a p t i c System i i . The A u d i t o r y System B. The Development of Normal In fan ts C. Sensory Responses and S o c i a l I n t e r a c t i o n in Normal In fan ts D. The Development of B l i n d In fan ts E. Sensory Responses and S o c i a l I n t e r a c t i o n in B l i n d In fan ts F. Review of Methodology CHAPTER III - Method A. S u b j e c t s B. Procedure CHAPTER IV - R e s u l t s and D i s c u s s i o n A. Bay ley Mental S c a l e s B. P r o f i l e s of S ix S u b j e c t s S u b j e c t Number One S u b j e c t Number Two S u b j e c t Number Three S u b j e c t Number Four S u b j e c t Number F i v e S u b j e c t Number S ix C. B e h a v i o u r a l Sequences i . Development of the Hap t ic Sense i i . Development of A u d i t o r y L o c a l i z a t i o n . , i i i . Development of S o c i a l Behav iours i v . Cross -moda l C o r r e l a t i o n s - i v -Tab le of Contents ( c o n t i n u e d ) Page CHAPTER V - Summary, C o n c l u s i o n s and R e c o m m e n d a t i o n s . . . 77 REFERENCES 85 APPENDIX A 93 APPENDIX B (Equipment L i s t ) 95 APPENDIX C (Data Sheet No. 1) 95 APPENDIX D (Data Sheet No. 2) 97 APPENDIX E (Key to Behav iour - Data Sheet No. 2) 101 LIST OF TABLES Page Table 1 - Domains of Sensor imotor Development 21(a) 2 K b ) Table 2 - S t u d i e s of E a r l y Development in the B l i n d . . . 27(a) 27(b) Table 3 - S u b j e c t s 41 Table 4 - Age Placement of S u b j e c t s on the Bay ley Mental S c a l e s 47 Tab le 5 - Sequence of Development of the T a c t i l e -K i n e s t h e t i c S k i l l s 61 Table 6 - Unusual Sequence of T a c t i l e - K i n e s t h e t i ' c S k i l l s in M u l t i - h a n d i c a p p e d S u b j e c t 64 Tab le 7 - Sequence of Development of the T a c t i l e -A u d i t o r y S k i l l s 68 Tab le 8 - The Development of L a t e r a l and M u l t i -d i r e c t i o n a l Reaching to Sound Cue 70 Tab le 9 - Sequence of S o c i a l Behav iours 73 Table 10- C r o s s - M o d a l C o r r e l a t i o n s 75 - v i -LIST OF ILLUSTRATIONS ' Page FIGURE 1 - T a c t i l e and K i n e s t h e t i c Pathways 8 FIGURE 2 - Anatomy of the Ear 12 FIGURE 3 - The Cochlea 12 FIGURE 4 - The Organ of C o r t i 12 FIGURE 5 - A u d i t o r y P r o j e c t i o n s 13 -1-CHAPTER I INTRODUCTION The improvement of s e r v i c e s f o r the v i s u a l l y impa i red is of concern to a wide v a r i e t y of p r o f e s s i o n a l s . A l though medica l s c i e n c e has conquered many causes of a c q u i r e d b l i n d n e s s , i t i s p r e d i c t e d that the p r e v a l a n c e o f c o n -g e n i t a l l y b l i n d i n d i v i d u a l s w i l l i n c r e a s e , as many b l i n d i n f a n t s who might have d ied from p r e m a t u r i t y or a s s o c i a t e d handicaps w i l l s u r v i v e due to improved neonata l c a r e (Jan et al , 1 977 ). While c o n g e n i t a l l y b l i n d c h i l d r e n wi th no u s e f u l v i s i o n compr ise a r e l a t i v e l y smal l group i n the v i s u a l l y impai red p o p u l a t i o n as a whole , they a t t r a c t the concern of e d u c a t i o n a l , medical and s o c i a l work p e r s o n n e l , because of the developmenta l e f f e c t s o f s e v e r e , c o n g e n i t a l b l i n d n e s s . Many a u t h o r i t i e s in the f i e l d of e a r l y development have s t r e s s e d the importance of v i s i o n f o r the a c q u i s i t i o n of reach and p r e h e n s i o n (Whi te , Held and C a s t l e , 1964) ; the development of r e c o g n i t i o n and c a t e g o r i z a t i o n o f o b j e c t s ( B r u n e r , 1968); the c o - o r d i n a t i o n of o b j e c t s in space and concept of o b j e c t permanence ( P i a g e t , 1952); and the development of means-end r e l a t i o n s h i p s (Bower, 1 9 7 7 b . ) . In c o n t r a s t to v i s u a l e x p e r i e n c e of the e n v i r o n m e n t , a u d i t o r y e x p e r i e n c e tends to be f l e e t i n g and d i s c o n t i n u o u s , and t a c t u a l e x p e r i e n c e i s f r a g m e n t a r y , and l i m i t e d to - 2 -those o b j e c t s w i t h i n arm's reach ( F r a i b e r g , 1977; S a n t i n and Simmons, 1977) . A number of au thors ( S a n d l e r , 1963; E lonen and C a i n , 1964; C h a s e , 1972) have d e s c r i b e d a wide range of d e v e l o p -mental problems which they have observed in some b l i n d c h i l d r e n . These i n c l u d e a r e l u c t a n c e to engage the hands in t a c t u a l e x p l o r a t i o n of o b j e c t s , a d i m i n i s h e d response to sound , and a tendency to withdraw from env i ronmenta l c o n t a c t . Instead of d e v e l o p i n g s u p e r i o r n o n v i s u a l s e n s e s , i t appears tha t some b l i n d i n f a n t s are at r i s k f o r i g n o r i n g the l e a r n i n g p o t e n t i a l of the remain ing s e n s e s . , Sonksen (1981) has s t r e s s e d the r o l e of v i s i o n as a s t i m u l a n t to the development of o ther senses in the s i g h t e d c h i l d , and the r e s u l t i n g r i s k of s e n s o r i m o t o r d e l a y in the b l i n d . She emphasized the importance of e a r l y sensory e x p e r i e n c e in the a t t a inment of developmenta l m i l e s t o n e s . In r e c e n t yea rs there has been a widespread upsurge of i n t e r e s t in the p r o v i s i o n of e a r l y i n t e r v e n t i o n to h a n d i -capped and a t - r i s k y o u n g s t e r s , aged b i r t h to th ree years ( T j o s s e m , 1976) . In B r i t i s h C o l u m b i a , many b l i n d i n f a n t s r e c e i v e home-based s e r v i c e s from one of twenty -seven In fant Development Programmes. Others are seen at one of the f i f t e e n C h i l d Development C e n t r e s , and some r e c e i v e a s s i s t a n c e from p r a c t i c u m s tuden ts in S p e c i a l E d u c a t i o n from U n i v e r s i t i e s -3-or Community C o l l e g e s . Workers from the Canadian N a t i o n a l I n s t i t u t e f o r the B l i n d p r o v i d e some home c o u n s e l l i n g to f a m i l i e s of b l i n d i n f a n t s , and act as c o n s u l t a n t s to o ther d e v e l o p m e n t a l i s t s a c t i v e with the f a m i l i e s (B. C. M i n i s t r y of H e a l t h , 1982) . S i m i l a r systems of s e r v i c e d e l i v e r y are g r a d u a l l y d e v e l o p i n g in o ther j u r i s d i c t i o n s in North A m e r i c a , B r i t a i n and Europe . With an i n c r e a s i n g number of paren ts and p r o f e s s i o n a l s i n t e r e s t e d in improv ing the developmenta l p r o g r e s s o f ' b l i n d i n f a n t s , there i s n a t u r a l l y a demand f o r f u r t h e r knowledge in o rder to improve programme p l a n n i n g . In a comprehensive review of the need f o r r e s e a r c h i n t o the developmenta l e f f e c t s of e a r l y b l i n d n e s s , Warren (1976) has s a i d : . . . . the l i t e r a t u r e does not p r o v i d e a very s a t i s f y i n g p i c t u r e of the compara t ive development of b l i n d and s i g h t e d c h i l d r e n . . . . there i s s imply not the r e s e a r c h a v a i l a b l e on which to b u i l d opt imal programmes . (page 5) For those c h i l d r e n who must depend on n o n - v i s u a l i n f o r m a t i o n in o rder to begin to respond to and act upon t h e i r e n v i r o n m e n t s , i t i s c l e a r that the b a s i c knowledge that i s r e q u i r e d c o n c e r n s , a t l e a s t in p a r t , the d e v e l o p -ment of the f u n c t i o n a l use of t h e i r remain ing s e n s e s , p a r t i c u l a r l y the h a p t i c and a u d i t o r y s e n s e s . A l though -4-the o l f a c t o r y and g u s t a t o r y senses are used by the b l i n d in a p p r o p r i a t e c i r c u m s t a n c e s , i t has been found tha t these senses are l i m i t e d as i n f o r m a t i o n g a t h e r e r s . Not a l l o b j e c t s s m e l l , and the sense of smel l very q u i c k l y h a b i t u a t e s , so that awareness of t h i s input tends to d i m i n i s h ( B a r r a g a , 1982). The g u s t a t o r y sense i s l i m i t e d to those o b j e c t s which have f i r s t been reached or ob ta ined through c h a n c e , or through use of one of the o ther s e n s e s ; not a l l o b j e c t s are small enough or sa fe enough to be brought to the mouth. T h e r e f o r e , the h a p t i c and a u d i t o r y senses are those most h e a v i l y depended upon by the b l i n d , and are emphasized in i n t e r v e n t i o n programmes ( H a r r e l l , 1 982 ). U n f o r t u n a t e l y , there i s l i t t l e i n f o r m a t i o n a v a i l a b l e r e g a r d i n g the normat ive development of the b l i n d i n f a n t ' s response tc a u d i t o r y and t a c t u a l s t i m u l i O ' a r r e n , 1976). A l though a rev iew of the l i t e r a t u r e can p r o v i d e some i n f o r m a t i o n on t h i s a s p e c t , none of the a v a i l a b l e s t u d i e s have looked d i r e c t l y at the development of the remain ing s e n s e s , but r a t h e r at more s p e c i f i c i s s u e s , such as r e a c h i n g behav iours ( B i g e l o w , 1982); at more genera l deve lopmenta l i s s u e s ( F r a i b e r g , 1977); or at b l i n d i n f a n t s performance on s t a n d a r d i z e d developmenta l t e s t s ( N o r r i s et al , 1 959 ; Parmalee et al , 1 959 ; L a i r y et a l , 1973; R e y n e l l and Z i n k i n , 1978) . Behav iours which have -5-been s t u d i e d , such as the development of r e a c h i n g to a sound c u e , have based c o n c l u s i o n s on r e l a t i v e l y smal l samples of c h i l d r e n , ( F r a i b e r g , 1977; B i g e l o w , 1982) , and t h i s work shou ld be repeated u s i n g d i f f e r e n t s a m p l e s . Much l e s s i s known about the development of the t a c t i l e sense f o r i d e n t i f y i n g o b j e c t s , and t a c t i l e - k i n e s t h e t i c c o - o r d i n a t i o n s f o r e x p l o r i n g space and f i n d i n g o b j e c t s . F r a i b e r g (1977) and A l s [1980) have s t u d i e d the d e v e l o p -ment of at tachment behav iours in b l i n d i n f a n t s , but have not f u l l y d e s c r i b e d the r o l e of the r e m a i n i n g s e n s e s in t h i s deve lopment . C o r r e l a t i o n between the deve lopmenta l l e v e l of s o c i a l i n t e r a c t i o n and deve lopmenta l i n t e r a c t i o n has been e x p l o r e d wi th the s i g h t e d ( B e l l , 1970) , but not with the b l i n d . T h u s , i t w i l l be the purpose of t h i s s tudy to e x p l o r e the f u n c t i o n a l ' development of the h a p t i c and a u d i t o r y systems in a group of c o n g e n i t a l l y b l i n d i n f a n t s . The rev iew of the l i t e r a t u r e w i l l i n c l u d e a d e s c r i p t i o n of the p h y s i o l o g y and development of the h a p t i c and a u d i t o r y s y s t e m s , a rev iew of those s t u d i e s which have i n v e s t i g a t e d the e a r l y development of b l i n d i n f a n t s , and a r e v i e w of r e s e a r c h t e c h n i q u e s commonly used in a d d r e s s i n g q u e s t i o n s in e a r l y deve lopment . Us ing t h i s background knowledge , an - 6 -a p p r o p r i a t e study w i l l then be d e v i s e d and c a r r i e d out with a smal l group of c o n g e n i t a l l y b l i n d i n f a n t s , in an e f f o r t to o b t a i n i n f o r m a t i o n r e g a r d i n g the s e q u e n t i a l development of the f u n c t i o n a l use c f t h e i r h a p t i c and a u d i t o r y senses in env i ronmenta l i n t e r a c t i o n . -7-CHAPTER II  REVIEW OF THE LITERATURE A. The Hap t ic and A u d i t o r y Sensory Systems i . The Hapt ic System For the purposes of t h i s s t u d y , the h a p t i c system w i l l be d e f i n e d as the combina t ion of the t a c t i l e and k i n e s t h e t i c s y s t e m s , from which an i n d i v i d u a l r e c e i v e s s i l e n t and non-v i s u a l i n f o r m a t i o n about h i s body, and about o b j e c t s in r e l a t i o n s h i p to h is body. The t a c t i l e system is s e n s i t i v e to cutaneous p r e s s u r e , whi le the more complex k i n e s t h e t i c system i s s e n s i t i v e to the ang les of j o i n t s , the d i s t a n c e and ra te at which the l imb moves, and the weight of o b j e c t s . The sense of touch p r o v i d e s i n f o r m a t i o n r e g a r d i n g the p h y s i c a l p r o p e r t i e s of an o b j e c t , whi le the k i n e s t h e t i c sense d e f i n e s i t s l o c a t i o n . Together they y i e l d i n f o r m a t i o n r e g a r d i n g the e x t e r n a l w o r l d , w i t h i n reach ( G i b s o n , 1966). It i s impor tant to note tha t w i t h i n the h a p t i c system there i s an o v e r l a p between the f u n c t i o n s of p e r c e p t i o n and per fo rmance . Mot on ly i s there a p a s s i v e r e g i s t r a t i o n of the e n v i r o n m e n t , but there i s a l s o a c t i v e e x p l o r a t i o n , the seek ing of new i n f o r m a t i o n , and ongoing guidance of the motor system as the i n d i v i d u a l makes changes in the env i ronment . A hand which l o s e s i t s h a p t i c sense through a c c i d e n t or d i s e a s e , l o s e s most of i t s f u n c t i o n a l a b i l i t y , d e s p i t e s p a r i n g of the motor system (Brown, 1980). - 8 -RECEPTORS -FOR KINESTHESIA' MUSCLE SPINDLE/, GOLGI TENDON ORGAN ANTERIOR SPINOTHALAMIC TRACT RUFFINI MENDINGS • HAIR-FOLLICLE FREE N ENDING FIGURE' 1 - TACTILE AND KINESTHETIC PATHWAYS compi led from C h u s i d , 1970. - 9 -Cutaneous r e c e p t o r s f o r the sense of touch i n c l u d e f r e e nerve e n d i n g s , h a i r f o l l i c l e e n d i n g s , R u f f i n i e n d i n g s , Merke ls d i s c s , . Me issner c o r p u s c l e s , and P a c i n i a n c o r p u s c l e s , a l l found in v a r i o u s l a y e r s of the s k i n . Receptors f o r k i n e s t h e s i a (.also known as c o n s c i o u s p r o p r i o c e p t i o n ) are the muscle s p i n d l e s ( l o c a t e d between muscle f i b r e s ) , G o l g i tendon o r g a n s , ( l o c a t e d at the j u n c t i o n of muscle and t e n d o n ) , and j o i n t r e c e p t o r s , ( l o c a t e d in the c o n n e c t i v e t i s s u e of the j o i n t c a p s u l e and l i g a m e n t s ) . S e n s a t i o n from a l l of these r e c e p t o r s both t a c t i l e and k i n e s t h e t i c , reach the s p i n a l cord v i a the sensory n e r v e s , and enter the cord through the d o r s a l r o o t g a n g l i a . Crude touch t r a v e l s to the thalamus in the a n t e r i o r s p i n o t h a l a m i c t r a c t , whi le d i s c r i m i n a t o r y t o u c h , p r e s s u r e , v i b r a t i o n and k i n e s t h e s i a t r a v e l in the d o r s a l co lumn, and then the medial l e m n i s c u s . Both t r a c t s synapse in the v e n t r a l p o s t e r o l a t e r a l nuc leus of the t h a l a m u s , and t e r m i n a t e in the p o s t c e n t r a l gyrus of the c e r e b r a l c o r t e x , in somatosensory areas I and II. (Brown, 1980) . A l though l i t t l e i s known about the development of k i n e s t h e s i a in the f e t u s , a number of s t u d i e s have y i e l d e d i n f o r m a t i o n r e g a r d i n g the t a c t i l e sys tem. As e a r l y as e i g h t to n ine weeks g e s t a t i o n , a f f e r e n t neurons connect the c e n t r a l nervous system to the p e r i p h e r y . The area around - 1 0 -the mouth ( t r i g e m i n a l nerve d i s t r i b u t i o n ) i s the f i r s t to become s e n s i t i v e , but by e leven to twelve weeks g e s t a t i o n the palm of the .hand i s s e n s i t i v e , as ev idenced by the b e g i n n i n g of a palmar grasp r e f l e x . At f o u r t e e n to s i x t e e n weeks g e s t a t i o n the f e t u s i s capab le of b r i n g i n g the hand to the mouth, a t a c t i l e - k i n e s t h e t i c c o - o r d i n a t i o n which u n i t e s the two most s e n s i t i v e areas of the body (Humphrey, 1 964) . Development of the h a p t i c sense c o n t i n u e s throughout the p r e n a t a l p e r i o d , and i t i s a common o b s e r v a t i o n tha t there i s a s t rong response to t a c t i l e input by the newborn or young i n f a n t . Less i s known about the i n f a n t ' s a b i l i t y to d i s c r i m i n a t e between d i f f e r e n t t a c t i l e s e n s a t i o n s , and to remember them. In a s e r i e s of e x p e r i m e n t s , Bryant et al [1974) were ab le to show that i n f a n t s s ix to twelve months of age were ab le to t a c t u a l l y r e c o g n i z e p r e f e r r e d o b j e c t s which they had s e e n , but never f e l t . In a l a t e r e x p e r i m e n t , i n f a n t s of the same age were ab le to t a c t u a l l y r e c o g n i z e o b j e c t s they had f e l t b e f o r e , but never s e e n . These data would i n d i c a t e a h igh l e v e l of v i s u a l - t a c t i l e c o - o r d i n a t i o n , and of t a c t u a l d i s c r i m i n a t i o n as w e l l . Researchers have made r e f e r e n c e to the development of tactua1 - k i n e s t h e t i c e x p l o r a t i o n in b l i n d i n f a n t s , and e a r l y r e c o g n i t i o n of p r e f e r r e d o b j e c t s through t o u c h , but -11-c o n t r o l l e d s t u d i e s have not been r e p o r t e d . Reach ing f o r o b j e c t s through a u d i t o r y c u e i n g has been much more t h o r o u g h l y s t u d i e d than the same behav iour d i r e c t e d by the h a p t i c sys tem. i i • The A u d i t o r y System The a u d i t o r y system not on ly p r o v i d e s the i n d i v i d u a l wi th i n f o r m a t i o n r e g a r d i n g the nature of an a u d i b l e e v e n t , p e r m i t t i n g i d e n t i f i c a t i o n and i n t e r p r e t a t i o n , but a l s o i n f o r m a t i o n r e g a r d i n g the l o c a t i o n of such an e v e n t , p e r m i t t i n g o r i e n t a t i o n towards i t . The v i s u a l system i s under c o n s i d e r a b l e v o l u n t a r y c o n t r o l , as the i n d i v i d u a l can c l o s e h is e y e s , or look away. The h a p t i c system i s under some c o n t r o l , as the i n d i v i d u a l can choose not to reach f o r an o b j e c t wi th h is hands (a l though he cannot avo id such t a c t i l e c o n t a c t as bu t tocks on a c h a i r , or f e e t on the f l o o r ) . The a u d i t o r y system can on ly c o n t r o l i t s inpu t through the process of a t t e n d i n g , or l i s t e n i n g , or a l t e r n a t i v e l y , the f a i l u r e to do so ( G i b s o n , 1966) . T h i s r e l a t i v e l ack of c o n t r o l over e x t e r n a l a u d i t o r y inpu t may d e t r a c t from the a u d i t o r y s y s t e m ' s u s e f u l n e s s in c o g n i t i v e development [Abramson et a l , 1980) , and c o n t r i b u t e to a p a s s i v e response to the env i ronment (Bower, 1977b . ) . -12 -OSSICLES SEMICIRCULAR CANAL'S COCHLEAR NERVE • COCHLEA EXTERNAL AUDITORY CANAL FIGURE 2 - ANATOMY OF THE EAR compi led from Brown, 1980 COCHLEAR NERVE TECTORIAL1'MEMBRANE BASILAR MEMBRANE ORGAN. OF. CORTI FIGURE 3 - THE COCHLEA FIGURE^4 - THE ORGAN OF CORTI . . c o m p i l e d from Brown, 1980 compi led from Brown, 1980 -13-FIGURE 5 - AUDITORY PROJECTIONS c o m p i l e d from Brown, 1 9 8 0 . -14-The ear c o n s i s t s of th ree p a r t s : (1) the outer e a r , wi th a u d i t o r y cana l and eardrum; (2) the middle e a r , w i th the o s s i c l e s ; and (3) the i n n e r e a r , with the c o c h l e a c o n t a i n i n g the a c t u a l r e c e p t o r s . Sound waves reach the c o c h l e a by a complex r o u t e : f i r s t sound waves cause the ear drum to v i b r a t e , and these v i b r a t i o n s are t r a n s m i t t e d in sequence to the three t i n y bones of the e a r , the o s s i c l e s . A c t i o n of the o s s i c l e s causes v i b r a t i o n of the oval window, which i s then t r a n s m i t t e d to the per i l ymph of the c o c h l e a , and thence to the b a s i l a r membrane, w i t h i n the c o c h l e a . T h i s causes bending of the h a i r c e l l s of the Organ of C o r t i , which i s d i s t r i b u t e d a long the l e n g t h of the b a s i l a r membrane, and thus an a c t i o n p o t e n t i a l is set up, which t r a v e l s v i a the c o c h l e a r nerve to the d o r s a l and v e n t r a l c o c h l e a r n u c l e i . From these n u c l e i , f i b r e s pass v i a the l a t e r a l l e m n i s c i to the i n f e r i o r c o l l i c u l i and thence to the medial g e n i c u l a t e b o d i e s ; then by way of the a u d i t o r y a s s o c i a t i o n c o r t e x , area 4 2 , on the s u p e r i o r temporal gyrus of Heschl ( C h u s i d , 1970) . The a u d i t o r y mechanism begins to deve lop e a r l y in f e t a l l i f e , and the a c o u s t i c g a n g l i o n d i f f e r e n t i a t e s in the second g e s t a t i o n a l month. F i b r e s of the l a t e r a l l e m i n i s c u s deve lop and reach the medial g e n i c u l a t e body around n i n e t y days (Lemire et a l , 1975). The l a t e r a l l e m i n i s c u s i s m y e l i n a t e d wel l be fore te rm, s i n c e the f e t u s i s c o n s t a n t l y exposed to s o u n d , but the c o r t i c a l end of - 1 5 -the a u d i t o r y s y s t e m , p a r t i c l a r l y the a u d i t o r y a s s o c i a t i o n a r e a , i s not m y e l i n a t e d u n t i l the c h i l d i s s e v e r a l years o l d , c o r r e l a t i n g with the a b i l i t y to i n t e r p r e t the most complex a u d i t o r y i n p u t , language^ (Yakovlev a r | d L e c o u r s , 1967). Pe iper (1963) was ab le to demonstrate a r e a c t i o n to s t r o n g sound s t i m u l i in a m a j o r i t y of unborn f e t u s e s over the age of seven months, by m o n i t o r i n g f e t a l movements. Premature i n f a n t s aged t w e n t y - e i g h t weeks have been found to weakly respond wi th movement at the sound of a b e l l , and t h i s response g r a d u a l l y i n c r e a s e s t i l l term ( G e s e l l , 1945). The response of the newborn c o n s i s t s of a change in r e s p i r a t i o n p a t t e r n , i n c r e a s e d motor a c t i v i t y or ( in some cases ) a c e s s a t i o n of a c t i v i t y , and s h u t t i n g of the eyes ( c o c h l e o p a l p e b r a l r e f l e x ) . R e p e t i t i o n of the same s t i m u l u s r e s u l t s in a decrease in r e s p o n s e , as the i n f a n t h a b i t u a t e s to i t ; some r e s e a r c h e r s have found that h a b i t u a t i o n takes longer in premature i n f a n t s than in f u l l term i n f a n t s ( P e i p e r , 1963). D i f f e r e n c e s in l o u d n e s s , and in the time of a r r i v a l of a sound , at each of the two ears can i n d i c a t e the p o s i t i o n of a sound s o u r c e . When a sound source which i s thus out of ba lance reaches the e a r s , the usual response i s to o r i e n t the head u n t i l the two inputs are s y m m e t r i c a l , -16-so tha t the person i s f a c i n g the source of the s o u n d , and can v i s u a l l y i n s p e c t i t ( G i b s o n , 1966) . In an exper iment by Wer.theimer (1961) , newborn i n f a n t s were found to turn t h e i r eyes c o r r e c t l y in the d i r e c t i o n of a sound presented from one s i d e or the o t h e r . The degree to which t h i s o r i e n t i n g response deve lops in b l i n d i n f a n t s , who l a c k the p o t e n t i a l f o r v i s u a l f o l l o w - u p of the i n i t i a l a u d i t o r y e v e n t , i s c o n t r o v e r s i a l (Warren, 1977) . Whi le F r a i b e r g (1977) and L a i r y (1973) d e s c r i b e a d e l a y in t u r n i n g of the head to sound in b l i n d i n f a n t s u n t i l the age of seven months, Freedman Cl9 64) and Sonksen (1979 ) , f e e l tha t a u d i t o r y l o c a l i z i n g responses are p r e s e n t in e a r l y i n f a n c y in the b l i n d as wel l as the s i g h t e d . D i s c r i m i n a t i o n between s o u n d s , and s e l e c t i v e r e s p o n s e s , have been shown to deve lop e a r l y as w e l l . The i n f a n t q u i c k l y l e a r n s f o r example , that the sounds of f o o t s t e p s i n d i c a t e tha t someone i s coming , the c l i n k of s a u c e p a n s , p r e d i c t s the s e r v i n g of f o o d , and the runn ing of bath water means he w i l l soon be t a k i n g a b a t h . He i s a b l e to p r e d i c t what i s about to happen on the b a s i s of p r e v i o u s sequences which have f o l l o w e d these s p e c i f i c a u d i t o r y c l u e s ( L i n g , 1978) . As f a r as speech sounds are c o n c e r n e d , by the age of s i x weeks babies can d i s t i n g u i s h r e l i a b l y between the sounds "pa" and " b a " , and can even d i f f e r e n t i a t e between s i m i l a r sounds in s t r a n g e l a n g u a g e s ; by the age of seven or e i g h t months they have deve loped to the p o i n t t h a t they become s u r p r i s e d or even f e a r f u l at the sounds of a f o r e i g n language (Mussen et a l , 1974) . As the i n t e r -p r e t a t i o n of s p e c i f i c sounds d e v e l o p s , so does the a b i l i t y to l i s t e n s e l e c t i v e l y , a p e r c e p t u a l e x e r c i s e in which meaningfu l or d e s i r e d sounds are a t tended t o , and background sounds are screened out ( G i b s o n , 1966) . B. The Development of Normal In fan ts Before c o n s i d e r i n g the a v a i l a b l e l i t e r a t u r e on the development of the b l i n d i n f a n t , i t would be wise to b r i e f l y rev iew the development of the normal i n f a n t . A l though t h e r e are o ther t h e o r e t i c a l frameworks f o r the s tudy of i n f a n t deve lopment , the approach of Jean P iage t i s w i d e l y a c c e p t e d , and i s u s e f u l f o r the p resen t s t u d y , as P i a g e t emphasized the importance of the s e n s e s , and the i n f a n t ' s a c t i v e invo lvement wi th the env i ronment . It i s not the e f f e c t of e x t e r n a l s t i m u l i a l o n e , but the c h i l d ' s s e n s o r i -motor r e s p o n s e s , and h is o r g a n i z i n g a b i l i t y upon e n v i r o n -mental o b j e c t s and events t h a t are r e s p o n s i b l e f o r developmenta l - change [ P i a g e t , 1952). - 1 8 -B a s i c to P i a g e t ' s e a r l y theory was the idea that development moves through a s e r i e s of s t a g e s . These s tages were c o n c e i v e d as being c o n t i n u o u s , wi th new p a t t e r n s b u i l t upon and i n c o r p o r a t i n g the o l d , and a l though the r a t e of development might v a r y , the sequence was thought to remain the same (Mussen et a l , 1974) . More r e c e n t l y , P i a g e t ' s theory of s tages has r e c e i v e d c r i t i c i s m from a number of s o u r c e s . For example , Brown and Des fo rges (1979) argue tha t P i a g e t does not o f f e r an adequate e x p l a n a t i o n of the m e c h a n i s m s w h i c h b r i n g about the t r a n s i t i o n from one stage to the n e x t . F l a v e l l (1977) i s a l s o s k e p t i c a l of P i a g e t ' s theory of s t a g e s , and f e e l s tha t the t r a n s i t i o n s are not a b r u p t , but c o n t i n u o u s , and tha t the development of the schemes and o p e r a t i o n s of one stage may go on f o r a wh i le a f t e r the s u b j e c t has s t a r t e d on the next s t a g e . Longeot (as quoted in V u y t , 1981) , c r i t i c i z e s P i a g e t ' s n e g l e c t of i n d i v i d u a l d i f f e r e n c e s in deve lopment . Longeot has performed many exper iments to e x p l o r e t h i s a s p e c t , and has found i n d i v i d u a l pathways to a common developmenta l g o a l , p roduc ing d i f f e r e n t sequences among h i s s u b j e c t s . He d i f f e r e n t i a t e s between l o g i c o - m a t h e m a t i c a l s t r u c t u r e s , which he f e e l s do demonstrate i n v a r i a n t s t a g e s , and - 1 9 -n a t u r a l t h i n k i n g , which he f e e l s do n o t . B i c k a r d (1979) on the o ther hand, does argue in f a v o u r of s tages in the development of knowledge, but does not b e l i e v e that they are c h a r a c t e r i z e d by p a r t i c u l a r forms of s t r u c t u r e s , but that one stage may c o n t a i n s e v e r a l of P i a g e t ' s s t r u c t u r e s , B r a i n e r d (1978) f e e l s tha t i n v a r i a b l e sequences e x i s t on ly when each i tem in the sequence c o n s i s t s of the immedia te ly p r e c e d i n g i t e m , p lus a new i t em. Hoppe et al (as quoted in V u y t , 1981) a l s o r e j e c t a n e c e s s a r i l y i n -v a r i a n t sequence , and f e e l , l i k e L o n g e o t , tha t the d e v e l o p -mental sequence i s i n f l u e n c e d by the c h i l d ' s environment and e x p e r i e n c e s . F l a v e l l (1977) puts forward a unique theory of p s y c h o l o g i c a l i n te rdependence to e x p l a i n unusual developmenta l sequences : "X may not on ly f a c i l i t a t e the development of Y, but Y may a l s o , once p a r t l y d e v e l o p e d , f a c i l i t a t e the f u r t h e r development of X" (page 252). P i a g e t h i m s e l f has r e a c t e d to t h i s c o n t r o v e r s y by s t a t i n g that he never in tended the d e f i n i t i o n of s tages to become a goal in i t s e l f but on ly to be a too l f o r the a n a l y s i s of p r o c e s s e s . While he has not a c t u a l l y r e t r a c t e d any of h i s e a r l y theory he appears to have l o s t i n t e r e s t in stage t h e o r y , and agrees tha t i n s t e a d of p e r i o d s of development f o l l o w e d by p e r i o d s of e q u i 1 i b r i a t i o n , there i s p r o b a b l y a c o n t i n u o u s p r o c e s s , which he compares to - 20 -to a s p i r a l ( V u y t , 1981). VJhile P i a g e t may thus have in l a t e r y e a r s de-emphasized the i n v a r i a n t nature of h i s sequence of s t a g e s , h i s s tages c o n t i n u e to be used to c l a s s i f y and d e s c r i b e deve lopmenta l behav iours in normal i n f a n t s ( U z g i r i s and Hunt, 1975; Corman and E s c a l o n a , 1969) , and in the handicapped (Kahn, 1 976 ; Wachs et al , 1 978; T e s s i e r , 1969 ; D e c a r i e , 1959; Best et a l , 1976; F r a i b e r g , 1977; B i g e l o w , 1982). P i a g e t ' s theory d i v i d e s i n t e l l e c t u a l development i n t o f o u r major p e r i o d s , and the f i r s t , the s e n s o r i m o t o r p e r i o d , o c c u r s d u r i n g the f i r s t two years of l i f e ; the s e n s o r i m o t o r p r i o d i s again s u b d i v i d e d in to s ix s t a g e s . Tab le 1 g i v e s an overv iew of the developmenta l a t t a i n m e n t s of the s e n s o r i m o t o r p e r i o d as s e l e c t e d by Dunst (1980) from P i a g e t ' s (1952) account of the development of s e n s o r i m o t o r i n t e l l i g e n c e . Some of the l a t e r deve lopmenta l p s y c h o l o g i s t s and t h e o r i s t s have found the young i n f a n t to be capab le o f more than P i a g e t d e s c r i b e d . Bower (19 7 7a , 1977b, 1979) has d e s c r i b e d exper iments showing tha t newborns were ab le to reach and g r a s p , and to i m i t a t e , and that f i v e month o l d i n f a n t s had deve loped a concept of o b j e c t pe r -manence. These f i n d i n g s have not been c o n s i s t e n t l y r e p l i c a t e d by o ther r e s e a r c h e r s , however ( M e i c l e r and G r a t c h , 1980; Ames, 1983). TABLE 1 - DOMAINS OF SENSORIMOTOR DEVELOPMENT Stages (age in months) P u r p o s e f u . problem s o l v i n g Object permanence S p a t i a l r e l a t i o n s h i p s C a s u a l i ty CM I Use of ( 0-D r e f l e x e s II Pr imary c i r c u l a r r e a c t i o n s (1-4) III Secondary c i r c u l a r r e a c t i o n s (4-8) IV C o o r d i n a t i o n of secondary c i r c u l a r r e a c t i o n s (8-12) V. T e r t i a r y c i r c u l a r r e a c t i o n s (12-18) VI R e p r e s e n t a t i o n and f o r e s i g h t (18-24) Shows on ly r e f l e x i v e r e -a c t i o n s in response to e x t e r n a l s t i m u l i . F i r s t a c q u i r e d a d a p t a t i o n s c o o r d i n a t i o n of two b e h a v i o u r a l s c h e m e s ( e . g . hand-mouth c o o r d i n a t i o n ) . P rocedures f o r making i n t e r e s t i n g s i g h t s l a s t : r epea ts a c t i o n s to ma in ta in the r e i n f o r c i n g consequence produced by the a c t i o n . S e r i a l i z e s two' h e r e t o -f o r e separa te behav iours in g o a l - d i r e c t e d sequences D i s c o v e r s " n o v e l " means behav iour needed to ob-t a i n a d e s i r e d g o a l . " Inven ts" means behaviour v i a i n t e r n a l thought p r o -c e s s e s , needed to ob ta in a d e s i r e d g o a l . Mo a c t i v e search f o r o b j e c t s v a n i s h i n g f r o m s i g h t . A t t e m p t s t o m a i n t a i n v i s u a l c o n t a c t with o b j e c t s moving out -s i d e the v i s u a l f i e l d R e i n s t a t e s v i s u a l con-t a c t with o b j e c t s by a n t i c i p a t i n g the t e r -minal p o s i t i o n of a moving o b j e c t and r e -moving a c l o t h p laced over f a c e . R e t r i e v e s a p a r t i a l l y hidden o b j e c t . Secures o b j e c t s seen hidden under , b e h i n d , e t c . a s i n g l e b a r r i e r . Secures o b j e c t s hidden through a s e r i e s of v i s i b l e d i s p l a c e m e n t s . Recreates sequence of d isp lacements to secure o b j e c t s : s e c u r e o b j e c t s hidden through a s e -quence of i n v i s i b l e d i sp lacements . No s i g n s of a p p r e c i a t i o n of s p a t i a l r e l a t i o n -s h i p s between o b j e c t s . Reacts to e x t e r n a l s t i m u l i as r e p r e s e n t i n g independent s p a t i a l f i e l d s ( e . g . v i s u a l , a ud i to r y ) . Shows s i g n s of under -s t a n d i n g r e l a t i o n s h i p s between s e l f and ex-t e r n a l events ( e . g . f o l l o w s t r a j e c t o r y of r a p i d l y f a l l i n g o b j e c t s . Rotates and examines o b j e c t s with s i g n s of a p p r e c i a t i o n of t h e i r three d i m e n s i o n a l a t t r i b u t e s . Combines and r e l a t e s o b j e c t s in d i f f e r e n t s p a t i a l c o n f i g u r a t i o n s ( e . g . p l a c e s b l o c k s i n t o a c u p ) . M a n i f e s t s the a b i l i t y to " r e p r e s e n t " the nature of s p a t i a l r e -l a t i o n s h i p s tha t e x i s t between o b j e c t s and be-tween o b j e c t s and s e l f No s i g n s of under -s t a n d i n g c a u s a l r e l a t i o n s h i p s . Shows s i g n s of pre-causa l under -s t a n d i n g ( e . g . p l a c e s thumb in mouth) . Uses"phenomenal -i s t i c p r o c e d u r e s " ( e . g . g e n e r a l i z e d exc i tement ) as a causa l a c t i o n to have an a d u l t r e -peat an i n t e r e s t -ing s p e c t a c l e . Touches a d u l t ' s hands to have t h a t person i n s t i g a t e or c o n t i n u e an i n t e r e s t i n g game. Hands an o b j e c t to an a d u l t to have that person repeat or i n s t i g a t e a d e s i r e d a c t i o n . Shows c a p a c i t y to i n f e r a c a u s e , g iven o n l y i t s e f f e c t , and f o r s e e an e f f e c t , g iven a c a u s e . TABLE 1 ( cont inued) Stages (age in months) Vocal imi t a t i o n Gestura1 i m i t a t i on I Use of r e f l e x e s (0-1) II Pr imary c i r c u l a r r e a c t i o n s (1-4) P lay Vocal c o n t a g i o n : c r i - e s on hear ing another i n f a n t c r y . Repeats sound j u s t p ro -duced f o l l o w i n g adu l t i m i t a t i o n of the sound. No s igns of i m i t a t i o n of movements he /she p e r f o r m s . Repeats movements j u s t made f o l l o w i n g adu l t i m i t a t i o n of the a c t i o n . No s i g n s of i n t e n t i o n a l p lay b e h a v i o u r . Produces pr imary c i r c u l a r r e a c t i o n s r e p e a t e d l y in an e n j o y a b l e manner. I l l Secondary c i r c u l a r r e a c t i o n s (4-8) IV C o o r d i n a t i o n of secondary c i r c u l a r r e a c t i o n s (8-12) Imi ta tes sounds a l r e a d y in h i s / h e r r e p e r t o i r e . Im i ta tes novel sounds but on ly ones that are s i m i l a r to those he /she a l r e a d y p r o d u c e s . Imi ta tes s imple ges tu res a l r e a d y in h i s / h e r r e p e r t o i r e that are v i s i b l e to s e l f . Imi tates (a) se l f -movements that are i n v i s i b l e ( e . g . s t i c k i n g out tongue) and (b) novel movements com-p r i s e d of a c t i o n s f a m i l i a r to s e l f . R e p e t i t i o n of i n t e r e s t i n g a c t i o n s a p p l i e d to f a m i l i a r o b J e c t s . Dur ing problem s o l v i n g s e q u e n c e s , he /she abandons the terminus in favour of p l a y i n g with the means. R i t u a l i z a t i o n : a p p l i e s app-r o p r i a t e s o c i a l a c t i o n s to d i f f e r e n t o b j e c t s . T e r t i a r y c i r c u l a r r e a c t i o n s (12-18) VI R e p r e s e n t a t i o n and f o r e s i g h t (18-24) Imi ta tes novel sound p a t t e r n s and words that he /she has not p r e v i o u s l y heard . Im i ta tes complex v e r b a l -i z a t i o n s . Reproduces p r e v i o u s l y heard sounds and words from memory; d e f e r r e d i m i t a t i o n . Imi ta tes novel movements that he /she cannot see s e l f perform ( i . e . i n v i s i b l e g e s t u r e s ) and that he /she has not p r e v i o u s l y performed Imi tates complex motor move-ments. Reproduces p r e v i o u s l y observed a c t i o n s from memory d e f e r r e d i m i t a t i o n . A d a p t a t i v e p l a y r b e g i n s to use one o b j e c t ( e . g . d o l l cup) as a s u b s t i t u t e f o r another ( e . g . a d u l t - s i z e cup) d u r i n g p lay wi th o b j e c t s . Symbol ic p l a y : uses one ob-j e c t as a " s i gni f i e r " f o r another ( e . g . a box f o r a d o l l b e d ) . S y m b o l i c a l l y enac ts an event w i thout having o r d i n a r i l y used o b j e c t s p r e s e n t . -22-The c o n t r o v e r s y between some of the newer deve lopmenta l t h e o r i s t s and those who favour a more t r a d i t i o n a l or l i t e r a l i n t e r p r e t a t i o n of P i a g e t i a n theory c o n t i n u e s , and many more s t u d i e s are needed. For those r e s e a r c h e r s i n t e r e s t e d in the development of the h a n d i c a p p e d , a f u r t h e r q u e s t i o n must o c c u r : in the presence of a s i g n i f i c a n t s e n s o r y hand icap such as b l i n d n e s s , are the u n d e r l y i n g c o g n i t i v e p r o c e s s e s the same as in the s i g h t e d i n f a n t , but wi th the s u b s t i t -u t i o n of o ther s e n s e s , or i s there a c o m p l e t e l y d i f f e r e n t p r o c e s s ? The d i f f i c u l t i e s in d e v i s i n g an a p p r o p r i a t e app-roach to answer ing t h i s q u e s t i o n would seem enormous. C. Sensory Responses and S o c i a l I n t e r a c t i o n in Normal  I n f a n t s Dur ing i n f a n c y , as the c h i l d uses h is senses to i n t e r -p re t and ac t upon h i s envi ronment and d e v e l o p i n c r e a s i n g l y complex schemes, he i s a l s o u s i n g these same senses to deve lop r e l a t i o n s h i p s wi th the s i g n i f i c a n t people in h i s l i f e . In a r a r e r e f e r e n c e to s o c i a l deve lopment , w h i l e comparing the a f f e c t i v e to the c o g n i t i v e a s p e c t of b e h a v i o u r , P iage t has s a i d : - 2 3 -While these two aspec ts cannot be reduced to a s i n g l e a s p e c t , they are n e v e r t h e l e s s i n s e p a r a b l e and compl imentary . For t h i s reason we must not be s u r p r i s e d to f i n d a marked p a r a l l e l i s m in t h e i r r e s p e c t i v e e v o l u t i o n . (P iage t and I n h e l d e r , 1969, page 21 ) . F l a v e l l (1977) uses the term "at tachment" to d e s c r i b e both an " u n d e r l y i n g d i s p o s i t i o n , and the v a r i o u s o v e r t behav iours tha t implement or express that d i s p o s i t i o n " , (page 50) . He a l s o sees a developmenta l r e l a t i o n s h i p be-tween c o g n i t i v e p r o c e s s e s and s o c i a l b e h a v i o u r . He p o i n t s to the a b i l i t y to make d i s c r i m i n a t i o n s , and a s p e c i f i c form of o b j e c t permanence c a l l e d "person permanence" as e s s e n t i a l f o r a t t a c h m e n t , and thus f e e l s t h a t s o c i a l behav iour must be at l e a s t p a r t l y dependent on the q u a l i t y of mental a b i l i t i e s . The c o g n i t i v e b a s i s f o r a t tachment he has termed " s o c i a l c o g n i t i o n " . ( F l a v e l l , 1977, p. 49-56) . That there i s a r e c i p r o c a l p r o c e s s go ing on i s a l s o s t r e s s e d by F l a v e l l , and he r e f e r s to the emot iona l r e l a t i o n -s h i p with c a r e t a k e r s as a " c r u c i b l e " f o r the f o r m a t i o n of c o g n i t i v e development ( F l a v e l l , 1977). B e l l (1970) a l s o sees the q u a l i t y of the i n f a n t ' s r e l a t i o n s h i p with the mother as a f a c i l i t a t o r f o r the emergence of person permanence, which in turn l e a d s to o b j e c t permanence. In her exper iment she compared the per formances of t h i r t y - t h r e e 8.5 to 11.5 month i n f a n t s on o b j e c t p e r -manence t e s t s (h idden o b j e c t s ) , person permanence t e s t s (h idden m o t h e r s ) , and measures of at tachment ( s t r a n g e -24 -s i t u a t i o n t e s t s ) . Seventy percent of the i n f a n t s in her sample demonstra ted a p o s i t i v e deca lage - that i s , a d i s -crepancy in the permanence t e s t s in f a v o u r of person per -manence being more advanced than o b j e c t permanence. A l l of the p o s i t i v e deca lage i n f a n t s a l s o demonstra ted s t r o n g e r at tachment b e h a v i o u r s in the s t range s i t u a t i o n t e s t , and dur ing an i n t e r v i e w , the mothers of these i n f a n t s r e -vea led s i g n i f i c a n t l y more p o s i t i v e a t t i t u d e s towards t h e i r i n f a n t s . The remain ing i n f a n t s in the sample , by com-p a r i s o n , were de layed in the a c q u i s i t i o n of o b j e c t pe r -manence, showed no d i s c r e p a n c y between the l e v e l of person permanence and o b j e c t permanence, demonstrated fewer at tachment b e h a v i o u r s , and were viewed l e s s p o s i t i v e l y by t h e i r mothers . These r e l a t i o n s h i p s i n d i c a t e a p a r a l -l e l i s m between c o g n i t i v e and s o c i a l deve lopment , and the importance of the i n f a n t mother r e l a t i o n s h i p to a l l aspec ts of deve lopment . The approach of Bowl by (1969) which has been f u r t h e r e l a b o r a t e d by A inswor th (1973) and o t h e r s , emphasizes the r o l e of the senses in the process of a t t achment . He suggests that at tachment i s i n i t i a t e d by i n s t i n c t i v e , s p e c i e s - s p e c i f i c behav iours such as g a z i n g , s m i l i n g , c u d d l i n g , v o c a l i z i n g and f o l l o w i n g on the par t of the i n f a n t . The c o m p e l l i n g nature of the g a z e - s m i l e -v o c a l i z a t i o n i n t e r a c t i o n s between mother and i n f a n t has been e x p l o r e d by a number of r e s e a r c h e r s ( L e w i s , 1974; - 2 5 -B r a z e l t o n , 1974; S t e r n , 1974) , but the r o l e of touch in the bonding p rocess has been l e s s wel l d e s c r i b e d . G r a d u a l l y at tachment behav iours on the par t of the i n f a n t become d i r e c t e d more and more p r e f e r e n t i a l l y towards f a m i l y members, and t h i s p r e f e r e n c e fo r f a m i l i a r persons e v o l v e s i n t o f e a r of s t r a n g e r s at around e i g h t months f o r most c h i l d r e n (a l though there i s v a r i a t i o n between i n f a n t s as to the age of t h i s phenomenon). (Yarrow and P e d e r s e n , 1972) . As the c h i l d becomes mobi le through c r a w l i n g and w a l k i n g , he i s seen to f o l l o w h is mother , and o t h e r s to whom he i s a t t a c h e d . In s t range e n v i r o n m e n t s , i t can be seen tha t the presence of the mother suppor ts e x p l o r a t o r y b e h a v i o u r , ( the " s e c u r e - b a s e " phenomenon), w h i l e i f she i s a b s e n t , the c h i l d i s more l i k e l y to become f e a r f u l and n o n - e x p l o r a t o r y . ( A i n s w o r t h , 1973). D. The Development of B l i n d In fan ts P i a g e t and h i s c o l l e a g u e s have never conducted s t u d i e s of b l i n d c h i l d r e n , but there have been s e v e r a l r e f e r e n c e s made by P i a g e t r e g a r d i n g the deve lopmenta l problems of the b l i n d . In g e n e r a l , he has argued that c o n g e n i t a l b l i n d n e s s must always r e s u l t in s e r i o u s , l o n g - l a s t i n g e f f e c t s . -26-. . . the sensory d i s t u r b a n c e p e c u l i a r to those born b l i n d has , from the o u t s e t , hampered the development of the s e n s o r y -motor schemes and slowed down genera l c o - o r d i n a t i o n . . . a c t i o n l e a r n i n g i s s t i l l n e c e s s a r y be fore these c h i l d r e n deve lop the c a p a c i t y f o r o p e r a t i o n s on a l e v e l with that of the normal c h i l d or the deaf -mute . ( P i a g e t and I n h e l d e r , 1969, page 89 ) . When we look f o r e m p i r i c a l r e s e a r c h d e t a i l i n g the development of b l i n d i n f a n t s , we f i n d that few s t u d i e s have been done. F u r t h e r m o r e , none of the a v a i l a b l e s t u d i e s have looked s p e c i f i c a l l y at the f u n c t i o n a l development of the remain ing s e n s e s , a l t h o u g h two ( F r a i b e r g , 1977; B i g e l o w , 1982) d i d so to some d e g r e e , and a l l p r o v i d e some r e l e v a n t i nformat i o n . Tab le 2 p r e s e n t s a summary of seven s t u d i e s . It i s p o s s i b l e to combine those f i n d i n g s from the s t u d i e s which do r e f l e c t the development of h a p t i c and a u d i t o r y s k i l l s in order to produce an overv iew of the a v a i l a b l e i n f o r -m a t i o n . In the f i r s t few months of l i f e , most au thors c i t e d have agreed that there is l i t t l e d i f f e r e n c e between b l i n d and s i g h t e d i n f a n t s , except f o r the b l i n d i n f a n t ' s d e l a y in t u r n i n g towards sound ( L a i r y et a l , 1973) . Between the ages of one and f o u r m o n t h s , ( P i a g e t ' s Stage 2 ) , \ TABLE 2 - STUDIES OF EARLY DEVELOPMENT IN THE BLIND RESEARCHERS BIGELOW ALS ET AL REYNELL ET AL FRAIBERG YEAR 1982 1980 1978 1964-1977 NO. SUBJECTS 5 . 1 97 b l i n d 106 p . s i g h t e d AGE SUBJECTS 9-32 months b i r t h b i r t h 1 year CRITERIA FOR INCLUSION L i g h t p e r c e p t i o n or l e s s T o t a l l y bl ind Visual" Impairment-b l i n d or p a r t i a l l y s i g h t e d L i g h t p e r c e p t i o n or l e s s INTERVALS Monthly N.A. 3 months-1 year two weeks DURATION V a r i e d 5-25 months 15 months N.A. V a r i e d 2-6 years TESTS USED (or a reas s t u d i e d ) Development of reach and search b e h a v i o u r s 1 . Development of a communicat ion system between b l i n d i n f a n t & h i s p a r e n t s . 2 . I n f a n t ' s development of competence R e y n e l 1 - Z i n k i n Developmental S c a l e s Human Attachment Prehens ion Gross Motor Object Permanence FINDINGS 1. Touch f i r s t e l i c - Development proceeded i t e d r e a c h , b e f o r e a long normal l i n e s sound. with suppor t to parents 2. Deve1opment of o b j e c t to understand i n f a n t ' s permanence p a r a l l e l e d s i g n a l s . s i g h t e d c h i l d r e n . 1 . A f t e r age of one year 1 .De lay & d i f f e r e n c e s v i s u a l l y impai red in at tachment c h i l d r e n f e l l behind 2 .Reach ing d e l a y e d to s i g h t e d . 8 months. 2 . O b j e c t permanence 3 . C r a w l i n g & w a l k i n g d e l a y e d . d e l a y e d . 4 .Language g e n e r a l l y norma l . TABLE 2 ( c o n t i n u e d ) RESEARCHERS LAIRY ET AL NORRIS ET AL PARMALEE YEAR 1973 1959 1959 NO. SUBJECTS 50 66 10 AGE SUBJECTS N.A. 15 months 1 year / CRITERIA FOR INCLUSION L e g a l l y b l i n d E d u c a t i o n a l l y b l i n d V i s u a l l y impai red R e t r o l e n t a l f i b r o p l a s i a INTERVALS' N.A. N.A. A n n u a l l y DURATION N.A. 5 y e a r s 4 years TESTS USED (or areas s t u d i e d ) 1. M a x f i e l d - B u c h o l z 2. B r u i n e t - L e z i n e 3. Hayes -B i net 1. C a t t e l 1 2. M a x f i e l d - F j e l d 1.Gesel1 Developmental S c a l e s FINDINGS 1.1 /3 of group dev- 1 . B l i n d c h i l d shou ld l . A t age of one y e a r , a l l e loped n o r m a l l y . be ab le to deve lop had normal D .Q.s 2.Some normal but 2 . C o n d i t i o n s f o r op- 2 .At age of two y e a r s , 3 p a s s i v e and timum development out o f 10 s c o r e d below dependent . have been i d e n t i f i e d . ave rage . 3.Some very wi thdrawn. ^ 4.Some r e t a r d e d . -28 -a l though both b l i n d and s i g h t e d bab ies grasp on c o n t a c t , the s i g h t e d i n f a n t begins to engage in bimanual f i n g e r i n g at m i d - l i n e , to reach out to touch and e x p l o r e , and to attempt a v i s u a l l y guided r e a c h , wh i le the b l i n d i n f a n t does n o t , a c c o r d i n g to F r a i b e r g (1977) . E a r l y in the Stage 3 p e r i o d , the s i g h t e d i n f a n t reaches d i r e c t l y f o r a t o y , on v i s u a l c u e , wh i le of c o u r s e , the b l i n d i n f a n t does no t . A c c o r d i n g to F r a i b e r g (1977) , the b l i n d i n f a n t does not reach on a u d i t o r y cue u n t i l the l a s t q u a r t e r of the f i r s t year (Stage 4 ) . Freedman (1969) and Bigelow (1982) have found tha t both b l i n d and s i g h t e d i n f a n t s reach on a u d i t o r y cue around the same t ime . P iage t (1956) has observed tha t s i g h t e d c h i l d r e n in Stage 3 can reach f o r o b j e c t s which they cannot s e e , but which are t o u c h i n g t h e i r b o d i e s . Not s u r p r i s i n g l y , B ige low (1982) has found tha t b l i n d i n f a n t s can do the same, at about the same age as the s i g h t e d . A l s o , when a b l i n d c h i l d has been in t a c t u a l c o n t a c t wi th an o b j e c t which i s then removed, he w i l l f o l l o w in t h e - d i r e c t i on of removal at about e i g h t months ( F r a i b e r g , 1977). As the b l i n d i n f a n t ' s t a c t u a l - k i n e s t h e t i c development p r o c e e d s , he does more thorough and s u s t a i n e d t a c t u a l e x p l o r a t i o n , and w i l l begin to turn an o b j e c t over to e x p l o r e a l l s i d e s . The secondary c i r c u l a r r e a c t i o n s w i l l - 2 9 -be a v a i l a b l e on an a u d i t o r y b a s i s ( i . e . r e p e a t i n g a n o i s y i n t e r e s t i n g e v e n t , such as shak ing a r a t t l e ) . De fe r red c i r c u l a r r e a c t i o n s , s e a r c h i n g f o r an o b j e c t where i t has been found b e f o r e , a l s o emerge in Stage 3, as ev idenced by p u r p o s e f u l s e a r c h i n g of the t r a y , c r i b or p l a y p e n , a f t e r the age of s i x months ( M o r r i s et a l , 1 959 ; L a i r y et al , 1973). As the b l i n d c h i l d e n t e r s Stage 4, both F r a i b e r g (1977) and Bige low (1982) found tha t he is l i k e l y to f i r s t l e a r n to reach to the sound of a toy wi th which he has had p r i o r t a c t u a l c o n t a c t ( i . e . the toy i s p u l l e d away and sounded) . L a t e r , the i n f a n t i s ab le to reach to a sound wi thout p r i o r c o n t a c t , f i r s t d i r e c t l y in f r o n t of h im, l a t e r s t i l l , in a v a r i e t y of d i r e c t i o n s [ F r a i b e r g , 1977; B i g e l o w , 1982). M o r r i s [1959] found the b l i n d i n f a n t c o u l d i m i t a t e a sound made by a model at the same age as the s i g h t e d , and a l s o engaged in s h a k i n g , banging and mouthing of .toys at the a p p r o p r i a t e t ime . Some of the Stage 5 n o v e l t y a c t i v i t i e s such as throwing o c c u r r e d s e v e r a l months l a t e r in the b l i n d , and d e l a y s in l o c o m o t i o n r e s t r i c t e d some a s p e c t s of t r i a l and e r r o r e x p e r i m e n t a t i o n , in F r a i b e r g ' s (1977) s t u d y . A c t i v i t i e s i n v o l v i n g o b j e c t r e l a t i o n s , such as s t a c k i n g b l o c k s and p l a c i n g o b j e c t s in c o n t a i n e r s o c c u r r e d as much as s i x - 3 0 -m o n t h s t o a y e a r l a t e r i n t h e b l i n d , a c c o r d i n g t o M o r r i s ( 1 9 5 9 ) . R e p o r t s o f ; t a c t u a 1 - k i n e s t h e t i c a n d a u d i t o r y p e r -c e p t u a l d e v e l o p m e n t n e a r t h e e n d o f t h e s e c o n d y e a r a r e s p a r s e . Many a u t h o r s ( F r a i b e r g , 1 9 7 7 ; R e y n e l l , 1 9 7 8 ) h a v e c o n c e n t r a t e d on l a n g u a g e d e v e l o p m e n t d u r i n g t h i s s t a g e ; a l t h o u g h l a n g u a g e h a s a b a s i s i n a u d i t o r y p e r c e p t i o n , i t s d e v e l o p m e n t i n t h e b l i n d i s b e y o n d t h e s c o p e o f t h e p r e s e n t s t u d y . T h e r e h a s b e e n some i n v e s t i g a t i o n o f t h e b l i n d i n f a n t ' s a b i l i t y t o e x p l o r e l a r g e r s p a c e s . F r a i b e r g ( 1 9 7 7 ) n o t e d t h a t a s t h e c h i l d m o v e d t o c r a w l a n d t o w a l k , h i s a w a r e n e s s o f s p a t i a l r e l a t i o n s i m p r o v e d a s h e b e c a m e a w a r e o f t h e c h a n g e s i n t h e l e v e l o f s o u n d i n r e l a t i o n t o d i s t a n c e . H o w e v e r , i t h a s n o t b e e n d e t e r m i n e d a t w h i c h a g e t h e a v e r a g e b l i n d c h i l d c a n c r a w l o r w a l k t o a s o u n d i n g o b j e c t a t a d i s t a n c e o f t e n f e e t o r s o . A l t h o u g h b o t h F r a i b e r g ( 1 9 7 7 ) a n d B i g e l o w ( 1 9 8 2 ) h a v e a r g u e d t h a t S t a g e 4 o b j e c t p e r m a n e n c e e m e r g e s a t t h e same t i m e f o r b o t h s i g h t e d a n d b l i n d , l i t t l e i s known r e g a r d i n g t h e d e v e l o p m e n t o f m o r e m a t u r e o b j e c t c o n c e p t s , a s d e m o n s t r a t e d by s u s t a i n e d t a c t u a l s e a r c h f o r a n o i s y o b j e c t . -31 -E • Sensory Responses and S o c i a l I n t e r a c t i o n in B l i n d i n f a n t s Much of the e a r l y i n t e r a c t i o n with normal i n f a n t s c o n s i s t s of mutual gaze encounters between parent and c h i l d (S te rn et a l , 1974) , but the parents of a b l i n d i n f a n t are met by a so lemn, e x p r e s s i o n l e s s , seemingly i n -d i f f e r e n t f a c e . V ideotaped r e c o r d i n g s of p e r i o d s of i n t e r -a c t i o n between young b l i n d i n f a n t s and t h e i r mothers ( A l s , 1980; Sykanda, 1983) i l l u s t r a t e the d i f f i c u l t i e s in ob-t a i n i n g an a n i m a t e d , s m i l i n g response from b l i n d i n f a n t s . Ten seconds or more of t a l k i n g to the b a b i e s , moving them and t o u c h i n g t h e i r hands and face was needed in order to o b t a i n a smi le at an age ( f o u r months) when s i g h t e d i n f a n t s u s u a l l y respond immedia te ly to a s o c i a l s m i l e from s e v e r a l f e e t away. A l s (1980) who conducted a comprehensive l o n g i t u d i n a l study of one i n f a n t , found tha t wh i le t a c t i l e input was n e c e s s a r y to o b t a i n a s o c i a l response d u r i n g the f i r s t s i x months, i n c r e a s i n g l y t h e r e a f t e r , the i n f a n t was ab le to respond to v o i c e s a l o n e . F r a i b e r g (1975) found that i n f a n t s in her study smi led o c c a s i o n a l l y , and with i n -c r e a s i n g f r e q u e n c y , at the v o i c e s of f a m i l y members, but never at s t range v o i c e s . She a l s o observed that the i n f a n t s sought t a c t i l e c o n t a c t with t h e i r m o t h e r ' s bodies -32-d u r i n g f e e d i n g from an e a r l y age , and in the second h a l f of the f i r s t y e a r , began to reach up and e x p l o r e the f a c e s of c a r e g i v e r s . Around the same time as the s i g h t e d , the b l i n d i n f a n t s d i s p l a y e d f e a r of s t r a n g e r s when p icked up by one of them ( F r a i b e r g , 1975) . S e p a r a t i o n a n x i e t y , however, d id not deve lop u n t i l a much l a t e r age , perhaps because the b l i n d i n f a n t i s accustomed to the mother being absent when she i s not m a n i f e s t e d through t o u c h , v o i c e or movement sounds. It may a l s o be that when the i n f a n t h i m s e l f becomes mobi le through c r a w l i n g , tha t he begins to understand about the d i s p l a c e a b i l i t y of p e r s o n s . At any r a t e , i t i s c l e a r tha t s e p a r a t i o n a n x i e t y depends on the achievement of person permanence whereupon the i n f a n t p r o t e s t s and f o l l o w s h i s mother or f a t h e r around the house , by the sound of t h e i r v o i c e s and f o o t s t e p s ( F r a i b e r g , 1975). V o c a l i z a t i o n s from the young i n f a n t are s p a r s e , and i n i t i a l l y on ly e l i c i t e d in response to voca l o v e r t u r e s from a p a r e n t . F r a i b e r g (1974) f e e l s tha t voca l c o n t a c t i s not i n i t i a t e d by the i n f a n t u n t i l wel l i n to the second y e a r , , but A l s (1980) r e p o r t s that the i n f a n t she s t u d i e d was i n i t i a t i n g c o n t a c t l a t e in the f i r s t y e a r . Vocal i m i t a t i o n and r e c i p r o c a l games such as p a t - a - c a k e , or - 3 3 -handing back and f o r t h , can occur in the b l i n d i n f a n t at or c l o s e to the age f o r s i g h t e d i n f a n t s , i f i n p u t i s s u f f i c i e n t ( A l s , - 1 9 8 0 ) . J u s t as with the s i g h t e d , the b l i n d i n f a n t uses the presence of the mother as a " s e c u r e base" f o r e x p l o r a t i o n . But because of the d i f f i c u l t y of m a i n t a i n i n g an awareness of the p a r e n t ' s p r e s e n c e , he may r e t u r n a f t e r v e r y s h o r t i n t e r v a l s . Once the c h i l d begins to s p e a k , he w i l l o f t e n keep in touch through c a l l i n g h is mother , a s k i n g r e p e t i t i o u s q u e s t i o n s and so o n , a p p a r e n t l y to o b t a i n the c o n t i n u o u s r e a s s u r a n c e of her v o i c e ( F r a i b e r g , 1977) . Many authors (E lonen et a l , 1964; K e e l e r , 1958; K l e i n , 1 962; S a n d l e r , 1 963; G r e e n , 1 957 ; M c G u i r e e t al , 1971; C h a s e , 1972) have d e s c r i b e d a d i s o r d e r of p e r s o n a l i t y and development in o l d e r b l i n d c h i l d r e n c h a r a c t e r i z e d by s o c i a l i s o l a t i o n , deve lopmenta l d e l a y , l a c k of c o m m u n i c a t i o n , and a p r e - o c c u p a t i o n wi th s t e r e o t y p e d , r e p e t i t i v e , s e l f -s t i m u l a t i n g b e h a v i o u r s . Most of these au thors have im-p l i c a t e d an inadequacy in the d e v i a n t c h i l d ' s bond wi th h i s mother in i n f a n c y , but have on ly o f f e r e d s u b j e c t i v e e v i d e n c e in suppor t of t h i s t h e o r y , and have not suggested c r i t e r i a by which an o b s e r v e r can d i f f e r e n t i a t e between a good m o t h e r - c h i l d r e l a t i o n s h i p , and a r e l a t i o n s h i p at r i s k , in the f i r s t year of a b l i n d c h i l d ' s l i f e . -34 -O b s e r v a t i o n s of b l i n d i n f a n t ' s use of t h e i r o ther senses in the p u r s u i t of s o c i a l i n t e r a c t i o n may thus y i e l d some u s e f u l i n f o r m a t i o n . F . Review of Methodology In o rder to determine an a p p r o p r i a t e methodology f o r s t u d y i n g the f u n c t i o n a l development of the b l i n d i n f a n t ' s use of h i s h a p t i c and a u d i t o r y s e n s e s , a number of r e s o u r c e s d e a l i n g wi th r e s e a r c h d e s i g n were c o n s u l t e d . S i n c e the problem to be s o l v e d i s one of i n v e s t i g a t i o n of p a t t e r n s and sequences of growth over t i m e , Isaac (1971) would c h a r a c t e r i z e the method of c h o i c e as deve lopmenta l r e s e a r c h . He s u b d i v i d e s the f i e l d of deve lopmenta l r e s e a r c h i n t o three b a s i c a p p r o a c h e s : l o n g i t u d i n a l growth s t u d i e s sampl ing the same c h i l d r e n at d i f f e r e n t s tages of d e v e l o p -ment; c r o s s - s e c t i o n a 1 growth s t u d i e s sampl ing d i f f e r e n t c h i l d r e n from r e p r e s e n t a t i v e age l e v e l s ; a n d t rend s t u d i e s u s i n g p a t t e r n s of change in the past in order to p r e d i c t f u t u r e p a t t e r n s . S i n c e i t i s the purpose of the p r e s e n t study to r e c o r d f a i r l y s u b t l e changes in s e n s o r i m o t o r s k i l l s r e l a t i v e to the h a p t i c and a u d i t o r y s e n s e s , and a l s o to compare deve lopmenta l p r o f i l e s of a number of c h i l d r e n to seek a c o n s i s t e n t p a t t e r n , the l o n g i t u d i n a l method would seem the most a p p r o p r i a t e . - 35 -G a l l a g h e r et al (1976) and Kessen (1960) support the use of the l o n g i t u d i n a l d e s i g n , r a t h e r than the exper imenta l d e s i g n , in the study of c h i l d deve lopment . G a l l a g h e r p o i n t s out tha t the c o n d i t i o n s which a f f e c t e a r l y behav iour and development are m u l t i - f a c t o r i a l , both on the s i d e of dependent and independent v a r i a b l e s , p r o d u c i n g d i f f i c u l t i e s in d e s i g n i n g a p r o p e r l y c o n t r o l l e d exper iment . He has found the l o n g i t u d i n a l d e s i g n to be p a r t i c u l a r l y a p p r o p r i a t e f o r s t u d y i n g the c u m u l a t i v e e f f e c t of independent v a r i a b l e s , the d imens ions under -l y i n g b e h a v i o u r a l change , p a t t e r n s of i n d i v i d u a l d i f f e r e n c e s , p rocess emergence, and v a r i a b l e s showing small change. There a r e , of c o u r s e , some problems wi th such a d e s i g n : f i n d i n g s may not be c o n s i d e r e d to be g e n e r a l i z e a b l e ; t h e study may become t ime-consuming and e x p e n s i v e ; masses of data which are d i f f i c u l t to o r g a n i z e may be c o l l e c t e d ; a r t i f a c t u a l r e s u l t s from repeated tasks or " t reatment e f f e c t " may o c c u r ; r e s e a r c h e r s may wish to a l t e r the methodology d u r i n g the course of the study as newer or more a t t r a c t i v e methods occur to them ( G a l l a g h e r et al , 1976; I s a a c , 1971). - 36 -Kaplan (1964) and Wright (1960) have both c r i t i c i z e d the tendency of b e h a v i o u r a l p s y c h o l o g i s t s to r e l y on s t a n d a r d i z e d t e s t s as measures of change in developmenta l r e s e a r c h . They po in t to a need f o r the r e c o r d i n g of behav iour t y p i c a l to the d e v e l o p i n g c h i l d through c a r e f u l o b s e r v a t i o n over t ime. The c o l l e c t i o n of such data shou ld take p l a c e in n a t u r a l i s t i c s u r r o u n d i n g s , w h i c h , in the case of the young i n f a n t would o b v i o u s l y be the home; in t h i s way r e s e a r c h e r s can l e a r n what n o r m a l l y happens in a c h i l d ' s w o r l d , and how he d e a l s wi th the changing events ( G a l l a g h e r , 1976; V a s t a , 1979) . In h i s d i s c u s s i o n of the conduct of o b s e r v a t i o n a l r e s e a r c h , Vasta (1979) suggests that the f o l l o w i n g q u e s t i o n s must be c o n s i d e r e d : 1) I',1 hat w i l l be observed? - behav iours must be chosen and then c l e a r l y d e f i n e d , to make them r e c o g n i z a b l e . 2) When w i l l the o b s e r v a t i o n s be made? - a p r e f e r r e d time of day in which the c h i l d i s most capable of demonst ra t ing t y p i c a l b e h a v i o u r s , wi thout i n f l u e n c e of hunger or f a t i g u e , shou ld be c h o s e n . 3) Which o b s e r v a t i o n a l method w i l l be used? - i n f o r m a l , -37 -i n d i r e c t , stream of behav iour and formal o b s e r v a t i o n s are a l l p o s s i b l e . 4) How w i l l the a c c u r a c y of the o b s e r v a t i o n s be v e r i f i e d ? -u s u a l l y another o b s e r v e r is used at some p o i n t in the s t u d y , and the s i g n i f i c a n c e of the s i m i l a r i t i e s between the two se ts of data can be computed m a t h e m a t i c a l l y ( V a s t a , 1979). In h i s c r i t i c i s m of o b s e r v a t i o n a l methods , Vasta p o i n t s out tha t in fo rma l o b s e r v a t i o n s y i e l d i n t e r e s t i n g i n f o r m a t i o n , but tend to be u n s y s t e m a t i c and l a c k i n g in o b j e c t i v i t y , making any kind of s c i e n t i f i c a n a l y s i s d i f f i c u l t . I n d i r e c t o b s e r v a t i o n , u s u a l l y c o n s i s t i n g of repeated parent i n t e r -views over t i m e , may be s u b j e c t i v e , and the a c c u r a c y of the data u n v e r i f i a b l e . In stream of behav iour r e s e a r c h , o b s e r v e r s r e c o r d e v e r y t h i n g the c h i l d does and e x p e r i e n c e s d u r i n g a l i m i t e d p e r i o d of t i m e , and repeat the sampl ing procedure over t i m e . V a l u a b l e data can be c o l l e c t e d in t h i s way, but b e h a v i o u r a l a n a l y s i s may be d i f f i c u l t , and c a u s e - e f f e c t r e l a t i o n s h i p s are not always c l e a r . Vasta (1979) c l e a r l y f a v o u r s a more formal method of o b s e r v a t i o n in which o b s e r v i n g and r e c o r d i n g procedures are s y s t e m i z e d , and r e l i a b i l i t y e s t i m a t e d . Targe t behav iours are c l e a r l y d e f i n e d , and can be r e c o r d e d as to o c c u r r e n c e w i t h i n a s h o r t i n t e r v a l , or time sample , u s i n g a s imple -38-y e s - n o or p l u s - m i n u s . Frequency of o c c u r r e n c e dur ing the same t ime-sample can a l s o be r e c o r d e d , and , i f a p p r o p r i a t e , a r a t i n g s c a l e d e s c r i b i n g the q u a l i t y of the behav iour may be u s e d . Having determined tha t d i r e c t o b s e r v a t i o n of t y p i c a l b e h a v i o u r s , r a t h e r than s t a n d a r d i z e d t e s t i n g , i s n e c e s s a r y in o rder to o b t a i n developmenta l i n f o r m a t i o n , another problem r e v e a l s i t s e l f . S i n c e in the present s t u d y , the d e s i r e d behav iours are response o r i e n t e d , d e a l i n g with the i n f a n t ' s use of the h a p t i c and a u d i t o r y systems in d e a l i n g with env i ronmenta l e v e n t s , a c o m p l e t e l y n e u t r a l o b s e r v a t i o n may f a i l to r e v e a l the r e q u i r e d r e s p o n s e , p a r t i c u l a r l y when time c o n s t r a i n t s l i m i t the l eng th of the o b s e r v a t i o n p e r i o d . Examples of a combined a p p r o a c h , in which both c a r e f u l o b s e r v a t i o n and in fo rma l e x p e r i m e n t a t i o n are u s e d , can be found in the l i t e r a t u r e ( G a l l a g h e r et a l , 1976). P i a g e t , f o r example, compensated fo r the d e f i c i e n c i e s of the n a t u r a l i s t i c p rocedure by c o n t r o l l i n g the s t i m u l i , m a n i p u l a t i n g the c h i l d ' s e n v i r o n m e n t , and o b s e r v i n g the r e s u l t s (G insburg and Opper , 1969). T h i s has been c a l l e d the "methode c l i n i q u e " d u r i n g the e a r l y yea rs of P i a g e t ' s work, and l a t e r was termed "the c r i t i c a l ex-p l o r a t i o n method" ( I n h e l d e r , S i n c l a i r and B o v e t , 1974) . - 3 9 -The task f o r the r e s e a r c h e r us ing t h i s approach must t h e r e f o r e be to d e s i g n s imple exper iments which are c l e a r l y d e f i n e d , and ye t i n v o l v e s t i m u l i which a r e so c l o s e l y a s s o c i a t e d wi th normal l i f e as to be r e l e v a n t to spontaneous deve lopment . As wi th a l l types of r e s e a r c h , sources of b i a s e x i s t . I n t e r n a l v a l i d i t y may be i n f l u e n c e d by h i s t o r y (non-measured events o c c u r i n g s i m u l t a n e o u s l y ) , s e l e c t i o n , ex-per imenta l m o r t a l i t y , and exper imente r b i a s . E x t e r n a l v a l i d i t y may be compromised by the r e a c t i v e e f f e c t o f repea ted t e s t i n g , and by the i n t e r a c t i v e e f f e c t s of s e l e c t i o n b i a s (Tuckman, 1978) . - 40 -CHAPTER III  METHOD A. S u b j e c t s S u b j e c t s c o n s i s t e d of s i x c h i l d r e n , f o u r boys and two g i r l s , who were r e f e r r e d to the study by the Canadian N a t i o n a l I n s t i t u t e f o r the B l i n d . C r i t e r i a f o r i n c l u s i o n were: 18 months of age or l e s s at the commencement of the s t u d y , wi th no u s e f u l v i s i o n ( l i g h t p e r c e p t i o n or l e s s ) and l i v i n g at home in the Lower Main land of B r i t i s h C o l u m b i a . They were not randomly s e l e c t e d , but r e p r e s e n t e d a t o t a l p o p u l a t i o n of such c h i l d r e n , as f a r as c o u l d be d e t e r m i n e d . No at tempt v,-as made to exc lude c h i l d r e n wi th a d d i t i o n a l h a n d i c a p s , p r o v i d e d i t was c l e a r tha t they were p h y s i c a l l y capab le of r e a c h i n g f o r and g r a s p i n g o b j e c t s . It was f e l t tha t s i n c e o ther handicaps are commonly found to accompany c o n g e n i t a l b l i n d n e s s , tha t the sample would be more r e p r e s e n t a t i v e of the c o n g e n i t a l l y b l i n d p o p u l a t i o n as a whole i f the m u l t i p l y handicapped were not e x c l u d e d . F u r t h e r m o r e , i t was a l s o f e l t that developmenta l o b -s e r v a t i o n s of the m u l t i p l y handicapped b l i n d as compared to c h i l d r e n wi th the s i n g l e h a n d i c a p , c o u l d y i e l d u s e -f u l i n f o r m a t i o n . TABLE 3 SUBJECTS 1 2 3 4 5 6 SEX Ma 1 e Female Fema1e Mal e Mal e Mal e Age at commencement ^ ( c o r r e c t e d f o r p r e -m a t u r i t y i f n e c e s s a r y ) 5 mos . 6.5 mos. 15 mos. 18 mos. 14 mos. 9 mos. O p h t h a l m o l o g i c a l c o n d i t i o n s r e t r o -1 en ta1 f i b r o -p l a s i a r e t i n a l d e t a c h -ment r e t r o -1 en ta1 f i b r o -p l a s i a o p t i c nerve hypo-pi a s i a o p t i c nerve hypo-pi a s i a r e t r o ! e n t a l f i b r o p l a s i a Parents s i n g l e mother s i n g l e mother both parents s i n g l e mother both parents both parents B i r t h o rder t h i r d of th ree second of two only c h i l d on ly c h i l d on ly c h i l d on ly c h i l d Number of v i s i t s 10 10 10 4 1 0 4 * when c o r r e c t i n g f o r p r e m a t u r i t y , the number of months of p r e m a t u r i t y i s added to the c h r o n o l o g i c a l age , in months, to o b t a i n the g e s t a t i o n a l age. -42-T h e i r o p h t h a l m o l o g i c a l c o n d i t i o n s c o n s i s t e d of r e t r o l e n t a l f i b r o p l a s i a ( t h r e e ) , o p t i c nerve h y p o p l a s i a ( two) , and r e t i n a l detachment (one ) . T h e i r ages v a r i e d between 5 and 18 months at the b e g i n n i n g of the s t u d y ; th ree of the c h i l d r e n belonged to s i n g l e parent f a m i l i e s , with both paren ts being p r e s e n t in the o ther th ree f a m i l i e s . Four of the c h i l d r e n were on ly c h i l d r e n , one was the second of two, and one the t h i r d of t h r e e . T a b l e 3 p r e s e n t s these data in t a b u l a r fo rm. B. Procedure Parents of the c h i l d r e n were c o n t a c t e d by the C . N . I . B . and informed consent was ob ta ined p r i o r to the f i r s t v i s i t (see consent f o r m , Appendix A ) . D e t a i l s r e g a r d i n g the cause of the b l i n d n e s s and v a r i o u s medical d iagnoses were o b t a i n e d . Dur ing the s t u d y , each i n f a n t who p a r t i c i p a t e d f u l l y was v i s i t e d at two week i n t e r v a l s f o r f i v e months: i . e . , ten t imes d u r i n g the p e r i o d between the beg inn ing of February and the end of J u n e , 1982. On the f i r s t v i s i t , a s t a n d a r d i z e d t e s t of i n f a n t d e v e l -opment, the Bay ley Mental S c a l e s ( B a y l e y , 1969) was per -formed w i t h ' e a c h c h i l d . T h i s was done in order to p r o v i d e a r e c o g n i z e d measure of development wi th which t h i s group of s u b j e c t s c o u l d be compared to any o t h e r . The Bay ley S c a l e s were chosen as they have been p r e v i o u s l y ana lyzed by -43-H i g u c h i (1971)" to determine the v i s u a l requ i rements of each i t em. A l though a l l i tems were a t t e m p t e d , i t was p o s s i b l e to o b t a i n an age e q u i v a l e n t u s i n g on ly the n o n - v i s u a l i t e m s . S t imu lus o b j e c t s , p r i m a r i l y t o y s , were c a r e f u l l y chosen wi th regards to t h e i r sensory c h a r a c t e r i s t i c s , e i t h e r a u d i t o r y or t a c t i l e , and c o n s i s t e d of toys brought by the examiner (see Equipment L i s t , Appendix B ) , and some of the c h i l d ' s own toys as w e l l . Dur ing each v i s i t there were genera l o b s e r v a t i o n s made r e g a r d i n g the i n f a n t ' s s t a t e on that day ( i . e . genera l h e a l t h , a l e r t n e s s , f a t i g u e l e v e l , c r a n k i n e s s , presence of t e e t h i n g and so o n ) , in o r d e r to p r o v i d e background data and p o s s i b l e c o r r e l a t i o n s between d i f f e r e n c e s in performance and d i f f e r e n c e s in s t a t e . For a p p r o x i m a t e l y ten minutes at the b e g i n n i n g of each v i s i t , the c h i l d was q u i e t l y observed p l a y i n g w i th h i s toys and i n t e r a c t i n g wi th h i s f a m i l y , in o rder to a s s e s s h i s spontaneous use of touch and h e a r i n g . A l s o , the mother was encouraged to d i s c u s s any changes in h i s use of these senses which she had noted s i n c e the l a s t v i s i t . These data were a l l r ecorded on a separa te sheet f o r each v i s i t , Data Sheet N o . l , an example of which can be seen in Appendix C. -44 -Th o s e s p e c i f i c b e h a v i o u r a l responses which i n v o l v e d the c h i l d ' s e x p l o r i n g of s p a c e , r e t r i e v a l of o b j e c t s , and m a n i p u l a t i o n of o b j e c t s u s i n g h is h a p t i c s e n s e , h is moving or r e a c h i n g towards n o i s y o b j e c t s u s i n g h is a u d i t o r y s e n s e , and h i s i n t e r a c t i o n s wi th h i s f a m i l y u s i n g both s e n s e s , were e l i c i t e d in the same way on each o c c a s i o n . As was noted in the p r e v i o u s c h a p t e r , pure o b s e r v a t i o n , wi thout c o n t a c t wi th the i n f a n t , may f a i l to r e v e a l the d e s i r e d behav iours in the time a v a i l a b l e . T h e r e f o r e , as has been done in o ther s i m i l a r s t u d i e s ( B i g e l o w , 1982; F r a i b e r g , 1977) , s imple exper iments were d e v i s e d i n v o l v i n g the p r e s e n t a t i o n of o b j e c t s , the m a n i p u l a t i o n of o b j e c t s in space in r e l a t i o n s h i p to the i n f a n t , and the m a n i p u l a t i o n c f p e r s o n s , in terms of t h e i r i n t e r a c t i o n wi th the i n f a n t . A f u l l d e s c r i p t i o n of the way the t a s k s were p r e s e n t e d and the c r i t e r i a f o r mastery can be found in the "Key to B e h a v i o u r s " , Appendix E. These data were recorded on Data Sheet No. 2, an example of which can be found in Appendix D, which was in the form of a + or - c h e c k - l i s t and which p r o v i d e d f o r the r e c o r d i n g of a l l such d a t a , f o r a l l v i s i t s to t h a t c h i l d , on the same s h e e t . E f f o r t s to i n c r e a s e the r e l i a b i l i t y of the data g a t h e r i n g were made by c o n t r o l l i n g as much as p o s s i b l e -45-f o r env i ronmenta l v a r i a b l e s : s u b j e c t s were v i s i t e d at the same time of day, on the same day of the week, on each o c c a s i o n . I n t e r - r a t e r r e l i a b i l i t y was a s s e s s e d through the use of a second examiner , making s imul taneous o b s e r v a t i o n s , wi th the same c r i t e r i a , on the f o u r t h v i s i t . I n t e r - r a t e agreement was computed us ing the formula computed by Vasta (1979): Number of i tems ra ted i d e n t i c a l l y by both o b s e r v e r s v , ~ n J _ X ] og T o t a l number of i tems observed The i n t e r - r a t e r agreement was 98%. L i m i t a t i o n s of the study were i t s shor t d u r a t i o n , the s e l e c t i o n of behav iours to be s t u d i e d which may have been i n c o m p l e t e , and the s i z e of the sample a v a i l a b l e at any g iven t i m e , which was too smal l to a l low f o r g e n e r a l -i z e a b i l i t y . N e v e r t h e l e s s , i t was hoped tha t t h i s study would to some degree i n c r e a s e the p resen t knowledge r e g a r d i n g the b l i n d i n f a n t ' s development of f u n c t i o n a l use of the h a p t i c and a u d i t o r y s e n s e s . - 4 6 -CHAPTER IV RESULTS AND DISCUSSION A. Bay ley Mental S c a l e s The Mental S c a l e of the Bay ley S c a l e s of I n f a n t Development ( B a y l e y , 1969) were a d m i n i s t e r e d to each s u b j e c t as pa r t of the c o l l e c t i o n of b a s i c d a t a . These s c a l e s have been ana lyzed by H iguch i (1971) and those i tems which depend on v i s i o n have been i d e n t i f i e d . T h e r e f o r e , when i n t e r p r e t i n g each c h i l d ' s s c o r e , it. was p o s s i b l e to o b t a i n an age -p lacement in n o n - v i s u a l mental a b i l i t i e s by ex-c l u d i n g those items which have been c l a s s i f i e d as i n -a p p r o p r i a t e f o r a b l i n d c h i l d . Out of a t o t a l of 6 s u b j e c t s , 3 o b t a i n e d mental age p lacements at or above t h e i r c h r o n o l o g i c a l or g e s t a t i o n a l a g e s . S u b j e c t No. 6, at a c o r r e c t e d age c f 9 months , passed a l l i tems to the 7.8 month l e v e l . S u b j e c t No. 3 , at a c o r r e c t e d age of 15 months, passed a l l i tems at the 12 month l e v e l , and s u b j e c t No. 5, at an age of 14 months, passed a l l i tems to a l e v e l of 7.6 months. T a b l e 4 summarizes these d a t a . - 47 -TABLE 4 AGE PLACEMENT OF SUBJECTS ON THE BAYLEY MENTAL SCALES S u b j e c t s 1 2 3 4 5 6 Age ( c o r r e c t e d 5mos. 6.5mos. 15mos. 18mos. 14mos. 9mos. f o r prematur i ty i f n e c e s s a r y ) . Sex Male Female Female Male Male Male Age placement on Bay ley Mental Sea 1 e s ( v i s u a 1 5mos. 6.5mos. 12mos. 18mos. 7 .6mos.7 .8mos. i tems exc luded) An unexpected f i n d i n g wi th the s c a l e s concerned those items which i n v o l v e t u r n i n g the head to sound ( i tems 47 and 48 ) . As has been m e n t i o n e d , two of the i n f a n t s s t u d i e d , who i n i t i a l l y were though to have l i g h t p e r c e p t i o n or l e s s , l a t e r were found to have some u s e f u l v i s i o n . These were the on ly i n f a n t s to turn t h e i r heads to sound, whi le the o ther f o u r , who were d e s t i n e d to remain f u n c t i o n a l l y b l i n d , d i d not t u r n . Dur ing the course of the s t u d y , a u d i t o r y i n -puts were c o n s t a n t l y be ing p r o v i d e d , but at no time d id the four b l i n d i n f a n t s turn to sound. At the end of the study - 4 8 -t h e i r ages ranged from 10 to 21 months, and they con t inued to assume an immobi le , l i s t e n i n g p o s i t i o n of the head but manual ly reached f o r a n o i s y t o y . These f i n d i n g s are in c o n t r a s t to those of F r a i b e r g (1977) and L a i r y (1973) who d e s c r i b e d t u r n i n g of the head to sound cue at about 7 months of age. As has been m e n t i o n e d , Wertheimer (1961) demonstrated a t u r n i n g towards sound on the par t of s i g h t e d newborns, and Sonksen (1979) f e e l s that there i s an a u d i t o r i l y i n i t i a t e d neonata l r e f l e x , p resent in b l i n d as wel l as s i g h t e d n e o n a t e s . She has noted that in the m a j o r i t y of t o t a l l y b l i n d i n f a n t s , t h i s r e f l e x d i s a p p e a r s by about f i v e months of age because v i s u a l r e - i n f o r c e m e n t i s l a c k i n g . On the o ther hand, even when the v i s i o n i s so poor tha t to an o b s e r v e r there i s a p p a r e n t l y no f o c u s s i n g on an o b j e c t or v i s u a l t r a c k i n g of i t s move-ments , she conc luded that a c h i l d who has had some shadowy v i s u a l e x p e r i e n c e can make an a u d i t o r y - v i s u a l c o - o r d i n a t i o n , and r e a l i z e tha t something heard can a l s o be s e e n , wh i le a t o t a l l y b l i n d c h i l d cannot . At any r a t e , f o r the smal l sample of s u b j e c t s f o l l o w e d d u r i n g t h i s s t u d y , - 4 9 -t u r n i n g of the head towards a sound ac ted as a p r e d i c t o r o f l a t e r v i s i o n . Of p a r t i c u l a r i n t e r e s t was the r e a c t i o n to sound of s u b j e c t No. 1, who at the b e g i n n i n g of the s t u d y , at a c o r r e c t e d age of 5 months, turned to sound cue on h is r i g h t , a l t h o u g h he d id not f o c u s or t r a c k o b j e c t s in any v i s u a l f i e l d at tha t t i m e . Two months l a t e r he began to r e a c t to v i s u a l s t i m u l a t i o n in the r i g h t v i s u a l f i e l d . S t i l l l a t e r , when he had l e a r n e d to turn h is head and thus became aware of v i s u a l i n p u t in a l l d i r e c t i o n s , he became r e s p o n s i v e to a u d i t o r y s t i m u l a t i o n from the l e f t as w e l l . T u r n i n g of h i s head to r i g h t - s i d e d a u d i t o r y i n p u t was the f i r s t h i n t ( u n r e c o g n i z e d at the t ime) of s p a r i n g of v i s i o n in the r i g h t v i s u a l f i e l d . Sonksen (1979) a l s o r e p o r t s a case of a c h i l d who turned to sound in her i n t a c t v i s u a l f i e l d , but ignored sound in her impa i red f i e l d , d e s p i t e good hear i ng . B. P r o f i l e s of S ix S u b j e c t s  S u b j e c t Number One L. P. was a male i n f a n t who had been born p r e m a t u r e l y by a p p r o x i m a t e l y th ree months, and was b l i n d as a r e s u l t of r e t r o l e n t a l f i b r o p l a s i a ; he had a t t a i n e d a c o r r e c t e d age of f i v e months at the commencement of the s t u d y . I n v a r i a b l y - 50 -c h e e r f u l and c o - o p e r a t i v e , he passed a l l n o n - v i s u a l i tems on the Bay ley S c a l e s at h i s c o r r e c t e d age i n c l u d i n g t u r n i n g to sound coming from the r i g h t . L . ' s use of t a c t u a l and k i n e s t h e t i c i n p u t deve loped q u i c k l y from the time he f i r s t grasped an o b j e c t on c o n t a c t . W i t h i n a month he had l e a r n e d to t r a n s f e r , turn a toy over to e x p l o r e a l l s i d e s , f i n d i t aga in a f t e r p u t t i n g i t down, and r e c o g n i z e h is f a v o u r i t e s . His o r i e n t e d reach to sound deve loped r a t h e r l a t e r . Between s i x and seven months c o r r e c t e d age he l e a r n e d to reach to sound cue at m i d - l i n e moving from c o n t i n u o u s to d i s c o n t i n u o u s , and from f a m i l i a r to u n f a m i l i a r sounds . At the age of seven and o n e - h a l f months he began to v i s u a l l y t r a c k o b j e c t s in h i s r i g h t v i s u a l f i e l d , but he was past nine months ( n i n t h v i s i t ) before he was ab le to reach f o r a toy on v i s u a l cue as a c c u r a t e l y as when there was a sound cue as w e l l . Around the same time he l ea rned to turn h i s head to the l e f t and make b e t t e r f u n c t i o n a l use of h is smal l f i e l d of p a r t i a l s i g h t . He d i d not crawl d u r i n g the course of the s t u d y , as h i s motor s k i l l s were a l i t t l e d e l a y e d , but he d i d l e a r n to r o l l to o b t a i n an o b j e c t , f i r s t on sound c u e , l a t e r on v i s u a l cue i f the o b j e c t were c l o s e ( f o u r f e e t away or l e s s ) . -51 -L . ' s r e l a t i o n s h i p with h is mother and b r o t h e r s was p a r t i c u l a r l y good , and he loved to i n t e r a c t , v o c a l i z i n g and l a t e r i m i t a t i n g sounds . I m i t a t i o n of g e s t u r e s and sounds took p l a c e at the same age as such b e h a v i o u r s emerge in s i g h t e d i n f a n t s a c c o r d i n g to U g i r i s and Hunt ( 1 976 ) . S u b j e c t Number Two S.M. was a female i n f a n t , the second of two c h i l d r e n , b l i n d as a r e s u l t of r e t i n a l de tachments . She l i v e d with her mother and o l d e r s i s t e r and was s i x and o n e - h a l f months of age at the b e g i n n i n g of the s t u d y , and e l e v e n and one-h a l f months when i t ended. On the Bay ley S c a l e s , she passed a l l n o n - v i s u a l i tems at her age l e v e l , except f o r t u r n i n g of the head to sound. S. began to e x p l o r e her environment with her hands at an e a r l y a.ge, but tended to use her hands in a l a t e r a l d i r e c t i o n , r a t h e r than in f r o n t at m i d - l i n e , and she was slow to deve lop b i l a t e r a l c o - o r d i n a t i o n . Her performance was not always c o n s i s t e n t , in that when she was t e e t h i n g she d id f a r l e s s manual e x p l o r a t i o n in favour of mouthing t o y s . Development of a reach to sound cue deve loped q u i t e e a r l y as w e l l . At seven months of age she was r e a c h i n g fo r a d i s c o n t i n u o u s , f a m i l i a r sound presented at m i d - l i n e , -52-and p r o g r e s s e d to u n f a m i l i a r sounds , and to l a t e r a l and m u l t i - d i r e c t i o n a l r e a c h i n g . She might have been a b l e to reach f o r a c o n t i n u o u s sound at an e a r l i e r a g e , but the c o n t i n u o u s sound source used was a music box , and S. p r e f e r r e d to s i t and l i s t e n to i t . She had had p r e v i o u s e x p e r i e n c e wi th music boxes , and appeared to have deve loped a schema f o r music which d i c t a t e d that i t was f o r " l i s t e n i n g t o " , "not r e a c h i n g f o r " . (In r e g a r d s to the use of the music box, i t i s r e a l i z e d tha t t h i s i s not a c o n t i n u o u s sound as compared to a pure t o n e , but r a t h e r a c o n t i n u o u s p a t t e r n of sounds that the c h i l d can n o n e t h e l e s s r e c o g n i z e as coming from a f i x e d l o c a t i o n . ) From the o u t s e t , S. was seen to e x p l o r e her m o t h e r ' s arm and face wi th her hands. Part -way through the s t u d y , she moved i n t o a temporary f o s t e r home, and i t was p o s s i b l e to gain some i n s i g h t s i n t o the r o l e of the h a p t i c and a u d i t o r y senses in the development of these new r e l a t i o n -s h i p s . For a s h o r t p e r i o d of time S. was f e a r f u l of everyone in her new home, but soon s e t t l e d down, and. began to g r a d u a l l y get to know each member of the f a m i l y by e x p l o r i n g t h e i r bodies and faces and l e a r n i n g to d i s c r i m i n a t e t h e i r v o i c e s . She f i r s t deve loped a bond with the f o s t e r mother , n a t u r a l l y enough, and then she ceased the f a c i a l e x p l o r a t i o n , but r e l i e d on the v o i c e , with o c c a s i o n a l v e r i f i c a t i o n by t a c t u a l l y s e e k i n g the watch and r i n g s which the mother u s u a l l y wore. She - 5 3 -c o n t i n u e d to c a r r y out f a c i a l e x p l o r a t i o n of the f a t h e r a l i t t l e l o n g e r , but had ceased t h i s behav iour by the end of the s t u d y , at which time she was s t i l l e x p l o r i n g the f a c e s of the s e v e r a l teenage c h i l d r e n in the f a m i l y . With t h i s p a r t i c u l a r s u b j e c t , t a c t u a l e x p l o r a t i o n of the face was c a r r i e d out on ly u n t i l i t c o u l d be r e p l a c e d by o t h e r , more r a p i d l y i n t e r p r e t e d c u e s . She en joyed i n t e r a c t i o n a l games, and a l t h o u g h she r e f u s e d to c r a w l , by the end of the study she was walk ing wi th s u p p o r t , and l o v e d to come to the f o s t e r mother when she was c a l l e d . S u b j e c t Number Three A . H . was a female i n f a n t , an on ly c h i l d , who l i v e d wi th both p a r e n t s . She had been born three months p r e -m a t u r e l y , and was b l i n d as a r e s u l t o f r e t r o l e n t a l f i b r o -p l a s i a . Her c o r r e c t e d age at the b e g i n n i n g o f the s tudy was f i f t e e n months, and on the Bay ley Mental S c a l e s she passed n o n - v i s u a l i tems to a twelve month l e v e l , except f o r t u r n i n g to sound. S i n c e A. was c o n s i d e r a b l y o l d e r than most of the o ther s u b j e c t s , she was a l r e a d y adept at t a c t u a l l y ex-p l o r i n g and r e c o g n i z i n g o b j e c t s , and f i n d i n g them on t a c t u a l - k i n e s t h e t i c cue ( s e a r c h i n g f o r them where they had been found b e f o r e ) . She was u n i n t e r e s t e d in a t t e m p t i n g h i g h e r l e v e l m a n i p u l a t i v e a c t i v i t i e s with the t o y s , i n v o l v i n g p l a c i n g them in r e l a t i o n s h i p to each o t h e r - 5 4 -( s t a c k i n g , a l i g n i n g , p l a c i n g o b j e c t s i n t o a c o n t a i n e r ) , s o l i t t l e p r o g r e s s was made in t h i s area d u r i n g the ten weeks she was f o l l o w e d . A. was r e a c h i n g f o r a sound at m i d - l i n e when the study began, and was observed d u r i n g the development of l a t e r a l and m u l t i - d i r e c t i o n a l r e a c h i n g . She was in the p r o c e s s of l e a r n i n g to search f o r a hidden n o i s y o b j e c t when the study ended. She was a l s o ab le to crawl to f i n d a c o n t i n u o u s l y n o i s y toy from a p p r o x i m a t e l y s ix f e e t away, but t h i s was i n c o n s i s t e n t , a c c o r d i n g to her mood. A . ' s t a c t u a l and a u d i t o r y s k i l l s were used l e a s t c o n s i s t e n t l y in her s o c i a l i n t e r a c t i o n s . She was o b -served to be a r a t h e r s o l i t a r y c h i l d , and a l t h o u g h she was seen on at l e a s t one o c c a s i o n to crawl to her mother when c a l l e d , i m i t a t e sounds and words , and i n t e r a c t in a " t u r n - t a k i n g " way wi th b o d i l y movements, these b e h a v i o u r s were d i f f i c u l t to e l i c i t . She was unhappy wi th the i n t r u s i o n of a s t r a n g e r i n t o her home, was f r e q u e n t l y i r r i t a b l e , and would take re fuge in s e l f - s t i m u l a t i n g behav iours when demands were p laced on her . These behav iours p e r s i s t e d d e s p i t e her parents c o n t i n u a l and l o v i n g e f f o r t s to i n v o l v e her in a l l a s p e c t s of t h e i r l i v e s . -55-S u b j e c t Number Four S. was e i g h t e e n months of age when he en te red the s t u d y , so was not ab le to c o n t r i b u t e data r e g a r d i n g e a r l y deve lopment . He was a f u l l term i n f a n t , born with l i g h t p e r c e p t i o n o n l y , due to severe o p t i c nerve h y p o p l a s i a . He l i v e d in a suburban home with h is mother who was in the l a t t e r s tages of a second pregnancy at the t ime . On the Bay ley Mental S c a l e s he passed a l l n o n - v i s u a l items to age l e v e l , except t u r n i n g of the head to sound. At the commencement of the study S . was r e a c h i n g a c c u r a t e l y in a l l d i r e c t i o n s on sound c u e , and d u r i n g the p e r i o d of o b s e r v a t i o n he l e a r n e d to move about the room to f i n d a c o n t i n u o u s l y n o i s y toy [a music box) from at l e a s t ten f e e t away, and f i n a l l y , to f i n d a d i s -c o n t i n u o u s l y n o i s y toy from the same d i s t a n c e . The l a t t e r task i n v o l v e s o r i e n t i n g the body and moving towards the memory of the sound c u e , or r a t h e r , to the p o i n t from which the i n d i v i d u a l remembers the sound to have come. He was a l s o noted to have a good mental r e p r e s e n t a t i o n of the p o s i t i o n of o b j e c t s in h is home, and c o u l d move q u i c k l y about wi thout bumping i n t o f u r n i t u r e . He had deve loped s t r a t e g i e s f o r f i n d i n g toys t h a t he wished to l e a v e and then come back t o : he would p u r p o s e f u l l y p l a c e them near the c o r n e r s of the c a r p e t , which he c o u l d f e e l wi th h is bare f e e t . -56 -Dur ing the study some new s k i l l s which r e q u i r e d i n -c r e a s e d development of c o n c e p t s i n v o l v i n g o b j e c t r e l a t i o n s emerged. S. had'" been p l a c i n g o b j e c t s i n t o a c o n t a i n e r , and now lea rned to s t a c k and a l i g n b l o c k s , p l a c e a l a r g e peg in a h o l e , and b r i n g a toy to h i m s e l f by p u l l i n g on a s t r i n g . S. was a very f r i e n d l y c h i l d , who was good at r e c o g -n i z i n g people by t h e i r v o i c e s . He had a very c l o s e r e l a t i o n -s h i p wi th h is mother , and y e t was d e v e l o p i n g r e a s o n a b l e autonomy f o r h is age. S i n c e had had a very wel l deve loped concept of o b j e c t permanence, one c o u l d assume a s i m i l a r l y deve loped concept of "person-permanence" ( B e l l , 1970) , and indeed he seemed to unders tand that h i s mother c o u l d be moving around the house w i thout h i s knowledge. S i n c e he needed to be ab le to r e t u r n to her from time to time ( the " s e c u r e - b a s e " phenomenon), he h a b i t a l l y c a l l e d her name as f r e q u e n t l y as every m i n u t e , thereby e l i c i t i n g an answer and p i n p o i n t i n g f o r him her c u r r e n t l o c a t i o n . F o r t u n a t e l y h i s mother understood tha t he was not being f e a r f u l or o v e r l y demanding, and was ab le to p a t i e n t l y answer "I'm over h e r e " , or "I'm on the c h e s t e r f i e l d " ( f o r example) e n d l e s s l y throughout the day . S i n c e he had completed a l l the t asks on the Data S h e e t , and the b i r t h of the new baby was imminent , v i s i t s were d i s c o n t i n u e d a f t e r the f o u r t h v i s i t . - 5 7 -S u b j e c t Number F i v e J . was a f o u r t e e n month o ld ma le , b l i n d as a r e s u l t of o p t i c nerve h y p o p l a s i a . He a l s o s u f f e r e d from c e r e b r a l p a l s y , m i c r o c e p h a l y , and s e i z u r e s . An o n l y c h i l d , he l i v e d with both paren ts in a suburban home. On the Bay ley Mental S c a l e s he passed a l l n o n - v i s u a l i tems to a 7.6 month age l e v e l , except , f o r t u r n i n g to sound cue . J . e x p l o r e d h i s t r a y , grasped and mouthed toys and c a r r i e d out some t a c t u a l e x p l o r a t i o n , but d i d not turn toys over to e x p l o r e the o ther s i d e . He reached to a n o i s y toy at m i d - l i n e e a r l y in the study at the age of f i f t e e n months but there was d e l a y be fore he reached to the s i d e , or up in the a i r . At f i r s t he reached more r e a d i l y f o r a f a m i l i a r sounding t o y , but l a t e r he appeared to p r e f e r a more novel sound. A l though J . en joyed being held and p layed w i t h , he d id not e x h i b i t s t r a n g e r a n x i e t y or s e p a r a t i o n d i s t r e s s . He d i d a v a r i a b l e amount of v o c a l i z i n g , depending upon h i s l e v e l of s e i z u r e c o n t r o l , a n d / o r s e i z u r e m e d i c a t i o n . He enjoyed v o c a l i z i n g in response to his mother ' s coo ing and b a b b l i n g , but d id not i m i t a t e . - 5 8 -S u b j e c t Number S ix B. L. was a male i n f a n t , b l i n d as a r e s u l t of r e t r o -l e n t a l f i b r o p l a s i a secondary to f o u r t e e n weeks p r e m a t u r i t y and a very low b i r t h we igh t . He was an on ly c h i l d and l i v e d wi th h i s parents in a suburban apar tment ; the paren ts were young and u n m a r r i e d , and home l i f e was r a t h e r c h a o t i c . At a c o r r e c t e d age of nine months, he passed n o n - v i s u a l i tems on the Bay ley Mental S c a l e s to an age of 7.8 months. From the onset B. was dex t rous at e x p l o r i n g h i s t r a y , g r a s p i n g and t r a n s f e r r i n g t o y s , and e x p l o r i n g them us ing f i n g e r - t i p s and mouth. He l e a r n e d about t u r n i n g them over by the second v i s i t , and soon began p r a c t i c i n g a v a r i e t y of a c t i o n s on the same t o y . At the b e g i n n i n g of the study B. was a l r e a d y r e a c h i n g f o r a n o i s y toy at m i d - l i n e , and soon a f t e r was seen to reach l a t e r a l l y and up. He tended to be more r e s p o n s i v e to d i s c o n t i n u o u s sounds , and to u n f a m i l i a r r a t h e r than h i s own t o y s . B. was q u i t e r e s p o n s i v e to h is mother , and was seen to enjoy e x p l o r i n g her face and body, and v o c a l i z e d when she t a l k e d to him, but was not i m i t a t i n g . He d id n o t , however, demonstrate s e p a r a t i o n a n x i e t y , or f e a r of s t r a n g e r s . -59-A b r u p t l y , a f t e r f o u r v i s i t s , B. and h is mother d i s a p p e a r e d f o l l o w i n g a break-up wi th the f a t h e r , and so no f u r t h e r data was a v a i l a b l e . A f t e r the c o n c l u s i o n of the study they r e t u r n e d , and by c o - i n c i d e n c e were seen f o r c l i n i c a l r a t h e r than r e s e a r c h r e a s o n s . At t h i s t i m e , he was seen to have some u s e f u l v i s i o n in each e y e . However, d u r i n g the two month p e r i o d when these d a t a were c o l l e c t e d he was not f u n c t i o n i n g v i s u a l l y . C. B e h a v i o u r a l Sequences S i n c e i t was not p o s s i b l e to c a r r y out a p r e l i m i n a r y p i l o t study of the s p e c i f i c behav iours being o b s e r v e d , i t was a n t i c i p a t e d that some items would be found to be i n -a p p r o p r i a t e f o r one reason or a n o t h e r . Such was the case wi th the s e r i e s of i tems concerned with the c h i l d ' s ex-p l o r a t i o n of h is own body, s i n c e these b e h a v i o u r s are re-a c q u i r e d at a very e a r l y age , and had been a c c o m p l i s h e d by a l l s u b j e c t s be fore the study began.- The i tems i n v o l -v i n g the c h i l d ' s u n d e r s t a n d i n g of c o n t e x t u a l cues (Appendix D, Number 5, a-d) were a l s o d i s c a r d e d as there was complete dependence on p a r e n t a l r e p o r t f o r these i t e m s , and r e l i a b i l i t y was d o u b t f u l . - 6 0 -1. Development of the H a p t i c Sense - Tab le 5 shows the s e q u e n t i a l o r d e r in which the tasks were m a s t e r e d , and the v i s i t number d u r i n g which each was a c c o m p l i s h e d . Bigelow (1982) has used a s i m i l a r method f o r d i s p l a y i n g her d a t a . As can be s e e n , S u b j e c t s 3, 4 and 6 had a l r e a d y mastered many of the tasks at the o u t s e t so u s e f u l l n e s s of the data was l i m i t e d . S u b j e c t 5 was m u l t i - h a n d i c a p p e d , ' which nay account f o r an unusual sequence . S u b j e c t s 1 and 2, however, showed a s i m i l a r sequence of development of use of the sense of t o u c h , and the sense of d i r e c t i o n a l i t y ( k i n e s t h e s i a ) . P i a g e t (1952) has d i s c u s s e d e a r l y s c r a t c h i n g and g r a s p i n g behav iours as be ing at l e a s t p a r t i a l l y d e l i b e r a t e , and they f a l l w i t h i n the d e s c r i p t i o n of pr imary c i r c u l a r r e a c t i o n s , as they are p r i m a r i l y concerned w i th the i n f a n t ' s own body. It i s noteworthy that S u b j e c t s 3 and 5, c o n t i n u e d these b e h a v i o u r s past the expected a g e ; as we have s e e n , S u b j e c t 3 was r a t h e r o v e r l y i n v o l v e d with s e l f - s t i m u l a t i n g b e h a v i o u r s , and S u b j e c t 5 was m u l t i p l y h a n d i c a p p e d . T r a n s -f e r r i n g o b j e c t s from hand to hand i n v o l v e s m i d - l i n e o r i e n t a t i o n , which F r a i b e r g (1977) found to be de layed in her s e r i e s ; however, a l l s u b j e c t s wi th the e x c e p t i o n c f S u b j e c t 5, who had a p h y s i c a l impediment to t h i s a c t i v i t y were t r a n s f e r r i n g from a r e a s o n a b l y normal age. -61 -TABLE 5 SEQUENCE OF DEVELOPMENT OF THE TACT ILE-KINESTHETIC SKILLS Tasks S u b j e c t s 1 2 3 4 5 6 S c r a t c h e s t a b l e 1 1 1 X 1 1 Grasps on c o n t a c t 1 1 1 X 1 1 T rans forms hand to hand 2 1 1 1 8 1 F i n d s one i tem on A c t i v i t y Centre 2 2 1 1 2 1 E x p l o r e s toy wi th f i n g e r t i p s 2 2 1 1 1 1 Searches t r a y randomly 2 2 1 1 3 1 < F inds toy a g a i n ( d e f e r r e d 1/1 c i r c u l a r r e a c t i o n ) 2 2 1 1 4 1 r+ Mouthes toy 4 2 1 1 4 1 is: Turns over to e x p l o r e £Z 3 other s i d e 3 3 1 1 - 1 O" ro F inds two items on A c t i v i t y Centre 4 3 1 1 3 3 Shows p r e f e r e n c e f o r c e r t a i n toy 3 4 1 1 - 1 Shakes r a t t l e 1 4 1 1 6 1 Bangs r a t t l e 4 5 1 1 1 1 Fo l lows on removal 4 - 4 1 6 1 F inds th ree i tems on A c t i v i t y Centre 5 6 1 1 4 3 Searches t r a y m e t h o d i c a l l y 5 6 1 1 -Performs s e v e r a l a c t i o n s on same toy 5 6 1 1 - 4 F inds f a v o u r i t e i tem on / A c t i v i t y Cent re 7 6 1 1 - -P u l l s s t r i n g to obta i n / toy(demo) 1 0 - 6 2 - -P l a c e s on ( s t a c k s ) - - - 2 - -P l a c e s in ( c o n t a i n e r ) - - - 2 - -P u l l s s t r i n g to o b t a i n toy (no demo) - - - 3 - -P l a c e s bes ide ( a l i g n s b l o c k s ) - - - 3 - -P l a c e s in (peg in ho le ) - - - 4 - -Age at f i r s t v i s i t 5rn. 6.5m. X- Behav iour outgrown sj - Use fu l v i s 15m. 18m. 14m. i on apparent 9m. - 62 -The e a r l y e x p l o r a t i o n of near space and of o b j e c t s u s i n g the sense of touch has not been c a r e f u l l y d e s c r i b e d in the l i t e r a t u r e . P iage t (1952) d i s c u s s e s t e n t a t i v e t a c t i l e ex-p l o r a t i o n d u r i n g Stage 3 (age e i g h t months) , but these b l i n d i n f a n t s were seen to be much more d e l i b e r a t e , even in the e a r l y s t a g e s . T h i s may be due to encouragement on the par t of the p a r e n t s , however, as F r a i b e r g (1964) has d e s -c r i b e d c h i l d r e n in whom t h i s e x p l o r a t o r y behav iour d id not d e v e l o p , a problem which she a t t r i b u t e d to developmenta l a r r e s t . The a b i l i t y to f i n d a toy on the t r a y where i t had been found b e f o r e does f i t n e a t l y i n t o the c a t e g o r y of d e f e r r e d c i r c u l a r r e a c t i o n s , and was the f i r s t Stage 3 b e h a v i o u r to be s e e n . The c o - o r d i n a t i o n between g r a s p i n g and s u c k i n g n e c e s s a r y f o r b r i n g i n g an o b j e c t to the mouth has a l s o been d e s c r i b e d by P i a g e t as o c c u r r i n g in the second or e a r l y in the t h i r d s t a g e ; i t seems s u r p r i s i n g tha t i t o c c u r r e d so l a t e in s e v e r a l s u b j e c t s , c o n s i d e r i n g some of the seeming ly more s o p h i s t i c a t e d t a c t i l e behav iours that have been d e s c r i b e d . S u b j e c t 1 was p a r t i c u l a r l y slow to adopt t h i s behav iour and t h i s may be r e l a t e d to a l i t t l e d e f e n s i v e n e s s around the mouth secondary to e a r l y tube -f e e d i n g . T u r n i n g over a toy to e x p l o r e the other s i d e may be ana logous to Stage 3 " r e c o n s t r u c t i o n of an i n v i s i b l e whole from a v i s i b l e f r a c t i o n " as d e s c r i b e d by Ginsburg and Opper - 6 3 -(1969) . It d e f i n i t e l y i m p l i e s a knowledge of more than i s d i r e c t l y under the f i n g e r - t i p s , as does the i n c r e a s i n g l y s o p h i s t i c a t e d e x p l o r a t i o n of the t ray and the A c t i v i t y C e n t r e . The shak ing and banging of toys i s the b l i n d i n f a n t ' s at tempt to r e p e a t an i n t e r e s t i n g e v e n t , a secondary c i r c u l a r r e a c t i o n . F o l l o w i n g a toy on removal was d e s -c r i b e d by both F r a i b e r g (1977) and Rigelow (1982) as being an e a r l y t a c t i 1 e - k i n e s t h e t i c s k i l l , but an at tempt to r e p l i c a t e t h e i r i n v e s t i g a t i o n was plagued by m e t h o d o l o g i c a l p rob lems: most of the c h i l d r e n r e a c t e d with annoyance at the l o s s of the toy and d i d not f o l l o w the toy u n t i l l a t e r in the sequence than e x p e c t e d . Sub jec t 2 never d i d get over her pique at such t rea tment and d id not produce the b e h a v i o u r . The a b i l i t y to demonstrate a p r e f e r e n c e f o r a s c e r t a i n toy should imply seme l e v e l of o b j e c t permanence t h a t one would expect to f i n d in the f o u r t h s e n s o r i m o t o r s t a g e . However, a l l s u b j e c t s except S u b j e c t 5 were ab le to r e c o g n i z e t h e i r f a v o u r i t e toy at an e a r l i e r s tage than e x p e c t e d . The a b i l i t y to f i n d the f a v o u r i t e i tem on the F i s h e r - P r i c e A c t i v i t y Cen t re r e q u i r e s a t a c t i 1 e - k i n e s t h e t i c c o o r d i n a t i o n , or "mapping" that makes i t much more d i f f i c u l t to a c c o m p l i s h than s imple d i f f e r e n t i a t i o n between t o y s . A l l the i n f a n t s except f o r S u b j e c t 5 a p p a r e n t l y deve loped some t e r t i a r y c i r c u l a r r e a c t i o n s , as they were ab le to ex-per iment with a v a r i e t y of a c t i o n s - s h a k i n g , b a n g i n g , mouth ing , e x p l o r i n g t a c t u a l l y and throwing - on the same t o y . Three of the s u b j e c t s were ab le to a c q u i r e a toy on the end c f a s t r i n g wi th help and d e m o n s t r a t i o n , but on ly S u b j e c t 4 was ab le to demonstrate t h i s Stage 5 behav iour s p o n t a n e o u s l y . He was a l s o the only s u b j e c t who was ab le to c a r r y out the Stage 5 o b j e c t r e l a t i o n tasks d e s c r i b e d . TABLE 6 UNUSUAL SEQUENCE OF TACT ILE-KINESTHETIC SKILLS IN MULTI-HANDICAPPED SUBJECT V i s i t 1 S c r a t c h e s t a b l e (age 14 months) Grasps on c o n t a c t E x p l o r e s toy wi th f i n g e r t i p s Bangs r a t t l e V i s i t 2 F inds one item on A c t i v i t y Centre V i s i t 3 Searches t r a y randomly F inds two items on A c t i v i t y Centre V i s i t 4 F inds toy aga in ( d e f e r r e d c i r c u l a r r e a c t i on) Mouthes toy F inds three items on A c t i v i t y Tj e n t r e . V i s i t 5 No new accompl ishments V i s i t 6 Shakes r a t t l e Fol1ows on removal V i s i t 7 No new accompl ishments V i s i t 8 T r a n s f e r s hand to hand V i s i t s 9-10 No new a c c o m p l i s h m e n t s . F a i l e d to (age 19 months) turn toys o v e r , show p r e f e r e n c e s , e x p l o r e m e t h o d i c a l l y , and so on . - 6 5 -One cannot l eave t h i s s e c t i o n wi thout l o o k i n g aga in at the development of S u b j e c t 5, who s u f f e r e d from both mental and p h y s i c a l h a n d i c a p s . As seen in T a b l e 6 he s l o w l y p r o g r e s s e d from minimal c o n t a c t , to i n c r e a s i n g t a c t u a l c o n t a c t w i th the environment at hand. However, he was a very long time moving from a f i x e d schema of banging t o y s , to shak ing them, and a l though he was capab le of a d e f e r r e d c i r c u l a r r e a c t i o n ( f i n d i n g an o b j e c t where i t had been b e f o r e ) , he was unable to demonstrate more advanced memory or o b j e c t permanence s k i l l s , as in t u r n i n g over a t o y , fo rming p r e -f e r e n c e s and so on . In summary, the development of the use of the h a p t i c sense in env i ronmenta l i n t e r a c t i o n c o u l d be observed in s e v e r a l s u b j e c t s to f o l l o w an o r d e r l y sequence , in most c a s e s f o l l o w i n g P i a g e t ' s s tages of s e n s o r i m o t o r deve lopment . U n f o r t u n a t e l y , th ree s u b j e c t s had a l r e a d y mastered most of the t a s k s , and t h e i r sequences are not known. The f i n d i n g s of B i g e l o w , tha t the h a p t i c system cues the c h i l d to the e x i s t e n c e and l o c a t i o n of an o b j e c t be fore the a u d i t o r y system can do s o , were s u p p o r t e d . -66-i i . Development of A u d i t o r y L o c a l i z a t i o n - T a b l e 7 shows the s e q u e n t i a l o rder in which the s u b j e c t s were ab le to reach f o r and a c q u i r e a t o y , on sound cue a l o n e . Both Bigelow (1982) and F r a i b e r g (1977) have r e p o r t e d that in t h e i r s t u d i e s , the f i r s t of these t a c t i l e - a u d i t o r y tasks to be mastered was to reach on sound cue f o l l o w i n g p r e v i o u s t a c t i l e c o n t a c t ; i . e . the sound toy i s removed from the b a b y ' s hands and sounded at m i d - l i n e . As has been r e p o r t e d in the t a c t i l e - k i n e s t h e t i c s e c t i o n , t h i s p a r t i c u l a r group of c h i l d r e n r e a c t e d so n e g a t i v e l y to having toys removed, tha t t h e i r t y p i c a l r e a c t i o n was to p u l l back t h e i r hands , and p r o t e s t . T h e r e f o r e , p r i o r t a c t i l e c o n t a c t d i d not p r o v i d e any advantage to these i n f a n t s . A c o n t i n u o u s sound shou ld t h e o r e t i c a l l y p r o v i d e a much more s u b s t a n t i a l a u d i t o r y cue than a n o n - c o n t i n u o u s s o u n d , f o r the purpose of l o c a l i z a t i o n and a t t a i n m e n t . T h i s i s because a c o n t i n u o u s sound a l l o w s the a u d i t o r y system to check and v e r i f y the d i r e c t i o n of the sound d u r i n g the act of r e a c h i n g , wh i le wi th a d i s c o n t i n u o u s s o u n d , the c h i l d ' s reach i s guided on ly by h i s memory of the d i r e c t i o n of the sound. However, i t i s i n t e r e s t i n g tha t the c o n t i n u o u s sound chosen f o r the s t u d y , a m u s i c - b o x , d id not s t r o n g l y mot iva te the c h i l d r e n to r e a c h , as they p r e f e r r e d to s imp ly l i s t e n to the m u s i c . It i s assumed tha t they had a l r e a d y - 6 7 -c a t e g o r i z e d music as being s o l e l y an a u d i t o r y e x p e r i e n c e . Most d i d , with a l i t t l e encouragement , reach f o r the music box, but S u b j e c t 2 d i d not do so u n t i l she had mastered s e v e r a l o ther r e a c h i n g t a s k s , and S u b j e c t 6 avoided r e a c h i n g f o r i t at a l l . Reaching f o r a n o n - c o n t i n u o u s sound toy at m i d - l i n e was a l r e a d y mastered by three of the s u b j e c t s at the commencement of the s t u d y . For the three in whom t h i s behav iour c o u l d be seen to emerge, on ly one , Sub jec t 2, f a v o u r e d her own r a t t l e over the e x p e r i m e n t a l v e r s i o n . The ages at which the c h i l d r e n were ab le to reach at mid -l i n e on sound cue were 7 months ( c o r r e c t e d age) f o r S u b j e c t 1, 7.5 months f o r S u b j e c t 2, and 15 months f o r Sub jec t 5 (who was m u l t i - h a n d i c a p p e d ) . In F r a i b e r g ' s s t u d y , the i n f a n t s f i r s t mastered t h i s task at ages r a n g i n g from 6.5 to 11 months, wi th the median age be ing 8 months, 27 d a y s , t h e r e f o r e the age at which S u b j e c t s 1 and 2 were s u c c e s s -f u l c o r r e l a t e s wel l wi th her d a t a . B i g e l o w , on the o ther hand, d id not observe r e a c h i n g on sound cue in her s u b j e c t s u n t i l the second year of l i f e . S e v e r a l a u t h o r s have been i n t e r e s t e d in the c o n n e c t i o n between r e a c h i n g on sound cue and the development of o b j e c t permanence in b l i n d c h i l d r e n . Freedman, et al (1969) t e s t e d 33 s i g h t e d i n f a n t s aged 5 to 12 months, and found that none - 6 8 -of them were able to r e t r i e v e a sounding toy h idden beneath a s c r e e n any sooner than they were a b l e to r e t r i e v e a s i l e n t toy which they had seen h i d d e n ; i . e . not u n t i l the a t t a i n -ment of Stage 4 o b j e c t permanence. F r a i b e r g (1977) has expanded on t h i s concept by p o i n t i n g out tha t for b l i n d c h i l d r e n , t h e i r b l i n d n e s s can be compared to the s c r e e n behind which the sounding toy i s hidden f o r s i g h t e d c h i l d r e n , and in t h i s way, m i d - l i n e reach on sound cue i s a Stage 4 t a s k . TABLE 7 SEQUENCE OF DEVELOPMENT OF THE TACTILE-AUDITORY SKILLS Tasks S u b j e c t s 1 2 3 4 5 6 Reaches m i d - l i n e , c o n t i n u o u s sound 3 4 1 1 3 < Reaches m i d - l i n e , non-c o n t i n u o u s f a m i l i a r sound 4 2 1 1 3 CO 1 « Reaches m i d - l i n e , non c o n -t i n u o u s u n f a m i l i a r sound 4 3 1 ! 3 Numt Reaches m i d - l i n e , p r e v i o u s c o n t a c t 5 4 1 4 ro 1 Cont inuous s o u n d , under h a n d e r k e r c h i e f 6 / 9 9 9 1 Cont inuous s o u n d , under bowl 9 10 1 - -Cont inuous s o u n d , 4 - 6 ' away 5 8 4 1 - -D i s c o n t i n u o u s s o u n d , 4 -6 ' away • J 1 9 3 Age at f i r s t v i s i t 5m. 6.5m. 1 5m. 1 8m. 1 4m. 9m. / - wi th v i s i o n - 6 9 -On the o ther hand s i n c e the c h i l d has been accustomed to f i n d i n g toys at m i d - l i n e , one may f e e l more c o m f o r t a b l e in c o n s i d e r i n g t h i s a d e f e r r e d c i r c u l a r r e a c t i o n o f Stage 3, and r e s e r v i n g the c a t e g o r y of Stage 4 o b j e c t permanence f o r m u l t i d i r e c t i o n a l reach to sound c u e . F r a i b e r g d id not s tudy the l a t t e r type of r e a c h i n g . Tab le 8 d e t a i l s the development of l a t e r a l and m u l t i -d i r e c t i o n a l ( l a t e r a l l y and up in the a i r ) r e a c h t o sound cue by the s u b j e c t s . It i s i n t e r e s t i n g to note t h a t in most cases there was a l ag of two to s i x weeks between mid-l i n e reach and m u l t i d i r e c t i o n a l r e a c h , wi th l a t e r a l reach u s u a l l y an i n t e r m e d i a t e s t e p . Bower (1977) has e x p l a i n e d tha t i t i s e a s i e r to l o c a t e o b j e c t s in a h o r i z o n t a l p lane by the f a c t tha t sound reaches the near ear sooner than the f a r e a r ; but tha t to l o c a t e o b j e c t s in the v e r t i c a l p lane the head may have to be t i l t e d to produce the same e f f e c t . T h e i n t e g r a t i o n of the two d imensions has made t h i s task of m u l t i d i r e c t i o n a l l o c a l i z a t i o n a complex o n e , and y e t i t was a c c o m p l i s h e d to some degree by a l l of the s u b j e c t s . A l s o of i n t e r e s t i s the o b s e r v a t i o n tha t the u n f a m i l i a r r a t t l e g r a d u a l l y became the p r e f e r r e d source of sound f o r r e a c h i n g and g r a s p i n g . P i a g e t 0 9 5 2 ) has noted the i n c r e a s i n g i n t e r e s t in n o v e l t y d i s p l a y e d by y o u n g s t e r s who are moving out o f the Stage 4 and i n t o Stage 5 of h i s s e n s o r i m o t o r -70-s t a g e s . It may be that t h i s i n c r e a s i n g p r e f e r e n c e f o r the u n f a m i l i a r toy i s connected to t h i s d e v e l o p m e n t , or i t may be that t h i s p a r t i c u l a r r a t t l e was i n h e r e n t l y more a t t r a c t i ve . TABLE 8 THE DEVELOPMENT OF LATERAL AND MULTIDIRECTIONAL REACHING TO SOUND CUE Tasks S u b j e c t s  D i s c o n t i n u o u s u n f a m i l i a r sound 1 a t e r a l l y m u l t i d i r e c t i o n a l l y Cont inuous sound 1 a t e r a l l y m u l t i d i r e c t i o n a l l y D i s c o n t i n u o u s f a m i l i a r sound l a t e r a l l y mul t i di r e c t i o n a l l y Age at f i r s t v i s i t 5m. 6.5m. 15m. 18m. 14m. 9m. R e t u r n i n g to Tab le 7 , i t can be seen t h a t f o u r s u b j e c t s were ab le to remove a b a r r i e r to f i n d a c o n t i n u o u s l y s o u n d i n g t o y , and a bowl was not much more d i f f i c u l t than a handker -c h i e f f o r three of them. Bigelow (1982) has c l a s s i f i e d t h i s a b i l i t y as Stage 4 o b j e c t permanence, as i t i s very s i m i l a r 1 2 3 4 5 6 < 4 4 2 4 2 5 5 3 6 3 i . _ 3 4 2 5 - _ 3 6 6 6 7 _ cr fD -s 6 4 4 1 6 3 6 5 5 1 _ 4 -71 -to the usual Stage 4 t e s t f o r s i g h t e d c h i l d r e n , and s i n c e i t i n v o l v e s a c o - o r d i n a t i o n of secondary schemes ( l i f t i n g the cover and p u l l i n g out the t o y ) . However, one can a l s o be a t t r a c t e d to the idea that f o r a b l i n d c h i l d , t h i s i s a Stage 5 task i n v o l v i n g two screens - h i s b l i n d -ness a c t i n g as one s c r e e n , and the h a n d k e r c h i e f or bowl a c t i n g as the s e c o n d . Four of the c h i l d r e n ach ieved s u f f i c i e n t m o b i l i t y to a t tempt to o b t a i n a n o i s y toy through r o l l i n g , c r a w l i n g or wa lk ing a shor t d i s t a n c e . In t h i s i n s t a n c e , c o n t i n u o u s sound was c l e a r l y more h e l p f u l , and i t was i n s t r u c t i v e to observe the methods of head t i l t and o r i e n t a t i o n as the c h i l d r e n " z e r o e d - i n " on the source of the sound . With d i s c o n t i n u o u s sound , of c o u r s e , the c h i l d was dependent upon h i s memory of the d i r e c t i o n from which the sound had come, and the f a s t e r the c h i l d c o u l d move, the more a c c u r a t e were h is a t tempts to l o c a t e the t o y . i i i . Development of S o c i a l B e h a v i o u r s - T a b l e 9 d e t a i l s the sequence of s o c i a l responses that were s t u d i e d . A l l i n f a n t s in the study were s m i l i n g s e l e c t i v e l y at the mother , and r e a c h i n g f o r her hand or body c l o s e by , a t the commencement of the s t u d y . These e a r l y bonding b e h a v i o u r s are r e p o r t e d as o c c u r i n g at the same age f o r b l i n d as f o r - 72 -s i g h t e d c h i l d r e n by F r a i b e r g (1975) and A l s (1980) . I t was not u n t i l c o n s i d e r a b l y l a t e r tha t most c h i l d r e n reached f o r the p a r e n t ' s f a c e , p r o b a b l y cued to i t s l o c a t i o n by the sound of the v o i c e . Reaching to the sound o f a v o i c e c e r t a i n l y o c c u r r e d wel l ahead of r e a c h i n g towards n o i s y o b j e c t s ; t h i s has been e x p l a i n e d by B e l l (1970) and o t h e r s , who d e s c r i b e "peop le permanence" as o c c u r r i n g b e f o r e o b j e c t permanence, or a l t e r n a t i v e l y , as o c c u r r i n g as the e a r l i e s t m a n i f e s t a t i o n of o b j e c t permanence. One s u b j e c t (Number 2 ) , moved i n t o a f o s t e r home par t way through the s t u d y . She was observed to use a t a c t i l e scann ing t e c h n i q u e o f the f a c e wh i le g e t t i n g to know the f o s t e r f a m i l y members, but abandoned t h i s behav iour w i th f a m i l y members as she d e v e l o p e d an a t t a c h -ment to them. Fear of s t r a n g e r s p r e d i c t a b l y o c c u r r e d soon a f t e r t a c t i l e scann ing of f a c e s in two s u b j e c t s , and s e p a r a t i o n p r o t e s t was seen one to one and o n e - h a l f months l a t e r . (Two s u b j e c t s had deve loped these r e a c t i o n s p r i o r to, the s tudy and two o t h e r s d i d not demonstrate i t d u r i n g the s t u d y ) . F r a i b e r g (1977) has h y p o t h e s i z e d tha t s e p a r a t i o n p r o t e s t i s a s i g n of Stage 4 o b j e c t permanence, as i t suggests tha t the c h i l d has begun to understand the movement of people from p l a c e to p l a c e . Three s u b j e c t s were a b l e to crawl or walk to t h e i r mothers when c a l l e d , and one demonstrated f o l l o w i n g - 7 3 -b e h a v i o u r s cued by mother ' s f o o t s t e p s . T h i s same c h i l d , S u b j e c t 4 , a l s o kept in touch with h is mother through f r e q u e n t c a l l s . ' TABLE 9  SEQUENCE OF SOCIAL BEHAVIOURS S u b j e c t s 1 2 3 4 5 6 Smi les s e l e c t i v e l y 1 1 1 1 1 1 E x p l o r e s mother ' s body 1 1 1 1 1 1 V o c a l i z e s to c o o i n g 1 1 1 1 3 ! E x p l o r e s mother 's face 3 2 1 1 1 <c V o c a l i z e s to babble 2 2 1 1 3 1 <-+ Causal a c t i o n to resume game 3 2 1 1 1 1 2-' CZ Fear of s t r a n g e r s 3 3 1 1 3 - cr Im i ta tes g e s t u r e Im i ta tes babble 6 V 7 3 9 3 8 1 2 ro 4^ S e p a r a t i o n p r o t e s t 6 1 0 8 1 Comes when c a l l e d - 9 6 1 Crawls a f t e r mother C a l l s mother Age at y: f i r s t v i s i t wi th v i s i o n 5m. 6.5m. 15m. 18m. 14m. 9m. -74 -A l though i t was not in tended to i n c l u d e a d e t a i l e d t rea tment of communicat ion b e h a v i o u r , i t was i m p o s s i b l e to c a r r y out o b s e r v a t i o n s of s o c i a l responses wi thout i n c l u d i n g some a s p e c t s of p r e - l a n g u a g e and motor i n t e r a c t i o n ' which s i m i l a r l y moved through a number of s t a g e s . Most i n f a n t s were v o c a l i z i n g to c o o i n g sounds at the b e g i n n i n g of the study and soon a f t e r commenced v o c a l i z i n g in response to a b a b b l i n g sound. Around the time tha t they f i r s t demonstrated a f e a r of s t r a n g e r s , s e v e r a l began to use a c a u s a l a c t i o n to ma in ta in a game ( p u l l i n g on mother ' s hands to s i g n a l a d e s i r e f o r more " p u l l to s i t " ) , a Stage 4 behav iour ( U z g i r i s and Hunt , 1975). I m i t a t i o n of babble and i m i t a t i o n of a f a m i l i a r ( n o i s y ) g e s t u r e are a l s o c l a s s i f i e d as Stage 4 accompl ishments ( U z g i r i s and Hunt , 197 5; D u n s t , 198 0 ) . i v. C r o s s - M o d a l C o r r e l a t i o n s - Tab le 10 i n d i c a t e s the a b i l i t i e s noted f o r S u b j e c t 2 on her t h i r d v i s i t (age 7.5 months) . As can be s e e n , there was f a i r l y good c o r r e l a t i o n a c r o s s the d i f f e r e n t b e h a v i o u r a l domains , wi th the c h i l d showing some s c a t t e r between Stages 3 and 4. The p e r s i s t e n c e of some Stage 2 b e h a v i o u r s ( s c r a t c h i n g and g r a s p i n g on c o n t a c t ) perhaps u n d e r s t a n d a b l e as the e x p r e s s i o n of a -75-TABLE 10 CROSS-MODAL CORRELATIONS S u b j e c t 2 V i s i t th ree Age 7.5 mos. T a c t u a l -k i n e s t h e t i c S c r a t c h e s grasps (Stage 2) and T a c t u a l -aud i t o r y Reaches at m i d l i n e on a u d i t o r y cue (Stage 3-e a r l y Stage 4 ) . Random search of t r a y (Stage 3) F inds again on t r a y (Stage 3) Turns over e x p l o r e (Stage 3) to S o c i a l At tachment E x p l o r e s face (Stage 3) V o c a l i z e s to c o o i n g & b a b b l i n g (Stage 3 ) . Fear of s t r a n g e r s (Stage 4) Causal a c t i o n to r e - s t a r t game (Stage 4) - 76 -need f o r i n c r e a s e d t a c t i l e i n p u t , in compensat ion f o r d e p r i v a t i o n of v i s u a l i n p u t . Other t a c t u a l - k i n e s t h e t i c , and t a c t u a l - a u d i t o r y b e h a v i o u r s f i t n e a t l y i n t o P i a g e t ' s Stage 3, which i s commensurate with her age. It was most e n c o u r a g i n g to see that in the area of a t tachment b e h a v i o u r s , she was u s i n g her touch and h e a r i n g wel l to i n t e r a c t wi th her f a m i l y , showing behav iours which have been c l a s s i f i e d as Stage 3 and Stage 4. Many authors p r e v i o u s l y quoted (E lonen et al , 1 964 ; K e e l e r , 1 958 ; S a n d l e r , 1 963 ; G r e e n , 1957; C h a s e , 1972) have emphasized the r i s k tha t c o n -g e n i t a l b l i n d n e s s w i l l serve to i s o l a t e an i n f a n t from forming adequate r e l a t i o n s h i p s . It might be a source of concern to observe a b l i n d i n f a n t us ing h i s r e m a i n i n g senses in a more' advanced or o r g a n i z e d way wi th o b j e c t s as compared to p e o p l e . S u b j e c t 5 however, showed good i n t e r a c t i o n a l s k i l l s on the t h i r d v i s i t , and i n f a c t , s h o r t l y t h e r e a f t e r moved i n t o a temporary f o s t e r home, where she aga in demonstrated her s o c i a l competence by q u i c k l y d e v e l o p i n g new r e l a t i o n s h i p s . - 77 -CHAPTER V SUMMARY, CONCLUSIONS AND RECOMMENDATIONS The purpose of t h i s study was to e x p l o r e the f u n c t i o n a l development of h a p t i c and a u d i t o r y r e s p o n s e s , in a group of c o n g e n i t a l l y b l i n d i n f a n t s . To t h i s e n d , a l o n g i t u d i n a l study l a s t i n g f i v e months, us ing o b s e r v a t i o n and i n f o r m a l t e s t i n g , was c a r r i e d o u t . S u b j e c t s c o n s i s t e d of f o u r boys and two g i r l s , r ang ing in age from 5.5 to 18 months at the commencement of the s t u d y . They were o b s e r v e d in a v a r i e t y of task s i t u a t i o n s y i e l d i n g data which c o u l d be c l a s s i f i e d a c c o r d i n g to whether i t i n v o l v e d r e s p o n s e to h a p t i c i n p u t , response to a u d i t o r y i n p u t , or the use of both a u d i t o r y and h a p t i c senses in i n t e r p e r s o n a l i n t e r -a c t i o n . The number of s u b j e c t s was too smal l f o r any d e f i n i t e c o n c l u s i o n s to be drawn, and the s t r e n g t h of the data was f u r t h e r weakened by the l o s s of two s u b j e c t s pa r t way through the study (one through a t t r i t i o n , and one because he had mastered a l l the t a s k s ) . N e v e r t h e l e s s , d e v e l o p -mental t rends were noted in a l l c a t e g o r i e s . In some c a s e s , f i n d i n g s of o t h e r r e s e a r c h e r s were s u p p o r t e d , and in o ther c a s e s , i n t e r e s t i n g v a r i a t i o n s were s e e n . Many of the b e h a v i o u r s observed had not been r e p o r t e d p r e v i o u s l y in - 78 -th e l i t e r a t u r e , and so some new i n s i g h t s were g a i n e d , p a r t i c u l a r l y with regard to the development of the t a c t i l e sys tem. In terms of programme p l a n n i n g f o r e a r l y i n t e r v e n t i o n , the o b s e r v a t i o n s made d u r i n g t h i s s tudy may be of h e l p , in d e t e r m i n i n g the most a p p r o p r i a t e sequence of a c t i v i t i e s . For example , the f i n d i n g s of Bigelow (1982) tha t t a c t i l e -k i n e s t h e t i c c o o r d i n a t i o n s o c c u r r e d wel l be fore t a c t i l e -a u d i t o r y c o o r d i n a t i o n s , were s u p p o r t e d . It thus f o l l o w s tha t t a c t i l e e x p l o r a t i o n and the t a c t i l e - k i n e s t h e t i c l o c a l i z a t i o n of o b j e c t s should be encouraged e a r l y in the i n f a n t ' s deve lopment , wel l b e f o r e he i s expected to l o c a t e and reach f o r an a u d i t o r y s t i m u l u s . S i m i l a r l y , a p r e f e r r e d sequence f o r the t e a c h i n g of a u d i t o r y l o c a l i z a t i o n and r e a c h i n g can be f o r m u l a t e d : f i r s t , the o b j e c t s h o u l d be sounded at m i d - l i n e , t r a y l e v e l . When the i n f a n t has become competent in o b t a i n i n g the n o i s y toy at t h a t l o c a t i o n , i t should g r a d u a l l y be moved l a t e r a l l y , and f i n a l l y , when the c h i l d has l ea rned to i n t e r c e p t the toy at a l l p o s i t i o n s on the t r a y i t shou ld be presented from a v a r i e t y of p o s i t i o n s above the t r a y . Other o b s e r v a t i o n s , such as the i n f a n t s ' v a r i e d r e s p o n s e s to n o v e l t y , and the problems wi th u s i n g a mus ica l s t i m u l u s f o r the purpose of - 7 9 -e l i c i t i n g r e a c h i n g , may a l s o prove u s e f u l to parents and p r o f e s s i o n a l s working wi th b l i n d i n f a n t s . O b s e r v a t i o n s of the s o c i a l responses shown by the i n f a n t s were a l s o most i n f o r m a t i v e . The importance of the parents making themselves c o n s t a n t l y a v a i l a b l e to t h e i r i n f a n t s through body c o n t a c t and v o i c e was c l e a r l y s e e n . And y e t , the r e c i p r o c a l nature of the r e l a t i o n s h i p was not easy to f a c i l i t a t e . A l though the parents needed to i n v e s t much more energy i n t o making c o n t a c t through sound and touch with t h e i r b l i n d i n f a n t s as compared wi th s i g h t e d o n e s , i t was n e c e s s a r y f o r parents to pause and a l l o w the c h i l d r e n to r e s p o n d . It had never o c c u r r e d to s e v e r a l mothers in the study to make t h e i r v o c a l i z a t i o n s d i s c o n t i n u o u s , in o r d e r to a l l o w the c h i l d r e n to v o c a l i z e in r e s p o n s e , u n t i l t h i s came up as one of the t e s t i t e m s . A barrage of t a c t i l e and a u d i t o r y i n p u t , wi th very l i t t l e o p p o r t u n i t y f o r r e a c t i o n , was seen in the case of one c h i l d , S u b j e c t 3, to r e s u l t in a degree of s o c i a l i s o l a t i o n s i m i l a r to tha t o f t e n seen in an u n d e r - s t i m u l a t e d b l i n d c h i l d . Parents have d i f f i c u l t y i n t e r p r e t i n g the s u b t l e cues they r e c e i v e from t h e i r b l i n d i n f a n t s as to how to modulate t h e i r input to best f o s t e r the d e v e l o p i n g r e l a t -i o n s h i p . It i s to be hoped tha t t h i s study w i l l p r o v i d e some u s e f u l i n f o r m a t i o n to those who must counse l - 80 -p a r e n t s , and help them i n t e r p r e t t h e i r i n f a n t ' s s i g n a l s . Developmental assessment of b l i n d i n f a n t s is c l e a r l y very d i f f e r e n t from tha t of the s i g h t e d , and s t a n d a r d i z e d i n f a n t assessments have been seen to be h e a v i l y weighted in favour of v i s u a l i tems (Sykanda, 1980) . A d a p t i n g s t a n d a r d i z e d t e s t s by e l i m i n a t i n g v i s u a l i tems i s un-s a t i s f a c t o r y , f i r s t because one i s l e f t w i th a p a u c i c i t y of i t e m s , and s e c o n d l y because the t a c t i l e - k i n e s t h e t i c and t a c t i l e - a u d i t o r y s k i l l s are not i n c l u d e d . U n t i l an i n f a n t assessment which has been s t a n d a r d i z e d on a b l i n d p o p u l a t i o n becomes a v a i l a b l e , in fo rma l o b s e r v a t i o n and t e s t i n g , us ing such tasks as were d e s c r i b e d in t h i s s t u d y , remains the most u s e f u l method of e v a l u a t i n g such i n f a n t s . Indeed, s i n c e b l i n d i n f a n t s vary so much in t h e i r a b i l i t i e s in n o n - v i s u a l domains , t h e g a t h e r i n g of t r u l y r e p r e s e n t a t i v e normat ive data r e l a t i n g to the age of s k i l l a c q u i s i t i o n , would seem very d i f f i c u l t , and perhaps of l i m i t e d v a l u e , as compared to the sequence of s k i l l a c q u i s i t i o n . It should be emphasized that no i n f a n t assessment is complete w i thout an e v a l u a t i o n of the c h i l d ' s i n t e r p e r s o n a l and a f f e c t i v e deve lopment . T h i s i s p a r t i c u l a r l y t rue f o r the b l i n d i n f a n t , who i s at r i s k f o r f a i l i n g to deve lop an adequate bond wi th h is p a r e n t s . -81 -As has been ment ioned , a l t h o u g h the number of s u b j e c t s in t h i s s tudy was s m a l l , some developmenta l t rends were noted due to c o n s i s t e n c i e s in the sequence of s k i l l ac -q u i s i t i o n . It i s impor tant to note tha t the one c h i l d wi th o ther hand icaps in a d d i t i o n to b l i n d n e s s deve loped more s l o w l y , wi th some behav iours emerging in a d i f f e r e n t sequence to t h a t of the c h i l d r e n who were o n l y b l i n d . T h i s l a t t e r p o i n t i s a very impor tant one , both on t h e o r e t i c a l as wel l as p r a c t i c a l g rounds . P i a g e t ' s theory of i n v a r i a n t o r d e r i n g of s tages of development was based on h is o b s e r v a t i o n s of p e r f e c t l y normal c h i l d r e n , but seemed to hold up f o r those c h i l d r e n in t h i s study who had on ly one h a n d i c a p , b l i n d n e s s . Could i t be that c h i l d r e n who are on ly b l i n d , d e a f , p h y s i c a l l y handicapped or m e n t a l l y handicapped may be ab le to conform to t h i s theory of deve lopment , but when there i s more than one h a n d i c a p , development i s so compromised that whatever a b i l i t i e s are p o s s i b l e , emerge h a p h a z a r d l y ? Wachs and de Reimer (1978) and Kann (1976) s t u d i e d m e n t a l l y handicapped c h i l d r e n , us ing the U z g i r i s and Hunt S c a l e s , and found tha t behav iours were a c q u i r e d in the same s tage sequence as non-hand icapped c h i l d r e n . S i m i l a r r e s u l t s were found with c e r e b r a l p a l s i e d c h i l d r e n ( T e s s i e r , 1969 /70 ) , t h a l i d o m i d e - a f f l i c t e d c h i l d r e n ( D e c a r i e , 1969) , and deaf c h i l d r e n (Best and R o b e r t s , 1976) . L i t t l e i s known, - 8 2 -however, of the e f f e c t on developmental sequences when the compounding e f f e c t of s e v e r a l hand icaps e x i s t s . Another i n t e r e s t i n g q u e s t i o n that a r i s e s i s whether the very young i n f a n t ' s response to sound i s r e l a t e d to h is u l t i m a t e degree of u s e f u l v i s i o n . In t h i s s t u d y , the t u r n i n g of the head towards the source of a sound in two seeming ly b l i n d i n f a n t s a p p a r e n t l y p r e d i c t e d l a t e r u s e f u l v i s i o n . T h i s was an unexpected f i n d i n g not s u p p o r t e d by the l i t e r a t u r e , but we l l worth i n v e s t i g a t i n g u s i n g a much l a r g e r sample of b l i n d i n f a n t s . To a modest d e g r e e , t h i s study has added to the body of i n f o r m a t i o n known about the development of b l i n d i n f a n t s ' use of t h e i r h a p t i c and a u d i t o r y s e n s e s . S i n c e at l e a s t one i n f a n t in t h i s s tudy mastered a l l the t asks a c c o r d i n g to the e s t a b l i s h e d c r i t e r i a , one i s l e f t wonder ing what the next deve lopmenta l s teps would be. A need f o r ongo ing r e s e a r c h i n t o the f u r t h e r development of the h a p t i c and a u d i t o r y responses in the b l i n d t o d d l e r and p r e - s c h o o l e r would seem i n d i c a t e d . I t i s hoped tha t the t e s t i n g and o b s e r v a t i o n a l methods used in t h i s s t u d y , as f a r as they went, w i l l be u s e f u l to o thers who wish to study the development of b l i n d i n f a n t s . With the e x c e p t i o n of the a forement ioned items which were - 8 3 -d i s c a r d e d , a l l o ther t e s t i tems were s u c c e s s f u l in demon-s t r a t i n g t rue developmenta l change. That i s to s a y , f o l l o w i n g the f i r s t o b s e r v a t i o n of a new developmenta l s k i l l i n v o l v i n g the a u d i t o r y or h a p t i c s e n s e s , i t c o n t i n u e d to be d e m o n s t r a t a b l e with good r e l i a b i l i t y at subsequent v i s i t s . F u r t h e r m o r e , the v a r i o u s p r o c e d u r e s were r e l a t i v e l y s i m p l e , wi th no need f o r c o m p l i c a t e d equipment or methods. The d e s c r i p t i o n s of the t e s t s and c r i t e r i a f o r mastery were c l e a r enough to produce an i n t e r r a t e r agreement of 98%, and so r e p l i c a t i o n shou ld be p o s s i b l e . S i n c e the i n c i d e n c e of severe c o n g e n i t a l b l i n d n e s s i s r a r e , b l i n d i n f a n t s tend to be l o c a t e d in s c a t t e r e d l o c a t i o n s , making a comprehensive l o n g i t u d i n a l s tudy by one r e s e a r c h e r i m p o s s i b l e to c a r r y o u t . However, a c o o r d i n a t e d e f f o r t u s i n g a number of p r o f e s s i o n a l s working wi th b l i n d i n f a n t s in a v a r i e t y of l o c a t i o n s may r e s u l t in a g r e a t e r volume o f d a t a , c o l l e c t e d through o b s e r v i n g a l a r g e r number of i n f a n t s . It i s t h e r e f o r e p lanned to produce a d a t a - g a t h e r i n g t o o l , in the form on an i n d i v i d u a l deve lopmenta l c h e c k - l i s t , us ing the task items from t h i s s t u d y . T h i s c h e c k - l i s t can be kept in the f i l e of a b l i n d i n f a n t r e c e i v i n g r e g u l a r v i s i t s on an i n t e r v e n t i o n programme. By r e c o r d i n g the date upon which each new s k i l l was f i r s t o b s e r v e d , the -84-sequence of developmenta l use of the h a p t i c and a u d i t o r y senses can be demonstrated f o r each c h i l d thus f o l l o w e d . 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Wachs, T. D. and deRemer, P. A d a p t i v e behav iour and U z g i r i s - H u n t S c a l e per formance of young d e v e l o p m e n t a l 1 y de layed c h i l d r e n . American J o u r n a l of Mental D e f i c i e n c y , 1978, 83, 171-176. Warren, D. H. B l i n d n e s s and e a r l y deve lopment : what i s known and what needs to be s t u d i e d . New Out look f o r the  B l i n d , 1976, 70, 5-16. Warren, David H. B l i n d n e s s and E a r l y C h i l d h o o d D e v e l o p - ment. New York: American Foundat ion fo r the B l i n d , 1977. Wer the imer , M. Psycho-motor c o o r d i n a t i o n of a u d i t o r y -v i s u a l space at b i r t h . S c i e n c e , 1961, 134, 1692. -9 2-Whi te , B. L . ; C a s t l e , P, and H e l d , R. O b s e r v a t i o n s on the development of v i s u a l l y d i r e c t e d r e a c h i n g . C h i l d D e v e l o p - ment, 1964, 35 , 349-364. W r i g h t , H. F. O b s e r v a t i o n a l c h i l d study in P. H. Mussen (Ed . ) Handbook of Research Methods in C h i l d Development , New Y o r k , W i l e y , 1960. Y a k o v l e v , P. I. and L e c o u r s , A. R. in A . Minkowski (Ed . ) Reg iona l Development of the B r a i n in E a r l y L i f e . O x f o r d , B l a c k w e l l , 1967. Yarrow, L. J . ; P e d e r s e n , F. A. A t tachment : i t ' s o r i g i n s and c o u r s e . Young C h i l d r e n , 1972, 302-312. - 9 3 -APPENDIX A Dear p a r e n t ; I am a p h y s i o t h e r a p i s t with c o n s i d e r a b l e e x p e r i e n c e in working wi th b l i n d c h i l d r e n in the V i s u a l l y Impaired Programme at C h i l d r e n ' s H o s p i t a l D i a g n o s t i c C e n t r e , and am c u r r e n t l y comple t ing a Masters Degree in S p e c i a l E d u c a t i o n . I am r e o u e s t i n g your p e r m i s s i o n to i n c l u d e your c h i l d in a study aimed at f i n d i n g out more about how b l i n d c h i l d r e n l e a r n to use t h e i r o t h e r senses to l e a r n about the w o r l d . S p e c i f i c a l l y , I would l i k e to v i s i t your c h i l d at home at two week i n t e r v a l s f o r the next f i v e months, at a time which i s conven ien t f o r y o u . Dur ing each v i s i t I w i l l s imp ly p lay wi th your c h i l d , us ing a v a r i e t y of t o y s , n o t i n g the way in which he uses h i s touch and h e a r i n g . V i s i t s w i l l l a s t about an h o u r , and the a c t i v i t i e s w i l l be p l e a s a n t and n o n - t h r e a t e n i n g f o r your c h i l d . Your p a r t i c i p a t i o n is c o m p l e t e l y v o l u n t a r y , and o ther s e r v i c e s you may be r e c e i v i n g w i l l not be a f f e c t e d . -94-Appendix A ( c o n t i n u e d ) N a t u r a l l y , you are c o m p l e t e l y f r e e to drop out of the p r o j e c t at any time tha t i t becomes i n c o n v e n i e n t f o r the v i s i t s to c o n t i n u e . Your c h i l d ' s name w i l l not be used in r e p o r t i n g the r e s u l t s . H o p e f u l l y , knowledge gained from t h i s study w i l l be of b e n e f i t to both paren ts and p r o f e s s i o n a l s who are c a r i n g f o r b l i n d i n f a n t s . S i n c e r e l y , Ann Sykanda I would be w i l l i n g to p a r t i c i p a t e in your s t u d y . Name , Address Te lephone - 9 5 -APPENDIX D EQUIPMENT LIST 1. 5 - 1" b l o c k s 2. Small squeeky toy c a t e r p i l l a r 3. Small square F i s h e r - P r i c e Music Box 4. H a n d e r c h i e f 5. Small p l a s t i c bowl 6. L o n g - h a n d l e d , l i g h t - w e i g h t Tommy T i p p e v R a t t l e 7. Wooden r a t t l e wi th b e l l s 8. F i s h e r - P r i c e l o c o m o t i v e on a s t r i n g 10. Wooden peg-board wi th 3/4" dowl ing p e g s . 11. F i s h e r - P r i c e A c t i v i t y Centre - 96 -APPENDIX C S u b j e c t Mo: Date: V i s i t No: Data Sheet No. 1 - General O b s e r v a t i o n s 1. M o t h e r ' s r e p o r t of changes s i n c e l a s t v i s i t : 2. I n f a n t ' s s t a t e , spontaneous a c t i v i t y , p r e f e r e n c e s , e t c . -97-APPENDIX D S u b j e c t No: B i r t h d a t e : Data Sheet No. 2 - S p e c i f i c Behav iours V i s i t Number E l i c i t i n g s i t u a t i o n s 1 2 3 4 5 6 7 8 9 1 0 Ha a) nds t o : mouth b) t o g e t h e r c) t runk d) l egs e) f e e t Mother holds a) s t i l l s and t a l k s b) s m i l e s c) e x p l o r e s body d) e x p l o r e s face e) v o c . to c o o i n g f ) v o c . to babble g) i m i t a t e s c o o i n g h) i m i t a t e s babble i ) i m i t a t e s word Mother p lays a ) r e - i n s t i t u t e s bounce b) r e - i n s t i t u t e s p . t . s i t c) r e - i n s t i stand t u t e s p . t . d) i m i t a t e s c l a p p i n g e) i m i t a t e s t a p p i n g f ) hands toy - 9 8 Appendix D ( c o n t i n u e d ) E l i c i t i n g s i t u a t i o n s 4. Handed to s t r a n g e r a) q u i e t s b) squ irms & c r i e s 5. Mother l e a v e s room a) c r i e s b) c rawls to c a l l c) c raw ls to f o o t s t e p s 6 . A n t i c i p a t e s from a) b ib b) sound of food p r e p . c) bath d) " o u t i n g " sounds 7. T a b l e a) s c r a t c h e s b) g rasps o b j e c t c) random search d) method ica l search 8. Toy a) grasps b) mouths c) t r a n s f e r s d) e x p l o r e d f a c t u a l l y e) tu rned over 9. Music box a) t u r n s to sound b) reaches at m i d l i n e c) l a t e r a l l y at t a b l e l e v e l d) m u l t i - d i r . reach 99- . V i s i t Number 1 2 3 4 5 6 7 8 9 1 0 e) f i n d s under h a n d k e r c h i e f f ) f i n d s under bowl 10. R a t t l e ( t a c t i l e c o n t a c t ) a) r e p e a t s shake b) finds aga in on t r a y c) f o l l o w s on removal d) hand movements at sound e) reaches sound cue (m i d - 1 i n e ) 11. F a m i l i a r r a t t l e , no p r i o r c o n t a c t a) tu rns b) hand movement c) reach at m i d - l i n e d) l a t e r a l l y at t a b l e l e v e l e) m u l t i - d i r . reach 12. U n f a m i l i a r r a t t l e , no p r i o r c o n t a c t a) tu rn s b) hand movement c) reach at m i d - l i n e d) l a t e r a l l y at t a b l e l e v e l e) m u l t i - d i r . reach 13. A c t i v i t y Centre a) e x p l o r e s - one b) " -two c) " - t h r e e d) f i n d s f a v o u r i t e Appendix D ( c o n t i n u e d ) E l i c i t i n g s i t u a t i o n s -1 00-Appendix D (con t inued ) E l i c i t i n g s i t u a t i o n s V i s i t Number 2 3 4 5 6 7 10 14 V a r i e t y of toys a) e x p l o r e s b) p r e f e r e n c e s c) shakes a l l d) bangs a l l e) mouthes a l l f) a l l a c t i o n s on one g) p u l l s s t r i n g (demo h) p u l l s s t r i n g (no d i ) in and out j ) s t a c k s k) a 1 i g n s 1) peg 15. C h i l d on f l o o r a) c o n t i n u o u s sound b) n o n - c o n t i n u o u s sound c) random search d) method ica l search e) " s t a s h e s " -101-APPENDIX E Key to Behav iour in Data Sheet Mo. 2 1. C h i l d l i e s on back , c o m f o r t a b l e and happy but w i thout toys in the hands; d u r i n g a f i v e minute p e r i o d of o b s e r v a t i o n c h i l d w i l l b r i n g hands to a) mouth b) t o g e t h e r c) t runk d) l e g s e) f e e t 2. Mother ho lds i n f a n t in the en f a c e p o s i t i o n in the curve of her arm ( f o r o l d e r i n f a n t s , too l a r g e or a c t i v e to be h e l d , c h i l d can be p laced s i t t i n g a s t r i d e her l a p , f a c i n g h e r ) ; d u r i n g a f i v e minute o b s e r v a t i o n p e r i o d , whi le mother t a l k s or s i n g s to i n f a n t , he w i l l a) become s t i l l , eyes widen b) smi le c) reach f o r m o t h e r ' s body (hand, arm, s h o u l d e r , b r e a s t ) d) reach f o r m o t h e r ' s face e) v o c a l i z e s sounds (o ther than c r y i n g ) in response to coo ing sounds from mother (vowel sounds made wi th r i s i n g and f a l l i n g p i t c h ) f ) v o c a l i z e s sounds (any th ing other than c r y i n g ) in response to m o t h e r ' s b a b b l i n g (bababa , dada e t c -w i th c o n s o n a n t s ) . g) i m i t a t e s coo ing - at tempts to r e p l i c a t e sound wi th i n t o n a t i o n -1 02-Appendix E ( c o n t i n u e d ) h) i m i t a t e s babble - a t tempts to r e p l i c a t e sound wi th consonants i ) i m i t a t e s word 3. Mother ho lds i n f a n t on lap and p l a y s w i th h im; he w i l l a) a f t e r being bounced on lap f o r about 1 minute and a b r u p t l y s t o p p e d , j i g g l e to s i g n a l d e s i r e to r e - i n s t i t u t e the game b) a f t e r be ing p u l l e d to s i t f i v e t i m e s , w i l l p u l l on Mom's hands as a s i g n a l to r e - i n s t i t u t e game c) a f t e r be ing p u l l e d to stand e t c . (as above) d) i m i t a t e a f t e r mother c l a p s hands ten t imes (wi thout her say ing "pat a cake") e) i m i t a t e a f t e r mother taps t a b l e th ree t i m e s , repea ted f i v e t imes (does not have to n e c e s s a r i l y repea t p a t t e r n ) f ) hand toy to mother on reques t (mother g i v e s a u d i t o r y or t a c t i l e cue as to p o s i t i o n of her hand) then s u p i n a t e forearm to r e c e i v e toy back . 4 . Mother hands i n f a n t to examiner , w i thout much p r e -p a r a t i o n ; c h i l d w i l l a) q u i e t , mold to examiner b) c ry and squirm 5. Mother l e a v e s room, making sure her f o o t s t e p s are a u d i b l e ; c h i l d w i l l a) c ry -1 03-Appendix E ( c o n t i n u e d ) b) c r a w l ; a f t e r mother when she c a l l s c) crawl a f t e r f o o t s t e p s d) c a l l mother by name 6. C h i l d shows exc i tement ( l a u g h s , v o c a l i z e s , i n c r e a s e s arm and leg a c t i v i t y , or uses words) when mother a) puts b ib on him b) p repares food with t y p i c a l n o i s e c ) pours bath d) p repares f o r o u t i n g wi th t y p i c a l n o i s e (can be by parent r e p o r t ) . 7. C h i l d seated in c h a i r wi th t r a y , or at t a b l e on Mom's knee; c h i l d happy and a l e r t , w i thout a toy i n i t i a l l y ; d u r i n g a two minute o b s e r v a t i o n p e r i o d c h i l d w i l l a) s c r a t c h t r a y b) grasp a 1" b lock on t r a y when hand a c c i d e n t a l l y c o n t a c t s i t c) search around f o r o b j e c t s on t r a y (w i th hands f l a t ) b u t not c o v e r i n g a l l of t a b l e d) sea rch m e t h o d i c a l l y , so t h a t a l l a reas w i t h i n reach are c o v e r e d . 8. C h i l d i s seated as above; toy c a t e r p i l l a r i s moved a c r o s s t r a y u n t i l i t c o n t a c t s hand; w i t h i n a two minute o b s e r v a t i o n p e r i o d c h i l d w i l l a) grasp toy b) b r i n g to mouth c) t r a n s f e r hand to hand -1 04-Appendix E ( c o n t i n u e d ) d) e x p l o r e near s i d e wi th f i n g e r s e) tu rn over to e x p l o r e o ther s i d e 9. C h i l d i s seated as above; " F i s h e r - P r i c e " music box is wound up and a) he ld to s i d e of c h i l d , about 12" from h is e a r ; w i t h i n 5 seconds c h i l d w i l l o r i e n t h i s head towards the sound. b) p l a c e d on t a b l e or t r a y at m i d - l i n e , w i t h i n arms-l e n g t h r e a c h ; w i t h i n 10 seconds c h i l d w i l l reach and touch or grasp music box c) p l a c e d l a t e r a l l y on t r a y near the s i d e , c h i l d w i l l reach and grasp w i t h i n 10 seconds d) he ld about 12" above the l e v e l of the t r a y , and to the s i d e but w i t h i n i n f a n t ' s a r m s - r e a c h ; he w i l l reach and grasp w i t h i n 10 seconds e) covered wi th a h a n d k e r c h i e f , c h i l d w i l l remove c l o t h and o b t a i n w i t h i n 1 minute f ) covered wi th an i n v e r t e d bowl , c h i l d w i l l remove bowl and r e c o v e r w i t h i n one minute 10. C h i l d i s seated as above , l o n g - h a n d l e d r a t t l e p laced in hand (Tommy T i p p e e ) , t e s t e r grasp c h i l d ' s hand and shakes r a t t l e ; c h i l d w i l l a) repeat shake w i t h i n 5 seconds b) p l a c e r a t t l e on t a b l e or t r a y and f i n d aga in w i t h i n 1 minute c) fol iovy wi th hands in c o r r e c t d i r e c t i o n when r a t t l e removed d) opens and c l o s e s hands at sound - 1 0 5 -Appendix E ( c o n t i n u e d ) e) reach at m i d - l i n e to o b t a i n a f t e r r a t t l e removed and immedia te ly shaken . 11. C h i l d i s seated as above; c h i l d ' s own r a t t l e shaken w i thout p r i o r t a c t i l e c o n t a c t a) to the s i d e , about 12" away from e a r , w i t h i n 5 seconds c h i l d w i l l o r i e n t head to sound b) opens and c l o s e s hands as i f t o grasp c) i f r a t t l e shaken at m i d - l i n e , w i l l reach and o b t a i n w i t h i n 10 seconds d) i f r a t t l e shaken l a t e r a l l y at t r ay l e v e l , w i l l reach and o b t a i n w i t h i n 10 seconds e) i f r a t t l e shaken about 12" above the l e v e l of the t r a y or t a b l e , and to the s i d e but w i t h i n arms r e a c h , he w i l l reach and grasp w i t h i n 10 s e c o n d s . 12. As a b o v e , but wi th an u n f a m i l i a r r a t t l e , with a d i f f e r e n t sound. 13. C h i l d i s seated as a b o v e , w i th F i s h e r - P r i c e A c t i v i t y Cent re propped or he ld v e r t i c a l l y w i t h i n r e a c h ; c h i 1 d wi 11 a) e x p l o r e with f i n g e r s , f i n d i n g one items in 2 minutes b) e x p l o r e with f i n g e r s , f i n d i n g three items in 2 minutes c) e x p l o r e wi th f i n g e r s , p l a y wi th a l l i tems i n 2 minutes d) demonstra te s p a t i a l memory by r e t u r n i n g to f a v o u r i t e a c t i v i t y ( a f t e r hands removed from i t ) th ree t imes in 2 m i n u t e s . -1 06-Appendix E ( c o n t i n u e d ) 14. C h i l d i s seated as above , w i th a v a r i e t y o f toys on t r a y ; he w i l l a) touch al1 randomly b) r e c o g n i z e f a v o u r i t e (shown by r e j e c t i n g o t h e r s in t u r n , but r e t a i n i n g f a v o u r i t e ) c) shakes a l l toys p i c k e d up d) bangs a l l toys p icked up e) mouthes a l l toys p i c k e d up f ) performs a l l above a c t i o n s (and o t h e r s ) on one toy in an exper imenta l manner g) o b t a i n s wheeled toy by p u l l i n g s t r i n g a f t e r d e m o n s t r a t i o n w i t h i n 30 seconds h) o b t a i n e d wheeled toy by p u l l i n g s t r i n g w i thou t d e m o n s t r a t i o n w i t h i n 30 seconds i ) puts o b j e c t s in c o n t a i n e r j ) puts one o b j e c t on top of another on r e q u e s t k) puts one o b j e c t bes ide another on r e q u e s t 1) p l a c e s peg in hole by f e e l i n g wi th one hand, p l a c i n g wi th o ther 15. C h i l d i s s i t t i n g f r e e l y on f l o o r a) music box a c t i v a t e d f o u r f e e t away, c h i l d w i l l crawl or h i t c h to o b t a i n w i t h i n 1 minute b) r a t t l e or o ther d i s c o n t i n u o u s sound a c t i v a t e d f o u r f e e t away, c h i l d w i l l crawl or h i t c h to o b t a i n w i t h i n 1 minute c) on r e q u e s t , c h i l d w i l l search f o r toy where he i s used to f i n d i n g i t , w i t h i n 1 minute -107-Appendix E ( c o n t i n u e d ) d) on r e q u e s t , w i l l m e t h o d i c a l l y sea rch room f o r t o y , c o v e r i n g a l l f l o o r a r e a , and f i n d w i t h i n 2 minutes e) w i l l p l a c e toys in r e l a t i o n to f i x e d o b j e c t s , in o rder to be ab le to f i n d again (parent r e p o r t ) 

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