Bathelt, JMC; (2015) Neural and socio-cognitive sequelae of congenital visual impairment during midchildhood. Doctoral thesis , UCL (University College London).

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Abstract

Previous studies identified cognitive difficulties in individuals with congenital visual impairment that significantly impacted on wellbeing and educational attainment. However, factors leading to adverse outcome remained unclear. The current study aimed to identify associations and mechanisms of specific cognitive deficits associated with visual impairment from a neurodevelopmental perspective. Based on recent theoretical advances (Johnson, 2011), it was assumed that visual impairment leads to differences in cognition by influencing experience-driven brain maturational processes, which support the integration between cortical areas to support cognitive processes. In order to explore this hypothesis, children with visual impairment due to disorders that were thought to only affect peripheral sensory parts of the visual system were assessed on neuropsychological instruments covering a range of functional domains. Further, structural and functional neurophysiological methods were employed to establish the impact of visual impairment on brain organisation. The results of the present work confirm earlier reports of specific deficits in spatial memory, social understanding, and aspects of executive function, despite typical performance in other domains. In addition, the current study is the first study to indicate dosage-dependence with some aspects of social communication being even impaired in children with only mild to moderate visual impairment, while aspects of executive function and spatial memory were only found to be deficient in children with more severe forms of visual impairment. Further, neurophysiological investigations indicated differences in structural and functional brain organisation in children with VI that related to differences in behavioural performance. In general, the results of the present study suggest that visual sensory impairment impacts on brain and cognitive development with important implications for education and clinical treatment of children with visual impairment.

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