MANNERISMS OR BLINDISMS
What are blindisms?
Blind and children with low vision frequently engage in what may seem to their parents to be rather strange and disturbing behaviour. Repetitive, self-stimulating mannerisms are almost universally enjoyed by blind children and almost universally worried about by their parents.
The developing brain wants input, both visual and motor. If there is not enough meaningful input through normal activity, the child then turns to his own body and uses repetitive mannerisms such as body rocking, head swaying, hand shaking, body spinning, eye poking or rubbing to provide such input.
“Eyes are buttons to push” was Kaare’s reply when asked what his eyes were for. Pressing one or both eyes is the most common of what are known as mannerisms. Apparently, pressure on the eyeball results in a pleasurable sensation to the child, who finds it both entertaining and relaxing. When a child presses his eyes, electrical currents are produced in the retina. It has been found that most children with atrophy of the optic nerve or cortical blindness hardly press their eyes because the messages to the brain or in the brain are blocked. Interestingly, the children with the retinal disorders are the most avid eye-pressers. Also, it has been found that the multi-disabled visually impaired child often engages in these self-stimulating mannerisms.
When a visually impaired child is about 12 months old, his parents may notice a lot of eye rubbing, and they naturally assume the child is sleepy or has uncomfortable, sore, teary or burning eyes – problems that could be related to the visual impairment. This eye rubbing is however the beginning of eye-pressing/poking. (Parents are therefore encouraged to stop the constant eye rubbing, as soon as this is noticed in the visually impaired baby). By 18 months of age the child may be doing the following: child may put the tip of the thumb up under the bone above the eye and press with a knuckle on the eye itself, a bent forefinger may be used in much the same way; or the child may like to lie on the floor with the head resting either on the back knuckles of both hands or on the closed fists. A child may favour one eye or press them both. Few blind children have been observed sucking their thumbs, and the few who do are rarely eye pressers. These children press their eyes in much the same way that other children would suck their thumbs, that is when they are tired, anxious, bored or in any situation when they need comforting.
While it does not look strange to see a young child apparently rubbing/holding his hand on his eyes, it does look strange in an older child and is an extremely difficult habit to break once it has become established. Many blind teenagers still resort to eye pressing when listening to music or when daydreaming. They say they are unaware of doing it, at the same time they do however acknowledge that it feels good. Unfortunately there are some negative effects of continued pressure on the eyes. Children who are habitual eye pressers commonly have deeply depressed eyes and considerable discoloration almost like big black circles – around their eyes, which obviously may detract somewhat from their appearance. The eyes seem to be literally pressed into their heads. As the child gets older it becomes more and more socially inappropriate for him to engage in this type of self-stimulating behaviour.
Another very common mannerism is rocking. Almost all babies like to rock back and forth when they first learn to sit up. They find that if they are put on a couch and rock vigorously against the back of the couch it shoots them forward and this is a lot of fun! As sighted children find so many other ways to entertain them, they naturally give up rocking and busy themselves in other ways. They visually impaired child however is much more limited in choosing other activities and therefore tends to use rocking more for entertainment – it feels good and relaxing. The blind child tends to become hooked on it as a way of spending time when no one suggests a more attractive alternative. Since rocking is pleasurable, the child should be taught from a young age already that it is quite okay to rock on a rocking horse/rocking chair or swing, but constant rocking against the back of the couch is not!
Spinning around and around in circles is another mannerism observed in blind children. They report that it “feels nice”, and they do not get dizzy and fall down!
Some children with some residual vision are greatly attracted to bright lights and will spend hours gazing at the sun or fluorescent lights, it is almost impossible to attract their attention without removing them from the light source. About half of light gazers will also play with shadows by waving their fingers in front of their eyes against the light.
I hear you say: “my child has already developed these mannerisms/blindisms – what can I do to get him to stop!!” You may find the following suggestions helpful.
Please be patient with your child – if he has been eye pressing for the past 2 or 3 years, he is not going to stop overnight merely because you tell him to stop! It will take time.
Do all you can to break these habits, but do not nag! The more you nag, the more the child presses his eyes and rocks, perhaps because the nagging makes him anxious and sad and he then needs to comfort himself, and what does he do to find comfort? Yes, he eye-presses or rocks or even more!
Instead, distract him and get his attention into doing something different or meaningful e.g.: if he is hand flapping, substitute that behaviour with banging on a drum or clapping his hands along to a song!
Alternatives to body rocking are rocking on a rocking horse, a rocking chair, or a swing, or dancing rhythmically to some music.
Praise your child when you observe that he is not eye pressing or body rocking etc … reinforcing his good behaviour may lead to a decrease in the negative behaviour.
Consider rewarding your child when you observe that he is not engaged in self-stimulating behaviour e.g. give him his favourite snack; play one of his favourite games with him; big hugs and lots of hand-clapping are some ways to reward his good behaviour.
Remember- this is a tedious process, which requires much patience, much repetition, and much commitment from you. Also remember however the long-term goal- allowing your child to develop good social skills.