Vision’s Link to Development
I was conducting a retinoscopy workshop in Thorkild Rasmussen’s office in Denmark in 2012 and saw the book, Developmental Diagnosis by Gesell and Amatruda on his bookshelf. I though I had seen all of Gesell’s books and had a copy of most but this was not one I had seen. When I turned to the third page in the Blindness chapter, the words below struck a chord that sent my mind into a tailspin. I began thinking about that comment throughout the rest of the workshop.
“The infant is born with visual hunger.”1
This statement solidifies why vision was so essential in Gesell’s thinking and writing. The above statement was followed with: “…so fundamental is the sense of vision that it is the traditional criterion of wakefulness as opposed to sleep. An infant does not really wake up until he begins to look and when he ceases look, he goes to sleep.”1
What is involved in this process of looking? What motivates a child to LOOK? Does LOOKING just happen by accident? When does looking begin? What is LOOKING beyond simple pointing of eyes toward an object or person?
LOOKING is a motor action by the individual. An intentional act. A reach into their surroundings. The developing child first responds without intention – all processes all at once in reaction to light, sound, touch, smell, and taste. However, it is very soon after birth that the responses become intentional and LOOKING begins. Looking becomes the first responder to light, sound, touch, smell, and taste. As these motor reaches evolve, the sensory processes evolve, i.e., as looking becomes better directed and controlled, seeing improves.
This concept is laid out by Gesell and discussed in the introductory episode, “..vision and the action system are so interfused that they must be considered inseparable.” LOOKING is an intentional action in response to many stimuli – light, sound, touch, smell, and even taste. Too often, we only consider vision as a response to light, however it is so very much more. We do respond to light but we also look in response to a touch, to a sound, to a smell, and even to a taste. When we look, movement slows, babbling decreases, and attention grows to allow full overall attention to be directed toward the stimulus which has become the object of visual attention.
In his book, Mind: A Journey to the Heart of Being Human , Daniel Siegel, MD makes the statement: “Where attention goes, neural firing flows and neural connection grows.”2 This is a great statement that is easily accepted. I suggest that because we can alter that from a visual point of view to say, “Where vision goes, engagement flows, and readiness connections grow.”
Gesell’s research captured the behaviors of over 10,000 babies from birth through age 16. Many of these are recorded in cinematography (video) at regular stages and periods through development and printed in the book Infant Development. Of particular interest is the baby at four months of age (p 18). Gesell states: “He moves his eyes, selectively: he looks from cube to hand and then back again from hand to cube. His eyes fasten on the test object, and they maintain a firm grasp. The hands are activated even though they cannot as yet obey precisely. It is again evident that the eyes have a top priority in the scheme of development. He can reach with his eyes but not with his hands.”3
This observation and subsequent recordings show that the eyes and intentional looking are in action well before the hands have sufficient ability to move toward or grasp the target. This is a concept often missed in the study of development. We look at the milestone of grasp as a first stage when we should be making observations of visual attention and focus, visual stability and sustainability, and how they let go to allow for ensuing engagements. By the time we observe the hands becoming accurately engaged, the eyes and vision have long established patterns for such engagement and the hands follow these patterns established through vision.
Does this pattern carry throughout life? If we observe the visual actions and patterns of developing children from early ages, these actions and patterns become the scaffolding for establishing default patterns of looking that are carried forward until redirected. If they are sufficient for engagement in the expected cultural activities (meeting a milestone), it is usually assumed that everything is “OK with the eyes.” However, we can only know if this is actually sufficient when we take the time to LOOK.
“What we do see depends mainly on what we look for.”4 Indeed, what the infant sees depends on what he looks for. This is not a new and unique concept and it is established early in life. Default patterns of engagement are established early in life and are set in motion through framework established in early patterns of LOOKING. The process of LOOKING then becomes a guide for all of development.
So where and how we look becomes the scaffolding for where and how we engage in the tasks and activities later in life. From the organization Zero to Three, it is stated that, “School readiness begins at birth.” I would suggest that life readiness begins at birth and vision emerges the primary explorer, instigator, initiator, and influencer of action and engagement of life beginning at birth. In the process of development, vision must emerge as the first responder in response to stimuli from all processes. As we accept this understanding, our role in early development must come to the forefront. When even minor aspects of vision are delayed, overall development is delayed.
References
Gesell and Amatruda, Developmental Diagnosis, Hoeber 1941
Siegel, D Mind: A Journey to the heart of being human, W.W. Norton 2017
Gesell, A, Infant Development, p 18 1952
Lubbock, John, The Beauties of Nature and the Wonders of the World We Live In, Macmillan, New York 1893