Dr. Mary Morse, an educational consultant with a private practice in Pembroke, New Hampshire, provides assessments, in-service training and consultations on behalf of children with special needs throughout the United States and Canada. We are grateful to Dr. Morse for allowing us to present her work in Reaching Out. Dr. Morse stresses that we also need to examine possible physiological reasons for gaze averting behavior.
"Why won't my baby look at me?" is the cry often heard from languished parents by Dr. Mary Morse. "It does not mean that your baby doesn't love you," Dr. Morse, an educational consultant, is quick to point out. "If your child is multiply-handicapped and visually impaired, as is frequently the case with children with CdLS, your child may be avoiding stimulation that cannot be processed."
Normal infants seem to come pre-programmed to shape the information they receive through their senses into meaning. One of the first intentional acts of newborns is to look around at their surroundings, pay attention to what they see and assign meaning to it. Newborns also seem to have built-in protection against receiving too much visual stimulation: their optimal focal range is about 8 inches, the distance from which adults normally interact with infants. A newborn gazes up at the face of the adult and makes eye contact, thereby engaging in an important form of social interaction and pre-linguistic communication. As infants mature, their focal range expands and their gaze behaviors become more complex and varied.
Gaze averting is a visual mechanism used in much the same as a pause in a conversation, that is, to give ourselves time to process the visual information we have received. Averting our gaze can also indicate that we perceive a task as too difficult, that we are feeling uncertain, or that we are feeling stressed. Interestingly, studies on adults have found that more dominant persons tend to gaze more frequently, for a longer period of time and at a greater range of stimuli, while more submissive persons tend to focus their gaze on neutral and non-threatening places.
Many multiply-handicapped and visually-impaired children, including children with CdLS, may not engage in normal gaze behaviors. For example, they may use peripheral vision more frequently than direct gazing, which may be because they have greater difficulty in choosing which of the varied stimuli before them should receive their attention. It has also been found that children who are lower functioning show greater sensory rejection and greater sensitivity to stimulation in their environment. Despite this, they appear to be more susceptible to changes in their environment than children who are higher functioning.
Dr. Morse concludes that many children with multiple handicaps have difficulty in determining when and how to respond to multiple stimuli in their environment. They react by engaging in "stimulus over-selectivity," that is, by responding to only part, and perhaps an irrelevant part, of the stimulus. As the visual cues from the environment grow more complex and more demanding, the children experience greater difficulty in processing the sensory in- formation. They may resort to gaze averting as a way of handling this sensory overload.
Thus, many children with multiple handicaps engage in unusual gaze behaviors in an effort to minimize the negative effects of an overly challenging environment. Knowing this, the parent and the professional should assess the environment from the child's point of view and make such changes to the environment as to accommodate the child's sensory needs.