This article describes a study of the manual development of 148 blind, visually impaired and visually impaired multi-handicapped children and adolescents between the ages of three and nineteen. The study was undertaken to determine the extent to which object manipulation, tool use and speech express active interaction and communication within the environment. Both manual function and speech depend upon interaction for their optimal development. The data derived from questionnaires confirmed the importance of interaction. The data also showed an inverse relationship between object manipulation and stereotypic hand mannerisms.
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