Children with Visual Impairments Chapter 11 Children with Visual Impairments © 2012 Cengage Learning. All rights reserved.

Definitions Blind Legal - visual acuity is 20/200 or less Educational - cannot use vision for learning Low Vision Legal visual acuity is 20/70- 20/200 Education - can use vision for learning with modifications Visual impairments fall along a continuum ranging from normal vision to blindness. If the child can see only at 20/200 or less, then the child is legally blind. A child with vision between 20/70 and 20/200 is legally partially sighted. Within the educational environment, visual impairment classifications are described as moderate, severe, and profound—based not on visual acuity but on the type of special educational services needed to help the child reach optimal learning and achievement. © 2012 Cengage Learning. All rights reserved.

Prevalence Rate of Visual Impairments is 4 per 10,000 in individuals in the school population. From U.S. Department of Education, 2003. Children with visual impairments qualify as having a low-incidence disability and make up a very small percentage of the school population. There are only about 4 of these children for every 10,000 students (U.S. Department of Education estimate, 2003). It has been estimated that the prevalence of children with visual impairments who have dual or multiple disabilities may be over 50 percent (Hatlen, 1998). © 2012 Cengage Learning. All rights reserved.

The Eye Vision or visual interpretation is a function of the brain, experience, and the adequacy of the sense organ that receives stimuli from the outside world—the eye (Figure 11.1). The eye has been called the camera of the brain. The iris, a colored muscular partition, expands and contracts to regulate the amount of light admitted through the central opening, or pupil. Behind the iris is the lens, an elastic biconvex body that focuses onto the retina the light reflected from objects in the line of vision. The retina is the light-sensitive innermost layer of tissue at the back of the eyeball. It contains neural receptors that translate the physical energy of light into the neural energy that results in the experience of seeing. The cornea is the transparent anterior (front) portion of the tough outer coat of the eyeball. The ciliary muscles change the shape of the lens so the eye can focus on objects at varying distances. © 2012 Cengage Learning. All rights reserved.

Causes of Visual Impairments Hereditary conditions Infectious diseases Injuries Retinopathy of prematurity To further understand the causes of legal blindness, it is important to realize that two-thirds of prenatal influences are hereditary. Visual impairments can be caused by hereditary conditions, infectious diseases such as rubella, cancer, injuries, and environmental conditions. Retinopathy of prematurity is a disorder that is associated with the over administration of oxygen to premature infants as well as low birth weight. © 2012 Cengage Learning. All rights reserved.

Characteristics Cognitive Development Project PRISM, a longitudinal study, administered 2,446 standardized tests to 202 preschool children with visual impairments (Ferrell, Shaw, & Deitz, 1998). They found that the majority of developmental milestones for these children were delayed, in comparison with those of typical children. Children with additional impairments achieved these milestones later than children without such impairments. See text for more details from this study. . Cognitive Development The information processing model (Figure 11.2 in text) is clearly impacted by the lack of vision. It affects the sensory input component and in turn the cognitive and expressive aspects are significantly affected. The emotional context of children with visual impairments may cause them to fall into a state of learned helplessness and be unable to read the emotional context of others needed to interact. This impacts the child’s ability to make decisions and choices and adequately use the executive function. A visual acuity problem in a young child is a primary impairment and a condition that can hamper cognitive development because it limits the integrating experiences and the understanding of those experiences that the visual sense brings naturally to sighted children (Kephart, Kephart, & Schwartz, 1974). Children with visual impairment tend to develop at a slower rate than children without disabilities. © 2012 Cengage Learning. All rights reserved.

Characteristics Language Development Sensory Compensation and Perception Personal and Social Adjustment Children with visual impairments learn language much the same way as able-sighted children except they do not have the visual reinforcement. Research indicates that visual impairments do not interfere with everyday language usage or communication abilities; however, children with visual impairments tend to have word understandings that are limited to personal experiences. Sensory Compensation and Perception Through sensory compensation our other senses become strengthened because of the loss of one or more senses. But research does not indicate this to be true with children with visual impairments. Personal and Social Adjustment Although no social problems inevitably follow from being visually impaired, some children have difficulty coping with the restricted mobility and limited experiences. Teachers can help children with visual impairments cope by emphasizing what the child can do, valuing the areas of life that the child can participate in, assisting the child in molding her own life, appreciating the child’s accomplishments, and assisting the child in accepting her limitations. Discuss the section of Successful Coping from the text. © 2012 Cengage Learning. All rights reserved.

Early Intervention A child’s experiences during the period from birth to age 5 are critical to subsequent development. Early intervention programs reduce the number of secondary problems So much of what is important for young children to learn is learned naturally through the visual sense. A child’s experiences during the period from birth to age 5 are critical to subsequent development. Parents and teachers must work together to ensure that young children have important experiences and the independence to learn from them. IDEA 2004 mandates services for infants and toddlers with disabilities. Early intervention programs can reduce the number of secondary problems that can occur for a child without treatment. Discuss the concept of object permanence and how visual impairments can impact on this. Discuss the impact of the family on early intervention. Use the box Basic Early Experience for Development from the text to further discuss family input. © 2012 Cengage Learning. All rights reserved.

Identification and Assessment Preschool vision screening Snellen Chart Near-Acuity cards Titmus Vision Tester Parents and physicians identify most children with severe and profound visual disabilities before they enter school, unless they are children with multiple handicaps, in which case the visual impairment may not have received primary attention. Therefore educators need to become aware of the components of a comprehensive assessment. Before age 3, the assessment of vision concentrates on the use of the eyes; from ages 3 to 5, both observation and the Snellen E chart are used. Near-acuity (see text) provides an indication of what students can read as a near point. The Titmus Vision Tester is the most widely used test of visual acuity. When assessing children from different ethnic or racial backgrounds, their cultural factors must be included into the assessment and plans for the students. © 2012 Cengage Learning. All rights reserved.

National Agenda Goal Statement Student’s and parent’s rights Appropriate and timely services Appropriate caseloads Personnel preparation programs See Table 11.1 in the text for more detailed items. Discuss each section with the class. The items include students’ and parents’ rights, appropriate and timely service, and appropriate caseloads and personnel preparation programs. © 2012 Cengage Learning. All rights reserved.

Educational Adaptations Adapting the Learning Environment Adapting the Curriculum Adapting Teaching Strategies Assistive Technology Adapting the Learning Environment Prior to recent federal legislation (PL 94-142, IDEA), state residential schools were the predominant form of education. Schools that are still in existence could serve new roles in the education of children with visual impairments. Examples are resource centers, life skills centers, and magnet schools (Erin, 1993). Placing children with visual impairments in least restrictive environments (LREs) gives them a wide range of services. See Figure 11.3 in the text. Fifty- seven percent of children with visual impairments are found in the general education classroom sixteen or more hours a week, another 16 percent are out of the classroom 20 to 60 percent of the time, and 15 percent are away more than fifteen hours a week. Only about 12 percent of these children can now be found in residential schools. Inclusion must involve a carefully planned approach to integrate children with visual impairments into general educational settings. A case coordinator brings together all the information that relates to the child (the comprehensive assessment, for example) and leads a team of professionals who, with the parents, develop an IEP for the student and see that the IEP is carried out successfully. A collaborative approach can also facilitate more effective services for children from culturally and linguistically diverse backgrounds. Consultations between the English Language Learners (ELL) teachers and the teachers of students with visual impairments can yield positive results. The IEPs for children with visual impairment should include a variety of goals—some focusing on the effective use of the learning environment, some on instructional content, and some on skills that the student will need to perform effectively in the inclusive classroom. Discuss Jerry’s IEP goals in Table 11.5. The RTI model Tier I, the enhanced regular classroom, reportedly serves 62 percent of children with visual impairments (U.S. Department of Education, 2007). This is crucial to help children with visual impairments to succeed in regular classrooms. Tier I activities can include technology to aid a student’s visual acuity in reading, can provide extended core curriculum, and provide occasional tutorial work. Tier II activities can help to increase a student’s independent living skills as well as orientation and mobility training. Tier III activities can consist of teaching Braille or other means of communication and a separate setting for individual tutoring and extended core curriculum activities. .Adapting Curriculum Lowenfeld (1973) proposed three principles for adapting instruction to the educational needs of children with visual impairments: (1) concreteness, (2) unifying experiences, and (3) learning by doing Modifications need to be made in the existing curriculum for students with visual impairments as well as developing an expanded core curriculum. See Table 11.2 for examples in both areas of adapting curriculum. Educators are increasingly recognizing that students who are blind require a modified curriculum, not just an adapted standard curriculum. Expanded core curriculum for students with severe visual impairments include compensatory or functional academic skills including communications modes, orientation and mobility training (discuss Table 11.3 for school orientation and mobility checklist), social interaction skills, independent living skills, recreation and leisure skills, career education, use of assistive technology, and visual efficiency skills. The Universal Design for Learning (UDL) framework helps us to see that inflexible curricular materials and methods are barriers to diverse learners, just as inflexible buildings with stairs as the only entry options are barriers to people with physical disabilities. Universally designed curricula include a range of options for accessing, using, and engaging with learning materials—recognizing that no single option will work for all students (Hitchcock, Meyer, Rose, & Jackson, 2002). .Adapting Teaching Strategies Emphasis on communication skills remains extremely important for students with severe and profound visual impairments. Many students are instructed in either print or Braille. Braille is a system of touch reading developed in 1829 by Louis Braille, a Frenchman who was blind. The system uses embossed characters in different combinations of six dots arranged in a cell two dots wide and three dots high (see the “Braille Alphabet and Numerals” box on page 393). Several different approaches can be helpful when teaching children with visual impairments. The language experience approach to reading is a very good approach to learning for a child with visual impairments. A directed listening skill in which the child learns to use auditory cues is another useful teaching strategy. Recordings for the Blind and live readers can also help the students with their class work. Discuss the auditory tools presented in the text. .Assistive Technology As reported by the American Foundation for the Blind (2007), students with visual impairment can complete homework, do research, take tests, and read books along with their sighted classmates thanks to advances in technology (AFB, 2007). Advances in computer technology have been responsible for students with visual impairments being able to receive information and also to deliver information to others. However, the use of technology to compensate for disabilities is a two-edged sword. Although synthetic speech programs, talking calculators, and Braille translators are available, they also call attention to the child using them. Therefore, it becomes important for the teacher in the general education environment to become familiar with technological devices and to acquaint sighted students with the devices so that they don’t seem so strange and foreign to the classroom environment. Access technology involves adaptations to a computer’s normal operations that allow a student with disabilities to use and benefit from the computer (Taylor & Murphy-Head, 1996.) See Table 11.4 for examples of assistive technology. © 2012 Cengage Learning. All rights reserved.

Transition Sacks, Wolffe, & Tierney, 1998 Time diaries 31% of students with low vision worked for pay 19% of students with blindness worked for pay Need a stronger focus on career development and social skills competences Increase training in mobility and orientation Mastering the environment is especially important for the physical and social independence of children with visual impairments. Life skills training for children with visual impairments must be specifically taught. A study by Sacks, Wolffe, and Tierney (1998) revealed that adolescents with visual impairments were not being adequately prepared to function independently. The majority of students with sight had worked for pay, whereas only 31 percent of students with low vision and 19 percent of students with blindness did likewise. The majority of the students with blindness and low vision reported that they spent their after-school time alone. The authors recommended that a secondary curriculum for adolescents with visual impairments should include a stronger focus on career development and social skills competencies and that travel training should also be emphasized. © 2012 Cengage Learning. All rights reserved.

Meet the Student Jerry Characteristics Strategies Strengths and challenges Strategies Table 11.2 RTI Tiers IEP goals - Table 11.5 Assistive Technology Devices - Table 11.4 IPM Review and discuss Jerry’s case study Have the class discuss the student’s strengths and challenges. Continue with the class discussion and talk about what strategies a teacher could use with this student, how the strategies would be applied at each RTI tier, and how they would be incorporated into the student’s IEP goals. Discuss which assistive technology devices would be best for this student. Discuss what his IPM would look like. © 2012 Cengage Learning. All rights reserved.