Children with Visual Impairments Chapter 11 Children with Visual Impairments

15 minute Braille hunt on campus 15 minute Braille hunt on campus. Go to as many buildings as possible where you can find Braille signs. Take sheets of copy paper and pencils to obtain rubbings of the Braille letters. Place the paper over the Braille and lightly but firmly rub the pencil over the paper to obtain an image of the raised dots. Label the paper with the location of the Braille signage and what the Braille image says (example: “EXIT,” front door of Turner Hall). Are the Braille signs located across campus or clustered at key points? What signs are not in Braille and why? Using a Braille alphabet, translate the Braille for accuracy and meaning (i.e., does the Braille on someone’s door have the professor’s name or just the room number, etc.). Braille exercise: Groups of 2 to 3 people. Braille alphabet: http://www.braillebug.org/braille_print.asp

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

Definitions Blind Low Vision 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

Prevalence 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). From U.S. Department of Education, 2003.

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.

Figure 11.1 :The Eye From Freberg, L. (2006). Discovering biological psychology. Reprinted by permission of Houghton Miffl in Harcourt Publishing Company.

Causes of Visual Impairments Hereditary conditions Infectious diseases Injuries Retinopathy of prematurity

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 overadministration of oxygen to premature infants as well as low birth weight.

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.

Characteristics Cognitive Development Language Development Sensory Compensation and Perception Personal and Social Adjustment

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; Tillman & Osborne, 1969).

Children with visual impairment tend to develop at a slower rate than children without disabilities. Children with visual impairments need to be tested to determine what accounts for their visual impairments. At present the verbal section of the Weschler scale seems to provide the best measurement of intelligence for children with visual impairments.

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. Warren (1994) found that visual impairment limits children’s conceptual understanding and generalizations in language and vocabulary.

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.

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. Early intervention programs can reduce the number of secondary problems that can occur for a child without treatment.

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. http://www.youtube.com/watch?v=zDOdAfRurGs .

https://www.youtube.com/watch?v=6rbHOAtBNew https://www.youtube.com/watch?v=H_m0ESrkQkY https://www.youtube.com/watch?v=9RJMKEJf63g

Near-acuity cards: http://www.west-op.com/chileyetesca.html 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: http://www.west-op.com/titmusi200.html

Identification and Assessment Preschool vision screening Snellen Chart Near-Acuity cards Titmus Vision Tester

Educational Adaptations Adapting the Learning Environment Adapting the Curriculum Adapting Teaching Strategies Assistive Technology

Placing children with visual impairments in least restrictive environments (LREs) gives them a wide range of services. . Sixty-two percent of children with visual impairments are found in the general education classroom sixteen or more hours a week, another 19 percent are out of the classroom 20 to 60 percent of the time, and 19 percent are away more than fifteen hours a week. Only about 10 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.

Erwin (1993) established guidelines for exclusion of young children with visual impairments because just placing a child without careful planning and without support personnel will not be beneficial to the child. Silverman (2000) considers the transdisciplinary model, which provides collaboration with the education team, and in which therapists and other specialists provide direct services to students in general education classrooms and other natural environments, to be the most desirable model for children with visual impairments.

An itinerant teacher can provide special materials, consult with school personnel, and provide individualized instruction to help make inclusion into a regular classroom successful. 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.

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.

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 For instance, practice in fluency, echo reading, and choral reading can bring more confidence to students with visual problems. Bold-lined paper, felt-tipped pens, magnifiers, computer screen enlargements, and synthetic speech can help students with writing tasks. Tactile materials such as manipulatives and an abacus can assist students with math activities.

Expanded core curriculum for students with severe visual impairments include compensatory or functional academic skills including communications modes, orientation and mobility training, social interaction skills, independent living skills, recreation and leisure skills and career education.

Emphasis on communication skills remains extremely important for students with severe and profound visual impairments. Many students are instructed in either print or Braille. 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.

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

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.

http://www.juniorblind.org/site/ http://brailleinstitute.org/Services/Children/Early_Childhood_to_Age_6.aspx http://brailleinstitute.org/Volunteer/Student_Volunteer_Opportunities.aspx http://www.youtube.com/watch?v=3D-hBUWb-lA http://www.youtube.com/watch?v=rIGN44XJ7bY&feature=related http://www.youtube.com/watch?v=QuSzTi6ZHps http://www.afb.org/default.asp