Teaching Students who are Blind or Visually Impaired in the Classroom -adapted from J. Northcott Aug./10

Vision Loss 80 – 85% of what people know is learned through vision. Vision loss has an impact on learning and development. J. Northcott

Congenital - Adventitious Congenital visual impairments are a result of eye conditions that are present at birth. Adventitious visual impairments are those that occur later in life as a result of illness or accident. Visual impairment can be classified by the age of onset. J. Northcott

Visual Acuity Levels Normal Vision (between 20/12 and 20/25) Near Normal Visions (between 20/30 and 20/60) Moderate Low Vision (between 20/70 and 20/160) Severe Low Vision (between 20/200 and 20/400) Profound Low Vision (20/500 and 20/1000) Near Blindness (Light Perception) Total Blindness (No Light Perception) J. Northcott

What is low vision? A person has low vision if the visual acuity in his or her better eye is between 20/70 and 20/200, with the best possible correction. Individuals with low vision still have significant residual vision, but may be considered “legally blind”. J. Northcott

Low Vision – Legally Blind A person is legally blind if his or her visual acuity is 20/200 or worse in the better eye with the best possible correction. A person is legally blind if his or her visual field is 20° or less in the better eye. LEGALLY BLIND is a term that can be misleading, as most legally blind people have some usable vision. A certification of legal blindness allows individuals access to important services from government and private agencies. J. Northcott

Visual Difficulties Loss of Visual Acuity Loss of Visual Fields Reduced Contrast Sensitivity Colour Blindness Oculomotor Problems Visual Processing Problems Fluctuating Functional Vision J. Northcott

Normal Visual Acuity Visual Acuity Visual acuity is the measurement of the sharpness of vision as it relates to the ability to discriminate detail. It includes distance and near visual acuity with and without correction. An acuity measurement of 20/20 is considered normal vision. An acuity of 20/200 means that this person must stand at 20 feet to see what someone with normal vision can discriminate at 200 feet. This does not mean that the person sees with the same clarity as one with 20/20 acuity, only that he/she is able to determine separations in detail at that distance. J. Northcott

Decreased Visual Acuity A person has low vision if the acuity in his/her best eye with the best correction is between 20/70 and 20/200. J. Northcott

Decreased Visual Acuity A person is legally blind if visual acuity is 20/200 or worse in the better eye with the best correction possible. Common disorders with associated visual acuity loss are: high refractive errors such as degenerative myopia cataracts retinal detachments ROP – retinopathy of prematurity glaucoma underdeveloped eye as in micophthalmia, retina, macula, and/or optic nerve hypoplasia optic nerve atrophy albinism aniridia (congenital malformation – usually incomplete – of the iris) nystagmus J. Northcott

Low Vision – Legally Blind Individuals with low vision usually read large print, or regular print with visual aids. Some individuals who are legally blind may use a combination of braille, large print, and low vision devices. J. Northcott

Decreased Visual Acuity Common disorders associated with visual acuity loss: Degenerative myopia Cataracts Retinal detachments Retinopathy of prematurity (ROP) Glaucoma Underdeveloped eyes such as microphthalmia and optic nerve hypoplasia Optic nerve atrophy Albinism Aniridia Nystagmus

Decreased Field of Vision An individual with a visual field loss is limited in how large an area he or she can see. Individuals often do not look at an object directly (eccentric viewing). A person is legally blind if their visual field is 20° or less in the better eye.

Loss of Central Vision Loss of Central Vision An individual with this type of field loss will only be able to see a blind or grey spot straight ahead no matter which way he turns his/her eye. It is like looking at a picture with a spot in the middle. J. Northcott

Loss of Peripheral Vision Field of Vision A individual with a visual field loss is limited in how large of an area he/she can see. It is possible to have good central vision with limited peripheral vision, to have good peripheral vision with limited central vision, and to have scattered field vision. Each eye may have different patterns of field vision loss. A person is legally blind if their field of vision is 20° or less in the better eye. A child with this type of field loss will be able to only see straight ahead and will not be able to see people or things at the sides without turning his/her eyes or head. This is sometimes called “tunnel vision” as it is like looking through an empty tube of toilet paper. J. Northcott

BLIND SPOTS or SCOTOMAS Scattered Blind Spots or Scotomas An individual with this type of field loss may loose “parts” of people or things when he is looking at them. How big the blind spots are, where they are located, and how many there are, will affect how severe an individual’s visual functioning will be. Common disorders that result or could result in field loss are: macular degeneration juvenile macular degeneration retinitis pigmentosa retinal detachments ROP – retinopathy of prematurity glaucoma colobomas optic nerve atrophy optic nerve hypoplasia tumours putting pressure on portions of the optic nerve J. Northcott

Hemianopsia Hemianopsia An individual with this type of field loss only sees half of the people or things when he is looking at them. This half of visual field could be left or right or top or bottom. The individual may not notice or bump into people or things “hidden” in the half of the visual field that has no vision. J. Northcott

Decreased Field of Vision Common disorders associated with visual field loss: Macular degeneration Retinitis pigmentosa Retinal detachments Retinopathy of prematurity – ROP Glaucoma Hemianopsia Colobomas Optic nerve atrophy Optic nerve hypoplasia

Reduced Contrast Sensitivity A simulation of loss of contrast sensitivity. Many low vision defects involve a loss of both acuity and contrast sensitivity. Reduced Contrast Sensitivity The ability to distinguish between the lightness and darkness of things we see The ability to tell things apart that are almost the same colour Everything can appear “washed out” like looking at a faded photograph Visual disorders associated with reduced contrast sensitivity are similar to reduced visual acuity J. Northcott

Colour Blindness Most colour perception defects involve red, green or both. Achromatopsia Students with Achromatopsia see the world in shades of grey. School work is frequently color coded. -control light and glare. “Colour blindness” is an inaccurate term for lack of perceptual sensitivity to certain colours. Absolute colour blindness is almost unknown. Most colour perception defects involve red, green or both. Achromatopsia is an eye condition associated with decreased colour vision. J. Northcott

Oculomotor Problems Characterized by difficulty with coordinated movements of the eyes One or both eyes may turn in (esotropia) or out (exotropia) May result in difficulties following fast moving objects or accurately reaching for objects May result in double vision or loss of depth perception Strabismus, Amblyopia and Ocular Motor Apraxia

Problems with Visual Processing This eye condition associated with this is: Cortical Visual Impairment Eyes are generally healthy and normal Damage is to the visual cortex – difficulty in processing information sent to it from the eyes Not the same as visual perceptual difficulties

Expanded Core Curriculum Consists of 9 disability-specific skills … Compensatory or Functional Academic Skills Orientation and Mobility Social Interaction Skills Independent Living Skills and Personal Management skills Recreation and Leisure Skills Career and Life Management Skills Assistive Technology Visual Efficiency skills Self-Determination J. Northcott

Low Vision

Things To Remember No two individuals with the same eye condition will function visually in exactly the same way. The majority of individuals with low vision will have fluctuations in visual functioning from day to day and situation to situation. Physical and mental health factors such as medications, seizure activity, fatigue, etc. and environmental factors such as lighting, seating, contrast, etc. will affect an individual’s visual functioning. Most individuals with visual impairments experience difficulty in more than one area. For example, a student with retinopathy of prematurity may have visual acuity, visual field and contrast sensitivity losses. No two individuals with the same eye condition will function visually in exactly the same way. The majority of individuals with low vision will have fluctuations in visual functioning from day to day and situation to situation. Physical and mental health factors such as medications, seizure activity, fatigue, etc. and environmental factors such as lighting, seating, contrast, etc. will affect an individual’s visual functioning. J. Northcott

What Can We Do? Environmental adaptations Material adaptations Teaching strategies J. Northcott

Seating Optimal seating Consider student’s visual acuity Consider student’s field of vision Consult the teacher of the visually impaired Optimal seating will depend on the student’s eye condition. For example, a student with decreased visual acuity should sit close to the teacher or board, and a student with a peripheral field loss should sit further away in order to see the “whole picture”. Discuss this with your vision strategist. Students with severe low vision should sit near the speaker. Students with severe low vision should sit close to the classroom door. Consider the student’s best field for presenting work, including null points for students with nystagmus. J. Northcott

Lighting Appropriate lighting Students should be seated so that they are not facing a window to reduce glare Time may be needed to adjust to changes in lighting conditions Consult the teacher of the visually impaired J. Northcott

Lighting: Glare Many students are sensitive to glare. Reduce glare by: -colour contrast of reading materials -use non-glare lamination -adjust blinds in the classroom (photophobia). Encourage students to wear sunglasses or a hat when outside. Use blinds, curtains or posters to cover windows producing glare. Avoid glare on tasks, work surfaces, etc. Avoid glossy paper. Laminated materials and whiteboards may cause difficulty for students with low vision. Some students find white paper gives off too much glare. Try pale coloured or buff paper. Adjust computer screens to minimize glare. J. Northcott

Contrast In The Environment Often contrast is as important, if not more important, than the size of print. Often contrast is as important, if not more important and the size of print. Contrast work areas by using contrasting coloured cloth, a coloured tray or a place mat to define work areas. Make objects more visible with electrical or coloured tape; i.e. the top of the volleyball net, court markings in the gym, a stripe on a drinking glass, etc. Consider areas in the school environment which need to be more visible; i.e. edge of steps. A painted strip (usually yellow or white) can be used for greater contrast. In Physical Education classes use brightly coloured pylons for court markings, pinnies to help identify team members, and brightly coloured balls and shuttlecocks. J. Northcott

Contrast In The Environment Things to try: contrasting coloured cloth, a coloured tray or a place mat to define work areas using coloured electrical or coloured tape to mark the top of the volleyball net, court markings in the gym, a stripe on a drinking glass, etc. using brightly coloured pylons for court markings, pinnies to help identify team members, and brightly coloured balls and shuttlecocks in PE J. Northcott

Contrast In Learning Materials Black boards: white or yellow chalk White boards: black dry erase markers Print materials: black print on white or yellow paper Font: plain bold font such as Arial, Verdana, or Tahoma with 1 1/2 line spacing Use white or yellow chalk on a clean blackboard. Do not use coloured chalk! Use black felt pens on clean whiteboards and overheads. Never use red or green! For print materials, use black print on white or yellow paper. With computer produced materials, use a plain bold font (i.e. Arial, Verdana, Tahoma) with 1 ½ line spacing. J. Northcott

Large Print 18 font is the standard font size for large print Arial Tahoma Veranda Maiandra Times New Roman Important to consider the size of print the student requires to access information 140% enlargement on a photocopier of 12 point font provides enlargement to 18 point print. Use white or yellow chalk on a clean blackboard. Use black felt pens on clean whiteboards and overheads. For print materials, use black print on white or yellow paper. With computer produced materials, use a plain bold font (i.e. Arial, Verdana, Tahoma) with 1 ½ line spacing. J. Northcott

Organization – the Classroom Alert student to any physical changes in the room Doors or cupboards should be either closed or open all the way Student may require extra space for all his/her materials Keep the classroom environment static. This helps the student with orientation to the classroom. Alert the student with low vision to any changes in the classroom layout. Keep the floors clear of backpacks, etc. and close cupboard doors. The student will require extra storage space for materials and equipment. Locked storage is required for expensive equipment, as the school is financially responsible for equipment borrowed from Alberta Education. The student may require two desks. J. Northcott

Organization – the Teacher Provide lists of novels, research topics, worksheets, readings etc. as soon as possible to the teacher of the visually impaired and/or education assistant Provide the vision strategist and/or education assistant with long range plans. Books and kits can then be ordered in advance for the student with low vision from the Materials Resource Unit for the Visually Impaired (MRU). Provide lists of novels, research topics, etc. as soon as possible (at least two weeks in advance) so accessible versions can be ordered from the MRU or produced by the education assistant. Provide copies of worksheets, readings, etc. to the education assistant and/or vision strategist as soon as possible for production in an appropriate format. J. Northcott

Organization – the Student Ongoing development of personal organization may be required. Consider: -put away materials, worksheets, etc. right after they are finished with them -develop a filing system -develop folders on the computer and/or braille electronic notetaker to organize files Students must put away materials, worksheets, etc. right after they are finished with them, as they may be unable to locate them visually at a later time. Students should develop a filing system; i.e. colour coded folders or binders, large print or braille labels, etc. Students should develop folders to organize files on the computer or Braille notetaker. J. Northcott

General Strategies Students may be missing background information Do not avoid the use of words “look” and “see” Visual fatigue may impact student’s functional vision Address the student by name Information from facial expressions or body language may be missed May require extra time for exams and assignments Provide feedback to the student in the same way that you would other students Consider reviewing school fire drill prodedures Have a contingency plan for fire drills. Inform the caretaker(s) that there is a visually impaired student in the school. Complete the “To My Substitute” form and leave it in your lesson plan book. Remember that the student with low vision may miss or misinterpret facial expressions, body language and/or tone of voice. Encourage the student to inform you of his or her visual needs Introduce new students or visitors when they enter the room. Do not avoid use of the words “look” or “see”. Remember that blindness does not affect hearing. Use verbal praise, as the student with low vision may not see a smile or nod. Criticize or praise the student with low vision in the same way that you would the other students. Expect the same quality of work from the student with low vision as you do from the other students. J. Northcott

General Strategies Near Tasks: materials should be clear against a simple background – good contrast use appropriate print size avoid clutter keep maps and diagrams simple Remember that a great deal of incidental learning takes place through visual exposure. Students with low vision require concise verbal instruction and opportunities to handle objects, models and manipulatives. Provide opportunities for close up viewing and allow time for looking. When greeting the student with low vision from a distance or in a crowded area, identify yourself. Address the student by name when addressing him or her in a group. Allow the student to hand out materials to classmates. This will help him or her to know who they are and where they are located in the classroom. Educational materials should be clear against a simple background. Avoid cluttered worksheets, diagrams and maps. Reduce the number or items or amount of information on a page. J. Northcott

General Strategies Distance Tasks: allow student to move within the class to see boards, charts, etc. read out loud as items are written on boards, charts, etc. provide a large print or braille copies of notes Students with visual impairments are entitled to extra time for exams. Depending on the individual student’s needs, you may allow extra time to complete assignments. Give a time limit! You may modify assignments by reducing the number of questions the student is required to complete or by changing the assignment if it is visual. Provide the elementary student with an end coat hook, and the secondary student with an end locker and key lock. Secondary students may benefit from using an option class to work on compensatory skills such as Braille, orientation and mobility, assistive technology and/or keyboarding. See “Essential Components of Educational Programming for Students who are Blind or Visually Impaired” (AB Ed. Standards for Special Education). Watch for signs of visual fatigue such as red or watering eyes, rubbing eyes, and/or headaches. Remember that the student with low vision will not be able to see boards, overheads, charts, posters and films located at a distance. Read out loud as you write on boards or overheads. Allow the student to sit as close as possible to the teacher during demonstrations. Allow the student to move closer to the board, overhead, chart, etc. at an appropriate time. J. Northcott

SSVI - LRC Specialized Services for the Visually Impaired (SSVI) 12360 – 142 Street N.W. Edmonton, Alberta T5L 4X9 Fax: 780-427-6683 Toll free calls – use Government RITE system. Dial 310-0000 and then dial 780-427-4681. www.lrc.learning.gov.ab.ca and click on Specialized Services for Students with Visual Impairments Provide the student with a large print or Braille copy of the lesson to follow at his or her desk. Provide the vision strategist and/or education assistant with a copy ahead of time. If produced on a computer, email the copy. Photocopy another student’s notes. A peer and/or education assistant could dictate to the student, or copy the information on the board or overhead onto a small whiteboard at the student’s desk. If there is important information on the walls of the classroom, provide the student with large print or Braille copies in a binder at his or her desk. Allow the student to preview the film, video or DVD prior to the lesson, either at home (by renting the video or DVD) or at school. The student will listen carefully and the teacher, education assistant and/or peer may describe any visual information that cannot be understood by listening alone. Stop the film at critical points for brief class discussions to ensure understanding of all students. Use descriptive videos when possible. J. Northcott

Helpful Low Tech Tools … 20/20 pens Bold lined writing paper and/or scribblers Highlighter pens Colored glue sticks Line markers Templates Provide the student with bold lined writing paper and/or scribblers. Provide students with black 20/20 and Eraser Mate pens. Use a highlighter pen to draw the student’s attention to words or sentences on a page. Provide the student with a coloured glue stick. Allow the student to use line markers or templates to focus on specific lines of print, if necessary. J. Northcott

Assistive Technology: Low Tech J. Northcott

Assistive Technology: Low Tech

Physical Education

Physical Education

Games

Guiding Documents Alberta Education’s Standards for Special Education http://education.alberta.ca/admin/special/legislation.aspx Essential Components of Educational Programming for Students who are Blind or Visually Impaired education.alberta.ca/media/511690/ecep_blind_or_visually_impaired.pdf Canadian National Standards for the Education of Children and Youth who are Blind or Visually Impaired, Including those with Additional Disabilities www.apsea.ca/Cdn_Nat_Stands.pdf These are the guiding documents which we use when programming for students who are blind or visually impaired are … Canadian National Standards for the Education of Children and Youth who are Blind or Visually Impaired, Including those with Additional Disabilities Alberta Education’s Standards for Special Education Essential Components of Educational Programming for Students who are Blind or Visually Impaired J. Northcott

… something to think about If students floated in life jackets for 12 years, would they be expected to swim if the jackets were suddenly jerked away? The situation is similar for students receiving vision services. All too often these students are not taught how to self-manage their own lives before they are thrust into the cold water of post-high school reality. - Martin, 1993 Provide the student with bold lined writing paper and/or scribblers. Provide students with black 20/20 and Eraser Mate pens. Use a highlighter pen to draw the student’s attention to words or sentences on a page. Provide the student with a coloured glue stick. Allow the student to use line markers or templates to focus on specific lines of print, if necessary. J. Northcott

In closing Students who are blind or visually impaired deserve “the opportunity to be equal and the right to be different.” Dr. Phil Hatlen