What Are Visual Impairments?1
The term visual impairments describes a wide variety of conditions that affect vision abilities. We use the term to denote mild to most severe vision loss, rather than to defects in the eye itself. According to the Individuals with Disabilities Education Act (IDEA) of 1997, a visual impairment refers to “an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness.”
Sight impairment terminology can sometimes be confusing. Most people classified as “blind” have a visual sense of lightness or darkness, as well as an ability to see some shapes and images. To avoid confusion, you should know the following terms commonly used to designate degrees of visual impairment:
- Totally blind. This term usually implies little or no visual sensitivity to light at any level. This condition is rare, and people who are totally blind typically have severe physical damage to the eyes themselves or to the visual nerves.
- Legally blind. A legally blind person has a visual acuity of 20/200 or less in the better eye, after correction. This means that what an individual with normal (20/20) vision sees at two hundred feet, the legally blind person cannot see until he or she is within twenty feet. In addition, a person can be classified as legally blind if she has a field of vision no greater than twenty degrees at the widest diameter. (A normal field of vision is close to 180 degrees.) Only about 20 percent of legally blind people are totally blind. Legally blind individuals typically use Braille and visual aids.
- Low vision. People with low vision can read with the help of large-print reading materials and magnifying objects. They may also use Braille.
- Partially sighted. Partially sighted individuals have less severe loss of vision than people in the other three categories. A person with partial sight may be able to see objects up close or far away and with corrective lenses may be able to function at normal levels.
(Note: Another version of visual impairment that does not fall along this spectrum is color blindness.)
A student with a visual disorder can succeed in school if given the right support and accommodations. If you have a student with a visual disorder in your class, remember this: An inability to see does not create an inability to learn.
To emphasize that the legal or medical classification may be less relevant than what a student can do in the classroom, educators often describe students with visual impairments in terms of classroom functioning. Typical educational classifications are moderate, severe, and profound visual impairment. These classifications refer to the extent to which the student needs special education adaptations to learn. A child with moderate visual impairment (a corrected visual acuity between 20/70 and 20/160) works well with visual aids, perhaps even to the point of eliminating the impairment’s effect. A student with severe visual impairment (a corrected visual acuity of 20/200 to 20/400) will have difficulty even with visual aids, but can use vision to some degree in the learning process. Students with profound visual impairment or total vision impairment (corrected visual acuity of 20/500 or worse) cannot use vision as an educational tool and must rely predominately on their remaining sensory functions.
Prevalence of Visual Impairments
Although many students have some type of visual problem, the great majority of cases resolve the difficulty, usually with eyeglasses or contact lenses. These students need no special education services. Among students who do receive services under IDEA, only about 0.5 percent have visual impairments (U.S. Department of Education, 2000). Severe visual impairments are even less common. According to the National Information Center for Children and Youth with Disabilities (NICHCY, 2001b), severe visual impairments occur in only .06 of every 1,000 individuals.
However small their numbers may be, students with visual impairments must have a free and appropriate public education like all other students. As a teacher, therefore, you should understand the implications of visual impairments for learning and the modifications and accommodations that are essential for the student’s success.
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Educational and Social Development
Children with visual impairments and children with unimpaired sight both go through a series of stages in their language development. Infants alter the quality of their cries to express different needs, move on to babbling, then to using one-word sentences, and eventually to constructing increasingly complex sentences as they refine their linguistic abilities and respond to input from adults. A visually impaired child STET (person first language) lacks the advantage of reinforcing and expanding his or her vocabulary through visual input. This child misses most types of body language and facial expressions, although tactile experiences provide an important alternative.
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As a result, most of the visually impaired child’s early language is based on his or her direct personal experiences. For example, Joey will quickly learn that Mom is the person with a certain voice, whose hands hold him a certain way, and who cares for him. He is less likely to grasp the meaning of an abstract word, such as mothering or motherhood. Such nuances would have to be explained to him.
Activity limitations have the greatest impact on the social domain of visually impaired individuals. Young children with visual impairments need a great deal of orientation and support to be as mobile and independent as sighted children. Even when support is available, such children are often restricted from certain activities, and this can significantly curtail the amount and quality of their interaction with peers. For example, soccer is a popular sport for most young children, boys and girls alike. A child with a visual impairment can play soccer, with support and training. A “beeping” ball can allow the child to know where the soccer ball is. A coach on the sidelines shouting clear instructions (instead of just shouting, as some coaches do) can help all players. A raised edge around the field can help all the young players notice when the ball goes out of bounds. Most important, the experience of playing soccer with his or her peers can help the child with a visual impairment socialize, compete, use language, and gain physical agility as well as confidence.
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Parents and teachers who push students with visual impairments to have as normal an experience as possible not only help them gain skills and develop self-reliance, but also help other students understand how to work with people who are different. For more information about including children with visual impairments in physical education programs, visit http://www.midlandschool.org/art1.htm to read an article by Kathy Letcher on adapted physical education for the blind and visually impaired. Sports and physical activities are obviously not the only way to increase the verbal, social, and mobility skills of children with visual impairments. Being active in music, clubs (such as the Girl Scouts), and after-school programs can help the child strengthen language skills and understand social situations.
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Placement Decisions
A central issue in placing a student with a visual impairment is whether the necessary specialized training is best delivered in the regular school setting or in a special school. Students with visual impairments often need to learn special skills such as how to use a walking cane and how to use special computer applications. Special schools for the visually impaired provide this training, but these skills can also be taught by an itinerant specialist at the student’s home school.
Special schools offer students a place to interact with other students with visual impairments. Such schools can give students a solid grounding in skills and techniques they will use throughout their lives, and with which they can succeed more easily in further education and at home. Because of the low prevalence of severe visual impairments, however, the school may be some distance from a child’s home and may require that the student live on campus, away from his or her family.
Many school districts offer resource programs for children with all degrees of blindness, in which the students attend a special program for part of the school day and then return to their home classrooms. For example, a student might spend the morning learning mobility skills or how to use specific technology tools, and then in the afternoon return to “regular” high school. Classes such as mathematics and science, in which much of the information is written on the board, might require the student to have special tutoring.
The pros and cons of deciding where to place a student with a visual impairment are significant and can have a major impact on the child’s long-term success. As the teacher, you can offer information, support, and insights to parents as they try to make this important decision.
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Adapting Instruction for Students with Visual Impairments
Just as visual impairments fall along a continuum, so do students’ abilities to see and use learning materials. Someone with low vision or moderate visual impairment can read with magnification aids, which might range from a simple magnifying glass to a computer technology like ZoomText Xtra (Ai Squared), which provides magnification and screen-reading capabilities. Students with profound visual impairment might use Window-Eyes (GW Micro) or JAWS (Henter-Joyce), two screen readers that use a voice synthesizer to read the contents of the computer screen aloud via the computer’s speakers.
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Classroom teachers can make many other modifications for the visually impaired student, too. Books on tape can replace textbooks. Tape recorders can capture lectures or assist in composition. Computers can help compose papers, while voice synthesizers can read each page back to the student. Partners assigned within the classroom can provide specific assistance such as help with gathering materials and organizing for work.
Young students find certain toys helpful and adaptive. The Explorer Globe (LeapFrog Enterprises) is an interactive globe that introduces the names, elevation, and other information about different geographical locations. Another LeapFrog toy, The Fun & Learn Phonics Bus, promotes language use by coordinating alphabet letters with phonetic sounds and words.
Before putting any toys, tools, or modifications in place, however, you must discover which skills or tasks present a challenge to an individual student, and how specific modifications will help overcome these challenges. Students with visual impairments can often explain exactly which experiences are the most useful to them; all you have to do is ask. The next section presents some guiding principles that can assist you in adapting instruction for a student with a visual impairment.
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Guiding Principles for Instructional Adaptations
Three principles are especially important when you consider how to modify your instructional practices to meet the needs of a student with a visual impairment:
- Concreteness. Students with visual impairments need opportunities to observe their environment through tactile means. Therefore, when discussing abstract concepts in your classroom, allow children to manipulate the object or some representation of it. For example, when teaching about human biology, you might want to borrow a skeleton so that the student can feel how the “hip bone is connected to the knee bone.” Characteristics like texture, weight, fragility, size, and shape make for a richer set of elements with which to create mental associations.
- Unifying experiences. Because students with visual impairments cannot automatically distinguish the part from the whole, you must provide this information. For example, at different points during the semester, the class may discuss trees and leaves, seasons, and the earth’s rotation. For a student with a profound visual impairment, who doesn’t see the leaves falling from the trees or the sun setting earlier in the evening, it may be necessary to provide a synthesis and context for those discussions, to explain the interconnectedness among topics.
- Learning by doing. Students with visual impairments need hands-on experiences. We know that everyone learns best by active involvement with ideas, and the same is true for students with visual impairments. Give students as many opportunities as possible to participate in a hands-on activity through which they can truly learn the day’s lesson. For example, if you and your students are studying ancient Egypt, you can have the students build a replica of a pyramid or make bricks using sand and water. This way, all your students will get a feel for the amazing architecture of the time.
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Responding to the Uniqueness of Each Student
Teachers should acknowledge the student with a visual impairment as a unique individual. One way to discover exactly what works best for a student is to ask him or her to describe what you (and the other students) can do to be helpful. Interviewing the student guides the educator to hidden talents that can aid learning. Hardships in learning can be counterbalanced by the student’s interests. Interviewing can also let you know which tasks and aspects of learning a student prefers to pursue independently.
When you have a child with a visual impairment in your classroom, you must be organized. For instance, you’ll want to prepare materials ahead of time so that they can be scanned into a Braille printer or recorded onto tape. Even more important, you must think especially clearly about your class learning objectives. Integrating each piece of the lesson plan into the whole will ensure that the visually impaired student gains the academic strengths to develop new skills and complete new material.
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Heredity and Visual Impairments in Children
In many cases, children develop a visual impairment because their parents have one. It could be as subtle as needing glasses, or it could be as severe as going completely blind. By doing tests early on, a parent could help his/her child get the visual diagnosis they need before it is too late and they are blind. Being able to see is important when learning in the classroom. It gives them a graphic sense as to how to describe things. When losing eye-sight from hereditary reasons, this is called Macular Degeneration.