Educational Interventions for Students with Low Vision

Approximately 90% of individuals with visual impairments have functional or low vision; just 10% are functionally blind. However, students with low vision are often an overlooked majority in the population of children who are visually impaired. Difficulties of students with low vision are often not as apparent as they are for students who are blind. Nonetheless, students with low vision require direct instruction in literacy, visual efficiency, accessing the core curriculum, compensatory skills and more. The following educational interventions are beneficial to students in any school setting.

Teacher of Students with Visual Impairments

Every child who meets the criteria of visual impairment in his/her state is eligible to receive services from a certified teacher of students with visual impairments (TVI). A TVI is a teacher who specializes in working with students who are visually impaired. Most often, when a new student with a visual impairment enters a school system, it is the TVI who is responsible for assessing the student, determining and aiding in adaptations and modifications, as well as creating individualized education programs (IEPs). If the situation does not permit the TVI to perform all necessary specialized instruction with a student, the TVI will generally oversee or direct the instructional process.

Accessing the Visual Environment

One of the principal concerns for students with low vision is their ability to access the visual environment. Just as students who are blind have difficulty with environmental cues such as facial expressions and eye contact, so too do students with low vision. One way for students to access the visual environment is through optical devices. Optical devices include magnifiers, microscopes, and telemicroscopes for accessing near information and monocular telescopes and bioptic lenses for accessing distance information. Near devices aid a child in viewing regular print materials, non-textbook materials such as baseball cards, and menus. Distance devices are used for viewing information that is beyond arms reach, such as the chalkboard, menus in fast food restaurants, or sporting events. Because every child's vision is different, a certified professional should always prescribe optical devices. Every child with low vision should receive a clinical low-vision evaluation from an optometrist or ophthalmologist who specializes in such services.

Access to Information

One of the most important academic areas related to accessing the visual environment is accessing information through print. While some students with low vision require their texts to be transcribed into braille, many are able to access regular or large print. Large print books and papers can be created through modern copy machines but such copies are often of poor quality. Many states have centers and agencies that can be contracted to create required large print and braille materials. For students who can access regular print through optical devices, instruction beyond the introduction of the optical device is required to make sure the student uses it effectively. Lengthy texts such as novels might also be presented on audiotape. However, it is recommended that audiotape materials not be stressed until later grades to ensure that students develop the requisite basic literacy skills. Audiotapes are often used more by students in university who must access large amounts of information from a variety of sources.

Many technology solutions exist for accessing information via computer. Progress is being made on the ability to download academic texts from publishers directly to student's computers, bypassing the print medium. Text on computer can be output through speech, large print, or braille, depending on the software and hardware available. Some students might also benefit from any combination of braille, large print, regular print, optical devices, and technology.

Access to the Core Curriculum

Students with low vision are often at a disadvantage when presented with information in regular classrooms. If a student has difficulty seeing material at a distance, writing on chalkboards will be hard to discern. A distance optical device, preferential seating, and handouts containing pertinent information are all ways that the information can be more easily accessed by the student. Curriculum areas such as the sciences that require hands on activity and interaction with materials can also present a challenge to students with low vision. Specialized instruments with larger numbers or inventive ways of using existing materials can overcome barriers. The use of groups to complete assignments is also useful for providing a support not only for students with visual impairments but for all students. Above all, teachers should encourage students to indicate when they are having difficulty in accessing information, completing a task, or understanding a process or skill. In most cases, between the student and the teacher for students with visual impairments and the classroom teacher a solution for any barrier will be discovered.

Expanded Core Curriculum

The expanded core curriculum is a set of skill areas developed to augment the traditional core curriculum. The expanded core curriculum includes areas of instruction specific to students with visual impairments. Intervention from a teacher for students with visual impairments is necessary to provide direct instruction in the expanded core. These areas are:

1. Compensatory or functional academic skills, including communication modes—skills that a student with a visual impairment must acquire to access the regular curriculum. These skills include learning braille, study and organizational skills, spatial understanding, and any adaptation of the existing curriculum.
2. Orientation and mobility—skills involved in independent travel and the concepts that underlie spatial reasoning and navigation.
3. Social interaction skills—acquisition of the subtle modes of interaction that people develop by watching, imitating, and reacting to each other.
4. Independent living skills—can include cooking, personal hygiene, money management, time monitoring, and organization. These are often skill areas that children with visual impairments do not develop because they do not observe them in others and they are often not explicitly taught.
5. Recreation and leisure skills—while physical fitness is generally addressed in the regular curriculum, activities that can be used to actively fill leisure time are often not addressed. Without direction instruction, it is not likely that a child will be exposed to the range of activities possible.
6. Career education—as in many of the other areas listed, children with visual impairments are often not exposed to a large variety of career options. This is both because of a lack of prior visual experiences and because of a perception that the range of options is severely limited for children with visual impairments. Unemployment and underemployment is one of the biggest problems facing adults with visual impairments in today's society.
7. Use of assistive technology—technology can be a great tool for providing access to information for people with visual impairments. Whether it is through speech, braille, or large print output, the use of technology gives a person with a visual impairment access to information at approximately the same time as a person who is sighted.
8. Visual efficiency skills—although the amount and type of vision varies greatly among individuals, a common requirement is instruction in using what vision they have efficiently. For a student with a field loss, it might be viewing print eccentrically to maximize clear perception of the print. For another student it might be paying attention to objects in their peripheral field when walking to get as much advance warning of impending obstacles as is possible. Every person's situation will be different: that is why it is important to involve the TVI in the development of the activities designed to answer the needs outlined in the expanded core curriculum.

Psychosocial Issues

Another issue relating to low vision is the psychosocial impact of a visual impairment. Children growing up with a visual impairment can experience many negative consequences including:

• feeling like they look different, either because they cannot visually verify how others look or because they wear glasses or use optical devices,
• feeling like an outsider because they cannot take part fully in activities,
• feeling less than capable because they do not understand visual concepts fully,
• feeling clumsy because they drop things or bump into objects.

All of these consequences can have the effect of lowering self-esteem. It is important that students identify themselves not by their visual impairment but see their visual impairment as one aspect of who they are. Intervention may be necessary so that a student can build successful experiences and find activities in which they excel.

Unique educational interventions are essential for students with low vision in order to ensure successful outcomes in the school setting.   The following is a list of resources to help guide the reader to additional information on such interventions.

Resources

Related Publications from AFB Press

Corn, A. L., & Koenig, A. J. (1996). Foundations of low vision.

New York: American Foundation for the Blind.

D'Andrea, F. M., & Farrenkopf, C. (2000). Looking to Learn:  Promoting literacy for students with low vision.

New York: AFB Press.

Ferrell, K. A. (1984). Parenting preschoolers: Suggestions for raising young blind and visually impaired children.

New York: American Foundation for the Blind.

Koenig, A. J., & Holbrook, M. C. (Eds.). (2000). Foundations of education, Vol. 2: Instructional strategies for teaching children and youths with visual impairments.

New York: AFB Press.

When you have a visually impaired child in your classroom: A guide for teachers. (2002).

New York: AFB Press.

Other resources

Bishop, V. (1996). Teaching visually impaired children.

Springfield, IL: Charles C Thomas

Corn, A. L. (1980).  Optical aids in the classroom.  Education of the Visually Handicapped,

12 (4), 114-121.

Cowan, C., & Shepler, R. (1990). Techniques for teaching young children to use low vision devices. Journal of Visual Impairment & Blindness,

70 (9), 376-379.

Smith, A. & O'Donnell, L.M. (1992). Beyond arm's reach: Enhancing distance vision.

Philadelphia: Pennsylvania College of Optometry Press.

Project IVEY: Increasing visual efficiency

(1983). Vol. V-E. Tallahassee: Florida Department of Education.

Web Sites

American Foundation for the Blind
www.afb.org

Lighthouse International
www.lighthouse.org

National Agenda for Children and Youths with Visual Impairments Including Those with Multiple Disabilities
http://www.afb.org/nationalagenda.asp

Texas School for the Blind and Visually Impaired
www.tsbvi.edu

V.I. Guide: A guide to Internet resources about visual impairments, for parents and teachers
www.viguide.com