Teaching Students with Sensory Impairments
Definitions, Identification, and Supportive Professionals
II. Identifying a Student with Vision Impairment
Dolly Bhargava
Sometimes vision problems develop over time or they are so subtle that they have gone
previously undiagnosed. Often a student can have vision impairment, but it may have
gone unnoticed. The student is often the last one to recognize or report a loss in vision
unless it has deteriorated. If the vision impairment remains undetected, it can result in the
student facing a substantial educational disadvantage because of adverse effects on the
student’s academic, communication, and social development. This can interfere with a
student’s ability to reach full potential. On a medical note, if the vision problem is left
undetected and untreated, it can cause permanent loss of vision and the long-term
consequences can be serious in terms of quality of life.
Consider the case of Koby, a 14-year-old boy who had undiagnosed type 2 diabetes.
The undiagnosed diabetes led to many complications, including progressive
cardiovascular disease, kidney disease, and vision impairment. Sadly, Koby’s teacher
failed to recognize behaviors that were attributable to undiagnosed vision impairment.
Some of them included his constant complaining that the lights in the classroom were
too bright, difficulties with copying work correctly from the board and bumping into
things in the room. The effects of the undiagnosed vision impairment were far-reaching
and were responsible for reading and writing difficulties that he experienced throughout
his schooling.
A. Indicators of a Vision Impairment
Source: Children with Low Vision: A Handbook for Schools
Elmwood Visual Resource Centre, Christchurch, New Zealand
Teachers need to be aware of the indicators that signal that a student has vision
impairment. Table 1 is a guide that you can use to identify whether a child in your class
has a vision impairment.
Table 1 - A Guide for Detecting Vision Problems in the Classroom
APPEARANCE OF EYES
One eye turns in or out at any time
Reddened eyes or lids
Eyes tear excessively
Encrusted eyelids
Frequent styes on lids
COMPLAINTS WHEN USING EYES AT DESK
Headaches in forehead or temples
Burning or itching after reading or desk work
Nausea or dizziness
Print blurs after reading a short time
BEHAVIOURAL SIGNS OF VISUAL PROBLEMS
Eye Movement Abilities (Ocular Motility)
Head turns as reads across page
Loses place often during reading
Needs finger or marker to keep place
Displays short attention span in reading or
copying
Too frequently omits words
Repeatedly omits "small" words
Writes up or down hill on paper
Rereads or skips lines unknowingly
Orients drawings poorly on page
Eye Teaming Abilities (Binocularity)
Complains of seeing double (diplopia)
Repeats letters within words
Omits letters, numbers or phrases
Misaligns digits in number columns
Squints, closes or covers one eye
Tilts head extremely while working at desk
Consistently shows gross postural deviations
at all desk activities
Must feel things to assist in any interpretation
Eye-Hand Coordination Abilities
required
Eyes not used to "steer" hand movements
(extreme lack of orientation, placement of
words or drawings on page)
Writes crookedly, poorly spaced: cannot stay
on ruled lines
Misaligns both horizontal and vertical series of
numbers
Uses hand or fingers to keep his place on the
page
Uses other hand as "spacer" to control spacing
and alignment on page
Repeatedly confuses left-right directions
Visual Form Perception (Visual Comparison, Mistakes words with same or similar
Visual Imagery, Visualization)
beginnings
Fails to recognize same word in next sentence
Reverses letters and/or words in writing and
copying
Confuses likenesses and minor differences
Confuses same word in same sentence
Repeatedly confuses similar beginnings and
endings of words
Fails to visualize what is read either silently or
orally
Whispers to self for reinforcement while
reading silently
Returns to "drawing with fingers" to decide
likes and differences
Refractive Status (Nearsightness,
Comprehension reduces as reading continued;
Farsightedness, Focus Problems, etc.)
loses interest too quickly
Mispronounces similar words as continues
reading
Blinks excessively at desk tasks and/or reading;
not elsewhere
Holds book too closely; face too close to desk
surface
Avoids all possible near-centered tasks
Complains of discomfort in tasks that demand
visual interpretation
Closes or covers one eye when reading or
doing desk work
Makes errors in copying from chalkboard to
paper on desk
Makes errors in copying from reference book to
notebook
Squints to see chalkboard, or requests to move
nearer
Rubs eyes during or after short periods of visual
activity
Fatigues easily; blinks to make chalkboard clear
up after desk task
Students with sensory disabilities have a wide variety of ways to learn and benefit from
a curriculum that is shaped to meet their unique needs, skills, interests and abilities.
They may need additional help in the form of special equipment and modifications in the
typical curriculum to further develop listening skills, communication, orientation and
mobility, vocational or career options, and daily living skills. But it’s exciting to realize
that once we make these modifications, students can become full participants in their
classes, establishing lasting friendships, and develop the skills to continue individual
growth and pursue knowledge.
B. Learning Characteristics
Dolly Bhargava
Vision is one of the most important senses. It plays a vital part in the learning process.
It is held that more than 80% of education is presented through the visual senses
(Pagliano, 1994). Lowenfield (1983), one of the early educational writers in the field,
stated that, blindness imposes three basic limitations on an individual in terms of
-
Range and variety of experiences
Ability to get about
Control of the environment and the self in relation to it
The extent to which a student is affected in these three areas will depend on the type
and degree of vision impairment, resulting in the student having unique educational and
learning needs. The student with vision impairment may lag behind in achievement in
comparison to sighted peers due to the impact of visual impairment on learning.
Therefore, the student will require skills to be specifically and explicitly taught, along
with considerable additional time and opportunities to practice these skills.
How do students who are blind or vision impaired develop an understanding of
concepts, communication, social, orientation and mobility skills? How do they develop
the ability to independently participate in everyday life activities?
B - 1 Understanding Concepts
Vision is the main sense that allows us organize, synthesize and integrate
information received from the environment to help us develop concepts about the
world and how it works. In the absence of vision or in the situation of limited
vision the student often has to rely on the remaining senses of hearing, touch,
smell, movement and taste to help assign meaning to the world. However,
learning through the other senses is not always accurate and can sometimes
result in a fragmented or partial understanding of the total concept. For example,
feeling a raised outline of a tree is not the same in terms of the texture or size of
a tree. This results in the student developing concepts based on limited and
fragmented information as the student is unable to use his or her sense of sight
to unify the different parts of the world and develop a complete picture of what is
happening.
Blindness and vision impairment result in a limited ability to explore the
environment. In the absence of vision or in the situation of limited vision, the
student cannot see classroom displays or range of activity options in the
environment. The student will need systematic instruction on how to explore the
environment, given the time to explore it in a way that is meaningful.
The development of spatial concepts is also affected by vision impairment. This
includes the ability to develop an understanding of where the body is positioned
in relation to the classroom environment (Is the student in the front, back, or
middle of the room? What is the distance from classroom objects such as a
bookshelf or the teacher’s desk?) This further impacts understanding of
directions such as up, down, right or left, in considering space and distance.
Our sense of vision provides information on how we look and how others look
and interact. This information is then incorporated into our own interactions.
Students who are blind use other senses such as touch and sound to gain this
information, limiting the extent of their knowledge. For example, knowing what
one looks like by feeling one body part at a time may cause “difficulties
understanding how all the different parts related to each other” (Lewis, 2002, pp.
63). And social appropriateness imposes restrictions on touching others. This
inability to see others may provoke emotional responses and a sense of isolation.
Time concepts such as morning, afternoon, and night are learned through
observation and use. A child perceives differences between morning and night
by seeing and making the connection between nighttime, associated with moon,
stars, dark environment, whereas morning equates with sun and light. For a
student who is blind, understanding such environmental concepts is difficult
because of limitations with visually associating the concept with the discussion.
We might consider the difficulty of explaining the concept of clouds or stars or the
moon in the sky to someone who is blind.
B - 2 Independent Living Skills
These areas include personal hygiene, food preparation, money management, time
management, and skills related to organizing personal space so it is easily
accessible. For example, a child needing to prepare cereal for breakfast should
first be familiar with the kitchen environment in order to locate the cereals, milk, and
utensils. The child needs to know the process involved in preparing cereal, such as
getting the bowl, spoon, cereal and milk. Next, it’s necessary to pour an adequate
amount of cereal and milk into a bowl and take it to the dining table and afterwards
wash and put things back in their original location. Students who do not have vision
impairment learn this incidentally by observing others. However, students who are
legally blind are unable to pick up these skills through observation and need direct
teaching of these skills.
B - 3 - Communication Skills
These areas include receptive and expressive language. Communication is
developed by having a variety of experiences where the involvement is as an active
participant or learning by watching others. Due to visual limitations, the student
may have had a limited variety of experiences and missed out on incidental
learning. This effects the student’s understanding and expression. For example, a
student without a vision impairment who has never given a speech before but has
watched peers present would still have learned how to stand in the front of the
room, face the audience, and speak in a loud voice. However, a student who is
legally blind’s knowledge of giving a speech might be limited to someone talking
about a particular topic, requiring direct teaching of such skills.
Often, students with vision impairments are unable to associate words with
discussion topics. For example, a student who is blind or has low vision may be
hearing what the teacher is saying but cannot associate it with the drawing that the
teacher has made on the blackboard or a demonstration of how to carry out an
experiment. This may result in the student using or appearing to be
comprehending words without fully understanding them
In the absence of vision, the student may have difficulty identifying the similarities
between objects via visual information (Dunlea, 1989) and difficulty with
categorization Tobin (1997). For example, the student may know that an apple is a
fruit. Yet, knowing that bananas, pears, peaches and oranges all belong to the
same category although they don’t feel, taste or smell the same is something that
would need to be taught explicitly.
B - 4 Social Skill Development
The term “social skills” is an all - encompassing one, which includes conversation
skills, making friendships, dealing with feelings and classroom skills. We think of
conversations as involving verbal and non-verbal communication. Non-verbal
communication includes body language, facial expressions, gestures,
mannerisms, tone of voice and appearance. A large part of messages is
communicated non-verbally, such as through a nod, frown, smile, and shrug. A
great deal of our interaction is based not only on our ability to understand verbal
communication, but also the ability to read and understand non - verbal
communication. We learn appropriate social behaviours by watching what other
people do and copying them. Therefore a student may have good oral language
but may lack the more subtle communication skills of gesture, posture, facial
expression and general body language, which are so important.
Students with legal blindness do not receive visual information from the
environment to know where their friends are in the playground or how to read
body language and facial expressions in order to judge how others are feeling or
whether what they are saying is being understood or is of interest to others.
B - 5 Orientation and Mobility Skills
Many students who are blind or vision impaired experience difficulties with creating
a mental map of their environment in order to figure out which direction to go or
how to find their way round obstacles to reach their goal (Mason et al, 1997). It is
extremely important that students receive orientation and mobility training to
develop concepts, skills, and techniques needed to travel safely, efficiently, and
independently in environments. Orientation skills refer to the thinking skills involved
in knowing where we are in relation to the environment and the objects in it and
how to find our way to the destination such as knowing that we are at the school
bus stop and its location in relation to classroom or the assembly hall or the school
office. Mobility skills involve the actual movement to our destination independently,
safely, and with confidence. For example, if students want to get from their
classroom to the school office, they need to be aware of the different clues or
landmarks that they can use to independently get there. A crucial point to keep in
mind all of these skills will need to be directly taught.