Developing a Local Offer for children and young
people with vision impairment: RNIB advice to LAs
Introduction
This document is intended for local authorities to use in preparing a Local Offer for
children with special educational needs and disabilities (SEND) and their families.
It provides advice and information relating to children with vision impairment and
their families.
Definition of vision impairment
Children with vision impairment have varying degrees and types of vision loss,
which may affect visual acuity (close or distance vision), visual field (peripheral
vision), visual processing, and/or eye movement disorders.
RNIB and the other organisations in the sight loss sector have adopted the
following functional definition, which is endorsed by the Vision2020 UK Children
and Young People's group. It is based on how an individual child's vision
impairment affects the way that s/he learns and develops and carries out
everyday activities.
The child or young person's vision impairment interferes with optimal
development, learning and achievements, unless adaptations are made in the
methods of presenting learning experiences, the nature of the materials used
and/or the learning environment.
(The term 'learning' includes not just academic learning but the acquisition of
mobility, life and social skills that in the case of a child or young person with vision
impairment would be provided through habilitation education. This definition
includes children and young people with other disabilities/ impairments in addition
to vision impairment, including those with profound and complex needs.)
Number and characteristics of children and young people
with vision impairment
An estimated 0.2% (2 in every 1,000) of children and young people up to the age
of 18 in the UK have vision impairment. This is based on the WHO international
classification of childhood vision impairment (see Appendix A). An estimated
0.05% (5 in every 10,000) of children up to the age of 16 are blind. This group of
children is included within the overall 0.2% estimate.
This estimate does not include children with 'mild' vision impairment or with
specific visual processing difficulties (such as face recognition) which, when
combined with other disabilities/SEN can have implications for the child's learning
and development.
There is a very high prevalence of vision impairment in the population of children
with learning disabilities. An estimated 5.6% (56 in every 10,000) children up to
the age of 16 with a learning disability are blind or partially sighted.
At least 50% of children and young people with vision impairment have additional
needs. The population of children with vision impairment can in fact be thought of
as two distinct sub-populations: those with, and those without additional
impairments/disorders. Experiences of health, education and social care are
different for children with vision impairment as their sole disability compared to
those with additional disabilities. The two groups also differ markedly on a range
of wellbeing and educational outcome measures.
Involving children and young people with vision
impairment and their families in developing and reviewing
the Local Offer
Vision impairment in children is a low incidence disability which is likely to have
high impact on their development and learning. Within this relatively small
population of children there is a wide range of abilities and needs. Because the
population is so small in comparison with other SEND groups, children with vision
impairment and their families are unlikely to be adequately represented by Parent
Forums. When consulting with children and young people with SEND and their
families, LAs need to ensure that the needs/voices of larger groups do not
subsume those of children and young people with vision impairment and their
families.
 Children and young people with vision impairment and their parents can be
contacted via:
o The LA vision impairment (VI) or sensory education advisory service
o Action for Blind People local Actionnaires group
o The local society for the blind which may have young people or parent
representation
o Other voluntary organisations such as Royal London Society for the Blind
(RLSB) and Blind Children UK (BCUK) which may have local groups
o LOOK, the National Federation of Families with Visually Impaired
Children which may have links to parents in the local area
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 When consulting with children and young people with vision impairment their
access needs must be taken into account. For example:
o Presentation of written information and self completion questionnaires
must be in the young person’s preferred format such as braille or large
print. If presented electronically it needs to be accessible to screen
readers as well as visually accessible. These factors are also essential
when communicating the Local Offer to young people with vision
impairment.
o Some materials with a highly visual content may not be appropriate for all
children with vision impairment.
o If conducting focus groups it is important to be aware that young people
with vision impairment may not be able to respond to visual cues
Involving other stakeholders to ensure the Local Offer is fit
for purpose
We suggest the following stakeholders are consulted when developing the Local
Offer for children and young people with vision impairment:
 Hospital ophthalmologists – particularly paediatric ophthalmologists
 Optometrists and orthoptists who work with children in local hospitals and low
vision clinics
 The local authority VI or sensory education advisory service
 Local schools with specialist resourced provision and (maintained and nonmaintained) special schools designated for pupils with vision impairment
 National and local voluntary organisations for blind and partially sighted people
 Local special schools with pupils with vision impairment on the school roll.
 The local authority social care sensory impairment team
What needs to be included in the Local Offer?
Screening for vision impairment
The Healthy Child Programme includes the National Screening Guidelines which
state that there are 3 key stages at which all children should receive screening
tests. These are at the new-born examination, the 6 to 8 weeks review, and the
pre-school or school-entry vision check at the age of 4-5 years.
 An area vision screening scheme for children aged 4-5 years should be in
place, which adheres to national guidelines. This can identify a reduction in
vision which may otherwise adversely affect a child’s educational development.
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Identification of vision impairment and referral pathways
Most children with vision impairment have conditions that are present from birth or
diagnosed in the first year of life. The majority of these children need specialist
support to minimise the developmental (and particularly in the case of older
children, the emotional and psychological) impact of vision impairment.
 RNIB would expect the Local Offer to have clear referral pathways from health
to education so that babies and children with vision impairment are referred as
soon as possible after identification to the LA VI or sensory education advisory
service for support from a qualified teacher of children with vision impairment
(QTVI)
o Vision 2020 UK Children and Young People’s group have developed
guidelines and a pathway which sets out the key needs and support
milestones for children and young people and their families from the
moment vision impairment is identified through to transition into the adult
pathway.
When and how a child with vision impairment is defined as having
SEN
Most children and young people with vision impairment will meet the DfE definition
of special educational needs, as they will require support which is additional to or
different from that normally provided in mainstream settings and the setting will
require specialist advice to ensure that the child is fully included and has full
access to the curriculum.
 LAs need to be clear and transparent about criteria for support:
 Access to education services should be based on an assessment, by a
QTVI, of the functional effects of the child's vision impairment. Clinical
criteria alone are not acceptable in determining a child or young person’s
access to specialist support because individual children may respond to
similar clinical levels of vision in different ways
 The requirement to involve a QTVI in assessment and support of children
and young people with vision impairment is clearly set out in the SEND
Code of Practice (e.g. paras 6.61, 9.49)
 Specialist assessment should be available for all children and young
people with VI including those who do not have an EHC plan, with
education and habilitation provision in accordance with their assessed
need
 LAs should consider using the NatSIP Criteria for Scoring Support Levels
(NatSIP, 2012) as part of this assessment.
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Provision and support that is available
The Local Offer should provide information about the support available, which
should include the following:
Early years support
 LAs need to ensure that resources are invested in early intervention and
support as soon as a vision impairment is identified
 Support should be provided by a QTVI and made available to babies and
young children with vision impairment in the home and in early years settings.
o The QTVI is frequently the professional best placed to take on a key
working role from birth and throughout a child’s education.
 Professionals supporting babies and young children and their families must
have specialist training in childhood vision impairment and should be
encouraged to use the Early Support Developmental Journal for Babies and
Children with Visual Impairment.
School support (access to curriculum, aids and equipment)
Because mainstream teachers rarely encounter learners with vision impairment
they may often struggle to teach them effectively, having had little training or
opportunity to develop appropriate teaching strategies. Support from a QTVI from
the LA VI or sensory service is therefore essential in order to provide:
o Direct teaching of specialist skills such as braille, the use of specialist
equipment and ICT
o Advice to education settings on strategies for curriculum access and
independent learning
o Guidance for teachers, TAs and therapists through INSET and ongoing
specialist advice
o Modification of learning resources and training to setting based staff in
how to do this
o Advice on access arrangements for exams
 A range of assistive and mainstream technology should be available to enable
learners with vision impairment to develop independent learning skills and
strategies
 Information should also be provided on the types of educational setting
available for children and young people with vision impairment both within and
beyond the local area.
Mobility and independence/habilitation
 Children with vision impairment should be given a mobility and
independence/habilitation skills assessment
o This should be provided by a suitably qualified practitioner such as a
children's mobility/habilitation officer and in accordance with national
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quality standards in the delivery of habilitation training (mobility and
independent living skills) for children and young people with vision
impairment
o Where the assessment identifies a need for training in mobility and
independence skills (including daily living activities) this should be
provided by a suitably qualified practitioner
o Assessments should be provided at various stages, as the child or young
person’s needs will change over time and they will require new/additional
skills to enable them to become independent.
Support from social care
 On receipt from Health of a Certification of Vision Impairment (CVI) for a child
or young person, a children’s social worker should contact the child or their
family to:
o Confirm the child’s registration as blind/severely sight impaired or
partially sighted/sight impaired
o Offer an assessment of need
o Provide information about benefits such as DLA and support in applying
for these benefits
Transition support
It is essential that transition planning is started at an early stage and that sufficient
time is allowed for decision making, to ensure that appropriate arrangements have
been made for provision of equipment, training and other access arrangements,
and that funding is in place.
 For effective transition planning the Local Offer should include:
o Information about courses available in a range of settings, including
specialist settings
o Whether the course is full-time or part-time
o For young people who will be attending part-time courses,
support/provision available to them on the days that they will not be in
education (this may be an issue in particular for young people with
additional needs and their families)
o Opportunities to take part in taster courses, and school/college or
university link programmes and for mentoring
o Opportunities for the young person to visit their new education location in
advance so they can familiarise themselves with the layout and other
aspects of the setting
o Information about the local authority’s policy on transport to local colleges
and who pays for this
o Information about support available including DSA, Access to Work
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o Assessment of the skills and training (such as mobility and
independence, use of technology) that the young person will require to
make a successful transition to a new education or work setting
o Arrangement of timely provision of specialist equipment and software in
the new setting
o Arrangements in place for co-ordination between schools, social care and
other adult services
Post-school support (16-25)
Advice and support from vision impairment specialists such as QTVIs and
mobility/habilitation officers should continue to be available to young people with
vision impairment in FE and other post-school settings.
 The Local Offer should also include information and advice to young people as
they move into higher education, training, apprenticeships and/or employment.
Information should include:
o How to access mobility/habilitation assessments and training
o Where to obtain specialist careers advice
o Work experience opportunities
o Support for young people with SEND on apprenticeships
o Where to obtain specialist employment advice
o Disability friendly employers and the ‘Two Tick’ symbol
o Disabled Students Allowance (DSA) in higher education
o Access to Work
o Advice on independent living, including accommodation
o Support for contributing to the local community and participating in wider
society
o Support to be as fit and healthy as possible in adult life, for example, by
managing their own eye health and through the provision of accessible
sports activities
Local and national support groups/organisations
The Local Offer should include a list of national and local organisations that offer
information and support to children and young people with vision impairment and
their families
Statistics and outcome measures
 When analysing and interpreting statistics and developing wellbeing and
educational outcome measures for children and young people with vision
impairment, the population should be divided into those with and those without
additional disabilities, taking into account the different needs of these groups
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 Local authorities should continue to maintain sight impairment registers for
children. This is because they are a crucial source of epidemiological
information about childhood vision impairment. They are also a route to
assessment for social care support for the child and family, as well as a way
back in to specialist support for young people making the transition back into
the home local authority after attending residential school or college.
Further information
Two key sources of research based information relating to children and young
people with vision impairment are:
1. RNIB Evidence Based Review: Children and young people
2. UK Vision Strategy: Eye health and sight loss: Statistics and information for
developing a Joint Strategic Needs Assessment
References
National Screening Guidelines (NSC) http://www.screening.nhs.uk/vision-child
NatSIP (2012) Eligibility Criteria for Scoring Support Levels. National Sensory
Impairment Partnership (NatSIP) www.natsip.org.uk
Quality standards in the delivery of habilitation training (mobility and
independent living skills) for children and young people with visual
impairment.
Quality standard in the delivery of habilitation training (PDF, 548KB)
Quality standard in the delivery of habilitation training (Word, 134KB)
RNIB (2013) Evidence-based review: Children and young people
http://www.rnib.org.uk/knowledge-and-research-hub-research-reports/evidencebased-reviews
UK Vision Strategy (2014) Eye health and sight loss: Statistics and
information for developing a Joint Strategic Needs Assessment
http://www.commissioningforeyecare.org.uk/commhome.asp?section=175&sectio
nTitle=Health+and+Wellbeing+Boards
Vision 2020 UK (2013) Pathway for Children and Young People (0 to 25 years)
with Vision Impairment, and their Families.
http://www.vision2020uk.org.uk/ukvisionstrategy/cyp-pathway
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Appendix A
Criteria for certification and registration as blind or partially
sighted in the UK
Generally, to be certified (and subsequently registered) as severely sight
impaired (blind) a person’s sight needs to fall into one of the following categories,
while wearing glasses or contact lenses that they need:
 VA of less than 3/60 with a full visual field
 VA of between 3/60 and 6/60 with a moderate reduction of field of vision,
such as tunnel vision
 VA of 6/60 or above, but with a very reduced field of vision especially if a lot
of sight is missing especially in the lower part of the field
To be certified (and subsequently registered) as sight impaired (partially
sighted) a person’s sight has to fall into one of the following categories, while
wearing glasses or contact lenses that they need:
 VA of 3/60 to 6/60 with a full field of vision
 VA of up to 6/24 with a moderate reduction of field of vision or with a central
part of vision that is clouded or blurry
 VA of up to 6/18 if a large part of their field of vision, e.g. a whole half of their
vision, is missing or a lot of their peripheral vision is missing.
For further information see:
http://www.rnib.org.uk/livingwithsightloss/registeringsightloss/Pages/vision_criteria
.aspx
World Health Organisation (WHO) definition of blindness and
visual impairment
Blindness is defined as a presenting visual acuity of less than 3/60, or a
corresponding visual field loss to less than 10° in the better eye with the available
correction.
Severe visual impairment is defined as a presenting visual acuity of between
less than 6/60 and 3/60
Moderate visual impairment is defined as a presenting visual acuity of less than
6/18 to 6/60. In this document “visual impairment” includes both severe and
moderate visual impairment.
For further information see: http://www.who.int/blindness/en/
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