Visually impaired children make up a small
number of students in the public school system. Only about 2 out of every 1,000
school age children are visually impaired (Rosenblum 2000). But however small
the number, these children need special attention and provisions in the
classroom. Mikie* is no exception to this. He is nine years old and has been
blind all his life. He uses a cane to maneuver and makes his way around quite
well. He is in a self-contained classroom in a public school. If Mikie’s only
problem was with his vision, he might not be in the self-contained class. Mikie
is in the fourth grade, but his thinking and processing level is that of a
three-year-old. He often repeats what is said to or asked of him. He is
tactually defensive in that he does not like touching or feeling new things. He
thinks of new feelings as being painful. Mikie does catch on fairly quickly to
things and his ability to recall songs and stories is amazing. He sings all the
songs in class and finishes stories that are being read. He is an active
participant in the classroom and often the only one to answer questions. While
all these things are what make Mikie who he is, I have chosen to mainly focus
on his blindness for this paper.
Mikie has been given numerous tests
throughout his young life. He was identified as an infant as being blind. He
has taken the Vineland Adaptive Behavior Scale, the Weschler Preschool and
Primary Scale of Intelligence, and the Slosson Intelligence Test. Mikie has also
taken the Visual Aural Digit Span Test, which is a test for memory. Every three
years he undergoes a test for social history that test several different
categories, such as communication, vision/hearing screening, individual
achievement and adaptive behavior.
*Name changed to protect privacy.
Mikie
annually participates in occupational and physical therapy evaluations. Also
every year his skills are tested by the Oregon Project Skills Inventory and the
Brigance Inventory of Early Development. The cut-off scores for all these tests
and evaluations were not accessible to me.
I was introduced to the class and spent most of the day watching the various activities taking place. I saw one-on-one worktime between Mikie and the teacher. She was helping him run his fingers quickly across a page of Braille letters. This was to help him learn to go from left to right across a page. He was given various coins, one a time, and asked to name them by touch. He did well on the quarter and dime, but confused the nickel and penny. He told the teacher his name, but when asked what her name was he said “ex-wife.” She asked him again and tried to hint by saying “Mrs.” But his response was “Mrs. Ex-wife.” One class had some baby chicks in the room and we stopped to see them on the way to recess. Mikie heard them chirping but was very adamant about not wanting to touch them. At recess he stayed on the swings while the teacher pushed him. I went with him to therapy where the therapist worked at first to cut down his defensiveness to touch. She brushed his arms and legs with a plastic brush, did joint compressions and gave him sour candy to stimulate his senses. She let me look at some of his weekly goals and some examples are:
§ Identify right and left body sides by putting hands on self within five seconds
§ Use one hand to retrieve and/or place five objects on the opposite side of the body
§ Consistently stabilize a bowl with one hand while stirring or scooping with the other hand
§ Use an auditorially directed unilateral hand approach in any direction
Visit #2
The day started with circle time where everyone was greeted with a good morning song. They went through which day of the week it was, the date and the month. Mikie counted and sang the loudest of all the children. The teacher held up the letter O and asked what it was. Mikie said ‘O’ and we kind of laughed because it was correct. He was given wooden shapes and asked to identify them. He correctly identified circle, square and rectangle. She began to read a book that Mikie had obviously heard a lot because he would finish the sentences. He then swung on the therapy swing. After that it was reading center for him. He let me read a book with him. He knew it so well that he finished the sentences for it too. He let me hold his hand and help him to his feet.
Visit #3
Today was pretty much the same as the visit before. He sang the songs during circle time and answered most of the questions. He seemed very affectionate and quiet today. He sat in a beanbag and read his books for the majority of the time that I was there.
Visit #4
Mikie was about 15 minutes late today. Soon after he arrived the therapist came to take him to occupational therapy. We went to leave and she asked him to open the door. He accidentally turned out the lights and everyone responded in a surprised manner. He kept apologizing over and over again, even after we told him it was all right. In therapy she first brushed his arms and legs. She asked him to lift his left leg and he did. She then asked him lay down on the floor. He was a bit awkward but made it down. She told me that at first he would not even lay on his stomach. She put some balls out to the side and had him feel around for them. He then had to find the cup on the other side to put them in. The goal was for him to reach over and place them in the cup rather than switch hands. After several times he finally got the hang of it and did it correctly. She had to put sour drops on his tongue a few times to get his attention. After going back to class, we went to the kitchen center. I asked him his phone number, which he knew very well.
Visit #5
During circle time Mikie identified a rectangle by description only. I began to really notice that he mixes up yes and no. Even if he means yes, he says no. I observed his worktime with the teacher. He opened and closed the lid of a box when asked. When given a dollar, he was able to identify it. She gave him a dime and he said quarter, got the penny correct, called the quarter a dime, and the nickel a penny. The second round he got the dime and quarter correct, but called the nickel a dime. He was asked to put some markers in a cup and bears in a box. He put the markers and the bears in the box every time. When I left he told me good-bye.
Visit #6
Today I went with him to physical therapy. He opened the door correctly the first time, but had trouble closing it behind him. He went up steps fairly well, but had difficulty coming back down. He responded correctly to directional instructions such as “turn right.” She helped him onto a trampoline. He bounced while holding her hands, but did not raise his feet. He was able to step over a beam with assistance. He could stand on one foot with assistance for 10 seconds.
Visit #7
Today I was able to work one-on-one with Mikie during his worktime. At first he seemed troubled about it. He did not want to hold anything or respond at all. However, after a few minutes of talking to him, he was fine. I gave him objects to identify such as coins, a Koosh ball, marble, piece of fur, Styrofoam ball, wooden square, watch and rock. He correctly identified all but the coins. It was interesting to see his reaction when he worked one-on-one with someone new.
Visit #8
Today Mikie and I went to the reading center. We looked at books especially for visually impaired children. They have protruding shapes and objects on each page. The main one we read was the Roly-Poly Man book. While reading it I asked him to find the roly-poly man’s arms, legs, head and belly. He was confident about the arms, legs and head. He had some trouble with the belly though. I would then ask them where his arms, legs, head and belly were. He did correctly point them out on himself.
Visit #9
Today at circle time the teacher asked what holiday was coming up. No one answered so she hinted by saying “Thanks” and Mikie answered with “giving.” They sang a number song about one through five. She asked what came next and he said six. He then went to the kitchen center where he played quietly alone.
IV. Development
A. Mikie’s physical development is pretty much the same as that of children his age. The biggest difference is that he is still working on toileting. His body is proportional and average size for his age group. His social development is good in my opinion. He gets along well with other children and everyone seems to really like him. He is a pleasure to be around. His cognitive development is what distinguishes him from other children his age. He thinks and processes on a younger level than his peers. He is working on memorization of basic survival things and recognition of money, shapes, etc. These are things that children his age have known for quite a while. He works on days of the week, months of the year and sorting objects. It requires much more time when teaching him new concepts than other children his age.
B. This experience has really opened my eyes to the life of a disabled student. I did not really have any prior experience with disabled students before these observations. I not only got involved with Mikie, but also the other students in the class. I saw several different cases of disabilities and how each requires special care and patience. I saw how frustrating it can be when no one answers questions that we see as so simple, like what day comes next. I saw the reaction of the children and teachers when a child becomes physically violent, and how it is handled. While this experience may have startled me a bit, I’m very grateful to have had it. It really made me aware of the variety of things going on in schools. It also gave me a bit of a sneak preview of the things I have to look forward to. I may not ever have a disabled student in my class, but that is a very small chance. This will help me prepare for things I will probably encounter in the future. And all of it has only made me more eager to get into the schools and do my part to help make the lives of these children better.
V. Research
Articles
Summaries
Knowing the environment around them is very important for visually impaired children. This knowledge helps in their movements and daily activities. Teachers and other students must help the child learn their surroundings through interaction. One manipulative that helps with this process is a tactile map. A group of visually impaired children, ages five to eleven, used these maps to familiarize themselves with the environment, and it was found that this resulted in a better understanding than exploration alone (Budd, LaGrow 2000). It was later found that age had an impact on the effectiveness of these two-dimensional maps (Budd, LaGrow 2000). An answer to this was to test the use of a three-dimensional model. Four visually impaired children between the ages of seven and eleven took part in a study using a 3-D, interactive, wooden model called the Buddy Road Kit which contains pieces representing roads, buildings, crosswalks, vehicles and people (Budd, LaGrow 2000). Three different layouts were set up to simulate various environments. The children were able to manipulate the pieces and work through various routes. They were then assessed through their knowledge of environmental concepts in the real environment (Budd, LaGrow 2000). This knowledge was mastered if thirteen concepts were executed safely; vehicles, pedestrians, park, traffic lane, yield/stop sign/traffic light, cardinal directions, landmarks and destination. The average score was 89% (Budd, LaGrow 2000).
The second article focuses on the problem of the lighting in classrooms for children with low vision. It suggests the use of fluorescent materials under blacklights. There have been few studies done on this, but it is claimed that under these conditions children perform better on discrimination tasks (LaGrow, Leung, Leung 1998). There were four conditions under which children were tested: ‘A’ which was nonreflective white stimuli on a black background viewed under standard fluorescent lighting, ‘B’ which was fluorescent orange stimuli on a black background viewed under standard fluorescent lighting, ‘C’ was nonreflective white stimuli on a black background viewed under ultraviolet or black lighting, and ‘D’ was fluorescent orange stimuli on a black background viewed under blacklights (LaGrow, Leung, Leung 1998). Thirty students with measurable visual acuity were used in the test. The children were tested in each condition with black cardboard that had a Snellen Illiterate E in the center that was turned four different directions (LaGrow, Leung, Leung 1998). Two sets were made, one in nonreflective white and one in fluorescent orange. The students had to identify the direction of the E at six different distances. After testing under all conditions, the child ranked the conditions in the order of their preference (LaGrow, Leung, Leung 1998). Condition ‘D’ was ranked the highest, then ‘B’, ‘A’, and lastly, ‘C’ (LaGrow, Leung, Leung 1998). It was concluded that more research needs to be done on this topic.
The third article addresses the motor development of children that are visually impaired. It is suggested that the motor development is influenced by the “insufficient stimulation of the tactile, kinesthetic, and auditory functions in the early years” (Reimer, Smits-Engelsman, Siemonsma-Boom 1999). The study consists of eight sections to test motor skills. The eight sections were then divided into four categories; one-handed skills (putting coins in a piggy bank and pegs on a ring), two-handed skills (screwing two nuts on a bolt, threading beads, threading a cord through a board), perception of movement (Kinesthetic Acuity Test and Kinesthetic Memory Trace), and for those with low vision, hand-eye coordination (Reimer, Smits-Engelsman, Siemonsma-Boom 1999). The study participants included both visually impaired, divided into blind and low vision, and sighted children. The results showed that the blind children needed more time on the one-hand and two-hand skills tests, and the low vision children took longer to perform the hand-eye coordination task (Reimer, Smits-Engelsman, Siemonsma-Boom 1999).
The fourth article focuses on the relationships between visually impaired adolescents and their best friends. There are usually very few visually impaired students in a school district, which can result in frustration and a lack of understanding by peers and teachers. The study consisted of visually impaired adolescents that attend general education classes and their best friends. Each student was interviewed ten times, all on the same day but in different locations. The interviews were divided into three parts: the visually impaired student alone, the friend alone, and the two together (Rosenblum 2000). These interviews gave the students the opportunity to talk about the friendship. The interviews showed that almost all the visually impaired students had negative feelings and wished they could do things their sighted friends could do, such as drive a car (Rosenblum 2000). All of the participants felt that they were involved in relationships in which they were respected. The sighted students felt that these friendships were “beneficial and worth any additional effort that might be necessary because of decreased or absent functional vision” (Rosenblum 2000).
The last article is about low vision care for visually impaired children in Iowa. Care is provided for students age birth to 21years old and at no cost (Wilkinson, Stewart, Trantham 2000). After an assessment of the care services, it was found that the best care was not being offered. The system was then made more comprehensive. A few examples of the standards are to provide clinical and functional vision information to families and teachers, screen students to determine their need for full orientation and mobility (O&M) evaluations, make services closer to students’ houses, lend optical devices to students or allow them to purchase the devices at a lower cost, and provide O&M follow-ups (Wilkinson, Stewart, Trantham 2000). They have also established a transdisciplinary team to provide services. The team consists of ten key players: low vision clinician, educational consultant, consultants for early childhood students and students with additional disabilities, technology consultant, O&M specialist, student, parents/caregivers, classroom teacher, teacher of visually impaired students, and eyecare professional (Wilkinson, Stewart, Trantham 2000). This team works together to provide the best services for the children’s optimal benefits.
VI. References
Budd, J., LaGrow, S. (2000). Using a three-dimensional interactive model to teach
environmental concepts to visually impaired children. Re:view, 32 (2),
83-94.
LaGrow, S., Leung, J., Leung,
S. (1998). The effects on visually impaired children viewing fluorescent materials under blacklight conditions. Journal of Visual
Impairment and Blindness, 92 (5), 313-321.
Reimer, A., Smits-Engelsman, B., Siemonsma-Boom, M. (1999). Development of an
instrument to measure manual dexterity in children with visual impairments aged
6-12. Journal of Visual Impairments and Blindness, 93 (10), 643-658.
Rosenblum, L. (2000). Perceptions of the impact of visual impairment on the lives of
adolescents. Journal of Visual Impairments and Blindness, 94 (7), 434-445.
Wilkinson, M., Stewart, I., Trantham, C. (2000). The Iowa model for pediatric low vision
services. Journal of Visual Impairments and Blindness, 94 (7), 446-452.
VII. Provisions
Mikie’s seat is at the end during circle time so he can easily access it. The space between centers is wide enough for him to use his cane to maneuver. He does not take paper-pencil tests so he is assessed by evaluation and observation. His file contains photos to show progress throughout the year. The work he does is documented by photos and the IEP Data Collection Form that is filled out weekly. There was not ever a discipline problem with him while I was there. He responded to the teacher’s directions very well. He sometimes would have to be retold to put his hands down, but nothing real serious ever occurred. He goes to therapy two or three times a week. He has specific weekly goals there too as I mentioned during visit #1. These goals seemed appropriate and attainable for him. One thing I would like to see in the classroom is more one-on-one time with him. I understand that it is hard in any class, and extremely difficult in a self-contained class, but I would still like to see more of it. He does get a session each day, and the length is probably appropriate for him, but it just does not seem like enough to me. he can respond correctly to a question, and then five minutes later he will answer it completely incorrectly. I also would like to see better use of the centers for him. He goes to a center and has no interaction. For example, he goes to the kitchen center alone and just stands there hitting objects together until it is time to switch. In my opinion, this could be valuable time with the child. One could just simply ask questions like what is your phone number, what is my name, lets count together. I do think the teacher is doing an exceptional job in her class and I know this would be impossible for her to do on her own. There are five other students in there that need her attention and help as well. There is an assistant that helps a lot, but no one that really works individually with him.
VIII. Floor
Plan/Centers
If I had a visually impaired student in my class I would make sure the walkways were wide and clear of objects so he or she could easily move around without running into anything. I would not hang anything too low from the ceiling so they would not walk into it. I would make sure his or her seat would be easily accessible and the right height so the feet are touching the floor. The door handle and light switch would be low enough so the child could learn to operate them. These seem like simple things, but are things that a visually impaired child would need to learn how to do. There would be plenty of materials appropriate for visually impaired children in the centers, as well as plenty of Braille manipulatives. There would be a reading center with beanbags, Braille books, and books with protruding shapes and pictures. There would be a kitchen center with kitchen objects and a telephone so the child can feel what these things feel like. There would be a therapy swing away from all the other centers so no one gets hurt. There would be a listening center with a comfortable seat. There would be headphones and music, as well as audio books. There would also be a sensory center with objects to stimulate the senses. For example, scented candles to smell, sour and sweet candies to taste, and rocks, yarn, soap, Koosh balls to feel. I feel this and the listening center would be important centers for visually impaired children, especially those that are tactually defensive. These children need somewhere to feel comfortable and a place to use their active senses.