By Andrew Kane Patrick Waldron Vision Impairments By Andrew Kane Patrick Waldron

Vision Impairments Is vision loss of a person to such a degree as to qualify as an additional support need through a significant limitation of visual capability resulting from either disease, trauma, or congenital or degenerative conditions that cannot be corrected by conventional means, such as refractive correction, medication, or surgery.

Classifications of Blindness In the United States, the terms "partially sighted," "low vision," "legally blind," and "totally blind" are used by schools, colleges, and other educational institutions to describe students with visual impairments.

Continued Partially sighted indicates some type of visual problem, with a need of person to receive special education in some cases Low vision generally refers to a severe visual impairment, not necessarily limited to distance vision. Low vision applies to all individuals with sight who are unable to read the newspaper at a normal viewing distance, even with the aid of eyeglasses or contact lenses. They use a combination of vision and other senses to learn, although they may require adaptations in lighting or the size of print, and, sometimes, Braille Myopic - unable to see distant objects clearly, commonly called near-sighted or short-sighted Hyperopic - unable to see close objects clearly, commonly called far-sighted or long-sighted

Continued Legally blind indicates that a person has less than 20/200 vision in the better eye after best correction (contact lenses or glasses), or a field of vision of less than 20 degrees in the better eye; Totally blind students learn via Braille or other non-visual media.

Facts Visual impairment is the consequence of a functional loss of vision, rather than the eye disorder itself. The leading causes of vision impairment and blindness in the United States are age-related eye diseases: macular degeneration, cataract and glaucoma. Other eye disorders, eye injuries and birth defects can also cause vision loss. Every year 50,000 Americans become blind. Blindness occurs most often with advancing age, with half of all blind people generally considered to be over sixty-five. A significant number of blind people, however, are children or young adults.

Causes Malnutrition Infectious Diseases Parasitic Infestations Other: Infants of mothers who have had rubella (German measles) in early pregnancy. Infants of mothers with gonorrhea (countered with administration of erythromycin ointment or silver nitrate solution at birth to newborn’s eyes).

Continued Diabetic Retinopathy: Retinitis Pigmentosa: The increased lifespan of diabetics has increased the incidence of this disorder. Changes in the tiny blood vessels of the diabetic’s retina can cause blindness. Abnormal blood vessels are formed, some may burst and the retina may even break loose for the back of the eye. Laser treatments to “seal” blood vessels or reattach the retina may help if undertaken early. Some diabetics, incidentally, do not experience vision loss. Retinitis Pigmentosa: Frequently beginning as what is called “night blindness,” this condition brings degeneration of the retina and the choroid (a related vascular area), usually involving an abnormal development of excess pigment. It is hereditary, with a variety of patterns of inheritance and development.

Characteristics Behavioral: Appears clumsy, especially in a new situation Holds head in an awkward position to look at something or holds a book or other objects in a peculiar position to look at them “Tunes Out” when information is on the chalkboard or in a book which the student cannot read Constantly asks a neighbor to tell him/her what is going on Shows signs of fatigue or inattentiveness Exhibits poor self concept and ego development Communicative Abilities: Less effective use of gesture and bodily action Uses less lip movement in the articulation of sounds

Continued Physical: Behavior: Rubs eyes excessively Shuts or covers one eye, tilts head or thrusts head forward Has difficulty in reading or in other work requiring close use of the eyes Blinks more than usual or is irritable when doing close work Holds books close to eyes I unable to see distant things clearly Squints eyelids together or frowns Appearance: Crossed eyes Inflamed or watery eyes Recurring styes

Continued Eyes itch, burn or feel scratchy Cannot see well Complaints: Eyes itch, burn or feel scratchy Cannot see well Dizziness, headaches, or nausea following close eye work Blurred or double vision Possible General Characteristics: Physical Fitness is below those of sighted peers Balance development is impaired Fundamental motor patterns and skills are delayed Physical growth and maturation may be imparired Wide variation in residual vision

Teaching Tips Use other sensory modalities for providing information (hearing, tactile, etc.) Use games for social development Use a beeper, constant sound source, etc. Place students where they can easily hear instruction Use contrasts / bright colors between figure and background, on target objects Increase or decrease the grade to indicate play boundaries Begin new game in slower motion

More Tips Determine the extent of the child’s visual impairment Ask students what they can see and determine what objects would be problematic for them Allow student to become familiar with the area before they start activity Have enough spacing for activities so that student does not become obstructed from any objects on the ground Be clear with instruction Do not overprotect the student, let them have as much control as possible over their own learning Break down skills into small steps Seek help from specialist teachers for other ideas Make playing distance smaller so that student does not have as much area to cover Make sure all students aware of safety rules

Suggested Activities Beep Baseball Car: Make a road out of tape and create different destinations in which a student will have to travel across Balloon Relay: Form a circle and pass a balloon around using hands to tap it Balloon Badminton: Use hands or large light mesh racquets to bat a balloon back and forth over a low net

Special Considerations Head Control: Must be encouraged because the visually impaired child may not become visually interested in his environment Trunk Control: Visually impaired children prefer to lie on their backs, but the must experience the prone position and learn how to roll back and forth and side to side Crawling: Requires help and encouragement to start crawling, create sounds to attract a child to crawl in that area Walking: Skills may be underdeveloped, confidence must be gained to enhance this skill Regard: Student may not be alert to a certain point or know how to handle an object Reaching, Grasping, and Release: Skills with hands may be underdeveloped Manipulation: Most children learn through watching, children with visual impairments learn through touch Balance: Vision affects movement and coordination

Contraindications Seek medical consultation Differs from range of vision impairment Contact Sports Diving and Swimming

Strategies for Inclusion Simple modifications (change color of ball) Team Teaching Dangerous if student is dumped into regular class

Continued Ask questions… What can the student see? When did student loose vision? Is it getting worse? How can I maximize what they can see? What type of activities does the student like to do?