1. Visual Impairment

2. An individual whose vision is impaired so that he cannot function normally in the classroom without help is said to have a visual impairment.
He may be able to see and read print but the print may have to be a particular size or colour.
He may not be able to see or read print but may see shapes and colours.
The inability to see any light whatsoever is total blindness, but this, however, is rare.
Most children can see something even if only the difference between light and darkness

3. There are varying degrees of visual impairment ranging from mild to severe.
The World Health Organisation (WHO) defines blindness as the inability to count fingers at 6 meters (20 feet or less).

4. Sight continues to develop after birth and vision must be stimulated to allow it to reach its full potential.
Seeing also requires perception to make sense of the images sent from the eye to the brain and communication skills to express what is perceived.
Therefore it may be many months before a final decision on the full extent of visual impairment in a young child is made

5. About half the children with impaired vision will have associated additional special needs – hearing or learning disabilities being the most common

6. causes The following are the main causes of visual impairment:
Before birth
Family history of blindness
Rubella or other infections such as syphilis or toxoplasmosis.

7. Around birth
Prematurity
Infections
Oxygen poisoning
After birth
Injury
Infections of the cornea or retina
Severe inflammatory diseases

8. It is thought that sight contributes to 80% of a child’s learning so when a child has a visual impairment, adaptations must be made to accommodate him.

9. Get to know the child as an individual, identify and respect the capabilities he brings to the classroom
Be aware of all the adapted materials necessary to ensure a positive and enjoyable learning experience
Ensure that the layout of the classroom remains constant to allow for independent mobility
Use materials that include the other senses when doing class activities, i.e. tactile or smell
Learn to describe class activities and interactions for those who cannot see what is happening
Read lots of stories and accompany them with objects that require touch, taste, smell and sounds.

10. Types of visual impairments vary and will depend on which part of the eye or nervous system is affected. The following are some of the more usual problems:
Albinism: too little coloured pigment is present in skin, hair and eyes resulting in too much light being admitted to the eye.
Cataracts: part of the lens becomes cloudy and the images received are blurred and unclear.
Conjunctivitis: inflammation or infection of the conjunctiva

11. Myopia: short sightedness – only near vision is clear
Nystagmus: involuntary flickering of the eyes
Optic atrophy: the optic nerve fails to send sight messages to the brain.
Strabismus (squint): weak muscles allow the eye to ‘wander’ – the eyes appear to look in different directions – affects 3 in every 100 children. Common in the new-born, it should disappear by three months of age.
Tunnel vision: only part of an image is seen, vision appears as if looking down a tube.

12. Braille
Some children will have insufficient sight to read print and therefore they will have difficulty in writing.
To overcome this, they will need to learn Braille.
This requires the child to discriminate by touch between patterns made by sets of raised dots representing letters or words.
This system was invented by Louise Braille.
Preparation for this involves helping the child to identify shapes and objects by touch.
The objects presented become smaller and smaller with increasingly subtle differences. Promoting fine motor development with strong fingers through play will provide a firm foundation and sensitivity for learning Braille.

13. General Implications
Visual impairment can delay a child’s development so stimulation and opportunities for play are important. Repetition and reinforcement of learning experiences may be needed for longer than for sighted children.
Occasionally some aspects of behaviour such as placing objects in the mouth or tapping and shouting for an echo may be mistaken for a learning disability. Developmental stages may be different and pretend play may show itself in sounds rather than in action.

14. Codes of behaviour must be applied to all children, including a child with a visual impairment. He needs the security and stability of learning right from wrong.
It would be additionally disabling for him if your expectations were low and you allowed his impairment to be used as an excuse for unacceptable behaviour.
Games and activities should be big, bright and colourful
Big: - the larger the object or the closer to the eye, the easier it is to see

15. Bright: - the more light there is, the better
Bright: - the more light there is, the better. Ensure work and play areas are well lit. Use additional lighting if necessary and use reflective or fluorescent lights.
Colourful: - eyes work best with contrasts so develop this using colourful objects against a contrasting background, spread a sheet on the floor to mark the play area.

16. Ways to help
Your understanding and thoughtfulness can make life much easier and more pleasant for blind and visually impaired people and yourself.
PLEASE
Speak to make contact – your smile may go unnoticed
Mention your name – your face may not be recognised
Ask if the person requires help and when assisting ensure the person is aware of what is around them by giving a commentary

18. When asked for directions, don’t point but give clear verbal instructions
When assisting someone who is visually impaired allow them to take your arm if necessary
PLEASE
Don’t assume that a person using a white cane or a guide dog is totally blind
Don’t assume that a person who can see to do one thing can see to do everythingDon’t shout – speak normally and clearly
Don’t try to guess what a person can and can’t see – ask them

19. Some common do’s and dont’s
Do let a blind person take your arm when you are guiding them
Don’t just take somebody’s arm and push them across the road/room
Do introduce yourself and let them know what you are doing
Don’t talk to a blind person through a third party. Speak directly to them
Do let a blind person know if you are leaving them so that they are not left talking to themselves

20. Don’t leave a blind person standing in space – let them have contact with some object e.g. wall/chair/desk
Don’t distract a guide dog that is in harness – he is a working dog. Never feed a guide dog
Do remember that a white cane with a red strip means that the person has a hearing impairment as well as a visual one.

21. Introduce yourself by name
Introduce yourself by name. Do not play the ‘Guess who’ game, it is not only childish but also infuriating to the visually impaired person.
Always excuse yourself when leaving a room or otherwise the visually impaired person could have a very embarrassing situation of talking into space
Do not speak through a third person; ask the visually impaired person themselves if they take sugar.
When guiding a visually impaired person, do remember that they should grip your arm lightly just above the elbow, fingers are on the inside of the elbow and thumb on the outside gripping lightly. An older person may prefer to link the arm through to give more security.

22. Guide’s arm should be close to the body
Guide’s arm should be close to the body. Try not to push, pull or turn a visually impaired person as this can be confusing.
At mealtimes, describe the position of meat and vegetables using the clock face positions
Any change in environment should be brought to the visually impaired person’s attention, e.g. furniture that has been rearranged, workmen with equipment that might be around the home.
Unnoted changes could mean confusion and extreme frustration for the visually impaired person

23. Avoid leaving doors ajar. Close the door or leave fully open
Avoid leaving doors ajar. Close the door or leave fully open. Do not leave objects lying around the floor. It is not only inconsiderate but also dangerous.
Do not leave a visually impaired person standing in space. Remember to leave him/her standing by a wall or chair to give a point of focus.
Encourage visually impaired people to use other senses, e.g. smell of food cooking, change of texture underfoot, making use of various sounds, as environmental clues are very important for a visually impaired person to orientate themselves to their precise location.

24. Lay out equipment in a familiar pattern each day
Provide plenty of light
Ensure there is no clutter
Brightly coloured arrows should lead to areas such as toilets and outdoors with bright Day-Glo strips on the edges of steps, including steps to the climbing frame.
Different textured surfaces to indicate specific outdoor areas such as the climbing frame area and the sand pit area

25. Raised or beaded edges to activity tables prevent objects falling off.
‘Feelie’ bags and boards help to develop muscle tone and flexible hands-necessary when using a Braille machine
Provide large print names, signs and symbols; magnifiers and signs in Braille
Provide large print books, talking books and tapes
Clear Vision (print and Braille) books can be read by a sighted or visually impaired person to children to begin to familiarise them with Braille in the same way that sighted children become familiar with print.