What Are the Foundations of Blindness and Low Vision?

• Special institutions and schools for teaching students with blindness and low vision emerged in the United Stated in the 1800s. Public school programs emerged in the 20th century. During the 1990s, experts and advocates developed a National Agenda for improving educational programming for students with blindness and low vision.
• Legal blindness is defined as visual acuity of 20/200 or worse in the best eye with the best possible correction. Legal blindness can also be defined as field of vision restricted to 20 degrees. Using the legal definition, low vision is defined as visual acuity of 20/70 to 20/200 in the best eye with the best possible correction and generally being able to read printed materials. Functional blindness is defined as having little or no residual or functional vision and requiring learning through tactile, auditory strategies, braille, or other assistive technologies rather than directly through printed materials.
• The IDEA 04 definition of a visual impairment focuses on vision loss that adversely affects educational performance and includes both blindness and low vision. Determining how a student is able to use any residual vision is more important for teachers than the legal definitions.
• The overall prevalence rate of students with blindness or low vision in schools is estimated to be .04%, although this figure may be low. More students are identified as being able to use print materials than are those who use only braille or auditory strategies for learning.

What Are the Causes and Characteristics of Blindness and Low Vision?

• Problems with vision are classified as optical defects, ocular motility defects, and external and internal problems of the eye. Optical defects are problems with refraction and refractive mechanisms in the eye. Ocular motility defects involve problems with binocular vision. External problems of the eye can affect the orbit, eyelids, and cornea. Internal problems of the eye include retinopathy of prematurity (ROP), which results in damage to the eye associated with complications from premature birth. Cortical visual impairment results from brain damage that affects the reception and interpretation of auditory nerve impulses. The actual components of the eye are normal or nearly so.
• Characteristics of students with blindness or low vision may depend on age of onset, whether the students are blind or low vision, and the specifics of the problem.
• Intellectual ability is generally unaffected in students with blindness and low vision. Play and social interaction skills can be delayed. Language development is generally typical, but some students have difficulty with nonverbal communication because they do not see these important aspects of communication. Academic achievement can lag, but most students should be able to achieve at least at average levels. Perceptual abilities are affected, resulting in the need for the development of orientation and mobility skills and wayfinding skills. Psychological and social adjustments are not uniquely affected by blindness and low vision, but peer relationships and friendships may be affected. The effect may stem from less sophisticated social skills on the part of a student with blindness or low vision or from negative reactions from peers.

How Are Students with Blindness or Low Vision Identified?

• Children with congenital and severe impairments are generally identified through medical procedures by 4 months of age.
• Routine visual screening is typically done when children enter school. Snellen chart procedures are often used for screening at this time.
• A comprehensive assessment is needed that includes functional vision assessment, learning media assessment, assessment of cognitive ability, academic achievement, orientation and mobility skills, and social and independent living skills.

What and How Do I Teach Students with Blindness or Low Vision?

• Early intervention is important for children identified with vision loss for typical development to occur. Family involvement should be considered and family members included in intervention efforts.
• Students with blindness and low vision generally learn the same academic content as peers. However, they may need to learn some skills not included in the general core curriculum or skills that are included in that curriculum, but not to the degree needed.
• Students with blindness or low vision should learn skills included in the expanded core curriculum including compensatory skills, literacy and braille skills, orientation and mobility skills, social interaction skills, independent living skills, recreation and leisure skills, career transition skills, and visual efficiency skills.
• Instructional procedures may need to be modified to ensure students with blindness and low vision can access learning activities and materials.
• Physical issues that may need to be addressed or planned for include physical appearance of the eyes, care for the eyes, unusual mannerisms, and the responses of others.
• Perceptual issues that may need to be addressed or planned for include learning how to use residual vision, seating arrangement, accommodating for depth perception, visual discrimination, and color discrimination problems.
• Teachers can provide copies of notes, read aloud, supply audiotapes of print materials, and provide for hands-on learning activities. The use of models and manipulatives may also be helpful.

What Are Other Considerations for Teaching Students with Blindness or Low Vision?

• The LRE for students with blindness and low vision is often the general education classroom with special adaptations and consultation from a special education teacher. Itinerant models of service delivery may be used in some school districts. Some students may attend special residential schools that are specifically designed for students with blindness and low vision.
• The physical environment of the classroom may need to be adapted to maximize use of functional vision.
• Materials may need to be adapted to suit both print readers and braille users. Teachers can modify visual materials by removing visual clutter, making materials tactile, converting them to auditory form, having narration for videos and other visual presentations, and using real objects as substitutes for pictures.
• Assistive technology should be chosen based on individual need and learning media assessment. A variety of technologies are available including software that allows for better access to print and scanned materials and to braille access software.
• Guide dogs can be of assistance in mobility.

What Are Some Considerations for the General Education Teacher?

• Factors that inhibit inclusion of students who are blind or have low vision are the belief that large print materials are always easily produced and that bigger is better, lack of training in optical device and computer software use, and a lack of available appropriately trained special education personnel.
• Factors facilitating inclusion of students who are blind or have low vision include a philosophy that students should be prepared for lifelong learning, the understanding that computer technologies may allow access to regular print materials, and a core group of individuals committed to excellence in service provision.
• The general education teacher may need to make adaptations in the physical environment, the teaching materials and activities, and in the assignments given. Planning should be done to support social relationships with peers.
• Feedback may need to be given in person, by recording, or by computer as some students will not be able to read written feedback from their teachers.
• General education teachers should maintain high expectations for learning and performance.