@OpenLibrary 0891286950

FOUNDATIONS
OF EDUCATION
THIRD EDITION
Volume I
HISTORY and THEORY OF TEACHING
CHILDREN and YOUTHS WITH
VISUAL IMPAIRMENTS
M. CAY HOLBROOK
TESSA McCARTHY
Copyright © 2017. American Foundation for the Blind Press. All rights reserved.
CHERYL KAMEI-HANNAN
Editors
KIM T. ZEBEHAZY
Multimedia Editor
Foundations of Education : History and Theory of Teaching Children and Youths with Visual Impairments, edited by M. Cay Holbrook, et al., American Foundation for the
Blind Press, 2017. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/wmichlib-ebooks/detail.action?docID=4821255.
Created from wmichlib-ebooks on 2020-06-04 19:05:24.
Foundations of Education, Third Edition, Volume I: History and Theory of Teaching C
hildren and Youths with Vi-
sual Impairments, is copyright © 2017 by AFB Press, American Foundation for the Blind, 2 Penn Plaza, Suite
1102, New York, NY 10121. All rights reserved. No part of this work may be reproduced or transmitted
in any form or by any means, electronic or mechanical, including photocopying and recording, or by
any information storage or retrieval system, except as may be expressly permitted by the 1976 Copy-
right Act, or in writing from the publisher. Requests for permission should be addressed in writing to
AFB Press, American Foundation for the Blind, 2 Penn Plaza, Suite 1102, New York, NY 10121.
Printed in the United States of America
Library of Congress Cataloging-in-P ublication Data

Names: Holbrook, M. Cay, 1955–editor. | McCarthy, Tessa, editor. | Kamei-Hannan,
Cheryl, 1973–editor.
Title: Foundations of education / M. Cay Holbrook, Tessa McCarthy, and Cheryl Kamei-Hannan,
editors ; Kim T. Zebehazy, multimedia editor.
Other titles: History and theory of teaching c hildren and youths with visual impairments. |
Instructional strategies for teaching c hildren and youths with visual impairments.
Description: Third edition. | New York, NY : AFB Press, [2017] | Includes bibliographical references
and index. Contents: Volume I. History and theory of teaching c hildren and youths with visual
impairments—Volume II. Instructional strategies for teaching c hildren and youths with visual
impairments.
Identifiers: LCCN 2016044181 (print) | LCCN 2017000553 (ebook) | ISBN 9780891286950
(vol. 1 : hardcover : alk. paper) | ISBN 9780891286967 (vol. 2 : hardcover : alk. paper) |
ISBN 9780891287698 (online subscription) | ISBN 9780891287728 (online subscription) |
ISBN 9780891287704 (vol. 1 : epub) | ISBN 9780891287735 (vol. 2 : epub) | ISBN 9780891287711
(vol. 1 : mobi) | ISBN 9780891287742 (vol. 2 : mobi) | ISBN 9780891287704 (epub) |
ISBN 9780891287711 (mobi)

Subjects: LCSH: People with visual disabilities—Education. | Children with visual disabilities—
Education.
Classification: LCC HV1626 .F65 2017 (print) | LCC HV1626 (ebook) | DDC 371.91/1—dc23
LC record available at https://lccn.loc.gov/2016044181
The supplemental web-based AFB Learning Center video clips from the Library of Video Excerpts for
Teaching Students Who Are Blind and Visually Impaired (L.O.V.E.) were compiled by Ellen Trief of
Hunter College with funding and support from the Lavelle Fund.
The American Foundation for the Blind removes barriers, creates solutions, and expands possibilities
so p
eople with vision loss can achieve their full potential.
It is the policy of the American Foundation for the Blind to use in the first printing of its books acid-
free paper that meets the ANSI Z39.48 Standard. The infinity symbol that appears above indicates that
the paper in this printing meets that standard.
We dedicate Volume 1 of Foundations of Education to the
memory of Geraldine Scholl and Alan J. Koenig in honor of their
forward-thinking commitment to preparing teachers of the highest
quality to work with c hildren and youths who are blind or visually
impaired. Based on their guidance, we have created a resource that
is grounded in our history and informed by a rich theoretical base.
Dr. Scholl edited the first edition of this textbook at a time when
written documentation for preparing teachers of students with
visual impairments was just beginning to be collected. Dr. Koenig
coedited the second edition and conceptualized the two-volume
format that remains a cornerstone of the current text.
I M P O R T A N T N O T I C E
Dear reader of Foundations of Education, Third Edition,

The American Foundation for the Blind has developed an online learning center to accompany this
book and supplement the material contained within t hese pages. Access to the AFB Learning Center is
complimentary for purchasers of the book, but registration is required.
The AFB Learning Center for Foundations of Education, Third Edition, contains short videos, courtesy of
Ellen Trief and Hunter College, which enhance the written content by demonstrating teaching tech-
niques. The Learning Center also includes audio introductions by chapter authors, chapter overview
presentations, downloadable assessment forms and checklists, chapter appendixes, resource lists,
learning activities, and more. If you purchased an online subscription of this book, you w ill be able to
access the full text through the Learning Center as well.
Registration for the AFB Learning Center is fast and simple. Just follow t hese steps:
• Go to www.afb.o
rg/FOE3Register
• Complete the short registration form by entering your name and e-mail address, creating a user-
name and password, and entering the code FOE3.
• Submit the form.
To access the AFB Learning Center once you have registered, go to www.afb.org/FOE3. Choose the link
to log in and enter the username and password you created during registration.
If you experience technical problems or have any questions, contact AFB at afbpress@afb.net.
C O N T E N T S
ACKNOWLEDGMENTS vii
ABOUT THE CONTRIBUTORS ix
INTRODUCTION xvii
PART ONE History and Theory

CHAPTER 1 Historical Perspectives 3
Susan J. Spungin and Kathleen M. Huebner
CHAPTER 2 Visual Impairment: Terminology, Demographics, Society 50
Missy Garber and Kathleen M. Huebner
CHAPTER 3 The Visual System 73
Bill Takeshita and Kelly Lusk
CHAPTER 4 Growth and Development of Young Children 114
Kay Alicyn Ferrell and Catherine A. Smyth
CHAPTER 5 Growth and Development in Middle Childhood and Adolescence 146
Karen E. Wolffe
CHAPTER 6 Psychosocial Needs of Children and Youths 185

Cynthia S. Bachofer
CHAPTER 7 Children and Youths with Visual Impairments and Other Exceptionalities 210
Rosanne K. Silberman
CHAPTER 8 Diversity and Its Implications 250
Madeline Milian, Paula Wenner Conroy, and Silvia M. Correa-Torres
CHAPTER 9 Educational Programming 280
Sandra Lewis and Carol B. Allman
CHAPTER 10 Professional Practice 322
M. Cay Holbrook and Karen E. Blankenship
v
vi Contents
PART TWO Connecting to the Broader Context

CHAPTER 11 Applying General Education Theory to Visual Impairment 347
Dawn L. Anderson and Robert Wall Emerson
CHAPTER 12 Motivation 361
Allison Cloth, Mary G. Turri, and Catherine Archambault
CHAPTER 13 Augmentative and Alternative Communication 376
Pat Mirenda and Ellen Trief
CHAPTER 14 Consultation and Collaboration 386
Ya-Chih Chang, Cheryl Kamei-Hannan, Kevin E. O’Connor, and Nancy Toelle
CHAPTER 15 The Changing Landscapes of Rural Education 400
Linda Farr Darling
CHAPTER 16 Tiered Models of Behavioral and Instructional Support 413
Kathleen Lynne Lane, Wendy Peia Oakes, and Caryn E. Butler
CHAPTER 17 Reading and Interpreting Research 427
Tessa McCarthy and Robert Wall Emerson
CHAPTER 18 Transition Planning for Young Adults with Disabilities 441
Gary Meers and Sally L. Giittinger
CHAPTER 19 Problem Solving and Critical Thinking 456
Kim T. Zebehazy and Rachel C. Weber
CHAPTER 20 Social and Emotional Learning: Recent Research and
Practical Strategies for Educators 471
Kimberly A. Schonert-Reichl and Shelley Hymel

GLOSSARY 489
INDEX 509
A C K N O W L E D G M E N T S
The acknowledgments page in a textbook is meant students with whom we work. As one chapter
to be a space where the authors or editors can author expressed it, “I’m excited to be writing this
express their appreciation to specific p
eople who chapter b ecause I believe that students with vi-
have made a contribution to the completion of sual impairments deserve to receive instruction
the text. Before we single out individuals, we from well-prepared teachers who can guide their
would like to express our gratitude to the larger students’ academic achievement and support the
community of scholars who contributed in a va- integration of skills included in the expanded
riety of ways to this major project. In this two- core curriculum.”
volume series, a multitude of respected scholars’ During the early planning stages of this text,
voices are heard. Some have passed on, some have the editors and publisher w ere keenly aware of
retired, but all would have eagerly promoted or the historical significance of this textbook, which
endorsed the significance of improving the future has been widely used in teacher preparation pro-
of education for students with visual impairments. grams for the past 30 years. Some chapter authors
We would like to acknowledge the authors’ re- from the previous edition of Foundations of Edu-
search and innovation seen in each of the chapters. cation have retired or passed on in the intervening
The field of education for students with vi- years since its publication, and others are nearing
sual impairments is small, and projects like this retirement. For this reason, and to maintain the
require extensive contributions of time and fi- continuity of this edition and f uture editions, a
nancial resources. We realize that for many people concerted effort was made to partner seasoned
who worked on this textbook, the task was above authors with knowledgeable and skilled novice
and beyond their normal work responsibilities, authors who may help provide this consistency
and we are grateful for their collective commit- not only for this edition but for f uture editions.
ment to transferring knowledge to teacher can- Most of the chapters in these volumes contain
didates who are beginning their journey in this contributions from authors that cover multiple
important work. In addition, we are grateful for fields and perspectives. We appreciate that the
the commitment to high-quality instruction, as original authors embraced this model of sustain-
well as respect and high expectations for the ability and provided guidance and mentorship
vii
viii Acknowledgments
to their coauthors. This collaboration w ill also who supported the project in its early stages and
support ongoing publications outside this text who have since retired.
and in other important forums. We would like to express our sincere appre-
We would like to extend our deepest appreciation to t hose who peer reviewed the chapters
ciation to Kim Zebehazy, who worked tirelessly in this book and those who provided technical
to produce and assemble all of the essential on- expertise on specific chapters. These reviewers
line multimedia components made available in are mostly anonymous and w ill not be named
the AFB Learning Center. We hope these sup- here, but they contributed to the quality of the
plemental resources w ill provide import ant in- chapters by providing valuable feedback to the
formation for teachers of students with visual authors throughout the development of the text.
impairments to take back with them to their Finally, if a picture is worth a thousand words,
classrooms, and Kim’s contributions to this goal then a video must be worth ten thousand! We
have been invaluable. would like to give special thanks to Ellen Trief and
We would be remiss, however, if we did not Hunter College for the video clips used through-
also use this space to acknowledge the major con- out the text. They w ere created for the Library of
tributions of some specific individuals. First, it Video Excerpts for Teaching Students Who Are
would not have been possible to complete this Blind and Visually Impaired (L.O.V.E.), funded
project without the support of the editorial team by the Lavelle Fund for the Blind. We would also
at AFB Press. George Abbott was the perfect like to thank Jim Lengel for editing the videos.
combination of task master and cheerleader. El- The editors appreciate this generosity and believe
len Bilofsky provided supportive leadership and that the use of t hese clips w ill enhance the learn-
guidance throughout our work, kept us on track, ing experience of professionals and future edu-
and attended to details that we would never have cators of students with visual impairments. In
considered. Alina Vayntrub provided consistent addition, the book was enhanced by the photo
support and editorial feedback, strong organiza graphs taken and shared by several individuals.
tional skills, and a knack for logistics. Jenese We appreciate those who provided photog raphs
Croasdale-Griffiths worked diligently on organiz and those who allowed their images to be in-
ing all the necessary information and paperwork cluded in this book.
for over 70 authors, and Beatrice Jacinto worked
on numerous components b ehind the scenes. We M. Cay Holbrook
would also like to acknowledge the web team at University of British Columbia
the American Foundation for the Blind who took Vancouver
our idea for an integrated experience and made it
work. Their willingness to color outside the lines Tessa McCarthy
and create something new and exciting—the AFB University of Pittsburgh
Learning Center—allowed us to work within a
new dimension as we strive to provide valuable Cheryl Kamei-Hannan
professional information. Special acknowledg California State University
ment goes to Carl Augusto and Natalie Hilzen, Los Angeles
A B O U T T H E C O N T R I B U T O R S
2002 C. Warren Bledsoe Award from the Associ-

EDITORS ation for Education and Rehabilitation of the
Blind and Visually Impaired, as well as the re-
M. Cay Holbrook, PhD, is Visual Impairment cipient of the 2009 Distinguished Serv ice Award
Program Coordinator, Deputy Department Head, from the Division on Visual Impairments and
and Professor in the Department of Educational Deaf blindness of the Council for Exceptional
and Counselling Psyc hology, and Special Educa- Children.
tion, University of British Columbia, Vancouver,
Tessa McCarthy, PhD, is Assistant Professor in
Canada. Dr. Holbrook is the editor of Children
the Department of Instruction and Learning in
with Visual Impairments: A Parents’ Guide; coeditor
the Vision Studies Program, School of Education,
of the second edition of Foundations of Education;
at the University of Pittsburgh and a consultant

coauthor of Experiencing Literacy: A Parents’ Guide
for the American Printing House for the Blind.
for Fostering Early Literacy Development of C hildren
Dr. McCarthy is an experienced instructor and
with Visual Impairments, Ashcroft’s Programmed In-
consultant in orientation and mobility and visual
struction: Unified En glish Braille, Learning Media
impairments who has taught throughout the
Assessment: A Resource Guide for Teachers, and The
United States and Canada and as an itinerant
Braille Enthusiast’s Dictionary; and author or coau-
teacher in France. She has authored or coauthored
thor of numerous book chapters and articles in
research articles and presented nationally on the
several journals. She has prepared teachers of
topics of the ABC Braille Study, braille literacy
students with visual impairments at Johns Hop-
and instruction, and orientation and mobility.
kins University and the University of Arkansas
at Little Rock and taught children with visual Cheryl Kamei-Hannan, PhD, is Associate Pro-
impairments in public school programs in South fessor in the Division of Special Education and
Carolina, Georgia, and Florida. Dr. Holbrook has Counseling at California State University, Los
presented numerous workshops for teachers and Angeles, where she coordinates the Education
parents relating to the education of c hildren with Specialist credential and master of arts degree pro-
visual impairments. She is the recipient of the grams in visual impairment and blindness. She
1992 Alfred Allen Award and corecipient of the has previously worked as an itinerant, resource
ix
x About the Contributors
room, and language arts teacher of students with ments: A Guide for Test Publishers, Test Developers,
visual impairments and as a reading specialist and State Assessment Personnel. She serves as an ed-
in school districts throughout California and at ucational consultant to Florida and other states
the Arizona School for the Deaf and Blind. on issues related to serving students with visual
Dr. Kamei-Hannan is coauthor of Reading Con- impairments and has authored or coauthored a
nections: Strategies for Teaching Students with Visual number of book chapters, as well as articles in
Impairments and has authored or coauthored nu- several journals.
merous articles on the topics of the ABC Braille
Dawn L. Anderson, PhD, is Assistant Professor
Study, reading efficiency, assessments, and the use
in the Department of Blind and Low Vision Stud-
of assistive technology related to teaching read-
ies, College of Health and Human Serv ices, and
ing to students who are blind or visually impaired.
Coordinator of the Teaching C hildren with Visual
She is also the primary investigator and lead
Impairments and Orientation and Mobility for
project coordinator for the iBraille Challenge, a
Children program at Western Michigan Univer-
mobile app developed to improve the literacy and
sity in Kalamazoo.
technology skills of braille readers.
Catherine Archambault, MA, is a doctoral can-
Kim T. Zebehazy, PhD, is Associate Professor in
didate in the Department of Educational and
the Special Education Blindness and Visual Im-
Counselling Psychology, McGill University, Mon-
pairment program in the Department of Educa-
treal, Quebec, Canada. Her research interests fo-
tional and Counselling Psyc hology, and Special
cus on studying the cognitive and academic
Education, University of British Columbia, Van-
functioning of students with developmental dis-
couver, Canada, where she serves as cocoordi-
orders.
nator of the blindness and visual impairment
program and coordinator of the graduate certifi- Cynthia S. Bachofer, PhD, is a certified low vi-
cate in orientation and mobility. She is a certi- sion therapist and Low Vision Consultant at the
fied orientation and mobility specialist and a Texas School for the Blind and Visually Impaired
certified low vision therapist. Dr. Zebehazy has in Austin. Her instruction focuses on the use of
authored or coauthored numerous book chap- optical devices, print reading strategies, and psy-
ters and journal articles on the topics of assess- chosocial issues for students with low vision.
ment, graphic access, low vision, and orientation Dr. Bachofer previously served as a teacher of
and mobility. students with visual impairments and a consul
tant with Project Providing Access to the Visual
Environment at Vanderbilt University in Nash-
CHAPTER AUTHORS ville, Tennessee.
Carol B. Allman, PhD, is a private consultant in Karen E. Blankenship, PhD, is Assistant Profes-
special education and assessment issues who sor of the Practice of Special Education in the
has worked in the field of visual impairment for Department of Special Education, Peabody Col-
over 35 years as a teacher of students with visual lege, Vanderbilt University, Nashville, Tennessee,
impairments, an instructor at Florida State Uni- and Director of Quality Programs for Students
versity, and an administrator. Dr. Allman is with Visual Impairments. Dr. Blankenship has
the coeditor of ECC Essentials: Teaching the Ex- published articles, led workshops, and presented
panded Core Curriculum to Students with Visual Im- extensively on the subject of the expanded core
pairments and the author of Test Access: Making curriculum and is cochair of the National Agenda
Tests Accessible for Students with Visual Impair- for the Education of Children and Youth with Vi-
About the Contributors xi
sual Impairments, Including Those with Addi- tically diverse students and families, orientation
tional Disabilities. She is currently chair-elect of and mobility, and promoting physical education.
the Personnel Preparation Division and has pre-
viously served as chair of the Itinerant Personnel Silvia M. Correa-Torres, EdD, is Associate Pro-
and Educational Curriculum Divisions of the As- fessor and Coordinator of the Doctoral Program
sociation for Education and Rehabilitation of the at the School of Special Education, College of
Blind and Visually Impaired (AER), as well as Education and Behavioral Science, University of
president of several state AER chapters. Northern Colorado, Greeley. Dr. Correa-Torres is a
certified orientation and mobility specialist and
Caryn E. Butler, MA, is a doctoral student at the has authored or coauthored numerous journal ar-
University of Kansas and currently works as an ticles and presented and led workshops nationally
early childhood special education teacher in Tuc- and internationally on the topics of orientation
son, Arizona. and mobility, deafblindness, students with visual
Ya-Chih Chang, PhD, is Program Coordinator impairments and additional disabilities, and cul-
of the Early Childhood Special Education pro- tural considerations in education.
gram and Assistant Professor in the Division of Linda Farr Darling, PhD, is retired as Eleanor
Special Education and Counseling, as well as Rix Professor of Rural Teacher Education, De-
Director of the Center for Early Intervention and partment of Curriculum and Pedagogy, Uni-
Low Incidence Disabilities at California State versity of British Columbia, Vancouver, Canada.
University, Los Angeles. Dr. Chang has coau- Dr. Farr Darling has authored or coauthored nu-
thored a number of journal articles and presented merous articles and book chapters on the topics
widely on the topic of autism and other develop- of rural education, critical thinking, moral rea-
mental disorders. soning, and pedagogy for early childhood class-
Allison Cloth, PhD, is Assistant Professor of rooms. She designed an interactive website that
School Psyc hology and the Director of Training provides resources, teaching tools, and examples
in the Department of Educational and Counsel- of innovative classroom projects and activities for
ling Psychology, and Special Education, Uni- teachers working in rural communities through-
versity of British Columbia, Vancouver, Canada. out British Columbia and currently teaches in a
Dr. Cloth is a registered psychologist and has au- master’s program for rurally based educators.
thored or coauthored numerous book chapters
Kay Alicyn Ferrell, PhD, is Professor Emerita of
and journal articles on the topics of adolescent
Special Education in the College of Education
development, school- based consultation and
and Behavioral Sciences, University of North-
mentoring, intervention, and alternative educa-
ern Colorado, Greeley. Dr. Ferrell is the author
tion systems and setting.
of Reach Out and Teach: Helping Your Child Who Is
Paula Wenner Conroy, EdD, is Professor of Spe- Visually Impaired Learn and Grow, which won the
cial Education in the School of Special Educa- 2014 C. Warren Bledsoe Award from the Associ-
tion and Coordinator of the Visual Impairment ation for Education and Rehabilitation of the
and the Orientation and Mobility programs at Blind and Visually Impaired (AER), and served
the University of Northern Colorado, Greeley. as guest editor of the 2015 special issue, “Critical
Dr. Conroy is a certified orientation and mobility Issues in Visual Impairment,” of the Journal of Vi-
specialist and a teacher of students with visual sual Impairment & Blindness. Dr. Ferrell has taught
impairments, and has authored or coauthored ar- individuals of all ages with visual impairments
ticles and presentations on culturally and linguis- and multiple disabilities, from infants through
xii About the Contributors
adults. She is currently the North American/ Board of Directors of the Acade my for Certifi-
Caribbean Regional Chair of the International cation of Vision Rehabilitation and Education
Council for Education of P eople with Visual Im- Professionals, and the Editorial Advisory Board
pairment and is the recipient of the 2012 Mary K. of the Journal of Visual Impairment & Blindness.
Bauman Award from AER, the 2013 Migel Medal She is coauthor of The National Agenda and co-
from the American Foundation for the Blind, editor of Hand in Hand: Essentials of Communi-
and the 2016 Virgil Zickel Award from the Amer- cation and Orientation and Mobility for Young
ican Printing House for the Blind. Students Who Are Deaf-Blind, which received the
1996 C. Warren Bledsoe Award from the Associa-
Missy Garber, PhD, is a Vision Support Teacher tion for Education and Rehabilitation of the
with the Montgomery County Intermediate Unit Blind and Visually Impaired (AER). Dr. Huebner
in Norristown, Pennsylvania. She is also an Ad- has published numerous journal articles and
junct Assistant Professor in the College of Edu- presented throughout the United States, Europe,
cation and Rehabilitation at Salus University in and Asia and is the recipient of the 2004 Mary K.
Elkins Park, Pennsylvania, where she was for- Bauman and 2008 Ambrose M. Shotwell Awards
merly the Director of the Teacher of the Visually from AER and the 2012 Migel Medal from AFB.
Impaired Preparation Program and Codirector
of the National Center for Leadership in Visual Shelley Hymel, PhD, holds the Lando Profes-
Impairment. sorship in Social-Emotional Learning, Faculty of
Education, University of British Columbia (UBC),
Sally L. Giittinger, MA, is Administrator of the Vancouver, Canada. Dr. Hymel is cofounder of
Nebraska Center for the Education of Children the Bullying Research Network and has coedited
Who Are Blind or Visually Impaired, Nebraska several peer-reviewed special journal issues on
City. Ms. Giittinger serves on the Board of Trust- school bullying. Her research on social-emotional
ees of the American Foundation for the Blind, is development, peer relations, and school violence
past president of the Nebraska Association of is widely recognized, and she works with students
Special Education Supervisors, is a former mem- experiencing social difficulties, as well as with
ber of the Board of Directors of the Nebraska school districts to address the social side of learn-
Council of School Administrators, and previously ing. Dr. Hymel is a member of the executive team
served as secretary and treasurer of the Council of PREVNet, Canada’s national organization for
of Schools and Serv ices for the Blind, which addressing school bullying, and is on the research
awarded her its William H. English Leadership advisory committees for UBC’s Human Early
Award in 2012. Learning Partnership; the Committee for Children
in Seattle, Washington; the Life Synergy for Youth
Kathleen M. Huebner, PhD, is Professor Emer-
program in Calgary, Alberta; and the Born This
ita and retired Associate Dean of the College of
Way Foundation in Los Angeles, California. She
Education and Rehabilitation, Salus University,
also serves on the Board of Directors for the BC
Elkins Park, Pennsylvania. Dr. Huebner previ-
Crisis Centre in Vancouver.
ously served as Director of National Program
Associates at the American Foundation for the Kathleen Lynne Lane, PhD, is Professor in the
Blind (AFB); Director of the National Center for Department of Special Education at the Uni-
Leadership and Visual Impairment, as well as of versity of Kansas, Lawrence. Dr. Lane previously
the National Leadership Consortium in Sensory worked as a classroom teacher of general and
Disabilities; and on the Board of Governors of special education students and provided consul-
the American Printing House for the Blind, the tation, intervention, and staff development ser
About the Contributors xiii
vices as a Program Specialist to school districts nication Disorders, College of Education and
in Southern California. She is coeditor of the Human Sciences, University of Nebraska–Lincoln.
Journal of Positive Behavior Interventions and Reme- Dr. Meers is a former member of the President’s
dial and Special Education. Dr. Lane’s research in- Committee on the Employment of Persons with
terests focus on school-based interventions with Disabilities, former editor of the Journal for Voca-
students at risk for emotional and behavioral tional Special Needs Education, and past president
disorders. of the Council for Exceptional C hildren Divi-
sion on Career Development and Transition. He
Sandra Lewis, EdD, is Professor and Coordina- has been an educator and consultant for over
tor for the Program in Visual Disabilities, School 30 years and has written numerous articles and
of Teacher Education, Florida State University, books about h uman resource development, c areer
Tallahassee. Dr. Lewis is coeditor of ECC Essen- and transition planning for persons with disabili-
tials: Teaching the Expanded Core Curriculum to ties, and student success.
Students with Visual Impairments and is currently
editor in chief of the Journal of Visual Impairment Madeline Milian, EdD, is Professor of Bilingual/
& Blindness. She is a former editor of the journal English as a Second Language and Special Educa-
RE:view, has worked as an educator of individu- tion in the School of Teacher Education, College
als of all ages who are blind or visually impaired, of Education and Behavioral Sciences, University
and has published widely on topics as varied as of Northern Colorado, Greeley. Dr. Milian is co-
educational programming, assessment, provision editor of Diversity and Visual Impairment: The Influ-
of low vision serv ices, and teaching c areer edu- ence of Race, Gender, Religion, and Ethnicity on the
cation to students with visual impairments in Individual and the Journal of Educational Research
elementary school. Dr. Lewis is the recipient of and Innovation, and has authored numerous jour-
the 2010 Mary K. Bauman Award from the As- nal articles, chapters, and conference present a
sociation for Education and Rehabilitation of the tions on bilingual students with and without
Blind and Visually Impaired and has previously disabilities, the education of students with low-
served on the organi zation’s board of directors. incidence disabilities, working with families of
students with disabilities, and early childhood

Kelly Lusk, PhD, is an independent consultant bilingualism.
in visual impairment and blindness in Florence,
Kentucky; a certified low vision therapist; and Pat Mirenda, PhD, is Professor of Special Edu-
teacher of graduate-level courses for multiple cation in the Department of Educational and
universities throughout the United States on top- Counselling Psyc hology, and Special Education;
ics such as anatomy and physiology of the eye, Coordinator of the Autism and Developmental
braille, Nemeth code, and educational methods Disabilities Program; and Director of the Centre
and procedures for c hildren with visual impair- for Interdisciplinary Research and Collaboration
ments. Dr. Lusk and has authored or coauthored in Autism at the University of British Columbia,
a number of book chapters and articles in sev- Vancouver, Canada. Dr. Mirenda is a board-
eral journals and has presented nationally and certified behavior analyst and coauthor of Aug-
internationally on the topics of low vision, dual mentative and Alternative Communication: Supporting
media, optical devices, and assessing c hildren Children and Adults with Complex Communication
with visual impairments. Needs and Autism Spectrum Disorders and AAC.
She is a former editor of the journal AAC: Aug-
Gary Meers, EdD, is Professor Emeritus in the mentative and Alternative Communication and pub-
Department of Special Education and Commu- lishes widely on topics related to augmentative
xiv About the Contributors
and alternative communication, autism, positive positive human qualities such as empathy, com-
behavior support, and inclusive education. passion, altruism, and resiliency in c hildren and
adolescents.
Wendy Peia Oakes, PhD, is Assistant Professor
of Early Childhood Special Education at the Rosanne K. Silberman, EdD, is Professor of
Mary Lou Fulton Teachers College, Division of Special Education and Coordinator of the Gradu
Teacher Preparation, Arizona State University, ate Teacher Preparation Programs in Blindness
Tempe. Dr. Oakes currently serves as associate and Visual Impairment and Severe Disabilities
editor of Remedial and Special Education and the Including Deafblindness at Hunter College, City
Journal of Positive Behavior Interventions and is past University of New York. Dr. Silberman is co-
president of the Council for C hildren with Be- editor of Educating Students Who Have Visual Im-
havioral Disorders of the Council for Excep- pairments with Other Disabilities and Educating
tional C hildren. She has published extensively Children with Multiple Disabilities (4th ed.), and has
on the topics of improving educational outcomes published numerous book chapters and journal
for children, school-based intervention research, articles and has presented nationally and inter-
school-w ide systems of prevention, systematic nationally on topics related to the assessment of
behavioral screenings, high-incidence disabili- learners with visual impairments and multiple
ties, and early reading instruction. disabilities and personnel preparation. She is
the recipient of the 1998 Distinguished Serv ice
Kevin E. O’Connor, MA, is a senior lecturer at Award from the Division on Visual Impairments
Loyola University in Chicago, Illinois. Mr. and Deafblindness of the Council for Exceptional
O’Connor is a leadership consult ant, executive Children, of which she is past president, and the
coach, professional speaker, and author who holds 2015 Migel Medal from the American Founda-
three master’s degrees and has earned the desig- tion for the Blind.
nation of a certified speaking professional. He
is the author of several books on presentation, Catherine A. Smyth, MS, is a grant project coor-
speaking, and facilitating skills and is past presi- dinator and a doctoral candidate at the Univer-
dent of the National Association of Parents of sity of Northern Colorado, Greeley. Ms. Smyth is
Children with Visual Impairments. also a teacher of students with visual impair-
ments and an early childhood intervention spe-
Kimberly A. Schonert-Reichl, PhD, is a profes- cialist, and has created educational content for
sor in the Department of Educational and Coun- courses in early childhood and visual impair-
selling Psyc hology, and Special Education, and ment. She is a research analyst for the Center for
Director of the Human Early Learning Partner- IDEA Early Childhood Data Systems, where she
ship, School of Population and Public Health at provides technical assistance for states on the
the University of British Columbia, Vancouver, Child Outcome Summary process, and has con-
Canada. Dr. Schonert-Reichl is an applied devel- sulted for the American Printing House for the
opmental psychologist, coeditor of Handbook of Blind, where she worked on the tactile and large-
Mindfulness in Education: Integrating Theory and print editions of the Boehm-3 basic concept tests
Research into Practice, and associate editor of for preschool and school-age c hildren.
the Journal of Applied Developmental Psychology.
She has authored numerous articles and pre Susan J. Spungin, PhD, is retired as Vice Presi-
sentations on social and emotional learning, dent of International Programs and Special Proj
and her research focuses on the identification ects at the American Foundation for the Blind
of the processes and mechanisms that foster (AFB), where she had served in executive capaci-
About the Contributors xv
ties since 1972. Dr. Spungin is consulting editor vices for students with visual impairments, which
of ECC Essentials: Teaching the Expanded Core Cur- results in the establishment of uniform stan-
riculum to Students with Visual Impairments, Reach dards of practice to benefit programming and
Out and Teach: Helping Your Child Who Is Visually outcomes.
Impaired Learn and Grow, and the When You Have a
Visually Impaired Student in Your Classroom series. Ellen Trief, EdD, is Professor in the Blind and
She has also served as a consultant, advisory Visually Impaired and Severe and Multiple Dis-
committee member, and officer of numerous na- abilities Programs, Department of Special Edu-
tional and international professional organiza cation, and an associate at the Roosevelt House
tions, including the World Blind Union. Dr. Public Policy Institute at Hunter College, City
Spungin is the recipient of the 2001 Distinguished University of New York. Dr. Trief is the author of
Serv ice Award from the Division on Visual Im- College Bound: A Guide for Students with Visual
pairments and Deafblindness of the Council for Impairments and coauthor of Everyday Activities to
Exceptional Children, the 2002 Mary K. Bau- Promote Visual Efficiency: A Handbook for Working
man Award from the Association for Education with Young Children with Visual Impairments. She
and Rehabilitation of the Blind and Visually Im- is a former associate editor of the Journal of Visual
paired, the 2003 Wings of Freedom Award from Impairment & Blindness, has coauthored numerous
the American Printing House for the Blind, and articles on tangible symbol systems and person-
the 2009 Migel Medal from AFB. nel preparation programs, and has worked on
courses and products for the Hadley School for
Bill Takeshita, OD, is Chief of Optometry in the the Blind and the American Printing House for
Center for the Partially Sighted and Consulting the Blind. Dr. Trief oversaw the creation of the
Director of Low Vision Education at the Braille National Library of Video Excerpts of exemplary
Institute, both in Los Angeles, California; Associ- practice by teachers of the blind and visually
ate Professor in the Western University of Health impaired. She is the 2013 recipient of the Dis-
Sciences College of Optometry, Pomona, Cali- tinguished Serv ice Award from the Division on
fornia; and Adjunct Professor in the Southern Visual Impairment and Deafblindness of the
California College of Optometry, Fullerton. Dr. Council for Exceptional C hildren.

Takeshita is also an instructor at California State
University, Los Angeles, and he has lectured ex- Mary G. Turri, MA, is a doctoral candidate in
tensively throughout the country on the topics the Department of Educational and Counselling
of low vision rehabilitation, computer technol- Psyc hology, and Special Education at the Uni-
ogy, and assistive technology for c hildren and versity of British Columbia, Vancouver, Canada.
adults with low vision. Dr. Takeshita is a fellow Her research interests focus on academic skills
of the American Acade my of Optometry and assessment and intervention within a response-
board certified in vision development and vision to-intervention framework, and implementation
therapy. In 2004 he founded the Dr. Bill Takeshita of school-w ide positive behavior support sys-
Foundation, which provides information and as- tems, including the use of rewards and barriers
sistance to help c hildren with visual impairments. to successful implementation.
Nancy Toelle, MS, is the Developer of Quality Robert Wall Emerson, PhD, is Professor and
Programs for Students with Visual Impairments, Cocoordinator of the Teacher of Children with
a model for providing technical assistance to Visual Impairments Program and the Orienta-
public schools and schools for students who tion and Mobility with Children Program, De-
are blind or visually impaired in improving ser partment of Blindness and Low Vision Studies,
xvi About the Contributors
College of Health and Human Serv ices, Western at Salus University in Elkins Park, Pennsylvania,
Michigan University, Kalamazoo. Dr. Wall Emer- and was previously Director of Professional De-
son has authored or coauthored several book velopment and CareerConnect at the American
chapters and numerous articles in a range of jour- Foundation for the Blind. Dr. Wolffe is the author
nals. His research interests span a wide range of of Career Counseling for People with Disabilities: A
topics, including accessible pedestrian signals, Practical Guide to Finding Employment, Transition
acoustics in blind navigation, braille literacy Tote System, and Pre-Employment Programme Train-
and reading, the biomechanics of long cane er’s Manual. She is editor of Skills for Success: A
use, describing math images for blind students, Career Education Handbook for C hildren and Youth
strategies for increasing drivers’ yielding at street with Visual Impairments and coeditor of Teaching
crossings, the use of underfoot surfaces for ori- Social Skills to Students with Visual Impairments:
entation, and winter travel techniques for p eople From Research to Practice. Dr. Wolffe also coau-
with visual impairments. thored Transition Issues for Students with Visual
Disabilities and the Focused on . . . Social Skills
Rachel C. Weber, PhD, is Assistant Professor in
series of instructional videos and study guides.
the Department of Educational and Counselling
She is the recipient of the 2002 John H. McAu-
Psyc hology, and Special Education, University
lay Award and the 2014 Ambrose M. Shotwell
of British Columbia, Vancouver, Canada, spe-
Award from the Association for Education and
cializing in pediatric neuropsychological assess-
Rehabilitation of the Blind and Visually Im-
ment and its implications for school-age c hildren
paired.
and in conducting assessment and interventions
in multidisciplinary, educational, and medical
settings. She is a registered psychologist and OTHER CON RIBUTORS
has coauthored several articles in a number of
Joan B. Chase, EdD, is a retired psychologist in
journals and has made numerous presentat ions
Dunedin, Florida.
on the topics of cognitive development in at-risk
populations, cognitive correlates of bilingualism Nicole Gaines, MA, is Codirector of the National
and second language learning, the development Instructional Materials Access Center Project at
and application of executive functioning skills, the American Printing House for the Blind in
and neurocognitive functioning in pediatric can- Louisville, Kentucky.
cer survivors.
Dawn Soto, MSEd, is a teacher of the blind and
Karen E. Wolffe, PhD, is a consultant and the visually impaired and an early childhood spe-
owner of Career Counseling and Consultation cial education teacher at the Wisconsin School
in Austin, Texas, and an adjunct faculty member for the Blind and Visually Impaired in Janesville.
I N T R O D U C T I O N
F
or nearly 300 years, efforts in education for sionals and a resource library for experienced
individuals who are blind or visually im- pract it ioners.
paired have been documented in a myriad Foundations of Education was the first in the
of texts. As early as the mid-1700s, Denis Diderot series and laid important groundwork for other
wrote about how individuals who w ere blind textbooks to come. The first edition, Foundations
could live independently. During this era, for- of Education for Blind and Visually Handicapped
mal education of students with visual impair- Children and Youth: Theory and Practice, was a
ments began at specialized schools such as groundbreaking textbook edited by Geraldine
L’Institution Nationale des Jeunes Aveugles (In- Scholl in 1986. It offered teachers of students
stitute for Blind Youths) in Paris, France. In the with visual impairments multiple perspectives
United States, residential schools for individuals and suggested best practices based on the un-
who w ere blind or visually impaired w ere opened derstanding of professionals at that time. The
in the early 1800s. Since then, numerous text- second edition was equally cutting edge. It in-
books have been written to provide teachers and cluded two volumes and over 30 chapters. As
t hose who strive to improve the lives of individu- Susan Spungin stated in the foreword to Vol-
als who are visually impaired with educational ume 1, it included “all the information teachers
resources. of students with visual impairments need to
The Foundations series published by AFB know.”
Press is an essential library of resources that pro- The third edition of Foundations of Education
vides critical information about low vision and also breaks new ground, and not only b ecause it
blindness. Each of the textbooks in this series provides the most up-to-date knowledge about
addresses a differe nt area of the field of visual the field. For the first time, this text explores in-
impairment and blindness and documents best formation about theory and practice in general
practices, including critical background knowl- education and related areas that inform this pro-
edge, clinical practices, assessment of skills, and fession. In addition, all readers of these texts,
strategies for working with individuals who are whether in print or in electronic media, w ill be
blind or visually impaired. This series of text- connected to a compendium of online resources
books provides an education for aspiring profes- through the AFB Learning Center.
xvii
xviii Introduction
impact on students and teachers in the low-

CONTENTS OF VO UME 1 incidence field of the education of students who
are blind or visually impaired. Educational trends
The current volume, History and Theory of Teaching
in the early years of this century related to test-
Children and Youths with Visual Impairments, high-
ing, a common core curriculum, and ways of
lights the history and theory of the education of
supporting c hildren with special learning needs
students who are blind or visually impaired,
have buffeted teachers of students with visual
while its companion volume, Instructional Strate-
impairments no less than others who work in
gies for Teaching Children and Youths with Visual Im-
the schools. Therefore, the second part of Vol-
pairments, focuses on assessment and instructional
ume 1, entitled Connecting to the Broader Con-
strategies. In Volume 1, beginning teachers of stu-
text, contains 10 chapters that provide additional
dents with visual impairments will find the foun-
perspectives on the educational system, including
dations of the profession they are entering: its
the impact of current educational trends and re-
history and structure, as well as the nature of the
cent policy changes that may affect how students
students with whom they will be working.
with visual impairments experience education.
The first 10 chapters feature essential infor-
These chapters include topics such as educational
mation about visual impairment and blindness,
theory, motivation, consultation, positive behav
as well as the role of the specialist teacher. Chap-
ior supports, rural education, research, and criti-
ter 1 provides a historical perspective on the field,
cal thinking.
including the key p eople and events that paved
the way for current work. Chapters 2 through 4
provide essential information about visual im- ACCESSING ONL NE RESOURCES
pairment, visual systems, and the growth and
To reflect its publication in the 21st century, this
development of c hildren from birth through
third edition includes access to an exclusive,
young adulthood. Additional chapters provide a
password-protected online resource center to sup-
psychological, social, and emotional context to
plement the print textbook. This innovative, fully
visual impairment and blindness, as well as mul-
accessible, web-based AFB Learning Center h ouses
ticultural perspectives. Chapters 9 and 10 focus

introductory audio presentations from chapter
on the professional role of teachers of students
authors, chapter overviews, learning activities
with visual impairments and how t hese teachers
for the use of both students and professors, re-
provide direct and indirect instructional serv ices
source lists, and downloadable forms. Also in-
to their students.
cluded are peer-reviewed videos from the Library
of Video Excerpts (L.O.V.E.), compiled by Ellen
CONNECT NG TO THE Trief, illustrating best practices, featuring teach-
BROADER CONTEXT ers from all over the United States and Canada
engaged in working with their a ctual students
The editors of the third edition of Foundations of and demonstrating some of the instructional
Education recognize that in today’s world, the strategies discussed throughout the book. In-
education of students with visual impairments cluded throughout the print textbook are direct
is not isolated from the issues, challenges, and references to the corresponding materials in the
efforts of education in general. Personnel prepa- AFB Learning Center, signaled by icons indicat-
ration, professional development, administrative ing whether the online material is an audio clip
decision making, and the passage of legislation , video clip , overview present at ion ,
are done in an inclusive framework that has an form , learning activity , or other docu-
Introduction xix
ment . Readers of the e-book or online ver- for lively course discussions through in-c lass or
sions of the book w ill be able to link directly to online discussions and w ill challenge preservice
the AFB Learning Center. T hese materials w ere and in-service teachers to embrace excellence and
curated by Kim Zebehazy. high expectations in their own teaching.
Instructors of courses using this textbook The rich resources offered to both students
have the opportunity to weave rich and varied and current pract it ioners in this third edition of
learning experiences by using core chapters in Foundations of Education are intended to provide
Volumes 1 and 2, support chapters in the Con- a comprehensive perspective on the students
necting to the Broader Context section of Vol- with whom we work, as well as the environment
ume 1, audio and text-based chapter overviews, in which they are educated. Ultimately, these
video examples, and suggested learning activi- volumes represent just the beginning of a life-
ties located in the AFB Learning Center. The long education for teachers of students with vi-
editors and chapter authors expect that these sual impairments, who w ill be learning every
resources w ill result in multiple opportunities day from their students and colleagues.
PART ONE
History and Theory

1
C H A P T E R
Historical Perspectives
Susan J. Spungin and
Kathleen M. Huebner
To hear an audio introduction to ♦ Formal, university-based personnel preparation

this chapter by an author, and to programs for training teachers of students with
view a chapter overview presen visual impairments were established in the
tation, log in to the AFB Learning Center. 1960s.
♦ The development of an effective, workable sys-
tem of reading and writing was critical to the
KEY POIN S establishment of educational programs for stu-
♦ Formal efforts to provide educational services dents who were blind.
to students with visual impairments began in ♦ The expanded core curriculum is the body of
France more than 200 years ago. knowledge and skills students with visual
♦ Early efforts to include students with disabili- impairments need to learn in order to lead full,
ties in general education classrooms involved independent lives.

students with visual impairments. Key leg ♦ The most powerful efforts to change educa-
islation provided support for educational tional systems and programming have involved
services but did not ensure appropriate pro- professionals, parents, and consumers work-
gramming. ing together.
INTRODUCT ON
The authors extend special thanks to the late Geraldine T.
Scholl, formerly Professor Emeritus, School of Education, The system in place today for educating individ-
University of Michigan, Ann Arbor, and the late Philip
Hatlen, past professor at San Francisco State University and
uals with visual impairments has evolved over
superintendent of the Texas School for the Blind and Visually hundreds of years, but many of the most signifi-
Impaired, for their prior contributions to earlier versions of cant developments have taken place over the last
this chapter.
The discussion on the early history of educational services century. A historical perspective on the prog ress
in this chapter is based largely on Roberts (1986) and Hatlen in providing an appropriate education for stu-
(2000). dents with visual impairments is brought to bear
Rebecca Renshaw, PhD, MSL, contributed substantially to
the information on legislation, as well as to the editing of the on the following dominant themes: educational
chapter. opportunities, legislation, accessible media and
3
4 Foundations of Education: History and Theory
technology, personnel preparation, educational the scattered attempts to educate children with vi-
content, and national initiatives. sual impairments resulted in the development of
systematic programs. However, during the mid-
18th century, France became the cradle of new at-
ED CATIONAL OPPORTUN TIES titudes toward blindness and the location of the
first school for children who were blind.
Educating Individuals with The philosophical groundwork for educat-
Visual Impairments ing persons with visual impairments was laid by
Dedicated individuals with a strong commit- Denis Diderot, great philosopher of the Enlighten-
ment to students with visual impairments fought ment. In 1749, Diderot published Letter on the
against prevailing negative societal attitudes to Blind for the Use of T hose Who See, much of which
establish a starting point from which all educa- was based on his contacts with Saunderson and
tional serv ices have grown. Knowledge and un- von Paradis. The competence of Saunderson and
derstanding of these key events and influential von Paradis convinced Diderot that people who
people help professionals today understand the were blind could be intellectually capable and
roots of efforts to educate students with visual could lead regular lives. However, a significant
impairments. (See Sidebar 1.1 for a representa- step in the education of persons with visual im-
tive listing of some of the most influential lead- pairments was taken in Paris in 1784 by Valentin
ers in the history of this field. A more extensive Haüy, who established L’Institution Nationale
list, as well as a list of major award winners in des Jeunes Aveugles (Institute for Blind Youths).
the field, is located in the online AFB Learning Among other motivations, Haüy attended a con-
Center. Also in the Learning Center is a timeline cert by von Paradis and was intrigued to learn
Chronology of Events in the History of about her ability to read and write using pin-
Education of People Who Are Visually pricked letters (Koestler, 1976/2004; Lowenfeld,
Impaired.) 1975). His first student, François Lesueur, was an
intelligent adolescent who was blind and had
been supporting his widowed m other and siblings
Early History
by begging. François agreed to study half the day
Throughout the early history of the field of visual and continue begging the other half; eventually
impairment, stories have been told about remark- Haüy subsidized his education so that he could be
able and talented p eople who w ere blind who educated full time.
educated themselves and made significant contri- The enrollment at the Institute for Blind
butions to their societies, including Homer, leg- Youths grew rapidly. Haüy emphasized reading,
endary figure and author of the Iliad and the fostered the development of embossed print,
Odyssey who lived before 700 BC; Nicholas Saun- and believed in the vocational potential of his
derson (1682–1739), a noted professor of mathe students by including vocational training at his
matics at Cambridge University whose sponsor school. He also supported demonstrations of stu-
was Isaac Newton; Francois Huber (1750–1831), dents’ ability to read and write, to perform music,
a Swiss naturalist who studied the life of bees; and to carry out everyday activities. With these
and Maria Theresia von Paradis (1759–1824), a demonstrations, Haüy hoped to elicit admiration
Viennese pianist and m usic teacher for whom for the students’ competence, not pity for their
Mozart wrote the Concerto for Piano and Orches- blindness, and in 1786 about 30 of the insti-
tra in B-fl at. Prior to the 18th c entury, none of tute’s students traveled to Versailles for six days to
S I D E B A R 1 . 1
Important Historical Figures
Many individuals have contributed to the wrote a philosophical essay, Lettre sur les
development of educational practice with aveugles (Letter on the Blind) in 1749, which
children who have visual impairments. Listed laid the philosophical foundation for educating
here is a representative sample of t hose who students who w ere blind. The essay recounted
have had broad national or international his personal contacts with two accomplished
impact. Early leaders, whose work established persons who w ere blind: Nicholas Saunderson,
the foundations of education for children with a mathematics professor at Cambridge;
visual impairments, are described in the first and Maria Theresia von Paradis, a Viennese
category. More recent professionals, who made pianist and m usic teacher. These experiences
significant contributions to educational practice convinced Diderot that p eople who were blind
in a developing field, are listed in a second group. could live productive lives if they were properly
(A more extensive list can be found educated.
online in the AFB Learning Center.)
Some of the people mentioned in this Frank H. Hall
sidebar, as well as others whose work has Superintendent, inventor. Frank H. Hall was
influenced adult services, have been recog- appointed superintendent of the Illinois
nized by induction in the Hall of Fame: Leaders School for the Education of the Blind in 1890.
and Legends of the Blindness Field at the In 1892 he exhibited his version of the braille
American Printing House for the Blind, which typewriter at the convention of the American
was established to recognize t hose who have Association of Instructors of the Blind. His
made a specific impact on education and machine was a significant factor in establish-
rehabilitation for individuals with vision loss. ing the dominance of the braille code during
(The list of inductees to the Hall of Fame can the time when t here were several competing
be found at www.aph.org/hall/inductees) embossed codes.
Valentin Haüy
EARLY LEADERS WHO ESTABLISHED
Pioneer in education of children who were

THE FOUNDATIONS OF EDUCATION FOR blind. Valentin Haüy, born in France, was the
STUDENTS WITH VISUAL IMPAIRMENTS founder of the first residential school for the
Louis Braille blind, the Institute for Blind Youths, in Paris
Teacher, inventor. Louis Braille became blind in 1784. He established the school a fter he
at an early age as the result of an injury. He observed people who were blind being
entered the Institute for Blind Youths in Paris at mocked at a public event. He undertook the
age 10, and at age 15 he developed the six-dot education of François Lesueur, a young man
code known today as braille. He also developed who was blind, who learned to read using
separate codes for mathematics and music and raised letters. From this experience he became
published the first braille book in 1827. Braille committed to providing opportunities for
later became a teacher at the Institute for people who were blind to be educated and
Blind Youths. employed.
Denis Diderot Samuel Gridley Howe
French encyclopedist, philosopher. As the Pioneer, educator, administrator. Samuel
physician for King Louis XV, Denis Diderot Gridley Howe was the founder of what became
(continued on next page)
5
S I D E B A R 1 . 1 (Continued)
the Perkins Institution for the Blind and later Education of the Blind), published in 1819,
the Perkins School for the Blind in the United described a harness for a dog guide and
States. He supported the first program for outlined the method of training dog and
students who w ere deafblind; among the early traveler that resembles those methods used
students were Laura Bridgman and Helen today. He wrote extensively on his theories of
Keller. His notes on the methods he used were education of students who are blind, including
instrumental in helping Anne S ullivan teach the belief in placing c hildren in local school
Helen Keller. (Hall of Fame: Leaders and programs.
Legends of the Blindness Field, Inducted
Anne S ullivan Macy
2002)
Teacher. Anne S ullivan Macy was educated at
Robert B. Irwin the Perkins Institution. Following graduation,
Research director, American Foundation for the she moved to Tuscumbia, Alabama, to educate
Blind. Robert B. Irwin was the first blind gradu Helen Keller. She used the manual alphabet to
ate of the University of Washington. He received give Helen the key to language, providing a
a graduate degree at Harvard Graduate School, model to f uture educators of students with
specializing in the education of students who deafblindness in linking meaning to sign
were blind. His book The War of the Dots language. Sullivan remained Helen’s lifelong
documents the struggle to standardize an teacher, companion, and guide until S ullivan
embossed code for p eople who were blind. died in 1936. (Hall of Fame: Leaders and
(Hall of Fame: Leaders and Legends of the Legends of the Blindness Field, Inducted
Blindness Field, Inducted 2002) 2006)
Helen Keller TWENTIETH-CENTURY LEADERS WHO

Advocate, counselor, fund-raiser, suffragette, SHAPED PRACTICES IN THE FIELD OF
and published author. Helen Keller became EDUCATING STUDENTS WITH VISUAL
deafblind at the age of 18 months. She was IMPAIRMENTS
the first deafblind person to receive a degree Georgie Lee Abel
from Radcliffe College. She began working Education specialist and consultant. Georgie
for the American Foundation for the Blind in Lee Abel taught at a residential school for
1924 as a fund-raiser and remained a member the blind for nearly 20 years. She joined the
of the staff until her death in 1968. She had American Foundation for the Blind in 1954 as
a distinguished 50-year c areer, providing an educational consultant. She conducted
lectures and contributing to magazines on the studies of programs for preschool children
topics of blindness, deafness, socialism, social who w ere blind, which revealed uneven quality
issues, and w omen’s rights; she was also a of services. (Hall of Fame: Leaders and Leg-
model for young people with deafblindness ends of the Blindness Field, Inducted 2002)
for her commitment to learning. (Hall of
Fame: Leaders and Legends of the Blindness Natalie Carter Barraga
Field, Inducted 2002) Researcher and teacher. Natalie Carter Barraga’s
research influenced professionals to recognize
Johann Wilhelm Klein the advantages of encouraging use of low
Pioneer, educator. One of the founding fathers vision by students with visual impairments;
for the education of children who are blind, her work resulted in expanded services for
Johann Wilhelm Klein’s book, Lehrbuch zum these students, both nationally and interna-
Unterrichte der Blinden (Textbook on the tionally. As a professor at the University of
6
Historical Perspectives 7
S I D E B A R 1 . 1
Texas, she initiated one of the first preparation the use of recorded books in the education of
programs for teachers of students with visual students who are blind. (Hall of Fame: Leaders
impairments. She presented her work in 22 and Legends of the Blindness Field, Inducted
countries, where she introduced approaches 2002)
to assessment and instruction of students
with low vision. (Hall of Fame: Leaders and Abraham Nemeth
Legends of the Blindness Field, Inducted Inventor. Abraham Nemeth was a professor of
2002) mathematics who created the Nemeth Code
for Mathematics and Science Notation, which
John Curtis became the official math and science code in
Pioneer, educator. John Curtis was an advocate the United States, Canada, and New Zealand.
of day school programs for the education of (Hall of Fame: Leaders and Legends of the
children who w ere blind. In September 1900, Blindness Field, Inducted 2005)
he established and taught the nation’s first day
classes in public schools for c hildren who Geraldine Scholl
were blind in Chicago. Professor, published author, and editor. Geraldine
Scholl was a professor at the University of
Everett Hill Michigan at Ann Arbor, where she established a
Teacher, researcher. Everett “Butch” Hill was an personnel preparation program for teachers of
orientation and mobility instructor who wrote children with blindness and visual impairments.
an essential textbook for orientation and She edited Foundations of Education for Blind
mobility specialists, as well as the Hill Perfor and Visually Handicapped C hildren and Youth:
mance Test of Selected Positional Concepts. He Theory and Practice, the first textbook published
was a strong advocate for the importance of for those studying to be teachers of c hildren
orientation and mobility for young children with who are blind or visually impaired.
visual impairments. Under a federal research
grant, the Preschool Orientation and Mobility Josephine L. Taylor
Project, he re-created standard orientation and Educator, advocate. Josephine L. Taylor was
mobility instructional processes to make them a strong advocate for and implementer of
appropriate for young c hildren. (Hall of Fame: public day school programs for blind and
Leaders and Legends of the Blindness Field, visually impaired c hildren while serving as
Inducted 2007) director of educational services for the
visually impaired in New Jersey. L ater, she
Berthold Lowenfeld served as project officer and branch chief
Author, researcher, administrator. Berthold with the special education section of the US
Lowenfeld was a prolific writer whose books Department of Education and helped to
Our Blind Children and The Changing Status of develop the funding for the establishment of
the Blind have become classics. He served as university training programs in visual impair-
superintendent of the California School for the ment. (Hall of Fame: Leaders and Legends of
Blind, and he conducted research to support the Blindness Field, Inducted 2002)
demonstrate the effects of their education for King early period, public expectations for people with
Louis XVI (Illingworth, 1910). Despite the many disabilities remained low. Furthermore, t here was
persons with visual impairments who succeeded little support for and encouragement of people
in educational or vocational activities during this who w ere blind.
Residential Schools in the United States in Ohio in 1837; the subsequent residential
schools were typically established by states when
Haüy’s contribution to the education of students they gained statehood. Sidebar 1.2 lists the dates
who were blind was nevertheless a lasting one. of establishment of specialized schools for stu-
The Institute for Blind Youths became a model for dents who are blind or visually impaired in the
other schools for the blind and visually impaired. United States and Canada.
Early educational programs in the United States These early educational programs for stu-
for students with visual impairments followed dents with visual impairments followed a resi-
the residential school model developed by Haüy. dential school model. Specialized schools in the
The first three US residential schools were the United States w ere founded not because of a phil-
New E ngland Asylum for the Blind (later the Per- osophical commitment to separate education for
kins School for the Blind), established by Sam- students with visual impairments, but because of
uel Gridley Howe in Boston in 1829; the New geographic necessity caused by the low preva-
York Institution for the Blind (later the New York lence of blindness in c hildren. Thus, it was logi-
Institute for the Education of the Blind and today cal that the first programs that were established
the New York Institute for Special Education), es- in general education were in large cities with pop-
tablished in New York in 1831; and the Pennsyl- ulations of children with visual impairments
vania Institution for the Instruction of the Blind that w ere sizeable enough to justify the provision
(now the Overbrook School for the Blind), es- of specialized serv ices in local schools. Through-
tablished in Philadelphia in 1832. T hese three out the 19th century, residential schools w ere
schools, which w ere privately funded and sup- usually the sole option for the education of
ported, were the forerunners of subsequent edu- c hildren with visual impairments.
cational programs b ecause they demonstrated However, the concept of separate residential
the success of educating students who w ere blind. schools for the blind came u nder attack when the
The first school established with state funds was first schools w ere founded. Even Howe was an
American Foundation for the Blind
Boys’ kindergarten class at the Perkins School for the Blind (c. 1880)
S I D E B A R 1 . 2
Residential Schools in the United States and Canada
School Date of Founding
Perkins School for the Blind (MA) 1829
New York Institute for Special Education 1831
Overbrook School for the Blind (PA) 1832
Ohio State School for the Blind 1837
Virginia School for the Deaf and the Blind (Staunton) 1839
Kentucky School for the Blind 1842
Tennessee School for the Blind 1844
Governor Morehead School (NC) 1845
Indiana School for the Blind & Visually Impaired 1847
Michigan School for the Deaf and Blind 1848
Mississippi School for the Blind 1848
South Carolina School for the Deaf and Blind 1849
Illinois School for the Visually Impaired 1849
Wisconsin Center for the Blind and Visually Impaired 1850
Missouri School for the Blind 1851
Georgia Academy for the Blind 1852
Iowa Educational Services of the Blind and Visually Impaired 1853
Maryland School for the Blind 1853
Texas School for the Blind and Visually Impaired 1856
Alabama Institute for the Deaf and the Blind 1858
Arkansas School for the Blind 1859

California School for the Blind 1860
Minnesota State Academy for the Blind 1866
Kansas State School for the Blind 1867
New York State School for the Blind 1868
Sir Frederick Fraser School (Nova Scotia) 1870
West Virginia Schools for the Deaf and the Blind 1870
W. Ross Macdonald School (Ontario) 1872
Oregon School for the Blind 1873
Colorado School for the Deaf and the Blind 1874
Nebraska Center for the Education of C hildren Who Are Blind or 1875
Visually Impaired
Florida School for the Deaf and the Blind 1885
Washington State School for the Blind 1886
9
School Date of Founding

Western Pennsylvania School for Blind Children 1887
Concordia Learning Center at St. Joseph’s School for the Blind (NJ) 1891
Connecticut Institute for the Blind (Oak Hill School) 1893
Montana School for the Deaf & Blind 1893
Utah Schools for the Deaf & the Blind 1896
Louisiana School for the Visually Impaired 1897
Oklahoma School for the Blind (Parkview School) 1897
South Dakota School for the Blind and Visually Impaired 1900
New Mexico School for the Blind and Visually Impaired 1903
Lavelle School for the Blind (NY) 1904
Idaho Educational Services for the Deaf and the Blind 1906
Virginia School for the Deaf, Blind and Multidisabled (Hampton) 1906
North Dakota Vision Services/School for the Blind 1908
Arizona State Schools for the Deaf and the Blind 1912
Hawaii Center for the Deaf and the Blind 1914
Instituto Loaiza Cordero Para Niños Ciegos (Puerto Rico) 1919
Royer-Greaves School for the Blind (PA) 1921
The Hope School Learning Center (IL) 1957
Note: Current names of the schools are shown. All schools listed are residential schools; no day schools are
included.
Source: Compiled by Stuart H. Wittenstein, retired superintendent, California School for the Blind, and
Kathleen M. Huebner, Professor Emerita, Salus University.
outspoken advocate of public day school educa- five independently administered schools for
tion. In 1871, at the convention of the American African American c hildren (Koestler, 1976/2004).
Association of Instructors of the Blind (AAIB)— Generally, the programs for t hese c hildren were in-
later the Association for the Education of the Vi- ferior. One of the reasons for this was the poor
sually Handicapped—Howe deplored the social quality of equipment and educational materials,
sequestration of residential schools and advo- which w ere often hand-me-downs, with the fre-
cated public, day school education in all subjects quently disastrous result that the dots in braille
not requiring visible illustration. books w ere so worn down that they w ere impos-
Residential school education of African sible to read. Another reason was that African
American children who w ere blind tended to fol- American teachers were often unable to attend
low the segregation or integration patterns of their the limited number of segregated training fa-
various geographic areas. In 1931, there w ere 10 cilities or to afford the cost of travel to nonsegre-
separate departments in residential schools and gated facilities (Koestler, 1976/2004).
Public School Programs The RLF Epidemic and the Move

into Public Schools
In the United States, the first classes in public
schools for students with visual impairments In the 1950s, certain medical advances had a
were established in Chicago in 1900 u nder the large impact on the education for students with
auspices of the Illinois School for the Blind visual impairments, making integration a v iable
(Lowenfeld, 1975). Soon programs w ere estab- option for an unexpectedly large population
lished in the larger cities in Michigan, Minne- of c hildren with visual impairments. Suddenly,
sota, New Jersey, New York, and Ohio. In most of babies born prematurely were surviving but with
these programs, c hildren participated in some permanent medical issues, including visual im-
regular classes and returned to special classes for pairments. Many were diagnosed with retrolen-
instruction in braille, typing, and other special tal fibroplasia (RLF, now called retinopathy of
subjects. prematurity [ROP]) (see Sidebar 1.3). As those
In the 1930s, some schools for the blind c hildren reached school age, educators and par-
began to send selected high school students to ents were faced with the fact that educational ser
secondary schools in the community for two vices, both residential schools and the few local
reasons. First, even the largest residential schools day school programs in existence, would not be
could offer only a limited academic curriculum able to meet the c hildren’s needs. The residential
for their students because they did not have the schools could serve only a limited number of stu-
number of students to justify offering, for exam- dents, and the local public schools were already
ple, an array of foreign languages. Second, some stretched to the maximum.
superintendents began to believe that the students The RLF population dramatically changed
whom they had so carefully educated at their resi- education for c hildren with visual impairments
dential schools for as many as eight years w ere in the United States. Three factors influenced
ready to learn and compete in an environment this change. The first factor was the sheer num-
with sighted students. Thus, some residential ber of children who needed educational ser
school administrators advocated for the “integra- vices, which prompted the realization that the
tion” or “inclusion” of students who were visually existing serv ices would fall far short of the de-
impaired with sighted students long before it be- mand. Although in the past a child who was the
came a common practice. only blind child in a 50-mile radius had to at-
In these early classes, some students spent tend a residential school for c hildren who were
most of the school day in a general education visually impaired, now many communities had
class alongside their sighted peers, while others a sufficient number of c hildren with visual im-
attended special classes full time. Thus, it would pairments to justify employing a teacher and
be difficult to describe a “typical” class because providing instructional resources. A low preva-
of the g reat variations in practices. The practice of lence of c hildren with visual impairments was
students in special classes spending some time in no longer a valid reason for sending c hildren to
general education classes was often termed inte- residential schools. The second f actor was that
gration by educators of students with visual im- many children with RLF w ere from m
iddle-to
pairments. Pioneers of educational integration upper-class families. The incubators that saved the
for students with visual impairments recognized lives of premature infants but often caused blind-
that without appropriate support, students likely ness were “high tech” for their time and were
would not succeed. available only in hospitals with modern neonatal
S I D E B A R 1 . 3
The Impact of Retrolental Fibroplasia, Now Known as
Retinopathy of Prematurity
When Dr. Edward E. Allen, director emeritus controlled light in incubators. Although some
of the Perkins School for the Blind, welcomed success was obtained with each form of
the new group of 12 students in the Harvard treatment, there was not sufficient evidence
Course on Education of the Blind (operated to make firm recommendations. Meanwhile,
in conjunction with the Perkins School) in all along there was a suspicion that oxygen
September 1941, he told them they were might be the contributing cause.
entering a d ying profession. Ophthalmia At the 1952 meeting of the American
neonatorum (sores in babies’ eyes) had been Academy of Ophthalmology and Otolaryngol-
wiped out with the insertion of silver nitrate ogy, it was decided to conduct a national
into the eyes of newborns; and inoculations study. After considerable debate, “it was
for viral conditions, such as measles and agreed that a joint effort should be under-
scarlet fever, which often caused visual taken to determine whether the frequency of
impairments in young children, had drastically occurrence of RLF is dependent upon the
reduced the incidence of visual impairments. amount of oxygen used in the management of
He did not know that at that time, pediatri- premature infants” (Silverman, 1980, p. 38).
cians and ophthalmologists at the Massachu Eighteen hospitals agreed to participate in the
setts Eye and Ear Infirmary w ere puzzling over National Cooperative Study, as it was called.
a strange eye condition that had recently been The Kresge Eye Institute in Detroit, under the
identified in premature infants. direction of Dr. V. Everett Kinsey, was desig-
Two infants who were born prematurely at nated the coordination center. The center was
the Boston Lying-In Hospital, one in July and to be notified of the births of all premature
the other in November 1940, “were the infants who had survived 48 hours. Infants
forerunners of an epidemic of blindness which were assigned to treatment categories in sets
rose to unsurpassed heights through the of three for each hospital: one was allotted to
world in the next twelve years” (Silverman, the routine oxygen group for every two
1980, p. 3), affecting approximately 10,000 assigned to the curtailed oxygen treatment
prematurely born infants throughout the group. The study began on July 1, 1953;
world. In 1942, ophthalmologists and pediatri- September 1954 was considered the earliest
cians in the Boston area puzzled over this possible date for a responsible report. Oxygen
strange condition. Retrolental fibroplasia for the curtailed group would not exceed
(RLF), as the condition later came to be 50 percent unless the clinical condition of an
known (which literally means “scar tissue infant required greater amounts. On Septem-
behind the lens of the eye”), was so named by ber 19, 1954, Kinsey presented the preliminary
one of the physicians, a scholar of Latin and results, which dispelled “all doubt concerning
Greek. (Today this condition is referred to as the causal role of oxygen in RLF” (Silverman,
retinopathy of prematurity [ROP].) 1980, p. 41). Thus the epidemic of RLF came
With no clues to the cause of RLF, physi- to a dramatic halt.
cians first treated the condition by trial and Although the epidemic was curtailed, a
error, using vitamin E, adrenocorticotropic flood of malpractice legal suits began, as well
hormone (a pituitary hormone that stimulates as ethical questions about assigning infants
the cortex of the adrenal glands), and randomly to treatment conditions. The
12
S I D E B A R 1 . 3
National Cooperative Study is considered a issues: “To this day, when oxygen is adminis-
milestone in medical research, but it left tered to premature infants, they are exposed to
unanswered many questions that were raised the intertwined risks of brain damage, death
during the experiment about the administration and RLF with nothing more than authoritative
of oxygen. Silverman (1980) summarized these guessing in protection” (p. 143).
Source: Adapted from Silverman, W. A. (1980). Retrolental fibroplasia: A modern parable. New York: Grune &
Stratton.
care (Koestler, 1976/2004). Many of the c hildren’s The Cooperative Plan. This plan is one in
parents were influential in their communities, which the blind child is enrolled with a teacher
and they did not want to send their c hildren of blind c hildren in a special room from which
several hundred miles away to attend residential he goes to the regular classrooms for a portion
schools. They asserted their considerable influ- of his school day. In this plan the special room
ence on local school boards and other decision becomes his home room from which his pro-
makers, and local districts often rapidly geared gram planning stems, in cooperation with the
up to serve c hildren blinded by RLF. The third regular classroom teachers.
factor was that both communities and profes-
The Integrated Plan. This plan is one in which
sionals were ready for a new approach to educating
the blind child is enrolled in the regular class-
students who w ere blind. Some basic adaptations
room. Available to him and to his regular teach-
of the general education curriculum to make it
ers is a full-time qualified teacher of blind
accessible to students who were blind had already
children and also a resource room. The regular

been made. Thus, the success of the few local day
teachers turn to the teacher of blind c hildren
school programs that began and thrived in the
for assistance in planning the child’s program,
first half of the 20th c entury was a strong impetus
for guidance in adapting the classroom proce-
for the rapid expansion of educational serv ices
dures, and for providing, as necessary, special-
in local school districts following the explosion in
ized instruction appropriate to the blind child’s
students with RLF.
needs.
In 1954, the American Foundation for the
Blind (AFB) published The Pine Brook Report, a The Itinerant Teacher Plan. This plan is one in
monograph that presented the proceedings of which the blind child is enrolled in the regular
one of the first professional meetings that ad- class in his home school where his needs are
dressed the urgent problem of educating the lit- met through the cooperative efforts of the regu-
erally thousands of c hildren who w ere blinded lar teacher and those of the itinerant teacher
by RLF. The Pine Brook Report (AFB, 1954) con- qualified to offer this special service. (p. 16)
tained clear definitions of several approaches
to the education of c hildren with visual impair- This publication, together with AFB’s employ-
ments in local day school programs: ment of several national education consultants
in the early 1950s, provided the best direction to The speed with which this revolution occurred
states and local districts for developing educa- was surprising. The large numbers of children with
tional ser v ices. RLF created pressures for rapid, systemic change
With solid support from parents, cautious and development. In little more than a decade, the
support from administrators, and the enthusi- entire thrust of education for c hildren who w ere
astic backing of many professionals, children blind had moved from residential schools to local
with RLF w ere welcomed into local elementary public schools. Parents were advocating for local
schools in increasing numbers in the mid-1950s. school services; local districts were amenable to,
Most of these programs a dopted an “inclusive” if not enthusiastic about, educating students who
philosophy. C hildren with visual impairments were visually impaired in their school districts of
were, for the most part, placed solely in general residence; and a slow, steady stream of teachers
education classrooms, where they spent the was becoming available to support students in
entire school day. Instead of only 1 child with a inclusive educational settings.
visual impairment in a local school, t here might Of part icular importance during this period
be 5 to 20 children with visual impairments. was recognition of the need for a strong support
Usually, t here was a separate classroom that was system for teachers in general education class-
designated as the resource room for students rooms. A common theme of the day was that
with visual impairments. This room housed a re- the success of students with visual impairments
source teacher whose responsibility was to facili- in resource rooms and itinerant programs was
tate inclusive education. The resource teacher directly related to the amount of support that
might spend part of the day working with the classroom teachers and students received from
general classroom teachers to ensure that each specialized teachers who were trained to in-
child had appropriate instructional materials struct students with visual impairments. In fact,
and that the classroom teachers knew how to local school districts were discouraged from
engage the c hildren in classroom activities, and beginning educational serv ices for students with
part of the day providing direct ser v ices to visual impairments u ntil they had employed
c hildren in the resource room. A child would be qualified, certified “vision specialists.” Many early
pulled out of the general education classroom efforts at inclusion would probably have failed
and be given individual, specialized instruction were it not for the recognition that the classroom
by the resource teacher in braille reading and teacher, the parents, and the teacher of students
writing and in typing. Instruction in orientation with visual impairments w ere equally important
and mobility (O&M) by a mobility specialist be- partners on an educational team.
gan around 1965. Lines of responsibility w ere carefully drawn
Literally thousands of children with RLF between the classroom teacher and the teacher of
received their entire education in this type of students with visual impairments. The classroom
setting during the 1950s and 1960s. Although teacher was not expected to develop expertise in
the profession has since discovered some flaws adapting or presenting curricula if that task fell
in this system, such as the assumptions that within the responsibility of the teacher of stu-
the only needs of t hese c hildren w
ere academic dents with visual impairments. For a child who
and that support for social skills and social- was visually impaired to be effectively served in
ization in general need not be provided, it was a general education classroom, the classroom
at the time an exciting, revolutionary approach teacher should not have had to spend more time
to the education of students who were visually working with that child than with any other child
impaired. in the classroom.
The Transformation of Residential Schools instances, constituted a small portion of the stu-
dent body.
This rapid growth of public school programs had
an effect on the role of residential schools. Most
‘Integration,’ ‘Mainstreaming,’
of these schools continued to thrive as educa-
and ‘Inclusion’
tional centers for academic students until well
into the 1950s. But as early as the mid-1950s, the Shortly after the passage of the 1975 Educa-
educational climate began to change. By the early tion for All Handicapped C hildren Act (EHA)
1960s, specialized schools for students with vi- (discussed later in this chapter), the term integra-
sual impairments were experiencing a significant tion, used by educators of students with visual im-
drop in referrals of students with academic goals, pairments to describe the placement of children in
often because t hese students were placed in inte- regular classrooms since the early 1950s, became
grated settings. These schools began receiving an the commonly used term for implementing the
ever-increasing number of referrals of students notion of least restrictive environment (the concept
with multiple disabilities. While local districts that c hildren with disabilities o ught to be edu-
increasingly provided serv ices to students with cated alongside their typically developing peers
academic goals who w ere visually impaired, they to the maximum extent possible). In practice,
were frequently unprepared and lacked person- early efforts toward integration of students with
nel who w ere trained to educate c hildren with disabilities took the form of abandoning segre-
dual sensory disabilities, cognitive disabilities, gated residential schools and placing classrooms
severe learning disabilities, or emotional distur- of t hese c hildren in general education schools.
bances in addition to visual impairment. The extent of integration with students without
During this period, it was not unusual for a disabilities varied greatly but often consisted of
residential school to make the transition from c hildren with disabilities being on playgrounds
a school that was mainly for academically and in cafeterias at the same time as nondisabled
proficient students to one that primarily served students. Education, for the most part, was still
students whose educational needs were func- provided in separate, segregated classrooms.
tional and developmental. Their adjustment to By 1980, the term integration had given way
the students’ needs and recognition of their role to mainstreaming. Mainstreaming was defined as
as part of a continuum of educational place- the placement of a child with disabilities for some
ments is a noteworthy chapter in the history of portion of the school day in a regular classroom
specialized schools. (See the section on Edu- with nondisabled classmates, often for non
cating Students with Multiple Disabilities later academic subjects. Late in the 1980s, mainstream-
in this chapter.) ing gave way to inclusion, a term that has been
From 1955 u ntil 1985, almost all residential interpreted in many ways. In practice, inclusion
schools maintained some population of students typically meant that a child with a disability was
working on academic goals. Given that the suc- assigned to a regular classroom as her or his
cess of students with visual impairments in local homeroom and spent the majority, if not all, of
schools required a strong support system for gen- the day in that setting. The term has had many
eral education teachers, students in rural areas by-products, including full inclusion, inclusive
often found it difficult to obtain adequate ser education, community-based instruction, education in
vices at the local level. Many c hildren from rural natural environments, and inclusive living. Some pro-
areas continued to attend specialized schools for ponents of inclusion believe so strongly in the
students with visual impairments and, in most philosophy of inclusion that they believe any
segregated setting is inherently bad. The most their role as residential schools a myriad of re-
adamant proponents of inclusion believe that sponsibilities that have an impact on all students
full inclusion is appropriate for all students with who are visually impaired in their states. Some
disabilities and that even pullout serv ices (the residential schools have added statewide assess-
practice of removing a child from a regular class- ment services, technical assistance to local school
room for a period of time to address a specific districts, and professional development for teach-
need) are not acceptable. ers of students with visual impairments to their
It is interesting to note that educators of missions. Some of these specialized schools for
c hildren with other disabilities followed a similar students with visual impairments are poised to
sequence to that taken by educators of c hildren become the hub of serv ices for all students in
with visual impairments. Early efforts to integrate their states and to coordinate outreach and other
children with severe and profound disabilities
functions.
consisted of moving t hese children from separate At the same time, local schools are examin-
facilities into general education schools but keeping the most effective ways to provide serv ices to
ing the children in separate classrooms. Then students in public school settings. T hese pro-
these educators, as educators of students with grams are looking for solutions to challenges
visual impairments had done, moved from using including the following:
the term integration to referring to mainstream-
ing, then least restrictive environment, and finally • Providing instruction to all students in the
inclusion. areas of the expanded core curriculum
Today, in general education classrooms, it is • Ensuring that all instructional materials are ac-
often a challenge to ensure that c hildren with vi- cessible to students with visual impairments
sual impairments receive adequate support from
• Ensuring that students with visual impairments
teachers of students with visual impairments. Yet
have high- quality instruction by qualified
the population of c hildren in today’s schools is
teachers in all areas of the curriculum, includ-
increasingly diverse and includes students with
ing literacy, mathematics, science, and other
multiple disabilities; of great cultural, ethnic, and
subjects
racial variation; and from homes in which one
parent is the head of the h ousehold, both parents • Serving students effectively in rural and
work, or a language other than English is spoken. sparsely populated regions
Given the multiplicity of the circumstances and • Obtaining an adequate supply of appropriately
needs of today’s children, cooperative efforts trained teachers
among general classroom teachers, teachers of
students with visual impairments, and families Evolution of the Definition of
are more important than ever.
Blindness and Low Vision
As the profession continues to define the role
of both residential schools and general education In 1909, while attending a conference in London,
programs in the education of students with visual Edward E. Allen, then director of the Perkins
impairments, many issues remain to be explored. School for the Blind, visited a newly established
Educators who are involved in delivering serv ices school for c hildren with low vision called the
are considering the best ways to take advantage Myope School. He saw this type of program as a
of the full continuum of serv ice and placement solution to the challenge of enrolling students
options. Some traditional residential schools who were blind who would read braille in the
have changed their role and function, adding to same school or class with t hose with sufficient
vision to read and write in print. In 1913, he up” and that c hildren with visual impairments
worked with school officials to initiate such a were at risk for further deterioration of their vi-
program in Roxbury, Massachusetts. Soon similar sion unless special care was taken. Most of t hose
programs were begun in Chicago, Cleveland, who read print used large-t ype books and mate-
Detroit, Milwaukee, and New York (Hathaway, rials, and their school activities were planned to
1959). The success of these classes changed the alternate “eye use” and “eye rest” periods (Hath-
practice of keeping c hildren with all degrees of away, 1959).
vision together. Even after the arrival of the population
of children who lost their vision to RLF, the dis-
Legal Definition of Blindness tinction between “blind students” and “partially
sighted students” continued. With still no educa-
Early residential schools for the blind and local
tional guidelines to determine appropriate place-
school programs relied on the legal definition
ments based on educational needs, educators
of blindness used in the medical community to
continued to turn to the medical profession’s defi-
qualify for government serv ices as the determi-
nition of legal blindness as the method for de-
nant in qualifying students for specific educa-
termining placements in educational programs.
tional programs. The legal definition used was
B ecause of the overreliance on acuity measure
the following:
ments from ophthalmologists, supervisors of
programs were often reluctant to move children
Central visual acuity of 20/200 or less in the from braille classes to sight-saving classes if the
better eye with corrective glasses or central ophthalmologists recommended braille. Consid-
visual acuity of more than 20/200 if t here is a eration of the most appropriate reading media for
visual field defect in which the peripheral field students was not even thought about u ntil well
is contracted to such an extent that the widest into the second half of the 20th c entury because
diameter of the visual field subtends an angu- of this reliance on the legal definition of blind-
lar distance no greater than 20 degrees in the ness in determining reading media.
better eye. (Koestler, 1976/2004, p. 45) B ecause students with visual acuities of

less than 20/200 w ere considered blind, they

At this time c hildren who w ere classified as le- were instructed in braille reading and writing
gally blind (even if there was remaining vision) even if they had sufficient vision to read print.
were generally taught as though they w ere totally Consequently, many students attempted to read
blind, were expected to learn braille, and pri- braille by sight rather than touch. Often, their
marily learned through their tactile or auditory teachers attempted to teach them braille by
senses. Children who needed serv ices based on blindfolding them to prevent them from read-
vision loss but were not legally blind were labeled ing using their remaining vision. Teachers and
“partially seeing.” The unofficial definition of many persons in the medical profession believed
“partial sight” was a visual acuity of 20/70 to that students would damage their eyes by using
20/200. C hildren in this category were expected them.
to use large-print books, receive instruction in
typing, and primarily learn through their visual
Barraga and Low Vision Training
sense. T hese children attended classes called
“sight-saving” or “sight-conservation” classes. The This situation changed quickly following the
instruction in these classes was planned based on publication of Barraga’s (1964) landmark study.
the prevailing theory that sight could be “used This study is widely viewed as responsible for
and those who built on it, c hildren t oday are given

the opportunity to learn to use the senses that are
most educationally appropriate for them.
Over the years, the terminology describing
c hildren with visual impairments has continued
to change. T oday, most educators use a functional
definition that is concerned with the impact of
visual impairment on the performance of daily
activities to identify c hildren who are eligible
for educational serv ices because of a visual im-
American Printing House for the Blind

pairment. The term partially sighted is no longer
in general use. Children (and adults) whose pri-
mary source for information is visual are now
referred to as individuals with low vision.
An additional influence on work with chil-
dren with low vision has been the development
of useful optical devices (such as magnifiers and
telescopes). In the early 1950s, students with low
vision seldom received optical devices, even pre-
scription eyeglasses. Often eye care professionals
Natalie C. Barraga were reluctant to prescribe expensive magnifiers
while the children’s eyes w ere still growing and
changing. Thus, it was rare to find a child below
age 14 with an optical device. Today preschool
changing the practices of educating c hildren who children are fitted with eyeglasses and optical de-
were legally blind and had remaining vision. vices that enable them to use their vision effec-
Through this research, Barraga found that a tively in a variety of ways at a very early age.
program of visual stimulation could improve the There was also a dramatic shift in the role
utilization of remaining vision. of ophthalmologists and optometrists during
Soon after Barraga’s study was published, ed- the 1960s and 1970s. In the 1950s, optometrists
ucators replaced reliance on the legal definition were considered to have less professional exper-
of blindness with a functional definition that tise than ophthalmologists and be less quali-
used information about how a student used his fied to provide advice for individuals with visual
or her vision in daily activities and was more ap- impairments. Some believe that this allegiance
propriate for education. The unofficial definition to ophthalmologists as medical professionals
of partial sight became broader, changing the significantly delayed the development of the use
primary reading medium from braille to print of optical devices for c hildren. Although this be-
for approximately two-thirds of the children who lief has not been documented by research, the in-
were labeled “legally blind,” so that vision became formation that follows is commonly accepted
their primary avenue for learning. Thus, t hose who among professionals in education of students
had been taught primarily through their auditory who are visually impaired.
and tactile senses now also learned through their During the first half of the 20th century, the
visual sense. Because of Barraga’s pioneering study belief prevailed that in practically all cases of
visual impairments in children, the medical cause educational and personal lives. (A detailed expla-
of the impairment was not stable, and hence the nation of functional vision assessments can be
child should be followed closely by a physician, found in Volume 2, Chapter 4.)
an ophthalmologist. Therefore, teachers routinely
referred children with visual impairments to oph-
thalmologists. At that time, it was thought that it
Reading and Writing
was acceptable to be examined by an optometrist One of the g reat challenges that early educators
for such conditions as astigmatism, myopia (near- of students who were blind faced was to find a
sightedness), and hyperopia (farsightedness) suitable system for reading and writing, and it is
because only the measurement of visual acuity a challenge that educators continue to grapple
and the prescription of lenses were involved. For with even today. Early efforts included various
children with significant visual impairments, methods such as writing on wax tablets, carving
however, it was believed that ophthalmologists letters in wood, forming letters with wire, and
were needed, in case the medical conditions re- using knots of a variety of thicknesses and at
quired attention. different distances on a thread (Illingworth, 1910;
A fter the publication of Barraga’s (1964) find- Lowenfeld, 1971).
ings on the use and benefits of stimulating vision, Haüy used Roman letters printed in relief,
many optometrists and some ophthalmologists and Howe developed Boston Line Type, an angular
began to emphasize the study and practice of modification of Roman letters. The most success-
low vision training and related issues. In the ful of these early codes was that of William Moon,
1970s, as students who lost their vision to RLF who used Roman capital letters in bare outline.
began to graduate from high school, educators Although Roman letters outlined in pin-
in general turned their attention to students points were more easily identified than the line
with low vision. This greater attention resulted type letters, it remained for Charles Barbier, a
in teachers and parents availing themselves more French engineer and cavalry officer, to develop
frequently of the skills and interests of optom- the first point system, in an attempt to create a
etrists, who were willing to work with and pre- signal code that could be read and written in the
scribe optical devices and lenses for young dark (Lorimer, 2000; Rex, Koenig, Wormsley, &
c hildren. T oday, low vision serv ices, encompass- Baker, 1994). Barbier used cells of 12 points—six
ing assessment, prescription of devices, and train- high and two wide—a nd developed a writing
ing in the use of devices, are delivered by teams board with grooves and window-like openings.
that are often headed by optometrists, who, along He exhibited his system at the institute for the
with other eye care specialists, are an important blind in Paris where the young Louis Braille was
source of clinical evaluations. In addition, the in attendance. Braille was impressed and a dopted
role of teachers and O&M specialists in conduct- the system, but he used cells three dots high
ing functional low vision evaluations has become and two dots wide, which made 63 possible com-
an essential and routine part of the process of binations of dots. By 1834, at the age of 25, he
determining the educational needs of students had carefully worked out his system for a braille
with low vision. Generally, a clinical low vision code, of which Koestler (1976/2004) wrote, the
evaluation is conducted in the office of a licensed “genius of Louis Braille’s system was its simplic-
eye care specialist, whereas a functional low vision ity” (p. 92). The genesis of the embossed dot code
assessment is conducted by professionals in edu- and Braille’s adaptation of it are discussed in
cation who collect data as students live their daily Sidebar 1.4. Braille’s contribution was significant
New York Point and American braille. William

Wait, of the New York Institute for the Education
of the Blind, developed New York Point, which
used a cell two points high and one to four points
in width, with the smaller number of points as-
signed to frequently occurring letters. By 1890
New York Point was known everywhere in the
United States. American braille, developed by
Joel Smith at Perkins, was announced at the AAIB
convention in 1878. Smith kept the braille cell,
but assigned letters on the basis of frequency of

occurrence (Rodenberg, 1955). T hese two sys-
tems, in addition to British Revised Braille, stim-
ulated what came to be called the War of the Dots
(Irwin, 1955), which incited professional argu-
ments over the use of various dot systems.
People who w
ere blind who lived in the last
decade of the 19th century and the first decade
of the 20th faced the dilemma of having to learn
at least two point systems and several line sys-
Louis Braille tems for reading. In addition, the relatively new
American Printing House for the Blind (APH)
had to publish books in two or more systems to
and long lasting, for without a system of effec- satisfy the needs of customers. It is l ittle wonder,
tive communication through reading and writ- then, that a group of people who w ere blind held
ing, it is doubtful that the education of students a charter meeting in Saint Louis in 1895 to ad-
who were blind would have progressed to the dress the situation. This group of educators and
extent that it did (Lowenfeld, 1975; Mellor, 2006). others in the field, many of whom w ere super-
Braille worked out the code for reading and intendents of specialized schools for the blind,
writing as well as for m usic, but his system was continued to meet to discuss the issue of a stan-
not officially accepted in his own school until dard tactile code and conduct small studies. The
two years after his death (Koestler, 1976/2004; group eventually became the American Associa-
Rodenberg, 1955). tion of Workers for the Blind (AAWB) in 1905.
Meanwhile, the British had taken Braille’s At their first meeting, they appointed a new
system and in 1905 worked out three levels of Uniform Type Committee. By 1912, the com-
braille that they called Revised Braille: Grade 1 mittee had tested 1,200 blind American and
(today know as uncontracted braille), which was British readers. Although the British system was
spelled out letter by letter; Grade 2 (contracted preferred by the majority, the American commit-
braille), which used some contractions; and tee accepted only part of the Grade 2 contractions
Grade 3, which was highly contracted (Roden- and called it Grade 1½ (also referred to as Stan-
berg, 1955). The Missouri School for the Blind in dard Dot). Thus began what Lowenfeld, Abel, and
Saint Louis was the first American school to adopt Hatlen (1969) named the “Battle of Contractions.”
braille, around 1860 (Lowenfeld, 1975). In the When a large number of books in the British sys-
United States, two other point systems emerged: tem was ordered from England to supplement the
S I D E B A R 1 . 4
Tactile Reading and Writing
The education of students with visual impair- teaching staff at the school, and it was t here in
ments did not truly begin u ntil a workable 1829, at age 20, that he published an explana-
method of reading and writing was devised. tion of his embossed-dot code, which, he
Early efforts to resolve this problem included believed, would be superior to the embossed
the use of a system of knots on a length of letters that Haüy had used. Braille’s point
twine, writing on wax tablets, and the use of system was based on the work of an army
carved-wood roman letters (Illingworth, 1910; artillery officer, Charles Barbier, who in the early
Lowenfeld, 1971). None of these systems gave 1800s devised a raised-dot code that could be
rise to an enduring, workable method. read by touch during night maneuvers. “Écri-
Valentin Haüy and his first student noticed ture nocturne” (night writing) had a 12-dot cell,
that the reverse sides of printed pages had with 6 vertical dots in two rows. By 1834, Braille
tactilely legible characters. At that time, had perfected the code for literary braille and
printers routinely used wet paper for printing, was working on a code for music notation. The
so the paper itself took on the forms of the officials at the institute w
ere not easily con-
letters to some extent. Haüy had letters cast vinced that Braille’s dot system was more
in reverse that, when printed on wet paper, left effective than Haüy’s embossed-letter system
tactile impressions in the correct position and and resisted using it because the teachers
order. Subsequently, he modified the letters would have had to learn a new code and
somewhat to make them easier to read. For because they believed that it would set people
writing, his students used a metal pen with who w ere blind apart from p eople who were
a rounded tip to produce raised letters in sighted. However, the students to whom Braille
reverse on the back of heavy paper (Illing- had taught his system preferred it. Finally, in
worth, 1910; Lowenfeld, 1973). This system for 1844, Joseph Guadet, the vice-principal of the
reading and writing was used at the residential institute, described the raised-dot system and
school in Paris u ntil 1854 and in all the other paid tribute to Braille (Roblin, 1960).
early schools in Europe and the United States. Braille died of pulmonary consumption
Louis Braille, born in 1809 in Coupvray near in 1852 and was buried in his hometown,
Paris, was blinded at age 3 while playing with Coupvray, France (Roblin, 1960). On the
one of his father’s harness-making tools. At centennial of his death, his body was to be
first, he attended the local village school, but at removed to the Pantheon in Paris. This
age 10 he was admitted to the Institute for proposed removal so incensed the citizens of
Blind Youths in Paris. That school emphasized Coupvray that the governmental authorities
music as a vocational goal for many of its finally made one concession: the bones from
students, and Braille later became a church Braille’s hands still lie in an urn at his original
organist. At age 19, he was asked to join the grave site.
libraries in the United States, it was found that The American Foundation for the Blind was
more people who were blind learned and preferred founded by the combined efforts of the AAWB
the British system. Rodenberg (1955) wrote that and the AAIB, and so its fundamental purpose
the system was “ushered to its universal triumph was to provide national leadership in education
by the intimate experience of the blind them- and rehabilitation. Robert B. Irwin, the first ex-
selves” (p. 11). ecutive director of AFB, was an ardent supporter
of braille, and he wanted an end to the contro- America (English Braille American Edition, Ne-
versy surrounding adoption of a single code. meth Braille Code for Mathematics and Science
These two f actors contributed to AFB’s leadership Notation, and Computer Braille Code) had be-
in settling some of the diverse issues surround- come complex and difficult to manage. In 1991,
ing braille. BANA charged a research committee to consider
In addition, M. C. Migel, philanthropist and whether a single code could be developed for the
AFB president, was willing to invest money in transcription of both literary and technical ma-
efforts that would result in the adoption of braille. terials. T
hese efforts attracted international inter-
Thus, for many reasons, the time was ripe to s ettle est, and a group of p eople from seven countries
the controversy of the War of the Dots and the created the International Council on Eng lish
Battle of Contractions. In July 1932, a conference Braille (ICEB) to continue work on the project.
of representatives from both countries was con- Braille readers, transcribers, and teachers worked
vened in London, resulting in a compromise that for over a dec ade to develop a code that was uni-
led to the publication of a handbook setting forth fied across literary material and mathematics and
Standard Eng lish Braille. The September 1932 could also be unified across English-speaking
issue of the Outlook for the Blind, published by countries throughout the world. By 2004, the code
AFB, announced the results in an article enti- was considered sufficiently complete for ICEB
tled “Uniform Braille for the English-Speaking member countries to vote for adoption of the
World Achieved” (Irwin, 1932). Unified English Braille Code (UEB). Canada voted
To ensure consistency of treatment by braille to adopt it in 2010, and the United States followed
printing houses and ongoing surveillance and in 2012. The implementation date for UEB in the
periodic updating of the braille code, the American United States was January 4, 2016, the birthdate of
Braille Commission was organized. The commis- Louis Braille.
sion was superseded by the Joint Uniform Braille
Commission of the AAIB and the AAWB in
1950, which became the AAIB-A AWB Braille Au-
Focus on Literacy
thority in 1959. In 1966, the National Advisory In the early 1970s, professionals, braille produc-
Council to the Braille Authority was formed to ers, and consumer groups expressed strong con-
ensure a closer working relationship between cern over a suspected significant drop in the
producers and users of braille. Finally, in 1976, percentage of c hildren who w ere legally blind
the Braille Authority of North America (BANA) and were being taught to read and write in
was constituted with 10 member organizations braille. Many educators explained this decline
including the Canadian National Institute for by pointing out that Barraga’s (1964) research had
the Blind (now known as CNIB), making the dramatically changed the number of children
orga ni zat ion international. Today BANA re- being taught braille. If vision was determined to
mains the official standard- setting body for be the most efficient sense for reading and writ-
braille producers and users in the United States ing, then c hildren were taught to read using their
and Canada. remaining vision. Although this research did not
Since its adoption t here have been many up- suggest that c hildren with any degree of remain-
dates and changes in the braille code in response ing vision should learn print reading and writ-
to changing needs in text transcription. However, ing, regardless of speed, efficiency, and fatigue, in
by the late 20th century t here was a recognition the 1970s and 1980s many students w ere gradu-
that the current braille codes in use in North ating from high school with very slow print-
reading rates. The dividing line between whether Curriculum

braille or print was the best medium for a part ic
ular child remained elusive u ntil the early 1990s, Early Curriculum
when the publication and use of learning media
assessments began (Koenig & Holbrook, 1993, In the early days of residential schools for the
1995). blind, educational programs w ere structured on
In the meantime, a number of theories about three tenets that Howe, founding director of what
what many educators, consumers, and parents became the Perkins School for the Blind, brought
were describing as a literacy crisis w ere proposed. home in 1832 from visiting schools in Europe:
Many consumers believed that the decline was re- each child who was blind must be considered an
lated to teachers’ and others’ lack of knowledge individual and be educated according to his or
or appreciation of braille. However, other con- her interests and abilities; the curriculum of the
sumers, educators, and parents stressed that the residential schools should conform as closely as
shortage of qualified teachers was a major prob possible to that of general education, with added
lem in providing literacy instruction. Still others emphasis on music and crafts; and students who
believed that the trend toward inclusion, and the were blind must be prepared to take their places
frequent, concomitant decrease in the amount of in the social and economic lives of their commu-
time that teachers of students with visual impair- nities (Lowenfeld, 1973). Throughout the history
ments were able to spend with students, was the of education for students with visual impair-
most serious issue. A teacher of students with ments, there have been changes in the focus of
visual impairments with a large caseload and a educational content. Professionals continually
sizable geographic area to serve would not be evaluate the emphasis of academic instruction
successful in teaching braille reading and writing and other curricular issues.
if instruction was provided for only one or two Early residential schools and day school
hours per week. classes for c hildren with visual impairments
Although unanimit y was not reached about followed the same, generally strongly academic
the reasons put forth for the decline in the liter- curriculum as did general education programs.
acy of students who were visually impaired, par- Residential schools frequently also offered
ents, consumers, and professionals did unite in a technical courses, such as piano tuning, broom
resolve to correct this problem. All major organ making, and chair caning. More capable stu-
izations of and for the blind, such as the National dents usually attended college and prepared for
Federation of the Blind and the American Foun- c areers in teaching, social work, law, and other
dation for the Blind, as well as many parents professions. Students who did not attend college
and educators, became advocates to improve lit- sometimes moved from a residential school
eracy and provide better access to textbooks for setting to a sheltered workshop that had resi-
students with visual impairments. (See the in- dential facilities. Sheltered workshops typically
formation on braille legislation and access to provided employment almost exclusively to
instructional materials in the section on Legis- people with disabilities, and the work environ-
lation and Policy.) T
oday, with the advent of tech- ment was carefully controlled to minimize the
nology, braille is more accessible than ever before, impact of the disability on the employees’ suc-
and data-based decisions regarding learning and cess. Participation in competitive employment
literacy media are being made by educational for individuals with visual impairments was
teams. unusual.
Two factors are impor t ant in describing visual impairments should be educated on the ba-
the curriculum of early schools for the blind. sis of their individual interests and abilities, as well
First, t hese schools w ere highly selective about as in the general education curriculum. However,
admitting students. They could be selective it was not until the 1990s that discipline-specific
because they were the only source of educational skills w ere fully documented and identified. The
serv ices for most c hildren who were blind, and expanded core curriculum (ECC) was first ar-
their limited resources made it most feasible (at ticulated by a small group of professional edu-
that time) to choose students with the most aca- cators, parents, and consumers concerned about
demic potential. Second, b ecause of the limited the quality of educational services for students
availability of teacher preparation programs in with visual impairments (Corn, Hatlen, Huebner,
the education of students with visual impairments, Ryan, & Siller, 1995; Corn & Huebner, 1998;
most teachers were grounded in subject matter, Hatlen, 1996; Huebner, Merk-Adam, Stryker, &
not in special education. Wolffe, 2004). The ECC is defined as the body of
However, limitations in the curriculum re- knowledge and skills, beyond the core academic
lated to vocational education w ere primarily curriculum, that students with visual impair-
the result of not exploring the extent to which ments need to learn in order to lead full, indepen
c hildren with visual impairments could be pre- dent lives. The need for instruction in each area
pared to work in competitive employment along- of the ECC is determined through assessment of
side sighted workers. Thus, specialized areas of individual students. The nine ECC areas include
employment, such as basket weaving and piano the following (see Chapter 9 in this volume for a
tuning, emerged. Most educational programs for description of each area):
students who w ere blind focused on preparing
non-college-bound students in one of t hese voca- 1. Assistive technology
tions. By the end of the 1950s most of t hese pro- 2. Career education
grams had disappeared b ecause of the emerging
3. Compensatory and functional academic skills
educational philosophy that stressed a liberal arts
education with no emphasis on c areer education 4. Independent living skills
until after high school graduation. 5. Orientation and mobility

Continual advancement in technology, re-
6. Recreation and leisure s kills
search, and curriculum development had a dra-
matic impact on instructional services for students 7. Self-determination
who w ere visually impaired. Adaptation of the 8. Sensory efficiency skills
curriculum for sighted students (traditional core 9. Social interaction skills
curriculum); recognition of the need for a spe-
cialized curriculum; development of a functional,
Orientation and Mobility
useful curriculum for students with multiple dis-
abilities; and recognition of curricular needs that Techniques for teaching individuals with visual
went beyond the traditional core curriculum all impairments to move independently through the
contributed to the beginning of an era in which environment have developed during the past
the individual needs of students w ere emphasized. century. In the late 1920s, people who were blind
were being trained to use dog guides as a means
Expanded Core Curriculum
of facilitating independent travel. The day a fter
Since the inception of residential schools for the Pearl Harbor in 1941, the Seeing Eye dog guide
blind, early educators believed students with school announced that it would supply dog
guides to any war-blinded veteran without charge some early mobility therapists (in early days
to e ither the veteran or the US government called “peripatologists” and t oday called “orienta-
(Koestler, 1976/2004). Although dog guides have tion and mobility specialists”) who w ere trained
been used by a relatively small part of the popu- as instructors (notably Pete Wurzburger and Stan
lation of individuals who are blind, formal train- Saturko) to offer summer institutes at various uni-
ing in the use of dog guides exerted a major versities for teachers of children with visual im-
influence on f uture training programs by demon- pairments. These teachers gained some skills in
strating the necessity for a formalized program of teaching independent travel techniques that they
O&M training. The importance of this concept knew would be important for youngsters, but they
was recognized by Richard Hoover at the Valley were not prepared to offer comprehensive O&M
Forge General Hospital and by Russell Williams training.
at the Hines Hospital rehabilitation centers for In 1960, Boston College established the first
veterans who were blinded during World War II university-based preparation program for O&M
(Miyagawa, 1999). However, both these programs specialists, and in 1961, Western Michigan Uni-
used the long cane as the mobility device, rather versity opened the second (Wiener & Siffermann,
than the dog guide, and their work became the 2010). Soon other university programs were
origins of mobility training. A further impetus for begun at institutions including California State
using canes was provided by the state white cane College at Los Angeles, Florida State University,
laws, which required d rivers to yield the right of San Francisco State College, the University of
way to p eople who w
ere blind and used canes. Northern Colorado, and the University of Pitts-
In the area of education, in recognition of the burgh. Originally, these graduate-level programs
importance of in de
pen dent travel before the concentrated on training O&M instructors for
teaching of travel techniques became a formal- adults who were blind in rehabilitation programs,
ized profession, schools for the blind offered but they soon recognized that O&M must also
“foot travel instruction” to students u ntil the be taught to school-age students. By 1974, almost
1960s. The instructors w ere usually teachers who half the O&M specialists were involved in deliver-
were blind and w ere considered proficient inde ing services to the school-age population (Mills,
pendent travelers. Often, this instruction was 1982; Welsh & Blasch, 1974). By 1970, instruc-
provided without any device, such as a long cane. tion in O&M was firmly ensconced as a required
Beginning in the early 1950s, some teachers course for high school students who were blind.
became aware of the mobility training approach In addition to braille, this subject became the first
to teaching independent travel to people who disability-specific educational need that was for-
were blind that had been pioneered at the Veter- mally identified as being necessary for students
ans Administration hospitals after World War II. who w ere blind.
A longer version of the white cane, called the
Hoover cane, had been developed, and system-
Transition
atic instruction in its use was being provided, on
the assumption that the cane was an important In 1986, Haring and McCormick stated, “The
tool for travel. achievement of full integration implies appropriate
By the late 1950s, many teachers concluded educational programming for successful transi-
that they could teach these approaches to inde tion from schools to community. . . . Transition
pendent travel effectively to students in school. is a new field” (p. 481). This quote implied, cor-
Educators such as Kay Gruber and Georgie Lee rectly, that the concept of transition grew from
Abel, both consultants with AFB, worked with concerted efforts to integrate students with
isabilities following the passage of legislation

d Perhaps the most profound impact of the
(see the section on Legislation and Policy later transition movement has been the increased re-
in this chapter). Although c hildren experience alization by professionals and parents that stu-
many transitions during their educational c areers dents who are visually impaired need more than
(from preschool to kindergarten and from ele- an academic education if they are to move easily
mentary school to middle school, for example), into the community. To live independently and
the early references to transition in the literature work in the community and to be socially assim-
of special education described it as moving from ilated into community groups requires knowl-
school to the world of work. edge that is not necessarily learned by casual
Wolffe (1998) described transition for exposure to the behavior of o thers or observing
students with visual impairments this way: “To the environment. In fact, many of the social and
successfully move from school environments to independent living skills that are needed during
community environments, students who have transition must be taught before the transition is
visual impairments with other disabilities must attempted. Both education and rehabilitation
receive instruction in activities of daily living professions have taken on some responsibility in
skills, social skills, and c areer exploration and providing instruction in the nonacademic areas
employability skills before they leave school” of learning that are essential to transition.
(p. 343). Thus, the ingredients of successful tran- As a result of the heightened awareness of the
sition parallel the expanded core curriculum for need to prepare students for life a fter school,
students who are visually impaired, which in- the term transition is now firmly embedded in
cludes the unique skills that students with visual the special education culture. Its meaning is
impairments need to live independently and pro- clear: a smooth process for youths in moving
ductively. from school and home to work and community.
In the early 1980s, an event occurred that Responsibility for the development of transition
strengthened efforts to achieve successful transi- lies with both educators and rehabilitation
tions of young people who are visually impaired. professionals. The Individuals with Disabilities
The professional association comprising reha- Education Act (IDEA), discussed in the next sec-
bilitation workers with blind adults (American tion, mandates that the Individualized Educa-
Association of Workers for the Blind) and the tion Program (IEP) w ill contain “appropriate
organizat ion representing educators of students measurable postsecondary goals” (IDEA, 2004,
with visual impairments (Association for the Ed- 34 C.F.R. § 300.320[b][1]) for students with dis-
ucation of the Visually Handicapped) merged abilities, beginning at age 16 or sometimes 14,
into a single professional association, the Associ- depending on the state. Thus, transition is a part
ation for Education and Rehabilitation of the of educational planning and services for every
Blind and Visually Impaired (AER). A strong ra- high school student with a visual impairment.
tionale for this merger was that the transition Also, in a growing number of rehabilitation cen-
from school and home to work and community ters for persons who are visually impaired, “tran-
should be as seamless as possible. If rehabilita- sition skills,” such as independent living skills,
tion personnel who work primarily with adults social skills, organizat ion skills, and vocational
and teachers had opportunities to share ideas, skills, are becoming a part of the curriculum. Al-
meet together, and better understand each o ther’s though the concept of transition is relatively re-
job responsibilities, then students would benefit cent in the context of the history of educational
by moving from school to the community much efforts, its impact on the curriculum of future
more easily. high school students is likely to be significant.
Educating Students with Deafblindness
During the mid-19th century, Howe supported

the education of a girl who was deafblind at the
Perkins School for the Blind. This effort, the ad-
mission of Laura Bridgman to Perkins in 1837,
was greeted with national and international
praise and astonishment. Laura became deaf and
blind after she contracted scarlet fever at the age
of 18 months. Howe heard about her, found her
family, convinced her parents that she could

be educated at Perkins, and provided much of
Laura’s instruction. As it turned out, Laura lived
the rest of her life at the school.
Laura learned to read raised letters, at first as-
sociating words with objects by rote. Howe was
with her when her breakthrough in understand-
ing the meaning of language occurred: “At once
the countenance lighted . . . it was an immortal
spirit, eagerly seizing upon a new link of union
Helen Keller
with other spirits” (Howe, 1840, p. 26). Laura
was the chief attraction at Perkins on visitors’
days, and many famous people, including Charles education Helen received, other families re-
Dickens (1907), went to see her. In 1841, Oliver quested attendance in school programs for their
Caswell, who also became deaf and blind from deafblind c hildren. Because of the success of the
scarlet fever, was admitted to Perkins, and he Perkins School for the Blind, and also because
and Laura w ere educated together (Schwartz, schools for deaf c hildren were not quick to at-
1956). tempt educational efforts with deafblind stu-

When Howe died in 1876, his son-in-law, dents, educational serv ices for these children
Michael Anagnos, succeeded him as director of with multiple disabilities became more widely
Perkins. Anne S ullivan had just graduated from available at schools for the blind. In the 1950s,
Perkins when, in 1887, Anagnos heard from a four such schools in the United States provided
father requesting a teacher for his daughter, Helen educational serv ices for deafblind c hildren: the
Keller. Helen’s mother had read American Notes, Alabama Institute for the Deaf and Blind, the
in which Dickens mentioned Howe’s education California School for the Blind, the Perkins
of Laura. Anagnos recommended S ullivan, gave School for the Blind, and the Washington State
her access to Howe’s extensive notes on his meth- School for the Blind.
ods of instructing Laura and Oliver, and lent his Rubella and Usher syndrome were common
moral support to her efforts to teach Helen (Koes- causes of deafblindness. In 1964–65, a major
tler, 1976/2004). epidemic of rubella occurred in the United States.
Helen Keller is probably the best-k nown per- If a woman contracted rubella in the first trimes-
son who was deafblind in the United States and ter of pregnancy, t here was a high probability that
perhaps the world. Her educational and other ac- her baby would be born carrying the live rubella
complishments w ere inspiring. As a result of the virus. Approximately 30,000 infants who were
born with the rubella virus in these years had Educating Students with
severe disabilities (Cooper, 1969). Most of t hese Multiple Disabilities
infants had multiple disabilities, including cata-
racts, glaucoma, heart disease, hearing defects, As late as the 1960s, it was a common practice for
and brain injury. local school districts to refuse educational place-
The United States responded quickly to what ment to students with disabilities (Smith, Pollo-
was viewed as a national emergency. In 1968, way, Patton, Dowdy, & Doughty, 2016). Many
Congress passed legislation that established the children w ere denied an education because of their
Helen Keller National Center for Deaf blind multiple disabilities, while a few w ere accepted by
Youths and Adults in New York and additional specialized schools. In the 1940s and 1950s, this
legislation that established regional offices of the practice was applied to many of the children who
center for the education of c hildren with deaf- lost their vision to RLF when they were referred for
blindness. Since the passage of this legislation, placement at local schools or residential schools
educational funding is now allocated to each state. for students who w ere visually impaired.
But before this change, it should be noted, the fed- By the late 1950s, local school programs for
eral legislation that established regional centers students who w ere visually impaired w ere grow-
for the education of children with deafblindness ing rapidly throughout the country. The majority
was the first time that education for students with of these were self-contained programs within
disabilities was offered across state boundaries. a neighborhood school or models that placed
Universities geared up to serve the population of children in general education classrooms and pro-
children who w ere deafblind as a result of rubella, vided resource room support from the teachers of
and soon several personnel preparation centers students with visual impairments. In fact, resource
were established, also with the assistance of federal room programs were often highly selective in
funds. Even before an adequate supply of teachers the children they admitted, hoping to ensure aca-
became available, dozens of new programs for demic success that would prove that the integra-
educating c hildren with deafblindness were estab- tion of children with visual impairments into
lished throughout the country. general education classrooms was successful.
Children who w ere deafblind as a result of Because c hildren with visual impairments
rubella frequently had severe to moderate hear- with no additional disabilities were typically
ing loss and cataracts that w ere often removed in accepted into local school programs but those
early childhood. These c hildren had more severe c hildren with additional disabilities were not,
hearing loss than vision loss. Many could see to students in local school programs tended to be
retrieve a small object from distances of up to enrolled in academic programs. Students with
20 feet but seemed to have visual problems that additional disabilities often had g reat difficulty
had an impact on their learning. Many also pre- obtaining access to educational serv ices. The re-
sented behavioral challenges that were often attrib- sult, as noted earlier, was a dramatic change in
uted to the isolation and resulting communication the role of residential schools for the blind. Be-
barriers experienced when two major sources of ginning in the early 1960s, the number of refer-
sensory input w ere impaired. rals for admission to schools for the blind for
Preventive medicine has substantially reduced c hildren enrolled in academic programs began
deafblindness from the rubella virus. However, to diminish and those for students with addi-
many programs that began in response to the tional disabilities soared (Sacks, 1998). Within a
epidemic continue to offer educational program- few years, the population of many residential
ming for c hildren who are deafblind. schools changed from almost all academic stu-
dents to one that included a significant number Federal Legislation

of students with developmental delays.
At this time, most teachers at specialized Throughout the 19th and 20th centuries, legisla-
schools knew little about how to instruct students tion had a profound impact on educational ser
with visual impairments and additional disabili- vices for students with visual impairments. Most
ties. However, they quickly undertook educational legislation addressed the larger population of
efforts on behalf of c hildren with complex dis- individuals with disabilities and also applied
abilities. This transition required extensive changes to individuals with visual impairments.
and adjustments in the curriculum and goals of all
schools, especially residential schools. Many teach- American Printing House for the Blind
ers who were well versed in academic subject An early example of legislation that specifically
matter found themselves teaching basic functional addressed blindness was Chapter 186— “An
and developmental skills to students whose chron- Act to Promote the Education of the Blind”—
ological ages were often far different from their passed by Congress in 1879 to establish the
developmental ages. A fter a period of adjustment, American Printing House for the Blind. APH
over a number of years, many teachers at schools was founded with federal money to produce
for the blind became knowledgeable in educating textbooks in braille, large type, and recorded
students with multiple disabilities. form and to develop or adapt instructional ma-
Educational serv ices for c hildren with visual terials for use by students with visual impair-
impairments and additional disabilities have ments. Congress divided the appropriation for
changed dramatically since that time. Today these APH into two funds: one to produce instruc-
students have an array of placement options. tional materials and the other to provide a
Placement decisions are made by the parents or means by which schools could use federal funds
caregivers and the educational team and are to purchase APH books and instructional mate-
based on assessment results and serv ice needs. rials. The system through which t hese special-
Placements can range from full inclusion in a ized materials are distributed is known as the
general education classroom with appropriate
Federal Quota Program.

supports and serv ices to a specialized setting
such as a school for students with visual impair-
Elementary and Secondary Education Act
ments. Educators in the field of visual impair-
ment were pioneers at providing ser v ices for The Elementary and Secondary Education Act of
students with significant needs. They provided 1965 (ESEA) was the first federal law authorizing
educational opportunities for c hildren with government spending on programs to support
visual impairments and additional disabilities K–12 education. ESEA was enacted as part of
long before any federal laws mandated educa- the Johnson administration’s War on Poverty
tional serv ices for all c hildren with disabilities. campaign. It gave states federal dollars to sup-
port the constitutional right for all c hildren,
with and without disabilities, to an education.
LEG SLAT ON AND POL CY Over the course of time, ESEA has been re-
newed and reauthorized. The 1994 reauthoriza-
(Log in to the online AFB Learning Center for a chro- tion, Improving Americ a’s Schools Act, put in
nology of legislation related to education of place key standards and accountability elements
people with visual impairments in the United for states and local school districts that receive
States.) funding under the law. In 2001, it was renamed
No Child Left B ehind Act and put a g reat deal of • An emphasis on comprehensive and appro-
emphasis on standardized testing. The latest re- priate assessment
authorization, the Every Student Succeeds Act • The requirement of an Individualized Educa-
of 2015, provided more clarification on the type tion Program for e very child with a disability
of testing required to be administered to stu-
• A four-step process of serv ices: identification,
dents in order to measure prog ress in the general
assessment, development of an IEP, and place-
curriculum.
ment
The impact of this law on students with vi-
sual impairments has been twofold. It gave states • The requirement to treat parents as equal
the federal funds to support the education of all partners with teachers in educational plan-
students and required schools to measure stu- ning and programming
dents’ prog ress in the general education curricu- • A due process procedure to mediate differences
lum. Because of the testing requirements of this between schools and parents
law, teachers of students with visual impair-
ments are tasked with making sure appropriate Despite the profound impact of EHA on edu-
test accommodations are in place and that t hose cational serv ices for students with visual im-
tests are not biased against students with vision pairments, it should be noted that parents and
loss. professionals who worked on behalf of t hese stu-
dents attempted to address some serious issues
Education for All Handicapped Children Act in educational practices even before the federal
law required some of t hese changes. Examples of
Although ESEA influenced the education of stu- EHA mandates that w ere already in practice in
dents with visual impairments, the passage of serv ices to students with visual impairments in-
the Education for All Handicapped C hildren Act clude t hose that addressed the following issues:
in 1975 dramatically changed educational op-
tions and serv ices throughout the United States.
• Students with multiple disabilities. Many schools
The impetus for this legislation was the growing
for students who were blind and some local

awareness that thousands of students with se-
day schools began educating students with vi-
vere multiple disabilities, many of whom w ere
sual impairments and additional disabilities
placed in large state institutions, had been de-
long before EHA mandated a “f ree and appro-
nied an education. Most states had legislation
priate education for all c hildren with disabili-
regarding the delivery of services to students with
ties” (Best & Winn, 1968).
disabilities long before the passage of EHA, of-
ten focusing on the “right” to an education, • Inclusive education. Since the 1900s, students
but those serv ices relied on sometimes limited who w ere visually impaired had, in many
funding available by the state. EHA helped states cases, been placed in general education classes.
supplement special education by creating a fund- The mandate of EHA, requiring that c hildren
ing stream from the federal government. The with disabilities spend as much time as appro-
power of EHA is that it stated in clear, unequivo- priate with age-mates without disabilities, was
cal language that all c hildren with disabilities are already a reality for many students who w ere
entitled to a “free and appropriate education.” visually impaired.
Other landmark aspects of the law included the • Parents as partners. Educators had discovered
following: years before the passage of EHA that it was
essential to include parents in instructional most, or all, of the day in a general education
planning and that the practice of discouraging classroom. As noted earlier, such placements
parents’ involvement was detrimental to stu- eventually became known as mainstreaming, a
dents’ education. term that narrowed the definition of “least re-
strictive environment” to definite placement in a
Although many of the practices outlined in the general education classroom for at least part of
provision of EHA w ere therefore not new to educa- the day. In the l ater dec ades of the 20th c entury,
tors of students with visual impairments, several many began using the term inclusion or full inclu-
aspects of this legislation proved challenging. sion to refer to an environment in which stu-
As was already indicated, the legislation re- dents with visual impairments attend general
quired that each student with a disability have education classes full time with their classmates
an IEP and that a four-step process should be fol- without disabilities. During this time, t here was
lowed for implementing serv ices for a child with some concern that an emphasis on placement
a disability: (1) identification and referral, (2) as- might overshadow an emphasis on the specific
sessment, (3) IEP development, and (4) place- educational needs of individual students. Some
ment. Shortly after the passage of EHA, formal professionals advocated for attention to a stu-
and informal conferences w ere held throughout dent’s most appropriate placement (Hatlen & Curry,
the United States to help special educators learn 1987).
to write IEPs. As an addition to the continuum of place-
During these conferences, many teachers dis- ment options available to all students with dis-
covered that they did not know how to properly abilities, inclusion is a potential option for t hose
assess students, since they had never been required who have the ability and skills to be successful in
to do so. Thus, it was necessary for many teachers such a setting or for t hose for whom this setting
to learn concurrently how to assess students, de- would be an appropriate learning environment.
velop IEPs, and determine placements on the basis However, placement needs to be determined by
of children’s educational needs. For many, perhaps educational needs, and the same student may re-
most, teachers of students with visual impair- quire differe nt environments at differe nt times
ments, the legislation required a higher level of during his or her education. (A more complete
accountability than had existed before its passage. discussion of placement decisions can be found
The original passage of EHA and subsequent in Chapter 9 in this volume.)
amendments touched on a number of issues re- EHA has been reauthorized four times since
lated to the amount of time a student might spend 1974, and it is well overdue to be reauthorized
in a classroom with classmates without disabili- again. The 1986 amendments provided funds to
ties. This concept was eventually referred to as the states for the enactment or expansion of develop-
least restrictive environment, a commonly used term mental services for infants and toddlers with dis-
that did not appear in the law. The concept of abilities. That reauthorization was the first federal
placement options began to be delineated in legislation that recognized the need for intense
terms of the number of minutes a child spent in intervention ser v ices for infants and toddlers
a general education classroom, a practice referred with disabilities and called for an Individualized
to as integration. Integration could mean anything Family Serv ice Plan for their families. Each state
from attending a segregated class (that is, a class that implemented this legislation identified a lead
for students with visual impairments) in a gen- agency to oversee this program, and expanded
eral education school building to being placed for serv ices to families and c hildren as a result.
Individuals with Disabilities Education Act Standard (NIMAS) and the National Instructional
Materials Access Center (NIMAC) were created.
During the second reauthorization of EHA in NIMAS is a technical standard used by publishers
1990, Congress renamed the law the Individuals to produce source files that may be used to de-
with Disabilities Education Act. The main addi- velop multiple specialized formats (such as digi-
tions in this reauthorization w ere the provision tized text, braille, or audiobooks) for students
of transition planning for life a fter secondary who are blind or visually impaired or have print
school for students by age 16, the inclusion of disabilities (see Sidebar 1.5). NIMAC is the elec-
assistive technology devices in the IEP, and tronic file repository managed by APH that makes
the extension of requirements to consider that NIMAS files available for download to authorized
c hildren with disabilities be educated alongside users through an online database. (See
their typically developing peers in the “least re- the Resources section in the online AFB
strictive environment” to the maximum extent Learning Center for more information.)
possible. Since 2004, a number of House and Senate
The third authorization occurred in 1997 and bills have proposed additional lists of amend-
brought about even more changes. These amendments; however, none of t hose made it through
ments included the addition of orientation and the House, Senate, and White House to become
mobility as a related serv ice (supportive serv ices a law. With such significant changes in the use of
required for a student with a disability to benefit technology since the 2004 amendments, the next
from special education), a focus on all students reauthorization w ill likely address standards for
having access to the general education curricu- electronic instructional materials and the acces-
lum, and the requirement that all students with sibility of mainstream technology abundant in
visual impairments (even t hose with additional today’s general education and special education
disabilities) receive instruction in braille and the classrooms.
use of braille, u nless the IEP team determines
through assessments that braille is not appropri-
Rehabilitation Act
ate for the student.
In 2004, the law was reauthorized for a fourth The Rehabilitation Act of 1973 was the first legis-
time and renamed the Individuals with Dis- lation to grant basic civil rights protection to all
abilities Education Improvement Act (although c hildren and adults with disabilities and prohibit
it is still commonly referred to as IDEA). This discrimination on the basis of disability. Under
reauthorization included some changes in IEP Section 504 of the Rehabilitation Act, students
procedures, further clarification regarding least with visual impairments are guaranteed neces-
restrictive environment, and a definition of sary accommodations within and outside school
highly qualified teachers who should be provid- (such as during extracurricular activities). Those
ing special education and related serv ices. accommodations could include modifications to
The most significant 2004 amendment for the classroom environment, adaptations to the
students with visual impairments was the require- curriculum, extensions in time to complete tasks,
ment that students have access to instructional assistance from a classroom aide, use of an assis-
materials in an accessible format and in a timely tive technology device, and other adjustments to
manner. As a result, publishers are required to allow for participation. Like IDEA, Section 504
produce electronic versions of their textbooks also calls for f ree appropriate public education,
and h ouse t hose files at a central location. Thus, has evaluation processes in place, and outlines
the National Instructional Materials Accessibility due process procedures as well. However, the two
S I D E B A R 1 . 5
What Is NIMAC?
NICOLE GAINES
The Individuals with Disabilities Education school instruction and are required by a State
Improvement Act (IDEA) of 2004 established educational agency or local educational
the National Instructional Materials Access agency for use by students in the classroom.”
Center (NIMAC) at the American Printing While NIMAC receives NIMAS for a wide
House for the Blind, in Louisville, Kentucky. variety of student materials, some materials
NIMAC opened in December of 2006, and that may be used in K-12 classrooms—such as
serves as a national repository of source files trade books, reference works, and college
for K-12 textbooks and related printed core textbooks—are NIMAS-exempt. There are
materials. Files are made available to the some exceptions, but for the most part NIMAC
states through a searchable online database does not receive these materials. NIMAC also is
system. Once downloaded from NIMAC, the unable to accept teacher editions of textbooks.
source files are used to produce accessible It is also important to note that, per the defini-
formats such as braille, digital text, audio, and tions provided under IDEA 2004, NIMAC
large print, on behalf of eligible students with cannot accept NIMAS files for born-digital
visual impairments or print disabilities. materials (content that is only published and
distributed digitally and not in a print format).
WHAT IS NIMAS?
IDEA 2004 required that states adopt a new file ARE NIMAS FILES DISTRIBUTED
format for use in the production of accessible DIRECTLY TO STUDENTS?
instructional materials, the National Instruc- NIMAS files are source files and generally
tional Materials Accessibility Standard (NIMAS). require additional conversion work before use
Based on the DAISY talking book standard, by a student. NIMAC itself does not produce or
NIMAS is the only format NIMAC can receive. distribute student-ready formats, and for this
reason, NIMAC does not work directly with
HOW DOES NIMAC RECEIVE FILES? individual students. Each state that opts to
When state and local educational agencies (SEAs work with NIMAC (currently all states and
and LEAs) purchase print materials, they include eligible outlying areas) designates a state
language in the adoption contracts and purchase coordinator and authorized users who manage
agreements requiring the publisher to submit the production and distribution of accessible
NIMAS to NIMAC. This is the only mechanism formats, in accordance with that state’s system
for requiring publishers to submit files to the for serving students with print disabilities.
repository. By 2016, NIMAC was working with
over 120 publishers and had received nearly WHO IS ELIGIBLE TO RECEIVE MATERIALS
45,000 file sets and continues to grow. PRODUCED FROM NIMAS?
Per IDEA 2004, students must be served u nder
WHAT KINDS OF BOOKS DOES IDEA to be NIMAS-eligible (i.e., they must be
NIMAC RECEIVE? an elementary or secondary school student
Per IDEA, NIMAC is to receive “printed with an IEP) and they must have a qualifying
textbooks and related printed core materials disability. NIMAC is not involved in determining
that are written and published primarily for eligibility for any student; this responsibility lies
use in elementary school and secondary with the states.
33
WHAT IS THE RELATIONSHIP BETWEEN into accessible formats and distribute

NIMAC AND ORGANIZATIONS LIKE those formats directly to students. States
LEARNING ALLY, BOOKSHARE, AND APH? work with t hese and other accessible
Organizations such as Learning Ally, media producers to obtain student-ready
Bookshare, and APH convert NIMAS files formats.
laws have differe nt results for students with vi- Landmark “braille legislation,” passed by the
sual impairments. Texas legislature in 1991, was seen as the most ro-
IDEA provides for accommodations and bust example of braille legislation and served as a
instruction from professionals (such as O&M model for legislation for other states. Several fea-
specialists and teachers of students with visual tures of the Texas legislation that w ere unique at
impairments) but the Rehabilitation Act is mainly the time have since been incorporated into other
about accommodations (such as an aide to help state laws. One such feature is the use of the term
in the classroom, increased time on tasks, and functional blindness instead of legal blindness. This
classroom modifications), not instruction, except new term referred to children and youths who use
as instruction relates to vocational training and tactile and auditory senses, rather than sight, as
job employment. A student who qualifies with a their primary avenues for gathering information.
disability u nder IDEA is automatically covered The Texas law included the following provisions:
u nder Section 504, but the reverse is not true.
School districts have been known to wrongfully • The administration of a learning media assess-
place students with low vision u nder the Reha- ment designed to help the educational team
bilitation Act, perhaps to avoid the requirement determine a student’s appropriate literacy
for serv ices by an O&M specialist or teacher of media
students with visual impairments u nder IDEA

• Teachers’ demonstration of proficiency in
because of staffing shortages.
braille
• The requirement that braille must always be
State Legislation: Braille Bills given equal consideration to print as a reading
As a result of the widespread concern about medium
literacy and braille literacy in particular, in the • The mandate that textbook publishers must
1980s many states passed laws to ensure that stu- furnish electronic files of textbooks with liter-
dents with visual impairments were taught braille. ary content in a timely manner that assures the
Beginning with Louisiana in 1985 and Minne- braille reader access to textbooks at the same
sota in 1988, several states passed legislation that time as sighted classmates
was intended to counteract the perceived decline
in students’ literacy and use of braille as well as As a result of these efforts by educators, par-
call for textbook publishers to provide materials ents, and national organi zations of and for the
in accessible formats. However, these state-level blind, many states introduced requirements
laws allowed for variations and did not produce similar to the Texas braille legislation. In fact,
consistency across states or across publishers. when IDEA was reauthorized in 1997 and 2004,
t hese requirements w
ere also included in those braillewriter, a mechanical device to emboss
amendments. braille, was developed by Frank H. Hall, superin-
tendent of the Illinois School for the Blind, and
was exhibited at the convention of the AAIB in
Policy Guidance Paper
1892. A limited number of Hall braillewriters
In 1995, the US Department of Education issued a were manufactured, and they w ere still in use
policy guidance statement on educating students well into the second half of the 20th c entury. AFB
with visual impairments (Heumann & Hehir, developed a quieter and more efficient braille-
1995), which, although not legislation per se, pre- writer in 1932, but this machine was heavy to
sented written guidelines on what constitutes ap- carry (16 pounds), so it did not become popular.
propriate educational services for these students. Until the middle of the 20th century, writing
The document was updated in 2000 (Riley, 2000). braille sometimes presented a challenge. Various
The introduction to the paper referred to concerns designs of braillewriters w ere available, as just
that “services for some blind and visually impaired indicated, but they were not dependable, were
students are not appropriately addressing their poorly designed, and were sometimes quite ex-
unique educational and learning needs.” With pensive. Thus, most braille users depended on a
these words, the department made a powerful slate and stylus. The slate is a frame containing
statement in support of specialized education and recessed holes that correspond to the dots of a
learning of students who are visually impaired. braille cell, over which paper is placed, and the
Of particular importance is that the document frame is closed. The stylus is a sharp, handheld
stressed the need for a continuum of placement rod that pushes into the paper through the holes,
options and for an expanded core curriculum for forming the raised dots of braille on the reverse
students who are visually impaired. The 2000 up- side of the paper. Although considered slow and
date of this policy statement included important laborious by some, p eople with visual impair-
information related to instruction in braille and ments find it to be an invaluable writing tool.
the use of braille, provision of appropriate assis- In the early 1950s, the Howe Memorial Press
tive technology, and the importance of O&M in- at the Perkins School for the Blind began mar-
struction. Although the policy guidance statement keting a new braillewriter called the Perkins
did not result in state or federal laws or regulations Brailler. The Perkins Brailler was a wonderfully
specifically mandating the provision of instruc- designed, almost indestructible machine, and it
tion in the ECC as such, aspects of the ECC may revolutionized the writing of braille. It was lighter
be identifiable throughout the national special and more efficient than older braillewriters. Al-
education landscape, such as the emphasis in fed- though technology has taken the production of
eral law on the needs of all students with disabili- braille, both commercial and personal, to an even
ties for appropriate transition services. higher level, the Perkins Brailler, now with an
updated version called the SMART Brailler that in-
cludes a visual display and voice output, is still
ACCESSIBLE MED A considered the faithful standby and the most de-
AND TECH OLOGY pendable method for producing small quantities
of braille, and it is still in use t oday. Even so, many
Braille Writing Machines alternative devices for the production of braille are
Teaching materials during the first half of the now available and becoming more widely used
20th century w ere relatively simple, compared (Holbrook, Wadsworth, & Bartlett, 2002; Presley
with t hose available by the second half. The first & D’Andrea, 2009).
Production of Books in groups was instrumental in supplying materials

Accessible Media to students with visual impairments.
Transcribing groups flourished primarily
Early books in braille were embossed on one side, because there was something exciting about sup-
which facilitated the reading of braille by sight. porting children who read braille in regular class-
However, the storage of books consumed a g reat rooms. Placing children with disabilities in regular
deal of space. The technique of embossing on classrooms was rare in the 1950s and 1960s, ex-
both sides (called interpoint) was not developed cept for a growing number of students who w ere
until the mid-1920s, amid much controversy, but blind or visually impaired. Without large num-
it reduced the bulk and weight of braille books. bers of braille transcribers, these students would
The introduction of contracted (Grade 2) braille not have succeeded in regular classrooms, where
and interpoint during the late 1940s helped allevi- having the same learning materials as their
ate the problem of book storage. The use of con- sighted peers was essential. At this time in his-
tracted braille was not widespread u ntil the 1950s. tory, women were not typically employed, and
Technology had a direct impact on educa- many w ere looking for new hobbies and inter-
tional content for students who are visually im- ests as their c hildren began to leave home. So,
paired by dramatically changing the quality and when teachers of students with visual impair-
quantity of adapted instructional materials for ments began advertising classes in braille tran-
students. Prior to 1950, t here was no way of pro- scribing, there was no shortage of interested
ducing braille other than by using a laborious people. T hese volunteers became the foundation
printing-press method at APH, Clovernook, and of support serv ices for braille readers in inclusive
other braille suppliers or through the use of vol- education settings.
unteer braille transcribers who produced braille Over the years and with the development of
materials by hand on a Perkins Brailler. The en- technology, the need for braille transcribers has
rollment of braille readers in general education diminished. As noted earlier, as a result of braille
classrooms caused significant challenges in the legislation in the 1990s and IDEA amendments
production of braille textbooks. APH could pro- in 2004, textbook publishers are required to fol-
duce only a limited supply, and those were most low technical standards (NIMAS) to produce ac-
often the ones requested by specialized schools cessible source files, housed at an electronic file
for students with visual impairments. However, repository (NIMAC). Those files may be used by
local school districts had the latitude of adopting authorized users to develop multiple specialized
any one of literally dozens of textbooks on e very formats (such as digitized text, braille, or audio-
school subject, except when their states adopted books).
specific ones. The chance that a local district
would select a textbook in reading, for example,
that had already been produced in braille was
Talking Books and Recorded Media
minimal. The evolution of auditory materials also ex-
Residential schools for students with visual panded the access of students with visual im-
impairments continued to use the books and pairments to educational materials. While p eople
materials that w ere available from APH. Local who w ere blind frequently lagged b
ehind people
school districts depended on volunteer transcrib- who were sighted in reaping the benefits of tech-
ers, and in many locations, each local district nological prog ress (Koestler, 1976/2004), t here
program had its own transcribing group. The was a notable exception. Talking Book machines,
rapid and efficient growth of braille transcribing developed in 1932 by AFB, were the forerunner of
Modern technology now provides high-

quality digital recordings that can be indexed
and read using compressed speech. The ability to
find one’s place on a recording quickly and to lis-
ten to material at a speed more rapid than the one

at which it was recorded are tremendous advances
for listeners with visual impairments.
With the development of technology and the
move from analog to digital recordings, standards
needed to be put in place. In 1996, the Digital
Accessible Information System (DAISY) Consor-
tium was formed to lead the transition from
analog to digital Talking Books. The DAISY stan-
dard was designed to be a complete audio substi-
A worker at AFB who is blind tests a Talking Book ma-
tute for print material and also provided options
chine (c. 1937).
for audio matched to highlighted print or DAISY-
formatted print to be read with a screen reader
other methods of recording and retrieving audi- or braille display. A major advance was enabling
tory information. T hese devices w ere designed to easy navigation through texts using chapters,
play recorded books and some educational ma- page numbers, headings, and the like. The DAISY
terials on long-playing records, which w ere also consortium of global organi zations continues to
developed by AFB in 1934, long before they were work toward creating accessible reading systems
available to the general public. It is interesting to and developing standards around inclusive pub-
note that Thomas Edison, in his application for a lishing. As e-books have proliferated, the DAISY
patent for his recording machine, listed as a po- Consortium and other accessibility experts have
tential use “phonograph books, which w ill speak worked to embed accessibility features in main-
to blind people without effort on their part” stream e-book specifications (currently EPUB 3)
(Koestler, 1976/2004, p. 130). so that people with visual impairments and other
Even with the creation of Talking Books, stu- print disabilities can read the same books as their
dents and adults with visual impairments de- sighted peers.
pended on live readers for access to materials
that were not easily available in braille. Shortly
after World War II, the wire recorder, the prede
Computer Technology
cessor to the tape recorder, was produced. In ad- The most dramatic technological advance yet for
dition, companies began manufacturing dictating students with visual impairments came toward
machines that students and adults with visual the end of the 20th century with the develop-
impairments could use. A major advantage of ment of the personal computer. Many adults with
t hese new machines over Talking Books was that visual impairments immediately realized that
they allowed students to record as well as listen. computers would allow them to do something
But it was the open-reel tape recorder that revo- they had never been able to do before: store and
lutionized the production of auditory books and retrieve information easily.
materials for students with visual impairments. Until the early 1980s it was not uncommon
High school students would often carry a brailler for students with visual impairments to produce
and a tape recorder with them from class to class. an assignment in braille and turn it in to the
teacher of students with visual impairments, who • Electronic files of books used by book publish-
would write the print word above each braille ers are now being used to produce literary-
word on the assignment (interline) and give it back style braille. This process w
ill soon be possible
to the student, who would take it to the general for mathematics, too.
classroom teacher. Today the student can write a
paper in braille, proofread it, and then produce As technological advances continue, the ben-
it in print to be turned in to the classroom teacher. efits for students with visual impairments w ill
Some of the advances that technology has pro- continue to increase at a rapid rate. (For more de-
vided are as follows: tailed information on technology, see Volume 2,
Chapter 19.)
• Through the use of computers with scanners,
optical character recognition (OCR) soft-
ware, braille translation software, a braille PERSONNEL PREPARATION
embosser, and a knowledgeable braille tran- PROGRAMS AND PROFESSIONAL
scriber, it is pos si
ble to produce literary Q A IFICAT ONS
braille of printed text in a fraction of the time
required in the past. This ability has resulted In the 1950s, Congress began to take a serious in-
in a revolution in how braille is produced and terest in the preparation of teachers for students
greatly increased its availability to braille with disabilities. Over the course of a few years,
readers. Congress passed multiple laws that provided
funding to colleges and universities for personnel
• Students now have electronic notetaking
preparation for teachers of students with cogni-
devices, tablet computers, and even smart
tive disabilities, teachers of students who are
phones that they can carry comfortably from
deaf, and teachers of students with all categories
class to class and use to obtain and record
of disabilities. Although these laws were put to-
information; they can then download that in-
gether in piecemeal fashion, since a comprehen-
formation to a computer to gain access through
sive federal special education system did not exist
braille, print, or large print or in an auditory

until the mid-1970s, the impact of this legislation
format.
was enormous. It authorized the US Department
• The increasing mobility of t hese devices and of Education to engage in programs of national
the abundance of apps—specialized programs training. Many universities added preparation for
for specific purposes—has eliminated the need teachers of students with disabilities to their cur-
to carry so many differe nt devices and in- ricular offerings b ecause of the financial support
creased the range of educational and everyday from the government. Federal support came in
tasks that students can complete in de
pen the form of stipends for individuals enrolled in
dently. t hese teacher preparation courses and funds to
• Computers with specialized hardware and universities to employ faculty and instructors.
software designed for users who are blind or Prior to the 1950s and this legislation, teach-
have low vision allow them to access informa- ers and house parents at residential schools for
tion by displaying text in the user’s preferred students with visual impairments acquired their
magnified size and color combination and also specialized skills through apprenticeship, the sys-
through synthesized speech. T
hese tools u
nlock tem that was developed in Europe. Most of the
a vast wealth of information that students can teachers in the early residential schools had no
use to achieve educational objectives. previous teaching experience. Many had only
high school degrees, and many were graduates of the direction of a Perkins faculty member and
the schools in which they were employed (Koes- included a residential apprenticeship of lectures,
tler, 1976/2004). observations, and student teaching. The total se-
When Allen in Boston and Irwin in Cleve- quence offered graduate credits toward a master’s
land pioneered day school classes for the “par- degree. Thus, the standard was set for teachers of
tially sighted” and the idea began to spread, the c hildren with visual impairments—
advanced
acuteness of the teacher preparation problem be- training at the graduate level (Koestler, 1976/2004).
came evident. The teachers in t hese programs did The program was subsequently moved to Boston
not even have the advantage of apprenticeship University and then to Boston College.
u nder experienced teachers because t here were Also in 1925, I. S. Wampler, superintendent
none. As Hathaway (1959) noted, of the Tennessee School for the Blind, initiated a
six-week summer course in cooperation with
For some years a fter the first educational facili- George Peabody College for Teachers. The train-
ties were made available to partially sighted ees lived at the Tennessee School for the Blind
c hildren in 1913, t here was no established pre and attended classes at Peabody, which were
cedent for teachers to follow, and no opportu- taught by Wampler and visiting faculty. This
nity for them to prepare for this very specialized course was discontinued in 1928 for financial rea-
work. Each teacher had, therefore, to try to sons and again during the G reat Depression,
solve through the trial and error method the u ntil 1935, when AFB gave Peabody College a
problems that were constantly arising, thus ex- one-year grant that enabled it to start up again
perimenting to a certain extent, with c hildren (Koestler, 1976/2004).
who had difficulties enough of their own to Beginning in the late 1940s, t here was a surge
meet. (p. 64) of interest in special education, and several uni-
versities established teacher preparation se-
University-Based Preparation quences in various areas of exceptionality. Four
factors appear to have influenced the renewal of
Programs
interest in preparing teachers of c hildren with vi-
The first university-based teacher preparation sual impairments. They w ere (1) the rapid ex-
course was offered at the University of California pansion of day and residential school programs
in 1918 (Best, 1934). However, the first enduring to meet the demand for placements for c hildren
sequences of training courses were established in with RLF; (2) the differentiation of teaching roles
Boston and Nashville in the early 1920s. In 1921, for various types of schools and programs ow-
Allen, superintendent of what was then the Per- ing to the philosophical shift t oward educating
kins Institution, took a g iant step t oward the pro- c hildren in their home communities; (3) new
fessionalization of residential school faculties teaching skills required by the shift from the con-
when he approached the Harvard Gradu ate servation of sight to the use of vision; and (4) the
School of Education with a proposal for a six- belief that techniques for teaching daily living
month training program to be operated in coop- skills and independent mobility, systematized
eration with Perkins. The program was established and demonstrated by the Veterans Administra-
as the Harvard Course on Education of the Blind. tion program for blinded veterans of World
By 1925, the need for supervised practice was rec- War II, were adaptable for use with c hildren
ognized, and a second six-month sequence was (Roberts, 1986). One of the first of this new
developed. This portion of the program, called wave of training centers was the Department of
the Special Methods Course, was given under Special Education at San Francisco State College,
a gradu ate-
level department that opened in ties that were, and remained, totally dependent
1948 with a full-t ime faculty position in each of on federal funds were severely threatened when
eight major areas of special education, including funds became scarce. The decline in applicants
visual impairment. for teacher preparation programs may have
In the 1950s, the sudden rise in the number been related to the reduction in federal funds,
of c hildren with visual impairments due to the but it may also have been part of a larger trend
postwar baby boom and the advent of RLF cre- that was taking place among young people away
ated an unprecedented need for teachers. In 1957, from the profession of education. Whatever the
Dr. Samuel Ashcroft, at that time the only educa- reasons for t hese trends, they had a severe impact
tor in the country with a doctorate in education on the preparation of teachers in the United
of students with visual impairments, was em- States.
ployed by George Peabody College to develop
and direct a year-round graduate teacher prepara- National Center for Leadership
tion program. In the 1960s and 1970s, full-time in Visual Impairment and in
gradu ate preparation became the predominant
Sensory Disabilities
pattern as a result of federal funding and the ris-
ing concern about teachers’ competencies. The National Center for Leadership in Visual Im-
As efforts to define teachers’ competencies pairment (NCLVI) was developed by the faculty
and educational standards continued, university at Salus University (then Pennsylvania College
programs grew rapidly, largely because of the of Optometry, Graduate Studies Department)
presence of Josephine L. Taylor, branch chief of to develop a collaborative model for training
the Personnel Preparation Division at the US De- leadership personnel in special education with
partment of Education. A fter years of experience an emphasis on blindness and visual impair-
as a teacher of children with visual impairments ment. Funded by the Office of Special Education
and an administrator of local day school pro- Programs (OSEP) of the US D epartment of Ed-
grams for children who were visually impaired, ucation from 2004 to 2009, NCLVI was created
Taylor brought her expertise to the federal gov- to increase the number of leaders in the field of
ernment and at once recognized the potential blindness and visual impairment, particularly
for meeting the desperate need for teachers by in- in the areas of public policy and advocacy, cur-
fusing federal funds into university preparation riculum development, research, personnel prepa-
programs. Universities that were interested in ration, and administration at national, state, and
preparing teachers of students with visual im- local levels.
pairments submitted grant proposals to the NCLVI established a national consortium of
Department of Education. If approved, the fund- 14 doctoral institutions and produced approx-
ing provided stipends for students, as well as imately 20 leadership personnel (those with
money for faculty salaries and other costs. earned doctoral degrees) to prepare for the pro-
Beginning in the 1970s, however, federal jected shortage to be created by retirements and
funds for the preparation of teachers of students a lack of doctoral graduates. The fellows, who
with visual impairments became scarce, largely received full tuition and an annual living sti-
because the total amount of funds available re- pend while they earned their doctorate at one
mained constant while the number of universities of the consortium universities, also partici-
that applied for t hese funds increased. Although pated together in unique enrichment activities,
federal funds resulted in many programs that including face-to-face seminars, online modules,
would not have existed otherw ise, the universi- electronic discussion groups, opportunities for
short-and long-term fieldwork experiences, and ers in various areas of exceptionality (Mackie &
funding for participation at national conferences Cohoe, 1956; Mackie & Dunn, 1955). In each
and meetings. study, 100 teachers identified and evaluated the
Due in part to the success of NCLVI, OSEP competencies that w ere important in their work.
funded a new collaborative agreement, starting in Subsequently, special education supervisors, spe-
2010, using NCLVI as a model but expanding the cialists in state departments of education, and
area of doctoral emphasis to blind or visual im- nationally recognized leaders grouped and eval-
pairment, deaf or hearing impairment, and deaf- uated the competencies. The consensus of the
blindness. The program, known as the National two studies in the area of visual impairment was
Center for Leadership in Sensory Disabilities, is that the optimum teacher preparation model
ongoing to date. should include an undergraduate major in ele-
mentary education, two or more years of success-
Professional Qualifications ful teaching in a general education classroom,
and graduate training in the education of children
of Teachers with visual impairments, including 50–250 hours
Within a dec ade a fter the first university-based of practice teaching.
teacher preparation courses w ere instituted, the In response to the field’s concern about pro-
field was actively working on delineating the fessional preparation, AFB published Training Fa-
qualifications of teachers of c hildren with visual cilities for the Preparation of Teachers of Blind C
hildren
impairments. At that time, state departments of in the United States in 1953. In 1957, AFB ap-
education did not have criteria or procedures for pointed a Teacher Education Advisory Commit-
certifying teachers of c hildren with disabilities. tee to work with its staff to formulate standards
In 1932, AAIB appointed a committee to for the preparation of teachers of c hildren who
formulate recommendations regarding qualifi- were blind, which convened two national work
cations for teachers of children with visual sessions to develop program objectives for a
impairments. Certification was to be granted on teacher education sequence. The resulting doc-
the completion of university-based preserv ice or ument, A Teacher Education Program for Those Who
in-service courses and a demonstrated ability to Serve Blind C hildren and Youth (AFB, 1961), proposed
read and write braille. There was a grandfather a broader view of the range of competencies re-
clause that allowed the substitution of successful quired for the adequate education of children with
teaching experience for some of the formal course visual impairments than that of earlier publica-
work. The certification system was a dopted at tions. It included the enlistment of assistance from
AAIB’s 1938 convention, and the first awards specialists within and outside schools to meet the
were made in 1940. As late as 1985, some schools personal, social, and learning needs of t hese
still relied on this certification system (at that c hildren and youths.
time through the Association for Education and Concurrently, the National Society for the
Rehabilitation of the Blind and Visually Im- Prevention of Blindness (NSPB; now Prevent
paired) b ecause their states had inadequate or Blindness America) was developing guidelines
no procedures for teachers of c hildren with visual for a basic teacher preparation program for teach-
impairments. ers of “partially sighted” c hildren. A minimum
In 1954, the US Office of Education pub- schedule of courses had been presented in 1925,
lished a status report (Mackie & Dunn, 1954), but a review was needed, and in 1957 an advisory
and in the next few years it issued consensus committee was appointed to assist in the fourth
reports on studies of the competencies of teach- edition (1959) of Hathaway’s book, Education and
Health of the Partially Seeing Child. At that time, it ments, which were subsequently validated by
was estimated that 70,000 c hildren who were a sample of the division membership. In the
partially sighted were in school but that only mid-1990s, the Professional Standards and
8,000 w ere being served by qualified teachers. It Practices Standing Committee of CEC for-
was recommended that a basic 120-c lock-hour mally adopted the Knowledge and Skills for
sequence that would prepare teachers to work in All Beginning Special Education Teachers of Stu-
cooperative, resource room, or itinerant programs dents with Visual Impairments. (The most recent
should include at least 30 clock hours in each of version, known as the CEC Standards Initial Spe-
the following areas: organization and administra- cialty Set: Blind and Visual Impairments,
tion of facilities for educating partially sighted appears in the online AFB Learning
c hildren; procedures for conducting work in ele- Center.)
mentary, junior high, and senior high schools;
observation and practice teaching with c hildren
Competency-Based Curriculum
in all three program models; and anatomy, phys-
iology, and hygiene of the eye (Hathaway, 1959; With the widespread development of competency-
NSPB, 1956). based education in teacher preparation pro-
Another step in the specification of qualifi- grams in the United States, educators of teachers
cations for teachers of c hildren with disabili- of c hildren with visual impairments worked to
ties was taken by the Council for Exceptional define the specialized competencies that w ere
Children (CEC) in the 1960s. The Professional necessary to teach c hildren with visual impair-
Standards Committee, with funding from many ments over and above those necessary to teach
agencies including AFB and NSPB, organized a sighted c hildren. Between 1973 and 1975, AFB
massive project on professional standards. Over coordinated six meetings of 28 professional
two years, approximately 700 special educators teacher-educators of c hildren with visual impair-
participated in the formulation of standards for ments from 22 colleges and universities. At t hese
preparing personnel for special education ad- meetings, the document Competency-Based Cur-
ministration and supervision and for preparing riculum for Teachers of the Visually Handicapped: A
teachers in seven areas of exceptionality, includ- National Study (Spungin, 1977) was compiled.
ing visual impairment. The standards for pre- The competencies involved seven teaching
paring personnel to teach c hildren with visual activities: assessment and evaluation, educational
impairments included basic preparation in gen- instructional strategies, guidance and coun-
eral education, an overview of all areas of excep- seling, administration and supervision, media
tionality, and specific preparation in the area of and technology, school-community relations, and
visual impairment (CEC, 1966). In the early research. Each goal area listed prerequisite entry-
1990s, CEC initiated an ambitious project to es- level behaviors in which teachers had to demon-
tablish and validate knowledge and skills for spe- strate proficiency before they could acquire new
cial educators. This project first validated a list of competencies for that area.
knowledge and skills, which was common across
all areas of special education. Then exceptionality-
Certification
specific sets of knowledge and skills w ere vali-
dated. The then–Division on Visual Impairment Certification for teachers of children who are
of CEC (now the Division on Visual Impairments blind or visually impaired is provided by individ-
and Deafblindness) initiated the process of draft- ual states. The requirements vary and t here is not
ing the knowledge and skills in visual impair- reciprocity among all states. Some states only re-
quire a few courses or credits specific to visual im- McCormick, 1999; Kim, Lee, & Skellenger, 2012;
pairments, whereas others require a full course of McDonnell et al., 2011). The continuing challenges
study. Most states work cooperatively with uni- of training teachers of students who are blind or
versities and require that practicing teachers of visually impaired, orientation and mobility spe-
students with visual impairments maintain their cialists, and low vision therapists (Kirchner & Di-
certifications by earning continuing education ament, 1999), along with the ability of distance
credits. education to reach students in much broader geo-
Efforts to identify and maintain high profes- graphic areas (Howard, Ault, Knowlton, & Swall,
sional standards have been supported by the es- 1992; Ludlow & Lombardi, 1992), incited uni-
tablishment of the National Blindness Professional versity personnel preparation programs in visual
Certification Board and the development of impairments to offer online and other types of
national certification processes (for example, the distance education courses beginning in the late
National Orientation and Mobility Certification 1990s (DeMario & Heinze, 2001). Programs such
and the National Certification in Literary Braille). as these attempt to accommodate experienced
The Academy for Certification of Vision Rehabil- classroom teachers and others who are exploring
itation and Education Professionals (ACVREP) new and different professional challenges. Often,
was established in January 2000 to offer profes- employed workers and practicing teachers are not
sional certification for vision rehabilitation and willing or financially able to leave their jobs for
education professionals in order to improve ser a year or enroll at a distant university. Therefore,
vice delivery to persons with vision impairments. universities have considered ways in which prac-
ACVREP offers certification in three disciplines: ticing classroom teachers and other employed
low vision therapy, orientation and mobility, and adults can receive high-quality preparation with-
vision rehabilitation therapy (formerly rehabilita- out leaving home and without quitting their jobs.
tion teaching). Currently personnel preparation programs
are using a myriad of models such as on-campus
classes, occasional weekend workshops, face-to-
Distance Education Programs face summer sessions, web-based courses using
In both the education of students with visual im- online learning platforms, virtual classroom ses-
pairments and O&M t here is a chronic challenge sions, or some combination of t hese models. The
in assuring the availability of qualified teachers move to distance education programs is an at-
in communities with needs (including rural and tempt to address the shortage of teachers and the
remote communities). B ecause of this challenge, need to provide appropriate educational serv ices
there have been some efforts in recent years to to all students with visual impairments.
attempt some innovative approaches to teacher
preparation. Although distance education has US NATIONAL INIT AT VES
been part of the educational system for many
dec ades, the advent of the Internet in the 1990s At the beginning of a new century and into a new
and a series of technological innovations such millennium, the profession is attempting to ad-
as online discussion boards, audio and video dress, among other questions, the best methods
conferencing, and streaming videos led to of educating students who are visually impaired,
widespread application of distance education the roles of residential and general education
strategies to personnel preparation for those programs in doing so, the competencies and
studying special education in vision impairment supports that teachers need to provide the best
(Bullock, Gable, & Mohr, 2008; Gallagher & general and special education for t hese students,
the range of options and resources to provide for designed to ensure the availability of specialized
students with a diversity of needs, and ways to instructional methods that truly meet the unique
remedy severe shortages of trained personnel. A needs of all c hildren and youths living with vi-
number of national initiatives have attempted to sion loss. T
here were many productive outcomes
bring the expertise of the entire profession to bear from the National Agenda movement, including
on finding solutions to t hese problematic issues. the development of the concept of the expanded
core curriculum, which clearly defines educational
areas of need unique to students who are visually
The National Agenda impaired, formulated to help meet Goal 8.
The National Agenda is a historical summary
and broad grassroots consumer and professional
The National Plan to Train Personnel
expression of consensus concerning the systemic
changes in education policy and practice required Students with visual impairments have unique
to effectively meet the needs of all students living needs, and the personnel who teach them re-
with vision loss. Initially crafted in 1995 (Corn quire specialized training to meet those needs.
et al., 1995) and significantly revised in June As federal funding became more competitive
2003 (Huebner et al., 2004) the National Agenda and less available, many university programs
intended to effect change in 10 primary areas: re- that prepare teachers of students with visual im-
ferral, parental education and involvement, per- pairments were dismantled, and it became more
sonnel prep, staff development and caseload, difficult to attract students into the remaining
placement, assessment, instructional materials, programs.
ECC, transition, and professional development. To address the crucial need for more person-
The 10 goals are listed in Sidebar 1.6. nel to work in this field, the Office of Special
The efforts of the movement w ere organized Education Programs of the US Department of
around several priorities related to the education Education funded a two-year project in 1997 to
of c hildren and youths with visual impairments, develop a national plan for training capable and
and t hese priorities are stated as goals. Through qualified personnel to educate c hildren with vi-
a collaborative process that began at that time, sual impairments. A consortium of organizations
hundreds of stakeholders in the field of blindness in the field, including the Division on Visual Im-
and visual impairment provided input on goals pairments of CEC, Division 17 on Personnel
they believed had the highest likelihood of being Preparation of AER, and AFB, worked together to
achieved as well as the greatest potential for pos- develop this national strategic plan (National
itive impact (Corn & Huebner, 1998). Plan, 2000). The five goals of the plan, which was
In 2007, the National Agenda Steering Com- intended to enhance the quality of education and
mittee agreed to focus attention on aligning pri- literacy of students and to respond to the overall
orities with Goal 8. This goal focuses on the needs of c hildren and youths of all ages, were the
educational needs of students with visual impair- following:
ments in the ECC.
Most states responded to the National Agenda 1. To conduct a systemic and systematic needs
and tailored it to meet its particular strengths and assessment of the shortage of personnel in
challenges. As a result of the National Agenda’s the United States
commitment to this priority, the field of blind- 2. To identify activities for developing a compre-
ness and visual impairment mobilized to formu- hensive approach to serving students with
late and implement policy and practice strategies blindness, deafblindness, or low vision
S I D E B A R 1 . 6
Goals of the National Agenda
Goal 1: Referral. Students and their families Goal 6: Assessment. All assessments and
will be referred to an appropriate education evaluations of students will be conducted by
program within 30 days of identification of or in partnership with personnel having
a suspected visual impairment. Teachers expertise in the education of students with
of students with visual impairments and visual impairments and their parents.
orientation and mobility (O&M) instructors
Goal 7: Access to Instructional Materials.
will provide appropriate quality services.
Access to developmental and educational
Goal 2: Parental Participation. Policies and services w
ill include an assurance that text-
procedures w ill be implemented to ensure books and instructional materials are available
the right of all parents to full participation to students in the appropriate media and at
and equal partnership in the education the same time as their sighted peers.
process. Goal 8: Core Curriculum. All educational goals
and instruction will address the academic
Goal 3: Personnel Preparation. Universities
and expanded core curricula based on the
with a minimum of one full-time faculty
assessed needs of each student with visual
member in the area of visual impairment will
impairments.
prepare a sufficient number of teachers and
O&M specialists for students with visual Goal 9: Transition Services. Transition services
impairments to meet personnel needs ill address developmental and educational
w
throughout the country. needs (birth through high school) to assist
students and their families in setting goals
Goal 4: Provision of Services. Caseloads will and implementing strategies through the life
be determined based on the assessed needs continuum commensurate with the students’
of students. aptitudes, interests, and abilities.
Goal 5: Array of Services. Local education Goal 10: Professional Development. To
programs w ill ensure that all students have improve students’ learning, service providers
access to a full array of service delivery will engage in ongoing local, state, and
options. national professional development.
Source: Huebner, K. M., Merk-Adam, B., Stryker, D., & Wolffe, K. (2004). National agenda for c hildren and youths
with visual impairments, including t hose with multiple disabilities (Rev. ed.). New York: AFB Press.
3. To improve the quality of personnel prepara- 5. To develop a national plan based on a consen-
tion programs that recruit and prepare teachers sus of the major groups in the field of blindness
and related personnel to instruct students who
Efforts related to the plan continue to ex-
are blind, are deafblind, or have low vision
plore the feasibility of working with a national
4. To identify successful models of preparing network to solve ongoing challenges in the ed-
personnel who teach students with visual im- ucation of c hildren and youths with visual im-
pairments pairments.
NASDE Guidelines c hildren who were blind received an education,

and nearly all of them were enrolled in special-
In 1999, the National Association of State Di- ized schools. T oday, all students with visual
rectors of Special Education (NASDE) and the impairments receive an education, and most of
Hilton/Perkins Program of the Perkins School them are enrolled in their neighborhood schools,
for the Blind disseminated educational serv ice in general education classes, with ongoing sup-
guidelines for students with visual impairments. port systems. Today’s profession has a strong
The intent of the guidelines was to provide as- commitment to a continuum of placement op-
sistance to state and local education agencies, tions in which the individual needs of students
serv ice providers, and parents and to describe are respected. At the beginning of the 20th
the essential elements and features of programs century, t here was no effective legislation to pro-
that must be considered when designing appro- tect and advocate for the rights of students with
priate serv ices for students with visual impair- disabilities. T
oday, IDEA and other federal and
ments, including t hose with multiple disabilities. state initiatives have guaranteed and solidified
A full continuum of educational options is in- educational rights for students with visual im-
cluded. The document was the collaborative pairments. The role of technology in daily ac-
effort of 13 national consumer, advocacy, and tivities has dramatically increased educational,
educational organi zations that have a special in- recreational, and vocational opportunities for
terest in the provision of serv ices to persons with persons with visual impairments. Teacher prepa-
visual impairments and their families. Repre- ration has come of age and has progressed from
sentatives of t hese organi zations formulated the an era in which education for students with vi-
guidelines, and a larger panel of content experts sual impairments was a “folk art,” passed on
reviewed them. Blind and Visually Impaired Stu- from generation to generation, usually by word
dents: Educational Service Guidelines (Pugh & Erin, of mouth, to an era of increasing professional-
1999) discusses the unique educational needs of ism and commitment to high standards of ex-
students with visual impairments, public policy cellence.
and legislation that affect these students and
their right to full participation in the general For learning activities related to this
school curriculum, and the role of parents as chapter, log in to the online AFB Learning
equal partners in the educational process. In ad- Center.
dition, it describes the processes of identifying
and assessing the needs of individual students;
program options and placements; and the spe- REFERENCES
cialized knowledge, skills, and attributes needed
American Foundation for the Blind. (1953). Training fa-
to provide educational and O&M serv ices to
cilities for the preparation of teachers of blind children
students.
in the United States. New York: Author.
American Foundation for the Blind. (1954). The Pine
Brook Report. New York: Author.
SUMMARY American Foundation for the Blind. (1961). A teacher
education program for those who serve blind children
The rich history of prog ress in educating c hildren and youth. New York: Author.
with visual impairments is one in which teach- Barraga, N. C. (1964). Increased visual behavior in low
ers of these students can take pride. At the be- vision children. New York: American Foundation
ginning of the 20th century, only a select few for the Blind.
Best, H. (1934). Blindness and the blind in the United Hatlen, P. (1996). The core curriculum for blind and
States. New York: Macmillan. visually impaired students, including t hose with
Best, J. P., & Winn, R. J. (1968). A place to go in Texas. additional disabilities. RE:view, 28(1), 25–32.
International Journal for the Education of the Blind, Hatlen, P. (2000). Historical perspectives. In M. C.
18, 2–10. Holbrook & A. J. Koenig (Eds.), Foundations of ed-
Bullock, L. M., Gable, R. A., & Mohr, J. D. (2008). ucation: Vol. 1. History and theory of teaching children
Technology- mediated instruction in distance and youths with visual impairments (2nd ed.,
education and teacher preparation in special ed- pp. 1–54). New York: AFB Press.
ucation. Teacher Education and Special Education, Hatlen, P. H., & Curry, S. A. (1987). In support of spe-
31, 229–242. cialized programs for blind and visually impaired
Cooper, L. (1969). The child with rubella syndrome. c hildren: The impact of vision loss on learning.
New Outlook for the Blind, 63, 290–298. Journal of Visual Impairment & Blindness, 81, 7–13.
Corn, A. L., Hatlen, P., Huebner, K. M., Ryan, F., & Heumann, J. E., & Hehir, T. (1995). OSEP policy guidance
Siller, M. A. (1995). The national agenda for the edu- on educating blind and visually impaired students.
cation of children and youths with visual impairments, Washington, DC: US Department of Education,
including those with multiple disabilities. New York: Office of Special Education and Rehabilitative Ser
AFB Press. vices, Office of Special Education Programs.
Corn, A. L., & Huebner, K. M. (1998). A report to the na- Holbrook, M. C., Wadsworth, A., & Bartlett, M. (2002).
tion: The national agenda for the education of c hildren Teachers’ perceptions of using the Mountbatten
and youths with visual impairments, including those brailler with young c hildren. Journal of Visual Im-
with multiple disabilities. New York: AFB Press. pairment & Blindness, 97(10), 646–655.
Council for Exceptional Children. (1966). Professional Howard, S. W., Ault, M. M., Knowlton, H. E., & Swall,
standards for personnel in the education of exceptional R. A. (1992). Teacher education and special edu-
children. Reston, VA: Author. cation. Journal of the Teacher Education Division of
DeMario, N. C., & Heinze, T. (2001). The status of the Council for Exceptional C hildren, 15, 275–283.
distance education in personnel preparation pro- Howe, S. G. (1840). Appendix A. In Eighth annual report
grams in visual impairment. Journal of Visual of the trustees of the Perkins Institution and Massachu
Impairment & Blindness, 95, 525–532. setts Asylum for the Blind. Boston: John H. Eastburn.
Dickens, C. (1907). American notes and pictures from Italy. Huebner, K. M., Merk-Adam, B., Stryker, D., & Wolffe,
New York: E. P. Dutton. K. (2004). National agenda for children and youths
Education for All Handicapped Children Act, Pub. L. with visual impairments, including those with multi-
No. 94-142 (1975). ple disabilities (Rev. ed.). New York: AFB Press.
Elementary and Secondary Education Act (ESEA), Illingworth, W. H. (1910). History of the education of the
Pub. L. No. 89-10 (1965). blind. London: Sampson, Low, Marston.
Elementary and Secondary Education Act (No Child Individuals with Disabilities Education Improvement
Left Behind), Pub. L. No. 107-110 (2001). Act (IDEA), 20 U.S.C. § 1400 (2004).
Every Student Succeeds Act, Pub. L. No. 114-95 (2015). Irwin, R. B. (1932). Uniform braille for the English-
Gallagher, P. A., & McCormick, K. (1999). Student speaking world achieved. Outlook for the Blind,
satisfaction with two-way interactive distance 26(3), 137–138.
learning for delivery of early childhood special Irwin, R. B. (1955). War of the dots. New York: American
education coursework. Journal of Special Education Foundation for the Blind.
Technology, 14, 32–47. Kim, D. K., Lee, H., & Skellenger, A. (2012). Comparison
Haring, N. G., & McCormick, L. (1986). Exceptional of levels of satisfaction with distance education
children and youth. Columbus, OH: Charles E. Merrill. and on-c ampus programs. Journal of Visual Im-
Hathaway, W. (1959). Education and health of the par- pairment & Blindness, 106, 275–286.
tially seeing child (4th ed.). New York: Columbia Kirchner, C., & Diament, S. (1999). Estimates of the
University Press. number of visually impaired students, their
teachers, and orientation and mobility specialists: Mellor, M. (2006). Louis Braille: A touch of genius. Bos-
Part 1. Journal of Visual Impairment & Blindness, 93, ton: National Braille Press.
600–606. Mills, R. J. (1982). Foundations of orientation and mobil-
Koenig, A. J., & Holbrook, M. C. (1993). Learning me- ity. New York: AFB Press.
dia assessment: Guidelines for teachers. Austin: Texas Miyagawa, S. (1999). Journey to excellence. Lakeville,
School for the Blind and Visually Impaired. MN: Galde Press.
Koenig, A. J., & Holbrook, M. C. (1995). Learning me- National plan for training personnel to serve children with
dia assessment of students with visual impairments: A blindness and low vision. (2000). Reston, VA: Coun-
resource guide for teachers (2nd ed.). Austin: Texas cil for Exceptional C hildren.
School for the Blind and Visually Impaired. National Society for the Prevention of Blindness.
Koestler, F. (2004). The unseen minority: A social history (1956). Recommended basic course for preparation
of blindness in the United States. New York: AFB of teachers of partially seeing children. New York:
Press. (Original work published 1976) Author.
Lorimer, P. (2000). Origins of braille. In J. M. Dixon Presley, I., & D’Andrea, F. M. (2009). Assistive technol-
(Ed.), Braille into the next millennium (pp. 19–39). ogy for students who are blind or visually impaired: A
Washington, DC: National Library Serv ice for the guide to assessment. New York: AFB Press.
Blind and Physically Handicapped and Friends of Pugh, G. S., & Erin, J. (Eds.). (1999). Blind and visually
Libraries for Blind and Physically Handicapped impaired students: Educational ser vice guidelines.
Individuals in North America. Watertown, MA: Perkins School for the Blind.
Lowenfeld, B. (1971). Our blind children (3rd ed.). Rehabilitation Act of 1973, 29 U.S.C. § 701 (1973).
Springfield, IL: Charles C Thomas. Rex, E. J., Koenig, A. J., Wormsley, D. P., & Baker, R. L.
Lowenfeld, B. (Ed.). (1973). The visually handicapped (1994). Foundations of braille literacy. New York:
child in school. New York: John Day. AFB.
Lowenfeld, B. (1975). The changing status of the blind. Riley, R. W. (2000, June 8). Policy guidance: Educat-
Springfield, IL: Charles C Thomas. ing blind and visually impaired students. U.S.
Lowenfeld, B., Abel, G. L., & Hatlen, P. H. (1969). Blind Department of Education, Office of Special Edu-
children learn to read. Springfield, IL: Charles C cation and Rehabilitative Serv ices. Federal Register,
Thomas. 65(111), 36585–36594.
Ludlow, B. L., & Lombardi, T. P. (1992). Special edu- Roblin, J. (1960). Louis Braille. London: Royal National
cation in the year 2000: Current trends and f uture Institute for the Blind.
developments. Education and Treatment of C hildren, Rodenberg, L. W. (1955). The story of embossed books for
15, 147–162. the blind. New York: American Foundation for the
Mackie, R. P., & Cohoe, E. (1956). Teachers of c hildren Blind.
who are partially seeing. Washington, DC: US Gov- Sacks, S. Z. (1998). Educating students who have vi-
ernment Printing Office. sual impairments with other disabilities: An
Mackie, R. P., & Dunn, L. M. (1954). College and uni- overview. In S. Z. Sacks & R. K. Silberman (Eds.),
versity programs for the preparation of teachers of excep- Educating students who have visual impairments with
tional children. Washington, DC: US Government other disabilities (pp. 3–38). Baltimore: Paul H.
Printing Office. Brookes.
Mackie, R. P., & Dunn, L. M. (1955). Teachers of c hildren Schwartz, H. (1956). Samuel Gridley Howe. Cambridge,
who are blind. Washington, DC: US Government MA: Harvard University Press.
Printing Office. Silverman, W. A. (1980). Retrolental fibroplasia: A mod-
McDonnell, J., Jameson, J. M., Riesen, T., Polychronis, ern parable. New York: Grune & Stratton.
S., Crocket, M. A., & Brown, B. E. (2011). Com- Smith, T. E. C., Polloway, E. A., Patton, J. R., Dowdy,
parison of on-c ampus and distance teacher ed- C. A., & Doughty, T. T. (2016). Teaching students
ucation programs in severe disabilities. Teacher with special needs in inclusive settings (7th ed.). Co-
Education and Special Education, 34, 106–118. lumbus, OH: Pearson.
Spungin, S. J. (1977). Competency-based curriculum for B. B. Blasch (Eds.), Foundations of orientation and
teachers of the visually handicapped: A national study. mobility: Vol. 1. History and theory (3rd ed., pp. 486–
New York: American Foundation for the Blind. 532). New York: AFB Press.
Welsh, R. L., & Blasch, B. B. (1974). Manpower need Wolffe, K. (1998). Transition planning and employ-
in orientation and mobility. New Outlook for the ment outcomes for students who have visual im-
Blind, 68, 433–443. pairments with other disabilities. In S. Z. Sacks &
Wiener, W. R., & Siffermann, E. (2010). The history R. K. Silberman (Eds.), Educating students who
and progression of the profession of orientation have visual impairments with other disabilities
and mobility. In W. R. Wiener, R. L. Welsh, & (pp. 339–368). Baltimore: Paul H. Brookes.
2
C H A P T E R
Visual Impairment:
Terminology,
Demographics, Society
Missy Garber and Kathleen M. Huebner
To hear an audio introduction ♦ Professionals who are concerned with the ed-
to this chapter by an author, ucation of students who are visually impaired
and to view a chapter overview must work to ensure that accurate data are
presentation, log in to the AFB Learning Center. available regarding the identification and num-
ber of students who are blind or visually im-
paired (child count).
KEY POINTS
♦ The population of students with visual impair- INTRODUCT ON
ments is diverse.
♦ It is important for teachers of students with Students who are blind or visually impaired are a
visual impairments to understand and use heterogeneous group. Just like those without vi-
correct and appropriate terminology. sual impairments, they have unique, individual
characteristics; they differ in intellectual ability,
♦ Perceptions and misunderstandings about developmental rate, social competence, and other
visual impairments have a great impact on the factors. Their one common characteristic is that
ways in which people who are visually impaired they are all visually impaired, that is, they have
are treated by others. less-t han-f ully functional visual systems, which
♦ Visual impairment among c hildren is considered can interfere with expected prog ress in general
a low-incidence and low-prevalence d
isability. education programs unless they receive special-
ized instruction. However, there are differences
even within this common characteristic. Students
differ in the nature of their visual impairments,
the extent of their visual capability, and their abil-
Rebecca Sheffield, PhD, senior policy researcher, American
Foundation for the Blind, contributed substantially to the ity to use whatever vision they have. Some stu-
sections on demographics and terminology in this chapter. dents have clear vision with significant field losses,
50
Visual Impairment: Terminology, Demographics, Society 51
as if they are looking through the tube of a paper nology they use when speaking or writing, espe-
towel roll or a drinking straw. Others may have cially to nonprofessionals or t hose who work in
significantly diminished visual acuities, or blurry other settings. To communicate effectively and
vision, as if they are looking through waxed paper to plan and implement educational programs,
but have full fields of vision. (See Chapter 3 in this teachers need to understand specific terms and
volume for more detailed information on visual be able to clarify subtle differences in definitions
impairments.) No two children with visual im- used from setting to setting and from one school
pairments see in the same way. In fact, the nature district or state to another. Furthermore, to meet
of visual impairment is such that children can each student’s unique individual needs, teachers
have identical mea sured visual acuities and of students who are visually impaired usually
fields of vision, but the way in which they use work with one student at a time. To do so, they
their vision, called functional vision, may differ. need to know all the f actors that influence each
Furthermore, their personalities, motivations, student’s learning. Knowledge of the terms and
and cognitive abilities, and the degree to which definitions included in this chapter will help
they have learned to use their other senses, vary teachers understand t hese individual factors.
and affect their visual per for
mance. Some stu- It is also important to understand the nature
dents naturally take full advantage of their exist- of this population as a w hole as it relates to how
ing vision, whereas o thers do not and may benefit instruction is provided, to how students learn,
from instruction in how to do so; adaptations and and to issues of teachers’ caseloads and serv ice
interventions may be required for them to be able delivery options. (See Chapter 9 in this volume
to take full advantage of educational experiences. for a fuller discussion of t hese issues.) Thus, this
Most students with visual impairments attend chapter presents information on the demograph-
school and receive specialized educational services ics (statistics about the population as a w hole) of
in their home communities through a variety of students who are visually impaired, including
service models, such as in resource rooms or self- those whose visual impairments are accompa-
contained classrooms or from itinerant teachers or nied by additional disabilities. It includes basic
teacher consultants, whereas others attend special information on child count, or how the number
schools for students with visual impairments (see of c hildren who are visually impaired are identi-
Chapter 9 in this volume). fied and counted, particularly for government
This chapter presents definitions of common funding of specialized educational serv ices.
terms related to visual impairment. Although In addition, the opinions and attitudes of
there may be some minor differences in termi- the general public toward p eople who are blind
nology from one geographic area to another, the or visually impaired can have a significant effect
terms and definitions given here are widely ac- on an individual’s education, socialization, op-
cepted. Individuals, vari ous professionals, de- portunities, and employment. Misconceptions
partments of education, the medical community, perpetuate inappropriate stereotypes and stigmas.
and parent and consumer organi zations, as well Therefore, the chapter gives examples of how the
as policy makers, often define terms used in spe- mass media continues to present misconceptions
cial education differently. Since teachers of stu- of and myths about individuals with visual im-
dents with visual impairments provide services in pairments, and provides factual explanations that
many different educational settings, it is impor can be used to counteract these myths. Teachers
tant for them to learn the meaning of the terms of students with visual impairments have a re-
used in each setting. It is also important for them sponsibility to educate the public not only about
to be able to clarify the meaning of the termi- the needs of students, but also about students’
abilities, potential, talents, complexity, and indi- impairments such as reduced visual acuities,
viduality (see Volume 2, Chapter 8). reduced visual fields, reduced central vision, or
scotomas (blind spots). Experiences had while
wearing various types of simulators can help pro-
UNDERSTANDING fessionals understand how dif fer
ent environ-
V SUAL IMPAIRMEN mental factors influence visual effectiveness and
efficiency, as well as the emotional impact of vi-
The ability to understand visual impairment is sual impairment. Such experiences help teachers
rooted in individual life experiences. Some people and other professionals anticipate what students
have interacted with family members, friends, or need to learn and to better understand students’
neighbors who are blind. O thers have only seen or potential strengths and frustrations related to
read about fictional characters and real p eople their sensory experiences in learning.
who were visually impaired in films, books, and Those who have limited knowledge of visual
other media. Most p eople have played childhood impairment might describe blindness as the in-
games such as pin the tail on the donkey or ability to see. Some use the terms total blindness,
blindman’s buff, and some thought t hese games blindness, legal blindness, and visual impairment
simulated blindness because they had to close interchangeably, yet these terms do not mean
their eyes or wear blindfolds. Such limited and exactly the same thing, and the differences are
indirect experiences, however, provide l ittle basis important. The differences among these terms
for a true understanding of the nature and effects are discussed later in this chapter.
of blindness.
During their university course work, teachers
and other professionals studying visual impair- COMMON ERMS
ment may wear blindfolds or goggles with vari AND IMPL CATIONS
ous lenses to simulate visual impairments. This
is intended to provide a better understanding of Social acceptance or rejection of terminology
how p eople function with limited or no vision. changes over time. For example, many years ago,
These simulations create only temporary situa- individuals with intellectual disabilities w ere
tions in which vision cannot be used, and they classified as and referred to by such terms as
do not give p eople who are sighted a true indica- idiot, moron, and feebleminded. These and other
tion of what it is like to be permanently visually terms were later determined to be demeaning,
impaired. P eople who are sighted have a visual and the terminology was changed to mentally re-
memory of what t hings, places, and p eople look tarded. Over time, the term retarded was used in
like even during t hese simulations. derogatory ways by people in the general public
Nevertheless, simulations may help profes- to refer to someone whom they considered to be
sionals gain some understanding of the impact “stupid” or incompetent. In 2010, u nder Rosa’s
of visual impairment on learning in general and Law, the terms mental retardation and mentally re-
in specific skill areas, such as social interaction; tarded w ere replaced in federal law language with
communication; independent travel (orientation intellectual disability and individual with an intellec-
and mobility [O&M]); daily living; personal, tual disability. Similarly, the label deaf and dumb
home, and financial management; recreation and was recognized as being inaccurate because the
leisure; and employment. Simulations may be inability to speak is not always associated with
accomplished by wearing blindfolds or goggles the inability to hear, and “dumb” had popularly
that have been made to simulate various visual come to mean unintelligent; thus, the disability
terms for this population that are most widely thers prefer the term blind. Thus, professionals
O
used today are deafness and hearing impairment. need to respect students’ and families’ prefer-
In the field of visual impairment, the termi- ences and should not impose their own favored
nology has also changed because of the desire to terms. The best way to determine the terminol-
refine and specify characteristics. Terms of the ogy that is preferred by a student or his or her
past included medically blind, economically blind, family members is to ask them and make note of
braille blind, partially seeing, partially blind, residual their responses for use in f uture conversations.
vision, visually limited, visually defective, and voca- In addition, it is important to be aware that the
tionally blind. Each of t hese terms had specific def- terminology individuals prefer to use may differ
initions and applications, and many were used depending on contexts. While it is now not
to categorize and demonstrate eligibility for gov- unusual to use person-fi rst language in profes-
ernment-or agency-f unded serv ices. Today, most sional reports, educational documents, and
descriptors do not provide specific information other professional contexts such as pre sent a
about what a person can or cannot see or the tions, some people feel such language is cumber-
quality of a person’s sight, and they do not indi- some in standard conversation. Throughout the
cate how functional vision may change because educational careers of students who are visually
of physical or environmental circumstances. For impaired, terminology is bound to change for a
teachers and o thers who provide ser v ices to variety of reasons (such as consideration for stu-
c hildren with visual impairments, it is essential dents and their parents and use of new termi-
to understand the functional implications of each nology in legislation). It is the responsibility of
student’s visual impairment (the impact of the vi- professionals to stay up to date, recognize when
sual impairment on an individual’s daily life), as changes are needed, and influence and support
well as the medical diagnosis and clinical char- positive changes.
acteristics of the student’s vision.
Likewise, it is important for professionals to Adventitious and Congenital
be sensitive in their written and spoken expres-
sion when referring to persons who are visually
Loss of Vision
impaired. When communicating about and with Partly b

ecause p eople with vision learn from ex-
individuals with disabilities, it has become periences of seeing, it is critical for teachers and
increasingly common to use “person-first” lan- O&M specialists to know whether individual stu-
guage. The thought b ehind person-first language dents ever had useful vision. (O&M specialists
is that when writing or speaking, the essential are professionals who teach c hildren with visual
words should be written or said first, emphasiz- impairments to travel safely and confidently.)
ing and prioritizing the w hole person, rather than Two terms are generally used to describe when a
one aspect of the person, that is, his or her dis- person first lost his or her vision: adventitious and
ability. Thus “a child who is blind” is used rather congenital.
than “a blind child.” Person-fi rst language is Adventitious means that the impairment or
widely preferred, but there are exceptions that condition was acquired after birth, generally as a
should be expected. Students or their family result of an accident or disease. The term is used
members may prefer a particular term and per- to refer to the loss of vision a fter visual memory
haps might feel offended by other terms they be- (the ability to remember what objects, places, and
lieve are not appropriate. For example, some people look like) is established, generally by
people who are severely visually impaired are of- age 2 (Lowenfeld, 1971; Sardegna & Otis, 1991).
fended when they are referred to as being blind. Students who had some vision u ntil they w
ere
2 years old are likely to have some visual mem- but w ill not be able to identify objects in the
ory and may use it to learn. Thus, teaching new room visually. Some individuals are born blind
concepts, strategies, skills, and information can (are congenitally blind), and others acquire blind-
be built on their visual memory, as well as their ness (are adventitiously blind).
senses other than sight (including hearing, touch, The term blind is sometimes misapplied to
and smell). Therefore, it is important to know individuals who have some vision. It is not un-
when a child became visually impaired and if he common for members of the medical community
or she remembers what things look like, as this to jot down “blind” when a person has significant
information may affect the child’s learning style low vision (frequently defined as a severe visual
and the teaching strategies that are used. impairment that, even with the best correction, in-
The general working definition of congenital is terferes with the performance of daily tasks; see
“before or at birth.” In the case of c hildren who the next section). In some cases this error occurs
are visually impaired, the term refers to a loss of because a person has multiple disabilities that se-
vision that occurred before visual memory was verely impede his or her motor and communica-
established, before the age of 2 years. Students tion skills, and the eye care specialist does not have
who never experienced vision or do not have vi- experience or training in assessing the visual abil-
sual memory learn differently from t hose who ity and potential visual ability of this population. At
lost it adventitiously. They rely totally on senses the same time, the term has often been used to refer
other than vision to learn and have nonvisual to all p
eople with visual impairments, as in “schools
learning styles that require differe nt teaching for the blind” or “blindness agencies,” although it is
strategies. To help them learn, teachers need to more common today to speak of p eople who are
emphasize the use of all their sensory potential. blind or visually impaired.
Students who have had poor visual acuity or re- Many in the general public do not have expe-
stricted fields of vision since birth experience rience with and thus do not fully understand what
the world differently from t hose who are adven- constitutes blindness. Some people believe that
titiously visually impaired or sighted, and they if an individual has a significant uncorrectable
may miss some visual learning opportunities. visual acuity, he or she is blind, although this is
Thus, they may require more direct instruction not necessarily the case. Everyone uses existing
that involves tactile and other sensory input. vision differently, but most people with visual
Many different terms convey information impairments learn to take advantage of the vision
about the way a person sees. Although most have they have. A person who is visually impaired can
precise definitions, some have many differe nt be blind under certain environmental conditions,
definitions and are sometimes carelessly or however, and have significant functional vision
unknowingly misused. u nder other conditions, as occurs with night
blindness. Therefore, it is important for teachers to
observe each student’s visual ability and potential
Blindness even if the student’s eye report simply says “blind.”
One term that is often misused is blind. Techni- Because of historical misperceptions, the

cally, the word blind is used to refer to individu- term blind may have a harsh or negative conno-
als with no vision or with only light perception tation for some p eople. It is therefore common to
(the ability to determine the presence or absence use a term such as visually impaired to describe all
of light). A person with light perception w ill no- people who are visually impaired, even t hose for
tice when he or she moves from a bright, sunlit whom the term blind is appropriate. Profession-
entryway into a dark family room, for example, als who work with individuals who are visually
impaired must carefully examine their own atti- or she still meets the criteria of legal blindness
tudes about blindness and use terminology ap- (Social Security Administration, 2008).
propriately. Blind is an accurate and appropriate To be classified as legally blind, a person must
term to use when referring to total blindness or have significantly reduced visual acuity or a sig-
light perception. The word blind is only a physi- nificantly reduced visual field. The expression
cal description of a person’s vision; it does not “20/200” refers to acuity, the measurement of the
indicate the person’s abilities, intelligence, per- sharpness of vision or the ability to discriminate
sonality, or interests. details (American Optometric Association, n.d.).
It is important to note, however, that, despite It means that a person who is legally blind can
the clinical definition of blindness, many indi- see what a person with typical visual acuity sees
viduals who are visually impaired, legally blind, at 200 feet only if the distance is reduced to no
or live with low vision prefer to use the term blind greater than 20 feet, even with the best possible
to describe their disabilities. Jernigan (2005), for correction through spectacles, contact lenses, or
example, defines blindness broadly: “One is blind surgical intervention. If a person has a visual acu-
to the extent that the individual must devise ality better than 20/200 but a visual field that is
ternative techniques to do efficiently those things reduced to only 20 degrees, he or she can also be
which he would do if he had normal vision.” classified as legally blind. The typical person has
Others who use vision for some tasks prefer to de- a visual field of approximately 160 to 180 degrees.
scribe their experience as “low vision,” “partial Definitions of l egal blindness do not consider an
vision,” or “visual impairment.” individual’s visual functioning (ability to use
Legal or statutory blindness is an arbitrary term vision), tolerance of light, and contrast sensitiv-
that has limited value for educational or rehabili- ity, or their motivation, age of onset of the visual
tation efforts, except that it is used to determine impairment, and cognitive ability.
eligibility for some government-f unded serv ices The clinical definition of l egal blindness was
(Social Security Administration, 2012). To be le- developed by a committee of the ophthalmology
gally blind, one does not need to be totally blind. section of the American Medical Association,
In the United States and Canada, legal blind- which was appointed to develop a scientific defi-
ness is defined as central visual acuity of 20/200 nition of blindness suitable for the creation of
or less in the better eye, with best correction, or a government statutes. It was incorporated into the
central visual acuity of more than 20/200 if t here Social Security Act of 1935 and the Blind Persons’
is a visual field defect in which the peripheral Rights Act (Canada) and continues to be used to
field is contracted to such an extent that the determine classifications of blindness and eligi-
widest diameter of the visual field subtends an bility for serv ices (Jutai et al., 2005). The defini-
angular distance of no greater than 20 degrees tion was later a dopted by most industrialized
(Jutai et al., 2005). In other words, an individual nations. In countries that use the metric system,
is considered to be legally blind if his or her visual the visual acuity measure of 20/200 is written
acuity cannot be corrected to better than 20/200 in as 6/60. Government and other benefits deter-
the better eye or if his or her field of vision is fewer mined by the classification of l egal blindness in-
than 20 degrees in the better eye. Sometimes vi- clude some special education and rehabilitation
sual acuity is measured using an eye chart that serv ices, Internal Revenue Ser v ice income tax
includes lines to determine acuity between exemptions and deductions, free telephone di-
20/200 and 20/100. If an individual is found to rectory assistance, transportation benefits, f ree
have a corrected visual acuity better than 20/200 mail postage of materials mailed by or for use by
but cannot read any letters on the 20/100 line, he individuals who are legally blind, and free library
serv ices (books and magazines in braille, audio, acuity between 20/200 and 20/400) (WHO, 2014),
and electronic formats). in addition to several categories of blindness.
Students do not necessarily need to meet the Clinical definitions—that is, definitions based
criteria for l egal blindness to receive special edu- on clinical measurements alone—do not consider
cation services related to visual impairment. Most an individual’s efficiency and effectiveness in
states in the United States follow the criteria set using existing vision, what an individual may
forth in the regulations from the Department of actually see, or other aspects of visual function-
Education for the Individuals with Disabilities ing, such as contrast and light sensitivity. Clinical
Education Act (IDEA) when determining if a stu- definitions also do not explain an individual’s
dent is eligible for special education and related visual functioning abilities or the deficits that
serv ices as a student with a visual impairment. can cause difficulties in communicating, traveling,
These criteria are broader than the definition of cooking, using a computer, performing a job, or
legal blindness: “Visual impairment including engaging in other daily living activities. B ecause
blindness means an impairment in vision that, of this, educators and rehabilitation specialists
even with correction, adversely affects a child’s may find a functional definition of low vision
educational performance. The term includes both more useful. An individual with low vision is a
partial sight and blindness” (34 C.F.R. § 300.8). “person who has measurable vision but has diffi-
Teachers of students with visual impairments culty accomplishing or cannot accomplish v isual
should become familiar with the serv ices, def- tasks, even with prescribed corrective lenses, but
initions, and regulations specific to the states who can enhance his or her ability to accomplish
or schools in which they are employed. They these tasks with the use of compensatory visual
can obtain copies of federal and state laws strategies, low vision devices, and environmental
and regulations from their state departments modifications” (Corn & Lusk, 2010, p. 20). Teachers
of e ducation and program supervisors, and, in are compelled to consider students’ level of visual
many states, can obtain special education and functioning and potential visual functioning, as
disability-specific handbooks of guidelines for well as existing acuities or visual fields when plan-
serv ices that have been developed for parents ning educational programs.
and teachers.
Visual Impairment, Disability,

Low Vision and Handicap
Definitions of low vision vary. The National Eye To classify and describe individuals’ characteris-
Institute defines low vision as “best corrected vi- tics, professionals in the fields of special educa-
sual acuity less than 6/12 (20/40) in the better- tion and rehabilitation make use of several related
seeing eye (excluding t hose who w
ere categorized terms, including impairment, disability, and the
as being blind by the U.S. definition [20/200 or now less commonly used handicap. These terms
less best-corrected visual acuity in the better- are sometimes used indiscriminately, without re-
seeing eye])” (NEI, n.d.b). The World Health gard to differences in their meanings, but it is
Organization (WHO) no longer uses the classifi- important to understand the differences.
cation of “low vision” but instead uses the Interna-
tional Classification of Disease (ICD-10; WHO,
Visual Impairment
2016) categories of “moderate” visual impairment
(distance visual acuity between 20/70 and 20/200) According to the World Health Organization’s
and “severe” visual impairment (distance visual (2002) International Classification of Functioning,
Disability, and Health (ICF), which provides a or activity limitations are not necessarily internal
standard language for the description and mea to the person with a disability; disability may
surement of health and health-related states, be caused by the intersection of a physical differ-
an impairment is a “problem in body function or ence with an external factor, such as a lack of ac-
structure such as a significant deviation or loss” cessible materials that limits a student’s ability to
(WHO, 2002, p. 10). Definitions of visual impair- participate in instruction. Two p eople with the
ment typically equate it to a range of visual acuity. same medical diagnosis may have very different
Thus, ICF has the following classifications: mild or levels of functioning and thus differing experi-
no visual impairment, with visual acuity equal to ences of disability, in part depending on their
or better than 20/70; moderate visual impairment, social and physical environments. Disability is
between 20/70 and 20/200; severe visual impair- thus “the interaction between individuals with a
ment, between 20/200 and 20/400; and several health condition . . . and personal and environ-
categories of blindness for vision worse than mental factors” (WHO, 2015). When an impair-
20/400. The National Eye Institute defines “vision ment results in a lack of or restriction in the
impairment . . . as best-corrected visual acuity less functional performance of an individual, it is con-
than 6/12 (20/40) in the better-seeing eye (exclud- sidered a “disability.” Disabilities are descriptions
ing t hose who were categorized as being blind by of the functional levels of the individuals experi-
the U.S. definition [20/200 best-corrected visual encing impairments.
acuity in the better-seeing eye])” (NEI, n.d.a). Pre- Two additional legal definitions of disability
vent Blindness America (2012) defines visual im- and impairment are relevant to the field of visual
pairment as having less than 20/40 visual acuity impairment. The Americans with Disabilities
even with corrective lenses. Act (1990) defines disability as having a close
Rosenblum and Erin (1998) surveyed 897 relationship to impairment and functioning,
professionals and university students (both t hose stating that an individual with a disability is a
studying special education and t hose not study- person who has “a physical or mental impair-
ing it), asking about 16 terms to describe people ment that substantially limits one or more major
with visual impairments that are commonly used life activities . . . ; record of such impairment; or
by professionals, the media, and people with being regarded by o thers as having such an im-
visual impairments. Participants w ere asked to pairment” (42 U.S.C. § 12102). Also, as mentioned
rate terms as positive, negative, or neutral. The re- previously in this chapter, federal regulations for
searchers found that, on average, there was a pos- the 2004 Individuals with Disabilities Education
itive perception of the term visually impaired across Act define “a child with a disability” to mean a
age groups and affiliations. child who has been evaluated and determined
to have one or more of a list of impairments and
who needs special education and related serv ices
Disability
because of his or her identified impairment(s)
Impairment contributes to disability. However, (34 C.F.R § 300.8).
according to ICF and for most professionals in Why are t here so many different definitions?
the field of visual impairment, disability has In the past, disability has been understood from
a functional definition; that is, it is based on a medical standpoint. The medical model of
the individual’s ability to function. According to disability emphasized impairments along with
WHO, disability is an umbrella term for “impair- treatments, fixes, and cures for physiological and
ments, activity limitations, and participation re- psychological differences, which w ere viewed as
strictions” (WHO, 2002, p. 2). These participation the cause of a person’s disability. More recently,
professionals and advocates around the world tional) that inhibits or prevents achievement
have promoted a social model of disability, which or acceptance (Kelly & Vergason, 1985; Sardegna
emphasizes external, social factors over impair- & Otis, 1991). It is a concept that is influenced
ments or physical differences. In its preamble, the by the society and culture in which a person lives.
United Nations (2006) Convention on the Rights of Handicapped is used to refer to individuals with
Persons with Disabilities states that “disability re- disabilities less commonly than it was in the past.
sults from the interaction between persons with However, the term is still frequently used in refer-
impairments and attitudinal and environmental ence to accessibility, such as in the terms handi-
barriers that hinders their full and effective par- capped placard, handicapped parking, handicapped
ticipation in society on an equal basis with restroom, and handicapped entrance. Even t hese
others.” Professionals in the field of visual im- common terms have been transformed in most
pairment work to support functioning by ad- places into disability placard, accessible parking, ac-
dressing impairments as well as the intersection cessible restroom, and accessible entrance.
of impairments with social and physical contexts.
They provide education and rehabilitation while Literacy and Learning
also working to make environments more acces-
sible (less “disabling”). Thus, the field of visual
Media Terminology
impairment draws from both the social and Two additional distinctions used in the field of
the medical models of disability in its standards education of students with visual impairments
and definitions for identification, evaluation, and make reference to a student’s primary literacy me-
serv ices. Many definitions of visual impairment dium, or the way that the student reads and
have resulted from variations in requirements for writes, which could be in braille, print, or both.
levels of functioning and functional tasks (such (Note that while the auditory channel is generally
as reading or driving) as well as variations in laws considered a learning medium, t here is contro-
and data collection methods. versy over w hether it can actually be considered
“reading” and hence a literacy medium.) Literacy
continues to be highly valued in most societies—
Handicap
“the very key to prosperity, since [it] opens the
Finally, the term handicap is rarely used t oday, as way to information by tearing down barriers of
it is perceived by many p eople with disabilities myth and ignorance” (Schroeder, 1989, p. 290).
and others to imply that someone who is disabled Both braille and print facilitate equal opportunity
is a burden or has been constrained. However, for mastery of basic literacy skills (Caton, 1991;
there are circumstances when this term is still Koenig & Holbrook, 1995). Some students use
used, mostly in situations involving individuals a variety of modes for reading, such as braille,
who are not aware of the negative connotations print, optical devices, electronic text, and audi-
of the word. In the past, the term handicap re- tory media. A print (or visual) reader is someone
ferred to circumstances in which impairment who primarily uses large print, regular print, or
and disability led to disadvantage for an individ- both with or without optical devices for reading,
ual and “limits or prevents the fulfillment of a whereas a braille reader mainly uses braille for
role that is normal (depending on age, sex, and reading and writing. Some students benefit most
social and cultural factors) for that individual” from using print only (sometimes enlarged or
(WHO, 1980, p. 29). Generally, handicapped with optical devices) or braille only. Others need
was used to describe the result of any condition to use various combinations of print and braille,
or deviation (mental, sensory, physical, or emo- depending on the visual and learning tasks. The
essential assessment for making this determina- visually impaired. This fact is exemplified in a
tion is a learning media assessment, a systematic study of the attitudes of p eople who are sighted
process for selecting appropriate learning and lit- toward blindness (Jorkasky, 2014). Of over 2,000
eracy media (Koenig & Holbrook, 1995; Sanford participants, more people rated loss of eyesight as
& Burnett, 2008; discussed in detail in Volume 2, potentially having the greatest impact on their
Chapter 4). daily lives than they did loss of hearing, memory,
The terms defined here are only some of the or speech.
many terms related to providing ser v ices to Many people have misconceptions about what
children who are visually impaired, including
visual impairment is and how it affects learning,
those with additional disabilities. What is impor socialization, emotions, travel, finances, personal
tant to remember is that since terms change over and h ousehold management, daily living skills,
time, teachers of students with visual impair- employment opportunities and employability,
ments need to know the specific terms used by and family responsibilities. People who are visu-
states and special schools at a given time and use ally impaired use numerous learning strategies,
them appropriately. They must also learn and be skills, and techniques to achieve daily and lifelong
sensitive to the terms that students and their fam- goals safely, independently, and confidently. T
hese
ilies prefer, be sure that all members of students’ strategies, combined with motivation, intelli-
educational teams are using the same definitions, gence, perseverance, talent, experiences, and other
and use the terms accurately in spoken and written qualities, should culminate in the realization of
communications. success as determined by individuals. (See Side-
bar 2.1 for discussion of some of the more
common misconceptions about people who are
BELIE S AND visually impaired.)
M SCONCEP IONS
In the United States and Canada, the word blind
Influence of the Mass Media
is used metaphorically in phrases, such as “blind Attitudes, perceptions, and opinions about dis-
faith,” “blind fate,” “blind destiny,” or “blind abilities, specifically about blindness and visual
belief,” to refer to what is intangible, unobserv- impairment, are influenced by several complex
able, and beyond human control. Metaphors fre- internal and external factors. The impact of
quently pair blind with negative concepts unrelated public perception has long been discussed as a
to the inability to see, as in such phrases as “blind challenge for social, educational, and vocational
greed,” “blind drunk,” “blind stupor,” and “rob- inclusion of people with disabilities. However, ef-
bing a person blind” (Rosenblum & Erin, 1998). forts by educators and advocates during the past
Other phrases, such as “betting on the blind,” decade have led to greater understanding of the
“blind date,” “blind alley,” and “blind chance,” value of meaningfully including individuals from
imply a lack of information or excessive risk tak- diverse backgrounds, cultures, languages, and
ing. The use of these phrases perpetuates negative ability levels in general education classrooms.
preconceptions about individuals who are visually One external f actor that has an influence on
impaired because the phrases express limitations public perception is the portrayal of individuals
without regard for ability and do not reflect so- with disabilities in mass media and increasingly
cially positive concepts (Bhushan, 2011). in social media. Telev ision, the Internet, video
Most people have little knowledge of the abil- sharing websites, social networking websites,
ities of and challenges faced by people who are and other mass media are major sources of
S I D E B A R 2 . 1
Myths and Facts about Visual Impairment
Myth: People who are blind have a sixth she described her dreams as “sensa-
sense. tions, odors, tastes, and ideas which
Fact: People who are blind do not have any I did not remember to have had in
additional senses. Some develop their reality. . . . Once in a dream I held
ability to use and trust their other in my hand a pearl. I have no mem-
senses (such as hearing and touch) ory vision of a real pearl. It was a
beyond that of people who are smooth, exquisitely molded crystal”
sighted. Some individuals who are (pp. 161–162).
blind develop their hearing to the More recently, research by Huro-
point where they have “object percep- vitz, Dunn, Domhoff, and Fiss (1999)
tion,” that is, the ability to recognize concluded that imagery and sensa-
the presence or absence of a wall in tions in the dreams of people who are
front of or beside them or of an blind generally incorporate the senses
overhead object, such as a marquee. they use in their waking lives. Kerr
People who are blind learn to hear (1993) found that those individuals
the change in the quality of sounds who w ere born totally blind or who
between an open and a closed-in lost all of their sight very early in
area. This ability is often mis childhood usually have little or no
construed as a sixth sense. visual imagery but show in their
Myth: People who are blind only see black- dreams the same detailed attention
ness or grayness. to sound, smell, touch, and taste that
Fact: The majority of people with visual they do in waking life. The findings on
impairments are not totally blind those who lost sight at varying ages
(Brilliant & Graboyes, 1999). T hose after early childhood suggest that
who are totally blind often report visual imagery is gradually replaced by
seeing a neutral gray, rather than the sensations that come to be more
blackness or light or dark. Some important in their waking lives. The

people who are blind report seeing fact is that p
eople who are blind or
flashes of colored light. In The World have low vision incorporate all their
I Live In, Helen Keller (1908) reported senses in their dreams, including
seeing a white-darkness. Some people visual imagery if they have memorable
who are blind are able to distinguish visual experiences.
the absence and presence of light, Myth: People who are blind need to be
which is called light perception. spoken for.
Myth: People who are blind do not dream. Fact: People who are blind should be
Fact: People who are blind do dream. In addressed directly. Most individuals
The Story of My Life, Helen Keller who are blind, like most p eople in the
(1976) stated, “I rarely sleep without general public, are able to form their
dreaming. . . . After Miss Sullivan own ideas and philosophies, and are
came to me, the more I learned, the able to express them. If you are in a
oftener I dreamed” (p. 269). Keller situation in which it may be difficult
described her dreams in several for a person who is visually impaired
books. In The World I Live In (1908), to know that you have approached
60
S I D E B A R 2 . 1
him or her, let the person know that individuals who are visually impaired
you are t here by verbally greeting him requires learning safety skills; the use
or her and identifying yourself. of some type of travel and/or low
Myth: People who are blind are easily able to vision device; knowledge of environ-
recognize a person by just hearing the mental concepts; orientation and
person’s voice. mobility skills; and auditory, tactile,
Fact: Although some people who are kinesthetic, and olfactory cues (Hueb-
visually impaired have excellent ner & Sidwell, 2004). Many people
auditory memories, all do not find it who are visually impaired are safe,
easy to identify a person by his or her confident, and independent travelers,
voice. It is impolite to ask a visually and many travel independently
impaired person to “guess” one’s whenever and wherever they choose.
identity just by hearing one’s voice. Some individuals who have low vision
The more appropriate social behavior can and do drive automobiles with or
is to greet the person and identify without optical devices such as
oneself, such as by saying, “Hi, bioptics (Corn & Rosenblum, 2000).
Madeline. It’s Herbert from your Myth: All p eople who are blind are sad,
chemistry class.” depressed, and angry. Or, all people
Myth: People who are blind have better- who are blind are jolly and fun loving.
than-average musical abilities. Fact: Every person who is visually impaired
Fact: Although t here are many well-known is an individual with a unique and
and accomplished musicians who are complex personality who experiences
visually impaired, there is no evidence a variety of emotions.
that the percentage of those who are Myth: When speaking with people who are
musically inclined is greater than visually impaired, never use such
among people without disabilities. terms as “see” or “look” or refer to
However, a greater percentage of specific colors.
people who are blind have been found Fact: People who are visually impaired use
to have perfect pitch than the general the same everyday language as is
population (Hamilton, Pascual-Leone, used in the cultures in which they live.
& Schlaug, 2004), although this does Sighted persons should not avoid
not guarantee that a person will have using visual terms when conversing
great musical ability or even become with people who are visually impaired.
a musician. For example, it is acceptable to ask a
Myth: People who are blind should not travel student, “Did you see the president’s
alone unless they use dog guides. State of the Union address on
Fact: People who are visually impaired television last night?” However, be
achieve independent mobility cautious about pointing and using
through different systems, only one expressions such as “over there.”
of which is the use of dog guides. When giving directions to a person
They also use h uman guides and long who cannot determine which way you
canes, and some also use electronic are pointing, give specific and usable
travel devices (ETAs), GPS systems, directions, such as “Continue in the
optical devices, or some combination direction you are facing (north) and
of these. Independent travel for cross the next two streets, Maple and

61
Cherry. Cross Cherry and turn right Fact: People who are visually impaired
(east). The library is the third building successfully hold a wide variety of
on your left.” In a classroom situation, jobs and enjoy fulfilling careers and
for example, read the mathematics occupations. For example, some are
problems presented; do not just point teachers, professors, carpenters,
to the problems. If the person is totally physicians, computer programmers,
blind, avoid using references to color beekeepers, judges, store o wners,
when giving directions. Do not say, accountants, budget analysts,
“The library is the red brick building customer service representatives,
with white shutters,” but rather, “The insurance professionals, managers,
library can be reached by following the real estate agents, salespersons,
third walkway on your left.” mechanics, stockbrokers, tax special-
Myth: When you talk to a person who is ists, interpreters, secretaries, librarians,
severely visually impaired, you must counselors, social workers, nurses,
speak loudly. massage therapists, computer
Fact: The majority of people who are programmers, and scientists. The
visually impaired do not have hearing American Foundation for the Blind
losses and do not require people to maintains a fully accessible website
speak to them more loudly. Do not called CareerConnect (www.afb.org
assume that a person who is visually /careerconnect) to promote employ-
impaired is also deaf or hard of ment for individuals who are visually
hearing. However, because someone impaired. In addition, both the
who is blind does not receive visual National Federation of the Blind and
cues such as gestures and mouth the American Council of the Blind
movements from a speaker, she or he have many professional divisions and
may have more difficulty understand- interest groups that are career ori-
ing spoken communication when there ented. Students who are blind or have
is a great deal of background noise. visual impairments should have many

Myth: People who are blind cannot hold opportunities to talk with adults who
self-supporting jobs and are on are blind or visually impaired who
welfare. work in a variety of professions.
information that influence and have the poten- When media messages portray individuals
tial to contribute to the public’s perception of in- who are blind as productive and independent,
dividuals who are blind or visually impaired. public perception of what it means to be visually
These influences are particularly important in the impaired is likely enhanced. But when media
absence of personal experience with a family messages produce or confirm stereot ypes and em-
member or friend with a visual impairment. T hese phasize p eoples’ limitations, rather than abili-
portrayals may lead to positive or negative im- ties and alternative methods of accomplishing
pressions and sometimes include mixed messages routine tasks, they can reinforce misconcep-
that may be interpreted differently depending on tions, negative attitudes, and fear about visual
the reader’s or viewer’s existing attitudes, expec- impairments. T hese misconceptions may have
tations, and personal experiences. a negative impact on the ways in which the gen-
eral public views and interacts with individuals useless, maladjusted, mysterious, evil, pitiful,
of all ages who are visually impaired. When ex- living in darkness, punished for past sins, to be
pressing concern about negative public percep- feared and avoided, possessing superhuman
tions, Jernigan (1999) stated, “The real problem powers and insights, or morally superior. This is
of blindness is not the loss of eyesight but the quite a range of characteristics, few of which
misconceptions and misunderstandings which most people would choose to emulate.
exist. The public (whether it be the general public, Norden (1994) and Wilkins (1996) exam-
the agencies, or the blind themselves) has created ined the historical roots of ste reo
t ypes about
the problem and must accept the responsibility people who are blind presented in visual images
for solving it” (p. 6). and films. They both found that people who are
Much attention has been paid to the respon- blind are depicted in similar ways in movies—as
sibility of journalists in realistic portrayal of dis- helpless, spiritually gifted, foolish, despairing,
ability. The International L abour Orga ni zat ion evil, saintly, exceptionally wise, easily tricked,
provides helpful guidelines for reporting on in- vengeful, superstars, and heroes who overcome
dividuals with disabilities in the media. In their obstacles and have special sensory abilities.
report they state, “Portraying w omen and men Clearly, these characterizations represent the ex-
with disabilities with dignity and respect in the tremes found in the general population; persons
media can help promote more inclusive and tol- with visual impairments are rarely depicted as or-
erant societ ies” (Sanchez, 2015, p. 7). This report dinary members of society. Norden (1994) con-
continues by providing some helpful tips for pos- cluded that the common concept of disability in
itive portrayal of people with disabilities includ- 20th-century films is the isolation of sweet in-
ing embracing the shift toward a human rights nocents, obsessive avengers, noble warriors, or
approach to reporting on individuals with dis- superstars, all of whom are outsiders, set apart
abilities; focusing attention on the person, not from general society. Similarly, Klobas (1988) con-
the disability, while emphasizing ability when cluded that television programs and films tended
possi
ble; showing realistic portrayals of per- to rely on mundane story lines and stereot ypes of
sons with disabilities as involved members of the past.
society; and fin ally, following the principle of A review of headlines of newspaper articles
“nothing about us without us” by allowing people provides a snapshot of how individuals who are
with disabilities to be fully involved in creating blind are portrayed in daily newspapers through-
their own stories. out the United States. Examples include these:
Modern scholars, educators, and journalists “Blind Radio Host’s Hands Guided by Faith,
have moved the narrative of disability forward in Radio Waves and His Community” (Adami, 2016);
a positive direction in many instances. Still, chal- “Margaret Smith Led Rich, Full Life Despite
lenges continue to exist in this realm (Special Blindness” (Cardenas, 1997); “St. John Vianney’s
Olympics, 2005). Anthony Ferraro Has Battled through Blindness to
Several scholars have analyzed the mass Find Success, Inspire Others” (Stanmyre, 2013).
media’s characterizations of individuals who While these represent only searchable articles
are visually impaired (Bina, 1993; Kent, 1989, that contain the words “blind” or “blindness,”
1990, 1996, 1997; Kirtley, 1975; Monbeck, 1973; and therefore may be skewed to more sensational
Norden, 1994; Twersky, 1955; Wilkins, 1996). representa
t ion, it should be recognized that
Monbeck (1973) identified the following traits these attitudes of the general public persist.
that are typically assigned to fictional characters Many of these and similar headlines emphasize
who are blind in lite rat ure: miserable, helpless, the individual’s disability (blindness) and, in
most instances, place blindness before the person. osity about the impact of this event on public per-
Placing the disability first attracts readers, but often ception about braille and blindness. At the end
carries an unspoken message of surprise or disbe- of the day t here w
ere over 100,000 results for this
lief that the individual has succeeded or prospered targeted search, which demonstrates the power
in spite of his or her blindness. of online communication to encourage ongoing
Other reports in the press represent not the conversations about important topics related to
distortion of the media but factual evidence that blindness and visual impairment.
society is far from realizing the capabilities of
individuals with disabilities. In 2010, Susan
Donaldson James reported, “Baby Sent to Foster
Effects of Public Perceptions
Care for 57 Days b ecause Parents Are Blind.” This According to Mauer (1989), how p eople speak
case was dropped, but only a fter the child was about blindness is at least as important to the
separated from the parents for this extended f uture of individuals who are blind as the build-
time period while in foster care. “Belgium Eu- ings in which they receive services, the funds that
thanizes Deaf Twins G oing Blind” (Goldman, are appropriated for serv ices, and the devices and
2013) reported that two 45-year-old men w ere technology designed specifically for their use.
provided with assisted suicide and legally put to Mauer further stated, “If the words used to de-
death by lethal injection at the Brussels University scribe the condition of the blind are dismal . . .
Hospital in Jette in December 2012. The govern- chances for equality are . . . bleak.”
ment sanctioned the notion that it would be An underlying belief of the National Federa-
better to be dead than deaf and lose vision. tion of the Blind (NFB), a leading consumer and
advocacy organi zat ion with 50,000 members,
speaks to the need for p eople who are blind to
Social Media “achieve self-confidence and self-respect” and to
The pervasive use of social media in today’s com- the role that public perception plays in the lives
munication provides a unique opportunity to of individuals who are blind. In 1992, Kenneth
emphasize the inclusion of individuals who are Jernigan (quoted in Severo, 1998), past president
blind in all aspects of life and, in some instances, of the NFB and blind himself, stated that “the real
to check public understanding through reactions problem of blindness is not the loss of eyesight.
to online conversations. On January 4, 2006, in The real prob lem is the misunderstanding and
honor of the birth of Louis Braille, Google re- lack of information that exist. If a blind person
placed its typical search page with the word has proper training and opportunity, blindness
“Google” represented in simulated braille. Hol- can be reduced to the level of a physical nuisance.”
brook (2009) analyzed public reaction during Carl Augusto, recently retired president of
the 24-hour period in which this “Google Doo- the American Foundation for the Blind, one of
dle” was displayed. She analyzed the top 100 sites the leading national organizations in the field
from a Google search with the words “Google of blindness and visual impairment, and himself
Louis Braille.” The analysis resulted in 10 con- visually impaired since an early age, stated, “Blind-
versation themes: confusion, use of simbraille, ness and severe visual impairment are serious
jokes or humor (often sarcastic), information disabilities that can have a profound effect on a
about the braille code, personal perspectives, person and family members. However, with the
errors or misperceptions, information about right attitude, the right skills, and if given an op-
Google’s branding, information about Louis portunity, blind and visually impaired p eople
Braille, statements about accessibility, and curi- can, and do, live and work alongside their sighted
peers with dignity and success” (C. Augusto, per- Both prevalence and incidence may be reported as
sonal communication, January 26, 2016). absolute numbers or rates, although incidence is
These leaders’ words further support the as- most often reported in ratios (such as 1 in 1,000
sertion that the public’s understanding of persons live births) and prevalence may be reported
who are visually impaired is not accurate and that in percentages (for instance, 5 percent of the
the realization of an individual’s potential is not population) or totals (for example, 13.9 million
diminished by the fact that the person is visually people). Except for conditions that are of short
impaired. All professionals in the field of visual duration, like a cold or flu, or that are rapidly ter-
impairment have a responsibility to work to elim- minal, prevalence will be larger than incidence
inate stereotypes by educating the public about (WHO, 2008).
the potential and capabilities of individuals who It is challenging to obtain precise and com-
are visually impaired. parable data on the incidence and prevalence of
blindness and visual impairment (AFB Public
Policy Center, n.d.; Kirchner, 1999), for several
DEMOGRAPH CS reasons:
Teachers of students with visual impairments
have the opportunity to work with c hildren of • The United States, Canada, and most other
all ages; degrees and types of visual, social- countries do not have mandatory national reg-
emotional, physical, neurological, and cognitive istries of individuals who are blind or visually
abilities; economic levels; and various ethnic impaired.
backgrounds and cultures (with different social • There is not a consistent, clear, and useful
values, beliefs, and traditions). Each student has definition of blindness and visual impair-
a unique personality and set of strengths and ment, and studies that gather data on these
needs. To gain a better understanding of the populations use differe nt definitions.
diversity of students who are visually impaired,
• Some studies do not report the definitions
some prevailing demographic information is pre-
they use, thus making it difficult to apply their
sented in this section. This information may help
findings.
teachers anticipate the variety of students with
whom they are likely to work.
Despite the difficulty in obtaining precise de-
mographic information about visual impairment,
Prevalence and Incidence some data are available. One frequently cited fig-
Demographics is a descriptive term that is applied ure comes from the National Health Survey; their
to statistical studies of physical conditions; vital 2013 estimate (National Center for Health Sta-
statistics, such as birth and health; and socioeco- tistics, 2015) was that 21,481,688 civilian, non-
nomic status. Much demographic information institutionalized, adult Americans have trouble
is reported as prevalence and incidence data. seeing (9 percent of the adult population). In con-
Prevalence is the number of new and existing trast, according to the US Census Bureau’s 2014
cases of a condition in a defined population at a American Community Survey (ACS), approxi-
specific point in time, such as five years; in other mately 7,824,035 or 2.5 percent of civilian, non-
words, how common a condition is in the pop- institutionalized individuals reported a visual
ulation. Incidence is the number of new cases of disability, which was defined as “blind or has seri-
a condition that occurred within both a defined ous difficulty seeing even when wearing glasses.”
population and a period of time, usually a year. Fifty-four percent were female and 46 percent
male. Seventy-two percent were white, 16 percent volume for a detailed discussion of c hildren with
black or African American, less than 1 percent Na- multiple disabilities.)
tive American or Alaskan Native, 3 percent Asian, Because c hildren receiving special education
4 percent of “some other race,” and 3 percent of serv ices can be reported in only one classifi
two or more races. Approximately 664,052 or 9 cation, the “primary” disability, t hose who have
percent were under the age of 21 (US Department visual impairments and additional disabilities
of Commerce, 2015b). (See Chapter 8 in this vol- are most often reported as having “multiple dis-
ume for more information about diverse popula- abilities” and are not identified as having a visual
tions with visual impairments.) impairment. T hese students are not included in
the count of the number of students who require
special education intervention b ecause of their
Child Count visual impairment. This practice may help to ex-
Special education services in the United States are plain the consistently low number of c hildren
based on federal requirements that were first estab- with visual impairments who are reported to the
lished in 1975 by the Education for All Handi- federal government compared to the higher num-
capped Children Act, later renamed the Individuals ber of students who are reported by the American
with Disabilities Education Act. This legislation Printing House for the Blind (APH). APH was
requires states to collect data on the numbers of designated u nder the 1879 Act to Promote the
children they serve in special education programs. Education of the Blind as the official United States
Briefly, the purposes of the legislation today is supplier of educational materials for students
to ensure free appropriate public education for with visual impairments paid for by federal funds;
c hildren with disabilities and prepare them for the organization was l ater tasked with performing
employment and independent living, protect the an annual census to guide the distribution of
rights of these c hildren and their parents, assist the funds to each state under a “quota system”
agencies in providing education for all c hildren according to that census (APH, 2015, n.d.; see
with disabilities, improve educational results for Chapter 1 in this volume).
children with disabilities, and assess and ensure According to the US Department of Educa-
the effectiveness of special education (34 C.F.R. tion’s Office of Special Education Programs,
§ 300.1; see Chapter 1 in this volume). 2,959 c hildren ages 3–5 and 25,567 c hildren ages
States are allowed to count each child receiv- 6–21 with the primary disability category of vi-
ing services only once. Yet many students who are sual impairment received special education ser
visually impaired have additional difficulties that vices in the 2014–15 school year in the United
require special attention, such as learning disabil- States and its outlying areas, not including an ad-
ities, speech or language impairments, hearing ditional 165 children ages 3–5 and 1,243 children
impairments or deafness, cognitive delay, autism, ages 6–21 with the primary disability category of
or traumatic brain injury. Indeed, in one study, deaf blindness (US Department of Education,
59.9 percent of those who registered with the 2015a, 2015b). As already noted, c hildren with vi-
project were diagnosed with an additional med- sual impairments whose primary disability cate-
ical condition or disability (Ferrell, 1998). More gory is something other than visual impairment
recent estimates suggest that approximately or deafblindness are not accounted for in these
65 percent of c hildren with visual impairments figures.
in the United States also present with additional According to APH’s 2015 annual report, how-
disabilities (Dote-Kwan, Chen, & Hughes, 2001; ever, in 2014, there w ere approximately 42,914
Hatton, Ivy, & Boyer, 2013). (See Chapter 7 in this infants and students (birth to grade 12, ages
birth to 21) in the United States who were regis- diagnoses for the c hildren in this study w ere cor-
tered by schools and programs as legally blind tical visual impairment (20.6 percent), retinopa-
or functioning at the definition of blindness thy of prematurity (ROP) (19.1 percent), and optic
(APH, 2015). The designation “function at the nerve hypoplasia (16.6 percent). The frequency of
definition of blindness” is given to a student visual disorders differed according to the severity
when a medical doctor determines that he or she of additional disabilities. For c hildren without
has visual characteristics such as cortical visual additional disabilities, optic nerve hypoplasia and
impairment (CVI) that result in visual function- albinism w ere the most frequent visual disorders.
ing to be equivalent to 20/200 or less, even if the For c hildren with mild additional impairments,
acuities measurements cannot be directly mea ROP and optic nerve hypoplasia w ere the most
sured or are estimated to be greater than 20/200 frequent, and for t hose with severe additional im-
(APH, n.d.). pairments, CVI and ROP w ere the most frequent.
The US Census Bureau provides another A more recent study (Hatton et al., 2013) using
source of population estimates for young p eople data from 5,931 severely visually impaired children
with visual impairments. In the Census Bureau’s from birth to age 3 in the Babies Count national
2014 American Community Survey, approxi- registry (meaning that the c hildren were referred
mately 532,184 c hildren (or 0.7 percent of the to specialized agencies providing serv ices) found
population) under the age of 18 were reported by the same three most prevalent conditions: CVI
a parent or guardian to have vision difficulty, that (24.9 percent), ROP (11.8 percent), and optic nerve
is, w
ere blind or had serious difficulty seeing even hypoplasia (11.4 percent) (see Chapter 4 in this
when wearing eyeglasses (US Department of volume for further discussion of t hese studies).
Commerce, 2015a). In considering the significant Recent estimates suggest that approximately
difference between the ACS data and the APH 65 percent of c hildren with visual impairments in
and Department of Education statistics, it is the United States also present with additional dis-
important to recognize the different definitions abilities (Dote-Kwan et al., 2001; Hatton et al.,
and qualifications used by each data source when 2013). (See Chapter 7 in this volume for a detailed
identifying c hildren or students with visual discussion of children with multiple disabilities.)
impairments.
It is important to realize that states and dis-
tricts typically use these unduplicated federal NTERNATIONAL PERSPEC VE
child counts to make decisions about funding
and programs. It is often necessary for state con Our world has gotten smaller as a result of the
sult ants or teachers to remind decision makers technology that exists today. Civil rights move-
that t hese unduplicated child counts do not rep- ments have influenced the younger generations
resent the actual number of students who are positively to learn more about cultures other than
visually impaired and who need to be receiving their own. Many professionals in the field of
serv ices. blindness and visual impairments are able to par-
ticipate in international activities through at-
tending international conferences, working short
Causes of Visual Impairment and long term in other countries, working with
Ferrell’s (1998) Project PRISM, a longitudinal students who represent cultures other than that of
study of the sequence and rate of development of North America, reading journal articles that in-
202 infants and toddlers from birth to age 5 who clude international authors, reading professional
were visually impaired found that the leading journals from other countries, and accessing
information available through the Internet. socioeconomic development and improvements

Consequently, it is important to consider the in public health (WHO, 2014).
worldwide situation of blindness in addition to Reviewing current lit e r
a
t ure from inter
that of North America specifically. national journals such as the Journal of Visual
According to the World Health Organizat ion Impairment & Blindness; International Journal of
(2016), approximately 285 million p eople world- Disability, Development, and Education; British
wide w ere visually impaired in 2010 (based on Journal of Visual Impairment; International Jour-
the ICD-10 classifications). Of this group, it is es- nal of Orientation and Mobility; and publications
timated that 39 million p eople are blind (WHO, from the World Blind Union and the Interna-
2013). Blindness and visual impairment are not tional Council for Education of People with
evenly distributed across the population. Approx- V isual Impairment demonstrates that braille
imately 90 percent of visually impaired people literacy, accessibility, orientation and mobility,
live in developing countries (WHO, 2014); this access to technology, and appropriate education
can be attributed to scarcity of medical and for all c hildren who are blind or visually im-
optometric resources in developing nations as paired are all important needs of c hildren who
well as the existence of tropical diseases and are blind or visually impaired throughout the
differences in income and education. It is esti- world.
mated that 80 percent of visual impairment
and blindness worldwide is preventable or cur- SUMMARY
able (WHO, 2014).
Globally, the major causes of visual impair- This chapter has presented a perspective on the
ment are uncorrected refractive errors (myopia, diversity of the population of individuals who are
hyperopia, or astigmatism; 43 percent), cataract visually impaired and the public’s perception of
(33 percent), and glaucoma (2 percent). Other them. It has defined some terms that are used
main c auses of visual impairment are age-related by professionals who provide serv ices to p eople
macular degeneration, corneal opacities, diabetic who are visually impaired. In time, definitions
retinopathy, childhood blindness, trachoma, and w ill become more precise, and more accurate
onchocerciasis (WHO, 2014). Among c hildren counts and demographic information about the
worldwide, the leading cause of blindness is cor- characteristics of the c hildren who are visually
neal opacification, caused by a combination of impaired w ill be available. Vigilance is required
measles, xerophthalmia (vitamin A deficiency), not only to maintain professional responsibili-
and poor eye care (Kong, Fry, Al-Samairrie, ties but also to expand them and effect positive
Gilbert, & Steinkuller, 2012). change. It is important that every member of a
Worldwide, the distribution of blindness student’s educational team uses the same terms
by age group in 2010 was 3.6 percent for those and has the same understanding of the terms be-
age 0–14, 14.7 percent for t hose age 15–44, 31.7 ing used.
percent for those age 45–49, and 82 percent for The population of students with visual im-
t hose age 50 or older (WHO, 2012). WHO (2014) pairments is diverse. Teachers need to adjust
estimates that 19 million children age 0–14 are vi- their educational strategies for each student and
sually impaired (0.01 percent of the population). consider all the student’s strengths and difficul-
In the last 20 years, the global prevalence of visual ties. Factors specific to a student’s impairment are
impairment has decreased, despite increases in critical to include in overall planning, such as
the numbers and lifespans of older p eople. Rea- cognitive ability, severity and type of visual
sons for this decrease i nclude increased levels of impairment, date of onset of visual impairment,
cause of visual impairment, and presence of ad- In R. L. Brilliant (Ed.), Essentials of low vision practice
ditional disabilities. (pp. 2–9). Boston: Butterworth Heinemann.
Bhushan, R. K. (2011, September) The Metaphor of
For learning activities related to this Blindness. Perspective. www.boloji.com/index.cfm
chapter, log in to the online AFB Learning ?md= Content&ad=A rticles& A rticleID=11457
Cardenas, E. L. (1997, January 28). Obituaries: Mar-
Center.
garet Smith led rich, full life despite blindness.
Detroit News.
REFERENCES Caton, H. (1991). Print and braille literacy: Selecting ap-
propriate learning media. Louisville, KY: American
Adami, L. (2016, May 1). Blind radio host’s hands Printing House for the Blind.
guided by faith, radio waves and his community Corn, A. L., & Lusk, K. E. (2010). Perspectives on low
[Video file]. EverythingLubbock.com. Retrieved vision. In A. L. Corn & J. N. Erin (Eds.), Founda-
from http://w ww.e verythinglubbock.com/news tions of low vision: Clinical and functional perspectives
/k lbk-news/blind-radio-hosts-hands-g uided-by (2nd ed., pp. 3–34). New York: AFB Press.
-faith-radio-waves-and-his- community Corn, A. L., & Rosenblum, L. P. (2000). Finding wheels.
AFB Public Policy Center. (n.d.). Research navigator: Austin: Pro-E d.
Just how many blind folks are t here anyway? Pop- Dote-Kwan, J., Chen, D., & Hughes, M. (2001). A na-
ulation and demographic statistics for adults tional survey of ser v ice providers who work
who are blind or visually impaired. Washington, with young c hildren with visual impairments.
DC: Author. Retrieved from http://w ww.a f b.org Journal of Visual Impairment & Blindness, 95, 325–
/i nfo/p rog rams-a nd-s er v ices/p ublic-p olic y 337.
-center/research-navigator-a-quarterly-series-on Education for All Handicapped Children Act, Pub. L.
-research-i n-blindness-a nd-v isual-i mpairment No. 94-142 (1975).
/research-n avigator-just-how-m any-blind-folks Ferrell, K. A. (1998). Project PRISM: A longitudinal study
-a re-t here-anyway/1235 of developmental patterns of children who are visually
American Optometric Association. (n.d.). Visual acuity: impaired. Executive summary. Greeley: University of
What is 20/20 vision? Retrieved from www.aoa.org Northern Colorado.
/patients-a nd-public/e ye-a nd-v ision-problems Goldman, R. (2013, January 14). Belgium eutha-
/g lossary - of - e ye -a nd -v ision - c onditions /v isual nizes deaf twins going blind [Web log post].
-acuity?550=y ABC News. Retrieved from http://abcnews.go.com
American Printing House for the Blind. (2015). An- /blogs/ headlines/2013/01/ belgium- e uthanizes
nual report 2015: Distribution of eligible students -deaf-t wins-going-blind/
based on the federal quota census of January 6, Hamilton, R. H., Pascual-L eone, A., & Schlaug, G.
2014 (Fiscal year 2015). Louisville, KY: Author. (2004). Absolute pitch in blind musicians. Neuro-
Retrieved from http://w ww.aph.org/federal-quota Report, 15(5), 803–806. Retrieved from http://
/distribution-2015 w w w.m usicianbrain.c om/p apers/H amilton
American Printing House for the Blind. (n.d.). An _ A PinBlinds.pdf
overview of federal quota. Louisville, KY: Author. Hatton, D. D., Ivy, S. E., & Boyer, C. (2013). Severe vi-
Retrieved from http://w ww.aph.org/federal-quota sual impairments in infants and toddlers in the
Americans with Disabilities Act of 1990, Pub. L. No. United States. Journal of Visual Impairment & Blind-
101-336 (1990). ness, 107, 325–227.
Bina, M. J. (1993). Review of the book Images of disabil- Holbrook, M. C. (2009). Google: “Louis Braille.” The
ity on television, by Guy Cumberbatch. Journal of ICEVI Educator, 22(1), 10–15. Retrieved from
Visual Impairment & Blindness, 87, 287–288. http://icevi.org /publications/e ducator/p df/July
Brilliant, R. L., & Graboyes, M. (1999). Historical over- _2009/ The_ E ducator-2009_ July-Braille_ L iteracy
view of low vision: Classifications and perceptions. -Vol_ X XII-Issue-1.pdf
Huebner, M. K., & Sidwell, L. (2004). Independent Kent, D. (1996). Review of the book The cinema of
travel. In D. W. Dew & G. M. Alan (Eds.), 29th In- isolation: A history of physical disability in movies, by
stitute on Rehabilitation Issues: Contemporary issues M. F. Norton. JVIB News Service, 90, 1–5.
in orientation and mobility. Washington, DC: The Kent, D. (1997). Review of the book Images that injure:
George Washington University Regional Reha- Pictorial stereotypes in the media, by P. M. Lester.
bilitation Continuing Education Program. JVIB News Service, 91, 7–10.
Hurovitz, C. S., Dunn, S., Domhoff, G. W., & Fiss, H. Kerr, N. (1993). M ental imagery, dreams and percep-
(1999). The dreams of blind men and w omen: A tion. In D. Foulks & C. Cavallero (Eds.), Dreaming
replication and extension of previous findings. as cognition. New York: Harvester Wheatsheaf.
Dreaming, 9(2), 183–193. Kirchner, C. (1999). Trends affecting prevalence of
Individuals with Disabilities Education Act (IDEA), visual impairment and demand for serv ices.
Pub. L. No. 101-467 (1990). Journal of Visual Impairment & Blindness, 93, 53–
Individuals with Disabilities Education Improvement 57.
Act (IDEA), 20 U.S.C. § 1400 (2004). Kirtley, D. (1975). The psychology of blindness. Chicago:
James, S. D. (2010, July 28). Baby sent to foster care for Nelson Hall.
57 days because parents are blind [Web log post]. Klobas, L. E. (1988). Disability drama in television and
ABC News. Retrieved from http://abcnews.go.com film. Jefferson, NC: McFarland.
/H ealth/m issouri-t akes-b aby-b lind-p arents Koenig, A. J., & Holbrook, M. C. (1995). Learning me-
/story?id=11263491 dia assessment of students with visual impairments
Jernigan, K. (1999). Blindness—Concepts and miscon- (2nd ed.). Austin: Texas School for the Blind and
ceptions. Baltimore: National Federation of the Visually Impaired.
Blind. Retrieved from https://nfb.org/images/nfb Kong, L. K., Fry, M., Al-Samairrie, M., Gilbert, C., &
/publications/convent/ blndnesc.htm Steinkuller, P. G. (2012). An update on the pro
Jernigan, K. (2005). A definition of blindness. Future gress and changing epidemiology of c auses of
Reflections, 24(3). Retrieved from https://n f b.org childhood blindness worldwide. Journal of American
/images/nfb/publications/f r/f r19/f r05si03.htm Association of Pediatric Ophthalmology and Strabis-
Jorkasky, J. F. (2014). Attitudinal survey of minority mus, 16(6), 501–507.
populations on eye and vision health and research Lowenfeld, B. (1971). Our blind children (3rd ed.).
[PDF slides]. Retrieved from http://w ww.e yere- Springfield, IL: Charles C Thomas.
search.org/pdf/A EVRslides91714.pdf Mauer, M. (1989, July). Language and the f uture of the
Jutai, J., Hooper, P., Strong, G., Cooper, L., Hutnik, C., blind. Present at ion at the annual convention of
Sheidow, T., . . . Russell-Minda, E. (2005). Vision re- the National Federation of the Blind, Denver, CO.
habilitation: Evidence based review. London, Ontario: Retrieved from https://nfb.org /images/nfb/pub
CNIB Baker Foundation for V ision Research. Re- lications/f r/f r8/issue4/f 080410.html
trieved from http://w ww.cnib.ca/en/about/P ublica Monbeck, M. (1973). The meaning of blindness: Attitudes
t ions/r esea rc h/D oc ument s/ V R EBR _C hap1 toward blindness and blind people. Bloomington:
_May2005.pdf Indiana University Press.
Keller, H. (1908). The world I live in. New York: C entury. National Center for Health Statistics. (2015). Na-
Keller, H. (1976). The story of my life. New York: Andor. tional Health Interview Survey, 2013. Public-use
Kelly, L. J., & Vergason, G. A. (1985). Dictionary of special data file and documentation. Atlanta, GA: Cen-
education and rehabilitation (2nd ed.). Denver: Love. ters for Disease Control and Prevention. Re-
Kent, D. (1989). Shackled imagination: Literary illu- trieved from http://w ww.cdc.gov/nchs/n his/n his
sions about blindness. Journal of Visual Impairment _questionnaires.htm
& Blindness, 83, 145–150. National Eye Institute. (n.d.a). All vision impairment.
Kent, D. (1990). Review of the book Disability drama Bethesda, MD: Author. Retrieved August 7, 2013,
in television and film, by L. E. Klobas. Journal of from http://w ww.nei.nih.gov/e yedata/v ision_ im
Visual Impairment & Blindness, 84, 82–84. paired.asp
National Eye Institute. (n.d.b). Low vision. Bethesda, Retrieved from https://w ww.ssa.gov/pubs/E N- 05
MD: Author. Retrieved July 17, 2013, from http:// -10052.pdf
www.nei.nih.gov/e yedata/lowvision.asp Special Olympics. (2005). Changing attitudes changing the
Norden, M. F. (1994). The cinema of isolation: A history world: Media’s portrayal of people with intellectual dis-
of physical disability in the movies. New Brunswick, abilities. Washington, DC: Author. Retrieved from
NJ: Rutgers University Press. http://w ww.specialolympics .org /uploadedFiles
Prevent Blindness Americ a. (2012). Vision impair- /L andingPage/W hatWeDo/R esearch_ S tudies
ment. Chicago: Author. Retrieved from http:// _Desciption_Pages/Policy_paper_media_portrayal
www.v isionproblemsus.org /v ision-i mpairment .pdf
/v ision-impairment- definition.html Stanmyre, M. (2013, March 1). St. John Vianney’s
Rosa’s Law, Pub. L. No. 111-256 (2010). Anthony Ferraro has battled through blindness
Rosenblum, L. P., & Erin, J. N. (1998). Perceptions of to find success, inspire others. NJ.com. Retrieved
terms used to describe individuals with visual im- from http://w ww.nj.com/hssports/blog/w restling
pairments. RE:view, 30, 15–26. /i ndex .s sf/2013/03/st _john _v ianneys _ a nthony
Sanchez, J. (2015). Reporting on disability: Guidelines _ f erraro _ h as _ b attled _t hrough _ blindness _t o
for the media (2nd ed.). Geneva, Switzerland: In- _find_success_inspire_others.html
ternational L abour Organizat ion. Retrieved from Twersky, J. (1955). Blindness in lite rature: Examples of
http://w ww.ilo.org /wcmsp5/g roups/public/— ed depictions and attitudes. New York: Alfred A.
_emp/—ifp_ skills/documents/publication/wcms Knopf.
_127002.pdf United Nations. (2006). Preamble. In Convention on the
Sanford, L., & Burnett, R. (2008). Functional vision and rights of persons with disabilities. New York: Author.
learning media assessment for students who are pre- Retrieved from http://w ww.u n.org/d isabilities
academic or academic and visually impaired in grades /documents/convention/convoptprot- e.pdf
K-12. Louisville, KY: American Printing House for US Department of Commerce, Bureau of the Census.
the Blind. (2015a). American Community Survey public use
Sardegna, J., & Otis, T. P. (1991). The encyclopedia of microdata sample, 2014. Universe: ((AGEP = 0-17)
blindness and visual impairment. New York: Facts on AND (DEYE = 1,2)); Weight used: PWGTP. Gener-
File. ated via DataFerrett. Retrieved from http://
Schroeder, F. (1989). Literacy: The key to opportu- dataferrett.census.gov/TheDataWeb/index.html
nity. Journal of Visual Impairment & Blindness, 83, US Department of Commerce, Bureau of the Census.
290–293. (2015b). American Community Survey public use
Severo, R. (1998, October 14). Kenneth Jernigan, ad- microdata sample, 2014. Universe: ((AGEP = 0-20,
vocate for the blind, is dead at 71. The New York 21-99) AND (DEYE = 1,2) AND (SEX = 1,2), AND
Times. Retrieved from http://w ww.nytimes.com (RAC1P= 1,2,3,4,5,6,7); Weight used: PWGTP.
/1998/10/14/u s/ kenneth-jernigan- advocate-for Generated via DataFerrett. Retrieved from http://
-t he-blind-is-dead-at-71.html dataferrett.census.gov/TheDataWeb/index.html
Social Security Act of 1935, Pub. L. No. 74-271 US Department of Education. (2015a). Part B child
(1935). count and educational environments: Number of
Social Security Administration. (2008). Blue Book: c hildren ages 3 through 5 served u nder IDEA,
Disability evaluation u nder social security. 2.00 Part B, by disability and state [Table]. IDEA Sec-
special senses and speech—Adult. Retrieved from tion 618 data products: Static tables. Retrieved from
http://w w w.s sa.g ov/d isabilit y/p rofessionals http://w w w2.e d.g ov/p rograms/o sepidea/618
/bluebook/2.0 0 - SpecialSensesandSpeech-Adult -data/static-tables/index.html
.htm US Department of Education. (2015b). Part B child
Social Security Administration. (2012). If you’re blind count and educational environments: Number
or have low vision: How we can help (SSA Publica- of children ages 6 through 21 served u nder
tion No. 05-10052). Washington, DC: Author. IDEA, Part B, by disability and state [Table].
IDEA Section 618 data products: Static tables. Re- World Health Organizat ion. (2012). Global data on vi-
trieved from http://w ww2.ed.gov/programs/osep sual impairments 2010. Geneva, Switzerland: Au-
idea/618-data/static-tables/index.html thor. Retrieved from http://w ww.who.int/ blind
Wilkins, L. (1996). The blind in the media: A vision ness/GLOBALDATAFINALforweb.pdf?ua=1
of stereot ypes in action. In P. M. Lester (Ed.), Im- World Health Org an i z at ion. (2013). Universal eye
ages that injure: Pictorial stereotypes in the media health: A global action plan 2014–2019. Geneva,
(pp. 127–134). Westport, CT: Praeger. Switzerland: Author. Retrieved from http://w ww
World Health Organizat ion. (1980). International clas- .w ho .i nt / b lindness /A P2014 _1 9 _ E nglish .p df
sification of impairments, disabilities, and handicaps. ?u a=1
Geneva, Switzerland: Author. Retrieved from World Health Or g a
n i
z a
t ion. (2014). Visual im-
http://w hqlibdoc .w ho .i nt /p ublications /1980 pairment and blindness. Geneva, Switzerland:
/9241541261_ e ng.pdf Author. Retrieved from http://w ww.who.int/media
World Health Organization. (2002). Towards a common centre/factsheets/fs282/en/
language for functioning, disability and health: ICF. Ge- World Health Organ iz ation. (2015). Disability and
neva, Switzerland: Author. Retrieved from http:// health. Geneva, Switzerland: Author. Retrieved
www.who.int/classifications/icf/icfbeginnersg uide from http://w ww.who.int/mediacentre/factsheets
.pdf?ua=1 /fs352/en/index.html
World Health Organizat ion. (2008). The global burden World Health Organizat ion. (2016). International sta-
of disease: 2004 update. Geneva, Switzerland: Au- tistical classification of diseases and related health
thor. Retrieved from http://w ww.who.int /health problems: 10th revision (ICD-10). Geneva, Switzer-
info/g lobal_burden_d isease/G BD_report_2004 land: Author. Retrieved from http://apps.who.int
update_f ull.pdf?ua=1 /c lassifications/icd10/ browse/2016/en
3
C H A P T E R
The Visual System

Bill Takeshita and Kelly Lusk
To hear an audio introduction to tances more quickly than the senses of touch,
this chapter by an author, and to taste, smell, and hearing. There are many simi-
view a chapter overview presen larities between the way that vision works and
tation, log in to the AFB Learning Center. the way that a camera works, but vision is much
more complex. The process of seeing and inter-
preting what you see involves millions of cells
KEY POI S and neurons that convert light energy into elec-
trical signals processed by the brain. Once infor-
♦ The ability to see is a complex process involv-
mation is processed, the visual cortex of the brain
ing millions of cells and neurons that convert
sends signals to other areas of the brain to re-
light energy into electrical signals that are pro
spond to what has been seen, resulting in what
cessed in the brain.
we call “vision.” Body movement, spoken words,
♦ Understanding the basic anatomy and physiol- cognition, and our executive reasoning are all
ogy of the h
uman eye may assist practitioners affected by vision. Two-t hirds of the brain is in-
in recognizing how damage to a structure may volved in the process of seeing and responding to
cause a visual impairment. what is seen (Crick & Khaw, 2003). As a conse-
♦ Some common visual problems may be cor- quence, disturbances in vision related to disease
rected with prescription lenses. or trauma of the eye or brain can affect all aspects
♦ There are many causes of visual impairment of life. Infants born with visual impairments
in children, some of which are genetic disor- can be delayed in reaching developmental mile-
ders. stones, including social and motor development.
In addition, students with visual impairments
♦ Children with visual impairments w
ill benefit may have difficulty reading and completing tasks
from being examined by a pediatric ophthal- in the classroom if appropriate supports are not
mologist or optometrist who can diagnose and provided.
treat vision-related problems. This chapter prese nts an overview of the
anatomy and physiology of the visual system to
INTRODUCT ON provide a foundation for understanding how
various visual disorders may affect a person’s
Vision is an incredibly powerf ul sense that allows functioning and level of independence in edu-
a person to retrieve information from various dis- cational, social, and career settings. Differe nt
73
approaches to eye care are discussed, including light rays and convert the light into electrical sig-
the multiple aspects of various examinations and nals processed by the brain. The eyes begin their
evaluations. When a child has a visual impair- embryonic development shortly after conception,
ment, it is vital to have a team of appropriate eye and by 11 weeks a fter conception, the eyes are
care professionals to evaluate and prescribe the visible in a developing fetus. This section provides
most appropriate treatments. Finally, numerous information about the structure and functioning
accommodations and interventions are described of the eye. In general, the structures are presented
that can be used by teachers of students with vi- here from the front of the eye to the back (see
sual impairments and orientation and mobility Figure 3.1).
(O&M) specialists.
Eyelids and Cranial Nerves
A ATOMY AND PHYS OLOGY Eyelids
OF THE H
UMA EYE
The eyelids protect the front portion of the eye
The eyes are complex organs consisting of many from dust, allergens, dirt, and radiation from the
structures and different types of cells that receive sun. The upper and lower eyelids contain muscles
Figure 3.1 Schematic Section of the Human Eye

Source: Reprinted, by permission of the publisher, from Utah State University. (1989). The INSITE model: A model of home
intervention for infant, toddler, and preschool aged multihandicapped sensory impaired children: Vol. 2 (p. 12). Logan: Utah State
University, SKI*HI Institute.
The Visual System 75
that can quickly open and close the eyes. The eye- Cranial Nerves
lids also contain glands that secrete fluids to pro-
duce tears (see Figure 3.2). In the upper outer The muscles of the eyelids and the extraocular
region of both upper eyelids are lacrimal glands muscles are stimulated by the cranial nerves (CN)
that secrete aqueous, or watery tears. Inside the located in the brain stem. There are 12 pairs of
eyelids are meibomian glands that secrete oil to cranial nerves that control many automatic func-
prevent the aqueous layer of tears from evaporat- tions in the body. The scientific name of the optic
ing, while a mucin layer serves to adhere the tears nerve is CN 2, and it transmits information from
to the cornea. Each time the eyelids blink, the the eye to the brain. CN 3 controls most of the
tears wash debris from the eyes, and the tears eye’s movement and is called the oculomotor
drain from the eye through the nasolacrimal ducts, nerve. CN 3 stimulates the muscles that move the
located in the upper and lower eyelids near eye and open the eyelids. A person with a third-
the nasal region. The nasolacrimal ducts drain nerve palsy may have a drooping eyelid, also
to the nose and throat, which is why a person known as ptosis, and an eye that is misaligned,
may have a runny nose when he or she cries. For pointing down and outward. CN 4 is the trochlear
some infants, one or both nasolacrimal ducts nerve, which stimulates the superior oblique mus-
may not function properly, and surgical inter- cle, while CN 6 is the abducens nerve, which stim-
vention may be needed to open the duct. ulates the lateral rectus muscle. CN 7 is the facial
Figure 3.2 Schematic Representation of Nasolacrimal Excretory System

Source: Reprinted, by permission, from Wright, K. W. (Ed.). (1997). Textbook of ophthalmology (p. 7). Baltimore: Williams & Wilkins.
nerve, which closes the eyelid and controls the ing eye movement in all directions. Figure 3.3
muscles of the face. People with an abnormality contains a diagram of the orbit and structures
to CN 7 may have a face that appears to be para surrounding the orbit.
lyzed and an eyelid that does not close. The medial rectus muscle attaches to the m
iddle
of the eye, closest to the nose, and moves the eye
toward the nose, an eye movement called adduc-
The Orbit and Ocular Muscles tion. The lateral rectus muscle attaches on the side
The eyes are positioned in the skull in a structure of the eye and moves the eye outward toward the
called the orbit. The orbit is made up of seven tri- ear, an eye movement called abduction. The supe-
angular bones that form the eye socket and pro- rior rectus moves the eye up, while the inferior rectus
tect the eyeball from trauma. The posterior (back) moves the eye down. The last two extraocular
portion of the orbit has an opening through muscles are the superior and inferior oblique mus-
which the optic nerve passes to transmit infor- cles, which move the eye diagonally. Each of t hese
mation to the occipital lobe (visual cortex) of the extraocular muscles moves the eyes in a particular
brain. The orbit also has appendages that connect direction based on where the eye is positioned.
to the six extraocular muscles of each eye, allow- They can also rotate the eyes, a movement called
Figure 3.3 Sagittal Cross-Section of the Left Eye Showing the Extraoccular Muscles
The superior rectus, lateral rectus, and inferior rectus muscles are shown; the medial rectus muscle is not.
Source: Reprinted, by permission, from Wright, K. W. (Ed.). (1997). Textbook of ophthalmology (p. 9). Baltimore: Williams & Wilkins.
intorsion and extorsion. The superior rectus and su- Figure 3.4 Photo of the Retina
perior oblique muscles intort the eye (rotate it
inward), while the inferior rectus and inferior
oblique muscles extort the eye (rotate it outward).
Eyeball
The eyeball, also known as the globe, is approxi-
mately 1 inch in diameter and consists of three
separate layers. The outer layer provides the globe
with its shape, the inner layer consists of the light-
sensitive retina, and the middle layer is the vas-
cular layer that distributes blood and nutrients to
the eye. The main function of the eye is to receive
light and convert it into electrical signals that are
Bill Takeshita
sent to the brain.
The outer layer of the eye consists of the cor-
nea and the sclera (see Figure 3.1). The cornea is
located in the front, or anterior region, of the eye,
and is a transparent tissue made up of five layers.
Light first enters the eye through the cornea. The then sends the electrical signals through the op-
cornea does not have blood vessels and receives tic nerve to be processed by the brain (see Fig-
its oxygen from the air and aqueous fluid located ure 3.4). The retina is made up of nine distinct
in the anterior chamber immediately b ehind the layers of neural connective tissue and contains
cornea. The cornea connects to the sclera, a white millions of rod and cone cells. The cone cells are
tissue that forms the remaining shape of the eye. located in the centermost region of the retina, or
The sclera is very durable and protects the inner macula, and are responsible for detailed vision,
structures of the eye from damage due to injury color vision, and the ability to see u nder bright
or trauma. The sclera is covered with a transpar- illumination. The center of the macula is called
ent tissue called the conjunctiva, which also lines the fovea, and has the highest concentration of
the inner surface of the eyelids. The conjunctiva is cone cells, thus providing the highest level of de-
susceptible to infection called conjunctivitis, which tail vision. As a result, when a person wants to
results in the eye becoming red and irritated. Red read the print in a book, the person w ill move
or pink eyes with a yellow or green discharge may the eyes such that the light information from
be indicative of a bacterial conjunctivitis, while a the words will focus on the macula. Eye diseases
clear, watery discharge with pink eyes may be an that damage the macula result in blurred vi-
indication of either viral conjunctivitis or aller- sion, reduced color vision, reduced ability to
gies. A referral to an eye care specialist is required identify details, and sensitivity to glare. Students
for proper diagnosis and treatment. who have diseases of the cone cells and macula
The innermost layer inside the globe is the may require magnification, enlarged print, or
retina. The retina is a very thin, complex tissue other assistive technologies to access materials in
that lines the inside portion of the eye. It receives the school, home, and community environments.
the light information from the environment, con- The rod cells of the retina are located in the
verts the light energy to electrical signals, and periphery of the retina, and they provide the ability
to see under dim illumination, perceive objects The choroid is connected at the front of the
in motion, and have peripheral vision. The rod eye to the ciliary body and the iris. The iris is the
cells are not able to resolve fine details and thus colored part of the eye that we see when we look
cannot be used for reading print, nor do they directly into it. In the center of the iris is a hole
provide detailed vision to recognize faces or com- or opening called the pupil, which grows when
plete other complex visual tasks. The organiza the iris dilates and shrinks when the iris con-
tion of the rod cells in the retina is such that the stricts, depending on the amount of light entering
rod cells receive light information from the op- the eye. Behind the iris is the ciliary body, con-
posite direction. The rod cells in the nasal (toward taining the ciliary muscle, which has zonules,
the nose or center of the face) region of the or ligaments, connecting it to the crystalline lens.
retina receive information from the temporal Constriction and relaxation of the ciliary muscle
(toward the temples or side of the face) visual changes the shape of the crystalline lens.
field. For example, the nasal rod cells of the left
eye receive information from the left side of the
person, while the temporal retina of the left eye HOW THE EYE WORKS
receives visual information from the right field of
vision. Similarly, the rod cells in the inferior, or Vision depends on light. Light from the sun, light
lower, region of the reti na receive information bulbs, or other sources of illumination emit small
from the upper visual field, while the rod cells packets of light called photons. The photons of
located in the superior, or upper, retina receive light travel in waveform and reflect off objects in
light information from objects in the lower visual our world. Objects of different colors w ill reflect
field. Thus, damage to the upper retina will affect the photons of light at different frequencies and
a person’s ability to see objects on the floor when wavelengths. For example, a blue flower w ill re-
walking, while damage to the inferior retina w ill flect the photons at a short wavelength, while a
affect a person’s ability to see tree branches or red rose w ill reflect the photons at a long wave-
birds in the sky when using peripheral vision. length. The difference in wavelength of the pho-
The rod and cone cells contain a photopig- tons that are absorbed by the cone cells results in
ment that absorbs light energy and produces an the perception of colors.
electrical signal. T hese signals are sent to the The first structure of the eye that photons of
nerve fiber layer, and the nerve fibers converge to light will encounter is the transparent cornea (see
form the optic nerve. Figure 3.5). Behind the cornea is a space called
The m iddle layer of the globe is called the the anterior chamber. It contains a clear fluid called
uveal tract, and it consists of the choroid, a layer of aqueous that is constantly produced by the ciliary
blood vessels that transport blood, oxygen, and body, located behind the iris. The aqueous fluid
nutrients to and from the eye. The choroid is sep- contains oxygen and nutrients for the cornea, and
arated from the retina by the retinal pigment epi- it is constantly drained through the trabecular
thelium (RPE). The RPE eliminates the metabolic meshwork at the peripheral corner of the anterior
waste from the rod and cone cells, and also re- chamber, very close to where the peripheral cor-
moves rod and cone cells that have become dam- nea meets the peripheral iris.
aged over time. Disease or damage of the RPE can A fter light passes through the cornea and
result in reduced function of the retina and may aqueous, it enters the pupil of the eye. The pupil
result in blood vessels from the choroid leaking is merely an opening in the iris. By adjusting the
blood and fluid into the retina, causing blurred size of the pupil, the iris regulates the amount of
vision. light that enters the eye and helps a person adapt
Figure 3.6 Illustration of the Visual Pathways vision from the left visual field of both eyes, while
to the Brain the left occipital lobe perceives peripheral vision
from the right visual field of both eyes.
The occipital lobe is the primary processing
region of the brain for visual information (Hoyt,
2007). The central occipital lobe receives informa-
tion from the macula and allows one to identify
details and colors and see u nder bright illumina-
tion. The central occipital lobe is also involved in
the ability to identify numbers, letters, and small
details when we read, write, and perform daily ac-
tivities. The peripheral occipital lobe processes
information from the peripheral retina and is in-
volved in helping one to maintain balance and
orientation in space, and it also provides the pe-
ripheral vision that helps alert us to dangers in our
environment. The occipital lobe is responsible for
our visual processing skills as well. The ability to
remember what has been seen (visual memory),
perceive subtle differences between similar ob-
jects (visual discrimination), perceive that some-
thing is written backward (visual spatial relations),
and visually attend to something within a crowded
background (visual figure-ground discrimination)
are important visual processing skills needed for
learning.
The occipital lobe communicates with other
regions of the brain to perform various actions

(see Figure 3.7). The occipital lobe may send sig-
nals to the parietal lobe to stimulate the body to
Source: Adapted, by permission, from Heller, K. W., Alberto, P.
move in response to what has been seen, or to di-
A., Forney, P. E., & Schwartzman, M. N. (1996). Understanding rect the eyes to follow a moving object. The pari-
physical, sensory and health impairments: Characteristics and etal lobe is located interiorly to the occipital lobe
educational implications (p. 221). Pacific Grove, CA: Brooks/ and controls the motor functions of the opposite
Cole.
side of the body. The right parietal lobe controls
the movements of the left side of the body, while
Conversely, the electrical signals from the left the left parietal lobe controls movements of the
temporal retina and right nasal retina merge at right side of the body. Injury to both the occipi-
the chiasm and send signals to the left optic tract, tal and parietal lobes on the same side of the
left lateral geniculate nucleus, and left optic radia- brain often results in paralysis or weakness to one
tions before synapsing (connecting) with the left side of the body, with a loss of peripheral vision
occipital lobe to perceive peripheral visual infor- on the same side as the paralysis. For example, a
mation from the right visual field of both eyes. person who suffered from a stroke to the right
Thus, the right occipital lobe perceives peripheral side of the brain that damaged the parietal and
Figure 3.7 The Principal Regions grows older and begins to reach for a b ottle, depth
of the Brain perception and peripheral vision are needed to
enable the child to locate and accurately grasp
the bottle. As the child begins to walk, visual in-
formation interacts with vestibular and proprio-
ceptive skills to help maintain balance and orient
the body to navigate to the desired location.
When the child is older and attends school, she
must be able to point and move both eyes to-
gether to the correct word when reading or she
w ill have double vision. Equally important is the
ability to process and interpret visual informa-
tion. Visual perception skills are used to enable
the student to assemble puzzles, interpret dia-
Source: Reprinted, by permission, from Lueck, A. H., & Dutton, grams, and understand how to assemble lines
G. N. (Eds.). (2015). Vision and the brain: Understanding to form letters and numbers when writing. The
cerebral visual impairment in c hildren (p. 22). New York: AFB
Press. Image copyright © Gordon N. Dutton. Snellen eye chart that is commonly used to mea
sure visual acuity in the eye care specialist’s office
(discussed later, in the section on the Vision
occipital lobes may be paralyzed on the left side Examination) does not provide any information
of the body and also have no peripheral vision on about these important visual skills. Thus, it is
the left side of both eyes. extremely important that teachers, parents, and
The left hemisphere of the brain is very professionals understand the various visual skills
important for the task of visual reading. The oc- and how each skill affects daily function. (The
cipital lobe sends information to the angular gy- section on the Vision Examination later in this
rus, a region on the left side of the brain where chapter describes how these skills are evaluated
the occipital, parietal, and temporal lobes meet. by an eye care specialist.)
The angular gyrus is involved in the process of

identifying a word as a w hole word. If the angu- Visual Acuity
lar gyrus recognizes the word, the word is quickly
read. This process of reading a word as a sight Near visual acuity, also called reading acuity, is the
word is called eidetic reading. If a student is not ability to identify details within arm’s length and
able to identify the word, a signal is sent to the closer. It is extremely important for such tasks as
Wernicke’s area in the temporal lobe, where the recognizing the print in a book and threading a
word is decoded. needle, and allows an infant to make eye contact
with his or her mother. Poor near acuity inter-
feres with reading, writing, and performing many
V SUA FUNCT ONING activities that involve the use of the hands.
Refractive status is a meas urement of how
Vision Is More Than Reading sharply light rays focus on the retina when one
Vision involves much more than the ability to looks at an object (see Figure 3.8). When the
read small letters. When an infant looks at her eye focuses light correctly on the retina without
mother’s face, she must be able to focus at a dis- the use of any lenses, the person is said to have
tance of 8 to 16 inches, not 20 feet. As the infant emmetropia.
Figure 3.8 Refractive Errors and Lenses to focus on the object more clearly. When this is
Used for Correction not possible, convex lenses, also known as plus
lenses, are used to correct the blurred vision.
Myopia, also known as nearsightedness, is a
condition in which the light rays focus in front
of the retina, causing a blurred image of distant
objects. Concave lenses, also known as minus
lenses, are prescribed to compensate for the my-
opia. Many adults with myopia may be fit with
contact lenses, or they may have refractive LASIK
surgery, to eliminate the need for eyeglasses.
Astigmatism is a third type of refractive status.
It c auses distorted vision at all distances if the
shape of the eye is not perfectly spherical. For ex-
ample, a person with astigmatism may look at a
cross and see the vertical line as sharp, but the
horizontal line will be blurred. Cylindrical glasses
and contact lenses are prescribed for astigmatism.
Myopia, hyperopia, and astigmatism may all be
treated with corrective lenses (or eyeglasses), con-
tact lenses, and/or refractive surgery.
Use of Peripheral Vision

Peripheral vision refers to the ability to see objects
to the right, to the left, above, and below our
central vision. People with severely reduced pe-
ripheral fields typically have what is referred to

as tunnel vision; a person with typical vision can
grossly simulate it by attempting to view the world
through a drinking straw. People with reduced pe-
ripheral vision often have difficulty seeing obsta-
cles and drop-offs (places where the level of the
Source: Ward, M. E. (2010). Anatomy and physiology of the ground changes abruptly, such as steps or curbs)
eye. In A. L. Corn & J. N. Erin (Eds.), Foundations of low vision: when they walk. Students with scotomas, or blind
Clinical and functional perspectives (2nd ed., p. 121). New York:
AFB Press. spots, in their peripheral vision may have signifi-
cant difficulty reading quickly, and they may lose
their place when they move their eyes from the
Hyperopia, also known as farsightedness, is the end of one line to the beginning of the next line.
most common cause of blurred vision among
young c hildren. For p eople with farsightedness,
the light rays are not yet focused when they reach
Color Vision
the retina, causing blurred vision. In many cases Color vision refers to the ability to identify and
of hyperopia, the eye can accommodate naturally discriminate various colors and shades of colors,
and it is controlled by the cone cells of the retina. number when performing schoolwork. (Nystag-
As many as 1 in every 12 males has a color vision mus is discussed further in the section on Com-
deficiency, which affects their ability to see the mon Vision Problems.)
difference between similar colors such as red, Visual pursuit refers to the eye movements
burgundy, and magenta (Kanski & Bowling, 2011). needed to follow a moving object, such as when
There are some cases where a person may be com- watching the ball move back and forth across the
pletely color-blind and is not able to identify any net at a tennis match. Visual pursuit is controlled
colors. This is a condition called achromatopsia. by the parietal lobe of the brain (Hoyt, 2007).
There is no current treatment to cure color vision Children who have poor visual pursuit may have
disorders. The use of various shading, dots, dashes, difficulty following a ball when playing sports.
and hatched graphics w ill help the person with a Activities that encourage the child to follow mov-
color vision problem to differentiate lines on a ing objects can develop their accuracy.
graph or other colors on a map. Saccadic eye movement refers to a rapid, jerky
shifting of the eye from one fixation target to
another, without following a moving object.
Contrast Sensitivity Saccadic eye movements are very important for
Contrast sensitivity refers to the ability to distin- reading. Students with poor saccadic eye move-
guish various shades of gray. Contrast vision is ments may lose their place on a page, skip or omit
very important in life b
ecause not everything that words when reading, and have difficulty copying
one looks at consists of a bold, black print on a from the board to their paper. Many p eople with
white background. Many educational materials dyslexia have poor saccadic eye movements that
are written in pencil on nonwhite paper, or may contribute to their reading problems (Fischer &
have been copied multiple times using various Hartnegg, 2008). Saccadic eye movements are
colors of print and backgrounds. One must have controlled by the frontal lobe of the brain. Stu-
adequate contrast vision in order to read such dents with poor saccadic eye movements may
materials, as well as to see curbs and steps when benefit from following their finger from left to
walking when t here is little difference in the con- right when reading, or using a line guide.
trast of such elevation changes. Increased con- Convergence eye movement skills refers to the
trast and specific illumination can help p eople ability to point both eyes at the same nearby tar-
with reduced contrast sensitivity identify items of get of interest. When a person looks at an object
low contrast more easily. very far away with both eyes, the eyes are parallel.
As the eyes focus on an object that is close, such
as a word in a book, both eyes must converge
Eye Motility properly in order to have each eye pointing at the
here are a number of distinct skills involved in
T same word. If one eye is not pointing properly at
eye motility, or movement. Fixation is the ability the correct word, the person w ill have double vi-
to keep the eyes steady on the target of interest. sion, also known as diplopia. Infants generally be-
When a child has steady fixation, he or she is able gin to develop normal eye coordination skills by
to focus on details and see them clearly. Nystag- 12 months of age. Prior to the age of 12 months,
mus is a condition in which the eyes constantly the child’s eyes may be misaligned.
shake. The eyes may shake from side to side, up Binocular vision refers to the act of coordinat-
and down, or in a pendular or rotational pating both eyes to look at the same target and the
tern. Nystagmus can affect how accurately a ability of the brain to fuse the images from each
student is able to point the eyes on a word or eye into one single image. When the eyes are not
Figure 3.9 Illustration of Esotropia during the developmental years of life. Since the
brain fuses the two images from the eyes to form
one image, it c auses problems if the two images
are drastically different. If left untreated, the
brain may eventually decide to use only the bet-
ter image from one eye and ignore the other eye’s
input. Amblyopia can occur for reasons other
than strabismus and w ill be discussed later in
Bill Takeshita
this chapter under Common Vision Problems.
Depth perception is another very important
factor used for walking, reaching, and perform-
ing other daily activities. Stereoscopic depth percep-
Figure 3.10 Illustration of Exotropia tion is one form of depth perception that involves
the use of both eyes together as a team. When one
attends a three-dimensional movie, the glasses
you are asked to place on your face allow one eye
to see one object while the other eye sees a sepa-
rate object. If a person has reduced binocular vi-
sion, he or she may not perceive the depth in
general life accurately. Fortunately, stereoscopic
Bill Takeshita
depth perception is not the only way that we per-

ceive depth. For example, a person can tell that
one object is closer than another object if it is
much larger than the other object. Similarly, if
aligned properly, known as strabismus, the indi- one object overlaps another object, an individual
vidual may not be able to coordinate the images can tell that the object that overlaps the other ob-
from the two eyes. Esotropia strabismus is a condi- ject is closer. Several factors are used to determine
tion in which one or both eyes are turned inward, depth perception, and only stereopsis requires
while exotropia strabismus is when one or both eyes the use of both eyes together. Thus, a person may
drift outward (see Figures 3.9 and 3.10). Hypertro- have only one eye and still have some level of
pia strabismus is when one eye points higher than depth perception. However, the person with only
the other eye. Any form of strabismus may cause one eye, also known as monocular vision, cannot
a person to have diplopia. Some c hildren w ill have stereoscopic depth perception.
cover one eye, turn their head, or wink one eye
to eliminate diplopia. Eye muscle surgery or eye-
glasses may be possible treatments prescribed for
Visual Perception
strabismus and other binocular vision problems. Visual perception is a very complex and impor
If strabismus is not detected and treated as tant skill that allows us to understand what we
early as possible, it can cause lingering implica- have seen. Visual perception is necessary to
tions and permanent vision loss known as ambly- understand how to read a map, assemble a piece of
opia (also called “lazy eye”). Amblyopia may furniture using the schematic diagram, read and
affect between 1 and 4 percent of the population, understand facial expressions, and solve many
and it occurs when the cells in the occipital lobe problems in mathematics and science. Visual pro
of the brain do not receive proper stimulation cessing takes place primarily in the occipital
and parietal lobes of the brain, but other visual crowded background, as in I Spy or Where’s Waldo
processing skills take place in the temporal and books.
frontal lobes. P eople who have suffered from Visual praxis refers to the understanding that
head trauma, brain injury, and stroke often have parts can be assembled to create a more complex
reduced visual perception skills. The following are object, and is an important skill that allows
the most basic visual perception skills. people to understand how to assemble jigsaw
Form perception refers to the identification of puzzles, build models, and draw. Students with
various geometric shapes as being different. Form poor visual praxis often have difficulty drawing,
perception is important for a young student to be understanding concepts in mathe matics and
able to identify various shapes, letters, and num- science, assembling projects, or performing home
bers. C hildren who cannot identify shapes w ill improvement activities.
often have significant difficulty learning to iden- Visual motor perception refers to the ability of
tify letters and numbers. the visual system to guide the hands to draw,
Size perception refers to the perception that an print, and assemble arts and crafts projects. Many
object may be a different size as compared to an- children with reduced visual motor skills w ill also
other object. Size perception plays an important have reduced visual praxis. As a result, they do not
role in the understanding of basic arithmetic understand how to assemble basic lines and geo-
concepts. metric shapes to draw a more complex picture. In
Visual discrimination refers to the perception other cases, a person may have reduced fine motor
that objects and images may appear similar but skills that contribute to the reduced visual motor
are actually different. For example, some p eople skills for printing and drawing.
with poor visual discrimination may perceive a Visual attention refers to the maintenance of
square as being the same as a rectangle. an elevated level of concentration to keep the eyes
Visual memory and visual sequential memory focused on a target of interest. Many students
refer to the recollection of what has been seen. who have reduced visual attention also have at-
Students with reduced visual memory often have tention deficit disorder, or hyperactivity. These
difficulty learning letters, or they may have dif- students often do not perceive details of objects
ficulty recognizing the f aces of people. and educational materials accurately.

Visual spatial relations refers to the understand- It is important for teachers, parents, and
ing that the direction that an object or image faces health care professionals to consider each of the
is important, and the ability to understand the visual skills described and how impairment of
relationships of objects’ positions in space to each these visual skills may interfere with a child’s
other and oneself. Student with poor visual spa- ability to learn. It is very important that all
tial relations may not understand the difference c hildren receive an examination that identifies
between the letters b and d. They simply perceive any weaknesses in these visual skills. Thus, an eye
a circle attached to a line, but they do not perceive examination that only measures visual acuity on
the significance of the orientation of the circle. the Snellen chart is not sufficient. In some in-
Visual figure-ground perception refers to the per- stances, vision therapy may be recommended by
ception of a visual image hidden within a crowded an eye care professional to address visual motor
background. Students with poor figure- ground skills. A teacher of students with visual impair-
perception often lose their place when they read a ments must be aware of the controversies surround-
crowded page, or they may become overwhelmed ing vision therapy and be able to communicate
in a crowded environment. They may also have why vision therapy services are not provided by a
difficulty finding a picture hidden within a teacher of the visually impaired (see Sidebar 3.1).
S I D E B A R 3 . 1
What about Vision Therapy?
Vision therapy is a non-evidence-based Often teachers of students with visual

intervention that claims to treat eye problems impairments and other special education
such as strabismus (crossed or misaligned personnel w ill be approached about providing
eyes), amblyopia (blurred vision due to the vision therapy for c hildren. Usually, these
lack of stimulation to the visual cortex of the children have fully correctable vision, but may
brain), tracking eye movement disorders that have difficulties with reading or tracking.
affect reading, and convergence insufficiency. Some optometrists recommend behavioral
A great deal of controversy surrounds the vision therapy, which can be very expensive.
effectiveness of vision therapy and the qualifi- Most insurance companies do not cover it,
cations of individuals who provide this service. and families are left with that burden. Often,
Vision therapy is not a research-based inter- they hear that school systems provide “vision
vention and t here is no evidence that it teachers” for children with “vision problems,”
improves vision. The American Association and it may be assumed that vision therapy
for Pediatric Ophthalmology and Strabismus could be provided by the district as a part of
(AAPOS; n.d.) provides more information on the child’s education under the Individuals
the types of vision therapy that may be recom- with Disabilities Education Act (IDEA).
mended. In addition, contrary to what some However, b ecause these children are not
eye care professionals may claim, vision therapy visually impaired as defined u nder IDEA
does not cure disabilities such as autism, (see Chapter 1), they would not be eligible
attention deficit disorder, dyslexia, and other for special education services.
specific learning disabilities. Students who have Another point of confusion is that the title
educational difficulties should be evaluated by of the professionals known as low vision
an educational specialist as well as an optom- therapists contains the words “vision thera-
etrist or ophthalmologist if vision is affecting pist.” Low vision therapists, who are certified
educational performance, to make the appro- by the Academy for Certification of Vision
priate diagnosis for the student. Rehabilitation and Education Professionals,
There is also debate regarding who is assess and work with persons who have low
qualified to provide vision therapy and who is vision and provide instruction in the use of
responsible for the costly service. Teachers optical, nonoptical, and electronic devices,
of students with visual impairments are not as well as other strategies and techniques to
qualified to provide vision therapy. If a teacher improve the use of functional vision. The
of students with visual impairments is defining words in their title are “low vision.”
approached by parents or members of the Anyone who has been prescribed vision
student’s educational team about vision therapy, and thus has correctable vision,
therapy, he or she should refer them to would not benefit from the services of a low
optometrists and ophthalmologists for vision therapist or teacher of students with
further guidance. visual impairments.
iesel performed experiments on kittens with

W
Developing Visual Skill healthy eyes and they showed that vision is a skill
Vision is a developed skill that involves the eyes developed over time. They took healthy newborn
and many regions of the brain. Nobel Prize– kittens with normal eyes and raised them in dif
winning scientists David Hubel and Torsten ferent environments (Hubel, 1988). One group of
kittens was raised in a very visually stimulating

environment with colors, patterns, toys, and COMMON V S ON PROBLEMS
lights, while the other group of kittens was de- THAT MAY BE CORRECTED
prived of visual stimuli when their eyelids w ere
sutured shut. Weeks later, they studied the vision hildren and adults may have vision problems
C
of the kittens to find that the kittens raised in that can be successfully treated. Eyeglasses, con-
the visually stimulating environment had very tact lenses, eye medications, and surgery are often
strong vision, while the kittens deprived of vi- very effective at improving the vision of those
sual stimulation w ere blind. This phase of their with common vision problems. The sooner a vi-
research revealed that the visual environment in sion problem is diagnosed, the better the progno-
which one is raised affects the development of sis for treating common vision problems. Some
vision. of t hese problems may be considered a visual im-
Hubel and Wiesel then studied the eyes and pairment, but if vision can be corrected to within
brains of the kittens and found that the eyes of the “typical” range, they are not considered a visual
both groups were identical but the brains of the impairment.
two groups were different. The kittens that were All c hildren should have their first eye exam-
raised in a visually stimulating environment had ination, provided by a pediatric eye care special-
cells in the occipital lobe of the brain that were ist, by the age of 6 months. Unfortunately, many
larger than the cells in the occipital lobe of the c hildren do not receive early eye examinations,
kittens that were deprived of visual stimulation. and if vision problems are not diagnosed u ntil
This suggests that the occipital lobe of the brain the child is in school they are likely to have a
is where vision takes place and that the environ- negative effect on learning. While many of t hese
mental stimulation affects the development of common vision problems will have an impact on
t hese cells. a child’s use of vision, they do not necessarily re-
Next, Hubel and Wiesel attempted to develop sult in a visual impairment.
vision in the blind kittens by placing them in an
environment with colors, patterns, lights, and
toys. The results of this phase of their research

Refractive Errors
revealed that the blind kittens developed vision Hyperopia (farsightedness) is the most common
when the vision stimulation occurred before the refractive status in children. Most infants’ eyes
end of a critical time period. For t hese kittens, the are hyperopic because of the small size of the eye.
cells in the occipital lobe of the brain developed, As the eyes grow, the hyperopia becomes less, and
and the kittens developed vision. many c hildren w ill not be hyperopic by the time
The research of Hubel and Wiesel laid the they reach the age of 10. Teachers, parents, and
foundation for the use of vision stimulation inter- professionals should keep in mind that most
vention for c hildren with vision impairment. It is children who are hyperopic may pass the Snellen
the rationale for eye care professionals recommend- eye chart that measures distance vision but have
ing that children wear a patch to treat amblyopia problems keeping their eyes focused on their read-
and for the use of visual intervention for c hildren ing materials. C hildren with hyperopia are often
with neurological vision impairment. Teachers, reluctant readers, especially at the early levels,
parents, and other professionals must under- because of the effort required to focus on close
stand the importance of early intervention in or- reading material for extended periods of time.
der to help c hildren with low vision to maximize Myopia (nearsightedness) is also a common
their ability to use their vision. condition in c hildren and adults. C hildren who
have parents with myopia also frequently have Accommodative dysfunction is another visual
myopia. Myopia w ill often prog ress as the length problem that can adversely affect a student’s
of the eye increases, and this results in the thin- academic performance. Accommodation dys-
ning of the retina. Continued stretching of the ret function is a focusing disorder that is similar to
ina or trauma to the head may result in a retinal presbyopia but it affects children and young
tear or a retinal detachment. Symptoms of seeing adults. Students with accommodative dysfunc-
flashes of light or significant “floaters,” spots in tion are not able to maintain a clear focus on
the eye that appear similar to flies and spider their reading materials, and the print may be-
webs, can be signs of a retinal tear or detachment. come very blurred, then clear, and then blurred
If a person experiences such symptoms, they again. They have difficulty reading, especially
should go immediately to the office of an oph- when shifting the focus of their eyes from, say,
thalmologist specializing in the retina, another the dry-erase board to their paper, and they fre-
ophthalmologist, or the emergency room and quently have eye pain and headaches located in
inform them that he or she has a possible reti the forehead area or around the eyes. Reading
nal detachment. glasses are extremely helpful for people with ac-
Astigmatism is another common refractive commodative disorders.
status of c hildren and adults. B ecause the shape
of the eye is causing the vision problem, people
Strabismus and Amblyopia
with astigmatism often squint, which temporar-
ily changes the shape of the eye and somewhat As mentioned previously, in the discussion of
improves their clarity of sight. strabismus, amblyopia is the result of a condition
Presbyopia is an age-related condition that af- in which a person’s sight is blurred, even with the
fects healthy adults near the age of 40 and older. use of eyeglasses, although there is no pathol-
Presbyopia is a condition in which the crystalline ogy or eye disease. T here are differe nt forms of
lens does not have the ability to change shape amblyopia. Refractive amblyopia is a condition in
easily. As a result, adults with presbyopia are not which an infant requires the use of eyeglasses in
able to see reading materials clearly and they re- one or both eyes to correct for hyperopia, myo-
quire the use of eyeglasses for reading. The read- pia, or astigmatism, but the eyeglasses w ere never
ing glasses may be prescribed in the form of a pair prescribed. For these c hildren, the photons of
of eyeglasses with a large lens or a half lens. The light do not focus sharply on the macula, and a
advantage of the half-eyeglasses is that a person weak signal is sent to the occipital lobe of the
who does not require eyeglasses for distance brain. The weak signals that stimulate the occipi-
viewing can simply look above and over the half- tal lobe of the brain result in the abnormal de-
eyeglasses to see the television or other dis- velopment of the brain. C hildren with amblyopia
tance object while reading. For those who require are often identified at school vision screenings
e yeglasses for distance viewing, a bifocal or a when entering kindergarten. When the eye care
no-line bifocal can be prescribed. In these eye- professional fits the child with eyeglasses, they do
glasses, the bottom portion has a differe nt pre- not improve the sight because the brain cells are
scription from that of the top of the lenses to not fully developed. These c hildren may require
allow the person with presbyopia to see both far a patching program to force the child to use a
and near. There are also multifocal contact lenses, part icular eye. The earlier a child with refractive
which have different powers in the lens to allow amblyopia receives treatment, the better the prog-
a person with presbyopia to see both in the dis- nosis. Generally, treatment before the age of 3
tance and near. greatly improves the prognosis.
Another form of amblyopia is strabismus am- coordination are very common consequences of
blyopia, in which the vision of one or both eyes is binocular vision disorders.
reduced as a result of misalignment of the eye, or The most common binocular vision disorders
strabismus. Strabismus may cause a person to see are esophoria and exophoria (see Figures 3.9
double vision and the brain may eventually “turn and 3.10 earlier in this chapter). Esophoria is a
off,” or suppress, the vision of one eye to avoid condition in which the eyes have a strong ten-
seeing double. This consequently affects the de- dency to cross or turn inward toward the nose,
velopment of the cells in the occipital lobe, and while in exophoria the eyes have a strong tendency
the clarity of sight is then reduced further in to drift outward. Esophoria and exophoria force
that eye. Strabismus amblyopia is more common the person to exert additional muscular effort to
when one eye is constantly misaligned, rather keep both eyes pointing at the same target and
than each eye alternately being misaligned. not have double vision. Headaches, eyestrain,
Children and adults with strabismus amblyopia loss of place when reading, and the appearance
often require patching therapy in which the of words moving on the page are common symp-
straight eye that has sharper vision is patched to toms of esophoria and exophoria. Eyeglasses are
force the child to use the misaligned eye. During an effective treatment for the symptoms caused
the patching therapy, it is recommended that the by esophoria and exophoria.
child look at smaller details to provide stimula- Convergence insufficiency is a very common
tion to the occipital lobe of the brain. The patch cause of vision-related reading problems. When
may be a translucent patch that sticks to the a person reads a book, the eyes must cross or
glasses. These patches are often more comfortable converge to allow each eye to point at the same
for the child than having a bandage patch over word, as noted earlier. Convergence is controlled
the eye. In other cases, black patches (like t hose by the medial rectus muscles of both eyes. When
supposedly worn by pirates) held on by elastic are a person is not able to converge properly, the per-
used. The length of time the patch is worn each son w ill see double and the words on the page
day as well as the duration of the entire patching w ill often overlap and move. Students with con-
treatment are prescribed by the child’s eye care vergence insufficiency may wink or close one eye
specialist. In cases where a child with amblyopia when reading. Prism glasses may be prescribed as
is not able to cooperate and wear a patch, an eye a treatment for convergence insufficiency.
drop may be used to blur the vision of the stron- As mentioned previously, strabismus is also
ger or better eye, again forcing the child to view a common problem with binocular vision among
objects with the other eye. c hildren (Mohney, Greenberg, & Diehl, 2007).
Binocular vision disorders are a common Any misalignment of the eyes can cause the per-
cause of vision problems of c hildren and adults. son to have diplopia or reduced stereoscopic
Binocular vision problems occur when the child depth perception, and the person may compen-
or adult is not able to coordinate the eyes to- sate by turning or tilting the head, winking or
gether. P eople with binocular vision problems closing one eye, or even covering one eye when
may have eyes that appear to be positioned reading. Strabismus is generally easily identifiable
straight, while in other cases the alignment of the by parents, but t here are cases of mild strabismus
eyes is severely reduced and easily detectable. when a person cannot easily detect that the eyes
Binocular vision disorders may cause significant are misaligned. Strabismus is more frequently ob-
problems when reading, writing, playing sports, served among c hildren who have family mem-
and driving. Blurred vision, double vision, re- bers with strabismus. Thus, it is important to ask
duced depth perception, and reduced eye-hand parents if there are family members with a
crossed or turned eye. Some c hildren born with eople with exotropia often suffer from double
P
esotropia may have a high degree of hyperopia, vision, reduced depth perception, frequent loss of
which contributes to the crossing of the eyes. This place when reading, and severe sensitivity to di-
form of esotropia is called accommodative esotro- rect sunlight. This sensitivity to sunlight may be
pia. Children with accommodative esotropia see so severe that they always wink one eye when
the world as blurred because the hyperopia does playing in direct sunlight. For this reason, any
not allow the light rays to focus sharply on the child who winks one eye when outdoors should
macula. The child accommodates to focus the be referred for a screening for exotropia. Exotro-
light rays on the macula, resulting in sharper pia may be treated with eye muscle surgery.
sight. However, when a person accommodates, Vertical strabismus is when one eye points
the eyes reflexively cross and may become mis- higher than the other eye. It is often very difficulty
aligned, resulting in double vision. Children and to observe the misalignment of the eye b ecause
adults with accommodative esotropia can be suc- vertical strabismus is generally not severe. How-
cessfully treated with bifocal eyeglasses or con- ever, vertical strabismus causes double vision,
tact lenses. and children will compensate by tilting their head
Another form of esotropia is called congenital toward one shoulder. Some children are diag-
esotropia. This form of esotropia is most often nosed as having torticollis (contracted neck mus-
present at birth, and the child does not have a sig- cles) when they actually are tilting the head to
nificant level of hyperopia that c auses the cross- eliminate double vision. The double vision may be
ing of the eye. Congenital esotropia may affect treated with prism eyeglasses or surgery.
one eye or both eyes. In cases when both eyes
cross, the child may alternately use the right and
the left eyes. Eye muscle surgery is frequently
Nystagmus
required to straighten the eyes of c hildren with Nystagmus is an eye muscle disorder in which the
moderate to severe congenital esotropia. eyes are not able to remain focused on the target
Pseudo-esotropia is the term that is used to de- of interest. Children are frequently born with
scribe the condition in which c hildren have eyes nystagmus, but other children and adults may
that are properly aligned but the appearance of develop it after suffering a head injury or trauma.
their eyes is such that the eyes appear to be crossed. While nystagmus can be the sole, or primary,
Many young infants have a wide bridge of the cause of visual impairment, it most often occurs
nose and the skin covers much of the white sclera as a secondary condition to other etiologies
of their eyes. As a result, the eyes appear to be where t here is anterior segment pathway dam-
crossed, though the alignment of the eye is in age (Schwartz, 2010). The most common form of
fact straight. Eye care professionals can perform nystagmus is horizontal nystagmus, in which the
special tests to determine if the alignment of the eyes shake uncontrollably from side to side. An-
eyes is straight. Babies and young c hildren of other form of nystagmus is pendular nystagmus, in
Asian descent often have pseudo-esotropia. which the eyes move similar to a pendulum in
Exotropia, also called divergent strabismus, is a grandfather clock. Vertical nystagmus is diag-
the binocular vision condition in which the eyes nosed when the eyes bounce up and down con-
drift outward, or point toward the ear, and may stantly. The presence of nystagmus alone does
be present at birth or appear at a later age. Exo- not indicate w hether a person has reduced acu-
tropia may affect one eye, and this form is called ity. Some people with nystagmus have perfect
unilateral exotropia. In contrast, exotropia that 20/20 sight, while o thers may have reduced
affects both eyes is called alternating exotropia. visual acuity. C hildren born with nystagmus
(congenital nystagmus) generally do not perceive ment includes reduced visual acuity, reduced
the world as shaking or moving from side to depth perception, and photophobia.
side. However, p eople who develop acquired (To watch a related video, log in to the AFB
nystagmus a fter an injury often perceive the Learning Center.)
world as shaking and moving. Most congenital
nystagmus is caused by damage to the anterior
visual pathway and is not neurological, as is ac-
Aniridia
quired nystagmus (Schwartz, 2010). In all forms Aniridia is a condition in which the iris is not
of nystagmus, the person must exert more effort present at birth. This causes the eye not to be able
to maintain his or her place when reading. They to control the amount of light that enters, as the
frequently lose their place when they read or iris usually constricts and dilates to appropriately
copy from the board to their paper. Some people accommodate different lighting conditions. Indi-
with nystagmus may have a null point where they viduals with this condition often complain of
are able to reduce the nystagmus by moving their severe photophobia (or light sensitivity) and dis-
eyes in a part icular direction. For example, some tortion of their vision, and they may perceive a
children with horizontal nystagmus can reduce rainbow effect around objects because of the ab-
their nystagmus by moving their eyes toward sence of the iris and, therefore, the pupil. Even
their right and turning their head toward their mild photophobia can cause pain, squinting, water-
left. In cases where a person has a null point, ing, and other symptoms b ecause of the inability
ophthalmologists may be able to perform eye of the eye to block out extra light and glare.
muscle surgery to move the null point to their
central gaze. However, in some cases, nystag-
mus surgeries w ill reduce the total amount that
Cataracts
a person is able to move the eyes. Cataracts are an eye condition that can cause mild
to severe vision impairment. A cataract occurs
when the crystalline lens of the eye becomes
CAUSES OF V SUAL MPA RMENT opaque and alters the manner in which light is
here are many c auses of visual impairment that

T transmitted through the eye to the retina. Cata-
affect c hildren and adults. racts cause blurred vision, double or multiple vi-
sion, severe sensitivity to glare, reduced peripheral
vision, and color vision disturbances, and they
Albinism can also affect night vision. C hildren may be
Albinism is an inherited condition in which t here born with cataracts because of the inheritance of
is a lack of pigment in the eyes, body, or both. an abnormal gene. Metabolic disorders, trauma,
Ocular albinism occurs when the lack of pigment medic ations, steroids, aging, and diabetes may
affects only the eyes; a lack of pigment in the eyes also cause cataracts. Surgery to remove a cataract
as well as the rest of the body (skin and hair) is is one of the most effective surgical procedures
oculocutaneous albinism. Reduced visual acuity oc- performed in the United States, and surgeons are
curs in people with albinism because pigment is able to remove the cataract and insert an intra-
needed for appropriate development of the retina ocular lens implant to restore the vision of people
(Schwartz, 2010). The level of visual impairment with cataracts (Colvard, 2009). Some children are
is usually in correlation with the lack of pigment: fitted with an intraocular lens implant, but most
lower levels of pigment cause a lower level of vi- c hildren w
ill not receive an implant u ntil their
sion. The impact of albinism on visual impair- eye has completed growth.
Coloboma on a crowded or cluttered background. They fre-

quently require extended time (up to 25–30 sec-
A coloboma is a congenital notch, gap, or hole in onds) to respond visually to a visual stimulus,
one or multiple structures of the eye that occurs and they may not exhibit a visually guided
when the eye is forming. As the structures fuse reach. Roman- L antzy (2007) developed a vi-
together, sometimes a cleft forms. This cleft can sion assessment tool that helps determine the
occur on multiple structures in the eye, includ- specific level of vision a child has and specific ac-
ing the iris or parts of the retina or optic nerve. tivities that may stimulate the visual centers of
This cleft causes a partial absence of tissue, which the brain through visual intervention. (See
can affect vision. A coloboma of the iris is often Chapter 7 in this volume for additional discus-
called a keyhole iris since a portion of the iris is sion of CVI.)
missing and the pupil extends outward. Colobo-
mas involving the retina or optic nerve often
cause a higher degree of visual impairment, in- Genetic Conditions
cluding possible restriction of the visual field. Many eye disorders of children are related to ge
netic changes that affect the development of struc-
tures of the eyes and visual system. There are three
Cortical Visual Impairment basic classifications of genetic abnormality. Auto-
Cortical visual impairment (CVI), also referred to as somal dominant genetic abnormalities are such that
cerebral visual impairment or neurological visual im- if either or both parents have the abnormal gene,
pairment, is the leading cause of vision impair- their offspring may have the abnormal trait. Auto-
ment among c hildren in the developed world. somal recessive genetic conditions are such that
CVI is a condition in which visual disorders or each parent must have the genetic abnormality in
visual perception issues result from damage to order for the child to have the trait. In cases of an
the visual pathways and centers of the brain (Lu- autosomal recessive condition, such as albinism,
eck & Dutton, 2015). It is frequently associated the child must inherit the abnormal gene from
with complicated birth, hypoxia, respiratory dis- each parent. If the child only inherits the abnor-
tress, meconium aspiration, seizure disorder, hy- mal gene from one parent, the child will be a car-
drocephalus, brain hemorrhage, intraventricular rier of the abnormal gene but will not show signs
hemorrhage, periventricular leucomalacia, and of the disease. Lastly, there are also X-linked reces-
trauma (Hoyt, Miller, & Walsh, 2008). Children sive genet ic conditions, which affect males who
with CVI may demonstrate various visual behav have a maternal grandf ather who also has the
iors. They generally do not make eye contact condition. For any person who has a condition
with p eople b
ecause of a reduced tolerance for vi- that is passed on genetically, it is important that
sual and environmental complexity. They may the f amily receive genetic counseling to gain a bet-
be more interested in looking at single-color ob- ter understanding of the probability of additional
jects or familiar objects rather than multicolored children having the condition.
or novel objects. They may be more interested in In addition to genetic eye disorders, t here are
looking at objects that move or have the ap- many other c auses of vision impairment among
pearance of movement (for example, rotating, c hildren and adults. The section on Vision Prob
illuminated, or shiny). They may tend to look lems Associated with Medical Conditions w ill
at objects that are closer to them rather than dis- discuss the most common conditions resulting
tant objects. In many cases, they tend to stare at in visual impairment and how they affect visual
bright lights and have difficulty looking at a toy function.
Glaucoma the control of the intraocular eye pressure with

the use of eye drops and surgery.
Glaucoma is a condition that affects both c hildren The second form of glaucoma is called
and adults, and it occurs when t here is too much angle-closure glaucoma. This form is less common
aqueous fluid in the eye. The intraocular pressure than primary open-a ngle glaucoma. In angle-
of the eye becomes too high, and this exerts pres- closure glaucoma, the anterior chamber angle
sure on the nerve fibers that form the optic nerve. where the aqueous fluid drains is shallow, and
Glaucoma may result in the loss of peripheral this impedes the aqueous from draining from the
vision, night blindness, blurred vision, and total eye. The intraocular pressure may suddenly rise
blindness (Allingham, Damji, Freedman, Moroi, and cause severe pain, headache, vomiting, and
& Rhee, 2011). It is also important to note that foggy vision. It is critical for p
eople who experi-
glaucoma may also develop when the intraocular ence t hese symptoms to go to the emergency room
pressure is within the normal range, a condition or to their eye care specialist immediately to re-
called low-tension glaucoma. Children born with ceive eye drops and medications to lower the
congenital glaucoma may be born with an en- pressure of the eye. If not treated, a person may
larged eye, also known as buphthalmos, and the become totally blind in a m atter of hours.
cornea may be clouded. Adults may develop glau- The most common treatment for glaucoma
coma and have no symptoms. African Americans, includes the use of various eye drops. The eye
Hispanics, and those over the age of 40 have a drops may increase the outflow of the aqueous or
higher prevalence of glaucoma. decrease its production. Some of the eye drops
There are two main forms of glaucoma. Pri- have side effects that may be hazardous for t hose
mary open-angle glaucoma is the most common who have respiratory problems.
form of glaucoma. In this type, the anatomical Eye surgeries are also used to reduce the pres-
a ngle where the aqueous fluid of the eye drains sure of the eye. A trabeculectomy is a surgical treat-
is open (see Figure 3.2), but the amount of ment in which the drainage system of the eyes is
aqueous fluid in the anterior chamber is too high, opened to increase the flow of aqueous out of the
resulting in pressure on the nerve fiber layer. eye. In other cases, tubes are surgically inserted
Continued pressure on the nerve fiber layer results into the aqueous chamber to enhance the drain-
in damage to the optic nerve. The intraocular pres- age of the aqueous to reduce the pressure. Other
sure of the eyes with glaucoma is generally over surgeries include the freezing of the ciliary body
21 mm Hg (see the discussion of Tonometry in to reduce the amount of aqueous fluid produced,
the section on the Vision Examination later in resulting in decreased pressure in the eye. Because
this chapter). The pressure buildup c auses an ar- glaucoma causes a permanent loss of peripheral
cuate (arch-shaped) blind spot that affects the vision, most p eople with glaucoma have diffi-
midperipheral field of vision. As the condition culty with their mobility. O&M training is rec-
progresses, it leads to tunnel vision, in which the ommended to teach such individuals to scan
patient is only able to see directly in front of him with their eyes to help them to see obstacles.
or her, similar to looking through a drinking
straw. At this stage, walking independently, locat-
ing objects around the home, reading, and per-
Hemianopsia
forming daily activities are difficult. In advanced Damage to the occipital lobe may result in the to-
cases of glaucoma, total blindness can occur. tal loss of peripheral vision on one side of both
How quickly vision loss progresses for people eyes, called a hemianopsia. The loss of peripheral
with primary open-angle glaucoma depends on vision on the left visual field of both eyes is called
a left hemianopsia, while the loss of peripheral macular degeneration are taught by their eye care
vision on the right visual field of both eyes is specialists to use their peripheral vision to see the
called a right hemianopsia. A hemianopsia is faces of people or other details. The use of optical
often the result of a cerebral vascular accident or electronic low vision devices (described in
(stroke), head trauma, or a tumor in the brain. the section on the Clinical Low Vision Evalua-
Low vision specialists can prescribe prism glasses tion) may be helpful to improve the use of vision
and training to help a person compensate for the for people with AMD.
loss of peripheral vision.
Stargardt Disease
Macular Degeneration Stargardt disease is a disorder of the retina that
Age-Related Macular Degeneration ften affects young p
o eople between the ages of 10
and 20, and is a juvenile form of macular degener-
Age-related macular degeneration, also known as ation. Initially, they notice that their clarity of sight
AMD or ARMD, is the leading cause of vision im- is blurred. As time proceeds, they may observe a
pairment among adults over the age of 65 years. small blind spot in the center of their vision, re-
AMD is a disease that damages the cone cells of duced color vision, and sensitivity to bright light.
the macula and results in blurred vision, a blind The cause of Stargardt is generally an autoso-
spot in the central vision, distorted vision, and mal recessive trait in which both parents must be
sensitivity to bright light (photophobia), and it a carrier of the gene. If such a c ouple has a child,
may also result in color vision abnormalities. the child has a 25 percent chance of inheriting
AMD is associated with aging, and is more com- the abnormal gene from both parents and having
mon among those who smoke, those who have Stargardt disease. People who are carriers of the
blond hair and blue eyes, and t hose who have a abnormal gene do not suffer from reduced vision.
family member with AMD. It is very important for students between the ages
There are two main forms of AMD. Dry AMD of 10 and 20 who complain of blurred vision to
is the most common form, affecting approxi- have a detailed vision examination so that the
mately 85 percent of the cases. In dry AMD, the cause can be accurately diagnosed. Stargardt dis-
cone cells die and there are areas of atrophy in the ease only affects the macular region of the eye,
macula. People with dry macular degeneration and people with Stargardt disease do not become
may have vision that ranges from 20/40 to totally blind. In the more advanced stages of Star-
20/200. Wet AMD is the second form of macular gardt disease, a person may have approximately
degeneration, and it affects 15 percent of p eople 20/200 distance visual acuity.
with AMD (Kanski & Bowling, 2011). In wet Presently, t here are research studies investi-
AMD, blood vessels under the macula of the eye gating the use of gene therapy, stem cells, and
bleed and leak blood and fluid u nder the macula. vitamin therapy to help people with Stargardt
The blood u nder the macula may cause the mac- disease. Students and adults with Stargardt dis-
ula to become distorted, and people with wet ease respond extremely well to optical and elec-
AMD may complain of seeing straight lines as tronic devices. It is very important to consider the
wavy. In other cases, the leakage of blood under emotional state of children who have been diag-
the macula is such that the person may have a nosed with Stargardt disease and to make sure
large blind spot that interferes with his or her they realize they will not become totally blind.
ability to identify details. Many people with wet Referral for counseling is also recommended.
Optic Nerve Hypoplasia of vision. The central vision of people with RP

may also become blurred, and some may be-
Optic nerve hypoplasia (ONH) is a condition in come totally blind. It is not possible to predict
which the number of optic nerve fibers that make the time that it may take for one to lose vision.
up the optic nerve is less than normal (Hoyt, In some cases, people with RP w ill maintain
2007). In the typical optic nerve, t here may be 20/20 sight, while o thers may only be able to see
750,000 to 1 million optic nerve fibers that send light.
information from the retina to the occipital lobe There are many forms of RP. Some are in-
of the brain. In a child with ONH, t here may be herited, while others do not appear to follow
as few as 300,000 to 400,000 fibers prese nt. As an inherited pattern (Hartong, Berson, & Dryja,
a result, the amount of information sent to the 2006). X-linked recessive RP is a form that affects
brain is significantly reduced. The level of vision boys, and t hese boys often demonstrate very re-
of the person with ONH is dependent on the duced vision during the first few years of life.
number of fibers that are functional and able to Autosomal dominant RP is an inherited form in
send information to the brain. If the fibers that which many members of the f amily w ill have RP
send information from the central vision are not within each generation, while autosomal recessive
present, the person will have reduced central vi- RP requires that both parents are carriers of the
sion, blurred vision, reduced color vision, and dif- gene. Simplex RP is an form in which only one
ficulty identifying objects and performing near person in a generation has RP and there are no
tasks. On the other hand, if the missing fibers are other members in the family with the disease.
those that send information from the peripheral There is no treatment to cure RP, but vitamin A
retina to the occipital lobe of the brain, the person palmitate has been reported to be helpful. Gene
will have reduced peripheral vision, reduced night therapy and stem cell research are presently be-
vision, and possibly difficulty walking safely. ing performed. Optical and electronic low vision
devices, O&M instruction, and instruction in in
dependent living skills, among other areas of the
Retinitis Pigmentosa expanded core curriculum, are extremely benefi-
Retinitis pigmentosa (RP) is another visual condi- cial for children with RP. (See Chapter 9 in this
tion that often manifests between the ages of 10 volume and Volume 2, Chapter 11 for discussions
and 20. However, t here are forms of retinitis pig- of the expanded core curriculum.)
mentosa that may arise sooner. RP is a disease of RP is often associated with other conditions,
the rod cells of the retina. The rod cells are located including hearing impairment, developmental
in the peripheral region of the retina and provide delay, and learning disability. Bardet-Biedl syn-
peripheral vision and night vision. Children with drome, also known as Laurence-Moon syndrome,
RP first lose their ability to see u nder dim light- is a disorder in which c hildren are born with
ing conditions. They may have difficulty locating retinitis pigmentosa, polydactyly (additional fin
a seat at the movie theater, or they may prefer not gers), syndactyly (fused fingers), hypogonadism,
to go trick-or-treating on Halloween. As the pe- short stature, and cognitive delay. The condition
ripheral vision worsens, the person w ill notice is inherited in an autosomal recessive manner,
that it is more difficult to see obstacles when that is, both parents must be carriers of the gene
walking, or sports activities may become more in order for their child to have the condition. Usher
difficult. Cataracts may develop at an early age, syndrome is a condition in which RP is associated
and surgery may be required to improve the level with hearing impairment (see the separate listing
for Usher syndrome in the section on Vision Prob for weeks a fter to monitor for the presence of ROP.
lems Associated with Medical Conditions). In cases where retinopathy of prematurity is identi-
fied, the ophthalmologists will identify the loca-
tion and the severity of it. In Stage I, the severity is
Retinoblastoma very mild and no treatment is necessary. Stage II is
Retinoblastoma refers to a rare and treatable eye more advanced, but it generally resolves on its
cancer. The first goal of treatment is to remove the own. In Stage III ROP, the ophthalmologist will
cancer, and the second is to preserve as much observe abnormally curved blood vessels, and
vision as possible (Schwartz, 2010). In some cases, these children must be monitored more closely.
enucleation (removal) of the affected eye is Stage IV ROP is more severe, with pulling on the
necessary. The impact to the child’s vision is di- retina, while Stage V is the most severe stage, in
rectly dependent on the location of the tumor or which the ROP has detached the retina. Stages IV
tumors and the level of treatment necessary to and V are stages where an ophthalmologist must
remove the cancer. C hildren with retinoblas- intervene with treatment to save the vision of the
toma should be observed carefully to monitor child (Kaiser, Friedman, & Pineda, 2014). Retinal
for the development of new eye tumors or other detachment surgery may be performed to reattach
cancers later in life. the retina, while a vitrectomy is used to remove
blood and scar tissue in the vitreous.
Children with Stage IV or Stage V ROP often
Retinopathy of Prematurity have reduced peripheral vision, high myopia,
Retinopathy of prematurity (ROP) is the second lead- strabismus, and visual perception problems. In-
ing cause of vision impairment among children. It struction by a teacher of students with visual
involves the abnormal development of the retinal impairments and an O&M specialist is usually
blood vessels when a baby is born before 32 weeks beneficial for a child with visual impairment
gestation or at very low birth weight (less than due to ROP. Also, the use of optical or electronic
1,500 grams or approximately 3.4 ounces). In the devices may assist in helping the child access
typically developing child, the blood vessels that the visual environment, both near and in the
supply blood to the various regions of the retina distance.

emerge through the optic nerve and supply blood
to the peripheral regions of the retina by 32 weeks
gestation. In c hildren born prior to 32 weeks ges-
Traumatic Brain Injury
tation, the blood vessels are not fully developed Traumatic brain injury, also known as TBI, is a
and do not extend to the peripheral regions of the significant cause of vision impairment. Each day,
retina. When the premature baby is removed from thousands of c hildren and adults suffer from
supplemental oxygen, the retina senses the lower head injuries. TBI is the leading cause of vision
level of oxygen and sends signals called vasogenic impairment among c hildren over the age of 10
factors that stimulate the formation of new blood and young adults under the age of 40. The degree
vessels. Unfortunately, these new blood vessels of- of the visual impairment may vary significantly
ten leak, and the blood leaks into the vitreous. from one person to another, and it depends on
This causes scar tissue to attach to the retina and the severity and location of the injury. In cases
in the most severe cases may detach the retina, where the occipital lobe has been injured, the
causing total blindness. person may experience total blindness. However,
Ophthalmologists examine the eyes of prema- t here may be other cases in which the MRI does
ture infants while they are still in the hospital and not identify severe trauma or injury to the visual
pathway, occipital lobe of the brain, or other re- standing how to assemble puzzles, identifying the
gions of the visual system, and less severe symp- correct shoe for the correct foot, matching shapes,
toms may exist. Many p eople who have suffered drawing and printing, and solving problems that
from TBI will have excellent distance visual acu- involve visual processing. Many also have diffi-
ity but may experience headaches, eyestrain, and culty interpreting facial and body language. It is
difficulty reading because of poor eye movement very important for children with autism to have
skills, convergence insufficiency, reduced accom- their vision as well as their visual processing skills
modation, and reduced visual perception skills. evaluated. A thorough eye examination is required
Others may have visual field deficits that affect to identify the need for eyeglasses or treatments to
their mobility and daily life. help the child to use his or her central vision.
When children with an autism spectrum disorder
do not use central vision, they are not able to per-
V S ON PROBLEMS ASSOCIA ED
ceive small details and utilize the information for
WITH MEDICAL COND IO S problem solving. A complete visual perception
here are many medical conditions associated
T evaluation, performed by an optometrist or a
with vision problems that may affect the educa- school psychologist, is also recommended to iden-
tion of students as well as the ability to access tify which visual perception skills are strong or
work materials when seeking employment. The weak. This information w ill help teachers to make
following sections summarize some of the more appropriate accommodations.
common medical conditions with associated vi- Some of the behavioral symptoms of autism
sion problems. Chapter 7 in this volume provides are similar to the stereot ypical behaviors exhib-
additional information about many of the con- ited by some c hildren with visual impairments,
ditions discussed h
ere. so it is important to carefully assess children
who exhibit such behaviors to ascertain whether
they have an autism spectrum disorder, a visual
Autism Spectrum Disorder impairment, or both. Chapter 7 discusses this is-
Autism spectrum disorder is one of the fastest- sue, along with additional discussion of the diag-
growing causes of speech and social problems of nosis of autism spectrum disorder and the dual
c hildren. Approximately 1 in e very 68 c hildren diagnosis of autism and visual impairment.
has the diagnosis of autism spectrum disorder
(Wingate et al., 2014). C hildren with autism,
who are not visually impaired, often have ab-
Cerebral Palsy
normal visual processing skills (Viola & Maino, Cerebral palsy is a neurological condition that
2009). They often do not make eye contact with affects the motor skills of c hildren and adults,
people, they do not look at what they are reach- often due to prenatal or perinatal dysfunction or
ing for, their peripheral vision is often stronger trauma. Children with cerebral palsy often have
than their central vision, and they often stare at refractive errors and require glasses to improve
moving, rotating, and changing objects. The eyes their clarity of sight. They often require reading
of children with autism are generally healthy and eyeglasses or bifocals to compensate for their re-
without eye disease. However, their visual pro duced accommodative focusing skills. Their eye
cessing skills are often very different from t hose movements are often very poor and they may lose
of c hildren without autism. Some c hildren with their place when reading, or may have double vi-
autism have tremendous difficulty processing vision. Strabismus eye muscle surgery may be pre-
sual information. They have difficulty under- scribed to help students who have poor eye muscle
control. Many c hildren with cerebral palsy are also retinopathy. During proliferative diabetic retinopa-
diagnosed with cortical visual impairment. thy, abnormal blood vessels are produced and ret
inal hemorrhages may impede light from passing
through the vitreous humor to the retina. Scar tis-
Diabetic Retinopathy
sue may develop and pull on the retina, causing a
Diabetic retinopathy, although rarely seen in tear or detachment of the retina. P eople with
c hildren, is the leading cause of legal blindness diabetes must be alert for seeing flashes of light,
among Americans over the age of 45 (American black objects floating in their vision, or the appear-
Diabetes Association, 2013). Diabetes is a dis- ance of a scalloped curtain moving up or down.
order where the amount of sugar in the blood is These can all be signs of a retinal detachment.
too high. There are two forms of diabetes, Type 1 Glaucoma may also develop for those with prolif-
and Type 2. In Type 1, or juvenile, diabetes, the erative diabetic retinopathy when abnormal blood
pancreas does not produce sufficient insulin to vessels and scar tissue block the drainage of aque-
break down the blood sugar. In Type 2 diabetes, ous humor from the anterior chamber.
the receptor sites for insulin are not normal and There are many treatments available for dia-
the insulin produced cannot reduce the blood betes and diabetic retinopathy. First, p eople with
sugar. People who have diabetes for over 15 years diabetes must understand how to control their
often experience vision changes and damage to blood sugar by eating properly, exercising, and
the retina. In the earliest stages of diabetes, the monitoring their blood sugar daily. Regular eye
person does not experience blurred vision, examinations by a retinal specialist are also rec-
double vision, or sensitivity to glare b ecause the ommended to have the retinas examined. Fluores-
damage occurs in the peripheral regions of the cein angiography is a test that involves injecting a
retina. Small “dot and blot” hemorrhages are small amount of dye in the arm. Then, photo
present in the peripheral retina but the person graphs are taken of the retina to identify any
does not experience any symptoms. As the dis- hemorrhages that may require medical interven-
ease progresses, the hemorrhages become larger tion. Vitrectomy surgery may be performed to re-
and may affect the macula. When the macula is move regions of the vitreous hemorrhage that
affected, blurred vision, changes in color vi- have blood or scar tissue. Cataract surgery may
sion, blind spots in the central vision, and sensi- also be needed if a cataract develops. A fter t hese
tivity to light (photophobia) occur. medical treatments have been performed, optical
When people with diabetes eat or drink sug- or electronic low vision devices may be helpful to
ary substances, the crystalline lens becomes improve the level of vision for t hese individuals,
thicker, which affects the person’s vision. Many as well as instruction in daily living skills and ori-
people report that their reading sight becomes entation and mobility.
better after eating but their distance sight be-
comes very blurred. Conversely, upon waking in
the morning, their blood sugar is low and they
Down Syndrome
may report that their reading vision is extremely Down syndrome is a genetic condition that is often
poor. As a result, many p eople with diabetes associated with nystagmus, strabismus, cataracts,
have numerous pairs of eyeglasses but none of reduced clarity of sight, and the need for eye-
them works well for all purposes. glasses. Many children with Down syndrome
Diabetic retinopathy may worsen to a more have a wide bridge of the nose and their eyes
severe stage that is called proliferative diabetic often appear crossed. It is important to have the
eyes carefully examined by an eye care specialist • A history of anoxia, hypoxia, asphyxia, meco-
to precisely measure the alignment of the eye. For nium aspiration, or a respiratory problem
children with cataracts, the surgical removal of • Intraventricular hemorrhage, periventricular
the cataract and the prescription of bifocal eye- leucomalacia, seizure disorder, hydrocephalus,
glasses are required. Photochromic lenses that or trauma to the head (these conditions may
convert into sunglasses when exposed to bright indicate cortical vision impairment)
light may be helpful for c hildren with Down syn-
• A medical diagnosis of cerebral palsy, Down
drome because these lenses eliminate the need
syndrome, autism, hearing impairment, dia-
for the student to change eyeglasses when g oing
betes, hypertension, cerebral vascular accident,
from one level of illumination to another.
or another syndrome
Usher Syndrome • An uncontrollable shaking of the eyes from

side to side (nystagmus)
Usher syndrome is the leading cause of dual
• Reduced alignment of the eyes in which the
hearing and vision impairment (deafblindness).
eyes are crossed or turn outward
In it, retinitis pigmentosa is associated with
hearing loss. Usher syndrome is passed through • Covering or winking one eye when reading,
an autosomal recessive gene, and both parents watching telev ision, or looking at objects
must be carriers in order for their child to have a • Sensitivity to direct sunlight and a tendency
25 percent chance of having RP and hearing to wink one eye when outdoors in the sun-
impairment. In Usher syndrome 1, the child is light
born with hearing impairment, while in Usher • Squinting or opening eyes widely when read-
syndrome 2, the hearing impairment may de- ing or watching telev ision (may be indicative
velop at a later age. Usher syndrome is not as- of the need for eyeglasses)
sociated with cognitive problems. C hildren and
• Getting close to the telev ision or computer
adults with Usher syndrome may experience
screen, or holding reading material close to the
reduced balance because of the dual loss of vi-
eyes
sion and hearing input.
• Turning or tilting the head when looking at
an object or when reading (this may suggest
S GNS AND SYMPTOMS that the person has double vision and may
OF V S ON LOSS have blurrier vision in one eye than the other
eye)
It is very important for teachers, therapists, and
other professionals to be aware of the signs and • Frequently tripping, stumbling, or falling
symptoms that may be indicative of a vision • Poor at playing sports or catching a ball
problem. Children with any of t hese visual signs
• Pupils of both eyes are smaller than the dia
or symptoms should be referred to a pediatric
meter of a pencil eraser
ophthalmologist.
• Pupils not completely black, which may be in-
• Premature birth at less than 32 weeks or a birth dicative of a retinoblastoma tumor in the eye
weight of less than 1,000 grams (approximately or a cataract
2.2 pounds), presenting a greater risk of reti- • Losing place or skipping and omitting words
nopathy of prematurity when reading
• Difficulty copying from the board to paper • Schedule the appointment at a time of day when
• Rubbing eyes or eyes becoming red a fter read- the child is at his or her best. Do not schedule
ing and performing near work an appointment for a child during nap time.
• Deteriorating reading performance with time • Bring a snack and your child’s favorite toys
with you for the appointment. If your child has
• Headaches after performing reading and writ-
a favorite DVD movie, bring that as well.
ing or other close work
• Bring a friend or a relative with you to the ex-
• Difficulty assembling puzzles or when trying
amination and ask that person to use a tape
to copy an arts and crafts project
recorder to record what the eye care profes-
• Difficulty finding objects in a crowded back- sional says. You can then share this with other
ground or finding the desired figure in I Spy or family members who ask questions about the
Hidden Pictures books results of the examination.
• Difficulty reading facial expressions and body • If possible, do not bring siblings of the child
language to the examination, as they may be disruptive
• Difficulty understanding diagrams and illus- for the child or the parent.
trations in workbooks • Write down the questions you have before you
go to the appointment so you do not forget to
HE VISION EXAM NAT ON ask about specific concerns.
• Create a notebook with the pertinent medical
hildren and adults who need an eye exami-
C information. Include your insurance card,
nation w ill schedule their appointment with copies of reports from other doctors, and pre-
an ophthalmologist or optometrist. C hildren scriptions for eyeglasses, contact lenses, and
w ill benefit from being examined by a pediatric medic ations that you have been given. Take
ophthalmologist or an optometrist who works this notebook to e very appointment you have
frequently with c hildren. Both ophthalmolo- to share with the eye care professional.
gists and optometrists can evaluate the health
• Bring samples of the types of t hings your child

of the eye, diagnose ocular conditions, and pre-
must see for school.
scribe medi cations and vision correction (eye-
glasses or contact lenses). Ophthalmologists are • Measure the size of your computer screen and
medical doctors, however, and are trained to measure the distance your child sits from the
perform more extensive medical and surgical computer monitor.
eye care and provide treatment for eye conditions • Bring a copy of your child’s most recent Indi-
that may also involve other systemic conditions vidualized Education Program, functional vi-
(such as diabetes). To determine the best type sion assessment, and orientation and mobility
of medical appointment to seek for eye care, see assessment, if applicable.
Sidebar 3.2.
Case History
Preparing for the Examination
All examinations begin with a case history, in
The following suggestions can help parents to be which the nurse, technician, or eye care profes-
prepared for the vision examination and to make sional will ask questions regarding the reason for
it easier for the child. the examination. Questions about the child’s past
S I D E B A R 3 . 2
Eye Care Professionals
One of the most difficult challenges for adaptive computer technology to allow the
teachers and parents is to know what type of person to read, write, and perform daily
eye care specialist to schedule an appointment activities. They may also recommend
with. Within the field of pediatric vision care, techniques, strategies, or nonoptical
there are optometrists and ophthalmologists, devices related to lighting, problems
and t here are specialists who have expertise with glare, or other issues that may further
in different conditions. assist in using vision effectively. Low
vision optometrists and ophthalmologists
• Optometrists are eye care professionals often prescribe training exercises to
who are licensed to diagnose and treat teach the person how to make maximum
disorders of the visual system by using use of the healthiest areas of vision, and
eyeglasses, contact lenses, prisms, vision they also refer the patients to other
therapy, medications, and low vision specialists.
aids. Optometrists must earn a bachelor’s • Opticians are professionals who are
degree before entering optometry licensed by the state to fit and dispense
school. Some optometrists pursue a eyeglasses. Opticians are not doctors and
residency and a fellowship program are not licensed to examine the eyes or to
where they gain more experience in provide prescriptions for eyeglasses or
pediatric vision care, low vision contact lenses. Opticians are highly
rehabilitation, contact lenses, pathology, skilled in understanding the various
or vision therapy. frames and lens materials available for the
• Ophthalmologists are medical doctors who patient. Opticians are very important in
enroll in a residency program where they are identifying a frame that w ill comfortably
trained to diagnose eye diseases and to fit a child.
perform surgery. Some ophthalmologists • Low vision therapists are eye care
may complete a fellowship program where professionals who provide instruction

they specialize in specific areas, such as to people with low vision on how to use
pediatric ophthalmology, diseases of the various optical, nonoptical, and electronic
retina, or glaucoma. In many managed care devices. Many low vision therapists
systems, the patient w ill first be examined work with low vision optometrists
by the optometrist, who w ill refer him or and ophthalmologists at low vision
her to a specific ophthalmologist as rehabilitation centers. Low vision
needed. therapists are not physicians and are
• Low vision specialists (both optometrists not licensed to prescribe eyeglasses,
and ophthalmologists) work to improve the contact lenses, or medic ations, nor
vision of p eople when corrective lenses or are they allowed to perform surgery.
surgery cannot restore typical vision. They Many low vision therapists are able to
perform a clinical low vision evaluation to provide training to teach p eople with low
determine the best eyeglasses, filters, vision to perform daily activities indepen
prisms, magnifiers, telescopes, and dently.
101
medical and eye history will be asked, along with Figure 3.11 Snellen Acuity Chart
questions about family members. The child’s par-
ents or family members should be prepared to
provide a list of the medications taken by the child
and any known allergies. It is important for them
to make clear their goals for the examination, such
as, “What can you do to help my daughter see bet-
ter?” or “What is causing my child’s difficulty in
reading?”
Distance Visual Acuity

Distance visual acuity is routinely measured dur-
ing all eye examinations. The distance visual
acuity test, also known as the Snellen Acuity Test,
uses the Snellen eye chart (see Figure 3.11). The
Snellen chart consists of a white background with
bold, black letters of various sizes. At the top of
the chart is the largest letter, called the 400 Snel-
len letter. The 400 Snellen letter is 8 inches tall,
meaning that a fully sighted person could
identify a 400 size letter at 400 feet. The next-
smallest line contains the 200 Snellen letters,
which are 4 inches tall. The 100 Snellen letters
are 2 inches tall. There are smaller lines of letters
called the 70, 60, 50, 40, 30, 25, and 20 Snellen
letters (see Table 3.1 later in this chapter). The 50
Snellen letters are approximately 1 inch tall,

while the 20 Snellen letters are approximately 3/8
Bill Takeshita
inch tall. The test is performed from a distance
of 20 feet. The patient is asked to cover one eye
and read the smallest letters possible. The visual
acuity is then recorded in the form of a fraction
(although it is not a true fraction in the mathe-
matical sense) for each eye. The first number of
the fraction designates the distance between could read at 400 feet. If we then measure the vi-
the patient and the chart. The second number sion of the other eye and find that the person is
designates the smallest line that the patient was able to see the 50 Snellen line, the person’s vision
able to see. of this eye is recorded as 20/50.
For example, let us assume that the patient The Snellen Acuity Test is one procedure to
was tested from a distance of 20 feet and could determine the visual status of a person. A per-
only read the 400 Snellen line. The visual acuity son who has a visual acuity of 20/200 or worse
would be recorded as 20/400. That is, the person in the better eye while wearing glasses or con-
could read at 20 feet what a person with full sight tact lenses is classified as being legally blind. A
person with a corrected visual acuity in the bet- distance of 3 feet. If the patient is able to identify
ter eye that measures between 20/70 and 20/180 the number of fingers correctly, the eye care spe-
is classified as being partially sighted, a term cialist will record the visual acuity as CF@3 feet.
that is used by the Social Security Administra- If the other eye is only able to count fingers from
tion. T
hose with a best corrected visual acuity of a distance of 1 foot, the visual acuity is recorded
20/60 or 20/50 in the better eye are visually im- as CF@1 foot. In cases where a person is not able
paired. Lastly, t hose with a best corrected visual to identify the number of fingers presented at any
acuity of 20/40 or better are classified as fully distance, the specialist will wave his or her hand
sighted. It is very important to note that visual and ask the person if he or she can determine that
acuity is always tested with the best vision cor- the hands are moving or stationary. If a person is
rection using eyeglasses or contact lenses with only able to see the hands moving, the visual acu-
the better eye to determine visual status. T hose ity is recorded as “HM” for hand movements.
classified as being legally blind by an eye care In the event that the patient is not able to per-
specialist are eligible for government benefits and ceive whether the hands are moving, a penlight is
serv ices. used to determine if the patient is able to see the
Distance visual acuity may be tested using penlight. If the patient is able to see the penlight
other charts and techniques. Charts designed from a distance of 1 foot, the visual acuity is docu-
specifically for p eople with low vision are de- mented as “LP” for “light perception.” If the patient
scribed later, in the section on the Clinical Low does not see the light and is totally blind, the vi-
Vision Evaluation. There are visual acuity charts sion is recorded as “NLP” for “no light perception.”
that contain numbers or symbols rather than let- In very young children or c hildren with
ters to measure the vision of those who are not severe additional disabilities, forced preferential

able to identify letters, such as young c hildren or looking (FPL) may be used to get an estimate of
those with cognitive disabilities. Also, if a patient visual acuity. In using FPL, the child’s eyes are
cannot see the 20/200 line on the Snellen chart at drawn to look at material known to be visually
the prescribed distance (20 feet), he or she may be stimulating. Even c hildren without speech or the
moved closer to the chart. To calculate the acuity, ability to communicate in typical ways can be as-
the top number is simply changed to the distance sessed using FPL. One example of the FPL tech-
the patient is from the chart. For example, if the nique is Teller cards. These cards have a gray
patient can read the 20/200 line at 10 feet, the pa- background and have black-a nd-white stripes
tient’s acuity is 10/200 or 20/400. If the patient known as gratings on one end of the card, while
needs to be moved up even farther, to only 5 feet the other end is blank. These gratings have visual
away, the acuity would be 5/200 or 20/800. acuity equivalents. As the lines on the gratings get
In some cases, the notations of “counts fin thinner and closer together, they seem to fade
gers” (CF) or “hand movements” (HM) may be away and disappear, so the child can no longer
given on an eye report. T hese notations are used see them and loses interest. When the child no
for patients who are not able to read any letters on longer looks at the end of the card with the grat-
the Snellen eye chart regardless of the distance. In ings, the estimated threshold of visual acuity has
such cases, the eye care specialist may estimate been reached and can be recorded.
the distance at which the person is able to count
the number of fingers the specialist presents. For
example, if a person is not able to read any letters
Pupil Examination
on the chart, the eye care specialist may hold up Eye care professionals measure the function of
his or her fingers in front of the patient from a the pupils of the eyes before any eye drops are
instilled in the eyes. The pupil test provides in- Tonometry

sight into the neurological function of the vi-
sual system. During the pupil test, the eye care Tonometry is a test that measures the intraocular
professional flashes a small penlight toward pressure of the eye. As already noted in the dis-
each eye and observes whether the pupils are cussion of glaucoma, the eye contains aqueous
round and equal in size, and if they both con- fluid that is constantly being produced and
strict in response to the penlight. The pupils are drained, and in the event that the production of
then examined to determine that they constrict the aqueous is greater than the drainage of the
when the patient focuses on a near object. In aqueous, the intraocular pressure may increase
the event that the pupils do not constrict or are to a level that c auses damage to the nerve fibers
not equal in size, the eye care professional w ill that compose the optic nerve. Intraocular pres-
perform additional testing of the neurological sure is measured with a tool called a tonometer.
system. Pressure greater than 21 mm Hg is considered to
be above normal in persons with typical vision,
although pressures lower than 21 mm Hg may
Ophthalmoscopy be too high for some people and still cause dam-
Ophthalmoscopy is a test that allows the eye care age to the nerve fibers.
professional to inspect the internal structures of Eye care professionals may perform addi-
the eye. Ophthalmoscopy may be performed with tional tests, depending on the reason that the
or without the use of eye drops to dilate the pu- patient scheduled an appointment. The following
pils of the eyes. When the pupils are dilated with are some of the more common tests performed by
eye drops, the eye care professional w ill have a general optometrists and ophthalmologists.
larger opening to inspect the peripheral tissues
of the retina. Using the ophthalmoscope, he or Reading Visual Acuity
she inspects the margins of the optic nerve, the The near vision visual acuity chart consists of
blood vessels of the retina, and the various areas print of various sizes. The patient is asked to read
of the retina. Glaucoma, retinal hemorrhages,
the smallest print possible with each eye at a typ-

diabetic retinopathy, macular degeneration, and ical reading distance.
retinal detachments are identified through oph-
thalmoscopy.
Eye Movement Skills
Testing of eye movement skills provides addi-
Slit Lamp Biomicroscopy tional information regarding the status of the
A slit lamp biomicroscope is an instrument that eye muscles, the cranial nerves, and the various
allows the eye care professional to view various lobes of the brain. The first test is to determine if
tissues of the eye with high magnification to in- the person is able to keep the eyes fixated steadily
spect for diseases of the cornea, conjunctiva, an- on a particular target of regard, such as a penlight
terior chamber, crystalline lens, and the optic or a pencil, or if the eyes shake (nystagmus). The
nerve and retina. The slit lamp provides the po- next test is to evaluate smooth pursuits, in which
tential of greater magnification than an ophthal- the eyes must smoothly follow the target. Next,
moscope, and the eye care professional w ill use the eye care professional uses a finger and the
it to remove foreign objects from the eye as well penlight and tests the saccadic eye movements,
as to inspect the fit of a contact lens. when the eyes must shift from one object to
another. Poor eye movement skills may affect as it is brought closer to the patient’s eyes. The eye
the accuracy and speed of reading, and they can care professional measures how close the penlight
also affect sports performance. can be to the eyes when the patient is still able to
point both eyes toward it. The patient should be
able to cross or converge both eyes to look at the
Binocular Vision penlight within a distance of 3 inches or closer
The eye care professional also mea sures the from the eyes. Reduced convergence is often a ma-
ability of the person to use both eyes together. jor cause of reading problems.
Binocular vision problems may cause double
vision, reduced depth perception, headaches,
eyestrain, loss of place when reading, and blurred
Stereoscopic Depth Perception
vision. The eye care professional uses a tool Stereopsis requires the use of both eyes together,
called an occluder, a device similar to a spoon that and a person who is blind in one eye w ill not
covers one eye at a time. The patient is asked to have normal stereopsis. The test involves wearing
look at a specific object, and the eye care profes- polarized three-dimensional glasses and point-
sional alternately covers one eye and then the ing to the objects in a book that appear to be
other. The eye care professional looks for move- floating off the page.
ment of the eye that suggests that the eyes are not
pointing in the same direction. This test is called
the cover test and it identifies strabismus and other
Color Vision
eye coordination problems. A second test used to Color vision is tested using pseudoisochromatic
check binocular vision is called the near point of plates, which are pages with dots of various sizes
convergence test, in which the eye care professional and colors that have a number, symbol, or design
holds a penlight and asks the patient to look at it on the plate (see Figure 3.12). Patients are asked
Figure 3.12 Color Vision Test

Bill Takeshita
This plate has a red square (left) and a yellow circle (right) embedded in the green dot pattern.
to inform the eye care professional of what he or blind spot that is located approximately 15 de-
she sees on the plates, to determine if they are grees temporally of the straight-a head position,
able to perceive the colored image embedded in where the optic nerve exits the retina. People
the pattern. do not perceive their physiological blind spot
because the position of the blind spot is differ
ent for each eye and when a person uses both
Refraction eyes, each eye compensates for the other eye.
The refraction test measures whether the patient’s The physiological blind spot exists b ecause t here
eyes are hyperopic, myopic, or astigmatic. T here are no rod or cone cells at the location of the
are two different portions of the test. The objec- optic nerve.
tive refraction involves the eye care professional us- Peripheral vision testing is done through con-
ing a retinoscope to shine a light into the eyes of frontation visual field testing or perimetry. Con-
the patient. The eye care professional is able to see frontation visual field testing is a gross measurement
the light reflect off the retina and determine the of peripheral field function, and is done with a
patient’s approximate prescription by placing two-person team. One person holds an object
lenses in front of the eye until the reflection of the in front of the patient to visually fixate on. The
light is focused sharply on the macula. The ob- second person brings a wand or other stimulus
jective refraction allows the eye care professional slowly around from behind the patient. When the
to determine the prescription of patients who are wand or stimulus enters the patient’s peripheral
not able to speak or communicate. field, the patient w ill either verbally or visually
The subjective refraction is the second part of attend to the stimulus entering the peripheral
the refraction in which the eye care professional field. This sequence is performed in all four quad-
places differe nt lenses in front of the patient’s rants of the patient’s visual field. This test is of-
eyes and asks the patient which lens he or she pre- ten used to determine if t here might be a need for
fers. The subjective portion of the test allows the more extensive peripheral field testing.
patient to choose if he or she prefers the image Automated perimetry can be performed us-
to appear softer or bolder. The refraction test is ing a computerized perimeter. To use this in-
performed to determine the best eyeglasses or strument, the patient places his or her head in
contact lens prescription to allow the patient to a dome and fixates on a spot in the center of
see clearly when looking at distance and near ob- the field. Small lights flash in the peripheral
jects. For p eople who work on the computer, re- and central fields of vision. The patient is asked
fraction should be performed for the distance of to press a button on a hand-held controller each
the computer screen. time he or she perceives the small light. The
test is performed for each eye. The pattern and
location of the visual field scotoma provide di-
Peripheral Vision Testing agnostic information for the eye care profes-
Peripheral vision testing is performed to identify sional to determine where the pathology may
problems with the retina, the optic nerve, or the exist.
visual pathway. Blind spots may be located in any Visual field abnormalities that only affect one
region of the field of vision and are called scoto- eye suggest that the pathology is in the affected
mas. A scotoma in the central visual field affects eye or anterior to the optic chiasm. Visual field
the ability to identify objects, faces, and words, abnormalities that exist in both eyes and are
while scotomas in the peripheral vision affect congruous suggest that the pathology is in the
mobility. Each eye has a normal physiological brain.
visual impairments, occupational therapists, so-

CLIN CA OW VIS ON cial workers, and assistive technology specialists.
EVA UATION Together, the team provides the evaluation and
instruction to allow the person with low vision to
The clinical low vision evaluation is a very spe- perform daily activities independently.
cialized type of examination that utilizes special The clinical low vision evaluation includes
techniques and instrumentation to measure and the tests carried out during a general vision exam,
enhance the vision of persons with low vision as described in the previous section, as well as
(Corn & Erin, 2010). Clinical low vision evalua- many others. Although the tests may appear to
tions are performed by ophthalmologists or op- be similar, the equipment and testing procedures
tometrists who have specialized training in low used for a patient with low vision are specialized
vision. The clinical low vision evaluation gener- to help the eye care professional to know how to
ally takes one to two hours to perform. The pur- prescribe optical, nonoptical, and electronic de-
pose of the evaluation is to measure the strengths vices to enhance the patient’s functional use of vi-
and weaknesses of the individual’s functional use sion. The following are some of the specialized
of vision and to then use optical devices, nonopti- tests used during the low vision examination.
cal devices, and assistive technology to enhance
that functional vision. Many eye care profession-
als who specialize in low vision work on a multi-
Feinbloom Visual Acuity Chart
or interdisciplinary team that may include low The Feinbloom Visual Acuity Chart is designed to
vision therapists, psychologists, orientation and measure the distance acuity of people with low vi-
mobility specialists, teachers of students with sion (see Figure 3.13). It consists of numbers rather
Figure 3.13 Comparison of the Feinbloom and the Snellen Acuity Charts

Bill Takeshita
TA B L E 3 .1 various distances. Thus, if a person is not able to

see a number from 20 feet, the eye care profes-
Approximate Sizes of Letters sional may bring the chart close to the patient
and Numbers on Feinbloom and measure his or her acuity from a distance of
and Snellen Visual Acuity 10 feet or closer. When documenting a patient’s
Charts visual acuity with the Feinbloom chart, the visual
acuity is written as a fraction (just as with the
Feinbloom Snellen Size in
Snellen chart), with the first number being the
Chart Chart Inches
distance between the patient and the chart in feet
700 n/a 14.0 and the second number being the physical size of
600 n/a 12.0 the number. For example, if a student is only able
400 400 8.0 to read the 600-size number from a distance of
350 n/a 7.0 10 feet, the visual acuity is documented as 10/600.
300 n/a 6.0 This suggests that the person is able to identify a
240 n/a 4.8 12-inch letter from 10 feet. This information w ill
200 200 4.0 provide his or her teachers with information re-
160 n/a 3.2 garding how close the student should be from the
140 n/a 2.8 board and how large the print should be pre-
sented on the dry-erase board.
120 n/a 2.4
100 100 2.0
80 80 1.6 Contrast Sensitivity
70 70 1.4 Contrast vision is a very important visual skill that
60 60 1.2 must be tested in patients with low vision. Contrast
50 50 1.0 sensitivity is a measurement that identifies the abil-
40 40 0.8 ity to perceive various shades of gray. As noted ear-
30 30 0.75 lier, an example of reduced contrast is words printed
25 25 0.5 with a pencil on recycled paper. The print is not

20 20 0.375 completely black, and the paper is not completely
n/a = not applicable
white. People with reduced contrast sensitivity
may have difficulty seeing steps and curbs when
walking.
There are various tests and instruments to
than letters, and there is a wider range of sizes measure contrast sensitivity. The tests generally
than is available on the Snellen chart. (Table 3.1 involve asking the patient if he or she is able to
compares the letter sizes available on each chart.) see large-print letters that are printed in various
This provides a more accurate and sensitive mea shades of contrast. In other tests, the patient may
surement of the patient’s visual acuity. be presented with sinusoidal gratings (patterns of
The Feinbloom Visual Acuity Chart is pro- alternating white and dark stripes) of various
vided as a tablet, similar to a legal-size notepad. widths, or spatial frequencies, and each test plate
This makes it easy to use when performing exam- will have a lower level of contrast (see Figure 3.14).
inations at sites outside the clinical or hospital The determination of low contrast sensitivity for
setting. The Feinbloom chart can also be used at specific spatial frequencies enables the eye care
Figure 3.14 Vision Contrast Test System Using Sinusoidal Gratings
Bill Takeshita
professional to identify which structure of the eye use of lenses and electronic enhancement. Non-
is causing the reduced contrast vision. Specialized optical devices do not use lenses to improve vision,
filters and tints can help p eople with reduced but may modify the environment or the task to
contrast vision to see low-contrast objects more make it easier to see; examples are high-intensity
easily. lamps, bold-line markers, and colored filters.
LOW V S ON DEV CES Optical Devices

Low vision devices are extremely helpful for
Magnifiers
c hildren and adults with low vision. The recent
advancements in optics and electronic technol- Magnifiers enlarge the objects or material in the
ogy have produced more visual aids to allow visual field. They come in a variety of types, a few
people with low vision to perform activities of which are described h ere (see Figure 3.15).
independently. Low vision devices are usually Magnifiers are now available with light-emitting
classified as optical, nonoptical, or electronic diode (LED) illumination to provide a bright light
devices. Optical devices use lenses or prisms to to enhance readability. The LED lights built into
compensate for an optical defect (such as near- the magnifiers provide a higher level of illumina-
sightedness) and are used to change the shape or tion to increase the contrast between the print
location of an image on the retina, for example, and the paper. The LED lights are also available
through magnification. Electronic devices, which in various colors to provide added visual comfort
are sometimes considered to be optical devices as for people who have problems with glare and
well, magnify the size of an image through the color vision deficiencies.
Figure 3.15 Various Types of Magnifiers prescribed for students and people who have spe-
cific visual requirements at work. A bifocal lens is
one in which the lens has two different powers to
focus at two distinct distances. A bifocal lens may
be focused such that one portion of the lens is
focused at the distance of a computer screen and
the other portion is set to allow the person to read
very small print. High-powered reading glasses may
also be prescribed to allow a person to read a book
or other documents comfortably without having
to hold on to a magnifier.
Telescopes
A telescope is a device that consists of two or more
lenses that are enclosed in a cylindrical tube
(see Figure 3.16). Telescopes magnify the size of
the image on the retina to allow the person to
see more clearly. Many of us think of the tele-
scopes used to look at the stars, but in the field
of low vision, eye care professionals use minia-
ture telescopes to bring information closer to a
Kelly Lusk
person with low vision.

A telescopic refraction allows the eye care pro-
fessional to refine the eyeglasses prescription to
obtain the highest level of sight. Telemicroscopes
are eyeglasses that use a small telescope to allow
Spectacle-mounted magnifiers (also called mi-
croscopes) are custom devices prescribed by low

vision specialists. Eye care professionals are
able to prescribe high levels of magnification in Figure 3.16 Various Types of Telescopes
the form of eyeglasses to allow the person to have
both hands available to use while reading or
working. Spectacle-mounted magnifiers can be
made to incorporate the patient’s myopic, hyper-
opic, and astigmatic prescriptions. Many times
the eye care professional w ill incorporate a high-
contrast tint to enhance the visibility of text.
These glasses are extremely helpful for students
and adults who perform extensive reading, writ-
ing, and work on the computer. They are also very
helpful for people who work on arts and c rafts.
Kelly Lusk
High-addition bifocal eyeglasses and high-

powered reading glasses are also very frequently
a person to see near or intermediate objects more Figure 3.17 Electronic Video Magnifier
clearly. T
hese types of eyeglasses are often used
by surgeons and dentists.
Bioptic telescopic lens systems are prescribed to
improve the distance vision of people with low vi-
sion. They may appear similar to a typical pair of
eyeglasses and can be placed in a designer frame.
High-index lens materials now allow power ful
prescriptions to be made very thin, thus increas-
ing the cosmetic appearance of the glasses. Tints
and prisms can also be prescribed in the eye-
glasses to eliminate double vision, improve the
ability to see objects of low contrast, and reduce
glare. Small telescopes may also be fit in the eye-
glasses to provide higher levels of magnification.
In many states, bioptic telescopes can be used
to allow one to meet the vision requirements for
driving a car. Students greatly benefit from using
bioptic telescopes to enable them to read text on
the board or in PowerPoint presentat ions.
Prism Eyeglasses
Kelly Lusk
Prism eyeglasses are another very beneficial low vi-
sion aid. A prism is a lens that w
ill bend light to
deflect in one direction. Prism eyeglasses are ex-
tremely helpful in eliminating double vision
higher level of magnification with better contrast
caused by strabismus or the abnormal function

than can be achieved with optical magnifiers and
of cranial nerves. Fresnel prisms are prescribed to
telescopes. For example, a high-power magnifying
help people who have reduced peripheral vision
lens may provide up to 14× magnification, while a
or hemianopsia to perceive objects in their blind
video magnifier can produce up to 100× magnifi-
field.
cation. Video magnifiers also have the ability to
increase the contrast to a level that is higher than
Electronic Magnification the original print. This is very helpful for p eople
when reading old newspapers and books. Another
Assistive technology and electronic magnifica-
very important feature of video magnifiers is that
tion can be extremely helpful tools for p
eople
the reader can customize the colors of the back-
with low vision.
ground and text. For example, many people with
low vision are able to read much more comfort-
Video Magnifiers
ably when reading yellow letters on a black back-
One advantage of electronic video magnification ground. In addition to large desktop models, t here
is that the technology, as employed in video mag- are portable video magnifiers, some of which are
nifiers (see Figure 3.17), can produce a much small enough to be slipped into a pocket or purse.
Computer Software to have a digital copy of the book. OCR software

programs are available for Windows and Mac op-
In addition to the demonstration of video mag- erating systems.
nifiers, the low vision specialist or assistive tech-
nology specialist w ill demonstrate specialized Nonoptical Devices: Tinted
computer software that can magnify the text Lenses and Filters
on the computer screen, software that will read the
text aloud, and many other pieces of assistive Examples of nonoptical devices that can greatly
technology for both near and distance viewing. improve the functional vision of people with low
Computer magnification software programs vision are tinted lenses and filters of various col-
are very helpful for people who use the computer. ors. Many people with low vision are photophobic,
These software programs are available for use on or highly sensitive to light, and require tinted
both Windows and Mac operating systems. They lenses to reduce the amount of light that enters
allow the user to quickly increase the magnifica- their eyes. Gray lenses are the most commonly
tion of the image on the screen, change the col- used lens by the general public, but for many with
ors of the background and text, and enhance the low vision, gray lenses are too dark. The low vi-
visibility of the mouse pointer and cursor, and sion specialist w
ill evaluate the benefits of vari
many have the ability to read the text aloud. Some ous colored lenses and filters to reduce eye
computer magnification software programs have discomfort from glare, and to improve the abil-
dual monitor functions that allow the user to have ity to see objects of low contrast. Yellow, amber,
one program on one monitor and a different pro- brown, and even red lenses may be helpful for
gram on the second monitor. T hese dual monitor patients with low vision.
systems can greatly assist those who perform
data entry on the computer. SUMMARY
Optical character recognition (OCR) scan-
ning software programs are very powerf ul tools In conclusion, the eye and the brain cooperate to
for people with low vision that can convert an im- form the very complex visual system. Problems
age of text into computer-readable print charac- anywhere in the eye, in the brain, or along the
ters that can be edited, searched, and read aloud visual pathway can cause problems with vision.
by screen readers. OCR systems use a camera that However, t here are many medical, surgical, and
can capture an image of a page and begin to pro functional techniques and products that may be
cess the document in a manner of three seconds able to treat visual impairments and other vision
or less. The data can be displayed in large print problems, or allow a person to use vision more
on the computer monitor in the desired back- functionally in educational, social, and career set-
ground and text colors of the user. The programs tings. There are also a wide variety of profession-
also have excellent speech output that w ill read als who assist in diagnosing, treating, instructing,
the text aloud. Users may type and take notes on educating, or otherwise taking an active role in
the documents that they have read and later re- providing eye care for c hildren, youths, and adults
view the areas they have highlighted. Some OCR with visual impairments.
software programs are capable of scanning an
entire book by simply turning the page of each For learning activities related to this
book to activate the camera to scan the page. This chapter, log in to the online AFB Learning
is a tremendous time saver for people who want Center.
Hubel, D. (1988). Eye, brain, and vision. New York: Sci-

REFERENCES entific American Library.
Kaiser, P. K., Friedman, N. J., & Pineda, R. (2014). The
Allingham, R. R., Damji, K. F., Freedman, S., Moroi, Massachusetts Eye and Ear Infirmary illustrated man-
S. E., & Rhee, D. J. (2011). Shields textbook of glau- ual of ophthalmology (4th ed.). London: Elsevier
coma (6th ed.). Philadelphia: Lippincott Williams Saunders.
& Wilkins. Kanski, J., & Bowling, B. (2011). Clinical ophthal
American Association for Pediatric Ophthalmology mology: A systematic approach (7th ed.). London:
and Strabismus. (n.d.). Vision therapy. San Fran- Butterworth-Heinemann.
cisco: Author. Retrieved from http://w ww.aapos Lueck, A. H., & Dutton, G. N. (Eds.). (2015). Vision and
.org/terms/conditions/108 the brain: Understanding cerebral visual impairment in
American Diabetes Association. (2013). Clinical prac- children. New York: AFB Press.
tice recommendations 2013: Standards of medical Mohney, B. G., Greenberg, A. E., & Diehl, N. N. (2007).
care in diabetes. Diabetes Care (Supplement 1), S5. Age at strabismus diagnosis in an incidence
Colvard, D. M. (Ed.). (2009). Achieving excellence in cat- cohort of c hildren. American Journal of Ophthal-
aract surgery: A step-by-step approach. Encino, CA: mology, 144, 467–469.
Author. Roman-L antzy, C. (2007). Cortical visual impairment:
Corn, A. L., & Erin, J. N. (Eds.). (2010). Foundations of An approach to assessment and intervention. New
low vision: Clinical and functional perspectives (2nd York: AFB Press.
ed.). New York: AFB Press. Schwartz, T. L. (2010). C auses of visual impairment.
Crick, R. P., & Khaw, P. T. (2003). A textbook of clinical In A. L. Corn & J. N. Erin (Eds.), Foundations of low
ophthalmology: A practical guide to disorders of the vision: Clinical and functional perspectives (2nd ed.).
eyes and their management (3rd ed.). Singapore: New York: AFB Press.
World Scientific. Viola, S. D., & Maino, D. M. (2009). Brain anatomy,
Fischer, B., & Hartnegg, K. (2008). Saccade control in electrophysiology and visual function/percep-
dyslexics. Optometry and Vision Development, 39(4), tion in c hildren within the autism spectrum
181–190. disorder. Optometry and Vision Development, 40(3),
Hartong, D. T., Berson, E. L., & Dryja, T. P. (2006). Ret- 157–163.
initis pigmentosa. Lancet, 368, 1795–1809. Wingate, M., Kirby, R. S., Pettygrove, S., Cunniff, C.,
Hoyt, C. (2007). Brain injury and the eye. Eye, 21, Schulz, E., Ghosh, T., & Yeargin- A llsopp, M.
1261–1263. (2014). Prevalence of autism spectrum disorder
Hoyt, W. F., Miller, N. R., & Walsh, F. B. (2008). Walsh among c hildren aged 8 years—autism and devel-
and Hoyt’s clinical neuro-ophthalmology: The essen- opmental disabilities monitoring network, 11
tials (2nd ed.). Philadelphia: Lippincott Williams sites, United States, 2010. MMWR Surveillance
& Wilkins. Summaries, 63(2), 1–21.
4
C H A P T E R
Growth and Development

of Young Children
Kay Alicyn Ferrell and
Catherine A. Smyth
To hear an audio introduction playgroups and inclusive preschools as any

to this chapter by an author, other child.
and to view a chapter overview
presentation, log in to the AFB Learning Center. INTRODUCT ON
All c hildren are unique, and c hildren with visual
KEY POIN S impairments are no different in their uniqueness,
including the need for loving home environments
♦ Early intervention services are critical for all that are both stimulating and supportive. Regard-
children with disabilities; for infants with a vi- less of how vision loss affects growth and devel-
sual impairment, services should begin as soon opment, c hildren who are visually impaired still
after diagnosis as possible. grow and learn. However, perhaps more than any
♦ There is tremendous variability in development other disability, visual impairment has the poten-
among children who are blind or have low vi- tial to influence how c hildren develop. Whether
sion, and developmental outcome depends on it does and how much it does depends on par-
a number of f actors. ents’ and teachers’ knowledge and understand-
ing of the potential impact of the disability and
♦ Practitioners apply a combination of child de-
the ability of professionals to support families in
velopment theories to best serve the c hildren
their daily routines.
and families they work with.
This chapter focuses on c hildren from birth
♦ Additional disability appears to have a greater to age 5. The following terms are commonly used
impact on development than does visual func- to describe children in this age range: infant, from
tion. birth to walking; toddler, from walking to 35
♦
Children with visual impairments have the months; and preschooler, from 36 months to 5 or
same right to participate in community-based 6 years, depending on each state’s mandatory
114
Growth and Development of Young Children 115
school age. Thus, the term early childhood is used intervention services. A continuum of early child-
in this chapter to refer to the c hildren with visual hood education settings continues to be avail-
impairments from birth to school age. able to families, depending on their geog raphical
location.
The 1986 amendments to the Education of
HISTORY O EARLY the Handicapped Act of 1970 mandated early
EDUCATION OR CHILDREN education serv ices to c hildren with disabilities
W H VISUAL IMPAIRMEN S from birth to age 8 and required states to develop
a comprehensive system of infant and toddler
The field of visual impairment has an impressive services for children from birth to age 3. Although
record in early education, beginning in the late the infant and toddler program was not manda-
1800s with homes for “neglected” c hildren. Ne- tory, every state participated by setting up its own
glect was determined simply on the basis of a system of early intervention services (Trohanis,
child’s visual impairment. It was assumed at that 2008). This national acceptance of early education
time that parents were incapable of providing an for children with disabilities and the paradigm
adequate home environment, and that babies shift toward the family created by the legislation
who were blind would develop much better in have affected the way in which early education
residential programs with trained staff (Koestler, services are delivered today. Supported by early
1976/2004). These programs existed u ntil the childhood special education program efficacy
late 1930s, when the Arthur Sunshine Home and data and improved understanding of neurologi-
Kindergarten for Blind Babies in Summit, New cal growth, a substantial body of evidence con-
Jersey, closed its residential program. The Arthur firms the benefit of early childhood education
Sunshine Home continued its home counseling services for all children (Dunst & Trivette, 2009;
and training functions and established a standard Dunst, Trivette, Hamby, & Bruder, 2006; National
of serv ice to c hildren who w ere blind and their Scientific Council on the Developing Child, 2007;
families that endured for many years. Shonkoff, 2012).
In the 1950s, families began to search for as- In the United States today, the reauthorized
sistance through home-based serv ices when the Individuals with Disabilities Education Act
number of c hildren who were blind from birth (IDEA, 2004) supports early intervention vision
increased dramatically as a result of retrolental fi- serv ices u nder Part C, and mandates preschool
broplasia (Silverman, 1980) (now called retinop- serv ices for 3-to 5-year-olds under Part B § 619.
athy of prematurity [ROP]). (See Chapter 1 in this All 50 states participate in this mandate and
volume for a discussion about the impact of ROP support a coordination of existing resources for
on this history of provision of services to c hildren families of infants and toddlers with disabilities.
who are visually impaired.) Consequently, home IDEA (2004) acknowledges that sensory impair-
counseling services were established that pro- ments are likely to have substantial effects on
vided support to parents in raising their c hildren early development, to the point that the diagno-
who w ere blind. T hese serv ices were an early sis of visual impairment alone often determines
version of the family-centered early interven- “categorical” eligibility for serv ices in the Part C
tion model recognized as best practice (Dunst system, with or without evidence of develop-
& Trivette, 2009). T oday, many of t hese serv ices mental delay. Although IDEA states that visual
are still provided through specialized private impairment means “an impairment in vision that,
organi zations or through federally funded early even with correction, adversely affects a child’s
educational performance” (34 C.F.R. § 300.8[c] education and the child study movement in psy
[13]), eligibility for preschool and school-age ser chology (Brehony, 2009).
vices is often determined by visual acuity and Early education was greatly influenced by the
field loss criteria established at the state level, as American experience, democ ratic ideals, and the
well as a clear understanding of how the learning perspective of schools as places to socialize a di-
process will be affected for an individual child. verse citizenry. As the population of the United
States grew, particularly through European immi-
gration, child-rearing practices— dependent as
FOU DA IONS OF EARLY
they were on cultural values, traditions, and
CHILDHOOD EDUCAT ON customs—became increasingly diverse. Theories
Early education is rooted in the European child- of childhood development have evolved, and re-
rearing practices dating back to the early 1800s search practices have demonstrated the impor-
(Lascarides & Hinitz, 2013). It was initially the tance of early social- emotional experiences
privilege of the children of wealthy parents. Froe- (Guralnick, 2010) and the promotion of founda-
bel’s kindergarten, however, began to change the tional learning skills, changing the way society
prevailing notion that young c hildren were sim- provides education for young c hildren.
ply biding time by demonstrating that they could
rapidly acquire skills if they w ere taught using THEORIES OF CHI D
materials that took advantage of their natural ten- DEVE OPMEN
dency to play (Froebel, 1887, 1895). According to
Lascarides and Hinitz (2013), Froebel’s theories Several theories of how c hildren grow and de-
were readily accepted in the United States, but velop have evolved from the child study move-
were adapted to meet the political, religious, ment in psy c hol
o gy. Like other aspects of
socioeconomic, intellectual, and cultural ideas of education, although t here may be agreement
the times. Simultaneously, education, in general, about research findings, t here is much less agree-
was abandoning metaphysical and classical stud- ment about the meaning and explanations of the
ies in favor of more scientifically based work, re- findings. As a result, it is appropriate that most
flected notably by the progressive movement in early education programs incorporate a variety of
theories into their philosophies and curricula.
The child development theories that are most fre-
quently used to support the practice of early
education include behavioral theory, cognitive
learning theory, nativist theory of mind, and cog-
nitive information processing theory (Goswami,
2011). (See Chapter 11 in this volume for a more
detailed discussion of some of these models from
the point of view of general education.)
Maria Ferrari
Behavioral Theory
Behavioral theory is best represented by the work
of Skinner (1968). It postulates that learning
Interacting with objects with the support of an adult is occurs in response to the environment; conse-
one way children learn. quently, by creating the right environment,
children’s behavior can be “shaped.” Skinner the objects they touch, smell, hear, and see, they
believed that children are born with a basic adapt their interactions (using their hands in dif
repertoire of responses and that they develop ferent ways) and organize what they know (cat-
new responses when the environment forces egorizing items in different situations) to develop
them to move outside this basic repertoire. Be- represent at ional understanding (Quinn, 2003).
havioral theory has been widely used in special The continued use of the senses leads to under-
education, but strict adherence to its principles standing concepts throughout the first years of
often results in programs that are rigid and in- life. An example of Piaget’s cognitive learning
flexible (Ledoux, 2012). Many professionals in- theory for a young child with a visual impairment
corporate elements of behavioral theory, such would be to have a “discovery” bowl that con-
as reinforcement, shaping, modeling, imitation, tains many small objects with different textures
and extinction, as a strategy to assist families in for the child to explore (Dunst & Gorman, 2011).
their daily routines. An example of using behav- Over time, the child would recognize objects by
ioral theory would include an applied behavioral their texture and build a representational con-
analysis (ABA) approach to encourage a child to nection of that texture to that object. These early
eat a greater variety of foods or to learn a particu tactile experiences support the complex under-
lar routine such as tooth brushing. The routine standing of braille symbols as c hildren mature.
would be broken down into small tasks, and Vygotsky (1986) also subscribed to cognitive
each task would be taught in order of occurrence learning theory, but emphasized the social role
and learned as a sequence. The consistent nature of the adult as the child’s teacher. Instruction pre-
of ABA strategies is often successful with young cedes development, as the teacher sees the po-
c hildren with visual impairments because it pro- tential for learning and creates new experiences
vides an environment that can be anticipated, for the child to acquire knowledge (Daniels,
and interactions are predictable. ABA is a com- 2011). The interaction between the teacher and
mon instructional strategy used by professionals the child, in which the adult guides the child
with a medical background or working with from his or her current level of knowledge to the
children on the autism spectrum (Ledoux, 2012). next level, is known as the zone of proximal devel-
(For additional information on behavioral the- opment. An application of Vygotsky’s cognitive

ory, see the section on Theories Based on Behav- learning theory for a young child with a visual
ioral Psychology in Chapter 11 of this volume.) impairment would be a small group of c hildren
with an adult participating in a tea party. The
adult would share verbal information about what
Cognitive Learning Theory usually happens at a tea party and would dem-
Cognitive learning theory (also known as the onstrate behavior and orientation skills while the
cognitive-developmental model, described in Chap- c hildren ask questions and share their ideas. The
ter 5 of this volume) holds that development oc- c hildren would have used language to learn a so-
curs through a combination of forces: biological cial protocol, and the teacher would have learned
maturation, physical experiences, and social in- what the c hildren know about manners, behav
teraction. For very young c hildren, Piaget (1972) ior, and sitting in a chair drinking tea.
believed that interactions with objects w ere the Dewey (1933) wrote that the interaction of
primary learning mode for understanding the work and play is the legitimate realm of educa-
world (Miller, 2011). Using vision, exploratory action. Play is both a condition of learning and an
tivity is oriented toward cognitive interest (Hat- activity that is worthwhile for its own sake. For
well, 2003). As infants and toddlers learn about c hildren older than 3 years, sociodramatic play
is particularly useful in helping them understand sory experiences in a child’s home or classroom.
others’ points of view. Bodrova (2008) believes Learning about how water, sand, or whipped
that “play is an important mechanism and source cream feels and responds differently when
of development of higher mental functions” touched is an opportunity to adapt and manipu-
(p. 361) necessary for academic learning. The Na- late new textures. The water can be poured, as can
tional Association for the Education of Young the sand, but the whipped cream must be moved
Children (NAEYC) emphasizes that play is one as- in different ways with the hands.
pect of developmentally appropriate practice The nativist theory of mind (Wellman, 2011)
(NAEYC, 2009). Early education continues to use has become a very popular method of under-
play as a basis for learning, building on the social standing how young c hildren learn as child de-
constructivist cognitive learning theories of Vy- velopment looks more closely at social-emotional
gotsky and Dewey and providing a stage to engage growth. The hypothesis that c hildren undergo a
in theory of mind activities. major conceptual change in how they interpret
others’ thinking, feelings, desires, and beliefs at
a very young age has been well established (Melt-
Nativist Theory of Mind zoff, 2011; Wellman, Cross, & Watson, 2001) in
In contrast, by focusing on the belief that concept research. How young c hildren with visual im-
understanding is innate, some researchers (Carey, pairments achieve an understanding of repre
2009; Gibson & Walker, 1984; Streri, 2003) sup- sentat ional salient m
ental states of o
thers is less
port the theory of evolutional acquisition, or understood, but evidence of young c hildren ac-
nativism. Gibson and Walker (1984) challenged quiring a more sophisticated understanding of
the maturational process by arguing that tac- theory-of-mind tasks through language is avail-
tile discrimination of objects does not happen able (Dunn, Brown, Slomkowski, Tesla, & Young-
because of the environment or the individual, but blade, 1991). Therefore, it is crucial that families of
occurs because of the interaction of both. Infor- infants and toddlers with visual impairments
mation is not out t here in the environment wait- identify and discuss the emotions and m ental
ing to be found. Instead, it is a learning process processes of other adults and peers from a very
that emerges as a child actively engages with his early age. An example of applying a theory-of-
or her surroundings. A nativist learning theory mind perspective is to encourage families to use
assumes that sensory and conceptual representa feeling words in their interactions with children,
tions are present at birth, and that as the child for example, “You must be angry; you are stomp-
experiences mental representations through ma- ing your feet and using a loud voice,” and to facili-
nipulation and language he or she develops un- tate an understanding of thought pro cesses
derstanding (Carey, 2009). Very young infants of through statements like, “Your friend is happy
3 to 5 months have been shown to differentiate that you want to sit by him! He is smiling!”
between textures and contours through active
mouthing and limited hand explorations (Gibson Cognitive Information
& Walker, 1984). A tactilely diverse environment
for learning results in increased adaptations and
Processing Theory
interactions by the young child, guided first by In recent years, cognitive information processing the-
perceptual experiences and progressing to execu- ory has explored the perspective of neuroscience
tive exploratory procedures. An example of this and how the physical development of the brain
learning theory in action for a young child with a affects learning. Using advanced imaging tech-
visual impairment would include a variety of sen- niques and breaking down learning into mem-
ory and processing tasks, evidence has shown ities, but theories themselves do not provide the
that the ongoing development of the brain corre- rationale for creating the ser v ices in the first
lates with improvement of understanding (Gentaz place. That impetus came from a series of stud-
& Badan, 2003; Gentaz & Rossetti, 1999; Halford ies conducted since the 1930s and from the fed-
& Andrew, 2011). This theory includes the acquisi- eral government’s increasing investment in the
tion of knowledge through the learning of salient future of c hildren with and without disabilities.
(unique) features of objects and the consistent Ongoing research continues to support the prem-
relationships that are experienced through short- ise that a connected, supportive medical and edu-
term memory. As c hildren move information cational environment helps build the capacity of
from short-term memory to more efficient work- families to assist their child with exceptionalities
ing memory, they are able to “encode” experiences (Bruder, 2010; Dunst & Trivette, 2009; Ferrell,
and additional skills. An example of using infor- 2011; Guralnick, 2010).
mation pro cessing theory with young children
with visual impairments would be in the learning
of braille symbols. Research shows that texture
Effectiveness of Early Education
is interesting to very young children and be- The first studies that are generally cited as pro-
comes more finely discriminated as they grow viding the basis for early education examined
older (Schellingerhout, Smitsman, & Cox, 2005). the effects of institutionalization on the cogni-
Children learn the feel of each letter representa tive and social-emotional development of in-
tion through the salient feature (dot patterns) fants. These studies included landmark research by
of the different braille cells, and move additional Skeels and Dye (1939), Spitz (1945), and Provence
symbols into working memory. Once the symbols and Lipton (1962). All these studies demonstrated
are learned, combinations are “chunked” so the that intelligence, previously thought to be fixed
reading process can begin. (For a deeper dis- and immutable (Gesell, 1925, 1940), was, in fact,
cussion of this topic, see the section on the malleable u nder a program of stimulation and
Information-P rocessing Model of Learning in enhanced experience. Skeels (1966) followed
Chapter 11 of this volume.) the babies in his original study u ntil adulthood
As the understanding of how young c hildren and found that the effects of the early stimula-
learn changes over time, t here are situations in tion persisted. Once Hunt (1961) and Bloom
which all the previously mentioned theories of (1964) published their research, the child de-
development appear to be appropriate. Depend- velopment movement changed its orientation.
ing on the goals of the family in daily routines, Whereas the field had talked about a continuum
professionals working with infants and toddlers of reproductive casualty, referring to the poten-
with visual impairments may find themselves tial of genetics and medical concerns to lead
promoting social, play-based strategies in one to developmental failure, it now referred to a
context and a structured, behavioral task analy continuum of caretaking casualty (Sameroff &
sis in another. A holistic approach to learning Chandler, 1975). “Although reproductive casual-
that meets all the needs of the family and child ties may play an initiating role in the production
is the best strategy. of later problems, it is the caretaking environ-
ment that w ill determine the ultimate outcome”
BAS S FOR SERV CES (Sameroff, 1975, p. 274). Clearly, intelligence was
affected by environment, and change was possible.
Theories of child development have influenced This preliminary research was followed by
early education services for children with disabil- a g rand experiment in social policy: Lyndon
wig & Miller, 2007), as well as increased parent

participation in elementary school activities that
may lead to c hildren’s overall outcomes (Gelber
& Isen, 2011). These social changes in educa-
tional policy are supported by more recent re-
search findings in neuroscience (Shonkoff, 2012),
although policy implementation has been incon-
Anchor Center for Blind Children

sistent (Lally, 2013).
Supporting Early Education

through Science and Research
At the beginning of the 21st c entury, serv ices to
infants and preschool c hildren with visual im-
pairments are widespread in the industrialized
world. Arguments for and against early education
Early learning experiences are crucial for the develop- are now moot, particularly since legislation
ment of young children. has rendered the debate unnecessary. Credible,
peer-reviewed child development research and
Johnson’s Great Society. According to Shonkoff neuroscience (National Scientific Council on the
and Meisels (1990), the Great Society was marked Developing Child, 2007; Shonkoff, 2012) corrob-
by three themes: (a) the belief in the society’s re- orate the benefits of early education in the fol-
sponsibility to care for and protect young c hildren, lowing ways:
(b) a special commitment to the needs of c hildren
who were particularly vulnerable as a result of • Early experiences and ge net ics determine
chronic disabilities or conditions of poverty, and whether a child’s brain architecture w ill pro-
(c) a sense that prevention was better than treat- vide a strong or weak foundation for all f uture
ment and that earlier intervention was better than learning, behavior, and health.
late intervention. Shonkoff and Meisels (1990) • Windows of opportunity, most available dur-
called these three themes the “spiritual origins of ing early childhood, help in acquiring devel-
early childhood intervention” (p. 15). opmental skills when the brain has increased
These experiments in social policy continue plasticity to build strong connections.
to be examined by research. The Head Start Im-
pact Study (Puma et al., 2012) was a longitudinal • Positive relationships, rich learning opportuni-
study that followed children as they left Head ties, and safe environments encourage healthy
Start early childhood programs and moved into brain development and are necessary for e very
elementary schools. It found that initial improve- child’s future success.
ments in children’s cognitive and social-emotional • Society, as a whole, benefits from implement-
skills persisted several years after the children ing proven intervention strategies that support
graduated from Head Start (Puma et al., 2012). Al- young c hildren and families who are at risk
though the results are mixed on long-term effects for poor outcomes, including home-v isiting
of Head Start programs, other studies report de- serv ices, high-quality center-based serv ices,
creased mortality rates for c hildren ages 5 to 9 and a variety of community resources aimed
and increased high school completion rates (Lud- at family needs.
These findings apply to all young c hildren, • acquiring knowledge and skills including
and society is just now beginning to understand problem-solving and reasoning, understand-
the economic and academic benefits of investing ing early concepts and skills, and demon-
in supporting early brain development and strating appropriate language, memory, and
the promotion of skills from the “bottom up.” attention skills; and
Ultimately, four dec ades of program evaluation • taking actions to meet needs such as taking
research point to practices that can enhance de- care of basic needs like eating and dressing, fol-
velopment in the first five years of life (Lally, lowing safety rules, moving from place to
2013; National Scientific Council on the Devel- place within the environment, and communi-
oping Child, 2007). T hese practices include (a) cating to express needs and using tools to ac-
access to basic medical care that supports healthy complish tasks.
development and early diagnosis; (b) early edu-
cation programs that provide highly skilled staff, Individual states are addressing this federal
small class sizes, age-appropriate curriculum, and mandate of program evaluation through train-
stimulating materials in a safe environment; and ing and data collection on developmental as-
(c) warm, responsive interactions among staff sessments, family participation, and clinical
and c hildren. Young c hildren with visual impair- observation. This system, which has a focus on
ments and their families are no exception. individualized, functional skill acquisition in a
From the early 1990s to the first decade of the variety of inclusive settings, promises to provide
2000s, the US government began to require out- educators and families with useful information
come data from all federal programs, including on the development of each child. Young children
the early education programs that were funded by with visual impairments and their families need
IDEA (2004) known as Part C and Part B § 619. to be included in this process to assure a basic
Beginning with the Government Performance level of quality of services and guide implementa-
and Results Act (GPRA; Senate Committee on tion of supportive practices.
Government Affairs, 1993) and reinforced by the
Office of Management and Budget (OMB) re-
views (OMB, 2007), federal evaluators requested

CH LDREN W H VISUAL
measurable accountability outcomes in order to
continue to fund early education programs. Ex-
IMPAIRMEN S
perts in all areas of early education created an ac- Common Visual Disorders
countability rating system to measure three broad
developmental outcomes for young c hildren in
in Early Childhood
early intervention and early childhood special Accurate reporting of the most common visual
education programs (National Early Childhood impairments in young c hildren requires a collab-
Technical Assistance Center, 2011). T hese three orative data-collection system between medical
outcomes should be demonstrated across age- and educational organi zations, as well as key in
appropriate settings and include formant studies. An attempt to collect this data
on a national level began with the Model Reg-
• positive social emotional skills including re- istry of Early Childhood Visual Impairment
lating to adults and other c hildren, regulating Consortium (Hatton, 2001) through a group of
emotions and feelings, following rules related specialized educational organi zations, state de-
to being in a group, and interacting with o thers partments of education, institutes of higher edu-
using social language; cation, and the medical community. This registry
was h oused at the American Printing House for was only 8.4 percent in 2014 (APH, 2015), limi-
the Blind (APH) in 2000 and collected data from tations of the study are clear.
28 states u nder the name of Babies Count (Hat- The high prevalence of c hildren with ROP
ton, Ivy, & Boyer, 2013). According to Ferrell, may seem surprising, since this eye condition was
Shaw, and Deitz (1998), the most common visual once thought to be eliminated (Hatfield, 1975).
disorders in c hildren w
ere cortical visual impair- This high proportion of c hildren with ROP is
ment (CVI, also known as cerebral visual im- probably due to the increased survival of low-
pairment) (20.6 percent of the participants), birth-weight babies, resulting in more severe
retinopathy of prematurity (19.1 percent), optic cases of ROP (Early Treatment for Retinopathy
nerve hypoplasia (ONH) (16.6 percent), and of Prematurity Cooperative Group [ETRPCG],
structural anomalies (11.1 percent). (See Chap- 2005). Another possible explanation for the con-
ter 3 in this volume for a discussion about com- tinued high prevalence of ROP in the United
mon causes of visual impairment.) The latest States is that it is a result of economic factors
analysis of the Babies Count registry (Hatton (poverty) and the rising immigrant population in
et al., 2013) indicated that the most significant the United States, which also contributes to the
visual impairments in young c hildren continue incidence of babies born with low birth weights
to be CVI (24.9 percent), ROP (11.8 percent), (Kong et al., 2012).
and ONH (11.4 percent). Efforts are u nder way to
simplify the Babies Count registry to encourage
greater nationwide participation. Understanding the Development of
A recent study of worldwide blindness (Kong, Children with Visual Impairments
Fry, Al-Samarraie, Gilbert, & Steinkuller, 2012)
Impact of Visual Impairment
found that there are marked differences in the
causes of blindness in c hildren that seem to be Lowenfeld (1973) stated that blindness imposes
related to socioeconomic factors and that as much three basic limitations on the individual: the
as 58 percent of childhood blindness is treatable range and variety of experiences, the ability to
and 28 percent is preventable worldwide. The move about, and control of the environment and
leading cause of childhood blindness in the world, the self in relation to it. B ecause of restrictions
for example, is corneal opacification, caused by a in the range and variety of experiences that are due to
combination of measles, xerophthalmia (vitamin the lack of vision, the individual relates to and
A deficiency), and poor eye care. Kong et al. (2012) learns about the world through the remaining
also determined that the leading causes of child- four senses, especially hearing and touch. Hear-
hood visual impairment in the United States ing is the source sense for language and commu-
were CVI, ONH, and ROP, findings that are
nication and provides information when a person
highly consistent with both Ferrell et al. (1998) moves about in the environment; however, it
and Hatton et al. (2013). The sample of c hildren does not supply all the necessary information
with visual impairments in the United States about objects and their shapes. Touch provides
was obtained from specialized schools for the information about objects, but a person needs to
blind only, which at that time composed only be close enough to an object to explore it by hand.
13 percent of the total population of visually im- Thus, an individual who is blind cannot com-
paired c hildren on the American Printing House pletely experience objects that cannot be fully
for the Blind Federal Registry (as cited in Kong touched by hand, such as skyscrapers, moun-
et al., 2012). As the proportion of c hildren with tains, and oceans, or touch at all objects that
visual impairments attending specialized schools are small, difficult, or dangerous to explore phys-
by crawling, walking, or r unning). Therefore, a

young child who is blind must have formal and
informal orientation and mobility (O&M) les-
sons to compensate for t hese restrictions.
Restrictions on control of the environment and the
self in relation to it include not being able to look
around an area and, in a few seconds, gain infor-
mation about the elements of the space and the
people who are present. In addition, individuals
who are blind cannot learn by visual imitation;
they need to learn by direct teaching or assistance
about relationships with others and their own
and others’ facial expressions and gestures. Thus,
Lowenfeld (1981) believed that “education must
aim at giving the blind child a knowledge of the
realities around him, the confidence to cope with
t hese realities, and the feeling that he is recog-
nized as an individual in his own right” (p. 77).
Children with low vision who have a severe
visual impairment that, even with the best cor-
rection, interferes with the performance of daily
tasks have some degree of t hese limitations. With
a systematic plan to develop their residual vision,
however, the obstacles w ill not be as g reat. For
example, children who can see color can gain
much information about the environment from
color cues, and t hose with light perception can
John Kelly
learn to use their ability to see shadows to help

them move around the environment (Barraga &
Erin, 2001).
Young children need to learn O&M skills to compensate Barraga and Erin (2001) highlighted the im-
for restrictions on their mobility. pact that visual impairment can have on the de-
velopment of c hildren by discussing the role that
ically, such as insects, soap bubbles, and fire vision plays in early development in general. Im
(Lowenfeld, 1981). Lowenfeld (1981) stated that portant aspects of vision that have the potential
“a g reat many experiences which are taken for to affect the development of c hildren with visual
granted with seeing c hildren are either impossi- impairments are highlighted in Sidebar 4.1. T hese
ble or much more difficult for blind c hildren” statements about the role of vision in early child-
(p. 70). hood do not imply that c hildren with visual
Restrictions on the ability of an individual who is impairments w ill not be able to develop con-
totally blind to move about have an impact on ori- cepts, communicate, or move about in the envi-
entation to the surrounding area, both inside (the ronment. They are presented h ere to acknowledge
type of room and furniture) and outside (the ter- the fact that visual impairment presents a risk to
rain and weather), and mobility (moving about development. Nor do they, or the discussion of
S I D E B A R 4 . 1
The Role of Vision in Early Development
Vision gives a reason for movement. Children curiosity to explore and increases c hildren’s
see something that is interesting or that they motivation to become independent.
want and move toward it. Vision is a distance sense and is under an
Vision gives an estimation of space. individual’s control. Individuals can regulate
Children can look at a desired object in a visual input by opening and closing their eyes,
room and calculate the movement necessary and they see both near and far. Hearing is a
to obtain it. They can also determine where distance sense, too, but t here is no way to
empty chairs and the food t able are located. control the presence or absence of sound
And they can do all this without moving. in the environment. Sound without visual
Vision allows for vicarious participation in verification is only noise coming from some
movement. With vision children can watch undefined place. It acquires meaning only
another person’s actions and be part of an after sustained tactile, motor, and auditory
activity. Young children can watch others interaction. In time, sounds become predict-
move around and develop an understanding able, but a sound must acquire meaning
of how to move their body parts. When an before it can provide information about
adult rolls a ball, for example, a child watches location, cause, or source.
the adult’s position, the shape of the hands, Vision provides an incentive for communi-
the pushing action of the arms, and the cation. Young children learn to communicate
movement of the ball. Thus, the child learns with the world by developing a bond with the
a great deal about rolling a ball without ever permanent p eople in their lives. For children
touching it. who are sighted, vision tells them that their
Vision provides consistent, coordinated, parents are constant and predictable p eople
and verifiable information. Vision is not subject in their worlds. By responding to the sight of
to the whims of opportunity—it is always there their parents and then turning to their parents’
unless one closes one’s eyes. Odors, on the voices, young c hildren begin to communicate
other hand, disappear, and touch can be used by directing visual attention, showing anticipa-
only if one is within reach. If a person hears a tion, and then gesturing and eventually making
noise, vision verifies where it came from. Other sounds. The communicative intent of the
sensations are discrete, one-time occurrences gestures and sounds receives constant
that are intermittent, inconsistent, and gener- feedback and reinforcement from vision. As
ally unverifiable. they observe the faces of adults, c hildren are
Vision is a strong motivator that stimulates motivated to continue this ever-increasing
self-initiated exploration of the environment. cycle of reaching out, response, motivation,
Vision alone can motivate sighted c hildren to reaching out, response, and so on. Adults take
move. If c hildren see a desired toy, they will advantage of children’s visual sense to teach
move to it without needing another person to communication by using such phrases as
encourage them. Vision encourages children’s “See this?,” “Look at this,” and “Over here.”
Source: Based on concepts presented in Barraga, N. C., & Erin, J. N. (2001). Visual impairments and learning (4th
ed.). Austin, TX: Pro-Ed.
124
the development of c hildren with visual impair- that of sighted children, but that some children
ments that follows, imply that t hese risks w ill with visual impairments developed some skills at
always materialize. All the research to date, from a slower rate. This belief was often referred to as
Norris, Spaulding, and Brodie (1957) to Hatton, more alike than different (Ferrell, 1986). However,
Bailey Burchinal, and Ferrell (1997) to Ferrell these early studies pointed out that children with
et al. (1998), has found that some c hildren visual impairments need more time to develop
with visual impairments grow and develop at the some skills, even u nder the optimum c onditions
same rate as do sighted c hildren. What seems to of high- quality early intervention, educated
make the difference are the opportunities avail- parents, and knowledgeable caregivers.
able to learn and the presence of additional Warren (1984) reviewed the research compar-
disabilities. ing c hildren with and without visual impair-
ments and suggested that this “more alike than
Research on the Development of different” approach might be misleading. He
thought that comparative studies were not help-
Children with Visual Impairments ful in understanding the development of c hildren
Historically, c hildren with visual impairments with visual impairments, since the premise of
were compared to sighted c hildren who w ere de- comparability was faulty. Warren (1984) im-
veloping typically. Two early studies found that plored professionals to take up the challenge of
in the absence of additional disabling conditions, conducting empirical studies to clarify the devel-
c hildren with visual impairments generally de- opment of c hildren with visual impairments:
veloped the same skills in the same sequence as
did sighted c hildren (Maxfield & Buchholz, 1957; Consider what our goal in working with the vi-
Norris et al., 1957). However, t hese studies also sually impaired child should be. Should it be to
concluded that although c hildren with visual im- make the child reach developmental milestones
pairments developed all the same skills as did at the same age as the sighted child, or should
c hildren without disabilities, they did so at a we instead seek to optimize the developmental
slower rate, even given the optimum conditions course of the visually impaired child? Compar-
of parent support and training. ative research tends to lead us toward the first
During the 1960s and 1970s, Fraiberg (see goal. I argue that it is the second goal that we
Fraiberg, 1977, for a summary of her various stud- should take as a guiding principle. (p. 4)
ies) conducted her crucial work that documented
the development of 10 children who w ere blind, Ferrell (1986) also questioned the use of a standard
none of whom w ere identified with additional based on sighted c hildren to judge the develop-
disabilities. She determined that children who ment of c hildren with visual impairments:
were visually impaired demonstrated delays in

developmental areas that were dependent on or The problem, however, may rest in the com-
greatly influenced by vision, such as motor skills, parison itself: It assumes that the experiences
perception, concept development, spatial rela- of visually impaired children are similar to
tionships, auditory skills, tactile exploration, and those of children without disabilities, when in
ego development. fact they may be totally different. Does the feel
The prevailing view in the field of visual im- and smell of a banana, for example, produce
pairment thus came to be that the development of the same concept in a child’s mind as the sight
children with visual impairments was similar to and taste of one? Is the sound of an object as
motivating to reach out to as the sight of it? Visually Impaired Infants

(p. 124) Research Consortium
The challenges posed by these issues w ere met
In a later publication, Ferrell (1997) described
by a group of ser v ice providers representing
the problem this way:
early childhood programs for visually impaired
c hildren in the New York City area. Working col-
hildren with blindness and visual impair-
C
laboratively to form the Visually Impaired Infants
ment learn differently, for no other reason than
Research Consortium (VIIRC; see Ferrell et al.,
the fact that in most cases they cannot rely on
1990), t hese pract it ioners collected information
their vision to provide information. The infor-
about the c hildren served by their agencies,
mation they obtain through their other senses
including demographic data and ages when de-
is inconsistent (t hings do not always make noise
velopmental milestones w ere achieved. In gen-
or produce an odor), fragmented (comes in bits
eral, the VIIRC pilot study determined that “the
and pieces), and passive (not u nder the child’s
median age for acquisition of these milestones
control). It takes practice, training, and time to
was at or near the age for typical children” (Deitz
sort all this out. (p. v)
& Ferrell, 1994, p. 470).
Subsequent analyses of the VIIRC database
In 1994, Warren reexamined the literature
(N = 314), enhanced by the voluntary data sub-
on the development of c hildren with visual im-
mission by serv ice providers across the United
pairments and provided a rationale for using an
States, yielded essentially the same information.
individual-differences approach in research with
Children with visual impairments exhibited de-
young c hildren with visual impairments. Want-
lays in the acquisition of certain milestones, par-
ing to move beyond comparing children who
ticularly fine motor skills, and t hese delays were
were visually impaired to t hose who w
ere sighted,
even greater for c hildren who had additional dis-
he looked within the population of c hildren who
abilities (Ferrell & Mamer, 1993). A perplexing
were visually impaired for variations and the rea-
difference in the sequence of reaching milestones
sons for the differences. He referred to the “adap-
was noted and thought to be an artifact of the

tive tasks approach,” the premises of which are
study’s limitations. But the implications of this
(Warren, 1994, pp. 6–7):
finding, including the possibility that families
and educators w ere expecting development
1. The developing child faces a set of adaptive
to proceed along a differe nt path or that the
tasks.
methodology used to teach c hildren with vi-
2. The child faces these adaptive tasks armed sual impairments might have actually created
with a set of personal capabilities and char- the difference in sequence, made the need for a
acteristics. scientifically rigorous study more critical.
3. The environment shapes not only the nature
of the adaptive tasks but also the child’s set Project PRISM
of capabilities and characteristics. The VIIRC pilot study thus set the stage for a grant
4. For the child with a visual impairment, there from the US Department of Education to conduct
are variations on the tasks, the capabilities a longitudinal study on the sequence and rate
and characteristics, and the environmental of development of c hildren (from birth to age
circumstances that must be taken into account 5) with visual impairments, known as Project
to understand development and its causality. PRISM: A National Longitudinal Study of the
Early Development of Children Who Are Visually at each age level, each box indicates the semi-
Impaired (Ferrell et al., 1998). Housed at the Uni- interquartile range (25th–75th percentile); the
versity of Northern Colorado, the project was a line within the box is the median, and the T-lines
collaborative effort by seven agencies across the at the top and bottom of each box indicate the
United States that contributed 202 c hildren, al- range of scores at that age interval.
most 60 percent of whom had additional disabil- In Figure 4.1, the median age- equivalent
ities, over the course of five years. The project scores of the three groups (totally blind [no light
trained personnel at each agency to administer a perception (NLP)] to relatively good vision) are
series of standardized assessment instruments, fairly close until the 18-to 23-month assessment
while parents independently completed a packet interval, when they begin to differ sharply. It is
of questionnaires. One of the project’s major find- important to note, however, that u ntil the 48-to
ings was that the greatest impact on develop- 59-month assessment interval, the ranges of scores
mental outcome appeared to be the presence of in all groups are highly variable but essentially
disabilities in addition to visual impairment, equal, demonstrating not only the variability of
although differences were also found on the ba- the population but also the inability to predict
sis of gestational age at birth (time elapsed from outcomes based on visual function alone.
conception to birth) and some types of visual In Figure 4.2, the median age- equivalent
disorders. Differences w ere documented in the scores of the three additional disability groups
rate and sequence of acquisition of develop- (no additional disability, mild, and severe) begin
mental milestones and developmental inven- to deviate at 6–11 months, and the range of scores
tory scores, but t hose differences tended to differs as well. The information in the figure lends
disappear over time (Ferrell et al., 1998, p. 2). A support to Ferrell et al.’s (1998) conclusion that
summary of the PRISM findings is given in Side- additional disability has a greater impact on de-
bar 4.2. velopment than does visual function alone.
In addition to differences between c hildren Whether analyzed by level of visual function
with and without disabilities, Project PRISM or additional disability status, the children in
documented the tremendous variability among Project PRISM exhibited tremendous variability
the participants. Figures 4.1 and 4.2 illustrate the at each assessment interval. This variability makes
range of age-equivalent scores on the Battelle De- predicting individual outcomes highly suspect and
velopmental Inventory (Newborg, Stock, Wnek, supports Warren’s (1994) conclusions. (For addi-
Guidubaldi, & Svinicki, 1984) of the participants tional information on assessment, planning, and
at different age levels. The Battelle Developmen- services and on supporting the development of
tal Inventory is a standardized developmental in- young children who are visually impaired, see
strument that measures young children’s behaviors Volume 2, Chapter 9.)
in the personal-social, adaptive, motor, communi- Project PRISM results w ere also analyzed for
cation, and cognitive domains. It is normed on delays in the age and sequence of acquisition of
children with disabilities and includes adapta- similar developmental milestones. Table 4.1 com-
tions for children with vari ous disabilities, in- pares the data from PRISM and VIIRC (Ferrell &
cluding visual impairments. Figures 4.1 and 4.2 Mamer, 1993), as well as from Fraiberg (1977),
utilize boxplots to illustrate the median, quar- Maxfield and Buchholz (1957), and Norris et al.
tiles, and extreme values for age-equivalent scores (1957). The columns indicate w hether the mile-
on the inventory, grouped by three levels of visual stone is delayed (D), out of sequence (S), on target
function (Figure 4.1) and three levels of addi- (T), or earlier (E) in comparison with children
tional disability status (Figure 4.2). For each entry without disabilities.
S I D E B A R 4 . 2
What Project PRISM Tells Us about the Development of Young
Children with Visual Impairments
• There is great variability in how young • The first six months of life seem to be a
children with visual impairments grow and relatively quiet period for development,
develop. but not an uneventful one. For babies with
visual impairments, the first six months are
• A large difference in time was found
used to “get acquainted” with the world
between the earliest age and the latest age
and to establish sensory patterns for
when different children acquired the same
obtaining information.
skill. T
hese differences became larger as
children grew older. Overall, two children of • Many infants with visual impairments
the same age, with the same type of visual begin their developmental progression at
impairment, even in the same family, may a disadvantage. Many visually impaired
progress at different developmental rates— children are born preterm—prior to a
and this can be seen even when children in gestational age of 37 weeks—and remain
a family do not have disabilities! in the hospital while their tiny bodies,
particularly their hearts and lungs,
• For this reason, it’s difficult to predict how
mature. . . . About 25 percent of the
a child will ultimately develop and behave
children in Project PRISM spent more
and also difficult to determine in advance
than 30 days in the hospital following
how an individual child’s development may
birth—some as long as 180 days.
progress. You never know what will make
the difference for [a] child. And what makes • The development of some PRISM children
a difference for [one] child may or may not fell into the same range of behavior as
be helpful to another child. This means children without disabilities. . . . Children
that c hildren develop at their own pace, achieved skills at a range of ages, but those
and you d on’t want to make assumptions without additional disabilities who were not
about what [a] child can and cannot learn. preterm did so within the range for c hildren
without disabilities.
• Children with visual impairments may learn
in a different manner. Project PRISM • Additional disabilities seem to have more
demonstrated that c hildren with visual impact on a child’s development than
impairments achieved developmental does visual impairment itself. . . . A child
milestones . . . in a different sequence from without additional disabilities who was
typically developing children. . . . PRISM totally blind achieved skills more quickly
demonstrated that some milestones . . . than a child who was totally blind and
were acquired earlier than typical children, had additional disabilities.
whereas some w ere acquired later.
• As children grew older, additional disability
• Better vision does not necessarily mean seemed to have less of an impact. At age
better performance. . . . Children whose 3 years, children with mild additional
development was most similar to children impairments . . . were more like the
without disabilities included both children children with no additional impairment . . .
who w ere totally blind as well as those with and they generally appeared to “catch up”
low vision. to the children with visual impairments
128
S I D E B A R 4 . 2
who did not have additional disabilities. . . . vision, but some of the other children
The effects of mild additional impairment did. . . . Functional vision improved simply
may dissipate with age. with the passage of time. As the c hildren in
the study grew older, they w ere better able
• The functional vision . . . of about one-third to understand what they were seeing, and
of the c hildren in Project PRISM improved so they used their vision more effectively in
over the course of the study. Children who testing situations. The functional vision
were totally blind or who only saw light of . . . one-third of the c hildren did not
tended not to improve their functional improve, however, and actually decreased.
Source: Adapted from Ferrell, K. A. (2011). Reach out and teach: Helping your child who is visually impaired learn and
grow (2nd ed.) (excerpted from pp. 10–16). New York: AFB Press.
Figure 4.1 Battelle Age-Equivalent Scores at Project End, by Degree of Visual Function,

at Each Assessment Interval
The three levels of visual function w

ere defined as the last Teller Acuity Card score (a test of visual ability) was obtained and
were divided into three groups: NLP (totally blind, or no light perception), severe low vision, and moderate low vision.
Source: Ferrell, K. A., Shaw, A. R., & Deitz, S. J. (1998). Project PRISM: A longitudinal study of developmental patterns of children
who are visually impaired (Final Report, CFDA 84.023C, Grant H023C10188). Greeley: University of Northern Colorado,
Division of Special Education.
129
Figure 4.2 Battelle Age-Equivalent Scores at Project End, by Additional Disability Status, at

Each Assessment Interval
Source: Ferrell, K. A., Shaw, A. R., & Deitz, S. J. (1998). Project PRISM: A longitudinal study of developmental patterns of children
who are visually impaired (Final Report, CFDA 84.023C, Grant H023C10188). Greeley: University of Northern Colorado, Division
of Special Education.
Project PRISM found the following (Ferrell Children with disabilities in addition to a vi-
et al., 1998, pp. 114–115): sual impairment w ere generally delayed in all the
developmental milestones examined. When the
• The age of acquisition for 12 milestones was milestones were examined by degree of visual
delayed in comparison to typically developing function, however, only one milestone (“plays in-
c hildren. teractively with adults”) resulted in a significant
difference among the groups. C hildren with no
• For five milestones (all related to expressive
light perception acquired this behavior signifi-
and receptive communication), median age of
cantly later than did t hose with greater levels of
acquisition was within the range of attainment
visual functioning.
for typical c hildren.
The results of Project PRISM support to-
• Two milestones w ere acquired earlier. Earlier day’s early interventionists who approach young
acquisition is somewhat suspect, however, since c hildren with visual impairments as individual
data were available for less than 10 percent of learners. C hildren with visual impairments do
the total sample. not necessarily follow the same sequence of de-
• Six milestones w
ere acquired in a differe nt velopment as do c hildren without disabilities.
sequence from that of c hildren without dis- The assumption that levels of visual function-
abilities. ing influence early child development was not
TA B L E 4 .1
Age of Acquisition of Selected Developmental Milestones
in Five Studies (in Months)
PRISM VIIRC Maxfield & Norris,
Milestone and Median Age (Ferrell, Shaw, & (Ferrell & Fraiberg Buchholz Spaulding, &
of Attainment by Typical Deitz, 1998) Mamer, 1993) (1977) (1957) Brodie
Children (in Months) (N = 202) (N = 314) (N = 10) (N = 398) (1957) (N = 66)
Reaches for and touches 8.3 (D) 8.0 (D) 8.3 (D) Median: 50 percent
object (5.4) 0–12 at 9.0 (D)
Transfers object from 9.3 (D) 8.0 (D) n/a n/a n/a
hand to hand (5.5)
Searches for a removed 15.0 (D, S) 12.0 (D) n/a n/a n/a
object (6.0)
Sits alone without support 10.9 (D) 9.0 (D, S) 8.0 (D, S) Median: 25 percent
for 5 seconds (6.6) 13–24 (D) at 9.0
Feeds self bite-size pieces 12.6 (D, S) 12.0 (D)a n/a Median:
of food (7.4) 13–24 (D)
Produces 1 or more 10.9 (D) 12.0 (D) n/a Median: n/a
consonant-vowel 0–12 (S)
sounds (7.9)
Moves 3 or more feet by 12.8 (D, S) 12.0 (D)a n/a Median: n/a
crawling (9.0) 13–24 (D)
Plays interactive 11.4 (T) 12.0 (D) n/a n/a n/a
game (9.7)
Walks 10 feet without 19.8 (D) 16.0 (D)b 19.3 (D) Median: 50 percent
support (13.0) 25–36 (D) at 24.0
Points to at least 1 19.5 (T) n/a n/a n/a n/a
major body part when

asked (17.5)
Removes a s imple 22.7 (D) 30.0 (D) n/a Median: n/a
garment without 37–48 (D)
assistance (20.5)
Generally follows 24.3 (D) 30.0 (D) n/a n/a n/a
daily-routine directions
(20.5)
Uses 2-word utterances 28.2 (D, S) 24.0 (D, S)b 26.3 (D) Median: n/a
to express meaningful 37–48 (D)
relationships (20.6)
Uses pronouns “I,” “you,” 25.8 (T) 36.0 (D)b n/a Median: n/a
and “me” (24.0) 49–60 (D)
Controls bowel movements 36.5 (D, S) 34.0 (D, S)b n/a Median: n/a
regularly (30.0) 37–48 (D, S)
Repeats 2-digit 33.4 (T) n/a n/a n/a n/a
sequences (30.0)
131
TA B L E 4 .1 (Continued )
PRISM VIIRC Maxfield & Norris,
Milestone and Median Age (Ferrell, Shaw, & (Ferrell & Fraiberg Buchholz Spaulding, &
of Attainment by Typical Deitz, 1998) Mamer, 1993) (1977) (1957) Brodie
Children (in Months) (N = 202) (N = 314) (N = 10) (N = 398) (1957) (N = 66)
Walks down stairs 33.4 (T)c 29.0 (E, S)b n/a Median: n/a
alternating feet (30.0) 49–60 (D)
Copies a circle (33.0) 31.8 (E, S)c 36.0 (D)b n/a n/a n/a
c
Relates his or her past 37.3 (E) 29.0 (E, S)b n/a Median: n/a
experiences (40.0) 49–60 (D)
Note: Letters after numbers indicate comparisons with the median for typical children: D = delayed, T = on target,
E = earlier, and S = out of sequence.
a
Less than 50 percent of the Visually Impaired Infants Research Consortium (VIIRC) respondents reported that the
children with additional disabilities had acquired this milestone.
b
Less than 50 percent of the VIIRC respondents reported that the c hildren had acquired this milestone.
c
Of the 16 participants in Project PRISM who were last assessed at 40.5–54.4 months, 14 had not met these milestones
at the end of the project; 85.7 percent of the 16 had additional impairments.
supported by the analysis of age-equivalent scores the various measures used in Project PRISM and
by level of visual function of the PRISM partici- has been replicated in other studies (see, for ex-
pants. (See, however, Hatton et al.’s [1997] com- ample, Hatton et al., 1997).
bined PRISM–North Carolina study, which did Certainly, the range of performance is as great
find differential scores by level of visual function among children with additional disabilities as it
using growth curve analysis.) Perhaps what is is among children without additional disabilities
more impor t ant is that the assumption that (see Figure 4.2). But it seems clear that additional
children with visual impairments follow the same disabilities may have a greater impact on develop-
sequence of development as c hildren without ment than does the degree of visual impairment.
disabilities must be challenged. For the field of visual impairment, this conclu-
sion, if supported by f uture studies, may neces-
sitate a paradigm shift from viewing visual
Impact of Additional Disabilities impairment as an inevitable disability to viewing
Additional disability clearly affects early devel- it as a risk that can be ameliorated and mastered.
opment. The c hildren who w ere categorized as
having no additional disabilities performed bet-
ter on developmental tests than did the c hildren MPLICAT ONS OR PRAC IC
with mild additional disabilities, who performed
better than the c hildren with severe additional
Delivery of Services
disabilities. Although differences in the acquisi- The field of early childhood education has taken
tion of skills based on the degree of functional on the challenges inherent in creating an inte-
vision were apparent for only one milestone, grated service system guided by legislation and es-
the age of acquisition was significantly later sentially starting from nothing (Dunst & Trivette,
for c hildren with additional disabilities for 2009; IDEA, 2004; Trohanis, 2008). The research-
63.2 percent of the milestones studied. This im- based practices developed for all c hildren identi-
pact of additional disabilities was consistent across fied with disabilities apply to young children
with visual impairments b ecause they have the rather than child centered, as are serv ices for
same general social and early learning needs as school-age children. Part C requires an IFSP to be
every child. Recommendations for current early reviewed and revised e very six months.
education ser v ices for infants and toddlers Today, early childhood research supports the
(Bruder, 2010; Division for Early Childhood, philosophy of building capacity and enhancing
2014; Hatton, McWilliam, & Winton, 2002) have the strengths and resources of the family through
three principal characteristics: a family-centered conceptual model (Dunst &
Trivette, 2009):
1. Infants and toddlers are part of a family, and
plans for learning need to include support to Early childhood intervention and family sup-
build the capacity of the family to participate port are defined as the provision or mobiliza-
and assist in their child’s development. tion of supports and resources to families of
young c hildren from formal and informal so-
2. The active learning style of very young
cial network members that e ither directly or in-
c hildren requires integrating learning experi-
directly influence and improve parent, family
ences into daily routines so that there are
and child behavior and functioning. (p. 126)
naturalized opportunities to practice skills
and acquire knowledge.
Efficacy research in early intervention ser
3. Development is a complex and integrated vices has established the benefits of coaching
process across domains in infants and tod- interactions (Rush & Shelden, 2011) between
dlers. A team of specialized professionals professionals and family members. Family mem-
to provide coaching to family members is bers should be full partners in the assessment
the optimal method of delivering serv ices and implementation process. However, recent
in early intervention. policy recommendations (Turnbull et al., 2007,
p. 187) have “focused on interactions of families
Part C of IDEA (2004) requires states that re- and professionals, not what ser v ices should
ceive federal funds to establish comprehensive be available.” As early intervention criteria are
early education serv ices that include at least the evaluated on a national level (OMB, 2007), it is
following components: (a) a definition of devel- important to establish the importance of support
opmentally delayed; (b) f amily engagement; (c) a for families as they learn about developmental
multidisciplinary evaluation; (d) an Individual- differences in learning because of visual impair-
ized Family Serv ice Plan (IFSP) for each family; ment. Transition to Part B services occurs when
(e) a child-find system to determine eligibility; (f) the child turns 3 years of age, and a child-centered
a central directory of early intervention services; and learning-based individualized education pro-
(g) a comprehensive system of personnel develop- gram (IEP) is created to guide instruction. Families
ment; (h) a designated lead state agency; and (i) a continue to be included in the assessment and ed-
system for interagency agreements. The organiza ucational process, and the IEP is reviewed
tion of these services is different from preschool- and revised annually. (To watch a related
or elementary-level special education services in video, log in to the AFB Learning Center.)
important ways. First, the lead agency for services
for children from birth to age 3 is not necessarily
an education agency. Second, t hese services are or
Natural Environments and Inclusion
ganized around the needs of families, rather than Part C mandates that serv ices to infants and tod-
c hildren. The serv ices are thus f amily centered, dlers are provided in a “natural environment,”
and thus most early education takes place in fam- disabilities (DEC/NAEYC, 2009). Center-based
ilies’ homes. Some specialized, privately funded, programs, particularly those without typically
center-based programs for young children with developing peers, are viewed as unnatural and in-
visual impairments are available throughout the appropriate environments for c hildren with dis-
country. These may be beneficial for families abilities. Experiential learning is most effective in
because they often provide opportunities to con- the setting that exposes young c hildren with vi-
nect with other families of children with visual sual impairments to everyday routines. The op-
impairments and usually employ personnel with portunity to participate in community- based
expertise and experience in visual impairment. playgroups and inclusive preschools has become
Depending on the specific needs of families with a right supported by legislation (Americans with
infants and toddlers with visual impairments, the Disabilities Act, 1990; IDEA, 2004; Section 504
availability of a combination of services at one lo- of the Rehabilitation Act of 1973), case law (Oberti
cation is optimal. Services for children ages 3–5 v. Board of Education, 1993), and best practices
occur primarily in preschool classrooms in child (DEC/NAEYC, 2009).
care, private nursery school, or inclusive public The current definition for inclusive practices
school facilities. in early childhood education is supported by the
The IDEA amendments and regulations since
1986 have grown stronger in their requirement
for natural environments for early education ser
vices, and research supports providing serv ices
in this manner (Adams, Tapia, & Council on
Children with Disabilities, 2013; Dunst & Trivette,
2009). A natu ral environment means “settings
that are natural or normal for the child’s age peers
who have no disabilities” (34 C.F.R. § 303.18). In-
teractions between early intervention and visual
impairment professionals and families in the
home provide ongoing learning opportunities for

the child based on daily routines (Ferrell, 2011;
Lueck, Chen, Kekelis, & Hartmann, 2010). Rather
than teaching families what to do, observing rou-
tines such as playtime, bath time, diaper chang-
ing, and mealtime in the home allows for creative
problem-solving strategies the family can im-
plement even when the professional is not pres Anchor Center for Blind Children
ent. Families that are an integral part of the
adaptation and learning process are much more
likely to continue to support their young child
with a visual impairment at this critical time.
The emphasis on inclusion as a method of
meaningful social interaction (Recchia & Lee,
2013) has led to the increased use of regular early
childhood settings as the primary site for deliv- A teacher guides a preschooler’s hands on the strings of
ering early education serv ices to c hildren with a guitar.
Division on Early Childhood of the Council for classroom. Sharing this information with general
Exceptional Children (DEC) and the National As- education early childhood classroom staff is
sociation for the Education of Young Children necessary to ensure the success of young c hildren
(NAEYC): with visual impairments.
The US Department of Health and H uman
Early childhood inclusion embodies the values, Serv ices (HHS) and the US Department of Edu-
policies, and practices that support the right of cation (DOE) seem to support this view. The two
every infant and young child in his or her
departments affirmed inclusive practices by issu-
family, regardless of ability, to participate in a ing a joint policy statement on inclusion in early
broad range of activities and context as full childhood programs to provide guidance to state
members of families, communities, and society. and local governments on why and how inclu-
The desired results of inclusive experiences for sion can be implemented for young c hildren
children with and without disabilities and their with disabilities (HHS & DOE, 2015). The state-
families include a sense of belonging and mem- ment noted, however, that barriers to inclusion
bership, positive social relationships and friend- include an untrained and understaffed early
ships, and development and learning to reach childhood workforce and a lack of comprehensive
their own potential. The defining features of in- services. The statement also acknowledged the
clusion that can be used to identify high quality lack of disability certification among early child-
early childhood programs and services are ac- hood providers and recommended that “instruc-
cess, participation and support. (DEC/NAEYC, tion should be delivered in consultation with and
2009, p. 2) under the supervision of professionals with spe-
cialized training and certifications, such as . . .
Unfortunately, specific research that ad- teachers of the blind and visually impaired, [and]
dresses the needs of young c hildren with visual orientation and mobility specialists” (p. 12). The
impairments in the inclusive classroom has not policy statement encouraged states to develop
moved past the exploratory stage (Crocker & Orr, early childhood systems that ensured access to
1996; Davis & Hopwood, 2007; Gray, 2005; Mc- specialized supports, such as those provided by
Gaha & Farran, 2001; Smyth & Phangia Dewald, specialists in visual impairment, that would result
2013). To evaluate the success of the child with a in meaningful inclusion that would encourage and
visual impairment in early education, validated support all children’s learning.
measurements and classroom evaluations are
necessary to determine what adaptations and Developmentally Appropriate
variables affect service quality. One way is to sup-
port new research frameworks that promote
Practice
moving forward in reimagining inclusion in the Developmentally appropriate practice (often ab-
early childhood classroom, including universal breviated as DAP) has been adopted by the Na-
design for learning classroom components and tional Association for the Education of Young
teacher competencies that benefit all learners Children (NAEYC, 2009) as the primary phi-
(Recchia & Lee, 2013). Another way is to use val- losophy that should drive programs for young
idated measurements that meet universal design c hildren. Developmentally appropriate practice
standards for all young children, including tactile ensures that children with and without disabili-
learners. It is critical to bring the developmental ties are seen as children first and bases the cur-
understanding that has been acquired about vi- riculum on how young c hildren learn. It requires
sual impairment to the early childhood preschool practi
tion
ers to understand child development
S I D E B A R 4 . 3
12 Principles of Child Development and Learning
1. All areas of development and learning are 7. Children develop best when they have
important. secure relationships.
2. Development and learning follow 8. Development and learning occur in and
sequences. are influenced by multiple social and
3. Development and learning proceed at cultural contexts.
varying rates. 9. Children learn in a variety of ways.
4. Development and learning result from 10. Play is an important vehicle for
an interaction of maturation and developing self-regulation and promoting
experience. language, cognition, and social
5. Early experiences have profound effects on competence.
development and learning. 11. Development and learning advance when
6. Development proceeds toward greater children are challenged.
complexity, self-regulation, and symbolic or 12. Children’s experiences shape their
representational capacities. motivation and approaches to learning.
Source: Reprinted with permission from the National Association for the Education of Young Children (NAEYC).
(2009). Developmentally appropriate practice in early childhood programs serving children from birth through age 8.
Washington, DC: Author. Copyright© 2009 NAEYC®. Retrieved from http://w ww.naeyc.org/dap/12-principles- of
-child- development
and work in partnership with families to de- all young c hildren, including t hose with visual
liver services that support and encourage young impairments. Understanding child develop-
children’s growth and learning in both early edu- ment allows early intervention and visual im-
cation and in day care. The guidelines for devel- pairment professionals to share adaptations and
opmentally appropriate practice are as follows: modifications to the early childhood curricu-
lum that w ill benefit all. Sidebar 4.3 presents 12
1. Create a caring community of learners. principles of child development and learning
2. Teach to enhance children’s development and that support developmentally appropriate prac-
learning. tice for all c hildren.
3. Plan curriculum to achieve important goals.
Role of the Teacher of Students
4. Assess c hildren’s development and learning.
with Visual Impairments in Early
5.
Establish reciprocal relationships with Intervention Programs
families.
The unique educational needs of families with
The guidelines to provide developmentally ap- young c hildren with visual impairments require
propriate practice are helpful in working with a team member with expertise to encourage ap-
inclusive classroom staff to meet the needs of propriate strategies and reflection on research-
based understanding of implications throughout have a functional, routines- based focus and
the early childhood years. Changing attitudes promote in depen dence and competence with
toward serv ice provision in early intervention peers (Farrell, 2009; Hebbler & Gurlach-Downie,
(Rush & Shelden, 2011; Sewell, 2012) and the 2002). An example of the role of the teacher of
proven effectiveness of inclusion in preschool students with visual impairments as collaborator,
and primary education settings (Cross, Salazar, information giver, and adapter of the environ-
Dopson-C ampuzano, & Batchelder, 2009; Rec- ment is given in Sidebar 4.4, based on a transcript
chia & Lee, 2013) require an evaluation of from an a ctual home visit.
practices of teachers of students with visual Ferrell (1997) and Ferrell, Raver, and Stewart
impairments. As in any early intervention setting, (1999) presented several principles for families
a family-centered coaching model of support in and professionals in providing early education
the home setting is recommended (Hatton et al., serv ices to young c hildren with visual impair-
2002). The practice of adult-focused relationship ments, listed in Sidebar 4.5. T hese principles
building to provide emotional, material, and in- include capitalizing on incidental learning, rec-
structional support and to guide outcome-based ognizing that c hildren with visual impairments
development is a valuable skill with families in learn from parts to wholes, and providing con-
both consultation models and collaborative in- crete experiences.
clusion settings. A final implication for families and profes-
A coaching and consultation model is not fo- sionals who work with young c hildren with vi-
cused on direct serv ices to the child, but rather sual impairments may be that it is better to avoid
on problem solving with other adults to meet the developmental checklists that list various skills
individualized needs of the learning community. by age level in f avor of more process-oriented ap-
It is the responsibility of the teacher of students proaches to understanding development. Two
with visual impairments to bring information examples of a process- oriented approach are
that highlights the unique abilities of the young Lueck et al.’s (2010) Developmental Guidelines for
child with a visual impairment as well as an un- Infants with Visual Impairments and Ferrell’s (2011)
derstanding of the adaptations and modifications Reach Out and Teach. Ferrell used a corequisite
that may be necessary for success. Contributions skills approach that postulates a minimal num-
to the educational team should include profes- ber of discrete skills that are related to and incor-
sional interpretation of medical vision reports porated into higher- level be
hav iors. National
and functional vision use in everyday envi- child outcome data requires early education pro-
ronments, specialized understanding of how fessionals to observe c hildren’s functional behav
development is affected by visual impairment, ior in natural environments (Hebbler, Barton, &
recommendations to adapt the home and class- Mallik, 2008), giving families and professionals
room environment, and strategies to improve al- a useful context for development.
ternative sensory use, such as tactile and listening
skills. As the child spends much more time in his SUMMARY
or her learning communities (family home, pre-
school or primary classroom, community play- Teachers who work with young children who are
grounds, stores, and restaurants), the teacher of visually impaired must keep in mind that theory
students with visual impairments needs to par- and research on this population is only a tool.
ticipate in and evaluate a variety of environ- Studies seldom conclude without posing more
ments. Assessments and skill instruction should questions than they sought to answer, so they
S I D E B A R 4 . 4
A Home Visit with Marianna and Her Mother
Jenna (an early childhood special educator) Jenna begins to ask Rita about the family’s
and Susan (a teacher of students with visual recent trip to Mexico, and the two women
impairments) knock on Rita’s door for several speak fluently in Spanish. Susan does not feel
minutes u ntil she answers. As the door opens, left out; she knows that Jenna will translate
Jenna and Susan see the familiar face of Rita, for her if anything important occurs. Rita is
who is a young Latina with long, beautiful, laughing, so they must have had a good time.
dark hair and a quiet manner. She speaks While this is happening, Marianna is sitting on
English, but prefers Spanish. As Jenna is the floor, supported by her mother. Marianna
bilingual, and Susan is only able to visit with is resting on her fisted hands, and Rita can let
the family one time a month, Susan accompa- go for around 30 seconds or so before Mari-
nies Jenna on her visits to the family. Jenna is anna falls over or throws herself backward. At
able to visit with the f amily e very week and this point, Rita’s sister enters the room,
is Marianna’s primary early intervention carrying her 7-month-old baby boy. Rita,
provider. Jenna and Susan work together with Marianna, and her f ather, Juan, live in a trailer
several different families and they trust and home with several other extended f amily
respect one another. members including Rita’s m other and f ather,
Rita is holding Marianna, who looks like a as well as her sister and her son. The h ouse is
miniature version of her mother. She is always small but spotless, except for the baby para-
dressed in brightly colored outfits, and today phernalia spread throughout. There are two
she has pink butterfly booties on her tiny feet. high chairs, a pink play seat and a blue one,
Marianna has a diagnosis of infantile spasms, multiple blankets, and several containers of
a form of seizures, and has little vision, toys. The carpet is soft and furniture is pushed
although it is still difficult to determine how back so the infants have more space to play.
much. Marianna is 18 months old, but cannot There is no TV in the living room. The dining
sit or roll on her own and has limited hand table is large and has many chairs. It takes up
movement and trunk control. Jenna and Susan over half of the living space. This is a home
have been working with Marianna’s family that is focused on family relationships. Child
since she was 4 months old. Marianna smiles care duties are the responsibility of all, so Rita
as Jenna’s voice greets her in Spanish. has a lot of support.
The f amily is pleased with Marianna’s Susan returns with the w ater mat, places it
current progress in eating from a spoon. Rita, on the floor, and asks if Rita will lay Marianna
Marianna, Jenna, and Susan sit in the living down and start by putting her feet on it.
room with Marianna in the m iddle. Susan has Jenna translates and says Rita has never seen
brought a w ater mat for Marianna to try to sit one of t hese. Susan explains how the w ater
on, and she excuses herself to the kitchen mat w ill provide a safe surface for Marianna
to fill it with warm water. A water mat is an to explore different parts of her body with
inflatable plastic object the size of a placemat. resistance and balance. The w ater w
ill “push
It is easily filled with whatever temperature back” when Marianna pushes on the mat.
of water is comfortable. B ecause the w ater Susan watches to see if Rita is comfortable
moves when sat on, it gives children the with moving the w ater u
nder Marianna’s
sense of moving through space. It is an feet. Rita keeps a watchful eye but does not
age-appropriate activity that w ill assist Rita in object to these unfamiliar interactions with
giving Marianna new postural experiences. Marianna.
138
S I D E B A R 4 . 4
Marianna begins to kick her feet and smile. Marianna is sitting up so much better than
Rita smiles and the three adults discuss how she was before they went to Mexico. They are
they should move slowly when introducing truly excited about her progress. Rita moves
something new. Susan asks Rita if she can Marianna into a sitting position, and Susan
help move Marianna’s upper body onto the shows Rita and Jenna how the feedback from
water mat. Jenna reflects out loud that it is the water mat can help Marianna work on
nice that we can use warm w ater, like in the her balance. Marianna laughs and Rita
bathtub. She asks, “Does Marianna like her smiles.
bath?” Marianna begins to tire, and Rita cradles
Rita smiles and explains that yes, her in her arms. Susan begins to talk about
Marianna loves to splash and play in the watching how she crawls. This is one way to
warm water. Jenna translates this to Susan. help Rita and other family members learn
Rita remarks that Marianna will smile, kick about crawling in order to help Marianna
her feet, and breathe faster in excitement more. Marianna is starting to push up on her
when she hears the water r unning in the arms and pull herself forward, but she moves
bathtub. Susan and Jenna both think that it stiffly in a straight line, not fluidly. Rita seems
is good that Marianna knows some daily interested, and though she does not say so,
routines and that Rita notices this commu- Jenna and Susan surmise that Rita wants Mari-
nication. Susan slowly moves Marianna anna to crawl someday. Susan points out that
from side to side on the w ater mat and the crawling is a side-to-side movement, not just
three adults share Spanish “knee-b ouncer” back and forth. When c hildren cannot see,
songs. they do not know how to move that way unless
Jenna struggles to remember a knee-bouncer an adult shows them. Susan suggests using
song in Spanish, and Rita and her sister help the water mat to help Marianna feel safer
with the words. Most mothers and babies share moving side to side. Jenna appreciates the
simple songs, but the Spanish songs are suggestion, and she demonstrates how Rita
different. This is an opportunity for Rita and her could hold Marianna in her lap and rock her
sister to be the “experts” and teach Jenna and side to side instead of back and forth. Rita
Susan. Marianna has favorite songs, although says she will try t hese games during the next
Rita is shy about singing in front of her visitors. week and see if Marianna is stronger. Susan
After the s isters have taught them a song about says she can keep the water mat. Jenna,
making tortillas (similar to “Pat-a-Cake”), Jenna Susan, and Rita sing “adios” to Marianna as
and Susan share “Row, Row, Row Your Boat” part of their home visit routine, and she
as an English alternative. smiles sleepily. Rita is rocking her side to side
At this point, Marianna’s cousin crawls as they leave.
over. He is curious about the water mat and Jenna and Susan reflect on the visit as
touches the surface with a hesitant gesture. they walk to their cars. Marianna certainly
Rita says she cannot believe he is crawling, has made some progress since they saw her
and looks like she might cry. Jenna says, a month ago. Is this because she has had a
“It must be hard for you to see him crawl.” break from weekly therapy, or is it because
Jenna’s comment, which acknowledges Rita’s her seizures have decreased? Susan realizes
feelings, is an appropriate thing to say. As she that she may understand t hese changes more
adjusts to Marianna’s abilities, Rita needs to fully after she has made several visits to Mari-
hear that her feelings are okay. Rita shakes anna’s home, and she looks forward to the
her head, and Jenna and Susan remark that next visit in two weeks.
139
S I D E B A R 4 . 5
Suggestions for Working with Children with Visual Impairments
• Make no assumptions. • Change the child’s position and objects of

• Understand that learning proceeds from interest often—but always tell the child
parts to wholes. what you are d oing.
• Use concrete objects. • Create situations that facilitate the next

developmental milestone.
• Adopt the child’s point of view.
• Encourage the child to follow walls with his
• Address the child by name. or her hands.
• Allow time. • Increase the amount of sensory input.
• Use the body as a reference point. • Describe what the child cannot see.
• Capitalize on past experiences. • Recognize that all objects in the home are
potential toys for learning.
• Resist the attraction to be the child’s
“fairy godmother” who brings objects • Encourage the child to run, climb, and play
to the child and takes them away without with other c hildren.
the child knowing what you are • Help the child experience something new
doing. every day.
• Tie together all the separate pieces of • Give the child a chance to respond.
information that the child receives—make
• Work from behind.
connections.
• Use a hand-under-hand approach, rather
• Provide physical contact and than placing your hand over the child’s, to
guidance. give the child a sense of the movement you
• Keep the child engaged. are trying to demonstrate.
Sources: Adapted in part from Ferrell, K. A. (1997). Preface. What is it that is different about a child with blindness or
visual impairment? In P. Crane, D. Cuthbertson, K. A. Ferrell, & H. Scherb (Eds.), Equals in partnership. Basic rights for
families of c hildren with blindness or visual impairment (pp. v–vii). Watertown, MA: Perkins School for the Blind and
the National Association for Parents of the Visually Impaired; and Ferrell, K. A., Raver, S. A., & Stewart, K. A. (1999).
Techniques for infants and toddlers with visual impairments. In S. A. Raver (Ed.), Intervention strategies for infants
and toddlers with special needs: A team approach (2nd ed., pp. 298–330). Upper Saddle River, NJ: Merrill.
should not be allowed to become self-fulfilling about stages and structures never capture all the
prophecies. Teachers, families, and administra- nuances of child development, and . . . the possi-
tion professionals should use the results of aca- bilities often do outrun the predictions” (Greene,
demic exploration to gain a greater understanding 1992, p. 37).
of the development of c hildren with visual im-
pairments and to develop new ways of respond- For learning activities related to this
ing to the children’s unique learning needs. It chapter, log in to the online AFB Learning
is import ant to remember that “generalizations Center.
673–696). West Sussex, United Kingdom: John

REFERENCES Wiley & Sons.
Davis, P., & Hopwood, V. (2007). Inclusion for c hildren
Adams, R. C., Tapia, C., & Council on C hildren with with visual impairment in the mainstream
Disabilities. (2013). Early intervention, Part C ser primary classroom. Education 3-13: International
vices, and the medical home: Collaboration for Journal of Primary, Elementary and Early Years Edu-
best practice and best outcomes. Pediatrics, 132, cation, 30(1), 14–46.
e1073–e1088. DEC/NAEYC. (2009). Early childhood inclusion: A joint
American Printing House for the Blind. (2015). An- statement of the Division for Early Childhood (DEC)
nual report 2015: Distribution of eligible students and the National Association for the Education of
based on the federal quota census of January 6, Young Children (NAEYC). Chapel Hill: University
2014 (fiscal year 2015). Louisville, KY: Author. Re- of North Carolina, FPG Child Development In-
trieved from http://w ww.aph.org/federal-quota stitute. Retrieved from http://npdci.f pg.unc.edu
/distribution-2015/ /resources/a rticles/Early_Childhood_ Inclusion
Americans with Disabilities Act of 1990, Pub. L. No. Deitz, S. J., & Ferrell, K. A. (1994). Project PRISM: A
101-336, 42 U.S.C. § 12131 et seq., (1990). national collaborative study on the development
Barraga, N. C., & Erin, J. N. (2001). Visual impairments of c hildren with visual impairment. Journal of
and learning (4th ed.). Austin, TX: Pro-Ed. Visual Impairment & Blindness, 88, 470–472.
Bloom, B. S. (1964). Stability and change in h uman char- Dewey, J. (1933). How we think. Lexington, MA: D. C.
acteristics. New York: John Wiley & Sons. Heath.
Bodrova, E. (2008). Make-believe play versus aca- Division for Early Childhood. (2014). DEC recom-
demic skills: A Vygotskian approach to today’s mended practices in early intervention/early child-
dilemma of early childhood education. European hood special education 2014. Retrieved from
Early Childhood Education Research Journal, 16(3), http://w ww.dec-sped.org/recommendedpractices
357–369. Dunn, J., Brown, J., Slomkowski, C., Tesla, C., &
Brehony, K. J. (2009). Transforming theories of child- Youngblade, L. (1991). Young c hildren’s under-
hood and early childhood education: Child study standing of other p eople’s feelings and beliefs: In-
and the empirical assault on Froebelian rational- dividual differences and their antecedents. Child
ism. Paedagogia Historica: International Journal of Development, 62, 1352–1366.
History of Education, 45(4–5), 585–604. Dunst, C. J., & Gorman, E. (2011). Tactile and object
Bruder, M. (2010). Early childhood intervention: A exploration among young c hildren with visual
promise to c hildren and families for their f uture. impairments. CELL Reviews, 4(2), 1–9.
Exceptional Children, 76, 339–355. Dunst, C. J., & Trivette, C. M. (2009). Capacity-building
Carey, S. (2009). The origin of concepts. New York: Ox- family-systems intervention practices. Journal of
ford University Press. Family Social Work, 12, 119–143.
Crocker, A. D., & Orr, R. R. (1996). Social behaviors Dunst, C. J., Trivette, C. M., Hamby, D. W., & Bruder,
of c hildren with visual impairments enrolled in M. B. (2006). Influences of contrasting natural
preschool programs. Exceptional C hildren, 62(2), environment experiences on child, parent, and
451–462. family well-being. Journal of Developmental and
Cross, L., Salazar, M. J., Dopson-C ampuzano, N., & Physical Disabilities, 18(3), 235–250.
Batchelder, H. W. (2009). Best practices and Early Treatment for Retinopathy of Prematurity Co-
considerations: Including young c hildren with operative Group (ETRPCG). (2005). The incidence
disabilities in early childhood settings. Focus on and course of retinopathy of prematurity: Find-
Exceptional Children, 41(8), 1–8. ings from the Early Treatment for Retinopathy of
Daniels, H. (2011). Vygotsky and psyc hology. In U. Prematurity study. Pediatrics, 116, 15–23.
Goswami (Ed.), The Wiley-Blackwell handbook Education of the Handicapped Act Amendments, Pub.
of childhood cognitive development (2nd ed., pp. L. No. 99-457, Part H (1986).
Farrell, A. F. (2009). Validating family-centeredness in Gelber, A., & Isen, A. (2011, December). Children’s
early intervention evaluation reports. Infants and schooling and parents’ investment in c hildren: Evidence
Young Children, 22(4), 238–252. from the Head Start Impact Study (NBER Working
Ferrell, K. A. (1986). Infancy and early childhood. Paper No. 17704). Cambridge, MA: National
In G. T. Scholl (Ed.), Foundations of education for blind Bureau of Economic Research.
and visually handicapped children and youth (pp. 119– Gentaz, E., & Badan, M. (2003). Anatomical and func-
135). New York: American Foundation for the Blind. tional organization of cutaneous and haptic per-
Ferrell, K. A. (1997). Preface: What is it that is different ceptions: The contribution of neuropsychology and
about a child with blindness or visual impair- cerebral functional imagery. In Y. Hatwell, A. Streri,
ment? In P. Crane, D. Cuthbertson, K. A. Ferrell, & & E. Gentez (Eds.), Touching for knowing: Cognitive
H. Scherb (Eds.), Equals in partnership: Basic rights psychology of haptic manual perception (pp. 33–47).
for families of children with blindness or visual im- Philadelphia: John Benjamins.
pairment (pp. v– v ii). Watertown, MA: Perkins Gentaz, E., & Rossetti, Y. (1999). Is haptic perception
School for the Blind and the National Association continuous with cognition? Behavioral and Brain
for Parents of the Visually Impaired. Sciences, 22, 378–379.
Ferrell, K. A. (2011). Reach out and teach: Helping your Gesell, A. (1925). The m ental growth of the preschool
child who is visually impaired learn and grow (2nd child. New York: Macmillan.
ed.). New York: AFB Press. Gesell, A. (1940). The first five years of life: A guide to the
Ferrell, K. A., & Mamer, L. A. (1993). Visually impaired study of the preschool child. New York: Harper &
infants research consortium, March 1993 analysis. Un- Row.
published manuscript, University of Northern Gibson, E. J., & Walker, A. (1984). Development of
Colorado, Division of Special Education. knowledge of visual-t actual affordances of sub-
Ferrell, K. A., Raver, S. A., & Stewart, K. A. (1999). stance. Child Development, 55, 453–460.
Techniques for infants and toddlers with visual Goswami, U. (2011). Introduction. In U. Goswami
impairments. In S. A. Raver (Ed.), Intervention (Ed.), The Wiley-Blackwell handbook of childhood
strategies for infants and toddlers with special needs: cognitive development (2nd ed., pp. 5–10). West Sus-
A team approach (2nd ed., pp. 298–330). Upper sex, United Kingdom: John Wiley & Sons.
Saddle River, NJ: Merrill. Gray, C. (2005). Inclusion, impact and need: Young
Ferrell, K. A., Shaw, A. R., & Deitz, S. J. (1998). Project c hildren with visual impairment. Child Care in
PRISM: A longitudinal study of developmental patterns Practice, 11(2), 179–190.

of children who are visually impaired (Final Report, Greene, M. (1992). Beyond the predictable: A viewing
CFDA 84.023C, Grant H023C10188). Greeley: of the history of early childhood education. In L.
University of Northern Colorado, Division of R. Williams & F. P. Fromberg (Eds.), Encyclopedia
Special Education. of early childhood education (pp. 31–39). New York:
Ferrell, K. A., Trief, E., Dietz, S. J., Bonner, M. A., Cruz, Garland.
D., Ford, E., & Stratton, J. M. (1990). Visually Im- Guralnick, M. J. (2010). Early intervention approaches
paired Infants Research Consortium (VIIRC): First- to enhance the peer-related social competence of
year results. Journal of Visual Impairment & Blindness, young c hildren with developmental delays: A
84, 404–410. historical perspective. Infants and Young Children,
Fraiberg, S. (1977). Insights from the blind. New York: 23(2), 73–83.
Basic Books. Halford, G. S., & Andrew, G. (2011). Information-
Froebel, F. W. A. (1887). The education of man (W. N. processing models of cognitive development.
Hairmann, Trans.). New York: Appleton. In U. Goswami (Ed.), The Wiley-Blackwell handbook
Froebel, F. W. A. (1895). Education by development: of childhood cognitive development (2nd ed., pp. 697–
The second part of the pedagogies of the kindergarten 722). West Sussex, United Kingdom: John Wiley
(J. Jarvis, Trans.). New York: Appleton. & Sons.
Hatfield, E. M. (1975). Why are they blind? Sight-Saving Lascarides, V. C., & Hinitz, B. F. (2013). History of early
Review, 45(1), 3–22. childhood education. New York: Routledge.
Hatton, D. D. (2001). Model registry of early child- Ledoux, S. F. (2012). Behaviorism at 100. American Sci-
hood visual impairment: First year results. Journal entist, 100(1), 60–65.
of Visual Impairment & Blindness, 95(7), 418–433. Lowenfeld, B. (Ed.). (1973). The visually handicapped
Hatton, D. D., Bailey, D. B., Jr., Burchinal, M. R., & child in school. New York: John Day.
Ferrell, K. A. (1997). Developmental growth curves Lowenfeld, B. (1981). Berthold Lowenfeld on blindness
of preschool c hildren with visual impairments. and blind people: Selected papers by Berthold Lowen-
Child Development, 68, 788–806. feld. New York: American Foundation for the
Hatton, D. D., Ivy, S. E., & Boyer, C. (2013). Severe vi- Blind.
sual impairments in infants and toddlers in the Ludwig, J., & Miller, D. L. (2007). Does Head Start im-
United States. Journal of Visual Impairment & Blind- prove children’s life chances? Evidence from a
ness, 107(5), 325–336. regression discontinuity design. Quarterly Journal
Hatton, D. D., McWilliam, R. A., & Winton, P. J. (2002). of Economics, 122, 159–208.
Infants and toddlers with visual impairments: Lueck, A. H., Chen, D., Kekelis, L. S., & Hartmann, E.
Suggestions for early interventionists. ERIC (2010). Developmental guidelines for infants with vi-
Clearinghouse on Disabilities and Gifted Education. sual impairments: A guidebook for early intervention
Retrieved from ED473829 2002-11-00 (2nd ed.). Louisville, KY: American Printing House
Hatwell, Y. (2003). Introduction: Touch and cognition. for the Blind.
In Y. Hatwell, A. Streri, & E. Gentez (Eds.), Touching Maxfield, K. E., & Buchholz, S. (1957). A social maturity
for knowing: Cognitive psychology of haptic manual per- scale for blind preschool children: A guide to its use.
ception (pp. 3–14). Philadelphia: John Benjamins. New York: American Foundation for the Blind.
Hebbler, K., Barton, L. R., & Mallik, S. (2008). Assess- McGaha, C. G., & Farran, D. C. (2001). Interactions
ment and accountability for programs serving in an inclusive classroom: The effects of visual
young c hildren with disabilities. Exceptionalities, status and setting. Journal of Visual Impairment &
16(1), 48–63. Blindness, 95, 80–94.
Hebbler, K., & Gurlach-Downie, S. (2002). Inside the Meltzoff, A. N. (2011). Social cognition and the origins
black box of home visiting: A qualitative analysis of imitation, empathy, and theory of mind. In U.
of why intended outcomes w ere not achieved. Goswami (Ed.), The Wiley- Blackwell handbook of
Early Childhood Research Quarterly, 17, 28–51. childhood cognitive development (2nd ed., pp. 49–75).
Hunt, J. M. (1961). Intelligence and experience. New West Sussex, United Kingdom: John Wiley & Sons.
York: Ronald Press. Miller, P. H. (2011). Piaget’s theory: Past, present and
Individuals with Disabilities Education Improvement f uture. In U. Goswami (Ed.), The Wiley-Blackwell
Act (IDEA), 20 U.S.C. § 1400 (2004). handbook of childhood cognitive development (2nd
Koestler, F. A. (2004). The unseen minority: A social his- ed., pp. 649–672). West Sussex, United Kingdom:
tory of blindness in the United States. New York: AFB John Wiley & Sons.
Press. (Original work published 1976) National Association for the Education of Young
Kong, L. K., Fry, M., Al-Samarraie, M., Gilbert, C., Children (NAEYC). (2009). Developmentally appro-
& Steinkuller, P. G. (2012). An update on the priate practice in early childhood programs serving
prog ress and changing epidemiology of c auses children from birth through age 8. Washington, DC:
of childhood blindness worldwide. Journal of Author. Retrieved from https://w ww.naeyc.org
American Association of Pediatric Ophthalmology and /files/naeyc/file/positions/PSDAP.pdf
Strabismus, 16(6), 501–507. National Early Childhood Technical Assistance Cen-
Lally, J. R. (2013). For our babies: Ending the invisible ne- ter. (2011). The outcomes of early intervention for
glect of America’s infants. New York: Teachers Col- infants and toddlers with disabilities and their fami-
lege Press. lies. Chapel Hill, NC: Author. Retrieved from
http://w ww .n ectac .o rg /~ pdfs /p ubs /o ut c ome- Sameroff, A. J. (1975). Early influences on develop-
sofearlyintervention.pdf ment: Fact or fancy? Merrill-Palmer Quarterly of
National Scientific Council on the Developing Child. Behavior and Development, 21, 267–294.
(2007). The science of early childhood development: Sameroff, A. J., & Chandler, M. J. (1975). Reproductive
Closing the gap between what we know and what we risk and the continuum of caretaking casualty. In
do. Cambridge, MA: Harvard University, Center F. D. Horowitz, M. Hetherington, S. Scarr-Salapatek,
on the Developing Child. & G. Siegel (Eds.), Review of child development re-
Newborg, J., Stock, J. R., Wnek, L., Guidubaldi, J., & search: Vol. 4 (pp. 187–244). Chicago: University
Svinicki, J. (1984). Battelle Developmental Inventory. of Chicago Press.
Allen, TX: DLM Teaching Resources [Available Schellingerhout, R., Smitsman, A. W., & Cox, R.
from Riverside Publishing]. (2005). Evolving patterns of haptic exploration in
Norris, M., Spauld ing, P. J., & Brodie, F. H. (1957). visually impaired infants. Infant Behavior and De-
Blindness in children. Chicago: University of Chi- velopment, 28, 360–388.
cago Press. Section 504 of the Rehabilitation Act of 1973, as
Oberti v. Board of Education, 995 F.2d 1204 (3d Cir. amended, 29 U.S.C. § 701.
May 28, 1993). Senate Committee on Governmental Affairs. (1993).
Office of Management and Budget. (2007). Guide to the Government performance results act of 1993 report
Program Assessment Rating Tool (PART). Washing- (No. 103.58). Retrieved from http://w ww.white
ton, DC: Author. Retrieved from http://w ww.white house.gov/omb/mgmt-g pra/g plaw2m#h2
house.gov/sites/default /f iles/omb/part /f y2007 Sewell, T. (2012). Are we adequately preparing teachers
/2007_ g uidance_ final.pdf to partner with families? Early Childhood Educa-
Piaget, J. (1972). Some aspects of operations. In M. tional Journal, 40, 259–263.
Piers (Ed.), Play and development: A symposium Shonkoff, J. P. (2012). Leveraging the biology of adver-
(pp. 15–27). New York: W. W. Norton. sity to address the roots of disparities in health
Provence, S., & Lipton, R. C. (1962). Infants in institu- and development. Proceedings of the National Acad
tions. New York: International Universities Press. emy of Sciences in the United States of America, 109,
Puma, M., Bell, S., Cook, R., Heid, C., Broene, P., Jen- 1–6. Retrieved from http://w ww.pnas.org/cgi/doi
kins, F., Mashburn, A., & Downer, J. (2012). Third /10.1073/pnas.1121259109
grade follow-up to the Head Start Impact Study Shonkoff, J. P., & Meisels, S. J. (1990). Early childhood
final report (OPRE Report # 2012-45). Washing- intervention: The evolution of a concept. In S. J.
ton, DC: US Department of Health and Human Meisels & J. P. Shonkoff (Eds.), Handbook of early
Serv ices, Research and Evaluation, Administra- childhood intervention (pp. 3–31). New York: Cam-
tion for C hildren and Families, Office of Plan- bridge University Press.
ning. Retrieved from http://w ww.acf.h hs.gov Silverman, W. A. (1980). Retrolental fibroplasias: A mod-
/p rograms /o pre /r esearch /p roject /h ead -s tar t ern parable. New York: Grune & Stratton.
-impact-study-and-follow-up Skeels, H. M. (1966). Adult status of c hildren with
Quinn, P. C. (2003). Concepts are not just for objects: contrasting early life experiences. Monographs of
Categorization of spatial relation information the Society for Research in Child Development, 31,
by infants. In D. H. Rakison, & L. M. Oakes (Eds.), 1–65.
Early category and concept development: Making sense Skeels, H. M., & Dye, H. B. (1939). A study of the
of the blooming, buzzing confusion (pp. 50–76). New effects of differential stimulation on mentally
York: Oxford University Press. retarded c hildren. Proceedings of the American
Recchia, S. L., & Lee, Y. (2013). Inclusion in the early Association of Mental Deficiency, 44, 114–136.
childhood classroom: What makes a difference? New Skinner, B. F. (1968). Science and human behavior. New
York: Teachers College Press. York: F ree Press.
Rush, D. D., & Shelden, M. L. (2011). The early childhood Smyth, C., & Phangia Dewald, H. (2013, April).
coaching handbook. Baltimore: Paul H. Brookes. Teaching on the fly: Concepts for children with visual
impairment. Paper presented at the American US Department of Health and Human Serv ices (HHS)
Educational Research Association Annual Meet- & US Department of Education (DOE). (2015,
ing, San Francisco, CA. September 15). Policy statement on inclusion of
Spitz, R. A. (1945). Hospitalism: An inquiry into the children with disabilities in early childhood programs.
genesis of psychiatric conditions in early child- Retrieved from http://w ww2.ed.gov/policy/speced
hood. In R. S. Eissler (Ed.), Psychoanalytic study of /g uid/earlylearning/joint-statement-f ull-text.pdf
the child. New Haven, CT: Yale University Press. Vygotsky, L. S. (1986). Thought and language. Cam-
Streri, A. (2003). Manual exploration and haptic percep- bridge, MA: MIT Press.
tion in infants. In Y. Hatwell, A. Streri, & E. Gentez Warren, D. H. (1984). Blindness and early childhood
(Eds.), Touching for knowing: Cognitive psychology of development (2nd ed.). New York: American Foun-
haptic manual perception (pp. 51–66). Philadelphia: dation for the Blind.
John Benjamins. Warren, D. H. (1994). Blindness and c hildren: An indi-
Trohanis, P. L. (2008). Prog ress in providing serv ices vidual differences approach. New York: Cambridge
to young c hildren with special needs and their University Press.
families: An overview to and update on the im- Wellman, H. M. (2011). Developing a theory of mind.
plementation of the Individuals with Disabilities In U. Goswami (Ed.), The Wiley-Blackwell handbook
Education Act (IDEA). Journal of Early Intervention, of childhood cognitive development (2nd ed., pp. 258–
30(2), 140–151. 284). West Sussex, United Kingdom: John Wiley
Turnbull, A. P., Summers, J. A., Turnbull, R., Brother- & Sons.
son, M. J., Winton, P., Roberts, R., . . . Stroup- Wellman, H. M., Cross, D., & Watson, J. (2001). Meta-
Rentier, V. (2007). F amily supports and serv ices analysis of theory of mind development: The
in early intervention: A bold vision. Journal of Early truth about false belief. Child Development, 72(3),
Intervention, 29(3), 187–206. 655–684.
5
C H A P T E R
Growth and Development

in M
iddle Childhood
and Adolescence
Karen E. Wolffe
To hear an audio introduction observation as well as challenges imposed by

to this chapter by the author, environmental and societal barriers.
and to view a chapter over ♦ Parents, teachers, and other professionals can
view presentation, log in to the AFB Learning help children and adolescents with visual im-
Center. pairments by providing opportunities for them
to participate actively in society and achieve
important developmental milestones through
KEY POINTS
engagement in rites of passage that parallel

♦ Four major theoretical models guide our under- those experienced by young adults without dis-
standing of growth and development in middle abilities.
childhood and adolescence: the maturational, ♦ Children and adolescents with visual impairments
psychoanalytic, behavioral, and cognitive- who are given honest, sensitive feedback—
developmental theories. and, as a consequence, feel genuinely cared for—
♦ During m iddle childhood and adolescence, are more likely to have the knowledge and skills
young people with and without disabilities un- they need to develop into strong, healthy, and
dergo major physical, cognitive, and emotional productive adults.
changes due to maturation. Recent findings us-
ing scanning technology to record brain activity
suggest that there are neurological under INTRODUCT ON
pinnings for many of t hese changes.
Adolescence is the ultimate disability. All teenagers
♦ Students with visual impairments face unique hate their hands or their hair, feel stupid or awk-
challenges b ecause of their limited access to ward, and are certain that their tiny flaws and foi-
incidental information gathered through casual bles are the only things that o thers see about them.
146
Growth and Development in Middle Childhood and Adolescence 147
So to be a teenager coping with a disability is to be Walsh, 2004) suggest that the neurological
doubly disabled. (Seligman & Darling, 2007) changes that teenagers undergo are profound and
result in unprecedented behaviors in the individ-
iddle childhood and adolescence are character-
M ual. Strauch (2003) calls it
ized by prodigious growth, change, and, often,
turmoil. All youngsters experience the throes of brief insanity. . . . In their own way, the brain
physical, cognitive, and emotional development; scientists, too, have detected this polysided ado-
however, the focus in this chapter is on c hildren lescence, a normal brain evolution that includes
and youths with visual impairments. While it is moments of mayhem as well as growing preci-
difficult to divide h uman beings’ lives neatly into sion and passion. Inside the teenagers’ brains—
limited periods like childhood, adolescence, or smart ones, shy ones, silly ones—they’ve found,
adulthood, numerous authors have defined ad- and this word comes from the neuroscientists’
olescence as extending from approximately age own ungainly language, exuberance. (pp. 8–9)
10 or 11 to age 18 or 21 (American Academy of
Child and Adolescent Psychiatry, 2008; American In a nutshell, neuroscientists have found, in ado-
Psychological Association, 2002; Anderson & lescence, a massive remodeling of brain structure
Clarke, 1982; Fenwick & Smith, 1998; Lerner & affecting logic, language, impulses, intuition, and
Lerner, 1999; Marshall, 2006; Spano, 2004; Tan- inhibition. This extensive growth is called exu-
ner, 1962, 1991; Weiner, 1992). The time limits berance.
of adolescence have changed from one histori- Insights gained through neuroscientific study
cal period to another, from one culture to an- have helped parents and professionals alike
other, and from one social class to another as a understand that t here are physiological changes
consequence of society’s expectations and envi- taking place in adolescents’ brains that contrib-
ronmental factors. ute to behaviors that teens frequently exhibit—
Adolescence appears to be largely a phenom- taking risks, giving in to peer pressure, being
enon of modern Western society—a culture that overly emotional, lacking concentration, and
indulges its youngsters in an extended time for sometimes seeming to regress intellectually or
education and growth that was unheard of even become forgetful. For example, their penchant
a century ago, when c hildren as young as 10 w ere for risk taking may actually be a consequence of
often expected to assume adult-like responsibili- thinking longer about risks than adults do and
ties at home and in the community. Recent re- deciding a risk is worth taking (Benjamin, 2012).
search has provided evidence that adolescence This chapter pres ents current models of
may be occurring earlier in Western society, and human development and then specifically dis-

t here is speculation about the
causes for this cusses the development of adolescents, including
phenomenon (Biro, Greenspan, & Galvez, 2012; the biological phenomenon. The similarities and
Herman-Giddens et al., 1997; Rittenmeyer & differences between youngsters from about age
Huffman, 2003; Weil, 2012). However, one as- 10 to age 21 with unimpaired vision and those
pect of adolescence is common to all cultures, with visual impairments are described in the con-
social classes, and historical eras: the biological text of physical, cognitive, and emotional charac-
phenomenon (Dasberg, 1983; World Health Or teristics. Several sidebars present insights from
ganizat ion, n.d.). the perspective of a psychologist who works with
New discoveries in brain science (Benjamin, students who are visually impaired. The chapter
2012; Jensen, 2015; Kolbert, 2015; Strauch, 2003; concludes with a look at some of the key studies
parison of the four models is presented in

Table 5.1, and in the following sections, each
model is briefly discussed.
Maturational Model
Developmental psychologists who support the
maturational model believe that heredity (innate
biological strengths and weaknesses) is para-
mount in an individual’s development and has
much more influence than nurturing or the
Maria Ferrari
environment. Genet ic and physiological f actors
contribute to and influence development more
than environmental factors like nurturance. In
Involvement with peer groups is an important develop- short, they believe that a child’s development is
mental process for teenagers. governed by a pattern built in at birth. Arnold
Gesell, a physician whose work in the 1920s
that have explored the impact of visual impair- was strongly influenced by Charles Darwin’s
ment on adolescents. studies of biological evolution, and Konrad Lo-
renz w ere two early theorists who espoused the
maturational model. Lorenz is perhaps best re-
MODELS OF membered for his experiments with newborn
HUMAN DEVELOPMENT ducklings in which he described imprinting—
the innate process in which a duckling (or other
A review of the literature on c hildren’s typical de- animal) follows the first thing that moves and
velopmental sequences reveals four major theo- perceives that “t hing” as “mother,” guardian, and
retical models: the maturational model, the teacher.
psychoanalytic model, the behavioral model, Both Gesell (1928, 1956) and Lorenz (1958,
and the cognitive-developmental model (Bee & 1965) believed that the sequence of human de-
Boyd, 2011; Dworetzky, 1996; Salkind, 2004). velopment was determined by the biological
These four theoretical models attempt to explain and evolutionary history of the species. In other
human behavior in different ways; some explain words, they thought that a child progresses
or try to predict behavior on the basis of environ- through a series of stages that recount the devel-
mental factors, whereas others emphasize the opmental sequence characterized by his or her
interaction between the environment and an in- ancestors. In addition to the contributions Gesell
dividual’s genet ic makeup. made to the maturational model, he made sig-
Although t here are adherents of all four mod- nificant contributions in research on human de-
els, t here is no consensus in the field of human velopment by introducing studies of twins to
development that one model is better or more ac- compare the effects of nature (heredity) versus
curate than another. Many contemporary child nurture (environmental factors) and document-
psychologists borrow from the array of models ing his efforts on film (Gesell & Thompson, 1929,
and consider the interaction between nature and 1941). His work chronicled the development of
nurture to be the real answer to the question of “normal” c hildren and greatly influenced mid-to
how children develop (Bee & Boyd, 2011). A com- late-20th-century child-rearing patterns, most
T A B L E 5 . 1
An Overview of Models of Human Development
Cognitive-
Maturational Psychoanalytic Behavioral Developmental
Models Model Model Model Model
Assumptions Development is Development is Development Development is
determined by based on a occurs as a contingent on
biological factors. person’s need to person learns the modification
satisfy basic from his or her of a person’s
instincts. environment. cognitive
structures over
time.
Implications for Importance of Impact of early Understanding Understanding
practitioners biological parent-child of behavioral of cognitive
determinants and relationships on analysis, processes and
how children are personality modification of how to engage
reared development behavior, and children in
extinction of appropriate tasks
maladaptive to match their
behavior developmental
level
notably through its incorporation in the work of Freud believed that p eople encountered psycho-
Dr. Benjamin Spock (Salkind, 2004). logical conflicts (weaning, toilet training, identi-
fication with the same-sex parent, development
of ego defenses, and mature sexual intimacy) at
Psychoanalytic Model each of t hese stages that had to be resolved for

Freud (1905) introduced the psychoanalytic model them to become healthy adults.
at the beginning of the 20th c entury. His basic as- According to Freud, biological needs w ere
sumption was that h uman development consists paramount in development, and behaviors w ere
of dynamic, structural, and sequential compo- expressions of unconscious psychological and so-
nents that are distinct and influenced by a con- cial conflicts. Resolution of these conflicts, he
tinual need to gratify basic instincts. Freud thought, was an ongoing pro cess. Although
defined the dynamic component of the model as Freud’s work met with resistance from the scien-
the psyche, or the mind, which he characterized tific community b ecause of its focus on the un-
as fluid and energized. The structural component conscious and his attempts to tap into the
of the model consisted of the id, ego, and super- unconscious through hypnosis, Freud’s efforts to
ego, three separate but interdependent psycho- document and systematically organize a theory
logical structures. The sequential component of of development w ere a significant contribution
the model focused on the notion that human be- (Salkind, 2004).
ings prog ress developmentally through different Many modern psychoanalytic theorists have
stages (oral, anal, phallic, latency, and genital) gravitated to the work of Erikson (1963, 1980),
that correspond to erogenous zones of the body. who deemphasized the centrality of the sexual
drive. Although he shared many of Freud’s positive emotional support from caregivers, un-
assumptions, Erikson focused on the gradual
derscoring the impact of good parenting and
emergence of self-identity, rather than the sex- positive family relationships on c hildren’s lives.
ual drive, as the primary motivation for growth The lack of empirical evidence to support this
and development. He proposed the following model’s various hypotheses limits its adherents
eight psychosocial stages, five of which occur in (Bee & Boyd, 2011).
childhood:
1. Basic trust versus mistrust (birth to 1 year). At

Behavioral Model
this stage, c hildren bond with their primary The work of Ivan Pavlov, who introduced the be-
caregiver and realize that they can make havioral model in the early 20th century, focused
t hings happen. on classical conditioning. In Pavlov’s (1927) most
2. Autonomy versus shame, doubt (2–3 years). At famous experiment, classical conditioning
this stage, c hildren engage in motor skills o ccurred when a dog learned a new behavior
to make choices and are toilet trained; they (salivating) in response to the pairing of an un-
learn control but may develop shame if train- conditioned stimulus (food) with a previously
ing in skills is not handled well. neutral stimulus (a bell); in time, the dog sali-
vated at the sound of the bell without seeing food.
3. Initiative versus guilt (4–5 years). At this stage,
The dog was already programmed (innately) to
c hildren organize activities around goals and
salivate at the presentation of food, which is con-
become more assertive; conflict with their
sidered an unconditioned response. Salivating
same-sex parents may lead to guilt.
at the sound of the bell was the conditioned re-
4. Industry versus inferiority (6–12 years). At this sponse. In summary, classical conditioning involves
stage, c hildren are absorbed in learning cul- attaching an old response to a new stimulus.
tural mores and acquiring academic and tool- Operant conditioning, in which an associa-
usage skills. tion is formed between a behavior and its con-
5. Identity versus role confusion (13–18 years). sequences through reward or punishment, is a
At this stage, youths adapt to the physical term defined by B. F. Skinner (1938). For exam-
changes of puberty, make career choices, ple, a teacher who wants a student to sit still in
achieve a sexual identity, and clarify values. class and do classwork may choose to reward the
student with tokens or praise for demonstrating
6. Intimacy versus isolation (19–34 years). At this
the appropriate behavior. The student learns to
stage, people form intimate relationships,
associate the desired behavior (sitting still and
marry, and start families.
doing classwork) with the reward (tokens or

7. Generativity versus stagnation (35–64 years). At praise). While classical conditioning involves a
this stage, individuals raise c hildren, perform subject making an association between an invol-
life work, and prepare the next generation. untary response and a stimulus (like Pavlov’s dog
8. Ego integrity versus despair (65 years and older). salivating at the sound of the bell), operant condi-
At this stage, p eople integrate the earlier tioning involves a subject making an association
stages and accept their basic identities. between a voluntary behavior and a consequence.
Adherents of the behavioral model view de-
Both Freud and Erikson emphasized the crit- velopment as a function of learning that proceeds
ical importance of the early years of c hildren’s according to certain laws or princi ples. The
lives and focused attention on c hildren’s need for human being is seen as reactive, not active, and
behavior is considered a function of its conse- haviors in order to meet the expectations of soci-
quences. If the consequences of a given behavior ety or others; for example, reinforcement programs
are good or positive, then the behavior is rein- to reduce self-stimulatory or acting-out behaviors
forced and is likely to continue. However, if a be have proven effective over time. Likewise, the suc-
havior is punished or ignored, then it is likely to cess of teaching multistep sequences to children
diminish or be extinguished. and youths with developmental disabilities using
The behavioral model is a mechanistic model behav ior modification techniques such as task
in that it assumes that the environment is more analytic sequencing and positive reinforcement
important in development than a person’s heredi- has encouraged use of the behavioral m odel.
tary attributes. Behaviorists (Bandura, 1977, 1979,
1986, 1989; Skinner, 1938, 1957, 1976) believe Cognitive-Developmental Model
that c hildren’s behaviors are modified or learned
over time with both positive and negative rein- Piaget (1932, 1952, 1977), a psychologist, pre-
forcement. They have shown, through extensive sented the cognitive-developmental model in re-
scientific study, the power of consistent and in- sponse to the behavioral model. (Chapter 4 in this
termittent reinforcement schedules. Consistent or volume contains additional information about
scheduled reinforcement occurs when a behavior is Piaget’s theory applied to young c hildren.) In his
reinforced at specified times, for example, re- theory, he stressed the individual’s active, rather
warding a child who gets to school on time every than reactive, role in the developmental process.
day in a semester. Intermittent reinforcement, which Cognitive- developmentalists believe that devel-
is the most powerful paradigm, occurs when a opment occurs in a series of qualitatively distinct
behavior is reinforced but not in a predictable stages and that all people undergo the same stages
fashion. In this instance, by randomly rewarding in the same sequence but not necessarily at the
the desired behavior, the child is more likely to same chronological time. The stages are consid-
continue getting to school on time because he ered hierarchical, and the later stages subsume
or she is waiting to be reinforced, rather than the characteristics of the earlier stages, so that
expecting a reinforcement at a scheduled inter- what c hildren learn in the earlier stages is used
val. Providing the reinforcement on a consistent to develop more complex and mature sensory
schedule requires diligence by the giver of the re- motor schemas to use in life.
inforcement that is often difficult to maintain, Piaget’s four proposed stages of development
and if the child becomes dependent on the rein- are as follows:
forcement, the behavior may not continue when
the reinforcement is withdrawn. Therefore, in- 1. Sensorimotor (birth to 18 months). At this stage,
termittent schedules of reinforcement are the children respond to the world almost entirely
most power f ul. Perhaps the greatest contribu- through sensory and motor schemas, operate
tions of the behaviorists have been an emphasis entirely in the present and without intentions,
on the scientific study of behavior, systematic and have no internal representation of objects.
analysis of behavior, specific techniques to mod- 2. Preoperational (18 months to approximately age
ify deviant behaviors, and encouragement of pro- 6). At this stage, c hildren begin to use sym-
grammed instruction (Salkind, 2004). bols and language, engage in pretend play,
Pract it ioners working in the fields of special exhibit egocentrism, and can perform simple
education and rehabilitation have found the classifications but cannot understand that
behavioral model helpful when working with two amounts that look differe nt can be the
c hildren or adults who need to modify their be same (conservation).
3. Concrete operational (from about age 6 to age Piaget’s work is the emphasis by contemporary
12). At this stage, c hildren discover strategies developmental theorists on qualitative change—
for exploring and interacting with the world how an adolescent approaches a problem or a
and master internal schemas that enable task is not only faster than but qualitatively dif
them to perform mathematical functions, fere nt from how an infant, toddler, or child ap-
categorize objects and entities into related proaches a similar problem or task.
groupings, and perform feats of logic. Vygotsky (1962, 1978), another cognitive-
4. Formal operational (from approximately age 12 developmental theorist, focused on the develop-
onward). At this final stage, youngsters can ap- ment of c hildren’s mental abilities such as problem
ply complex m ental operations to ideas and solving through the integration of emotion and
thoughts, as well as to objects and experi- cognition. (See Chapter 4 in this volume for a dis-
ences, and exhibit deductive reasoning. cussion about Vygotsky’s theory applied to young
children.) At the core of his theory is the notion
Piaget believed that c hildren actively partici- that children develop through interactions be-
pate as they develop an understanding of the tween themselves and their social environment.
world in which they live. He thought that babies He emphasizes the salience of language and cul-
are born with a small repertoire of basic sensory ture; however, his construct of a child’s zone of
schemas, such as tasting, touching, looking, proximal development has likely had the greatest
hearing, and reaching, and that they develop impact on modern education (Aldridge & Gold-
mental schemas, such as categorizing, over time. man, 2007; Sroufe, Egeland, Carlson, & Collins,
Schemas are often loosely defined as concepts or 2005).
a “complex of ideas,” but Piaget used the term to The zone of proximal development equates to a
denote the action of categorizing in some part ic child’s instructional level. The zone of proximal
ular mental or physical fashion (Bee & Boyd, development occurs when a youngster has emerg-
2011). ing skills or concepts and can add to his or her un-
According to Piaget, c hildren shift from the derstanding with instruction or help from an adult
simplistic schemas of infancy to increasingly or a more knowledgeable peer (Vygotsky, 1978).
complex m ental schemas through assimilation, The assistance an adult or a more knowledgeable
accommodation, and equilibration. Assimilation peer provides is known as scaffolding; however,
is the process of absorbing an experience or an Vygotsky did not use the term, scaffolding—he
event into a schema—connecting the concept to simply referred to the process as assistance from
whate ver other concepts are similar. Accommo- t hose more knowledgeable. (For more
dation (the reorganizat ion of thoughts) is a com- information about the Vygotskian ap-
plementary process that requires changing a proach, see the Resources section in the
schema as a result of the assimilation of new in- online AFB Learning Center.) Vygotsky’s prem-
formation. Equilibration is the means by which ise is that what a youngster can do today with
c hildren achieve balance in their lives between help from an instructor or peer with greater com-
what they know and the new things they are petence, he or she can do tomorrow without as-
learning. sistance (Vygotsky, 1978).
Although some of Piaget’s ideas have been
called into question, his notion that a child is ac-
tively engaged in constructing an understanding
Disability and Models of Development
of his or her world has been widely accepted The difficulty for prac
ti
tion
ers and families of
(Bee & Boyd, 2011). An import ant outgrowth of children and youths with disabilities in applying
t hese theories is that all of them are based on ob- growth spurt, which usually begins at age 10 or
servations of children without disabilities, and the 11 in girls and at age 12 or 13 in boys, includes
theorists have paid little attention to the impact of considerable physical changes. For girls, t hese
disability on development, seeing variations from physical changes include the development of
the norm as evidence of abnormality. While it is breasts; the appearance of pubic, underarm, and
important to understand how typical children de- body hair; menstruation; and the production of
velop, there are many professionals and adults underarm perspiration. For boys, the changes in-
with disabilities who do not feel compelled to “fix” clude growth of the testes; darkening of the skin of
the impairment or problem but instead determine the scrotum; lengthening and thickening of the
how to enable individuals to function to the best penis and the onset of ejaculation; the appearance
of their abilities (Skelton & Rosenbaum, 2010). of pubic, underarm, body, and facial hair; the pro-
A more promising con temporary approach duction of underarm perspiration; and a deepen-
may involve integrating aspects of traditional, ing of the voice (Fenwick & Smith, 1998). Although
normative developmental models with disability- these physical changes often begin in the late ele-
specific developmental thinking and pro cesses. mentary school years, they continue through
For instance, the International Classification of Func- middle school and often extend into high school.
tioning, Disability, and Health combines contextual Perhaps the greatest physical changes occur
factors (personal and environmental) to describe during middle school (sixth, seventh, and eighth
and measure health without a prognosis or defini- grades) or junior high school (eighth and ninth
tion of expected outcomes (WHO, 2001). This ap- grades). For many young p eople, this period is
proach recognizes people’s individuality and the truly a transition from childhood to adulthood.
uniqueness of their situations in order to narrow Many young women reach physical maturation at
the gap between their abilities (capacity) and age 14 or 15, and many young men do so at age
what they usually do (performance) holistically— 15 or 16, while they are in high school. Young
without adherence to a normative developmental people may continue to gain height and weight
sequence (Skelton & Rosenbaum, 2010). in their 20s, but, for the most part, they complete
the bulk of their physical development before
they leave high school.

DEVELOPMENTAL
CHARACTER ST CS OF Appearance, Self-Esteem, and Fitting In
ADOLESCEN S
hese physical changes and milestones in growth
T
In the sections that follow, three significant areas are usually the same for youths with and without
of development in adolescence are detailed: physi- visual impairments. However, Western society
cal, cognitive, and social and emotional. In each adheres to a “body-perfect” tenet that basically
section, the attributes that are universal to young- presupposes that being intact physically is criti-
sters at this age are described. Any differences or cal to life satisfaction (Buscaglia, 1975). The most
concerns pertinent to c hildren and youths with popular c hildren, youths, and adults are often
visual impairments are then discussed. those who look most attractive to others; they
have no apparent cosmetic flaws. This notion of
a perfect body c auses many adolescents sig-
Physical Characteristics nificant stress (Rittenmeyer & Huffman, 2003;
During the later years of elementary school, girls Wiseman, 2002). Young sighted girls and boys
and boys typically experience a growth spurt. This spend an inordinate amount of time in front of
their mirrors, scrutinizing their appearance. They 1971). However, what these and other studies
gain and lose weight as they judge themselves to have consistently indicated is that young people
be too skinny or too fat to fit the body-perfect im- who are visually impaired and who have positive
age presented in the popular press and on film. support from their families and strong peer net-
They paint their faces and dye their hair, tattoo works have higher levels of self-esteem than do
and pierce their body parts, and dress differently t hose without such supports (Huurre et al., 1999;
from adults in their midst as they emulate popu Kef, 1997; Lewis & Wolffe, 2006; Rosenblum,
lar musicians, athletic superstars, and film char- 1997; Wolffe & Sacks, 1997).
acters. Adolescence is a time to experiment with In addition to cosmetic or surface appear-
matching one’s body and appearance to whatever ance, how one prese nts oneself “in total” is a
the popular image of the body-perfect is (Benja- significant issue in adolescence. Teenagers often
min, 2012; Elkind, 1997; Fenwick & Smith, 1998; adopt certain ways of walking, sitting, standing,
Wolf, 1991). and posturing that are indicative of how they feel,
Without good, functional vision (vision that how they want to be seen, and how they see
is reliable and useful for performing activities of themselves. In some cases, their movements and
daily living), this task is difficult, if not impossi- mannerisms may identify them as belonging to
ble. It is difficult for c hildren and youths with vi- specific cliques or social groups. Certainly, how
sual impairments to discern what their cosmetic they walk or move through space tells others
liabilities may be—unless someone with good vi- about their level of comfort and how well they “fit
sion gives them feedback on their appearance. If in” to the social milieu.
youngsters have any kind of overt cosmetic flaw, For c hildren who are congenitally blind or se-
such as damaged eyes or facial scarring, the task verely visually impaired, this may be another
of fitting the body-perfect mold is nearly impos- area of concern. If c hildren with visual impair-
sible. Sidebar 5.1 provides some insight into ments skip early developmental stages, such as
some of the more common physical character- the critical crawling stage, they may demonstrate
istics that may cause concern and cosmetic differences in gait, posture, and fluidity of move-
options to diminish the overall impact these ment (Dewerchin & Keppens, 2013; Fazzi &
characteristics may have. Often c hildren with Bianchi, 2016; Gunaratne, 2016; Lechelt & Hall,
cosmetic flaws are teased at school and at play, n.d.). These observable differences between stu-
which contributes to their poor body image and, dents who are sighted and students who are visu-
in turn, lowers their self-esteem (Rittenmeyer & ally impaired may cause difficulties for c hildren
Huffman, 2003; Schonfeld, 2000; Tuttle & Tut- who are trying to fit in with nondisabled peers.
tle, 1996). Likewise, the tendency of some students with vi-
Positive self-esteem is the first internal capac- sual impairments to engage in stereotypic man-
ity or resource for developing social competence nerisms, such as rocking, eye poking, or flicking
(Peterson & Leigh, 1990). Studies of the impact their hands in reaction to the lack of visual sen-
of visual impairment on self-concept and self- sory input, negatively influences their sighted
esteem have been contradictory. Some research peers’ perception of them (MacCuspie, 1996;
indicates that t here are differences in the levels of Sacks, 2014) b ecause t hese behaviors do not con-
self-esteem evidenced by youths with visual dis- form to the socially age- appropriate be haviors
abilities and those without disabilities, while demonstrated by sighted teenagers. Teenagers
other research has found no differences between do not necessarily conform to the adult world
the two groups (Beaty, 1991, 1994; Head, 1979; in which they live, but they conform avidly to
Huurre, Komulainen, & Aro, 1999; Meighan, the teenage world they aspire to join. Thus, the
S I D E B A R 5 . 1
Teens with Challenging Physical Characteristics
Young adults want to be like o thers. It is a signed for people with sensitive skin, and
driving force in their emotional makeup and self-tanning products may not work and
the subject of many popular books and can turn their skin an orangey color. Many
blogs targeted to parents and professionals individuals also dye their eyebrows or use
(Benjamin, 2012; Newman, 2010; Pickhardt, cosmetics to darken their brows and eye-
2013; Wiseman, 2002). These authors are lashes, or try coloring their hair. Again, dye
trying to help caregivers and professionals may damage hair or turn it an unexpected
ameliorate any psychological damage that color, and due to the lack of pigmentation
may be perpetrated by teasing or bullying the color added tends to last longer than in
of teens who do not fit the “body-perfect” individuals with normal pigmentation.
mold. (Rinses may be a safer way to trial a change
Cosmetic variations from the norm are in hair color.) The National Organization on
frequently associated with some of the Albinism and Hypopigmentation (NOAH)
syndromes resulting in visual impairment. and the United Kingdom’s Albinism Fellow-
For instance, albinism, glaucoma, CHARGE ship both support community discussion
syndrome, Miller syndrome, optic nerve forums on albinism on their websites.
hypoplasia, retinoblastoma, WAGR syndrome, (For more information, see the
and so forth. Such syndromes and related eye Resources section in the online AFB
disorders may result in aniridia, strabismus, Learning Center.)
nystagmus, or other observable eye or facial Aniridia, or the apparent absence of an iris,
anomalies as well as physical characteristics which is frequently associated with optic
that are overt. nerve hypoplasia and may occur with other
A prime example is albinism, which syndromes, results in eyes that look as if they
typically results in little or no pigmentation in have only a pupil in the white of the eye or a
the eyes, skin, and hair. This lack of pigmenta- fully dilated pupil. Individuals with aniridia
tion tends to result in stark white skin and typically also have nystagmus and are prone to
hair (including eyelashes and eyebrows) or other disorders such as glaucoma. Colored or
unnaturally pale skin and yellow or reddish opaque contact lenses can give the appear-
hair in individuals of Asian or African decent, ance of an iris and improve an individual’s
and pale blue or brown eye color, which, due cosmetic appearance, as well as help with
to the translucence of the irises, sometimes glare and photophobia.
makes the eyes appear red or purple. Al- Glaucoma, particularly congenital and
though many young people choose to do juvenile glaucoma, can cause the eyes to
nothing to change these physical characteris- appear bulbous and protruding; in addition,
tics, o
thers are uncomfortable with them and there is often edema and opacification of the
desire cosmetic fixes. Tinted contact lenses or cornea, which cause additional cosmetic
spectacles to aid vision may complement eye issues. Tinted spectacles are an important
color and minimize photophobia. Some consideration as long as they do not interfere
young people with albinism choose to wear with visual acuity. Likewise, nystagmus, which
light cosmetics to add color to their skin tone causes involuntary movement of eyes and is
or experiment with self-tanning lotions. associated with many syndromes resulting in
However, they must use cosmetics de- visual impairment, may be perceived as
155
cosmetically unattractive and can be less so as Crouzon and Miller may cause cosmeti-
when the individual is able to wear tinted cally unattractive features that may need to
spectacles without interfering with visual be addressed in the adolescent years, if not
acuity. beforehand. If an eye has been enucleated,
Strabismus (misaligned eyes) is another the individual may wear a shield or pros-
condition that may result in a cosmetic flaw thetic eye and rectify much of the cosmetic
that can lead to prejudice in school and challenge. Cosmetic surgery may help
employment (Schonfeld, 2000). In many alleviate some craniofacial malformations
instances, strabismus can be corrected and should be seriously considered if the
nonsurgically if treated when c hildren are young adult is uncomfortable with his or her
young, but for teens and young adults the appearance. Cover makeups such as Derm-
problem may require surgery. Although ablend can also be used judiciously to hide
surgical intervention may help cosmetically, birthmarks or ameliorate other cosmetic
it may not correct visual acuity, and concerns.
individuals considering such surgery need Ultimately, the use of cosmetics or cos-
to be apprised of the possible consequences metic approaches such as tinted glasses is
in advance of electing to have such surgeries the individual’s decision. It is important to
performed. respect young people’s rights to use or not to
Some conditions, such as retinoblastoma, use cosmetics or other disguising techniques
may involve treatments that result in enucle- to minimize cosmetic flaws. Some teens and
ation of an eye or both eyes, in some in- young adults are comfortable with their
stances, and, if surgeries or radical radiation differences and only need support from
to remove tumors is required, may result in family members, their friends, and the
facial scarring or structural damage to the professionals with whom they work to
bones of the face. Likewise, syndromes such continue to feel good about themselves as
as CHARGE or craniofacial syndromes such they are.
behaviors and mannerisms they adopt must fit many hardships on teenagers with visual impair-
the be haviors and mannerisms demonstrated ments (Chase, 1986; Corn & Rosenblum, 2000;
by their friends or the groups they wish to join Corn & Sacks, 1994; Erin & Wolffe, 1999; Lowen-
because anything that sets people apart from the feld, 1971; Sacks & Rosenblum, 2006; Wolffe,
strictures of t hose cliques or groups will frequently 2006). Driving is an important milestone in the
be disdained (Wiseman, 2002). developmental process, and adolescents who are
not able to drive need support from their families
and friends to participate actively in social and
Driving
vocational activities. These youngsters also need
Issues surrounding physical limitations, par- to learn how to negotiate and solve transporta-
ticularly the inability to drive, are particularly tion problems that w ill only increase with the
poignant for teen a gers with visual impair- demands of adult responsibilities. Sidebar 5.2
ments. Getting a driver’s license is a rite of pas- describes observations about and interventions
sage for many teenagers in Western society, and for adolescents who are faced with this difficult
being physically restricted from d
oing so imposes issue.
S I D E B A R 5 . 2
Perspectives on Driving
JOAN B. CHASE
If an individual is blind, two important however, t hose who have conditions that
disability-specific areas of learning are literacy result in severely limited or no vision are not
and mobility. The latter objective is often among the citizens with driving privileges.
attained by training with an orientation and However, they are eligible to obtain a picture
mobility (O&M) specialist (see Volume 2, identification card in lieu of a driver’s license,
Chapter 20). Safe travel permits a person which is recognized in the same way a driver’s
without sight to explore a variety of environ- license is for travel or other official identity
ments. When visual acuity is diminished, the purposes.
same two issues exist but may involve different Although the age at which a person may
options, particularly concerning mobility and obtain a driver’s license varies from state to
transport. Advances in technology and optics state, high school students throughout the
have opened possibilities for driving vehicles United States eagerly anticipate this “rite of
among various groups of disabled individuals, passage” into adulthood for about a year
including t hose with low vision (Corn, Lipp before they take the required driving tests.
mann, & Lewis, 1990; Corn & Rosenblum, Many adults can remember the feelings
2000; Jose, 1983; Quillman & Goodrich, associated with learning to drive and the
2004). excitement and fear the process aroused.
For example, bioptic lenses and other Driving a car is highly valued by most
telescopic devices have been recommended people in the United States both for trans-
for drivers with albinism (National Organiza portation purposes and status (unless they
tion for Albinism and Hypopigmentation, live in one of the rare metropolitan areas
2015) and others with stable visual impair- where public transportation is preferred).
ments (BiopticDrivingUSA, 2015; Quillman & Furthermore, cars are marketed as objects of
Goodrich, 2004). There are additional strate- desire and beauty. T hese f actors lead young
gies for travel that are becoming available with people to yearn for cars of their own and the
the advent of new tools for individuals who are ability to drive them, and young people with
blind and those whose vision may preclude visual impairments feel left out and sad
seeing enough to drive an automobile safely when they consider a life without driving a
(Rosenblum, 2011). car. This is particularly true for teenagers
The latest among these options is still in whose friends own and drive automobiles.
the developmental stage: self-driving cars. Visual impairment can raise feelings of
Many large automotive and technology deprivation and incompetence when a
companies are involved in the developmental teenager cannot do everything his or her
process. T hese cars may be the answer for friends are doing.
many people without sight or with impaired Discussions in groups for adolescents with
sight. However, this advance is yet to be visual impairments invariably include trans-
supported by an easily accessible infrastruc- portation and the students’ dependence on
ture, nor has the construct gained widespread others for rides. Counselors, teachers, and
acceptance (Rettinger, 2015). These automo- other professionals may find that some
biles may also be costly, which is another teenage group members, including many
limiting f actor (Szlyk et al., 2000). Currently, who are totally blind, admit to having driven
157
friends’ cars. One can only hope that such • Similarly, teenagers with visual
experiments take place in the safety of open, impairments should consider all available
untraveled areas, but the attempt represents options for public transportation. If mass
teenage desire and daring at its starkest. transportation is not available, it is usually
Friends of students who are blind are willing possible to obtain special taxi passes or
accomplices to t hese actions, partly b
ecause access to paratransit systems so they can
they want to help their classmates and partly get where they want to go without always
because of their desire for thrill seeking. depending on f amily, friends, or hired
What interventions are helpful when the drivers.
dilemma of automobile travel arises in group
discussions among visually impaired adoles- • Some young people who are totally blind
cents? The following suggestions can be are unaware of the complexity of streets
helpful to group leaders as well as teachers, and highway patterns and how challenging
family members, and others who work with managing traffic flow can be. Rides on
these students: carnival bumper cars, for example, may
give them some idea of the jolting they may
experience while riding in cars in heavy,
• Although teenagers with visual impairments stop-and-go traffic. Slowly driving old cars in
need to feel some self-pity b ecause driving open fields with a sighted guide along (or
is not possible, it is not helpful to generalize driving on a protected track) may also
this feeling to a “poor-me” attitude t oward provide a meaningful simulation for
all forms of transportation. In fact, the group adolescents with visual impairments,
discussion is often timed so that each although environmental safety is paramount
person is given a two-minute period of for these trials. Furthermore, tactile traffic
sorrow about one or another deprivation maps, driving simulations, and other
and then is encouraged by the group to interventions can help them become aware
move on. (This technique is used in many of the nature and mechanics of driving,
groups, not just those for people with which enhances their general understanding
disabilities.) of the environment and helps them discuss

driving-related issues with peers and family
• O&M training is an essential ingredient of members comfortably.
independence. Students with visual
impairments need to receive this training • Family members, school personnel, and
in order to become optimal travelers. friends can offer consistent schedules for
Sophisticated use of a long cane, for transportation. However, a serious prob
example, along with sensitive interaction lem arises when drivers for teenagers
with helpful o
thers, such as f amily members who are visually impaired offer or withhold
and teachers, can ensure that the person rides contingent upon requirements or
who is visually impaired is viewed as expectations of the d rivers; in other words,
competent and independent in most using transportation as a reward or
settings. Teenagers may shun aspects of punishment. Each time a person must be
O&M training, but firm instruction for safety assisted, he or she loses a measure of
and practice for smooth movement is independence. To ensure interdependence,
essential. Professionals thereby express true teenagers with visual impairments may need
concern for students’ well-being and respect to engage in a process where they exchange
for students’ independent strivings. rides for helping the drivers in other ways,
158
S I D E B A R 5 . 2
such as assistance with homework or chores. and a sample ballot. Most communities
There is a delicate balance between needing provide transportation to the polls.
help or feeling dependent at one end of the Alternatively, independent shopping trips,
spectrum of independence and feeling pride unescorted prevocational job-site interviews,
in not needing help at the other end. The or a local volunteer job, such as at a
emotional aspects of relying on o thers for hospital, allow adult role opportunities.
transportation must be considered. A Students should be encouraged to share
colleague who is blind once said, “The worst their experiences with o thers, so that they
days begin when I must ask my wife for a provide the “bragging rights” that
ride to work after having had an argument accompany coming of age.
the night before.”
• Find alternative means of marking the onset Tension is produced in relation to travel,
of adulthood. For example, one f amily even under the best circumstances, since
arranged for their visually impaired 16-year- people leave the security of their homes and
old to visit a friend in a distant city, a trip face risks whenever they go out. Because
that entailed solo airline travel. The young risk-taking behavior is such a central feature of
person had a chance to feel “grown up” and adolescence, it is not surprising that automo-
on her own. Other methods of helping an bile travel is the source of such pleasure for
adolescent gain a sense of having “arrived” teenagers and such worry for the adults who
at adulthood might be considered. Election care about them. When a visual impairment is
Day provides an excellent marker for a factor in the process, transportation be-
attaining an age of responsibility. A person comes a complicated issue that requires
who is visually impaired can apply for an recognition, discussion, and openness during
identification card, a voter registration card, the teen years.
McDonnall, 2011; Ryles, 1996). Therefore, it is

Use of Assistive Devices
incumbent on parents and professionals to
Another area of concern for young people with vi- encourage youngsters to use disability-specific
sual impairments is w hether to use the tools that tools and techniques regardless of their disap-
enable them to improve their functional abilities, proval or to negotiate compromises that involve
such as optical devices or speech-and braille- the use of such tools in private whenever feasible.
output devices for reading and writing and a
long cane or dog guide for mobility. Since t hese
Human Sexuality
tools obviously set them apart from their sighted
peers, adolescents with visual impairments often Finally, no discussion of the physical attributes of
abandon them when the desire to fit in over- adolescents can be comprehensive without con-
whelms the desire to see or improve functional- sidering human sexuality and the importance of
ity (Warnke, 1991a, 1991b). However, research objective information on this topic for adolescents
indicates that use of disability-specific tools and with visual impairments. Fully sighted p eople tend
techniques can increase competence and lead to learn about sexual differences, behaviors, acts,
to success in postsecondary training activities and intimacies through observation. Youngsters
and gaining employment (Kelly & Wolffe, 2012; surf the Internet and television stations and are
exposed electronically to stimulating material. ber of relevant resources available (see Volume 2,
Many such images are purely visual. For adoles- Chapter 17). Discussions of many of these teach-
cents who are severely visually impaired or blind, ing resources are also available in journals
the visual aspect of this learning process is absent (Kapperman & Kelly, 2013; Kef & Bos, 2006; Kelly,
or altered; therefore, much of what they learn is 2014, Krupa & Esmail, 2010) and on
vicarious, through talk with adults or peers, and specialty websites (see the online AFB
through exploration of their bodies (Wolffe, Learning Center).
2006). Likewise, although many educational set- In today’s media-drenched society, few young
tings incorporate h uman sexuality training in the people are entirely unknowledgeable concerning
general curriculum for young adults, the content sexual information, w hether or not they have any
may be difficult to access for students without experience. Students with disabilities are often as
good vision because of its reliance on pictorial theoretically savvy about the facts of life as their
information (Kapperman & Kelly, 2013; Kelly & peers. Visual impairment does not limit a per-
Kapperman, 2012; Krupa & Esmail, 2010). son’s potential for meaningful and pleasurable
Researchers have confirmed t hese concerns sexual experiences. However, t here is consider-
(Kapperman & Kelly, 2013; Krupa & Esmail, able research indicating that youngsters without
2010) and determined that the following points good vision are at risk and may have fewer ro-
are critical for youths with visual impairments: mantic relationships and smaller social networks
than their sighted peers (Huurre & Aro, 2000; Kef,
• Tactile models are needed to help youngsters 1997; Kef & Bos, 2006; Pfeiffer & Pinquart, 2011;
make sense of pictorial information shared in Shaw, Gold, & Simson, 2005); therefore, structured
sex education courses. learning in this area can ameliorate some of the
• Parents, peers, and professional staff need to barriers that may inhibit them in forming satis-
share information without censorship and in fying relationships as adolescents and adults.
a nonjudgmental way. (See Volume 2, Chapter 17, for more discussion
of h uman sexuality education.)
• Sex education instruction needs to address the
Many writers have noted an increased risk of
emotional and psychological aspects of sexual

sexual abuse when a person is disabled (Kapper-
health, particularly with regard to vulnerabil-
man, Brown-Ogilvie, Yesaitis, & Peskin, 2014;
ity and self-esteem issues.
Kvam, 2005; Pava, 1994; Sobsey, 1994; Turnbull
• Instruction with nondisabled peers is impor & Turnbull, 1997). P eople may move in on a per-
tant to overtly demonstrate that all people are son without being seen or heard, creating vulner-
sexual beings and experience normal sexual ability and potential for fear. This is one reason
issues. why families hesitate to allow freedoms to
• Sex education needs to include information c hildren in m iddle school and early high school.
about body language and how to use these Turnbull and Turnbull (1997) stated, “There is
social cues in communication with o thers hardly a parent who does not worry that his or
effectively. her child—especially one who has a disability—
may be a victim of sexual abuse.” Pava (1994) re-
If possible, it can be helpful for instructional ported that almost 30 percent of her study group
staff with expertise in blindness and low vision to (N = 105) had been targets of assault. She recom-
team up with general educators and parents or mended that individuals, particularly w omen,
caregivers to present sex education content to stu- take special precautions and learn methods
dents with visual impairments. There are a num- of self-defense. Kapperman et al. (2014) offer
specific strategies to help prevent sexual abuse of range indicates that their parents do not necessar-
youngsters with visual impairments, including: ily believe that their grades or acquisition of skills
are truly comparable to those of their sighted
• Teach younger c hildren the difference between classmates and that their exposure to the commu-
“good” and “bad” touching, using the bathing nity and world around them may be inhibited by
suit model as a reference. their lack of active participation in activities of
daily living, leisure pursuits, and vocational expe-
• Role play with c hildren scenarios in which they
riences (Gold, Shaw, & Wolffe, 2005, 2010; Sacks
say “No” to an adult, including topics such as
& Wolffe, 1998; Sacks, Wolffe, & Tierney, 1998;
receiving gifts in exchange for sexual f avors.
Shaw et al., 2005; Wolffe & Sacks, 1995, 1997).
• Modify standard print and pictorial materials The parents’ lack of confidence in their c hildren’s
for teaching h
uman sexuality so that they can skills may be due to their reflection of society’s
be accessed by c hildren without vision. low expectations of p eople with disabilities in
general and their inability to closely monitor their
Cognitive Characteristics children’s work if it is produced in an alternative
format to print. However, when parents evidence
Cognitively, c hildren in the late elementary
high expectations of their c hildren, the youngsters
and middle school years begin to think more ab-
are more likely to participate in higher levels of
stractly and creatively. For example, most cogni-
education and achieve employment (Gold et al.,
tively intact youngsters appear to enter Piaget’s
2005; Shaw et al., 2005; Shaw, Gold, & Wolffe,
formal operational stage at about age 12. Thus, as
2007). These concerns are discussed in further de-
teenagers, they can use their reasoning abilities to
tail later in this c hapter.
think abstractly and not only consider real things
or a ctual occurrences. Although they can under-
stand more than one point of view and are able Whole-Picture Perspective
to solve problems on their own, they tend to see
Similar to the description in the classic poem by
global issues in terms of just and unjust or black
John Godfrey Saxe (Felleman, 1936) about the
and white, with little room for compromise. By

men who are blind and the elephant, children and
the time young p eople are in high school, most
youths without functional vision or with severely
of them are well into thinking independently
limited eyesight have g reat difficulty acquiring a
and making decisions about matters like cloth-
“whole- picture” perspective. In the poem, each
ing, friends, and where they want to spend their
man approached the elephant and felt a different
time.
part of it— its side, tusk, trunk, knee, ear, and
Academic Success tail—and each thought that what he had felt was
the elephant in its entirety. None of them had any
here is evidence that students with visual im-
T idea of what a w hole elephant was like. Similarly,
pairments as a group have considerable academic for students who are blind or visually impaired,
success; they tend to receive fairly good grades and their world is literally at their fingertips, and if
enter into higher education settings in numbers they happen to encounter only a portion of an ob-
comparable to their sighted peers (Newman, ject, that portion may be their perception of the
2005; Newman et al., 2011; Wagner, D’Amico, object. This is the challenge, in a nutshell, for stu-
Marder, Newman, & Blackorby, 1992; Wagner dents who are blind—how to know the whole
et al., 1991). However, a closer inspection of when they have the opportunity to come into
youngsters with visual impairments in this age contact with only a part of something.
Children with severe visual impairments de- rigidity in thinking may be due to the lack of con-
velop in an environment that is proximate and se- sistent and realistic input from o thers, coupled
rial, rather than in the environment of their with limited incidental learning. It has been es-
sighted peers, which includes input from afar as timated that the average child learns 60 percent
well as input that is near and serial. Sighted to 80 percent visually, through scanning the en-
c hildren can also receive input that is sometimes vironment and observing what p eople and t hings
disjointed or multifaceted and still make sense of are doing (Kelley, Sanspree, & Davidson, 2000;
it, whereas for c hildren with visual impairments, MacCuspie, 1996). Without constant and casual
such input may be confusing or overwhelming. access to information, c hildren who are visually
Thus, youngsters who are visually impaired may impaired can easily come to believe that there are
view the environment narrowly and in fragments, fewer choices available to them than children
rather than as whole gestalts. Although c hildren with unimpaired vision recognize. This problem
who are totally blind evidence the greatest expe- is often exacerbated by well-meaning p eople in
riential consequences of this phenomenon, any the lives of children who are visually impaired
degree of visual impairment w ill have an impact who attempt to protect them from the complexity
on learning (Batshaw, Roizen, & Lotrecchiano, and hardships of daily life by filtering the infor-
2013; Bishop, 2004; Chase, 1986; Gunaratne, mation they share with them. Rather than provide
2016; Lewis & Allman, 2014; Lowenfeld, 1987; uncensored information about what choices are
Scholl, 1986). available, sighted in formants sometimes tell a
child who is blind only about the available choices
Abstract Concepts that they believe are good or right for him or her
based on their own value systems. This filtering
Difficulty acquiring abstract concepts without
can lead to the child’s misunderstanding of the
good, functional vision is another cognitive issue
full spectrum of choices, and, consequently, the
for c hildren and youths. If something is too dis-
child may appear rigid. Examples of this phenom-
tant, such as a planet or a star, or if something is
enon may be seen in the responses many young
inaccessible through touch, such as a color, body
adults with severe visual impairments give when
language, or a facial expression, the concepts may

questioned about careers they are interested in
be too abstract for many c hildren with severe vi-
pursuing— that they w ill work with computers
sual impairments to truly understand. A child
because people have told them that such jobs are
who is blind may form a concept based on a ste-
accessible to blind people through technology, be-
reotypic understanding of what something is. For
come singers or musicians b ecause they know of
example, one young woman reported to her
gifted blind performers, become lawyers b ecause
teacher that the color black was a poor choice for
others say they are good with words, or masseuses
a prom dress because only bandits and outlaws—
because they are good with their hands, and so
bad guys—wore black. She had not understood
forth—rather than assume that they might be able
that black could also be elegant and was often a
to grow up to do any of the thousands of jobs
choice color for evening or formal wear.
within the labor market.
Rigid Thinking
Executive Functioning
Another cognitive concern frequently seen in
c hildren and youths with severe visual impair- Finally, t here are conflicting results reported in
ments is a tendency to appear inflexible or un- research related to the cognitive abilities of youths
imaginative in their thinking patterns. This with visual impairments, particularly w hether
executive functioning may be adversely affected elements of their brains that interpret tactile, kin-
by blindness or low vision (Daugherty & Moran, esthetic, and auditory input (Kurson, 2007; Sacks,
1982; Dunkerton, 1995; Heyl & Hintermair, 2015; 1996). On the other hand, those with neurologi-
Warren, 1994; Zihl & Dutton, 2015). Although cal visual impairment seem likely to experience
executive functions such as inhibitory control long-term difficulty with executive functioning
typically begin in childhood and preadoles- (Lueck & Dutton, 2015; Wolraich, Drotar, Dwor-
cence, it is during adolescence that dif fer
ent kin, & Perrin, 2008).
brain systems become better integrated. In ado-
lescence, young p eople implement and improve
executive functions more efficiently and effec-
Social and Emotional Characteristics
tively (Leon- Carrion, García- Orza, & Pérez- Although teenagers sometimes act in ways that
Santamaría, 2004; Luna, Garver, Urban, Lazar, & seem to be selfish and egocentric, their outward
Sweeney, 2004). appearance of bravado often masks feelings of in-
Executive function is used in complex cogni- security. Their acting-out behaviors may be irk-
tions such as problem solving, modifying one’s some to parents and other adults, but for teenagers,
behavior in response to new information, and us- they are an important part of confidence building
ing past experiences to strategize, organize, and (Fenwick & Smith, 1998; Rice, 2008). By acting as
plan for the future (in other words to achieve if they are in control and comfortable with them-
goals). Most available research indicates that selves, teenagers can influence the people around
while the prefrontal cortex is critical to executive them to think of them in a similar way. Ideally,
function, posterior cortical regions and subcorti- they receive positive feedback from their peers
cal structures collaborate with the prefrontal and families that builds their self-esteem. They
cortex to mediate successful executive processing need to know that they look good, that they are
(Elliott, 2003; Zihl & Dutton, 2015; Zuidhoek, performing well, and that the people in their
2015). Therefore, youngsters with ocular rather lives care about them even when they misbehave.
than neurological visual impairment seem un- If they do not receive constructive positive input,
likely to demonstrate difficulty with executive their insecurities multiply, and they tend to act
function in adolescence (Cass, Sonksen, & McCo- out more and more outrageously.
nachie, 1994) beyond the anticipated struggles This lack of self- confidence is often com-
all teens experience because of developmental pounded for youngsters with visual impairments
brain changes in adolescence (Jensen, 2015; because their efforts to act out and behave in re-
Strauch, 2003; Walsh, 2004). In fact, t here is a bellious ways are often thwarted by their inability
growing body of brain research that indicates that to see who is around to notice or to observe how
individuals who depend on nonvisual informa- other teenagers are presenting themselves. A con-
tion may develop sensory compensation, or the sequence of this inability to rebel effectively or
ability to use their other senses to substitute for mold themselves to the style of a particular group
visual information, and actually show evidence is that teenagers with visual impairments often
of anatomical differences in their brains (Catta- find it difficult to fit into social groups or cliques.
neo & Vecchi, 2011; Rieser, Ashmead, Ebner, & In terms of how c hildren view and come to
Corn, 2008; University of California–L os Ange- understand other p eople’s feelings, it is impor
les, 2009). This is borne out in literature describ- tant to understand that sighted c hildren can vi-
ing the experiences of individuals who have sually discern the difference between positive and
recovered vision but can only truly see and make negative facial expressions in the first year of life.
sense of what they are seeing by using the rewired This ability to “read” people’s facial expressions
appears to be cross-cultural, meaning that there before interest in members of the opposite sex be-
is g reat similarity in p eople’s expressions of basic gins to encourage the partnering that is more
emotions, such as fear, happiness, anger, and sad- common in high school (Fenwick & Smith, 1998;
ness, throughout the world (Ekman, 1993, 2007). MacCuspie, 1996; Scholl, 1986; Wolffe, 2006).
Children and youths with severe visual im- Difficulty with peer relationships and dating
pairments often have difficulty understanding the may be partly due to the delays in perspective tak-
impact of their behavior on o thers because they ing (the ability to comprehend that another per-
cannot see their reactions—they miss visual cues, son may perceive a situation differently from the
particularly facial expressions and body language. way one does) in c hildren who are visually
Just as they cannot see what is going on in the envi- impaired (MacCuspie, 1996; Rosenblum, 2006;
ronment, they cannot see how people look and Wolffe, 2006). Since relationships are built on rec-
discern their approval or disapproval of what they iprocity, it is critical for partners in a relationship
see and hear through facial expressions and body to be able to understand each other’s needs and
language when they are communicating with them wants. For teenagers with visual impairments, this
or others. This inability to read body language and concept of reciprocity may be delayed, along with
facial expressions cannot be fully compensated for the delay in perspective taking, and dating activity
through auditory means, so youngsters with visual may subsequently be delayed as well.
impairments need to be taught to interpret verbal Again and again, the inability to observe
messages (Matsuda, 1984; Minter, Hobson, & others incidentally and casually seems to threaten
Pring, 1991; Pfeiffer & Pinquart, 2011; Pring & Ta- the socialization process of children and youths
dic, 2010; Wolffe & Sacks, 2000). with visual impairments and may have its greatest
Compounded by other people’s unwilling- negative impact on teenagers in relation to dating.
ness to provide realistic, honest feedback, this Much of the preliminary behavior in dating cen-
inability to observe o thers’ reactions to their be ters on nonverbal communication: ogling, smil-
haviors puts teenagers with visual impairments ing, winking, nodding, and other ways of noticing
at risk in social situations. For teenagers, involve- and expressing interest in one another. In addition
ment with peer groups is an important devel- to noticing one another and indicating interest,
opmental process that sets the stage for f uture observational skills are used routinely to identify
separation from their parents and other family where individuals of interest are in relation to
members. Emotional issues surrounding depen- others—on the bus, outside the classroom, in the
dence, independence, and interdependence are cafeteria, and so forth. Without vision to direct
often at the crux of many adolescents’ seemingly one into close proximity with someone of interest,
rebellious and self-centered behavior. T here is an a young person must rely on others to know both
almost constant struggle between wanting to stay who is in the vicinity and who is available. Once
safely within the dependent structure of their all the obstacles are overcome, teenagers who
families and wanting to experiment with self-r ule are interested in dating another must muster the
early in adolescence. In this regard, Sidebar 5.3 assertiveness skills to ask and have something to
discusses the various tensions in families of ado- offer in the way of an activity of interest.
lescents with visual impairments and how par- Difficulties expressing intent through non-
ents can provide the supports that the adolescents verbal communication and interpreting the
need. Then, as youngsters mature, they move intent of others are frequently mentioned as
toward mutually beneficial, interdependent rela- outcomes of growing up with a severe visual im-
tionships. Involvement in peer groups is perhaps pairment (MacCuspie, 1996; Wolffe & Sacks,
the most intense in the junior high school years, 2000). In addition, some c hildren and youths
S I D E B A R 5 . 3
Perspectives on Families
JOAN B. CHASE
Families respond to visual impairment in the As youngsters reach middle childhood, they
myriad ways they respond to all challenges have an increased impact on their families.
in life. For some, the experience of having a They begin to bring home new ideas from
family member with impaired vision strength- school and peers who may differ from t hose
ens bonds and relationships, but for o thers, it raised in the f amily circle (Fine, 1995; Pick-
is a source of tension. For most, the emotional hardt, 2013; Wiseman, 2002). Furthermore,
impact falls somewhere in between. In many youngsters with visual impairments recognize
instances, the quality and quantity of interven- that they may be viewed as “different” by
tion at the time of diagnosis or onset can have people outside their families.
dramatic effects on the way in which people Adolescence is a period of turmoil for many
adapt to changed circumstances. Families young people. Because teenagers often bring
manifest unique interactive patterns and intense energy into their homes, charged in
modes of communication. They process the both positive and negative ways, they may
news of a visual impairment in ways that create engage in a struggle for independence from
reverberations for all f amily members (de Klerk their parents and for autonomy that surprises
& Greeff, 2011; Scott, Jan, & Freeman, 1995). and raises anxiety in their parents. All f amily
The role of families in the lives of p eople with members experience many emotions in rapid
visual impairments is extensively documented succession (Larson & Richards, 1994; Pick-
in the biographical life histories of such p eople hardt, 2013). The father of a 12-year-old may
portrayed by Neer (2000). wonder, “How did my sweet young d aughter
Families operate as systems (McGoldrick learn to be sarcastic?” Some struggles for
& Gerson, 1985; Nixon, 1994), and changes independence are particularly intense when a
in one part of a system affect all the other young person has a visual impairment because
parts. Chase (1993) applied family systems the parents tend to feel more protective than
theory to families with young children with other c hildren in the family (Barton, 1997).
who were visually impaired. In this research, Families often exercise extreme caution
interviews revealed that the parents’ when their children with visual impairments
response to any disability served as a source want to explore on their own, out of fear of the
of change in relationships. Of the dimensions many risks to safety when young people travel
studied, most did not reach statistical alone unless they have had expert instruction
significance when parents of c hildren with in orientation and mobility. Suddenly, it
disabilities were compared to those not seems, the youngsters want to gallivant
affected. The two psychological issues that around with friends or by themselves in ways
were different were confidence and trust. In that strike terror in the parents’ hearts. Such
other words, most parents feel anxious about anxiety about separation and individuation is
their role, but t hese parents were less confi- typical among parents of adolescents with
dent and trusting of their own skills. Overall, visual impairments, but it is exacerbated when
however, the parents resembled parents of all the parents fear for their youngsters’ safety
children on measures of distance, closeness, (Nixon, 1991). A blind colleague recalled that
and acceptance. he purposely “lost” his mother in the New York
165
subway system to prove to her that he could visual impairment, but the presence of such a
get home on his own. complicating f actor adds to the tension of
Other issues that create family tension adolescence. Cowen, Underberg, Verrillo, and
include transportation, self-initiated activities, Benham (1961) found that although the
and routines. Parents continue to transport their adjustment variables for teenagers with visual
adolescents with visual impairments long after impairments were the same as those for
sighted adolescents are driving on their own teenagers who w ere sighted, parents’ (in their
or with friends who own cars (Tuttle & Tuttle, study, mothers’) understanding was a signifi-
2004). This added symbol of dependence may cant contributor to the teenagers’ ultimate
exacerbate the tension caused by any high adjustment. For those with visual impairments,
school student “pulling away” from his or her parents and other family members have the
family. In addition, other family members may task of understanding the disability, along with
view teenagers with visual impairments as all the other ingredients that combine to make
more pliable or passive, so when the teenagers the complex beings called adolescents.
strike out on their own, the family members Recent research emphasizes the impor-
may be surprised and sometimes impose tance of resilience in families of c hildren with
restrictions on them that are not imposed on disabilities (de Klerk & Greeff, 2011) and
other teenagers. provides insight into how professionals might
Routines are a source of contention in most assist families as they acclimate to, support,
families, particularly because middle school and love their children with visual impair-
and high school students prefer activities of ments. De Klerk and Greeff (2011) identify
their choice to t hose required at home. Even three components that build resilience: family
the neatest, most compliant child may become values (attitude, faith, and closeness), inclusion
less concerned with the state of his or her (accepting help and seeking help from institu-
things than with the state of his or her friend- tions), and a sense of accomplishment (pride in
ships as adolescence approaches (Crary, 1995; the child and finding meaning in the f amily
Pickhardt, 2013; Walsh, 2004). For a young supporting the child). Professionals can help
person with a visual impairment, neatness families gather resources and information
counts, in that things that are moved or in to facilitate inclusion by encouraging f amily
disorder are more difficult to find again when members to draw on their own internal
needed, so conflicts arise that are more intense resources. Where needed, services and
in a family with a child who has impaired vision. therapeutic interventions will enhance the
None of the issues raised is specific to experience of participating in the development
families in which t here is a teenager with a of a capable adult.
with visual impairments evidence eccentric lar and unpopular teenagers so they can strive to
behaviors or mannerisms, unusual language assimilate the characteristics of popular teenagers
patterns, self-centeredness, and preference for that are feasible in their lives.
interaction with adults, social be hav
iors that Numerous authors have described popu lar
can inhibit accept ance by same-age peers (Sacks, teenagers as those who are good communicators,
2014; Sacks, Kekelis, & Gaylord-Ross, 1992). It is cheerful and friendly, like to joke and suggest
important for youths with visual impairments to games or activities, and are physically attractive or
be taught the attributes demonstrated by popu have athletic ability (Fenwick & Smith, 1998;
Hudson, 2016; Pickhardt, 2013; Steinberg, 2010). from a psychologist’s perspective and how to help
Attributes that contribute to rejection are restless- young people with visual impairments cope with
ness and overtalkativeness, being quiet or shy, resulting stress.
being unattractive (especially fat), and being “dif Another emotional concern is that because
ferent” (Rice, 2008; Wiseman, 2002). Obviously, parents, teachers, and other well-meaning adults
teenagers with visual impairments have some attend to shelter or overprotect many teenagers
tributes over which they have little or no control, who are visually impaired, t hese teenagers are of-
such as being or looking “dif ferent,” that may ten socially immature. In addition, Western so-
have negative social consequences. However, they ciety tends to support the notion that p eople with
can develop many positive attributes that can con- disabilities are “children” for life. Behavior is con-
tribute to the likelihood of their acceptance by textual, meaning that people act in ways that re-
peers. Sidebar 5.4 discusses interpersonal issues flect the expectations or perceived expectations of
S I D E B A R 5 . 4
Perspectives on the Onset of Visual Impairment
JOAN B. CHASE
Information about the onset of visual impair- together to determine the student’s strengths
ment is one of five important medical f actors and needs, and educational planning rely on
to document in the record when a teacher information about all these factors. Onset of
or other professional begins to work with a the visual impairment is discussed here.
student with a visual impairment. T hese Congenital conditions require specialized
factors are the following: interventions early in life to provide c hildren
with opportunities to learn about the environ-
1. Eye diagnosis, confirmed with a formal eye ment using residual sensory pathways (Allman
report or ophthalmological record & Lewis, 2014; Ferrell, 2011; Koenig, 1996;
2. Etiology (cause) of the impairment, such as Scott, Jan, & Freeman, 1995). Furthermore, a
inherited condition, prenatal/postnatal event, family in which a child is born with a visual
or disease of the eye or brain impairment is apt to benefit from developmen-
tal counseling and training. Thus, parents and
3. Extent of the visual loss, acuity readings,
siblings “grow up” along with that child,
and distance and near measurements
gaining awareness of what support activities
4. What the person can see and u nder what may be needed and accepting the c hildren as
conditions (in schools, this is included in family members with possible special needs
the required functional vision and learning (Bolinger & Bolinger, 1996; Ferrell, 2011;
media assessments) Langley, 1996; Oldham, 2010).
5. Age of onset, whether the condition is When older children and teenagers become
congenital (present at birth) or adventitious visually impaired, they have the advantage of
(acquired), and when and how the loss was having seen well during their earlier, formative
discovered years. Educationally, such experience with sight
is helpful in that the young people have learned
Collaborative assessment (Barclay, 2003), in environmental features by visual observation
which educational and other professionals work and pictures. Even a very small amount of
vision can make a huge difference in learning health crisis, in such a way as to open communi-
and behavior. Children who are congenitally cation channels for adolescents.
visually impaired must rely on their other It is important that youngsters with visual
senses or the vicarious experiences that others impairments know and understand the
provide to learn concepts. But for those who diagnosis of their impairment so that they can
lose their vision later, even a brief period of identify and discuss their situation with family,
vision allows for association and incidental friends, and medical personnel. Teachers,
learning (Barraga, 1986; Sanspree, 2000). counselors, and other professionals should
Emotionally, however, older children and take any opportunity to facilitate these discus-
teenagers who lose vision must adapt to sions. T hose who have no vision, or whose
altered learning circumstances, and the vision is accompanied by additional disabili-
adaptation may not be smooth. For students ties, may have a more difficult task and can be
who are beginning to establish body image, aided in their understanding and ability to
any newly acquired feature can lead to conflict. express diagnoses, ideologies, and other
Many middle-school-aged children begin features that impact their education.
spending hours before mirrors. Visual data are Other issues arise around the onset of visual
often primary in t hese efforts, and “How do impairments in middle childhood and adoles-
I look?” becomes a frequent query to parents cence. In some instances, the eye disease or
and friends. When vision is impaired at that condition, such as childhood-onset macular
age, the developmental sequence of self- degeneration, is hereditary. The parents may
reference is interrupted. Furthermore, the not have been aware that they both carried the
youngsters may have to undergo treatments or gene for the particular eye disease or condition
use visual aids that affect their self-perceptions until the child reached the age at which the
and may be embarrassed by the new circum- symptoms are expressed. At about age 11 or 12,
stances (Seligman & Darling, 2007). when visual acuity worsens, the child is becom-
In adolescence, depression is a common ing aware of biology and may even be studying
response to a newly diagnosed visual impairment genetics at school. In this way, family members
and is a widespread problem (Lang, 2000; may then become aware that siblings or future
Peterson et al., 1993), often triggered by changing generations might be affected, which may have
life circumstances. A compounding element in social and emotional consequences. For such
this society is the likelihood that visual impair- reasons, open communication about inheri-
ments may result from at-risk behaviors, such as tance is crucial.
automobile accidents, the use of firearms, drug Dealing with the depression that accompanies
overdoses, and sports injuries. These etiologies any health problem that arises in adolescence is
during the teenage years exacerbate the tendency never easy. It is best addressed in a group
for diagnoses of visual impairments to lead to setting because teenagers are far more likely to
severe emotional reactions. share their feelings with peers than with adults,
If the etiology is an illness or physical condi- even trained counselors. Family counseling is
tion, such as a brain tumor or severe infection, critical in hereditary disorders, so that all affected
the young person often has a string of “Why members of the family can be screened, tested,
me?” questions. Family members are often so and advised about the probability of offspring
pleased that the person has lived through the being affected. Whatever the diagnosis, allowing
health ordeal that they are unprepared for the adolescents to express feelings of sadness and
emotional aspects of the situation. Families other emotions and to share their struggles with
need time to express their reactions, as with any their altered circumstances is essential.
168
t hose around them (Chase, 2000). By over help- Ferrell, 1994; Ferrell, 2000; Fraiberg, 1977; Nor-
ing or d
oing t hings for young p
eople with visual ris, Spaulding, & Brodie, 1957; Pring & Tadic,
impairments that they could do for themselves, 2010; Warren, 1984, 1994) have found evidence
adults send these youngsters the message that of similarities and differences in the early devel-
they are expected to do l ittle or nothing for them- opment of c hildren who are visually impaired
selves and that they are unable or incapable and sighted. (See Chapter 4 in this volume for a
(Wolffe, 1999). The consequence of overprotec- discussion of early development.) There are no-
tiveness is that it impedes the social and emo- ticeable differences in the developmental mile-
tional development of young people with visual stones achieved by infants and toddlers with
impairments. As Scott, Jan, and Freeman (1995) visual impairments versus t hose with vision
noted, youngsters who lose their vision in adoles- (for example, babies who are blind are often de-
cence may suffer greater emotional and physical layed in walking, reaching, and pulling up)(Fer-
effects than those who lose vision earlier in life. rell, 2000, 2011; Warren, 1984, 1994). Although
For teens with some conditions, such as retinitis not all of the developmental differences are re-
pigmentosa, that allow masking of the impair- solved between sighted and visually impaired
ment in many situations (allowing the individual individuals by adolescence, only a few issues ap-
to present as sighted rather than as having low pear to remain and those are primarily in the
vision), the individual may reject serv ices rather social milieu—peer engagement and romantic
than accept the need for intervention. Together relationships (Pfeiffer & Pinquart, 2011). How-
with adjustment to adolescence, the strugg les ever, longitudinal studies, such as the 1990s
with peer pressure, social acceptance, and con- study in British Columbia that is described l ater
cerns about life and work in the f uture, the loss in this chapter, have presented empirical evi-
of vision may exacerbate teenagers’ emotional dence that these differences dissipate and may
concerns. These concerns are discussed from a well dis appear over an individual’s life span
psychologist’s perspective in Sidebar 5.5. (Freeman, Goetz, Richards, & Groenveld, 1991;
Identity development is achieved when young Freeman et al., 1989).
adults explore and question o thers’ values, beliefs, Age at onset of visual impairment must also
and goals, then make commitments to their own be considered because the older children are
set of values, beliefs, and goals. A recent study, when they lose vision, the more likely they w ill
which is discussed in detail later in this chapter, have acquired basic psychomotor skills through
investigated the construct of identity development visual channels and, therefore, less delay in t hese
and found that youths with congenital visual im- skills w ill be evident. In other words, the earlier
pairments showed lower levels of identity explora- the onset of visual impairment, the greater the ef-
tion than their peers with acquired visual fect on all areas of development, including spatial
impairments (Pinquart & Pfeiffer, 2013). The re- awareness, mobility, nonverbal communication,
searchers also found that more severe disability personality, and general information (Fazzi &
was associated with less exploration of identity. Molinaro, 2016; Fazzi et al., 2011; Gunaratne,
2016). Making up for early developmental deficits
is qualitatively and quantitatively differe nt from
MPACT OF V SUA MPAIRMENT restoring or substituting for abilities that have
ON DEVELOPMENT been acquired (Freeman, 1987; Scholl, 1986).
Sidebar 5.4 discussed some effects that time at
Studies of the impact of visual impairment on onset of visual impairment may have on young-
child development (Cass et al., 1994; Deitz & sters’ development.
S I D E B A R 5 . 5
Perspectives on Interpersonal Issues and Stress
JOAN B. CHASE
Students in middle or high school may as they pass them or sit next to them can
experience an array of social stressors. For “disappear” from their radar. Even known
those with visual impairments or blindness, acquaintances may not acknowledge a blind
interactions with peers often present the student’s presence, which may reinforce the
same type of stress, although issues requiring student’s tendency to withdraw and not
observational skills may be intensified. become a true social participant in school.
Findings among 1,950 adults and 1,018 teens Those with some vision may misidentify
in the United States reported in an online others, adding to their sense of separation
American Psychological Association article, from the “norm.” At times, these interac-
“Stress in America: Are Teens Adopting tions contribute to the discomfort of the
Adults’ Stress Habits?” (APA, 2014), suggest teen, just as social interaction scenarios
that unhealthy behaviors associated with create tension for all t hose young adults who
stress may begin manifesting earlier in crave acceptance.
people’s lives than was true in former Peers might shun t hose students who are
generations. considered in the “out-group.” When the
Friendships are an important feature for shunned teen is visually impaired, this reac-
adolescents. The optimal interactions during tion, on the part of others, is frequently
the teen years are friendships that provide fun, attributed to the disability. In fact, research
sharing new experiences and ideas, and has demonstrated this reaction may occur for
learning acceptance of o thers. Many p
eople any student with an unusual condition, even
remember their high school and college years behavioral symptoms (Fabiano, 2014). Adoles-
as having been extremely meaningful and cents are prone to want to be the same as
memorable. Interactions during adolescence their classmates, and this feeling of not
can shape the nature of future relationships. measuring up to the current standard in a
At best, teenagers experience acceptance, school can be painful. Further, as underscored

affection, and shared positive experiences by interview research, body image issues rise
with friends (McElhaney, Antonishak, to the fore as natural changes occur (Pruitt,
& Allen, 2011). 1999), and many find fault with even small
It may be challenging for teenagers with differences from their “ideal” self. Visual
visual impairments to become part of the impairment intensifies this self-examination
social scene in high school. Many of the and worry about appearances. When avoided
interactive messages are visual at this age. by age-mates, young people may become
Schoolmates may show indifference or avoid depressed and argumentative at home and
interaction out of their discomfort with manifest extreme mood changes, as attested
someone they perceive as “different.” Peer to in biographical statements (Magee &
groups do not know how to interpret their own Milligan, 1995; Neer, 2000).
discomfort and tend to engage in avoidance. Verbal criticism and sarcasm frequently
In the case of students with severe visual characterizes teenage conversation. Physical
impairments, others need to identify them- attributes are frequent subjects of teasing.
selves so that the person knows who is People are given nicknames or jeered at for
approaching. For students who are totally height, weight, facial features, and so on freely
blind, o
thers who do not identify themselves during this time of life (Pickhardt, 2013). When
170
S I D E B A R 5 . 5
vision is absent or distorted in any way, it is statements or behaviors challenging, their

less likely that characteristics are seen and own teenage lack of restraint may prevail.
teasing understood. Moreover, a person with Arguments, ugly name-calling, and even
any disability is more likely to be stereot yped physical fights may ensue. Self-defense
or have others adopt less accepting attitudes training has been advised in areas of risk
(Erin, 2001). Adolescents can be verbally (Pava, 1994). Fear of additional damage to
abusive when their intention may be softer their eyes or bodily injury has been reported
(such as teasing or engaging in a funny by some students. T hese tensions add to
interaction). Visual impairment becomes an the caution and, in some cases, the retreat
easy target for joking and name-calling. If the to depression and inwardness. Psychological
student engages in self-stimulating or stereo interventions can be helpful, particularly in
typical activities, such as body rocking or hand groups.
movements, teasing and mimicry by other Even in the best circumstances, a visual
students can occur. Those with no vision may impairment intensifies stress. Each person
miss the feedback that observation can has a threshold for experiencing anxiety.
provide. Adolescents and young adults often exceed
The most serious and extreme level of the tension level they w ill later experience as
interaction in teen years is bullying. This adults; however, they frequently believe that
type of interaction sometimes leads to the fears and feelings experienced w ill last
violence, both verbal and physical. Students forever. Teenagers who meet in groups with
with disabilities are more vulnerable to others who also have visual impairments
being bullied than o thers (Carter & Spencer, share stories of embarrassment and other
2006; Young, Ne’eman, & Gelser, 2011). In negative emotions they hide from people
the author’s experience, visually impaired who are not similarly affected. They speak of
students are equally at risk. They have ways in which they feel or dispel anxiety.
issues around mobility. They do not see Strategies for reaching out to positive poten-
dangers approaching with the same rapidity tial friends and ways to avoid the known
as those with full sight. At times, loss of school bullies can help. Professionals have a
sight and other impairments may lead role to play in providing opportunities for
students to say inappropriate t hings or act such interactions and preventing those
in a way that unknowingly accentuates a situations in which fear and depression
disability. When another student considers become chronic.
By adolescence, many behaviors and patterns Comparative Study of Adolescent

are in place. However, the developmental process
does not end at a particular age for anyone. In fact,
Adjustment
many developmental milestones are achieved An early study by Cowen, Underberg, Verrillo,
during and beyond adolescence. Only a few stud- and Benham (1961) provided empirical evidence
ies have looked closely at the development of of the social and emotional adjustment of adoles-
adolescents with visual impairments— t hose cents with visual impairments in comparison to
that have done so are described in the sections their sighted counterparts. The study included 167
that follow. adolescents aged 13–18 in grades 7–12 and their
others as well as some fathers. Adolescents who

m alike than different in their social and emotional
were visually impaired were clustered by degree adjustment to adolescence.
of vision (totally blind, legally blind, and visually
impaired), and the control group of sighted ado- Longitudinal Outcomes Study
lescents was matched for age, gender, intelligence,
socioeconomic level, and educational status. First studied as young c hildren (Freeman et al.,
In addition to the assessment of the young- 1989), 69 adults who w ere legally blind in Can-
sters’ acceptance of visual impairment, the re- ada participated in a follow-up study 14 years
searchers evaluated the parents’ attitudes, using later with essentially the same research team
instruments that they designed, items borrowed (Freeman et al., 1991). With the exception of cog-
from standardized measures, and subscales of nition, the follow-up study looked at the same
standardized tests. The study’s findings w ere as aspects as the original study: social-emotional
follows: functioning, health, vision, mannerisms, and
family. These are the key points detailed by the
researchers:
• Basically, no differences in adjustment among
the adolescents who w ere sighted and those
• Just over half (54.5 percent) of the 57 partici-
who were visually impaired were indicated on
pants who could be questioned on the subject
the three test instruments.
of marriage and sexuality reported having
• Better adjustment tended to be associated with had a romantic relationship.
greater visual impairment, that is, adolescents
• Except for a few participants who had mul-
with low vision evidenced greater adjustment
tiple disabilities, almost all stereotypic man-
difficulties than those who w ere totally or
nerisms had disappeared from those in the
legally blind. However, t hese differences w
ere
sample. Some participants said that they
not statistically significant.
still engaged in their mannerisms when they
• Strong relationships w ere found between pa- were alone, but that they understood the nega-
rental, particularly maternal, understanding and tive social effect of such mannerisms on p
eople
adolescent adjustment across all the groups who w ere sighted. None of the participants
(blind, low vision, and sighted participants). credited any systematic treatment program
with having helped them eliminate such be
The study was the first to question some of haviors; most of them indicated that they had
the traditional ideas concerning the psychosocial stopped b ecause family members and friends
development and adjustment of c hildren and had told them that their mannerisms were un-
youths with visual impairments. The researchers acceptable.
studied both adolescents who were blind and
• Many participants had taken a longer time
those who were visually impaired and who were
than usual to complete their secondary school
living at home or in residential settings and com-
programs.
pared them to a group of sighted youngsters. Until
this study was reported, many p eople assumed • Thirty-nine p ercent of the participants were
that maladjustment was unavoidable when visual employed (46.7 percent of the men and 32.7
impairment occurred. Cowen and his colleagues percent of the w
omen).
disputed this notion and pointed out that al- • Seventy-one percent of the participants en-
though there w ere individual differences, the gaged in some regular sports or physical fit-
groups of youngsters they studied were more ness program.
The researchers pointed out that most of ere evident in reports of whom they received
w
these young adults w ere d
oing remarkably well help from with their homework. The youths
without the help of sophisticated and systematic who were blind reported receiving help from
intervention; in fact, they w
ere performing better six sources: a parent, sibling, friend, tutor, paid
than anticipated. However, they cautioned that reader, and volunteer. T hose with low vision
they w ere unable to locate the original control reported receiving help from four sources: a
group for comparisons. Another interesting point parent, sibling, friend, and tutor. Although
the researchers mentioned was that many of the one-fifth of the students who were sighted re-
participants with severe visual impairments reported receiving no assistance, t hose who did
fused to acknowledge their visual differences and receive help identified only three sources: a
tended to “pass” as normally sighted. Finally, the parent, friend, or tutor.
researchers suggested that there might well be
• Another difference between adolescents who
some benefit to developing interactive programs
were sighted and those with visual impair-
to improve the social skills of both p eople who
ments was where they studied. Only the ado-
are blind and people who are sighted in their
lescents who were blind or had low vision
dealings with individuals with visual impair-
reported studying in classrooms with the guid-
ments. The perceived benefit would be to decrease
ance of their teachers. The sighted adolescents
the social isolation the researchers discerned in
studied at home, in the public library or school
their participants, especially during the ju nior
library, and at friends’ houses. In addition to
high school years (Freeman et al., 1991).
studying in classrooms, t hose who were visu-
ally impaired reported studying in the same
Lifestyles Studies settings as the sighted adolescents: home, li-
braries, and at friends’ h
ouses.
Social Network Pilot Project (SNPP)
• The adolescents with visual impairments
In the mid-1990s, researchers in the United States tended to take longer to prepare for activities
investigated how adolescents with visual im- than did the adolescents who w
ere sighted.
pairments compared in major life areas to their

sighted peers (Sacks & Wolffe, 1998; Sacks et al., • Almost all the adolescents (88 percent of t hose
1998; Wolffe & Sacks, 1995, 1997). The SNPP re- who w ere blind and 94 percent of t hose with
sults were based on both quantitative and quali- low vision and t hose who w ere sighted) had
tative data collected from adolescents and their worked for pay.
parents. However, because of the small sample • Whereas 81 percent of the adolescents who
size (N = 48), it is important not to overgeneralize were sighted had found their own jobs, only
the results but, rather, to consider them as possi 31 percent of the adolescents with low vision
ble indicators of adolescents’ be haviors. High- and 19 percent of t hose who w ere blind had
lights of the SNPP findings included the following: done so. (For the most part, teachers and coun-
selors found jobs for the adolescents with vi-
• Most of the adolescents who w ere blind or sual impairments.)
sighted were receiving As and Bs in school, and • The most obvious differences in activities of
most of the adolescents with low vision w ere daily living between the groups of adolescents
receiving Bs and Cs. were in performing h ousehold chores, grocery
• The differences between youths who were shopping, cleaning, cooking, and general
sighted and t hose who were visually impaired housekeeping. Those with low vision reported
having the least amount of responsibility for the adolescents spent their time a fter school
performing home management tasks, and alone. Only 25 percent of the adolescents with
those who were blind reported having only visual impairments and their parents reported
slightly more responsibility. On the other that the adolescents spent time a fter school
hand, the sighted adolescents reported having with friends.
considerably more responsibility at home. The • There were also differences among the groups
greatest discrepancies w ere in activities cen- in their friendship networks and levels of in-
tered on cooking, helping with yardwork, and teraction within these networks. Overall, the
simple clothing repairs. adolescents with visual impairments reported
• In response to probes about what kinds of as- fewer social interactions than did the adoles-
sistance the adolescents and their parents an- cents who w ere sighted.
ticipated w ere necessary for youths to live • At each of the three interviews, the adolescents
independently in the future, all the parents with low vision reported greater amounts of
and adolescents anticipated an ongoing need time devoted to sleeping than did t hose who
for financial assistance. However, financial as- were blind or sighted.
sistance was the only kind of assistance antici-
• The adolescents with low vision engaged in the
pated by the sighted adolescents and their
most passive leisure activities, followed by
parents. In contrast, 50 percent of the parents
those who w ere blind. The adolescents who
of the adolescents with visual impairments
were sighted w ere the least involved in such
(both those who w ere blind and those with
passive activities.
low vision) anticipated that their c hildren
would need assistance in the financial area, in • Overall, the adolescents with low vision
the household-and personal-management ar- appeared to be involved in the fewest activi-
eas, and with transportation. The youths who ties and were the least likely to be in social
were blind likewise thought they would need situations that involved others (high-level
assistance in all the areas identified, and t hose activities).
with low vision thought they would need

a ssistance in all the areas except personal SNPP Replication
management.
Researchers in Canada replicated the SNPP and
• According to the reports of both the adoles- increased the subject pool to 330 young adults
cents and parents, the students who w ere aged 15 to 30, albeit without sighted participants
sighted in this sample w
ere the most active so- (Gold et al., 2005; Shaw et al., 2005). The meth-
cially. odology employed was very similar to that used
• The types of social interactions the adolescents in the SNPP; however, the researchers added
were involved in a fter school differed by the items to their questionnaires related to romantic
amount of vision they had. The sighted adoles- relationships as well as job-seeking activities and
cents and their parents reported that the ado- incorporated two standardized assessment scales,
lescents spent their time almost exclusively the Multidimensional Scale of Perceived Social
with their friends and only occasionally with Support (Zimet, Dahlem, Zimet, & Farley, 1988)
their parents or siblings. On the other hand, and the Satisfaction with Life Scale (Diener, Em-
the majority of adolescents who w ere blind or mons, Larsen, & Griffin, 1985). Key findings from
had low vision and their parents reported that this study follow:
• Although the majority of these young p eople ment of romantic relationships, close friendship,
(71 percent) indicated that they had worked for gender role awareness, and sociopolitical aware-
pay, only 29 percent w ere employed at the time ness. In the second study, 178 adolescents with
of the study. Thirty-seven p ercent of those who visual impairments (blindness or low vision)
were not working stated that they were actively and 526 sighted adolescents completed the Ego
looking for employment. However, when asked Identity Process Questionnaire. Key findings in-
how much time they spent looking for work on cluded the following:
a daily basis, 78 percent indicated they spent an
hour or less per day on job search activities. • There were fewer differences on attainment of
• Responses plotted on histograms suggested pat- developmental tasks overall between youths
terns of greater involvement in passive and mid- who w ere visually impaired and those who
level social activities for youths with visual were sighted than the researchers anticipated.
impairments than in high-level social activities. • Two differences between the groups the re-
• There were no significant differences between searchers observed w ere in attainment of the
youths who were blind and t hose who had low goal of peer group integration and the forma-
vision in the size of their social networks; how- tion of romantic relationships.
ever, fewer youths who were blind reported • The students with visual impairments w ere no
having boyfriends or girlfriends and dating less successful than were the sighted students
than t hose who had low vision. in developing friendships.
• Youths who w ere blind performed fewer activ- • There were no differences between the adoles-
ities of daily living than youths who had low cents with and without sight in levels of iden-
vision. tity exploration and commitment making.
• Higher levels of parental expectations w
ere • Youths with congenital visual impairments
associated with greater likelihood of being evidenced lower levels of identity exploration
employed. than t hose with acquired visual impairments.
• Identity exploration appeared to vary by age,

Attainment of Developmental Tasks parental education, social support, and severity
and Identity Development of disability.
Researchers in Germany looked at attainment of
developmental tasks by adolescents (Pfeiffer & SUMMARY
Pinquart, 2011) and identity development specif-
ically (Pinquart & Pfeiffer, 2013). In the first This chapter presented an overview of the four ma-
study of developmental task attainment, the re- jor developmental models: maturational, psycho-
searchers matched 158 youths with visual im- analytic, behavioral, and cognitive-developmental.
pairments and 158 sighted youths for a total Although youths with visual impairments develop
sample size of 316 with ages from 12 to 19. The in ways much like their sighted peers, some
developmental tasks identified included peer disability-
specific considerations for those who
group integration, acceptance of physical maturity, work with young p eople who are visually impaired
identity development, autonomy from parents, were noted. These considerations or issues centered
career choice, gain of occupational competence, on three aspects: physical attributes (how a person
development of realistic self-perception, develop- looks), cognitive attributes (how a person learns),
and emotional attributes (how a person feels). The

common thread r unning through t hese issues was REFERENCES
the importance of making sure that children and
youths with visual impairments have access to in- Aldridge, J., & Goldman, R. (2007). Current issues and
formation acquired incidentally— that is, picked trends in education (2nd ed.). Upper Saddle River,
NJ: Pearson Education.
up casually through observation—by children
Allman, C. B., & Lewis, S. (Eds.). (2014). ECC essentials:
with good, functional vision.
Teaching the expanded core curriculum to students with
The areas where adolescents with visual im- visual impairments. New York: AFB Press.
pairments seemed to be most at risk in compari- American Acade my of Child and Adolescent Psychi-
son to their sighted peers w ere social and atry. (2008). Stages of adolescent development.
vocational. They seemed to have more difficulty Retrieved from http://eclkc.ohs.acf.hhs.gov/hslc
integrating into social groups and forming ro- /t ta- s ystem/e hsnrc /docs/_ 3 4 _ S tages _of _ adole
mantic relationships (Huurre & Aro, 2000; Kef & scence1.pdf
Bos, 2006; Pfeiffer & Pinquart, 2011; Rosenblum, American Psychological Association. (2002). A reference
2006; Wolffe, 2006) and w ere less likely to secure for professionals: Developing adolescents. Washing-
employment without intervention in the social ton, DC: Author. Retrieved from http://w ww.apa
skills area and support to gain work experiences .org /pi/families/resources/develop.pdf
American Psychological Association. (2014, Febru-
while in high school (McDonnall, 2011; Shaw
ary 11). Stress in America: Are teens adopting
et al., 2007; Wolffe & Sacks, 1997). Therefore,
adults’ stress habits? Retrieved from http://w ww
practitioners and parents may want to pay special
.apa.org /news/press/releases/2014/02/teen-stress
attention to these areas as they consider appro- .aspx
priate programming for young adults with visual Anderson, E. M., & Clarke, L. (1982). Disability in ado-
impairments. lescence. London: Methuen.
Finally, the chapter described studies of ado- Bandura, A. (1977). Social learning theory. Englewood
lescents with visual impairments and their levels Cliffs, NJ: Prentice Hall.
of adjustment and involvement in various aspects Bandura, A. (1979). Principles of behavior modification.
of life. As evidenced in t hese studies, adolescents New York: Holt, Rinehart, & Winston.
with visual impairments are performing in Bandura, A. (1986). Social foundations of thought and ac-
many ways like their sighted peers. However, tion: A social cognitive theory. Englewood Cliffs, NJ:
their families and others who care for them need Prentice Hall.
Bandura, A. (1989). Social cognitive theory. Annals of
to provide supports, such as assistance with
Child Development, 6, 1–60.
transportation, instruction in social skills, and
Barclay, L. A. (2003). Preparation for assessment. In
feedback on objects, p eople, and events in the en- S. A. Goodman & S. H. Wittenstein (Eds.), Collab-
vironment that they may miss because they are orative assessment: Working with students who are
unable to see or see well. At the same time, sig- blind or visually impaired, including those with addi-
nificant adults need to allow adolescents who are tional disabilities (pp. 37–70). New York: AFB Press.
visually impaired to take the risks inherent in ad- Barraga, N. C. (1986). Sensory perceptual develop-
olescent development, socialize with their peers, ment. In G. T. Scholl (Ed.), Foundations of educa-
and experience life as independently as possible. tion for blind and visually handicapped children and
youth: Theory and practice (pp. 83–98). New York:
American Foundation for the Blind.
For learning activities related to this Barton, D. D. (1997). Growing up with Jed: Parents’
chapter, log in to the online AFB Learning experiences raising a son who is blind. Journal of
Center. Visual Impairment & Blindness, 91(3), 203–212.
Batshaw, M. L., Roizen, N. J., & Lotrecchiano, G. R. Chase, J. B. (2000). Technology and the use of tools:
(2013). Children with disabilities (7th ed.). Balti- Psychological and social factors. In B. Silverstone,
more: Paul H. Brookes. M. A. Lang, B. P. Rosenthal, & E. E. Faye (Eds.),
Beaty, L. A. (1991). The effects of visual impairments The Lighthouse handbook on vision impairment and
on adolescents’ self-concept. Journal of Visual Im- vision rehabilitation (pp. 983–1002). New York: Ox-
pairment & Blindness, 85, 129–130. ford University Press.
Beaty, L. A. (1994). Psychological f actors and academic Corn, A. L., Lippmann, O., & Lewis, M. C. (1990). Li-
success of visually impaired college students. censed d rivers with bioptic telescopic spectacles:
RE:view, 26, 131–139. User profiles and perceptions. Re:view, 21, 221–
Bee, H., & Boyd, D. (2011). The developing child (13th 230.
ed.). New York: Pearson. Corn, A. L., & Rosenblum, L. P. (2000). Finding wheels:
Benjamin, K. (2012, February 2). 5 reasons teenagers act A curriculum for non-drivers with visual impairments
the way they do [Web log post]. Retrieved from for gaining control of transportation needs. Austin,
http://m entalf loss/a r ticle/2 9895/5 -r easons TX: Pro-E d.
-teenagers-act-way-t hey- do Corn, A. L., & Sacks, S. Z. (1994). The impact of non-
BiopticDrivingUSA. (2015). An introduction: Driving driving on adults with visual impairments. Journal
with bioptic glasses. Retrieved from http://w ww of Visual Impairment & Blindness, 88, 53–68.
.biopticdrivingusa.com/ Cowen, E. L., Underberg, R. P., Verrillo, R. T., & Ben-
Biro, F. M., Greenspan, L. C., & Galvez, M. P. (2012). ham, F. G. (1961). Adjustment to visual disability in
Puberty in girls of the 21st c entury. Journal of Pedi- adolescence. New York: American Foundation for
atric and Adolescent Gynecology, 25(5), 289–294. the Blind.
Bishop, V. E. (2004). Teaching visually impaired children. Crary, E. (1995). Pick up your socks and other skills grow-
Springfield, IL: Charles C Thomas. ing c hildren need. Seattle: Parenting Press.
Bolinger, R., & Bolinger, C. (1996). Family life. In M. C. Dasberg, L. (1983). A historical and transcultural view
Holbrook (Ed.), C hildren with visual impairments: A of adolescence. In W. Everaerd, C. B. Hindley,
parents’ guide (pp. 129–157). Bethesda, MD: Wood- A. Bot, & J. J. van der Werff ten Bosch (Eds.), De-
bine House. velopment in adolescence: Psychological, social and
Buscaglia, L. (1975). The disabled and their parents: A biological aspects (pp. 1–15). Boston: Martinus
counseling challenge. Thorofare, NJ: Charles B. Slack. Nijhoff.
Carter, B. B., & Spencer, V. G. (2006). The fear factor: Daugherty, K. M., & Moran, M. E. (1982). Neuropsy-
Bullying and students with disabilities. Interna- chological, learning and developmental charac-
tional Journal of Special Education, 21, 11–23. teristics of the low vision child. Journal of Visual
Cass, H. D., Sonksen, P. M., & McConachie, H. R. Impairment & Blindness, 76, 398–406.
(1994). Developmental setback in severe visual Deitz, S. J., & Ferrell, K. A. (1994). Project PRISM: A
impairment. Archives of Disease in Childhood, 70, national collaborative study on the early devel-
192–196. opment of c hildren with visual impairments.
Cattaneo, Z., & Vecchi, T. (2011). Blind vision: The neu- Journal of Visual Impairment & Blindness, 88, 470–
roscience of visual impairment. Cambridge, MA: MIT 472.
Press. De Klerk, H., & Greeff, A. P. (2011). Resilience in par-
Chase, J. B. (1986). Psychoeducational assessment of ents of young adults with visual impairments.
visually-impaired learners. In P. J. Lazarus & S. S. Journal of Visual Impairment & Blindness, 107,
Strichart (Eds.), Psychoeducational evaluation of 414–424.
children and adolescents with low-incidence handicaps Dewerchin, L., & Keppens, K. (2013, September). Mo-
(pp. 41–74). Orlando: Grune & Stratton. tor development and (early) intervention in blind
Chase, J. B. (1993, Fall). Family systems. EnVision: A and severely visually impaired babies, toddlers and
publication of the Lighthouse National Center for Vi- children. Presentation at the European Pediatric
sion and Child Development, 1, pp. 1–5. Neurology Society Congress, Brussels, Belgium.
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. Felleman, H. (1936). Best loved poems of the American
(1985). The Satisfaction with Life Scale. Journal of people. New York: Doubleday.
Personality Assessment, 49, 71–75. Fenwick, E., & Smith, T. (1998). Adolescence: The sur-
Dunkerton, J. (1995). Examination results of visually vival guide for parents and teenagers (2nd ed.). Lon-
impaired students. British Journal of Special Educa- don: Dorling Kindersley.
tion, 22, 34–39. Ferrell, K. A. (2000). Growth and development of young
Dworetzky, J. P. (1996). Introduction to child development children. In M. C. Holbrook & A. J. Koenig (Eds.),
(6th ed.). Saint Paul, MN: West. Foundations of education: Vol. 1. History and theory of
Ekman, P. (1993). Facial expression and emotion. teaching children and youths with visual impairments
American Psychologist, 48, 376–379. (2nd ed., pp. 111–134). New York: AFB Press.
Ekman, P. (2007). Emotions revealed: Recognizing faces Ferrell, K. A. (2011). Reach out and teach: Helping your
and feelings to improve communication and emotional child who is visually impaired learn and grow (2nd
life (2nd ed.). New York: Henry Holt. ed.). New York: AFB Press.
Elkind, D. (1997). All grown up and no place to go: Teen Fine, M. J. (1995). F amily-school intervention. In R. H.
agers in crisis (Rev. ed.). Reading, MA: Addison- Mikesell, D. D. Lusterman, & S. H. McDaniel
Wesley. (Eds.), Integrating family therapy: Handbook of family
Elliott, R. (2003). Executive functions and their psychology and systems theory (pp. 481–495). Wash-
disorders. British Medical Bulletin, 65, 49–59. ington, DC: American Psychological Association.
Erikson, E. H. (1963). Childhood and society (2nd ed.). Fraiberg, S. (1977). Insights from the blind. New York:
New York: Norton. Basic Books.
Erikson, E. H. (1980). Identity and the life cycle. New Freeman, R. D. (1987). Psychosocial interventions
York: Norton. (Originally published in 1959) with visually impaired adolescents and adults.
Erin, J. N. (2001). Individual and societal responses to In B. Heller, L. Flohr, & L. S. Zegans (Eds.), Psycho-
diversity and visual impairment. In M. Milian & social interventions with sensorially disabled persons
J. N. Erin (Eds.), Diversity and visual impairment: (pp. 153–166). Orlando: Grune & Stratton.
The influence of race, gender, religion, and ethnicity on Freeman, R. D., Goetz, E., Richards, D. P., & Groen-
the individual. New York: AFB Press. veld, M. (1991). Defiers of negative prediction: A
Erin, J. N., & Wolffe, K. E. (1999). Transition issues re- 14-year follow-up of legally blind c hildren. Jour-
lated to students with visual disabilities. Austin, TX: nal of Visual Impairment & Blindness, 85, 365–370.
Pro-Ed. Freeman, R. D., Goetz, E., Richards, D. P., Groenveld,

Fabiano, G. A. (2014). Interventions for high school M., Blockberger, S., Jan, J. E., & Sykanda, A. M.
students with attention-deficit/hyperactivity dis- (1989). Blind c hildren’s early emotional develop-
order: Considerations for f uture directions. School ment: Do we know enough to help? Child: Care,
Psychology Review, 43, 203–209. Health and Development, 15, 3–28.
Fazzi, E., & Bianchi, P. E. (Eds.). (2016). Visual impair- Freud, S. (1905). The basic writings of Sigmund Freud
ments and neurodevelopmental disorders: From diag- (A. A. Brill, Trans.). New York: Random House.
nosis to rehabilitation. Paris: John Libbey Eurotext. Gesell, A. (1928). Infancy and human growth. New York:
Fazzi, E., & Molinaro, A. (2016). Visual function and Macmillan.
neurodevelopment in c hildren: From neurosci- Gesell, A. (1956). Youth: Years ten to sixteen. New York:
ence to rehabilitation. In E. Fazzi & P. E. Bianchi Harper & Row.
(Eds.), Visual impairments and neurodevelopmental Gesell, A., & Thompson, H. (1929). Learning and
disorders: From diagnosis to rehabilitation (pp. 3–12). growth in identical infant twins: An experimen-
Paris: John Libbey Eurotext. tal study of individual differences by the method
Fazzi, E., Signorini, S. G., Bomba, M., Luparia, A., Lan- of co-t win control. Genetic Psychology Monographs,
ners, J., & Balottin, U. (2011). Reach on sound: A 6, 1–124.
key to object permanence in visually impaired Gesell, A., & Thompson, H. (1941). Twins T and C
c hildren. Early Human Development, 87, 289–296. from infancy to adolescence: A biogenetic study
of individual differences by the method of co-twin Jensen, R. E. (2015). The teenage brain: A neuroscientist’s
control. Genetic Psychology Monographs, 24, 3–121. survival guide to raising adolescents and young adults.
Gold, D., Shaw, A., & Wolffe, K. E. (2005, September). New York: HarperCollins.
The status of Canadian youth who are blind or vi- Jose, R. T. (1983). Treatment options. In R. T. Jose (Ed.),
sually impaired: A study of lifestyles, quality of Understanding low vision (pp. 211–248). New York:
life and employment. Elsevier International Con- American Foundation for the Blind.
gress Series, 1282, 1148–1152. Kapperman, G., & Kelly, S. (2013). Sex education in-
Gold, D., Shaw, A., & Wolffe, K. E. (2010). The social struction for students who are visually impaired:
lives of Canadian youth with visual impairments. Recommendations to guide pract it ioners. Journal
Journal of Visual Impairment & Blindness, 104, of Visual Impairment & Blindness, 107, 226–230.
431–443. Kapperman, G., Brown-Ogilvie, T., Yesaitis, J., & Pes-
Gunaratne, L. A. (2016, February 19). Visual impair- kin, A. (2014). Prevention of sexual assault against
ment: Its effect on cognitive development and be- c hildren who are visually impaired. DVI Quarterly,
haviour. University of Hertforshire. Retrieved from 59, 33–37.
http://w ww.i ntellectualdisability.i nfo/physi c al Kef, S. (1997). The personal networks and social
-health/a rticles/v isual-impairment-its- e ffect- on supports of blind and visually impaired adoles-
-cognitive-development-and-behaviour cents. Journal of Visual Impairment & Blindness,
Head, D. (1979). A comparison of self-concept scores 91, 236–244.
for visually impaired adolescents in several class Kef, S., & Bos, H. (2006). Is love blind? Sexual behav-
settings. Education of the Visually Handicapped, 10, iour and psychological adjustments of adolescents
51–55. with blindness. Sexuality and Disability, 24, 89–100.
Herman-Giddens, M., Slora, E. J., Wasserman, R. C., Kelley, P. A., Sanspree, M. J., & Davidson, R. C. (2000).
Bourdony, C. J., Bhapkar, M. V., Koch, G. G., & Vision impairment in c hildren and youth. In
Hasemeier, C. M. (1997). Secondary sexual char- B. Silverstone, M. A. Lang, B. P. Rosenthal, & E. E.
acteristics and menses in young girls seen in of- Faye (Eds.), The Lighthouse handbook on vision impair-
fice practice: A study from the Pediatric Research ment and vision rehabilitation (pp. 1137–1151). New
in Office Settings Network. Pediatrics, 99(4), York: Oxford University Press.
505–512. Kelly, S. (Guest Ed.). (2014, Winter). Special issue on
Heyl, V., & Hintermair, M. (2015). Executive func- sex education and students with visual impair-
tion and behavioral problems in students with ments. DVI Quarterly, 59(2).
visual impairments at mainstream and special Kelly, S. M., & Kapperman, G. (2012). Sexual activity
schools. Journal of Visual Impairment & Blindness, of young adults who are visually impaired and the
109, 251–263 need for effective sex education. Journal of Visual
Hudson, C. (2016). Teenagers & popularity: Life can be Impairment and Blindness, 106, 519–526.
hard at the top [Web log post]. Understanding Kelly, S., & Wolffe, K. E. (2012). Internet use by
Teenagers. Retrieved from http://understanding transition-aged youth with visual impairments in
teenagers.com.au/blog /teenagers-popularity-life the United States: Assessing the impact of post-
-can-be-hard-at-t he-top/ secondary predictors. Journal of Visual Impairment
Huurre, T. M., & Aro, H. M. (2000). The psychosocial & Blindness, 106, 597–608.
well-being of Finnish adolescents with visual im- Koenig, A. J. (1996). Growing into literacy. In M.C. Hol-
pairments versus t hose with chronic conditions brook (Ed.), Children with visual impairments: A par-
and t hose with no disabilities. Journal of Visual Im- ents’ guide (pp. 225–257). Bethesda, MD: Woodbine
pairment & Blindness, 94, 625–637. House.
Huurre, T. M., Komulainen, E. J., & Aro, H. M. (1999). Kolbert, E. (2015, August 31). The terrible teens: What’s
Social support and self-esteem among adolescents wrong with them? The New Yorker. Retrieved from
with visual impairments. Journal of Visual Impair- http://w ww.newyorker.com/magazine/2015/08
ment & Blindness, 93, 26–37. /31/t he-terrible-teens
Krupa, C., & Esmail, S. (2010). Sexual health educa- Lorenz, K. Z. (1958). The evolution of behavior. Scien-
tion for c hildren with visual impairments: Talk- tific American, 199, 67–78.
ing about sex is not enough. Journal of Visual Lorenz, K. Z. (1965). Evolution and modification of
Impairment & Blindness, 104, 327–337. behavior. Chicago: University of Chicago Press.
Kurson, R. (2007). Crashing through: A true story of risk, Lowenfeld, B. (1971). Our blind children: Growing
adventure, and the man who dared to see. New York: and learning with them (3rd ed.). Springfield, IL:
Random House. Charles C Thomas.
Kvam, M. (2005). Experiences of childhood sexual Lowenfeld, B. (1987). The influence of blindness and
abuse among visually impaired adults in Norway: visual impairment on psychological develop-
Prevalence and characteristics. Journal of Visual Im- ment. In B. Heller, L. Flohr, & L. S. Zegans (Eds.),
pairment & Blindness, 99, 5–14. Psychosocial interventions with sensorially disabled
Lang, M. A. (2000). The role of psychosocial factors persons (pp. 99–114). Orlando: Grune & Stratton.
in adaptation to vision impairment and habilita- Lueck, A. H., & Dutton, G. (Eds.). (2015). Vision and
tion outcomes for c hildren and youth. In B. Silver- the brain: Understanding cerebral visual impairment in
stone, M. A. Lang, B. P. Rosenthal, & E. Faye (Eds.), children. New York: AFB Press.
The Lighthouse handbook on vision impairment and Luna, B., Garver, K. E., Urban, T. A., Lazar, N. A., &
vision rehabilitation (pp. 1011–1028). New York: Sweeney, J. A. (2004). Maturation of cognitive
Oxford University Press. processes from late childhood to adulthood. Child
Langley, B. (1996). Daily life. Your child’s develop- Development, 75, 1357–1372.
ment. In M. C. Holbrook (Ed.), C hildren with visual MacCuspie, P. A. (1996). Promoting acceptance of children
impairments: A parents’ guide (pp. 97–127). Bethesda, with disabilities: From tolerance to inclusion. Halifax,
MD: Woodbine House. Nova Scotia: Atlantic Provinces Special Education
Larson, R., & Richards, M. H. (1994). Divergent reali- Authority.
ties: The emotional lives of mothers, fathers and ado- Magee, B., & Milligan, M. (1995). On blindness. New
lescents. New York: Basic Books. York: Oxford University Press.
Lechelt, E. C., & Hall, D. L. (n.d.). The impact of vision loss Marshall, I. (2006). Puberty and adolescence. The New
on the development of children from birth to 12 years: A York Times Health Guide. Retrieved from http://
lite rature review. Toronto, ON: CNIB. health.nytimes.com/health/g uides/specialtopic
Leon-Carrion, J., García-Orza, J., & Pérez-Santamaría, /puberty-and-adolescence/overview.html
F. J. (2004). Development of the inhibitory com- Matsuda, M. M. (1984). A comparative analysis of blind
ponent of the executive functions in c hildren and and sighted children’s communication skills. Jour-
adolescents. International Journal of Neuroscience, nal of Visual Impairment & Blindness, 78, 1–5.
114, 1291–1311. McDonnall, M. C. (2011). Predictors of employment
Lerner, R. M., & Lerner, J. V. (Eds.). (1999). Theoretical for youths with visual impairments: Findings
foundations and biological bases of development in from the second National Longitudinal Transition
adolescence. New York: Tufts University. Study. Journal of Visual Impairment & Blindness, 105,
Lewis, S., & Allman, C. B. (2014). Learning, develop- 453–466.
ment, and c hildren with visual impairments: The McElhaney, K. E., Antonishak, J., & Allen, J. P. (2011).
evolution of skills. In C. B. Allman & S. Lewis They like me, they like me not: Popularity and
(Eds.), ECC essentials: Teaching the expanded core adolescents’ perceptions of acceptance predicting
curriculum to students with visual impairments social functioning over time. Child Development,
(pp. 3–14). New York: AFB Press. 79, 720–731.
Lewis, S., & Wolffe, K. E. (2006). Promoting and nur- McGoldrick, M., & Gerson, R. (1985). Genograms in
turing self-e steem. In S. Z. Sacks & K. E. Wolffe family assessment. New York: W. W. Norton.
(Eds.), Teaching social skills to students with visual Meighan, T. (1971). An investigation of the self-concept of
impairments: From theory to practice (pp. 122–162). blind and visually handicapped adolescents. New
New York: AFB Press. York: American Foundation for the Blind.
Minter, M. E., Hobson, R. P., & Pring, L. (1991). Rec- Oldham, J. (2010). Being legally blind: Observations for
ognition of vocally expressed emotion by congen- parents of visually impaired c hildren. Anchorage, AK:
itally blind c hildren. Journal of Visual Impairment Shadow Fusion.
& Blindness, 85, 411–415. Pava, W. S. (1994). Visually impaired persons’ vulner-
National Or ga niza
t ion for Albinism and Hypo ability to sexual and physical assault. Journal of
pigmentation. (2015). Information bulletin: Al- Visual Impairment & Blindness, 88, 103–112.
binism and driving. Retrieved from http://w ww Pavlov, I. P. (1927). Conditioned reflexes. London: Ox-
.a lbinism.org /site/c.fl KYIdOUIhJ4H/b.9260365 ford University Press.
/k .2158/I nformation _ Bulletin _ _ A lbinsim _ a nd Peterson, A. C., Compas, B. E., Brooks-Gunn, J., Stem-
_Driving.htm mler, M., Ey, S., & Grant, K. E. (1993). Depression
Neer, F. L. (2000). Breaking barriers: Blind rites of pas- in adolescence. American Psychologist, 48, 155–168.
sage. Berkeley, CA: Creative Arts. Peterson, G. W., & Leigh, G. K. (1990). The f amily and
Newman, L. (2005). Postsecondary education par- social competence in adolescence. In T. P. Gullotta,
ticipation of youth with disabilities. In M. Wag- G. R. Adams, & R. Montemayor (Eds.), Developing
ner, L. Newman, R. Cameto, N. Garza, & P. social competency in adolescence (pp. 97–138).
Levine (Eds.), After high school: A first look at the Newbury Park, CA: Sage.
postschool experiences of youth with disabilities. A Pfeiffer, J. P., & Pinquart, M. (2011). Attainment of de-
report from the National Longitudinal Transition velopmental tasks by adolescents with visual im-
Study-2 (NLTS2). Menlo Park, CA: SRI Interna- pairments and sighted adolescents. Journal of
tional. Retrieved from www.n lts2.org /reports Visual Impairment & Blindness, 105, 33–44.
/2 005_0 4/n lts2_r epor t _2 005_0 4_c omplete Piaget, J. (1932). The moral judgment of the child. New
.pdf York: Macmillan.
Newman, L., Wagner, M., Knokey, A.-M ., Marder, Piaget, J. (1952). The origins of intelligence in children.
C., Nagle, K., Shaver, D., . . . Schwarting, M. New York: International Universities Press.
(2011). The post- high school outcomes of young Piaget, J. (1977). The development of thought: Equilibra-
adults with disabilities up to 8 years after high tion of cognitive structures. New York: Viking Press.
school: A report from the National Longitudinal Pickhardt, C. (2013). Surviving your child’s adolescence.
Transition Study-2 (NLTS2) (NCSER 2011-3005). San Francisco: Jossey-Bass.
Menlo Park, CA: SRI International. Retrieved Pinquart, M., & Pfeiffer, J. P. (2013). Identity develop-
from http://w ww.n lts2.org /reports/2011_ 09 ment in German adolescents with and without
_ 02/i ndex .html visual impairments. Journal of Visual Impairment &
Newman, S. (2010, September 14). Why your teen in- Blindness, 105, 338–349.
sists on dressing exactly like her friends [Web log Pring, L., & Tadic, V. (2010). The cognitive and behav-
post]. Psychology Today. Retrieved from https://w ww ioral manifestations of blindness in children.
.p sycholog ytoday .c om / b log /a pologies -f reud In R. D. Nass & Y. Frank (Eds.), Cognitive and be-
/201009/why-your-teen-i nsists-d ressing- e xactly havioral abnormalities of pediatric diseases (pp. 531–
-her-friends 543). New York: Oxford University Press.
Nixon, H. L. (1991). Mainstreaming and the American Pruitt, D. B. (Ed.). (1999). Your adolescent: Emotional, be-
dream: So cio
log
i
cal perspectives on parental coping havioral and cognitive development from early adoles-
with blind and visually impaired c hildren. New York: cence through the teen years. New York: HarperCollins
American Foundation for the Blind. and American Academy of Child and Adolescent
Nixon, H. L. (1994). Looking soc iologically at family Psychology.
coping with visual impairment. Journal of Visual Quillman, R. D., & Goodrich, G. (2004). Interventions
Impairment & Blindness, 88, 329–337. for adults with visual impairments. In A. H. Lueck
Norris, M., Spauld ing, P. J., & Brodie, F. H. (1957). (Ed.), Functional vision: A practitioner’s guide to eval-
Blindness in children. Chicago: University of Chi- uation and intervention (pp. 423–470). New York:
cago Press. AFB Press.
Rettinger, J. (2015, October 21). How close are we to a Sacks, S. Z., & Rosenblum, L. P. (2006). Adolescents
real self-d riving car? [Web log post]. Huffington with low vision: Perceptions of driving and non-
Post. Retrieved from http://w ww.huffingtonpost driving. Journal of Visual Impairment & Blindness,
.com/jonathan-rettinger/how- c lose-a re-we-to -a 100, 212–222.
-rea _ b_ 8346966.html Sacks, S. Z., & Wolffe, K. E. (1998). Lifestyles of ado-
Rice, W. (Ed.). (2008). There’s a teenager in my h ouse: 101 lescents with visual impairments: An ethno-
questions parents ask. Downers Grove, IL: Inter- graphic analysis. Journal of Visual Impairment &
Varsity Press. Blindness, 92, 7–17.
Rieser, J. J., Ashmead, D. H., Ebner, F. F., & Corn, A. Sacks, S. Z., Wolffe, K. E., & Tierney, D. (1998). Life-
L. (Eds.). (2008). Blindness and brain plasticity in styles of students with visual impairments: Pre-
navigation and object perception. New York: Erl- liminary studies of social networks. Exceptional
baum. Children, 64, 463–478.
Rittenmeyer, L., & Huffman, D. M. (2003). Health, Salkind, N. J. (2004). Introduction to theories of h uman
illness, and disability during adolescence. In D. development. Thousand Oaks, CA: Sage.
M. Huffman, K. L. Fontaine, & B. K. Price (Eds.), Sanspree, M. J. (2000). Pathways to habilitation: Best
Health problems in the classroom: 6–12. An A–Z refer- practices. In B. Silverstone, M. A. Lang, B. P. Rosen-
ence guide for educators (pp. 3–15). Thousand Oaks, thal, & E. Faye (Eds.), The Lighthouse handbook on
CA: Corwin Press. vision impairment and vision rehabilitation (pp. 1167–
Rosenblum, L. P. (1997). Adolescents with visual 1182). New York: Oxford University Press.
impairments who have best friends: A pi lot Scholl, G. T. (1986). Growth and development. In
study. Journal of Visual Impairment & Blindness, G. T. Scholl (Ed.), Foundations of education for blind
91, 224–235. and visually handicapped children and youth: Theory
Rosenblum, L. P. (2006). Developing friendships and and practice (pp. 65–82). New York: American
positive social relationships. In S. Z. Sacks & K. Foundation for the Blind.
E. Wolffe (Eds.), Teaching social skills to students Schonfeld, A. R. (2000, June 20). P eople with visible
with visual impairments: From theory to practice eye deformities face prejudice. WebMD Health
(pp. 163–194). New York: AFB Press. News. Retrieved from http://w ww.webmd.com/eye
Rosenblum, L. P. (2011). Nondriving: Strategies for -health/news/20000620/eye-deformity-prejudice
preparing children and youth [Webcast]. Water- Scott, E., Jan, J., & Freeman, R. (1995). Can’t your child
town, MA: Perkins School for the Blind. Retrieved see? (3rd ed.). Austin, TX: Pro-E d.
from http://support .perkins.org /site/PageS erver Seligman, M., & Darling, R. B. (2007). Ordinary fami-
?pagename=Webcasts_ Nondriving_ Strategies lies, special c hildren: A systems approach to childhood
Ryles, R. (1996). The impact of braille reading skills disability (3rd ed.). New York: Guilford Press.
on employment, income, education, and reading Shaw, A., Gold, D., & Simson, H. (2005). The status of
habits. Journal of Visual Impairment & Blindness, 90, Canadian youth who are blind or visually impaired: A
219–226. study of lifestyles, quality of life and employment. To-
Sacks, O. (1996). An anthropologist on Mars. New York: ronto: Canadian National Institute for the Blind.
Vintage Books, Random House. Shaw, A., Gold, D., & Wolffe, K. E. (2007). Employment-
Sacks, S. Z. (2014). Social interaction. In C. B. Allman related experiences of youths who are blind or
& S. Lewis (Eds.), ECC essentials: Teaching the ex- visually impaired: How are these youths faring?
panded core curriculum to students with visual impair- Journal of Visual Impairment & Blindness, 101, 7–21.
ments (pp. 324–368). New York: AFB Press. Skelton, H., & Rosenbaum, P. (2010). Disability and
Sacks, S. Z., Kekelis, L. S., & Gaylord-Ross, R. J. (Eds). child development: Integrating the concepts. Can-
(1992). The development of social skills by blind and Child. Retrieved from https://w ww.canchild.ca/en
visually impaired students. New York: American /resources/35- disability-a nd- c hild- development
Foundation for the Blind. -integrating-t he- concepts
Skinner, B. F. (1938). The behavior of organisms: An exchanges, implying brain can re-organize itself to
perimental analysis. New York: Appleton-C entury- adapt. S cienceDaily. Retrieved from http://w ww
Crofts. .sciencedaily.com/releases/2009/11/091118143259
Skinner, B. F. (1957). Verbal behavior. New York: .htm
Appleton-C entury-Crofts. Vygotsky, L. S. (1962). Thought and language. Cam-
Skinner, B. F. (1976). Walden two. New York: Mac- bridge, MA: MIT Press.
millan. Vygotsky, L. S. (1978). Mind in society: The development
Sobsey, D. (1994). Violence and abuse in the lives of people of higher psychological processes (M. Cole, V. John-
with disabilities: The end of silent acceptance? Balti- Steiner, S. Scribner, & E. Souberman, Eds.). Cam-
more, MD: Paul H. Brookes. bridge, MA: Harvard University Press.
Spano, S. (2004, May). Stages of adolescent develop- Wagner, M., D’Amico, R., Marder, C., Newman, L., &
ment. ACT for Youth Upstate Center of Excellence Re- Blackorby, J. (1992). What happens next? Trends in
search Facts and Findings. Retrieved from http:// postschool outcomes of youth with disabilities. Menlo
w w w.a ctfor youth.n et/r esources/r f/r f_ s tages Park, CA: SRI International.
_0504.pdf Wagner, M., Newman, L., D’Amico, R., Jay, E. D., Butler-
Sroufe, L. A., Egeland, B., Carlson, E. A., & Collins, Nalin, P., Marder, C., & Cox, R. (1991). Young people
W. A. (2005). The development of the person: The with disabilities: How are they doing? Menlo Park,
Minnesota study of risk and adaptation from birth to CA: SRI International.
adulthood. New York: Guilford Press. Walsh, D. (2004). Why do they act that way? A survival
Steinberg, L. (2010). Adolescence (9th ed.). New York: guide to the adolescent brain for you and your teen.
McGraw-Hill. New York: Free Press.
Strauch, B. (2003). The primal teen: What the new dis- Warnke, J. W. (1991a). Becoming an everyday mystic.
coveries about the teenage brain tell us about our kids. Saint Meinrad, IN: Abbey Press.
New York: Doubleday. Warnke, J. W. (1991b). Special needs of children
Szlyk, J. P., Seiple, W., Laderman, D. J., Kelsch, R., and adolescents. In S. L. Greenblatt (Ed.), Meet-
Stelmack, J., & McMahon, T. (2000). Measuring ing the needs of people with vision loss (pp. 37–45).
the effectiveness of bioptic telescopes for persons Lexington, MA: Resources for Rehabilitation.
with central vision loss. Journal of Rehabilitation Warren, D. H. (1984). Blindness and early childhood de-
Research and Development, 1, 101–108. velopment (2nd ed.). New York: American Founda-
Tanner, J. M. (1962). Growth at adolescence (2nd ed.). tion for the Blind.
Oxford, United Kingdom: Blackwell. Warren, D. H. (1994). Blindness and c hildren: An indi-
Tanner, J. M. (1991). Secular trends in age of menarche. vidual differences approach. New York: Cambridge
In R. M. Lerner, A. C. Peterson, & J. Brooks-Gunn University Press.
(Eds.), Encyclopedia of adolescence (pp. 637–641). Weil, E. (2012, March 30). Puberty before age 10: A
New York: Garland. new “normal”? New York Times Magazine. Retrieved
Tuttle, D., & Tuttle, N. (1996). Self-esteem and adjusting from http://w ww.nytimes.com/2012/04/01/maga
with blindness (2nd ed.). Springfield, IL: Charles C zine/puberty-before-age-10 -a-new-normal.html
Thomas. ?pagewanted=all& _r = 0
Tuttle, D., & Tuttle, N. (2004). Self-esteem and adjusting Weiner, I. B. (1992). Psychological disturbance in
with blindness (3rd ed.). Springfield, IL: Charles C a dolescence (2nd ed.). New York: John Wiley &
Thomas. Sons.
Turnbull, A. P., & Turnbull, H. R. (1997). Families, pro- Wiseman, R. (2002). Queen bees and wannabes. New
fessionals, and exceptionality: A special partnership York: Three Rivers Press.
(3rd ed.). Upper Saddle River, NJ: Prentice-Hall. Wolf, A. E. (1991). Get out of my life but first could you
University of California–L os Angeles. (2009, No- drive me and Cheryl to the mall? New York: Noonday
vember 19). Blindness c auses structural brain Press.
Wolffe, K. E. (Ed.). (1999). Skills for success: A c areer ed- pediatrics: Evidence and practice. Philadelphia:
ucation handbook for children and adolescents with Mosby Elsevier.
visual impairments. New York: AFB Press. World Health Organization. (n.d.). Adolescent develop-
Wolffe, K. E. (2000). Growth and development in ment. Retrieved from http://w ww.who.int/mater
middle childhood and adolescence. In M. C. Hol- nal_child_adolescent/topics/adolescence/dev/en/
brook & A. J. Koenig (Eds.), Foundations of educa- World Health Organ i z at ion. (2001). International
tion: Vol. 1. History and theory of teaching children and classification of functioning, disability and health. Ge-
youths with visual impairments (2nd ed., pp. 135– neva, Switzerland: Author.
160). New York: AFB Press. Young, J., Ne’eman, A., & Gelser, S. (2011). Bullying and
Wolffe, K. E. (2006). Theoretical perspectives on the students with disabilities. A briefing paper from the
development of social skills in adolescence. In S. National Council on Disability. Washington, DC:
Z. Sacks & K. E. Wolffe (Eds.), Teaching social skills National Council on Disability.
to students with visual impairments: From theory to Zihl, J., & Dutton, G. (2015). Cerebral visual impairment
practice (pp. 81–116). New York: AFB Press. in c hildren: Visuoperceptive and visuocognitive disor-
Wolffe, K. E., & Sacks, S. Z. (1995). Social Network Pilot ders. New York: Springer.
Proje ct: Final report. Department of Education Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley,
grant H023A30108. Unpublished manuscript. G. K. (1988). The Multidimensional Scale of
Wolffe, K. E., & Sacks, S. Z. (1997). The lifestyles of Perceived Social Support. Journal of Personality
blind, low vision, and sighted young youths: A Assessment, 52, 30–41.
quantitative comparison. Journal of Visual Impair- Zuidhoek, S. (2015). The role of attention and execu-
ment & Blindness, 91, 245–257. tive brain functions in seeing and behavior in
Wolffe, K. E., & Sacks, S. Z. (Eds.). (2000). Focus on: c hildren with CVI. In A. H. Lueck & G. N. Dutton
Social skills. New York: AFB Press. (Eds.), Vision and the brain: Understanding cerebral
Wolraich, M. L., Drotar, D. D., Dworkin, P. H., & Per- visual impairment in children (pp. 124–144). New
rin, E. C. (Eds.). (2008). Developmental-behavioral York: AFB Press.
6
C H A P T E R
Psychosocial Needs of
Children and Youths
Cynthia S. Bachofer
To hear an audio introduction

to this chapter by the author, V GNETTES
and to view a chapter over
view presentation, log in to the AFB Learning Donavon is in the seventh grade and describes
Center. himself as a total geek for technology. He is
blind and his eye condition is congenital glau-
coma. Anything related to technology captures
his attention. Vision services for Donavon began
KEY CONCEPTS
when he was 4 years old. Initially he was very
♦ Developing psychosocial confidence (belief tactilely defensive, and his first teacher of stu-
in self- worth and unique value as a social dents with visual impairments spent months
member of society) is a dynamic process for developing trust with Donavon and his mom.
all children that continues across the life span Hearing stories was a favorite activity, and ex-
in a range of environments. ploring objects mentioned in the story helped to
build his tactile tolerance. His first braille lessons
♦ Supportive attention from a parent or signifi-
began at age 6 when he entered kindergarten.
cant adult is needed throughout the stages of
His early elementary school years also focused
growth for healthy development.
on concept development and orientation and
♦ Current evidence does not support a distinct mobility (O&M) skills. By second grade he en-
psychology of blindness (dif ferent psycholog- joyed braille lessons and he was happy to have
ical development based on absence of vi- more story choices. His discovery of science fic-
sion). The topic warrants further investigation tion books in fourth grade was a great incentive
as the understanding of h uman psychology for improving his reading rate and stamina. His
unfolds. reading speed had improved to 80 WPM and he
♦ Support for psychosocial needs can be pro- was now practicing his route to the neighbor-
vided through instructional activities and hood public library with his O&M specialist.
lessons. Donavan was diagnosed with attention deficit
185
hyperactivity disorder in his fourth-grade year. use. Her mother and her teacher of students
He has always liked listening to audiobooks, but with visual impairments, Miss Kay, felt that the
he continues to have difficulty paying attention in iPad would support both academic and social
class and finishing one task before moving to goals set this year. She was much more willing
another. His teacher of students with visual im- to use her iPad to see information in the dis-
pairments quickly recognized that getting on the tance in her classroom, and one of the terms
computer and reading about futuristic inven- of the contract was using her telescope with-
tions was very motivating for Donavon. out prompting when running errands with her
Social interaction was of little interest to mom. She is performing on a first-grade level
Donavon unless his peers wanted to talk about in math and her reading scores place her on a
technology or futuristic machines. His teacher second-grade level. Now that she is reading
of students with visual impairments suggested more, she and the librarian have become good
that he register for the regional Tech Olympics, friends.
a statewide skills competition among students Lots of things about school frustrate Mari-
using assistive technology, which involved a so- ana. Outbursts resulting in tears and shutdown
cial component of working with a partner and behavior were common in previous years, but
meeting a large group of students with visual new behavior strategies have helped her respond
impairments. Donavon placed second in his age more positively to the stressors and to monitor
group for advanced skills with screen-reading her emotions. Mariana struggles to make friends,
software. Participating in the Tech Olympics was and she told Miss Kay that she knows the other
a huge boost to Donavon’s self-esteem, and the girls whisper about her. Part of their lesson time
principal at his middle school announced his each week focuses on “how to be a friend.” To
success at the school assembly when he re- force the girls in her class to pay attention to her,
turned. Other students started asking him ques- Mariana’s habit has been to stand very close to
tions about computer video games and different someone and talk loudly. These negative social
operating systems. Donavon even reported to behaviors occur less often during iPad Club meet-
his teacher of students with visual impairments ings, where everyone in the group shares a com-
that he had been invited to join a lunchtime mon interest. In the first club meeting, students
gaming group in the library. agreed on a signal word to use when a club mem-
ber was showing unkind or disrespectful behav
ior. This honesty in the club has helped Mariana
Mariana is in the fourth grade and has just to see how one person’s actions affect a single
joined the library’s iPad iCan Club at her member as well as the group. A fifth-grade girl
school. She has low vision and her eye condi- named Cami is her iPad partner; they solve prob
tion is optic atrophy. In addition, she has cere lems, share tips, and giggle a lot, according to
bral palsy and delays in processing. Her the librarian. Mariana is starting to feel more in-
recorded distance acuity is 20/280 in her left cluded at school, and her mother told Miss Kay
eye and 20/600 in her right, and her near acu- that Mariana’s self-esteem is more evident dur-
ity is 2M@12cm. Mariana receives services for ing their conversations at home.
physical therapy, speech, and reading interven-
tion. Getting her own iPad is an important ac- INTRODUCT ON
complishment because she had to meet her
mother’s tough definition of “being responsi- “What is it like to be blind?” When answering this
ble” and sign a contract about its appropriate question, a person who is blind may be chal-
Psychosocial Needs of Children and Youths 187
lenged to explain what it is like to perceive and For students with visual impairments, the
understand the world through senses other than attainment of a fulfilling, enjoyable quality of
vision. Conversely, c hildren and youths who are life is a long-term goal, just as it is for other people
visually impaired often ask sighted parents and across cultures, developmental levels, and ages.
teachers about what it means to see. They are Quality of life is an umbrella expression for one’s
trying to make sense of the difference between perceived well-being and spans multiple domains
seeing and not seeing (Erin & Corn, 1994), a of life. Jutai, a researcher who has focused on psy-
distinction that cannot be easily described. The chosocial mea surement across disabilities for
reality of vision loss adds challenges to maintain- over 20 years, defines quality of life as “the degree
ing the desired quality of life for many p eople. to which the individual enjoys the important
Responses from a 2010 Eye on Eyesight survey possibilities of life” (Jutai, 1998, p. 3). Measuring
(PRWeb, 2010) conducted by Surge Research sug- quality of life in c hildren is an emerging field
gest that Americans fear blindness more than (Cochrane, Lamoureux, & Keeffe, 2008), and de-
heart disease (67 percent versus 37 percent), the velopment of instruments focusing on c hildren
leading cause of death for both w omen and men with disabilities is a specialized need. For exam-
in the United States. Researchers (Moradi et al., ple, researchers reported that psychosocial and
2007) reported that teens feared blindness more school functioning scores w ere statistically but
than lung cancer, heart disease, or stroke. The not clinically lower (warranting medical inter-
human reliance on vision for gathering myriad vention) for a group of healthy adolescents with
forms of information provides some explanation visual impairments compared to peers with
for t hese extreme reactions. T
hese reports also in- typical vision (Wong, Machin, Tan, Wong, & Saw,
dicate the need for public education on adapting 2009). Certain possessions and personal qualities
to a visual impairment while still leading a suc- are fundamental for a desirable quality of life.
cessful life. These may include sharing affection with

Vision is an individual’s predominant sense others, feeling membership in a community, or
for understanding the world. It is used to gauge having a comfortable home for inviting o thers
practical information, such as texture, distance, into. These common desires support the idea that
size, and color, of objects in our surroundings. human beings are social creatures by nature. Both
The ability to see is also used to gauge affective intrapersonal and interpersonal aspects are in-
information, such as emotion in facial expres- separable components in achieving one’s desired
sions, appreciation of art or scenery, and attrac- quality of life.
tion to color. The paired questions “What is it like to Intrapersonal attributes, such as healthy self-
see?” and “What is it like to not see?” illustrate concept and positive self-esteem, are necessary
two perceptions. The magnitude of this difference for individuals to reach the life that they perceive
between seeing and not seeing can seem over- as having a high quality. The internal psycholog-
whelming. Lack of understanding may lead ical development of each person and the human
sighted peers to view their classmate who is vi- need for external social interaction compose the
sually impaired as inferior. Both the competence two parts of the term psychosocial. The work of
to manage tasks independently in a sighted world psychologist Erik Erikson and his study of the
and confidence in one’s ability to be a full partici- stages of social development (Erikson, 1950,
pant are necessary for c hildren and youths with 1968) brought the term into common usage. To
visual impairments, including t hose with addi- further explain, psychosocial refers to the interac-
tional or severe disabilities, to make plans and tion of one’s unique psychological develop-
look forward to challenges at home and school. ment and interpretation of responses received
during social interaction. Individuals come to ment. The presence of blindness or low vision
know themselves in comparison to others. The in- does not move them into a separate category of
tersection of these factors is a constant because psychosocial development. In other words, most
of social exchanges throughout the day, and the professionals believe that there is no unique “psy
nuances of t hese interactions can be confusing chology of blindness.” Fraser (1917) referred to
for a young child. this expression nearly a century ago in his address
This chapter focuses on examining the influ- to the American Association of Instructors of the
ences and forces that affect the psychosocial de- Blind. He said, “The science of psychological
velopment of c hildren and youths with visual e xperience is confined to the individual. It is un-
impairments. It is organized into three sections. shared experience, whereas in the physical sci-
The opening section describes f actors within and ences we deal with experiences common to the
around us that have an important impact on psy- world and shared by everyone alike” (p. 229).
chosocial development. These include concepts His reference to the two sciences highlights
of early development; the nature of the eye con- the continuing challenge to describe and measure
dition, including etiology and age of onset; and the psychological state, especially in c hildren.
public response to visual impairment. The second Blindness and Psychological Development in Young
main section reviews the increasing role of tech- Children (Lewis & Collins, 1997), published
nology and media, emphasizing the positive de- 80 years later, highlighted new factors, such as the
velopments t hese changes have made possible for critical role experience plays in development and
fuller integration into school, work, and commu- social relationships. The significant role that envi-
nity settings. The third main section addresses ronment plays in early brain development was
the significance of self-esteem for psychosocial highlighted in 1997 with lengthy reports in Time
development across the age span from infancy, (Nash, 1997) and Newsweek (Bagley, 1997) and a
early childhood, and school years through tran- White House Conference on Early Childhood De-
sition to adulthood. Instructional strategies to velopment and Learning in April 1997. Experi-
promote psychosocial development for students ence and environment have compounding and
at all levels are offered at the end of the chapter. lasting effects across domains in the earliest
months of life (Goode, 2006). C hildren with vi-

sual impairments, like all children, require and
ACTORS THA AFFEC
F
desire safety, approval, and a sense of belonging
PSYCHOSOCIAL DEVE OPMEN at all stages of growth. Early intervention helps
Although a variety of factors affect the psycho- families and caregivers shape supportive and con-
social development of all p eople, individuals sistent routines that are the basis of healthy psy-
with visual impairments have distinctive ex chosocial development.
periences related to early development, effects of With their earliest learning, all infants rely on
their visual condition, and the impact of public multiple sensory experiences (for example, their
responses. mother’s smell, the sound of footsteps in the

hallway, or the texture of a hand) to get to know
their family and home, and then to recognize
Effects of Early Development different environments and different people
hildren and youths with visual impairments are
C (Ferrell, 2006; Wittmer & Petersen, 2014). Adults’
as diverse, complex, and need-driven as c hildren most common interactions with an infant are
and youths with typical vision; they are much shared gaze, soothing vocalizations, and strok-
like their typical peers in psychological developing. When connecting through these activities is
not possible or the baby’s reaction is confusing, of the visual impairment (for example, restriction
parents feel at a loss to know how to initiate and of field of view or sensitivity to light), age of on-
establish this essential bond. The image of par- set, and degree of vision loss. In describing t hese
enting they envisioned has been shattered, and factors, the term blindness w ill refer to c hildren
parents need time to reimagine their role. Putting who are not able to gain consistent, meaningful
the emotions they are feeling into words and hav- information for learning through use of their
ing someone hear t hose words of anger, anxiety, v ision. Low vision w ill describe the experience
and fear also takes time. Allowing the time to of c hildren who do rely on their vision to gain
process and acknowledging t hese emotions is the meaningful information. The development and
precedent of family-centered intervention. Chen needs of c hildren who are blind can vary greatly
(2014) describes the steps parents or caregivers from t hose of c hildren with low vision, and t hese
and early interventionists may need to take to distinctions w ill be discussed throughout the
identify the sensory channels and fine-tune the chapter when pertinent.
strategies needed to establish these early bonds. The nature of the child’s visual impairment
The power of touch cannot be overemphasized is a major factor. A broad range of etiologies ex-
as a crucial connection, especially through in- ists in the pediatric population. T hese conditions
fancy. Bonding and Relaxation Techniques fall within the three categories of refractive er-
(BART, n.d.) is an innovative program using baby rors, disruption in the visual pathways, or issues
massage that can bring a connection when none in the visual cortex. A child who has reduced acu-
seemed possible. ity and peripheral field loss (for example, quali-
With early intervention from professionals fies as visually impaired) due to retinopathy of
and caregivers, reliance on multisensory intake prematurity (ROP) has had very different medical
strengthens for infants with visual impairments interventions from the child who has a visual cor-
as they explore their immediate space. That tex disorder and fluctuating vision caused by
e nvironment includes food, material textures, cortical visual impairment (CVI, also known as
objects’ features, and the like (Kostelnik, Soder- cerebral visual impairment). A child with fluctuat-
man, & Whiren, 2014; Langley, 2006). These ing vision or a progressive condition (decreasing
initial milestones in exploration may take more over time) carries the challenge of constant adap-
time and seem curious to observers outside the tation or fear of future loss and adjustment to life
home, such as people in the neighborhood, the and learning without sight. Each variation pres
family’s place of worship, or the infant’s pre-
ents a different, and often confusing, definition to
school, who watch an infant or toddler learn the public of having a visual impairment. For ex-
about his or her surroundings and join in com- ample, a child who uses large-print textbooks may
munication. The ways in which the child en- also be able to recognize and pick up a dime on
gages in this exploration depends to some degree the floor, and a child who is able to detect the
on the nature of the visual impairment, as de- walk signal flashing may also use a cane to cross
scribed in the next section. busy intersections. T hese situations can seem in
contradiction to the general public’s understand-
Effects of Visual Conditions on ing of visual impairment.
Age of onset is another significant con
Psychological Development sideration. Congenital (present at birth) visual im-
Many factors are involved in the effect of visual pairments are more common than adventitious
impairment on the individual and his or her ful- (occurring after birth or delayed onset during de-
fillment of goals. These factors include the nature velopment) conditions for children (Schwartz,
2010). Visual impairment later in childhood may eople around c hildren with visual impairments
p
occur as a result of injury; with the delayed on- can be felt by the children as limiting projections
set of a condition, such as Stargardt disease; or as of their abilities. By this logic, if blindness is the
an outcome of medical intervention, such as can- complete absence of the sense, then having some
cer treatment. Children who are born with low vision must ensure greater ability. Children hear
vision recognize the visual aspects of their sur- expectations early on of what they can accom-
roundings as a normal view of the world. A child plish in comparison to peers or siblings. That in-
with an acquired visual impairment must adapt ternal sense of feeling capable or not as capable as
to reinterpreting the world with residual or no vi- others in completing tasks is gained over time
sion. The older a child is, the longer he or she has and has a significant impact on self-worth. The se-
had to form a self-identity and envision a f uture verity of the visual impairment and the presence
as a person with typical sight. Tuttle and Tuttle of additional disabilities may cause lower expec-
(1996) described the struggle with adjustment as tations that parents or teachers impart in subtle
grieving the loss of the sighted life. For a time, the and direct ways. F actors related to ability that are
visual impairment can dominate thoughts and more significant than degree of vision loss in-
restrict personal goals. Grieving is a process, and clude personal attitude and motivation, home
adult support is essential to help a child regain environment, and range of experiences for the
confidence and establish a positive self-definition. child. Degree of vision loss does not determine
Life, for the child and the family, is not what it personal ability to complete tasks.
was before, and c hildren with an acquired vision Managing daily tasks with some vision or
loss must in their own time reconcile personal at- with no vision are two very different challenges.
titudes and beliefs about living with a visual im- Children with low vision are still learning to use
pairment, adopting habits of learning that may their vision and coming to recognize what is be-
rely on other senses, and returning to familiar yond and what is within their visual reach (Flom,
social environments that may now feel foreign. 2004; Sticken & Kapperman, 2010). Parents and
The quality and consistency of serv ice delivery in family members are also trying to understand
this adjustment period are critical factors for a this same puzzle. The aspects of vision (for exam-
child’s success (Sacks, 2010; Topor, Lueck, & ple, field and contrast sensitivity) that are affected
Smith, 2004). Children have an adaptive quality and the degree of impairment w ill determine
and an enthusiasm for learning new skills. Their adaptations that are needed. In a number of ways
goals are the same—to learn alongside peers in the condition of low vision is uniquely different
the classroom, feel part of a larger community, from blindness. Finding words to explain vision
and build friendships. Gee (2004) references the that is somewhere between fully sighted and
primary goals of skills, membership, and rela- blind can be an emotional and linguistic strug
tionships when focusing on c hildren with mul- gle. Teenagers may have a better sense of their
tiple disabilities. The disability is only one aspect visual capabilities but often have greater reti-
of a complete person. cence to talk about the differences in their vision
Degree of vision loss is a third factor that (Gold, Shaw, & Wolffe, 2010; Kroksmark & Nor-
affects psychosocial development. A natural as- dell, 2001; Uttermohlen, 1997). Not wanting to
sumption may be that the greater the vision loss, be categorized with blindness and wanting to
the more difficulty a person has with participating pass as typically sighted are often of critical im-
in activities of daily living, fitting in socially, and portance. Figuring out a definition of self that fits
developing independence. These assumptions and in between the two absolutes of blindness and
lower expectations based on level of vision from typical vision is a process that takes time. (See
Sacks, 2010, for a comprehensive discussion of fulness with getting to the seat, a grumbling
needs of individuals who have low vision.) heavy sigh for having to move, and an averted
gaze to avoid observing the situation.
Effects of Public Response Adults and c hildren in the classroom can
mirror t hese same responses seen on the bus. Ex-
to Visual Impairment tra attention in the form of too much helpful-
The condition of visual impairment, especially in ness with getting a cafeteria tray, avoidance on
a young child, raises strong reactions in the pub- the playground, or resentment of special treat-
lic, and t hese reactions may be felt even if a child ment such as receiving extended test time are
cannot explain the uncomfortable feelings that examples from school. A child with a visual im-
result. Reactions to visual impairments in c hildren pairment w ill need support in understanding
can range from pity to fear to intrigue (Mahoney, these reactions from peers and learning to re-
2014). These reactions, w hether subtle or out- spond in a positive way. (See Volume 2, Chap-
right, are perceptible and incorporated into a ter 8, for further discussion of this topic.)
child’s psychosocial development as a sense of
self-worth and acceptance in the world. Young
c hildren can feel that they bring out a differe nt TECHNOLOGY AND MEDIA
reaction as compared to their siblings or play- IN THE 2 S C
ENTURY
mates, though they are often not able to express
what they feel in relation to t hese perceived dif- oday, it is more possible for c hildren and youths
T
ferences. They recognize that the tone of voice who are blind or visually impaired to participate
used or the expectation of competence in a task actively in society than in any other era. In recent
is different from that for c hildren around them. dec ades popular culture has provided slogans
It is the role of parents, caregivers, and educators and images that celebrate differentness. T-shirts
to recognize the importance of incorporating and bumper stickers proclaim, “Dare to be rare,”
positive perceptions of visual impairment into a “Different is not broken,” and “I live life through
sense of self-identity and to dedicate time to guid- my own lens.” Understanding and appreciating
ing a child’s development in this area. individual differentness is essential for healthy
Interpreting how others respond is a power psychosocial development. The last few decades
ful factor in psychosocial development. The have brought incredible changes in the lives of
symbols and actions that go along with having a people with disabilities through technology and
disability can draw unwanted attention and are public awareness. Even 15 years ago social inter
an unavoidable part of visual impairment. Sym- actions looked very different from how they do
bols of blindness or low vision such as a white today. Smartphones, Bluetooth capability, and so-
cane or a handheld telescope and behaviors such cial networking have allowed people with varying
as maintaining an unconventional head position abilities to interact on a level playing field. The
or bringing print close to the eyes can evoke an rapid updating of equipment has made accessibil-
emotional response from the public. An example ity more prevalent than in previous generations.
on the city bus illustrates different reactions to In the 21st century, it is the expectation rather
visual impairment: Two passengers with white than the exception that c hildren with visual impair-
canes board and are directed by the driver to seats ments work alongside classmates, plan employ-
reserved for passengers with a disability, causing ment, and establish social connections.
other passengers to find new seats. Responses Assistive and mainstream technology that
from neighboring passengers include extra help- allows access to visual information holds g reat
sense of responsibility are essential components

in the process of setting and meeting educational
and personal goals. Along with parents and edu-
cators, in developmentally appropriate ways, the
child can be a part of defining shared expecta-
tions, monitoring goals, and envisioning scenes
of a f uture fulfilling life.
Along with popular culture and technological
advances, the disability rights movement has im-
proved the quality of life for people with disabili-
ties (Scadden, 2000). These advances are making
the goal of blending in with everyone e lse, w
hether
it is in the classroom or the office, a reality. Celeb-
rities, television shows, and ad campaigns regu-
larly feature individual difference. The influence
of this media trend can lead to a likelihood of
Maria Ferrari
children hearing language that acknowledges

their specialized skill set (for example, to use a
monocular or to read braille) and that recognizes
that having a visual impairment brings alternate
ways of learning (for example, a picture commu-
Access to technological tools is crucial for a child’s inte-
nication board to indicate choices or an audio
gration in a social group or classroom.
graphing calculator to represent a line’s slope).
Certainly children with disabilities still struggle
potential for independent functioning, positive for inclusion in familiar places such as math class
well-being, and a fulfilling quality of life across and the playground. The promising future for
development. The technological advances of the these c hildren is dependent on continuing efforts
digital era (for example, GPS and screen-reading by individuals, businesses, and nations to support
software) have positively changed the lives of and maintain standards of accessibility.
many p eople with visual impairments. Stable The field of visual impairment has never
employment, more choices in leisure pastimes, known such a heightened and sustained level of
and accessible transportation are all more likely national attention resulting from the onset of age-
because this technology is available. These ad- related vision loss as in the Baby Boomer genera-
vances have helped to shift societal views away tion. The research, product manufacturing, and
from the stigma of disability to an image of em- education directed at a high-incidence need for
powerment. Having a visual impairment is an the older adults in the population has also had an
obstacle to be met with tools and strategies. Hav- impact on the low-incidence need at the youngest
ing consistent instruction to use these tools ef- end of the population. The rehabilitation needs of
fectively, access to uses across environments, and older adults who have known a lifetime of reli-
family members and educators who support
ance on vision are different from the habilitation
t hese accommodations are critical factors for a needs of the group that was born with a visual
child’s integration in a social group or a class- impairment. Nonetheless, this attention on older
room (Presley, 2010). The child’s motivation and adults has brought improvements for children.
Children with visual impairments are part extended f amily members, neighbors, and peers
of a low-incidence population. They may not meet in play settings and expands to the classroom and
another person with the same disability until experiences in the community. These aspects of
adulthood or they may serve as the representative self-definition shape and are shaped by the experi-
of children with visual impairments at their school ences that occur in the multiple phases of growth
or in their neighborhood. These children and from infancy through teenage years and into
youths may often feel that they have the spotlight adulthood, as described in this section.
on them to perform. The constant stream of digi- Erikson (1950) presented a new way to think
tal information sharing through our handheld about childhood and psychosocial develop-
screen technology—whether a YouTube video, ment (see Sidebar 6.1). His theory of the eight
an Instagram image, or a Twitter exchange— stages of psychosocial development spans growth
includes perceptions, opinions, as well as factual from infancy through adulthood. He empha-
stories on people with disabilities. This unchecked sized the importance of social experience and
range of images and online discussions has in- believed that daily interactions served to define
creased public awareness and sometimes rein- and redefine us through the stages of develop-
forced unfounded beliefs. The old stereotypes of ment. The initial stage of trust versus mistrust
visual impairment still exist, and instruction is lays a foundation for each of the following stages.
necessary to help c hildren respond in a healthy
way when these ideas are projected onto them.
Some of the stereot ypes that are still common in S I D E B A R 6 . 1
media or in casual conversation include depen-
Erikson’s Stages of
dence on government support, the superpower
of hearing, and reliance on a caregiver. The ac-
Psychosocial Development
tions and attitudes of c hildren with visual im-
pairments serve, by choice or not, as important Basic trust versus 0–1 years
education to the public. Parents, caregivers, and basic mistrust
educators play a critical role in helping c hildren Autonomy versus 1–3 years
develop the self-confidence and positive sense shame and doubt

of worth to seek and enjoy opportunities along- Initiative versus guilt 4–6 years
side their typically developing peers. Industry versus inferiority 7–11 years
Identity versus role 12–18 years
THE ROLE OF SELF E
STEEM confusion
Intimacy versus Young
Our understanding of how personal aspects such
isolation adulthood
as self-esteem, self-concept, and self-worth de-
Generativity versus Middle
velop is an evolving field and only gained prom-
stagnation adulthood
inence in the 20th century. The very earliest
interactions— tone of voice, touch, level of Ego integrity versus Later
despair adulthood
attention—are now recognized as having an im-
pact on an infant’s and a child’s developing sense
of worth and place in the world (Copple & Bre- Source: Erikson, E. H. (1950). Childhood and
society. New York: W. W. Norton.
dekamp, 2010; Tuttle & Tuttle, 2006). This con-
tinues in the early days of interaction with
Erikson theorized that learning and feeling com- that does not rely on vision? This can be a tem-
petence in a specific skill defined the beginning porary or an enduring sense depending on factors
and end of that stage and was necessary for suc- such as the presence of a support network, con-
cess in the next stage. For example, developing tact with early interventionists or other resources
a balanced sense of safety and security is the in the field of visual impairment, and a personal
outcome of stage 1, trust versus mistrust. In the sense of hopefulness. As noted in the opening
preschool years of stage 3, initiative versus guilt, paragraphs of this chapter, c hildren with visual
c hildren’s experiences need to help them gain a impairments have the same needs and desires as
sense of control over their world (for example, their sighted peers, and this awareness is a starting
by making choices) and feel able to direct ac- point to provide care as a parent. A subset of liter
tions or lead others through play and requests. ature (Behl, Akers, Boyce, & Taylor, 1996; Camp-
The outcome of stage 5, identity versus role con- bell, 2003; Dote-Kwan, Hughes, & Taylor, 1997;
fusion, is development of a strong sense of self Kekelis & Prinz, 1996; Kesiktas, 2009; Loots, Devise,
and independence. Stage 5 encompasses the ad- & Sermijn, 2003; Rowland, 1984) describes how
olescent years, where the strug gle for self- parents develop bonds with their visually impaired
definition apart from parents is so prominent. children, for example, through soothing vocaliza-
This theory of psychosocial development, with tions (for example, cooing), nurturing touch, and
its emphasis on social environments, is depen- consistency of affection. The span of these studies
dent on a wide array of rich experiences where demonstrates the importance of this connection
c hildren feel safe to explore and test themselves between parent and child. An infant who reaches
in their world. Further work on Erikson’s theory out to a voice, grasps a fin ger tightly, or curls
has focused on determining the factors that against a shoulder in a relaxed position is partici-
cause movement from one stage to the next or a pating in that cycle of affection that leads to the
return to a previous stage, and identifying the parent-c hild bond.
experiences that are necessary for success within However, this establishment of a maternal or
each stage. a paternal bond is not automatic; a mother and
father must be especially perceptive at reading
signals from their baby that are a return of affec-

Psychosocial Development in Infants
tion (Fazzi et al., 2002). Countless images in US
Parents who learn that their infant is visually im- culture show that exchange of gaze, a founda-
paired face an avalanche of emotions including tional piece in the developing bond of intimacy,
dismay, guilt, fear, anger, and, eventually, accep is a privilege of parenthood. Warren (1994) de-
tance. The need for extended hospital care or sur- scribed vision as a link to communication, and
gical procedures for infants who are medically Loots et al. (2003) discussed the importance of
fragile compounds this emotional storm. Parents creating joint attention between caregiver and
may have difficulty expressing affection when infant. Learning to communicate love and care
their overwhelming emotions are fear for their through means other than eye contact is the chal-
child’s f uture and distress at how they w
ill learn lenge of the parent of a child with a visual im-
to cope as the parent in this situation (Fazzi, pairment. Initially, energy is consumed in dealing
Klein, Pogrund, & Salcedo, 2002; Forster, 2006). with the shock and despair that parents feel, less-
“They and their child have been placed in two ening their ability to sense affection through
dif
fer
ent worlds” (Mangold, 1988, p. 6). How differe nt channels (Forster, 2006). Infants can
does a parent translate the world understood sense negative emotions in the venues of touch
through vision and begin to perceive the world and voice. A cycle of uncertainty and stress can
threaten the development of a caring, reliable t hese f actors are present, c hildren are more likely
bond. Learning to parent the visually impaired to have the internal tools to take risks, establish
child can be a challenge, but parents do find their friendships, and find enthusiasm for personal
way, and this first social attachment is the begin- interests beyond home. These conditions are
ning of psychosocial development. Researchers necessary whether visual impairment is present
explained (Warren, 2000; Wittmer & Petersen, or not. News stories and research have docu-
2014) that at about 6 months of age the infant mented instances of c hildren with visual im-
shows a preference for certain adults, usually a pairments who enjoy adventure sports, get
parent, over any other adult. Security in the first invited to slumber parties, and set ambitious
relationship allows a child to have desire and goals for a realistic career—all things that par-
courage to venture beyond familiar space and ex- ents envision for their child. However, t hese ac-
plore the world (Lewis & Wolffe, 2006; Tuttle & tivities may be more difficult for a child with a
Tuttle, 1996). The parents’ role of supporting visual impairment to achieve because of issues
healthy psychosocial development begins with with accessibility, unfamiliarity with social set-
moving from providing love and protection to tings, or limited c areer awareness. C hildren in
providing love and encouragement for explora- this category are also known to fail a test, avoid
tion of surroundings, interaction with others, cleaning their room, and strugg le with separat-
and eventual independence in the world. The ing from home. Thus, visual impairment alone
next section gives examples of interpersonal does not prevent normal development as com-
guidelines for both home and school that all pared to sighted children. It is this ability to
c hildren, especially c hildren with visual impair- fully participate in a range of settings, to feel pre-
ments, need to feel valued. pared to take risks, and to make choices about
participation and risk that ensures a healthy
sense of psychosocial confidence.
Building Self-Esteem Much has been written about the importance
Common precepts guide the learning experiences of a wide array of interactive experiences, at home
of children, whether in the classroom or the and at school, for c hildren to develop concepts,
home, to develop confidence and a positive sense to sort objects and events into categories, and
of self-esteem (Glen & Nelsen, 2010; Kostelnik to build vocabulary around t hese experiences
et al., 2014). T hese precepts include a sense of (Copple & Bredekamp, 2010; Jessup, Cornell, &
security in affection and basic needs, clear and Bundy, 2010; Pogrund, 2002; Sacks, 2006). Envi-
consistent bounda ries of appropriate behavior, ronments rich with learning potential include a
realistic expectations for learning, and shared trip to the farm, the hardware store, and the
communication that shows trust and honesty. In plant nursery. Interaction with real objects of all
his book The Antecedents of Self-Esteem, Cooper- shapes and sizes is essential for these experi-
smith (1967) presented the findings of his work ences to be meaningful. Outings can begin with
with 711 participants. His work is important for shorter trips such as r unning errands to the dry
its attention to c hildren with visual impairments. cleaner, the post office, and the grocery store.
He named three conditions as antecedents of self- This gives c hildren a broad base for engaging in
esteem that held true across his large study group: conversation, for developing exploration skills,
“total or nearly total accept ance of the child by and for finding hobbies—a ll characteristics of
the parent; clearly defined and enforced limits; normal development. C hildren with visual im-
and the respect and latitude for individual action pairments are often not able to benefit from the
that exist within the defined limit” (p. 6). When introduction to these topics that other c hildren
carrying dishes to the sink and completing 10

math problems for homework can be expected.
Learning the importance of standards of behavior
and per formance based on individual abilities
lets us belong to and contribute to a group—the
family, the school, or the club. Understanding ex-
pectations, accepting responsibility, and agreeing
to boundaries are important aspects of Erikson’s
psychosocial stages 2–4. No member contributes
Maria Ferrari
in exactly the same way, but membership is con-
fusing if the standards vary significantly for differ
ent members. It is important that children with
visual impairments receive clear messages on the
Experiencing competence leads to self-esteem. role of being a helper, a study partner, or a team
member like their peers. Setting up a pattern of
special standards can lead to a sense of entitle-
ment across activities. A paradox is set up, as Tuttle
gain through telev ision shows or videos because and Tuttle (1996) explain, when someone who is
these introductions are often incidental and visual visually impaired expects both special treatment
in nature. T hese early experiences are necessary for and equal treatment at the same time. This brief
a child to have an adequate knowledge base to join discussion is meant to recognize the importance
in cooperative play and conversations with peers. of well-defined expectations and boundaries in a
A number of impediments, such as time needed to child’s development of positive self-esteem and
explore and provide explanations, caution with sense of earning a place in the world.
travel in busy or unpredictable locations, and com- The respect and latitude for individual action
fort with public observation, can prevent or limit a within defined limits is the third of Cooper-
parent’s willingness to schedule such outings. smith’s conditions. Promoting individual action
However, t hese experiences are essential for cogni- is the beginning of building responsibility and
tive growth as adults guide c hildren in developing independence. The goal is for a child to become
curiosity about the larger world. the agent of action rather than reception alone.
Use of consistent bounda ries or limits and Feeling a sense of power to do for one’s self initi-
defined expectations to guide behavior is another ates a belief of influence and significance in the
principle for helping c hildren gain traits such as world. The child comes to recognize in what ways
self-awareness and self-regulation. Setting bound he or she is distinct and unique from all o thers
aries and holding expectations is the disciplinar- who are not him or her. Even very young c hildren
ian side of parenting, teaching, and supervising learn that their own actions bring consequences
work. T hese earliest lessons at home affect suc- and rewards; they learn by their decisions and
ceeding roles at school and work as a person mistakes. As development progresses, a child be-
who is accountable to the group. Boundaries in- gins to recognize himself with the realization
clude limits on preferred food, transition from that the locus of control is now more internal
play to work, and awareness of personal space. than external (Bowen, 2010). These beginning
The child’s responsibilities can begin with pick- steps of self-esteem can emerge when parents and
ing up toys; later, more complex chores such as teachers allow for individual action.
The School Years and ance to identify t hese traits and to recognize
Psychosocial Development their own preferences. This recognition process is
ongoing and subtle as c hildren participate in the
hildren’s unique sense of self (or self-concept)
C multiple environments of the school day.
and psychosocial awareness further develop as
their time beyond the home increases with entry
into school. Comparison is a natural outcome of Physical Competence
social opportunities from the playground to the The school playground generally holds images of
classroom to the cafeteria. T hese settings de physically active c hildren having fun. Bouncing
signate three domains of competence that are balls on the blacktop, racing to the swings for the
represented in the lite rat ure and are considered best seat, and knowing how to position for the
here—physical competence, social competence, fastest r ide down the slide all require physical
and academic competence (Harter, 1985, 1988; prowess. Abilities recognized on the playground
Piers & Herzberg, 2002; Reynolds & Kamphaus, often lead to skills on the sports field. Physical
2004). Individuals know their own characteris- competence and athletic skill are highly valued in
tics through comparison with another human US culture, and the people who possess these
being. They come to each stage of development qualities hold high social standing, as seen in the
with a changing set of inherent and learned traits school hallway and the media. Skills needed to
that makes them both distinct from and similar make the most popular sports teams (for example,
to classmates. Individuals are a product of the val- basketball or football) rely on vision. Children
ues learned at home and what each person indi- most often learn how to play on the playground
vidually brings with his or her personality and equipment (for example, pumping your legs for
psychological needs. Traits such as being curious greater acceleration on the swing), take pleasure in
and energetic, hardworking and serious, or easy- r unning, or follow gymnastic movements through
going and optimistic may be valued. C hildren are observation. Taking advantage of the outlet of
drawn to playmates and friends through the val- physical activity has positive physical components
ues they admire, whether or not they are similar. as well as internal (for example, motivation or
As language ability develops, c hildren need guid- pride) and interpersonal ones.
The playground and the sports arena often
hold a very differe nt, less appealing image for
c hildren with a visual impairment. Physical com-
petence develops only when the necessary condi-
tions exist—opportunities are provided by adults
to build agility, cardiovascular fitness, and muscle
strength, and adult guidance is available for in-
struction in these areas. Teachers of physical edu-
cation classes and coaches of community sports
teams may need support and resources from vi-
Maria Ferrari
sual impairment and special education profes-

sionals for ensuring safe and regular participation
for all children with disabilities. Awareness of
Children are drawn to friends and playmates through the adaptive physical education and expectations of
values they admire. accessibility in community sports (for example,
yoga, martial arts, or swimming) are increasing 1988) was used. Researchers reported that overall
with the nation’s heightened focus on physical the group felt high self-worth and discounted
fitness across the life span. Level of physical fit- the importance of the three domains of physical
ness, motor skills, and stamina also affect school- competence, social competence, and physical ap-
related activities, such as traveling efficiently pearance. Participants felt more positive about
between classes, carrying books and equipment, their social competence than about their athletic
and having muscle development for prolonged competence. Eric (George & Duquette, 2006), for
work sessions. A number of studies (Robinson & example, recognized that he was valued for his
Lieberman, 2004; Shapiro, Moffett, Lieberman, & academic contribution and felt closest to these
Dummer, 2008; Stuart, Lieberman, & Hand, peers who also valued academic success. Other
2006) documented the importance of the physi- researchers (Beatty, 1992; Huurre, Komulainen, &
cal domain for overall health, completion of ac- Aro, 1999; Kef, 2002) found that the self-concept
tivities of daily living, and use of recreation and of adolescents with visual impairments was posi-
leisure outlets, as well as its contribution to self- tive and similar to that of sighted peers.
esteem. Assessing how c hildren with visual im- Anecdotes from the field tell a far differe nt
pairments respond to the cultural pressure for story, indicating the complexity of this topic. The
physical competence and athletic skill can help idealistic self-concept of young participants re-
combat their potential feelings of inadequacy or ported by researchers may conflict with the real
low self-esteem where physical prowess is con- experiences of adulthood; however, it may be a
cerned. necessary illusion as a young person learns to
Physical competence and athletic competence manage life with a disability. A longitudinal study
are examples of competencies within a larger sense that compares p eople’s adulthood self-concept
of global self-worth. These examples carry high with that of their adolescent self-concept would
value in the school years, when playground and be telling.
gym time are routine parts of the day and can
present barriers of access when visual impair-
Social Competence
ment is involved. For example, Eric, an adolescent
with albinism (George & Duquette, 2006), ex- Social acceptance is a second competence that has
plained that he was a successful athlete on the received much attention in the field of visual im-
wrestling team but is still excluded in physical pairment. The presence of a visual impairment
education. Self-worth is a personal determination can disrupt the communicative link, and when
of the added value or worth one individual brings that link is missing or compromised, then social
to a group, a significant factor of self-esteem. isolation often results (Rosenblum, 2006). Stu-
Maintaining positive self-worth, influenced by dents with visual impairments may miss cues for
both internal and external perceptions, is an on- understanding social hierarchy within a class-
going challenge, as self-e valuation occurs con- room, signals for group inclusion or exclusion, or
stantly across settings and interactions. shared humor or disapproval. Nuances of social
To better understand the self-perception of a interaction include recognition of facial expres-
group of c hildren and youths with visual impair- sions, accurate use of hand gestures, and appropri-
ments, researchers (Shapiro, Moffett, Lieberman, ate use of body posture. Constructive peer-to-peer
& Dummer, 2005, 2008) examined assessments feedback can be a timely and especially effective
completed by participants before and after a means of gaining social understanding. Circle of
weeklong sports camp. The Self-Perception Pro- Friends (Peavey & Leff, 2002) is an example of a
file for children and adolescents (Harter, 1985, structured peer group (disabled and nondisabled)
with adult support that focused on open commu- (Huurre et al., 1999) found that strong predictors
nication and positive outcomes for all members. of higher self-esteem for adolescents w ere having
This area of peer acceptance carries a powerful a number of friends, fitting in easily with peers,
emotional component, as the range and depth of and making friends with ease. Being successful
friendships and social connections figure greatly in this social role is especially critical in adoles-
in the definition of a fulfilling life. Social hard- cence, the stage for testing independence and
ship or triumph figured far more prominently shaping self-identity. The availability and acces-
than academics or any other domain in the nar- sibility of social media (for example, Facebook
ratives parents shared (LaVenture, Lesner, & Za- and Twitter) have opened up new avenues for
belski, 2006) of their children with disabilities building social competence for adolescents and
growing up. Guiding the development of social young adults who have visual impairments (Gold
skills starts in the first months of life, and c hildren et al., 2010; Kelly & Smith, 2008). This digital in-
with visual impairments present a high risk for teraction allows exchanges on pop culture, cur-
deficit in this area. A feeling of heartbreak and in- rent events, and recreational interests that are
adequacy can be overwhelming as parents see often learned through visual observations. De-
their child excluded from play groups, left alone velopment of social skills is just as critical when
at a table in the cafeteria, or patronized with re- socializing over the computer or on a smartphone.
sentful inclusion. A number of studies (Chien- Establishing and maintaining relationships of all
Huey Chang & Schaller, 2000; Kef, 2002; forms involves a range of social skills; acquisition
Pinquart & Pfeiffer, 2013; Wolffe & Sacks, 1997) of these skills must begin early and progress as the
examined the high level of dependence on parents child moves into less familiar social settings (Lif-
rather than peers for emotional and social sup- shitz, Hen, & Weisse, 2007). T hese skills include
port throughout a child’s school years. This rela- showing interest in o thers’ needs, offering engag-
tionship is understandable since a parent’s primary ing topics of conversation, setting bound aries,
instinct is to protect and shield a child from pain- voicing dissatisfaction, and h andling conflict. Vi-
ful experiences. The most difficult parental role is sual messages are a significant part of the emotional
to quiet that instinct and promote what Maslow connection, and instructional support is often
(1968) referred to as “growth motivation.” needed for c hildren and youths who have visual
Growth motivation is demonstrated when a impairments to learn compensatory strategies for
person has interest in exploring the world, seeks nurturing high-quality friendships.
interaction with others that involves giving and A positive self-identity is critical when taking
receiving support, and strives to fulfill his or her steps to make friends. Positive self-identity is impor
potential. Support through resources and profes- tant for children and youths who are visually im-
sional guidance is especially helpful in establish- paired, especially if they are the only member of
ing the healthy parent- c hild relationship that their social group with a visual impairment. A
leads to a fulfilling life for both. young person’s development of positive self-
An individual’s need for attention and ap- identity begins with having accurate information
proval from others is a common trait of human- about his or her eye condition and being able to
ity. The social networks p eople build range from communicate this information to others (Erin &
emotionally close to casual relationships with Corn, 1994; Guerette, Lewis, & Mattingly, 2011;
family, friends, and acquaintances throughout Sacks & Corn, 1996). Information is empower-
the day. T hese relationships figure prominently ing, and children who are blind or who have low
into a person’s self-esteem. In a study focused on vision benefit from understanding the cause and
youths with visual impairments, researchers implications of their eye condition. Deciding
how much to explain about the disability be- disabilities shortly a fter the law’s passage, gen-
comes a personal choice over time and is likely to eral education teachers were least willing to
change with age and social setting. Questions, have a student with a visual impairment in their
whether they be curious, insensitive (for exam- classroom (Horne, 1983). MacCuspie (1996)
ple, “What’s wrong with your eyes?” “Why c an’t conducted teacher interviews and noted unreal-
you see that?”), or supportive, will always come istic expectations, both too high and too low,
up, and having a ready response can set the tone and confusion over helpfulness of modifications
for the most positive interactions. Young c hildren (for example, large-print books). More recently,
and those with developmental delays can give research has shown (Ajuwon, Sarraj, Griffin-
simple explanations about adaptations they
Shirley, Lechtenberger, & Zhou, 2015; Wall,
use or how much they see. Making vision a ta- 2002) that t hese attitudes persist but simple strat-
boo topic highlights the disability rather than egies can bring improvement. Anecdotal com-
downplaying it as simply one aspect of the per- ments from participating teachers noted that
son (Sacks, 2010; Tuttle & Tuttle, 1996). Sup- time to observe the student before teaching him
port is necessary from parents and teachers to or her was especially beneficial.
help c hildren learn about their eye condition, Working alongside sighted peers can hold
to practice responses to uninvited questions, particular challenges and opportunities for stu-
and to discuss frustration with the topic of be- dents with a visual impairment, and comparison
ing visually impaired, which never completely is a natural response to being in a group. Three
goes away. aspects of the demands of the learning day re-
lated to visual access to information that can af-
fect student self-esteem have received researchers’
Academic Competence
attention and w ill be discussed h
ere. These as-
Learning in the classroom is the core activity of pects are reading performance (Guerette et al.,
the school day. Learning, w hether it is felt as en- 2011; Khadka, Ryan, Margraine, & Woodhouse,
gaging or intimidating, is work, and having a dis- 2012), the stress of keeping up with peers during
ability can make this work harder. Students with instruction, and anxiety about having to use ad-
visual impairments typically require a number of ditional tools (Corn et al., 2002; Khadka et al.,
accommodations or individualized strategies to 2012; Mason, 1999; Vik & Lassen, 2010). Reading
help them participate in instruction alongside is a predominant activity throughout the day, and
their sighted classmates. The sense of approval mastery of this highly visual task is a marker of
and acceptance one feels in the classroom greatly academic success. As is true for all students, the
affects one’s self-esteem. Teachers must assess their routine task of reading, whether braille or
own comfort level in interacting with a student print, can be a boost or a threat to the reader’s
with a visual impairment and the confidence they self-esteem. A broader definition of literacy (for
feel in teaching the student. The Education for All example, use of tactile experience books or word-
Handicapped Children Act (which became the symbol communication) is essential when stu-
Individuals with Disabilities Education Act, or dents with visual impairments and additional
IDEA) was passed 40 years ago; this ground- disabilities participate in traditional literacy in-
breaking legislation and its implementation are struction. Parker and Pogrund (2009) present a
still debated among educators and in the public. valuable literature review on this topic in the era
Research across the de cades shows that ac cep of No Child Left B ehind.
tance in the classroom continues to be a concern. Two studies reported different findings about
When asked about integration of students with students’ attitudes toward reading. Reading was
described as a favorite pleasure activity by a ma- an especially good memory for and superior
jority of participants (Guerette et al., 2011) and comprehension of the material. Considering its
as a “hated” activity to be avoided by some others importance as a life skill, the topic of reading
(Khadka et al., 2012). Stressful aspects include warrants far more research attention.
consistent and timely access to modified reading Students also describe the challenges associ-
materials and response from peers for receiving ated with keeping up in classroom instruction
special materials. Researchers’ comparisons of and managing additional tools (Mason, 1999; Vik
reading rates of typically sighted peers with low & Lassen, 2010). These tools (for example, opti-
vision readers (Corn et al., 2002) and adult braille cal devices and braille notetakers) can support
readers (Wetzel & Knowlton, 2000) showed independence but may also slow down task per
slower rates for readers with visual impairments. formance. This slower performance may be a re-
Corn et al. (2002) reported a lag of two to four sult of student ability, inexperience with matching
years for their group of readers with low vision in the tool to the task, or inadequate training (Bell
comparison to reading rates of typically sighted Coy & Andersen, 2010; Topor et al., 2004). Par-
students, and Wetzel and Knowlton (2000) esti- ticipants stated that keeping up was their pri-
mated that their braille readers would need mary goal and, when available, their preferred
50 percent more time on average than their adult default method was to have an adult read. This
peers to compensate for the difference in reading extra attention and the provision of special ma-
rate. No studies w ere found comparing reading terials sometimes brought resentment (Mac
rates of typically sighted students who use print Cuspie, 1996). Adverse comments from classmates
and students who use braille. were common (Mason, 1999), as reported by
Literacy in the classroom carries a natural 38 percent of the friends of the students with a
social component, as class discussion about the visual impairment, and over 40 percent of peers
story being studied leads to sharing of personal reported giving support in reading tasks (for ex-
experiences and opinions. As part of the Alpha- ample, of the whiteboard or a textbook). Students
betic Braille and Contracted Braille Study, Sacks, explained that classmates cannot know what it is
Kamei-Hannan, Erin, Barclay, and Sitar (2009) like to be visually impaired and do not under-
focused on the social experiences and literacy ac- stand what is needed to manage classroom tasks.
tivities of beginning braille readers and their Young adult participants with low vision in a
classmates. This longitudinal analysis showed no study on long-term device use (Bachofer, 2013)
significant differences in type of braille instruc- recognized their independence in completing
tion and social interaction, but qualitative data viewing tasks but voiced frustration at being
reported effective instructional activities and slower than peers and often deferred to someone
meaningful connections through reading for with better vision for assistance. This uneasy cli-
classmates. More research like the ABC Braille mate can directly or subtly extend beyond the
Study (Wall-Emerson, Holbrook, & D’Andrea, classroom to social areas such as the hallway,
2009; Wall-E merson, Sitar, Erin, Wormsley, & cafeteria, and playground. Adult awareness is
Herlich, 2009) is needed to increase the field’s needed to support and help students advocate in
understanding of improving reading performance a respectful manner for their needs, clarify mis-
in c hildren with visual impairments. Successful understandings, and establish clear expectations
readers in this population may exceed the stan- of how work is to be completed. Student involve-
dard of performance and take pride in their read- ment in this process at an age-appropriate level
ing strategies. Extra time spent with the text or is a critical factor in developing self-esteem as an
use of audio to supplement reading may result in equal member in the classroom.
Forming Self-Identity found focusing on college students and identity.

Research that presents similar qualitative data is
As they grow older, all students face an identity critical for the field’s understanding of how young
dilemma (Erikson, 1968)—they seek indepen adults with visual impairments and additional
dence and to make connections in environments disabilities perceive their role and inclusion in
beyond home and school. Having a visual im- supported employment settings. Insights from
pairment compounds this dilemma. Utter- such interviews would provide a compelling view
mohlen (1997) explained that the transitional on the effectiveness of their transition goals and
stage of adolescence introduces this strugg le to career readiness programs.
balance the need for assistance and the desire to Having a sense of belonging and making a
be seen as competent and normal. Entering a new contribution in the world are universal desires
environment forces a decision between portray- for all c hildren. The presence of a visual impair-
ing “who I want to be” and “who others expect ment and the desire to feel comfortable along-
me to be.” Following her interviews with nine side peers bring a range of emotions, from
college students, Low (1996) referred to this pro loneliness to extra determination to confidence.
cess as “negotiating identities.” This negotiation Personal narratives (Sacks, 2006; Uttermohlen,
of identities is more pronounced in young adult- 1997) are valuable as reflective essays giving a
hood but is often prese nt for teenagers as well. voice of experience on growing up with a visual
These students described achieving the ultimate impairment. T hese readings are one type of re-
victory of passing as “normal” or blending into source to consider. The compassionate support
the scene so smoothly that they are not seen as and consistent instruction of a teacher or parent
different. Students (Low, 1996) commented that who genuinely cares about the child’s well-
their need to negotiate was brought on by re- being is another valuable resource. This guiding
sponding to another’s discomfort with their dis- role involves identification of realistic and chal-
ability and reducing the possibility of social lenging expectations to learn alongside sighted
isolation. In contrast, participants in a l ater study peers and purposeful support for development
(Hodges & Keller, 1999) provided proactive re- of a positive self-concept. Lessons are needed to
sponses about their visual impairment when learn the letters of the alphabet, and lessons of a
they felt a sense of discomfort from a peer in col- different sort are needed to build psychosocial
lege. One student described this as being per- confidence. (See Volume 2, Chapter 22, for ac-
ceived as “stand-offish” because others do not tivities focused on nurturing the psychosocial
know how to approach you. Students agreed that needs of c hildren and youths with visual im-
it was important to take the initiative and be “up- pairments.)
front” from the beginning rather than delaying
disclosure. Another student commented on in-
INSTRUCTIONAL STRATEG ES
creased acceptance of differences in the college
community. Seeing someone with purple hair The following are instructional strategies that can
made him more comfortable with his own indi- be implemented in the home or school setting
vidual difference. In both studies, the goal for the across a child’s developmental years.
students with a disability was to have primary
control over how they were perceived. Visually • Starting with early years, engage in conver-
impaired college students (Roy & McKay, 2002) sation about the differences as well as the
generally felt a positive self-perception, but exter- similarities seen in peers and family mem-
nal locus of control scores for the group w ere bers. Model the affirming language that shows
higher than internal ones. No recent studies w ere value for diversity and unique characteris-
tics. Acknowledge the success of completing a extended family to help introduce the visual
task with tools or strategies outside the norm impairment and preferred modifications. Sec-
(see Cleveland et al., 2007). tions may include My Eye Condition, Tools
• Practice the words that name and describe and Technology I Use, Samples of Good Print,
the child’s eye condition. This includes an and Personal Goals (Krebs, 2002).
age-appropriate understanding of how the eye • Visit with a school counselor or educational
works and the implications of a specific specialist (for example, a teacher of students
eye condition. Use of a three-d imensional with visual impairments or a diagnostician)
model in a doctor’s office helps a child to more regarding assessments that can help to iden-
fully grasp the interconnectedness of the parts tify a child’s strengths and deficits in the af-
of the eye (Schwartz, 2010; Ward, 2010). fective domains. (See Volume 2, Chapters 2
• Promote a child’s sense of pride in learning a and 3.)
disability-specific skill, such as reading braille, • Initiate a weekly physical fitness routine. The
using keyboard commands, or finding targets benefits of regular exercise extend beyond
in the distance with a telescope, and share this physical health to mental and emotional
knowledge, with adult support as needed, in a health. Beginners may prefer to start with at-
show-a nd-tell lesson with classmates or ex- home exercise using workout or yoga videos
tended f amily members. with audio description. Most communities
• Select movies or stories that showcase char have free indoor/outdoor walking tracks. An
acters with a disability and set a time to talk effective workout routine relies on basic
about reactions to what was viewed or read. equipment such as an exercise mat, a jump
Develop questions that encourage discussion rope, or arm weights. See Going Places (Lieber-
about characters’ decisions, challenges faced, man, Modell, Ponchillia, & Jackson, 2006) for
and feelings evoked when someone is unfairly a more detailed discussion of individual and
treated. Provide incentives to write about the team sports, and Everybody Plays (Aillaud & Li-
personal feelings brought out and opportuni- eberman, 2013).
ties for ongoing discussion. A variety of web- • Investigate school or community clubs and
sites provide sample questions or guidelines organizations that present recreation and lei-
for facilitating a conversation with school-age sure options or support for developing young
participants. skills. These include Scout troops, technology
• Role-play situations that show another per- focus clubs, c hildren’s choirs, or arts and crafts
son’s discomfort with or misunderstanding of groups. Feeling a sense of accomplishment in
having a visual impairment. Consider school, learning a skill or creating an art object sup-
neighborhood, and community settings. Ad- ports a positive sense of self-esteem.
just the story line to allow for instances of • Talk with other young p eople who also have a
simply giving a brief definition or fuller expla- visual impairment. School districts, organ
nations, and experiment with dif fer
ent re- izations for individuals with visual impairments
sponses in both awkward and more comfortable (for example, the National Organization for Al-
scenes. Take turns being the one with a visual binism and Hypopigmentation [NOAH] and
impairment and being the other person. (See the National Association of Parents of Children
Cowan & Bachofer, 2014, for a description of with Visual Impairments [NAPVI]; see the
the role-playing game It Bugs Me.) Resources section in the online
• Develop a personal notebook or portfolio that AFB Learning Center for more infor-
can be shared with teachers, club sponsors, or mation), and nonprofit organizations
(for example, Lions Club) offer summer camp youths with visual impairments include fostering
programs, weekend events, and family nights. multisensory awareness, helping them to under-
Meeting in person is ideal, but getting ac- stand the cause and impact of their eye condition,
quainted on the phone or through social media and developing techniques for catching social
(with adult approval) is a good place to start. cues. Research has documented the importance of
These events may only happen once a year but these and additional practices as critical to a child’s
can bring a powerful boost to self-esteem. healthy self-concept and positive psychosocial de-
velopment. The presence of a visual impairment
does not ensure that deficits in psychosocial do-
SUMMARY mains will occur. Consistent attention to such
practices by parents and educators will increase the
hildren and youths with visual impairments
C
likelihood of healthy development. Additional re-
have a promising future. They live in a world where
search is needed to continue building the knowl-
generally people are curious and want to learn
edge base of theory and best practice.
about living with a visual impairment. Research-
Even in the 21st century a student may say,
ers’ recognition of the importance of nurturing
“You d on’t know how tough it is b ecause you
self-esteem in early childhood, especially for
can see.” This child is boldly voicing a deeply felt
young children with disabilities, has brought this
ity. Support from parents and teachers,
real
topic to the forefront of childhood development.
throughout the developmental years, is neces-
Technological advances and increased attention to
sary to help students come to know their psy-
access to visual information have allowed greater
chological traits and social characteristics as
participation across activities from play to study to
they envision life beyond the school years. De
work. Having a visual impairment is an obstacle to
cades later, the conversation with family at a
be met with tools and strategies. Support from
grandparents’ golden anniversary celebration or
family and educators, purposeful opportunities to
with past classmates at a 30-year high school re-
learn and practice skills, and regular discussions
union may be “Would you trade it in—g rowing
on realistic expectations are essential components
up with a visual impairment for a life of typical
for healthy psychosocial development for all levels

sight?” The answer w ill hinge on supports and
of learners. Students with visual impairments have
guidance throughout the stages of psychosocial
a desire to make friends, feel approval from peers,
development.
join in classroom jokes, and even hear constructive
criticism when it is appropriate. They are more
For learning activities related to this
similar to their peers than they are different.
chapter, log in to the online AFB Learn
Historically, research has presented a deficit
ing Center.
view on psychosocial development in children
and youths with visual impairments. In recent
years, research has shown a more encouraging
view in this area. Examples of best practice in posi- RE ERENCES
tive psychosocial development for all c hildren in-
Aillaud, C. L., & Lieberman, L. (2013). Everybody
clude nurturing self-esteem beginning with very plays! How kids with visual impairments play sports.
young infants; providing rich, hands-on experi- Louisville, KY: American Printing House for the
ences for young c hildren to learn about their envi- Blind.
ronment; and supporting independence through Ajuwon, P. M., Sarraj, H., Griffin-Shirley, N., Lechten-
guided risks. Examples particular to children and berger, D., & Zhou, L. (2015). Including students
who are visually impaired in the classroom: Atti- tionnaire for students with low vision (the Impact
tudes of preserv ice teachers. Journal of Visual Im- of Vision Impairment on C hildren: IVI_C). Oph-
pairment & Blindness, 109, 131–140. thalmic Epidemiology, 15, 114–120.
Bachofer, C. (2013). Long-term optical device use by young Coopersmith, S. (1967). The antecedents of self-esteem.
adults with low vision (Doctoral dissertation). San Francisco: Freeman.
Available from Vanderbilt University Electronic Copple, C., & Bredekamp, S. (2010). Developmentally
Theses and Dissertation database. (etd-03262013- appropriate practice in early childhood programs
102147) serving c hildren from birth through age 8 (3rd ed.).
Bagley, S. (1997, Spring–Summer). How to build a Washington, DC: National Association for the
baby’s brain. In Your child from birth to three Education of Young Children.
[Special issue]. Newsweek. Corn, A. L., Wall, R. S., Jose, R. T., Bell, J. K., Wilcox,
Beatty, L. A. (1992). Adolescent self-perception as a K., & Perez, A. (2002). An initial study of reading
function of vision loss. Adolescence, 27, 707–714. and comprehension rates for students who re-
Behl, D. D., Akers, J. F., Boyce, G. C., & Taylor, M. J. ceived optical devices. Journal of Visual Impair-
(1996). Do mothers interact differently with ment & Blindness, 95, 322–334.
children who are visually impaired? Journal of Cowan, C., & Bachofer, C. (2014, January 22). It Bugs
Visual Impairment & Blindness, 90, 501–511. Me game [Web log post]. Retrieved from http://
Bell Coy, J. K., & Andersen, E. A. (2010). Instruction in www.t sbvi.edu/t sbvi-blog/it-bugs-me-game
the use of optical devices for c hildren and youths. Dote-Kwan, J., Hughes, M., & Taylor, S. L. (1997). Im-
In A. L. Corn & J. N. Erin (Eds.), Foundations of low pact of early experiences on the development of
vision: Clinical and functional perspectives (2nd ed., young c hildren with visual impairments: Revis-
pp. 527–588). New York: AFB Press. ited. Journal of Visual Impairment & Blindness, 91,
Bonding and Relaxation Techniques. (n.d.). Massage 131–144.
your special needs child. Retrieved June 5, 2015, Education for All Handicapped C hildren Act, Pub.
from http://bartspecialneeds.com/ L. No. 94-142 (1975).
Bowen, J. (2010). Visual impairment and its impact Erikson, E. H. (1950). Childhood and society. New York:
on self-esteem. British Journal of Visual Impairment W. W. Norton.
& Blindness, 28, 47–56. Erikson, E. H. (1968). Identity: Youth and crisis. New
Campbell, J. (2003). Maternal directives to young York: W. W. Norton.
c hildren who are blind. Journal of Visual Impair- Erin, J. N., & Corn, A. L. (1994). A survey of
ment & Blindness, 97, 355–365. c hildren’s first understanding of being visually
Chen, D. (2014). Interactions between young c hildren impaired. Journal of Visual Impairment & Blind-
and caregivers: The context for early intervention. ness, 88, 132–139.
In D. Chen (Ed.), Essential elements in early inter- Fazzi, D. L., Klein, M. D., Pogrund, R. L., & Salcedo,
vention: Visual impairment and multiple disabilities P. S. (2002). F amily focus: Working effectively
(2nd ed., pp. 34–84). New York: AFB Press. with families. In R. L. Pogrund & D. L. Fazzi
Chien-Huey Chang, S., & Schaller, J. (2000). Perspec- (Eds.), Early focus: Working with young children who
tives of adolescents with visual impairment on are blind or visually impaired and their families (2nd
social supports from their parents. Journal of Vi- ed., pp. 16–51). New York: AFB Press.
sual Impairment & Blindness, 94, 69–84. Ferrell, K. A. (2006). Your child’s development. In
Cleveland, J., Clinkscales, R. M., Hefner, N., Houghtling, M. C. Holbrook (Ed.), Children with visual impair-
D., Cubacak, C., & Sewell, D. (2007). Empowered: ments: A parents’ guide (2nd ed., pp. 85–108).
An activity based self-determination curriculum for Bethesda, MD: Woodbine House.
students with visual impairments. Austin: Texas Flom, R. (2004). Visual functions as components of
School for the Blind and Visually Impaired. functional vision. In A. H. Lueck (Ed.), Functional
Cochrane, G., Lamoureux, E., & Keeffe, J. (2008). De- vision: A practitioner’s guide to evaluation and inter-
fining the content for a new quality of life ques- vention (pp. 25–59). New York: AFB Press.
Forster, E. (2006). Adjusting to your child’s visual im- Individuals with Disabilities Education Improvement
pairment. In M. C. Holbrook (Ed.), Children with Act (IDEA), 20 U.S.C. § 1400 (2004).
visual impairments: A parents’ guide (2nd ed., Jessup, G. M., Cornell, E., & Bundy, A. (2010). The trea
pp. 51–83). Bethesda, MD: Woodbine House. sure in leisure activities: Fostering resilience in
Fraser, C. F. (1917). Psyc hology of the blind. American young people who are blind. Journal of Visual
Journal of Psychology, 28, 229–236. Impairment & Blindness, 104, 419–430.
Gee, K. (2004). Developing curriculum and instruc- Jutai, J. (1998). Quality of life impact of assistive tech-
tion. In F. P. Orelove, D. Sobsey, & R. Silberman nology. Rehabilitation and Community Care Man-
(Eds.), Educating children with multiple disabilities: A agement, 14, 2–7.
collaborative approach. (4th ed., pp. 67–114). Balti- Kef, S. (2002). Psychosocial adjustment and the mean-
more: Paul H. Brookes. ing of social support for visually impaired students.
George, A. L., & Duquette, C. (2006). The psychosocial Journal of Visual Impairment & Blindness, 96, 22–38.
experiences of a student with low vision. Journal of Kekelis, L. S., & Prinz, P. M. (1996). Blind and sighted
Visual Impairment & Blindness, 100, 152–163. c hildren with their m others: The development
Glen, S., & Nelsen, J. (2010). Raising a self-reliant child of discourse skills. Journal of Visual Impairment &
in a self-indulgent world: Seven building blocks for de- Blindness, 90, 423–436.
veloping capable young p eople. New York: Random Kelly, S., & Smith, T. J. (2008). The digital social interac-
House. tions of students with visual impairments: Find-
Gold, D., Shaw, A., & Wolffe, K. E. (2010). The social ings from two national surveys. Journal of Visual
lives of Canadian youths with visual impair- Impairment & Blindness, 102, 528–539.
ments. Journal of Visual Impairment & Blindness, Kesiktas, D. (2009). Early childhood special education
104, 431–443. for c hildren with visual impairments: Problems
Goode, S. (2006). Brain research and early childhood and solutions. Educational Sciences: Theory and
development: A selection of online resources. Re- Practice, 9, 823–832.
trieved from http://ectacenter.org/~pdfs/pubs/brain Khadka, J., Ryan, B., Margraine, T., & Woodhouse, J. M.
research.pdf (2012). Listening to voices of c hildren with a vi-
Guerette, A., Lewis, S., & Mattingly, C. (2011). Students sual impairment: A focus group study. British
with low vision describe their visual impairments Journal of Visual Impairment, 30, 182–196.
and visual functioning. Journal of Visual Impair- Kostelnik, M. J., Soderman, A. K., & Whiren, A. P.
ment & Blindness, 105, 287–298. (2014). Developmentally appropriate curriculum: Best
Harter, S. (1985). Manual for the self-perception profile for practices in early childhood education (5th ed.). Wash-
children. Denver: University of Denver. ington, DC: National Association for the Educa-
Harter, S. (1988). Manual for the self-perception profile for tion of Young C hildren.
adolescents. Denver: University of Denver. Krebs, C. (2002). Self- advocacy skills: A portfolio
Hodges, J. S., & Keller, M. J. (1999). Visually impaired approach. RE:view, 33, 160–173.
students’ perceptions of their social integration in Kroksmark, U., & Nordell, K. (2001). Adolescence: The
college. Journal of Visual Impairment & Blindness, 93, age of opportunities and obstacles for students
153–165. with low vision in Sweden. Journal of Visual Impair-
Horne, M. D. (1983). Elementary teachers’ attitudes ment & Blindness, 95, 213–225.
towards mainstreaming. Exceptional Child, 30, Langley, B. (2006). Daily life. In M. C. Holbrook (Ed.),
93–98. Children with visual impairments: A parents’ guide
Huurre, T. M., Komulainen, E. J., & Aro, H. M. (1999). (2nd ed., pp. 109–152). Bethesda, MD: Woodbine
Social support and self-esteem among adolescents House.
with visual impairments. Journal of Visual Impair- LaVenture, S., Lesner, J., & Zabelski, M. (2006). In S. Z.
ment & Blindness, 93, 26–37. Sacks & K. E. Wolffe (Eds.), Teaching social skills to
Individuals with Disabilities Education Act (IDEA), children with visual impairments: From theory to prac-
Pub. L. No. 101-467 (1990). tice (pp. 20–46). New York: AFB Press.
Lewis, S., & Wolffe, K. E. (2006). Promoting and nur- Nash, J. M. (1997, February). Fertile minds. Time, 149,
turing self-e steem. In S. Z. Sacks & K. E. Wolffe 48–56.
(Eds.), Teaching social skills to students with visual Parker, A., & Pogrund, R. (2009). A review of re-
impairments: From theory to practice (pp. 122–162). search on the literacy of students with visual
New York: AFB Press. impairments and additional disabilities.
Lewis, V., & Collins, G. M. (Eds.). (1997). Blindness and Journal of Visual Impairment & Blindness, 103,
psychological development in young c hildren. Leices- 635–648.
ter, United Kingdom: BPS Books. Peavey, K. O., & Leff, D. (2002). Social acceptance of
Lieberman, L. J., Modell, S. J., Ponchillia, P., & Jack- adolescent mainstreamed students with visual
son, I. (2006). G oing places: Transition guidelines for impairments. Journal of Visual Impairment & Blind-
community-based physical activities for students who ness, 96, 808–811.
have visual impairments, blindness, or deafblindness. Piers, E. V., & Herzberg, D. S. (2002). Piers-Harris
Louisville, KY: American Printing House for the children’s self-concept scale (2nd ed.). Torrance, CA:
Blind. Western Psychological Serv ices.
Lifshitz, H., Hen, I., & Weisse, I. (2007). Self-concept, Pinquart, M., & Pfeiffer, J. P. (2013). Perceived social
adjustment to blindness, and quality of friendships support in adolescents with and without visual
among adolescents with visual impairments. Jour- impairment. Research in Developmental Disabilities,
nal of Visual Impairment & Blindness, 101, 96–107. 34, 4125–4133.
Loots, G., Devise, I., & Sermijn, J. (2003). The interac- Pogrund, R. L. (2002). Independence focus: Pro-
tion between m others and their visually impaired moting in de pendence in daily living and
infants. Journal of Visual Impairment & Blindness, 97, recreational skills. In R. L. Pogrund & D. L. Fazzi
403–417. (Eds.), Early focus: Working with young children
Low, J. (1996). Negotiating identities, negotiating en- who are blind or visually impaired and their fami-
vironments: An interpretation of the experiences lies (2nd ed., pp. 218–249). New York: AFB
of students with disabilities. Disability and Society, Press.
11, 235–248. Presley, I. (2010). The impact of assistive technology:
MacCuspie, A. (1996). Promoting acceptance of children Assessment and instruction for c hildren and
with disabilities: From tolerance to inclusion. Halifax, youths with low vision. In A. L. Corn & J. N. Erin
Nova Scotia: Halcraft. (Eds.), Foundations of low vision: Clinical and func-
Mahoney, R. (2014, January 4). Why do we fear the tional perspectives (2nd ed., pp. 589–654). New
blind? The New York Times. Retrieved from http:// York: AFB Press.
www.nytimes.com/2014/01/05/opinion/sunday PRWeb. (2010, August 11). Americans fear blindness
/why- do-we-fear-t he-blind.html?_ r =1 more than heart disease survey finds. Retrieved
Mangold, S. (1988). Nurturing high self-esteem in ad- from http://w ww.prweb.com/releases/2010Surge
olescents with visual handicaps. Journal of Vision ResearchInc/08/prweb4372854.htm
Rehabilitation, 2, 5–9. Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior
Maslow, A. (1968). Toward a psychology of being (2nd assessment scale for children (2nd ed.). Circle Pines,
ed.). Princeton, NJ: Norstrand. MN: AGS.
Mason, H. (1999). Blurred vision: A study of the use Robinson, B., & Lieberman, L. (2004). Effects of
of low vision aids by visually impaired secondary v isual impairment, gender, and age on self-

school pupils. British Journal of Visual Impairment, determination. Journal of Visual Impairment & Blind-
17, 94–97. ness, 98, 351–363.
Moradi, P., Thornton, J., Edwards, R., Harrison, R. A., Rosenblum, L. P. (2006). Developing friendships and
Washington, S. J., & Kelly, S. P. (2007). Teenagers’ positive social relationships. In S. Z. Sacks & K. E.
perceptions of blindness related to smoking: A Wolffe (Eds.), Teaching social skills to students
novel message to a vulnerable group. British Jour- with visual impairments: From theory to practice
nal of Ophthalmology, 91, 605–607. (pp. 163–194). New York: AFB Press.
Rowland, C. (1984). Preverbal communication of Sticken, J., & Kapperman, G. (2010). Integration of
blind infants with their mothers. Journal of Visual v isual skills for independent living. In A. L. Corn
Impairment & Blindness, 78, 297–302. & J. N. Erin (Eds.), Foundations of low vision: Clini-
Roy, A. W., & McKay, G. F. (2002). Self-perception and cal and functional perspectives (2nd ed., pp. 97–
locus of control in visually impaired college stu- 110). New York: AFB Press.
dents with different types of vision loss. Journal of Stuart, M. E., Lieberman, L., & Hand, K. E. (2006). Be-
Visual Impairment & Blindness, 96, 254–266. liefs about physical activity among c hildren who
Sacks, S. Z. (2006). The development of social skills: A are visually impaired and their parents. Journal of
personal perspective. In S. Z. Sacks & K. E. Wolffe Visual Impairment & Blindness, 100, 223–234.
(Eds.), Teaching social skills to students with visual im- Topor, I., Lueck, A. H., & Smith, J. (2004). Compensa-
pairments: From theory to practice (pp. 3–19). New tory instruction for academically oriented stu-
York: AFB Press. dents with visual impairments. In A. H. Lueck
Sacks, S. Z. (2010). Psychological and social implica- (Ed.), Functional vision: A practitioner’s guide to eval-
tions of low vision. In A. L. Corn & J. N. Erin uation and intervention (pp. 353–421). New York:
(Eds.), Foundations of low vision: Clinical and func- AFB Press.
tional perspectives (2nd ed., pp. 67–96). New York: Tuttle, D., & Tuttle, N. (1996). Self-esteem and adjusting
AFB Press. with blindness. Springfield, IL: Charles C Thomas.
Sacks, S. Z., & Corn, A. L. (1996). Students with visual Tuttle, D., & Tuttle, N. (2006). Nurturing your child’s
impairments: Do they understand their disabil- self-esteem. In M. C. Holbrook (Ed.), Children with
ity? Journal of Visual Impairment & Blindness, 90, visual impairments: A parents’ guide (2nd ed., pp. 187–
412–422. 200). Bethesda, MD: Woodbine House.
Sacks, S. Z., Kamei-Hannan, C., Erin, J., Barclay, L., & Uttermohlen, T. L. (1997). On “passing” through ad-
Sitar, D. (2009). Social experiences of beginning olescence. Journal of Visual Impairment & Blindness,
braille readers in literacy activities: Qualitative 91, 309–314.
and quantitative findings of the ABC Braille Vik, A. K., & Lassen, L. M. (2010). How pupils with
Study. Journal of Visual Impairment & Blindness, severe visual impairments describe coping with
103, 680–693. reading activities in the Norwegian inclusive
Scadden, L. A. (2000). Technology and society. school. International Journal of Disability, Develop-
In B. Silverstone, M. A. Lang, B. P. Rosenthal, & ment, and Education, 57, 279–298.
E. E. Faye (Eds.), The Light house handbook on Wall, R. (2002). Teachers’ exposure to p eople with vi-
v isual impairment and vision rehabilitation: Vol. 1
sual impairments and the effect on attitudes
(pp. 907–919). New York: Oxford University Press. toward inclusion. RE:view, 34, 111–119.
Schwartz, T. L. (2010). C auses of visual impairment: Wall-E merson, R., Holbrook, C., & D’Andrea, F. M.
Pathology and its implications. In A. L. Corn & J. (2009). Acquisition of literacy skills by young
N. Erin (Eds.), Foundations of low vision: Clinical c hildren who are blind: Results from the ABC
and functional perspectives (2nd ed., pp. 137–191). Braille Study. Journal of Visual Impairment & Blind-
New York: AFB Press. ness, 103, 610–624.
Shapiro, D. R., Moffett, A., Lieberman, L., & Dummer, Wall-Emerson, R., Sitar, D., Erin, J., Wormsley, P., &
G. M. (2005). Perceived competence of c hildren Herlich, S. L. (2009). The effect of consistent struc-
with visual impairments. Journal of Visual Impair- tured reading instruction on high and low literacy
ment & Blindness, 99, 15–27. achievement in young c hildren who are blind. Jour-
Shapiro, D. R., Moffett, A., Lieberman, L., & Dummer, nal of Visual Impairment & Blindness, 103, 595–609.
G. M. (2008). Domain specific ratings of impor- Ward, M. E. (2010). Anatomy and physiology of the
tance and global self-worth of c hildren with eye. In A. L. Corn & J. N. Erin (Eds.), Foundations
visual impairments. Journal of Visual Impairment of low vision: Clinical and functional perspectives (2nd
& Blindness, 102, 232–244. ed., pp. 111–136). New York: AFB Press.
Warren, D. (1994). Blindness and children: An individual Wittmer, D. S., & Petersen, S. (2014). Infant and toddler
differences approach. Cambridge: Cambridge Uni- development and responsive program planning: A
versity Press. relationship-based approach. Boston: Pearson.
Warren, D. (2000). Developmental perspectives: Youth. Wolffe, K. E., & Sacks, S. Z. (1997). The lifestyles of
In B. Silverstone, M. A. Lang, B. P. Rosenthal, & blind, low vision, and sighted youths: A quanti-
E. E. Faye (Eds.), The Lighthouse handbook on visual tative comparison. Journal of Visual Impairment &
impairment and vision rehabilitation: Vol. 1 (pp. 325– Blindness, 91, 245–257.
337). New York: Oxford University Press. Wong, H., Machin, D., Tan, S., Wong, T., & Saw, S.
Wetzel, R., & Knowlton, M. (2000). A comparison of (2009). Visual impairment and its impact
print and braille reading rates on three reading on health- related quality of life in adoles-
tasks. Journal of Visual Impairment & Blindness, 94, cents. American Journal of Ophthalmology, 147,
146–157. 505–511.
7
C H A P T E R
Children and Youths with

Visual Impairments and
Other Exceptionalities
Rosanne K. Silberman
To hear an audio introduction ♦ Students who are visually impaired and gifted
to this chapter by the author, present unique challenges in identification and
and to view a chapter over intervention.
view presentation, log in to the AFB Learning
Center. INTRODUCT ON
C
KEY POINTS
often have a range of other exceptionalities that
♦ Many students who are visually impaired also have an impact on their development, on deci-
have other disabilities. sions regarding their educational placement,
and on the formulation of Individualized Family
♦ Students with visual impairments and other ex-
Serv ice Plans (IFSPs) and Individualized Educa-
ceptionalities are a diverse group with a wide
tion Programs (IEPs) to meet their unique needs.
variety of strengths and needs.
Combinations of two or more disabilities are
♦ Teachers of students with visual impair- sometimes referred to as multiple disabilities. Ac-
ments and additional disabilities work in a va- cording to the Individuals with Disabilities
riety of service delivery systems with a variety E ducation Act (IDEA), multiple disabilities refers
of professionals. to “concomitant impairments (such as mental
♦ The additional disabilities of students who retardation- blindness or mental retardation-
are visually impaired represent a similar orthopedic impairment), the combination of
range of disabilities to those present in which c auses such severe educational needs
students who are sighted. However, some
that they cannot be accommodated in special
syndromes or disabling conditions are ac- education programs solely for one of the im-
companied by a greater prevalence of visual pairments”(34 C.F.R. § 300.8[c][7]). Although
impairments. deafblindness is treated u nder a separate cate-
210
Children and Youths with Other Exceptionalities 211
gory in IDEA, it w ill be referred to as a multiple

disability for the purposes of this chapter. Note PREVALENCE
that individual states may have differing defi-
Estimates of the number of students with visual
nitions of multiple disabilities and dif fer
e nt
impairments and additional disabilities range
methods of classification of students for the
from 50 to 70 percent, depending on the source
purpose of Individual Education Plans (IEPs).
(Dote- Kwan, Chen & Hughes, 2001; Hatton,
Multiple disabilities that include visual im-
Schwietz, Boyer, & Rychwalski, 2007; Pogrund &
pairments may be caused by prenatal, perinatal,
Fazzi, 2002). Regardless of the source, informa-
or postnatal factors. Prenatal factors include
tion on the prevalence of c hildren and youths
congenital infections and abnormalities, hypoxia
with visual impairments and other exceptionali-
(a low amount of oxygen in the blood and lungs),
ties is limited and frequently inaccurate because
chromosomal and genetic defects, and parental
students with visual impairments may be counted
alcohol and drug abuse (Heller, Forney, Alberto,
in several disability areas other than visual im-
Best, & Schwartzman, 2009). F actors that cause
pairments, including intellectual disabilities,
multiple impairments during the perinatal pe-
multiple disabilities, hearing impairment, and
riod (shortly before, during, or right a fter birth)
neurological disabilities. Child counts are further
and the postnatal period include trauma, hy-
influenced by f actors such as placement, admin-
poxia, infection, and prematurity (Batshaw, Roi-
istrative decisions, and lack of knowledge about
zen, & Lotrecchiano, 2013).
the identification of visual impairments. Under-
The combined exceptionalities result in unique
estimating child counts has led to implications
characteristics that are not present in c hildren and
that relate to shortages of personnel needed to
youths with visual impairments alone. Although
teach this low-incidence population. (For a more
the types of combinations of these exceptionali-
detailed discussion of the general problem of
ties are numerous, this chapter discusses the
child counts, see Chapter 2 in this volume.)
characteristics and medical and educational im-
pacts of the following combinations that a teacher
may find among students with visual impair- TYPES OF SERV CE
ments: DEL VERY SYSTEMS

• Visual impairments and intellectual disabilities hildren and youths with visual impairments and
C
• Visual impairments and learning disabilities other exceptionalities can receive an appropriate
education in a variety of service delivery systems,
• Visual impairments and neurological dis-
depending on such factors as their families’ prefer-
abilities
ences, unique educational needs, recommenda-
• Visual impairments and orthopedic and health tions of the IFSP or IEP team, and the availability
impairments of qualified personnel. It is important to note that
• Visual impairments and auditory impairments placement decisions should be reevaluated regu-
(deafblindness) larly because appropriate placement decisions are
based on the student’s current needs, strengths,
• Visual impairments and emotional and behav-
and preferences; one decision is not necessarily
ioral disorders
appropriate throughout a student’s schooling.
• Visual impairments and autism spectrum dis- The variety of placement options for
orders (autism spectrum disorder) c hildren and youths with other exceptionalities
• Visual impairments and giftedness may include disability-specific environments such
as residential or day-school programs for students tion, e very collaborative team must include the
who are visually impaired; public and private day student’s parents and relevant paraprofessionals
programs for students who are visually impaired; to participate in decisions regarding educational
and specialized classes, resource rooms, and itin- placement, assessment, program planning and
erant programs in public schools. In addition, this development of IEPs, and program evaluation
population can also be served in inclusive general (Orelove, Sobsey, & Silberman, 2004; Silber-
education classes and in special programs for stu- man, Sacks, & Wolffe, 1998). (For additional in-
dents with other disabilities, such as centers for formation on working in educational teams, see
children with cerebral palsy and classes for stu- Volume 2, Chapter 1.)
dents with severe disabilities, deafblindness, or The four types of teams that are evident in
neurological impairments. The teacher of students educational programs for children and youths
with visual impairments must be a key member of with visual impairments and other exceptionali-
the professional team, regardless of where a stu- ties are the multidisciplinary team, the interdisci-
dent who has a visual impairment and other ex- plinary team, the transdisciplinary team, and the
ceptionality is placed. (See Chapter 9 in this collaborative team models. The models that are
volume for a more detailed discussion of place- highly recommended as being most effective with
ment options.) students with multiple disabilities are the trans-
disciplinary model and collaborative team model
COLLABORAT VE EAMING (Browder, Spooner, & Meier, 2011; Cloninger,
2004). Therapists and other specialists with unique
A range of expertise is needed to meet the unique expertise provide direct services to students in
challenges that c hildren and youths with visual classrooms and other natu ral environments as
impairments and other exceptionalities present. part of the daily routine, rather than in isolated
No one professional can be expected to be totally therapy rooms. An example of this practice is a
competent in providing for all the needs of t hese speech-language therapist assisting a student with
students. Depending on the types of additional a visual impairment and an intellectual disability
disabilities, participants on a collaborative to interact with his peers at lunch using an aug-
team may include a teacher of students with vi- mentative communication device.
sual impairments, a rehabilitation teacher, other The transdisciplinary model and collaborative
special educators, and general education teach- team model also enable a related-service profes-
ers of specific subjects. They may also include sional to gradually provide less direct service and
related-services personnel, such as an orienta- to serve as a consultant to the classroom teacher
tion and mobility (O&M) specialist; a physical once the teacher learns to implement a specific
therapist to assist with gross motor develop- strategy. All team members in the collaborative
ment; an occupational therapist to assist with team model incorporate each other’s expertise into
fine motor development, particularly in daily integrated assessment, development of instruc-
living skills; a speech-language therapist to as- tional goals, and implementation. T hese shared
sist in developing appropriate augmentative responsibilities lead to “role release” of each of the
communication systems; a psychologist; and a team members. An example of role release is when
social worker. Other significant members of the an O&M specialist shows a special education
collaborative team may be the audiologist to as- teacher how to help a student trail a wall in her
sess hearing, a nurse and physician to address wheelchair to go from the classroom to the cafete-
medical concerns, and a behavioral interven- ria. Then the O&M specialist observes the teacher
tionist to address emotional difficulties. In addi- instructing the student and gradually fades from
the activity. (For a more thorough explanation of received. Supports can be both strategies and re-
various team models, see Volume 2, Chapter 1.) sources that encourage participation in natural
settings (Hallahan, Kauffman, & Pullen, 2012).
V SUAL MPA RMENTS AND
NTELLECTUAL DISAB LIT ES Impact on Development
and Learning
Definitions and Characteristics
C
Some c hildren and youths with visual impair- and intellectual disabilities have difficulty at-
ments also have various degrees of intellectual tending to certain stimuli, dimensions, and cues.
disability. As defined by the American Associa- Without the ability to observe visually, they also
tion on Intellectual and Developmental Disabili- have difficulty imitating others and synthesiz-
ties (AAIDD, 2010), intellectual disability refers to ing separate skills into meaningful wholes. They
substantial limitations in both intellectual func- are unable to learn some skills incidentally and to
tioning and adaptive behavior. It is characterized generalize from one environment to another (Sil-
by significantly subaverage intellectual function, berman et al., 1998; Westling, Fox, & Carter, 2015).
or intelligence, existing concurrently with related In addition, because they have limited access to
limitations in adaptive behavior including con- information, they are less motivated to explore,
ceptual skills, social skills, and practical skills. The initiate interactions, or participate in everyday
AAIDD “stresses that additional factors must be situations (Chen, 2014). These students learn at
taken into account, such as the community envi- slower rates, need more time to learn new skills,
ronment typical of the individual’s peers and cul- and learn fewer skills than their peers with only
ture. Professionals should also consider linguistic visual impairments or those without disabilities
diversity and cultural differences in the way (Sacks, 1998).
people communicate, move, and behave.” The In the area of gross motor development, these
AAIDD definition also assumes that limitations of children and youths frequently exhibit motor
each individual will be described along with a pro- delays b ecause of the combination of visual im-
file of needed supports. Given appropriate, individ- pairment and intellectual disabilities. For exam-
ualized supports, the adaptive functioning of the ple, many have difficulties rotating parts of their
individual with intellectual disability is likely to bodies, such as their heads and trunks. A child
improve. Intellectual disabilities manifest before with central vision loss who is unable to rotate his
age 18 (AAIDD, 2010; Heward, 2009). or her head cannot turn to locate an object placed
Unlike earlier definitions from professional on the left side of his or her desk or wheelchair.
organizations, the current definition focuses on Some are also unable to ambulate independently
the strengths and needs of the individual, as well from place to place in their environment. In the
as the types and degrees of support necessary to area of fine motor development, these children
appropriately serve that individual’s needs. The and youths have delays in fine motor skills in-
level of supports can be intermittent, limited, volving the use of arms, hands, and fingers. They
extensive, or pervasive, and the type of support have difficulty reaching for, grasping, and releas-
varies across environments and depends on the ing objects because vision plays an extremely sig-
skills of a specific student. The AAIDD empha- nificant role in encouraging physical contact with
sizes the direct relationship between the func- the hands or near objects (Silberman, Bruce, &
tioning level of an individual with intellectual Nelson, 2004; Silberman & Erin, 2007). In addi-
disabilities and the amount of quality supports tion, delays in fine motor skills may prevent these
c hildren from acquiring skills in activities of daily tral field loss, and photophobia, as well as devel-
living, such as dressing, eating, and grooming. opmental delays and spastic paraplegia (Simpson,
In the area of social development, students 2013). Still another example is Down syndrome, a
with visual impairments and intellectual disabil- chromosomal defect that causes intellectual dis-
ities are at even greater risk for social isolation ability, endocrine abnormalities, hypotonia, con-
than those with visual impairments alone because genital heart defects, refractive errors, cataracts,
they are likely unable to integrate social skills strabismus, and keratoconus. (For a complete list
into their daily lives without external supports. of ocular changes in pediatric syndromes, see Nel-
They are in need of specific interventions to en- son & Olitsky, 2013.) Several syndromes that re-
able them to interact with other peers with and sult in visual and auditory impairments are
without disabilities (Silberman & Erin, 2007). described in the section on deafblindness.
With regard to the development of communica-
tion skills, many of these students are unable to
acquire speech and need to use a combination of V SUA MPA RMENTS AND
unaided and aided augmentative and alternative LEARNING D SABI IES
communication techniques. Unaided techniques
include touch cues, manual signs, tactile signs,
and gestures. Aided techniques can be nonelec- Students with visual impairments and learning
tronic, such as real objects, tangible symbols that disabilities have a sensory loss combined with
feel or sound like what they represent, photo significant difficulties in listening, speaking,
graphs, black-and-white enlarged line-drawing reading, writing, reasoning, or mathematical
symbols, and textured symbols. Other aided tech- abilities (Silberman & Sowell, 1998). As defined
niques incorporate external electronic devices in the reauthorization of IDEA in the Individu-
such as computers, microswitches, or voice-output als with Disabilities Education Improvement Act
communication aids (Beukelman & Mirenda, of 2004 (IDEA, 2004), the definition of specific
2013; Johnston, Reichle, Feeley, & Jones, learning disability includes the following concepts:
2012). (To watch a related video, log in to
the AFB Learning Center.) • The student has a disorder in one or more of
the basic psychological pro cesses, such as
Common Syndromes memory, auditory perception, visual percep-
tion, oral language, and thinking.
Chromosomal and ge netic defects, caused by
• The student has difficulty learning, that is, in
missing or extra chromosomes or interactions of
speaking, listening, writing, reading (word-
different types of genes, can result in syndromes
recognition skills and comprehension), and
that have combinations of disabilities that include
mathematics (calculation and reasoning).
visual impairments. Some examples include
Cri-du-chat syndrome (a chromosomal defect that • The student’s difficulty is not due primarily to
causes intellectual disability), microcephaly (an ab- other c auses, such as visual or hearing impair-
normally small head), hypotonia (low muscle ments; motor impairments; intellectual dis-
tone), myopia, glaucoma, microphthalmos (abnor- abilities; emotional disturbance; or economic,
mally small eyes), optic atrophy, and corneal opacity. environmental, or cultural disadvantage.
Another example is Laurence-Moon-Bardet-Biedl • A severe discrepancy exists between the stu-
syndrome, which is an autosomal recessive disorder dent’s potential for learning and his or her
characterized by night blindness, progressive cen- low level of achievement.
The recent Diagnostic and Statistical Manual integrating the ele ments of the environment
of Mental Disorders (DSM-5) provides a defini- into a meaningful whole, and their learning dis-
tion of “specific learning disorder” that empha- ability may hinder their development of short-
sizes a “single, overall diagnosis, incorporating term memory. Therefore, the students with
deficits that have an impact on academic achieve- both of t hese disabilities may become confused
ment. Rather than limiting the definition spe- and unable to follow directions to get from one
cifically to reading, mathe matics, and written place to another (such as from the cafeteria or
expression, the criteria describe shortcomings in gym back to the classroom).
general academic skills and provide detailed spec- In the area of language, these students may
ifiers for areas of reading, mathematics, and writ- experience difficulties with oral expression, since
ten expression” (American Psychiatric Association, they may not have all the salient details of a par
2013). Furthermore, rather than emphasize the ticular experience b
ecause of their visual impair-
ability-achievement discrepancy approach for ment. Furthermore, they may find it more difficult
identifying c hildren with learning disabilities, the to write a high-quality composition because they
response-to-intervention model focuses on early lack the visual experience of reading the plethora
identification and prevention rather than fol- of information presented in newspapers and mag-
lowing a “wait-to-fail” model (Vaughn & Fuchs, azines. In the area of reading, they may find it dif-
2003). ficult to decode unfamiliar words, a common
Students with visual impairments and learn- difficulty of students with learning disabilities
ing disabilities have myriad limitations that vary (Hallahan et al., 2012). This difficulty is height-
from individual to individual. The most frequent ened for students with low vision who use their
limitations are in information processing, lan- vision as their primary sensory channel because
guage, mathematics, attention, motor abilities, it takes them longer to decode print letters read
organizational skills, test taking, and social in- with a low vision device or in large print. The dif-
teractions. Although no student with a learning ficulty may also be heightened for students who
disability has difficulties or limitations in all ar- are blind with a learning disability who are chal-
eas, it is important to note that t hese characteris- lenged by the variety of ways to represent the
tics are heightened or intensified in a student who same letter combinations (for example, the “er”
also has a visual impairment. (See Silberman & contraction is used in the word “better” but not in
Sowell, 1998, for a more detailed discussion of the words “mother” or “here” since those words
students with visual impairments and learning use other contractions that incorporate the letter
disabilities.) combination “er”) (Silberman & Sowell, 1998).
With regard to reading comprehension, students
with visual impairments and learning disabili-
Impact on Learning in School ties may have difficulty because of their reduced
Some of the difficulties that students with visual experiential background. They may have prob
impairments and learning disabilities may expe- lems bringing together all the parts into a mean-
rience relate to such areas as information pro ingful whole and sometimes are unable to find
cessing, language skills (both oral and written the appropriate line, to track words on a line, and
expression), reading (decoding and comprehen- to shift to the next line (Silberman & Sowell,
sion), and mathematics, which affect their learn- 1998).
ing in school. In the area of mathematics, many c hildren
In the area of information processing, the and youths with visual impairments and learn-
lack of visual cues hinders these students from ing disabilities have difficulty solving word
problems because of their difficulties with oral Seizure Disorders

language and reading just described. B ecause of
blindness or low vision, they may find it difficult A seizure is a sudden, involuntary disruption of the
to learn concepts that relate to one-to-one corre- normal functioning of the nervous system that
spondence, groups of items, or number relation- may be characterized by changes in consciousness,
ships at a glance. In addition, many of these motor activity, sensory phenomena, or inappropri-
students have not had enough opportunities to ate behavior that occurs alone or in combinations
manipulate objects, and b ecause of the combined (Engel, 2013; Holmes, 2002; Mikati, 2011; Zelleke,
disabilities, they have prob lems understanding Depositario-Cabacar, & Gaillard, 2013). Seizures
concepts related to space, form, order, time, dis- usually last a few seconds to a few minutes and
tance, and quantity (Silberman & Sowell, 1998). end spontaneously. A seizure that is continuous
Many are unable to remember geometric shapes, and lasts for 30 minutes or more is known as status
memorize basic mathematics facts, and perform epilepticus and is considered a medical emergency,
mathematics tasks that require recalling steps and since it may result in brain damage or death if
sequences (Friend & Bursuck, 2012; Heward, immediate intervention is not provided. A seizure
2009). Furthermore, students with low vision are may be caused by a short-term condition, such as
likely to have difficulties with visual-motor tasks a high fever or meningitis; when it occurs at least
related to mathematics. They may have particular two times and is unrelated to a short-term condi-
difficulty with spatial organization, and may be tion or is ongoing, the condition is considered to
unable to read, copy, and align numbers in the be a seizure disorder.
appropriate columns to do various types of nu- Seizures are classified into two major types:
merical operations. Due to difficulties with visual partial seizures and generalized seizures. Partial sei-
detail, they may misread mathematical signs. zures occur in one area of the brain in one cere
Children with low vision may have prob
lems bral hemisphere, and generalized seizures occur
forming numbers correctly; they may write them in both hemispheres or begin in one area and
too large or illegibly, and are unable to read back then move to both hemispheres.
their own numbers to solve computations (Friend
Partial Seizures
& Bursuck, 2012).
Partial seizures are divided into three types:
simple partial, complex partial, and complex partial
V SUAL MPA RMENTS AND with secondary generalization. Simple partial sei-
NEUROLOGICAL DISAB LIT ES zures usually last 10–30 seconds, and c hildren
remain awake and alert during them. The local-
Some students with visual impairments also have ized electrical discharge commonly occurs in
neurological disabilities that affect the brain, spi- the neurons in the motor area of the brain, and,
nal cord, and peripheral nerves that connect the depending on the location of the abnormal dis-
spinal cord to the skin and muscles of the body charge in the motor area where movements are
(Batshaw et al., 2013). Three of the most prevalent controlled, the arm may make a jerking motion
neurological conditions that affect this popula- or the foot may move. When a simple partial
tion in educational programs are seizure disorders, seizure moves from one motor area of a limb to
cerebral palsy, and traumatic brain injury. The follow- another, the foot may move, then the lower leg,
ing section describes these common neurological and then the upper leg. The sequential involve-
disorders and discusses their medical and educa- ment of body parts is referred to as a Jacksonian
tional impacts on learning in the classroom. march (Holmes, 2002). Sometimes small mus-
cles that control the movements of the face or onds before the onset of the seizure. A head-
fingers may be affected as well. Additional ob- ache, a mood change, irritability, difficulty
servable and experienced symptoms of simple sleeping, or a change in appetite may also occur
partial seizures (see T able 7.1) are dependent hours or days before a seizure and serve as a
on the specific area of the brain affected and warning that a seizure is going to occur (Holmes,
the involvement of the autonomic nervous sys- 2002). The seizure begins with a sudden loss of
tem. All s imple partial seizures can occur as an consciousness. During the tonic (rigid) phase,
“aura” that precedes complex partial seizures or which occurs first and lasts less than a minute, a
generalized seizures (Heller et al., 2009; Rosen, child may fall and his or her muscles become
1998). rigid, the arms and legs extend, and the back
Complex partial seizures, known as temporal arches. In addition, the eyes may roll upward,
lobe or psychomotor seizures, usually last from 30 and the lips, skin, and nailbeds may turn blue.
seconds to several minutes, during which a stu- The next phase, the clonic (jerking) phase, begins
dent’s consciousness is affected. These seizures with rhythmic, jerking motions of the body that
are often multisymptomatic and usually involve gradually lessen. During this phase, a child may
involuntary motor movements and psychic be lose bladder or bowel control, saliva may pool
haviors (see T
able 7.1) (Heller et al., 2009). When in the mouth, and breathing becomes noisy and
the seizure is over, the student may feel confused, shallow. The child also may aspirate saliva, bite
be tired, or sleep (known as the postictal phase). the tongue, and vomit. The entire seizure lasts
Sometimes a partial complex seizure may spread from 2 to 5 minutes, then the child wakes up
to other parts of the brain and result in a gener- confused and sleeps for 30 minutes to two hours
alized seizure. (Heller et al., 1996; Rosen, 1998). T here are sev-
eral other types of seizures that are less com-
Generalized Seizures mon; for additional information, see Heller et al.
(2009) and Mikati (2011).
Generalized seizures occur in both hemispheres
of the brain. The two most common are absence
seizures and tonic-clonic seizures. Medical Implications

It is extremely important for the teacher to follow
Absence Seizures. Absence seizures, previ- specific procedures if a student in the class has a
ously called petit mal seizures, cause a child to seizure. It is essential to observe the student while
suddenly stop whatever activity he or she is doing, the seizure is taking place and to submit an ac-
lose consciousness, and e ither stare ahead or roll curate report of the seizure. (See Table 7.1 for in-
the eyes upward. In addition, the child may formation on types of seizures, ways to recognize
make involuntary movements, such as blinking them, and what to do and what not to do during
the eyes or twitching the mouth. These seizures a seizure.)
last from a few seconds to 30 seconds. At the end Most seizure disorders are treated effectively
of a seizure, a child w
ill resume the activity as with medications. However, it is important to be
if nothing had happened (Heller et al., 2009; aware of the side effects that the different anti-
Rosen, 1998). epileptic medications may cause. Some of the
drugs that are given to c hildren and youths to
Tonic-Clonic Seizures. Tonic-clonic seizures, control seizures (for example, dilantin) may af-
previously called g rand mal seizures, usually fect visual functioning by causing blurry or dou-
start a fter an aura, which begins minutes or sec- ble vision.
T A B L E 7 . 1
218
Seizure Recognition and First Aid
Seizure Type What It Looks Like What to Do What Not to Do
Generalized Tonic Clonic During the seizure, the Give care and comfort first on’t use artificial
D
(Also called a compulsive person: aid for seizure with loss of respiration (help breathing)
seizure. Previously called • Cries out and falls consciousness. Steps unless person inhaled water

Grand Mal.) include: or isn’t breathing.
• Loses consciousness
(seems to “pass out”) • Stay calm Don’t put anything in
• Make sure the person person’s mouth.
• Muscles jerk rapidly
can breathe Don’t restrain or hold the
• Has trouble breathing
• Time the seizure person down.
• Loses bladder or bowel
• Protect from sharp Don’t give the person any
control
objects or other dangers water, food, or pills by mouth
fter the seizure, the person:
A unless fully alert.
• Keep onlookers away
• May not become fully and explain what is
conscious right away (if happening
it takes 30 minutes, the
• Turn person on one side
person needs to go to ER)
• Stay with the person
• May appear confused for
until the seizure is over
a period of time, need to
and be supportive
sleep, or have a headache
• May go to sleep for
minutes or hours

• Breathes normally
• Eventually becomes fully
conscious (awake and
aware)
Note:
• Usually lasts 2 to 3
minutes
• These seizures are
sometimes confused with:
■ Heart attack
■ Stroke
Absence During the seizure, the person For a single absence seizure,
(Previously called Petit Mal) may: give comfort and
• Stare blankly reassurance. No other first
aid is needed.
• Blink quickly
For clusters of absence
• Make chewing
seizures, give care and

movements
comfort first aid for a seizure
• Be unaware (doesn’t with altered awareness. Time
know what’s going on) the cluster; if it lasts longer
A than 5 minutes, get help.
• Becomes fully conscious
(awake and aware) right
away
Note:
• Most common in children
seconds
sometimes confused
with:
■ Daydreaming
■ Not paying attention

■ Ignoring instructions
Focal Seizure—with Altered During the seizure, the person Give care and comfort first on’t restrain or grab the
D
Awareness may: aid for a seizure with altered person.
(Also called Complex Partial, • Stare blankly awareness. Steps include: Don’t assume the person can
Focal, Psychomotor, or • Make chewing • Stay calm hear you or will follow
Temporal Lobe) movements • Keep onlookers away instructions.
• Move body in unusual and explain what is
ways happening
• Gently guide the person
away from hazards
219
T A B L E 7 . 1 (Continued )
220
• Be unaware and • Keep person in an
seemingly confused enclosed area if possible
(doesn’t know what’s • Speak calmly, telling
going on) them they are safe
• Mumble

• Be sensitive and
• Not be able to answer supportive, and ask
questions others to do the same
• Pick at clothing
• Pick up objects
• Try to take off their
clothes
• Run or seem scared
A
• Is confused
• Can’t remember what
happened
Note: T
hese seizures are
• Being drunk or on drugs

• Mental illness
• Acting out
Focal Seizure—No Change During the seizure, the person Give care and comfort first
in Awareness may: aid for a seizure with no
(Also called Simple Partial • Jerk body, arm, leg, or change in awareness. This
Seizure. Often called auras.) face (this may spread to would include:
other parts of the body) • Stay calm
• See or hear things that • Make sure the person
aren’t there can breathe
• Feel scared, sad, angry, or • Time the seizure
happy for no reason
• Feel like vomiting or have • Protect the person from

a stomachache any dangers
Note: • Make the person as
comfortable as possible
minutes • Keep onlookers away
and explain to others
• During the seizure, the
what’s happening if
person usually stays
necessary

aware and knows what’s
going on • Stay with the person
until the seizure is over
• Sometimes this seizure
type turns into a • Be sensitive and
generalized tonic-clonic supportive, and ask
seizure (see above) others to do the same
sometimes confused
with:
■ Acting out or acting
unusually
■ Mental illness
Atonic Seizure During the seizure, the Give care and comfort first
(Also called Drop Attacks) person: aid for a seizure with altered
• Suddenly falls awareness (like for complex
partial seizures listed
• Loses consciousness
earlier).
(seems to “pass out”)

seconds
A
• Becomes fully conscious
(awake)
• Can stand and walk
Note: T hese seizures are
• Being clumsy
• In a child, poor walking
skills
221
• In an adult, being drunk

T A B L E 7 . 1 (Continued )
222
Myoclonic Seizure During the seizure, the Give care and comfort first
person: aid for a seizure with no
• J erks whole body or parts change in awareness.
of the body

•S pills a drink or drops
objects
• Falls off a chair
Note:
• These
seizures are
sometimes confused with
being clumsy
Infantile Spasm During the seizure, the child: Take the baby to the doctor
• Moves body suddenly or emergency department if
this is the first time a seizure
• If sitting up, head and
happened.
arms fall forward
• If lying down, knees fold up
and arms and head lift up
Note:
• Happens in babies,

typically between 3
and 24 months old
• These spasms are
sometimes confused
with:
■ Asking to be picked up
■ Colic
Source: Reprinted by permission from Epilepsy Foundation of America. (2016). Seizure recognition and first aid. Landover MD: Author.
Effects on Learning and Social Behavior • Monoplegia: Increased muscle tone in one
e xtremity.
Students with disabilities have a higher prevalence
of seizure disorders that may result in the need to • Hemiplegia: Increased muscle tone or paralysis
modify academic content. They may miss infor- of the arm and leg on one side of the body. A
mation while seizures are occurring and afterward child with right-side hemiplegia would have
if they become fatigued or disoriented. In addi- damage to the left side of the brain.
tion, high dosages of medi cation that they are • Diplegia: Increased muscle tone in the legs
given to prevent future seizures sometimes cause more than in the arms. A child with diplegia
drowsiness, a reduced attention span, and loss of may have knees that come together tightly and
short-term memory. Since the occurrence of sei- legs that cross over (scissoring).
zures is unpredictable, students with seizures may • Paraplegia: Increased muscle tone or paralysis
feel dependent and have a sense of loss of control of the legs only.
and decreased self-worth (Heller et al., 2009).
• Quadriplegia: Increased muscle tone or paraly-
Cerebral Palsy sis of all four limbs, as well as of the trunk and
muscles that control the mouth, tongue, and
Cerebral palsy is a nonprogressive disorder of vol- pharynx.
untary movement and posture that is caused by
damage to the brain before or during birth or The types of cerebral palsy that are caused by
within the first few years of life (Hoon & Tolley, damage to the extrapyramidal system of the brain
2013). The majority of the cases are due to prob involve abnormalities of muscle tone that affect
lems during intrauterine development and to pre- the entire body. One type, athetoid cerebral palsy,
maturity (Heller et al., 2009). is caused by damage to the basal ganglia; a stu-
Visual impairments are common and diverse dent with this type of cerebral palsy has abnor-
in c hildren with cerebral palsy. They include ocu- mal, involuntary movements that may be slow
lar impairments (such as strabismus, retinopathy of and writhing or quick and jerky. Another type is
prematurity, and homonomous hemianopsia) and neu- dystonic cerebral palsy, which is characterized by ri-
rological (cortical) visual impairments (Dufresne, gidity and tenseness in the trunk and neck; a
Dagenais, & Shevell, 2013; Hoon & Tolley, 2013). student with this type shows greater rigidity or
There are several classifications of cerebral resistance (no release of tension) to slow move-
palsy. One classification system that is frequently ment than to rapid movement. Still another type,
used is based on the predominant type of motor ataxia, is caused by injury to the cerebellum and
impairment and the region of the brain that is af- results in e ither decreased or increased muscle
fected (Hoon & Tolley, 2013). Damage to the py- tone. A student with ataxia has difficulty coordi-
ramidal motor system of the brain causes spastic nating voluntary movements and balance and
cerebral palsy. A child with spastic cerebral palsy walks with a wide-based, unsteady gait. He or she
w ill have increased muscle tone (hypertonicity) may also have problems controlling his or her
and difficulty with voluntary gross motor and hand and arm while reaching for an object and
fine motor movements (of the hands and fingers). timing motor movements.
Depending on the a ctual part (or parts) of the Other types of cerebral palsy caused by dam-
body that is affected and the extent of the injury, age to the extrapyramidal system include tremor
this type of cerebral palsy is further categorized (regular and rhythmical involuntary shaking
according to the specific limbs involved. These movements) and atonia (no tone or extremely
classifications are as follows: low muscle tone). There are also cases of mixed
cerebral palsy in which there is more than one Traumatic Brain Injury
type of motor pattern, neither of which predom-
inates (Heller et al., 2009; Hoon & Tolley, 2013; Characteristics
Rosen, 1998). Traumatic brain injury (TBI) refers to acquired in-
juries to the brain that prese nt at least one or
more of the following symptoms: changes in the
Effects on Development
level of consciousness, posttraumatic amnesia for
hildren and youths with cerebral palsy have
C five or more minutes, and physiological docu-
varying difficulties with motor movements, re- mentation that is determined by a physical exam-
sulting in abnormal patterns and problems with ination or diagnostic testing (Heller et al., 2009).
coordination. Many retain primitive reflexes that The most frequent causes of TBI are falls from
interfere with the achievement of higher-level heights; sports and recreation-related injuries;
postural reactions, such as changing positions, motor vehicle crashes; and assaults, such as
and motor milestones, such as voluntary sitting shaken infant syndrome, which results from child
and walking. Some also develop contractures, that abuse (Trovato & Schultz, 2013).
is, permanently shortened muscles that reduce TBI, a specific category of disability defined
their range of motion and ability to move limbs in IDEA (2004, 34 C.F.R. §300.8[c][12]), is “an ac-
fully. B ecause of limited range of motion and ab- quired injury to the brain caused by an external
normal movement patterns, students with visual physical force, resulting in total or partial func-
impairments and cerebral palsy may have diffi- tional disability or psychosocial impairment, or
culty moving their heads or eyes (or both) to track both, that adversely affects a child’s educational
across their midline and scan the environment. performance . . . resulting in impairments in one
These students also have difficulty with ex- or more areas, such as cognition; language; mem-
pressive and nonverbal forms of communication ory; attention; reasoning; abstract thinking; judg-
that are exacerbated when they also are blind or ment; problem-solving; sensory, perceptual, and
have low vision. Some who retain primitive re- motor abilities; psychosocial behavior; physical
flexes have difficulty with the muscles that control functions; information processing; and speech.”
the mouth; as a result, they may be unable to de- The nature and extent of impairments de-
velop speech or have difficulty articulating their pend on the specific part of the brain that was
words and slur them. The combination of lack of injured, the type of force that caused the injury,
vision and the inability to move facial muscles and the severity of the injury (Trovato & Schultz,
and maintain eye contact causes problems with 2013). Impact forces, when the head strikes a sur-
social interactions as well as communication. face or is struck by a moving object, result in scalp
In the area of daily living skills, some stu- injuries, skull fractures, bruises to the brain (con-
dents with visual impairments and ce re
bral tusions), or collections of blood beneath the
palsy with severe motor involvement have g reat skull (epidural hematomas). Inertial forces, when
difficulty dressing, toileting, feeding themselves, the brain undergoes violent motion inside the
taking care of their personal hygiene, and groom- skull and tears the nerve fibers and blood vessels,
ing. Visual impairment, combined with poor result in injuries that range from mild concus-
motor coordination and range of motion, and sions to more severe injuries, such as subdural
difficulty with balance and fine motor control all hematomas (blood clots that form beneath the
adversely affect a student’s ability to become in duramater, the hard, outer membrane covering
dependent (Heller et al., 2009). the brain and spinal cord) and diffuse injuries to
axons (nerve fibers). Most brain injuries are the rapidly during the first few months; then signifi-
result of both impact and inertial forces. See Tro- cant improvements continue during the first year.
vator and Schultz (2013) and Heller et al. (2009) This progress becomes slower, and a gradual re-
for more detailed descriptions of the specific covery of deficits may occur up to five years fol-
types of brain injuries. lowing the injury. C hildren who sustain a TBI at a
TBI may cause several types of visual impair- younger age are likely to have impairments across
ments that can affect a student’s visual acuity or all areas and may have difficulty attaining new
visual fields, and the severity can range from developmental milestones beyond those they
mild visual impairment to total blindness (Bodack, achieved prior to the trauma (Chapman, 2007;
2010). Two common visual impairments are dip- Crowe, Catroppa, Babl, Rosenfeld, & Anderson,
lopia (double vision), caused by eye-muscle palsy, 2012; Trovato & Schultz, 2013). The brains of young
and nystagmus (rapid, involuntary movement of children are more plastic and can take on new
the eyeballs), caused by injury to the cerebellum. functions after a trauma, making it possible for
Two less common injuries that affect the eyes are children to recover skills that might not be re-
a crush injury (from a blow by a blunt object) and learned by adults after head trauma. This section
a missile injury (from a gunshot), both of which describes specific difficulties that may occur in
sever a portion of the visual pathway and cause students’ cognitive, communication, motor, and
irreversible damage. Severe brain swelling caused behavioral areas of functioning.
by a TBI can result in cortical blindness that may Students with visual impairments and TBI
go away fully or partially over time (Trovato & usually have cognitive impairments that result in
Schultz, 2013). Since the vision of students with problems with both short-term memory, essen-
TBI may fluctuate, ongoing visual evaluations are tial for new learning, and long-term memory,
essential to help students function visually as ef- needed for retaining previously learned material.
ficiently as possible. They also have difficulty returning to a specific
Students with visual impairments and TBI task a fter a pause or interruption and become
may also have a unilateral sensorineural hearing confused or misinterpret what is required of them
loss, caused by a fracture of the temporal bone or because of their inconsistent memory function.
transverse fractures of the cochlea of the ear, and Like students with learning disabilities, they may
a unilateral conductive hearing loss, caused by be easily distracted and have poor concentration.
fractures of the m iddle-ear structures (Munjal, These students also find it difficult to follow in-
Panda, & Pathak, 2010; Trovato & Schultz, 2013). structions and shift attention from one activity to
Therefore, hearing assessments are important so another and to organize and process information
the student can obtain amplification, if necessary. (and therefore have problems with summarizing,
sequencing, outlining, and prob lem solving)
(Dikmen et al., 2009; Rosen, 1998).
Impact on Learning
Students with visual impairments and TBI
C may have speech and language impairments that
and TBI can have myriad difficulties that have accompany cognitive impairments following
an impact on their learning. Depending on the their injuries that cause a slower rate of speech,
nature and the severity of the TBI, some of t hese dysarthria (slurred speech), and aphasia (impair-
difficulties may be minimal or last for a short ment of receptive or expressive language). They
period, while o thers may be significant and last have difficulty naming t hings, retrieving words,
indefinitely. Recovery from TBI usually occurs abstracting, distinguishing relevant from less
relevant information, and organizing ideas ex- brain, or the optic radiations (the visual pathways
pressively. In addition, when required to read and from the eyes that lead to it), whether experienced
write information, they tend to respond at a slower prenatally, perinatally, or later in life. Some defini-
rate and need extra time beyond that of students tions refer to it more broadly as cerebral visual im-
with only visual impairments (Heller et al., 2009; pairment, and include visual/perceptual centers
Rosen, 1998). and parts of the brain that are not necessarily re-
In the area of motor functioning, these stu- lated to the eye (Lueck & Dutton, 2015). CVI is the
dents may have some of the same motor impair- leading cause among children of visual impair-
ments as those with ce re
bral palsy discussed ment in the United States today, and can occur
previously. These include abnormal muscle tone, congenitally or as the result of acquired damage to
reduced motor speed, and loss of motor coordi- the brain (Roman-Lantzy, 2007). (See Chapter 3
nation (Rosen, 1998). They may also exhibit be- for additional details about CVI.) Children with
havioral challenges, such as hyperactivity or congenital CVI may also have developmental and
hypoactivity, inattention, emotional swings (for physical-motor disabilities associated with prema-
example, laughing or crying inappropriately), ag- ture birth or neurological disorders (Dutton, 2013;
gression (for instance, hitting or talking out of Roman et al., 2008; Roman-Lantzy, 2007).
turn), and a lower tolerance for stress and frustra-
tion. Some may overreact; become restless, irrita-
Characteristics
ble, and destructive; have temper tantrums; and
lack goal-directed behavior. Others may become Individuals with CVI have a range of visual acu-
withdrawn and apathetic and be poorly motivated. ities and peripheral visual fields, often with typi-
Frequently, these students are unaware of their cal ocular appearance. According to Roman-Lantzy
inappropriate behaviors, have poor relationships (2007), CVI is suspected “when the child has (1) a
with their peers, and lack the internal feedback to normal or near normal eye exam that cannot ex-
correct their behavior (Trovato & Schultz, 2013). plain the child’s impaired vision; (2) a history or
Due to the unexpected nature of an injury presence of neurological problems; and (3) the
causing visual impairment and possible addi- presence of behavioral responses to visual stim-
tional neurological damage, specific supports uli that are unique to CVI.” The stereotypical
are essential for families of c hildren who have behavioral characteristics associated with CVI,
traumatic brain injury. F amily resources include as outlined by Roman-L antzy (2007), are the
national associations such as the Brain Injury As- following:
sociation of America, and a wealth of online and
in-person communities and support groups offer- • Strong color preference, especially for red or
ing shared perspectives and information to ad- yellow
dress a range of topics from grief and feelings of
• Need for movement to elicit or sustain visual
guilt, to medical and educational approaches and
attention; either the viewer or the object
interventions (Brain Injury Association of Amer
viewed needs to be moving to maximize the
ica, n.d.; Brain Injury Resource Center, n.d.).
viewer’s ability to view the object
• Visual latency—delayed responses in looking
at objects
CORT CAL V S A MPA RMENT
• Visual field preferences— t he presence of
Cortical visual impairment (CVI) is a condition u nusual field locations in addition to loss of
resulting from damage to the visual cortex of the visual field
• Difficulties with visual complexity—difficulty perience with controlled interventions and

when an object itself presents a complex visual adapted materials, the child w ill begin to dis-
display, when an object is viewed within an play visual attention in more functional applica-
environment that presents a complex display, tions (Roman-L antzy, 2007).
or when an object is viewed at the same time A child with CVI in Phase II may be able to
that other sensory input is competing for the fixate on a wider range of objects and colors, re-
viewer’s attention and ability to manage sen- gard familiar faces without a matching audio
sory stimuli component, and fixate on targets presented at an
• Light-gazing and nonpurposeful gaze increased distance (up to 4–6 feet). In this mod-
erate range of CVI, the child still experiences vi-
• Difficulty with distance viewing
sual latency and relies on movement to some
• Absent or atypical visual reflexes—t he reflex to degree in attending. At this point, the visual re-
blink in response to an approaching object is flexes to blink have been achieved, and the child
impaired is able to attend with a decreased level of adapta-
• Difficulty with visual novelty—a preference for tion. As a child reaches Phase III, she is able to
viewing familiar objects is shown locate two-dimensional targets in arrays and back-
grounds of increased complexity with reduced
• Absence of visually guided reach—t he ability
latency and reliance of movement. In addition,
to look at and touch an object at the same time
at this stage the child’s peripheral vision is less
is not displayed, and t hese two actions are per-
restricted, and the amount of time needed to be-
formed separately
come familiar with a novel item is reduced
(Roman-L antzy, 2007).
Display of each of these characteristics varies According to Dutton (2013), children with
from individual to individual, and improvement CVI also typically experience difficulty with con-
in visual functioning can usually be achieved to trast perception and visual memory, and they may
some degree by structured interventions. Roman- have a low threshold for visual fatigue. For some
Lantzy (2007) characterizes the range in severity individuals, vision “may be intermittent on an
of the visual impairment and specific display of hourly or even a day to day basis” (Dutton, 2014).
these visual behaviors into Phases I, II, or III, with Dutton (2014; Lueck & Dutton, 2015) notes
Phase I being the most severe. Children with CVI marked differences in the deficits resulting from
are likely to improve their visual functioning damage to the dorsal stream (affecting visual com-
through targeted interventions that “resolve” t hese plexity and the use of vision to assist in movement)
characteristic visual behaviors in each phase. and damage to the ventral and ventro-dorsal
Children with CVI on the more severe side streams (visual recognition of people or objects
of the spectrum (Phase I) exhibit minimal func- and recognition of visual cues in mobility).
tional vision across these behavioral categories.
They do not fixate or attend to objects or faces,
and may have prolonged visual latency, have a
Effects on Learning
singular color preference, and exhibit constant at- The impact of cortical visual impairment on
tention to lights or ceiling fans. They tend only to learning depends on the severity of visual impair-
respond visually to preferred, familiar objects ment as identified in the three phases, as well as
presented in movement or with reflective surfaces the presence of additional disabilities, including
and within highly structured environments. As ocular visual impairments and cognitive, phys-
t hese visual behaviors are resolved through ex- ical, and sensory disabilities. It is difficult for
professionals to measure visual acuity because a severe orthopedic impairment that adversely
of the presence of multiple disabilities and sub- affect a child’s educational performance [and]
tle displays of visual behavioral characteristics includes impairments caused by a congenital
associated with CVI; however, Roman- Lantzy anomaly (e.g., clubfoot, absence of some mem-
(2007) and Lueck and Dutton (2015) offer a vari- ber), impairments caused by disease (e.g., polio-
ety of ways of assessing c hildren with CVI. In ad- myelitis, bone tuberculosis), and impairments
dition, as Roman et al. (2008) stated, “Milder from other c auses (e.g., cerebral palsy, ampu-
forms of CVI are often not detected because tations, and fractures and burns that cause
visual difficulty is attributed to such factors as contractures).
communication- language or motor delays.” Vi-
sual functioning in c hildren with CVI is depen- Other health impairments include physical con-
dent on the specific visual environment in which ditions that affect educational performance, in-
the child is learning, the level of adaptations made cluding “limited strength, vitality, or alertness . . .
to materials, and the specific manner in which due to chronic health problems” such as heart
materials are presented (Roman-Lantzy, 2007). conditions, tuberculosis, rheumatic fever, nephri-
In general, damage to the visual pathways tis, asthma, sickle-cell anemia, hemophilia, or
and processing centers of the brain results in sig- diabetes (IDEA, 2004, 34 C.F.R. § 300.8[c][9]).
nificant deficits in accessing information, visually
guided movement, and social interaction (Dut-
Juvenile Rheumatoid Arthritis
ton, 2014; Lueck & Dutton, 2015). C hildren with
CVI across the spectrum of severity may appear Juvenile rheumatoid arthritis refers to chronic in-
to have a variety of strong visual skills in certain flammation of the joints that affects children
applications and significant gaps or deficits in and youths under age 22. Sometimes called Still’s
other areas or routines. For example, a child with disease, it is characterized by inflammation of the
CVI may have the ability to navigate a familiar joints, pain when joints are moved, stiffness a fter
environment easily, and may turn corners and immobility, limitations in the motion of joints,
walk around obstacles; however, the same child and sometimes fever (Heller et al., 2009). The se-
may not appear to localize an object directly in verity of the symptoms can vary greatly from one
front of her on a table if it is not familiar (Roman- time of the day to another, from day to day, and
Lantzy, 2007). from month to month. Some students with JRA
develop iritis (inflammation of the iris) that
c auses photobia (hypersensitivity to light) and
V SUA MPA RMENTS AND blurred vision (Rosen, 1998); in some cases, in-
ORTHOPEDIC AND HEA TH dividuals with the condition lose all vision. It is
IMPAIRMENTS important for t hese students to use nonglare ma-
terials and to be positioned so that they do not
Several orthopedic and health impairments are face bright light.
associated with visual impairments. They include Although no cognitive impairments are asso-
juvenile rheumatoid arthritis (JRA), sickle-cell ane- ciated with JRA, the academic performance of
mia, acquired immunodeficiency syndrome (AIDS), students with JRA may vary, depending on the
and Type I (juvenile-onset) diabetes. amount of pain and discomfort they feel. Some-
IDEA (2004, 34 C.F.R. §300.8[c][8]) defined times students with visual impairments may
orthopedic disabilities and health impairments need extended keys for computers or braillewrit-
to include the following: ers to reduce the pressure in the fi ngers.
Sickle-Cell Anemia Type I, or Juvenile-Onset, Diabetes

Sickle-
cell anemia is an inherited disorder Type I diabetes usually develops between the ages
whereby red blood cells, instead of being round, of 10 and 16. The pancreas stops producing insu-
have pinched-in sides and are s haped like sickles, lin or sufficient insulin, and injections of insulin
resulting in their inability to flow smoothly are necessary to prevent unused sugar from build-
through blood vessels. The walls of these red cells ing up in the blood. Monitoring blood sugar is
rupture, destroying the blood cells. This reduc- critical to prevent diabetic emergencies and re-
tion in blood cells and their reduced ability to duce some long-term effects that include blind-
carry oxygen cause students to be chronically ness, kidney failure, and poor circulation. Students
anemic, which retards their growth and leads to with Type I diabetes sometimes develop diabetic
other developmental disorders (Rosen, 1998). retinopathy in their teens and early 20s, character-
Some students with this disorder who also have ized by scotomas (patches of vision loss in the vi-
had an injury to the brain may have damage to sual field where the retina has been damaged by
the optic nerve or cortex. They may have central the disease) (Rosen, 1998); the associated vision
vision or peripheral vision losses that require the losses become worse over time, leading to total
assistance of trained teachers of students with vi- blindness. Students who have vision losses fre-
sual impairments. quently need adaptive devices to monitor their
sugar levels and administer their insulin injec-
tions. (See Rosen, 1998, and Heller et al., 2009, for
Acquired Immunodeficiency more detailed information on these conditions
Syndrome that are associated with visual impairments.)
AIDS is the final stage in the progression of the
human immunodeficiency virus (HIV), which
weakens the body’s immune system and gradu- VISUAL AND AUD ORY
ally infects and destroys important cells that pro- IMPAIRMEN S
tect the body from disease. HIV infection in (DEA BLINDNESS)
infants frequently occurs either prenatally or dur-

ing birth and sometimes through breast-feeding. Definition
Children with HIV may develop opportunistic The federal definition of deafblindness is “concom-
infections (those that usually do not affect the itant hearing and vision impairments, the combi-
general population) that damage both the im- nation of which c auses such severe communication
mune system and the central ner vous system. and other developmental and educational needs
Some of these infections cause the loss of cogni- that they cannot be accommodated in special ed-
tive abilities, seizures, and visual impairments ucation programs solely for children with deaf-
(Heller et al., 2009). ness or c hildren with blindness” (IDEA, 2004,
Some c hildren with AIDS develop cytomeg- 34 C.F.R. § 300.8[c][2]).
alovirus, which damages the retina and results in
severe visual impairment and blindness. O thers
develop severe infections of the central nervous
Prevalence and Characteristics
system, such as toxoplasmosis and cryptococcal- The National Child Count of C hildren and
meningitis, that damage the optic nerve and re- Youth Who Are Deaf-Blind, compiled yearly by
sult in diplopia or difficulty in moving the eyes deafblind projects in each of the states, is col-
(Jabs, 2008; Rosen, 1998). lected for c hildren with the single disability of
deafblindness as well as for c hildren with deaf- ment or early hearing impairment and later visual
blindness and additional disabilities. Ninety impairment (Prickett & Welch, 1998).
percent of the c hildren and youths on the National In addition to the combinations of visual and
Child Count have one or more additional dis- auditory impairments just described, some stu-
abilities. According to the most recent summary dents have sensory losses that are progressive or
available, the 2014 National Child Count re- fluctuate daily. Therefore, their sensory access to
ported 9,384 children and youths (National information from the environment may be irreg-
Consortium on Deaf- Blindness, 2014). This ular and unpredictable or is gradually reduced
number is considerably higher than the data re- as the student gets older (as in Usher syndrome,
ported by Westat (2012) in the 2011 Part B Special described in the next section).
Education Child Count for the federal Depart- C hildren who are deaf blind represent a

ment of Education’s Office of Special Education highly diverse, heterogeneous group of learners
Programs (OSEP), submitted by state education whose combined sensory losses are frequently ac-
agencies. Westat (2012) reported 1,587 students companied by additional physical or cognitive
(3–21 years old). The lower number reported by disabilities, complex medical needs, or behavior
Westat for OSEP is likely the result of children and challenges (Malloy & Killoran, 2007).
youths with deafblindness being reported as de-
velopmentally delayed, multiply disabled, and/or Syndromes Commonly Associated
visually impaired or hearing impaired, rather than with Deafblindness
deafblind. This serious issue has been consistent
and has resulted in either a lack of appropriate ser The eyes and the ears develop during the first 12
vices or a delay in implementing appropriate in- weeks of pregnancy, both originate from some of
tervention techniques to meet the unique needs of the same types of embryonic cells and tissue, and
young c hildren who are deafblind (Muller, 2006). they are anatomically similar in some ways
In rare instances, some children are born with (Heller & Kennedy, 1994; Regenbogen & Coscas,
significant hearing and vision losses or acquire 1985). Therefore, it is easy to understand why
both losses early. For these children, called con- some prenatal syndromes and conditions cause
genitally deafblind, visual and auditory information injury to both organs and result in deafblind-
is inaccessible, and they need to rely on their other ness. This section describes several genetic disor-
senses for gaining information about the environ- ders and syndromes that are frequently associated
ment. Most c hildren and youths who are identi- with both auditory and visual impairments.
fied as deafblind at birth, in infancy, or in early
CHARGE Syndrome
childhood have e ither some useful vision or some
useful hearing (Prickett & Welch, 1998; Silberman hildren with CHARGE syndrome are a heteroge-
C
et al., 2004). Distance sensory information is neous group who exhibit major or minor charac-
accessible to them, although it is limited and dis- teristics or both. CHARGE is a genetic condition
torted. They can acquire information from these caused by a mutation in a single gene (usually
senses (vision or hearing), as well as their other CHD7, located on the long arm of chromosome
senses of touch, smell, taste, and movement. 8). The CHARGE Syndrome Foundation describes
Other children are born with the loss of one dis- the major and minor identifying characteristics of
tance sense and lose the other distance sense later CHARGE (CHARGE Syndrome Foundation, n.d.).
in childhood a fter they have acquired basic early The major characteristics (very common in
childhood concepts. These students have either CHARGE and relatively rare in other conditions)
early visual impairment and later hearing impair- are the following:
• Coloboma: An ocular deformity involving ab- The letters in “CHARGE” originally stood for
sence of part of the eye. It is a slit or groove in some of the earliest identified features in the syn-
the iris, ciliary body, choroid, or retina that is drome, and while the letters do not fully repre-
caused by the failure of the optic cleft to close sent all the characteristics of the population, this
completely at about 6 weeks of fetal life. It can acronym is still used to classify the full range of
range from no visual impairment to a small characteristics in individuals with this condition.
eye (microphthalmia) to a missing eye (anoph-
thalmia). Coloboma of the iris may reduce a Cockayne Syndrome and Cornelia
child’s ability to adjust to bright light; colo- de Lange Syndrome
boma of the retina w ill cause blank areas in a
Cockayne syndrome is an autosomal- recessive
child’s visual field.
progressive disorder, characterized by retinitis
• Atresia of the choanae (nasal passage): A narrow- pigmentosa (RP) with optic atrophy, deafness,
ing or blockage of the passages between the dwarfism, and intellectual disability. In one form
nasal cavity and the nasopharynx (windpipe). of the syndrome, symptoms appear a fter birth,
If it is bilateral (both sides), an infant w
ill be and c hildren live only until age 5 or 6. In the
in severe respiratory distress and w ill die from second form, the symptoms develop during the
asphyxiation unless it is corrected. second year, and the syndrome progresses for
• Cranial nerve abnormality: Depending on the 20 years (Regenbogen & Coscas, 1985). In the
cranial nerve affected, (I) Missing or decreased second form, hearing is usually normal at birth,
sense of smell; (IX/X) Swallowing difficulties, but a progressive sensorineural loss develops in
aspiration; (VII) Facial palsy. both ears and results in a moderate to severe
hearing loss. Visual impairments caused by RP re-
• Ear abnormalities: Outer ear: Short, wide ear
sult in a gradual loss of vision in the peripheral
with little or no lobe, “snipped off” helix (outer
field, night blindness, and eventually total blind-
fold), prominent antihelix (inner fold) that is
ness when the person is in his or her 20s (Heller
discontinuous with tragus, triangular concha,
& Kennedy, 1994).
decreased cartilage (floppy), often sticking out,
Cornelia de Lange syndrome is a ge net ic

usually asymmetric. M iddle ear: Malformed
syndrome that results in visual impairments, in-
bones of the m iddle ear, causing conductive
cluding hyperopia (farsightedness), sensorineural
hearing loss. Inner ear: Malformed cochlea,
hearing impairments, and intellectual disability.
causing hearing loss and balance problems.
Children who are born with this syndrome have
The minor characteristics of CHARGE (which are common physical appearances that include
significant, but more difficult to diagnose and excessive body hair; thick, continuous eyebrows;
less specific to CHARGE) include the following: and possibly cleft palates.
• Heart defects (defects in the heart present from Usher Syndrome

birth, including ventricular septal defects, pat- Usher syndrome, a hereditary condition, is the
ent ductusarteriosus, and bicuspid aortic valve) leading cause of deafblindness in adults. It is
• Cleft lip and/or cleft palate autosomal recessive and consists of a combined
congenital hearing loss and slowly progressive
• Kidney abnormalities
RP. In Type 1, c hildren are born profoundly deaf
• Growth deficiency and develop RP usually in adolescence or early
• Genital abnormalities adulthood. In Type 2, c hildren are born with a
T A B L E 7 . 2
Frequently Found Impairments of STORCH Congenital Infections
Syphilis Toxoplasmosis Rubella CMV Herpes
Eye/vision impairments X X X X X
Ear/auditory impairments X X X X X
Anemia X X X X X
Brain calcifications X X
Bone abnormalities X
Congenital heart defects X
Encephalitis X X X X X
Hydrocephalus X X X X
Jaundice X X X X X
Liver/spleen enlarged X X X X X
Low birth weight X X X X X
Low platelet count X X X X X
Microcephaly X X X X X
Pneumonia X X X
Seizures X X X X X
Skin rash X X X X X
Source: Reprinted, with permission, from Heller, K. W., & Kennedy, C. (1994). Etiologies and characteristics of deaf-blindness.
Monmouth, OR: Teaching Research.
moderate hearing loss and develop RP usually in nancy, they are likely to cause visual impairments,
adolescence or in early adulthood. The loss of vi- auditory impairments, or both as well as other
sion begins with night blindness and progresses anomalies. The effects of STORCH infections vary
to tunnel vision and sometimes to total blindness according to the area of the brain affected and the
in adulthood (Heller & Kennedy, 1994; Mar, extent of infection. Children may have visual
1991–1992; Musarella & MacDonald, 2010). impairment, hearing impairment, cognitive and
motor disabilities, or combinations of t hese con-
Intrauterine Infections—STORCH ditions. (See Table 7.2 for frequently found im-
Intrauterine infections that are passed from the pairments of STORCH congenital infections.)
mother to the embryo via the placenta may cause
Congenital Rubella Syndrome
fetal malformations. A group of the most prevalent
infections are referred to by the mnemonic acro- Congenital rubella syndrome (CRS), a STORCH in-
nym “STORCH”—syphilis (S), toxoplasmosis (T), fection, is described in detail h
ere, since at one
varicella and other congenital infections (O), ru- time it was the most common viral cause of
bella (R), cytomegalovirus (C), and herpes simplex birth defects in infants whose m others had the
virus (H). If t hese infections occur early in a preg- rubella virus during their first three months of
pregnancy. Infants who are born with CRS are sensory information, concept development, O&M,
most likely to have visual and auditory impair- and core and expanded core curriculum areas. In
ments and other multiple disabilities. Since the the area of attachment, the lack of vision and hear-
development of the rubella vaccine, which is ing impedes the development of interactive dia-
typically given to virtually all infants aged 12– logues that occur between an infant or young child
15 months, the incidence of maternal rubella and his or her parents. The infant who is congeni-
has decreased substantially. Fewer than 100 tally deafblind is unable to have face-to-face eye
cases occur annually in the United States (Miller contact, respond to facial expressions or tones of
et al., 1994). According to the Centers for Dis- other’s voices, and has difficulties in establishing
ease Control and Prevention (n.d.), CRS has joint attention and regulation of arousal patterns.
been eliminated by vaccination in the United These restrictions affect development of trust, se-
States as of 2004. It is important to note that in- curity, and social relationships with the outside
fants with this syndrome can transmit the virus world (Janssen, Riksen-Walraven, & Van Dijk,
up to age 2; therefore, nonimmunized women 2003; Nelson, Van Dijk, Oster, & McDonnell,
who are health care workers and become preg- 2009; Prickett & Welch, 1998; Silberman
nant are at g reat risk of contracting rubella. et al., 2004). (To watch a related video, log
The types of visual impairments in c hildren in to the AFB Learning Center.)
with CRS include cataracts; keratoconus; pigmen- In the area of motor skills, the lack of vision
tary retinopathy; and sometimes secondary and hearing prevent an infant or young child
glaucoma, micro-ophthalmia, strabismus, and from exploring and moving toward objects or in
optic nerve atrophy. In addition to visual impair- teresting sounds. Experiences are limited to only
ments, some c hildren with CRS whose mothers what is within reach. Reduced movement and ex-
contracted the virus during the first trimester may ploration in the environment also impact the de-
have sensorineural hearing losses in both ears, velopment of communication skills. A child who
from mild hearing impairment to profound deaf- is deafblind will have fewer opportunities to use
ness, and mild conductive losses. Other defects actions with people and objects as well as associ-
that c hildren with CRS have include cardiac ate concrete experiences during daily routines
defects; intellectual disabilities; movement prob with symbols, words, and concepts (Bruce, 2005;
lems; balance difficulties caused by vestibular Miles & Riggio, 1999). In addition, they have fewer
involvement; excessive be haviors, such as self- communication partners, resulting in fewer op-
injury, aggression, sensory stimulation, and emo- portunities for social interaction. B ecause of lim-
tional difficulties; specific learning problems; and ited or no access to both distance senses, children
delayed-onset problems, such as diabetes (Heller who are deafblind obtain incomplete, inaccurate,
& Kennedy, 1994; Mar, 1991–1992). (See Heller & and distorted concepts about the world, more so
Kennedy, 1994, for a detailed description of syn- than children who lack either vision or hearing.
dromes and disorders that result in combined vi- They are unable to anticipate transitions in their
sual and auditory impairments.) environment (Miles & Riggio, 1999). The combined
sensory losses also cause delays in concept devel-
Impact on Development opment, particularly in acquiring object concepts
and categorization skills.
and Learning In the area of O&M, these students are unable
The combined losses of vision and hearing severely to use auditory cues that assist t hose with only
affect numerous areas of learning, including at- visual impairments to move from one location to
tachment, motor skills, communication, access to another or to locate a person or object. Without
visual and auditory cues, they are unable to use are deaf and may be hired as an “educational in-
modeling and imitation to interact socially with terpreter,” an “interpreter-tutor,” or an “interpreter-
their families and peers. In addition, t hese teaching aide” (Prickett & Welch, 1995; McCann,
combined disabilities significantly hamper their 2013; Morgan & Ci, 2001).
abilities to acquire core academic skills in written Interpreters who work with individuals who
language and specific content areas, such as are deafblind undertake specialized training to ef-
mathematics and science, and in all the expanded fectively accommodate low vision and blindness.
core content areas (in addition to social interac- The interpreter provides both auditory and visual
tion and O&M, already mentioned). information, modifies the signing space and dis-
Children and youths with deafblindness and tance from the deafblind student, and may in
additional disabilities are susceptible to abnor- corporate subtle grammatical markers ordinarily
mally high levels of stress, resulting in self-abusive, visible on the face into signing received tactilely.
challenging, or aggressive behaviors (Janssen The most recent working definition of inter-
et al., 2003). They often develop these behaviors veners (NCDB, 2013b) incorporates feedback from
owing to frustration because their unconventional a variety of sources, as the role of interveners con-
communication attempts are often missed or mis- tinues to become more prominent in educa-
interpreted. Without structured interventions by tional settings:
trained support personnel, these children are
likely to increase their severely challenging behav Interveners, through the provision of inter-
iors and incur physical illness (Hartshorne & vener serv ices, provide access to information
Cypher, 2004; Janssen, Schuengek, & Stolk, 2002; and communication and facilitate the develop-
Nelson, Greenfield, Hyte, & Shaffer, 2013). ment of social and emotional well-being for
c hildren who are deaf-blind. In educational en-
vironments, intervener services are provided by
Support Personnel an individual, typically a paraeducator, who has
Students with deafblindness need assistance received specialized training in deaf-blindness
from others to enable them to participate effec- and the process of intervention. An intervener
tively with their teachers, peers, and other people provides consistent one- to-
one support to a
in school and the community. Since both audi- student who is deaf-blind (age 3 through 21)
tory information and visual information are to- throughout the instructional day.
tally or mostly inaccessible to them, they require
specialized serv ices from an interpreter or an An intervener works as a member of the collab-
intervener (Alsop, Blaha, & Kloos, 2000; Chen, orative team, u
nder the supervision of the spe-
Alsop, & Mionor, 2000; Correa-Torres, 2008; cial education or classroom teacher (NCDB,
Prickett & Welch, 1998). 2013b).
An interpreter for a student who is deafblind
has an additional role besides conveying auditory V SUAL MPA RMENTS AND
and visual information. He or she also may serve
as a sighted guide to help the student move from
EMO IONAL AND BEHAVIOR
class to class and may present visual information, DISORDERS
such as material on a chalkboard or a printed
handout, to the student (Prickett & Welch, 1998).
Characteristics
Such an individual may have fewer formal qual- hildren and youths with visual impairments
C
ifications than an interpreter for individuals who may have various types of emotional and be
hav ior disorders that interfere with their should not be misconstrued as an inattentive-
educational functioning. Many are served in ness problem. A student with a visual impair-
programs for students with visual impairment may exhibit hyperactivity (does not stay in
ments, with and without the necessary support his or her seat without constant reminders or
personnel who are qualified to work with stu- jumps up when he or she hears a loud, unfamil-
dents with behavioral disorders. The term used iar sound). T hese disruptive behaviors may be a
in IDEA (2004) for emotional and be havior result of missing visual cues, such as modeling
disorders is emotional disturbance. It is defined and imitation, rather than of severe emotional
as a condition exhibiting one or more of the problems (Mar & Cohen, 1998; Nelson, Green-
following characteristics over a long period of field, Hyte, & Shaffer, 2013; Van Hasselt, 1987).
time and to a marked degree, which adversely Some students with visual impairments have
affects educational performance (IDEA, 2004, such severe emotional and behavior difficulties
34 C.F.R. § 300.8[c][4][i]): that they are unable to attend or relate socially to
others and therefore cannot participate in any

• An inability to learn which cannot be explained structured activities or daily routines in school.
by intellectual, sensory, and health factors These students are described as having a pervasive
• An inability to build or maintain satisfactory developmental disorder, and some are diagnosed
interpersonal relationships with peers and as having autism or autistic-like behaviors. The
teachers characteristics of these conditions include the in-
ability to respond when addressed by name, the
• Inappropriate types of behavior or feelings
failure to respond to an interaction initiated by a
under normal circumstances
teacher or peer, lack of interest in activities that are
• A general pervasive mood of unhappiness or popular with other students, and the persistent re-
depression fusal to be in close proximity or physical contact
• A tendency to develop physical symptoms with others.
or fears associated with personal or school
problems
Effects on Learning
The term includes c hildren who are schizo- Teachers of students with visual impairments
phrenic. The term does not apply to children may observe various types of emotional and
who are socially maladjusted u nless it is deter- behavioral problems in their students that will
mined that they have an emotional disturbance have an impact on the students’ learning. When
(IDEA, 2004, 34 C.F.R. § 300.8[c][4][ii]). t hese behaviors become relentless, they prevent
It is important to identify behavioral prob students from acquiring knowledge and skills
lems and their c auses accurately in students with and from participating in structured activities,
visual impairments. For example, a teacher may such as cooperative groups. T hese problems
label a specific student inattentive b ecause the include self-stimulatory behaviors; hyperactivity,
student is not paying any attention to visual cues inattention, and impulsivity; disruptive behav
of an activity. Since students who are blind or iors, including acting-out and oppositional be
who have low vision may not orient visually or haviors; social interaction problems; behaviors
maintain eye contact with objects or individuals, that threaten the safety of a student or peers;
they may become distracted easily when the vi- and problems of mood, affect, and emotional
sual information has no meaning or is unrelated adjustment (Mar & Cohen, 1998). Some behav
to their concrete experiences. This be havior iors, such as hand flapping or waving fingers in
front of the eyes, may interfere with both at- V SUA MPA RMENTS AND
tending to a task and interacting with peers. AUTISM SPEC RUM DISORDERS
Students with visual impairments may dem-
onstrate variations in be haviors that may or
may not be associated with emotional difficulty
during daily routines in the classroom in infi- Some children with blindness and visual impair-
nite ways. There may be g reat variability in the ment also may have autism spectrum disorder. IDEA
frequency, duration, or intensity of these diffi- defines autism as “a developmental disability sig-
culties, as well as in the academic and social con- nificantly affecting verbal and nonverbal commu-
sequences to the student and his or her nication and social interaction, generally evident
classmates (Mar & Cohen, 1998). In addition, a before age three, that adversely affects a child’s ed-
teacher may observe different behaviors in the ucational per for
mance. Other characteristics
class from those observed by a clinician in an often associated with autism are engagement in
isolated setting. T hese students frequently ex- repetitive activities and stereotyped movements,
hibit self-stimulatory or stereot ypical behaviors resistance to environmental change or change
that interfere with attending to and staying on in daily routines, and unusual responses to
tasks. In the past, some p eople used the term sensory experiences” (IDEA, 2004, 34 C.F.R.
blindisms; however, this term is considered by § 300.8[c][1][i]).
many people to be inappropriate since t hese be Many of the behavioral characteristics that
haviors are not unique to this population (Free- typically are associated with autism spectrum
man et al., 1989; Mar & Cohen, 1998; Warren, disorder may also be observed in c hildren
1994). Some examples include eye pressing or who have congenital visual impairments and
flicking fingers in front of the eyes near fluo blindness, including deficits in achieving de-
rescent lights; body swaying, rocking, or twirl- velopmental milestones in the areas of lan-
ing; and head nodding. These may occur as a guage or communication and social interaction
result of missing visual cues such as modeling. (Gense & Gense, 2005; Pawletko, Chokron, &
Others include twisting or pulling hair and re- Dutton, 2015). C hildren with congenital blind-
peatedly manipulating objects (such as tapping ness may also exhibit repetitive and ste reo
or hitting an object or hand on oneself). One ex- typed movements such as rocking, spinning,
planation of why students with visual impair- and handflapping, as a result of sensory defi-
ments exhibit t hese behaviors is that they e ither cits. B ecause of overlapping behavioral charac-
increase or decrease the general level of stimula- teristics, it is impor t ant to carefully assess
tion (Freeman et al., 1989). c hildren with visual impairments who also

Some students with visual impairments ex- may have autism spectrum disorder. Table 7.3
perience fluctuations in their visual functioning prese nts a detailed comparison of development
from day to day, and some gradually lose their vi- among c hildren who are sighted and typically
sion. These changes may cause a variety of severe developing, blind or visually impaired, and
emotional reactions and consequent behaviors. blind or visually impaired with an autism spec-
These students can become depressed, fearful, or trum disorder.
angry and exhibit noncompliant behaviors, such Children who are diagnosed with autism

as angry outbursts, refusal to participate in a spectrum disorder must have characteristics in
learning activity, and exaggerated responses. four areas: sensory difficulties; restricted, repet-
They may need specific individual counseling or itive, and stereotyped patterns of behavior, in-
therapy (Mar & Cohen, 1998). terests, and activities; impairments in social
TA B L E 7 . 3
Comparison of Development among C hildren Who Are Sighted and
Typically Developing, Blind or Visually Impaired, and Blind or Visually
Impaired with an Autism Spectrum Disorder (ASDVI)
Typical Development Blind or Visually Impaired ASDVI
Communication Behaviors
Makes cooing and gurgling The process of acquiring Language develops slowly or
sounds (3–6 months) speech and language appears not at all
Copies speech sounds to be the same for visually Development is frequently
(6–12 months) impaired c hildren as it is for “splintered”; language
typical c hildren, but slower development may or may
physical development, a not be consistent with
more restricted range of developmental norms or
experiences, and the lack of sequences
visual stimulation may
cause a child’s language May show no interest in
development to be slower communicating
(Scholl, 1986)
Uses much jargon Speech is echolalic but for a Exhibits concrete

(unintelligible speech) short duration understanding and use of
with emotional content Language may be delayed if language; has difficulty with
Is able to follow simple experiences are limited, but is generalizations
commands (18 months) not distorted Echolalic; often has difficulty
Has a vocabulary of 150–300 Responds appropriately to breaking this pattern.
words (24 months) language requests; enjoys The echolalia often leads
communication “give and to patterns of verbal
take” perseveration with

idiosyncratic meanings.
Has difficulty initiating and
engaging in meaningful
conversations. The range of
“topics of interest” is narrow.
Has difficulty maintaining a
topic chosen by others;
exhibits limited or no
conversational reciprocity
Understands most simple Vocabulary is built through Uses words without attaching
questions dealing with his concrete experiences the usual meanings to them
or her own environment and Can experience difficulty with Uses nonconventional or
activities (36 months) abstract language b ecause of nontraditional behaviors
Relates experiences so that limited concrete experiences (such as gestures, pulling) as
they can be followed with a form of communication
reason
237

May briefly exhibit pronoun May reverse pronouns, but Has long-term difficulty using
reversals such reversals are brief in pronouns appropriately
Takes part in s imple duration
conversations (2–3 years) Difficulties with concepts are
common because of the lack
of a visual model; once
understood, concepts can
be generalized
Language development
usually follows developmental
norms
Follows a logical pattern of Language development is Has apparent lack of common

concept development from based on concrete, sense; may be overly active or
the concrete to the abstract “hands-on” experiences passive
Has difficulty with abstract
concepts and often focuses
on “irrelevant” information;
has a literal translation of
language; a literal or concrete
understanding of concepts
makes generalizations difficult
Develops language from Learns language from an early If verbal, may converse
experience and interaction age; adjusts the topic of but focus on a topic of
with the environment; can conversation perseverative interest
adjust the topic of interest
Had difficulty with abstract Has difficulty generalizing

from an early age concepts for which there is information, even with
limited “hands-on” experience; instruction
develops a broader
understanding based on
experiences; is able to
generalize information with
instruction
Social Interactions
Responds to his or her Responds to his or name; Appears not to hear; does not
name (6–9 months) responses are more defined orient toward sound
when paired with tactile
contact
Needs to learn that a world
exists beyond reach; may
exhibit social interest through
changing or shifting posture
(leaning or turning)
238
TA B L E 7 .3
Takes turns while playing with Engages in social give-and- Has limited, if any, social
an adult (for example, using take; seeks to share interests
actions, sounds, or facial information or experiences Has a limited understanding
expressions) (6–12 months) with others of social give-and-take
Makes s imple choices Play is sometimes observed Plays repetitively; often does
among toys to be less “imaginative” and not use toys for their intended
Mimics another child’s play more concrete because of purpose
(18–24 months) the lack of a visual model;
redirection of an activity is
possible
Often indulges in make- ecause of limited visual

B Does not engage in
believe (48 months) references, may have difficulty spontaneous or imaginative
in observing, organizing, and play or initiate pretend play
synthesizing the environment; Perseverative behavior is a
imitative and make-believe problem, and a redirection of
play may be delayed, but can activities may be difficult
be specifically “taught”
Requires a variety of
opportunities to learn and to
generalize; needs feedback to
understand and comprehend
some social situations
Enjoys playing with other Enjoys playing with other Prefers to spend time alone,
children (3–4 years) children rather than with o thers;
Shows social curiosity; peer relationships are often

is curious about the distorted
environment (for example, Exhibits little social curiosity;
may ask who may be in the may find interactions with
room or where a peer may be) others to be unpleasant
Is able occasionally to use Demonstrates empathy; is May treat other people as

feelings to explain reasons able to comprehend another’s objects; has a limited ability
(48 months) feelings to understand another’s
feelings
Enjoys playing organized Enjoys playing organized Is often anxious and

games with other children games with other children uncomfortable in social
(5–6 years) Has difficulty observing, situations; prefers to follow
organizing, and synthesizing routines and rituals; has
the environment; requires a difficulty adapting to change
variety of opportunities
239
Demonstrates empathy ill acknowledge emotions of
W Appears to ignore when
toward others self and others someone is hurt
Seeks out others if hurt, sick, Shows little bonding with
sad, or angry family members
Restricted, Repetitive, and Stereotyped Patterns of Behavior

Reaches for a toy (3–6 Stereotypic behaviors Plays repetitively; toys are not
months) (rocking, eye poking) may used as intended
Puts in and dumps objects occur in novel and unfamiliar May perseverate on a specific
from containers (12–18 situations; management of feature of a toy (such as
months) these behaviors can be spinning the wheel of a car) or
accomplished with redirection may engage in a repetitive
Looks at storybook pictures
into meaningful activities that action with a toy or objects
with an adult (18–24 months)
provide sensory feedback; the
The interruption of a favorite
child learns to control these
activity or of a stimulatory
behaviors when older
motor behavior (such as hand
Interests may be limited flapping or rocking from one
because of limited exposure; foot to another) is often met
demonstrates an interest in a with extreme resistance
variety of toys or objects
once they are experienced
Historically, stereotypic
behaviors have been
attributed to the lack of
stimulation of the vestibular
system. These behaviors
occur more in young children
and lessen as the children
learn to interact with the
environment
Helps with s imple tasks Interest may be limited to Has highly restricted
(2–3 years) toys, tasks, or objects that interests; has difficulty being
Follows two-step directions were previously experienced; redirected from high-interest
is able to engage in a variety toys or objects
Uses materials and toys to
of activities with adults and Exhibits an extreme interest
make t hings (3–4 years)
peers in one part of an object or
Redirection of an activity is one type of object
possible; response to changes
is easier with greater
experiences
Shifts attention from one Exhibits typical flexibility in Challenging behaviors

person, item, or activity managing changes in routine escalate when changes in
to another routine or structure are
experienced; demonstrates
inflexibility when transitioning
between activities
240
TA B L E 7 .3
Stereotypic behaviors
occur throughout life and
are difficult to break
Behaviors increase with
anxiety and with stressful
situations and can be difficult
to redirect
May perseverate on a single
item, idea, or person; may
rigidly perform a seemingly
nonfunctional routine
May engage in aggressive or
violent behavior or injure
himself or herself; may throw
frequent tantrums for no
apparent reason
Responses to Sensory Information

Turns head toward sounds Often has poor posture Has unusual reactions to
(3–6 months) because of the lack of a visual physical sensations, such as
Feeds self with spoon; drinks model; learns to orient to being overly sensitive to touch
from a cup (12–18 months) sounds with instruction or underresponsive to pain;
Interests may be restricted sight, hearing, touch, pain,
Moves body in time to m usic
because of the lack of vision; smell, and taste may be
(18–24 months)
interests expand with affected to a lesser or greater
Puts on clothing with a little degree
experiences
help (4–5 years)
Exhibits little delay in motor Unusual postures and hand
Jumps, runs, throws, and movements are common and
development until the onset
climbs using good balance
of locomotion can be difficult to redirect

(3–4 years)
Can be easily engaged Commonly perseverates
Tolerates a normal range of various sensory stimuli
touch, movement, sounds, Because of the lack of visual
stimulation, often creates Tactile defensiveness is
and smells
his or her own stimulation; common and is usually not
Attends to relevant stimuli overcome with time
can usually “redirect” the
stimulatory behavior Often appears not to hear or
Uses residual senses to gain focus
information
Attends to relevant stimuli
Source: Adapted with permission from Gense, M. H., & Gense, D. J. (1994, Summer). Identifying autism in c hildren with
blindness and visual impairments. RE:view, 26, 55–62. Copyright © 1994, Heldref Publications, Washington, DC.
241
interaction; and impairments in communication. and “has extreme difficulty changing routines.”
Each is described below with specific application Some of these behaviors may occur in children
to c hildren with visual impairments: who only have visual impairments, or visual
impairments and additional developmental
• Sensory difficulties may include avoidance of disabilities. It is the presence of impairments in
gentle physical contact, extreme or intense all four areas of behavior that confirms a diag-
preferences for specific foods, and inappropri- nosis of autism spectrum disorder.
ate or no responses to sound. Children with au-
tism spectrum disorder may exhibit apparent • Impairments in social interaction in children
insensitivity or lack of response to physical with autism spectrum disorder include deficits
pain; under-or oversensitivity to certain tex- and abnormalities in adaptive nonverbal be
tures, sounds, tastes, or smells; and negative or haviors including both recognizing and using
defensive reactions to ordinary stimuli (Boutot conventional social gestures such as waving
& Myles, 2011; Gense & Gense, 2005). Gense hello or pointing, maintaining eye contact with
and Gense (2005) reported observed behav a conversation partner, and understanding and
iors of children with visual impairments and maintaining socially appropriate body postures.
autism spectrum disorder demonstrating sen- Children with autism spectrum disorder have
sory difficulties to include “flicks her fin ger difficulties with age-appropriate and reciprocal
and eyes when in sunlight,” “tantrums when a social interactions, and often are challenged to
neighbor, three houses away, mows the lawn,” develop relationships with same- age peers
“can identify the makes and models of cars by (Boutot & Myles, 2011; Gense & Gense, 2005).
their sound of the engines,” and “is tactilely Children with visual impairments experi-
defensive; has trouble reading braille for long ence similar difficulties due to lack of inciden-
periods.” tal information to aid in social exchange, and
• Restrictive, repetitive, and stereotyped pat- the concomitant diagnosis of autism spectrum
terns of behavior, interests, and activities can disorder can exacerbate t hese difficulties.
include repetitive physical or tangible play that Gense and Gense (2005) observed the behav
is not meaningful or relevant, or fixation on iors of children with visual impairments and
one part of an object, such as repeatedly spin- autism spectrum disorder to include “has dif-
ning a lid on a box rather than playing with the ficulty working with anyone whose ideas are
contents. It can also take the form of a personal different from hers,” “has difficulty with social
interest that is abnormal e ither in intensity or judgments; w ill sit and stand too close to
focus, such as a persistent and restricted preoc- others,” “does not know her classmates’

cupation with Disney characters. C hildren with names,” and “has delayed responses to vocal
autism spectrum disorder experience delays or interactions from other c hildren.”
abnormal functioning in symbolic play, and • Impairments in communication refers to both
they may therefore have difficulty in relating to delays in achieving communication and lan-
and playing with typical peers (Boutot & Myles, guage milestones, and the persistence of ab-
2011; Gense & Gense, 2005). Be hav iors ob- normal communicative behaviors. Children
served by Gense and Gense (2005) in c hildren with autism spectrum disorder may experience
with visual impairments and autism spectrum delays in or failure to achieve jabbering or im-
disorder include “can locate obscure braille itative vocalizations, which are typically
classroom notes taken a year ago,” “walks on tip- achieved at 9–18 months. They may also de-
toes,” “constantly spins and turns in circles,” velop babbling as infants, then regression and
loss of babbling vocalizations. Children with disorder can affect the ability of a child to partici-
autism spectrum disorder may also persist in pate in small group or cooperative learning ac-
using repetitive, echolalic language beyond the tivities, and can result in isolation from peers and
typical period, and may not develop the use of unbalanced social reliance on adults (Gense &
gesturing or pointing. Depending on the sever- Gense, 2005).
ity of the disorder, they may have delayed ac-
quisition of first words and phrases, or may
remain nonverbal and prelinguistic. C hildren V SUAL MPA RMENTS AND
with autism spectrum disorder who have ver- GI TEDNESS OR ALENT
bal abilities may use idiosyncratic or repetitive
language, such as repeatedly spelling out words Definitions and Characteristics
or discussing tangential and irrelevant content.
Most states have their own conceptions and defi-
Children with congenital visual impairments
nitions of “giftedness” based on priorities and
also tend to experience significant delays in the
needs. Historically, the term giftedness has been
acquisition of linguistic and communicative
broadened to include other descriptors besides
milestones and conventional uses of nonverbal
intellectual ability. The most common elements
communication and language (Boutot & Myles,
of state definitions are “general intellectual abil-
2011; Fraiberg, 1977; Gense & Gense, 2005).
ity, specific academic aptitude, creative thinking
Behaviors of c hildren with visual impairments
ability, advanced ability in the fine arts and per-
and autism spectrum disorder, as observed by
forming arts, and leadership ability” (Hallahan
Gense and Gense (2005), include “engages in
et al., 2012). It is important to recognize that what
repeated vocal play; expresses sounds and
is considered as giftedness and how it is evaluated
words through rhythmic patterns,” “sings songs
is dependent on the values and beliefs of differ
backwards,” “becomes stuck on certain ques-
ent cultures.
tions; asks the same question repeatedly in all
The National Association for Gifted Children
environments,” and “is nonverbal; has several
(NAGC), a professional association, in 2010 cre-
‘odd’ vocalizations . . . may try to pull a person
ated a position paper on redefining giftedness for

to get something that she wants.”
a new century that has been adopted in many
states and local education agencies. Their defini-
Effects on Learning tion is as follows:
The dual diagnosis of visual impairment and au- Gifted individuals are t hose who demonstrate
tism spectrum disorder has a significant impact outstanding levels of aptitude (defined as
on the instructional strategies and curricular ac- an exceptional ability to reason and learn),
commodations required to meet a child’s educa- or competence (documented per for
mance or
tional needs. Children with visual impairments achievement in the top 10 percent or rarer) in
and autism spectrum disorder experience diffi- one or more domains. Domains may include
culties in the previously explained four areas, any structured area of activity with its own
each of which has a profound impact on the symbol system (e.g. mathematics, music, lan-
child’s ability to learn and engage in the social, guage) and/or set of sensorimotor skills (e.g.
communicative, and curricular routines in an ed- painting, dance, sports).
ucational setting. In particular, the social and
communication deficits manifest in c hildren The development of ability or talent is a life-
with visual impairments and autism spectrum long process. It can be evident in young c hildren
as exceptional performance on tests or other objects. Lawrence A. Becker (Hogg Foundation

measures of ability; a rapid rate of learning, com- for Mental Health, 1981) described a student who
pared to other students of the same age; or actual was legally blind. The boy’s early test results indi-
achievement in a domain. As individuals mature cated that he had an IQ in the 30s, and his par-
through childhood to adolescence, however, ents were advised to put him in an institution.
achievement and high levels of motivation in the His artwork was later appraised by a professor who
domain become the primary characteristics of was “thunderstruck by Richard’s precise and in-
their giftedness. Various f actors can either enhance spiring realism” (Corn, 1986). This student who
or inhibit the development and expression of was legally blind was identified as gifted (tal-
abilities (NAGC, 2010). ented); however, if the theory of multiple intelli-
Children and youths with visual impair-
gence were used, he would be identified as having
ments may have characteristics that would iden- exceptional spatial intelligence.
tify them as being gifted and talented. This group
of exceptional c hildren has superior ability or tal-
ent in certain areas of development that results
Identification
in unique educational challenges for them, their The field of gifted education has been focusing
families, and their educational programs (Davis, more attention on concerns regarding diversity
Rimm, & Siegle, 2010; Hallahan et al., 2012). and underrepresentation of key groups (Brown,
Another definition that some prac ti
tion
ers Avery, Van Tassel-Baska, Worley, & Stambaugh,
use in schools, particularly in relation to some 2006). It is difficult to identify students with vi-
students with disabilities, is the one proposed sual impairments who also would be considered
by Gardner (1993). Gardner described eight spe- gifted and talented, since some of the characteris-
cific intelligences; t hese multiple intelligences are tics of these students may mask their potential
musical, bodily- k inesthetic, linguistic, logical- gifts. Obstacles to the identification of these stu-
mathematical, spatial, interpersonal, intraper- dents include stereotypic expectations, develop-
sonal, and naturalistic. This theory moves mental delays, incomplete information about the
educators away from emphasizing limitations and students, inappropriate test instruments, and the
remediation; instead, it emphasizes finding per- lack of opportunities for students to demonstrate
sonal strengths in all individuals and finding ways superior abilities (Corn, 1986; Johnsen & Corn,
to compensate for their limitations to enhance 1989; Montgomery, 2013; Whitmore & Maker,
learning outcomes (Davis et al., 2010; Silberman 1985). For example, a student with a visual im-
et al., 1998). By applying Gardner’s theory, more pairment may have had a lack of sufficient con-
c hildren and youths with visual impairments
crete experiences, rather than a lack of cognitive
could be identified more appropriately as gifted abilities, to respond to object words on a vocabu-
and talented. lary test. This lack of prior experience would in-
Students who are blind can demonstrate su- hibit the emergence of gifts and talents. Corn
perior intelligence by using a variety of alternate (1986) noted that although it is easy to identify
strategies. For example, a student who is blind those who excel in all endeavors, for those whose
can demonstrate linguistic intelligence by ver- gifts and talents have not been identified, educa-
bally responding to taped stories or by accessing tors must provide and interpret appropriate as-
technological devices that produce voice output. sessment pro cesses to search for giftedness. In
A student with low vision and an intellectual dis- addition, some children may be overlooked in
ability could demonstrate spatial intelligence the referral process if an assessment instrument is
by acquiring concepts through three-dimensional not adapted for students with visual impairments.
For example, a checklist that includes “is visually ness or low vision that must be examined and
perceptive of the environment” and “understands addressed individually for each student.
abstract concepts” would not be a reliable indica-
tor of giftedness for students with visual impair- For learning activities related to this c hapter,
ments (Johnsen & Corn, 1989). log in to the online AFB Learning Center.
Other characteristics of t hese students that
would delay or prevent the recognition of their
giftedness are learned helplessness, problems RE ERENCES
with social interactions and communication, and
lack of attention to certain activities in their Alsop, L., Blaha, R., & Kloos, E. (2000). The intervener
in early intervention and educational settings for
environment because of their lack of vision.
children and youth with deafblindness. Monmouth,
Furthermore, a critical concern that affects the
OR: National Technical Assistance Consortium
identification of this population is the need for
for Children and Young Adults Who Are Deaf-
students with visual impairments to learn both Blind.
the general education curriculum and an ex- American Association on Intellectual and Develop-
panded core curriculum that is disability specific mental Disabilities. (2010). Intellectual disability:
(Corn, 1999) to enable them to lead independent Definition, classification, and systems of support (11th
lives and fulfill their maximum potential. The na- ed.). Washington, DC: Author.
ture of the core curriculum and the expanded American Psychiatric Association. (2013). Diagnostic
core curriculum is explored further in Chapter 9 and statistical manual of mental disorders (5th ed.).
of this volume, which also discusses the impor- Arlington, VA: Author.
tance of educational teams in work with students Batshaw, M. L., Roizen, N. J., & Lotrecchiano, G. R.
with visual impairments, including t hose with (Eds.). (2013). C hildren with disabilities (7th ed.).
Baltimore: Paul H. Brookes.
additional exceptionalities.
Beukelman, D. R., & Mirenda, P. (2013). Augmentative
and alternative communication: Supporting c hildren
SUMMARY and adults with complex communication needs (4th
ed.). Baltimore: Paul H. Brookes.

Students with visual impairments often have a Bodack, M. I. (2010). Pediatric acquired brain injury.
range of other exceptionalities in addition to their Optometry, 81, 516–527.
visual impairment. The combination of visual Boutot, E. A., & Myles, B. S. (2011). Autism spectrum
impairment with other disabilities or giftedness disorders: Foundations, characteristics, and effective
presents a unique challenge that must be met by strategies. Upper Saddle River, NJ: Prentice Hall.
a collaborative educational team that w ill work Brain Injury Association of America. (n.d.). Resources.
closely together to address all the needs of each Retrieved 2015 from http://w ww.biausa.o rg/brain
student. This chapter has presented general char- -injury- community.htm
Brain Injury Resource Center. (n.d.). F amily resources.
acteristics of students with various exceptionali-
Retrieved 2015 from http://w ww.headinjury.com
ties including intellectual disabilities, learning
/families.htm
disabilities, neurological disabilities, orthopedic
Browder, D. M., Spooner, F., & Meier, I. (2011). In-
and health impairments, deafblindness, emo- troduction. In D.M. Browder & F. Spooner (Eds.),
tional and be havior disorders, and giftedness Teaching students with moderate and severe disabil-
and talent. While an understanding of the char- ities (pp. 3–22). New York: Guilford Press.
acteristics associated with each disability is Brown, E., Avery, L., Van Tassel-Baska, J., Worley, B., &
important, it is critical to remember that it is the Stambaugh, T. (2006). A five-state analysis of gifted
combination of t hese exceptionalities with blind- education policy. Roeper Review, 29(1), 11–16.
Bruce, S. M. (2005). The impact of congenital deaf- outcome following traumatic brain injury. Journal
blindness on the strugg le to symbolism. Inter of Head Trauma Rehabilitation, 24(6), 430–438.
national Journal of Disability, Development and Dufresne, D., Dagenais, L., & Shevell, M. I. (2013).
Education, 52(3), 233–251. Spectrum of visual disorders in a population-
Centers for Disease Control and Prevention. (n.d.). based cerebral palsy cohort. Pediatric Neurology,
Chapter 15: Congenital rubella syndrome. Re- 50(4), 324–328.
trieved from http://w ww.cdc.gov/vaccines/pubs Dutton, G. N. (2013). Types of impaired vision in
/surv-manual/c hpt15-crs.html c hildren related to damage to the brain, and ap-
Chapman, S. B. (2007). Neurocognitive stall: A para- proaches towards their management. Journal of the
dox in long term recovery from pediatric brain in- South Pacific Educators in Vision Impairment, 6(1),
jury. Brain Injury Professional, 3(4), 10–13. 14–30.
CHARGE Syndrome Foundation. (n.d.). About Dutton, G. N. (2014). Ce re
bral visual impairment in
CHARGE. Retrieved from http://c hargesyndrome children: Designing strategies to help. Presentat ion
.org /about- c harge.asp at the California School for the Blind in Fremont,
Chen, D. (Ed.). (2014). Essential elements in early inter- CA.
vention: Visual impairment and multiple disabilities Engel, J. (2013). Seizures and epilepsy (2nd ed.). Oxford:
(2nd ed.). New York: AFB Press. Oxford University Press.
Chen, D., Alsop, L., & Mionor, L. (2000). Lessons from Epilepsy Foundation of America. (1998). Seizure recog-
Project PLAI in California and Utah: Implications nition and first aid. Landover, MD: Author.
for early intervention serv ices to infants who are Fraiberg, S. (1977). Insights from the blind. New York:
deaf-blind and their families. Deafblind Perspec- Basic Books.
tives, 7, 1–23. Freeman, R. D., Goetz, E., Richards, D. P., Groenveld,
Cloninger, C. J. (2004). Designing collaborative edu- M., Blockberger, S., Jan, J. E., & Skylanda, A. M.
cational serv ices. In F. P. Orelove, D. Sobsey, & (1989). Blind c hildren’s early emotional develop-
R. K. Silberman (Eds.), Educating children with mul- ment: Do we know enough to help? Child: Care,
tiple disabilities: A collaborative approach (pp. 1–29). Health, and Development, 15, 3–28.
Baltimore: Brookes Publishing Company. Friend, M., & Bursuck, W. D. (2012). Including students
Corn, A. L. (1986). Gifted students who have a visual with special needs: A practical guide for class-
handicap: Can we meet their educational needs? room teachers (6th ed.). Upper Saddle River, NJ:
Education of the Visually Handicapped, 18, 71–84. Pearson.

Corn, A. L. (1999). Gifted children with sensory Gardner, H. (1993). Multiple intelligences: The theory in
impairments. In S. Cline & D. Schwartz (Eds.), practice. New York: Basic Books.
Diverse populations of gifted children: Meeting their Gense, M. H., & Gense, D. J. (1994, Summer). Identi-
needs in the regular classroom and beyond. Upper fying autism in c hildren with blindness and vi-
Saddle River, NJ: Merrill. sual impairments. RE:view, 26, 55–62.
Correa-Torres, S. M. (2008). The nature of the social Gense, M. H., & Gense, D. J. (2005). Autism spectrum
experiences of students with deaf-blindness who disorders and visual impairment: Meeting students’
are educated in inclusive settings. Journal of Visual learning needs (p. 176). New York: AFB Press.
Impairment & Blindness, 102(5), 272. Hallahan, D. P., Kauffman, J. M., & Pullen, P.C. (2012).
Crowe, L. M., Catroppa, C., Babl, F. E., Rosenfeld, J. V., Exceptional learners: An introduction to special educa-
& Anderson, V. (2012). Timing of traumatic brain tion. Upper S addle River, NJ: Pearson.
injury in childhood and intellectual outcome. Hartshorne, T. S., & Cypher, A. (2004). Challenging
Journal of Pediatric Psychology, 37(7), 745–754. behavior in CHARGE syndrome. Mental Health
Davis, G. A., Rimm, S. B., & Siegle, D. (2010). Education of Aspects of Developmental Disabilities, 7, 41–42.
the gifted and talented (6th ed.). New York: Pearson. Hatton, D. D., Schwietz, E., Boyer, B., & Rychwalski,
Dikmen, S. S., Corrigan, J. D., Levin, H. S., Machamer, P. (2007). Babies count: The national registry for
J., Stiers, W., & Weisskopf, M. G. (2009). Cognitive c hildren with visual impairment, birth to 3 years.
Journal of the American Association of Pediatric Oph- gram to foster harmonious interactions between
thalmology and Strabismus, 11, 351–355. deaf-blind c hildren and their educators. Journal of
Heller, K. W., Alberto, P. A., Forney, P. E., & Schwartz- Visual Impairment & Blindness, 97(4), 215–229.
man, M. N. (1996). Understanding physical, sen- Johnsen, S. K., & Corn, A. L. (1989). The past, present,
sory, and health impairments. Pacific Grove, CA: and f uture of education for gifted c hildren with
Brooks/Cole. sensory and/or physical disabilities. Roeper Re-
Heller, K. W., Forney, P. E., Alberto, P. A., Best, S., & view, 12, 13–23.
Schwartzman, M. N. (2009). Understanding physi- Johnston, S. S., Reichle, J., Feeley, K. M., & Jones, E. A.
cal, health, and multiple disabilities (2nd ed.). Upper (Eds.). (2012). AAC strategies for individuals with mod-
Saddle River, NJ: Merrill/Prentice Hall. erate to severe disabilities. Baltimore: Paul H. Brookes.
Heller, K. W., & Kennedy, C. (1994). Etiologies and char- Lueck, A. H., & Dutton, G. N. (Eds.). (2015). Vision and
acteristics of deaf-blindness. Monmouth, OR: Teach- the brain: Understanding cerebral visual impairment in
ing Research. children. New York: AFB Press.
Heward, W. L. (2009). Exceptional children: An introduc- Malloy, P., & Killoran, J. (2007). C hildren who are
tion to special education (9th ed.). Upper S addle deaf-blind. Practice perspectives— Highlighting in
River, NJ: Pearson. formation on deaf-blindness. Monmouth: Western
Hogg Foundation for Mental Health. (1981). A conver- Oregon University, Teaching Research Institute,
sation with Lawrence A. Becker on the gifted- National Consortium on Deaf-Blindness.
handicapped, adapted from a radio series, “The Mar, H. H. (1991, December–1992, January). Deaf-
Human Condition,” produced by the Communi- blindness: Some causes and challenges. Califor-
cation Center of the University of Texas, Austin. nia Deaf-Blind Services reSource, 4, 1–2.
Holmes, G. L. (2002). Childhood-specific epilep- Mar, H. H., & Cohen, E. J. (1998). Educating students
sies accompanied by developmental disabilities: who have visual impairments and who exhibit
Causes and effects. In O. Devinsky & L. E. emotional and behavior problems. In S. Z. Sacks
Westbrook (Eds.), Epilepsy and developmental dis- & R. K. Silberman (Eds.), Educating students who
abilities (pp. 23–40). Woburn, MA: Butterworth- have visual impairments with other disabilities
Heinemann. (pp. 263–302). Baltimore: Paul H. Brookes.
Hoon, A. H., Jr., & Tolley, F. (2013). Cerebral palsy. In McCann, J. A. (2013). Definition of intervener serv ices
M. L. Batshaw, N. J. Roizen, & G. L. Lotrecchiano and interveners in educational settings technical
(Eds.), Children with disabilities (7th ed., pp. 423– report. Retrieved from http://nationaldb.org
450). Baltimore: Paul H. Brookes. Mikati, M.A. (2011). Seizures in childhood. In R.
Individuals with Disabilities Education Improvement Kliegman, B. Stanton, R. Behrman, J. St. Geme, &
Act (IDEA), 20 U.S.C. § 1400 (2004). N. Schor (Eds.), Nelson textbook of pediatrics (19th
Jabs, D. A. (2008). AIDS and ophthalmology. Archives ed., pp. 2013–2038). Philadelphia: Saunders.
of Ophthalmology, 126(8), 1143–1146. Miles, B., & Riggio, M. (1999). Remarkable conversations:
Janssen, C., Schuengel, C., Stolk, J. (2002). Under- A guide to developing meaningful communication with
standing challenging be hav
ior in p
eople with children and young adults who are deafblind. Water-
severe and profound intellectual disability: A town, MA: Perkins School for the Blind.
stress-attachment model. Journal of Intellectual Dis- Miller, E., Tookey, P., Morgan, C. P., Hesketh, L.,
ability Research, 46, 445–453. Brown, D., Waight, P., . . . Peckham, C. (1994).
Janssen, M. J., Riksen-Walraven, J. M., & Van Dijk, Rubella surveillance to June 1994: Third joint re-
J. P. M. (2002). Enhancing the quality of interac- port from the PHLS and the National Congenital
tion between deaf-blind c hildren and their edu- Rubella Surveillance Programme: Communicable
cators. Journal of Developmental and Physical disease report. CDR Review, 4, 146–152.
Disabilities, 14, 87–109. Montgomery, D. (2013). Gifted and talented children
Janssen, M. J., Riksen-Walraven, J. M., & Van Dijk, J. P. with special educational needs: Double exceptionality.
M. (2003). Contact: Effects of an intervention pro- New York: Routledge.
Morgan, S., & Ci, C. (2001). “What’s My Role?” A com- A collaborative approach (4th ed.). Baltimore: Paul
parison of the responsibilities of interpreters, H. Brookes.
interveners, and support serv ice providers. Deaf- Pawletko, T., Chokron, S., & Dutton, G. N. (2015).
Blind Perspectives, 9(1), 1–3. Considerations in the behavioral diagnosis of
Muller, E. (2006). Deaf-blind child counts: Issues and CVI: Issues, cautions, and potential outcomes.
challenges. Alexandria, VA: Proj e ct Forum at In A. H. Lueck & G. N. Dutton (Eds.), Vision and
NASDSE. the brain: Understanding cerebral visual impairment in
Munjal, S. K., Panda, N. K., & Pathak, A. (2010). Audio children (pp. 145–173). New York: AFB Press.
logical deficits a fter closed head injury. The Jour- Pogrund, R. L., & Fazzi, D. L. (Eds.). (2002). Early fo-
nal of Trauma, 68, 13–18. cus: Working with young blind and visually impaired
Musarella, M. A., & MacDonald, I. M. (2010). Current children and their families (2nd ed.). New York:

concepts in the treatment of retinitis pigmentosa. AFB Press.
Journal of Ophthalmology, 2011. Prickett, J. G., & Welch, T. R. (1995). Adapting envi-
National Association for Gifted Children. (2010). Rede- ronments to support the inclusion of students
fining giftedness for a new century: Shifting the para- who are deaf-blind. In N. G. Haring & L. T. Romer
digm. Position statement. Washington, DC: Author. (Eds.), Welcoming students who are deaf-blind into
National Consortium on Deaf-Blindness. (2013a).The typical classrooms: Facilitating school participation,
2012 national child count of children and youth who learning, and friendships (pp. 171–193). Baltimore:
are deafblind. Retrieved from http:// documents Paul H. Brookes.
.nationaldb.org/products/2012- Census-Tables.pdf Prickett, J. G., & Welch, T. R. (1998). Educating stu-
National Consortium on Deaf-Blindness. (2013b). dents who are deafblind. In S. Z. Sacks & R. K. Sil-
Definition of intervener services and interveners in ed- berman (Eds.), Educating students who have visual
ucational settings technical report. Retrieved from impairments with other disabilities (pp. 139–160).
https://nationaldb.org/library/page/2267 Baltimore: Paul H. Brookes.
National Consortium on Deaf- Blindness. (2014). Regenbogen, L., & Coscas, G. (1985). Oculo-auditory
The 2014 national child count of children and syndromes. New York: Masson.
youth who are deafblind. Retrieved from https:// Roman, C., Baker-Nobles, L., Dutton, G. N., Luiselli,
91372e5f ba0d1f b26b72-13cee80c2bf b23b1a8fc T. E., Flener, B. S., Jan, J. E., . . . Nielsen, A. S.
edea15638c1f .s sl .c f1 .r ackcdn .c om /c ms /2 014 (2008). Statement on cortical visual impairment.
_ N ational _ D eaf -B lind _C hild _C ount _ R eport Retrieved from http://w ww.a f b.org /info/living
_v112015_641.pdf -w ith-v ision-loss/e ye- conditions/cortical-v isual
Nelson, C., Greenfield, R. G., Hyte, H. A., & Shaffer, J. -i mpair ment-t raumatic-brain-i njury-a nd-neuro
P. (2013). Stress, behavior and c hildren and youth logical-v ision-loss/statement-on-cortical-v isual
who are deafblind. Research and Practice for Persons -impairment /1235
with Severe Disabilities, 38(3), 139–156. Roman-L antzy, C. (2007). Cortical visual impairment:
Nelson, C., Van Dijk, J., Oster, T., & McDonnell, A. P. An approach to assessment and intervention (p. 20).
(2009). Child-g uided strategies: The Van Dijk ap- New York: AFB Press.
proach to assessment for understanding c hildren and Rosen, S. (1998). Educating students who have visual-
youth with sensory impairments and multiple disabili- impairments with neurological disabilities. In S. Z.
ties. Louisville, KY: American Printing House for Sacks & R. K. Silberman (Eds.), Educating students
the Blind. who have visual impairments with other disabilities
Nelson, L. B., & Olitsky, S. E. (Eds.). (2013). Harley’s (pp. 221–260). Baltimore: Paul H. Brookes.
pediatric ophthalmology (6th ed.). Philadelphia: Sacks, S. Z. (1998). Educating students who have vi-
Lippincott, Williams & Wilkins. sual impairments with other disabilities: An over-
Orelove, F. P., Sobsey, D., & Silberman, R. K. (Eds). view. In S. Z. Sacks & R. K. Silberman (Eds.),
(2004). Educating children with multiple disabilities: Educating students who have visual impairments with
other disabilities (pp. 3–38). Baltimore: Paul H. G. L. Lotrecchiano (Eds.), Children with disabilities
Brookes. (7th ed., pp. 473–485). Baltimore: Paul H. Brookes.
Simpson, K. L. (2013). Syndromes and inborn errors of Van Hasselt, B. B. (1987). Behavior therapy for visu-
metabolism. In M. L. Batshaw, N. J. Roizen, & G. ally impaired persons. In M. Hersen, P. Miller, &
L. Lotrecchiano (Eds.), C hildren with disabilities R. M. Eisler (Eds.), Prog ress in behavior modifica-
(7th ed., pp. 757–801). Baltimore: Paul H. Brookes. tion: Vol. 32 (pp. 13–44). Thousand Oaks, CA:
Silberman, R. K., Bruce, S. M., & Nelson, C. (2004). Sage.
Children with sensory impairments. In F. P. Ore- Vaughn, S., & Fuchs, L. S. (2003). Redefining learning
love, D. Sobsey, & R. K. Silberman (Eds.), Educating disabilities as inadequate response to instruction:
children with multiple disabilities (4th ed., pp. 425– The promise and potential problems. Learning
527). Baltimore: Paul H. Brookes. Disabilities Research & Practice, 18, 137–146.
Silberman, R. K., & Erin, J. (2007). Visual impair- Warren, D. H. (1994). Blindness and c hildren: An indi-
ments. In E. L. Meyen & Y. N. Bui (Eds.), Excep- vidual differences approach. New York: Cambridge
tional children in today’s schools: What teachers need University Press.
to know (4th ed., pp. 283–305). Denver: Love. Westat. (2012). Part B annual report tables. Retrieved
Silberman, R. K., Sacks, S. Z., & Wolffe, J. (1998). In- from https://ideadata.org /resource-library/5489
structional strategies. In S. Z. Sacks & R. K. Silber- eeaf150ba00a438b4568/
man (Eds.), Educating students who have visual Westling, D. L., Fox, L., & Carter, E. W. (2015). Teach-
impairments with other disabilities (pp. 101–138). ing students with severe disabilities (5th ed.). Upper
Baltimore: Paul H. Brookes. Saddle River, NJ: Pearson Education.
Silberman, R. K., & Sowell, V. (1998). Educating stu- Whitmore, J. R., & Maker, C. J. (1985). Intellectual gifted-
dents who have visual impairments with learning ness in disabled persons. Rockville, MD: Aspen Sys-
disabilities. In S. Z. Sacks & R. K. Silberman (Eds.), tems.
Educating students who have visual impairments with Zelleke, T. G., Depositario-Cabacar, D. F. T., & Gail-
other disabilities (pp.161–185). Baltimore: Paul H. lard, W. D. (2013). Epilepsy. In M. L. Batshaw, N.
Brookes. J. Roizen, & G. L. Lotrecchiano (Eds.), Children
Trovato, M. K., & Schultz, S. C. (2013). Traumatic with disabilities (7th ed., pp. 487–506). Baltimore:
brain injury. In M. L. Batshaw, N. J. Roizen, & Paul H. Brookes.
8
C H A P T E R
Diversity and Its Implications

Madeline Milian, Paula Wenner Conroy,
and Silvia M. Correa-Torres
To hear an audio introduction ♦ When students are learning English as a new

to this chapter by an author, language, content needs to be modified to ad-
and to view a chapter over dress their language needs.
view presentation, log in to the AFB Learning ♦ University programs and school districts need
Center. to provide opportunities for preservice and in-
service teachers to obtain knowledge and skills
KEY POINTS that w
ill assist them in understanding the com-
plexities and rewards of working with culturally
♦ Teachers of students who are visually impaired and linguistically diverse students and their
will encounter students and families who come family members.
from diverse cultural, social, religious, and lan-
guage groups, regardless of the geographic area

in which they work.
INTRODUCT ON
♦ Working with students and families who come
from diverse backgrounds provides multiple and Perhaps travel cannot prevent bigotry, but by dem-
significant opportunities for teachers to learn onstrating that all peoples cry, laugh, eat, worry,
about cultures, languages, and new ways to con- and die, it can introduce the idea that if we try
ceptualize their understanding of the world. and understand each other, we may even become
friends. (Angelou, 1993, p. 12)
♦ Teachers need to develop sensitivity to stu-
dents’ diversity and learn effective teaching and Diversity has become a consistent factor in US
communication strategies that will facilitate their schools. As the student population continues to
work with culturally and linguistically diverse become more diverse, educators need to gain a
students and their family members. better understanding of how diversity affects
♦ Professional collaboration is essential when their daily work with students who are blind or
teaching culturally and linguistically diverse stu- have visual impairments and their families. Cul-
dents with visual impairments who may have tural values and beliefs influence the manner in
language needs that require support. which students and families perceive their edu-
250
Diversity and Its Implications 251
cational and personal needs, the ways in which diversity in the US student population, including
they interact with teachers and other school per- students with visual impairments, has global di-
sonnel, and how families perceive visual impair- mensions. Although immigration has historically
ment and its ramifications for the present and the been associated with the United States, political
f uture of their child. Consequently, to be more and religious conflicts around the world as well
effective in their role, teachers need to constantly as economic prob lems and natu ral disasters
question how the diversity of their students needs have forced many p eople to leave their countries.
to be taken into consideration when interacting, Others, however, willingly move because of job
instructing, and understanding students and their transfers or to pursue educational opportunities.
family members. Initially, educators may per- According to figures from the United Nations
ceive their work with students and families from (2013), around 232 million international mig rants
diverse backgrounds as an overwhelming chal- were living in the world at the time the data was
lenge, but as they become better informed and collected (with many more individuals having
more comfortable with their work, teachers of- migrated since b ecause of regional turmoil),
ten appreciate and value the new learning that and 6 out of every 10 international mig rants re-
takes place when educating culturally and lin- side in developed regions.
guistically diverse students. More recently, there has been an increase of
This chapter has three major goals. The first people who have been displaced worldwide due to
goal is to remind practicing teachers, college profes- persecution, conflicts, generalized vio lence, or
sors, administrators, and future teachers of their human rights violations (The United Nations Ref-
responsibility to educate themselves about and ad- ugee Agency, 2015). Worldwide, as of 2015, there
vocate for the educational rights of students who were 65.3 million people who were forcibly dis-
come from diverse cultural and linguistic back- placed, including 12.4 million who were displaced
grounds, which, in many communities, constitute in 2015. More than half of all refugees worldwide
the majority of the teachers’ caseloads. The second came from Syria, Afghanistan, and Somalia.
goal is to remind all educators to examine their Consequently, it is imperative that educators
views and beliefs about their expectations for stu- around the world consider the language and cul-
dents from diverse backgrounds. Although it is es- ture students bring to the school setting as a re-
sential to learn effective teaching strategies for sult of either immigration or forced displacement
working with this population, it is equally impor from their country.
tant to examine one’s beliefs and expectations
about these students’ abilities and potential for
learning. The third goal is to communicate that di- DEFIN T ON OF D VERSITY
versity offers unlimited and positive opportuni-
ties for educators to learn more about themselves, Diversity has come to signify the heterogeneous
their students, their colleagues, and other mem- nature of US society. Typically, the term diversity
bers of their communities. When they view di- has a broad meaning that can refer to human
versity as an asset, educators learn to incorporate characteristics, such as culture, language, race, class,
aspects of it into their teaching, and thus their in- disability, age, and gender; personal affiliations
struction becomes more culturally relevant and to religious and political groups or ideologies; or
appropriate for their students, regardless of cul- sexual orientation. Because every person is dif
tural or linguistic background. ferent, diversity includes everyone and refers to
It is important to note that while this chap- the ways in which p eople are different, including
ter targets readers in North America, the topic of individual and group differences. Diversity has
always existed in US schools, but the assimila- unequal; in 1964, Title VII of the Civil Rights Act
tionist philosophy that long ruled the educa- prohibited discrimination based on race, color,
tional system e ither ignored or tried to eradicate religion, sex, or national origin; in 1974, Lau v.
differences so that all students would ultimately Nichols ruled in favor of Chinese students in San
be “the same.” In the case of students with dis- Francisco by stating that the civil rights of stu-
abilities, appropriate education was often denied. dents who did not understand the language of
Today, the term diversity implies a positive view instruction were being v iolated when the stu-
of the differences of students and often the desire dents were provided with the same facilities, text-
to integrate students’ unique differences into the books, teachers, and curriculum as students who
curriculum so they can be validated. Students’ di- spoke Eng lish. In 1975, perhaps the most sig-
versity is associated with important educational nificant legislation on behalf of students with
factors that need to be validated by t hose who disabilities, the Education for All Handicapped
work with c hildren and their family members. Children Act, now known as the Individuals with
Knowledgeable teachers with appropriate skills Disabilities Education Act (IDEA), mandated
and attitudes can help all students bridge their educational serv ices for all students with disabil-
worlds of home, school, and community and suc- ities in public schools and ended decades of edu-
cessfully engage in learning experiences (Phelan, cational neglect for many students (Nieto, 1996;
Davidson, & Cao, 2009). Schwartz & Dunnick Karge, 1996; Sleeter &
Consciousness of diversity has contributed to Grant, 1993; also see Chapter 1 in this volume).
the rise and value of cultural pluralism. Cultural
pluralism is a belief system guided by the idea that
diversity adds an overall richness when members D VERS TY AND V SUA
of different groups participate fully in the domi- IMPAIRMENTS
nant society yet maintain their own cultural val-
ues. In this view, becoming bicultural is seen as Diversity is a concept that is difficult to measure
an asset instead of a problem to be solved; conse- or quantify because some information is subjec-
quently, diversity is viewed as a resource rather tive and thus difficult to collect. Statistics on
than a deficit. New metaphors are replacing the other characteristics including gender, race, eth-
traditional “melting pot” concept of diversity, in nicity, socioeconomic status, and language status
which all values w ere “melted” and combined to have been collected concerning t hose with visual
form some other, ideal culture that replaced what impairments and are included here. Prevalence
immigrants brought from their country of origin. numbers in the area of visual impairment must
Bertsch (2013) described how terms such as salad be interpreted with caution, as the definition of
bowl, mosaic, tapestry, and kaleidoscope are examples visual impairment used to report figures may vary
of words currently used more often to describe a from study to study. (See Chapter 2 in this vol-
population in which one’s culture and its individ- ume for additional discussion of demographic
ual characteristics are maintained and valued. data on visual impairment and blindness.) Some
The shift in the view of diversity can be attrib- studies use the definition of legal blindness (visual
uted partly to the social changes that took place acuity of 20/200 or less) to determine whether an
in the 1960s and 1970s and the expansion of the individual is visually impaired, while others use
legal, educational, and civil rights of students and the more subjective definition of difficulty in see-
their parents. In 1954, Brown v. Board of Education ing. Additionally, many tools combine the preva-
established that racially segregated schools were lence of visual impairment among c hildren with
that of adults. As explained by the World Health & Clarke, 2014) established that 20.6 million
Organizat ion (WHO, 2014) this is problematic adult Americans (10 percent of all adult Ameri-
because visual impairment is strongly associated cans) have trouble seeing, while the US Census
with aging. Bureau’s survey (2010) reported that 0.9 percent of
The American Community Survey (ACS) re- c hildren under the age of 15 have difficulty see-
ports prevalence for visual disability by age and ing words or letters. T hese figures confirm the
race or ethnicity, based on the question, “Is this strong association that exists between age and
person blind or does he/she have serious difficulty visual impairments, as indicated by the World
seeing even when wearing glasses?” According Health Organ i z at ion in 2014.
to the report for the 2014 survey, t here were an The racial and ethnicity identity of t hose with
estimated total of 7,358,400 of people of all ages visual impairments in the United States was col-
living in the United States who can be classified lected through the 2014 ACS (Erickson et al.,
as having serious visual difficulty even when 2016). Table 8.1 shows the prevalence of visual
wearing glasses. Of those, 3,336,100 were male impairment in t hese data.
and 4,022,200 w ere female (Erickson, Lee, & von According to the figures provided by the 2014
Schrader, 2016). ACS, approximately 38 percent of individuals
Additionally, findings from the 2012 Na- with visual impairments living in the United
tional Health Interview Survey (Blackwell, Lucas, States are members of a nonmajority racial or
TA B L E 8 . 1
Racial and Ethnicity Identity of Individuals with
Visual Impairments in the United States in 2014
Group Numbers
White, non-Hispanic 4,588,500 (2.3%)

White, Hispanic 760,300 (2.1%)
Black, Hispanic 33,900 (3.1%)
Black/African American, non-Hispanic 1,109,600 (2.9%)
Native American or Alaska Native 81,800 (4.0%)
Native American/Alaskan Native, Hispanic 13,500 (2.7%)
Asian, non-Hispanic 227,700 (1.4%)
Asian, Hispanic 2,700 (1.7%)
Other, non-Hispanic 171,100 (2.1%)
Other, Hispanic 369,300 (2.2%)
Percentages are of non-institutionalized, male and female, all ages, in the United
States who reported a visual disability.
Source: Erickson, W., Lee, C., von Schrader, S. (2016). Disability statistics from the
2014 American Community Survey (ACS). Ithaca, NY: Cornell University Yang Tan
Institute (YTI). Retrieved from http://w ww.disabilitystatistics.org/reports/acs.c fm
?statistic=1
ethnic group. For the purpose of this chapter, it is

important to note that some individuals identify V SUAL IMPAIRMENT
themselves as members of more than one ethnic IN CHI DREN
group (Asian and Hispanic, Native American and
Hispanic), illustrating the multicultural nature of Data gathered through the Babies Count national
US society. As adults marry others from outside registry, conducted by the American Printing
their original ethnic or racial group, US society House for the Blind (see Chapter 4 in this volume)
has become increasingly diverse. In many families, which collected information on 5,931 babies
more than one culture shapes family members’ with visual impairments in 28 states in the United
beliefs, more than one language is spoken, or States from 2005 to 2011 (Hatton, Ivy, & Boyer,
more than one religion is practiced. In fact, projec- 2013), reported that ethnicity distribution of the
tions from the US Census Bureau (2012) pre- babies registered was 57 percent European Ameri-
dicted that the population w ill be considerably can, 22 percent Hispanic, 8 percent African Amer-
older and more racially and ethnically diverse by ican, 12 percent other, and 1 percent unknown.
2060. Both of t hese characteristics have implica- The Digest of Education Statistics (National
tions for professionals in the field of visual im- Center for Education Statistics, 2014b), using the
pairments. information reported by states required by IDEA
A study comparing the differences of visual Part B, reported the ethnicities of children be-
impairments between immigrants and natives tween the ages of 3 and 21 who have been identi-
in the United States conducted by Wilson et al. fied as visually impaired and who received
(2014) concluded that among nonusers of correc- special education during the 2012–13 school year
tive lenses, immigrants were significantly less (Table 8.2).
likely than US natives to have 20/40 or better vi- Of t hese 29,004 visually impaired students
sion. In addition, immigrants also had 3.5 times counted through IDEA, 13,363 (or 46 percent)
the odds of being legally blind in comparison to belong to diverse ethnic or racial groups (National
US natives a fter adjusting for confounding f actors. Center for Education Statistics, 2014). It is also
The authors suggested that research is necessary important to note that the number reported under
to identify the underlying f actors that explain the the IDEA count for the total number of students
visual disparities found in the two groups. who are visually impaired is likely much lower
TA B L E 8 .2
Race and Ethnicity for Children 3–21 Years Old with Visual
Impairments (2012–2013 School Year)
American
Indian/ Two or
Pacific Alaska More
Total White Black Hispanic Asian Islander Native Races
29,004 15,641 4,476 6,663 1,142 93 356 633
(54%) (15%) (23%) (4%) (0.03%) (1%) (2%)
Totals percentages do not add to 100% b ecause of rounding.
Source: National Center for Education Statistics. (2014b). Digest of education statistics. Washington, DC: US Department
of Education. Retrieved from https://nces.ed.gov/programs/digest/d14/tables/dt14_ 204.50.asp
than the actual number of children who are and Durando (2011) found that in a sample of
served by educators of students who are visually 204 teachers of students with visual impairments
impaired. For example, c hildren who have mul- who participated in their study, about 7 students
tiple disabilities that include a visual impair- in a typical teacher caseload of 19 were from a
ment are typically not included as part of the culturally and linguistically diverse group.
visually impaired count; resulting in a lower
number of c hildren who receive serv ices for their
visual impairment educational needs (see Chap- CONTR BUT ONS OF
ter 2 in this volume). MM GRATION TO DIVERSITY
The 36th Annual Report to Congress on the Im-
plementation of the Individuals with Disabilities Ed- Immigrants and refugees contribute greatly to the
ucation Act from the US Department of Education’s diversity found in many countries around the
Office of Special Education Programs (2014) world, and this is the case in the United States,
noted that in 2012, American Indian or Alaska where the term a nation of immigrants is typically
Native, black or African American, and Native used to describe how its population growth can
Hawaiian or Pacific Islander c hildren ages 6 be attributed to those who have come to this
through 21 were more likely to be served u nder country searching for political and religious free-
Part B of the IDEA Act than were c hildren in the dom as well as economic prosperity. Immigrants
same age range in all other race/ethnic groups and refugees contribute to the linguistic, cultural,
combined. Asian, white, and c hildren associated and religious diversity found in US schools and
with more than one race ages 6 through 21 w ere communities.
less likely to be served u
nder Part B than w ere the Table 8.3 provides the numbers of p eople
children in all other race/ethnic groups combined. who have most recently obtained legal resident
Latino students in the same age group were just status in the United States.
as likely to be served under Part B as any other race/ Since the United States first started keeping
ethnic groups combined. While this is a general records of the nationalities of immigrants and nat-
finding applying to all c hildren who were re- uralized citizens in the 1820 census (Rose, 1995),
ceiving special education serv ices, rather than more than 75 million immigrants have entered
specific to those with visual impairments, it is the country, according to the US Department of
an important factor for educators to consider, as Homeland Security (2016). In addition to immi-
the statistics also include the population of stu- grants, refugees also play an important role in
dents with visual impairments. Correa- Torres adding diversity to American communities. Since
T A B L E 8 . 3
Number of L egal Immigrants Entering the United States from
2000 to 2014
Year(s) 2000–2009 2010 2011 2012 2013 2014
Number 10,299,430 1,042,625 1,062,040 1,031,631 990,553 1,016,518
Source: Adapted from US Department of Homeland Security. (2016). T able 1: Persons obtaining lawful permanent
resident status by region and selected country of last residence: FYs 1820 to 2014. Washington, DC: Author. Retrieved
from https://w ww.dhs.gov/yearbook-immigration-statistics-2014 -lawful-permanent-residents
1975, the United States has resettled over 3 mil- below grade level, and some may never have at-
lion refugees who came from areas such as So- tended school before. T hese students have differ
malia, Burma, Iraq, Sudan, Iran, and Bhutan, ent levels of English fluency and may need to be
where po liti
cal conflicts forced them to leave placed in bilingual education or English language
and settle in a new country. Another group that acquisition programs in addition to special educa-
also contributes to the overall cultural and lin- tion services for their visual impairments. More-
guistic diversity of the United States is that of over, although some immigrant students may come
foreign nationals who enter the country without from affluent or middle-class families and may
proper visas or stay after the termination date of have had stable childhoods, o thers may have come
their travel visas. When that occurs, these indi- from areas with political or religious conflicts and
viduals come to be known as undocumented or may have confronted extremely stressful situa-
unauthorized immigrants. While accurate counts of tions and the loss of family members.
unauthorized immigrants are difficult to esti- Students’ experiences before they entered
mate, Baker and Rytina (2013) reported that as of school could have an impact on their adjustment
January 2012, this group consisted of 11.4 million to the new situation; hence, it is useful for school
people. The report further explained that an personnel to understand individual students’ cir-
estimated 8.9 million (78 percent) of the total cumstances. However, this is an area that requires
11.4 million unauthorized immigrants were from extreme sensitivity because some immigrant fam-
North America, including Canada, Mexico, the ilies have precarious legal statuses and may be
Caribbean, and Central America. The next lead- hesitant to provide personal information that, if
ing regions of origin w ere Asia (1.3 million) and divulged, may threaten their chance of staying in
South America (0.7 million). Mexico continued the United States. Immigrants’ fears, intensified
to be the leading source country of unauthorized by anti-immigrant sentiments reflected from time
immigration to the United States. T here were to time in recent years in the media and various
6.7 million unauthorized immigrants from Mex- legislative initiatives and attempts to cut back ser
ico in 2012, representing 59 percent of the unau- vices, may also inhibit some families from request-
thorized population. The next leading source ing needed services. The following questions are
countries w ere El Salvador, Guatemala, Honduras, examples of possible areas to explore with recent
and the Philippines. Collectively, and regardless of immigrant or refugee families and their c hildren
legal status, new immigrants and refugees, in ad- with visual impairments.
dition to the long-established citizens and Ameri-
can Indians or Alaska Natives, continue to enrich
the cultural and linguistic traditions of the United
Medical Issues: Previous Care
States and contribute to its world-famous reputa- and Current Needs
tion of being a proud multicultural country. • When was the student diagnosed with the
v isual impairment?
• Was the visual impairment the result of an
S PPORT NG STUDENTS WHO accident?
ARE RECENT IMM GRANTS • Are t here medical records available that could
For teachers of students who are visually im- be shared with the school?
paired and belong to one of the new immigrant • What type of treatment (modern or tradi-
or refugee groups, it w ill be important to know tional) has the student received to improve or
that these students might perform at, above, or maintain vision?
• Has the student visited an ophthalmologist in • What opportunities does the student have to
the United States? read and write at home?
• Has the student ever used low vision devices • Has the student been introduced to any type
to assist with school-
related or functional of technology that facilitates literacy?
activities?
• Are t here other medical concerns in addition Social Skills: Past and Present
to the visual impairment?
• How important is it for the family that the
child make friends in school or in the commu-
Language: Home Language and nity?
Language of Instruction • What types of opportunities does the student
• What languages are spoken at home? have to make friends in the community?
• What are the family’s language expectations • How are p eople typically greeted in the stu-
for the student? dent’s culture?
• How does the f amily view the student’s • What may be some of the differences between
language skills in the native language in com- the socially acceptable norms of the student’s
parison to the skills of other c hildren in the culture and t hose of the United States?
family? • What is the nature of relationships between
• How important is it to the f amily that the stu- teachers and students in the student’s country
dent maintain the native language(s)? of origin?
• What opportunities does the student have to
continue to develop the native language(s) at Daily Living Skills: Current Levels
home or in the community? and Cultural Differences
• What type of opportunities does the student
• What daily home responsibilities are typically
have to practice Eng lish at home and in the

assigned to c hildren from this culture?
community?
• Are t here gender-based differences in the as-
signment of chores that are usually found in
Literacy: Previous Exposure and the student’s culture?
Present Needs • Does the family think that it is not appropri-
ate for c hildren to perform chores at home or
• What was the last grade the student completed
in the classroom? If so, what are the reasons?
in the native country?
• What responsibilities does the family expect
• Did the student receive braille instruction in
the student to have in relation to feeding, dress-
the native country?
ing, cleaning, and other developmentally ap-
• How does the family view the student’s ability propriate skills?
to read and write?
• If applicable, does the family expect their
• Does the student read and write independently sighted c hildren and their child with a visual
at home? impairment to perform or contribute differ-
• Does the student enjoy reading or listening to ently in areas related to daily living skills?
family members read?
Other Areas year, seven of the eight states with the highest
percentages of English language learners in their
• What do families from the student’s culture public schools were in the West. In eight states,
think about the role of the school? Alaska, California, Colorado, Hawaii, Nevada,
• How do families from the student’s culture New Mexico, Oregon, and Texas, 10.0 percent or
view their involvement in the formal educa- more of public school students were emergent bi-
tion of c hildren with visual impairments? lingual students or those who are learning En
• Does the family expect to stay in the current glish as an additional language (Garcia &
neighborhood or city, or are they t here only Kleifgen, 2010, as discussed in the following sec-
temporarily? tion). In California, these students constituted
23.2 percent of public school enrollment. In 14
• What are some of the family’s most immedi-
states and the District of Columbia, the percent-
ate needs?
age of emergent bilingual students enrolled in pub-
lic schools was between 6.0 and 9.9. In addition to
Students who are recent immigrants or refu-
the District of Columbia, these states were Arizona,
gees, particularly those who speak languages
Arkansas, Florida, Illinois, Kansas, Mary land,
other than Eng lish, require serv ices that target
Massachusetts, Minnesota, New York, North Car-
both their disability-specific and language devel-
olina, Oklahoma, Rhode Island, V irginia, and
opment needs. Special education programs that
Washington. In 15 states the percentage of emer-
do not take into consideration the language
gent bilingual students in public schools was be-
needs of students who are learning English as a
tween 3.0 and 5.9, and the percentage was less than
new language, fail to provide an appropriate edu-
3.0 in 13 states. West Virginia has the lowest per-
cation for these students. One of the roles of edu-
centage of emergent bilingual students enrolled
cators of students with visual impairments is to
in its public schools with only 0.7 percent. Given
knowledgably advocate for services that w ill also
these figures, it appears that educators for stu-
improve the students’ English skills and, when
dents who are visually impaired may have the
available, support the native language as well.
opportunity to work with emergent bilingual stu-
dents and their family members regardless of

L NG ISTIC D VERS TY geographical location, particularly t hose who are
employed in public school districts where these
While Eng lish is the language spoken by most students constitute 10 percent or more of the stu-
people in the United States, 21 percent of t hose dent population.
5 years and older speak a language other than
English at home (Ryan, 2013). Although the US
Students with Visual Impairments
Census Bureau lists 325 languages spoken at
home, Spanish continues to be the most common
Who Are Emergent Bilinguals
non- English language spoken in the United Students who come from homes where English is
States, followed by Asian languages such as Chi- not the primary language often enter schools
nese, Korean, Vietnamese, and Tagalog. Accord- with En g lish language proficiency levels that
ing to Ryan (2013), some of the non-English necessitate additional language development in-
languages spoken in the United States are native struction. T hese students have typically been iden-
North American languages such as Navajo. tified as Eng lish language learners. As explained
According to the National Center for Educa- by Milian (2013), multiple labels have been used
tion Statistics (2014a), during the 2011–12 school to refer to the abilities of these students, start-
ing with limited English proficiency, and more re- Determining the exact number of Eng lish
cently the term emergent bilinguals has been language learners with disabilities is a challenge
proposed by Garcia and Kleifgen (2010), as the because of the limited published information on
label indicates that the students are becoming students who share both characteristics (Trainor
bilingual. For the purpose of this chapter, the & Kim, 2014; Watkins & Liu, 2013). Using infor-
term emergent bilingual students is used because it mation published by the Data Accountability
illustrates what the students are gaining rather Center (2013), Watkins and Liu (2013) estimated
than what they are lacking, as previous terms im- that in 2011 about 8.5 percent of all students who
plied. Sidebar 8.1 defines t hese and other terms have a disability were also classified as Eng lish
used in the provision of education in English as language learners. The National Center on Edu-
a second language. cational Outcomes explained that in school year
S I D E B A R 8 . 1
Useful Terms in the Area of English as a Second Language
Basic interpersonal communicative skills perform the cognitively demanding tasks of

(BICs): The language skills one needs for schoolwork (see Cummins, 1981).
face-to-face or other informal communication
Emergent bilingual students: Students who
when meaning is negotiated through contex-
are learning two or more languages.
tual cues (see Cummins, 1981).
English as a second language (ESL): A com
Bilingual education: An educational approach
ponent of a bilingual program that aims to
that aims to develop a student’s native
develop the English listening, speaking,
language, help the student acquire a second
reading, and writing skills of students who
language, and use the native and the second
speak languages other than English.
languages for instruction. There are a number
of bilingual education models, including the English language learners (ELLs): A term used
transitional model, in which only non-English- to describe students who are in the process
speaking students participate and instruction of learning English.
in the native language is used only until the
Limited English proficient (LEP): The federal
students have achieved a certain level of
term used to identify students who need
fluency in English, and the dual-language
specialized language instruction because they
model, in which native English speakers and
have not yet achieved the required language
non-English speakers participate to learn
proficiency to function in an English-only
each other’s languages and instruction
environment.
is provided in both languages until the
students leave the school. Sheltered Instruction Observation Protocol
(SIOP): A widely used instructional delivery
Bilingual special education: The combination
approach to address the educational needs
of bilingual education approaches in the
of emergent bilingual students. It provides a
special education setting. A student’s
specific structure for planning and delivery of
native language is used to provide
instruction that takes into consideration both
instruction.
language and content instruction. (See the
Cognitive academic language proficiency Center for Applied Linguistics website [www.cal
(CALP): The language skills required to .org] for more information on this model.)
2013–14, it was estimated that percentages of Milian & Ferrell, 1998; Topor & Rosenblum,
emergent bilingual students with disabilities 2013) have confirmed that educators for stu-
ranged according to disabilities from 3 percent to dents with visual impairments often have stu-
12 percent. Nine percent of students with visual dents on their caseload that have been identified
impairment and blindness were also learning En as emergent bilinguals. For example, of the 66
glish as a new language. Kena et al. (2014) also teachers in the United States and Canada who
documented the regional demographic variances participated in the Topor and Rosenblum (2013)
of English learners, with southwestern and coastal study, 60 reported that they had worked with a
states having the largest populations of students student who is visually impaired and learning En
(including Alaska and Hawaii), and California glish during the previous five years.
having the largest percentage (23 percent) of stu- One major concern related to educating stu-
dents who are English learners with disabilities. dents who are learning English as an additional
In addition to not having reliable information language is the risk of misidentifying the normal
on the numbers of emergent bilingual students process of second language acquisition as a
with disabilities, the Office for Civil Rights re- language-related disability. As indicated by Hama-
ported that in 2006, nationwide, only about yan, Marler, Sanchez-Lopez, and Damino (2013),
88 percent of students with disabilities who w ere students who are learning English and those who
in need of instruction in English as a second lan- have language learning disabilities share many
guage or bilingual instruction actually received characteristics that can lead to misidentification.
it (US Department of Education, Office for Civil T hese characteristics may include difficulty

Rights, 2013). Obtaining reliable data on the following directions, distractibility, poor memory,
number of emergent bilingual students who also difficulty retelling a story, difficulty with math
have disabilities and who are receiving English problems, withdrawn behavior, and a tendency to
language and special education serv ices is still a add, delete, or replace words. While students with
challenge in the field of special education; how- visual impairments receive special education
ever, recent efforts at the national level are be- based on a medically identified disability, for those
ginning to provide valuable information that who are learning English as another language and
can guide instruction and educational planning. are suspected of having a language learning
For example, the E very Student Succeeds Act disability, the task of identifying the additional
(ESSA) signed by President Obama on Decem- disability becomes a monumental challenge for
ber 10, 2015, requires reporting on emergent bi- educators, as problems with the use of visually bi-
lingual students with disabilities as part of the ased assessment tools written in English often do
information states have to submit to the federal not lead to an accurate diagnosis of the problem.
government. This is a positive step as it w ill pro- Delivery of appropriate educational services fo-
vide a more realistic count that w ill guide policy cusing on the academic needs of the student may
makers and educators to address this often un- be the most beneficial solution.
derserved population of students. Educators who work with students who are
The difficulties of estimating the number of learning English as a new language, regardless of
students at the national level who are visually im- disability status, need to be aware of language
paired and are emergent bilinguals are similar to and cultural factors that can influence how and
those with other disabilities. However, studies what they teach t hese students. Milian (2013) rec-
that have been conducted since the 1990s (Correa- ommended the following guidelines that teach-
Torres & Durando, 2011; Milian & Conroy, 1999; ers could use to guide instruction:
• We are all language teachers. Although educa- limited use. Informal assessments that include
tors for students with visual impairments con- observation in dif fer
ent settings and per
for
centrate on skills that may not be viewed as mance assessments provide much more useful
directly teaching language development, most information while English language learners are
teaching and learning requires understanding not yet fluent English speakers.
of language. Hence, any skill that teachers are • Native language support provides short-and
introducing through English becomes an En long-term benefits for emergent bilinguals. Us-
glish language development lesson for emer- ing the student’s native language will facilitate
gent bilinguals. This is particularly important transition into the new setting and w ill assist
when teachers of students with visual im- students in receiving important new content area
pairments are supporting students in literacy instruction while they are learning English. Sup-
instruction through either braille or print. porting and maintaining the students’ native
Information about how the students’ native language will foster bilingual skills that will likely
language differs from English in terms of read- be advantageous as students enter an increas-
ing and writing directionality, word order, ingly global job market that requires knowledge
capitalization, punctuation, and other con- of more than one language.
ventions of writing is important to consider.
• Cultural knowledge will help with teacher, stu-
• Information on native language academic levels dent, and family interactions. As cultural be-
is key to English instruction. Understanding the liefs and practices, including understandings
native language levels of students who are of disability, vary within cultural groups, it is
learning English w ill provide important infor- important for educators to understand that
mation, as students who have strong native factors such as the number of years in the
language skills w ill make an easier transition United States, age, religion, and levels of edu-
into learning the new language. Also, knowl- cation can influence the way a specific family
edge about the students’ language can facilitate may acculturate to the new community and
making connections when teaching English. school environment. Additionally, educators
• Collaboration is key for academic growth. Given will need to examine their own understanding
the complexities of effectively teaching emer- and perceptions based on their own cultural
gent bilinguals, it is important that communi- beliefs to avoid forming opinions or judgments
cation about language and culture take place that may prevent alternative explanations to a
among all educators who work with these specific situation. Sidebar 8.2 provides some
students. Family members and community recommendations to guide instruction with
members knowledgeable about the student’s emergent bilingual students.
language and cultural group can offer valuable
information that can facilitate instruction. In addition, educators w ill also benefit from
• Ongoing classroom assessments, observations, understanding the findings of Thomas and
and performance assessments are critical for Collier (1997), who studied the rec ords of
teachers to use. Emergent bilinguals are a “mov- 700,000 language-minority students in K–12 in
ing target” b
ecause their English language de- five large school districts. They found that t here
velopment is in constant growth when effective are three key predictors of academic success that
instruction is provided. Consequently, results can overcome such factors as poverty and the
of formal assessments given once per year are of school’s location in an economically depressed
S I D E B A R 8 . 2
Recommendations for Educators Working with Emergent
Bilingual Students
• Become familiar with the English • Analyze the language of your academic
proficiency standards in your state. It will content tests to determine if they contain
help you understand the English proficiency language that is too advanced for the
level of your students and assist you proficiency level of your emergent bilingual
in planning instruction. Many states students. Tests should measure content,
have adopted the World-Class not language proficiency.
Instructional Design and Assessment (WIDA) • Consider different ways of obtaining
standards (see the Resources information about students’ academic
section in the online AFB Learning growth that are not always based on
Center), while others have created language.
their own language proficiency standards.
• Gather relevant information about the
Regardless, knowing the English language
students’ native languages, including
proficiency standards w ill benefit instruction
the braille code, if the students are braille
for emergent bilingual students.
users. The following questions are
• Take students’ English language proficiency important to consider:
levels into consideration when dividing them ■ Are the students proficient in their own
into groups. To facilitate interactions, groups native language?
should have students from different
■ Are they functioning at grade level in the
proficiency levels in English so that they
can help each other. native language?
■ Did they receive braille instruction in the
• Encourage students to help each other by
using their native language as needed. native language?
Frequently, students who share the same ■ What are the differences and similarities
native language can help each other when between oral and written English and
new content is being introduced. the students’ native language?
• Develop a positive working relationship with • Learn about important factors of your
the teacher of English language learners to students’ culture. Increasing understanding
facilitate collaboration related to teaching of your students’ culture will help you to
and assessment strategies based on vision understand their behaviors and worldviews.
and language needs. Also, you can share The more you understand the students’
materials and other resources that may be culture, the more you will be able to
needed for students. incorporate it into the curriculum.
Source: Adapted from Milian, M. (2013, Fall). Emergent bilinguals with visual impairments: Guidelines for instruction.
DVI Quarterly, 58(2), 26–33.
262
area. These predictors are (1) using cognitively in their overall goals, the degree to which they
complex, on- g rade-
level academic instruction include the students’ native languages, the dura-
in a student’s first language for as long as neces- tion of instruction in the native languages, and
sary and cognitively complex, on- g rade-
level whether native English speakers also participate
academic instruction in Eng lish for part of the in the program. Schools can offer a given pro-
school day in each grade throughout a student’s gram or a combination of programs, depending
schooling; (2) using current approaches to teach- on their population. For example, while some
ing the academic curriculum in two languages, students in a school may participate in a dual-
such as using thematic units, employing coopera- language program because their parents want
tive learning strategies, incorporating students’ them to become bilingual, others may only re-
diversity into the curriculum, combining the teach- ceive instruction in English as a second language
ing of language and academic content, and devel- because the dual-language program is not avail-
oping oral and written language simultaneously; able at their grade level or in their particular na-
and (3) transforming the sociocultural context for tive language, or because their parents prefer an
language-minority students’ schooling to create a English-only program. Following is a summary of
supportive environment for learning in two lan- some of the most frequently found language pro-
guages. Transitional bilingual programs, in which grams that are used in different communities that
students receive instruction in their home language provide instruction for emergent bilinguals.
in kindergarten with increasing levels of English
instruction over time through early elementary Programs That Include Instruction in
grades, have been reaffirmed in more recent liter Native Languages
ature (Valentino & Reardon, 2015). Students re-
ceiving transitional bilingual instruction had Two-Way Bilingual Programs or Dual-Language
higher test scores in both English language arts Programs. Students in these programs are na-
and math than students who received instruction tive English-speaking students who want to learn
in English only. Furthermore, students in bilin- a second language and students who speak another
gual programs who continued into upper elemen- language who are learning English. Instruction is
tary grade levels had significantly higher test provided in both languages, and the goal is to pro-
scores in math compared with students in English duce students who are bilingual. T hese programs
immersion programs. have become very popular throughout the United
States because many English- speaking families
welcome the opportunity to have their children
Types of Language Programs learn a second language in the early grades. (For
Emergent bilingual students, with or without vi- an example of how these programs can provide
sual impairments, attend many different educa- services to students with visual impairments, see
tional settings, depending on language needs or Milian & Pearson, 2005.)
availability of program options. Teachers of stu-
dents with visual impairments should be familiar Maintenance Bilingual Education. These pro-
with how each language program functions so that grams are for emergent bilingual students who
they can understand the type of support their belong to the same language group. Instruction
students may need, depending on the program. is provided in the native language and in English.
School districts throughout the nation offer a The aim of t hese programs is to develop English
number of programs to meet the needs of emer- language proficiency and academic proficiency in
gent bilingual students. These programs differ the native language.
Transitional Bilingual Education. Students in to a student may be limited by what is available

t hese programs are emergent bilingual students. at the school the student attends.
Instruction is provided in the native language Students who are visually impaired present a
and in Eng lish. However, the students are ex- special challenge to ESL instructors or bilingual
pected to move out of the bilingual program and teachers who often rely on visual presentations as
into an English-only program within a certain one of their primary instructional strategies.
period, typically around third grade. The goal of However, methodological concerns should not
the program is to develop English language s kills. prevent students who are visually impaired from
attending programs that w ill best meet their lan-
English-Only Programs guage needs, nor should program options be elim-
Structured Immersion. Structured immersion inated b ecause the students are receiving special
programs serve emergent bilingual students who education serv ices. Consultations between the
generally belong to different language groups. In- English language acquisition teacher and the
struction is provided in English with modifica- teacher of students with visual impairments
tions so that students can understand the content can yield positive results for both. The former
being taught. can learn how to modify material and instruc-
tion, and the latter can learn about the sequence
Content-Based Eng lish as a Second Language of acquiring a second language.
(ESL). The content-based ESL program is struc- Emergent bilingual students who use braille
tured around academic content, rather than should also be able to participate in specialized
the traditional grammar-based approach. Lan- language programs in the schools they attend.
guage is taught through instruction in science, When a program offers a native-language com-
mathematics, social studies, and other academic ponent, some modifications are necessary if the
areas. teacher of students with visual impairments is
not bilingual in the student’s native language.
English as a Second Language or English Lan- The long-term benefits of maintaining the native
guage Acquisition Classrooms. Students are languages of students are worth any apparent
instructed for specific periods (daily or weekly) in challenge that teachers have to face to achieve
English language skills: grammar, vocabulary, and this goal. Teachers of students with visual impair-
communication. T hese programs are implemented ments can play important roles even when they
either as pullout programs in which students go are not able to provide direct instruction in
to an ESL classroom or as integrative programs in literacy in the students’ native languages. They
which teachers go to the students’ classrooms. can (1) arrange for the transcription of materials in
braille in the students’ native languages, which is
frequently a challenge because braille text-
Participation of Students with
books in languages other than English are usually
Visual Impairments not available in the United States; (2) work with
Emergent bilingual students with disabilities, in- the bilingual teacher, ESL teacher, and paraprofes-
cluding t hose with visual impairments, are enti- sional to modify the instruction and to help them
tled to participate in any of the program models understand the braille system; (3) provide spe-
just described. Typically, programs with native- cialized equipment and materials to support
language components exist in schools in which the program; and (4) provide instruction in En
a large number of students belong to the same glish that w
ill support or extend the ESL teacher’s
language groups. As a result, the program offered efforts. Clearly, some creativity is required in pro-
viding appropriate services to emergent bilingual ing able to increasingly engage in using the En
students who are visually impaired; however, t hese glish language in more complex, cognitively
students have the right to services, and will benefit demanding situations. . . .
from those that address both their visual impair- Bridging: As En glish learners pro gress
ments and their language needs. through the Bridging level, they move from be-
ing able to communicate in ways that are appro-
priate to different tasks, purposes, and audiences
S AGES OF SECOND in a variety of social and academic contexts
LANGUAGE DEVELOPMENT toward being able to refine and enhance their
English language competencies in a broader
While most teacher preparation programs offer range of contexts. (p. 20)
information on first language development,
teachers who work with students who are learn- The complete California English Language Develop-
ing English as an additional language also need ment Standards: Kindergarten through Grade 12
to understand the stages of second language ac- (California Department of Education, 2014) illus-
quisition. When teachers are familiar with the trates skills that are found at each level and pro-
normal process of learning a second language, vides additional information that can assist all
they w ill be better prepared to plan effective in- teachers to interpret the standards.
struction and use or develop assessment tools Many states that have not developed their
that will be more appropriate for the student’s En own second language proficiency standards are
glish language level. Teachers who are knowledge- using the World-class Instruction Design and As-
able of second language development are more sessment (WIDA) En glish Language Develop-
likely to explain and reflect on students’ academic ment (ELD) Standards (WIDA Consortium, 2012)
challenges and needs based on what they know and its corresponding assessment, ACCESS for
about how a student learns a second language. ELLs 2.0, to identify and follow the language
Many state departments of education have pro g ress of En glish language learners. As of
created language development or proficiency 2016, 38 states were members of the WIDA Con-
standards to guide educators in their work with sortium, which identifies the stages of language
English learners. For example, the California development in the four language domains (lis-
Department of Education (2014) revised its lan- tening, speaking, reading, and writing) as enter-
guage proficiency standards in 2012 to use three ing, emerging, developing, expanding, and
proficiency levels: bridging. The WIDA Consortium website (www
.wida.us) offers many materials that can be down-
Emerging: English learners enter the Emerging loaded f ree of charge and with explanation about
level having limited receptive and productive their standards and language development levels.
Eng lish skills. As they prog ress through the A very useful document for teachers is the Can Do
Emergent level, they start to respond to more Descriptors, which provides information on activi-
varied communication tasks using learned ties teachers can do and the language behaviors
words and phrases with increasing ease. . . . that can be expected from emergent bilinguals at
Expanding: As En g lish learners pro
g ress different language proficiency stages according to
through the Expanding level, they move from grade level.
being able to refashion learned phrases and Another useful way to understand the natu
sentences in Eng lish to meet their immediate ral process of second language acquisition is
communication and learning needs toward be- through the use and understanding of the
five stages of second language acquisition that • Speech emergence: Students begin to use ba-
were initially discussed by Krashen and Terrell sic sentences, expand their vocabulary beyond
(1983). These five stages include: preproduction the classroom and school environment, can
(silent/receptive), early production, speech emer- answer “how” and “why” questions, improve
gence, intermediate fluency, and advanced fluency. comprehension, and begin creating their own
Unlike the language proficiency levels developed language, but they continue to have limited
by the California State Department of Educa- understanding of jokes and comments that re-
tion and the WIDA Consortium, which include quire cultural understanding. For students who
both oral and written language, the stages of are visually impaired, teachers can begin us-
second language acquisition proposed earlier by ing simple explanations to introduce new
Krashen and Terrell (1983) w ere primarily used concepts, however, the use of tangible objects
for oral language development. A brief descrip- and experiential activities w ill still be neces-
tion of t hese levels follows. sary when comprehension is limited.
• Intermediate fluency: Students have better
comprehension and experience fewer gram-
• Preproduction (silent/receptive): At this
matical problems. They are able to initiate and
stage students are concentrating on receptive
follow conversation without difficulties and are
language and have very limited expressive lan-
able to participate in conversations about mul-
guage. Single words are learned and teachers
tiple topics. They also exhibit greater vocabulary
may ask yes/no questions. Students who can
and are able to answer questions that require
use visual cues for learning language are very
multiple sentences. At this stage, teachers for
observant at this stage b
ecause they make many
students with visual impairments w ill be able
connections through observations. For stu-
to rely less on tangible objects and experien-
dents who are blind or have limited vision, the
tial activities and use more language to intro-
use of real objects, activities that require move-
duce and discuss new concepts.
ments, and explanations in the native language
may be necessary to facilitate understanding • Advanced fluency: Students have near native
and instruction in English. It is important not oral language abilities, but still may require
to misinterpret this stage or make comparisons academic support and cultural clarifications
with other English language learners b ecause when new concepts are introduced.
the process of moving into the next stage may
vary depending on students’ characteristics, As students enter American school systems
such as familiarity with school culture, desire with differ
ent school experiences and varied
to communicate, and social skills. academic and native language levels, t hese
• Early production: Students begin to use one- stages of second language acquisition may not
or two-word responses, answer simple questions, always be reached by all students in the same
have limited comprehension, and typically manner, as students’ characteristics play a sig-
only use the present tense of verbs. For students nificant role in achieving fluency in a new lan-
who are visually impaired, the use of real ob- guage. While comparisons among students may
jects, experiential activities, and books and be tempting for educators to make, this is not
music with repetitive patterns is appropriate, always a recommended practice b ecause it may
as they continue to have very limited com- lead to erroneous conclusions about students’
mand of the new language. second language growth.
hearing and visual impairments (V irginia ELP

ASSESSING ENG SH Checklist K–12; V irginia Department of Educa-
LANG AGE PROF CIENCY tion, n.d.). The checklist is an English language
AND PROGRESS proficiency assessment for emergent bilingual
students in kindergarten through grade 12 whose
One area of considerable concern is the assess- hearing and visual impairments prevent partici-
ment of English language proficiency levels and pation in the ACCESS test. It was developed us-
prog ress for students who are visually impaired, ing the Model Performance Indicators of the WIDA
as mandated by the US Department of Educa- ELD Standards for kindergarten and grade-level
tion. According to the Every Student Succeed Act clusters 1–2, 3–5, 6–8, and 9–12. The use of this
(ESSA), annual assessments need to be conducted checklist requires that English language learner
that w ill measure the Eng lish language profi- professionals and the Individualized Education
ciency of all English language learners enrolled Program (IEP) team work collaboratively to de-
in public schools in the four language domains termine a student’s eligibility to be assessed with
of speaking, listening, reading, and writing. Ad- the checklist.
ditionally, ESSA requires that states adopt En The availability of assessment tools that
glish language proficiency standards that w ill take into consideration the literacy medium of
facilitate following the prog ress of emergent bi- students with visual impairments and provide
lingual students’ in the four Eng lish language accommodations for administration does not elim-
domains. inate the complex questions related to assessing
For the purposes of assessing the develop- the academic language of students whose life and
ment of academic English language proficiency, educational experiences are remarkably different
the ACCESS for ELLs 2.0, which is a language pro- from those of other students and whose cultural
ficiency test used by states that have adopted the understanding of their new school situation is
WIDA language proficiency standards, contains still being constructed while they are learning
four distinct parts in the assessment, each de- English. Many immigrant students come to the
voted to assessing one of the four language do- United States from developing countries and
mains: listening, speaking, reading, and writing countries with internal conflicts that deeply affect
(WIDA, 2014, p. 19). The ACCESS for ELLs 2.0 is the quality of education they offer to students,
available in large print and in braille, either in particularly those with disabilities. The assess-
contracted or uncontracted forms, and provides ment of language proficiency is particularly chal-
for the use of accommodations for students with lenging for students who use braille for literacy
visual impairments. In order for students to be and are now learning to read and write English as
able to use the braille version of the assessments, a new language. Questions of testing validity still
they need to be proficient in the use of braille exist for English language learners, and data should
and tactile graphics. It is expected that begin- be interpreted with caution. (See Volume 2, Chap-
ning the 2016–17 school year, the Unified En ter 2, for additional information on cultural and
glish Braille code w ill be used for the ACCESS linguistic diversity and assessment.) Efforts to
for ELLs 2.0 (WIDA Consortium, 2015). measure students’ performance should be con-
The V irginia Department of Education uses centrated on the collection of authentic artifacts
the V irginia English Language Proficiency Check- that will demonstrate academic English language
list for Limited English Proficient Students in growth in listening, speaking, reading, and
Kindergarten through Grade 12 who have both writing.
LANGUAGE VARIATIONS ETHN C AND RACIAL D VERS TY
Language proficiency concerns in assessment Before embarking on a description of ethnic and

and instruction are primarily associated with racial groups, it is important to emphasize that
students who are learning English as a new lan- ethnicity or race is only one of the many charac-
guage; however, t here are many other language- teristics that define p eople from different cul-
related concerns that involve students who are tures. The values, belief systems, and practices of
native speakers of the language of instruction, individuals from diverse backgrounds go far be-
which is English in the case of the United States. yond racial and ethnic characteristics. Although
As languages differ to some degree from region to impor tant, membership in a specific racial or
region as well as with social status, these variations ethnic group does not imply that all members
create changes in pronunciation, grammar, and of the group hold the same opinions or values
vocabulary use. As Adger, Wolfram, and Chris- about education, disability, and the roles of pro-
tian (2007) noted, “a mismatch between standard fessionals. All people are diverse and may or may
tests and students’ language can put children at a dis- not fit ste reot ypes typically attached to racial
advantage quite early in their academic careers” groups. Cultural characteristics are presented
(p. 90). here so that the reader is aware of important
In the context of schooling, educators need to considerations when working with individuals
realize that a language variation does not consti- and families from diverse backgrounds. Histori-
tute a language disability. This is particularly crit- cally, however, there are important differences
ical when t here are differences in pronunciation among ethnic and racial groups in the United
that could be mistaken for an articulation diffi- States that have influenced their educational
culty, or grammatical differences that may be per- and economic trajectories, and those need to
ceived as a language problem. The language use be acknowledged.
within a linguistic community influences the Instead of concentrating at length on ethnic
manner in which individuals express themselves; and racial diversity and addressing individual
consequently, educators who do not belong to groups, this chapter attempts to respect and honor
the same linguistic community as their students racial and ethnic identity by generally address-
need to learn about the features that are charac- ing the needs of all culturally and linguistically
teristic of their students’ communities so as not diverse students and their families, and making
to make erroneous assumptions about possible recommendations and suggestions on how to
difficulties. work with different groups while avoiding cul-
Language variations can also affect the tural stereotypes. At the same time, some rele-
ways in which parents and teachers interact with vant facts and information that are group specific
each other about the child’s education. When and important for educators to know are in-
parents and teachers belong to different linguistic cluded, with the understanding that being edu-
communities because of e ither regional or class cated about distinctive characteristics and beliefs
differences, the possibility exists that miscom- attributed to a specific culture can be helpful in
munications may occur. In such cases, mutual understanding different points of view. All stu-
respect is imperative to maintain open and pro- dents and their families are unique, even when
ductive communications for the benefit of the they belong to the same culture or share similar
child’s education. cultural backgrounds.
Historical Discrimination significantly in their identification with Western

culture and Native American traditional culture,
Knowledge of the historical burden and the con- thus creating a psychological impact known as
sequences of the denial of education, educational acculturation stress. Acculturation stress can lead to
segregation, and unequal education opportuni- alienation that disrupts the transmission of cul-
ties w ill help teachers understand the poor aca- ture from generation to generation and results
demic achievement of many students from in the loss of linguistic traditions and other impor
underrepresented groups. However, t hese histor- tant cultural knowledge (Celenk & Van de Vijver,
ical factors should not be used to justify and ac- 2011).
cept low performance. Instead, better practices to Today, students from traditionally underrep-
teach these students should be implemented so resented groups who are blind are educated in ra-
that educational achievement becomes a reality, cially and ethnically integrated classrooms and
rather than an elusive dream. are typically taught by white teachers (Correa-
As an example, the first educational program Torres & Durando, 2011; Milian & Ferrell, 1998).
for African American students with visual im- However, t here is limited knowledge about the
pairments began in North Carolina in 1869. It needs and concerns of t hese students or educa-
was called the “Colored Department” of the tional areas that need to be improved to provide
North Carolina Institution for the Education of better opportunities for them and their families.
the Deaf and Dumb and the Blind, and it was Teachers, both visually impaired and sighted,
located in a separate building in southeast Ra- who come from culturally diverse communities
leigh. In 1929, 345 acres southeast of Raleigh w ere can share aspects of their culture with students
purchased for new facilities for African American who are blind, educate other school personnel
students, known as the Garner Road Campus. Ex- about their community, and serve as role models
changes between white and African American stu- for all students who are blind.
dents and teachers who attended the two separate
campuses began in 1967, but it was not until 1977
Cultural Discrepancies
that full racial integration was achieved and the
Garner Road Campus was closed (Governor More- The pressures experienced in the past by many
head School, 1995). underrepresented groups to abandon their tradi-
American Indian or Alaska Native students tional culture and language, coupled with more
are a heterogeneous group with diverse languages recent efforts to use students’ culture and language
and cultures. However, they share a common his- to improve educational outcomes, lead to the con-
tory of social and cultural oppression and clusion that programs for students with visual
native-language attrition as a result of their con- impairments who are from diverse backgrounds
quest by European and American settlers and the should incorporate the students’ language and
later policies of the US government. Robinson- culture into the curriculum to help them main-
Zanartu (1996) recounted how historically, ag- tain their culture and become bilingual and bi-
gressive measures were taken to assimilate Native cultural. Although the presence of students from
Americans into the mainstream culture and to underrepresented groups varies by geographic
pressure them to abandon their traditional life- area, it is very likely that teachers will encounter
styles. Native Americans’ experiences with the US students from these groups in both rural areas
government, educational system, and religious and urban school districts (see Chapter 15 of
institutions have created a population that varies this volume regarding rural education). Teachers
working with underrepresented groups could families’ attitudes toward teachers and school
benefit from understanding cultural views and programs for families, ability to help their children
factors that influence education with this group with schoolwork, and perception about how
of students and their family members and how much they need to participate in their c hildren’s
they compare to their own views. education.
Asian American Families

Hispanic/Latino Families
Cheng (1993) summarized some prevailing views
Hispanics in the United States, also known as La-
about learning that many Asian American fami-
tinos, include t hose whose families have been in
lies hold: Education is formal, so teachers are ex-
this country for centuries, as well as those who
pected to be formal and to lecture; teachers are to
are relatively new immigrants. Latino families’
be highly respected and not challenged or inter-
immigration history, experiences in the native
rupted; humility is an important virtue, so students
country, language use at home, length of time liv-
are not to show off or volunteer information; read-
ing in the United States, legal status, income
ing factual information is studying, therefore, fic-
level, educational level, religious beliefs, family
tion is not valued as serious reading; order and
structure, intention to return to the native coun-
obedience are important, so students need to sit
try, and reasons for living in the United States are
quietly and listen; since learning is done by ob-
among the factors that create much diversity
servation and memorization, rote memorization
within the population of Hispanics. T hese f actors
is an effective teaching strategy; and since pattern
may determine the familiarity or unfamiliarity of
practice and rote learning are valued, homework
individuals with the educational system and in-
that reinforces memorization is expected.
fluence how they react to serv ice providers.
Latino families with c hildren in both general
European American Families
and special education have been studied by a
number of researchers (Gallegos & Gallegos, Most of the focus of this section on race and eth-
1988; Harry, 1992; Hayes, 1992; Lynch & Stein, nicity has been on ethnic and racial minority
1987; Mary, 1990). In special education, studies groups, a focus based on the reality that the num-
have suggested that these families often have ber of students from t hese groups is growing and
difficulties with the printed information that that most teachers come from nonminority com-
schools send home b ecause it is written in En munities. However, there also is g reat diversity
glish or in technical terms even when Spanish is among the groups that originated from European
used. T hese families frequently feel that they countries. Some of t hese differences are in religious
should not question the decisions made by school affiliations, politi
cal views, educational levels,
personnel. In addition, despite their c hildren’s connection to ethnic traditions and food, linguis-
placement in special education, Latino parents tics, contact with the countries of ancestors, socio-
want their c hildren to achieve better education economic status, loyalty to the language of
and obtain higher-level jobs in the f uture than ancestors, generations removed from original an-
they themselves have been able to obtain. In cestors, and geographic location (leading to rural
reference to students with visual impairments, or urban lifestyles).
Milian (1999) stated that students’ characteristics, Although many European American teachers
such as age and reading mode, and parents’ char- feel comfortable when working with other Euro
acteristics, including educational level and lan- pean American students and families, social class,
guage spoken, are associated with differences in linguistic variations, religious differences, and
urban versus rural upbringing sometimes pres shared with f uture teachers in the field of visual
ent challenges in the classroom and to an other impairments so that they can identify and design
wise amicable relationship with f amily members. more successful educational practices for t hese
In recent years, immigrants from Eastern Europe students.
who have been educated u nder a different politi
cal system have challenged the skills of teachers
who have been relatively secure in their ability PARTNERSH PS WITH
to work with students with European roots. Con- AM LY AND COMMUNITIES
sequently, it is important to recognize the differ
ent groups that have been clustered u nder the The most recent reauthorization of the Individu-
umbrella of “Eu ro
pean Americans” and the als with Disabilities Education Act in 2004 em-
many factors that create variations within this phasizes the importance of the role of the f amily
large group. in the special education process. Parents (or a per-
Schools’ personnel can play an important role son serving in the role of a parent) are entitled to
in minimizing cultural discrepancies by under- be active members of the Individualized Educa-
standing, accepting, and promoting students’ cul- tion Program team, and although they are not re-
tural practices and beliefs as well as their language quired to participate in the IEP, schools must use
as valuable components of the school and commu- methods to ensure their participation. Parents
nity. In her book The Dreamkeepers, Ladson-Billings and other family members can provide impor
(1994) presented suggestions for ways that teacher tant information about their child including ed-
preparation programs could assist preser vice ucational background, language acquisition and
teachers in developing attitudes that will lead to challenges in student’s first language, changes or
successful teaching experiences with students events at home that could be impacting school
from underrepresented groups. They include the performance, and culturally appropriate behav
following: iors (Friend & Bursuck, 2012; Grassi & Barker,
2010).
• Recruit preservice teachers who have expressed Best practices for teachers working with stu-
a desire to work with students from underrep- dents from diverse backgrounds should include
resented groups. the use of strategies to promote and enhance ef-
• Provide educational experiences that help fective communication with families, awareness
preserv ice teachers understand the central role of one’s belief system, and use of culturally rele-
of culture. vant teaching (Araujo, 2009). Trask and Hamon
(2007) suggested that many p eople from diverse
• Give preserv ice teachers opportunities to cri-
backgrounds have strong religious beliefs and ties
tique the educational system in ways that w ill
to family. The values and beliefs of families are
help them choose to be either agents of change
also influenced by socioeconomic status. The
or defenders of the status quo.
family structure helps support individuals within
• Require preserv ice teachers to have a pro- the cultural group, especially when t here is a dis-
longed immersion in specific cultures. ability present. In many cultures, t here is an ex-
• Provide preservice teachers with opportunities tended f amily unit and each child is born into a
to observe culturally relevant teaching. circle of immediate and extended family mem-
bers who share the responsibilities for raising
The stories of individuals from underrepre- the child. The role of grandparents and other ex-
sented groups, both past and present, need to be tended family members is very import ant, and
often, multiple generations live in one h ouse or Beliefs about Disability and Religion
in close proximity. The idea of kinship, whereby
t hose who may not be biologically related are re- Individuals from many cultures consider faith
ferred to in family terms, is common. to be an import ant part of their lives, and they
Major responsibilities for child rearing, disci- maintain strong ties to religion and religious
pline, and family issues vary among families institutions. O thers may worship outside of a reli-
and are often influenced by the cultural tradi- gious institution and only attend sporadically. Re-
tions of each family. Some families are matriar- ligion can be helpful to cope with stressful events
chal, which means that m others are the dominant and many find personal strength from faith in a
people and the center of the family even when higher power. Religious institutions can fulfill
males are present. In these families, all females many basic needs in the community and serve as
(grandmothers, mothers, daughters, and so on) an extended family. In many communities, reli-
tend to work together to support the family needs. gious institutions provide supports such as finan-
Other families are patriarchal, meaning that the cial assistance, clothing, child care, and food.
father is the wage earner and decision maker in Organized religion can provide opportunities to
the f amily. The mother in a patriarchal f amily is build self-esteem by establishing a positive iden-
typically in charge of child rearing. However, the tity. Some individuals from diverse backgrounds
responsibility for raising a child is often shared practice ancestor worship and make special offer-
among adults in the f amily and sometimes the ings to their ancestors. T here may be an emphasis
community. Various cultures place an impor- on the link between the living and t hose who are
tance on having a male heir, and sons are con- in the afterlife. When considering disability, reli-
sidered of higher status than d aughters. It is gious beliefs can be integral to the families’ per-
import ant in many cultures for c hildren to learn ception of the cause of the disability. Disability
the traditions and beliefs and pass them on to can be perceived as a gift from God or a punish-
their own c hildren. Extended family can help en- ment for a sin in a past life. It can also be perceived
sure the individual family and collective group as a test of personal strength, a belief that can be
culture gets passed on through generations. central to coping with the needs of a child. Reli-
Many cultures are collectivist, meaning that the gion can help answer the question of “why” for
family or group is considered more important than some p eople and encourage acceptance of them-
any one member. The needs of the group trump selves and their child.
the needs of an individual. Important decisions The prevalence of visual impairments in mi-
may be made in consultation with other members nority groups could be the result of inadequate
or a religious leader. As Meyer (2010) explained, nutrition, poor quality of water, inaccessibility of
t hese families work together to support one an- health care, or absence of prenatal care, among
other rather than separately to obtain personal other causes. Members of minority groups in the
goals. United States and those who may have immi-
Following is a summary of factors that are grated from developing countries may have less
important to consider when working with cul- access to higher education, leading to unemploy-
turally and linguistically diverse families. For a ment and underemployment. Consequently, it is
more expanded discussion on how some of t hese not uncommon for members of minority groups
factors can impact the life of individuals who are to be employed in occupations that are more
visually impaired, the reader is referred to Milian likely to be physically demanding, so they may
and Erin (2001). be more prone to injury.
Beliefs about disability vary across cultural Some cultures are prese nt-oriented rather than
backgrounds, socioeconomic status, and religion. future-oriented and so they are less tied to the
There are folk beliefs that attribute visual impair- clock. Concepts of work and education are cul-
ment to superhuman causes like witchcraft, spirit turally based, so the type of work and kind of
loss, or spirits choosing to inhabit bodies. Disabil- education encouraged by the family can vary
ity may be believed to be caused by something greatly. It is important for school personnel to
the m other did or thought while pregnant, such understand that open conflicts are not valued in
as eating the wrong food or breaking a cultural some cultures and members of those cultures
taboo. Loss of vision is also thought of as the re- often avoid conflicts; instead, in many cultures
sult of some transgression made earlier in life. In people strive for harmony. F amily members may
certain cultures, it is believed that looking at appear to agree to a recommendation or change
something considered taboo may cause the per- when in fact they do not, so there may not be
son to gradually lose his or her vision. Religious follow-t hrough with the recommendation or
rites, prayer, and healers are used to treat disease change. School personnel often perceive this be
and disabilities in many cultures. Many turn to havior as noncompliance when in fact it is a cul-
tribal healers before Western medicine. How- tural misunderstanding.
ever, people from all cultures share concerns
about a child’s f uture, educational issues, health,
independence, and safety. In many cultures, it
Poverty and Visual Impairment
is thought that the person with a disability Worldwide, 90 percent of the p eople who are
should be looked a fter or cared for rather than visually impaired live in developing countries
educated and encouraged to become indepen (WHO, 2014). Poverty affects p eople from all
dent and employed (Meyer, 2010). As a result, races. Female householders, without a husband
educators often encounter issues related to in present, and related c hildren under the age of 6
dependence when educating students with visual are among the largest group of the poor, without
impairments who come from culturally diverse consideration of race or ethnicity (US Census Bu-
communities. reau, 2010). In 2005, 39 percent of c hildren in
the United States lived in low-income families.

Individuals from diverse backgrounds who face
Communication special challenges also suffer a high level of pov-
Communication and styles of interacting influ- erty. These include those with disabilities, mi
ence or regulate the ways individuals talk to each grant workers, and the homeless. Poverty rates
other, their use of body language and silence, and are higher among those with disabilities than
so forth. Physical contact, proximity, and eye con- t hose without disabilities. In 2013, 30 percent of
tact differ between cultural groups when commu- noninstitutionalized adults who w ere between 21
nication is concerned. Some groups are more and 64 years old and had a visual impairment
comfortable with distance and others are more were reported to live below the poverty line, and
comfortable with close personal space. Some ad- only 40.2 percent of adults who reported signifi-
dress adults in a formal manner, while o thers are cant vision loss were employed in the same year
more informal. In some cultures, respect is shown (Erickson et al., 2015).
for people by not making eye contact and not ask- Proper health care has been shown to de-
ing direct questions. Gestures, nonverbal cueing, crease or prevent vision loss, especially in cases of
or touch may be more respectful than speaking. cataracts and glaucoma (WHO, 2014). Evidence
shows that some eye diseases like trachoma are Gender

directly related to consequences of poverty in
developing countries (Gilbert, Shah, & Jadoon,
Gender roles refer to attitudes and behaviors so-
2008). It is important to realize that visual impair- cially expected from the members of a part icular
ment may also cause some people to become poor. gender group within a culture that are widely
A review on poverty and its consequences found considered to be socially appropriate for individ-
that although some individuals become disabled uals of that specific gender (King & Beattie, 2004).
because of low income, 64 percent of those with Socially accepted gender roles exist in all socie
disabilities w ere not in poverty prior to the onset ties and differ widely between cultures. Fami-
of the disability. Further, is difficult for p eople lies of a part icular culture tend to socialize their
with visual impairments who become poor to es- young c hildren to embrace culturally expected
cape poverty because of the increased health care gender roles. When children are young, the games
costs and reduced earnings associated with dis- they are taught and play contribute to socializing
ability. It is evident that disabilities such as visual them into masculine and feminine cultures. For
impairment may not only be a result of living in example, playing house promotes a focus on per-
poverty, but also may lead to poverty (Holden, sonal relationships in girls, and playing h ouse
2007). does not necessarily have fixed rules or objectives.
Socioeconomic diversity among c hildren Boys, however, tend to play more competitive
affects their overall quality of life as well as team sports with different goals and strategies.
their education. C hildren in families who have These early experiences then contribute to future
low income are more likely to live in the central gender-based expectations (Allen & Beitin, 2007).
cities of large, metropolitan areas or poor rural There are different expectations of boys and
areas. Many of the schools t hese c hildren attend girls in different cultures (King & Beattie, 2004).
are high-poverty schools and lack resources to In some cultures, males tend to be more highly
provide high- quality education. Substandard valued and expected to take on leadership roles,
housing, inadequate health care, and poor nu- while females are expected to be followers and at-
trition all contribute to lower-level outcomes for tend to household responsibilities. How people
t hese students. Students who come from cultur- of different genders relate to one another is also
ally and linguistically diverse communities are significant. In some cultures, individuals of the
disproportionately represented in families with same gender may reduce distance in communica-
poverty- level income. Lamentably, students tion, while those of different genders can increase
with the lowest rate of academic prog ress also distance. Therefore, the gender of a student and
have the highest rates of poverty. The interac- the gender of a teacher may influence their rela-
tion between poverty and poor academic tionship and, in d oing so, affect the educational
achievement can create barriers to successful experience of the child (Ahmed, Hundt, & Black-
lives. Educators need to be aware of and under- burn, 2011).
stand the negative consequences of low socioeco- The roles of women and men in society are
nomic conditions and the impact on academic influenced and s haped by both their gender and
achievement. Students who come from families their disability (Allen & Beitin, 2007). The prev-
who experience poverty often need to receive alence of visual impairments in males and fe-
additional academic support and access to op- males has been shown to be about equal, only
portunities in order to made adequate academic slightly higher in females (WHO, 2014). While
prog ress. gender is not associated with the prevalence of
visual impairments, it may affect expectations the knowledge and skills they need to teach
families have of their c hildren. In many cultures, students from diverse backgrounds. While con-
t hose with disabilities are viewed as being help- tent about language and cultural diversity is
less and as needing someone to constantly care required in many states for teacher certification,
for them. Traditional roles held by men or w omen this is not always the case in the preparation
within a specific culture may be thought of as un- programs for educators of students with visual
attainable for the individual with a disability. This impairments.
is especially the case for w
omen b
ecause t here may Program administrators need to support
be a lower expectation that the w oman will get teachers and provide opportunities for them to
married and have c hildren. Instead of the expecta- strengthen their skills when teaching students
tion that the woman would care for the children, from diverse language and cultural communi-
the w oman would need to be cared for by rela- ties. Teachers need to identify areas in their pro-
tives. For men, the expectation of being the wage grams that require improvement and share their
earner may be adjusted, as he would need to be ideas with colleagues and administrators so that
cared for rather than expected to work and help changes can be made. Agencies that are respon-
provide for his family. T hese low expectations, es- sible for developing instructional and informa-
pecially for women who are members of diverse tional materials need to become more involved
cultures, impact the level of education and employ- in creating materials that can be used with stu-
ment opportunities offered to the person with a dents and families who speak languages other
visual impairment (King & Beattie, 2004). than English. In general, all professionals in the
Educators of students with visual impair- field need to increase their level of awareness and
ments need to reflect on how the areas discussed advocacy in order to improve services for students
relate to the students and families on their case- with visual impairments and their families who
load, and how t hese factors can hinder the edu- are members of culturally and linguistically di-
cation students receive and the communication verse groups.
among teachers, students, and f amily members.
SUMMARY
IMPROVING SERVICES
Educators need to perceive diversity as an oppor-
As diversity among the population of students tunity to grow both personally and profession-
and adults with visual impairments continues to ally. The cultural characteristics and experiences
grow, changes need to be made at different levels that students bring to the classroom provide an
in the fields of education and rehabilitation of in- immense opportunity for teachers to learn and
dividuals with visual impairments. One needed reflect on cultural practices, different worldviews,
change is to have a better data reporting system religious differences, and the challenges faced by
that can provide reliable information to profes- t hose who live with or without disabilities in dif
sionals in both education and rehabilitation; this ferent parts of the world. Indeed, educators can
applies both to data on the numbers of individu- envision the world through their students’ lives
als with visual impairments and to information and experiences.
on racial, ethnic, and language status.
University training programs need to con- For learning activities related to this
tinue to incorporate content into the curriculum chapter, log in to the online AFB Learning
that w
ill provide teachers entering the field with Center.
Retrieved from http://s cholarworks.g vsu.e du

REFERENCES /orpc/vol8/iss1/10/
Cheng, L. L. (1993). Asian-A merican cultures. In D. E.
Adger, C. T., Wolfram, W., & Christian, D. (2007). Battle (Ed.), Communication disorders in multicul-
Dialects in schools and communities. Mahwah, NJ: tural populations (pp. 38–77). Stoneham, MA:
Lawrence Erlbaum. Butterworth-Heinemann.
Ahmed, D. A. A., Hundt, G. L., & Blackburn, C. (2011). Correa-Torres, S. M., & Durando, J. (2011). Perceived
Issues of gender, reflexivity and positionality in training needs of teachers of students with visual
the field of disability: Researching visual impair- impairments who work with culturally and lin-
ment in an Arab society. Qualitative Social Work, guistically diverse backgrounds. Journal of Visual
10(4), 467–484. Impairment & Blindness, 105, 521–532.
Allen, K., & Beitin, B. (2007). Gender and class in cul- Cummins, J. (1981). The role of primary language
turally diverse families. In B. S. Trask & R. R. development in promoting educational success
Hamon (Eds.), Cultural diversity and families: Ex- for language minority students. In California
panding perspectives. Thousand Oaks, CA: Sage. State Department of Education, Schooling and
Angelou, M. (1993). W ouldn’t take nothing for my jour- language minority students: A theoretical framework
ney now. New York: Bantam Books. (pp. 3–49). Los Angeles: California State Uni-
Araujo, B. (2009). Best practices in working with lin- versity, Evaluation, Dissemination and Assess-
guistically diverse families. Intervention in School ment Center.
and Clinic, 45, 116–123. Data Accountability Center. (2013). Individuals with
Baker, B., & Rytina, N. (2013, March). Population esti- Disabilities Education Act (IDEA) data [data tables for
mates: Estimates for unauthorized immigrant popula- OSEP state reported data]. Retrieved from https://
tion residing in the United States: January 2012. www.ideadata.org/tables33rd/a r_1–7.pdf
Washington, DC: Department of Homeland Secu- Education for All Handicapped C hildren Act, Pub.
rity, Office of Immigration Statistics. Retrieved L. No. 94-142 (1975).
from http://w ww.dhs.gov/sites/default/files/publi Elementary and Secondary Education Act (No Child
cations/ois_ ill_ pe_ 2012_ 2.pdf Left Behind), Pub. L. No. 107-110 (2001).
Bertsch, A. (2013). The melting pot vs. the salad bowl: Every Student Succeeds Act, Pub. L. No. 114-95

A call to explore regional cross-c ultural differ- (2015).
ences and similarities within the USA. Journal of Erickson, W., Lee, C., & von Schrader, S. (2016). Dis-
Organiz ational Culture, Communications and Con- ability statistics from the 2014 American Community
flict, 17(1), 131–148. Survey (ACS). Ithaca, NY: Cornell University,
Blackwell, D. L., Lucas, J. W., & Clarke, T. C. (2014). Yang Tan Institute (YTI). Retrieved from http://
Summary health statistics for U.S. adults: Na- www.disabilitystatistics.org
tional Health Interview Survey, 2012. National Friend, M., & Bursuck, W. D. (2012). Including stu-
Center for Health Statistics. Vital Health Statistics, dents with special needs: A practical guide for class-
10(260). Retrieved from http://w ww.cdc.gov/nchs room teachers (6th ed.). Upper S addle River, NJ:
/data/series/sr_10/sr10_ 260.pdf Pearson.
Brown v. Board of Education, 347 U.S. 483 (1954). Gallegos, A., & Gallegos, R. (1988). The interaction be-
California Department of Education. (2014). Califor- tween families of culturally diverse handicapped
nia English language development standards: Kinder- children and the school. In H. S. Garcia & R. Chavez
garten through grade 12. Sacramento, CA: Author. (Eds.), Ethnolinguistic issues in education (pp. 125–
Retrieved from http://w ww.cde.c a.gov/sp/e l/e r 132). Lubbock: Texas Tech University.
/documents/eldstndspublication14.pdf Garcia, O., & Kleifgen, J. A. (2010). Educating emer-
Celenk, O., & Van de Vijver, F. (2011). Assessment of gent bilinguals: Policies, programs, and practices for
acculturation: Issues and overview of measures. English language learners. New York: Teachers Col-
Online Readings of Psy chology and Culture, 8(1). lege Press.
Gilbert, C., Shah, S., & Jadoon, M. (2008). Poverty and Mary, N. L. (1990). Reactions of black, Hispanic, and
blindness in Pakistan: Results from the Pakistan white m others to having a child with handicaps.
national blindness and visual impairment survey. Mental Retardation, 28(1), 1–5.
British Medical Journal, 336(7634), 29–32. Meyer, H.-D. (2010). Framing disability: Comparing
Governor Morehead School. (1995). 150th anniversary individualist and collectivist societ ies. Compara-
edition: Exclusive one-time issue. Raleigh, NC: Author. tive Sociology, 9(2), 165–181.
Grassi, E. A., & Barker, H. B. (2010). Culturally and linguis- Milian, M. (1999). Schools and family involvement:
tically diverse exceptional students. Los Angeles: Sage. Attitudes among Latinos who have c hildren with
Hamayan, E., Marler, B., Sanchez- L opez, C., & visual impairments. Journal of Visual Impairment &
Damino, J. (2013). Special education considerations Blindness, 93, 277–290.
for English language learners: Delivering a continuum Milian, M. (2013, Fall). Emergent bilinguals with vi-
of services (2nd ed.). Philadelphia: Caslon. sual impairments: Guidelines for instruction. DVI
Harry, B. (1992). Making sense of disability: Low- Quarterly, 58(2), 26–33.
income Puerto Rican parents’ theories of the Milian, M., & Conroy, P. (1999). Preparing teachers to
problem. Exceptional Children, 59, 27–40. educate culturally and linguistically diverse students
Hatton, D. D., Ivy, S. E., & Boyer, C. (2013). Severe vi- with sensory impairments: A survey of administrators.
sual impairments in infants and toddlers in the Greeley: University of Northern Colorado, Divi-
United States. Journal of Visual Impairment & Blind- sion of Special Education.
ness, 107(5), 325–337. Milian, M., & Erin, J. N. (Eds). (2001). Diversity and vi-
Hayes, K. G. (1992). Attitudes toward education: Vol- sual impairment: The influence of race, gender, reli-
untary and involuntary immigrants from the gion, and ethnicity on the individual. New York: AFB
same families. Anthropology & Education Quarterly, Press.
23, 250–267. Milian, M., & Ferrell, K. A. (1998). Preparing special ed-
Holden, B. (2007). Blindness and poverty: A tragic ucators to meet the needs of students who are learning
combination. Clinical and Experimental Optometry, English as a second language and are visually impaired:
90(6), 401–403. A monograph. Greeley: University of Northern Col-
Individuals with Disabilities Education Improvement orado, Division of Special Education.
Act (IDEA), 20 U.S.C. § 1400 (2004). Milian, M., & Pearson, V. (2005). Students with a vi-
Kena, G., Aud, S., Johnson, F., Wang, X., Zhang, J., Rath- sual impairment in a dual language program: A
bun, A., . . . Kristapovich, P. (2014). The condition case study [Research report]. Journal of Visual Im-
of education 2014 (NCES 2014-083). Washington, pairment & Blindness, 99(11), 715–720.
DC: U.S. Department of Education, National Cen- National Center on Educational Outcomes. (n.d.). ELs
ter for Education Statistics. with disabilities. Minneapolis: University of Min-
King, U., & Beattie, T. (2004). Gender, religion and diver- nesota. Retrieved from https://nceo.info/student
sity: Cross cultural perspectives. Portland, OR: Ring- _g roups/ells_w ith_disabilities
gold. National Center for Education Statistics. (2014a). The
Krashen, S. D., & Terrell, T. D. (1983). The natural ap- condition of education 2014. Washington, DC: US
proach: Language acquisition in the classroom. Hay- Department of Education. Retrieved from http://
ward, CA: Alemany Press. nces.ed.gov/pubs2014/2014083.pdf
Ladson-Billings, G. (1994). The dreamkeepers: Success- National Center for Education Statistics. (2014b).
ful teachers of African American students. San Fran- Digest of education statistics. Washington, DC: US
cisco: Jossey-Bass. Department of Education. Retrieved from https://
Lau v. Nichols, 414 U.S. 563 (1974). nces.ed.gov/programs/digest/d14/tables/dt14_ 204
Lynch, E. W., & Stein, R. C. (1987). Parent participa- .50.a sp
tion by ethnicity: A comparison of Hispanic, black Nieto, S. (1996). Affirming diversity: The sociopolitical
and Anglo families. Exceptional Children, 54(2), context of multicultural education (2nd ed.). White
105–111. Plains, NY: Longman.
Phelan, P., Davidson, A., & Cao, H. (2009). Students’ sharedm edia/2016/2016- 0 6-20- g lobal- t rends
multiple worlds: Negotiating the bounda ries of /2016- 06-14-Global-Trends-2015.pdf
family, peer, and school cultures. Anthropology & United Nations, Department of Economic and Social
Education Quarterly, 22(3), 224–250. Affairs, Population Division. (2013, October).
Robinson-Z anartu, C. (1996). Serving Native Ameri- World migration in figures. Retrieved from http://
can c hildren and families: Considering cultural www.u n.org /e n/development /desa/p opulation
variables. Language, Speech, and Hearing Services in /publications/p df/m igration/m igration/ World
Schools, 27, 373–384. _Migration_ Figures_UNDESA_OECD.pdf
Rose, P. (1995). They and we: Racial and ethnic rela- US Census Bureau. (2010). Current population survey.
tions in the United States (5th ed.). New York: Annual Social and Economic Supplement. Retrieved
McGraw-H ill. from http://w ww.census.gov/population/foreign
Ryan, C. (2013, August). Language use in the United /files/c ps2010/ T 2.2010.pdf
States: 2011. American Community Survey Reports. US Census Bureau. (2012, December). U.S. Census
Washington, DC: US Census Bureau. Retrieved Bureau projections show a slower growing, older,
from http://w ww.census.gov/prod/2013pubs/acs more diverse nation a half c entury from now.
-22.pdf Retrieved from http://w ww.census.gov/newsroom
Schwartz, S. E., & Dunnick Karge, B. (1996). Human /releases/a rchives/population/c b12-243.html
diversity: A guide for understanding (2nd ed.). New US Department of Education. (2014). Questions and an-
York: McGraw-Hill. swers regarding inclusion of English learners with dis-
Sleeter, C., & Grant, C. A. (1993). Making choices for abilities in English language proficiency assessments and
multicultural education: Five approaches to race, class, Title III annual mea sur
able achievement objectives.
and gender. New York: Macmillan. Washington, DC: Author. Retrieved from http://
Title VII of Civil Rights Act of 1964, Pub. L. No. 88- www2.ed.gov/policy/speced/g uid/idea/memosd-
352 (1964). cltrs/q-and-a-on-elp-swd.pdf
Thomas, W. P., & Collier, V. (1997). School effective- US Department of Education, Office for Civil Rights.
ness for language minority students. Washington, (2013). 2006 national and state estimations: Civil
DC: National Clearing house for Bilingual rights data collection. Retrieved from http://
E ducation. ocrdata.ed.gov/StateNationalEstimations/projec-
Topor, I., & Rosenblum, L. P. (2013). Eng lish language tions_ 2006
learners: Experiences of teachers of students with US Department of Education, Office of Special Edu-
visual impairments who work with this popula- cation and Rehabilitative Serv ices, Office of Spe-
tion. Journal of Visual Impairment & Blindness, cial Education Programs. (2014). 36th annual report
107(2), 79–91. to Congress on the implementation of the Individuals
Trainor, A. A., Murray, A., & Kim, H. (2014). Postsec- with Disabilities Education Act, 2014. Washington,
ondary transition and English language learners with DC: Author. Retrieved from http://w ww2.ed.gov
disabilities: Data from the second National Longi- /about/reports/a nnual/osep/2013/parts-b- c/35th
tudinal Transition Study (WCER Working Paper -idea-a rc.pdf
No. 2014-4). Madison: University of Wisconsin– US Department of Homeland Security. (2014a). Table 2:
Madison, Wisconsin Center for Education Re- Persons obtaining lawful permanent resident
search. Retrieved from http://w ww.wcer.w isc.edu status by region and selected country of last resi-
/publications/workingPapers/papers.php dence: FYs 1820 to 2013. Washington, DC: Au-
Trask, B. S., & Hamon, R. R. (Eds.). (2007) Cultural di- thor. Retrieved from https://w ww.dhs.gov/year
versity and families: Expanding perspectives. Thou- book-immigration-statistics-2014-lawful-perma-
sand Oaks, CA: Sage. nent-residents
United Nations High Commissioner for Refugees US Department of Homeland Security. (2016). Yearbook
(2016). Global trends: Forced displacement in 2015. of immigration statistics: 2014 legal permanent resi-
Retrieved from https://s3.amazonaws.com/unhcr dents. Washington, DC: Author. Retrieved from
https://w w w.d hs.g ov/y earbook-i mmigration WIDA. (2014). The WIDA standards framework and
-statistics-2014-lawful-permanent-residents its theoretical foundations. Madison, WI: Author.
US Department of State. (2014). FY13 refugee Retrieved from https://w ww.w ida.u s/get.a spx
admission statistics. Washington, DC: Author. Re- ?id=731
trieved from http://w ww.state.gov/j/prm/releases WIDA Consortium. (2012). English language proficiency
/statistics/228666.htm standards and resource guide: Pre-kindergarten through
Valentino, R. A., & Reardon, S. F. (2015). Effectiveness grade 12 (2007 ed.). Madison, WI: Board of Re-
of Four Instructional Programs Designed to Serve gents of the University of Wisconsin S ystem.
English Learners. Educational Evaluation and Policy WIDA Consortium. (2015). ACCESS for ELLs 2.0 acces-
Analysis, 37(4), 612–637. sibility and accommodations guidelines. Madison,
Virginia Department of Education. (n.d). Virginia English WI: Author. Retrieved from http://w ww.doe.in
language proficiency assessments.. Richmond, VA: Au- .gov/sites/default/files/assessment/w idaaccessacc-
thor. Retrieved from http://w ww.doe.virginia.gov guidelines.pdf
/t esting /e nglish _ l anguage _ proficiency _ a ssess Wilson, F. A., Wang, Y., Stimpson, J. P., Kessler, A. S.,
ments/index.shtml Do, D. V., & Britigan, D. H. (2014). Disparities in
Watkins, E., & Liu, K. (2013, Winter/Spring). Who are visual impairment by immigrant status in the
Eng lish language learners with disabilities? In United States. American Journal of Ophthalmology,
K. Liu, E. Watkins, D. Pompa, P. McLeod, J. Elliott, 158(4), 800–807.
& V. Gaylord, V. (Eds.), Impact: Feature Issue on Edu- World Health Organization. (2014, August). Visual
cating K–12 English Language Learners with Disabili- impairment and blindness. Retrieved from
ties, 26(1), 2–33. Retrieved from http:// ici .
umn http:// w w w.w ho.i nt/m ediacentre/f actsheets
.edu/products/impact/261 /fs282/en/
9
C H A P T E R
Educational Programming
Sandra Lewis and Carol B. Allman
To hear an audio introduction ♦ When determining appropriate placement for a

to this chapter by an author, student with a visual impairment, the IEP team
and to view a chapter over must consider the environment in which iden-
view presentation, log in to the AFB Learning tified goals or benchmarks can best be met.
Center. ♦ Parents of students with visual impairments
play a critical role in the educational process.
♦ Teachers of students with visual impairments
KEY POIN S have an ethical obligation to make educational
decisions that will result in the educational pro
♦ The provision of educational services for stu-
gress of the students assigned to them.
dents with disabilities has been federally man-
dated since the passage of the Education for All
Handicapped Children Act of 1975. When this INTRODUCT ON
legislation was reauthorized in 1990, its name
was changed to the Individuals with Disabilities The foundation of educational programming for
Education Act (IDEA). Although since renamed students with visual impairments is based on the
the Individuals with Disabilities Education Im- principles of meeting the educational needs of
provement Act (IDEIA), it is still commonly re- students that have been described throughout
ferred to as IDEA. this book. Educational programming, the fo-
cus of this chapter, involves planning through
♦ This law has been reviewed and updated fre-
the identification and assessment of a student,
quently, and future reauthorizations are likely
development of the student’s Individualized Ed-
because of the importance of federal mandates
ucation Program, and determination of the ap-
for persons with disabilities.
propriate placement for implementing the IEP.
♦ All the steps in the process of educational pro- The IEP is a required annual plan for addressing
gramming should be followed to ensure that the strengths, weaknesses, needs, and services for
students receive appropriate services. a student with a disability. Also covered in this
♦ Each student who receives special education chapter are issues related to the administration of
services has a specially designed plan, called an educational programming, including account-
Individualized Education Program (IEP), to guide ability, placement in private schools, legal rights
the efforts of the student’s educational team. of parents, collaboration with f amily members,
280
Educational Programming 281
liability, determination of caseloads, use of Figure 9.1 Educational Programming

paraeducators, and links to postschool rehabil-
itation serv ices. Each component of educational
programming interacts with the others to pro- Referral and Identification
vide direction to achieve the desired outcome
for students with visual impairments: develop-
ment into healthy, happy adults who can function
in and contribute to society with the interde-
Assessment
pendence typical of the general population of
adults.
PROCESS OF EDUCA IONAL Eligibility Determination
PROGRAMMING
In 1975, President Gerald R. Ford signed Public
Law 94-142, the Education for All Handicapped IEP Development
Children Act, into law. This groundbreaking law
mandated that students with disabilities be edu-
cated in the public school system, ensured the
right of parents to participate in the development
of programs for their c hildren, and established a Placement Determination
process for the determination and provision of

an appropriate education. Through reviews and
reauthorizations of the law (in 1990, 1997, and
2004), Congress has evaluated these requirements Administration of Educational Programming
and confirmed their key importance for imple-
menting the law, which is now officially titled

the Individuals with Disabilities Education Im-
provement Act, but is commonly referred to as
IDEA, or the Individuals with Disabilities Educa- team determines his or her abilities, strengths,
tion Act. (See Chapter 1 in this volume for more and needs; develops goals and objectives to ensure
information about the history of this legisla- the student’s educational progress; and identifies
tion.) the educational placement in which the student
The process of determining educational pro- will receive special education and related services
gramming, depicted in Figure 9.1, begins with the (services other than special education, including
identification of a student with a potential dis- “transportation and such developmental, correc-
ability, receipt of permission from the parents to tive, and other supportive services as are required
assess their child, and the creation of a collabor- to assist a child with a disability to benefit
ative educational team to evaluate the student from special education” [IDEA, 2004, 34 C.F.R
and plan the student’s IEP. This team evaluates § 300.34]). Each step is important, and it is es-
the student and, on the basis of the results of the sential that all the steps be followed in order, to
evaluation, determines if the child is eligible for ensure that a student’s individual needs are ad-
serv ices. A fter the student is deemed eligible, the equately addressed.
Identification for appropriate ser v ices is beneficial to the

family’s adjustment and the child’s progress (Fer-
School districts are required to make efforts to rell, 2011; LaVenture & Allman, 2007). The period
identify students who may have disabilities that immediately after parents learn that their child
interfere with learning. Most states have exten- has a visual impairment is often one of confusion
sive “child-find” activities that are designed to and turmoil. Frequently, the family’s efforts are
meet this component of IDEA. These activities in- directed toward understanding and managing the
clude the distribution of general public notices child’s medical condition and confirming the di-
or brochures in places where parents of young agnosis. Some families need time to process and
children tend to spend time, such as day care cen- adjust to this unanticipated change in their lives
ters, pediatricians’ offices, and libraries; presen and are not aware that this adjustment can be
tations at public meetings; and media advertising made easier through the intervention of educa-
of the availability of serv ices for students with tors who are trained in working with c hildren
disabilities. Parents and o thers may disclose to with visual impairments.
school districts their suspicions of a child’s need It is not unusual for students with low vision
for special education serv ices, and given this in- who also have severe developmental or multiple
formation, districts are compelled to honor the disabilities to be unidentified as students with
request for evaluation. visual impairments (Fellinger, Holzinger, Dirm-
A child’s visual impairment is usually identi- hirn, Van Dijk, & Goldberg, 2009; Van den Broek,
fied by an eye care specialist, either an ophthal- Janssen, Van Ramshorst, & Deen, 2006). Although
mologist or an optometrist, who can inform the these students may be receiving educational ser
parents of the availability of serv ices from the lo- vices as students with a disability, needs related to
cal education agency (LEA) or school district. It their visual impairment may not be addressed. Ex-
is not appropriate for t hese medical pract it ioners amples of such needs are presentation of materi-
to recommend educational placement or appro- als in appropriate learning media, necessary
priate media for learning, but the results of their accommodations that increase access to classroom
evaluations should be used by educational activities, and instruction in the expanded core
personnel in recommending t hese important as- curriculum (ECC, discussed later in this chapter).
pects of the child’s placement and learning needs. Teachers of students with visual impairments who
Some students, particularly t hose with multiple provide services in classrooms and schools where
impairments, often are not appropriately identi- students with multiple disabilities are placed need
fied as having visual impairments because their to be alert to the possible undiagnosed presence of
unusual and often unreliable response patterns low vision or blindness in these students and make
make it difficult for eye care specialists without referrals as appropriate.
experience with similar c hildren to test them. In the same way, additional disabilities that
Sometimes, a visual impairment is identified explain delayed development and learning prob
through a child’s participation in vision screen- lems may go undetected in some students who
ing offered to all students of a certain age in a are identified as having a visual impairment. In
school district. t hese circumstances, students are not able to get
There is evidence that parents may delay
the full range of serv ices that they need to make
contacting the LEA for several months a fter a vi- prog ress b ecause professionals with important
sual impairment is identified (Hatton, Ivy, & expertise have not been involved in their educa-
Boyer, 2013; Huebner, Merk-Adam, Stryker, & tional programming. It is important that all stu-
Wolffe, 2004), even though immediate referral dents receive a comprehensive assessment that
addresses all suspected areas of disability and • Educational decisions cannot be based on the
all areas of functioning potentially impacted by results of a single test.
t hose disabilities.
The assessment of the abilities, strengths, and
needs of students with visual impairments is ex-
Assessment tremely complex, and in some cases, it is difficult
Given a referral and signed permission by the to adhere to the IDEA guidelines. For example,
parent or guardian, the school district must iden- t here are few tests that have been designed spe-
tify members of the educational team who w ill cifically for use with this population, and the
assess the child. The educational team usually validity and reliability of tests designed for sighted
consists of a school psychologist, an educational students are usually questionable for use with
diagnostician, teachers, support serv ices person- students who are visually impaired (Evans, n.d.).
nel such as physical therapists or speech-language Similarly, it is often difficult to find personnel
pathologists, and the child’s parent or guard- (such as speech-language specialists, school psy-
ians. In most cases, the team has two primary chologists, and occupational therapists) who
responsibilities: (1) to determine if the student is are trained to assess students who are visually im-
eligible for special education and related serv ices paired. T hese circumstances make it essential for
and (2) to identify the student’s current level of an assessment of a student with a visual impair-
performance, including strengths, abilities, and ment to be conducted by a team of individuals
needs. Team members should collect information who work closely together, including a teacher
about the student and be familiar with curricula, of students with visual impairments. Team
instruction, related serv ices, and special consid- members should share findings, observations,
erations that are beneficial to the student’s edu- and insights throughout the collection and in-
cation. IDEA specifies the following guidelines terpretation of data (Liefert & Silver, 2003). The
for assessing the eligibility of students with dis- teacher of students with visual impairments fre-
abilities for serv ices: quently serves as the coordinator of the assess-
ment team, helps the other team members to
understand the impact of visual impairment on

• Evaluations must be completed in a timely
learning, and facilitates appropriate accommoda-
manner.
tions and interpretation of the tests.
• The parents must give permission for assess- At a minimum, teachers of students with vi-
ments and must be informed of the specific sual impairments w ill need to conduct two key
evaluations to be conducted. assessments: a functional vision assessment (FVA)
• The child must be assessed in all areas related and a learning media assessment (LMA). The FVA
to the suspected disability or disabilities. involves an evaluation of the way that the student
uses his or her vision to access information. Al-
• Assessments must be provided and adminis-
though a medical eye report is usually required
tered in the child’s native language and must
for determining eligibility and provides impor
not be racially or culturally discriminatory.
tant information about the clinical measures of
• Assessments must be conducted by a team of visual functioning, such as measures of visual
trained personnel and based on the needs of acuities, degree of field loss, and the usefulness
the student. of spectacle lenses for refraction, the FVA con-
• Assessment instruments must be valid and ducted by the teacher considers the child’s func-
reliable. tioning in real-world environments.
An extension of the FVA is the learning media (See Volume 2, Chapter 6, for additional discus-
assessment, which is conducted to determine the sion of instruction in the ECC components, as
sensory channels that are most efficient for a par well as Chapters 1 and 10 in this volume.)
ticular child. Those data, combined with the re-
sults of the FVA, are used to identify the most Determination of Eligibility
efficient ways to access the various learning me-
A student is eligible for special education serv ices
dia, including printed materials, that are used in a
if his or her disability “adversely affects [the stu-
student’s learning environments. (See Volume 2,
dent’s] educational performance” (IDEA, 2004, 20
Chapter 4, for more information about how to
U.S.C. § 1401[a]; 34 C.F.R. § 300.7[a][1]-[b][13]).
conduct these two assessments.) It is critical that
Most students whose visual acuities are not cor-
the results of the FVA and LMA be shared early in
rectable to typical levels or who have visual field
the pro cess with other team members, so that
limitations are eligible for services, since signifi-
findings can be used as they plan for, conduct, and
cant visual impairments are known to interfere
interpret their own assessments of the student.
with expected methods of learning (Ferrell, 2011).
Since a visual impairment often limits a
Children with visual impairments for whom a

child’s access to information and results in lim-
comprehensive assessment reveals no educational
ited opportunities to engage in everyday activi-
needs (academic and functional) technically do
ties, an educational evaluation of a student with
not require or qualify for special education and re-
a visual impairment will involve much more than
lated services, but they may be eligible for services
the typical academic and achievement testing
under Section 504 of the Rehabilitation Act. See
(Barclay, 2003; Goodman, 2003). Much of the
Sidebar 9.1 for an explanation of the differences
evaluation of a student with a visual impairment,
between Section 504 and IDEA.
including one with multiple disabilities, involves
careful observations of the student in a variety
of environments. In addition, surveys, interviews,
Development of the IEP
and inventories that are completed by the stu- fter a student is determined to be eligible for spe-
A
dent, parents, and teachers help the team members cial education, the education team begins to es-
assess the student’s level of mastery of the com- tablish priorities among the student’s needs and
ponents of a comprehensive curriculum for stu- to determine goals and objectives for the student
dents with visual impairments, which consists of based on the results of the assessment of eligibil-
the general curriculum and, as listed below, the ity. In some instances, the team develops goals
ECC (Sapp & Hatlen, 2010): and objectives, which form the basis of the IEP, at
its eligibility meeting. (See Volume 2, Chapter 5,
• Compensatory access for a detailed explanation of goals and objectives.)
• Sensory efficiency skills In other school districts, membership on the team
• Assistive technology skills changes to include additional personnel who may
be providing services to the child.
• Orientation and mobility (O&M)
The IEP is the one document that describes
• Independent living skills the curriculum, instruction, and assessment that
• Social interaction skills is to be provided to the student with a disability
so that a f ree appropriate public education can be
• Recreation and leisure skills
implemented. This document is jointly created by
• Career education skills school personnel, the student (when appropri-
• Self-determination skills ate), and the student’s parents or guardians.
S I D E B A R 9 . 1
The Differences between Section 504 and IDEA
Section 504 of the Rehabilitation Act of 1973 heart disease, may be handicapping conditions
prohibits discrimination against p eople with under Section 504. While Section 504 requires
disabilities who participate in programs that that the condition “substantially limit a major
receive funding from the federal government, life activity,” such as seeing, hearing, speaking,
including public schools. U nder Section 504, breathing, learning, or walking, it need not
discrimination is defined as any unequal necessarily adversely affect a student’s
treatment solely on the basis of a disability. educational performance (Zirkel, n.d.).
Students who are protected by Section 504 are Regulations for Section 504 basically entitle
entitled to an equal opportunity to benefit qualified students to a “free appropriate public
from their education, and schools must take education,” which is defined as “special or
action to provide the appropriate aids and regular education or related aids and
services that allow for this equal opportunity services.” Students needing access to free
to occur. appropriate public education typically require
Under Section 504, a person is considered “a reasonable modification of policies, prac-
to have a disability if he or she “has a physical tices, or procedures” (US Department of
or m
ental impairment which substantially Education, Office for Civil Rights, 2015).
limits one or more . . . major life activities, . . . IDEA requires that an Individualized
has a record of such an impairment, . . . or is Education Program (IEP) be developed by a
regarded as having such an impairment” team of professionals. No such plan is re-
(Section 504, 29 U.S.C. § 706[7][B]). Except quired by Section 504, but most districts
for the use of ordinary eyeglasses or contact create what is called a 504 plan to describe
lenses that are intended to fully correct visual the services that will be provided to eligible
acuity or eliminate refractive error, students students (Zirkel, n.d.). Parents are not re-
are eligible for services u
nder Section 504 quired to be members of the team that
even if they use medication or corrective identifies a student as eligible for services
devices that mitigate the impact of their under Section 504, nor are any specific
eligible condition (Zirkel, n.d.). assessments required to make this determina-

The Individuals with Disabilities Education tion, though schools are required to consider
Act (IDEA) lists the specific types of disabling a variety of sources of information about the
conditions that entitle c hildren to receive child. Parents or guardians of students must
special education. In addition, for children to be give written consent for an assessment to occur
entitled to receive services u nder IDEA, their and be informed what services and supports,
disabling conditions must result in the need if any, will be provided u nder Section 504 (US
for special education services. Department of Education, Office for Civil Rights,
Section 504 is much broader than IDEA, 2015) to meet students’ rights to a free
since it contains no categorical listing of appropriate public education.
disabling conditions. However, if a child is IDEA provides parents and guardians with
eligible for services u
nder IDEA, he or she will an elaborate system of due process in order to
also be protected u nder Section 504. The protect their children’s rights to services
regulations also make clear that certain under the law. T hese same protections are not
conditions that would not qualify a child under guaranteed under Section 504. Parents who
IDEA, such as drug or alcohol addiction and disagree with the plan for providing services
285
nder Section 504 can make an appeal to the

u plan are entitled to the protections that are
Office for Civil Rights. inherent in being identified as having a
While the United States Congress has disability u
nder IDEA. A student with a visual
appropriated funds to implement IDEA, no impairment who needs only accommodations,
such funding is provided for the implementa- such as a scribe, preferential seating, or
tion and enforcement of Section 504. The materials in an adapted medium, might be
Office for Civil Rights is responsible for ensur- placed on a 504 plan. If, however, instruction
ing that Section 504 is appropriately applied. is needed to use t hese accommodations, to
As mentioned previously, all students with access the curriculum, or to be prepared in
visual impairments who have IEPs are pro- one or more areas of the expanded core
tected under Section 504. However, the curriculum, then identification as a student
reverse is not true; not all students with a 504 with a disability u
nder IDEA is appropriate.
Source: Adapted in part from Florida Department of Education. (1992). Meeting the needs of students: Section 504 of
the Rehabilitation Act of 1973. Tallahassee, FL: Author.
More and more frequently, schools and dis- identify and include a special bank of goals and
tricts prepare IEPs in an electronic format. While it objectives typically related to the needs of students
is extremely convenient to have legible, searchable, who are blind or who have low vision.
online documents available a fter the IEP meeting,
Basic Tenets of the IEP
some concerns have been voiced by experienced
educators about the process of creating an electronic Plans for instructing c hildren with disabilities
IEP. Not surprisingly, the dynamics of the IEP have been the focus of legislation since the Edu-
meeting are changed somewhat when team mem- cation for All Handicapped C hildren Act (Public
bers are focused on the screen on which the IEP Law 94-142) was passed in 1975. IEPs for students
is projected, instead of on one another. Many with disabilities include descriptions of goals and
electronic IEP systems are prepopulated with a objectives agreed on by members of the student’s
comprehensive library of goals, objectives, and IEP team that are based on the results of appro-
benchmarks that are aligned with the state’s cur- priate assessments of the student. In 1990, when
riculum and content standards. Teachers of stu- Public Law 94-142 was amended and its name
dents with visual impairments may discover that changed to the Individuals with Disabilities Ed-
the options related to goals and objectives do not ucation Act, emphasis was placed on expanding
include the kinds of skills that they address in their programs, mandating that transition services be
work with students or that pre-entered schedules included in IEPs, and including assistive technol-
do not meet the support needs of their students. In ogy devices and services as items to be considered
these circumstances, teachers must be assertive
in the education of students with disabilities.
about insisting that the IEPs accurately reflect stu- In 1997, IDEA was reauthorized to reflect an
dent needs, even if it means increasing the time emphasis on educational programming with nec-
that the team spends in the IEP meeting. To avoid essary accommodations for students with disabil-
this kind of situation, teachers of students with vi- ities in the general education (core) curriculum.
sual impairments can work with administrators to It also stressed the identification of needs based
on assessments, the reporting of students’ pro kept confidential. The IEP team, as defined by
gress to parents at least as often as progress is re- IDEA, must include the following:
ported for students without disabilities, and the
inclusion of all students in the state and local • The child’s parent(s) or guardian(s)
testing designed to measure student learning for • At least one general education teacher if the
purposes of school accountability. With the 2004 child is expected to participate in the general
reauthorization, further emphasis was placed on education environment
the importance of using scientific, research-based
• At least one special education teacher (who
interventions when making decisions about the
should be a specialist in visual impairments if
instructional services students are to receive, which
the student is visually impaired)
more closely aligned IDEA to the requirements
of the No Child Left B ehind Act (2001), the main • A representative of the local school district or
federal funding legislation governing K-12 edu- LEA
cation in the United States. The 2004 amend- • An individual who can interpret the results of
ments to IDEA also clarified that schools must the evaluation
ensure that students be provided with supple-
• Other individuals at the discretion of the
mentary aids and serv ices (defined as “aids, ser
family or the school district
vices, and other supports . . . to enable c hildren
with disabilities to be educated with nondisabled
The student should participate in the devel-
children to the maximum extent appropriate”

opment of the IEP, when appropriate, especially
[34 C.F.R. § 300.42]) necessary to participate in
as he or she advances in school. Each member of
extracurricular activities to which their peers
the IEP team is responsible for reporting any in-
have access as well as in education-related set-
formation that will be helpful in determining the
tings and that students be provided with access to
student’s abilities and educational needs at the
instructional materials in accessible formats at
IEP meeting.
the same time as other children receive these ma-
terials (Wright, 2006). The process of developing
The Process of Formulating the IEP

an IEP is discussed in the next section.
IDEA requires that a student with a disabil- The teacher of students with visual impairments
ity have an IEP at the beginning of the school may be the most appropriate person to lead the
year and that the IEP be revised at least annually. IEP team’s discussion of the student’s strengths
More frequent revisions should take place when- and needs. He or she w ill also inform the other
ever a change in the student’s placement occurs team members of the results of appropriate as-
and as necessary to address the student’s pro- sessments of the student’s progress in both the core
gramming needs. A revised IEP must note any and expanded core curriculum, and needs for
lack of expected progress toward the annual goals modifications (changes in the level of material
and objectives, the results of any reevaluation being taught) and accommodations (changes in
that has been conducted, information about the the pre senta
tion of materials). The strength of
child provided to or by the parents, and the these assessments will lead to the writing of an IEP
child’s anticipated needs. that team members can agree to and implement.
A parent or guardian must be invited to the At the IEP meeting, other members of the IEP
IEP meeting, afforded due-process rights, and team must also inform the team about the cur-
guaranteed that evaluation procedures are non- riculum, instruction, and related serv ices they
discriminatory and that the child’s records are recommend and provide explanations of how
these educational components may be imple- communication mode, academic level, and
mented. For example, the general education full range of needs including opportunities for
teacher provides information on the scope and direct instruction in the child’s language and
sequence of the curriculum and on typical in- communication mode
structional methodologies that the team may • The child’s need for assistive technology de-
find valuable as they discuss how the student vices and serv ices
with a visual impairment can best gain access to
the general curriculum. The parents provide in- It is appropriate for many children with vi-
sights on the strengths and needs of their child sual impairments to attend and participate in the
from the perspective of their home life and ob- IEP meeting. It may be helpful for the teacher of
servations of their child in f amily activities. The students with visual impairments to practice or
representative of the local school district supplies role-play in advance with the student so that he or
information about general program elements and she can effectively contribute to the meeting. Prac-
can assist in determining the setting that may be tice sessions may involve having the student list
appropriate for the student to receive the serv ices his or her perceived strengths, abilities, and weak-
and instruction that he or she needs. nesses and identify desired postschool outcomes.
For students with visual impairments, the IEP Some special educators have recommended the
team must consider “the strengths of the child opportunity for self-directed IEPs; in such cases,
and the concerns of the parents for enhancing the the student is actually in charge of the IEP meet-
education of their child” (IDEA, 2004, 20 U.S.C. ing and conducts the meeting so that the desired
sec. 1401[a] Sec. 614[d][3][A][i]). Also, the need postschool outcomes can be addressed from his
for instruction in braille must be considered. De- or her perspective (Martin et al., 2006). These op-
termination of the use of braille by a student must portunities reinforce the development of impor
be based on an evaluation of the child’s reading tant social and self-determination skills.
and writing skills, needs, and appropriate reading
and writing media (including an evaluation of Contents of the IEP
the child’s future needs for instruction in braille
Although the format of IEPs varies from one lo-

or the use of braille) (IDEA, 2004, 20 U.S.C.
cal area to another, as well as from state to state,
sec. 1401[a] Sec. 614[d][3][B][iii]). Other factors
each IEP must contain the elements mandated by
that must be considered by the IEP team are these:
IDEA. There are generally three types of individ-
ualized plans: the Individualized Family Serv ice
• In the case of a child whose behavior impedes Plan (IFSP), written for a young child from birth
his or her learning or that of others, strategies to age 3 and similar to but not the same as an IEP;
and support to address that behavior, includ- the general IEP, written for a student in prekin-
ing positive behavioral interventions dergarten (age 3) through the seventh or eighth
• In the case of a child with limited English pro- grade; and the Transition IEP, typically written for
ficiency, the language needs of the child as a student age 16 or older, which addresses the
the needs relate to the IEP need for transition serv ices.
• The communication needs of the child and, in

the case of a child who is deaf or hard of hear-
IFSP
ing, the child’s language needs, opportunities The IFSP is a written document that is developed
for direct communication with peers and pro- by the parents of young c hildren up to age 3 and
fessional personnel in the child’s language and the appropriate providers of school and commu-
nity serv ices. It must include the components to identify specific training for the family to ac-
listed in Sidebar 9.2. commodate t hese concerns.
For a young child with a visual impairment, IDEA states that an IFSP may be used for a
the IFSP should address the unique skill areas child from age 3 to age 5 if the agency implement-
that are necessary for success in prekindergarten ing the IEP provides the parent with a written
and the skills that w ill be reinforced throughout statement describing the difference between the
the child’s school experience. Of particular im- components of IFSPs and IEPs. The agency must
portance to the development of an IFSP for a ensure that the parents understand their rights
child with a visual impairment are input from the and know that they are protected by the require-
parent or guardian and identification of the ments of the IEP when the child turns 3 years old.
family’s priorities and concerns. For families of
c hildren with visual impairments, the under-
standing of how t hese youngsters experience
General IEP
their world and of the necessary modifications to The general IEP for a student in preschool (age 3)
instruction, skill building, and experiential ac- through the grade of his or her 16th birthday
tivities that facilitate learning in c hildren with must contain the written components as defined
visual impairments is critical. The IFSP may need in IDEA, which are described in Sidebar 9.3.
S I D E B A R 9 . 2
Required Components of an Individualized Family Service Plan
• A statement of the infant’s or toddler’s • A statement of the natural environments

present levels of physical development, in which early intervention services s hall
cognitive development, communication appropriately be provided, including a
development, social or emotional develop justification of the extent to which the
ment, and adaptive development, based services w

ill not be provided in a natural
on objective criteria environment
• A statement of the family’s resources, • The projected dates for initiation of
priorities, and concerns related to services and the anticipated duration
enhancing the child’s development of the services
• A statement of the major outcomes • The identification of the service coordinator
expected to be achieved for the infant from the profession most immediately
or toddler and f amily and the criteria, relevant to the infant’s or toddler’s and
procedures, and timelines used to family’s needs (or who is otherwise
determine the degree to which progress qualified to carry out all applicable
toward achieving the outcomes or services responsibilities) who w ill be responsible
has occurred for the implementation of the plan and
• A statement of specific early intervention coordination with other agencies
services necessary to meet the unique and persons
needs of the infant or toddler and the • The steps to be taken to support the
family, including the frequency, intensity, transition of the toddler with a disability to
and method of delivering services preschool or other appropriate services
S I D E B A R 9 . 3
Required Components of the General Individualized
Education Program
• A statement of the child’s present levels of disabilities and nondisabled children in

educational performance, including how t hese activities
the child’s disability affects the child’s • An explanation of the extent, if any, to
involvement and progress in the general which the child w
ill not participate with
curriculum or, for preschool-age c hildren, nondisabled children in the general
how the disability affects the child’s education class and in the activities
participation in appropriate preschool described
activities
• A statement of any individual
• A statement of measurable annual
accommodations in the administration
goals to enable the child to be involved
of state-or district-wide assessments
in and progress in the general curriculum
of students’ achievement that are
and to meet each of the child’s other
needed for the child to participate in
educational needs that result from his
such assessments, and, if the IEP team
or her disability, and, for students who
determines that the child will not participate
have been identified as needing to
in a particular state- or district-wide
pursue alternate standards and whose
assessment of achievement (or part of
progress is being evaluated by an
an assessment), a statement of why
alternate assessment, the benchmarks
that assessment is not appropriate for the
or short-term objectives that will be
child and how the child will be assessed
used to measure c hildren’s progress
toward those measureable goals at • The projected date of the beginning of the
specified intervals throughout the services and modifications described and
school year the anticipated frequency, location, and
duration of t hose services and
• A statement of the special education,
modifications
related services, and supplementary aids
and services to be provided to the child and • A statement of how the child’s progress
a statement of the program modifications toward meeting the annual goals w ill be
or supports for school personnel that w ill measured and how the child’s parents w ill
be provided for the child to advance be regularly informed (at least as often as
appropriately toward attaining the annual parents are informed of the progress of
goals, to be involved and progress in the their c hildren without disabilities) of their
general curriculum, to participate in child’s progress toward the annual goals
extracurricular and other nonacademic and the extent to which that progress is
activities, and to be educated and sufficient to enable the child to achieve the
participate with other children with goals by the end of the year
As discussed in Sidebar 9.3, all seven compo- lates to the o

thers. Each component is a building
nents of the IEP must be addressed for the IEP block of the entire program for the student and
team to make carefully considered decisions about should form a plan for the student that addresses
the appropriate setting or settings for the IEP’s his or her needs related to access to general edu-
implementation. Each component necessarily re- cation and the desired school or postschool out-
comes for the student. The following sections gating the use of low vision aids. She recog-
discuss each of the seven components. nizes the braille contractions in isolation with
90 percent accuracy, but reads braille material
Present Level of Educational Performance written at the sixth-grade level slowly, at approx-
If the assessment thoroughly and specifically iden- imately 10 words per minute with 70 percent
tifies the student’s strengths and needs and the word- recognition accuracy and 100 percent
modifications needed for instruction and assess- comprehension.
ment, the IEP team can write an accurate statement
Annual Goals
describing pres ent levels of educational per for
mance, a statement that will guide the team in The annual goals reflect the priorities for the stu-
completing the remaining components of the IEP. dent on the basis of the student’s present level of
For a student with a visual impairment, the assess- educational performance and the desired school
ment must include information on the child’s or postschool outcomes. Annual goals are broad
functional use of his or her vision, most efficient statements related to knowledge, skills, behavior,
learning media, and progress in the areas described or attitudes that w ill enhance the student’s per
in the ECC. formance. Each statement of an annual goal
The following is an example of a statement of should reflect a reasonable and realistic expecta-
the present level of educational performance of tion that is compatible with the student’s age;
Marie, a ninth-g rade student with a visual im- cognitive, social-emotional, and physical abili-
pairment, which provides some of the information ties; rate of learning; and interests. Annual goals
that is helpful to the IEP team when establishing must be measurable so that the IEP team can de-
a student’s specific strengths and needs. termine, at the end of the year, if the student has
mastered them.
On the basis of observations, the parents’ re- For students with visual impairments, an-
ports, and the teacher’s checklist evaluations, it nual goals should reflect areas of need related to
was noted that Marie visually locates familiar ob- the student’s prog ress in the core curriculum (ac-
jects in her environment. Her mobility in familiar ademic subjects and general education curricu-
environments is sufficient to travel safely around lum) and in the ECC (the areas of instruction that
her home and within the school setting. Marie is must be specifically designed for students with
insecure when traveling in unfamiliar environ- visual impairments). Given the complexity of the
ments and does not plan her travel routes or use needs of many students with visual impairments,
low vision aids to locate objects in her environ- IEPs often contain many annual goals. In the fol-
ment. Academically, Marie maintains average lowing example, one of the annual goals for Ma-
grades if accommodations are made so that she rie is presented. Note its relation to the prese nt
is allowed to obtain classroom notes from a peer level of educational performance regarding her
and handouts from the teacher before they are braille skills:
distributed to the rest of the class. She often
chooses to use her video magnifier for reading. Goal: Marie will read materials written at the be-
Because of a progressive vision loss, Marie’s
ginning eighth-grade level prepared in contracted
reading speed has decreased in the past year so braille at 30 words per minute with 90 percent
that when large amounts of material have to be word- recognition accuracy and greater than
read, she must use a reader or listen to the mate- 95 percent comprehension on at least four of
rials on audiotape. Marie has shown an interest five days per week for six consecutive weeks,
in expanding her braille skills and further investi- based on teacher records.
Special Education, Related Services, for providing serv ices in the general education
and Supplementary Aids classroom and for the student to participate in
the activities of peers without disabilities. A de-
For a student with a visual impairment, the con-
scription of the activities that remove students
tent of the IEP must indicate the student’s involve-
from the general education classroom for special
ment in the core curriculum with the appropriate
education serv ices is part of this requirement.
accommodations. All components of the IEP
Opportunities to participate with nondisabled
should reflect the effect of the student’s visual im-
peers may include off-campus activities, such as
pairment on access to the curriculum, instruc-
vocational work on a job site, a fter-school com-
tion, and assessment. Accommodations may
munity activities, or other extracurricular activi-
include the provision of materials in the stu-
ties in which the student participates a fter school
dent’s preferred reading and writing media
or on weekends. The following is a description of
(braille or large or regular print with appropriate
this component of Marie’s IEP:
accommodations), changes in the physical envi-
ronment (such as lighting or nearness to the pre To maximize progress through one-to-one in-
sentation of instruction), changes in instructional struction in a quiet environment, Marie will be
and assessment strategies, or instruction in areas removed from activities in the general class-
of the ECC. Decisions regarding appropriate ac- room for braille skill instruction and instruction
commodations must be based on a functional vi- in other skills related to the ECC, as appropriate.
sion assessment, learning media assessment, and O&M services, which w ill be community based,
accommodations noted during other assessments will also require her removal from the regular
that w
ere conducted. class.
For Marie, the required special education ser
vices, related serv ices, and modifications and ac- Modifications Needed for State-or
commodations w ere as follows: District-Wide Assessment of Students’
Achievement
• Special education services: Teacher of stu-
This requirement of IDEA is intended to describe

dents with visual impairments
the specific modifications and accommodations
• Related services: O&M that students need to participate in state-and
• Modifications and accommodations: Supple- district-wide assessment programs, as in the fol-
mentary aids, including a video magnifier, lowing statement for Marie:
braille, a telescope, a variety of handheld
magnifiers, an accessible computer, a record- Marie w ill participate in regular state-and
ing device, a personal notetaking device, district-wide assessments, using braille and
and braille handouts; extended time on and print materials (with appropriate electronic and/
individual administration of tests; use of al- or handheld magnification equipment) as nec-
ternate method to record test answers essary. She w ill be given extended time limits
for tests in both braille and print, tested either
Participation with Nondisabled Peers in small groups or individually, and provided an
alternate way to record her answers, as appro-
The IEP must include a statement of the extent, priate for each test.
if any, that a student w
ill participate with non-
disabled children in the general education Decisions about modifications and accom-
classroom. This requirement reflects a preference modations in testing should be based on the
consideration of several factors, including the al- pated frequency (how often and for what length
lowable accommodations for the test in question of time during the school week), the anticipated
and the accommodations that the student typi- location (where the serv ice w
ill take place), and
cally uses in classroom instruction and testing, the expected duration (such as a nine- week
such as the allowance of additional time and the grading period, the regular school year, or the
use of alternate response sheets or braille formats. extended school year) of the serv ices and mod-
In all states, braille and large print are considered ifications. All these elements are determined
acceptable test formats (Smith & Amato, 2012). on the basis of the educational needs and an-
Teachers w ill need to be familiar with their state’s nual goals. This information for Marie was as
and district’s guidelines for other allowable ac- follows:
commodations, such as use of an abacus or talk-
ing calculator. • The provisions of this IEP w
ill become effec-
If it is determined that a student cannot par- tive on May 26, 2016.
ticipate in these state-and district-wide assessment
programs, the IEP team must indicate why this de- • Instruction in braille w ill be conducted
cision was made and how the student’s progress throughout the regular school year for a period
on state standards w ill be assessed through an al- of one hour each day, five days a week, by a
ternate procedure. According to the National Cen- teacher of students with visual impairments
ter on Educational Outcomes (NCEO, 2013), three in a quiet room in which appropriate instruc-
types of alternate assessments are used: (1) alter- tional materials and equipment for teaching
nate assessments based on alternate achievement braille skills are available.
standards; (2) alternate assessments based on • Two one-hour sessions of O&M services w ill
modified academic achievement standards; and be provided each week throughout the regu-
(3) alternate assessments based on grade- level lar school year by an O&M specialist e ither
achievement standards. Usually, alternate assess- on campus or in the local community.
ments are available as an option only for students • Instruction in targeted ECC areas (career ed-
with the most significant cognitive disabilities or
ucation, self-determination, independent liv-

for students who need to be tested using nontradi- ing, assistive technology, recreation and
tional test formats. These tests are not the same as leisure, and social skills) will be provided by
a diagnostic assessment, but instead are used to a teacher of students with visual impairments
hold educators accountable for the learning of all throughout the regular school year for a pe-
students. The IEP teams of students eligible to take riod of one hour each day, five days a week,
an alternate assessment must carefully consider in a setting in which appropriate instructional
the best way for a particular student to demon- materials and equipment for teaching tar-
strate progress toward achievement of state stan- geted skills are available.
dards and document u nder what conditions the
test is to be given (NCEO, 2013).
Reporting Students’ Progress
IEPs must provide information to parents about
Date of Beginning, Anticipated Frequency,
the schedule for reporting the prog ress of their
Location, and Duration of Services and
children on the specific goals listed in the IEPs, as
Modifications
well as the c hildren’s general academic prog ress,
Four specific elements of a student’s program in- by the end of the year. Parents must receive
clude the initiation date of serv ices, the antici- these progress reports at least as often as do parents
of c hildren who are not receiving special edu- • Short-Term Objective 1: When his pants have
cation serv ices. On the IEP, an evaluation plan been pulled to his knees by the adult work-
statement includes a description of the assessing with him, upon hearing the phrase, “Pull
ment procedure, the criteria for determining if your pants up,” Matt w ill pull his pants from
the student has met the annual goal (usually a his knees to his waist without assistance and
percentage or ratio of errors made), and a sched- with no additional prompting on 3 of 4 con-
ule of evaluation related to the annual goal (for secutive days.
example, every six weeks or once a semester). An • Short-Term Objective 2: When his pants have
example of an evaluation plan statement for Ma- been pulled over his feet and are at his ankles,
rie follows: upon hearing the phrase, “Pull your pants
up,” Matt will pull his pants from his ankles
Progress on the annual goals w ill be evaluated to his waist without assistance and with no
by direct observation and biweekly reviews of additional prompting on 3 of 4 consecutive
her braille reading rate, word recognition, and days.
comprehension levels. Her progress will be re-
• Short-Term Objective 3: Given his pants,
ported to her parents on the report card every
upon hearing the phrase, “Pull your pants
nine weeks.
up,” Matt will place each foot in the correct
pant leg opening and pull his pants to his
Benchmarks and Short-Term waist without assistance and with no addi-
Objectives tional prompting on 3 of 4 consecutive days.
Benchmarks and short-term objectives describe
the major milestones that must be accomplished
Transition IEP
to achieve the annual goals. They do not neces- Beginning at age 16 (or younger if determined by
sarily reflect the complete scope and sequence of the IEP team), a student’s Transition IEP must
a curriculum. Instead, they are sequential and re- contain statements of the student’s need for tran-
flect substeps of an annual goal. Delineation of sition serv ices.
These statements focus on the
short-term goals is required for students with the student’s course of study and generally describe
most severe disabilities, who will be evaluated us- the desired postschool outcomes in relation to in
ing alternate assessment. dependent living, enrollment in a vocational pro-
For example, consider Matt, a 5-year-old who gram or postsecondary educational institution,
has cognitive impairments, cerebral palsy, and involvement in the community, and other areas
low vision. Based on assessment of his current of preparation for postschool life, depending on
functioning that is reflected in the present level the student’s strengths and needs. The IEP must
of performance statement, his IEP team has de- include statements of transition serv ices that
termined that an important and achievable goal the student needs, including interagency respon-
for him is to pull on his pants. sibilities and linkages that are necessary for at-
taining postschool outcomes.
• Annual Goal: Matt will increase his active par- The meeting at which the Transition IEP is de-
ticipation in dressing from being cooperative veloped is attended by a team that usually con-
during the process to putting his feet into sists of the student, parents or guardians, special
the leg holes and pulling up the pants from educators, general educators, and appropriate
the floor to his waist when requested on 9 of adult serv ice providers from the student’s com-
10 consecutive days. munity. The Transition IEP must include a state-
ment of goals or outcomes in four areas: and special classes, separate schooling, or other
employment, education training, leisure/recreation removal of c hildren with disabilities from the
activities, and living arrangements. It details the regular educational environment occurs only
proposed activities to achieve desired outcomes, when the nature or severity of the disability of
lists timelines for performing these activities, and a child is such that education in regular classes
assigns responsibility for providing support for with the use of supplementary aids and services
each activity to the agencies or individuals repre- cannot be achieved satisfactorily.
sented at the meeting or to collaborative arrange-
ments among them. Later, if it is discovered that an This component of IDEA, referred to as the
agency has not followed through on its assign- least restrictive environment provision, has been the
ment, the school must identify another responsi- source of considerable debate. B ecause the phrase
ble party or devise alternate plans to “to the maximum extent appropriate” is vague,
achieve the desired outcome. (The com- state agencies and LEAs have been left to interpret
plete transition IEP for Marie is avail- the intent of the law and implement it accord-
able online in the AFB Learning Center.) ingly. Some educators and parents and advocacy
It should be noted that IEPs for students at the groups believe that the least restrictive environ-
preschool and early elementary levels can also ment for all students is the general education
contain annual goals related to career and voca- classroom, despite the IDEA regulations that re-
tional education, one area of the ECC. For stu- quire that a continuum of alternative educational
dents with visual impairments who have difficulty placements be made available. Even though ser
acquiring information about work, it is essential vices for the majority of students with visual im-
to provide instruction about career alternatives; pairments are provided in general education
acceptable work habits; and the relationships classrooms for most of the school day (US Depart-
among school, work, and economic in depen ment of Education, 2015), experienced educators
dence throughout their entire school c areers. of t hese students have generally been opposed to
this “one size fits all” approach to providing edu-
Determining Placements cational services. Many students with visual im-
pairments have complex educational needs that

The last step in the process of the development of may be difficult to address appropriately in only
the IEP is the determination of where the identi- the general education classroom; other educa-
fied educational serv ices w
ill be provided. A fter tional placements may be more appropriate and
the IEP team has written goals, the members less restrictive at any time during the students’
need to determine the appropriate environment education.
in which the student w ill be educated. As with In 2000, the Office of Special Education and
other activities of the IEP team, the parents’ in- Rehabilitative Serv ices (OSERS) of the US De-
put is vital to this decision. partment of Education issued a policy guidance
IDEA places a high priority on educating stu- on “Educating Blind and Visually Impaired
dents with disabilities with peers without disabil- Students” that clarified OSERS’s position with re-
ities. Section 612(5)(a) states, gard to the placement of students with visual
impairments:
To the maximum extent appropriate, c hildren
with disabilities, including children in public or In making placement determinations regarding
private institutions or other care facilities, are c hildren who are blind or visually impaired,
educated with c hildren who are not disabled, it is essential that groups making decisions
regarding the setting in which appropriate ser environment varies according to the intensity of
vices are provided consider the full range of the specialized instruction and serv ices the stu-
settings that could be appropriate depending dent needs. Since placement must be reevaluated
on the individual needs of the blind or visually at least annually, it is likely that the placement for
impaired student, including needs that arise a part icular student w
ill change as the student’s
from any other identified disabilities that the needs, abilities, and strengths are appropriately
student may have. (US Department of Educa- addressed. See Sidebar 9.4 for a review of the
tion, OSERS, 2000, p. 36592) placement considerations for Marie.
The regulations of IDEA require public agen-
This document emphasizes the importance cies to make available a continuum, or range, of
of determining placements on the basis of indi- placement options to meet the needs of students
vidual needs: with disabilities who receive special education and
related services. The options on this continuum in-
The overriding rule in placement is that each stu- clude general education classes, special classes,
dent’s placement must be determined on an in- separate schools, and instruction at home and in
dividual basis. In addition, as is true for students hospitals and institutions. As was described in
with other disabilities, the potential harmful ef- Chapter 1 of this volume, certain kinds of services
fect of the placement on the blind or visually im- for students with visual impairments have evolved
paired student, or the quality of services he or over time, and these services now include itiner-
she needs, must be considered in determining ant and resource room instruction, the consultant
the LRE [least restrictive environment]. As in model, and residential placement.
other situations, placements of blind and visually
impaired students, including those with other PLACEMENT OPTIONS
disabilities, may not be based solely on factors
such as category of disability, significance of dis- The placement options identified in the discus-
ability, availability of special education and re- sion that follows are presented in order from the
lated services, availability of space, configuration least intensive to the most intensive direct ser
of the service delivery system, or administrative vices. It is important that readers not infer that
convenience. (US Department of Education, any one placement is more desirable than any
OSERS, 2000, p. 36592) other. Students who receive itinerant serv ices are
not necessarily “better” or “more capable” than
When determining the appropriate educa- are students who receive serv ices at a residential
tional placement and least restrictive environment, school. Placement in a part icular setting or with
the IEP team must consider in what environ- a part icular kind of serv ice should reflect only a
ment or environments the goals and objectives student’s need for specialized instruction at a spe-
that have been identified for the student can best cific time in his or her development, as occurred
be met. This environment becomes, by defini- for Marie (see Sidebar 9.4). Receiving appropriate
tion, the least restrictive environment. One serv ices from a qualified teacher of students with
factor that should be considered in deliberations visual impairments is indicative that identified
on the least restrictive environment is the impor- needs are being addressed; students who are ap-
tance of being educated with peers who are not propriately placed are more likely to be chal-
disabled and of having meaningful contact with lenged by t hese teachers to master more complex
peers with similar disabilities. The least restrictive skills in more complex environments.
S I D E B A R 9 . 4
The Changing Placements for Marie
When Marie first started school, she had not Mr. Gewirtz and the O&M instructor, Katie
yet been diagnosed with Stargardt disease, Harrison, served Marie at her neighborhood
which causes progressive vision loss. She school on an itinerant basis.
attended a local school with her neighbor- At Marie’s last IEP meeting, team members
hood peers. Late in fifth grade, however, discussed the impact of her continued deterio-
Marie started to experience difficulty with ration of vision on her learning and her need
seeing objects in her central field clearly and, for more intensive services. Because her
after an assessment, it was determined that progress in braille had been slow, they dis-
she qualified for special education services. cussed the possibility of having her spend a
The teacher, using the results from the year at the state’s residential school for
functional vision assessment and learning students who are blind, where she could be
media assessment and a clinical low vision immersed in the development of the skills she
examination, recommended that Marie needed. Ultimately, it was decided to increase
continue to use print as her primary medium. the amount of time that Marie received special
Goals were written on the Individualized education services. She was transferred to a
Education Program (IEP) to address Marie’s high school where Melanie Sansoni, another
need to learn to use the prescribed magnifica- teacher of students with visual impairments,
tion devices and to develop keyboarding skills. manages a resource room. Ms. Sansoni now
To work toward achievement of these goals, provides a minimum of 2 hours per day of
her teacher of students with visual impair- instruction, with an additional hour allocated
ments, Jonathan Gewirtz, met her daily before for the preparation of materials for Marie
school. At first, when he was addressing both and for the support of Marie’s teachers.
the low vision device and keyboarding goals, Ms. Harrison continues to provide O&M
these sessions lasted 45 minutes, but as services, though t hese now include community-
Marie became proficient with using the based travel in unfamiliar environments, which
magnifiers, the sessions were reduced to the necessitates longer sessions. The IEP notes that
30 minutes necessary to work on the goal. she w ill provide 12 hours of O&M instruction
As Marie’s vision decreased and she per month to meet Marie’s needs.
entered middle school, Mr. Gewirtz’s assess- The IEP team agreed that they would
ment of her expanded core curriculum skill reconsider placement at the residential school
development revealed that she would benefit at their next meeting, when they w ill be able to
from instruction in additional skills, including review Marie’s progress during the year that she
use of a video magnifier and other assistive receives instructional and support services from
technology, career education, self- Ms. Sansoni. Only then will they know whether
determination, and braille skills. At the IEP the current placement is sufficient to meet
team meeting, he recommended that she be Marie’s needs or if an environment where more
seen daily for one hour to address this needed intensive services are available, even for a short
instruction. In addition, the orientation and time, is more appropriate.
mobility (O&M) evaluation revealed that For Marie, as it should be for all students,
Marie’s travel at school was not always safe, placement decisions are driven by her
and weekly half-hour-long O&M lessons were assessed needs, and her placement has
included as a related service on her IEP. Both changed based on t hose needs.
297
The Consultant Model ate the impact of interventions. However, provid-

ing consultation ser v ices does imply that the
Students who are served u nder the consultant serv ice is provided to another adult on behalf of
model require minimal, or no, direct services from the child with a visual impairment and that this
a teacher of students with visual impairments. serv ice may be intermittent, based on the chang-
These students function at the same level as do ing needs of the child or the changing environ-
other students in their classes, and their general ments in which the child spends time.
or special education teachers make the necessary Some students who do not currently qualify
modifications or adaptations in conjunction with for more intensive serv ices b ecause they do not
the teacher of students with visual impairments. currently function as visually impaired may also
Many students who are appropriately served benefit from consultant services from a teacher of
under the consultant model are children whose students with visual impairments. For example,
multiple disabilities include visual impairment. a student with a visual impairment with an un-
These students are often given the most beneficial certain prognosis whose visual functioning is still
services when their teachers adopt a transdisci- within the normal range may not need direct ser
plinary approach to programming. In the trans- vices. In this situation, classroom teachers, par-
disciplinary approach, one primary teacher uses ents, and o thers may need to consult with a teacher
assessment and instructional strategies that have of students with visual impairments about po-
been devised by a team that may include a parent, tential changes in the student’s vision and ways
a physical therapist, a speech-language pathologist, to prepare the child for the future. Similarly, a
a teacher of students with visual impairments, an student who no longer qualifies as visually im-
O&M specialist, and an occupational therapist. paired b ecause of a new prescription may require
Together, the team members identify appropriate consultative services while he or she is adjusting
routines in which the student can engage that to the new lenses and life conditions. Infre-
maximize the number of skills to be mastered quently, a comprehensive assessment may re-
in each categorical area. They note the language veal that a student is making adequate academic
to be used, how the child should be positioned, prog ress, is not lacking any disability-specific
and appropriate modifications for each task. Gen- skills, and has appropriate natural supports that
erally, however, only one teacher implements facilitate the ongoing development of skills re-
t hese suggestions. (See Volume 2, Chapter 1, for lated to functioning in all areas. The student may
additional information on creating effective only need accommodations for testing, or the
teams.) student’s general education teachers and parents
Consultation does not necessarily imply a may benefit from consultation with the teacher
limited time commitment. In fact, the consulta- of students with visual impairments. This stu-
tive involvement of the teacher of students with dent may be appropriately served through a
visual impairments on the educational team of- consultant model.
ten requires that the teacher devote considerable
time to his or her role. Time is needed to become
acquainted with the student and family, under-
Itinerant Services
stand the student’s complex needs, learn about Under the itinerant teaching model, students with
the student’s educational environments, meet visual impairments are assigned primarily either
with other team members for planning, explain to the general classroom teacher they would have
the unique learning experiences of c hildren with been assigned to if they did not have a visual im-
visual impairments to other teachers, and evalu- pairment or to a special educator who provides
serv ices in a resource or self-contained classroom erally limited support from a teacher of students
to students with other disabilities. A teacher of with visual impairments. Unlike students who
students with visual impairments is assigned to are served under the consultant model, however,
each student to address the special educational these students have some instructional needs that
needs related to the visual impairment described must be provided directly and regularly by a
in the student’s IEP. Any special equipment or teacher of students with visual impairments, an
materials that the students need, such as video O&M specialist, or both.
magnifiers, braille dictionaries, embossers, or In communities where few students with vi-
tactile graphics, must be brought to the students’ sual impairments are enrolled in the local school
schools by the teacher of students with visual im- districts, serv ice by itinerant teachers is the only
pairments and left for students to access when option regularly available. Nonetheless, students’
needed. The time that the itinerant teacher spends needs, as detailed in the goals and objectives
with any student represents the time required to listed on the IEPs, must drive the determination
meet the specific education goals related to the vi- of the anticipated frequency and duration of ser
sual impairment identified in the IEP and may vices. It is unethical and illegal to write goals and
vary from several hours a day to short weekly or objectives on the basis of the amount of time that
biweekly instructional periods. an itinerant teacher has available or the number
Generally, teachers of students with visual of times the teacher can drive to a part icular lo-
impairments who provide itinerant serv ices do cation. In these circumstances, other profession-
not have classrooms at each of the schools their als and parents assume that all the students’
students attend, although they may occasionally needs have been identified and are being ade-
be assigned small work areas in which they can quately addressed, when, in fact, the duration and
store equipment and materials and provide in- number of hours of serv ice are based on other
struction. More often, they are based at a school factors. Determining ser
vices according to the
district’s office and spend their time traveling convenience of administrators and teachers may
among their students’ schools. While some spe- limit the skills that students learn in school and,
cial skills are best addressed in the general educa- ultimately, the vocational, in de
pen
dent living,
tion classroom, others require privacy or a quiet and other life options of students after they leave
environment. Itinerant teachers of students with the educational system.
visual impairments should work with school ad- It is critical that teachers of students with vi-
ministration to find locations where they can sual impairments document the frequency, dura-
provide appropriate instruction to students. tion, and content of their instruction and engage
Students who are best suited for serv ices in ongoing prog ress monitoring to demonstrate
under the itinerant teaching model are t hose with the effectiveness (or lack of effectiveness) of this
few instructional needs related to their visual im- level of serv ice delivery. Annual, or even more
pairments and those whose needs can best be frequent, assessment of students’ demonstration
met by general education or other teachers. In the of growth in ECC skills is necessary to ensure
case of Marie (see Sidebar 9.4), itinerant serv ices that students are receiving the instruction that
were provided by Mr. Gewirtz when her primary they need to access the curriculum and to achieve
needs were related to the development of visual successful postschool outcomes. The time to
efficiency and assistive technology (keyboarding) document instruction and conduct assessments
skills. Students served itinerantly must be able to and prog ress monitoring needs to be included
function in the educational environment in when determining the caseloads of itinerant
which they are placed with intermittent and gen- teachers.
The limited interaction of the itinerant dents with visual impairments. It differs from the
teacher of students with visual impairments with itinerant model in two basic respects: (1) Students
students is both a strength and a weakness of this may not attend the neighborhood school to which
model. Students who do not receive unnecessary they would be assigned if they did not have visual
special treatment by their teachers; who attend impairments; rather, they attend a local public
their neighborhood schools; and for whom edu- school that has been designated as a “magnet”
cational, social, and community expectations are school for students of their age with visual im-
similar to t hose for the other students with whom pairments who need daily contact with a teacher
they are educated can develop a strong sense of of students with visual impairments; and (2) The
efficacy, interdependence, and competence. Stu- teacher of students with visual impairments is
dents in itinerant placements must rely on their based at the school these students attend and
own resources to solve problems, locate necessary typically does not travel among schools in the
assistance, and manage their school activities. area.
Often, their schoolmates are their siblings and Students who receive serv ices in resource
other c hildren from their neighborhoods, and rooms, like t hose who receive itinerant serv ices,
school-and peer-related activities occur in loca- are assigned to a general or special education
tions that are geog raphically accessible. classroom for most of the school day, and the
On the other hand, it can be difficult for itin- teacher of students with visual impairments is
erant teachers of students with visual impairments generally not their primary teacher. Students as-
to get to know these students, their instructional signed to resource rooms, however, have inten-
programs, and their needs well. As a result, some sive instructional needs related to their visual
students may struggle unnecessarily with both impairments. Although the amount of time spent
academic and nonacademic issues related to in the resource room varies among students, they
their visual impairments of which they, their par- usually spend part of each day receiving instruc-
ents, or their teachers are not aware and, conse- tion in the areas of the core curriculum and sup-
quently, may experience distress and sometimes port that facilitates their academic prog ress. It
failure, both of which could have been pre- should be noted that the teacher of students with
vented. To avoid such circumstances, teachers of visual impairments is not an academic tutor, but
students with visual impairments and other he or she may spend some time in the resource
members of assessment teams must be certain room ensuring that students understand concepts
that their assessments are comprehensive and ad- introduced in academic courses. Some students
dress all the potential needs of students with vi- even receive instruction in basic academic sub-
sual impairments. It also is critical that those who jects, such as reading or mathematics, in resource
are in contact with the students communicate ef- rooms to build a strong foundation on which
fectively and regularly, so they can quickly rec- f uture learning can occur.
ognize any difficulties students are experiencing There are many advantages to the resource
and adjust the frequency or intensity of serv ices room model. First, teachers of students with vi-
as needed. sual impairments have more opportunities in
this model to observe students in a variety of sit-
uations, including classrooms, bus lines, the caf-
Resource Room Model eteria, and the playground, and are thus more
The resource room model of providing serv ices to likely to get to know the students well. Second,
students with visual impairments offers more in- since they are available to students and general
tensive, ongoing support from teachers of stu- education teachers throughout the school day,
they can provide immediate assistance to teach- In many communities, especially t hose in ru-
ers who are uncertain how to include students ral areas, maintenance of resource rooms is not
with visual impairments in the curriculum by feasible, primarily because the number of stu-
helping t hese teachers adapt materials or modify dents with visual impairments in the area is so
instruction or by teaching classroom activities in low. Even school districts in some suburban areas
the resource room that cannot be easily adapted find this option of serv ice delivery to be expen-
in other ways. sive to maintain, even though as a part of the
Third, as members of the school staff, teach- continuum of placements identified in the IDEA
ers of students with visual impairments who regulations (34 C.F.R. § 300.115[b]), the option
teach in resource rooms have assigned classrooms should be made available to students who need
where books, materials, and electronic equip- it. As mentioned previously, placement is based
ment can be stored and made available to students on student needs and the intensity of instruction
as needed. They also attend faculty meetings; required to meet those needs. If a student requires
monitor halls; and supervise students in the caf- intensive educational supports and a resource
eteria, on bus lines, or on the playground as room option is not available, then the IEP team
other teachers at the school do. Being on site fa- must identify another way to ensure that the stu-
cilitates these specialists’ familiarity with teach- dent’s needs can be met, e ither through the estab-
ers, staff, and administrators, so that discussions lishment of this placement within the district or
of issues related to students’ progress and the by assigning an itinerant teacher to work with the
means to achieve students’ goals are more re- child more frequently and for longer periods of
laxed. Teachers in resource rooms learn which time.
general education teachers have high expecta-
tions for the performance of students with visual Settings Designed Specifically for
impairments and can develop ongoing in-service
programs to increase the faculty’s and staff ’s
Students with Visual Impairments
awareness of these students’ needs. Finally, stu- Settings that are designed specifically for students
dents in resource rooms meet and frequently in- with visual impairments include special day classes
teract with other students who have visual (located in either regular or special schools) and
impairments. Through planned and unplanned classes at schools that have a residential option.
activities, they can discover issues they may have Usually, only densely populated areas and those
in common and solutions to problems related to with a large number of students with similar, in-
their visual impairments. tensive special education needs offer special day
The primary disadvantage of the resource classes. In a special day class, the teacher of stu-
room model is that students may not attend their dents with visual impairments is responsible for
home schools and therefore may not attend the majority of the educational goals identified in
school with their siblings and other c hildren in the IEPs in both academic and nonacademic ar-
their neighborhoods. Because of the geographic eas. Special day classes are typically established
distances between their homes and the school, for preschoolers who are working on basic foun-
students may find it impossible to attend planned dation skills or students whose multiple disabili-
or impromptu after-school or evening activities, ties include visual impairments. In the latter case,
and parents may find it challenging to feel part the teacher is also skilled in working with c hildren
of the school community and to participate in who have severe and multiple disabilities and
parent- teacher activities or school advisory devises programs that are based on the best
committees. practices of both specializations.
Originally based on the boarding- school No one description can characterize all resi-
model, residential schools served the majority of dential or special day schools. Residential schools
students with visual impairments without ad- have evolved differently in each state or region,
ditional disabilities until the 1960s. Leaders at depending on the state’s history and politics, and
residential schools developed comprehensive the services provided by LEAs. In some states, res-
programs that w ere based on the unique needs of idential schools serve only students whose mul-
students with visual impairments, addressing tiple disabilities include visual impairments. In
both the academic and the nonacademic needs of other states, the residential schools primarily serve
this population as they w ere understood at the students with no other disability besides visual
time. T hese schools have evolved so that many impairment. Some schools have identified as their
of them now provide serv ices to students with mandate the provision of services to all students
visual impairments who live at the school and to with visual impairments in their states and have es-
qualified local students who attend as day stu- tablished extensive outreach programs—technical
dents. T oday, special purpose schools for stu- assistance, assessment, and other serv ices in ad-
dents who are visually impaired (including both dition to their on- c ampus activities. Some
residential schools and a few special day schools) schools offer short-term placements designed to
serve approximately 8.4 percent of the students provide intensive instruction in one or more ar-
who have been identified as being blind or hav- eas of the ECC (such as assistive technology, rec-
ing low vision (American Printing House for the reation skills, or human sexuality) for students
Blind, 2015). (For additional information on the who need them.
evolution of t hese and other educational services, Such comprehensive, long-term residential
see Chapter 1 in this volume.) serv ices are not only expensive to provide but are
These special purpose schools offer an envi- also associated with nonmonetary issues, the
ronment in which the adults who are involved in foremost being the psychosocial impact of being
the students’ education understand the unique separated from one’s parents and other family
learning style of the population. In theory at members for extended periods. Many residential
least, all the instructors are teachers of students schools for c hildren who are blind attempt to al-
with visual impairments and hence can identify leviate the impact of this separation by providing
the students’ needs and adapt materials and mod- transportation for students to return home fre-
ify the curriculum to meet t hose needs. Because quently and regularly and by working with fami-
instruction is specifically designed for students lies to develop and maintain strong ties with their
for whom visual activities are difficult, the stu- c hildren.
dents spend their entire days engaged in learn- Students who attend special purpose schools
ing, not in waiting while the larger number of usually require special education and support
sighted students receive visually based instruc- services beyond those that can reasonably be pro-
tion, as may happen in classrooms where most vided in local school programs (Hazekamp &
of the students have unimpaired vision. At resi- Huebner, 1989). For some students with intensive
dential schools, students have opportunities to needs from remote or rural areas where a teacher
continue their education after the typical six-hour of students with visual impairments is not avail-
school day, with instruction in dormitories and able, a special school placement is the only avail-
community-based settings a fter school and on able option. Some families believe that their
weekends, during which goals related to all areas c hildren w ill receive higher-quality educational
of the ECC are easily infused for all students. serv ices in residential schools or recognize that
they cannot deal effectively with the extensive pairments and O&M specialists can be altered to
needs of their c hildren at home (Corn, Bina, & take advantage of time before or a fter school or
DePriest, 1995). Indeed, for many c hildren, spe- on weekends. Some teachers of students with vi-
cial purpose schools provide the opportunity to sual impairments and O&M specialists work with
develop compensatory and disability- specific local agencies that serve adults who are blind to
skills naturally, interact with other students and plan optional summer programs that focus on
adults who have visual impairments, and, through the acquisition of new independent living, recre-
these interactions, come to terms with them- ational, or c areer skills. Many residential schools
selves as competent and capable individuals with offer short-term placements for students who
visual impairments. need intensive instruction in specific areas, such
Most special day classes, special schools, and as the use of assistive technology or O&M. Inter-
residential schools are not “segregated” environ- ested and involved parents can also provide
ments in which students with visual impairments valuable assistance by giving their c hildren op-
have no contact with individuals without disabil- portunities to practice newly mastered skills at
ities in typical community settings. It is the pol- home and in the community, although some con-
icy of most of t hese schools to take full advantage sultations with a teacher of students with visual
of the benefits of community-based instruction, impairments may be required to discuss adapted
providing appropriate educational and vocational methods or techniques.
serv ices in local community settings. Many resi- Once again, it is essential for educators to view
dential schools enroll students, as appropriate different placement options as equally valuable.
and directed by the IEPs, in courses offered by lo- Any placement can be the most or least “restric-
cal school programs, so that the students spend tive,” depending on a particular student’s needs
part of their instructional days in general educa- (Huebner, Garber, & Wormsley, 2006). If a place-
tion programs and part of their days in the spe- ment enhances a student’s understanding of the
cial school’s programs. world, offers appropriate socialization opportuni-
ties, creates an environment in which intended
learning occurs, and maximizes the child’s skills
The ‘Ideal’ Placement to engage with more sophisticated materials in more

It is important to recognize that the ideal place- complex environments, then it should be consid-
ment, in which all of a student’s needs can be ered appropriate for the student. If a placement
met, proba bly does not exist in most cases. restricts a particular student’s ability to learn, then
Because students with visual impairments have it is inappropriate for that student, regardless of its
many complex needs, it is challenging to find value to other students.
time in the school day or year to meet them all.
Teachers and parents may need to establish pri-
ADM NIS RA ION OF
orities among a student’s needs and be creative in
discovering options for instruction that are not EDUCAT ONA PROGRAMS
among the continuum of serv ices described in
Involvement of Families
the law. When setting priorities, members of an
IEP team may choose to focus on a student’s most The success of any educational program for a
pressing needs but must resolve not to lose sight child is largely dependent on the ongoing mean-
of the less immediate goals. Sometimes, the work ingful involvement of the child’s parents and
schedules of teachers of students with visual im- other family members. Teachers cannot—a nd
should not—be the only individuals involved in the identification, evaluation, and placement
a child’s education. The level of involvement of of their children. Furthermore, parents can ob-
parents and families, while mandated in the law, tain independent educational evaluations of their
is often influenced by the attitudes and actions of c hildren, and t hose results must be considered in
teachers. any decisions regarding the c hildren. Upon the
The passage of the Education for All Handi- parents’ request, school districts must provide
capped C hildren Act in 1975 was in large measure the names of independent evaluators and, in
the result of the work of parents whose c hildren some circumstances, pay for independent evalua-
with disabilities had been denied appropriate tions when the parents dispute the findings and
educational programs and serv ices. Since parents conclusions of the educational teams.
were instrumental in writing both the law and its With regard to the development of IEPs and
regulations, it is not surprising that the law placement of c hildren, parents have the right to
strongly supported the role of parents in design- be notified in their primary language or system
ing programs for their c hildren and guaranteed of communication before IEP meetings are held.
them certain rights in the educational planning It is the school district’s responsibility to provide
process. Successive reauthorizations, including these accurately translated documents and to
the IDEA amendments of 2004, have reiterated make available trained interpreters to assist par-
the pivotal role of families and strengthened the ents during the IEP meeting.
importance of teaming with family members Similarly, parents must be notified of any
during all phases of educational programming. changes in educational placement, including
recommendations for assignment, reassignment,
or denial of assignment in any special education
Legal Rights of Parents program. In addition, parents must sign con-
IDEA established certain rights of parents of sent forms for the initial placement of c hildren
c hildren with disabilities, among which are
in a special education program, and they have
protections in (1) evaluation procedures, (2) the the right to refuse serv ices at that time. School
development of IEPs and placement decisions, personnel may not further assess students or
(3) impartial hearing procedures, and (4) the change students’ placements without the parents’
assurance of confidentiality. Confidentiality is consent.
protected by guaranteeing that parents may re- When t here are serious disputes or disagree-
view and make copies of their c hildren’s educa- ments between parents and educators regard-
tional rec ords and correct errors in these ing the provision of the f ree appropriate public
records. In addition, parents are guaranteed the education of their child, including the child’s
rights to have reasonable requests for interpre- identification, evaluation, and educational place-
tations of records by knowledgeable school per- ment, each party has the right to request a medi-
sonnel honored in a timely way and to give ation or due process hearing. According to IDEA,
their consent before identifiable personal infor- a due process hearing must be held within a
mation is disclosed. strictly defined period and is presided over by a
Parents must give their consent for evalua- hearing officer, an impartial third party who has
tions of their children to take place, and they no connections with either the parents or the
have the right to review the procedures and in- school and no personal or professional interest
struments to be used in the evaluations. They in the outcome of the case. During a due process
must be informed of the results of the evaluation hearing, the parents and the school district have
and have the right to review all records related to the right to be accompanied by and consult with
counsel and educational experts, present evidence, made much easier by the trust, support, and
compel witnesses to appear, cross-e xamine wit- participation of such committed, involved
nesses, prohibit the introduction of evidence that family members.
has not been disclosed at least five days before the In most cases, parents are not trained for the
hearing, and obtain a verbatim record of the hear- roles they must play in their c hildren’s lives and
ing. The child may be present during the hearing, may find it difficult to achieve control over
which is open to the public. The decision of a due unanticipated circumstances. Most new parents
process hearing can be appealed. have never known p eople who are blind and
To avoid costly due process hearings that are have only limited knowledge of the abilities of
clearly litigious, IDEA requires states to establish people with visual impairments—
often based
a mediation process that can be used to resolve on negative stereotypes—to guide them in
differences. Participation in a mediation must be developing expectations for their c hildren. Fur-
voluntary, cannot be used to delay the parents’ thermore, although effective techniques for
right to due process, and must be conducted by a communicating with and involving children with
qualified and impartial mediator who is familiar visual impairments may seem simple, they are
with effective mediation techniques. As with a actually not very intuitive. Because of t hese vari
due process hearing, the school district must pay ous limitations, parents may approach the task
for the mediation. An agreement reached by the of raising their children who are visually im-
parties during the mediation must be written. In- paired with low expectations and self-confidence
volvement in a mediation does not preclude e ither and a lack of understanding of how their c hildren
party from requesting a due process hearing, al- learn and of the specialized techniques that can
though information disclosed during the media- lead to success.
tion is confidential and may not be used in other Therefore, it is the role of teachers of students
hearings (34 C.F.R § 300.506[b][1]; 20 U.S.C. with visual impairments to help parents change
1415[e][2][A]). t hese circumstances by helping them to under-
stand their c hildren’s specific ways of experienc-
Collaborating with Parents ing the world, learn specialized techniques for
introducing and reinforcing skills, develop self-

and Families confidence, and dream of their c hildren’s poten-
Although it is import ant for special educators to tial. Similarly, it is the parents’ role to help teachers
know and understand the legal protections af- of students with visual impairments and other
forded parents, it is even more critical that they educators to understand the be hav
ior, prefer-
respect the ethical rights of parents to be per- ences, joys, dislikes, and other critical attributes
ceived as the most significant adults in their of their c hildren. By working together, parents
child’s life and hence the p eople with the most and teachers discover each other to be valuable
to offer the educational team during all phases allies in determining appropriate outcomes and
of educational programming. Effective teachers delivering meaningful instruction to c hildren
of students with visual impairments sincerely with visual impairments.
welcome the involvement of the parents and Establishing a relationship with parents re-
other family members of all their students and quires teachers to facilitate the establishment of a
recognize that t hese are the people, besides the true partnership that is characterized by “mutual
student, who have the most to gain from the re spect; trust and honesty; mutually agreed
student’s optimal development. These teachers upon goals; and shared planning and decision
are also the first to realize that their jobs are making” (Keen, 2007, p. 340).
Effective teaming occurs when teachers and Teaming can occur during e very phase of ed-
f amily members view one another as competent, ucational programming. Teachers can help par-
communicate effectively, and focus on a common ents understand this process and encourage them
goal. Parents do not want to be told what is best to participate fully by helping them, if neces-
for their c hildren; rather, they want to be given sary, to acquire the skills they need to ensure
information and options and be empowered to success. Specifically, teachers can
make decisions that are based on their families’
needs. Sheehey and Sheehey (2007) provided sev- 1. be positive, proactive, and solution oriented; 2.
eral recommendations for teachers who wish to respect families’ roles and cultural backgrounds
establish meaningful collaborative relationships in their c hildren’s lives; 3. communicate consis-
with the families of their students: tently, listen to families’ concerns, and work to-
gether; 4. consider s imple, natural supports that
• Provide information in a way that is under- meet individual needs of students; and 5. em-
standable to parents; assist families with any power families with knowledge and opportuni-
advocacy needs they express. ties for involvement in the context of students’
• At IEP or other team meetings, introduce all global needs. (Edwards & Da Fonte, 2012, p. 8)
team members by name and explain their re-
For more information on creating and nurturing
lationship to the child or f amily.
educational teams, see Volume 2, Chapter 1; for
• Volunteer to meet with the family in their an in-depth discussion of the interaction be-
home, where they are likely to be more com- tween blindness and culture, see Chapter 8 in
fortable. this volume.
• Be welcoming to parents and families and en-
courage them to visit with you at their child’s Involving Parents in Assessments
school or to assist in your classroom. Parents should be invited to establish the empha-
• Empathize with parents who express fears ses of assessments, describe their c hildren’s level
about their inadequacies when they are asked of involvement in typical routines, provide infor-
to teach or provide therapeutic activities to mation about their c hildren’s past and present
their child. levels of functioning, and share their hopes and
• Acknowledge the dreams of parents; identify expectations for their c hildren. T hose parents
what they believe is important for their child who watch formal and informal testing can con-
to learn and celebrate with them their child’s firm the results or be asked to indicate their
strengths. c hildren’s typical performance. In addition, par-
ents can be asked to demonstrate the techniques
• Recognize fatigue in parents and assist them
that work for them as they involve their c hildren
to find respite care if desired.
in everyday tasks, through either videotapes of
• Listen to parents as they describe their experi- t hese techniques or observations by the assessors
ences; help them to understand how they can in the c hildren’s natural environments. The ex-
facilitate skill mastery in their child. tensive involvement of parents during assess-
• Respect the decisions of parents with regard ments can help all the adults involved to gain a
to the amount of resources (time, money, en- better understanding of the c hildren, to trust one
ergy) they can direct t oward the development another, and to develop shared goals (Barclay,
and education of their c hildren. 2003; Erin & Levinson, 2007).
Involving Parents at IEP Meetings Involving Parents in Instruction

Parents should be encouraged to come to
Although parents generally choose not to be in-
IEP meetings with their own lists of proposed
volved in the day-to-day instruction of their
goals for their c hildren, as well as any ques-
c hildren at school, they should be invited to ob-
tions they would like answered about their
serve their c hildren in the school environment
c hildren’s educational programming. They

and welcomed when they feel the need to do so.
should be encouraged to take time to fully re-
Observation of their c hildren may give parents
view the documents that are written during
valuable information about how their c hildren
IEP meetings and to ask questions to clarify
function when they are away from home, the
their understanding of the proposals (Allman,
techniques that school personnel use to manage
2007). For parents who are new to the special
children’s behavior, and the demands of the envi-
education system, it may be helpful if the
ronment on students with and without disabili-
teacher of students with visual impairments
ties. It may be necessary to provide visiting parents
spends time before the first IEP meeting ex-
with guidelines to ensure that instruction is not
plaining the process, predicting who w
ill attend,
unnecessarily interrupted. Teachers may feel
and making the parents comfortable about
threatened when parents observe them working
their important role in planning their child’s
with students; instead, they should consider fre-
education. Parents should be informed that
quent visits from parents to be a signal that the
they have the right to bring a friend or advo-
parents want to improve their communication
cate to this meeting, for moral support or ad-
with the educational team about their child’s ed-
vice or to help them remember the decisions
ucational programming.
a fter the meeting.
Students with visual impairments, as well as
their parents, benefit when instruction in some
Involving Parents in Placement Decisions skills is provided at home by teachers of students
Placement should be discussed during e very IEP with visual impairments. T hese students, who of-
meeting. No assumptions about a child’s place- ten have difficulty generalizing skills, frequently
ment should be made until the goals and objec- are more successful in developing independent
tives have been determined (US Department of living skills when they learn to perform tasks, such
Education, OSERS, 2000). If, during the discus- as cleaning the bathtub, folding laundry, and
sion of placement, the parents are unfamiliar preparing snacks, at home. In children’s homes,
with one or more of the options being recom- the individual tasks are introduced as part of a
mended or considered, the IEP team should stop routine in which the c hildren play an important
the meeting and resume it only a fter the parents role. Parents benefit from watching this instruc-
have had a chance to observe the class or pro- tion, since they do not always know about the
gram in question and evaluate it in relation to techniques used by teachers of students with vi-
their child’s needs. Parents need to be informed sual impairments, which may seem mysterious or
of the entire continuum of placement options complicated to them. By watching effective teach-
that are mandated by law, including the serv ices ing strategies, listening to instructional prompts,
offered by their state’s residential school, and and noticing words of praise, parents discover
be given guidelines to help them determine a that the mystery of teachers’ success often is in
program’s appropriateness for their child (Erin, the expectation for performance, not necessarily
2007). some “magic” way to accomplish tasks.
If parents do not have the time to come to • Help the young adult develop self-
school or students cannot be instructed in their determination and self-advocacy by creating
homes, the teacher of students with visual impair- opportunities for making choices and express-
ments needs to ensure that parents are informed of ing preferences.
their children’s progress, are familiar with the ways • Become knowledgeable about the laws govern-
in which their children accomplish tasks, and feel ing transition and the criteria for high school
comfortable reinforcing the skills their children graduation.
are mastering. Frequent, short e-mails, text mes-
• Insist that these young adults participate in
sages, and telephone conferences are three ways to
planning and IEP meetings.
communicate with parents, although telephone
conferences and written notes do not have the same • Provide guidance to the transition planning
impact as face-to-face conversations in which the team in their development of goals that reflect
parents and teacher can sensitively exchange infor- the f amily’s values and preferences.
mation about the students’ challenges and the so- • Advocate for the development of an IEP that
lutions for overcoming them. integrates the young adult into the community
and reduces his or her dependence on family
Involving Parents during Transition and social systems.
• Request information on the potential supports
It is also essential for parents to be involved in
that the young adult or the family think w
ill
decisions related to their children’s postschool
be needed as the young adult moves to post-
outcomes and the entire transition process. As was
school educational, vocational, recreational,
mentioned earlier, transition planning is a highly
and living settings.
individualized process that is based on students’
and families’ preferences, strengths, weaknesses, • Provide opportunities for the young adult to
and resources. It is during transition planning develop and practice independent living skills.
that most parents—some for the first time—come
to terms with their c hildren’s continued depen-
dence or need to exert autonomy and indepen

Non–Public School Placement
dence from them. Parents can experience severe The provisions of IDEA guarantee a free appropri-
stress when they contemplate issues related to inate public education to all eligible students with
surance, medical care, income and benefits main- disabilities enrolled in publicly funded schools.
tenance, and the like without the ongoing and Over the years, questions have been raised about
continuing support of the school system, on the responsibilities of public school districts with
which they have relied for the past 13 to 20 or regard to students who attend private, including
more years. Transition planning and services help parochial (that is, religious), schools. As detailed
to ease parents’ stress by providing a framework in IDEA, public school districts are obligated to
for joint action among students, parents, school conduct child-find activities with students in pri-
personnel, and representatives of adult ser vice vate schools and to evaluate students who are
agencies. suspected of having disabilities in t hese schools.
According to Crane, Cuthbertson, Ferrell, These students, however, are not entitled to a f ree
and Scherb (1998, p. 81), it is the parents’ re- appropriate public education, and an IEP does
sponsibility to do the following during the tran- not have to be developed unless they also are
sition: enrolled in the local public school for some ser
vices, such as speech and language therapy. For (Education Department General Administrative
students enrolled in both private and public Regulations [EDGAR], 34 C.F.R. § 76.532[a]), but
schools, the local school district is required to de- if the funds are provided in a “religiously neu-
velop IEPs for students who are found to meet tral” manner, they may be acceptable. In Zobrest
eligibility requirements as students with disabil- v. Catalina Foothills School District (1993), the Su-
ities. As part of the development of IEPs, special preme Court ruled that serv ices on a parochial
education and related serv ices to achieve goals school site are permissible if they “provide assis-
and, if appropriate, objectives, must be identi- tance to the student without regard to the reli-
fied and made available to students. In addition, gious nature of the school.” Although the Zobrest
a serv ices plan that describes the specific special case specifically addressed the provision of a sign
education and related serv ices that w ill be pro- language interpreter, who was deemed to be mak-
vided to eligible students must be developed ing class material accessible to the student, not
through consultation with a representative from advancing a particular religious philosophy, its
the private school. T hese serv ices may be con- principle has been applied to the provision of
strained by the funding that is available to the books in alternate media that are used in paro-
school district to be used for this purpose, as de- chial school classrooms.
termined by a formula outlined in IDEA (Tucker, As might be imagined, deliberations related
2014). to non–public school placement often are emo-
If an IEP team determines that the appropriate tionally charged and contentious; it is not un-
placement for a student is a private school, then usual for families to bring advocates or attorneys
it is the school district’s responsibility to pay that to assist them to get the serv ices that they believe
school’s fees. If the parents choose to place their their child deserves. Teachers of students with
child in a private school, however, and the visual impairments in these situations should
school district has made an appropriate educa- be supported by school district officials who un-
tional placement available to the student, then derstand applicable policy. In all cases, it is impor
the school district is not obligated to pay the pri- tant for the teacher to keep focused on the
vate school’s fees. assessed academic and functional needs of the
The location in which special education and child and on communicating t hose needs in a re-
related serv ices can be provided has been consid- spectful way.
ered by policy- making bodies and the courts
and has frequently been determined by the poli-
cies of local school districts. Generally, the courts
Accountability
have found that school districts are not required Accountability for the achievement of all students
to provide serv ices on the grounds of private has become a critical focus of the educational sys-
schools, but such a practice is permitted to the ex- tem. School personnel are mandated through
tent consistent with the law. IDEA and, often, state legislation to provide in-
It is import ant for teachers of students with formation about students’ prog ress and the effec-
visual impairments to be aware of a district’s pol- tiveness of programs. The public’s demand for
icy on the provision of serv ices to students en- accountability has forced the educational com-
rolled in parochial schools, particularly with munity to develop plans for determining students’
regard to instruction in O&M and the provision progress, evaluating programs for efficiency and
of religious texts in alternate media. The use of effectiveness, and reporting these accountabil-
public funds for religious purposes is prohibited ity measures. Of particular importance are the
reauthorizations of the No Child Left Behind Act dards, but modified in such a manner that they
of 2001 and the Every Student Succeeds Act of reflect reduced breadth or depth of grade-level
2015. Both of these laws place emphasis on ap- content” (US Department of Education, 2007,
propriate and accountable education for all stu- p. 17748). T
hese students must be given an alter-
dents. Although trends in the early part of the nate assessment that shows progress toward the
century were toward the adoption of a common goals and alternate standards that have been de-
standard for the core curriculum by states (Com- termined to be appropriate for them by the state.
mon Core State Standards Initiative, n.d.), the As in the general assessment, appropriate ac-
newer legislation (Every Student Succeeds) gives commodations must be provided so that the stu-
more power to states for making decisions about dent can access the assessment.
accountability through state-adopted standards Students with visual impairments and no
and assessment of t hose standards. The federal other disabilities can be easily included in regu-
role w
ill continue to be the assurance that all stu- lar state-and district-required testing programs if
dents have equal opportunity and access to an attention is given to appropriate testing accom-
appropriate education. For students with visual modations. The results of t hese assessments help
impairments, as for all c hildren, t hese laws man- administrators and other school personnel un-
date their inclusion in state and district testing derstand the effectiveness of students’ educa-
as a means to demonstrate that they are meeting tional programming with regard to the general
established state standards. education common core curriculum. When ap-
Students with visual impairments must be as- propriate testing accommodations have been
sessed periodically to determine their prog ress provided, the students’ academic prog ress can be
in the academic or core curriculum, as well as in compared to that of their grade-level peers. If the
unique skill areas (the ECC). (For additional in- students are not making the same academic
formation on the core curriculum and ECC, see gains as their grade-level peers, then the effec-
Chapters 1 and 10 in this volume and Volume 2, tiveness of the students’ entire programs must be
Chapter 6.) As was discussed earlier, appropriate evaluated. Of course, these comparisons are only
assessments provide invaluable information to permissible if the standardized tests given to
teachers and parents that can help guide effective students have been developed in such a way that
learning strategies and teaching techniques. (For they truly measure the knowledge and skills of
additional information on assessment, see Vol- students who are blind or who have low vision,
ume 2, Chapters 2, 3, and 4.) and do not primarily reflect the impact of their
In order to measure student performance on disability on access to the test itself. Issues re-
state standards, states have developed or adopted lated to the validity of standardized tests and
two types of assessments, standard and alternate. their accessibility, especially when administered
The determination of which type of assessment electronically, have been raised and w ill need to
students w ill take is made by the IEP team and is be monitored.
based on the team’s expectation of the ability of Program evaluation involves the examina-
the child to achieve grade-level standards. For tion of the principles and procedures that are
students with the most significant intellectual used by a school district or other educational
disabilities for whom general assessments are not entity to guide the development, documentation,
appropriate, or approximately 1 percent of stu- and implementation of services provided to stu-
dents, IDEA regulations allow “modified academic dents with visual impairments. Information must
achievement standards as academic achievement be gathered and analyzed systematically to en-
standards aligned with grade-level content stan- sure that decisions that impact student services
are based on both valid and reliable data. Each sive, evidence-based services that meet state and
school or program should develop a plan for using federal guidelines (Toelle & Blankenship, 2008).
evaluative data to improve special programs. The
types of data that are needed for program evalua-
tion include students’ pro gress in attaining aca-
Liability
demic goals and unique skills, as identified Parents and administrators sometimes voice con-
through progress monitoring; students’ and staff’s cerns about the safety of students with visual
attendance rates; parents’, students’, and staff’s sat- impairments that are grounded in the belief that
isfaction; graduation rates; and postschool out- these students are at a greater risk of injuring
comes. The ECC provides a basis for general school themselves b ecause of their lack of (or limited)
outcomes for students with visual impairments vision than are students with unimpaired vision.
(see Hatlen, 1996, and Sapp & Hatlen, 2010). Typical administrative concerns center on the use
Hazekamp and Huebner (1989) described stan- of private automobiles to transport students with
dards and criteria for evaluating programs that visual impairments for O&M lessons and the pro-
serve students who are visually impaired. vision of training in other skills in environments
The Quality Programs for Students with Vi- away from the school. Parents occasionally ex-
sual Impairments (QPVI) is a model program press fears that students may be hurt in class-
evaluation process designed specifically to facili- rooms, cafeterias, and playgrounds, and some
tate the accountability and continuous im- request that special treatment or personnel be
provement of local and special school programs provided to their c hildren to prevent such acci-
provided to students with visual impairments. dents. Generally, school personnel are re-
QPVI incorporates a comprehensive, multiyear sponsible for the safety of students with visual
pro cess that requires the commitment and impairments in the same way that they are re-
involvement of administrators, teachers of stu- sponsible for the safety of all other students. All
dents with visual impairments, and O&M in- school staff must perform their jobs safely and
structors within the school district. Evaluation responsibly so that no student is unnecessarily
activities are facilitated by an individual trained put in danger.
for this purpose, who leads participants in the It is wise to make parents aware of all aspects
three phases of the process: (1) self-study, which of the programs for students with visual impair-
includes the development of a master list of stu- ments, including transportation in private vehi-
dents currently being served and a review of eli- cles, teaching environments away from the school,
gibility requirements, procedures for identifying and what is involved in O&M training. Some
and addressing unique student needs, staff and administrators may insist that parents sign con-
caseload issues, and student outcomes; (2) the sent statements to ensure that they are in-
identification of priorities for change; and (3) pro- formed. Any signed release of liability may not
active planning, which involves implementing be honored by the legal system if school person-
strategies that foster growth and development of nel are found to be negligent in performing du-
the program while delivering promising educa- ties that involve students. Teachers of students
tional practices that change to meet student needs. with visual impairments and O&M specialists
Schools and districts that implement QPVI find who transport students in their private automo-
that they increase staff effectiveness and satisfac- biles are encouraged to obtain liability insurance
tion, improve communication among team mem- through their personal automobile insurance
bers, assure that critical skills are taught in a timely plans or through insurance plans issued to their
manner, and provide more comprehensive, cohe- school districts. Professional liability insurance,
available for members of the Association for must be considered in making caseload decisions.
Education and Rehabilitation of the Blind and The most important and ethical consideration,
Visually Impaired (see Chapter 10 in this vol- of course, is that students’ needs, as identified
ume), is also recommended. through a thorough assessment and delineated on
Teachers and O&M specialists also must be their IEPs, are met. Next in importance, however,
careful not to place themselves in situations that is that the time of teachers be used efficiently to
might be dangerous or misconstrued by others. provide needed direct and indirect services and to
School and district policies must be followed meet other responsibilities, such as evaluation of
when making home visits. Professionals should potential new students and completion of paper-
be aware of behaviors and situations that indi- work requirements, as well as travel to various lo-
cate potential risk and be alert to the presence of cations within the district.
danger when providing serv ices in the homes of Teachers’ responsibilities change as students’
families or in community settings. When work- needs change, and caseload or class size determi-
ing with students of any age, education profes- nations may need to be altered and reconsidered
sionals should take precautions to protect against frequently. Administrators must be aware of the
accusations of physical or sexual abuse, including roles of teachers of students with visual impair-
avoiding being alone with a student in a closed ments, O&M specialists, and other support per-
room. sonnel to make informed decisions. Consultation
with these professionals before any changes are
made is essential. Teachers and O&M specialists
Workloads and Class Sizes w ill need to keep their supervisors informed of
ecause the needs of each student with a visual
B changes in their students’ needs, the impact of
impairment are so unique and the time required t hese changes on their ability to meet the needs
for teachers to meet those needs is based on so of all students on their caseload, and of other is-
many f actors, it has been challenging for the pro- sues that may impact changes in the assignment
fession to identify an ideal number of students of students to other professionals. Of paramount
that any one teacher or O&M specialist should importance is that students’ needs, as identified
serve. In determining the national need for teach- through a comprehensive assessment, are ad-
ers of students with visual impairments and dressed. To shortchange the provision of needed
O&M specialists in 2000, Mason and Davidson serv ices described on students’ IEPs b ecause a
used a student–teacher ratio of 8:1 as a reasonable teacher’s workload is too large is never acceptable.
national average. They emphasized that this na- A caseload, class size, or workload analysis
tional average, however, provided “little guid- provides data that are useful in making staff and
ance” (p. 30) for determining local caseloads assignment decisions. Such analysis should be
and called for more research on the issue. This done at least twice each year and requires teach-
research is still lacking and may not be possible, ers working within an educational serv ice area to
given the uniqueness of each student’s situation. assess students’ needs similarly, to interpret t hose
The determination of appropriate caseloads assessments with fidelity, and to have reached
and class sizes is the responsibility of school or consensus on the appropriate serv ice levels to
district administrators and is crucial for effective meet t hose needs (K. Ratzlaff, personal commu-
teaching and learning to occur. Since the role of nication, May 31, 2015; N. Toelle, personal com-
the teacher of students with visual impairments is munication, July 4, 2015). Decisions on workload
varied (as discussed previously), many factors size generally incorporate the following f actors:
• Direct service to students, which may be influ- number of students each teacher serves and the
enced by the students’ severity of vision loss; need for paraeducators and other support person-
age; additional disabilities; and intensity of nel, such as braillists or clerical workers who pro-
assessed needs as identified in the IEP, includ- vide braille materials or complete documentation
ing instructional needs to facilitate academic for services (Texas School for the Blind and Visu-
access and the teaching of skills of the ECC, as ally Impaired, n.d.). T hese meetings ideally
well as the time required to provide environ- should occur at the end of the academic year to
mental and educational adjustments and mod- discuss workloads for the following year, at the
ifications, such as transcribing and adapting beginning of the school year to confirm that the
materials into braille or another accessible spring’s decisions are still reasonable, and then
medium immediately after the winter break to determine
• Indirect serv ice, including consultation with if adjustments are necessary. Adjustments in the
other school personnel, medical personnel, sizes of caseloads and classes w ill allow programs
community agencies, and parents for students with visual impairments to meet the
needs identified on each student’s IEP.
• Travel time, including time needed to safely
travel to each individual student or fac ilit y to
provide serv ices Meeting the Needs of C hildren
• Related professional responsibilities, including
and Families in Rural Areas
the time required to obtain or produce spe- It is a special challenge for teachers and O&M
cialized and adapted materials, keep records, specialists to meet the needs of c hildren with vi-
write reports, order textbooks, and perform sual impairments and their families living in ru-
other organizational tasks ral areas. Parents and students can feel isolated
• Contracted time for lunch or other negotiated and alone as they try to cope with the demands
breaks of acquiring needed health and educational ser
vices. Rural environments can be particularly dif-
It is recommended that the administrator ficult for adolescents and young adults who do
meet with the teachers of students with visual im- not drive but need the social and work experi-
pairments, O&M specialists, and other support ences that may only be available in more popu-
personnel to discuss the size of caseloads and lated areas.
classes and include t hese staff members in the It is important to keep in mind that the pro-
decision-making process a fter an analysis has visions of IDEA related to the determination of
been made of the program. Once the sizes of the most appropriate placement for students ap-
caseloads and classes are established, the admin- ply regardless of where the students live. None-
istrator must continually monitor the caseloads, theless, the placement options for students living
keeping the factors just listed in mind. Being in rural areas can be limited by the scarcity of the
aware of spur-of-t he-moment and hidden time population and the distances involved, and, of-
commitments (such as the evaluation of new stu- ten, students are identified as needing itinerant
dents or students’ immediate need for special- support, consultative serv ices, or a more inten-
ized instruction in part icu lar areas) that affect sive, residential placement. Even when itinerant
teachers of students with visual impairments, services are available, the frequency and intensity
O&M specialists, and other staff w ill allow the of serv ices that can be provided may be limited
administrator to make sound decisions about the by the distances involved. Easy and frequent
access of teachers of students with visual im- to needy individuals who live in rural areas. The
pairments and O&M specialists to students, their field of serv ices to c hildren with visual impair-
instructors, and the environments in which they ments can learn from t hese model programs and,
receive educational serv ices may not be realistic. as technology improves, experiment with new
In these situations, teachers and districts ways to facilitate academic and functional achieve-
must be especially creative in the design of ser ment by students who are blind or have low vision.
vices to meet students’ needs. The use of video Chapter 15 in this volume contains information
and audio technology as a tool for communicat- on education in rural areas.
ing with families, teachers, and administrators
may allow collaboration and some training to oc-
cur, even though participants may not be at the
Paraeducators
same location. For example, Harrison, Cooch, Even when students do not live in rural areas, it is
and Alsup (2003) described students’ positive not uncommon for the IEP team to consider the as-
changes in attitudes and motivation related to signment of a paraprofessional to a student with
braille instruction a fter parents and paraeduca- visual impairment or to the teacher of the class
tors in South Dakota participated in a nine-week where the child is placed. Well-meaning adminis-
course delivered through an interactive video trators and parents and overwhelmed teachers
teleconferencing system. may believe that the assignment of a paraprofes-
In addition, it may be possible to provide sional may increase the access of the student to
some instructional support—not instruction in the curriculum or facilitate the student’s safety. In
new skills—t hrough the use of well-t rained and some cases, of course, access is indeed increased
well-supervised paraeducators. Paraeducators with the help of a paraprofessional, but often, the
who are present when teachers of students with student or classroom assistant interferes with the
visual impairments and O&M specialists are pro- achievement of academic, functional, and social
viding initial instruction to students can be en- goals by the student (Giangreco, 2009). Team mem-
couraged to pay attention to the instructional bers need to think carefully about the potential
techniques being used, then given detailed direc- advantages and disadvantages of the assignment
tions for practicing t hese new skills and document- of paraprofessionals and make this decision on a
ing the students’ performance of them during the case-by-case basis.
absence of the teacher. Teachers and paraeduca- The presence of “overly helpful” paraeduca-
tors in these circumstances need to maintain tors can impair students’ acquisition of inde
close communication with each other, fre- pen dent work and advocacy skills and can
quently sharing information about student pro inadvertently foster dependence in c hildren by
gress and be haviors during practice sessions. solving their problems for them. Students with
Only the professionals involved—teachers of t hese kinds of paraeducators rarely have to ad-
students with visual impairments and O&M vocate for themselves because they rarely have
specialists—should be assessing student prog ress problems to solve. Their classrooms are well orga
and providing direct instruction of new skills, as nized, their materials are always available, and
paraeducators lack the professional training to do their needs are magically met by the paraeduca-
these jobs. (The following section contains a tors who have been assigned to them. However,
more detailed discussion of paraeducators.) some students with overly helpful paraeducators
Other helping professions, such as medicine may begin to perceive themselves as incompe-
and psyc hology, have demonstrated the efficacy tent. Without the daily challenges of encounter-
of using technology to provide sensitive serv ices ing and solving problems, these students may
not develop the organizational, social, and func- quately assessed and the instructional approach
tional skills they need to be successful adults. is changed if necessary.
Paraeducators may also interfere with typical
interactions among c hildren in the classroom
and with the access of the child with a visual im-
Links to Rehabilitation
pairment to his or her teacher’s instruction. Many One primary purpose of the transition process is
teachers of students with visual impairments to provide a formal link between educational ser
attempt to solve this problem by assigning para- vices and serv ices provided to adults with and
educators to general education teachers. In this without disabilities. When transition planning is
case, although the primary duty of a paraeduca- successful, students are taught the skills they need
tor is to facilitate the successful involvement of a to be advocates for themselves; are made aware
child with a visual impairment, the paraeducator of the vocational, independent living, and rec-
helps all the c hildren with their work and is per- reational options that are available to them; and
ceived by the c hildren as just another adult in the are encouraged to establish links with adult ser
classroom. vice agencies that w ill enhance their function-
Decisions regarding assignment of paraedu- ing as adults.
cators should be made by the IEP team only a fter Not all students with visual impairments will
thoughtful consideration (Giangreco, 2009). For need or be eligible for services provided by state
some students, a readily available adult provides or private agencies after they graduate. Some stu-
the support necessary to function successfully in dents who are visually impaired who receive spe-
a particular educational environment. This indi- cial education and related serv ices through IDEA
vidual may support the student by transcribing w ill not qualify for serv ices, since most state and
classroom materials into accessible formats, de- private agencies require that their clients be le-
scribing videos, explaining visual events that are gally blind or demonstrate substantial limitations
occurring in the classroom, and reinforcing newly in activities of daily living. O thers w ill find that
introduced or emerging skills. In addition, a para they have the skills necessary to function success-
educator can effectively facilitate the partial par- fully as adults without formal or continuing
ticipation of a young student or a student with contacts with agencies serving individuals with
additional disabilities in the social, functional, visual impairments. Still o thers will need inten-
and academic activities of the class. sive and ongoing services to participate in voca-
B ecause paraeducators require training and tional and adult living environments. As indicated
supervision, administrators need to consider earlier, the transition needs of students must be
t hese two activities when they develop the
addressed in their IEP by the time that they turn
schedules of teachers of students with visual im- 16. Linking eligible students to appropriate adult
pairments. In addition, administrators need to service agencies and other community supports
remember that good teachers are constantly assess- while they are still in school facilitates a more
ing while they instruct their students, evaluating seamless transition that benefits both students
the rate at which the students are acquiring and their families.
skills and the effectiveness of their teaching. Ad- Most students with visual impairments
ministrators should ensure that students who should view participation in rehabilitation ser
are assigned paraeducators who are reinforcing vices as a means to an end, not the end itself, and
newly learned skills are also seen frequently by hence should not think that they w ill always be
the teacher of students visual impairment or clients of one system or another (Erin, 1988).
O&M specialist, so that their prog ress is ade- Rather, they need to be provided with services
that encourage them to strengthen their sense While they are still in school, students with
of autonomy and control over their lives. Educa- visual impairments benefit from close coopera-
tional programming from early elementary school tion between providers of educational and re-
through high school should include instruc- habilitation serv ices. Rehabilitation counselors
tional goals and objectives in self-k nowledge, can assist teachers in their efforts to help stu-
career and work awareness, and job-seeking and dents understand the reality of the demands of
maintenance skills. Teachers and parents need to adult life and can facilitate planning to meet
convey their high expectations for students, pro- t hose demands. Through such coordination and
vide realistic feedback, facilitate opportunities to linkages, the transition to adult living is made
work, and promote the development of socializa- smoother for students and their families.
tion and compensatory skills—key skills for the Coordinated transition services are mandated
successful transition to adult living (Wolffe, by IDEA, and a commitment to the spirit of the
2007). law truly improves students’ outcomes. Success-
Individuals who have developed these skills ful transition to rehabilitation services begins not
can use rehabilitation services to their best advan- at age 16 but with the development of attitudes of
tage. Most state vocational agencies provide young self-sufficiency, competence, and personal value
adults with financial support while they attend that are achieved through careful educational
college or trade school, search for employment, planning, thoughtful involvement of parents and
and become established in new jobs. T hese families, and high-quality instruction. Educators
serv ices are most effective when clients of reha- must always keep in mind the reality that their
bilitation services do not depend heavily on reha- students will become adults someday and hence
bilitation counselors but, rather, recognize their need to direct educational programming toward
own personal responsibility for finding and keep- the needs of their students as adults.
ing jobs and for honing their independent living
skills.
Many young adults with visual impairments ROLE OF THE EACHER OF
require direct instruction in, and frequent practice STUDENTS WITH VISUAL
of, the skills necessary to get and maintain jobs or MPAIRMENTS N EDUCATIONAL
to live independently or with support. For them,
ongoing contact with state vocational rehabilita-
PROGRAMMING
tion services or private agencies is necessary. Many Teachers of students with visual impairments wear
state vocational agencies operate residential reha- many hats when it comes to the educational pro-
bilitation centers, in which skills related to voca- gramming of their students. In many school dis-
tional training and independent living are taught tricts, they and their O&M colleagues are the only
to adults. Some private agencies offer similar ser professionals who have a deep understanding of
vices, both in center-based settings and individu- the impact of visual impairment on learning and
ally in clients’ homes. Again, except in cases when development. One of their primary roles, then, is to
additional disabilities limit the independent func- share this understanding with administrators, other
tioning of adults with visual impairments, these educators, and parents so that they, too, can better
services should be viewed as necessary only in the appreciate the access issues these students encoun-
short term, with occasional consultations occur- ter at home, in schools, and within the community.
ring when adults need disability-specific instruc- Spungin and Ferrell (2016) identified the fol-
tion to master new skills or to use acquired skills lowing seven areas for which teachers of students
in new environments. with visual impairment are responsible:
1. Assessment and evaluation dents are assigned about ways to make classroom
2. Educational and instructional strategies: instruction and activities meaningful for students
learning environment who are blind or who have low vision.
3. Educational and instructional strategies: ac-

cessing the general curriculum Educational and Instructional
4. Educational and instructional strategies: col-
Strategies: Accessing the
laborating to assure instruction in the ex- General Curriculum
panded core curriculum Since visual impairment often interferes with stu-
5. Guidance and counseling dents’ understanding of the world around them,
teachers of students with visual impairments
6. Administration and supervision
often are required to assist students to increase
7. School-community relations their conceptual knowledge in order to access
the curriculum that is presented in class. It is
Assessment and Evaluation frequently necessary to preteach certain skills
and concepts needed to access the general cur-
Teachers of students with visual impairments riculum. For example, the teacher of students
must assess students to identify their use of func- with visual impairments might bring a turtle
tional vision, the learning medium with which for her first-g rade student to examine if she
they are most efficient, and their strengths and knows that the class w ill be reading a story
weaknesses related to all areas of the ECC. In about and studying turtles as part of a science
addition, they must assist other diagnostic per- unit. Similarly, instruction in use of a talking
sonnel to adapt, administer, and interpret the ed- calculator to a student who w ill be using this
ucational assessments that they give. instrument in the general mathematics class-
As members of IEP teams, teachers of students room might take place over several periods in
with visual impairments use their professional advance of when it is needed, and map reading
knowledge and judgment to interpret assessment skills might be taught before the social studies
results and, based on these findings, to make rec- class begins using maps to understand the geog-
ommendations related to educational needs, the raphy of the United States.
intensity of services required to meet those needs,
and the placement in which they believe those
needs can best be met.
Educational and Instructional
Strategies: Teaching the ECC
Educational and Instructional Instruction in the unique learning needs of stu-
dents with visual impairments is a critical re-
Strategies: Learning Environments sponsibility for teachers of students with visual
Teachers of students with visual impairments are impairments. Without t hese skills, the deep aca-
responsible for ensuring that classrooms and in- demic learning expected of all students in school
struction are accessible to their students. To is compromised for c hildren who are blind or
achieve this accessibility, they order textbooks and who have low vision, who may not share the same
other materials in the medium most efficient for experiences as their peers. Mastery of t hese skills
each student, teach students the skills to access is also critical to the long-term functioning of in-
t hese materials, and provide suggestions to the dividuals with visual impairments as they nego-
general and special educators to whom their stu- tiate the challenges of adulthood: traveling within
communities, participating in families, maining in-service instruction to educational per-

taining employment, engaging in leisure pursuits, sonnel to whom students have been assigned,
and so forth. student scheduling, monitoring of braillists, and
writing grants to acquire funding to pay for ex-
pensive equipment or learning e xperiences.
Guidance and Counseling
Helping students to cope with issues related to
growing up with a disability, adjusting to the sud-
School-Community Relations
den onset of a visual impairment, or dealing with Teachers of students with visual impairments
a progressive vision loss is another important re- typically are key contacts when students are
sponsibility of teachers of students with visual transitioning from one educational program to
impairments. It is not unusual for students to be another, as when a student moves from being pro-
teased, or even bullied, and the emotions vided serv ices on an IFSP to an IEP, or when a
brought about by these situations can prevent young adult initiates the serv ices of the state re-
learning from occurring, so they must be dealt habilitation agency. This liaison role is also
with as they occur. Even in the absence of nega- important when t here are questions that must be
tive actions by peers, students often have doubts asked of the eye care specialists who provide ser
about their ability to cope in a society in which vices to students or when students are engaged in
visual functioning is so valued. Teachers of stu- community recreation activities for which accom-
dents with visual impairments need to be pre- modations may be necessary.
pared to guide their students as they work through Promoting the abilities of individuals with vi-
t hese issues and to recognize when a referral to a sual impairments to a variety of audiences is an-
mental health counselor is appropriate. other key role of teachers of students with visual
Similarly, teachers of students with visual im- impairments. Students benefit when community
pairments frequently find that the families of members view them as potentially competent
their students turn to them for emotional support contributors to society. Teachers of students with
and guidance. Teachers can facilitate the positive visual impairments often discover that the special
experience of families by being available, taking needs of their students are addressed with dona-
the time to listen to concerns, and getting fami- tions of volunteer time and funding after they
lies in touch with one another. Recommending have made presentations to civic groups that are
involvement in a parent organizat ion such as the focused on what students with visual impairments
National Association of Parents of Children with can do for themselves if provided the appropriate
Visual Impairments or the National Organization educational supports (see Volume 2, Chapter 8).
of Parents of Blind Children can be extremely Obviously, the roles of teachers of students
helpful to some family members. with visual impairments w ill vary depending on
the type of school at which they are employed.
Teachers of students at specialized schools may
Administration and Supervision have additional instructional responsibilities, as
The administrative and supervisory role of teach- they are required to address both the common
ers of students with visual impairments w
ill vary, core curriculum and the ECC. It is likely that
depending on the size of the employing school t hese institutions have designated personnel to
district. Among the kinds of activities in which supervise paraeducators, adapt materials, order
teachers may be involved are record keeping and equipment, and facilitate public relations within
reporting, supervising paraeducators, provid- the community. The same division of labor may
be true for teachers employed by larger school cational programming requires a positive attitude
districts. In medium-and small- size school on the part of teachers who believe that their job
districts, however, the diverse roles described is to work closely with parents to facilitate the de-
previously for teachers of students with visual im- velopment of young people into adults who can
pairments must be adopted by each profes- manage their own lives. Through such collabora-
sional. While sometimes overwhelming, with tion, students with visual impairments can
experience and practice in keeping the needs of make steady progress and achieve exciting results.
their students in mind, the job can be accom-
plished, bringing much satisfaction to teachers For learning activities related to this
and success for students. chapter, log in to the online AFB Learning
Center.
SUMMARY
Federal legislation in the form of IDEA defines REFERENCES
the process of educational programming. It estab- Act to Promote the Education of the Blind, Pub. L.
lishes the requirements that LEAs must follow in No. 45-186 (1879).
their efforts to locate and appropriately serve Allman, C. B. (2007). The Individualized Education
c hildren with disabilities, including students
Program: Blueprint for serv ices. In S. LaVenture
with visual impairments. Among these require- (Ed.), A parent’s guide to special education for children
ments are (1) that LEAs actively search for stu- with visual impairments (pp. 90–125). New York:
dents with disabilities, (2) that they assess each AFB Press.
student referred for special education, (3) that American Printing House for the Blind. (2015). Dis-
they hold a meeting to determine the referred stu- tribution of eligible students based on the Federal
Quota Census of January 6, 2015 (fiscal year
dent’s eligibility for serv ices, (4) that they create
2014). Retrieved from http://w ww.aph.org /fi les
a plan describing the special education and re-
/annual-reports/A PH-A nnual-Report-F Y15.pdf
lated serv ices they w
ill provide that student, (5)
Barclay, L. (2003). Preparation for assessment. In S. A.
that they place the student in the least restrictive
Goodman & S. H. Wittenstein (Eds.), Collaborative

environment, and (6) that they provide appropri- assessment: Working with students who are blind or vi-
ate serv ices. For most students with visual im- sually impaired, including those with additional dis-
pairments, appropriate serv ices include receiving abilities (pp. 37–70). New York: AFB Press.
needed instruction in the ECC, as determined by Common Core State Standards Initiative. (n.d.). Pre-
assessment. IDEA also describes the responsibil- paring America’s students for college and career.
ity of the school to work with families of children Retrieved from http://w ww.corestandards.org
with disabilities and sets forth a process that par- Corn, A. L., Bina, M. J., & DePriest, L. B. (1995). The
ents may follow if they are not satisfied with parent perspective on schools for students who are blind
their child’s education. and visually impaired: A national study. Alexandria,
VA: Association for Education and Rehabilitation
All teachers need to be familiar with the com-
of the Blind and Visually Impaired.
ponents of educational programming as identi-
Crane, P., Cuthbertson, D., Ferrell, K. A., & Scherb, H.
fied in IDEA. They must understand the impact (1998). Equals in partnership: Basic rights for families
of visual impairment on learning, know how to of c hildren with blindness or visual impairment. Water-
assess that impact, and be prepared to provide in- town, MA: National Association for Parents of the
struction to support participation in the core Visually Impaired.
curriculum and development of skills in the ECC. Education Department General Administrative Regu-
In addition, they must realize that quality edu- lations (EDGAR), 34 C.F.R. sec. 76.532(a).
Education for All Handicapped C hildren Act, Pub. laborative assessment: Working with students who are
L. No. 94-142 (1975). blind or visually impaired, including those with addi-
Education of the Handicapped Act Amendments, tional disabilities (pp. 23–36). New York: AFB Press.
Pub. L. No. 99-457, Part H (1986). Harrison, J. R., Cooch, C. G., & Alsup, J. (2003). Using
Edwards, C. C., & Da Fonte, A. (2012). The 5-point distance education for families to improve chil-
plan: Fostering successful partnerships with fam- dren’s braille literacy [Research report]. Journal of
ilies of students with disabilities. Teaching Excep- Visual Impairment & Blindness, 97(3), 169–172.
tional Children, 44(3), 6–13. Hatlen, P. (1996). The core curriculum for blind and
Elementary and Secondary Education Act, Pub. L. No. visually impaired students, including t hose with
89-10 (1965). additional disabilities. RE:view, 28(1), 25–32.
Elementary and Secondary Education Act (No Child Hatton, D. D., Ivy, S. E., & Boyer, C. (2013). Severe vi-
Left Behind), Pub. L. No. 107-110 (2001). sual impairments in infants and toddlers in the
Erin, J. N. (1988). Better to give than to receive? United States. Journal of Visual Impairment & Blind-
RE:view, 20(1), 35–37. ness, 107(5), 325–337.
Erin, J. N. (2007). From regular classroom to special- Hazekamp, J., & Huebner, K. M. (Eds.). (1989). Program
ized program: Exploring the options for your planning and evaluation for blind and visually impaired
child. In S. LaVenture (Ed.), A parent’s guide to spe- students: National guidelines for educational excellence.
cial education for children with visual impairments New York: American Foundation for the Blind.
(pp. 171–199). New York: AFB Press. Huebner, K. M., Merk-Adam, B., Stryker, D., & Wolffe,
Erin, J. N., & Levinson, T. S. (2007). Assessment: Identi- K. E. (2004). The national agenda for the education
fying your child’s needs. In S. LaVenture (Ed.), of children and youth with visual impairments, includ-
A parent’s guide to special education for children with ing those with multiple disabilities (Rev. ed.). New
visual impairments (pp. 61–89). New York: AFB Press. York: AFB Press.
Evans, C. (n.d.). Testing visually impaired c hildren. Huebner, K. M., Garber, M., & Wormsley, D. P. (2006).
Austin: Texas School for the Blind and Visually Student-centered educational placement decisions: The
Impaired. Retrieved from http://w ww.t sbvi.edu meaning, interpretation, and application of least restric-
/i nstructional -r esources /165 -t esting -v isually tive environment for students with visual impairments
-impaired- c hildren [Position paper]. Arlington, VA: Council for Excep-
Every Student Succeeds Act, Pub. L. No. 114-95 (2015). tional Children, Division on Visual Impairments.
Fellinger, J., Holzinger, D., Dirmhirn, A., Van Dijk, J., Improving America’s Schools Act, Pub. L. No. 103-382
& Goldberg, D. (2009). Failure to detect deaf- (1994).
blindness in a population of p eople with intellec- Individuals with Disabilities Education Act (IDEA),
tual disability. Journal of Intellectual Disability Pub. L. No. 101-467 (1990).
Research, 53(10), 874–881. Individuals with Disabilities Education Act Amend-
Ferrell, K. A. (2011). Reach out and teach: Helping your ments of 1997, Pub. L. No. 105-17 (1997).
child who is visually impaired learn and grow (2nd Individuals with Disabilities Education Improvement
ed.). New York: AFB Press. Act (IDEA), 20 U.S.C. § 1400 (2004).
Florida Department of Education. (1992). Meeting the Keen, D. (2007). Parents, families, and partnerships: Is-
needs of students: Section 504 of the Rehabilitation Act sues and considerations. International Journal of Dis-
of 1973. Tallahassee, FL: Author. ability, Development and Education, 54(3), 339–349.
Giangreco, M. F. (2009). Concerns about the proliferation LaVenture, S., & Allman, C. B. (2007). Special educa-
of one-to-one paraprofessionals. Critical issues brief. Ar- tion serv ices: What parents need to know. In
lington, VA: Council for Exceptional C hildren, Di- S. LaVenture (Ed.), A parents’ guide to special educa-
vision on Autism and Developmental Disabilities. tion for c hildren with visual impairments (pp. 3–36).
Retrieved from http://eric.ed.gov/?id=ED543012 New York: AFB Press.
Goodman, S. A. (2003). The role of the administrator. Liefert, F. K., & Silver, M. A. (2003). Introduction. In
In S. A. Goodman & S. H. Wittenstein (Eds.), Col- S. A. Goodman & S. H. Wittenstein (Eds.), Collab-
orative assessment: Working with students who are blind https://w ww.u nderstood.org/en/school-learning
or visually impaired, including those with additional dis- /c hoosing-c hanging-schools/finding-r ight-school
abilities (pp. xvii–x xii). New York: AFB Press. /6 -t hings-t o -k now -a bout-private- s chools -a nd
Martin, J. E., Van Dycke, J. L., Christensen, W. R., -special- education
Greene, B. A., Gardner, J. E., & Lovett, D. L. (2006). US Department of Education. (2007). Title I—
Increasing student participation in IEP meet- Improving the academic achievement of the disad-
ings: Establishing the self-d irected IEP as an vantaged; Individuals with Disabilities Education
evidenced-based practice. Exceptional Children, Act (IDEA); final rule. Federal Register, 72(67),
72(3), 299–316. 17747–17781.
Mason, C., & Davidson, R. (2000). National plan for US Department of Education, Office of Special Edu-
training personnel to serve children with blindness and cation and Rehabilitative Serv ices, Office of Spe-
low vision. Arlington, VA: Council for Exceptional cial Education Programs. (2015). 37th Annual
Children. Report to Congress on the Implementation of the Indi-
National Center on Educational Outcomes. (2013). Al- viduals with Disabilities Education Act, 2015, Wash-
ternate assessments for students with disabilities. ington, DC: Author.
Retrieved from http://w ww.cehd.umn.edu/NCEO US Department of Education, Office for Civil Rights.
/TopicAreas/A lternateAssessments/altAssessTopic (2015). Protecting students with disabilities: Fre-
.htm quently asked questions about Section 504 and
Rehabilitation Act of 1973, 29 U.S.C. § 701 (1973). the education of c hildren with disabilities. Re-
Sapp, W., & Hatlen, P. (2010). The expanded core cur- trieved from http://w ww2.ed.gov/about/offices
riculum: Where we have been, where we are going, /list/ocr/504faq.html
and how we can get t here. Journal of Visual Impair- US Department of Education, Office of Special Educa-
ment & Blindness, 104, 338–348. tion and Rehabilitative Serv ices. (2000). Educat-
Sheehey, P. H., & Sheehey, P. E. (2007). Elements for ing blind and visually impaired students: Policy
successful parent- professional collaboration: The guidance. Federal Register, 65(111), 36585–36594.
fundamental t hings apply as time goes by. TEACH- Retrieved from https://w ww.g po.gov/fdsys/pkg
ING Exceptional C hildren Plus, 4(2), Article 3. /FR-2000-06-08/pdf/00-14485.pdf
Smith, D. W., & Amato, S. (2012). Synthesis of avail- Van den Broek, E. G., Janssen, C. G., Van Ramshorst, T.,
able accommodations for students with visual im- & Deen, L. (2006) Visual impairments in people
pairments on standardized assessments. Journal with severe and profound multiple disabilities:
of Visual Impairments & Blindness, 106(5), 299–304. An inventory of visual functioning. Journal of In-
Spungin, S. J., Ferrell, K. A., & Monson, M. (2016). The tellectual Disability Research, 50(6), 470–475.
role and function of the teacher of students with visual Wolffe, K. E. (2007). Transition: Planning for the world
impairments [Position paper]. Arlington, VA: beyond school. In S. LaVenture (Ed.), A parent’s
Council for Exceptional Children. guide to special education for c hildren with visual im-
Texas School for the Blind and Visually Impaired. pairments (pp. 245–290). New York: AFB Press.
(n.d.). Program info and administrative resources: Wright, P. W. D. (2006). Summary of major changes
Caseload analysis guidelines. Austin, TX: Author. in the regulations. Retrieved from http://w ww
Retrieved from http://w ww.t sbvi.edu/program .w r ig htslaw.c om/i dea /l aw/i dea.r egs.s umr y
-and-administrative-resources/490-caseload-analy .c hngs.pdf
sis-g uidelines Zirkel, P. A. (n.d.). The common lore of Section 504.
Toelle, N. M., & Blankenship, K. E. (2008). Program CEC Today. Retrieved from http://oldsite.cec.sped
accountability for students who are visually im- .org /A M / Template .c fm ?S ection= C EC _ Today1
paired [Practice report]. Journal of Visual Impair- &T E M P L A T E =/C M /C o n t e n t D i s p l a y .c f m
ment & Blindness, 102(2), 97–102. &CONTENTID=19095
Tucker, G. C. (2014). 6 t hings to know about private Zobrest v. Catalina Foothills School District, 113 S. Ct.
schools and special education. Retrieved from 2462 (1993).
10
C H A P T E R
Professional Practice
M. Cay Holbrook and
Karen E. Blankenship
To hear an audio introduction ♦ National and state organizations provide valu-

to this chapter by an author, able support to teachers and parents.
and to view a chapter over
view pre
sen
ta
tion, log in to the AFB Learning INTRODUCT ON
Center.
hose who are preparing for c areers in educat-
T
ing students with visual impairments need to
KEY POIN S learn about and appreciate the richness of the
professional practice that guides the provision
♦ Teachers of students with visual impairments of educational serv ices for t hese students. Pro-
face complex ethical issues and need to use fessionalism is nurtured by t hese f actors:
both personal and professional standards to ad-
dress these issues. • Adherence to the best professional practices

♦ Teachers of students with visual impairments and established ethics in the practice of the
must navigate professional and personal atti- profession
tudes and biases in their involvement in deci- • Understanding of the roles that professionals
sion making. play in the educational process and decision
♦ Specialized organ
izations provide professional making regarding a student’s educational pro-
development opportunities and literature for gram
teachers as well as collective professional • Knowledge about the preparation and continu-
advocacy. ing development of professionals
♦ Teachers of students with visual impairments • Familiarity with the professional literature
participate in specialized training opportunities
• Knowledge of and the ability to gain access to
and receive certification in visual impairment.
professional organi zations, consumer organ
♦ Teachers of students with visual impairments izations, and specialized agencies
work with parents and a wide variety of profes-
sionals to provide educational ser vices to Teachers of students with visual impairments
students. face many complex issues. They work in a variety
322
Professional Practice 323
of serv ice delivery settings, with a wide range of ter 5 in Volume 2 of this text extends the explo-
other professionals and school administrators. ration of professional practice in a discussion
Therefore, they may need to adjust their working of strategies for moving from assessment to
practices to the demands of particular settings instruction.
while maintaining high professional standards.
Furthermore, those who work in itinerant settings
need to work effectively with principals, general DEF NING HE ROLE OF THE
education teachers, and other personnel in many TEACHER OF S UDEN S W H
different schools or even school districts. In addi- V SUAL MPAIRMENTS
tion, specialists in visual impairment often have
limited resources available to them and must be Throughout Volume 2 of this book, t here are state-
creative in meeting pressures associated with ments regarding the role of the teacher of stu-
time and money. dents with visual impairments in various areas
The students with whom t hese teachers work of the core curriculum and expanded core cur-
have a wide variety of needs, and their teachers riculum (ECC). The role of the teacher of stu-
serve them using a wide variety of methods. In dents with visual impairments is not static; it
many situations, teachers of students with visual changes according to the needs of each student
impairments are independent professionals and on the teacher’s caseload and varies depending
have little contact with others who have exper- on other supports available to the student. De-
tise in visual impairment. Although the chal- termining the role of the teacher of students
lenges are sometimes daunting, the rewards of with visual impairments is a complex issue in-
teaching students with visual impairments are volving many competing factors, including the
just as g reat as the challenges. Teachers of t hese following:
students routinely describe their profession as
“exciting,” “interest ing,” and “fascinating.” This • The abilities and needs of individual students
chapter discusses the professional practices of • The resources available to support student
teachers of students with visual impairments learning and achievement
and provides information about addressing the

• The specific IEP goals and objectives for each
challenges t hese teachers face.
student
Chapter 9 in this volume outlines the process
of developing a student’s Individualized Educa-
Among the f actors that should not determine the
tion Program (IEP) goals and objectives (based
role and responsibility of the teacher of students
on assessment data and the opinions of the stu-
with visual impairments are t hese:
dent’s educational team), deciding on the stu-
dent’s appropriate placement, and conducting
• Available time on the teacher’s workload
an analysis of the makeup of the workload of a
teacher of students with visual impairments • Financial constraints from the school district
based on students’ needs. This chapter w ill • Availability of qualified teachers of students
build on that discussion by providing informa- with visual impairments
tion about the roles and responsibilities of the
teacher of students with visual impairments as Any discussion regarding the roles and re-
well as about embracing best professional prac- sponsibilities of the teacher of students with
tices, determining teachers’ competencies, and v isual impairments must occur in the context
adhering to ethical professional practice. Chap- of discussions regarding the teacher’s workload
(that is, the number of students that the teacher • Teacher of the visually impaired
takes responsibility for in either direct or indi- • Vision resource teacher
rect ways plus other responsibilities such as
• Vision itinerant
travel time, material preparation, and rec ord
keeping or report writing). Wilton (2015) cau- Legislation (No Child Left Behind, 2001;
tions that members of a student’s educational very Student Succeeds Act, 2015) has encour-
E
team should take care to distinguish between a aged the creation of teacher standards that may
teacher’s caseload (the number of students being have an impact on how the broader fields of ed-
provided direct or indirect instruction by the ucation and special education perceive and de-
teacher of students with visual impairments) fine the role of the teacher of students with
and workload, which also encompasses all nonvisual impairments. Ferrell and Sacks (2006)
instructional responsibilities (for example, consul- caution that t hese standards may limit the abil-
tation with general education teachers, planning ity of a teacher of students with visual impair-
for instruction, travel requirements for itinerant ments to participate in direct instruction in
teachers). academic subject matter, which may lead to
characterizations of teachers of students with
Assigned Teacher Titles visual impairments as “related serv ice profes-
sionals” instead of teachers. T hese issues must
Teachers of students with visual impairments be addressed in a systematic way to ensure that
hold many different titles or school designa- exercise of the role and responsibility of the
tions. The job title that is given to (or accepted teacher of students with visual impairments
by) a teacher of students with visual impair- with individual students is not prohibited
ments provides impor t ant information about because of a philosophical decision regarding
what that professional is required, or even al- teacher categories.
lowed, to do. In some cases, the job title is pro- Regardless of the definition of their roles
vided without much thought to its implications. and responsibilities and the IEP goals and ob-
In other cases, the job title is given in order to
jectives of individual students, teachers of stu-

conform to that of professionals in similar roles dents with visual impairments must have time
within a school district. Other titles are given in their schedule to provide direct, ongoing,
to reflect a philosophical belief regarding roles and consistent instruction in order to effectively
and responsibilities. In this textbook, the term support students in areas of both the core cur-
teacher of students with visual impairments is used riculum and the ECC. Unfortunately, teachers
to reflect the belief that knowledgeable profes- of students with visual impairments often have
sionals working with students who are blind or caseloads and workloads that are inappropri-
visually impaired are teachers first and fore- ately large and prevent them from addressing all
most. The following is a list of some of the other IEP goals and objectives for the students on
terms used for teachers of students with visual their caseloads. The following suggestions may
impairments. help teachers address the problem of unman-
ageable caseloads/workloads.
• Vision teacher
• Have conversations with school district ad-
• Vision specialist
ministration regarding the needs of students
• Vision consultant with visual impairments throughout the school
• Vision strategist year, not just in times of crisis.
• Ensure that all students have complete and eated the “disability-specific needs” or “unique
comprehensive IEPs with all goals and objec- needs” of students with visual impairments. This
tives listed, along with plans for addressing approach placed the focus of the curriculum on
t hose goals and objectives. what was special or unique about t hese students’
• Collect ongoing data regarding your ability to educational needs. However, when some pract i
address IEP goals and objectives and share this tion ers in general education interpreted the
information with administrators with decision- concept of unique needs to mean that the fulfill-
making authority on a weekly, biweekly, or ment of t hese needs was something “extra,” not
monthly basis. necessary, the original conceptualization was re-
fined.
• Make sure that parents are well informed
Today, the curriculum for students with visual
about their student’s goals and objectives as
impairments has two parts: the core curriculum
well as about teacher time assigned to address
(general education) and the expanded core cur-
all instructional issues in the core curriculum
riculum. The core curriculum consists of the gen-
and the ECC.
eral education curriculum that all students are
expected to master, including literacy, language
BEST PROFESS ONA PRACT CES arts, science, mathematics, and social studies. The
ECC proposes that instruction for students with
Much has been written about “best professional visual impairments should include all the tradi-
practices” in education, and the field of educat- tional areas of academic instruction as well as in-
ing students with visual impairments is no differ struction in areas that are directly affected by a
ent. However, t here has not always been a clear child’s visual impairment (Sapp & Hatlen, 2010).
delineation of the roles of educational specialists Teachers of students with visual impairments
in visual impairment and the part t hese special- generally use the ECC as a guide in providing
ists play in developing and implementing pro- appropriate educational services for their students.
grams for students. When students with visual In most situations, it is their role to support aca-
impairments were first being integrated into gen- demic progress in areas of the core curriculum
eral education classrooms, teachers believed that through direct instruction or provision of adapted
their role was to ensure that their students made or modified instructional materials and to assume
prog ress in academic classes, and their practices primary responsibility for addressing the skills in
involved modifying materials and making adap- the ECC, which include the following:
tations to allow this integration to occur (Hatlen
& Curry, 1987). However, this approach ignored • Career education
the development of other essential skills, such as • Compensatory access skills, including commu-
daily living skills and vocational skills. nication modes
Like other professions, the field of visual im- • Independent living skills
pairment has grown from early practices. Many
• Orientation and mobility (O&M) skills
of these practices, while well intentioned, failed
to address holistically and comprehensively the • Recreation and leisure s kills
special and unique needs of students with vi- • Self-determination skills
sual impairments. Today, there is a clearer dif-
• Sensory efficiency skills
ferentiation of the focus of professional practice
in educating students with visual impairments. • Social interaction skills
In 1987, for example, Hatlen and Curry delin- • Use of assistive technology
valuable resource, it should not be considered a

TEACHER COMPETENC ES substitute for a qualified teacher.
Attempts to define competencies for all teachers,
including special educators and teachers of stu- ETH CS
dents with visual impairments, have occurred on
a regular basis for many years. The current em- Codes of Ethics
phasis on accountability in education has in-
One key characteristic of a profession is the col-
creased efforts to ensure that teachers have the
lective commitment to a code of ethical behav
appropriate qualifications to provide proper in-
ior by individuals who have expertise through
struction to their students. The field of visual
training in a body of specialized knowledge
impairment has seen ongoing efforts to define
(Welch, 2006). The professional practice of spe-
skills that are critical for teachers of students with
cialists in visual impairment is governed by
visual impairments and personnel preparation of
codes of ethics, both internal and external.
t hese skills in the following areas:
One’s internal code of ethics is a personally de-
fined set of beliefs and standards that governs
• Braille transcription (Bell, 2010; D’Andrea, one’s life in general, as well as one’s professional
Lewis, & Rosenblum, 2009; Lewis, D’Andrea, practice. These beliefs and standards are molded
& Rosenblum, 2012) from, and develop through, one’s sense of per-
• Nemeth Braille Code for Mathematics and Sci- sonal responsibility and worth, parental influ-
ence Notation (Smith & Rosenblum, 2013) ences, religious and moral convictions, schooling
and professional preparation, and all other life
• Abacus (Rosenblum, Hong, & Amato, 2013;
experiences. How p eople respond to ethical di-
Rosenblum & Smith, 2012)
lemmas in life (for example, w hether to “tattle”
• Tactile graphics (Rosenblum & Smith, 2012) on a friend, tell a store clerk when one is given
• Skills specific to working with students with back too much change, or engage in an unau-
cortical visual impairment (Erin, 2010; Griffin- thorized rally to promote a social cause) is gov-
Shirley & Pogrund, 2010; Hatton, 2010; Mc erned by their individual internal belief systems
Kenzie, 2010) and personal codes of ethics. Since teachers have
• Assistive technology (Zhou et al., 2012; a major influence on the lives of c hildren and
Zhou, Parker, Smith, & Griffin-Shirley, 2011) youths, it is essential that they have high stan-
dards of personal ethics. External codes of ethics
• Supervision of paraeducators (Lewis & Mc
govern professional practice. The Council for Ex-
Kenzie, 2009)
ceptional Children (CEC), the largest profes-
sional organization that addresses issues faced
Identifying the knowledge and skills needed by special education teachers, has a widely rec-
by teachers of students with visual impairments ognized code of ethics, which is presented in
is important in establishing high-quality educa- Sidebar 10.1.
tional programs that meet students’ academic The first principle states that special educators
and functional needs. However, the identification must be committed to “maintaining challenging
of these competencies is only valuable if qualified expectations for individuals with exceptionali-
teachers are given the time and opportunity for ties to develop the highest possible learning out-
direct, ongoing, and consistent instruction. While comes and quality of life potential in ways that
the use of support by a paraprofessional can be a respect their dignity, culture, language and back-
S I D E B A R 1 0 . 1
Special Education Professional Ethical Principles
Professional special educators are guided by exceptionalities in educational decision

the CEC professional ethical principles and making.
practice standards in ways that respect the F. Using evidence, instructional data,
diverse characteristics and needs of individu- research, and professional knowledge to
als with exceptionalities and their families. inform practice.
They are committed to upholding and
advancing the following principles: G. Protecting and supporting the physical and
psychological safety of individuals with
A. Maintaining challenging expectations exceptionalities.
for individuals with exceptionalities H. Neither engaging in nor tolerating any
to develop the highest possible learning practice that harms individuals with
outcomes and quality of life potential in exceptionalities.
ways that respect their dignity, culture, I. Practicing within the professional ethics,
language, and background. standards, and policies of CEC; upholding
B. Maintaining a high level of professional laws, regulations, and policies that influence
competence and integrity and exercising professional practice; and advocating
professional judgment to benefit individuals improvements in laws, regulations, and
with exceptionalities and their families. policies.
C. Promoting meaningful and inclusive J. Advocating for professional conditions and
participation of individuals with resources that will improve learning
exceptionalities in their schools and outcomes of individuals with
communities. exceptionalities.
D. Practicing collegially with o
thers who are K. Engaging in the improvement of the
providing services to individuals with profession through active participation in
exceptionalities. professional organizations.
E. Developing relationships with families L. Participating in the growth and

based on mutual respect and actively dissemination of professional knowledge
involving families and individuals with and skills.
Source: Reprinted, with permission, from Council for Exceptional Children. (2010). Special education professional
ethical principles. Arlington, VA: Author. Retrieved from http://w ww.cec.sped.org/Standards/Ethical-Principles-and
-Practice-Standards
ground” (CEC, 2010). This principle, and the ac- or expected to do so. Following a carefully de-
tions that a professional would undertake to fined professional code of ethics and applying
carry out this commitment, reflects elements of it throughout one’s professional life helps to
best professional practices. Clearly, this com- ensure that the education offered to c hildren
mitment must emerge from one’s internal code and youths with disabilities is of the highest
of ethics; a professional could not simply “practice” quality and that improvements are continually
this commitment b ecause he or she was told to sought.
The Association for Education and Rehabili- a professional in an ethical dilemma from which
tation of the Blind and Visually Impaired (AER), several questions arise, such as the following:
the professional organizat ion in North America
for teachers and other specialists in visual im- • Do I provide the amount of instructional ser
pairment, addresses issues that face professionals vice that fits into my schedule? Is providing
who serve individuals with visual impairments of some instructional time better than not pro-
all ages. AER has also established a code of ethics viding any?
as a general guide for all professionals that reflects • Do I refuse to sign a student’s IEP until an ap-
the commitment of professionals within propriate level of serv ice is provided, even
this field to act ethically (available in the though I run the risk of angering my supervi-
online AFB Learning Center). sor or losing my job?
The Acad emy for Certification of Vision
Rehabilitation and Education Professionals
• Do I advocate for the student and his or her
(ACVREP), the largest certifying body in North parents, or do I fulfill the expressed or implied
America for specialists in visual impairment, has wishes of my supervisor?
established individual codes of ethics for O&M • Do I allow a paraeducator to do some of my
specialists, vision rehabilitation therapists, low teaching, even though he or she is not quali-
vision therapists, and assistive technology in- fied to do so?
structional specialists for people with visual im-
pairments (available at www.acvrep.org). Those Questions like these are asked more often
who are certified to practice any of t hese profes- than professionals and school administrators
sions must follow the specific code of ethics of would like to admit, and there are no simple an-
their part icu lar specialization. The certification swers or solutions. The internal struggle between
guidelines for each profession contain a section high-quality standards of practice and day-to-day
on ethical practices, the professional’s due pro reality is unsettling and uncomfortable for pro-
cess rights, and the appropriate appeals proce- fessionals until they take appropriate action. To
dure that must be followed if a professional is address this strug g le, each professional must
reported to have v iolated the established code of consider internal and external codes of ethics, the
ethics. If the professional is found to be in viola- needs of students and their families, and other
tion, his or her certification could be revoked. factors that are affected by any decision, and then
These codes take precedence over the AER general decide on a course of action. In making such deci-
code if they are in conflict. sions, it is important for members of a student’s
educational team to take actions that will benefit
the student and his or her family. To achieve this
Ethical Dilemmas goal, the following guidelines may be used.
Many professionals in visual impairment face con- Do what is right for all students on the basis of
tinuing ethical dilemmas in providing appropri- their individual needs as revealed by objective assess-
ate, high-quality educational services to students ment, and focus on these needs in everything you do.
who are blind or visually impaired. Since there is a Begin by clearly and convincingly establishing
shortage of professionals in the field and case each student’s needs through a high-quality, thor-
loads tend to be high (Emerson & Anderson, ough assessment that presents clear and justified
2014), the amount of time required to meet a stu- recommendations. Work within the IEP process
dent’s needs may be compromised by logistical or to match the student’s assessed needs with appro-
administrative factors. T
hese f actors instantly place priate educational serv ices. When the discussion
shifts to logistical or administrative m atters, im- vide. Use of data-driven recommendations for pro-
mediately refocus on the student’s needs. The IEP vision of services is most helpful (Corn & Koenig,
team meeting must focus on the student, not on 2002; Koenig & Holbrook, 2000) when advocat-
the limitations of the school district or agency. ing for appropriate serv ices.
Serve as an advocate for the student and his or her Advocate continually for high-quality and appro-
family. Meeting students’ educational needs is the priate services for students who are visually impaired.
teacher’s primary goal. In determining how to do Work within the school district or agency to
so and implementing this goal, teachers can avail increase the available continuum of program
themselves of many resources, such as experi- options for students so that IEP teams can better
enced educators, trusted colleagues, and represen- match students’ needs with the appropriate con-
tatives of the many national organizations in the figuration of serv ices.
blindness field (for instance, the American Coun- Dealing with ethical dilemmas is extremely
cil of the Blind [ACB], the American Foundation difficult. Although it may be uncomfortable to
for the Blind [AFB], and the National Federation deal with t hese issues, addressing them directly
of the Blind [NFB]; see the section on organ w ill help solve them in the long run. When
izations later in this chapter). faced with an ethical dilemma, use a basic rule
Be a professional, not an employee. Profession- to guide the team’s decision: do what is right for
als in visual impairment rarely have nine-to-five the student.
jobs. The role is demanding and complex, re-
quiring the highest commitment to professional REFLEC IVE PRACTICE
practice. In most situations, teachers of students
with visual impairments are not supervised by Reflective practice has long been recognized as
other specialists in visual impairment. Therefore, important. Almost 100 years ago, reflective prac-
they may need to educate their supervisors and tice, defined as encompassing the “active, persis
coworkers about the needs of their students and tent, and careful consideration of any belief or
the kinds of educational services that are r equired supposed form of knowledge in light of the
to address these unique needs. By educating ad- grounds that support it and the further conclu-
ministrators and coworkers, teachers are in a bet- sions to which it leads” (Dewey, 1933, p. 9), was
ter position to advocate for an increased quality valued. Using the principles of reflective practice
or quantity of specialized services. to guide one’s professional life is a proactive way
Do not accept or condone the practice of allowing to address the complexities and challenges of be-
nonqualified persons or paraprofessionals to perform ing a specialist in visual impairment (or any
a teacher’s duties. Having someone other than a other field).
teacher perform a teacher’s duties violates both Given that empirical research in this field is
logic and laws, undermines the principle of ad- sparse, many common professional practices are
herence to the highest professional standards, rooted in what is “commonly accepted” as good
and ultimately results in substandard educational and effective. For example, some professionals
programs for students with visual impairments. “accept” that learning in an inclusive setting is
To help ensure appropriate staffing, develop preferable to learning in a segregated or special-
written policies or guidelines on the role of para- ized setting. However, no body of research pro-
educators and have these documents approved by vides convincing support for either setting, and
administrators. Also, use the IEP process to iden- decisions about placement should be based on the
tify and document the amount of instructional individual needs of the student. Through reflec-
time that a qualified professional needs to pro- tive practice, professionals weigh the advantages
and limitations of a technique or method and among professionals and parents is critical in pro-
gather information to support, reject, or mod- viding seamless serv ices that build skills each
ify their practice. The goal is to implement t hose year of students’ school careers to prepare the
practices that w ill be of maximum benefit to stu- students for adult life. The following section
dents. The following suggestions are offered to describes t hese professionals and the roles they
promote reflective practice. play in the education of children with visual
impairments. It should be noted, however, that
• Keep up to date with the latest research or some professionals receive training and are qual-
promising practice in the field of visual impair- ified to serve in more than one role, so that one
ments by attending national and statewide professional may provide serv ices in a variety of
conferences and reading journals. ways.
• Do not immediately embrace e very profes-
sional fad. Like other fields, the field of visual
Education Professionals
impairment is prone to many swings of the
pendulum, which may sometimes be disrup- Teachers of Students with Visual
tive to cohesive education. Professionals should Impairments
take time to gather information and reflect on
Teachers of students with visual impairments have
what is best for individual students.
specialized qualifications beyond t hose needed
• Seek advice and information from t hose who to teach in general or special education. Their
have experience dealing with pertinent issues. contribution is thus essential. These teachers are
Because the field of visual impairment is small, trained at the undergraduate or graduate level to
it is not difficult to contact p eople who are address the specialized needs of students who are
leaders in the field for advice and guidance. blind or visually impaired and to teach the ECC.
• Take advantage of professional development op- They are also knowledgeable about and compe-
portunities and professional conferences to up- tent in conducting needed assessments to provide
grade and expand instructional skills. It may be accommodations and adaptations to the core
helpful to return to college to seek an advanced curriculum based on this data and in construct-
degree or to take needed graduate courses. ing adapted materials. A teacher of students with
visual impairments, with input from other mem-
• Be open and flexible on professional issues,
bers of a student’s educational team, may be re-
rather than closed to emerging ideas, issues,
sponsible for designing and implementing each
and practices. Make sure that changes in pro-
student’s IEP. (Chapter 9 in this volume presents
fessional opinions and practices are made on
detailed information on the requirements for and
a sound basis, not using the bandwagon
development of IEPs.) In some instances a case
approach.
worker or lead teacher w ill be responsible for as-
sembling the entire IEP, while the teacher of
PROFESS ONA S N students with visual impairments w ill take re-
V SUAL IMPAIRMENT sponsibility for goals and objectives specifically
related to the student’s visual impairment.
Several types of professionals, each of which is Teachers of students with visual impairments
important for a comprehensive educational pro- usually are certified by the state in which they live.
gram, provide serv ices to students who are blind State certification is provided as part of teacher
or visually impaired. The coordination of services licensure procedures, and the certification is spe-
cialized in visual impairment. Most employment those who work in public school settings with
opportunities for teachers of students with visual children who are blind or visually impaired are
impairments are advertised with all other job also required to have basic teacher certification; in
postings for individual school districts. However, other situations, they can work with school-age
to recruit specialists in visual impairment (who children with only national O&M certification.
are not as readily available as other school profes- O&M is often a pullout program b ecause
sionals), school districts often send job an- most skills must be taught in a community-based
nouncements to universities with training setting using real-life situations. Therefore, O&M
programs in visual impairment and post notices specialists typically work with students on a one-
in professional journals and newsletters or at pro- to-one basis at various times of the day and in
fessional conferences, and some use professional various school or community situations. When it
lists or web pages to post these job openings. is necessary for them to provide serv ices to stu-
Some school districts have found that it is most dents at home, in the neighborhood, at a shop-
effective to “recruit from within.” T hese school ping center, or on public transportation, they need
districts, often in rural or remote geographic ar- to coordinate their instruction with students’
eas, w ill find a teacher who is currently employed classroom teachers and other members of the
in the district and thus may have a commitment students’ educational teams.
to living in the area; the district may support him
or her in receiving the special training to meet Paraeducators
qualifications as a teacher of students with visual
Serv ices for students who are visually impaired
impairments. T here are many benefits to this
are often provided with the assistance of paraed-
practice, including the teacher’s familiarity with
ucators, for whom t here are no national standards
the school district policies and procedures and es-
for qualifications. The following are appropriate
tablished collegial relationships.
activities for paraeducators:
O &M Specialists • Producing adapted materials

Students with visual impairments may also re- • Assisting in the provision of classroom assis-
ceive serv ices from O&M specialists to learn how tance to allow the classroom teacher to provide
to maneuver safely, efficiently, and gracefully direct, individualized instruction to a student
around their environment. O&M serv ices, which who is blind or visually impaired
were recognized in the 2004 reauthorization of • Helping a student with a visual impairment
the Individuals with Disabilities Education Act as practice skills that have been taught by a qual-
a related serv ice (that is, any serv ice that w ill as- ified teacher of students who are blind or vi-
sist a student who has a disability to benefit from sually impaired
special education serv ices), include, among other
t hings, instruction in using the long cane. O&M Paraeducators are used in classrooms with
specialists receive training at the graduate or un- students with visual impairments in many ways,
dergraduate level and may or may not have a and the method used by a particu lar school is
background in visual impairment before their based on the policy of its school district. In some
O&M training. They typically receive national cases, a classroom teacher is assigned a paraedu-
certification through ACVREP (for additional cator when the class contains students with
information, see the section on Certification Or special needs; in these cases, the paraeducator
ganizations in this chapter). In some situations, receives work assignments and reports to the
classroom teacher. In other cases, a paraeducator habilitation therapists to instruct students, espe-
is u
nder the direct supervision of a teacher of stu- cially those who are older and who are beginning
dents with visual impairments. In all cases the the transition from school- based to adult ser
importance of support and training for parapro- vices, in daily living skills.
fessionals is critical (Lewis & McKenzie, 2010; Li-
eberman & Conroy, 2013).
Rehabilitation Counselors
Some research (McKenzie & Lewis, 2008) has Rehabilitation counselors are trained to work with
suggested that t here may be some differences in children and adults on adjustment issues related
perceptions of teachers of students with visual to acquired disabilities and may work with f amily
impairments and paraprofessionals regarding the members of these individuals. There is no na-
paraprofessional’s responsibilities related to sup- tional certification for rehabilitation counselors in
port in areas of the core curriculum. Caution visual impairment; rather, certification standards
must be exercised when assigning paraeducators for rehabilitation counselors are used and supple-
duties related to working with students who are mented with course work in visual impairment.
blind or visually impaired. T hese students need
to be given opportunities to complete work inde Vocational Rehabilitation Counselors
pendently and to socialize with peers without the Vocational rehabilitation counselors focus on the em-
intervention of adults, and they must be taught ployment needs of individuals with disabilities.
and encouraged to develop independent orga They, too, should have additional course work in
nizational skills. Thus, the temptation to provide visual impairment to be considered qualified to
one-to-one paraeducator assistance to students provide services to individuals with visual impair-
with visual impairments should be avoided so ments, although they are not specially certified.
as not to compromise students’ need to explore
and learn independently. Clinical Specialists
Ophthalmologists
Rehabilitation Professionals
Ophthalmologists are physicians who specialize in
Vision Rehabilitation Therapists

treating diseases of the eyes. They are often in-
Professionals who work primarily with adults on volved in the care of c hildren who are blind or
inde
pen dent living, such as cooking, sewing, visually impaired because of the children’s need
ironing, and labeling, are called vision rehabilita- for long-term, continuing treatment of eye condi-
tion therapists (previously known as rehabilitation tions. For example, a child who has glaucoma
teachers). Often, vision rehabilitation therapists (increased pressure in the eyes that leads to per-
work for state agencies or private agencies for in- manent damage of the nerve fibers in the light-
dividuals who are visually impaired. They are not sensitive layer of the eyes) requires ongoing
certified teachers of students with visual impair- treatment from an ophthalmologist, who moni-
ments u nless they have fulfilled those qualifica- tors the pressure in the eyes and controls the pres-
tions in addition to the requirements for vision sure with medication. An ophthalmologist also
rehabilitation therapists and are certified in both monitors children for secondary eye conditions
fields. National professional certification for vi- (that is, those that are caused by or associated
sion rehabilitation therapists of persons with vi- with the primary eye condition). For example, a
sual impairments is available through ACVREP child with retinopathy of prematurity (a condi-
(see the section on Certification Organizations in tion that affects premature infants in which blood
this chapter). Some school districts use vision re- vessels grow into and damage the retinas of the
eyes) is more likely to experience glaucoma and facilities are responsible for participating in low
detached retinas, so an ophthalmologist watches vision evaluations of c hildren to help determine
for and treats these conditions. Ophthalmologists appropriate optical devices given the c hildren’s
are qualified to examine eyes, perform surgery, specific needs and to provide training in using
and prescribe eyeglasses and medications. They t hese devices. They are often trained as teachers
are sometimes involved in students’ educational of students with visual impairments, O&M spe-
teams to provide information on the students’ vi- cialists, or rehabilitation teachers. T
here is also
sual conditions and visual prognoses. national professional certification for low vision
therapists through ACVREP.
Optometrists
Optometrists are eye care specialists who receive Opticians
training in graduate programs in optometry but Opticians grind and fit lenses into eyeglasses. They
do not have medical degrees; the abbreviation are often responsible for filling complicated pre-
OD (doctor of optometry) follows their names. scriptions for eyeglasses and optical devices, such
Optometrists are qualified to examine eyes, pre- as spectacle-mounted telescopes.
scribe lenses, and, in some locations, prescribe
selected medications. They are often involved in
determining the best possible visual correction GENERAL TEACH NG
for individuals through optical devices. Optom- APPROACHES
etrists frequently work with teachers of students
with visual impairments to determine the type of Roles and Responsibilities of Teachers
optical device or devices (for near and/or distance of Students with Visual Impairments
vision) that may be appropriate for individual For teachers to be effective, they must have a
students with visual impairments. Ophthalmol- clearly defined role in the students’ educational
ogists and optometrists may work together in a teams that is clearly communicated to other mem-
clinic to provide comprehensive medical and op- bers of t hese teams. As mentioned earlier, sev-
tical serv ices. eral attempts have been made to determine the
role of teachers of students with visual impair-
Clinical Low Vision Specialists
ments (Spungin & Ferrell, 2013). In general, this
Clinical low vision specialists are e ither ophthalmol- role can be divided into three categories of re-
ogists or optometrists who have gained additional sponsibilities:
training and expertise in the area of low vision.
They provide clinical low vision evaluations, 1. Direct instruction in areas of the ECC that
prescribe optical and nonoptical devices, and students need (for example, teaching braille
offer follow-up serv ices. T hese specialists may reading and writing, use of optical devices,
work in a specialized low vision clinic or may self-determination, or independent living
offer low vision serv ices as part of their regular skills)
ophthalmological or optometric practice. 2. Consultation and collaboration with other
educational professionals and adaptation to
Low Vision Therapists
make the regular classroom curriculum ac-
Some c hildren have access to low vision clinics cessible to students (for instance, ordering
that address the needs of children with visual im- braille textbooks or helping a general educa-
pairments. Low vision therapists who work in t hese tion teacher plan adaptations for a field trip)
3. Provision of indirect serv ices needed to in- the educational team, especially in relation to
form and gather information from members roles and responsibilities:
of students’ educational teams, including par-
ents (for example, communicating with • Written information. Teachers often prese nt
members of educational teams or conducting written reports and memos that address roles
specialized assessments) and other issues to other members of the
educational team. The use of written infor-
Defining One’s Role mation is helpful because it provides docu-
Teachers of students with visual impairments are mentation that can be referred to in the
ultimately responsible for defining their role in f uture and offers a starting point for discus-
relation to other members of c hildren’s educa- sions among team members. Copies of writ-
tional teams. This role must be defined in the ten communication should be maintained
context of the documented needs of each student for f uture reference.
and should not be based on the availability of • Technology. Teachers may communicate with
time, funding, or resources from the school dis- members of the educational team using e-mail
trict. For example, if a student needs direct, daily or video conferencing.
instruction in skills related to the ECC, then the • Conferences and meetings. It may be effective for
teacher must define his or her role as the provider teachers of students with visual impairments
of that direct instruction, even though it may be to hold annual conferences during which the
difficult to obtain the resources to do so. In some roles and responsibilities of team members are
cases, the teacher’s role may be more supportive discussed and clearly delineated.
and less direct. The teacher’s role must be con-
• Informal discussions. In many cases, informal
stantly evaluated and redefined to meet each
discussions over time are the most effective
student’s current needs.
in defining the role of teachers of students
with visual impairments. Periodic contact in
Communicating One’s Role
which specific situations are discussed may
Since the role of the teacher of students with vi- be helpful, especially when the roles of team
sual impairments is dynamic and cannot be de- members truly overlap (for example, in teach-
fined in general, only in relation to a particular ing the use of optical devices for reading in-
student, it becomes even more important to com- struction).
municate that role clearly to the members of each
student’s educational team, who should also
clearly define and communicate their roles to the
Educational Settings
team. Communication among team members Teachers of students with visual impairments
helps to eliminate gaps and overlaps of serv ice. work in a variety of settings (for a detailed discus-
(For additional information on working in teams, sion of t hese settings, see Chapter 9 in this vol-
see Volume 2, Chapter 1.) ume). Therefore, they must use sound professional
Teachers of students with visual impairments judgment to determine the best way to encourage
have various communication styles and use a effective communication among members of an
range of communication systems. The following educational team. The ser v ice delivery model
are some of the most common ways in which greatly influences the type of communication
teachers communicate with other members of that the team members need to use.
• Foundations of educating students with visual

PROFESS ONA PREPARAT ON impairments
University Preparation • Braille reading and writing
• Anatomy and physiology of the eye
Teachers of students with visual impairments and
O&M specialists are prepared in recognized and • Educational implications of low vision
accredited university programs throughout the • Instructional strategies for teaching students
United States and Canada. Most universities offer with visual impairments, including t hose with
such preparation at the graduate level, although multiple disabilities
several include the option for undergraduate spe-
• Basic O&M skills
cializations. The course of study depends, to a
great extent, on the requirements for certification • Student teaching or a practicum in teaching
of the state or province in which the teacher or c hildren with visual impairments
O&M specialist is to practice.
Students in undergraduate programs typically
Teachers of Students with take four years to complete their bachelor’s de-
Visual Impairments grees. They generally take courses and complete
The knowledge and skills that teachers of stu- student teaching in another field of education—
dents with visual impairments must have as be- elementary, secondary, or generic special
ginning teachers have been delineated by the education—along with preparation in visual im-
CEC (CEC, 2015). (See the online AFB pairment. This approach gives them a broad base
Learning Center for more informa- of preparation for teaching that many in the pro-
tion.) The CEC standards for all begin- fession believe is highly desirable. An understand-
ning teachers are outlined in the ing of the total educational context is essential for
following sequence: developing and implementing educational pro-
grams for students with visual impairments.
Most students in graduate programs are al-
• Learner development and individual learning

differences ready certified in another area of education and
have returned to a university to pursue special-
• Learning environments
ization in visual impairment. A typical master’s
• Curricular content knowledge degree program takes at least one calendar year
• Assessment to complete if students are enrolled full time,
but many students attend school part time to
• Instructional planning and strategies
complete this specialization. In addition, many
• Professional learning and practice universities offer options for distance learning
• Collaboration through off- c ampus courses, Internet- based
courses, teleconference courses, or other arrange-
hose who are preparing to teach students with
T ments that are designed for those who want to at-
visual impairments generally take a sequence of tend classes part time. To complete a master’s
courses in which t hese skills and knowledge are degree, a university may require that a student
infused. Although the courses vary widely from spend one semester on campus to take courses
university to university, classes in the following and final examinations. Some universities have an
topics are typical: option or requirement for students to complete
master’s theses or final projects, e ither in place certification process for specialists. At present
of or in addition to the comprehensive examina- they offer the National Orientation and Mobil-
tion that students generally take at the end of the ity Certification (NOMC), which emphasizes
program. nonvisual instruction and structured-discovery
Colleges of education have the option of learning.
obtaining accreditation from the Council for the National program approval is available for
Accreditation of Educator Preparation (CAEP), a universities that offer courses in O&M. Program
national organizat ion that ensures that teacher approval is granted through the university review
education programs meet fundamental criteria process of the Association for Education and Re-
for offering sound, professional preparation in habilitation of the Blind and Visually Impaired
education. As part of the CAEP accreditation pro (AER, the professional or gan i
z a
t ion for the
cess, teacher preparation programs in special field of visual impairment, discussed u nder
education must meet the standards established Organizations later in this chapter). Approved
by CEC. In searching for a university program, a university programs demonstrate that they meet
student may want to inquire as to w hether a uni- standards approved by a professional committee
versity has CAEP accreditation. of AER members.
O&M Specialists Doctoral Programs

O&M specialists are generally prepared to meet According to AER, fewer than 20 universities in
the rules and guidelines for national certification the United States and Canada offer doctoral pro-
by ACVREP. Many states use national certification grams in the area of visual impairment. Individ-
rather than state-specific certification to ensure uals with doctoral degrees generally work as
that they are hiring qualified O&M specialists. Na- faculty members in university programs that pre-
tional certification standards do not indicate the pare specialists in visual impairment, as adminis-
number or type of courses that must be taken, but trators or supervisors in agencies that serve
require candidates to show that they have taken persons who are blind or visually impaired, as
course work and successfully completed a 350- private consultants, or in other similar leader-
hour internship that addresses mastery of specific ship roles. Although a doctoral degree is some-
competencies. Applicants determined eligible by times required as a condition of employment,
demonstrating the above requirements then sit for some leadership roles and positions, including
an Orientation and Mobility Certification Exami- some in university programs, do not require doc-
nation. Successful completion of all of t hese steps torates.
leads to certification being awarded (ACVREP, The requirements and programs of study for
2014). doctoral programs vary widely and are established
National certification is valid for five years, by individual universities. These programs re-
a fter which it must be renewed. The renewal quire their students to have bachelor’s degrees at
process includes providing the ACVREP Certifi- a minimum and generally master’s degrees and
cation Committee with proof of continuing several years of successful teaching experience.
education, work experience, and professional
Full-time doctoral study usually takes about three
activities. In addition, the National Blindness to four years to complete, including two years for
Professional Certification Board (NBPCB) was all or most of the formal courses and one to two
created in collaboration with NFB to offer a years of an internship and dissertation research.
Most doctoral programs require students to fulfill Ongoing Professional Development

“residency” requirements, that is, students must
be enrolled on campus in full-time studies for a Part of professional practice is engaging in ongo-
specified period, usually one or two (or more) ac- ing professional development to update and ex-
ademic years. The purpose of residency is to allow pand one’s professional knowledge and skills.
students to immerse themselves fully in scholarly This type of professional development is most of-
activities and pursuits without the demands of ten sponsored by school districts or other educa-
other daily work responsibilities. tion agencies. In-service programs and workshops
Course requirements for doctoral degrees for teachers are offered throughout the school
typically include a “research tool” requirement. year and in the summer to provide more or new
This block of instruction, ranging from about 12 information on specific topics, which are gener-
to 18 semester hours, focuses exclusively on really identified as needed in a systematic needs as-
search methodology and statistics. A student then sessment. For teachers of students with visual
uses the research tools to prepare a proposal for impairments, targeted in- service programs and
the dissertation research that must be approved workshops may be offered at residential schools
by the student’s dissertation advisory committee for students with visual impairments, universi-
before the student can conduct the research and ties, or other specialized educational agencies.
prepare a written doctoral dissertation. The stu- Attending professional conferences also pro-
dent defends his or her dissertation in a final oral vides for continuing professional development.
examination, during which members of the com- AER hosts biennial international conferences at
mittee ask a variety of questions and assess the which the sessions relate specifically to teaching
student’s responses. Often, final revisions to the c hildren or adults with visual impairments and
dissertation are agreed on during the d efense. specific areas of interest to professionals in visual
impairment are highlighted. CEC hosts an an-
Alternative Approaches to nual international conference at which the CEC
Division on Visual Impairments and Deafblind-
Personnel Preparation ness (DVIDB) holds a number of sessions that tar-
Some specialists in visual impairment are pre- get the needs of teachers of students with visual
pared in nonuniversity programs, although this is impairments. In addition to the national and
not usually the case. T hese alternative certification international conferences, state or local chapters
programs are generally sponsored by education of professional organ izations host conferences
agencies according to guidelines established by and workshops that provide for continuing profes-
the states in which they are located. sional development. Many teachers also belong
In the field of O&M, a number of rehabilita- to and participate in professional organizations
tion agencies that serve adults who are blind and with emphases other than visual impairment
visually impaired offer their own preparation (for example, the International Literacy Associ-
programs. Generally, O&M specialists who are ation).
trained in such programs are employed only at Engaging in continuing professional develop-
the specific agencies that offered the training. ment is an essential aspect of professionalism.
There may not be reciprocity with other agencies All professionals must continue to expand their
or states. Agency-t rained O&M specialists are not knowledge and skills to address the complex
eligible for national professional certification needs of students with visual impairments. An-
through ACVREP. other aspect of professionalism is sharing one’s
professional expertise with others by presenting contains articles, personal profiles, schedules
in-service programs or speaking at conferences. of upcoming events, and announcements.
Teachers’ presentat ions on effective practice and
innovative, creative materials are important ad-
ditions to state, regional, and national confer- ORGANIZAT ONS
ences. Some school districts provide financial
Professional Organizations
support for teachers to attend conferences if the
teachers are also presenting at them. Many states Professionals in the field of visual impairment
require a certain number of hours of continuing can become involved in organizations that are
professional development each year for teachers designed specifically to address issues related to
of students with visual impairments, as AER re- serv ices for the individuals they serve. The many
quires for O&M specialists. benefits conferred by membership in professional
organi zations include t hese:
Professional Publications
Maintaining a body of literature documenting the • A voice. Professional organizations advocate for
knowledge base of theory and practice grounded issues that are important to the field. Although
in professional research, expert opinion, and pol- individuals may write letters and otherw ise
icy decisions and identifying critical professional present issues of importance to the field, the
issues is an important responsibility of profes- efforts of membership organizations have a
sionals in any field, including the field of visual stronger impact because of the sheer number
impairments (Bina, 2006; Welch, 2006). A variety of the organi zations’ members.
of written information is available to profession- • Written materials. Members of professional
als in the field of educating students with visual organizations receive journals, newsletters, up-
impairments, including journals on visual im- dates on important issues, and announcements
pairment, journals on general special education, of job openings.
newsletters, and other sources of professional in- • Professional development. Many professional
formation. The following are among the primary organizations regularly hold conferences that
sources of information for professionals: address relevant issues. These meetings are
excellent opportunities for professionals to
• Journal of Visual Impairment & Blindness (JVIB). receive current information and to network
Considered the premier professional scholarly with colleagues. As mentioned earlier, AER
journal in the field of visual impairment and holds biennial international conferences, and
the official journal of AER, JVIB contains arti- CEC holds annual international conferences.
cles on research, practice, and other areas of in-
terest to the field, as well as comments on timely
Teachers can be involved in professional
issues, news items, and a calendar of events.
organizations at the national, state, or local level
• AER Report. The AER Report is a newsletter pub- by attending conferences, presenting at confer-
lished by AER that includes information on ences, holding office, writing for professional
legislative actions, new products and serv ices, journals and newsletters, and partici-
news items, and membership updates. pating in advocacy activities. (See the
• Visual Impairment and Deafblind Education Quar- Resources section in the online AFB
terly. The newsletter of DVIDB, the Visual Im- Learning Center for more information about these
pairment and Deafblind Education Quarterly organizations.)
• Association for Education and Rehabilitation S I D E B A R 1 0 . 2

of the Blind and Visually Impaired (AER).
AER is the only professional organization for
Divisions of the Association
teachers, O&M specialists, and rehabilitation for Education and
personnel that focuses on issues related to Rehabilitation of the Blind
providing serv ices to individuals with visual and Visually Impaired
impairments at all ages and through all ser
vice delivery models. According to its bylaws, Administration and Leadership
the purpose of AER is “to support profession-
Aging
als who provide education, independent liv-
ing, employment, and rehabilitation serv ices Education Curriculum
to individuals who are blind or visually im- Infant and Preschool
paired” (AER, 2000). Each of its divisions Information and Technology
(see Sidebar 10.2) addresses specific issues re- International Services and Global Issues
lated to the field. AER’s website (www.aerbvi
Itinerant Personnel
.
org) provides timely information and re-
sources for its members. Low Vision Rehabilitation
Multiple Disabilities and Deafblind
• Council for Exceptional C hildren, Division
on Visual Impairment and Deafblindness Neurological Visual Impairment
(CEC/DVIDB). CEC, the largest professional Orientation and Mobility
organizat ion focusing on special education, Personnel Preparation
has 17 special interest divisions (see Side- Physical Activity and Recreation
bar 10.3). The division that most directly ad-
Psychosocial Services
dresses the needs of professionals in the field of
visual impairments is DVIDB. In addition to Rehabilitation Counseling and
Employment
conducting annual international conferences,
Vision Rehabilitation Therapy
CEC publishes two journals— Teaching Excep-

tional Children, which contains practical articles
Note: Divisions are subject to change.
on classroom methods, materials, and programs, Source: Association for Education and Rehabili-
and Exceptional Children, which includes ma- tation of the Blind and Visually Impaired. (n.d.).
jor research reports in the field of special AER divisions. Alexandria, VA: Author. Retrieved
education—and a newsletter, CEC Today, which from https://aerbvi.org/about/divisions/
provides information on special education pro-
grams at the local, regional, national, and inter-
national levels. CEC also has a website (www
.cec.sped.org) that is continually updated for
current issues and events in special education. specialists, rehabilitation teachers, and low
vision therapists. The option of seeking national
certification is impor t ant for these profes-
Certification Organizations sionals, since many states and provinces do not
• Academy for Certification of Vision Rehabili- provide such certificates or licenses. Each certi-
tation and Education Professionals (ACVREP). fication discipline has guidelines and standards
ACVREP is a national certification organization for gaining initial certification, as well as national
that offers professional certificates for O&M examination within the discipline. In addition,
S I D E B A R 1 0 . 3 emy offers Continuing Education Units (CEUs)

for professionals.
Council for Exceptional
Children Special Interest • National Blindness Professionals Certifi-
cation Board (NBPCB). NBPCB was created
Divisions to certify qualified specialists who work
with people who are blind or visually im-
Council of Administrators of Special paired. At prese nt, the board oversees four
Education (CASE) certifications—the National Orientation and
Council for Children with Behavioral Mobility Certification (NOMC), the National
Disorders (CCBD) Certification in Rehabilitation Teaching for
Division for Research (CEC-DR) the Blind (NCRTB), the National Certifica-
CEC Pioneers Division (CEC-PD) tion in Literary Braille (NCLB), and the Na-
tional Certification in Unified Eng lish Braille
Council for Educational Diagnostic
Services (CEDS) (NCUEB).
Division on Autism and Developmental
Disabilities (DADD)
International Organizations
Division for Communicative Disabilities
and Deafness (DCDD) • International Council for Education of
Division on C
areer Development and People with Visual Impairment (ICEVI).

Transition (DCDT) ICEVI is a professional nongovernmental orga
Division for Culturally and Linguistically nization that does not provide direct service
Diverse Exceptional Learners (DDEL) but, rather, serves as a point of contact for indi-
Division for Early Childhood (DEC) viduals who need information about services to
people who are visually impaired throughout
Division of International Special
the world. It publishes an international journal
Education and Services (DISES)
(The Educator) that is distributed worldwide
Division on Learning Disabilities (DLD) and holds international conferences e very five
Division for Physical, Health, and Multiple years. Their website (www.icevi.org) is another
Disabilities (DPHMD) resource. According to the website, the organi
Division on Visual Impairment and zation’s mission is to promote “equal access to
Deafblindness (DVIDB) appropriate education for all visually impaired
Association for the Gifted (TAG) children and youth so that they may achieve
Technology and Media Division (TAM) their full potential” (ICEVI, n.d.).
Teacher Education Division (TED) • World Blind Union (WBU). WBU is an inter-
national organization that addresses the needs
of p eople who are blind around the world and
works actively to promote positive attitudes
each discipline has ethical guidelines. ACVREP and a good quality of life for them. The orga
is governed by a board of directors, which in- nization has a website (www.worldblindunion
cludes professionals, an individual who is blind .org) and publishes a magazine, The World
or visually impaired, an employer, ACVREP, and Blind, which updates activities related to people
a representative of AER. In addition, the acad who are blind. WBU provides a voice for the
estimated 285 million persons who are blind fessionals who work with c hildren who have vi-
or visually impaired around the world. sual impairments can also facilitate informational
meetings on specific topics and can support lo-
Consumer Organizations cal contacts among interested families.)
• American Council of the Blind (ACB). ACB is • Council of Families with Visual Impairment.
a membership organization that addresses is- The Council of Families with Visual Impair-
sues faced by individuals who are blind. It holds ment, associated with ACB, seeks to address
an annual conference, has a website (www.acb the needs of families. The purpose of the coun-
.org), publishes the Braille Forum, and, in addi- cil is to provide help when any member of a
tion to a range of other activities, produces a family is blind or visually impaired. The coun-
monthly half-hour radio information program cil provides information, assists with advo-
for broadcast on local radio reading programs. cacy efforts, and provides resources to families.
• National Federation of the Blind (NFB). NFB • National Organiz at ion of Parents of Blind
is a membership organization of p eople who Children. This division of NFB is dedicated to
are blind. It provides help and support to in- the needs of parents of c hildren who are blind.
dividuals who are blind and their families It has a website (http://nopbc.org); publishes a
through public education, publications, advo- quarterly publication, Future Reflections, which
cacy serv ices, and other types of support and provides information that is relevant to par-
is dedicated to increasing the self-confidence ents and teachers of young c hildren; and pro-
and self-respect of individuals who are blind. motes contact among family members of
NFB holds annual conferences, maintains a c hildren with visual impairments.
website (www.nfb.org), and publishes two ma- • National Association of Parents of C hildren
jor magazines (Braille Monitor and Future Re- with Visual Impairments (NAPVI). NAPVI is
flections) that address a variety of issues that a nonprofit organizat ion dedicated to provid-
people who are blind and their families may ing parents of c hildren who are visually im-
face. In addition, it sponsors an annual contest, paired with support and information. NAPVI
Braille Readers Are Leaders, which is open to is a national organization with state-level af-
braille readers from kindergarten through filiates that provide parent education seminars
grade 12, to encourage students to read braille and workshops, parent support groups, and a
and reinforce them for doing so. national network connecting parents around
the topic of c hildren and visual impairments.
Organizations of Parents NAPVI publishes a quarterly newsletter, Aware-
ness, that is sent to its members; has a website
Parents of c hildren with visual impairments have (w ww.lighthouseguild.org/programs- services
always played a vital role in advocating for appro- /education/napvi); conducts workshops and
priate serv ices for their c hildren. Many local par- conferences; and sponsors parent support
ents’ groups meet regularly and provide support groups.
for and advice to local school programs. Three
national parents’ organi zations offer support for SUMMARY
parents and families of c hildren who are blind or
visually impaired by providing written material, This chapter has presented many elements that
conferences, and links with other parents. (Pro- encompass professional practices for specialists in
visual impairment. Professionals in visual im- Council for Exceptional Children. (2010). Special ed-
pairment should rely on professional and con- ucation professional ethical princi ples. Arling-
sumer organizations and specialized publications ton, VA: Author. Retrieved from http:// w ww
to gain information and advice on addressing the .c ec .sped.org /Standards/Ethical-P rinciples -a nd
needs of students with visual impairments. In ad- -P ract ice-Standards
Council for Exceptional C hildren. (2015). CEC Stan-
dition, their professional practices should be
dards Initial Specialty Set: Blind and Visual
guided by their adherence to codes of ethics and
I mpairments. In What every special educator must
by reflective analysis. Professionals’ deepest com-
know: Professional ethics and standards. Arlington,
mitment is to provide students with visual impair- VA: Author.
ments with high-quality educational experiences D’Andrea, F. M., Lewis, S., & Rosenblum, L. P. (2009).
and services that are based on sound instructional The need for braille standards in university prep-
practices. Practicing in a manner that upholds this aration programs. Journal of Visual Impairment &
commitment ensures that each student w ill make Blindness, 103(6), 325–327.
maximum gains, given his or her individual Dewey, J. (1933). How we think: A restatement of the re-
abilities. lation of reflective thinking to the educative process.
Boston: DC Heath.
For learning activities related to this Elementary and Secondary Education Act (No Child
chapter, log in to the online AFB Learning Left Behind), Pub. L. No. 107-110 (2001).
Emerson, R. W., & Anderson, D. (2014). Michigan se-
Center.
verity rating scale: Usage and validity. Journal of
Visual Impairment & Blindness, 108(2), 151–156.
REFERENCES Erin, J. N. (2010). Developing the university to include
CVI: A work in prog ress at the University of Ari-
Academy for Certification of Vision Rehabilitation and zona. Journal of Visual Impairment & Blindness,
Education Professionals. (2014). Orientation and 104(10), 656–658.
mobility specialist certification handbook. Tucson, Every Student Succeeds Act, Pub. L. No. 114-95 (2015).
AZ: Author. Ferrell, K. A., & Sacks, S. Z. (2006). A call to action: Are
Association for Education and Rehabilitation of the we ready for related services? Do we want to be?
Blind and Visually Impaired. (2000). AERBVI by- Journal of Visual Impairment & Blindness, 100(10),
laws. Alexandria, VA: Author. Retrieved from 603–605.
https://w ww.aerbvi.org /a bout/aerbylaws07-23 Griffin-Shirley, N., & Pogrund, R. (2010). Roundtable
-2016/ inclusion of CVI in Texas Tech University’s person-
Association for Education and Rehabilitation of the nel preparation program. Journal of Visual Impair-
Blind and Visually Impaired. (n.d.). AER divi- ment & Blindness, 104(10), 660–661.
sions. Alexandria, VA: Author. Retrieved from Hatlen, P. H., & Curry, S. A. (1987). In support of spe-
https://aerbvi.org/about/divisions/ cialized programs for blind and visually impaired
Bell, E. (2010). US national certification in literary children: The impact of vision loss on learning.
braille: History and current administration. Journal Journal of Visual Impairment & Blindness, 81(1), 7–13.
of Visual Impairment & Blindness, 104(8), 489–498. Hatton, D. D. (2010). Personnel preparation and CVI at
Bina, M. (2006). Celebrating 100 years of knowledge: Vanderbilt University. Journal of Visual Impairment
A review and f uture perspective. Journal of Visual & Blindness, 104(10), 661–663.
Impairment & Blindness, 100(12), 709–714. Individuals with Disabilities Education Improvement
Corn, A. L., & Koenig, A. J. (2002). Literacy for stu- Act (IDEA), 20 U.S.C. § 1400 (2004).
dents with low vision: A framework for deliver- International Council for Education of People with Vi-
ing instruction. Journal of Visual Impairment & sual Impairment (ICEVI). (n.d.). Mission state-
Blindness, 96(5), 305–321. ment. Retrieved from http://icevi.org/
Koenig, A. J., & Holbrook, M. C. (2000). Ensuring high- ics at universities in the United States and Can-
quality instruction for students in braille literacy ada. Journal of Visual Impairment & Blindness, 106(6),
programs. Journal of Visual Impairment & Blindness, 339–350.
94(11), 677–694. Sapp, W., & Hatlen, P. (2010). The expanded core
Lewis, S., D’Andrea, F. M., & Rosenblum, L. P. (2012). curriculum: Where we have been, where we are
The development of accepted performance items going, and how we can get there. Journal of Visual
to demonstrate competence in literary braille. Impairment & Blindness, 104(6), 338–348.
Journal of Visual Impairment & Blindness, 106(4), Smith, D., & Rosenblum, L. P. (2013). The development
197–211. of accepted per for
mance items to demonstrate
Lewis, S., & McKenzie, A. R. (2009). Knowledge and braille competence in the Nemeth Code for Mathe
skills for teachers of students with visual impair- matics and Science Notation. Journal of Visual Im-
ments supervising the work of paraeducators. Jour- pairment & Blindness, 107(3), 167–179.
nal of Visual Impairment & Blindness, 103(8), Spungin, S. J., & Ferrell, K. A. (2013). The role and func-
481–494. tion of the teacher of students with visual impairments.
Lewis, S., & McKenzie, A. R. (2010). The competencies, A position paper of the Division on Visual Impair-
roles, supervision, and training needs of paraed- ments, Council for Exceptional Children. Reston,
ucators working with students with visual impair- VA: Council for Exceptional C hildren.
ments in local and residential schools. Journal of Welch, R. L. (2006). 100 years of professionalism in
Visual Impairment & Blindness, 104(8), 464–477. services for people who are blind or visually im-
Lieberman, L. J., & Conroy, P. (2013). Training of para- paired. Journal of Visual Impairment & Blindness,
educators for physical education for children with 100(9), 517–522.
visual impairments. Journal of Visual Impairment Wilton, A. (2015, November). Time for literacy in-
& Blindness, 107(1), 17–28. struction and itinerant service delivery: Workload
McKenzie, A. R. (2010). Personnel preparation for train- implications. Paper presented at the Getting in
ing professionals to work with individuals with Touch with Literacy Conference, Albuquerque,
CVI at Florida State University. Journal of Visual New Mexico.
Impairment & Blindness, 104(10), 655–656. Zhou, L., Parker, A. T., Smith, D. W., & Griffin-Shirley, N.
McKenzie, A. R., & Lewis, S. (2008). The role and train- (2011). Assistive technology for students with visual
ing of paraprofessionals who work with students impairments: Challenges and needs in teachers’
who are visually impaired. Journal of Visual Impair- preparation programs and practice. Journal of Visual
ment & Blindness, 102(8), 459–471. Impairment & Blindness, 105(4), 197–210.
Rosenblum, L. P., Hong, S., & Amato, S. (2013). The Zhou, L., Ajuwon, P. M., Smith, D. W., Griffin-Shirley,
abacus: Teachers’ preparation and beliefs about N., Parker, A. T., & Okungu, P. (2012). Assistive
their abacus preservice preparation. Journal of Vi- technology competencies for teachers of students
sual Impairment & Blindness, 107(4), 274–285. with visual impairments: A national study. Jour-
Rosenblum, L. P., & Smith, D. (2012). Instruction in nal of Visual Impairment & Blindness, 106(10),
specialized braille codes, abacus, and tactile graph- 656–665.
PART TWO
Connecting to the
Broader Context
To hear an audio introduction to this Effective, practical instructional strategies
section from the editors, log in to the AFB should be based on evidence (research), and re-
Learning Center. search begins with a well-defined theoretical base.
Because we believe that students with disabilities,

Volume 1 of Foundations of Education explores and specifically students with visual impairments,
the rich history of the field of educating c hildren are more alike than dif fer
ent from their peers
and youths who are blind or visually impaired, without disabilities, professionals who educate
as well as the theory that underlies both histori- individuals who are blind or visually impaired
cal and current practices. It is important that pro- must avoid becoming isolated in silos where they
fessionals today understand where the field of focus only on the knowledge generated by other
blindness and visual impairment has been, so professionals in visual impairment. T hose who
the focus of our goals for the f uture remains clear. isolate themselves from the wealth of knowledge
It is also important that professionals explore the from other educational disciplines run the risk of
foundation of our practices within the broader perpetually using one-dimensional or outdated
framework of education, psychology, social sci- information.
ences, and educational research so that we can The chapters in Part 2 of this volume, Con-
make thoughtful, informed decisions about ap- necting to the Broader Context, are concerned
propriate services that reflect current understand- with major topics of interest and application to
ing of the way that c hildren and youths develop teachers of students with visual impairments.
and learn. These chapters connect to the broader educational,
social, and psychological knowledge base and, these chapters connect to multiple chapters in
therefore, serve as an important companion to the the remainder of the textbook, and readers will
chapters in Part 1 that focus specifically on visual likely benefit from reading them as supplements,
impairment by providing background and sup- referring to them before, a fter, or during the read-
porting information. ing of specific chapters in Part 1 and Volume 2. By
To ensure the most current and applicable re- including the following chapters in the sequence
source possible, most of the following chapters of study, the reader w ill come away with knowl-
were written by a specialist outside the field of vi- edge and understanding that may allow better
sual impairment who partnered with a profes- collaboration with other professionals as well as
sional inside the field of visual impairment. The inspiration to more fully explore practices that
chapters in the “Connecting to the Broader Con- can be successfully implemented with students
text” section of this volume are meant to explore who are visually impaired. In addition, we antici-
some of the most important areas of inquiry for pate that readers of these chapters w ill have a
educating all individuals. T hese chapters are not greater understanding of current research, theory,
intended to provide comprehensive information and practice and w ill be able to apply informa-
leading to expertise in a subject, but rather to give tion from other disciplines to their decision-
readers a broad and up-to-date overview of knowl- making regarding effective instructional strategies
edge in specific key areas in education. Most of for students with visual impairments.
11
C H A P T E R
Applying General Education

Theory to Visual Impairment
Dawn L. Anderson and
Robert Wall Emerson
very field of study begins with theory. Many theories

E educational practices. An educator cannot modify gen-
in education date back to much earlier days of deep eral education practices for a student with a visual im-
thinking about “why” and “how” questions. How do pairment if he or she does not understand the theory
children learn? Why do students react to teaching in behind the educational practice. This chapter provides
a certain way? How does cognitive development have an overview of general education theory and practice
an impact on learning? Most educators examine edu- and a basis for modifying and applying practices for
cational theory as a part of introductory education students with visual impairments. —Eds.
course work for an initial degree and certification in
education. INTRODUCT ON
Teachers of students with visual impairments, ori-

entation and mobility specialists, and vision rehabili- The field of special education was born out of the
tation therapists are professionals with specialized and larger field of education. It makes sense that strat-
specific knowledge and are often defined first and fore- egies developed for teaching students in general
most as hands-on educators. Keeping up with current education could be modified and applied to teach-
educational theories and research supporting those ing students with special needs. Carrying this
theories is often difficult, therefore, given the daily line of reasoning further, it is logical that strat-
challenges of their jobs. As an educator, however, it is egies and theories developed for teaching stu-
vital to have a deep understanding of the theoretical dents with special needs could be modified and
underpinnings and research leading to the develop- applied to the more targeted group of students
ment of current practices. Just as scientists cannot de- with visual impairments. Although general edu-
velop research questions that make sense for a new cation has existed for a longer time, the current
study if they do not understand the underlying theo- application of theories and techniques flows from
ries and the studies that have already been conducted, special education to general education as often as
educators cannot choose the best educational practices it does the reverse. This chapter takes a wide view
for a student if they do not have a broad knowledge of of educational theory in general and examines
347
how theory used in general education applies to younger ages is more experiential and concrete,
the education of students with disabilities, with while older students are given opportunities to
emphasis on students with visual impairments. work with increasingly abstract concepts.
Professionals in education and related fields Educational theories about c hildren are of-
who work in schools often work together in the ten based on information gained by observing
best interests of the students. General education and documenting the development of c hildren
and special education professionals do not oper- and matching instructional approaches with the
ate in isolation. Developments in each field influ- typical needs at each developmental stage (Cof-
ence developments in the other. Professionals in field, Moseley, Hall, & Ecclestone, 2004). A typi-
each field need to be cognizant of what is hap- cal child’s learning is described as a sequential
pening in the other field so that best practices progression or maturation of cognitive skills and
can be maintained in both fields. thinking. Each child’s ability to learn is depen-
Since most educational specialties w ere born dent on his or her current maturation. A prime
from general education, this chapter w ill review example of this approach in education is the work
classic general education theories and trace the lin- of Jean Piaget. He studied the intellectual devel-
eage from these theories to current theoretical opment of children, beginning by describing
developments in general education; the chapter what he discovered through observation of his
also describes how t hese developments apply to own c hildren as they moved through childhood
special education. Theories developed in general (Piaget, 1933, 1952). His theory suggests that cog-
education help to explain basic ideas of how nitive growth occurs in four stages that occur in
children learn, how humans process informa- a sequential order and are interdependent: sen-
tion, and how c hildren interact most effectively. sorimotor, preoperational, concrete operational,
In this context, a theory is defined as a set of ideas and formal operational. As the child matures, the
used to explain a phenomenon or observed be quality, quantity, depth, and breadth of learning
havior. Findings based on t hese general theories, that is possible depends on the child’s current stage
while not applicable to e very child, w ill apply of development (Piaget, 1970; Piaget & Inhelder,
to a large portion of c hildren in various situa- 2008). This framework is often referred to as cog-
tions. nitive learning theory or the cognitive-developmental

model.
The concept of readiness, the assumption that
H STORY A D EVOLUT ON OF a specific level of development must be attained
before a child is ready to learn a new skill, was
GE ERAL EDUCAT ON THEORY:
adopted as part of developmental psychology
LEARN NG HEORIES (Burman, 2008; Shaffer & Kipp, 2013). In many
Theories Based on schools, children with disabilities were not given
access to many parts of the curriculum because
Developmental Psychology they did not have the prerequisite knowledge or
Developmental psychology theory has influenced skills to learn a part icular concept. This has his-
much of educational practice during the 20th torically been debated in the education of students
century. The idea that c hildren mature, moving with disabilities. Since students with disabilities
through a series of hierarchical and sequential often attain developmental milestones at ages
steps, has informed most school curricula (San- that differ from those of typically developing
trock, 2009; Shaffer & Kipp, 2013). Based on a de- children, and sometimes in a different sequence,
velopmental approach, work given to c hildren at educators sometimes disagree on w hether devel-
Applying General Education Theory to Visual Impairment 349
opmental readiness is important before a new event or stimulus, which is followed by a target be
skill or concept is introduced. havior or response and finally a consequent event
The concept of matching instruction to devel- or reinforcement (Skinner, 1969, 1976/2011). The
opmental stage and using developmental stages learning for the individual is directed from out-
to determine readiness for certain skills and con- side. This theory was easy for education and teach-
cepts is not invalidated by variations in developers to embrace b ecause the control for planning
ment, but it is sometimes necessary to establish and response both rest outside the student and
new developmental expectations and sequences within the teacher’s control.
for c hildren with disabilities. Some important In special education, teachers have been en-
work in this regard was done by Ferrell in Project couraged to conduct task analyses (see Volume 2,
PRISM (Ferrell, Shaw, & Deitz, 1998). In this Chapter 3) to determine what steps in a skill can-
project, students with visual impairments were not be completed by a student. In dealing with
followed over time to determine whether they c hildren who exhibit difficult be
haviors (not
achieved identified developmental milestones at uncommon when dealing with c hildren with dis-
a similar rate and in the same sequence as sighted abilities), teachers often create behavioral mod-
c hildren. The researchers found that although ification plans designed to shape the problem
children with visual impairments were delayed in behaviors into more acceptable ones (see Chap-
their acquisition of many developmental mile- ter 16 in this volume). In fact, this focus has led to
stones, they gained a few skills earlier, and the the creation of an entire professional specializa-
sequence in which they acquired developmental tion in applied behavioral analysis (Cooper, Heron, &
milestones was not always the same as for non- Heward, 1987; Pierce & Cheney, 2013). Profes-
disabled peers. This differe nt sequence may be sionals in this field receive advanced training in
related to the effects of visual impairment on how applying behavioral analysis assessments and in-
the c hildren interacted with the world. (A more terventions. One of the benefits to other educa-
complete description of Project PRISM can be tors who work with these professionals is the
found in Chapter 4 of this volume.) opportunity to apply behavioral theories to the
teaching of specific skills (Dunlap, Carr, Horner,
Theories Based on Behavioral Zarcone, & Schwartz, 2008).

In sum, behavioral theories assume a pro-
Psychology gression in learning from simple to complex. Ex-
A classic approach to education called behavioral plicit or direct instruction may be necessary for
conditioning or behavioral psychology focuses on a some students to acquire or master a skill. The
child’s behavior and how to shape it. This theory teacher sets goals and objectives for the learner,
contends that any target behavior can be achieved lessons are carefully sequenced to teach each skill
by gradually shaping closer and closer approxi- necessary to meet the objective, and practice
mations of the target behavior (Kearney, 2015; and refinement are provided with feedback and
Simonsen, Fairbanks, Briesch, Myers, & Sugai, correction to ensure success. Regular assessment is
2008). The shaping is achieved by either providing provided to monitor success and refine teaching
a positive reward when a closer approximation strategies. Learning progresses through the stages
is observed or providing a negative consequence of acquisition, proficiency, maintenance, and general-
when the behavior moves further from the target. ization (Haring, Lovitt, Eaton, & Hansen, 1978;
Skinner, considered the father of behavioral Umbreit, Ferro, Liaupsin, & Lane, 2007).
psyc hology, described a behavioral unit that con- Prompting and cuing are used to bring atten-
sists of three parts. First there is an antecedent tion to salient or critical features of the stimulus.
Prompts vary from being minimally invasive to with visual impairments backward chaining has
quite invasive and can be verbal, tactile, or phys- proved to be useful in learning new complex
ical in nature. A verbal prompt could be as simple tasks such as following a long mobility route.
as the teacher reminding a student to scan an One of the benefits of backward chaining is that
entire workspace. A tactile prompt could be the the ultimate goal of the more complex skill is evi-
teacher tapping the four corners of a workspace dent from the start of the process.
to ensure the student scans the entire workspace. The behavioral approach to instruction is very
A physical prompt could involve the teacher ac- concrete and, as a result, can fit easily with the
tually guiding a student’s hands to scan a work- needs of c hildren with disabilities. Students with
space. This example of a physical prompt could cognitive or perceptual disabilities often benefit
even involve using hand-over-hand guidance to from a more concrete approach to skill and con-
lead the student through a series of movements cept instruction. Cognitive psychology, described
necessary to complete a task. This became a strat- in the next section, is increasing in popularity,
egy that was used extensively to demonstrate and but new research is constantly being conducted
encourage engagement for students with visual to learn how older behavioral approaches may
impairments. However, to encourage exploration be relevant and effective, especially for students
and self-confidence and to respect a child’s au- who have limitations in their ability to think,
tonomy, it is often more useful to use hand-under- plan, and reason.
hand with students with a visual impairment. In
this technique, the student places his or her hands Theories Based on Cognitive
on the teacher’s and follows the teacher’s move-
ments rather than being forced through an unfa-
Psychology
miliar task. Cognitive psyc hology provides a contemporary
Physical guidance is often used when a child view of how individuals learn, think, and acquire
is not able to physically follow a teacher’s move- knowledge. This theory identifies cognitive pro
ments (for example, requires additional physical cesses, which are clusters of mental skills essen-
support) or is reluctant to perform a movement. tial to h
uman functions. They enable one to know,
Fading means to decrease the prompts when perceive, think, conceptualize, use abstractions,
the desired behavior is under stimulus control or reason, criticize, and be creative. Three educational
when it occurs with only a natural stimulus. Shap- strategies have been proposed to apply cognitive
ing is a strategy used in operant conditioning in psyc hology to learners: training the deficit pro
which the reinforcement is given as the child cess, teaching through the preferred process, and a
demonstrates a behavior that move successively combined approach (Riding & Rayner, 2013).
closer to the desired response. Chaining can be In training the deficit process, instruction fo-
used to build complex skills. The child is first re- cuses on an identified weak area in cognitive pro
warded when he or she completes a portion of a cessing. The belief is that by focusing on this weak
skill, then as the next portion is mastered, and area, it w ill be trained to operate at the same level
lastly when the entire skill is successfully com- as other cognitive processes, bringing the entire
pleted. Chaining can be set up to be done forward cognitive processing system into line. In teach-
or backward. In forward chaining, skill portions ing through the preferred process, the mode of pro
are mastered from the beginning of the complex cessing or sensory acquisition a child appears to
task to the end. In backward chaining, skill por- prefer is used as the primary channel for most
tions are mastered from the last part of the com- instruction. The belief is that some c hildren are
plex task to the beginning. For many students not able to process information equally well in all
sensory modes and so instruction needs to be tai- information through the learning process. It be-
lored to fit a child’s individual learning style. The gins with the initial reception of information (in-
combined approach takes a middle path and both put), which is followed by processing function
addresses weaknesses and plays to a child’s (processing), and then by an action or behavior
strengths. Children who have a visual impair- (output).
ment are not automatically viewed as nonvisual Individuals experience input stimuli that can
learners. A child with low vision might experi- be external or internal in the following forms:
ence visual learning as a strength and thus be auditory, visual, tactile, olfactory, gustatory, hap-
described as a visual learner, but, b ecause that tic, and kinesthetic. It can be challenging for in-
sensory channel is compromised, he or she might dividuals with visual impairments to access
be forced to access information through channels information through certain stimulus channels.
that are less efficient. This is not to say that vision The output responses include thought and be
is the most efficient instructional channel; only havior and include motor responses (how one
that it is for some p eople, and that can include physically moves about given certain input stim-
people with a visual impairment. uli); behaviors (how one responds emotionally
An example of how this theory might be ap- given certain input stimuli); talking (what one
plied to practice involves a student who is learn- says in response to input stimuli); writing (how
ing to take comprehensive and efficient notes one conveys thoughts in text); and learning (what
during a lecture. If the student is a visual learner one retains in memory, the relation of stimulus
and has trouble absorbing information that is de- to other prior experiences, and the ability to
livered orally, the teacher might support the stu- generalize input).
dent by teaching through the preferred process The central feature of this theory is the multi-
and giving the student a copy of the teacher’s store memory system, which includes (1) the sensory
PowerPoint presentat ion. If the teacher uses the register, (2) short-term memory, and (3) long-term
approach of training the deficit, the teacher would memory (Atkinson & Shiffrin, 1968, as cited in
have the student practice taking in the informa- Lutz & Huitt, 2003). Information from the senses
tion by listening to the lecture and not using any must be attended to for it to flow to the sensory
visual supports. If the teacher w ere to use a com- register. Even though a person may not be con-
bined approach, the teacher might compromise sciously aware of incoming stimuli, the sensory
and give the student an outline of the presenta register acts as a buffer, helping to interpret and
tion with some of the words deleted. This ap- maintain the information long enough for it to
proach would provide the student with valuable be perceived. Perception is the process of using
information in a visual format but would require past knowledge and experiences to organize and
the student to listen to the lecture to fill in key attach meaning to the stimuli. Data that has been
pieces of i nformation. received and perceived is ready for memory.
Memory is the ability to store and retrieve al-
ready experienced sensations and perceptions
Information-Processing Model of Learning
when the stimulus is no longer present. Short-term
Each of the approaches just discussed in the area memory acts as a temporary storage fac ilit y and is
of cognitive psyc hology employs the information- where the individual becomes consciously aware
processing model of learning or cognitive information of the information. It is also known as working
processing theory (Atkinson & Shiffrin, 1968, as memory, and information is only held t here until
cited in Lutz & Huitt, 2003). The information- it moves on to long-term memory or is lost when
processing model of learning follows the flow of the individual shifts his or her attention to the
next stimulus. Long-term memory is where infor- tutor or mentor the student in a given concept or
mation is stored permanently. Retrieval is the pri- skill. Sometimes peer groups are used to create
mary issue with memory stored in this area. Two group instruction settings. This approach makes
forms of long-term memory are episodic and se- use of cognitive psyc hology’s understanding of
mantic. Episodic memories are visual and sensory how active processing of information enhances
images. Semantic memories consist of general retention.
knowledge, language, concepts, and generaliza- In anchored instruction, students are encour-
tions. aged to become more actively engaged in learning
Executive control, a function of the information- by basing instruction on a topic that is interest
processing model, deals with directing the course ing to them. The creation of a personally inter
and regulations for one’s own thinking and esting link between the student and the material
mental activity (Logan, 1985). Executive control re- being learned enhances memory retention.
fers to keeping track of what is being processed Graphic organizers make content area informa-
and involves planning, evaluating, and regulating tion more accessible by converting complex in-
information-processing routines. Executive deci- formation into manageable chunks. This also plays
sion making requires metacognitive skills. T hese are into developed knowledge of how the h uman
the functions that allow you to think about think- brain most easily processes information.
ing. Efficient learners use metacognitive strategies
that include classification, checking, evaluation,
Cognitive Constructivism
and prediction.
The information-processing model of learn- Educational approaches that stem from a cog-
ing, as developed out of cognitive psyc hology, nitive psyc hology structure not only apply an
supports several teaching strategies. They include understanding of how sensory processing and
scaffolding, learning strategies instruction, peer cognition works to the educational process but
tutoring, anchored instruction, and the use of also include a theory of how cognitive processes
graphic organizers. are involved in the method by which a person de-
Scaffolding involves providing individualized velops a sense of self. This theory, cognitive con-
supports to a student to assist them in accom- structivism, holds that individuals actively use
plishing a task but then gradually removing the incoming information to build or modify their
supports as the student gains skills and under- idea of who they are. Cognitive constructivists
standing. This approach makes use of knowledge believe that individuals construct their own knowl-
of how short-and long-term memory work in order edge and in turn themselves. This theory brings
to optimize a student’s content retention. Learn- together many of the ideas from developmental
ing strategies instruction enhances the educational psyc hology that have been shown to stand the
outcomes of students through explicit training test of time with a current understanding of cog-
in learning strategies that are based on a student’s nitive psyc hology (Borg, 2015; Fosnot, 2005). A
personal strengths and weaknesses and modified person’s beliefs about himself or herself influ-
according to his or her academic prog ress or ence learning, suggesting that self-regulation is
changing needs. This approach recognizes dif- key to learning.
ferences in how individuals process incoming Teaching strategies that take advantage of cog-
information and in their preference of sensory nitive constructionist ideas may include problem-
channels. based instruction (using assessment to identify
Peer tutoring is when students similar in age to areas of need and data to inform decisions), link-
or older than the target student are employed to ing new information to prior knowledge and skills
(making connections between what a student weaknesses. This framework notes that specific de-
previously learned or experienced and new knowl- mands in the classroom are often a mismatch for
edge), scaffolding, and motivation (a student’s individual students (Levine, 1998). It is this mis-
inherent desire to learn or explore new ideas). match that produces frustration and failure. The
Problem-based instruction uses real-world prob suggestion is that the medical and educational com-
lems and realistic scenarios in an effort to encour- munity have developed and refined processes for
age students to use communication, cooperation, identifying problems and placing labels on c hildren.
and resources to formulate ideas and develop Educationally, the challenge is to create the right
reasoning skills. In a similar vein, when instruc- match between the individual strengths, the edu-
tors link to a student’s prior knowledge and skills, cational environment, and the task to be mastered.
use scaffolding to provide supports that are gradu- Through a better understanding of the devel-
ally removed, or tailor lessons to an individual’s opmental needs of an individual child, an appro-
specific level of functioning and d evelopment, priate match can be made to create success for
they use knowledge of the individual, including each student. This view builds on developmental
the individual’s self-knowledge, to design instruc- learning theory and the social-cognitive and cog-
tion specifically targeted to that individual. nitive constructivist theories. It is also informed
by recent brain research that demonstrates the
Social-Cognitive Theory plasticity and resiliency of the brain. The neurode-
velopmental framework holds open the possibil-
Social-cognitive theory (Bandura, 1977) suggests ity for new learning, even when everything one
that social interactions influence learning. A social- has tried before has not worked. Adherents of this
cognitive theory directs one’s attention to the framework suggest that the key is to find the right
sociocultural context of learning and supports match between the learner and the educational
the use of learning communities, apprenticeship environment or teaching strategy (Levine, 1998).
learning, and the use of natural settings and rou- Although consistency of implementation, appro-
tines. Vygotsky, a Russian psychologist, identi- priate frequency and duration of instruction, and
fied learning as interpersonal and theorized that ample opportunities to practice new skills are re-
it happens best when one individual is better quired for learning, this framework encourages
informed or more skilled than the other (Vy- teachers, parents, and students to try something
gotsky, 1978). Vygotsky extended social-cognitive different and keep trying u
ntil success is attained.
theories to include and highlight the social and
cultural influences on learning. He purported
that learning involves a transfer of responsibility Current Developments in
as abilities pass along the interpersonal plane. Educational Theory
It requires the teacher’s analysis of the task and
the presentat ion of the material on a level that is Distributed Learning
within the zone of proximal development (ZPD). A current development in educational theory that
The ZPD is the sweet spot for learning, neither is building on past strategies is distributed learn-
too easy nor too difficult for the child to grasp. ing. In distributed learning, learning is distributed
among individuals (a community of practice that
Neurodevelopmental Framework
includes teachers, specialists, peers, and caregiv-
With roots in Vygotsky’s ZPD, a neurodevelopmental ers), and a material dimension is involved, such
framework for learning suggests that children come as using a calculator to complete math problems
to the educational environment with strengths and or using a computer to link remotely located
individuals. The key to distributed learning is that theories, and no one theory addresses all needs
learners are not required to all be in the same phys- or is entirely without weaknesses. A trend in ed-
ical location or access the content at the same time. ucational theory has been a movement toward
Postsecondary institutions and other venues ori- individualizing instruction based on the learner’s
ented to adult learners have been d eveloping this characteristics, a trend that has been influenced
approach to education since the 1990s through the by the practices developed in special education.
use of online education, but the approach is be- However, all these theories assume that knowl-
ginning to be seen now in K–12 schools as well. edge is essentially a commodity that can be trans-
Distributed learning involves situated learning, ferred from one person to another. The issue to
in which the learner is not learning alone. Al- be solved is the optimal manner in which to ac-
though individual learners may not be in the same complish the transfer.
physical space or accessing information at the In contrast, more recent theories stemming
same time, the use of technology such as social from cognitive psyc hology (especially cognitive
media and online learning platforms allows the constructivism) conceive of knowledge as some-
creation of a virtual learning community that can thing each learner constructs or creates afresh
bring a more robust experience to the learning. rather than something that is assimilated in its
preexisting form. This idea was developed par-
tially in reaction to behaviorism’s focus on ob-
General Trends
servable behaviors. Behaviorism was initially
Proponents of the traditional educational theo- developed by John Watson, expanded on by Skin-
ries described earlier in this chapter, such as t hose ner and Ivan Pavlov (Keller & Schoenfeld, 2014),
based on developmental psychology, behavioral and later developed by theorists such as Perry
psychology, and cognitive psychology, conceived (Perry, 1999; Schunk, 2008). According to current
of knowledge as a commodity capable of being theories, truly “objective” knowledge does not
transmitted, more or less intact, from one indi- exist, although something similar exists in the
vidual to another. According to t hese theories, form of collective knowledge within a part icular
knowledge is something an individual acquires; culture or discipline. Knowledge resides in the
when a student successfully learns it, he or she community of learners (individuals) that creates
can reproduce the knowledge in its original form. it and is distributed among members of the com-
Most of the theories use knowledge of the indi- munity by virtue of the various actions made pos
vidual learner to structure the design of the in- sible to the group. B
ecause each person constructs
struction. This knowledge might involve the his or her own understandings, the knowledge
student’s developmental level, previous skills or each individual acquires is unique.
acquired concepts, perceptual abilities, challeng-
ing behaviors, or preferred learning style. The
organizational framework of the instruction pro-
Applying Theory in Practice
vided might focus on shaping a target behavior, In educational circles, the phrase “linking theory
involving a community of learners, increasing in- to practice” is often used, especially when new
ternal motivation, optimizing a sensory path- ideas or approaches are touted. This brief over-
way, or providing a system of supports that are view of some of the main educational theories
gradually removed. that have driven educational approaches in the
This overview of educational theory demon- past and recently has occasionally mentioned
strates that t here are certain commonalities across how they might look when put into practice. The
next section discusses specific models of educa- educational system for African American c hildren
tional practice that were born out of the prevail- was much more forward thinking in practice than
ing educational theories at the time they were was previously thought (Siddle Walker, 1996; Sid-
developed, but also often reflected movement dle Walker & Byas, 2009). In many ways, educa-
beyond theory: an attempt to take theory and tional practices in schools run by and for African
make it significant within practice. Americans in the 1920s through the 1940s were
making use of educational approaches only now
being “discovered” and adopted by the main-
TRENDS N EDUCA IONAL stream educational system as best practice. One
PRACTICE of t hese educational practices is the use of learn-
ing communities.
Factory Model
In the United States, the 20th c entury was dom-
inated by a factory model of education. Schools
Learning Communities
were dominated by teachers who dictated mate- In learning communities, e very participant in the
rial and learning activities. Knowledge was a community brings knowledge and experiences
commodity, u nder the control and management that enhance and benefit the w hole. Students are
of the teacher. This model was partially a result active learners and participate in the selection of
of lingering effects of the Industrial Revolution learning objectives. Problem-based learning is
and the view of the world as a system of mecha- often used to illustrate to students how the con-
nisms (Schwahn & McGarvey, 2012). C hildren tent they are learning applies to the real world
were taught in a systematic manner, and indi- around them. Students are active participants in
vidualization of instruction was not typical. In generating new knowledge and understanding.
this “one design fits all” approach, the impacts This approach to education can benefit from a
of income, race, disability, and academic ability range of social and material resources and tools
were largely ignored in the mainstream of edu- to support the process. While the creation and
cation. While t here were pockets of educational use of learning communities has a long history,
innovation that sought to match instruction to the modern technological era, with its quick ac-
individual needs, students who could not adapt cess to a larger, global community and the capac-
to the instructional environment e ither left school ity to share information in a variety of formats
or found a segregated placement. easily through computers, has enhanced the pos-
Examples of t hese segregated placements in- sibilities of this approach. In general, the history
clude schools for students with specific sensory of education has seen a gradual shift from isolated,
deficits (for example, blindness or deafness) (de- segregated, and specialized schools that often
scribed in Chapter 1 of this volume), as well as provided serv ices only to a select portion of
the parallel system of education for African society (think of medieval guilds or the early
American c hildren operating in the early 20th universities) to gradually more inclusive and ex-
century. While these segregated systems did allow pansive systems. While educational practice has
for specialized training such as in braille for blind not always kept pace with changes in society
students, they generally could not offer the range and possibilities presented by available resources,
and depth of instruction offered by the main- there has also been a gradual expansion of the
stream educational system. Interestingly, it is be- or
gani
zat ion of instruction to increase inclu-
coming more acknowledged that the parallel siveness.
Mainstreaming t hose of the other students in a class. While they

still serve this purpose, they have become more
An example of the trend of expansiveness and in- standardized and also serve to protect the rights
clusiveness of education is the increasing inclu- of students, parents, and educators (Wright &
sion of students with different abilities and needs Wright, 2012). The modern IEP lists short-term
in the general education system. Since the 1960s, and long-term goals for a student in all of the con-
and certainly since the enactment of the Educa- tent areas that apply but also serves as a legal
tion for All Handicapped Children Act in 1975, document that contains the evidence that entitles
more students with disabilities are being edu- a student to specialized education.
cated in the general education classroom. This The recognition that students often require
mainstreaming movement (now often referred to very different ways of being educated has mi-
as inclusive education) has had an impact on both grated from the field of special education to the
general and special education in many ways (see field of general education. Teachers have recog-
Chapter 1 in this volume). nized that not all students learn in the same
Recognizing the need for and usefulness of way. Each student in the general education class-
individualization of instruction for each student room has a learning style that is unique. An indi-
has led educators to look at how the context of vidual’s learning style may represent a preference
instruction impacts learning. This is an extension for receiving information through a particular
of the process of inclusion to require teachers in sensory modality (vision, hearing, or touch) or it
the general education classroom to meet the may represent a preference for receiving infor-
specific needs of students with a wide range of mation at a certain rate or under part icular con-
abilities, cultural backgrounds, socioeconomic ditions (Sternberg & Zhang, 2014).
backgrounds, and Eng lish language competen- One way educators have tried to structure in-
cies. This comes on the heels of desegregation of struction so that students can approach content in
the races, the movement of students with disabil- several different ways at once is through contextual
ities into the classrooms, and the development learning, where information is presented in a way
of differentiated instruction designed to meet the that allows students to construct meaning out of
needs of each individual learner. Once educators their own experiences. A good example is found in
realized that one type of instruction was inade- physical education classes. The learner has the op-
quate for all students and began looking at how portunity to observe the skill, try it himself or her-
students learned best, they also recognized that self, and, through practice and refinement, become
a student’s background had an impact on how increasingly more proficient. Knowledge of a skill
they learned. (See Chapter 8 in this volume for such as shooting a basketball through a hoop is
an in-depth discussion of student diversity.) obtained through performance of the skill itself.
Problem-based learning, though introduced de
cades ago, has recently been widely embraced and
Individualizing Instruction is now common in academic subjects where stu-
The need to track improvement in c hildren with dents are presented a problem and given tools
vastly differe nt abilities and goals, who receive and time to come to a solution. Project-based learn-
very different kinds of instruction, led to the cre- ing provides students with a real-life situation,
ation of a system of Individualized Education such as participating in a service project, in which
Programs (IEPs). At first IEPs were mainly ways to practice skills that are being developed.
for teachers to note how a given student’s educa- In a similar vein, active learning is a process
tional experience needed to be differe nt from identified by Nielsen (Nielsen, 2001) to meet the
needs of learners with visual impairments who of students to understand the content and to
are at the stage of beginning to interact with their think and prob lem solve for themselves, pre-
environment. Nielsen’s approach expands on assumptions that are consistent with the majority
pects of the information-processing theory and of modern-day schools.
provides students with sensory input that can
influence memory. Based on her observations, Current Trends
Nielsen created materials that are responsive to
even minute actions by the learner. Active learn- The theoretical underpinnings of general edu-
ing is evident when a child who may have very cational practices and the ways in which these
limited movement is placed on a resonance theories have been applied within general edu-
board and can feel the vibration of the board cation and special education continue to lead to
across her body with e very breath or the small- innovations and refinements. While some of the
est movement. Even though the child may have trends illustrated in this section may not seem
limited self-movement, the resonance board aug- new or innovative to some readers, they represent
ments interaction of the child’s body with the some of the more recent developments in general
environment so that cause-a nd-e ffect relation- education theory to practice. Other recent trends,
ships can be experienced and the child can be- such as standards-based reform and curriculum-
gin to develop more conscious linkages between based measurement, are covered in other chapters.
self-movement and effects of that movement.
Assessment of Core Skills
Through the use of specialized materials such as
the resonance board, the Little Room (a box laid The recent drive in assessment research has been
over a child that has toys and other stimuli hang- toward assessment of skills, specifically in the core
ing from it for the child to explore and play academic areas of reading, math, science, and so-
with), and the hopsa dress (a sling that holds a cial studies. Data from assessment may be used
student in a vertical position without the need for in a problem-solving approach to identifying a
weight bearing), many of the most fragile learn- student’s needs and pinpointing an instructional
ers experience the opportunity to interact with level (Vaughn & Fuchs, 2006). The 2001 No
their environment in ways that allow them to Child Left Behind legislation required annual
grow and develop. measurement of academic skills to determine if
Theories of learning are efforts to explain adequate yearly progress was being made by e very
how people learn. Different theories are based on learner. As with many educational reforms, this
different assumptions and are appropriate for ex- was well intentioned but led to unforeseen con-
plaining some learning situations but not others. sequences. For many years the field of special edu-
Theories of learning can inform teaching and the cation has been developing procedures whereby
use of different instructional resources including assessment data are used to determine specific
technology, but ultimately the learning activities interventions, target instruction, and assess goal
in which the student actually engages (mental, achievement. However, in recent years assessment
physical, and social) determine what a student data in the general educational system have been
learns in the classroom. Classroom learning in- used not only to gauge students’ prog ress and
volves social, emotional, and participatory factors adapt instruction but also to assess the relative
in addition to cognitive ones, and theories of learn- merits of schools, teachers, and educational ap-
ing need to take t hese f actors into account. Most proaches. In this age of assessment, using test
current theories of learning presuppose that scores to rate schools—as a measure of student,
the goal of education is to develop the ability teacher, and school performance—w ith data
gathered, analyzed, and reported publicly has abilities. B

ecause of this separateness, specialized
led to some instances of teaching to the test, schools and special programs for students with
cheating by teachers and administrators, and disabilities developed instructional techniques
high-stakes closing and reorganizing of schools. and educational approaches designed to fit a wide
Very little of that information was used to meet range of student abilities and needs. Similarly, the
individual student needs. general education system developed and em-
ployed theories of psychology and development
Response to Intervention that were designed to apply to the majority of stu-
dents but that often did not fit students with dis-
When used properly, assessment based on qual-
abilities. In more recent decades these two streams
ity data is critical for making informed educa-
of educational theory and practice have experi-
tional decisions. However, policy should not get
enced much more of a cross-communication.
in the way of the primary intent of assessment:
Increased inclusion in general education has
optimizing instruction for students. Response to
meant that special education techniques and ap-
intervention (RTI) (see Chapter 16 in this volume)
proaches have filtered into the general education
is an approach that is currently in use in schools
realm. This is especially evident in the increased
across the country (Fuchs & Fuchs, 2006; Lane,
design of specialized curriculum for part icu lar
Oakes, Menzies, & Harris, 2013; Sugai & Horner,
challenges. Mainstream educational develop-
2006). RTI uses early identification of learning
ments such as learner-centered plans and response
problems, frequent prog ress measurement, and
to intervention are applications of instructional
progressively more intensive instructional inter-
approaches first developed in special education.
ventions to prevent academic failure for c hildren
Similarly, special education has benefited from
who are having difficulties in the classroom. A fter
applying larger theories of mind and develop-
each measurement the student is placed in one of
ment to students with disabilities in order to bet-
three tiers: general education, more intense in-
ter understand their needs and match instruction
struction, or special educational assessment. One
to the individual.
of the primary impulses of RTI is the communica-
tion of educational practice between general and

special education. It was originally designed in
REFERENCES
response to an observed overidentification of stu-
dents as needing special education services; it was Atkinson, R., & Shiffrin, R. (1968). Human memory.
an attempt to identify learning problems and ad- A proposed system and its control processes. In
dress them before the problems warranted special K. Spence & J. Spence (Eds.), The psychology of learn-
education services. It also makes clear that only ing and motivation (pp. 89–195). Princeton, NJ:
instructional practices based on valid research are Van Nostrand.
to be used. Bandura, A. (1977). Social learning theory. Englewood
Cliffs, NJ: Prentice Hall.
Borg, S. (2015). Teacher cognition and language educa-
SUMMARY tion: Research and practice. London: Bloomsbury.
Burman, E. (2008). Deconstructing developmental psy
General education and special education devel- chology (2nd ed.). New York: Routledge.
oped along parallel but different lines for many Coffield, F., Moseley, D., Hall, E., & Ecclestone, K.
years. There was a distinct separateness in how (2004). Learning styles and pedagogy in post-16 learning:
education was conceived of and implemented for A systematic and critical review. London: Learning
the main student body and for students with dis- and Skills Research Centre.
Cooper, J. O., Heron, T. E., & Heward, W. L. (1987). dosta State University. Retrieved from http://w ww
Applied behavior analysis. Columbus, OH: Merrill. .edpsycinteractive.org/papers/infoproc.pdf
Dunlap, G., Carr, E. G., Horner, R. H., Zarcone, J. R., & Nielsen, L. (2001). Early learning: Step by step in c hildren
Schwartz, I. (2008). Positive be hav
ior support with vision impairment and multiple disabilities.
and applied behavior analysis: A familial alliance. Copenhagen, Denmark: SIKON.
Behavior Modification, 32(5), 682–698. Perry, W. G. (1999). Forms of ethical and intellectual devel-
Education for All Handicapped C hildren Act, Pub. opment in the college years. San Francisco: Jossey-Bass.
L. No. 94-142 (1975). Piaget, J. (1933). The moral judgment of the child. Lon-
Elementary and Secondary Education Act (No Child don: Routledge.
Left Behind), Pub. L. No. 107-110 (2001). Piaget, J. (1952). The origins of intelligence in c hildren.
Ferrell, K. A., Shaw, A. R., & Deitz, S. J. (1998). Project New York: International Universities Press.
PRISM: A longitudinal study of developmental patterns Piaget, J. (1970). Genetic epistemology. New York: W. W.
of children who are visually impaired. Final report. Norton.
(CFDA 84.0203C, Grant H023C10188). Greeley: Piaget, J., & Inhelder, B. (2008). The psychology of the
University of Northern Colorado, Division of Spe- child. New York: Basic Books.
cial Education. Pierce, W. D., & Cheney, C. D. (2013). Behavior analy
Fosnot, C. T. (Ed.). (2005). Constructivism: Theory, persis and learning. New York: Psyc hology Press.
spectives, and practice (2nd ed.). New York: Teach- Riding, R., & Rayner, S. (2013). Cognitive styles and
ers College Press. learning strategies: Understanding style differences in
Fuchs, D., & Fuchs, L. (2006). Introduction to response learning and behavior. London: Routledge.
to intervention: What, why, and how valid is it? Santrock, J. W. (2009). Life-span development. Boston:
Reading Research Quarterly, 41(1), 93–99. McGraw-Hill.
Haring, N. G., Lovitt, T. C., Eaton, M. D., & Hansen, Schunk, D. H. (2008). Learning theories: An educational
C. L. (1978). The fourth R: Research in the classroom. perspective. Upper Saddle River, NJ: Pearson/Mer-
Columbus, OH: Charles E. Merrill. rill Prentice Hall.
Kearney, A. J. (2015). Understanding applied behavior Schwahn, C., & McGarvey, B. (2012). Inevitable: Mass
analysis: An introduction to ABA for parents, teachers, customized learning: Learning in the age of empower-
and other professionals (2nd ed.). London: Jessica ment. US: CreateSpace Independent Publishing
Kingsley. Platform.
Keller, F. S., & Schoenfeld, W. N. (2014). Principles of Shaffer, D., & Kipp, K. (2013). Developmental psychol
psychology: A systematic text in the science of behav ogy: Childhood and adolescence (9th ed.). Indepen
ior. Cambridge, MA: B. F. Skinner Foundation. dence, KY: Cengage Learning.
Lane, K. L., Oakes, W. P., Menzies, H. M., & Harris, Siddle Walker, V. (1996). Their highest potential: An Afri-
P. J. (2013). Developing comprehensive, inte- can American school community in the segregated south.
grated, three-t iered models to prevent and man- Chapel Hill: University of North Carolina Press.
age learning and behavior problems. In T. Cole, Siddle Walker, V., & Byas, U. (2009). Hello professor: A
H. Daniels, & J. Visser (Eds.), The Routledge inter- black principal and professional leadership in the
national companion to emotional and behavioural segregated south. Chapel Hill: University of North
difficulties (pp. 177–183). New York: Routledge. Carolina Press.
Levine, M. D. (1998). Developmental variation and learn- Simonsen, B., Fairbanks, S., Briesch, A., Myers, D., &
ing disorders (2nd ed.). Cambridge, MA: Educa- Sugai, G. (2008). Evidence-based practices in class-
tors Publishing Serv ice. room management: Considerations for research to
Logan, G. (1985). Executive control of thought and ac- practice. Education and Treatment of C hildren, 31(3),
tion. Acta Psychologica, 60, 193–210. 351–380.
Lutz, S. T., & Huitt, W. G. (2003). Information Skinner, B. F. (1969). Contingencies of reinforcement: A
processing and memory: Theory and applications. theoretical analysis. New York: Appleton-C entury-
Educational Psychology Interactive. Valdosta, GA: Val- Crofts.
Skinner, B. F. (2011). About behaviorism. New York: Ran- Vaughn, S., & Fuchs, L. S. (2006). A response to “Com-
dom House. (Original version published in 1976) peting views: A dialogue on response to interven-
Sternberg, R. J., & Zhang, L. F. (Eds.). (2014). Perspec- tion”: Why response to intervention is necessary
tives on thinking, learning, and cognitive styles. New but not sufficient for identifying students with
York: Routledge. learning disabilities. Assessment for Effective Inter-
Sugai, G., & Horner, R. H. (2006). A promising ap- vention, 32(1), 58–61.
proach for expanding and sustaining school-wide Vygotsky, L. S. (1978). Mind in society: The development
positive behavior support. School Psychology Review, of higher psychological processes (M. Cole, V. John-
35, 245–260. Steiner, S. Scribner, & E. Souberman, Eds.). Cam-
Umbreit, J., Ferro, J., Liaupsin, C., & Lane, K. (2007). bridge, MA: Harvard University Press.
Functional behavioral assessment and function-based Wright, P., & Wright, P. (2012). Wrightslaw: Special ed-
interventions: An effective, practical approach. Upper ucation law (2nd ed.). Hartfield, VA: Harbor House
Saddle River, NJ: Prentice-Hall. Law Press.
12
C H A P T E R
Motivation
Allison Cloth, Mary G. Turri,
and Catherine Archambault
Educators of students with visual impairments fre- age, and his use of optical devices made him
quently consider the impact of motivation on students’ feel self-conscious around classmates. He did
progress and engagement in learning opportunities. In not think that going to a new school would be
fact, the general term motivation is often used as a any different. He believed that his classes would
“catch-all” for emotions that relate to whether or not a be hopelessly difficult for him.
student shows interest in an area of learning. Moti- On the first day at his new school, Blake was
vation, however, is not simply a vague concept or surprised that his teacher listened to his opin-
something educators innately know how to address. ions about homework and that she asked the
Motivation is an important and rich area of study in students to help her develop guidelines for the
general education and psychology. Furthermore, dif Founding Fathers’ US Constitution celebration
ferent individuals and different situations are affected that was coming up. Blake was excited that he
by different types of motivation. To effectively explore would get to explore his interest in optometry and
how motivation interacts with student behavior, pro- play the role of Benjamin Franklin during the cele
fessionals in visual impairment need at least a basic bration. Ever since Blake was prescribed his first
knowledge of motivation theory and practice. Having set of bifocals, he was fascinated by the invention
this basic understanding w ill allow the teacher of stu- of bifocal lenses. Blake loved the positive learning
dents with visual impairments to accurately discuss environment at his new school, and for the first
motivation with the other members of a student’s edu- time, he believed that he could do well in school.
cational team. —Eds. His teacher praised him for his hard work, and
Blake’s attitude toward learning changed. He no
longer felt hopeless. He believed that with a lot of
V GNETTE hard work, he could do well in school. His motiva-
tion soared, and so did his grades.
When Blake entered eighth grade at a new
school, he was worried about not being as smart INTRODUCT ON
as the other students. He had low self-esteem
that stemmed from poor academic achievement To be motivated means to be energized or acti-
in his previous school. As a student with low vi- vated t oward a goal; motivation is “to be moved to
sion, his reading speed was slower than aver- do something” (Ryan & Deci, 2000a, p. 54). There
361
are many theories of motivation, and some of the Ryan, 2008). For example, a student may choose
most relevant to education are discussed in this to read a novel for the enjoyment of learning in-
chapter. It can be helpful to lay a foundation of formation, because of interest in the subject, or
motivation using Maslow’s (1943) hierarchy of because of an engagement with the characters
needs for understanding basic h uman motiva- and plot. In contrast, extrinsic motivation is under-
tions. Certain basic human needs are biological, stood as engaging in activities for some external
and an individual’s instinct to achieve or obtain reason or outcome, such as receiving a reward,
them builds on his or her most primal motiva- avoiding punishment, or satisfying a demand
tions (for example, food, shelter, sleep, and safety). (Ryan & Deci, 2000a). For example, a student may
Maslow constructed this hierarchy in part to de- read a novel because it is an assignment or because
lineate how humans’ most basic motivations— he or she has been offered an incentive.
those necessary for survival—a re precursors to The concept of intrinsic motivation arose in
higher-order needs such as learning, belonging, the early 1960s as a contrast to the previously
self-esteem, purpose, and actualization. Many dominant paradigm of motivation, which focused
students walking through the school doors each on learning and conditioning through the study
day may be attending to basic or lower-order of animal behavior (Lepper, Sethi, Dialdin, &
needs that require attention in order for them to Drake, 1997). Lepper and Henderlong (2000)
be ready to learn. noted that the study of motivation prior to the
In this chapter, the topic of motivation is ex- 1960s was dominated by studies on the effects of
plored in depth. Theories and research about external stimuli on an organism’s behavior, lead-
what shapes motivation and self-perception are ing to a unitary focus on extrinsic motivation. At
described in detail. In addition, theories about that time, motivation theorists w ere learning that
self-determination and its connection to motiva- organisms w ere moved to engage in activities for
tion are discussed, as well as theories about self- an outcome, such as gaining access to something,
perception and its connection to motivation receiving a reward, or avoiding punishment. De-
toward achievement and expectations.
These spite the dominance of t hese views, eventually
theories and research are import ant in shaping researchers began to recognize that t hese theories
learning environments and promoting positive could not explain situations in which organisms
learning models that may affect all students’ mo- were motivated to engage in behaviors in the ab-
tivation to learn, including students with visual sence of external stimulus (Lepper et al., 1997;
impairments. Sansone & Harackiewicz, 2000).
Early work in the area of intrinsic motivation
focused on the idea that h umans (and other or-
INTRINSIC AND ganisms) are often motivated to engage in behav
EXTR NS C MOTIVAT ON iors for reasons such as enjoyment, curiosity, or
interest (Lepper & Henderlong, 2000). For ex-
The concept of motivation is often understood ample, White (1959) described the concept of
through the distinction of intrinsic versus extrin- effectance, the propensity for an organism to inter-
sic motivation. Although t here is not consensus act with the challenges of its environment, even
for a definition among motivation researchers in the absence of external outcomes. Following
(Sansone & Harackiewicz, 2000), the construct of his analysis of numerous studies of h uman and
intrinsic motivation is generally understood as the animal behavior, he concluded that it was inaccu-
engagement in activities for enjoyment, for satis- rate to consider motivation as an interaction oc-
faction, or because of inherent interest (Deci & curring solely between an individual and sources
Motivation 363
external to the individual, a conclusion he felt et al.’s (1999) meta-analysis regarding the un-
opened the way for new models of motivation, dermining effects of rewards, no undermining
“considering in their own right t hose aspects of effects of rewards on intrinsic motivation were
animal and human behaviour in which stimula- found when the measured task was uninterest-
tion and contact with the environment seem to ing. Therefore, Hidi and Harackiewicz (2000)
be sought and welcomed . . . and in which nov- concluded that the judicious use of external re-
elty and variety seem to be enjoyed for their own wards combined with increasing interest in school
sake” (White, 1959, p. 328). activities may assist academically unmotivated
This early inquiry paved the way to what is students to become more engaged with tasks,
now recognized as intrinsic motivation (Lepper such as those that are uninteresting to them,
et al., 1997; Sansone & Harackiewicz, 2000). which may ultimately foster interest and intrin-
Intrinsic motivation appears to be a quality in- sic motivation.
nate in h umans; young c hildren have a naturally Understanding extrinsic motivation and
inquisitive nature with an inclination for learn- acknowledging its value are import ant to educa-
ing, and a playful curiosity to understand their tors, particularly with regard to how intrinsic
surrounding environment (Deci, 1975). In schools, and extrinsic motivation interact in the school
fostering and maintaining intrinsic motivation in environment. Brophy (2004) found that although
students is highly valued, leading to extensive re- intrinsic motivation is a valuable goal to foster
search into the factors that either facilitate or un- and strive for, it is unrealistic to expect that stu-
dermine it (Hidi & Harackiewicz, 2000; Ryan & dents will be intrinsically motivated across all
Deci, 2000a). A concern coming out of this re- activities for all of their schooling. Regardless of
search is that in some scenarios extrinsic rewards whether students are intrinsically motivated,

may undermine feelings of intrinsic motivation they are still required to attend school and work
(Deci, Koestner, & Ryan, 1999; Lepper, Greene, & within externally imposed curricula and de-
Nisbett, 1973). This has led to the notion that mands. Using classroom strategies that boost
extrinsic motivation is a less desirable type of intrinsic motivation as well as using external re-
motivation (Ryan & Deci, 2000a). More recent wards effectively can be important facets of stu-
perspectives, however, do not necessarily pit ex- dent success and engagement in the c lassroom.
trinsic against intrinsic motivation, but acknowl-
edge the interplay of both factors (Sansone &
Harackiewicz, 2000). SE F-DETERMINATION THEORY
Several researchers have argued that intrin-
sic and extrinsic motivation are not opposing Self-determination, simply defined, is a desire to act
forms of motivation, but rather two separate that is unaffected by external influences. It is an
constructs, both with benefits, that may, in some area of the expanded core curriculum for students
cases, work together (Hidi & Harackiewicz, who are blind or visually impaired (see Volume
2000; Lepper, Corpus, & Iyengar, 2005; Lepper 2, Chapter 25). Vision is often used to determine
& Henderlong, 2000). In response to concerns how, what, or why t hings in the environment ex-
regarding extrinsic rewards, Hidi and Harack- ist the way they do. C hildren with sight observe
iewicz (2000) argued that these concerns are a actions that lead to consequences. For example,
“reaction to behaviourism” (p. 169) and devalue a remote control may be used to turn on a telev i
the positive effects that extrinsic motivation may sion, a golden color of toast may signify that it is
have in some situations, particularly for unmoti- cooked, and a fence in front of a barking dog may
vated students. The authors note that in Deci signal that it is safe to walk down the sidewalk.
Without vision, the causal relationship is not read- (Ryan & Deci, 2000a). A central tenet of SDT is
ily understood b ecause of the lack of incidental the importance of satisfying the basic human
learning that vision provides. Complete under- needs of feeling competent, autonomous, and con-
standing of situations by an individual with sig- nected with o thers (Ryan & Deci, 2000b, 2009).
nificant vision loss may require explanation or As outlined by Ryan and Deci (2000a), and
actual experiences, often mediated by another Deci and Ryan (2008), motivation in SDT is
person, perhaps an adult, teacher, sibling, or broadly categorized into autonomous and con-
friend. The lack of understanding of situations trolled motivation. Autonomous motivation en-
and the need for further explanation may lead to compasses identified, integrated, and intrinsic
passivity, which places an individual at risk for regulation, and controlled motivation encompasses
lacking self-determination. In the field of visual external and introjected regulation. The delinea-
impairment and blindness, the need to provide tion of the continuum of extrinsic motivation be-
direct instruction in self-determination should be gins with external regulation, which is the least
emphasized. Understanding theoretical models internalized type of extrinsic motivation along
of self-determination and its link to motivation the continuum. Behaviors motivated by external
may provide a necessary foundation for foster- regulation are performed solely for external rea-
ing self-determination in c hildren with visual sons, such as to receive a reward or to comply with
impairments. an externally imposed demand. A student who
Self-determination theory (SDT; Deci & Ryan, engages in reading solely because her teacher is
1985) delineates several different types of e xtrinsic offering her a reward for the number of books
motivation, differing in the level of autonomy, she reads would be externally regulated accord-
or self-determination, experienced by the indi- ing to this theory. In some cases, externally reg-
vidual. ulated behaviors are associated with feelings of
being controlled, as well as a lack of persistence
Students can perform extrinsically motivated and interest. This type of motivation would rep-
actions with resentment, resistance, and disin- resent the most commonly understood, but also
terest or, alternatively, with an attitude of will- most criticized, form of extrinsic motivation.
ingness that reflects an inner accept ance of the The second type of extrinsic motivation is in-
value or utility of a task. In the former case— trojected regulation, which, although somewhat
the classic case of extrinsic motivation—one internalized, is still associated with external con-
feels externally propelled into action; in the lat- trol. Individuals acting through introjected regu-
ter case, the extrinsic goal is self-endorsed and lation do so either to avoid negative feelings such
thus a dopted with a sense of volition. (Ryan & as guilt or anxiety or to maintain positive feel-
Deci, 2000a, p. 55) ings such as self-esteem. For example, a student
may complete his homework in order to avoid
The theory also encompasses intrinsic moti- feeling guilty. On the other side of the continuum,
vation, as well as amotivation, described as a lack of under autonomous motivation, is identification, in
intention, or being devoid of self-determination. which the individual recognizes that a part icular
Taken together, motivation according to SDT is action has personal relevance and value, and,
represented on a continuum of the extent to which therefore, he or she has internalized its value. An
individuals have internalized external values and individual acting through identification would
regulations that lead to desired outcomes, such as engage in an undesired activity if he or she views
increased engagement and greater self-regulation it as important for a personal goal. For example,
Motivation 365
a girl may practice boring piano scales because

she understands the importance of the scales for AUTONOMY-SUPPORTIVE
becoming a good pianist, which is ultimately TEACHING
important to her.
Integrated regulation represents the type of ex- Through their research, proponents of SDT have
trinsic motivation that is mostly highly internal- identified classroom factors that can promote
ized, that is, self-determined. Individuals acting intrinsic motivation and self-determination in
through integrated regulation have fully internal- students. Reeve and Jang (2006) described the
ized and integrated the purpose of a behavior with concept of autonomy-supportive teaching, in which
their personal values, beliefs, and needs. For ex- teachers assist students in integrating their be
ample, a student may work hard on an assignment havior in the classroom with their motivational
because being a good student is part of her iden- resources (that is, personal values, goals, and
tity. Given the autonomous nature of integrated needs). To do so, it is essential to create an envi-
regulation, it is viewed as similar to intrinsic mo- ronment of belongingness that is supportive of
tivation; however, behaviors performed through student autonomy, provides adequate challenges
integrated regulation are still done so for a sepa- with feedback, and avoids harshly critical or con-
rable (external) outcome, albeit one of high value trolling evaluations (Deci & Moller, 2005; Ryan,
to the individual (Ryan & Deci, 2000a). Stiller, & Lynch, 1994). Listening to students and
A number of studies have been conducted acknowledging their opinions and questions,
to examine the relation between the differe nt having them co-construct assignments or rules,
types of motivation and learning, and these creating opportunities for them to work in their
studies have found positive outcomes to be gen- own way (for example, giving them choices), and
erally correlated with more autonomous forms providing targeted assistance are all strategies
of motivation, such as intrinsic motivation and that have been identified as helping students re-
internalized and identified regulation (see, for alize a greater sense of autonomy (Reeve & Jang,
example, Burton, Lydon, D’Alessandro, & Koest- 2006).
ner, 2006; Connell & Wellborn, 1990; Kusurkar, As seen with Blake in his new school, the
Ten Cate, Vos, Westers, & Croiset, 2013; Mise- teacher created an inclusive classroom commu-
randino, 1996; Ryan & Connell, 1989; Valle- nity. The teacher actively listened to her stu-
rand & Bissonnette, 1992). Specifically, intrinsic dents and provided a safe learning environment
motivation has been found to be correlated with for them to voice their opinions. She solicited
interest, enjoyment, positive coping, psycho- feedback from students about assignments
logical well-being, and academic per formance and incorporated their input into the assign-
(Burton et al., 2006; Ryan & Connell, 1989). ment guidelines. In using these strategies, the
More internalized types of extrinsic motivation teacher skillfully promoted the students’ sense
such as internalized and identified regulation of autonomy.
have also been associated with positive outcomes,
such as greater enjoyment of school, engagement, A RIBUTION HEORY
academic performance, psychological well-being,
and reduced dropout rates (Connell & Well- Attribution theory first gained attention through
born, 1990; Grolnick & Ryan, 1987; Kusurkar the work of Heider (1958), a social psychologist
et al., 2013; Miserandino, 1996; Vallerand & who developed the theory to describe how p eople
Bissonnette, 1992). come to explain o thers’ behavior and their own.
Heider proposed that individuals usually attri- In the opening scenario, Blake’s locus of con-
bute behavior either to personal disposition (for trol shifts from an external locus of control to an
example, personality traits, motives, or attitudes) internal one. In his previous school, he did not
or to situations (for example, external pressures, feel that he had the power to change his situation.
the environment, or random chance). His work He felt that his classes w ere too difficult and that
led to the elaboration of concepts such as the he was not as smart as the other students. How-
“hedonic bias” (Miller & Ross, 1975), or people’s ever, in the new school, Blake’s locus of control
tendency to attribute successes to their disposi- shifts as he witnesses his teacher embrace his opin-
tion and to blame situations for failures, and ions and voice. His perception of his new situa-
“fundamental attribution error” (Ross, 1977), tion shows that he has the ability to shape f uture
or the tendency to overestimate the influence of outcomes.
traits and underestimate the influence of situa- Building on Heider’s and Rotter’s theories,
tions when judging the behavior of o thers. Weiner (1986, 1995, 2010) elaborated a widely
Rotter (1966) also published a very influen- recognized attribution theory of motivation. This
tial monograph discussing the concept of “locus theory is especially relevant to students’ achieve-
of control” and its effect on learning. Locus of con- ment motivation because it addresses both the
trol describes the degree to which individuals antecedents and the consequences of the attri-
believe they can control events affecting them. butions p eople use to explain their successes and
Individuals with an internal locus of control are failures (Graham & Williams, 2009). In school
said to perceive situations or outcomes as a con- and in life, individuals experience a number of
sequence of their own behavior, and individuals failures and successes and usually try to find
with an external locus of control perceive them reasons to explain them. For instance, a student
as controlled by forces outside themselves such as who received a bad grade could explain the grade
luck, chance, or powerf ul others. Rotter describes as the result of a lack of effort, intelligence, bad
locus of control as a fairly consistent trait that dif luck, or the difficulty of the exam. Through attri-
ferent individuals could possess in different de- bution theory, Weiner (1986) a ttempted to find
grees, and that influenced people’s expectations the underlying dimensions or properties of the
for success (Rotter, 1966). causes used to explain dif

fer
ent achievement
Students with visual impairments may feel as outcomes.
though they have less control of the environment
and their self in relation to it (see Volume 2,
Chapter 25). Vision may act as a clarifying agent
Causal Attributions
that helps the learner interpret how outside forces The theory identified three main causal dimen-
in the environment impact one’s existence. When sions: stability, whether a cause is likely to change
c hildren lack visual information, they often are over time; locus, whether a cause is internal or ex-
not able to observe the causal agents that lead to ternal; and controllability, whether a cause is sub-
situations. Students with visual impairments may ject to volitional change. Consequently, all c auses
be more likely to perceive their situations as un- can fall into one of the nine categories formed by
controllable, thus leading to an external locus of a three-by-t hree matrix combining the dimen-
control. However, with a positive learning envi- sions. For instance, effort can be classified as in-
ronment, individuals who are visually impaired ternal, unstable, and controllable; intelligence
may experience how they can be an agent of can be classified as internal, stable, and uncon-
change by altering their behavior. trollable; and luck can be classified as external,
Motivation 367
stable, and uncontrollable (Graham & Williams, stable, and controllable (Dweck, 2000; Dweck
2009). & Molden, 2005).
Attribution Consequences Self-Theories and Achievement

The classification of causes into these dimensions According to Dweck (2000, 2007a), the theories
is crucial to an attribution theory of motivation students have about intelligence can have an
because each dimension has specific implications important effect on their behavior and academic
for people’s achievement-related thoughts, feel- performance. For instance, entity theorists would
ings, and actions. The c auses individuals use to have a tendency to avoid challenges, as they
explain successes and failures have an influence make mistakes more likely and might make the
on their emotional reactions to the event. For in- student appear less intelligent. On the other hand,
stance, the causal locus is linked to pride and self- incremental theorists attribute m istakes to lack
esteem; causal stability is linked to feelings such of effort and not lack of ability, and therefore
as hope, hopelessness, and helplessness; and see challenges as an opportunity to learn and
causal control is linked to feelings such as guilt, improve.
shame, and regret (Weiner, 2010). In turn, the The hypotheses proposed in this theory are
psychological consequences of the different causal supported by a number of studies. For instance,
attribution dimensions have also been found to in one study Blackwell, Trzesniewski, and Dweck
lead to different achievement-related behaviors, (2007) found that students’ implicit theories of
such as effort, persistence, and self-handicapping intelligence were predictive of their mathematic
(Graham & Williams, 2009). achievement. Specifically, the incremental view
of intelligence (seeing it as malleable) was predic-
SEL HEORIES tive of an increase in grades over the two years of
junior high school, while an entity view of intel-
Through her research on self-theories, or individ- ligence (seeing it as a fixed trait) predicted stable
uals’ beliefs and understanding about their own grades over the two years. Incremental theorists
intelligence, Dweck (2000, 2007a) contributed to believed that learning was more important than
the understanding of the link between attribu- getting good grades, and w ere more likely to be-
tions and behavior. In particular, her work fo- lieve that hard work was a necessary and effective
cused on describing the relationship between way to achieve well. When confronted with a bad
children’s implicit theories about intelligence and grade, incremental theorists w ere more likely to
their behavior. Dweck proposes that individuals, say that in the future they were going to invest
and especially students, can have one of two more effort or try a different strategy to master the
views, or “theories,” of intelligence: some see in- material. On the other hand, the entity theorists
telligence as a fixed trait that cannot be changed, reported being more concerned about looking
and others see it as malleable and developed smart than about learning and reported negative
through hard work and education. The former, views of effort, viewing hard work as a sign of
labeled entity theorists, attribute intelligence to low ability. In addition, when confronted with a
innate ability, and therefore see it as internal, bad grade, they w ere more likely to say that in the
stable, and uncontrollable. The latter, labeled in- f uture they would study less and consider cheat-
cremental theorists, attribute it to f actors such as ing and never taking that subject again (Black-
hard work and learning, which are internal, un- well et al., 2007; Dweck, 2007b).
How to Foster Incremental was malleable and that his hard work could lead
Theory in Students to higher academic achievement.
Given the impor tant implications of students’

theories about intelligence, Dweck and her col- ACH EVEMENT MOT VATION
leagues also studied the f actors that can influence
Another popular theory of h uman motivation
the formation of different attributions. They found
is McClelland’s trichotomy of needs. This theory
that an important source of attribution informa-
posited that humans are moved by three main
tion, especially in schools, is feedback from teach-
motives: the need for affiliation, power, and
ers. In particular, they found that praising students
achievement (McClelland, 1961). The link be-
for their intelligence encouraged an entity view of
tween achievement and motivation has been
intelligence, whereas praising their effort or hard
studied over the decades, leading to the develop-
work encouraged an incremental view of intelli-
ment of the field of achievement motivation
gence (Mueller & Dweck, 1998).
(Wigfield & Eccles, 2002a).
A computer workshop called “Brainology” was
Achievement motivation has been defined as
also developed to help students acquire an incre-
motivation in situations in which individuals
mental view of intelligence by providing explicit
strive to feel or show competence (Nicholls, 1984).
instruction for regarding the mind as a learning
More recently, research in this field has focused
machine (Mindset Works, 2008). Through a series
on trying to explain what effects achievement-
of online activities and challenges, students are
related be haviors and outcomes, such as task
taught how the brain works and shown that learn-
choice and persistence on tasks, have on task en-
ing prompts neurons in the brain to grow new con-
gagement and effort. Although different theo-
nections. They are encouraged to view the brain as
rists conceptualize achievement motivation in
a muscle that gets stronger with use. The workshop
different ways, current models in the field gener-
also explains to students what they can do to make
ally propose that achievement behaviors result
their brain work better. This computer program
from an individual’s goals, beliefs, and values
has been shown to have positive short-term effects
(Wigfield & Eccles, 2002b).

in promoting an incremental theory of intelligence
in students. However, research findings suggest
that the effects of the program are not sustained SEL EFF CACY THEORY
over time after students stop using the program
(Donohoe, Topping, & Hannah, 2012). Fortu- Bandura’s (1977) theory of self-efficacy also has
nately, studies have also shown that teachers can clear implications for feelings of motivation. In a
use similar strategies to teach students that intelli- way similar to SDT, self-efficacy theory is based on
gence is malleable and encourage them to main- the idea that what an individual believes will im-
tain an incremental view of intelligence (Blackwell pact how they behave. If a person believes they
et al., 2007; Good, Aronson, & Inzlicht, 2003). have the ability and support needed to succeed in
In the opening scenario Blake’s perception of a task, they are more likely to engage in the task.
school changes from one of hopelessness to one Perceptions of self-efficacy play an important role
in which he believes he can be an agent of change. in how challenges are approached, how much ef-
The lack of motivation that he felt in the previ- fort w ill be expended, and how long an individ-
ous school setting turned into a soaring desire to ual w
ill persist in the face of obstacles. Feelings
learn when he was placed in a positive learning of self-e fficacy can be influenced by modeling,
environment. He began to see that his intelligence prior successes, and p ersuasion.
Motivation 369
upcoming activities (Wigfield & Eccles, 2002b).

EXPECTANCY-VA UE THEORY On the other hand, ability beliefs are self-
perceptions of one’s current competence at any
Expectancy and value w ere identified as impor
given activity (Eccles & Wigfield, 1995). Al-
tant constructs early in the field of motivation,
though t hese two constructs are highly related,
and their influence on attitudes, intentions, and
they differ in the fact that expectancies for suc-
behav ior has now been discussed for many
cess are focused on the future, while ability
years (Higgins, 2007; Rose & Sherman, 2007).
beliefs are focused on the pres
e nt (Eccles &
The first formal expectancy-value model in the
Wigfield, 1995).
field of achievement motivation was proposed
by Atkinson (1957). This model proposed that
Value
achievement-related behaviors, such as striving
for success, task choice, and persistence, were de- Achievement or task values are conceptualized as
termined by achievement motives, expectancies the qualities an individual perceives in an activ-
for success, and incentive values. The theory also ity and how these qualities influence his or her
postulated that, in contrast with achievement desire to perform said activity. This value is sub-
motives, which were relatively stable personal jective in nature, since the same activity can have
dispositions, expectancies for success and achieve- a different value for different individuals. In the
ment motives were situational and task specific model, the broader construct of achievement value
(Atkinson, 1957; Wigfield, Tonks, & Lutz Klauda, is divided into four components (Wigfield & Ec-
2009). cles, 2000):
In their expectancy-value model, Wigfield
and Eccles (1992, 2000, 2002b) keep with the tra- 1. Achievement value or importance: The impor-
ditional theory by arguing that the value indi- tance of doing well on a given task.
viduals attribute to an activity and their beliefs
2. Intrinsic value: The enjoyment gained from
about how well they w ill do on the activity
doing a task.
strongly influence their choice of, persistence
3. Utility value or usefulness of the task: How a task
with, and performance in an activity. Their the-

ory, however, differs from Atkinson’s in its richer fits into an individual’s f uture plans.
definition of expectancy and value as constructs, 4. Cost: The individual’s assessment of the effort
and in the importance given to the influences of that w ill be needed to accomplish the activ-
social, cultural, cognitive, and affective factors on ity, of what he or she has to give up to do a
these constructs. In addition, several field stud- task, and of its emotional cost.
ies have now been conducted to provide support
for the constructs proposed by this theory and a Performance and Choice
better understanding of the developmental course
Support for the validity of the expectancy-value
of c hildren’s expectancies and values (Wigfield
model has been provided by a number of studies
009).
et al., 2
examining the relationship between the expec-
tancy and value associated with achievement
Expectancy-Value Model and academic choices (see, for example, Bong,
2001; Durik, Vida, & Eccles, 2006; Greene, De-
Expectancy
Backer, Ravindran, & Krows, 1999; Steinmayr
Expectancies for success are defined as an indi- & Spinath, 2009). For instance, Spinath, Spinath,
vidual’s beliefs about how well they w ill do on Harlaar, and Plomin (2004) examined the e xtent
to which c hildren’s ability beliefs and values Development of Expectancies for

contributed to the prediction of their school Success and Achievement Values
achievement in de
p endently from their gen-
eral mental ability, or intelligence. They asked Numerous studies have examined the structure
9-year-old students to indicate how much they of c hildren’s ability beliefs and expectancies for
liked dif fer
e nt activities from their En g lish, success and the values they attribute to tasks to
mathe matics, and science curricula (interest determine how t hese constructs change through-
value) and how good they thought they were at out development (for example, Eccles & Wigfield,
t hese activities (ability beliefs). Their results
1995; Eccles, Wigfield, Harold, & Blumenfeld,
show that both ability beliefs and interest val- 1993). T hese studies generally suggest that
ues were predictive of the students’ academic children’s beliefs and values become more differ-
achievement in elementary school even after entiated over time. For instance, studies examin-
controlling for general mental ability. Other ing the relation between ability beliefs and
studies have also found that children’s ability expectancies for success in c hildren from 1st to
beliefs and task values are predictive of later life 12th grade have found that while adolescents do
choices such as class enrollment and c areer aspi- distinguish between the two constructs, younger
rations (Durik et al., 2006; Plante, O’Keefe, & students do not. Younger c hildren also appear to
Théorêt, 2013). differentiate less between the components of task
value than do adolescents (Eccles & Wigfield,
1995; Eccles et al., 1993).
Determinants
On the other hand, results from the same
While it is important to understand the influ- studies found that even young students have dis-
ences of expectancies and values on task choice, tinct ability beliefs, and therefore distinct expec-
performance, and persistence, it is also important tancies for success, for different domains, such as
to consider the factors determining what expec- math, reading, general school, physical ability, or
tancies and values an individual has for a specific peer relations. Research also suggests that c hildren
task (Wigfield & Eccles, 2000; Wigfield et al., of all ages perceive the value they attribute to an
2009). The expectancy-value model argues that activity and their expectancies for success for
the expectancies and values c hildren associate this activity as different, and are therefore able
with different tasks are indirectly influenced by to distinguish between what they consider impor
their previous experiences and their socializ- tant and what they are good at. These results
ers’ (for example, parents and teachers) beliefs, provide strong support for the expectancy-value
values, and be haviors, in addition to vari ous model (Eccles & Wigfield, 1995; Eccles et al.,
contextual and cultural influences. Specifically, 1993).
c hildren’s interpretations of their past experi- While it has been shown that early mastery
ences and of their socializers’ attitudes and ex- experiences and parenting styles have a strong in-
pectations have an effect on the formation of fluence on a child’s sense of competence and ex-
task- specific cognitive variables such as ability pectations for the f uture (Dweck, 2002), research
beliefs, perception of the difficulty of a task, per- also indicates that the school environment plays
sonal goals, self-schema, and affective memories. an important role in the development of expec-
T hese task-specific variables then influence the tancies for success. Most studies in fact show that
expectancies and values an individual attributes expectancies of success and value of academic
to a task (Eccles et al., 1983; Wigfield & Eccles, subjects decline across the elementary and high
1992). school years (Eccles et al., 1993; Wigfield, Eccles,
Motivation 371
Mac Iver, Reuman, & Midgley, 1991; Wigfield ued, and in other cultures motivational themes
et al., 1997). of interdependence and relatedness are empha-
This decline is believed to be due to a num- sized. In this way, levels of optimal autonomy
ber of factors. First, the frequent formal evalua- and incentives may be more or less salient de-
tions students receive in schools lead students to pending on culture (for example, accomplish-
develop clear ideas about their competence in ment, praise, or a tangible gold star sticker).
different areas. These ability beliefs in turn influ- One way to explore motivation in relation to
ence the expectancies for success c hildren hold culture is through Adams’s (1963) equity theory.
for f uture tasks (Wigfield et al., 2009). In addi- This theory posits that p eople compare their per
tion, the comparisons c hildren make with same- formance to that of o thers and are interested in
age peers in school can lead them to modify the seeing similar rewards or outcomes based on sim-
ability beliefs they had acquired since infancy. ilar efforts or input. If efforts or outcomes are
While schools and teachers can attempt to mini- dissimilar, then people are motivated to do some-
mize social comparisons, c hildren will use all in- thing to restore equity. For example, in the class-
formation available about the performance of room, when students with challenges strugg le
others to judge their own experiences, and adjust with the same material, they can have feelings of
their ability beliefs and expectancies for success helplessness, hopelessness, or injustice that can
in consequence (Schunk & Pajares, 2009; Wig- impact their individual feelings of motivation.
field et al., 2009). For students with visual impairments, contact
The school environment can also have an ef- with others who have visual impairments pro-
fect on the value c hildren place on certain tasks vides a culture-like connection that supports per-
or activities. For instance, the messages a child re- ceptions of their own abilities and helps them to
ceives in school about the cultural norms and understand how variations in achievement may
ideas about what is expected of or appropriate for be affected by a visual disability. These opportu-
them can influence the value they attribute to dif nities may provide a subculture within a broader
ferent activities (Eccles, 2005). Students’ valuation culture that allows students to interpret their
of an activity can be influenced by the feedback distinctive experiences.
they get from teachers about its importance and

usefulness (for example, being good at sports is SUMMARY
important, reading is important if you want to
go to college; Wigfield et al., 2009). Finally, the Motivation, self-determination, and self-efficacy
social comparisons students make in school can are factors that are integrally linked to one’s self-
also have an impact on their interest in different perception and expectations for success. Research
activities (Wigfield et al., 2009). and theory inform us of how students may per-
ceive internal and external influences on their
motivation to learn. The studies discussed in this
MOT VATION, CULTURE, chapter have shown that teachers who promote
AND DISAB LIT ES positive learning environments foster a sense of
autonomy in students, and that teachers who
Motivation is important to people across cultures, praise effort over intelligence promote students’
from one’s most basic needs to one’s need for a perception that effort and hard work leads to
sense of belonging, which can be culturally driven. better outcomes. Likewise, students who view
In some cultures independent motivations such achievement as internal and controllable are
as independent achievement or ambition are val- more likely to work hard and believe that their
efforts w ill lead to success, and students who be- fects of extrinsic rewards on intrinsic motivation.
lieve they w ill be successful at a task are more Psychological Bulletin, 125, 627–668.
likely to engage in the task than students who do Deci, E. L., & Moller, A. C. (2005). The concept of com-
not believe they w ill do well at the task. Social petence: A starting place for understanding in-
competencies may have a positive or negative im- trinsic motivation and self-determined extrinsic
motivation. In A. J. Elliot & C. S. Dweck (Eds.),
pact on self-perception, and students may alter
Handbook of competence and motivation (pp. 579–
their expectancies for success based on social
597). New York: Guilford Press.
comparisons.
Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation
and self-determination in human behavior. New York:
REFERENCES Plenum.
Deci, E. L., & Ryan, R. M. (2008). Facilitating optimal
Adams, J. S. (1963). T owards an understanding of in- motivation and psychological well-being across
equity. Journal of Abnormal and Social Psychology, life’s domains. Canadian Psychology/Psychologie
67(5), 422–436. Canadienne, 49(1), 14–23.
Atkinson, J. W. (1957). Motivational determinants of Donohoe, C., Topping, K., & Hannah, E. (2012). The
risk taking behavior. Psychological Review, 64, impact of an online intervention (Brainology) on
359–372. the mindset and resiliency of secondary school
Bandura, A. (1977). Self-e fficacy: Toward a unifying pupils: A preliminary mixed methods study. Edu-
theory of behavioral change. Psychological Review, cational Psychology, 32, 641–655.
84, 191–215. Durik, A. M., Vida, M., & Eccles, J. S. (2006). Task val-
Blackwell, L. S., Trzesniewski, K. H., & Dweck, C. S. ues and ability beliefs as predictors of high school
(2007). Implicit theories of intelligence predict literacy choices: A developmental analysis. Journal
achievement across an adolescent transition: A of Educational Psychology, 98, 382–393.
longitudinal study and an intervention. Child De- Dweck, C. S. (2000). Self-theories: Their role in motiva-
velopment, 78, 246–263. tion, personality, and development. Philadelphia:
Bong, M. (2001). Role of self-efficacy and task-value in Psyc hology Press.
predicting college students’ course performance Dweck, C. S. (2002). The development of ability con-
and f uture enrollment intentions. Contemporary ceptions. In A. Wigfield & J. S. Eccles (Eds.), De-
Educational Psychology, 26, 553–570. velopment of achievement motivation (pp. 57–88).

Brophy, J. E. (2004). Motivating students to learn (2nd San Diego, CA: Academic Press.
ed.). Mahwah, NJ: Erlbaum. Dweck, C. S. (2007a). Mindset: The new psychology of
Burton, K. D., Lydon, J. E., D’Alessandro, D. U., & success. New York: Ballantine Books.
Koestner, R. (2006). The differential effects of in- Dweck, C. S. (2007b). The secret to raising smart kids.
trinsic and identified motivation on well-being Scientific American Mind, 18, 36–43.
and performance: Prospective, experimental, and Dweck, C. S., & Molden, D. C. (2005). Self-theories:
implicit approaches to self-determination theory. Their impact on competence motivation and ac-
Journal of Personality and Social Psychology, 91, 750– quisitions. In A. J. Elliot & C. S. Dweck (Eds.), Hand-
762. book of competence and motivation (pp. 122–140).
Connell, J. P., & Wellborn, J. G. (1990). Competence, New York: Guilford Press.
autonomy and relatedness: A motivational analy Eccles, J. S. (2005). Subjective task-value and the Ec-
sis of self-system processes. In M. R. Gunnar & cles et al. model of achievement-related choices.
L. A. Sroufe (Eds.), The Minnesota symposium on child In A. J. Elliot & C. S. Dweck (Eds.), Handbook of
psychology (pp. 43–77). Hillsdale, NJ: Erlbaum. competence and motivation (pp. 105–121). New
Deci, E. L. (1975) Intrinsic motivation. New York: Plenum. York: Guilford Press.
Deci, E. L., Koestner, R., & Ryan, R. M. (1999). A meta- Eccles, J. S., Adler, T. F., Futterman, R., Goff, S. B.,
analytic review of experiments examining the ef- Kaczala, C. M., Meece, J. L., & Midgley, C. (1983).
Motivation 373
Expectancies, values, and academic be hav iors. in the classroom: Age differences and academic
In J. T. Spence (Ed.), Achievement and achievement correlates. Journal of Educational Psychology, 97(2),
motivation (pp. 75–146). San Francisco: W. H. 184–196.
Freeman. Lepper, M. R., Greene, D., & Nisbett, R. E. (1973). Un-
Eccles, J. S., & Wigfield, A. (1995). In the mind of the dermining children’s intrinsic interest with ex-
achiever: The structure of adolescents’ academic trinsic reward: A test of the “overjustification”
achievement-related beliefs and self-perceptions. hypothesis. Journal of Personality and S ocial Psy
Personality and Social Psychology Bulletin, 21, 215– chology, 28, 129–137.
225. Lepper, M. R., & Henderlong, J. H. (2000). Turning
Eccles, J. S., Wigfield, A., Harold, R., & Blumenfeld, P. B. “play” into “work” and “work” into “play”: 25 years
(1993). Age and gender differences in c hildren’s of research on intrinsic versus extrinsic motiva-
self-and task perceptions during elementary tion. In C. Sansone & J. M. Harackiewicz (Eds.),
school. Child Development, 64, 830–847. Intrinsic and extrinsic motivation: The search for opti-
Good, C., Aronson, J., & Inzlicht, M. (2003). Improv- mal motivation and performance (pp. 257–307). San
ing adolescents’ standardized test performance: Diego, CA: Academic Press.
An intervention to reduce the effects of stereot ype Lepper, M. R., Sethi, S., Dialdin, D., & Drake, M. (1997).
threat. Journal of Applied Developmental Psychology, Intrinsic and extrinsic motivation: A develop-
24, 645–662. mental perspective. In S. S. Luthar, J. A. Burack, D.
Graham, S., & Williams, C. (2009). An attributional Cicchetti, & J. R. Weisz (Eds.), Developmental psy-
approach to motivation in school. In K. Wentzel, chopathology: Perspectives on adjustment, risk, and dis-
A. Wigfield, & D. Miele (Eds.), Handbook of moti- order (pp. 23–50). New York: Cambridge University
vation at school (pp. 11–33). New York: Routledge. Press.
Greene, B. A., DeBacker, T. K., Ravindran, B., & Krows, Maslow, A. H. (1943). A theory of human motivation.
A. (1999). Goals, values, and beliefs as predictors Psychological Review, 50(4), 370–396.
of achievement and effort in high school mathe McClelland, D. C. (1961). The achieving society. New
matics classes. Sex Roles, 40, 421–458. York: D. Van Nostrand.
Grolnick, W. S., & Ryan, R. M. (1987). Autonomy in Miller, D. T., & Ross, M. (1975). Self-serving biases in
c hildren’s learning: An experimental and individ- the attribution of causality: Fact or fiction? Psycho-
ual difference investigation. Journal of Personality logical Bulletin, 82, 213–225.
and Social Psychology, 52(5), 890–898. Mindset Works. (2008). Brainology. Retrieved from
Heider, F. (1958). The psychology of interpersonal rela- http://w ww.mindsetworks.com/ brainology/
tions. New York: John Wiley & Sons. Miserandino, M. (1996). Children who do well in
Hidi, S., & Harackiewicz, J. M. (2000). Motivating the school: Individual differences in perceived com-
academically unmotivated: A critical issue for the petence and autonomy in above-average c hildren.
21st century. Review of Educational Research, 70(2), Journal of Educational Psychology, 88, 203–214.
151–179. Mueller, C. M., & Dweck, C. S. (1998). Praise for intel-
Higgins, E. T. (2007). Value. In A. W. Kruglanski & ligence can undermine c hildren’s motivation and
E. T. Higgins (Eds.), Social psychology: Handbook of per formance. Journal of Personality and Social Psy
basic principles (2nd ed., pp. 454–472). New York: chology, 75, 33–52.
Guilford Press. Nicholls, J. G. (1984). Achievement motivation: Con-
Kusurkar, R. A., Ten Cate, T. J., Vos, C. M. P., Westers, P., ceptions of ability, subjective experience, task
& Croiset, G. (2013). How motivation affects choice, and performance. Psychological Review, 91,
academic perform ance: A structural equation 328–346.
modelling analysis. Advances in Health Sciences Plante, I., O’Keefe, P. A., & Théorêt, M. (2013).
Education, 18, 57–69. The relation between achievement goal and
Lepper, M. R., Corpus, J. H., & Iyengar, S. S. (2005). expectancy- value theories in predicting
Intrinsic and extrinsic motivational orientations achievement- related outcomes: A test of four
theoretical conceptions. Motivation and Emotion, Schunk, D. H., & Pajares, F. (2009). Self-efficacy the-
37, 65–78. ory. In K. Wentzel, A. Wigfield, & D. Miele (Eds.),
Reeve, J., & Jang, H. (2006). What teachers say and do Handbook of motivation at school (pp. 35–54). New
to support students’ autonomy during a learning York: Routledge.
activity. Journal of Educational Psy chol
ogy, 98, Spinath, B., Spinath, F. M., Harlaar, N., & Plomin, R.
209–218. (2004). Predicting school achievement from gen-
Rose, N. J., & Sherman, J. W. (2007). Expectancy. In A. eral cognitive ability, self-perceived ability, and
W. Kruglanski & E. T. Higgins (Eds.), Social psychol intrinsic value. Intelligence, 34, 363–374.
ogy: Handbook of basic principles (2nd ed., pp. 91– Steinmayr, R., & Spinath, B. (2009). The importance of
115). New York: Guilford Press. motivation as a predictor of school achievement.
Ross, L. (1977). The intuitive psychologist and his Learning and Individual Differences, 19, 80–90.
shortcomings: Distortions in the attribution pro Vallerand, R. J., & Bissonnette, R. (1992). Intrinsic, ex-
cess. Advances in Experimental Social Psychology, 10, trinsic, and amotivational styles as predictors of
173–220. behavior: A prospective study. Journal of Personal-
Rotter, J. B. (1966). Generalized expectancies for inter- ity, 60(3), 599–620.
nal versus external control of reinforcement. Psy- Weiner, B. (1986). An attributional theory of motivation
chological Monographs: General and Applied, 80(1), and emotion. New York: Springer-Verlag.
1–28. Weiner, B. (1995). Judgments of responsibility: A founda-
Ryan, R. M., & Connell, J. P. (1989). Perceived locus tion for a theory of social conduct. New York: Guil-
of causality and internalization: Examining rea- ford Press.
sons for acting in two domains. Journal of Person- Weiner, B. (2010). The development of an attribution-
ality and Social Psychology, 57, 749–761. based theory of motivation: A history of ideas.
Ryan, R. M., & Deci, E. L. (2000a). Intrinsic and ex- Educational Psychologist, 45, 28–36.
trinsic motivations: Classic definitions and new White, R. W. (1959). Motivation reconsidered: The
directions. Contemporary Educational Psychology, concept of competence. Psychological Review, 66(5),
25, 54–67. 297–333.
Ryan, R. M., & Deci, E. L. (2000b). Self-determination Wigfield, A., & Eccles, J. S. (1992). The development
theory and the facilitation of intrinsic motivation, of achievement task values: A theoretical analysis.
social development, and well-being. American Psy- Developmental Review, 12, 265–310.
chologist, 55, 68–78. Wigfield, A., & Eccles, J. S. (2000). Expectancy–value

Ryan, R. M., & Deci, E. L. (2009). Promoting self- theory of achievement motivation. Contemporary
determined school engagement: Motivation, learn- Educational Psychology, 25, 68–81.
ing, and well-being. In K. Wentzel, A. Wigfield, & Wigfield, A., & Eccles, J. S. (Eds.). (2002a). Development
D. Miele (Eds.), Handbook of motivation at school of achievement motivation. San Diego, CA: Aca-
(pp. 171–196). New York: Routledge. demic Press.
Ryan, R. M., Stiller, J. D., & Lynch, J. H. (1994). Repre Wigfield, A., & Eccles, J. S. (2002b). The develop-
sent at ions of relationships to teachers, parents, ment of competence beliefs, expectancies for
and friends as predictors of academic motivation success, and achievement values from child-
and self-esteem. Journal of Early Adolescence, 14(2), hood through adolescence. In A. Wigfield & J. S.
226–249. Eccles (Eds.), Development of achievement moti-
Sansone, C., & Harackiewicz, J. M. (2000). Looking vation (pp. 91–120). San Diego, CA: Academic
beyond rewards: The problem and promise of in- Press.
trinsic motivation. In C. Sansone & J. M. Harack- Wigfield, A., Eccles, J. S., Mac Iver, D., Reuman, D. A.,
iewicz (Eds.), Intrinsic and extrinsic motivation: The & Midgley, C. (1991). Transitions during early ad-
search for optimal motivation and per for
mance olescence: Changes in c hildren’s domain-specific
(pp. 1–9). San Diego, CA: Academic Press. self-perceptions and general self-e steem across
Motivation 375
the transition to junior high school. Developmen- mentary school years: A three-year study. Journal
tal Psychology, 27(4), 552–565. of Educational Psychology, 89, 451–469.
Wigfield, A., Eccles, J. S., Yoon, K. S., Harold, R. D., Wigfield, A., Tonks, S., & Lutz Klauda, S. (2009).
Arbreton, A., Freedman-Doan, K., & Blumenfeld, Expectancy-value theory. In K. Wentzel, A. Wig-
P. C. (1997). Changes in children’s competence field, & D. Miele (Eds.), Handbook of motivation at
beliefs and subjective task values across the ele- school (pp. 55–76). New York: Routledge.
13
C H A P T E R
Augmentative and
Alternative Communication
Pat Mirenda and Ellen Trief
A majority of students with visual impairments have speaks a few words, Samuel is a successful com-
concomitant disabilities. Many of the students who municator both at school and at home. When
professionals in visual impairment serve have diffi- he wants to ask for a desired item or activity, he
culties communicating with speech. These students may vocalizes to let a family member, classmate, or
use a variety of sensory information to access augmen- teacher know that he needs tangible symbols.
tative and alternative communication (AAC) devices. When they provide the tangible symbols, at-
The teacher of students with visual impairments will tached to a felt board with Velcro, Samuel uses
have an important role to play in analyzing how a stu- his fingers to tactilely scan the symbols u
ntil he
dent might effectively use vision, touch, and hearing gets to the one he wants, and then hands the
during communication. While the professional in vi- desired symbol to his communication part-
sual impairment may not be primarily responsible for ner. Samuel also uses tangible symbols that
prescribing or teaching a student how to use an AAC represent the activities in his daily schedule,
device, he or she should have an understanding of the which are presented to him in a calendar box
importance of such devices and how they work so that so that he knows what will happen next. Dur-
appropriate support and reinforcement can be offered ing recess and at lunchtime, his friends inter-
to the student who is learning to use an AAC device. act with him using a simple partner-assisted
This chapter provides general information about scanning technique whereby they ask him ques-
AAC devices and w ill provide teachers of students tions and then provide verbal answers, one at a
with visual impairments with valuable information time, so that he can respond. For example, his
that they can use as they partner with other special friend Mica might say, “What did you do last
educators and therapists to make decisions about com- weekend, Samuel? Did you go to the park?
munication and implement associated educational [pause] To your grandma’s house? [pause],” and
plans. —Eds. continue listing possibilities until Samuel nods
his head in response to one of the options. Last
V GNETTE but certainly not least, Samuel uses his speech
to say “Hi!,” to ask for help, and to protest and
Samuel is a 10-year-old boy who is blind and has say “No!” when he does not like what is hap-
a severe intellectual disability. Although he only pening.
376
Augmentative and Alternative Communication 377
AAC techniques create shared communica-

INTRODUCT ON tion opportunities that can reduce the frustra-
tion experienced by many c hildren with complex
Samuel is a very fortunate child! It is clear that
communication needs and visual impairments.
he has been supported by family members and
For example, AAC techniques can be used to
school personnel who understand that his lack of
teach students to ask for what they want, ask for
speech does not mean he has nothing to say,
help, or ask for a break from an activity instead
and who have made systematic efforts to provide
of tantruming, screaming, or engaging in other
him with an individualized augmentative and al-
problem behaviors. When a student learns to
ternative communication (AAC) system. Just like
communicate—regardless of the modality used
everyone e lse, Samuel communicates in a vari-
to do so—he or she then w ill be better able to
ety of ways, depending on the situation. One AAC
participate in play and other school activities,
technique will never meet all of a child’s commu-
and is more likely to be perceived in a positive
nication needs, so a combination of approaches
light by peers, teachers, and parents.
w ill be needed. This is important to remember
Given the potential problems that can de-
when supporting children with visual impair-
velop when c hildren with complex communica-
ments and complex communication needs who
tion needs and visual impairments do not have
require AAC.
a means with which to communication (for ex-
ample, problem behavior, loss of learning and
WHAT IS AAC? social opportunities, and so on), a “wait and see”
approach to AAC intervention can be detrimen-
AAC techniques can be used to both understand tal. Based on current information, it is better to
communication from o thers (augmented input) introduce AAC early (Cress & Marvin, 2003). As
and communicate more effectively to others (aug- they grow older, some c hildren may develop suf-
mented output). AAC involves the use of various ficient speech and no longer require AAC, some
types of symbols that can be combined to con- may continue to use AAC along with speech, and
struct messages for communication. A symbol is some may continue to use AAC as their primary
something that stands for something else (the ref- mode of communication. Withholding AAC in-
erent). There are two main types of AAC symbols: tervention while waiting for the possibility of
unaided and aided. Unaided symbols do not require speech to develop may result in the child devel-
any equipment or materials to produce, and in- oping additional problems such as challenging
clude gestures, body language, vocalizations, and behavior. A better alternative is to provide AAC
manual signs. Aided symbols include real objects, early. This w ill help the child to communicate
tangible symbols, photo graphs, line drawings, with greater ease, thereby reducing frustration.
letters, braille, and written words that represent
messages. Aided symbols are often contained in
devices that are external to the individuals who AAC AND ST DENTS
use them, such as communication books or digi- W TH S GNIFICANT
tized devices that produce speech output. De- V SUA MPAIRMENTS
pending on the context and the communication
partner, most p eople use a combination of un- ecause most AAC techniques involve visual
B
aided and aided AAC techniques in addition to media (for example, photog raphs, line drawings,
whatever functional speech is in their repertoire and so on) to represent messages, it is often chal-
(Beukelman & Mirenda, 2013). lenging to provide appropriate AAC supports to
individuals with complex communication needs describe the use of each of these AAC options
who are also blind or visually impaired. For the with this population.
most part, t hese are students who are unable to
produce speech because of either severe motor Tangible Symbols
impairments (for example, some students with
cerebral palsy) or significant developmental de- Rowland and Schweigert (1989, 2000) coined the
lays (for example, some students with autism term tangible symbol to refer to a three-dimensional
spectrum disorder, intellectual disability, or Down symbol that is permanent, manipulable with a
syndrome). They may also be students with low simple motor be
hav ior, tactilely discriminable,
vision or cortical visual impairment (CVI) who and highly representative of its referent. Tangible
are able to process and use visual information if symbols can be discriminated based on tangible
it is presented to them in appropriate ways. properties (for example, shape, texture, and con-
Most students who are totally blind access sistency), and are often used by and with individu-
their information tactilely and auditorily. When als who are blind, deafblind, or visually impaired
presenting anything tactile, the instructor should and also have severe intellectual disabilities. Usu-
provide a verbal description of what w ill occur ally, each symbol is affixed to a background card
before presenting the object or symbol using a made of sturdy material (for example, heavy card-
hand-under-hand technique. If possible, the ob- board), and the word or phrase represented by the
ject or symbol should be presented to the student symbol is printed and brailled on the card to clar-
by a trusted partner. Hand-under-hand instruction ify its meaning for t hose who can read. Tangible
occurs when the student places his or her hand on symbols may include real objects, partial objects,
top of the partner’s hand so that the two can ex- and artificially associated and textured symbols.
plore the object or symbol together. The partner
Real Object Symbols
gently guides the student through the activity until
the student can tactilely explore independently. If Real object symbols can be identical to, similar to,
the student has an array of tangible symbols on a or associated with their referents. For example, an
display, the partner should first provide a tactile identical symbol for BRUSH YOUR TEETH might be a
orientation to the display by guiding the student toothbrush that is the same size and type as a stu-
to feel the top-to-bottom and left-to-right symbol dent’s a ctual toothbrush. A similar object symbol
layout. The student is then encouraged to track might be a toothbrush of a different size or type,
the symbols using two hands (if possible) to ex- and an associated symbol might be a small tube of
amine them with the fingertips. toothpaste. Other examples of associated object
In most cases, the AAC techniques that w ill symbols include a sponge that represents CLEAN-
be most useful for students with complex com- ING THE KITCHEN COUNTER or a set of headphones
munication needs and visual impairments include that represents MUSIC TIME in a preschool class-
gestures, tangible symbols, manual or tactile signs, room. Associated symbols may also include rem-
and auditory scanning. Students with low vision nants of activities, such as a ticket stub from a
might benefit from high-contrast photog raphs or movie theater or a hamburger wrapper from a fast-
line drawings, whereas students with CVI might food restaurant, which bear some tactile similar-
also be able to use line-drawing symbols if they ity to the activities they represent.
are adapted and presented appropriately. In addi- It is important to note that miniature object
tion, some students may benefit from the use of symbols are not appropriate to use with students
digital devices such as portable tablets that pro- who are blind, deafblind, or visually impaired.
duce speech output. The sections that follow w ill For example, it is unlikely that a student who has
never seen a toilet w ill recognize the relationship Research on Tangible Symbols
between a miniature plastic toilet and a real toilet,
because the two objects feel very differe nt with A recent review of the research on tangible sym-
respect to size, shape, and texture. In this case, bols (Roche et al., 2014) identified nine studies,
a real object symbol that is associated with the seven of which included primarily students with
toilet (for example, a small roll of toilet paper) is complex communication needs who w ere blind
more appropriate. or visually impaired and also had other disabili-
ties (for example, severe intellectual disability,
Partial Object Symbols hearing impairment, or cerebral palsy). In all of
the studies, students were taught to use real ob-
In some situations, especially those that involve
jects, partial objects, or associated symbols to re-
referents that are quite large, partial objects may be
quest preferred items or activities; and in five
used as symbols. For example, the top of a spray
studies, students w ere also taught naming, pro-
bottle of window cleaner may be used to represent
testing, and choice making with tangible sym-
WASHING THE WINDOWS at a vocational instruction
bols. The authors found that 54 percent of the
site. Also included in this category are thermoform
129 students involved in these studies learned
(molded plastic) symbols that are the same size and
to use at least one tangible symbol for commu-
shape as their referents. The use of partial objects
nicative purposes. They concluded that tangible
may be a good alternative when tactile similarity
symbols are a “promising” AAC option for indi-
cannot be achieved using objects.
viduals with complex communication needs who
are blind or visually impaired and have a devel-
Artificially Associated and Textured Symbols
opmental disability (Roche et al., 2014, p. 30).
Tangible symbols can also be constructed by se- In the largest of the nine studies included in
lecting shapes or objects that are not an essential the aforementioned review, Trief, Cascella, and
part of the referent or task but can be associated Bruce (2013) provided seven months of practice to
with it. T
hese are known as artificially associated 43 students with complex communication needs
symbols. For example, Casey, a deafblind w oman, and visual impairments, using a set of 25 stan-
began to wear a pair of leather half-gloves (gloves dardized tangible symbols that were highly iconic;
with the tops of the fingers cut off) whenever she for example, the tangible symbol for DRINK is half
went h orseback riding. She was then able to use of a plastic cup embedded in thick cardboard.
the same gloves as a tangible symbol for HORSE The purpose of introducing standardized symbols
BACK RIDING , because they reminded her of (and was to maintain consistency across environments
smelled like!) this activity. Similarly, a teacher so that, when the c hildren moved to a new school
might attach an empty puzzle form of an apple or from classroom to classroom within a school,
to the door of the school cafeteria and teach a stu- the symbols remained constant. This symbol
dent to place the wooden apple puzzle piece into set, called the Standardized Tactile Augmentative
the form in order to locate the correct room at Communication Symbols kit (STACS; Trief, 2013),
lunchtime. is available from the American Printing House
Alternatively, textured symbols may be either for the Blind.
logically or arbitrarily associated with their ref- In another review, Sigafoos et al. (2008) ex-
erents. For example, a piece of spandex material amined the AAC research for individuals who
might be used as a textured symbol to represent are deafblind. They located 17 studies that met
a bathing suit because many suits are made of their inclusion criteria, two of which w ere also
this material. included in the article by Roche et al. (2014).
Participants included 103 individuals who re- neously with manual signs for the critical words
ceived AAC interventions, 89 percent of whom in a sentence, such as nouns, verbs, prepositions,
both were deafblind and had at least one addi- and adjectives. Thus, the sentence “Go get the cup
tional disability; and 56 percent of whom had and put it on the t able” might involve the use of
severe-profound levels of both hearing and vi- the signs GET, CUP, PUT, ON, and TABLE , while the
sion impairment. Tangible symbols (including entire sentence is spoken.
textured symbols) were the most frequently used Most often, students with complex commu-
form of AAC and w ere used in six studies that nication needs who are blind or visually impaired
covered more than half of all participants. Most are able to learn and produce a few manual signs
often, students w ere taught to request p referred to communicate basic wants and needs. For ex-
items, activities, or attention from caregivers with ample, a student might learn to produce the signs
their symbols. In all cases, students acquired the for EAT, DRINK , MORE , FINISHED, and HELP in appro-
use of one or more tangible symbols, although the priate contexts and situations. However, because
strength of the evidence was limited by weak ex- reception of manual signs depends on a stu-
perimental designs in most cases. Still, the authors dent’s ability to see the signs produced by o thers,
noted that “the generally positive outcomes . . . manual signing is not typically used for ongoing
are encouraging . . . [and] conclude[d] that AAC face-to-face interactions or for instructional pur-
is certainly promising for individuals who are poses. The exception is that some deafblind in-
deaf and blind” (Sigafoos et al., 2008, p. 95). dividuals are often able to use tactile signing for
reciprocal communication. In this method, the
deafblind person places one or two hands on the
Manual and Tactile Signs dominant hand of the signer and traces the mo-
Many dif fere nt manual sign systems are used by tion of the signing hand. Thus, the properties of
people in North America and other English- signs are received tactilely by the deafblind per-
speaking countries. Perhaps the best-k nown sys- son, who then communicates expressively using
tem is American Sign Language (ASL), the ASL or one of the MCE systems.
predominant language used in the deaf commu- Very little research has been conducted on
nity in the United States and Canada for face-to- the use of manual signing with or by individuals
face interactions. The grammar and word order of who are blind or visually impaired without hear-
ASL is different from English and makes use of ing loss, primarily b ecause this form of AAC is
spatial relationships, facial expressions, and body not typically a primary communication system
positioning, in addition to manual signs. In ad- for t hese individuals. However, in the previously
dition, a number of sign systems that code English mentioned review of AAC for individuals who are
word order, syntax, and grammar, known as com- deafblind, Sigafoos et al. (2008) identified four
mon manually coded English (MCE), have been studies that aimed to teach the use of manual
developed for educational use with students who signs (among other AAC techniques), with only
have a wide range of communicative impairments. modest results. In contrast, research suggests that
In North America, the most common MCE sys- individuals with experience in the tactile recep-
tem is called Conceptually Accurate Signed English tion of signing can receive approximately 1.5 signs
(CASE), which combines Eng lish grammatical per second; this compares favorably with typical
order with ASL signs, invented signs, and finger- signing rates of 2.5 signs per second for visual
spelling. Another version of MCE is keyword reception of signs by individuals who can see
signing, in which spoken English is used simulta (Reed, Delhorne, Durlach, & Fischer, 1995).
Auditory Scanning selection choices (for example, “Does your head

hurt? Hand?” and so on); (c) operate a single switch
Auditory scanning, either with or without partner or produce a reliable v ocalization or gesture (for
support, can be appropriate for students with example, looking up to say yes or to make se
complex communication needs who understand lection); and (d) if constructing a sentence word
at least basic spoken language and have a severe by word, remember the selections previously made
visual impairment (Kovach & Kenyon, 2003). In (Kovach & Kenyon, 2003). However, if all of these
auditory scanning, choices for content selection skills are not in a student’s repertoire but he or she
are presented using a verbal auditory cue that understands at least basic spoken language, audi-
usually consists of a word, phrase, or sentence. tory scanning may still be v iable, at least in a sim-
For example, when Eli’s teacher notices that he is plified form.
distressed, she uses partner- assisted auditory Almost no research has been done to exam-
scanning to find out what is wrong. First, she asks ine the effectiveness of auditory scanning or the
content category questions such as, “Are you in best way to design AAC systems that employ it.
pain? Do you want to change position? Do you Similarly, aside from clinical reports (for e xample,
want something to eat? To drink?” and so forth, Burkhart & Porter, 2006; Kovach & K enyon, 2003;
u ntil Eli looks up to say yes to a question. She Porter & Burkhart, 2004), little information is
then asks more specific questions on the topic he available about how to teach auditory scanning
selected; for example, if he indicates that he is in skills to individuals who have no more v iable
pain, she asks, “Does your head hurt? Hand? Arm? AAC option. Research in this area is greatly
Foot? Leg? Back?” and so forth, u ntil he looks needed.
up again to make a selection.
Alternatively, the verbal auditory cues can be
delivered via a computer, with the person receiv-
Graphic Symbols
ing the cues activating a microswitch in whatever Unlike most individuals with complex commu-
manner they are capable of to make a selection nication needs who are blind or visually impaired,
after the desired category or selection is announced students with low vision or CVI are sometimes
(Porter & Burkhart, 2004). In the example just able to use visual symbols that represent mes-
given, the computer would replace the teacher’s sages, if the symbols are adapted and presented
questions, and microswitch activation would re- appropriately. Of course, low vision and CVI
place Eli’s looking-up gesture to say yes. occur across a continuum of characteristics that
Because auditory scanning is quite laborious, must be evaluated in each student, using an ap-
it is most applicable to blind or visually impaired propriate functional vision assessment tool (Lu-
students with complex communication needs eck, 2004; Lueck & Dutton, 2015; Roman-L antzy,
who also have significant motor impairments that 2007). A number of characteristics that affect a
prevent them from using their hands. It can also student’s ability to use visual media for com-
be used by individuals with intact vision, although munication are likely to be present to various
more efficient options are often available to them. degrees. T hese include difficulty with near, inter-
In order to use auditory scanning, a student needs mediate, or distance viewing; visual field differ-
to be able to (a) comprehend content category ences; and difficulties with visual complexity and
cues that represent the message (for instance, in visual novelty (Burkhart & Costello, 2008; Bur-
the previous example, the questions such as “Are khart & Porter, 2012; Dupuis, 1996; Lueck & Dut-
you in pain?”); (b) comprehend spoken words as ton, 2015; Roman-L antzy, 2007). Each of these
characteristics and strategies for accommodating visual field and then move it toward the central
them will be discussed briefly in the sections that field slowly. The instructor should make sure
follow. that the background of the student’s view does
not include complex patterns or objects that
distract the student’s attention or create poor
Difficulty with Near, Intermediate,
contrast. Close observation w ill be required to
and Distance Viewing
determine the best present at ion technique to
Many students with low vision experience re- use with individual students with CVI.
duced visual acuity for near, intermediate, or dis- Students with either low vision or CVI may
tant viewing. Because of this, they are unable to also benefit from a technique called auditory-visual
retrieve visual information at a normal viewing scanning, whereby the communication partner
distance, even with corrective lenses. These stu- presents one line-drawing symbol at a time se-
dents may benefit from enlarged symbols in the quentially while verbalizing its meaning out
form of line drawings (for example, 4 × 4 inches) loud. For example, the partner might say, “I can
that accommodate their reduced acuity. It might see you want to tell me about something that
also be helpful to thicken (that is, darken) the happened at home. Is it about Mom? [show MOM
outline of each symbol, so that t here is an obvi- symbol] Dad? [show DAD symbol] Your dog? [show
ous contrast between the image and its back- DOG symbol],” and so forth u ntil the student
ground. In addition, moderate inner detail (not chooses a symbol with a “yes” response or a ges-
too much, not too little) is likely to aid recogni- ture. If a student does not have a conventional
tion of the symbol. Finally, if enlarged symbols “yes” response (for example, a head nod), the
are presented in an array, they should be pre- communication partner should be attentive to
sented a few at a time and spaced fairly close to- any movement or behavior that occurs after the
gether to make them easy for the student with present at ion of a symbol and might be shaped
low vision to scan, without need for extraneous into a consistent affirmative response. This tech-
head and trunk movement. nique enables the student to use graphic symbols
In contrast, students with CVI may be un- without placing an excessive cognitive burden on
able to process visual information b ecause of the compromised visual system.

damage to one or more parts of the brain that con-
tribute to vision. B
ecause of this, they may need
Visual Field Differences
to view symbols at close range to reduce the level
of complexity in the environment that they are Both students with low vision and those with
unable to process, but they may also have diffi- CVI may experience a variety of visual field dif-
culty coordinating their eyes for depth percep- ferences. For example, a student might rely pri-
tion. In addition, many students with CVI see marily on peripheral vision, or have blind spots
better when movement that captures their visual resulting in vision that is somewhat analogous to
attention is involved. To accommodate t hese char- looking through a piece of Swiss cheese. Further-
acteristics, graphic symbols can be offered one at more, the visual field deficit may e ither improve
a time at close range (and within the student’s or worsen over time, resulting in visual abilities
visual field) and then moved back to an appro- that are neither stable nor predictable. It is criti-
priate distance to enable the student to focus. Al- cal to observe students carefully in order to un-
ternatively, a communication partner can gently derstand how they position their heads and eyes
shake the symbol in the student’s peripheral to optimize vision, and to position their commu-
nication displays accordingly. For example, if a to block vision when listening intently. Insisting
student sees best when images or items are placed on eye contact or forward gazing during listening
on his left side, his communication symbols tasks is not appropriate when this is the case.
should be made available in that location as much Rather, students should be encouraged to use
as possible. their auditory strengths in situations that require
listening (for example, content lessons in a class-
room), and their vision skills should be devel-
Difficulty with Visual Complexity
oped during times when their full attention can
It is import ant to reduce the learning and pro be devoted to this type of task. (To watch
cessing demands imposed by graphic symbols a related video, log in to the AFB Learning
when they are used by students with low vision Center.)
or CVI. From a visual standpoint, graphic sym-
bols that are used to represent messages can range Difficulty with Visual Novelty
from very simple to quite complex. For example,
Students with low vision and CVI may be able to
photog raphs usually contain more information
use their vision best when images are presented
than line-drawing symbols and are more difficult
consistently with regard to location, sequence,
to process visually because of this. Even line-
and pattern. Thus, if a visual symbol array (that
drawing symbols may be difficult to process if
is, a layout of more than one symbol at a time) is
they are quite busy or detailed or consist of mul-
used, it is important to stabilize the placement of
tiple colors. Consider the difference between a
symbols in order to make it easier for the student
photog raph of a h ouse and a simple black-and-
to locate the one he or she needs. In addition, com-
white line drawing of a h ouse. The former is prob
munication symbols related to a specific topic
ably composed of more than one color, as well as
(for example, what the student did on the week-
many elements (house frame, door, windows, and
end, what he or she wants to eat) should always
so on) that must be visually integrated to be recog-
be presented in the same order or in the same
nized together as “house.” A line drawing, on the
configuration (for example, two rows of three sym-
other hand, might consist of a s imple, solid outline
bols each) to enhance predictability. The more

of a h ouse, with none of the details included. It is
familiar and predictable the communication dis-
often helpful to place such s imple line-drawing
play, the better the student w ill be able to use it
symbols on a black background and fill in the
for functional communication.
symbols with a single, bright color (for example,
yellow or red) to enhance figure-ground contrast
Research on the Use of
(Burkhart & Porter, 2012; Dupuis, 1996). In short,
Line-Drawing Symbols
simple line-d rawing symbols that are brightly
colored against a dark background are likely to As is the case with auditory scanning, very little re-
be most useful to students with low vision or search is available to guide the use of line-drawing
CVI. In addition, transparencies of line drawings symbols with students who have either low vision
displayed on a light box might provide appropri- or CVI. However, as noted in this section, practical
ate contrast and lighting for some students with advice is readily available from experienced clini-
CVI or low vision. cians who have worked with this population for
Many students with CVI have difficulty look- many years. In part icular, numerous assessment
ing and listening simultaneously. They may drop tools and other materials are available from the
their heads, avert their gaze, or roll their eyes up American Printing House for the Blind.
Speech-Generating Devices
SUMMARY
and Tablets
Despite the fact that AAC relies heavily on visual-
Speech- generating devices are digital devices
graphic media to represent messages, students
that, when activated, produce speech output. Al-
with complex communication needs who are also
though dedicated speech-generating devices have
blind or visually impaired have access to a range
been available commercially for many years, they
of options to support their communication and
have not been widely used by students with com-
language development. In this chapter, we have
plex communication needs and visual impair-
summarized the AAC techniques that are most
ments, largely because of limitations related to
widely used by experienced clinicians, some of
cost, lack of portability (most dedicated speech-
which have considerable empirical support as well.
generating devices are quite heavy and difficult
It is possible to provide at least a basic commu-
to carry around), and limited accessibility fea-
nication system to virtually e very child with
tures related to vision. However, the newest gen-
complex communication needs, through the
eration of speech- generating devices include
collaborative efforts of parents who are working
relatively low-cost and lightweight (that is, por-
alongside vision, speech-language, educational,
table) tablet devices such as the Apple iPad that
and physical or motor professionals. It is impor
allow a communication partner to set numerous
tant that all members of the team use the same
features that enhance accessibility. These include
communication approach across all environments
a variety of voices and voice rates (for example,
and contexts, as communication effectiveness for
male and female voices, slow and more rapid
students who rely on AAC is largely dependent on
speech), auditory and visual feedback, and page
the consistency of routines and responses by
display options such as white-on-black text con-
partners. Although more research is needed,
trast and enlarged pictures and fonts. In addition,
much prog ress has been made over the past de
editing settings such as auto text and the ability
cade in this area and is likely to continue in the
to store text and pictures are available on some
years to come.
tablets.
Many of the apps designed for these tablets

allow them to be used as dynamic display com- REFERENCES
munication devices that are similar to much
more expensive dedicated speech- generating Beukelman, D., & Mirenda, P. (2013). Augmentative and
devices. These apps allow a communication part- alternative communication: Supporting c hildren and
ner (for example, a teacher, therapist, or parent) to adults with complex communication needs (4th ed.).
customize a voice-output system that incorpo- Baltimore: Paul H. Brookes.
rates any of the symbol types described previ- Burkhart, L., & Costello, J. M. (2008). CVI and complex
communication needs: Characteristics and AAC strat-
ously (except for manual and tactile signs). The
egies. Workshop presented at 23rd annual Interna-
size and number of symbols appearing on the
tional Technology and Persons with Disabilities
screen can be adjusted to fit students’ functional Conference, California State University at North-
vision needs, as determined by a functional vision ridge. Retrieved from http://w ww.lindaburkhart
assessment. The widespread availability of tablets .com/lindaJohnCVIhandout.pdf
has meant that voice-output communication is Burkhart, L., & Porter, G. (2006). Partner-a ssisted
now readily available to students who are blind communication strategies for learners who face mul-
or have low vision or CVI. tiple challenges. Workshop presented at the bien-
nial conference of the International Society for from http://w ww.lindaburkhart.com/hand_design

Augmentative and Alternative Communication, _auditory_syst.pdf
Dusseldorf, Germany. Retrieved from http:// Reed, C., Delhorne, L., Durlach, N., & Fischer, S.
www.l indaburkhart.c om/I saac _i nstructional (1995). A study of the tactual reception of sign
_ 06.pdf language. Journal of Speech and Hearing Research,
Burkhart, L., & Porter, G. (2012). Combining visual and 38, 477–489.
auditory scanning for c hildren with CVI and complex Roche, L., Sigafoos, J., Lancioni, G., O’Reilly, M.,
communication needs. Workshop presented at the Green, V., Sutherland, D., & Edrisinha, C. (2014).
biennial conference of the International Society Tangible symbols as an AAC option for individu-
for Augmentative and Alternative Communica- als with developmental disabilities: A systematic
tion, Pittsburgh, PA. Retrieved from http://w ww review of intervention studies. Augmentative and
.l indabu rk ha r t.c om/h a ndout s/ V ision%20 Alternative Communication, 30, 28–39.
symbols%20handout.pdf Roman-L antzy, C. (2007). Cortical visual impairment:
Cress, C., & Marvin, C. (2003). Common questions An approach to assessment and intervention. New
about AAC in early intervention. Augmentative and York: AFB Press.
Alternative Communication, 19, 254–272. Rowland, C., & Schweigert, P. (1989). Tangible sym-
Dupuis, J. (1996, May). Modifying communication bols: Symbolic communication for individuals
symbols for persons with visual impairment. The with multisensory impairments. Augmentative and
ISAAC Bulletin, 44, 1–5. Alternative Communication, 5, 226–234.
Kovach, T., & Kenyon, P. B. (2003). Visual issues and Rowland, C., & Schweigert, P. (2000). Tangible symbol
access to AAC. In J. Light, D. Beukelman, & systems (2nd ed.). Portland: Oregon Health & Sci-
J. Reichle (Eds.), Communicative competence for indi- ence University.
viduals who use AAC (pp. 277–319). Baltimore: Sigafoos, J., Didden, R., Schlosser, R., Green, V.,
Paul H. Brookes. O’Reilly, M., & Lancioni, G. (2008). A review of
Lueck, A. H. (Ed.). (2004). Functional vision: A practi- intervention studies on teaching AAC to individ-
tioner’s guide to evaluation and intervention. New uals who are deaf and blind. Journal of Develop-
York: AFB Press. mental and Physical Disabilities, 20, 71–99.
Lueck, A. H., & Dutton, G. N. (Eds.). (2015). Vision and Trief, E. (2013). STACS: Standardized augmentative com-
the brain: Understanding cerebral visual impairment in munication symbols. Louisville, KY: American Print-
children. New York: AFB Press. ing House for the Blind.
Porter, G., & Burkhart, L. (2004). Designing light-tech Trief, E., Cascella, P., & Bruce, S. (2013). A field study
and high- tech dynamic auditory scanning systems. of standardized tangible symbol system for learn-
Workshop presented at the biennial conference of ers who are visually impaired and have multiple
the International Society for Augmentative and Al- disabilities. Journal of Visual Impairment & Blind-
ternative Communication, Natal, Brazil. Retrieved ness, 107, 180–191.
14
C H A P T E R
Consultation and Collaboration

Ya-Chih Chang, Cheryl Kamei-Hannan,
Kevin E. O’Connor, and Nancy Toelle
Teachers of students with visual impairments provide all c hildren. Regardless of the service delivery op-
support to students through a variety of service deliv- tion chosen as most appropriate for an individ-
ery options. Historically, these students were served ual child, it is important to carefully consider the
primarily in residential school settings, but with the in- student’s access to teachers with the qualifica-
creased emphasis on inclusion there has been a sig- tions necessary to meet the child’s unique needs.
nificant rise in the provision of service for students in For students with visual impairments, this should
general education classrooms, including, for some stu- be considered in the context of both the core
dents, the option of consultation provided by a teacher curriculum and the expanded core curriculum
of students with visual impairments. The use of con- (ECC).
sultation in education is becoming more and more Volume 2 of this textbook contains chapters
common, and the body of literature about this practice focusing on a teacher’s role in direct instruction
is growing in general education. The information in and support for academic subject areas and the
this chapter provides an overview for professionals in nine areas of the ECC. This chapter w ill examine
visual impairments about how consultation is being more broadly the models and frameworks of con-
defined and organized in the broader education consultation, including consulting in a comprehen-
text. —Eds. sive Individualized Education Program (IEP). In
a school setting, consultation generally refers to
INTRODUCT ON the practice in which a professional, such as spe-
cial education teacher or teacher of students with
Professionals and parents concerned with the visual impairments, serves as an expert and works
education of students with disabilities have em- collaboratively with educational team members
phasized individual choices regarding goals, ob- such as general education teachers, educational
jectives, and appropriate serv ice delivery settings specialists, IEP team members, family members,
since before the passage of the Education for All and caregivers. Consultation within a collabora-
Handicapped Children Act in 1975. While an ar- tive model may involve sharing information,
ray of serv ice delivery options for educating stu- coaching, demonstrating instructional strategies,
dents with disabilities continues to exist (see and designing instructional programs. Principles
Sidebar 14.1), today’s special education profes- of consulting, as well as the benefits and chal-
sionals tend to recognize inclusion as a value for lenges associated with consultation as a serv ice
386
S I D E B A R 1 4 . 1
Educational Service Delivery Options for Students with
Visual Impairments
An array of options for providing educational day in a special education class. In some cases,
services are available to students with visual the special education classroom teacher is a
impairments. Among the most common are teacher of students with visual impairments,
the following. in which case the teacher of students with visual
impairments is located at the students’ school
ITINERANT SERVICES
campus for most or all of the day. In other
Students who are served by an itinerant teacher
instances, when a child has additional disabili-
of students who are visually impaired usually
ties, the special education teacher may be a
attend their home school, or the school that is
specialist who works with students with mild to
closest to their home. The students who are
moderate or moderate to severe disabilities.
served by an itinerant teacher are most often
Students served in a non–visually impaired
mainstreamed or fully included in a general
resource room or special day class setting may
education classroom where they are taught by
receive services from an itinerant teacher of
a general education teacher for most or all of
students with visual impairments.
their day. The itinerant teacher travels to
students and may see the student periodically SPECIALIZED SCHOOL FOR STUDENTS
throughout the week. The level of service is WHO ARE BLIND OR VISUALLY IMPAIRED
determined by the Individualized Education Some students may attend a specialized school
Program team and may range from daily service for students who are blind or visually impaired.
to periodic consultative services. In most cases, the specialized school is not in
the students’ neighborhood, and in some cases
CONSULTATIVE SERVICES
students must travel g reat distances to attend
Consultative services are provided to students
the specialized school. For students who live
who do not require direct instruction from a
considerable distances from the school, many
teacher of students with visual impairments.
specialized schools offer residential programs.
Students who receive consultative services
This is an option for students who live in rural
have a visual impairment, but the visual
areas where teachers of students with visual
impairment does not affect their educational
impairments may not be able to travel and

performance. Thus, students who receive
provide the necessary time and frequency of
consultative services have minimal needs.
services that the student needs. Students in
Services may include providing adapted
this type of placement receive services from a
materials and consultation about how a visual
teacher of students with visual impairments
impairment may impact the student’s learn-
for most or all of their day. In some instances,
ing. Students should not receive consultative
the placement at a specialized school for
services if they require instruction by a
students who are blind may be short term, in
teacher of students with visual impairments.
which case the student attends the specialized
If instruction by a teacher of students with
school for a short period of time, such as a
visual impairments is needed, then other
month, semester term, or summer. Some
service delivery models should be explored.
specialized schools for the blind or visually
RESOURCE ROOM OR SPECIAL DAY impaired partner with neighboring school
CLASS SETTING districts and offer a program in which stu-
Students who are served in a resource room dents spend a portion of their day in main-
or special day class setting spend a part of their stream settings.
387
S I D E B A R 1 4 . 1 (Continued)
NONPUBLIC SCHOOL a teacher of students with visual

Some students may need an intensive program impairments may not be able to visit. If
that specializes in particular needs and may appropriate, t hese students may receive
thus attend a nonpublic school. For example, a services via an online distance-learning
student with significant behavior problems may platform, most often through the use of
need a placement at a school with specially video conferencing.
trained professionals with expertise in behavior.
HOME OR HOSPITAL MODEL
Students in these settings are most often
Some students may have medical conditions
served by itinerant teachers of students with
that require them to be educated at home
visual impairments.
or in a hospital. Itinerant teachers of the
DISTANCE-LEARNING MODEL visually impaired may provide services
In some instances, students may live in a home or hospital setting for t hese
and attend schools in rural settings where students.
delivery option for special education students, implement, and these w ill then be followed up
w ill also be presented. and modified as necessary. Typically, in working
with families of children with special needs,
there w
ill be elements of both consultation mod-
MODELS AND FRAMEWORKS els, but most professionals prefer the collabora-
FOR EFFECT VE CONSUL AT ON tive consultation model (Buysse et al., 1994). In
PRACT CES each situation the consultant w ill need to iden-
tify the appropriate consultation model to use,
Two different types of consultation models, the depending on the context and preferences of t hose
expert consultation model and the collaborative who are receiving consultation (Harris & Klein,
consultation model, are most often used when 2002).

working with families of c hildren with special While consulting with colleagues is a part of
needs (Buysse, Schulte, Pierce, & Terry, 1994). In all educational team relationships, pure consul-
the expert consultation model, the consultant plays tation models include only indirect serv ice de-
the role of a specialist who provides information livery where the consultants provide indirect
and demonstrates specific strategies to teachers, supports (via training of professionals and other
caregivers, specialists, or other team members. In team members), while t hose receiving consulta-
the collaborative consultation model, both the edu- tion w ill provide direct instruction and sup-
cational team member and the consult ant pro- ports to c hildren with special needs. The type
vide input about the child and work together to and level of indirect support can vary depend-
address the child’s challenges and needs. Addi- ing on the needs of educational team members,
tionally, the educational team members’ sugges- and it is essential that the consultant is able to
tions and recommendations w ill also be taken recognize the type of support that may be needed.
under full consideration for implementation in The supports may vary depending on the specific
the student’s educational program. The educational needs of the student, the context (for example,
team, including the consultant, will decide col- school or home), and the primary roles and re-
laboratively which of the recommendations to sponsibilities of the team member (for example,
Consultation and Collaboration 389
teacher, paraprofessional, related service provider, bers’ preferences, experience, and comfort level
or caregiver) (see Table 14.1). Good consulting during the consultation. Within a coaching ses-
often requires observation of and interaction sion, the consultant may
with the student, and it may involve frequent
visits and discussions with team members
1. model the intervention (highest level of
(Durkel, 2010). Furthermore, consulting is often
support),
used in conjunction with direct ser v ices (see
Sidebar 14.2). 2. provide concise verbal feedback and sugges-
Coaching is a type of support that is frequently tions to the educational team member while
used during collaborative consultation. There are he or she works with the child,
several levels of support within this model, the use 3. provide environmental support to the educa-
of which depends on the educational team mem- tional team member while that team member
T A B L E 1 4 . 1
Consultative Supports
Type of Support Example
Modeling Demonstrating an intervention (for example, use
of a token system) for consultee
Coaching With consultee’s permission, observing his or her
interaction with child and providing positive and
constructive feedback for teaching and engaging
children
Collaborating with specialists Making referrals to visual impairment specialist
for functional vision assessment
Problem solving Meeting with consultee to discuss child’s
challenging behaviors and developing a
behavioral plan
Sharing information Providing handouts and information about
similarities between c hildren with visual
impairments and autism spectrum disorder or
giving a short, 15-minute presentation on
targeting play skills in c hildren with an autism
spectrum disorder
Adapting learning environment or curriculum Providing developmentally appropriate ways for
children to access their materials and curriculum
(for example, use of visual support for c hildren to
make choices during activities)
Involving parents Providing information to parents about a child’s
progress and sharing strategies to be used at
home
Coordinating team meetings Setting up time with all team members (teachers,
paraprofessionals, specialists, administrators,
parents) to discuss child’s challenges and
problem solve
S I D E B A R 1 4 . 2
Direct Versus Consulting Service Delivery
When individuals hear the term consulting, tunities to practice skills with professionals
what frequently comes to mind is a hands-off who use consistent teaching strategies and
approach to delivering service and a limited instructional techniques. For example, a teacher
amount of time spent with a student. Some of students with visual impairments who is
individuals fear that consulting may mean that teaching a student to use a video magnifier to
the student is not visited by the consultant, read near and distance materials may demon-
and o thers may worry that the student will strate to a general education teacher how the
receive fewer services in general. However, technology is used, provide direct instruction to
consulting, when successful and effective, is the student on how to locate things within the
a method of providing robust services that camera’s field of vision, and then have the
involves frequent visits with the student and general education teacher reinforce use of the
the educational team that works with the device when the teacher of students with visual
student. Consulting should not replace direct impairments is not present.
services. Rather, a focus on the student’s Additionally, consultation involves active
needs and the best way to address t hose participation and follow-through on the part of
needs must be at the core of consultation those receiving consultation services. If they
services. Ultimately, consultation should be are not willing to carry out the services and
chosen as a service delivery model b ecause “it implement strategies consistent with what is
is the best way to meet a particular student’s being suggested, then direct services may be
IEP [Individualized Education Program] the best model for service delivery (Durkel,
objectives” (Durkel, 2010). Consultation 2010).
should never replace direct services, unless Lastly, regarding the fear that a student w ill
the IEP team determines that consultation is receive fewer services, “consulting is as time
appropriate, direct services are not necessary, consuming as direct service and is done to
and assessment data supports the decision to guarantee that a student is getting as many
provide only indirect services. opportunities to meet a particular IEP objec-
Furthermore, “direct service and consulting tive as possible. In this context, consulting is
are not mutually exclusive. Any time a student the means by which a student receives more,
is receiving direct service, some consulting not less, service” (Durkel, 2010). Effective
should . . . also be occurring so that the consultation requires that the consultant
student can have opportunities to generalize frequently observe the child and interact with
the use of skills” (Durkel, 2010). Consulting him or her. “A good consultant will know a
frequently occurs in conjunction with direct child as well as they would if providing direct
services and allows a student multiple oppor- service” (Durkel, 2010).
works with the child (for example, by selecting Within one coaching session, the consultant
developmentally appropriate toys), or may use all four levels of support, depending
4. observe the educational team member work on both the educational team member’s com-
with the child and allow time for him or her fort with the strategies and the child’s behav
to self-reflect before providing verbal feed- ior and response to implementation of the
back (lowest level of support). strategies.
Gravois, Groff, and Rosenfield (2008, as cited

in Gravois, 2012) proposed a framework to evalu- PR NC P
LES OF CONSU TING
ate how effective practices work for consultation N SPEC A EDUCAT ON
models. Within this framework, Gravois and col-
leagues identified three key features of consulta- Guiding princi ples of consulting in special
tion models: focus, function, and form. According education stem from the fields of consulting
to the model, the focus person, or the individual psyc hology and mental health. The American
receiving the impact of consultation, must be iden- Psyc hology Association (O’Roark, Lloyd, & Coo-
tified. Examples of focus p eople include teachers, per, 2005) has established a common framework
students, schools, parents, and members of a stu- and guidelines for effective consultation serv ices.
dent’s educational team. Next, the function, or the At the root of these guidelines are assumptions
established goal, must be defined. Examples of that pract it ione rs w ill be familiar with and use
function include modeling, coaching, sharing evidence-based practices, and continue to seek
knowledge, and collaborating to create an in- professional development to maintain up-to-date
structional program. Finally, the form, or the way knowledge in their respective fields. Also, pract i
in which consultation is to be delivered, must be tioners should use assessment data to develop
identified. Form refers to the manner in which a appropriate interventions. Highlights of the APA
consultant provides consultative services and may guidelines include:
include individual consultation, distance webi-
• Emphasis on prac t it ione rs’ “self-awareness &
nars or teleconferencing, collaborative teamwork,
self-management”
or group discussions. Although consultants may
work with several individuals on an educational • Importance of “relationship development”
team, Hylander (2012) emphasized that the f ocus • Application of “theory, case studies, [and] em-
should always be on improving student outcomes, pirical research,” including understanding
and often involves improving how a teacher de- evaluation methods
livers instruction.
• Need for multicultural and international aware-
Importantly, Gravois (2012) also emphasized
ness, including knowledge of sociopo liti

c al
the need for consultants to clearly define the con-
backgrounds and cultural values and patterns
sultative serv ices by identifying who the consul
tant is, the purpose of the consultation, who w ill • Use of “research methods and statistics”
be affected by the consultative serv ices, and who • Application of professional “ethics and stan-
w ill carry out the serv ices (for example, head dards”
teacher or specialist or both). Gravois (2012)
stated that the risk of not defining t hese terms is Additional themes consistently found in the liter
that the consultant “becomes all t hings to every ature on educational consulting include using a
one” (p. 85), which may detract from the main problem-solving approach to effectively determine
objectives and goals of the consultation serv ices. and implement educational programming, estab-
In practice, the consult ant and the educational lishing open and respectful communication, and
team members must clearly define roles, expec- keeping up to date with current literature on and
tations, and goals or purposes. Once identified, practices in education (Rosenfield & Humphrey,
open lines of communication and regular contact 2012). A closer examination of selected principles
between the consultant and educational team of consulting shows further pertinent informa-
member should be established. tion, as discussed in the following sections.
Relationship Development keen observations of the educational team mem-

ber’s strengths, followed by clear communica-
For effective consultation, professionals must build tion with the individual receiving consultative
and maintain relationships with all members of serv ices about their strengths, often builds mem-
the educational team. Professionals who typically orable moments, better rapport, and ultimately
provide direct instruction must make a shift from a more effective educational experience for the
being the individual who provides instruction to student.
being part of a collaborative, team- based ap- In addition, good consult ants listen actively.
proach in which several individuals may be re- They are ready to listen regardless of their level
sponsible for delivering instruction. The emphasis of knowledge about the situation or needs. They
of effective consultation is on team-centered service listen first and carefully consider the situation
delivery more than individual, direct instruction before providing any suggestions (Sakaduski,
(Rosenfield, 2013). This is especially important 2003). Consultants must be open to consider-
because in most consultative situations, the con ing a broad mix of ideas, even if those ideas
sultant is not providing direct serv ice. Therefore, seem to differ from those based on research,
building relationships with those who are pro- current theory, or experience. For example, re-
viding the instruction is essential for the success- search may provide guidance for best practices,
ful implementation of the consultant’s strategies. but some practices may need to be adapted for
(For more details on working in teams, see Vol- an individual and may not conform with tradi-
ume 2, Chapter 1.) tion or research (for example, a student who is
Erchul (2009) suggested that relationships home schooled due to medical fragility may
may be strengthened when the consultant focuses not be able to participate in traditional group
on the problems of the educational team mem- social skills activities, and a modified approach
ber within a shared context. He emphasized the using technology may need to be used). Being
value in maintaining a collaborative partner- respectful of ideas and differences of opinions
ship for determining effective solutions rather is crucial. Listening and discussing do not al-
than having the consultant establish a suggestive, ways equate to agreement. Rather, they demon-
advice-g iving role with the educational team strate a willingness to hear, understand, and
member. Erchul also stressed the need to respect discuss.
an educational team member’s decision to accept One strategy for effective communication is
or reject the proposed strategies. to summarize frequently, which demonstrates
active listening. Another important aspect of com-
munication is to maintain a well-paced conver-
Open and Respectful Communication sation. Conversations that are rushed may imply
Communication that is open and respectful is a sense of unimportance, and the individual
key to effective consultation. Respect is essen- receiving consultative serv ices may feel slightly
tial for building trust, and building trust is an disrespected. When time is a f actor, it may be nec-
important component of relationship develop- essary to reschedule conversations that would
ment. Effective consult ants build trust by being otherw ise be hurried. Another strategy for effec-
genuinely interested in the teacher, caregiver, tive communication is to share similar experiences
specialist, or other team member and the issues (though consultants must be careful to maintain
facing him or her. Additionally, when educational focus on the situation at hand). Doing so may pro-
members share feelings openly, trust is strength- vide a common ground and personal connections
ened when their confidence is maintained. Finally, to the teacher, caregiver, specialist, or other team
member. Sometimes being open and sharing quired. Educators often think of cultural re-
t hese experiences provides the individual re-
sponsiveness in the context of the students and
ceiving consultative serv ices with a safe envi- families that they serve. However, in a consulta-
ronment to also share openly. Finally, effective tive model, cultural responsiveness must extend
consultants are able to provide empathy. They to the larger community within which the student
enter into the world of t hose with whom lives and attends school. Educational con sul
they work. They understand their frustrations. tants are not a part of the day-to-day function-
They may feel the sadness and desperation of ing of the school, and their interactions on the
parents, and they recognize the challenges, con- school campus are often intermittent. Therefore,
fusion, and aspirations of the student. In some effective consultation requires that consultants
cases, parents may be so consumed by grief, lack have an understanding of the school commu-
of control, unclear diagnoses, and confusing nity within which they work, the individuals
laws that they may not be able to identify their who make up the community, and the c ulture
chief concerns or be able to articulate their aspi- within each school (Knotek, 2012). For example,
rations for their child. Good consultants are able if a consultant suggests that accommodations be
to listen and respond to their feelings while made to the building, such as applying tactile
gently probing for specific needs. In a case such symbols to the wall to denote key landmarks,
as this, a consultant may be able to provide re- the consultant should understand the broader
sources and a network of other parents who may school community and the implications of mak-
be experiencing similar feelings. ing such accommodations (for example, the
school could be a historic building with fragile
plaster walls). The consultant may need to dis-
Organizational Context cuss the suggested accommodations with other
Given the various settings and contexts that con members of the school community such as the
sultants may work in, consultants should under- principal, other teachers, custodians, and so on.
stand the organizational context and structure in
which the educational team members function to Child-Centered and
promote teamwork (Harris & Klein, 2002). De-

pending on the settings, teamwork may not be
Data-Driven Decisions
inherent to the organizational structure. For ex- Although consultative services are team centered,
ample, t here may be multiple specialists (special the needs of the individual student must be at the
education teacher, behavior specialist, speech forefront of serv ice delivery decisions. There may
language pathologist, and so on) who work with be several individuals who work with a student,
the same child and f amily in one context (for ex- and it is most effective if all participants have
ample, school), but each may be from a different common goals in mind for the student. The goal
program or agency and have differe nt agendas, of the consultant is to identify these common
treatment approaches, and goals for the child and goals and provide expertise that w ill enhance the
the f amily. It is part of the consultant’s responsi- serv ices delivered by team members and the ed-
bilities to communicate and coordinate with t hese ucational outcomes for the student (Rosenfield &
different serv ice providers for effective inclusive Humphrey, 2012). Ser v ice delivery decisions,
programming (Harris & Klein, 2002). For effec- especially related to consultation, should be re-
tive consultation, it is also important to consider visited regularly to determine if changes are
the institution or organizational culture of the necessary because of increased or decreased
school system where consultative serv ices are re- educational demand. These decisions should be
made collaboratively, and the use of a formal mitments of others is essential. Therefore, when
venue, such as an IEP meeting, may be necessary meeting with teachers, caregivers, specialists, or
to implement programmatic changes. When con- other team members, keeping the meeting on time
sidering serv ice delivery models, it is extremely and on task establishes a sense of respect for par-
important to base decisions on proper assessment ticipants’ time. Appropriate demeanor is another
results and evidence. Consultation support alone important aspect of professionalism. Politeness is
by a qualified teacher is rarely adequate for a stu- essential when communicating with teachers,
dent who needs specialized direct instruction. specialists, staff, and caregivers. Small measures
Proper assessment provides evidence of student of politeness such as writing follow-up notes, posi-
needs and informs decisions regarding service de- tive encouragements, and notes of appreciation
livery options. are gestures that help maintain communication
and a positive rapport. Although an effective con
sultant should have confidence, he or she should
Culturally Responsive Consultation not be overconfident, domineering, or authori-
Effective consult ants have fundamental knowl- tarian. Additional skills that consultants should
edge about how culture affects values, actions, and possess are the abilities to problem solve and re-
decisions. They are committed to learning about solve conflicts. When conflict arises, it is often the
diversity and are able to use a variety of instruc- result of a team member’s feeling of being disre-
tional strategies and assessments that respond spected, which can stem from any one of the fol-
to cultural differences (Knotek, 2012). Consul lowing perceptions (whether articulated verbally
tants may work in several schools, each of which or not) (see also Sidebar 14.3):
may have diverse student demographics with a
variety of languages spoken at home, ethnicities, • My right to decide is being weakened.
and cultures. Effective consultants are able to • My judgment and my ideas are not being
easily move between and within the diverse popu- considered.
lations with an open mind and an understanding
• My right to control is being jeopardized.
of differences. In particular, culture may influ-
ence how one perceives disability. Thus, caregiv- • My prestige and my status are being questioned.
ers, specialists, teachers, and students may receive • My feelings do not seem to count here.
knowledge and information through varying
• I feel unfairly treated, defeated, powerless,
lenses. For example, in a culture that encourages
or inferior.
independence, an individual may embrace the
use of a cane as a symbol of independence, but
in a culture that values looking a fter individuals
who are disabled, a cane may be a symbol of loss
BENEFITS AND CHA LENGES
or even an unnecessary tool for an individual. OF CONSULTATION
Benefits
Professionalism Consultation, when successful, has many positive
Successful consultation requires a high level of benefits. First, consultation provides a venue for
professionalism. S imple measures to demonstrate experts to share information. Sharing informa-
professionalism include being reliable and on tion may be as simple as providing resources,
time, maintaining appropriate etiquette, and explaining discipline- specific terminology or
dressing professionally. Respecting the time com- expertise, interpreting results from medical re-
S I D E B A R 1 4 . 3
Dealing with Conflicts and Disagreements in Consulting Situations
Even when everyone is d oing their best and • Develop an effective communication plan
trying their hardest to support students that takes advantage of current methods
through the use of a consulting model, conflicts (meeting in person, e-mailing, talking on
and disagreements can be expected as a part of the phone). Teams who communicate
the complexity of the task and the challenge of regularly and effectively may be able to
human interactions (Myatt, 2012). These resolve difficult situations before they
situations often have negative consequences become conflicts. Continue to monitor
(damaged professional relationships, avoid- the effectiveness of the plan by checking
ance, or increased emotional stress). However, with all members of the educational
if handled productively and skillfully, these team regarding their level of comfort
situations may also have surprising positive with how important information is
consequences, such as increased trust and communicated.
respect, unexpected problem solving, and
understanding of varied perspectives. Since Even with the best of intentions, however,
conflict and disagreement are inevitable, conflicts and disagreements w ill arise. Use the
educational teams would be wise to plan for following suggestions to work through con-
them ahead of time. Skilled consultants sulting conflicts:
anticipate conflicts and disagreements and
work to minimize negative impact. • Develop a plan for dealing with conflicts
The following suggestions may help and disagreements ahead of time. It may
educational teams avoid conflicts and disbe more comfortable to discuss possible
agreements that can have a negative impact conflicts prior to experiencing a difficult
on the consulting relationship: situation. Document agreed-on processes
for handling conflicts and revisit t hese
• Spend time getting to know each other and periodically to make sure that everyone
continues to believe the plan w ill be
the perspectives that each team member

brings to working with the student. Time effective.
invested in building a professional • Determine if the conflict is a short-term or
relationship among team members can pay long-term disagreement and find ways to
off in greater trust and understanding when address each appropriately. A short-term
conflicts arise. conflict may be solved through short-term
• Make sure that all members of the solutions (such as a period of intense
educational team and others in the school support or a vacation from stressful
understand the roles and responsibilities efforts). A long-term conflict, on the other
of all team members. This can be a hand, w ill likely require a more systemic
challenging task since roles and solution (for example, a change in
responsibilities of team members often curriculum or teaching method, or access
overlap and change to address shifts in the to professional development or
learning activities over time. Still, under professional training).
standing the broad definitions of how each • Try to take alternate perspectives when
team member contributes to a student’s approaching a situation. For example,
educational plan can be helpful. have each team member take the

395
perspective of another team member and difficult situation. At other times, it is not
role-play a discussion from the alternate enough to have an objective observer, and
point of view. The act of trying to it is necessary to have someone who can
understand another person’s argument mediate the situation.
can help defuse conflicting ideas and
emotions. Once the conflict or disagreement has been
addressed and the educational connection
• Schedule an extended period of time to between team members is healthy and
work through areas of conflict. It is unlikely working well, it will be important for all team
that significant conflicts and disagreements members to move forward professionally,
can be addressed in short time periods without carrying resentment, using the
available in the regular schedule. management of the conflict and disagreement
• Bring in a connected outsider. Sometimes as a learning opportunity to make the team
the presence of a third party can defuse a stronger.
ports or other educational assessments, or dismay be an invaluable tool, and it is sometimes
cussing a child’s abilities. Consultation fosters used to provide services to students in rural com-
collaboration and requires team members to ex- munities. These tools, when used appropriately,
amine multiple points of view (Wilber, 1992), provide an avenue for consultation, and they may
which often leads to consensus regarding the be helpful with distance service delivery, espe-
most appropriate teaching strategies and develop- cially in the case of rural students. However cau-
ment of an instructional program. Effective con- tion must be taken not to undercut students’
sultation cultivates positive communication and needs out of convenience, as discussed in the next
nurtures relationships. It also provides a model section.
for demonstrating to caregivers and t hose who
work with an individual the most how to carry

out strategies and techniques and coaching them
Challenges
in these practices. Consultation may be perceived Due to the multifaceted dimensions of consulta-
as a model for less serv ice from an expert, but tion, consultants need more than just knowledge
because effective consultation often involves fre- and expertise in special education to be effective.
quent visits by the consultant, observations, and Leadership, interpersonal communication, and
interactions with the student, in actuality, when teamwork skill sets are also necessary to be a great
successful, consultation is a way for the student consultant. These skill sets can be challenging and
to receive robust serv ices that allows caregivers, come with experience. Beginning teachers may
specialists, teachers, and other team members to find it challenging to have confidence when shar-
be consistent in how instruction takes place ing knowledge, making suggestions, or demon-
(Durkel, 2010). Lastly, consultation may be used strating instructional strategies. They may feel that
to provide highly specialized expertise from a their knowledge and skills are still developing.
distance. Technology allows team members to In the field of visual impairment and blindness,
easily share information including videos, docu- in particular, teachers of students with visual im-
ments, and resources. Video conferencing also pairments are perceived as experts in a highly
specialized field. Yet, students with visual impair- Another challenge regarding the use of con-
ments are very heterogeneous and have varying sultative models is the struggle to balance appro-
diagnoses, degrees of functional vision, ages of priate levels of direct and indirect serv ice, given
onset of vision loss, stability of vision, and addi- the demands of students’ needs, administrative
tional disabilities, as well as varying cognitive costs of serv ice delivery, and varying workload
abilities and diverse language and cultural back- requirements. When identifying an appropriate
grounds. It is challenging for many teachers of serv ice delivery model, direct serv ice should not
students with visual impairments to feel as though be replaced by consultation unless it is suitable to
they are experts in all that there is to know meet the needs of the student. Such decisions
about visual impairment and blindness. The should be made based on assessment data and a
most import ant t hing, however, is that a teacher team decision. It is important to comprehensively
has resources. Teachers should continue to seek examine the student’s needs as well as placement
professional development and know where to options before making a decision to provide con-
gather information and expand their knowledge sultative, indirect serv ices instead of direct ser
when needed. vices. Similarly, when appropriate, changes from
The roles and responsibilities of the consul a consultative serv ice delivery model to a model
tant vary by context and need, and communica- of more intensive serv ices may be needed to ad-
tion with the teacher, caregiver, specialist, or other dress a student’s changing needs. For example, a
team member is also variable, depending on his kindergarten student with 20/80 vision who was
or her preferences and personality. Even skilled receiving consultation serv ices, minor accommo-
consultants will still come across challenges that dations, and materials from a teacher of students
need to be thoughtfully communicated and ad- with visual impairments may have received indi-
dressed. One of t hese challenges is that different rect serv ices, but as the student’s academic needs
professionals may have differences in teaching change, more intense serv ices may be necessary
philosophies and curriculum for students with and a consultative model may no longer be ap-
special needs. Consultants may need to carefully propriate. Administratively, consultation may be
navigate how to respectfully disagree and still pro- perceived as a way to increase caseload sizes. How-
vide appropriate interventions. Also, some indi- ever, effective and successful consultation may in
viduals receiving consultative serv ices may have fact require more time for observations and fre-
negative attitudes and perceptions of the con quent discussions with several team members
sultant’s role. For example, a general education than direct serv ices would (Durkel, 2010). Simi-
teacher may feel pressured to differentiate instruc- larly, consultation may be favorable for serving
tion for the student who is visually impaired and students at a distance, particularly students living
harbor resentment for having to make accom- in rural communities. Distance technology re-
modations. The consultant may need to spend duces or eliminates travel time and costs. Teach-
additional time modeling, coaching, and co- ers of students with visual impairments or other
teaching with the general education teacher to educational specialists may feel pressured to pro-
effectively implement a recommended strategy. vide consultation as a way of mitigating a demand
Additionally, the family’s expectations of the for their services. However, if consultation is not
consultant may not be aligned with the goals and appropriate for a given student, then workload
purpose of the consultation, so discussing the demands should be revisited, and an appropriate
roles and expectations of consultation may help number of qualified staff should be appointed.
to identify and clearly define its goals. Teachers of students with visual impairments
may need to provide evidence documenting the Education for All Handicapped C hildren Act, Pub.
students’ needs for serv ices and present literature L. No. 94-142 (1975).
supporting a change in caseload size to their ad- Erchul, W. P. (2009). Gerald Caplan: A tribute to
ministrators to justify appropriate levels of ser the originator of mental heath consultation.
vice and manageable workloads. Journal of Psychology and Educational Consultation,
19, 95–105.
Gravois, T. A. (2012). Consultation ser v ices in
SUMMARY schools: A can of worms worth opening. Consult-
ing Psychology Journal: Practice and Research, 64(1),
Consultation is a common practice in educational 83–87.
serv ices for c hildren who have disabilities. Over- Gravois, T. A., Groff, S., & Rosenfield, S. A. (2008).
all, consultative practices should “enhance the Teams as value added consultation serv ices. In
academic and behavioral outcomes for students, T. Gutkin & C. R. Reynolds (Eds.), Handbook of
while supporting teachers, caregivers, specialists, school psychology (4th ed., pp. 808–820). New
or other team members to be more effective York: Wiley.
and proactive in their practice” (Rosenfield & Harris, K. C., & Klein, M. D. (2002). The consultant’s
Humphrey, 2012, p. 2). Several principles guide corner: Itinerant consultation in early childhood
effective collaboration, and g reat consultants have special education: Issues and challenges. Journal
of Educational and Psychological Consultation, 13(3),
additional skill sets and strategies in addition to
237–247.
their educational expertise. These skills and strate-
Hylander, I. (2012). Conceptual change through
gies include communication, collaboration, child- consultee- centered consultation: A theoretical
centered and culturally responsive teaching, and model. Consulting Psychology Journal: Practice and
professionalism. When successful, there are many Research, 64(1), 29–45.
benefits to consultation, including being able to Knotek, S. E. (2012). Utilizing culturally responsive
share expertise with educational team members; consultation to support innovation implementa-
coach and model instructional practices; promote tion in a rural school. Consulting Psychology Jour-
collaboration; and nurture relationships. Although nal: Practice and Research, 64(1), 46–62.
some challenges and barriers to effective consul- Myatt, M. (2012). 5 keys of dealing with workplace
tation exist, t hese challenges may be minimized conflict. Forbes. Retrieved from http://w ww.forbes
when consultants have strong skill sets and are .c om /s ites /m ikemyatt /2 012 /0 2 /2 2 /5 -k eys -t o
-dealing-w ith-workplace- conflict/
able to establish clear roles and expectations of
O’Roark, A. M., Lloyd, P. J., & Cooper, S. E. (2005).
team members. In general, successful consulta-
Guidelines for education and training at the
tion may be used as a model for delivering indi-
doctoral and postdoctoral level in consulting psy
rect services to students with disabilities. chology/organizational consulting psyc hology.
Prepared for the Society of Consulting Psyc hology
RE ERENCES (SCP) Division 13 of the American Psychological
Association, approved by APA Council of Repre
Buysse, V., Schulte, A. C., Pierce, P. P., & Terry, D. sent at ions, February 18–20, 2005.
(1994). Models and styles of consultation prefer- Rosenfield, S. A. (2013). Consultation in the schools—
ences for professionals in early intervention. Journal are we there yet? Consulting Psychology Journal:
of Early Intervention, 18(3), 302–310. Practice and Research, 65(4), 303–308.
Durkel, J. (2010). Related serv ices: Direct versus con- Rosenfield, S. A., & Humphrey, C. F. (2012). Consulting
sult. Austin: Texas School for the Blind and Visu- psyc hology in education: Challenge and change.
ally Impaired. Retrieved from http://w ww.t sbvi Consulting Psychology Journal: Practice and Research,
.edu/seehear/spring98/related.html 64(1), 1–7.
Sakaduski, N. D. (2003). What you always wanted techniques for educators. Paper presented at
to know about consultants . . . but w
ere afraid to the Midwest Symposium for Leadership in Be
ask. Proofs, 86(5), 44–45. havior Disorders, Kansas City, MO. Retrieved
Wilber, M. M. J. (1992). Three is a crowd? No from http://fi les.e ric.e d.gov/f ulltext/E D346661
way—T hree is a team! Collaborative consultation .pdf
15
C H A P T E R
The Changing Landscapes

of Rural Education
Linda Farr Darling
Educators who work with students in rural and re-

mote settings face a unique set of challenges. Profes- INTRODUCT ON
sionals in visual impairment, who often serve students
Students with visual impairments live in all
using an itinerant model, face additional complica-
types of communities: remote, rural, suburban,
tions in their attempts to provide high-quality ser
and urban. These students, along with students
vices to students in rural settings b ecause students
without disabilities, face a wide range of bene-
may be geog raphically spread out. This can lead stu-
fits and challenges in all environments. B ecause
dents to feel isolated, which should be addressed for
of the low-incidence nature of visual impair-
the sake of the student’s social and emotional well-
ment among c hildren, t here may be particu lar
being. Likewise, it is common for a rural area to only
issues that need to be understood in relation to
have access to one professional with expertise in
education of t hese c hildren in rural areas. This

working with students who are blind or visually im-
chapter includes general information about
paired. Almost every state and province has rural
rural education that w ill be useful when con-
and sometimes remote areas where provision of ade-
sidering information in other chapters of this
quate services is challenging. However, research and
textbook.
educational practice focusing on rural education
provides some insight about the benefits and difficul-
ties that may inform educators and decision makers THE NATURE OF RURAL
in visual impairment. When professionals in visual COMMUN TIES
impairment have an understanding of issues in rural
education, they may be better able to serve their stu- Rural communities across North America are as-
dents, solve problems that arise owing to the nature tonishingly diverse, representing hundreds of dif
of working in rural settings, and address the concerns ferent geographies, histories, cultural mixes, and
of administrators who oversee education and special economic bases. Whether t hese rural communi-
education. —Eds. ties are dependent on agriculture, resource ex-
traction, recreational tourism, or other means
for their residents’ livelihoods, they are struggling
400
The Changing Landscapes of Rural Education 401
to find v iable new footholds in a globalizing and S I D E B A R 1 5 . 1

urbanizing world. Even the definition of rural has
undergone changes in the 21st century as metro-
Why People Live in
politan centers spread out across the suburbs to the Rural Places
countryside, new telecommunications proliferate,
and giant agribusinesses replace most of the re- • Family ties
maining f amily farms. Rural landscapes are chang- • Inherited property or business
ing rapidly, and as they transform, the meaning of
• Established livelihood
the word rural changes, too (Budge, 2006).
For researchers, the word rural can be as much
• The sense of community
about a “state of mind” (Bonner, 1997; Clarke, • Peace and quiet, an escape from
Imrich, Surgenor, & Wells, 2003) as a geog raphi city life
cal concept that contrasts with urban, or it can be • Access to outdoor pursuits
a statistical term referring to low population den- • Clean air and water
sity. Corbett (2013) claims that rurality is about • Scenic beauty
“connections and stewardship” (p. 2), and one
quip regarding what it means to be rural has
nearly legendary status among researchers: “If
there’s no smoke coming from my neighbor’s organic gardens—and home-based entrepreneur-
chimney, I go check on her.” (See Sidebar 15.1 for ial initiatives and outdoor pursuits, which have
common reasons for choosing to live in a rural attracted some young families “back to the land.”
community.) Residents of rural communities have Also, emerging communicative technologies and
often been regarded in positive ways: as resource- expanding transportation networks have closed
ful, resilient, and practical. At the same time, many of the access gaps for rural and remote
people who live rurally have also been viewed as communities, connecting them in close and im-
resistant to change, closed to progress, and suspi- mediate ways to the commerce and goods of the
cious of outsiders (Theobald & Wood, 2010). Edu- rest of the world as well as its educational oppor-
cation for students with visual impairments in tunities (Stevens, 2012; Wallin, 2009). However,
rural areas has been associated with challenges in remote pockets of both Canada and the United
such as lack of access to specially qualified teachers States, rural residents still find themselves living
(Jager, 1999). Rural life has often been defined by apart from the mainstream, isolated by steep
its deficits and its lacks: the lack of services, such as mountains, large bodies of water, harsh climates,
those provided by health care professionals or
or vast and difficult distances to travel to reach
shopping malls, or the lack of educational and eco- population centers. The isolation extends to com-
nomic opportunities for youths (Corbett, 2007; munication channels, too; in parts of the United
Howley & Howley, 2010). In the media, rural States and Canada, Internet access is limited and
people have been pictured as backward “bump- unreliable, and bandwidth too narrow to support
kins,” and their villages portrayed as quaint and video or other media (Rajabiun & Middleton,
frozen in time (Theobald & Wood, 2010). 2013). For individuals living in t hese places, “be-
The “deficit discourse” surrounding rural ing rural” is still a key signifier of identity.
life has lessened somewhat with the recent re- In many rural areas, students have fallen
surgence of interest in small-scale agricultural behind their urban and suburban counterparts in
enterprises—dairies, vineyards, orchards, and terms of formal academic success, high school
graduation rates, and enrollment in postsecondary ising ways these challenges are being addressed
institutions, leading to what educational research- within and across particular school communities.
ers refer to as a persistent rural-urban achievement
gap (Canadian Council on Learning, 2006). For
students with special needs, or students with
CHA ENGES FACED
physical or social differences that set them apart BY R RAL SCHOO S
from their peers, realizing their potential in a rural
Lack of Access
environment can be particularly hard (Varga-
Toth, 2006). Cases of youth depression and disen- Access is a concept that, like rural, is almost always
gagement are not uncommon in small, rural defined in relative terms, and can be interpreted
communities (Howley & Howley, 2010). Nor are in multiple ways. For statisticians interested in
cases of severe poverty unusual, and extreme fi- working with population maps, geographical access
nancial strain can often result in family and so- typically refers to the average or typical driving
cial disintegration that affects students’ abilities time between a person’s residence and a specific
to succeed in schools (Howley & Howley, 2010). resource such as a hospital, or the distance to
These conditions are sometimes much better hid- goods and serv ices a f amily needs in order to live
den from view in rural communities than their comfortably. Researchers may also refer to digi-
counterparts in urban or suburban areas (Nadel tal access and the digital divide between urban
& Sagawa, 2002). and rural populations. The g reat majority of
But the picture is complex. For every educa- people in Canada and the United States live
tional story of rural failure or limitation, t here is where there is ready access to health serv ices,
another story of resurgence and school success shopping, and cultural and educational institu-
(Jordan, Kostandini, & Mykerezi, 2012). Descrip- tions such as theaters and libraries. And most Ca-
tions of the disadvantages rural youths experience nadians and Americans take it for granted that
are countered by illustrations of the advantages they can easily and quickly connect to the Inter-
found in community nurturance and close con- net from home.
nections to the environment (Sobel, 2003). Re- When researchers think about access to edu-
cent studies in Canada and the United States cational opportunities, they consider the distance
suggest that small schools can be powerf ul places students need to travel to attend elementary and
for learning and can offer students an excellent secondary schools. They also consider whether
foundation for later academic success (Barley & students w ill be able to take courses they need for
Beesley, 2007; Corbett & Mulcahy, 2006; Darling- university admission (either in person or online)
Hammond, 2006). Careful investigation is needed and whether they will have chances to participate
to determine if researchers are asking the right in team sports, or learn to play a musical instru-
questions about rural schooling, much less find- ment and perform with others. Sometimes stu-
ing answers that w ill deepen understandings dents who do not live in a town but are located
about it. A close examination of existing rural nearby w ill be able to take advantage of these
schools is needed in order to illuminate the next t hings and more, but for students who live in re-
steps for refining rural policies and preparing ru- mote rural locations, gaining full access to edu-
ral teachers. For t hese reasons, this chapter pres cational opportunities, whether in schools or in
ents an overview of the rural education terrain extracurricular settings, can be a significant chal-
in the United States and Canada, beginning with lenge (Chance & Segura, 2009).
a look at challenges rural educators and students In order to provide a more nuanced picture
commonly face, followed by a glimpse into prom- of the relationship between urban, suburban,
and rural places and the access people have to halls, cultural hubs, and recreation centers, some-
various goods and serv ices, statisticians may re- times the only public building for miles around
fer to certain areas between the countryside and that can accommodate large groups. “Commu-
the city as metropolitan-influenced zones, or MIZs. nity connectedness to schools” is an unchanging
These are the small towns and villages located value in such areas, wrote one administrator on
within commuting range of the nearest metrop- a survey about qualities of rural schools (Mac-
olis. Usually a highway connects them. The goods Donald & Farr Darling, 2011).
and serv ices of the city are readily accessible to Because of the distance or difficulty of travel
MIZ residents. Families with automobiles w ill be to larger centers, rural schools are most often on
able to travel easily to a wide range of shopping op- their own when it comes to providing educa-
tions, medical facilities, cultural or sports events, tional, cultural, and recreational opportunities
and so on. T here is also a greater chance for reg- for students. Transporting students over long dis-
ular public transportation (trains and buses) to tances by school bus is an expensive proposition
reach and cross MIZs. Schools located in MIZs for rural districts. Lack of easy access to large
benefit from easy access, too. Itinerant special- museums, art galleries, libraries, science centers,
ists and therapists can travel between them, edu- sports arenas, performance halls, and other ur-
cational resources can be shared between regional ban assets has traditionally caused rural schools
learning centers, and students can be bussed to create their own kind of cultural capital (Prest,
without difficulty to sports team competitions 2013). Local festivals, fairs, sporting events, and
and field trips. concerts in the community augment schools’ ef-
By way of contrast, rural communities are so forts to offer extracurricular activities. In elemen-
far from urban areas that a daily commute be- tary school grades, these efforts typically enjoy
tween home and the city for a job is virtually im- more sustained success than in secondary schools.
possible, and a drive to the mall and back is Researchers believe that by the time rural youths
at least an all-day proposition, sometimes longer. reach adolescence, they are beginning to feel iso-
In rural communities, residents’ employment (if lated from the larger world and removed from
outside the home or off the farm) is usually lo- significant movements, events, and issues, both
cated nearby. Jobs are often based on resource ex- historic and contemporary (Theobald & Wood,
traction in the area, such as logging, mining, or 2010). Studies suggest that even by their early
fishing. Fluctuations in markets or supplies that teens, many rural students are already struggling
result, for example, in mill, mine, or fishery clo- with the deficit image of rurality they see reflected
sures will directly affect local school populations back to them by the rest of society (Howley &
because families may be forced to move to find Howley, 2010).
work (White et al., 2011). On the other hand, ru- Students with special needs are often ad-
ral schools, and particularly consolidated high versely affected by their rural location, even when
schools that draw students from a wide geo they have the emotional support of a small and
graphical area, may be important employers for nurturing community (Varga-Toth, 2006). Lack of
a small village or town. Even if they do not em- access to appropriate services and resources may
ploy more than a handful of local residents as cause these students to find it especially challeng-
teachers and principals, custodians, bus d rivers, ing to flourish intellectually, socially, or physically.
and secretaries, rural schools are almost always In her study of rural families raising c hildren
considered to be the heart of the community with disabilities or developmental d elays, Stewart
(Clarke et al., 2003; Wallin & Reimer, 2008). They (2012) found that parents far from metropolitan
serve as social gathering places, civic meeting areas experience frustration on several levels.
ecause of the low incidence of any one particular

B Preparing Teachers for Service
disability in a remote area, appropriate therapists in Rural Schools
and specialists who are experts on the c hildren’s
disabilities are hard to locate and access. Schools Teacher preparation programs rarely focus atten-
are challenged to provide adequate resources for tion on the unique characteristics and demands
students with special needs, sometimes sharing of rural teaching; more often than not, programs
itinerant specialists across large areas. Itinerant feature a generic approach to becoming a teacher
teachers of students with visual impairments that virtually ignores issues of place and context
may make fewer visits due to travel distances (Edmondson & Butler, 2010; Green & Reid, 2004).
and sometimes visits by teachers may need to be In Canada and the United States, relatively few
canceled because of travel challenges. Travel to the student teachers are supported to take part in
nearest city for exams and treatments for c hildren student teaching and practicum experiences in
may require lengthy hotel stays for families and rural sites, so they do not learn to appreciate the
sometimes require that parents miss work. Sup- strong links between rural schools and their
port groups are also hard to find. Families, even surrounding contexts (White & Reid, 2008).
if they benefit from a sympathetic community, Researchers point to disconnection between what
want to be connected to o thers who are in simi- teacher candidates learn and the rural realities
lar circumstances. This can be difficult if the they discover on the job (Gambhir et al., 2008).
nearest f amily raising a child with a similar con- Not only do new teachers need to contend with
dition or challenge is hours away. Online net- assignments they may be unprepared for (multi-
works have helped considerably in recent years, age classes that span four or five grades, for
connecting families with each other and with e xample), but t hose that come from urban envi-
health care and special education professionals ronments may also have to “overcome loneliness
who can offer much-needed counsel and advice. and culture shock” (MacDonald & Farr Darling,
2011). One surprise is the absence of anonymity
in a small community, a concept that rural educa-
Issues for Teachers and Teaching tion researchers commonly refer to as the fishbowl
Although some rural schools in North America phenomenon. New rural teachers quickly discover
are under threat of closure b ecause of declining that nearly everyone knows their daily business;
populations (Howley & Howley, 2006), in other often, it is an uncomfortable realization.
rural locations school boards struggle to find and Retention of high-quality teachers can also
keep appropriately qualified teachers, especially be difficult in isolated rural areas (Howley &
in disciplines such as languages, math, and phys- Howley, 2010; Wallin, 2009); as one rural princi-
ics, or in areas such as special education (Wallin, pal put it, “The more remote you are, the more
2009). To further complicate matters related to turnover” (MacDonald & Farr Darling, 2011).
preparing, recruiting, and retaining qualified Teachers offer a number of reasons for leaving ru-
staff, many rural educators are challenged, as are ral communities: few employment opportunities
their urban counterparts, by increasing cultural for spouses, unanticipated teaching assignments
and language diversity in their schools due to that do not match their specializations, lack
changing patterns of immigration (Schafft & of preparation time for lessons and homework,
Jackson, 2010). In Canada, in part icular, educa- and the absence of opportunities for relevant
tors are challenged to meet the needs of a grow- professional growth (Abel & Sewell, 1999; Ar-
ing number of aboriginal students (Gambhir, nold, Newman, Gaddy, & Dean, 2005). Recruit-
Broad, Evans, & Gaskell, 2008). ing and retaining school administrators is also a
challenge for rural districts, in part because prep- in today’s digital world is also delivered to rural
aration for educational leadership addresses the students through online means. But even in this
kinds of problems that arise mainly in urban and technologically sophisticated age, some educators
suburban contexts. Researchers (Arnold et al., point to the ongoing existence of a significant
2005) also explained that “digital gap between urban and rural settings”
(MacDonald & Farr Darling, 2011). Technologi-
rural administrators have to assume more re- cal support can be unevenly distributed across
sponsibilities in small districts (e.g., instructional geog raphically large districts, and rural teachers
leader, athletic director, bus driver) b ecause generally have fewer opportunities for profes-
t here are fewer administrators in the district. sional development training that is focused on
They also receive less compensation and have new technological applications (Canadian Coun-
greater visibility in their communities. In short, cil on Learning, 2006).
being a rural administrator is a difficult job that
fewer and fewer people are willing to take. (p. 18)
Policy Concerns
Rural education researchers have also exam- In recent years, conversations among rural edu-
ined the curriculum most students are exposed cational leaders reveal another common chal-
to in rural schools, noting how little of it reflects lenge: persistent stereotypes and myths about
their lives and interests. This seems to be a peren- rurality itself (Howley & Howley, 2010) magnify
nial concern. Nearly two decades ago, Theobald the difficulties encountered by teachers, princi-
(1997) argued that pedagogy itself had been sev- pals, and senior administrators when they at-
ered from the lived experiences of rural students. tempt to insert their perspectives into policy and
Twelve years later Corbett (2010) remarked that funding discussions where rural realities (such as
in rural localities, the community is rarely repre- unreliable Internet, winter travel risks, and lack
sented in teaching practices or in the learning ma- of specialists) are often misunderstood or simply
terials students use. “If we were to look at the ignored. Rural school superintendents can some-
school as a large text,” he wrote about the rural times feel invisible in state or provincial delib-
school where he taught, “it was fundamentally a erations that may ultimately decide the fate of
story about somewhere e lse” (p. 117). Critics also schools in their districts.
point out that current school offerings across Finally, rural educators live with an uneasy
North America do not develop the dispositions tension when they consider policies related to
and skills the next generation needs in order to curriculum choice, program options, or postsec-
care for an increasingly endangered planet (Gru- ondary transfers: schools are providing educa-
enewald, 2006; Sobel, 2003). In rural settings, tional experiences that may effectively broaden
where c hildren almost always enjoy close rela- students’ horizons but at the same time result in
tionships with the natural world, the lack of at- graduates who abandon (figuratively and literally)
tention to environmental education seems a lost the very communities that raised them (Hektner,
opportunity to engage students in the subjects 1995). This is an irony thoughtfully investigated
that may matter most to them. by Corbett (2007) in his landmark study of iden-
Of course, school curriculum is never limited tity and loss situated in coastal Nova Scotia. The
to content that is delivered explicitly through continual struggle, then, is to create school cur-
textbooks and classroom teachers, or even implic- riculum that w ill open up possibilities for t hese
itly through the messages rural c hildren receive students to engage constructively with the world
about who and what is important. Curriculum beyond their rural boundaries, but at the same
time find ways to underscore the value that can ral world are readily cultivated, and where the
be found in the rural experiences, resources, pace of life tends to be slower and less hectic
and perspectives they bring to the classroom. than in a city (Corbett, 2007). Sometimes rural
students flourish despite their geog raphic al cir-
cumstances; sometimes they thrive because of
POSSIB LIT ES FOR them (Corbett & Mulcahy, 2006). Researchers are
RURAL SCHOO S beginning to discover some reasons why. The
next section w
ill look at promising directions for
The previous section of this chapter attempts to rural teaching, followed by a brief glimpse into
present a full picture of the rural school story. the ways teacher preparation programs are re-
This section goes beyond the challenges and lim- sponding to rural challenges.
itations faced by rural educators and students to
explore strengths and potentials that exist within Teaching in Rural Schools
rural schools by describing examples of promis-
ing practices that have been presented in recent Teachers and principals who stay in rural schools
rural literature. often share with people in the surrounding com-
First, a caution should be raised. It is all too munities qualities of resourcefulness, adaptabil-
easy to preserve the extreme binaries that people ity, and resilience. Often, they have grown up in
have used to divide rural from urban, seeing the small communities themselves (Budge, 2006) and
one as antiquated and the other as modern, and are already familiar with the rhythms and priori-
viewing the residents of the former as backward ties of rural life. They know how to thrive as cre-
and t hose of the latter as progressive. The reality ative, curious educators who can provide rich
is that rural communities are not the isolated learning experiences for the students in their
places they might once have been, and schools classrooms and schools (Corbett, 2013; Edmond-
have been shaped and reshaped by forces within son & Butler, 2010). Even in the face of challenges
and outside their communities that represent outlined in this chapter, pockets of promising
nearly constant movement and change: immigra- practices are evident throughout the rural schools
tion, out-migration, digital connectivity, economic landscape of North America in the form of inno-
booms and busts, and more. As Corbett (2010) vative curriculum and pedagogy, engaging online
reminds us, “Globalization transforms, compli- learning, and effective school-community part-
cates and infuses necessarily local lives” (p. 130) nerships (Edmondson & Butler, 2010; Stevens,
in powerf ul ways. It is up to teachers, at least in 2012). Many teachers have discovered that there
part, to build bridges between the local and global are genuine benefits to teaching in small country
so students can cross easily and confidently be- schools and even the bigger consolidated second-
tween them. ary schools that are located far from city centers.
Some enduring aspects and qualities of rural- Some of the factors that are identified in the liter
ity still command our attention. Without overro- ature about rural teaching as contributing to the
manticizing rural living and its obvious hardships, success of rural schools include collaboration
t here are at the same time genuine benefits to be among teachers, participation in decision mak-
found, and these extend to students who are ing, and engagement with the community.
members of all kinds of rural school communi-
Teacher Collaboration
ties. T
here are many positive things to be said
about growing up in a place where every one Collaborative efforts among teachers may be eas-
knows you, where relationships with the natu ier to develop and sustain in small, rural ele-
mentary schools where multigrade teaching is the rienced university researcher,” writes Peterson.
general practice and cross-c urricular activities The research is conducted by teams of teachers
sometimes involve the w hole school. At the sec- who meet in their own or neighboring schools.
ondary level, teacher collaborations have been ef- Much of the support takes place through online
fective across subject areas, often made easier by meetings, effectively addressing the rural-urban
the possibilities in smaller schools for flexible gap in teachers’ access to experts and resources.
scheduling. The British Columbia Task Force on Rural Educa-
A recent case study (Chance & Segura, 2009) tion also found that the action research they saw
looked at one rural high school’s approach to teachers carrying out had the potential to build
school improvement. The study showed that the “expertise in instructional practices through
school realized significant improvement in interactive, systematic and collaborative means”
achievement over a three- year period in test (Clarke et al., 2003, p. 26).
scores, adequate yearly prog ress, and attendance A related form of professional collaboration
and graduation rates. The researchers identified can arise from online networks of rural teachers
various factors associated with the positive who communicate regularly to support each
changes, including modified leadership behav other’s work and respond to inquiries across school
iors, improved organizational structure, and the districts (see, for example, www.ruralteachers
particular characteristics of the school in relation .com). Sometimes digital networks are established
to its rural context. They concluded that a con- because of shared interests in trying out new ped-
certed effort to develop successful collaboration agogical approaches or constructing alternative
among staff led to improved student achieve- tools for assessment. Online literature circles have
ment. They identified three essential elements also been developed between schools within and
for successful collaboration: scheduled time for across districts so that teachers and students can
teachers to work together, structured sessions benefit from sharing multiple perspectives on
devoted to cooperatively improving instruction, their common readings. In other instances, rural
and a focus on student-centered planning and ac- teachers find that connecting classrooms of stu-
countability in collaboration with families. Rela- dents on a systematic basis allows teachers to ex-
tionship factors associated with the surrounding change subject-area resources and expertise, and
communities were also identified as important to offers students rich opportunities to share their
the collaborative process. W hether the findings ideas and present their work and assignments to a
could be used to develop a template for rural new and like-minded audience.
school improvement more generally remains to
be seen, but case studies such as this one suggest
Local Decision Making and Meaning Making
that collaboration within rural schools can ben-
efit everyone involved. A special sort of administrative freedom ex-
One kind of collaboration that is presented as ists when one is not so obviously tied to the
a potential strength for rural schools is collabora- bureaucratic structures of large urban and sub-
tive action research (Peterson, 2012). Given the urban school districts. “We can turn on a dime,”
geog raphical barriers to providing traditional wrote a rural school principal who believes in-
kinds of professional development, some rural novation is more easily cultivated in small set-
school districts are using teacher-directed action tings outside metropolitan areas (MacDonald &
research as an alternative. “Collaborative action Farr Darling, 2011). Rural teachers also report
research draws on the professional expertise of experiencing more autonomy in developing the
teams of teachers who are mentored by an expe- curriculum and determining how it is delivered
than teachers in other jurisdictions (Budge, 2006). duction for a coastal village, helped to revitalize
Some school boards and district administrators in a small port to encourage more tourism, restored
North America are actively encouraging the devel- stream and lake habitats for local wildlife, and
opment of locally sourced, place-conscious curric- contributed to local reconciliation efforts involv-
ulum (Corbett, 2013; Edmondson & Butler, 2010; ing aboriginal or immigrant communities that
Farr Darling, 2014). Often this involves the study have suffered at the hands of proponents of past
of area histories and cultures, or projects based on policies and practices (Farr Darling, Dooley, &
habitat exploration or mapping regional architec- Taylor, 2012). Students with visual impairments
ture. Investigation of local assets and resources has would learn a g reat deal from their inclusion in
rewards for both teachers and students, who are such educational opportunities. Much of this
usually excited to discover that the particular char- learning would connect directly to areas of both
acteristics of their own environment and social the core and the expanded core curricula.
context, as familiar as they may be, are worth for- These efforts to reconsider relationships with
mal recognition and study (Theobald, 1997). the land and its inhabitants are often fully sup-
Learning how to identify, describe, and ana- ported by administrators who believe in the value
lyze the unique qualities of one community is of autonomy and self- determination when it
also a transferable skill for students to cultivate. comes to teaching and learning, especially learn-
As Budge (2006) remarks, “Students who develop ing that has deep local meaning. Corbett (2013)
a critical sense of place wherever they live w ill would identify these locally responsive and cre-
know how to live better anywhere they live” ative efforts to go outside the standardized texts
(p. 9). They w ill begin to understand the deeper and teaching materials as examples of “curricular
layers of a community’s past and present, includ- improvisation,” an approach to teaching he be-
ing the tensions and conflicts that are part of any lieves has great potential for rural schools. In each
social space over time. This critical sense of one’s of these initiatives, students and teachers have
place (or place consciousness) often emerges from actively engaged in decision making at the local
students’ attempts to grapple with an aut hent ic level, beginning with making classroom decisions
political, social, economic, or environmental is- about potential inquiries and activities, and ex-
sue that has local significance, perhaps even im- panding their sphere of participation to encom-
plications for their own f utures. When Corbett pass many subject areas as well as local resources
(2010) taught school in Digby Neck, Nova Sco- and people. Resulting projects, often generating
tia, students invited a local fisherman to tell the video documentaries, photography exhibits, vol-
history of fishing in the community: “So, into the unteer efforts, or position papers that are presented
space of my classroom with its language arts, to the public, have led students and teachers to
math, science, social studies, m usic, physical ed- realize the potential of their own actions to effect
ucation, and health time slots and curriculum civic change, an empowering learning experience.
outcome expectations, this visitor from life intro-
duced a problem” (p. 127). For many, it was “the
Community Engagement
problem facing the community.” And students
wanted to do something about it. In rural areas, community engagement takes
Faced with similar “real-life” problems in many forms beyond the critical examination of
British Columbia, Canada, students first re- local pasts, experiential exploration of regional
searched then engineered alternative energy geography, or analysis of waves of economic de-
sources for an island community off the grid, velopment and decline. There are dozens of illus-
constructed solar greenhouses to aid in food pro- trations of schools that have responded creatively
and successfully to part icular community prob generations, a kindergarten in a rural community
lems, interests, and needs, drawing on a wide in southeastern British Columbia has relocated to
range of community participants for consulta- the center of a local senior residence. Seniors act as
tion, work partnerships, apprenticeships, and volunteer tutors and partners in activities, greatly
more (Edmondson & Butler, 2010). Sometimes increasing the one-on-one attention available to
community engagement involves creating recip- the young students, and also improving kinder-
rocal learning opportunities that cross genera- gartners’ communicative and cognitive skills. Early
tions of residents. Rural schools rely on local studies suggest that the intergenerational learning
experts to extend and deepen students’ learning that has resulted from both structured and infor-
throughout the curriculum; to bring authenticity mal daily encounters has been beneficial for both
to local social studies investigations, for example, groups socially, emotionally, and physically, as
or to lend an experienced and knowledgeable well as intellectually (see Rural Teachers, n.d.a).
hand to projects in design or carpentry. But such
engagement can also lead to productive ex- Learning to Teach
changes between disparate groups that may not
otherw ise interact, or interact in positive ways. here is also evidence in some teacher prepara-
T
One high school on a small island off the tion programs that the unique characteristics of
coast of British Columbia constructed a rich and rural schools and communities are beginning to
extensive archive of 400 individuals in the com- be more widely appreciated by teacher educators
munity who are willing to share their talents, (Butera & Costello, 2010). Edmondson and But-
experience, and stories with w hole classes or indi- ler (2010) believe that society now has the oppor-
vidual student partners (Rural Teachers, n.d.b). tunity to reconceptualize what it means to be a
Coordinators sift through the database to match rural teacher and bring that vision to new designs
community members’ experiences and expertise for preparation programs. In part icular, the two
with students’ needs and interests. Called Con- authors are committed to the idea that rural
necting Generations, the program initially made it teachers must be deeply engaged in the civic
possible for older adults to work with youths on sphere and take active roles in the democ ratic
everything from career preparation to biology processes that shape the public good in rural
projects and the restoration of antique cars. As it communities. They write,
evolved, the program responded to the students’
desires to “give something back” to the many To prepare teachers for such engagement, rural
adults who donated their time and talents, and to teacher education programs could foster op-
reciprocate with teaching of their own. Classes and portunities for preserv ice teachers to partici-
tutorials led by the students for seniors and others pate in the public sphere. This would involve
now range from using social media to working deepening understandings of the various po
with digital photography, designing web pages, litical, social and economic pressures that in-
and working effectively with audio equipment. fluence the discourses of p eople participating
Rural residents of all ages interact with each in these spaces in particular communities. It
other on a daily basis b
ecause of the small popula- would also require deepening understandings
tion and intimate community context. Yet interac- of the role and purposes of education in rural
tions between older adults and youths are not communities. (p. 168)
always positive and respectful. Therefore, in an ini-
tiative aimed explicitly at building empathy, un- Courses in place-based education and place-
derstanding, and social responsibility across consciousness learning for aspiring teachers are
being developed in Australia as well as in North on constructive possibilities for the f uture of ru-
American contexts (Farr Darling, 2014; White & ral schooling. Rural educators, like all educators,
Reid, 2008). Other promising signs in rural teacher share the responsibility to help prepare students
preparation are the inclusion of creative approaches to live well in the world. As Schafft (2010) writes,
to multiage instruction and differentiated assess- “In the end the issue is not which community
ment in curriculum and methodology courses. education prepares students for, but rather that
Finally, more accounts of efforts to rethink education is able to equip p eople to live in com-
the practicum experience for teacher candidates munity, regardless of where that community might
(White, 2003) are emerging in the academic and be” (p. 286). The essential lesson is this: all our
professional literature on teacher education. The c hildren and youths deserve and need full access
traditional model narrows the focus to the rela- to the educational opportunities that w ill help
tion between teacher, student teacher, and stu- them flourish as individuals and members of
dents in one classroom, instead of recognizing societ ies, wherever they happen to live.
the complex social realities of teaching and par-
ticipating in larger contexts.
Teacher educators from Pennsylvania to RE ERENCES
Washington State to Nova Scotia are responding
Abel, M. H., & Sewell, J. (1999). Stress and burnout in
to the problem of “metro-centric” teacher prepa-
rural and urban secondary school teachers. Jour-
ration with calls for more opportunities for teacher
nal of Educational Research, 92(5), 287–293.
candidates to experience teaching in classrooms Arnold, M. L., Newman, J. H., Gaddy, B. B., & Dean, C. B.
that are outside urban and suburban areas and (2005). A look at the condition of rural education re-
located instead in a variety of rural and remote search: Setting a difference for future research. Jour-
settings (Edmondson & Butler, 2010). nal of Research in Rural Education, 20(6), 1–25.
Barley, Z. A., & Beesley, A. D. (2007). Rural school suc-
cess: What can we learn? Journal of Research in Ru-
SUMMARY ral Education, 22(1), 1–16.
Bonner, K. (1997). A great place to raise kids: Interpreta-
This chapter has introduced some of the chal- tion, science, and the rural-urban debate. Montreal,
lenges rural educators and schools face in both QC: McGill-Queen’s University Press.
Canada and the United States, including chal- Budge, K. (2006). Rural leaders, rural places: Prob
lenges related to teacher preparation; the profes- lems, privilege and possibility. Journal of Research
sional lives of teachers in small, rural schools; in Rural Education, 21(13), 1–10.
and the fluctuating circumstances of surrounding Butera, G., & Costello, L. H. (2010). Growing up rural
communities. The chapter has also presented cre- and moving toward family- school partnerships:
ative initiatives that are helping to enhance edu- Special educators reflect on biography and place.
In K. A. Schafft & A. Y. Jackson (Eds.), Rural educa-
cational experiences for rural c hildren and youths
tion for the twenty-first century: Identity, place, and
and support the preparation and professional
community in a globalizing world (pp. 253–274). Uni-
growth of their teachers.
versity Park: Pennsylvania State University Press.
The landscapes of rural education are con- Canadian Council on Learning. (2006). The rural-
stantly in flux in the global age, transformed and urban gap in education. Retrieved from http://en
complicated by economic, political, and social .copian.c a/library/research/ccl/r ural_u rban_ gap
forces that are sometimes in the background and _ed/r ural_urban_gap_ed.pdf
difficult to see. However, it is important to keep Chance, P. L., & Segura, S. N. (2009). A rural high
shining a light on current rural conditions and school’s collaborative approach to school im-
provement. Journal of Research in Rural Education, das, challenging f utures, chasing chimeras? Asia-
24(5), 1–12. Pacific Journal of Teacher Education, 32(3), 255–273.
Clarke, H., Imrich, J., Surgenor, E., & Wells, N. (2003). Gruenewald, D. (2006, August 2). Resistance, reinhab-
Enhancing rural learning: Report on the task force on ru- itation, and regime change. Journal of Research in
ral education. Victoria, BC: Ministry of Education. Rural Education, 21(9), 1–7.
Retrieved from http://w ww.llbc.leg.bc.ca/public Hektner, J. M. (1995). When moving up means mov-
/pubdocs/bcdocs/361321/r ural_task _rep.pdf ing out: Rural adolescent conflict in the transition
Corbett, M. (2007). Learning to leave: The irony of to adulthood. Journal of Research in Rural Education,
schooling in a coastal community. Blackpoint, NS: 11(1), 3–14.
Fernwood. Howley, A., & Howley, C. B. (2006). Small schools and
Corbett, M. (2010). Wharf talk, home talk and school the pressure to consolidate. Educational Policy
talk: The politics of language in a coastal commu- Archives, 14(10), 1–31.
nity. In K. A. Schafft & A. Y. Jackson (Eds.), Rural ed- Howley, C. B., & Howley, A. (2010). Poverty and school
ucation for the twenty-first century: Identity, place, and achievement in rural communities: A social-c lass
community in a globalizing world (pp. 115–131). Uni- interpretation. In K. A. Schafft & A. Y. Jackson
versity Park: Pennsylvania State University Press. (Eds.), Rural education for the twenty-first c entury:
Corbett, M. (2013). Improvisation as a curricular Identity, place, and community in a globalizing world
metaphor: Imagining education for a rural cre- (pp. 34–50). University Park: Pennsylvania State
ative class. Journal of Research in Rural Education, University Press.
28(10), 1–11. Jager, B. K. (1999). Educational services for students with
Corbett, M., & Mulcahy, D. (2006). Education on a visual impairment in rural communities: Myths and
human scale: Small rural schools in a modern context realities. Proceedings from ACRES: Rural Special
(Research Report 61). Wolfville, NS: Acadia Cen- Education for the New Millennium, Morgan-
tre for Rural Education. town, WV.
Darling-Hammond, L. (2006). The features of effective Jordan, J. L., Kostandini, G., & Mykerezi, E. (2012).
design. Stanford, CA: Stanford University, School Rural and urban high school dropout rates: Are
Redesign Network. they different? Journal of Research in Rural Educa-
Edmondson, J., & Butler, T. (2010). Teaching school in tion, 27(12), 1–21.
rural America: Toward an educated hope. In K. A. MacDonald, T., & Farr Darling, L. (2011, June). Rural
Schafft & A. Y. Jackson (Eds.), Rural education for school landscapes: Lessons for teacher education from
the twenty-first c entury: Identity, place, and commu- rural administrators. Paper presented at the CSSE
nity in a globalizing world (pp. 150–174). University Annual Meeting, Fredericton, NB.
Park: Pennsylvania State University Press. Nadel, W., & Sagawa, S. (2002). America’s forgotten
Farr Darling, L. (2014). Research and remembrance in children: Child poverty in rural America. Washing-
rural communities: A step toward ethical learning. ton, DC: Save the C hildren.
In S. White & M. Corbett (Eds.), Doing education Peterson, S. S. (2012). Action research supporting
research in rural communities (pp. 151–165). Lon- students’ oral language in northern Canadian
don: Routledge. schools: A professional development initiative.
Farr Darling, L., Dooley, P., & Taylor, T. (2012). Grow- Journal of Research in Rural Education, 27(10), 1–16.
ing innovation in rural sites of learning: Develop- Prest, A. (2013). The importance of context, reflection,
ment. Adminfo: Journal of the BCSSA, 25(2), 12–13. interaction, and consequence in rural music edu-
Gambhir, M., Broad, K., Evans, M., & Gaskell, J. (2008). cation practice. Journal of Research in Rural Educa-
Characterizing initial teacher education in Canada: tion, 28(14), 1–13.
Themes and issues. Toronto, ON: International Al- Rajabiun, R., & Middleton, C. (2013). Rural broadband
liance of Learning Education Institutes. development in Canada’s provinces: An overview
Green, B., & Reid, J.-A . (2004). Teacher education for of policy approaches. Journal of Rural and Commu-
rural and regional sustainability: Changing agen- nity Development, 8(2), 7–22.
Rural Teachers. (n.d.a). Growing innovation projects. Theobald, P., & Wood, K. (2010). Learning to be rural:
Retrieved from http://w ww.r uralteachers.com Identity lessons from history, schooling, and the
/g rowing-innovation-2011 U.S. corporate media. In K. A. Schafft & A. Y. Jack-
Rural Teachers. (n.d.b). Rural teachers video gallery. son (Eds.), Rural education for the twenty-first c entury:
Retrieved from http://w ww.r uralteachers.com Identity, place, and community in a globalizing world
/gallery/gi-images/vid (pp. 17–33). University Park: Pennsylvania State
Schafft, K. A. (2010). Conclusion: Economics, commu- University Press.
nity, and rural education: Rethinking the nature Varga-Toth, J. (2006). Meeting the needs of children and
of accountability in the twenty-first century. In adolescents with special needs in rural and northern
K. A. Schafft & A. Y. Jackson (Eds.), Rural education Canada: Summary report of a roundtable for Canadian
for the twenty-first century: Identity, place and com- policy-makers. Ottawa, ON: Canadian Policy Re-
munity in a globalizing world (pp. 275–286). Univer- search Networks. Retrieved from http:// w ww
sity Park: Pennsylvania State University Press. .c prn.org/doc.c fm?doc=1390&l= en
Schafft, K. A., & Jackson, A. Y. (2010). Introduction: Wallin, D. C. (with Anderson, H., & Penner, C.) (2009).
Rural education and community in the twenty- Rural education: A review of provincial and territorial
first century. In K. A. Schafft & A. Y. Jackson (Eds.), initiatives, 2009. Winnipeg: Manitoba Education,
Rural education for the twenty-first c entury: Identity, Citizenship and Youth. Retrieved from http://w ww
place, and community in a globalizing world (pp. 1–11). .edu.gov.mb.c a/k12/docs/reports/r ural _ed/r ural
University Park: Pennsylvania State University _ed_final.pdf
Press. Wallin, D. C., & Reimer, L. (2008). Educational priori-
Sobel, D. (2003). Place-based education. Great Barrington, ties and capacity: A rural perspective. Canadian
MA: Orion Society and the Myrian Institute. Journal of Education, 31(3), 548–613.
Stevens, K. (2012). The integration of actual and vir- White, S. (2003). Learning in a field-based teacher edu-
tual learning spaces in rural schools. International cation program: Stories from the field. Sydney, Aus-
Journal on New Computer Architectures and Their tralia: University of Technology.
Applications, 2(1), 91–102. Retrieved from http:// White, S., Lock, G., Hastings, W., Cooper, M., Reid, J., &
sdiwc.n et /d igital-l ibrar y/d ownload.p hp?i d Green, B. (2011). Investing in sustainable and resil-
=0 0000146.pdf ient rural social space: Lessons for teacher educa-
Stewart, M. (2012). Experiences of families in rural areas tion. Education in Rural Australia, 21(1), 67–78.
raising children with disabilities or developmental de- Retrieved from http://ro.ecu.edu.au/cgi/viewcon

lays (Unpublished master’s thesis). University of tent.cgi?article=1338&context=ecuworks2011
British Columbia, Vancouver. White, S., & Reid, J. (2008). Placing teachers? Sustain-
Theobald, P. (1997). Teaching the commons: Place, pride ing rural schooling through place consciousness
and the renewal of community. Boulder, CO: West- in teacher education. Journal of Research in Rural
view Press. Education, 23(7), 1–11.
16
C H A P T E R
Tiered Models of Behavioral

and Instructional Support
Kathleen Lynne Lane, Wendy Peia Oakes,
and Caryn E. Butler
Tiered systems of support models of education are rel-

atively new and their application holds challenges for INTRODUCT ON
students with visual impairments and their teachers.
It is therefore important that professionals who work Few individuals would argue that teaching K–12
with students who are blind or visually impaired un- students is an incredibly complex task. The com-
derstand t hese models and communicate how the mod- plexity is compounded by recent trends such as
els do and do not fit with service delivery decisions for the move t oward common core standards (Com-
students with visual impairments. mon Core State Standards Initiative, n.d.) across
Students who are blind or visually impaired are the continuum, the push for academic excellence
not and should not be isolated from the other practices for all students, efforts to dismantle antisocial
in their schools. This means that even itinerant vision networks among students, and requirements for
professionals who are not based at a single school are inclusive programming for students with excep-
responsible for understanding and participating in the tionalities (Council of Chief State School Offi-
practices of the school as a whole. Many schools imple- cers & National Governors Association Center for
ment tiered models such as positive behavior support Best Practices, 2011; Every Student Succeeds Act,
systems and response to intervention to ensure that all 2015; Individuals with Disabilities Education Im-
students benefit from an environment where they have provement Act, 2004; Satcher, 2001). Clearly, ex-
the supports they need to learn. This chapter provides pectations for teachers are extraordinary, as they
the reader with an understanding of how tiered sys- are responsible for f uture generations of citizens.
tems work to create an environment in which behav Not surprisingly, teachers are often chal-
ior does not interfere with learning. Understanding lenged by meeting these multiple demands and
how tiered systems work will allow vision profession- must be vigilant in their efforts to protect instruc-
als to not only better support the students they serve tional time with students (Adelman, 1998; Lane,
but also contribute more as members of the school’s Menzies, Ennis, & Bezdek, 2013). For example,
team. —Eds. approximately 70 percent of teachers report that
413
paperwork and routine duties take away from • Response-to-intervention (RTI) models that focus
their instructional duties (National Center for primarily on academic domains such as read-
Education Statistics, 2008). Teachers also rarely ing and math (Fuchs & Fuchs, 2006)
have extended blocks of time for essential tasks • Positive behavior interventions and supports (PBIS)
such as planning for instruction, collaborating models that focus heavily on behavioral do-
with colleagues within and across grade levels, mains (Sugai & Horner, 2006)
and meeting with parents. Most teachers indi-
• Comprehensive, integrated, three-
tiered (CI3T)
cate that they can only devote relatively short
models that focus on academic, behavioral,
periods of time (10–15 minutes) to t hese activi-
and social domains, incorporating RTI and
ties and that they often work beyond the regular
PBIS (Lane, Oakes, Menzies, & Harris, 2013)
school day— including weekends (Adelman,
1998). Managing and monitoring so many tasks
(often in already busy schedules) creates a (See Sidebar 16.1 for additional explanations of
unique type of pressure (Brante, 2009), with some of t hese models, as well as definitions of
teachers feeling rushed on a daily basis (Michel- other terms used in this chapter.) These systems
son & Harvey, 2000). Findings from a nation- are based on the use of data from screening tools
wide survey of 1,200 US K–12 teachers suggest and about students’ prog ress to make decisions,
that teachers were exhausted from the goal of as well as on evidence-based, scientifically vali-
meeting their students’ multiple needs (Rich- dated interventions.
ards, 2012). In each model there is an important shift
away from viewing learning and behavioral
challenges as problems located within the child.
TIERED SYSTEMS OF S PPORT Instead, these models embrace a systems-level ap-
proach in which general and special education
In an effort to respond to some of these chal- teachers collaborate to support all students within
lenges, many school districts are designing, im- inclusive environments according to individual
plementing, and evaluating a variety of models, students’ needs. These are deliberate models in
known as tiered systems of support. In general, t hese which systems and structures are developed both
models provide a cascade of supports to reduce to prevent learning and behavior problems from
the probability of students’ developing academic, occurring and to respond efficiently when such
behavioral, or social challenges. T hese models problems do occur (Lane, 2007). This chapter fo-
include school- w ide screening to identify stu- cuses on CI3T models, highlighting how students’
dents who may be at risk for such difficulties. multiple needs can be met within this system in a
Students are then supported with more intensive manner that facilitates collaboration by building
interventions assistance. These models hold the in efficiencies at the systems level.
potential not only to meet students’ varied needs The chapter begins by describing each level
in academic, behavioral, and social domains, of prevention constituting the graduated contin-
but also to support teachers and other school- uum of supports offered by CI3T models. Next,
site personnel (such as school psychologists, it describes how data from academic and behav
social workers, behavior specialists, reading spe- ior screening tools can be used in tandem to iden-
cialists, paraprofessionals, and administrators) tify and assist students who need instruction or
by building in efficiencies at a systems (school supports beyond primary prevention efforts. The
and district) level. Some such models include chapter concludes by showing how this model
the f ollowing: offers benefits for all students—including those
Tiered Models of Behavioral and Instructional Support 415
S I D E B A R 1 6 . 1
Key Terms and Definitions
Following are definitions of terms used in this and special education contexts to support all
chapter. Dates following the names of models learners. CI3T models are frameworks for
of support indicate when the terms w ere organizing and delivering instruction and
introduced to the educational community. supports to enhance academic, behavioral, and
social outcomes for all students. The model is
MODELS OF SUPPORT a blending of RTI and PBIS models, and
Positive behavior interventions and supports incorporates validated programs to address
(PBIS; 1996). The term PBIS was included in social skills across all levels of prevention (Tiers
the Individuals with Disabilities Education 1, 2, and 3).
Act, referring to a framework for delivering OTHER KEY TERMS
practices and systems to facilitate behavioral Contingent. Describes reinforcement (or
and academic outcomes for students with punishment) that is given only after a behavior
exceptionalities and their families. occurs (for example, a PBIS ticket is paired
Response to intervention (RTI; 1997). The term with behavior-specific praise only after a
RTI refers to a framework initially used with the student demonstrates a behavior that meets
special education community to support detec- a given expectation).
tion and delivery of educational supports for Positive reinforcement. Takes place when a
students with specific learning disabilities. Later, behavior (for example, coming to class on
the term broadened to refer to a framework to time) is followed immediately by the introduc-
support the academic needs for all students. tion of a stimulus (for example, a PBIS ticket
Multitiered system of supports (MTSS; 2013). paired with behavior-specific praise) that
The term MTSS is used by general and increases the f uture likelihood of the behavior
special education communities to refer to a happening again in similar conditions.
framework for delivering practices and Positive reinforcer. A stimulus (for example, a
systems for facilitating student performance
PBIS ticket paired with behavior-specific

in behavioral and academic domains. praise) whose presentation (being given by
Comprehensive, integrated, three-tiered (CI3T; the adult to the student) functions as rein-
2011). The term CI3T is used in K–12 general forcement.
Source: Definitions of models of support based on OSEP Technical Assistance Center on Positive Behavioral Interven-
tions and Supports. (2015, October). Positive Behavioral Interventions and Supports (PBIS) implementation blueprint:
Part 1—Foundations and supporting information. Eugene: University of Oregon. Retrieved from www.pbis.org
with visual impairments—as it affords a system-

atic approach for meeting students’ multiple C 3T MODE S
needs, often using low-intensity supports (such as A COMPREHENS VE, NTEGRATED
behavior-specific praise and self-regulation tech- CONT NUUM OF SUPPORT
niques) before exploring more intensive targeted
supports (such as functional assessment–based As with RTI and PBIS models, CI3T models in-
interventions) for students requiring more inten- clude three levels of prevention (Lane, Oakes, &
sive assistance. Menzies, 2010):
1. Primary (also referred to as Tier 1): Offered content area that addresses Common Core Stan-
to all students dards for states that have adopted them as well as
2. Secondary (also referred to as Tier 2): Offered district-level standards. This curriculum selection
to the approximately 10–15 percent of stu- is a rigorous process in which data are reviewed
dents for whom primary prevention efforts to determine if there is sufficient e vidence to
are insufficient suggest that implementing the adopted curricula
with integrity will yield the desired academic out-
3. Tertiary (also referred to as Tier 3): Offered to
comes for students (McIntyre, Gresham, DiGenn-
the approximately 5 percent of students who
aro, & Reed, 2007). Once the selection process is
demonstrate the most intensive needs
completed, professional development is needed
to ensure that teachers are prepared to imple-
Each level is grounded in research-based pro- ment the curricula according to the specified par
grams, strategies, and practices, vetted to ensure ameters. Treatment integrity data should be
that if implemented with treatment integrity collected and examined to make certain teachers
(meaning implemented as planned), the intended are implementing Tier 1 efforts with adequate in-
outcomes for students are likely to be achieved tegrity (80 percent or greater) so that inaccurate
(Cook & Tankersley, 2013). Rather than relying conclusions are not drawn regarding students’
on teachers’ judgments or often imprecise data responsiveness (discussed more fully l ater in this
sources to make decisions as to which students chapter).
may benefit from secondary or tertiary efforts, es-
tablished academic and behavior screening tools
Social Skills Components
are used in conjunction with other existing school-
wide data to inform decision making. The fol- In terms of the social skills domain, district lead-
lowing sections discuss each level of prevention ers would engage in a similar process to select a
in more detail. validated program to address social skills accord-
ing to the district-identified goals. For example,
in some districts, office discipline referrals (ODRs),
Tier 1: Primary Prevention for All suspension, and expulsion data may suggest a
Primary prevention efforts are offered to all stu- problem exists in the areas of bullying, conflict
dents, with the goals of leveling the playing field resolution, or even simply social graces. (An
for students who may arrive at school with dif- ODR is a form used for data gathering to note
fering skill sets and preventing learning and problem behaviors and the antecedents or con-
behavioral problems from occurring. In a CI3T tributing factors, such as time, location, actions
model, primary prevention efforts include aca- just prior to the behavior, student’s motivations,
demic (RTI), social, and behavioral (PBIS) com- and other students involved.) In other instances
ponents with the intent of addressing the full t here may be state mandates that character edu-
range of skills a student would need to be success- cation programs be implemented school-w ide
ful within and beyond the K–12 setting. (see, for example, Character Education Partner-
ship, 2013). Once specific targets of concern and
any state mandates are identified, district lead-
Academic Components
ers review available curricula to again select a
In terms of the academic domain, the district lead- program with sufficient evidence to suggest that
ers (or in some situations, school leaders) select if it is implemented with sufficient integrity, it
a validated curriculum in each core academic w ill yield the desired student performance. Ex-
amples of such programs include t hose designed ble, give best effort). In CI3T models, a data-based
to teach social skills (for example, Social Skills approach is used to determine t hese expectations
Improvement System—Classwide Intervention; for each key setting (for example, classrooms,
see Elliott & Gresham, 2007), develop character hallways, buses), which are then displayed in an
(for example, Positive Action, 2008), and prevent expectation matrix.
violence (for example, Second Step Violence Pre- Rather than relying solely on the input of a
vention Plan; see Committee for C hildren, 2
007). CI3T team, all adults in a building (faculty and
School-w ide social skills instruction is par- staff) have an opportunity to rate the extent to
ticularly relevant to students with visual impair- which given behaviors are critical to success in
ments, who benefit from long-term, proactive each setting. T hese data are used by the CI3T
social skills instruction for improved social inter- team to construct expectation matrices, which
actions with sighted peers (Celeste, 2007; Celeste are displayed throughout the school and used as
& Grum, 2010; D’Alura, 2002; Jindal-Snape, 2005). instructional tools. The matrix is posted for use
In selecting such a curriculum, it is important to by all stakeholders (students, parents, teachers,
select one not only with sufficient evidence, but and staff). Making t hese expectations available
also one that has a mechanism for assessing for all includes ensuring that print materials are
treatment integrity (for example, behavioral com- made accessible for students with visual impair-
ponent checklists used to monitor implementa- ments (Bardin & Lewis, 2008). Expectations and
tion) and a plan for students who do not respond schedules should be provided in braille, through
to the program (for example, what to do for stu- use of an audio device, or in large print with high
dents who need more than this global level of contrast, as appropriate for the visually impaired
support). T hese lessons are taught school-wide student. It is important for the student with vi-
according to the guidelines provided (for example, sual impairment to have access to all materials
weekly or monthly lessons) and then revisited to promote self- determination skills, increase
within the context of the school day to promote motivation and initiative, and build inclusive
acquisition as well as generalization and mainte- environments (Agran, Hong, & Blankenship, 2007;
nance of the target skills (Sugai, 2013). For exam- Bardin & Lewis, 2008).
ple, teachers might precorrect their class (remind These expectations are then taught explicitly,
them of expectations) on the use of the skills be- with students afforded an opportunity to practice
fore moving into cooperative learning activities and receive reinforcement (often using PBIS
(for instance, by saying, “Just a gentle reminder, tickets—tickets given as rewards, to be exchanged
I am g oing to be looking to see how well you lis- later for a more concrete reward—paired with
ten to and respond to other people’s ideas when behavior-specific praise) on an intermittent ba-
you are working on your science projects during sis when expectations are met (Lane, Kalberg, &
our lab time”). Menzies, 2009). Teachers must be cognizant of
the types of visual cues, such as facial responses
or gestures (for instance, pointing to the expecta-
Behavioral Components
tions, use of proximity, modeling), that may com-
The behavioral domain is distinct from the aca- municate expectations to students; these visual
demic and social skills domains because it is cues can be paired with auditory cues, self-
not a curriculum. PBIS is a framework in which evaluation, and feedback (Jindal-Snape, 2004).
leadership teams establish and define three to In essence, faculty and staff subscribe to an
five school-wide expectations for student perfor instructional approach to behavior in which all
mance (for example, be respectful, be responsi- students are taught and prompted to engage
in expected be hav

iors. The use of a school- relying on a heavily consequence-based system,
wide ticket system requires the entire school as is characteristic of some classroom manage-
community—administrators, teachers, parapro- ment systems, PBIS is focused on teaching and
fessionals, related serv ice providers, office staff, prompting behaviors that support teaching and
cafeteria workers, and custodians—to have a con- learning, including prosocial interactions be-
sistent, common understanding of what is—and tween peers and academic engagement. Proso-
is not—acceptable in each school setting. The cial peer interactions and academic engagement
uniformity in the reinforcement systems allows have been noted concerns for students with vi-
students to be successful in multiple settings, sual impairments (Bardin & Lewis, 2008, 2011).
with the opportunity to be recognized for their In fact, students with visual impairments have
success by all adults in the building. been found to be academically engaged at com-
In behavioral terms, the ticket system creates mensurate rates with low-achieving sighted peers
a method to generalize and maintain the skill about 51 percent of the time (Bardin & Lewis,
sets that have been acquired through the use of a 2008). Using PBIS, teachers can avoid losing
universal reinforcement system. As part of this valuable instructional time by having to respond
system, tickets earned are exchanged by students to rule infractions and other problem behaviors
for a range of reinforcers that allow students to that might occur. Instead, teachers can spend more
access (positive reinforcement) or avoid (negative time engaging students in instructional tasks,
reinforcement) attention, activities or tangibles, creating opportunities for students to utilize
or sensory experience (Umbreit, Ferro, Liaupsin, self-determined behavior, and recognizing stu-
& Lane, 2007). This variety in reinforcers is very dents for engaging in desired behaviors. Collec-
import ant, as students are motivated in differ tively, this may result in less stress for teachers
ent ways. For example, whereas some students (Brouwers & Tomic, 2000).
would prefer to access activities such as longer Developing a primary prevention model that
recess or free passes to the homecoming dance incorporates academic, social, and behavioral do-
(positive reinforcement in the form of preferred mains and recognizes the transactional relation-
activities), others would prefer to avoid activities— ship between t hese domains enables teachers to
for example, skipping odd or even numbers in a better meet students’ multiple needs. Yet, it can
homework assignment or getting a front-of-the- still be expected that some students w ill require
lunch-line pass to avoid waiting in line (negative assistance beyond primary prevention efforts.
reinforcement in the form of escaping nonpre- Nonresponsiveness is not a tragedy, but an ex-
ferred activities). Students often contribute to the pected outcome for approximately 10–15 percent
menu of reinforcers, which is important to ensure of the student body. Preferably, students in need
that the preferences of all students, including of t hese additional supports would be identified
those with visual impairments, are represented. using systematic screening data.
Contingent reinforcement increases the likelihood
of desired behaviors occurring in the f uture, a
core objective of any school-w ide plan.
Tier 2: Secondary Prevention for Some
The logic behind the PBIS framework is to Secondary prevention supports—those offered to
incorporate an instructional approach to behav students in Tier 2 of the program—are offered as
ior to assist students in developing the skills and supplemental strategies, practices, and programs
behaviors needed to facilitate instruction (Lane, for those students who are identified by screen-
Oakes, Menzies, & Germer, 2014). Rather than ing tools as needing extra assistance. For exam-
ple, Dynamic Indicators of Basic Early Literacy ports are of low to moderate intensity with
Skills (DIBELS; Good & Kaminski, 2002) and the sufficient evidence to warrant implementation
Student Risk Screening Scale (SRSS; Drummond, (Cook & Tankersley, 2013).
1994) were used to identify second-g rade stu- School teams developing CI3T models can
dents who were in need of reading intervention begin by formulating the supports currently
(Oakes, Mathur, & Lane, 2010). Those students available in their building, creating a blueprint
who received sufficient levels of primary preven- that includes the following:
tion reading instruction but required additional
reading instruction to meet expected bench- • A description of the support, including the lo-
marks participated in a Tier 2 intervention. Stu- gistics of how the support is delivered (for ex-
dents participated in 30 minutes of additional ample, three days a week, 30-minute sessions
reading instruction paired with a behavioral sup- lead by the literacy coach)
port four days per week with a school specialist. • Entry criteria showing the specific scores on
The behavioral support was designed to facilitate academic and behavior screening measures that
students’ access to the reading instruction. Like- suggest the extra support may be warranted
wise, Savaiano and Hatton (2013) implemented
a Tier 2 repeated reading intervention for three • Data on integrity of implementation, stake-
students with visual impairments in grades three holders’ views (social validity), and student
through six using regular text or large print. per formance
The students had average cognitive abilities and • Exit criteria showing when the support is no
were reported to be poor readers by their teach- longer needed
ers (although screening data w ere not reported).
The reading intervention occurred five days per fter creating this intervention grid, it is neces-
A
week for four consecutive weeks during the sum- sary to ensure that there is research to suggest
mer. Findings indicated a functional relation be- that t hese current practices should be retained
tween repeated readings (a par tic
ular type of and then determine what other supports are
reading intervention) and reading comprehen- warranted to assist students beyond what is cur-
sion scores for all students and oral reading rate rently available (Lane, Oakes, Menzies, Oyer, &
for two students. Jenkins, 2013). For example, a school site might
In general, secondary supports are low- already utilize repeated readings to build oral
intensity supports designed for students identi- reading fluency skills (Chard, Ketterlin-G eller,
fied using systematic screening tools as needing Baker, Doabler, & Apichatabutra, 2009) or be-
supplemental assistance. Examples of t hese low- havioral contracts to support work completion
intensity supports include check- in/check- out (Downing, 2002). However, they may not yet
programs (for example, Behavior Education Pro- have study skills groups for students with orga
gram; see Hawken & Horner, 2003) that allow nizational difficulties (Kalberg, Lane, & Lambert,
students to receive feedback on their per for 2012) or social skills groups for students with
mance over the course of the school day, behav- skill deficits (Miller, Lane, & Wehby, 2005). Still
ioral contracts focusing on homework completion, other schools may need to work toward blend-
self-determination or social skills groups for stu- ing these supports, for example, adding a self-
dents with common areas of concerns, and liter- monitoring support for students participating in
acy groups needing to build similar skills sets Tier 2 reading groups to help some of the students
(for example, oral reading fluency). T hese sup- stay focused during this time (Oakes et al., 2012).
One benefit of establishing t hese interven- plements strategies likely to improve quality of
tion grids is that it communicates the available life for all involved” (Eber, Breen, Rose, Unizycki,
supports with a high level of clarity and trans- & London, 2008, p. 18).
parency. In this way, students can be connected Given the heavy resource investments of ter-
swiftly with research-based supports according tiary support in terms of time and personnel
to their specific needs. For example, the lite ra costs, it is particularly important to invest wisely
ture on students with visual impairments iden- (Lane, Menzies, et al., 2013). It is particularly
tifies needs related to developing prosocial peer important to
interactions, social skills, self-determined be
haviors, and academic engagement. Interventions • introduce only those tertiary supports with
directed at supporting students in developing requisite evidence of effectiveness to the max-
t hese skills at the secondary level of prevention imum extent possible;
should be included on the school’s interven-
• implement them with g reat care, monitoring
tion grid.
all the components needed to draw accurate
It is import ant to note that students should
conclusions regarding effectiveness (for exam-
not be categorized as “Tier 2 students,” but
ple, treatment integrity, reliability of student
rather as “students with Tier 2 needs.” Second-
outcome measures, and stakeholders’ views);
ary supports—like tertiary supports—a re fluid
and
and temporary (Lane, Menzies, et al., 2013), in
that they shift over time according to students’ • reserve them only for students who truly need
needs. For example, it may be that a student is re- this intense level of support.
sponsive to a particular Tier 2 support, in which
case the support is concluded and the student For example, functional assessment–based inter-
continues on with only Tier 1 efforts. In other ventions have been shown to be effective for
instances, the student may not be responsive to students with visual impairments engaging in
one or more Tier 2 supports. In this case, the self-injurious behavior, such as eye poking (Mac-
student would then be supported with Tier 3 Donald et al., 2002).
assistance. The graduated systems of support represented

by CI3T are appealing in the sense that they of-
fer a transparent, resource-efficient, collaborative
Tier 3: Tertiary Prevention for a Few structure in which educators can work together
Tertiary supports, those offered in Tier 3, are the to offer students equal access to a continuum of
most intensive levels of support within the supports according to students’ needs (Lane,
CI3T model. As previously noted, approximately Oakes, Menzies, & Germer, 2012). As discussed
5 percent of the student body is likely to need this by Lane, Menzies, et al. (2013), the strength of
level of additive assistance. Examples of tertiary this model depends in part on (a) implementa-
prevention include functional assessment-based tion of research-based strategies and practices at
interventions (Kern & Manz, 2004; MacDonald, each level, (b) the treatment integrity of each
Wilder, & Dempsey, 2002) and wraparound ser level of prevention (Lane et al., 2010), and (c) the
vices, which ensure that the “student, family, accuracy with which students are detected and
teacher(s), and others who may have ongoing linked with needed supports (Lane, Menzies,
contact and interaction with the student are key Oakes, & Kalberg, 2012). The next section focuses
members of the strength-based team that deter- on the third point: using data from both aca-
mines and prioritizes needs and designs and im- demic and behavioral screening tools to deter-
mine which students require more than primary These screenings occur during three specified
prevention efforts have to offer. windows in fall, winter, and spring to see if all
students enrolled are making adequate prog ress.
In the event that students are performing below
IMPORTANCE OF
benchmark, they are connected to relevant Tier
SYSTEMAT C SCREENING 2 or Tier 3 supports. T
hese additive supports oc-
Systematic screening for behavior challenges has cur in addition to primary prevention efforts,
been a prominent feature in the authors’ work with treatment integrity, social validity, and stu-
within multitiered systems of support, since it is dent performance monitored by teachers or other
absolutely essential that students receive supports interventionists more frequently (for example,
in academic, social, and behavioral domains ac- with weekly reading probes) to see how the extra
cording to their individual needs. While many support shifts a student’s learning trajectory and
school sites are now regularly conducting aca- performance level. Data collected from frequent,
demic screenings three times a year (fall, winter, repeated assessments are used to inform instruc-
and spring) according to established guidelines, tion, shaping a range of experiences for students
be
havior screenings are just now gaining mo- (Lane, Menzies, et al., 2013). Although t here are
mentum. fewer of t hese tools available commercially for
middle and high schools, prog ress is being made
and benchmarking practices are now common-
Academic Screenings
place, such as the recent inclusion of 9th–12th
Currently t here are a number of options for con- grade measures by AIMSweb. And some schools
ducting academic screenings to monitor K–12 are now seeing the utility of similar tools for use
students’ academic performance at three points in monitoring social and behavioral performance
each year to determine if students are perform- (Lane, Menzies, et al., 2012).
ing at the expected rate and level in core academic
areas such as reading, math, and written expres-
sion. Some tools are commercially available, such
Behavior Screenings
as AIMSweb (Pearson Education, 2012) and Mea As with academic screening tools, data from be
sures of Academic Prog ress for Primary Grades havior screening tools are used to detect students
(Northwest Evaluation Association, 2013), which whose characteristic behavior patterns exceed es-
were designed to benchmark student per
for tablished norms at the first sign of concern. These
mance. Other tools are f ree-access tools such as screenings also occur three times per year to ex-
DIBELS (Good & Kaminski, 2002). Many general amine the behavioral and social performance of
and special education teachers have received all students, but the fall screening takes place later
pre-and in-service training on how to use t hese in the fall (four to six weeks a fter the onset of the
curriculum-based measures. This is encouraging school year) than the academic screening. This is
given that t hese validated tools offer an effective done to allow teachers sufficient time to become
and feasible method for identifying and monitor- familiar with all students’ behaviors.
ing the prog ress of students requiring secondary Behavior screenings do not require time with
and tertiary support as previously discussed. For students, as they are teacher-completed tools
example, the AIMSweb Prog ress Monitoring and (although some behavior screening tools contain
RTI System features brief probes (one to three parent and student versions). Available screen-
minutes for completion) in reading, mathematics, ing tools range in cost, complexity, and focus.
and writing for kindergarten and first grade. Examples of screening tools include the Strengths
and Difficulties Questionnaire (Goodman, 1997), early in a student’s school experience, it can also
the BASC2 Behavioral and Emotional Screen- mean early in terms of when the strugg le be-
ing System (Kamphaus & Reynolds, 2007), the comes evident—t hus, early detection means at the
Social Skills Improvement System Performance first sign of concern.
Screening Guide (Elliott & Gresham, 2007), and Screening tools afford school systems a reli-
the Systematic Screening for Be hav ior Disor- able, valid, feasible, and transparent mechanism
ders (Walker & Severson, 1992). Lane, Menzies, for detecting students who may need supplemen-
et al. (2012) detail the scope of available screening tal supports. Ideally, academic and behavioral
tools and corresponding research. data can be used in tandem to detect students
There is ample evidence to suggest that be with multiple concerns and connect them with
havior screening tools predict important social, research-based intervention strategies. For exam-
behavioral, and academic outcomes for students. ple, several studies have examined the effect of ac-
Given that t hese screening tools require as little ademic and behavioral interventions for students
as 10 minutes three times a year, schools cannot with identified needs in academic and behavioral
afford not to use them. It is possible to rely instead domains (Harris, Oakes, Lane, & Rutherford, 2009;
on current practices that involve examining data Lane et al., 2002; Oakes et al., 2010).
on ODRs to connect students with supports, with While these screening tools have not been
current guidelines suggesting that a student earn- specifically examined for use with students with
ing one ODR or less over the course of an aca- visual impairments, given the social needs of this
demic year is at low risk, one earning two to five group of students, they should be included in
is at moderate risk, and one earning six or more school-w ide screenings. Just as the use of RTI is
is at high risk (McIntosh, Frank, & Spaulding, beginning to be examined for this specialized
2010). Yet, t here are concerns surrounding the re- population (Kamei-Hannan, Holbrook, & Ricci,
liability of t hese data because although students 2012), additional research is needed to examine
may perform in the same manner in two differ the use of screening tools for it.
ent settings, only one teacher or staff member
may write an ODR for the rule infraction. Thus,
such data do not always accurately portray stu-

dent performance. Also, when thinking about CI3 MODELS BENEF TS
both major categories of behavior—e xternalizing FOR ALL STUDEN S
(for example, aggression and noncompliance)
and internalizing (for example, social withdrawal Designing and implementing any new system to
and anxiety)—it becomes clear that if ODR data improve student outcomes w ill require a substan-
are the only data examined (and not data from tial investment of time, money, energy, and other
screening tools), it is quite likely students with in- resources (Lane, Menzies, et al., 2013). Yet, gradu-
ternalizing issues w ill be overlooked (McIntosh, ated, data-informed systems such as the CI3T
Campbell, Carter, & Zumbo, 2009). This is just model described in this chapter capitalize on and
one of many reasons why behavior screening develop the existing talents teachers have in the
tools are needed in K–12 schools. areas of instructional and classroom management
Screenings are important in middle and high skills. The power of CI3T models rests in building
schools as well as elementary school. When one consistency in core curricula, instructional mod-
thinks about the importance of early detection, els, and plans for preventing and responding to
one often thinks of preschool and elementary individual differences—for all learners, including
school students. While early detection may mean those with exceptionalities.
The commitment to doing whate ver is nec- benefit of models such as CI3T models of preven-
essary to meet all students’ academic, social, and tion is that they foster collaborative partnerships
behavioral needs is at the foundation of inclusive between general and special education teachers
programming and commitment to excellence. by establishing school-wide expectations and the
The building of such models offers faculty and methods by which these expectations can be
staff the opportunity to decide on and develop achieved (Lane, Oakes, Menzies, Oyer, et al., 2013).
a common, positive, inclusive school culture, CI3T models blend the academic, behavioral,
establishing priorities such as respect for indi- and social domains. The levels of prevention in
vidual differences that manifest in differentiated this model constitute a graduated continuum of
instruction, strong behavioral programming, support: specifically, primary (Tier 1, for all),
and integrated social skills instructions. Es- secondary (Tier 2, for some), and tertiary (Tier
sentially, such models create an opportunity to 3, for a few). The chapter also illustrates how
eliminate silos (contexts in which individuals data from academic and be havior screening
work in isolation) in which educators attempt to tools can be used in tandem to identify and as-
address academic, behavioral, and social consist students who need more support than pri-
cerns through separate committees rather than mary prevention efforts can offer. These models
looking at students holistically. This is critically hold benefits for all students— including those
important for students with visual impairments, with visual impairments—as they encourage a
who may have difficulty integrating into the class systematic approach for meeting students’ mul-
and school social community (Celeste & Grum, tiple needs, often using low- intensity supports
2010) and developing self-determined behaviors before exploring more intensive targeted supports
(Agran et al., 2007) without additional and inten- for students requiring more assistance.
tional supports. In addition, such models may
create an opportunity to eliminate the silos of
general and special education, creating a context REFERENCES
in which all students are everyone’s concern.
Adelman, N. (1998). Trying to beat the clock: Uses of
This systems-level approach is a major shift
teacher professional time in 3 countries. Washing-

from the way many schools operate, allowing dif ton, DC: US Department of Education.
ferent expectations for each classroom, focusing Agran, M., Hong, S., & Blankenship, K. (2007). Pro-
on responding to rather than preventing learning moting the self-determination of students with
and behavior problems from occurring, and in- visual impairments: Reducing the gap between
corporating the input of all faculty and staff knowledge and practice. Journal of Visual Impair-
rather than a select few. Yet this model holds great ment & Blindness, 101, 453–464.
potential, as it can coordinate the existing prac- Bardin, J. A., & Lewis, S. (2008). A survey of the aca-
tices available in school systems and create a demic engagement of students with visual im-
model in which each level of prevention can be pairments in general education classes. Journal of
Visual Impairment & Blindness, 102, 427–483.
streamlined and systematized, building efficien-
Bardin, J. A., & Lewis, S. (2011). General education
cies to support all students and their teachers.
teachers’ rating of the academic engagement level
of students who read braille: A comparison with
SUMMARY sighted peers. Journal of Visual Impairment & Blind-
ness, 105, 479–492.
This chapter focuses on a systems-level approach Brante, G. (2009). Multitasking and synchronous
to encourage positive behaviors and facilitate the work: Complexities in teacher work. Teaching and
instructional experiences for all students. One Teacher Education, 25, 430–436.
Brouwers, A., & Tomic, W. (2000). A longitudinal study Fuchs, D., & Fuchs, L. (2006). Introduction to response
of teacher burnout and perceived self-efficacy in to intervention: What, why, and how valid is it?
classroom management. Teaching and Teacher Reading Research Quarterly, 41(1), 93–99.
Education, 16, 239–253. Good, R. H., & Kaminski, R. A. (Eds.). (2002). Dynamic
Celeste, M. (2007). Social skills intervention for a Indicators of Basic Early Literacy Skills (6th ed.). Eu-
child who is blind. Journal of Visual Impairment & gene: University of Oregon, Center on Teaching
Blindness, 101, 521–533. and Learning. Retrieved from http:// d ibels
Celeste, M., & Grum, D. K. (2010). Social integration of .uoregon.edu
c hildren with visual impairment: A developmen- Goodman, R. (1997). The Strengths and Difficulties
tal model. Elementary Education Online, 9, 11–22. Questionnaire: A research note. Journal of Child
Character Education Partnership. (2013). Character Psychology and Psychiatry, 38, 581–586.
education legislation. Retrieved from http://w ww Harris, P. J., Oakes, W. P., Lane, K. L., & Rutherford,
.character.org/more-resources/character-education R. B. (2009). Improving the early literacy skills of
-legislation/ students at risk for internalizing or externalizing
Chard, D. J., Ketterlin-Geller, L. R., Baker, S. K., Doabler, behaviors with limited reading skills. Behavioral
C., & Apichatabutra, C. (2009). Repeated read- Disorders, 34, 72–90.
ing interventions for students with learning dis- Hawken, L. S., & Horner, R. H. (2003). Evaluation of
abilities: Status of the evidence. Exceptional Children, a targeted intervention within a schoolwide
75, 263–281. system of behavior support. Journal of Behavioral
Committee for Children. (2007). Second step violence Education, 12, 225–240.
prevention. Seattle: Author. Individuals with Disabilities Education Improvement
Common Core State Standards Initiative. (n.d.). Pre- Act, 20 U.S.C. § 1400 (2004).
paring Americ a’s students for success. Retrieved Jindal-Snape, D. (2004). Generalization and main-
from http://w ww.corestandards.org tenance of social skills of c hildren with visual
Cook, B., & Tankersley, M. (Eds.). (2013). Effective prac- impairments: Self-e valuation and role of feed-
tices in special education. Boston: Pearson. back. Journal of Visual Impairment & Blindness, 98,
Council of Chief State School Officers & National 470–483.
Governors Association Center for Best Practices. Jindal-Snape, D. (2005). Use of feedback from sighted
(2011). Common Core State Standards Initiative. peers in promoting social interaction skills. Jour-
Washington, DC: Author. nal of Visual Impairment & Blindness, 99, 403–412.
D’Alura, T. (2002). Enhancing the social interaction Kalberg, J. R., Lane, K. L., & Lambert, W. (2012). The
skills of preschoolers with visual impairments. utility of conflict resolution and social skills
Journal of Visual Impairment & Blindness, 96, interventions with
middle school students at
576–584. risk for antisocial behavior: A methodological
Downing, J. A. (2002). Individualized behavior con- illustration. Remedial and Special Education, 22,
tracts. Intervention in School and Clinic, 37, 168–172. 23–38.
Drummond, T. (1994). The Student Risk Screening Scale Kamei-Hannan, C., Holbrook, M. C., & Ricci, L. A.
(SRSS). Grants Pass, OR: Josephine County Mental (2012). Applying a response-to-intervention model
Health Program. to literacy instruction for students who are blind
Eber, L., Breen, K., Rose, J., Unizycki, R. M., & London, or have low vision. Journal of Visual Impairment &
T. H. (2008). Wraparound as a tertiary level inter- Blindness, 106, 69–80.
vention for students with emotional/behavioral Kamphaus, R. W., & Reynolds, C. R. (2007). BASC-2
needs. Teaching Exceptional Children, 40, 16–22. Behavioral and Emotional Screening System (BASC-2
Elliott, S. N., & Gresham, F. M. (2007). Social Skills BESS). San Antonio, TX: Pearson.
Improvement System: Performance screening guides. Kern, L., & Manz, P. (2004). A look at current validity
Bloomington, MN: Pearson Assessments. issues of school-wide behavior support. Behavioral
Every Student Succeeds Act, Pub. L. No. 114-95 (2015). Disorders, 30, 47–59.
Lane, K. L. (2007). Identifying and supporting stu- geted supports. Journal of Applied School Psychol
dents at risk for emotional and behavioral dis- ogy, 29, 203–229.
orders within multi-level models: Data driven Lane, K. L., Wehby, J. H., Menzies, H. M., Gregg, R. M.,
approaches to conducting secondary interven- Doukas, G. L., & Munton, S. M. (2002). Early lit-
tions with an academic emphasis. Education and eracy instruction for first-g rade students at-r isk for
Treatment of C hildren, 30, 135–164. antisocial behav ior. Education and Treatment of
Lane, K. L., Kalberg, J. R., & Menzies, H. M. (2009). Children, 25, 438–458.
Developing schoolwide programs to prevent and man- MacDonald, J. E., Wilder, D. A., & Dempsey, C. (2002).
age problem behaviors: A step-by-step approach. New Brief functional analysis and treatment of eye
York: Guilford Press. poking. Behavior Interventions, 17, 261–270.
Lane, K. L., Menzies, H. M., Ennis, R. P., & Bezdek, J. McIntosh, K., Campbell, A. L., Carter, D. R., & Zumbo,
(2013). School-w ide systems to promote positive B. D. (2009). Concurrent validity of office disci-
behaviors and facilitate instruction. Journal of Cur- pline referrals and cut points used in school-w ide
riculum and Instruction, 7, 6–31. positive behavior support. Behavioral Disorders, 34,
Lane, K. L., Menzies, H. M., Oakes, W. P., & Kalberg, 100–113.
J. R. (2012). Systematic screenings of behavior to sup- McIntosh, K., Frank, J. L., & Spaulding, S. A. (2010).
port instruction: From preschool to high school. New Establishing research-based trajectories of office
York: Guilford Press. discipline referrals for individual students. School
Lane, K. L., Oakes, W. P., & Menzies, H. M. (2010). Psychology Review, 39, 380–394.
Systematic screenings to prevent the development McIntyre, L. L., Gresham, F. M., DiGennaro, F. D., &
of learning and be hav ior prob lems: Consider- Reed, D. D. (2007). Treatment integrity of school-
ations for practitioners, researchers, and policy based interventions with c hildren in the Journal
makers. Journal of Disabilities Policy Studies, 21, of Applied Behavior Analysis 1991–2005. Journal of
160–172. Applied Behavior Analysis, 40(4), 659–672.
Lane, K. L., Oakes, W. P., Menzies, H. M., & Germer, Michelson, M., & Harvey, A. S. (2000). Is teachers’
K. A. (2012). Screening and identification ap- work never done? Time-use and subjective out-
proaches for detecting students at risk. In comes. Radical Pedagogy, 2(1). Retrieved from http://
H. Walker & F. M. Gresham (Eds.), Handbook of www.r adicalpedagogy.org /r adicalpedagogy /I s
evidence-based practices for emotional and behavioral _Teachers _Work _ Never_ Done _ _T ime-Use _ a nd
disorders: Applications in schools (pp. 129–151). New _Subjective_Outcomes.html

York: Guilford Press. Miller, M. J., Lane, K. L., & Wehby, J. H. (2005). Social
Lane, K. L., Oakes, W. P., Menzies, H. M., & Germer, skills instruction for students with high incidence
K. A. (2014). Increasing instructional efficacy: A disabilities: An effective, efficient approach for
focus on teacher variables. In S. G. L ittle & A. addressing acquisition deficits. Preventing School
Akin-Little (Eds.), Academic assessment and inter- Failure, 49, 27–40.
vention (pp. 300–315). New York: Routledge. National Center for Education Statistics. (2008).
Lane, K. L., Oakes, W. P., Menzies, H. M., & Harris, P. Teachers’ perceptions about teaching and school
J. (2013). Developing comprehensive, integrated, conditions, by control and level of school: Selected
three- t iered models to prevent and manage years, 1993–94 through 2007–08. Retrieved from
learning and behavior problems. In T. Cole, H. http://n ces.e d.g ov/programs/d igest /d11/t ables
Danniels, & J. Visser (Eds.), The Routledge interna- /dt11_ 077.asp
tional companion to emotional and behavioural diffi- Northwest Evaluation Association. (2013). Measures
culties (pp. 177–183). New York: Routledge. of Academic Progress (MAP) for Primary Grades.
Lane, K. L., Oakes, W. P., Menzies, H. M., Oyer, J., & Portland, OR: Author. Retrieved from http://w ww
Jenkins, A. (2013). Working within the context of .N WEA.org
three-tiered models of prevention: Using school Oakes, W. P., Lane, K. L., Cox, M., Magrane, A., Jen-
wide data to identify high school students for tar- kins, A., & Hankins, K. (2012). Tier 2 supports to
improve motivation and per for

mance of ele- Satcher, D. (2001). Youth violence: A report of the sur-
mentary students with behavioral challenges and geon general. Washington, DC: US Department of
poor work completion. Education and Treatment Health & H uman Serv ices, Office of the Surgeon
of Children, 35, 547–584. General.
Oakes, W. P., Mathur, S. R., & Lane, K. L. (2010). Read- Savaiano, M. E., & Hatton, D. D. (2013). Using repeated
ing interventions for students with challenging be reading to improve reading speed and comprehen-
havior: A focus on fluency. Behavioral Disorders, 35, sion in students with visual impairments. Journal
120–139. of Visual Impairment & Blindness, 107, 93–106.
OSEP Technical Assistance Center on Positive Behav- Sugai, G. (2013). Keynote address. Unpublished paper
ioral Interventions and Supports. (2015, October). presented at North East Positive Behavior Support
Positive Behavioral Interventions and Supports (PBIS) Conference, Cromwell, CT.
implementation blueprint: Part 1—Foundations and Sugai, G., & Horner, R. H. (2006). A promising ap-
supporting information. Eugene: University of Ore- proach for expanding and sustaining school-wide
gon. Retrieved from w ww.pbis.org positive behavior support. School Psychology Review,
Pearson Education. (2012). AIMSweb. San Antonio, TX: 35, 245–260.
Author. Retrieved from http://w ww.aimsweb.com/ Umbreit, J., Ferro, J. B., Liaupsin, C., & Lane, K. L.
Positive Action. (2008). Positive action: Positive develop- (2007). Functional behavioral assessment and function-
ment for schools, families and communities. Twin Falls, based intervention: An effective, practical approach.
ID: Author. Upper S addle River, NJ: Prentice-Hall.
Richards, J. (2012). Teacher stress and coping strategies: Walker, H. M., & Severson, H. (1992). Systematic Screen-
A national snapshot. The Educational Forum, 76, ing for Behavior Disorders: Technical manual. Long-
299–316. mont, CO: Sopris West.
17
C H A P T E R
Reading and Interpreting

Research
Tessa McCarthy and Robert Wall Emerson
Educators are increasingly being asked to defend their and special education. The reauthorization of the
instructional practices through evidence of effective- Individuals with Disabilities Act (IDEA) in the
ness. The demand for “evidence-based practice” re- United States in 2004 highlights this movement.
quires that teachers in all fields of education have an According to this legislation, decisions that teach-
understanding of the basics of educational research. ers make regarding a student’s education need to
This is especially important for teachers of students be based on “peer-reviewed research.” The lan-
with visual impairments because they are often the guage of IDEA states that a child’s Individual-
only professionals on a team with expertise in blind- ized Education Program (IEP) must contain a
ness and visual impairment, and there are unique “statement of the special education and related
challenges for research with low-incidence disabilities. serv ices and supplementary aids and serv ices,
Education professionals need not only to be able to based on peer-reviewed research to the extent
read research to learn about the practices they should practicable, to be provided to the child” (34 C.F.R.
be using with students, but also to be able to interpret § 300.320[a][4]).
and evaluate the strength of the research that provides The increased emphasis on evidence-based
the basis for the evidence on which their practices are practices, or practices that are supported by peer-
based. If practitioners cannot effectively read and in- reviewed research, reflects a growing realization
terpret the research literature, they must rely on others that educational practices need to be backed up
to tell them what practices they should be employing by methods proven through the use of data and
with the individuals they educate. This chapter pro- reviewed by experts to make sure the research is
vides information about what constitutes high-quality of high quality. For instance, does the type of
research so that educators can read, interpret, and de- cane a person uses help him or her detect drop-
termine the strength of the available research litera offs more accurately (Kim, Wall Emerson, Nagh-
ture. —Eds. shineh, & Auer, 2016), or does it matter if a student
reads braille with one hand or two (Wright,
INTRODUCT ON Wormsley, & Kamei-Hannan, 2009)? Without
this, it can be hard to make an argument that a
Research is becoming more central to the profes- given approach should be used if someone calls
sional life of teachers, in both general education the chosen approach into question.
427
Additionally, educators in t oday’s schools are search is of sufficient quality to disseminate. This
required to be more and more accountable for the is generally done when a manuscript is submit-
prog ress students make. Policy makers, govern- ted to a journal for publication. While t here are
ment officials, and school administrators strongly many places a person can go for easy informa-
rely on documentation of progress to determine tion, the quality control exhibited by a review of
effectiveness of instruction. Consequently, there peers is one of the best ways to make sure that
is greater emphasis on research and data collec- what a reader is getting is not biased, wrong, or
tion than ever. Given the increased emphasis on misleading.
peer-reviewed research, evidence-based practice, The best way to find peer-reviewed research
and empirical measures of student progress, edu- is to look in a peer-reviewed journal. ProQuest
cators must be able to locate, read, and understand (www.proquest.com) and WorldCat (w ww.oclc
high-quality research. This chapter provides an .org/worldcat-discovery.en.h
tml) are examples of
overview of how educators can read and interpret the types of databases that are used to search
research, and describes sources of research and for high-quality research. An advanced search al-
components of a research r eport. lows readers to request only results that come
from peer- reviewed sources. These databases,
however, require a subscription. Google Scholar
HIGH-Q ALITY SOURCES is an academic search engine that is available f ree
OF RESEARCH of charge. If you are not affiliated with an institu-
tion of higher learning, you may not be able to
here are many sources of evidence on which to
T access anything more than the abstract of some
rely when examining effective educational prac- of the articles you find without paying for the ar-
tice or determining methods of effective instruc- ticle, u nless access to the journal is a benefit of
tion. While almost all sources of information are belonging to a specific professional organization.
important, some of t hese sources are considered There are dozens of peer-reviewed journals
research and o thers are not. This distinction is that include content related to both special and
important. (Sidebar 17.1 summarizes the indica- general education, but some of the better-k nown
tors of high-quality research discussed in this journals that focus specifically on special educa-
chapter.) Sometimes an educator may read mate- tion include Exceptional Children, International
rials, such as professional newsletters, that Journal of Early Childhood Special Education, Jour-
provide information to keep readers abreast of nal of Special Education, Journal of Special Education
upcoming events and trends. This information, Technology, Remedial and Special Education, and
however, is not usually research; it may just be Teacher Education and Special Education. Specific to
the author’s thoughts or opinions. This informa- visual impairments, the Journal of Visual Impair-
tion is still valuable, but if the educator is read- ment & Blindness is a valuable source for peer-
ing in an attempt to determine the best practice reviewed research. Some journals, such as Teaching
to suggest during an IEP meeting, a research- Exceptional Children, are peer reviewed and provide
based article would be more appropriate. practitioners with great information, but the arti-
An important term with regard to research is cles are considered “research-to-practice papers”
peer reviewed. This refers to a process by which a (Council for Exceptional Children, n.d.), also re-
piece of research—a study, program, or set of ob- ferred to as “practice pieces,” rather than research
servations—is critically examined by experts reports.
both in research techniques and in the content To determine if an article is research rather
area being studied to determine w hether the re- than a practice paper, first consider the source of
Reading and Interpreting Research 429
S I D E B A R 1 7 . 1
A Quick Reference for Readers of Research Articles
The following list of questions is meant to serve 6. After reading the method section, can the
as a quick checklist of the basic information a reader state
reader of a research article should look for a. what type of methodology was used?
when determining its quality. The more ques-
tions to which the reader answers no, the more b. how many participants were in the study?
skeptical the reader should be of the research c. what characteristics the participants
presented in the article. possessed?
1. Is the article describing a study? d. what the participants did as a part of the
study?
2. Is the article in a peer-reviewed
journal? 7. After reading the results section, can the
reader state
3. Does the article have an
a. what type of analysis was used?
a. introduction?
b. if the findings supported or refuted the
b. method section? authors’ hypotheses?
c. results section?
c. if the results were statistically significant?
d. discussion section?
8. After reading the discussion section, can
4. Does the introduction provide enough the reader state
background to understand why this study
was the next logical step based on what a. how the current findings relate to the
was already known? larger body of study on the topic?
5. Did the authors clearly state the research b. the limitations of the study?
questions? c. the next topic for study?
the article. Is the article from a peer-reviewed terial that does not go through the peer-review
journal that publishes research? If the reader is process.
unsure, this information can be found in the The peer-review process is important in deter-
front m atter of the journal or on the journal’s mining and maintaining the high quality of re-
website. If the journal is peer reviewed, t here w
ill search articles. When a manuscript is submitted
be a list of the individuals who serve as peer re- to a journal for publication, first, it is given to a
viewers for the journal. Databases like ProQuest set of experts on the topic of the potential arti-
and WorldCat provide information about w hether cle. T
hese experts, who are chosen by the journal
the journal is peer reviewed, along with the de- editor to match each article submitted, read the
scriptive information on a particular journal or potential article critically and decide w hether it is
article. Note, however, that not all writing in a quality research, whether the topic is important
peer-reviewed journal is peer reviewed. T hese enough to publish, and whether the article is
journals may have book reviews, lite rature re- written well enough. Feedback is given to the edi-
views, short reports, practice pieces, or other ma- tor, who corresponds with the authors and rejects
the submission, accepts the submission, or ac- sults with a new type of student or in a new situa-
cepts the submission if certain changes, based tion? Is it an attempt to delve more deeply into a
on the input from the experts, are made. topic that is not yet fully understood? Placing the
current study into context allows the reader to see
a larger vision and get a sense of how this research
PARTS OF A RESEARCH REPORT fits into that larger vision. In addition to placing
Research almost always follows a specified for- the current study into context, authors need to
mat. A research report or article typically con- clearly describe the current research topic and ex-
tains four sections: an introduction, a method plain why it is important. Authors need to be able
section, a results section, and a discussion. While to communicate to readers how a topic relates to a
certain fields of study present t hese sections in a teacher’s professional life.
slightly different order, t hese four sections should
always be present in a research article. The pur- Purpose of the Research
pose of each of these sections will be described
next, along with indices of a high-quality paper Broadly speaking, research can be categorized
and common prob lems that might indicate as basic or applied research. Basic research seeks
reduced quality or problems with published re- to understand an issue or topic rather than de-
search. termining a targeted solution to a given prob
lem. Basic research is conducted simply for the
knowledge that the research develops. An ex-
Introduction ample is charting the neural framework of the
human brain. Basic research often brings some
Purpose of an Introduction
powerful practical applications, but these can
In the introduction of a research paper or research be unforeseen by the original researchers and
report, an author puts his or her piece of research are often not the intent of the research. None-
into context and lets the readers know why it is theless, authors of basic research need to be able
an important topic. The author also familiarizes to clearly explain their research and why they
readers with other important research in the area. think it is important to o thers. Beyond com-
This is generally referred to as a literature review. municating with readers, if researchers cannot
Most research is not of momentous significance in clearly communicate the importance of their
itself, but represents a small piece of a larger puz- work, they will have difficulty obtaining funding
zle being solved. In a research article or report, the for doing the research and they w ill not gain
literature review presented by the authors should support from a wider community for continu-
be comprehensive. The authors should not rely too ing it.
heavily on only one article or only one point of In education, the more common type of re-
view that has come out of a body of research. This search is applied research. The main goal of applied
is also important for the consumer of research. A research is to determine how well a given inter-
researcher who is turning to research for informa- vention, idea, or piece of technology works to
tion about evidence- based practice must read solve an observed problem. An example is using
the literature in a comprehensive way. Therefore, a prescribed way of demonstrating algebra prob
knowing how any given piece of research relates lems to see w
hether m iddle school students’ math
to other research is important. Has this study di- scores improve. Although applied research in edu-
verged from the norm in an attempt to question cation is often focused on determining the effi-
previous results? Is it a replication of previous re- cacy of interventions or educational approaches,
researchers are often also faced with the chal- Common Problems with the Introduction
lenge of clearly explaining why they think their
research is the right approach. Poorly executed When researchers spend years looking deeply into
research might have the effect of both hiding the a single topic, they can become so engrossed in it
value of an effective instructional approach and and so knowledgeable about the content area that
giving inappropriately positive regard to an in they sometimes find it hard to pare down the
effect ive instructional approach. amount of information they think is critical to un-
derstanding the topic. This leads to a long and
complex introduction. Similarly, if researchers are
Signs of a Strong Introduction
too familiar with a subject area, they may forget
A good introduction w ill be easy to understand that readers who are novices to the topic may not
by the reader (as is true with all the sections of a understand basic information about it. The author
research paper) and give the reader a good sense needs to write an introduction for the full span of
of the place this piece of research holds in a thread readers: those who are new and also those who are
of inquiry. It is not mandatory (or possible) that knowledgeable about the subject.
an author cite every study ever conducted on the In an attempt to address a robust survey of
topic back to the mists of time. An introduction previous research on a topic, authors might leave
w ill present a synthesis of previous research on out crucial pieces of background information.
the topic being studied, without bogging the Since space in a published article is limited, and
reader down with too much information. The au- since authors generally want to spend more time
thor must perform a balancing act, referencing on their own research than on telling a reader
all important previous research and summariz- about other people’s work, key pieces of previous
ing studies and findings in as concise a manner research might not be properly cited. T hese holes
as possible, but without becoming too detailed or in citing key works might also lead to an author’s
long winded. Most journals have firm limits on not putting the current study into context or not
how long articles can be, so the introduction painting a clear line from previous research to the
must be concise. current study. If other studies are simply listed
In the introduction, the author w ill also without providing a summary of the results, it
clearly explain the importance of his or her study. might be hard for a reader to determine how the
By explaining the importance well, the author current study relates to the flow of previous work.
w ill achieve a sense of “buy in” from the reader. There is also a tendency for authors to cite their
Not only w ill the reader continue reading further own previous work more heavily. While this does
in the article, but the explanation w ill ensure that provide a clear, logical flow of results across stud-
any suggestions the author makes l ater about out- ies, it might skew a reader’s perception of what
comes being tried in the larger community w ill constitutes important work in an area.
gain traction. If an author ignores the fact that many read-
A strong introduction usually culminates ers will not be knowledgeable about the topic be-
with the research questions. A fter the author has ing researched, the author may end up making
relayed the pertinent background knowledge and statements that are not backed up with evidence
helped the reader understand why the current or references to previous work. This reflects poorly
study is the next logical step in studying the on the article b ecause the reader is forced to as-
matter at hand, the author w ill explicitly state the sume that the foundation the researcher is basing
research questions. This may be done in para- current work on is solid without the evidence to
graph form or as a bulleted list. independently check the basis for the current
research. By ignoring the need to engage the reader ity, etiology, and so on), how the participants
in a meaningful way, an author reduces the likeli- were selected, what measures were taken, what
hood that the research they worked so hard to equipment was used to collect information, and
produce w ill be viewed seriously. This may oc- what questions were asked of participants, and it
cur when an author is focused more on quickly will state the fact that participants signed consent
disseminating results than on truly communi- documents. If a survey or questionnaire was used
cating findings to an audience for them to digest and space permits, inclusion of the actual ques-
and use. tions is useful. Since research results can only be
generalized to individuals who share character-
istics with the participants, it is important to
Method know who participated in the study.
Central to a good method section are de-
Purpose of the Method Section
tails about what type of research methodology
The purpose of the method section is to allow the was used. (See Sidebar 17.2 for definitions of
authors of the article to explain in detail what terms frequently used in the method section of
they did during the study. A strong method sec- a research article.) Was the study one in which
tion should provide enough detail so that another comparisons were made between groups of in-
researcher would be able to replicate the study. dividuals, or did the study look at one or a few
The method section should also provide enough participants and changes in their behavior over
detail to allow the reader to make judgments time? An explanation of whether the study was
about w hether what the authors did was appro- experimental or quasi- e xperimental is also
priate. For instance, if a study focuses on teach- important. When considering whether a prac-
ing c hildren to read braille, it is important to tice is evidence based, experimental, or quasi-
know whether the intervention being tested was experimental, research carries much more weight
used with c hildren who had sight and read braille than preexperimental research or case studies.
visually or c hildren who were blind and read Information about how long the study lasted,
braille tactilely. If you are reading research in how often the participants received an interven-
hopes of gaining new strategies to teach your tion, how information was collected, and how
young student who is blind to read braille, a study sources of unexplained error or variation due to
that taught c hildren with sight to read braille chance were controlled for is also critical for a
visually w ill not be of use to you, even if the reader to be able to fully understand how the
c hildren in the study learned braille effectively study was conducted. Descriptions of what was
and efficiently. As a result of all the information measured (independent and dependent variables)
that needs to be included in the method section, and how that information was measured should
it is often the longest section of an article. also contain information about quality assurance
checks such as interrater reliability, interobserver
agreement, and procedural fidelity.
Signs of a Strong Method Section
As mentioned previously, a high-quality method
Common Problems in the Method Section
section w ill contain enough detail so that other
researchers can replicate the study and readers The most common problems found in the method
can make decisions about the quality of the study. section relate to a lack of detail. If the method
A complete method section will include thorough section does not contain enough detail about how
information on the participants (age, gender, acu- the research was conducted, it makes it difficult
S I D E B A R 1 7 . 2
Key Terms Used in the Method Section of a Research Article
TYPES OF RESEARCH Single-subject design. This type of research

Experimental design. Any type of research in design focuses on information about one
which something is systematically varied in participant over a length of time. Multiple
order to see or measure the effect of that measurements are taken on this participant’s
variation. This class of research design has performance of some skill or behavior across
specific features like random assignment many time periods (hours, days, or weeks).
of participants to groups and the use of a Sometimes two or three participants can be
control group. used in this design, but in those cases they all
operate as separate small studies that work in
Quasi-experimental design. Similar to experi-
tandem to demonstrate experimental control.
mental design, but this kind of design specifi-
cally lacks random assignment of participants Qualitative research. Research in which a
to groups. Instead, the researcher chooses problem is systematically studied by collecting
which group to place participants in. information based on the actions participants
Preexperimental design. Preexperimental perform or what the participants say. The data
research employs many of the same conven- are often collected by observing or interview-
tions as quasi-experimental designs and ing participants. Once data are collected, the
experimental designs, but all participants researcher analyzes them by looking for trends
receive the treatment. The researcher does not and commonalities across participants’
compare the results of a group of participants actions or words.
who received the treatment against a group Case study. Qualitative research in which the
of participants who did not receive treatment, researcher takes an in-depth look at a person
a control group. in a real-life setting. The perspective of the
Quantitative research. Research in which a participant or participants is at the forefront of
problem is systematically studied by collecting this type of study.
numerical data. T hese numerical data can be ASPECTS OF RESEARCH DESIGN
collected in many forms, but some examples Research design. The way the research is
include test scores, the number of times a
structured. Certain kinds of questions are

participant engages in a specific behavior, or better answered with specific kinds of infor-
the number of times a participant needs to mation. The design can relate to w hether the
perform a task before completing the task research involves interviews or measurements
correctly. Once the numerical data are of performance. The design might also relate
collected, they are typically analyzed using to how the participants are grouped or even
statistical and mathematical models to how many participants t here are.
determine that the results of the study cannot
be attributed to a chance happening. Participants. People (or animals) who take
part in a study. These are the individuals from
Group design. Research in which the average whom the researcher gets data. However, the
performance of one group of participants is unit of analysis may end up being groups of
compared to the average performance of participants, like a classroom of students or
another group (or several groups). By using people with one type of eye condition.
average performances or measures, this
design is less affected by random errors than Control group. In group designs, one group of
some other design t ypes. participants is often created that does not get
433
any treatment or intervention at all. The the thing that is changed by the researcher to
per formance of this control group can be see if it influences the other variable.
compared to that of the groups that get
Dependent variable. In a study where some-
different interventions to see which interven-
thing is changed to see how it affects some-
tion is more effective than getting nothing at
thing e lse, the dependent variable is the t hing
all. Sometimes the control group is referred to
potentially being influenced by the change.
as the “business as usual” group.
It is dependent on what is done to the other
Pretest/posttest measures. Measures taken variable.
before and a fter the research intervention for
QUALITY ASSURANCE MEASURES
purposes of comparison. Often, in research,
Interrater reliability (also interobserver
researchers want to know what happens after
agreement). In studies where researchers are
they do something. But to know this, they
making judgments about what they are observ-
have to know what things are like before they
ing, it is often useful to have more than one
do whatever it is they plan to do. In t hese
person code, rate, or evaluate the observations.
cases, they need to take measures before
How closely these two people’s codings or
anything happens, then do those measures
ratings agree is the interrater reliability, and it
again after they have done whatever they
reflects how well controlled the data collection
planned to do (the intervention), and then
was. This is also called interobserver agreement.
compare the pretest measures to the posttest
measures to see if t here was a change. Validity. The degree to which a measure or
study reflects the t hing it is supposed to.
TYPES OF VARIABLES
Independent variable. In a study where Procedural fidelity. A measure of how well the
something is changed to see how it affects procedures or independent variables in a
something e lse, the independent variable is study are set down and followed.
to make judgments about the study on multiple the method section of a research report needs to
levels. The reader may not know if the methods supply enough detail to allow for replication.
used were appropriate for what was being studied While a clear and thorough method section
or actually demonstrated experimental control. does allow for a study to be replicated, it should
In these situations, the reader loses the ability to also provide reliability information to illustrate
make accurate judgments about the quality of the precision of the current study. Reliability is a
the research. Furthermore, if the description measure of how closely the researchers who col-
of the participants and the methods used is lected or coded the data agreed on observations
sparse, the reader may not be able to make ac- or definitions. Strong studies typically measure
curate judgments about the types of people for reliability for at least 25 percent of data collection
whom the results are generalizable. Evidence- sessions with levels of agreement of more than
based practices cannot be determined on the ba- 80 percent. If the percentage is below 80, it may
sis of only one study. True evidence-based practice be an indication that the data collection was not
is supported by multiple studies that have been as objective as it should have been; therefore, the
done by different researchers. For this to happen, reader should question the results.
Results sults section. For example, parametric statistics is

a set of tests that assume that the data fall along
Purpose of the Results Section what is called a normal curve (also called a bell
curve). T here are special tests that can be done on
The results section of an article presents the data
a set of data to test how closely it conforms to the
from the research and any important statistical
normal curve. A thorough results section w ill
tests run on those data. Typically, a research proj
also explain how the researcher tested to see
ect includes far more data and more tests run
whether the data conformed to these assump-
than can be put into one article. (See Sidebar 17.3
tions and, if they did not, what was done to ad-
for definitions of terms frequently used in the re-
dress this issue. Without this kind of information,
sults section of a research article.) This means an
the results of any testing might be invalid. Unfor-
author must decide what is most important to
tunately, some researchers do not bother r unning
report. Enough data should be included so that
this kind of check on their data, much less re-
readers can get a sense of the data set for them-
porting the results of such checks. Similarly, if the
selves, without having to rely on the word of the
researcher uses statistical tests that are out of
author. Often, a t able of means and standard de-
the ordinary, he or she should explain the test
viations is enough to allow for this, although
and why it is appropriate for the data in that
there are many types of statistical tests whose re-
study.
sults might be presented. The nice thing about
While the strength of a good results section
such a table is that it allows an informed reader to
is largely in its success at helping readers under-
be able to judge w hether any later statistical test-
stand the tests used and results found, a good
ing is done appropriately or whether the new re-
writer w ill draw the line at discussing the implica-
sults match the original data. When the statistical
tions of any statistical testing. It is best if an au-
test results are presented, there is also the expec-
thor gives a very brief summary of what a series of
tation that enough information w ill be presented
statistical tests means but then leaves the larger
so that an informed reader can match the results
implications or discussion for the discussion sec-
with the data. This means giving the test statistic,
tion of the article. A good rule of thumb is to use
the degrees of freedom, the significance level, and of-

one short sentence to explain the numerical re-
ten a measure of effect size or power.
sult of a statistical test in plain language. For ex-
ample, imagine that a group of men and a group
Signs of a Strong Results Section
of women were compared on their knowledge of
A good results section w ill provide a summary ancient Greece, and that this comparison was
table of results (for example, means and standard done using a statistical test that compared the av-
deviations) so that readers w ill be able to assess erage of the two groups. The bare reporting of the
the data on their own, to some degree. This kind statistical test would be a row of letters and num-
of information allows readers to “follow along” bers that might look like this: t(36) = 4.78, p = .02
with the author as statistical tests are conducted (where t represents a certain kind of test and p rep-
and help the reader see why certain tests are done resents the significance of the results). While this
and how the results fit into the bigger picture. information is important for a reader knowledge-
Since readers may not be well versed in statistics able about statistics, adding a sentence that says,
or in all possible tests that could be used, some “The women demonstrated significantly more
level of explanation of the assumptions that go knowledge than the men,” puts the result into a
into a given statistical test is a sign of a good re- real-world context.
S I D E B A R 1 7 . 3
Key Terms Used in the Results Section of a Research Article
Average. Although commonly used as a the sample and so is more a measure of the
synonym for the mean, an average is techni- actual difference being tested.
cally a number that summarizes or repre-
sents the central or typical value in a set of Normal curve. This is also referred to as a bell
data. Averages include the mean, median, and curve or a normal distribution. When data are
mode. distributed in a normal curve, the mean is truly
the central numerical value and is not biased to
Mean. The most commonly used average the left or right when plotted on a graph.
of a set of numbers, calculated by dividing
the sum of the numbers by how many Power. A measure of how likely the statistical
numbers there are. test being run will give a true result rather than
one that results from chance.
Median. The point in a set of numbers
ranked in order at which half are above and Significance level. The level of confidence an
half are below. analyst has in the results of a statistical test. In
Mode. The most frequently occurring education, it is common to set the level of
number in a group. uncertainty an analyst is willing to accept at
5 percent before running any tests. If the
Data. Any information collected in a study that significance of any statistical test is below
is used to understand the topic of the study. 5 percent (generally written as .05), the analyst
Data can be numbers or words. Data can be is willing to accept that result as “statistically
gathered by almost any action, including significant” because the likelihood of getting that
measuring things, talking to p
eople, or observ- result just due to chance is less than 5 percent.
ing people or things. Note that data is the
plural form of the word—datum is the Standard deviation. A measure of spread,
singular—so when talking about “data,” one variation, or range, commonly calculated to
is talking about more than one thing. provide information that complements the mean.
It is calculated by adding all the differences of

Degrees of freedom. A number associated each number from the mean, then squaring the
with a statistical test determined by how many result and dividing by the square root of how
groups of numbers and individual numbers many numbers there are in the group.
went into the test. If a statistical model has
too few or too many degrees of freedom Statistical test. Any test done on a set or
relative to the number of observations that subset of data to demonstrate the likelihood
make up the data set, the resulting data may of a given supposition. T here are many
be called into question. statistical tests out there, and each is de-
signed for use in specific situations, depend-
Effect size. A measure of the strength of the ing on what kind of data a person has,
difference being measured, regardless of whether the data fulfill certain mathematical
the significance of a statistical test. The requirements, and in what way the analyst is
mathematics of many statistical tests lead comparing the numbers.
to a greater likelihood of significance as the
number of individuals being tested increases. Test statistic. The numerical result of a
The effect size is less impacted by the size of statistical test run on a set of data.
436
Common Problems in the Results Section Discussion

Most of the common problems found in results Purpose of the Discussion Section
sections are similar to t hose in the other sections
If using the metaphor of a multicourse meal to
of an article and stem from a lack of clarity or
describe the sections of a research article, the re-
explanation. If not enough data are provided to
sults section would be the entrée and the discus-
readers, they are left to simply trust that what the
sion section would be a satisfying dessert that
author says is true. The intent of published re-
completes the dining experience. The discussion
search is to convince readers, by a presentation
section should not merely be a summary of the
of evidence, that your data accurately support
results. It may briefly summarize the results of
your conclusions. If not enough data is provided,
the study, but it should then take the extra step
the weight of evidence is removed. Similarly, an
of making connections to current theory and
author should refrain from providing so much
practice. The discussion section should include
data that a reader is overwhelmed by numbers,
a frank and transparent discussion about any
graphs, and figures.
limitations or events during the study that may
When statistical tests are run on data, they
a ffect one’s ability to interpret the results. The
need to be explained clearly and thoroughly, the
discussion section should also provide sugges-
results need to be linked to the data in plain lan-
tions for f uture research.
guage, and the implications assessed. A logical ac-
count of what groups, measures, or variables are
being compared; what test is being used; the sta-
Signs of a Strong Discussion Section
tistical or mathematical results of the test; and a
summary of the results and their implications in A good discussion section should summarize the
plain language w ill go a long way to guiding a results in professional but clear language. The in-
reader through the results section. The section troduction sets up the context and rationale for
can be thought of as the author’s opportunity to the study, and the discussion should help the
lay out the evidence to convince the reader of the reader link the new findings presented in the ar-
meaning of the results of the study. ticle to what was previously known and presented
Clear and thorough explanation is especially in the introduction. Often, some of the key stud-
important for novice readers. Too often, authors ies that w ere cited in the introduction w ill be
assume knowledge on the part of readers and do cited again in the discussion, and the authors will
not put in the work to plainly explain the statis- explain how their findings support or refute the
tical testing presented or the graphs and figures previous studies.
used. Many readers are prone to skip results sec- Even the strongest research study has limita-
tions entirely because of an unfamiliarity with tions. The findings of the study might only be ap-
statistics and because results sections are often plicable to a small group or a particular type of
written in a dry, terse style. Structuring the sec- participant or student. Perhaps the study failed to
tion with a logical flow and providing plain- look at how well a participant maintained the in-
language interpretations of e very test run and formation he or she was taught over time or gen-
every graph and figure helps readers unfamiliar eralized the information to another setting. For
with statistics become acquainted with the re- instance, if participants in a study went through a
sults. However, as noted before, authors need to classroom-based curriculum about road safety,
restrain themselves from giving conclusions that and then took a written test about road safety,
should be in the discussion section. the students may not be able to generalize the
information they learned in the class to be able methodology that is used. It is fine for the re-
to cross a street safely without practice in a natu searchers to share their theories, but it is a prob
ral setting, even if the students did well on the lem when they state these theories as if they are
test. So a limitation of the study would be that, supported by the current findings rather than dis-
although the researchers learned that students cussing the theories as topics for f uture research.
had content knowledge about road safety, they Another common problem to be aware of in
are not actually sure if the class would increase the discussion section is when the authors do not
the participants’ ability to cross the street because mention any limitations. Research is rarely con-
this ability was not tested. This limitation does ducted without a hitch, and no single study is
not make the study bad; it just means the re- comprehensive enough to answer all the ques-
searchers are limited to making predictions about tions related to a topic. Every study has limita-
how well the students will do on a test after the tions. While having limitations is not bad, as a
class, not how safe they w ill be when making an reader of research, you should be wary of any pa-
actual street crossing. per that is not transparent about the limitations
A fter summarizing current findings, explain- of the research being described.
ing how the new findings fit in with current One of the most difficult parts of writing a
theory or practice, and acknowledging any limi- research report is tying the bow at the end. Some-
tations of the study, a high- quality discussion times authors simply summarize the results
section should suggest directions for f uture re- without taking the next step to tie the findings
search. The authors should share what they see back to current theory or practice (or discuss how
as the next logical steps along the path to solv- the results contradict current theory and practice
ing or learning more about the problem at hand. or take it in a new direction). The results have al-
ready been described. A good discussion section
should answer the question, “So what?” It should
Common Problems in
synthesize information from the introduction
the Discussion Section
(the setup for why the researcher is d oing the cur-
The discussion section is the part of a research parent study), point out the most salient results,
per where the authors are most at risk for losing and explain to the reader how the current results
objectivity. Despite the fact that researchers need add to the knowledge base. The discussion sec-
to maintain, and typically do maintain, objectiv- tion should be exciting. It should leave the reader
ity to engage in the scientific process, researchers eager to know what the authors think is the next
are also passionate about the areas they study. logical direction for research. It should not leave
Through studying a particular area in depth, over the reader with a summary of the results section.
time, researchers gain an intimate knowledge of
their topic. This leads them to develop theories.
Developing theories helps the researchers con- CHALLENGES TO RESEARCHERS
tinue their lines of research. It is sometimes easy,
however, for the researchers, when authoring a pa- Researchers always face challenges when con-
per, to interject their theories into the discussion ducting studies. No study is perfect, which is
section as fact. In the discussion section, you w ill why articles and reports almost always include
sometimes find that authors make claims that are limitations in the discussion section. While it is
not actually supported by the results or are an ex- unrealistic to expect studies not to have any lim-
trapolation of what can be determined with the itations, a frank discussion of the limitations that
do exist is essential to the authors’ credibility. to strengthen the results of the study. Single-
One limitation that is common within the litera subject research is also perfect for heterogeneous
ture that pertains to blindness and visual impair- populations b ecause comparisons are made
ment is the number of participants. Blindness and within individuals instead of across a large group
visual impairment are considered low-incidence of individuals.
disabilities. This means that compared to other Qualitative research (also defined in
populations, t here are not many potential partici- Sidebar 17.2) is another research design well

pants b ecause blindness and visual impairments suited to groups of heterogeneous individuals.
occur rather infrequently. This is especially true in In qualitative research designs, more attention is
the school-age population because many individ- paid to individual differences and data on indi-
uals who are blind or visually impaired lose vision viduals is generally gathered in more depth and
adventitiously as a result of eye conditions typi- breadth than in focused, quantitative group de-
cally associated with the aging process. signs. By collecting a larger and deeper data set
Furthermore, the population of individuals from disparate individuals, patterns in the data
who are blind or visually impaired is a heteroge- are discovered using analysis of participant re-
neous population. This means the potential par- sponses and behaviors rather than focused nu-
ticipants often have characteristics that vary quite merical measurements. This type of data allows
a lot. Some individuals who are blind or visually for a more unrestricted type of data gathering but
impaired may be highly academic, while a major- often requires much more work in identifying
ity of individuals who are blind or visually im- patterns and themes within the data gathered.
paired have additional disabilities. T here are many
ocular and neurological conditions that lead to SUMMARY
blindness and visual impairment, and they often
have vastly different manifestations. Since most ex- Basic knowledge of the usefulness of research ar-
perimental research involves group designs with ticles as well as what to look for when distin-
large numbers of homogeneous participants, con- guishing high- quality articles from articles of
ducting experimental group research with individ- questionable quality should make readers feel
uals who are blind or visually impaired can be quite more comfortable reading research. For readers
challenging. This, however, does not mean that without a background in statistics or research
quality research is not possible. methodology, some of the processes and infor-
There are approaches to research designed mation might still be difficult to understand,
specifically for small numbers of participants or particularly in the methods and results sections.
that build on individual rather than group infor- However, reading more research will generally
mation. One quantitative, experimental alterna- increase the level of comfort in reading and un-
tive to group research is single-subject research, derstanding research articles. This chapter can
which is defined in Sidebar 17.2 (Wright, 2010). In serve as a useful reference on characteristics that
single-subject research, experimental control can indicate an article’s high or low quality. It is also
be demonstrated with only one participant if the helpful to discuss research with colleagues and
participant is tested across different settings or friends. Talking about what you read not only
activities. It is more common, however, to have promotes a deeper understanding of the research,
three or more participants in experimental single- but it provides an opportunity to collaborate with
subject studies. In this way, results with one par- colleagues, which can help you think of new ways
ticipant can be replicated with other participants to implement what you have learned.
Effect of cane shaft weight and rigidity on perfor

REFERENCES mance. Ergonomics.
Wright, T. (2010). Looking for power: The difficulties
Council for Exceptional Children. (n.d.). Teaching and possibilities of finding participants for braille
e xceptional
c hildren. Retrieved August 20, research. Journal of Visual Impairment & Blindness,
2013, from http://w ww.cec.sped.org/P ublications 104, 775–780.
/CEC -Journals/T EACHING -E xceptional-Children Wright, T., Wormsley, D. P., & Kamei-Hannan, C.
Individuals with Disabilities Education Improvement (2009). Hand movements and braille reading ef-
Act (IDEA), 20 U.S.C. § 1400 (2004). ficiency: Data from the Alphabetic Braille and
Kim, D. S., Wall Emerson, R., Naghshineh, K., & Auer, Contracted Braille Study. Journal of Visual Impair-
A. (2016). Drop-off detection with the long cane: ment & Blindness, 103, 649–661.
18
C H A P T E R
Transition Planning for

Young Adults with Disabilities
Gary Meers and Sally L. Giittinger
By law in the United States, transition services must Serv ices (OSERS), part of the US Department of
be included in the Individualized Education Program Education, and focused on helping persons with
when a student reaches age 16, or sooner in some disabilities prepare for secure employment. In a
cases. This means that all professionals in visual im- position paper, W ill (1984) defined a “new”
pairment who work with high school–age students federal initiative called “transition,” noting,
should have a firm understanding of what is involved “The transition from school to working life is
in transition. While the most common focus of transi- an outcome- oriented pro cess encompassing a
tion is the transition from high school to postsecondary broad array of serv ices and experiences that lead
education or the world of work, transition is a more to employment” (p. 2). While this was a good
general term and has a broader definition. All people start, the definition of transition left out the two
are constantly transitioning from one role or setting to other areas for which individuals need training,
another. Students who are blind or visually impaired guidance, and experience: participation in the
transition from early childhood services to preschool, community and independent living, which w ill
from preschool to kindergarten, from elementary school be discussed later in this chapter. In addition,
to middle school and high school. Students who are transition programming was targeted for stu-
blind or visually impaired also transition from settings dents in middle and high school, whereas today
where one-on-one support is offered to settings involv- it is known that transition is a process that be-
ing small groups or large classrooms. When vision pro- gins in early childhood and continues through-
fessionals have an understanding of the basics of out a student’s education.
transition, they may be more able to help students who Like many other students with disabilities,
are blind or visually impaired transition and those students with visual impairments have many
transitions are much more likely to go smoothly. —Eds. transitions to make before they start focusing on
educational and c areer-selection areas. For many
INTRODUCT ON students, for example, making the transition
from home or early childhood settings to kinder-
The first model for transition was advanced by the garten is a major step in learning about self-
Office of Special Education and Rehabilitative management, new environments, and dealing
441
with individuals other than parents. Each of Sustained Independence

t hese transition steps needs to be planned for and
carefully integrated into the experience of stu- Sustained independence is the concept that individ-
dents with visual impairments. uals need to identify a personal level of indepen
With the understanding that students with dence that is supportive and satisfactory to them.
visual impairments undergo many transitions, This independence is personal but also must be
this chapter w ill focus on the postsecondary in compliance with the rules of the community
school transition process for young adults with and social structure in which they live. To be-
disabilities, particularly those with visual im- come in depen dent adults, students moving
pairments, which is mandated by the Individu- through the educational system need varied ex-
als with Disabilities Education Improvement periences and practice in developing expertise in
Act (IDEA). The first sections of the chapter pro- self-advocacy and self-determination.
vide a general overview of the components and
principles of transition planning. The rest of the Community Participation
chapter presents the transition planning pro
cess in more detail and discusses its principles Community participation involves activities such
and components. as consuming community serv ices, purchasing
goods and serv ices, voting, performing public
services such as volunteering, and engaging in so-
cial interactions through personal interests,
COMPONENTS OF RANS ION
hobbies, and spiritual development.
uman beings spend their lives making transi-
H
tions from one stage, age, location, or relation-
ship to another. They transition from being
Career Development
infants to toddlers to preschoolers and so on, Career development is an ongoing process that
throughout life. In the meantime they make tran- starts early in the lives of c hildren when they be-
sitions from elementary school to middle school gin to identify with community helpers with
to high school. As adults they leave high school whom they interact, learning about them and the
and go on to postsecondary education, employ- work they do to make life better. During the
ment, career development, and then retirement. middle and early high school years, career explo-
Preparation for and success in making t hese tran- ration is undertaken when youths start to ex-
sitions depend on a number of elements such press interest in certain c areer fields and work
as experience, education, support, and personal environments. Career preparation occurs during
preferences. the latter high school years and beyond. During
Based on the research conducted and the tran- t hese years, individuals secure the training and
sition model developed by one of the chapter au- education they need to enter into their chosen
thors (Meers), at every stage, transition is believed career field.
to involve three major components: sustained in Career development is a longitudinal process
dependence, community participation, and career that requires dedication and effort by students if
development. Transition specialists, professionals they are going to realize career success. Accord-
who may work in middle and high schools or for ing to 2010 figures from the Bureau of L abor Sta-
the school district, focus their efforts in these three tistics (American Foundation for the Blind, 2016),
areas as they assist students with disabilities in 75 percent of adults who are visually impaired are
moving from secondary to postsecondary settings. not in the labor force. Of the approximately four
Transition Planning for Young Adults with Disabilities 443
million people who reported vision loss, only Transition with Ongoing Services
875,000 (22 percent)
were identified as em-
ployed. For students who are blind or visually This bridge provides support and serv ices to in-
impaired, c areer development is needed to en- dividuals with disabilities who w ill require cer-
hance access to employment and build the skills tain levels of assistance, financial aid, and
to succeed in the workplace. ongoing c areer aid throughout the duration of
their lives. Persons with more severe types of dis-
abilities would use this bridge most often.
THE BRIDGES MODEL
What had been missing in c areer development
CURRENT TRANSIT ON MODELS
before the OSERS position paper (Will, 1984) was
a formal way to facilitate the transition process Current models of transition include the provi-
and efforts for students with disabilities moving sion of extensive c areer exploration opportuni-
from high school to postsecondary education ties throughout the m iddle and high school years,
and life in the community. That position paper although earlier work in this area is helpful for
articulated a transition model that became some students. Career exploration includes ac-
known as the bridges model. The model outlined tivities like job shadowing (discussed later in this
three types of serv ices, or “bridges,” that are chapter), where students go out into the commu-
needed to facilitate transition from school to nity and follow workers to observe what they do
adult life (Will, 1984): transition without special and learn what preparation they need for that job.
serv ices, transition with time-limited serv ices, As the students get older, they spend time in their
and transition with ongoing serv ices. classes and out in the community expanding
their knowledge and skills in areas of indepen
Transition without Special Services dent living, consumerism, transportation, social
interactions, leisure time use, work experience,
This bridge involves the use of generic serv ices
and c areer preparation. The purpose of t hese ex-
available to anyone in the community. Postsec-

periences is to assist them in expanding their
ondary education, such as that provided by com-
functional skills. For many years the educational
munity colleges, is an example of a generic
focus in the schools was on remedial academics,
serv ice. The key for success in crossing this bridge
but this thinking has changed over the years.
is for persons with disabilities to have knowledge
Today more effort is expended to assist students
of the serv ices that are available and how to ac-
to develop functional skills that are generalizable
cess them. Also, they need to know how to advo-
to adult and community settings.
cate for themselves if there is a need for any
Students with disabilities need to acquire, to
adaptation or modification of t hese serv ices.
the maximum extent possible, knowledge and
experience of the skills needed for everyday liv-
Transition with Time-Limited Services ing in the community as well as methods for
Time-limited services are specialized, short-term generalizing that knowledge to settings outside
serv ices that a person is qualified to access with school. This is why many transition programs in-
the presence of a disability. Vocational rehabili- clude short-term residential programs in which
tation serv ices, which help individuals overcome students live for a few days in a supervised setting
barriers to employment, are an example of this and learn about home management, menu plan-
type of specialized serv ice. ning, food preparation, laundry, and so on. In
such programs, they use their academic skills, but these goals and have a plan for achieving the
in real- world applications. Many residential goals once the student graduates high school.
schools for students who are blind or visually im- This plan can be incorporated into the transition
paired offer transitional living programs, in component of the student’s IEP, but also can ex-
which teachers of students with visual impair- tend beyond high school or age 21.
ments and orientation and mobility specialists
provide the students with specialized instruction. The School’s Role
Students gain skills while living away from home
for a period of time, continuing their academics, The school serves as the initial and primary
and refining their daily living skills in a super- source for transition planning and development.
vised dorm or apartment-like setting. Educational personnel involved in the provision
As the current models of transition evolve, of transition serv ices include teachers, guidance
researchers as well as t hose who implement the counselors, c areer and technical educators, spe-
models are becoming more aware of how school cial educators, social workers, psychologists, and
and employment reform movements provide administrators. These individuals, along with stu-
transition serv ices to and for students with dis- dents and family members, make up the transi-
abilities. With the development of social net- tion planning team. Each person on the transition
works, job listing and seeking have changed team has a role to play as students prog ress
dramatically. Jobs are being restructured, shared, through the differe nt levels of transition plan-
and reformatted, which provides more opportu- ning and implementation. Sidebar 18.1 lists
nities for employment for persons with disabili- some of the steps that students can take during
ties. For t hese individuals to take advantage of the early years of transition planning to prepare
these opportunities, they need to have experi- themselves for the changes to come.
ences that enable them to generalize to multiple
settings. Transition Curriculum
Areas of transition curriculum align with the ex-
panded core curriculum for students who are visu-

COMPONENTS OF ally impaired, including career development,
TRANSITION P ANNING independent living, social skills, and self-advocacy
skills. Instruction in these areas will provide a
Planning for transition is mandated by IDEA in
smooth transition for students moving from one
the United States. Youths age 16 and older (and
setting to another and into adulthood.
younger if deemed necessary) must have an In-
dividualized Education Program (IEP) with a
Career Development
postsecondary transition plan. The postsecond-
ary transition component of the IEP must in- areer awareness should start for students with
C
clude measureable postsecondary goals for disabilities during the upper elementary years.
students based on age-appropriate transition as- Students need to learn about their community,
sessments related to training or education, em- including people who help the community func-
ployment, and in de
pendent living skills (if tion and provide serv ices to t hose that live t here.
appropriate), and a description of transition ser C areer exploration starts during the
m iddle
vices including courses of study needed to assist school years and continues on through high
students in reaching their goals. Students and school. C areer exploration includes spending
parents need to be a part of the development of time in the community observing and talking
S I D E B A R 1 8 . 1
Transition Planning Steps for Early High School Years
As students with disabilities finish their parents this may be the start of a
middle school years and start high school, conditioning process that w ill help them
there are a number of steps they can follow realize their child may leave home and so
and work through that will help start the needs to plan for a f uture placement.
transition planning process. • Expand their identity. As students
mature, their identities expand. Interests,
• Understand the disability. As students get preferences, and needs start to surface and
older they need to understand the disability be articulated in relation to c areer and
they have and how it affects their lives. personal planning. At this time of their
Parents need to come to this understanding lives, students typically start to see
as well. The students and parents need to themselves in a more adult role.
see that the disability may explain them but • Increase self-advocacy. As students come
it does not define them. The members of to know their disability better and
the transition planning team need to be understand how it impacts their life, they
knowledgeable about the disability so they start to see the ways in which they need to
can be a part of realistic planning for the be advocates for themselves. They start
student. learning what accommodations work best
• Understand the transition process. It is for them and how they can ask for them.
important that students understand, to the • Participate more in decision making. As the
extent possible, why focus is being placed high school years begin, students start to
on independence, self-determination, career make more decisions about their lives.
exploration, and other aspects of transitional They need to start learning about self-
life development. determination and the results of the
• Be invited to the transition planning decisions they make. They need oppor
meeting. School officials and the family tunities to do more problem solving and
should encourage the student to participate career planning.

to the maximum extent possible. As with • Use technology. The IEP and transition
any student, some may want to participate planning team need to help students to
and o thers not. The functional level and explore different technologies that will
interest of the student should always be assist in the learning process. As technology
a consideration. is constantly changing and expanding, there
• Complete a vocational assessment. are more and more new devices, programs,
Students should have a comprehensive and applications that can assist students in
vocational evaluation done to identify and their academics and c areer development.
focus their interests, abilities, and aptitudes. • Get involved in community activities.
The results of the evaluation can be used to Students should start to go into the
select courses and training that will support community more via school programs as
the career interests of the student. well as parental efforts. They should start
• Begin discussion of independent living to learn how to use transportation (taxi, bus,
arrangements. This discussion needs to and so on), participate in recreational
start early, as it lays the groundwork for opportunities, expand their social networks,
later decisions that w ill be made. For and, in general, interact in the community.
445
with individuals who are employed in career food preparation, cleaning, and purchasing. (See
areas that are of interest to the student. While Volume 2, Chapter 21, for more information about
developing c areer awareness, students not only independent living skills.)
need to have exposure to the components of the
c areer but also must understand the contribu- Social Skills
tions, responsibilities, and functions of the Personal living may also include maintaining
c areer being explored. In addition, they need to emotional or social relationships. Thus, social
explore and be aware of the other components skills development is an important part of tran-
of a job, such as transportation to and from sition. As students with disabilities mature, the
work, work environment, and social require- requirements for social interaction change. Ex-
ments for job s uccess. pectations for appropriate behavior increase, as
Job-seeking and job-keeping skills should be does the intolerance for inappropriate be hav
a part of each transition effort with secondary iors. Strategies need to be introduced that w ill
students. These abilities build on good social enable students to generalize appropriate behav
skills that have been and are currently being ior to settings beyond school. Time also needs to
refined as students mature. J ob seeking today re- be spent helping students understand how to
quires the use of technology and social network- avoid becoming a victim of t hose that would in-
ing. Students need to learn the use of technology jure or take advantage of them. (See Volume 2,
to the best of their ability to find and apply for Chapter 22, for more information about social
employment. They also need to understand how skills.)
to network and use all the resources they have
available to them to find potential employment. Self-Advocacy
Job-keeping skills that should also be learned in-
Self-advocacy is a major goal of transition. Help-
clude coping with different social interactions,
ing students to understand how their disabilities
responding to supervision, employing self-
impact their lives is an important part of their
discipline, and responding to criticism. (See Vol-
development of a personal identity. All students,
ume 2, Chapter 24, for more information about
even those with intellectual disabilities, need to

career education.)
acquire basic skills in letting their preferences be
Independent Living known. For many years it was assumed that people
with certain types of disabilities w ere better suited
Inde
pen dent living success is based on under-
for certain jobs, but, like typical students, students
standing one’s abilities and how to use resources
with disabilities should explore, experience, and
and individuals to maintain a level of indepen
expand their abilities to make choices about the
dence that is appropriate and supportive. Devel-
place they live, the friends they have, and the type
opment of in dependent living skills starts in
of work they do. (See Volume 2, Chapter 25, for
preschool and often continues throughout the life
more information about self-advocacy.)
of the individual. Successful planning for inde
pendent living skills depends on a realistic under-
standing of what independence is for that person.
Location for Transition Education
Personal living is maintaining an independent Locations for transition planning and instruction
lifestyle in a way that is personally rewarding and may include a number of differe nt sites. Some
consistent with how the individual defines his or transition planning can and w ill be done in a
her life. Personal living involves the ability to per- school setting. Other portions w
ill be conducted
form certain personal tasks such as hygiene, in the community, where students can transfer
and generalize their knowledge and skills to site involves work in the school cafeteria, such as
other settings. Ideally, locations for transition ed- cleaning tables, it is best to place the students in
ucation would be real-world settings, such as a an elementary setting. This way the student
workplace or apartment, so that the students can worker is older and w ill have more status; in addi-
start to see themselves in such settings when they tion, they w ill not be cleaning up a fter peers. The
graduate or age out of school. job sites should be selected based on the specific
skills that need to be developed or behavior that
Career Exploration needs to be shaped. They are safe places to help
students to gain experience in working through
Vocational Assessment specific tasks, learning work discipline, and devel-
oping confidence that can be carried into the
To select specific c areer goals, students must un-
workplace. Students can then move into the com-
derstand their own interests, abilities, and apti-
munity for experiences such as job shadowing
tudes. Their interests can be explored using some
and community-based work experiences.
of the strategies that have been discussed previ-
As mentioned previously, job shadowing is a
ously, and a comprehensive vocational assess-
career learning experience in which students se-
ment w ill do much to help them identify their
lect a number of career areas that interest them,
abilities and aptitudes. T hese assessments iden-
and they go out and follow, or “shadow,” individ-
tify cognitive and psychomotor abilities that
uals that work in t hese fields. Job shadowing has
students w ill need for certain c areers. A com-
many benefits because students get the opportu-
prehensive vocational assessment can take hours
nity to observe the sites and workers over a pe-
or days, depending on the results that are being
riod of time, allowing them to see different parts
sought for the student. The resulting report should
of a job. Job shadow programs are frequently set
be used to help plan the courses that w ill be taken
up to last a semester in length. The students do
or skills that w ill be developed. The assessment
in-school exploration of careers that they are
w ill reveal other abilities of the student, such as
interested in learning more about by performing
being able to stay on task; follow directions; and
Internet searches and interviews, and they write
distinguish colors, sizes, and shapes. A vocational

up their findings. Then they select four to six
rehabilitation counselor typically starts working
sites that they w ill shadow. They spend between
with students with disabilities at age 16, so this
one and five days shadowing individuals (one or
professional can be involved in reviewing the
several workers) at each site. During the shadow
results of the assessment and making recom-
phase, they not only observe but have the op-
mendations for f uture opportunities a fter high
portunity to perform some of the work tasks.
school.
A job shadow coordinator works with the
sites to coordinate the experiences. A training
Vocational Training
agreement is developed and reviewed with par-
In-school job sites help to get students with disabil- ents and with personnel at the job site. Since the
ities started in developing workplace be havior student receives credit for the shadowing and
and discipline. The job site can be anywhere that t here is a training agreement in place, safety and
gives students responsibility, is safe, and involves insurance responsibility rests with the school.
work they are capable of d oing. Secondary stu- Once the students have completed their job shad-
dents should not be placed in job sites that require owing experiences, they return to the school,
them to interact with their nondisabled peers in a where they report on their experiences and share
visible service role. For example, if the school job what they have learned.
Community-based work experience is designed transition process. As students reach the later
for students to go into the community and work years of their secondary education, they need
at specific jobs. The jobs are identified and se- to spend time with their families exploring
cured by the work experience coordinator, most where and what w ill be the next steps a fter they
frequently a special educator who is assigned graduate high school or leave public education.
this duty and given time to supervise and coor- Sidebar 18.2 explains many of the steps involved
dinate t hese job sites. Community-based work in the planning process during the last two years
experience may be paid or unpaid. Most stu- of a student’s high school career.
dents start their community-based work experi- Transition planning meetings to set postsec-
ences at unpaid sites b ecause they do not have ondary goals need to include the individuals and
the social and interactive skills needed to be suc- agency representatives that w ill be a part of the
cessful workers. postsecondary placements. These may include
A job coach works individually with students adult service providers, employers, and represen-
to develop their so-c alled soft skills, facilitate tatives from colleges and residential agencies.
proper workplace behavior, and help with self- Depending on the student’s life goals, his or her
management. Since the students generally start disabilities, and the support system in place, the
out in unpaid positions, employers typically are number of individuals and agencies that will be
more lenient about expectations, allowing time involved in the planning w ill vary; however, ef-
for the job coach to help students to develop ac- forts need to be made to ensure that no service or
ceptable workplace skills and habits. As students option is left out during the transition planning.
prog ress in their workplace development, they
become more valuable to the site and as a result
they start to receive pay.
Stakeholders in Transition
Work experience coordinators and job The stakeholders in transition—those individuals
coaches work with vocational rehabilitation who receive or provide serv ices as well as those
counselors during this time because typically who have an emotional or supportive connection
students with disabilities become eligible for vo- to a student with disabilities—need to be incor-
cational rehabilitation serv ices at age 16. Among porated into all phases of transition planning and
t hese ser
v ices are funds for paying students development. All planning needs to center on
while they are on community job sites. In addi- students with disabilities and their goals for life
tion to the clear benefit that students receive pay after high school if transition is to be successful.
for their work, this coordination also allows the By taking a student-centered approach, advocates,
vocational rehabilitation counselor to get to teachers, parents, and adult serv ice providers will
know and plan with the student, so that when keep the end goal of student self-determination
the student graduates or leaves school the coun- in mind. Transition models must include all
selor is knowledgeable about the student and stakeholders at key times during the transition
where he or she is in career development. This process. The transition planning case manage r
helps the transition to post–high school experi- needs to make sure to keep everyone informed as
ences much easier. meetings are held and decisions made. Success-
ful transition planning includes listening to the
stakeholders. Assumptions should not be made
Postsecondary Planning nor directions taken without everyone having
Postsecondary planning for the time when stu- input and all the stakeholders listening to each
dents have left high school is a key part of the other and, most importantly, the student.
S I D E B A R 1 8 . 2
Planning Steps for Transition to Adulthood
The last two years of high school are very busy • Explore postsecondary education options.
with regard to transition planning. It is during Students and their families should explore
this time that major decisions are made about postsecondary education options and
the next steps that w
ill be followed upon identify support services that are available
leaving high school. It is critical that the in these programs. Students should set
transition planning process is comprehensive up an appointment with their guidance
and clearly understood by all involved. The counselors to discuss accommodations that
following are some transition steps for the are needed to take college entrance exams.
planning team, the student, and the family to Visits to postsecondary sites should be
follow as students complete their high school scheduled to allow students and families
careers. to talk with faculty and personnel in the
Students with Disabilities Office to learn
• Identify adult service agencies. Students, about accommodations and supports.
parents, and the transition team identify Students must have the skills of self-
adult and community service agencies that disclosure—that is, know and understand
can provide assistance to students based how to explain their disability or vision loss
on their disabilities. The transition team and its impact on their learning—in order
needs to make sure that all possible to access services available at the
options have been identified, explored, and postsecondary education level.
discussed with all of the stakeholders. • Explore alternative career options. Students
• Meet with adult service providers. Adult should participate in job shadows, job
service providers should be invited to the internships, work experience, or paid
transition planning meetings. This will give employment to gain insight about post–
an opportunity for the parents and students high school employment options. Students
to ask questions and get information about need to complete an inventory of the
the services that can be provided. The preferences, strengths, and interests that
adult service providers will get to know the they have discovered as a result of their
students and can start to develop a plan for community-based career exploration.
helping the students when they are out of • Determine eligibility for financial support.
high school. The transition planning team should
• Identify students’ strengths. The help in determining student eligibility for
comprehensive vocational evaluation that financial support. Students and f amily
has been completed should be reviewed. If members should contact the appropriate
one has not been done, then this needs to agencies to begin the application process
be completed as soon as possible. This for such support (for example, Medicaid,
information w ill be used, along with Supplemental Security Income, or
academic and functional assessments, vocational rehabilitation).
to identify student strengths. All of this • Transfer of rights. Prior to the student’s
information w ill be compiled and used by birthday at which he or she reaches the age
the team so the appropriate vocational or of majority, or adulthood (usually between
educational programming can be 18 and 21, depending on the state), the
developed for the students. transition planning team should discuss

449
with parents and students the educational copy of all educational records before
rights that w
ill transfer from parents to exiting high school. This set of records,
student at that point. Options, such as along with the transition portfolio, can
guardianship or conservatorship, for then be used as needed in postsecondary
students who are not able to provide settings such as colleges or workplaces.
informed consent with respect to their
educational programs should also be • Establish measurable postsecondary
discussed at this time. outcomes. The postsecondary transition
plan mandated by the Individuals with
• Create a transition portfolio. Students Disabilities Education Act for students age
should complete a transition portfolio by the 16 and older must include postsecondary
time they graduate from high school. The goals. Students and parents need to be
portfolio should contain a summary of integrally involved in developing t hese
transition services received as well as c areer goals. The goals must be measurable
experiences such as vocational assessments, and based on age-appropriate transition
job shadows, and job interviews and the assessments. The plan has to include a
student’s resume and references. description of transition services,
• Copy educational records. Students and including courses of study, needed to
their parents should request a complete assist students in reaching their goals.
Interagency Collaboration services. Each of these agencies needs to know

what the others are doing and what services they
The school transition planning team collaborates are providing; services need to be coordinated but
with agencies that w ill help with the transition not duplicative. By bringing these agencies to-
process and assume responsibility for services for gether at transition meetings, schools w ill support
students with disabilities once they leave school. parents or guardians and agencies in developing a
It is important to get these agencies involved as longitudinal transition plan that is customized for
early as is possible under the law so they can de- the student.
velop an ongoing relationship with the student The relationship of these adult agencies to the
and his or her parents or guardians. The school individual are not time limited, as they w ill be
transition specialist should identify all of the providing serv ices and funding for the life of the
agencies that can provide adult resources and sup- transitioned adult. They aim to help each client
port for the student and arrange referrals. Most to be successful in all aspects of his or her life and
agency representatives focus on their own agen- w ill strive to provide necessary serv ices; if they
cy’s role; each will need to educate the entire team cannot, they w ill provide referral to agencies that
about their programs and services. The transition can. They function as long-term life coaches.
specialist or case manager will need to facilitate For students who are blind or visually im-
the collaboration of these agencies and services paired or those with multiple disabilities, nu-
and make sure that the team remains focused on merous agencies may be involved in providing
the needs and interests of the student. transition serv ices. The state vocational rehabili-
Some agencies deal with employment, o thers tation agency for the blind can provide a variety
with therapy, medical support, or residential of services related to employment, postsecondary
education, and independent living. The serv ices needs and quality of life desired for young adults
provided may include, but are not limited to, the transitioning to their level of greatest indepen
following: dence. The key is to be focused on the individual
and plan from t here, with circles of support po-
• Job seeking and obtaining employment sitioned as needed for success in an adult living
• Career counseling and guidance resulting in situation.
employment In working with the differe nt agencies and
organi zations that provide adult serv ices, transi-
• Job-related equipment, tools, technology, and tion planners need to look beyond just residen-
supplies tial and c areer options to include quality-of-life
• Educational assistance such as tuition, books, issues for persons with disabilities. T
hese options
equipment, and readers may include the following:
Adult agencies that deal with vocational training • Respite care opportunities to allow families a
and placement have knowledge of the job market break from caregiving
and the location of potential jobs. They know
• Leisure or recreational programs
what training and skills are needed for c areer suc-
cess and w ill be able to direct students to such • Financial planning
programs.
For students who are blind or visually im- Parents of adult c hildren with disabilities that
paired and those with additional or multiple prevent them from living independently need to
disabilities, adult agencies that serve t hose with be made aware of the options they have for respite
developmental disabilities may be involved. If care for their child so that the parents can take
they are eligible for serv ices, this type of agency some time off from caregiving. Respite care can take
may be involved in coordinating serv ices and many different forms, ranging from a few hours
also w ill assist the individual and his or her during an evening to a weekend to a stay in a spe-
family in accessing additional resources, living ar- cialized setting such as a home or camp for sev-
rangements, daily programs, and employment. eral weeks. Parents need to become aware of respite
A typical progression for a young adult is to options and how they can use them.
move through high school, graduate, and go to a The original transition model was designed
postsecondary educational setting or employ- to help prepare young adults for employment
ment and live on his or her own. Depending on after high school. As specialists have realized that
the situation or disability, a young person may there is a lot more to transitioning from high
not be able to live independently and w
ill require school to adulthood than just employment, the
ongoing care and support. Working with transi- model has been expanded to include leisure and
tion planners, students with disabilities and their recreational planning as well. The transition team
parents need to explore different living situations needs to work with the students to learn of their
that are available. During the past few years, cus- interests and preferences so that they can assist
tomized living options that utilize the functional them in expanding their hobbies, community
skills and independence abilities of students with activities, and use of leisure time. It is easy for
disabilities have expanded. Group homes, sup- young adults with disabilities to become isolated
ported living situations, and personal attendant if a concentrated effort is not made to keep them
options need to be considered with regard to the engaged within their social network.
Parental Involvement • Set realistic goals. Parents want the best for
their children, which is reasonable and ex-
Parental involvement is essential in the transition pected; however, they need to be realistic in
effort. The school transition planning team needs the goals they set for themselves and their
to create a process for communicating with par- children. Parents need to work with their

ents and guardians. Since parents are typically in- children through the m iddle and high school
volved in the IEP team throughout the school years so that together they can identify and set
years, they are accustomed to working with and realistic goals. As the students move into adult-
interacting with educators and agency personnel. hood, goals that are being set need to be recon-
When the transition planning process starts, they sidered to see how realistic they are. If the goals
can be used as resources and their input solicited are impossible to achieve, the student w ill be-
to provide direction for the transition compo- come frustrated, and if they are too low, the
nents. Some parents w ill be actively involved in potential of the child is not being achieved.
the educational and transitional prog ress of their Parents need to consult as many resources as
children, and others will play l ittle or no role. The they can as they help their children set realistic
important t hing for the school to do is commu- goals, and it is crucial for the teacher of stu-
nicate with all parents and guardians on a regu- dents with visual impairments to connect
lar basis and seek their input. W hether they them to agencies such as the state Department
participate is their choice, but at least the oppor- of Vocational Rehabilitation and Commission
tunity has been provided. for the Blind and Visually Impaired, local and
Parents or guardians may not be aware of the national advocacy groups for p eople with vi-
agencies or options that are available to their sual impairments, and local and national par-
child as he or she reaches adulthood. Since spe- ent groups (see the Resources section in
cial education is required by IDEA to provide the online AFB Learning Center for list-
serv ices from birth (when serv ices are enumer- ings). As parents gather more informa-
ated in an Individualized F amily Serv ice Plan) tion, they will be better able to develop goals
through graduation or age 21 (through an Indi- that are realistic and achievable by the child.
vidualized Education Program starting usually at

age 3), parents or guardians get used to the IEP • Encourage gradual independence. Parents
case manager identifying and securing the needed need to work on developing maximum inde
educational, therapeutic, and support services to pendence for their c hildren. As they w ill not
keep students progressing in their lives. As stu- always be around, they need to help their
dents get older and graduation or the age of c hildren to set goals and create opportunities
school completion gets closer, parents need to be for independence to develop. A good place to
made aware of what agencies can help their son start is with personal hygiene. Self-care abili-
or daughter and what serv ices they provide when ties should be developed and mastered. Then
the individual is no longer eligible for education- other independence elements can be intro-
based serv ices u nder IDEA, as discussed in the duced over time, such as transportation use,
previous section. money management, decision making, social
The following are some suggestions that pro- interactions, leisure activities, and residential
fessionals can share with parents about ways they management. At times, parents are unsure how
can help their child’s transition from school to to teach their c hildren who have vision loss
adult life: basic independent living skills such as these.
Parents can partner with teachers of students lenges they need to have opportunities to de-
with visual impairments and orientation and velop self- esteem and confidence. Parents
mobility specialists to learn strategies for should teach their c hildren, to the extent pos
teaching t hese visually based skills. sible, the same skills they would teach any
• Become knowledgeable about transition. child. Assigning them chores to do around the
Parents need to get all the information they house, such as having them do laundry, sew
can about how the transition process works. on a button, w ater the lawn, or feed the dog,
With knowledge about transition they can ask is a way to teach them responsibility as well as
key questions and identify needed resources. develop their self-esteem. When parents hover
They can work with their maturing children on over their c hildren and do not ask anything of
self-
advocacy and self- determination skills them, they are d oing a disserv ice to the child
and assist in the development of indepen and slowing down the development of that
dence. Awareness of the process of transition child’s self-confidence.
helps parents to think more long term and • Encourage social integration. At times it is
globally about how their adult c hildren are easier for parents to allow their c hildren with
going to function and cope in the f uture. disabilities to sit at home rather than encourag-
• Become familiar with the adult service sys- ing them to get out and interact with others.
tem. Parents need to become informed about Students need to be encouraged to participate
the available programs and the criteria for each in community, religious, leisure, and serv ice
one. In many cases there are long waiting lists activities so they can continue t hese a fter they
for adult services, and the earlier a child’s name complete high school. Parents need to be
gets on the list, the quicker he or she will get knowledgeable about what social opportuni-
adult services. As already noted, in the adult ties are available and then help their c hildren
service system it is up to the parents or adult to become involved. Students who have higher
child to find the serv ices that need to be se- levels of peer social interaction w ill be more
cured. The range of information about re- satisfied with their quality of life.
sources, such as how to obtain Supplemental • Provide real experiences. As a result of their
Security Income (the federal income supple- disability, students may not have extensive
ment program that assists people who are aged, real-life experiences. For example, their health
blind, or disabled and have limited income), or level of functioning may not permit them
where to find residential care providers, how to to hold part-time jobs. As a result they may
identify vocational training sites, and ways not have a lot of real-life experiences to use
to secure adult day care, can be overwhelming, as they make decisions about their c areer or
so the more information the school can pro- job. The more experiences the students have,
vide and the more familiar parents are with the the more foundational knowledge they have
resources available, the more services can be se- from which to make choices. Also, experiences
cured that meet the specific needs of their child. in real-world situations provide students with
• Build self-esteem. Every child has a future. the experience of being accountable for their
This fact needs to be the center of all that is actions. When taking directions from someone
done to help a child move t oward adulthood. outside the home or being supervised by some-
Students with disabilities face many challenges one other than a parent, students with dis-
as they grow up. In coping with these chal- abilities face some challenges in discerning
how they should respond. The more real-life The Community’s Role in Transition
experiences they have, the more realistic they
The ultimate site for a successful transition is the
can be in their life choices.
community in which the students w ill spend
• Encourage development of good work hab- their lives. The community is where they w ill live,
its. Good work habits are desirable for every travel, vote, drive, worship, and work. The stu-
one. Being well groomed, using appropriate dents need to know what resources are available
language, understanding social bounda ries, to them and, in turn, the community needs to
being on time, and working hard at assigned know how they can help t hese young adults to be
tasks are characteristics that are desired in successful. Working with business organi zations
all workplaces. Understanding how valuable such as the Chamber of Commerce is a way to
t hese good work habits are and how to prac- help communities and business leaders learn
tice them is important for students with dis- about how they can help persons with disabili-
abilities. If parents are able to develop good ties to be successful. Business leaders and others
work habits in their c hildren over the growth within communities are usually familiar with the
years when they participate in work experi- Americans with Disabilities Act, but they often
ences in high school, they are going to be do not know specifics about disabilities and how
sought a fter as employees once their school- they can help t hose with disabilities become pro-
ing is completed. ductive citizens. This is where schools, parents,
• Foster the acceptance of criticism. It is some- and advocacy groups can step forward and share
times easy for parents to become too protective information about opportunities to help persons
of their children owing to the disability or the with disabilities in the areas of employment, res-
care that they have given them over the years. idence, and r ecreation.
The process of letting go of an adult child is
difficult. They need to work with their c hildren
and help them to understand and accept criti- FOL OW- P PROCED RES
cism when it is warranted. Employment suc-
cess depends to a large extent on the ability Schools should have a formal method of follow-
to accept criticism and learn from it. If employing up with special education graduates to see if
ees do not understand that criticism can be a their transition from high school was success-
learning tool rather than just a negative inter- ful. The follow-up method can take a number of
action, they are g oing to have a hard time in different forms, such as interviews, surveys, or
the workplace. The more parents can help their phone calls. The results need to be reviewed
children in this area, the better prepared they carefully to identify the successful parts of the
will be when working. transition process as well as determine where
improvements need to be made.
• Provide opportunities to manage money.
Teenagers should be paid for their work. Once
paid, they need to learn how to manage their SUMMARY
money. Parents should work with their
c hildren to show them how to budget, shop, hildren with disabilities are in need of long-
C
and save their money. This is an important term and specific transition planning efforts
part of life for everyone, disability or not. A from preschool all the way through their high
better understanding about money manage- school c areers. This is a process that involves
ment w ill help students to cope as adults. educators, family members, adult serv ice agen-
cies, and other stakeholders, as well as students to expand. As everyone involved in transition
themselves. For transition to be successful in gains more experience and barriers to career suc-
fostering the development of an independent, cess continue to fall, students w
ill enjoy even
productive adult, planning needs to center on more opportunities to achieve their c areer and
the students with disabilities and their goals for personal goals.
life after high school. By having a transition plan
in place that coordinates all of the serv ices and RE ERENCES
personnel of schools and agencies and involves
family members, students with disabilities will American Foundation for the Blind. (2016). Interpret-
be able to prog ress toward personal, career, and ing Bureau of L abor Statistics employment data.
community goals while increasing their level of New York: Author. Retrieved from http://w ww.afb
.org /i nfo /blindness -s tatistics /i nterpreting -bls
satisfaction with the life choices they have made.
-employment- data/24
The transition process for young adults with
Individuals with Disabilities Education Improvement
disabilities w ill continue to be defined and re- Act (IDEA), 20 U.S.C. § 1400 (2004).
fined as more is learned about how to effectively Will, M. (1984). OSERS programming for the transition of
assist t hese individuals in charting their f utures. youth with disabilities: Bridges from school to working
It is an exciting time for t hose involved in transi- life. Washington, DC: US Department of Educa-
tion planning because the postsecondary oppor- tion, Office of Special Education and Rehabilita-
tunities that exist for t hese individuals continue tive Ser v ices.
19
C H A P T E R
Problem Solving and

Critical Thinking
Kim T. Zebehazy and Rachel C. Weber
eople often quote Moses Maimonides, saying, “Give

P while taking one of the dogs for a walk. The
a man a fish and you feed him for a day; teach a man other dog was now locked inside and Zoë could
to fish and you feed him for a lifetime.” It is important hear him barking. Her purse, keys, and phone
for educators not only to provide for the moment, but were also all inside, sitting on the kitchen
also to teach their students how to provide for them- counter. Zoë’s mind raced as she thought about
selves at any time. The focus on critical thinking in what to do. Given that the obvious options were
schools today reflects a desire to support students’ inde not available, she had to be creative. Was there
pendent problem solving. Professionals in visual im- a doggie door? Could Fido sprout opposable
pairment spend a g reat deal of time teaching students thumbs? Were there any windows unlocked?
how to problem solve and think critically. For instance, What was that neighbor’s name again? Was any-
orientation and mobility specialists do not limit their one outside who could help? Clearly, Zoë had
teaching to fixed routes with most students. They teach started the problem-solving process and was
students how to analyze, plan, and travel a variety of thinking critically about possible solutions.
different routes so that they will eventually be able to
analyze and travel any necessary route. In that spirit,
professionals in visual impairment need to understand INTRODUCT ON
how to teach students to think critically. Examining the
broader context of this effort in general education can As illustrated in this vignette, problem-solving
be helpful. This chapter provides important general in- skills are necessary on a daily basis. While you
formation about this topic that can be applied to many may not have faced a scenario like Zoë’s, you can
situations in the core and expanded core curriculum for probably think of many instances in which you
students with visual impairments. —Eds. needed to quickly resolve a challenging situation.
It may be hard to remember where you first ac-
V GNE E quired t hese skills, but it is likely that they devel-
oped through a combination of your everyday
Zoë could not believe what she had just done. experiences and your formal schooling. In edu-
While dog sitting for her professor, she some- cational settings, problem-solving and critical
how managed to lock herself out of the house thinking skills span all content areas and can
456
Problem Solving and Critical Thinking 457
improve with direct instruction, exposure, mod- as bad report card grades, and it may need to be
eling, and practice (Diamond, 2012; Ku, Ho, narrowed down to a manageable one to begin
Hau, & Lai, 2014). While they may not have this process. Depending on the problem, this
been explicitly taught in the past, the importance may involve identifying the source of the issue or
of educators’ supporting the development of these people involved in the situation. It is also

skills is currently highlighted by their prominence import ant to identify the f actors related to why
in the common core standards now adopted by the problem exists. Students may struggle with
many US states (Common Core State Standard recognizing reasons for the problem. Using a
Initiative, n.d.). questioning technique with a student might help
In addition, as mentioned, problem solving with this difficulty. For example, using the situa-
and critical thinking are necessary in everyday tion of bad report card grades, Evan narrowed
contexts, not just academics. Successful problem his focus to just Eng lish class and then identi-
solving and critical thinking can also contribute fied several reasons for the poor grade, one of
to one’s quality of life and social-emotional well- which is being repeatedly late to class. F actors
ness (Ciairano, Bonino, & Miceli, 2006; Siu & that Evan identified as being related to the prob
Shek, 2009). Teachers play an important role in lem included the fact that English is after lunch,
helping c hildren become good thinkers. The ex- the distance of his locker from the cafeteria and
tent of the teacher’s role is dependent on mind- English classroom, the cafeteria lines reducing
ful and reflective instruction that provides the amount of eating time, and lunch being the
children with opportunities to problem solve and only time of day he sees his best friend.
critically think. This chapter w ill discuss some of There are many different ways to look at any
the import ant concepts and theories related to given problem, but for skill development pur-
t hese skills as well as provide some suggestions poses it is important that the teacher follow the
for how to promote them. The general theories student’s lead in defining the problem. Real-life
and ideas presented in this chapter are applicable problem solving is a complex process; however,
to students who are blind or visually impaired, when first learning these steps, narrowing the
particularly b ecause they may not be encouraged, problem is crucial for simplifying and modeling
in some contexts, to solve problems indepen the process.

dently.
2. Brainstorm Solutions
WHAT IS PROBLEM SOLVING?
Based on the defined problem and related f actors,
Steps to Problem Solving the second step of the process involves coming
up with a list of possible solutions. Initially,
While the steps to problem solving vary between
this list should not be limited by feasibility
models, the main components are basically the
or imposed judgments by other individuals.
same. This six-step version illustrates the thought
Judgment of t hese solutions is the next step. In
process as well as the skills necessary to be a suc-
the example, solutions Evan brainstormed in-
cessful problem solver.
cluded
1. Define the Problem
• skipping lunch,
The first step to solving a problem involves un-
derstanding exactly what the problem is. The ini- • dropping English,
tial problem identified may be too broad, such • leaving lunch early,
• making sure to have all English materials with both positive and negative consequences. Stu-
him during lunch, and dents may need support to come up with both
• using the time in the cafeteria line to talk with types of consequences as well as to consider those
his friend. consequences that are not immediate.
4. Choose the Best Option

While it is important to encourage broad brain-
storming, some students may need help in limit- Once the potential positive and negative conse-
ing the number of solutions they generate, in quences have been listed, it is time to choose
order to make the task more manageable. Other the overall best option. Students may need to be
students may need assistance in generating real- guided through the process of elimination. By
istic solutions or withholding judgment u
ntil the eliminating those options with intolerable nega-
next step. tive consequences (or few positive consequences)
or those that are not feasible, students may be
3. Evaluate the Solutions able to better manage selection of the best re-
maining options. In the example, owing to their
In this third step of problem solving, each solu- potential to optimize social time, Evan identified
tion is evaluated in terms of its potential conse- his top two choices as standing in line with his
quences (positive and negative) and feasibility. friend in the cafeteria and bringing his English
There are two components to feasibility: external materials to lunch. However, bringing his English
and internal restrictions. External restrictions materials to lunch could also have the negative
would include limitations set by law, policy, and consequence of fatigue, so Evan selected the for-
interested parties in the problem. Internal restric- mer as the first solution to try.
tions would include the individual’s skill set
used to implement the solution. 5. Implement the Solution
In Evan’s example, external restrictions in-
cluded school policy related to skipping or drop- In the fifth step, it is time to implement the solu-
ping classes as well as parental concern about tion. Depending on the complexity of the prob
missing class or lunch. Internal restrictions in lem and the solution, the student may need to list
this case were probably unlikely, but, depending the steps for implementation. The teacher may
on the student, could have included a lack of time find it is necessary to talk with the student about
management skills, inability to carry all materi- how he or she w ill know if the plan worked and
als needed, or a health condition requiring daily work with him or her to develop a timeline for
lunch. In addition to the restrictions, negative how long it w ill take to implement the solution.
consequences for t hese solutions could have been The teacher may also want to schedule a time to
hunger (in the case of skipping lunch), summer check in on the student’s prog ress. In the exam-
school (in the case of dropping English), losing ple provided, Evan should not expect to be able
time with his friend (in the case of leaving early), to proceed to the sixth step of problem solving
or physical fatigue (in the case of an overstuffed without giving the solution at least a week of im-
backpack). Positive consequences, in addition to plementation.
being on time to English, might have included ex-
6. Evaluate the Outcome
tra time with his friend (in the case of chatting
while in line) and not feeling rushed (in the case In this final step, the outcome of the selected so-
of leaving early). Any given solution might have lution is evaluated in terms of how well it solved
the problem. Ideally, this will have addressed the ful process that involves analyzing, synthesizing,
initially defined source of the problem as well. It and evaluating information obtained through a
is possible that the problem will not be solved, or variety of methods. This is typically viewed as an
only partially so, by the selected solution. This re- internal process guided by a person’s own reflec-
quires revisiting the original list of solutions and tive thinking. To think critically, a student must
possible additional brainstorming. In this case, possess reasoning and processing skills and be
a student may need help to identify why the able to apply them to guide his or her thoughts
solution did not work and consider how other and behavior (Foundation for Critical Thinking,
solutions differ in a way that addresses the short- n.d.). In this digital age, where a vast amount of
coming. If, after a week of implementation, Evan information of variable quality is readily avail-
only made it to English on time three of the five able, the ability to critically think about and
days, it would indicate that he had only arrived at evaluate this information is crucial.
a partial solution to the problem. Evan may need Paul and Elder (2009) list the following char-
to consider why he was still late on the other days acteristics of a “well-c ultivated critical thinker”:
and revisit other solutions.
A well-c ultivated critical thinker raises vital
Considerations for Teaching questions and problems, formulating them
clearly and precisely; gathers and assesses
When initially teaching t hese steps, this process relevant information, using abstract ideas to
will be time intensive and may seem unnatural. interpret it effectively; comes to well-reasoned
As adults, we engage in t hese steps automatically conclusions and solutions, testing them against
and very rapidly. The goal for teachers is to pro- relevant criteria and standards; thinks open-
mote this automatic, quick progression through mindedly within alternative systems of thought,
the problem-solving steps. This w ill require fre- recognizing and assessing, as needs be, their
quent practice, scaffolding (that is, the provi- assumptions, implications, and practical con-
sion of instructional supports to facilitate new sequences; and communicates effectively with
learning [Rosenshine, 2012; see also Chapters 5 others in figuring out solutions to complex

and 11 in this volume]), and the present at ion of problems. (p. 2)
increasingly complex prob lems. In addition,
students should be encouraged to bring forward
real-life problems they are facing, which w ill
Considerations for Teaching
support transfer and generalization of the skills. Opportunities for critical thinking can be em-
Quality prob lem solving also involves more bedded into prob lem-solving instruction. Stu-
than just knowing the steps. It requires several dents should also have opportunities across core
higher-order thinking processes that are com- content areas to engage in the critical thinking
monly known as critical thinking. process. Like problem solving, this process may
initially need to be broken down and scaffolded
for the student. Teachers, however, need to be
WHAT IS CRIT CA THINKI G? mindful about how they design the learning ex-
periences so as not to inadvertently inhibit op-
Definition portunities to think critically. Sternberg (1987)
While definitions of critical thinking vary, all have discusses some teacher behaviors that can inhibit
common components that describe it as a skill- critical thinking. T hese include believing that
nothing can be learned from the student, doing

all the thinking as the teacher, and focusing CONCEPTS AND THEORIES
attention on a “right” answer rather than on the OF PROBLEM SOLVING AND
process. CRITICAL THINK NG
Paul and Elder (2009) have provided a set
of standards by which to judge an individual’s
line of thinking. Teachers can use these stan-
Executive Functioning
dards to guide students’ critical thinking and One frequently discussed group of cognitive skills
to assess where more targeted instruction is that contributes to successful problem solving
needed. These intellectual standards include clar- and critical thinking is the executive functions.
ity, accuracy, precision, relevance, depth, breadth, A person’s ability to perform these skills is re-
logic, and fairness. Within each of these stan- ferred to as executive functioning. This term is
dards, questions can be posed to help a student broad, referring to several underlying skills that
evaluate the quality of his or her thinking. Some interact in varying ways to support higher-order
examples of these questions include: How can cognitive processes like planning and organizing,
we check the truth of that statement (accuracy)? as well as creative problem solving and critical
What might this look like from a different point thinking (Christoff, Ream, Geddes, & Gabrieli,
of view (breadth)? Is t here bias in our interpreta- 2003). While definitions and models of executive
tion (fairness)? functioning differ, one current and prominent
Critical thinking is most frequently men- model includes the underlying skills of inhibition,
tioned in regard to the acquisition of specific working memory, and cognitive flexibility (Mi-
content area skills such as an ability to create a yake & Friedman, 2012). The neuroanatomical cir-
comparative essay discussing world governments cuitry used during executive functioning is
or engage in a conversation about health care complex and requires many structures throughout
solutions. However, the ability to think critically the brain; one important area in this circuitry is
has broader applications and is generally linked the prefrontal cortex, which is located in the frontal
to problem solving. For example, if a teacher is lobes of the brain (Anderson, Jacobs, & Anderson,
working with students in his or her classroom to 2008). It is important for teachers to know that
resolve a peer conflict, the teacher may lead them the prefrontal cortex is one of the slowest to de-
in discussing their own thoughts and feelings, velop, so even high school students are still devel-
evaluating conclusions they have drawn about oping the necessary circuitry to engage in
others, considering all viewpoints, and identify- executive functioning. This should highlight the
ing supporting evidence for their conclusions. extent to which students need educators’ support
These discussions could be used to identify the and guidance in acquiring and learning how to
problem behind this conflict as well as to evalu- apply these developing skills. In addition, the ex-
ate the potential solutions to the problem, but ecutive functioning circuitry is also extremely
should probably be avoided during the brain- sensitive to developmental or medical insult and
storming process, as they could detract from the injury, meaning that difficulties with these skills
goal of broad, nonevaluative generation of solu- are common across various student populations
tions. The preceding example illustrates the and identified disabilities. The good news is that
manner in which critical thinking is embedded executive functioning skills can be taught and are
within the problem-solving process, though its amenable to change (Diamond, 2012), making
role may vary depending on the step. teachers and their practice all the more important.
Inhibition Cognitive Flexibility

Inhibition refers to the ability to avoid or delay an Cognitive flexibility is also referred to as shifting,
initial reaction to something. The term behavioral and it is the ability to consider multiple possi-
inhibition specifically refers to preventing a possibilities, alter perspective, and change courses of
bly inappropriate behavioral reaction, which in action. Cognitive flexibility can occur purely
the educational setting might involve a student internally, in a person’s thought process, but can
talking out of turn, grabbing an object on his or also be evident in a person’s behavioral response
her own desk or a peer’s desk, or getting out of his to a situation or problem, in that this change in
or her seat. While the reaction or behavior being perspective or selected course of action results in
inhibited is typically inappropriate, this does not a related change in observable behavior. In the
have to be the case. Inhibition can also be internal problem-solving process, this is demonstrated
or cognitive, such as when a person tries to avoid a when a student changes plans after realizing the
certain thought or line of thinking. During the initial plan is not producing the desired result.
problem-solving process, inhibition is necessary Cognitive flexibility is also used when an indi-
in several ways. For example, individuals must in- vidual must consider the various outcomes and
hibit judgment and perhaps limit themselves in barriers associated with each possible plan or
the number of options they generate during the approach.
brainstorming step. In addition, behavioral inhi-
bition would be necessary before an individual
even began the problem-solving process, as this Higher-Order Processes
would prevent the individual from acting on the
When reading about or discussing executive func-
first solution that came to mind rather than taking
tioning, additional terms that represent more
the time to follow the steps in this process.
complex interactions of t hese three underlying
executive functions are often found. One of t hese
terms is theory of mind, which refers to a person’s
Working Memory
understanding of others as having their own per-
Working memory includes what is commonly spectives and thought processes (Stone, Baron-
known as short-term memory, or the ability to hold Cohen, & Knight, 1998). Use of theory of mind
information in mind and recall it fairly quickly. In requires the successful integration of all three of
addition, working memory also involves the more the above skills, but seems to especially tax a per-
complicated m ental manipulations performed son’s cognitive flexibility during social problem-
with that information, such as computing arith- solving situations. These are situations in which
metic problems without using paper and pencil. an individual may be in conflict with another
Working memory can involve visual or verbal ma- person, which means he or she must be able to
terial (or both). During the problem-solving pro flexibly consider the other person’s point of view
cess, working memory is utilized when holding in the conflict as well as think about ways to come
multiple pieces of information in mind, such as to a resolution that w ill satisfy both parties. An-
the step sequence, the current step instructions or other important and complex term is metacogni-
rules, and the ideas generated during the current tion. This term commonly refers to a person’s
step. It
will also be necessary when a student ability to consider his or her own thinking pro
needs to formulate a plan of action and accurately cesses and evaluate the quality or validity of his
sequence the steps in that plan. or her own thoughts. During problem solving
and critical thinking, metacognition is important developing tools, or skills, that promote m ental
because it allows an individual to identify any ability and an ability to solve problems. As a child
biases or logical fallacies that may exist in his or develops and learns to think at higher levels, the
her own thinking before making a decision or child also improves the ability to self-regulate
coming to a conclusion. Like theory of mind, his or her own learning (Vygotsky, 1978). Self-
metacognition also requires a coordination of all regulation refers to an ability to control one’s own
three of the identified underlying executive func- attention, thoughts, and actions. From Vygotsky’s
tioning skills. perspective, the development of self-regulation is
linked to the social interactions and experiences
of the child through language (Fox & Riconscente,
Teacher Considerations
2008).
Executive functioning skills appear to improve A child’s interaction with his or her environ-
the most when students are provided with in- ment, including with p eople such as the teacher,
struction and practice within the context in offers potential development of his or her think-
which they need to use t hese skills (Diamond, ing skills. Careful consideration of how learning
2012). In other words, students will better be able is structured is imperative. Vygotsky’s theory of
to apply their inhibition, working memory, and the zone of proximal development (ZPD; 1978) can
cognitive flexibility when required, with support, be useful to keep in mind when working with
and to use t hese skills during problem-solving students. Figure 19.1 illustrates this zone. The
and critical thinking processes. It is crucial that ZPD represents “a developmental continuum be-
support gradually be removed to allow for growth tween what a child can do independently, repre-
in students’ ability to use their executive func- senting his or her actual level of development,
tioning skills in this context. In addition, to pro- and what the child can do with assistance from
mote further generalization of t hese skills, others, representing the proximal level of devel-
support w ill likely be necessary within each con- opment” (Moll, 2013, p. 33). In other words, tar-
text in which skill generalization is required. The geting instruction between where a child is
support students w ill require and their skill tra- already independent and where the child would
jectory w ill vary greatly depending on their need to be maximally assisted is the zone where
development and individual needs, but e very the student can best prog ress. It represents learn-
student has the potential to improve his or her ing potential, not just what a child can currently
executive functioning. do (Fani & Ghaemi, 2011). The future zone in
Figure 19.1 represents what is currently too dif-
Vygotsky and the Zone ficult even with support but w ill become the
f uture ZPD as skills prog ress. Depending on the
of Proximal Development level of the task and how far it has moved from
Another way to conceptualize the identification the area of independence, scaffolding of learn-
of the proper levels of support individual stu- ing may be necessary. This relates directly to
dents need is articulated in Dr. Lev Vygotsky’s how teachers can approach providing opportu-
theories of learning. Vygotsky, a Russian psychol- nities for problem solving and critical thinking.
ogist in the early part of the 20th c entury, still The ZPD reminds teachers to identify the correct
holds a prominent place in educational discus- level of support a child needs to practice these
sion and his theories are particularly related to skills as well as to make sure that they are re-
promoting critical thinking and problem-solving moving unnecessary supports to ensure skill
skills. Vygotsky acknowledged the importance of growth. As children internalize the supported in-
T A B L E 1 9 . 1
Bloom’s Taxonomy Revised
Knowledge Dimension Cognitive Dimension
Factual Remember
Basic elements of a discipline: terminology, Recall, retrieve
specific details, and so on What are the steps of the scientific method?
(procedural knowledge)
Conceptual
Relationships of elements to a larger structure: Understand
classifications, models, theories, and so on Explain in your own words, summarize,
classify, give examples, and so on
Procedural
Give examples of skills you can use at each step
Knowing how to do something: specific skills
of the scientific method.
or techniques, methods, procedures, and so on
Apply
Metacognitive
Use skills, procedures, or strategies in a new
Awareness of one’s cognition: strategy use,
situation
self-knowledge (strengths/weaknesses),
Use the scientific method to investigate your
cognitive tasks
question.
Analyze
Break material or ideas into parts and relate
parts to one another or other structures:
compare and contrast, organize, differentiate,
and so on
How does what you did in each step compare to
what your peer did?
Evaluate
Make judgments based on criteria; critique
How successful was your method? What could
you do differently?
Create
Combine or reorganize elements to generate
something new: plan, generate, produce
Create a flow chart that illustrates your thinking
during your experiment. (metacognitive knowledge)
Source: Adapted from Anderson, L. W., Krathwohl, D. R., Airasian, P.W., Cruikshank, K. A., Mayer, R. E., Pintrich, P. R., . . .
Wittrock, M. C. (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom’s taxonomy of educational
objectives (Abridged ed.). New York: Longman.
if a categorization example included eating uten- tant to the mediated experience, depending on
sils, it would be important to include t hose with the situation. Among t hese criteria are the impor-
which the child is culturally most familiar (such tance to mediate feelings of competence and the
as chopsticks). regulation of behavior for the experience to be
In addition to the three main components optimally successful. Among other reinforcers,
of MLEs, Feuerstein, Feuerstein, Falik, and Rand the child should feel as if he or she belongs, is
(2002) discuss 10 other criteria that are impor sharing in the experience, and is experiencing
success and pride in his or her accomplishment. examples. Another contemporary look at educa-
In addition, the mediator can encourage the child tional objectives that promote metacognition and
to slow down and think and help the child focus thinking skills comes from Marzano and Kend-
on the important aspects of the task. all (2007), who delineate four processing levels
within the cognitive system: retrieval, compre-
hension, analysis, and knowledge utilization.
Bloom’s Taxonomy Whether teachers focus on the traditional
Benjamin Bloom’s taxonomy (Bloom, 1956), as a taxonomy or more contemporary iterations of
framework, relates to the ideas of targeting the constructing educational objectives, it is helpful
ZPD and MLEs in ways that promote problem- to keep the different levels of thinking in mind
solving and critical thinking skills. Bloom pub- when designing instruction in order to move stu-
lished his study of the cognitive domain of the dents toward more complex problem solving and
taxonomy of learning objectives in 1956, fol- critical thinking. Consider the types of questions
lowed later by an examination of the affective and prompts that could be embedded into a les-
and psychomotor domains. As a whole, the intent son that w ill support student engagement in
of the taxonomy of educational objectives was to higher-order thinking. For example, the use of
help educators improve their design of instruc- open-ended questions without fixed answers w ill
tion and assessment to support students’ use of generally tap into critical thinking more than
lower-order knowledge and prerequisite skills to factual questions with already known answers
engage in higher-order tasks. In the taxonomy, (Mathews & Lally, 2010). Using questions that be-
being able to remember facts and information gin with “How?” or “Why?” can also promote stu-
(knowledge) and show understanding of informa- dent thinking. As the taxonomy suggests, students
tion (comprehension) are lower-level skills that lead need enough “tools” (lower-order skills and in-
to being able to apply the information learned to formation) to be able to engage in more elaborate
a new situation (application) as well as to analyze a thinking, which requires well-designed instruc-
situation (analysis). Additionally, higher-order ob- tion. However, even if a student needs scaffolded
jectives involve students synthesizing what they support to work with higher-order questions or
know to create something new (synthesis) and activities, this is preferable to never giving the stu-
evaluating situations or ideas (evaluation). While dent a chance to experience them.
lower-order learning is important, if instruction
stops at the knowledge and comprehension lev-
PROMOT NG PROBLEM SOLV NG
els, then students are not engaged in higher-order
tasks that help support their ability to problem AND CR ICAL TH NK NG
solve and think critically (Bloom, 1956).
Scaffolding Learning
Anderson et al. (2001) created a revision of the
cognitive domain of Bloom’s taxonomy. Their re- Throughout this chapter the authors have referred
vision illustrates the interaction of the knowledge to the need to scaffold learning for students as they
dimension with the cognitive dimension. The develop their independent problem-solving and
knowledge dimension is composed of different critical thinking skills. Scaffolds can include mod-
types of knowledge: factual, conceptual, proce- eling (for example, using teacher think-alouds, in
dural, and metacognitive, all of which can be en- which the teacher verbalizes the thought process
gaged at the different cognitive levels: remember, required to demonstrate the necessary steps),
understand, apply, analyze, evaluate, and create. prompting (for example, using questions to focus
Table 19.1 describes the dimensions and provides student thinking and attention), and providing
S I D E B A R 1 9 . 1
Strategies to Encourage Problem Solving and Critical Thinking
The general ideas listed here encourage 6. Once students have enough background
students to problem solve and develop good information and skills, try declarative
thinking skills. This is by no means an exhaus- statements or nonexamples that require
tive list but is meant to spark thinking about the student to evaluate the truth of the
how to put the concepts and theories intro- statement or analyze why it is a
duced in this chapter into action when teaching. nonexample.
1. Use knowledge of Bloom’s taxonomy to a. Example 1: “Look at this website. Why
design questions, lesson objectives, and is it not a good example of a reputable
activities that help a student think at higher source?”
levels. b. Example 2: “Which of these two
2. Use a think-aloud procedure to model examples incorporates all the criteria of
thinking and tap into what a student is the rubric? Why does the other one not
thinking. meet the criteria?”
a. Example 1: “Now I am going to go back 7. Bridge responses with questioning.
to the table of contents to figure out a. Example 1: “Yes, that’s a good
where I would find that information. observation. What else did you
Hmm . . . Chapter 3 says ‘animal notice about the setting of the story?
kingdoms.’ That might be where I [Wait for the student to respond.]
can find out what type of animal an The author mentioned a glistening
iguana is.” lawn. What might that be
b. Example 2: “Why d on’t you talk out loud referring to?”
about what you are thinking and doing b. Example 2: “You noticed that the
right now? I see you just changed your two graphs were both above the
answer. Why did you do that? How did x-axis. If you look at the height of
you know it was wrong?” the graphs, what do you notice is

3. Use mind mapping or modeling (having dif ferent?”
the student create a map or create a model 8. Provide a little more wait time than what
out of objects showing his or her thinking is really needed to ensure that the student
and the connections made about a topic or has time to engage in thinking.
concept) (Call & Featherstone, 2010). 9. Use prediction and why and how
4. Have the student teach you. questions.
5. End lessons with the student summarizing 10. Avoid yes or no questions or ask a
and evaluating instead of the teacher. follow-up question for elaboration.
a. Example 1: “How do you think you did 11. Once students are developing
on that activity? What did you do well critical thinking and problem-solving
and what do we need to work on some skills, use activities that promote
more?” efficiency.
b. Example 2: “If you were going to do this 12. Whenever possible, have students make
again, how would you do it differently? observations, look for patterns, and note
Why?” similarities and differences.
466
S I D E B A R 1 9 . 1
13. Incorporate practice in the Core Skills of 15. Use problem-based learning activities.
Thinking (Orlich, Harder, Callahan, 16. Incorporate activities that involve students
Trevisan, & Brown, 2007, p. 294): changing their point of view.
a. Perception of a problem or issue a. Example 1: “I see you grouped those
b. Ability to gather relevant information items by size. I am going to group
them in a different way. How did
c. Competence in organizing data
I group them?”
d. Analysis and evaluation of data
b. Example 2: “You came up with some
(patterns, inferences, sources, errors)
good solutions to that problem. Which
e. Communication of the results ones do you think your friend would
(suggestions, alternatives, and agree with? Would your parents also like
so on) that solution? Why or why not?”
14. Implement an “Executive Functioning 17. For teachers of young children,
(EF)–Smart Classroom” through the use incorporate the use of “play plans”
of “tune-up tools”: mindful planning, to promote the development of self-
allotting sufficient time, providing regulation. These plans help children
opportunities for frequent repetition, understand their role during play so that
and cultivating a positive mind-set they can act purposefully (Tools of the
(Cooper-Kahn & Foster, 2013, p. 46). Mind, 2014).
guides or cues to support the student in accom- CONS DERA IONS FOR
plishing the more challenging parts of a task STUDENTS WITH VISUAL
(Rosenshine, 2012). Starting with simpler material IMPAIRMEN S
on which the complexity is gradually increased,
breaking down a procedure into smaller steps (task Like all students, students with visual impair-
analyzing), and giving feedback are other compo- ments w ill benefit from the process of problem
nents of scaffolding (Rosenshine & Meister, 1992). solving and experiencing the need to try, revise,
It is important for teachers to be able to antici- and reattempt within the process. While the ten-
pate where students may have difficulty in order to dency of some families and educators is to “pro-
provide the appropriate level and type of scaffold- tect” students with visual impairments, it is
ing. Teachers w ill want to avoid providing more crucial to identify and prevent instances of over-
support than the student needs since this would assistance in order to allow for natural opportu-
make the task too easy, affecting opportunities for nities and frequent practice with critical thinking
higher-order thinking and problem solving. It is and prob lem-
solving skills. The content pre-
also important to withdraw scaffolds as students sented in this chapter applies to all students, in-
no longer need them and set up tasks in a way that cluding students with visual impairments.
allows students to assume more responsibility for However, when designing instruction that sup-
the thinking when they are ready. ports students with visual impairments’ abilities
Sidebar 19.1 provides some general ideas to to increasingly engage in thinking skills, some
encourage students to problem solve and develop special considerations may need to be kept in
good critical thinking skills. mind.
First, the ways students approach a problem dents with visual impairments. Watching to
may be influenced by the range of their direct ex- make sure that students with visual impairments
periences with concepts related to a problem. A are provided the same level of opportunities to
lack of incidental learning opportunities due to use their executive functioning skills as their
visual impairment may initially limit how many peers is a first step. In addition, many areas of the
options a student generates to solve a problem or expanded core curriculum lend themselves to
the student’s ability to identify the factors related students practicing the application of their exec-
to a problem. For example, in the problem- utive functions. For example, within the area of
solving example earlier in the chapter, if Evan compensatory access, organizational skills are an
had a visual impairment he may not have gener- identified instructional need for many students
ated some of the same factors related to the prob with visual impairments. By directly instructing
lem. The length of the lunch line, while visually in this area of the expanded core curriculum in a
apparent, may not have been something Evan way that incorporates instructional concepts like
would have noticed without learning to ask about ZPD and scaffolding, teachers of students with vi-
that kind of visual information. Temporal con- sual impairments are also targeting executive
cepts such as the time it takes to get from the functioning.
cafeteria to the English classroom may be depen- Another consideration includes the accessi-
dent on Evan’s orientation and mobility skills bility of the environment to promote full en-
and how independently and consistently he is gagement by students with visual impairments
traveling between t hese locations. Helping stu- and relates to both the physical environment (for
dents generate more options to solve a problem example, materials, spatial layout) and the qual-
may require targeting specific skills so students ity of interactions within the environment (for
can broaden their knowledge about possibilities. example, specific feedback, peer connections).
Having Evan time how long it takes him to travel By addressing these and other special consider-
from the cafeteria to class or practice asking a ations, teachers can mindfully structure learning
peer for information about how many p eople are experiences to promote growth in the thinking
in line at lunch are just two examples of how a skills of students with visual impairments.
teacher might accomplish this. In addition, stu- Finally, it is important to remember that
dents with visual impairments may identify students with visual impairments and multiple
unique factors that contribute to a particular disabilities or cognitive challenges can also ben-
problem that sighted peers may not. For exam- efit from working on problem-solving and criti-
ple, a social problem in school in which a stu- cal thinking skills. These students typically need
dent has no one to play with during recess may additional support and modified approaches to
include the student recognizing that he or she the problem-solving process. For example, a stu-
cannot find where on the playground his or her dent can partially participate in decisions
friends are located. around prob lem solving by selecting from a
Next, while there is currently a lack of re- number of choices. Initial problems to be solved
search in the area, there is some evidence that can focus on known student routines. A student
students with visual impairments may strugg le might engage with a teacher about a missing step
with the use of their executive functioning skills in a personal hygiene routine, or needing to take
to a greater extent than their sighted peers (Heyl a detour on a known route between the class-
& Hintermair, 2015). This makes understanding, room and gym. In addition, students with visual
assessment, and instruction in the area of execu- impairments and multiple disabilities may strug
tive functioning important for teachers of stu- gle more with executive functioning (Heyl &
Hintermair, 2015) and related skill development Bloom, B. S. (1956). Taxonomy of educational objec-
in the area of theory of mind, which would im- tives: The classification of educational goals. New
pact their social problem solving (Begeer et al., York: Longmans, Green.
2014). As it is unlikely that t hese students will ex- Call, N., & Featherstone, S. (2010). The thinking child:
perience success on their own, their teachers Brain- based learning for the early years foundation
stage. New York: Continuum International.
need to be all the more deliberate in designing
Christoff, K., Ream, J. M., Geddes, L. P., & Gabrieli, J. D.
opportunities for successful problem solving that
(2003). Evaluating self-generated information: An-
are actually within each student’s ZPD.
terior prefrontal contributions to human cogni-
tion. Behavioral Neuroscience, 117, 1161–1168.
Ciairano, S., Bonino, S., & Miceli, R. (2006). Cognitive
SUMMARY
flexibility and social competence from childhood
Problem solving and critical thinking are impor to early adolescence. Cognition, Brain, Behavior, 10,
tant higher-order skills that promote success in 343–366.
school and beyond for all students, including Common Core State Standards Initiative. (n.d.). About
the standards. Retrieved from http://w ww.core
students with visual impairments. Teachers play
standards.org/about-the-standards/
a crucial role in the development of t hese skills,
Cooper-Kahn, J., & Foster, M. (2013). Boosting executive
and current curriculum standards acknowledge skills in the classroom: A practical guide for educators.
this role. By keeping in mind relevant concepts San Francisco: Jossey-Bass.
like executive functioning, scaffolding, the zone Diamond, A. (2012). Activities and programs that
of proximal development, and taxonomies of improve children’s executive functions. Current
educational objectives, teachers can engage in Directions in Psychological Science, 21, 335–341.
mindful planning. This intentionality in plan- Fani, T., & Ghaemi, F. (2011). Implications of Vygotsky’s
ning w ill best support periodic opportunities for zone of proximal development (ZPD) in teacher
students to practice problem solving and critical education: ZPTD and self-scaffolding. Procedia—
thinking. Frequent rehearsal of these skills w ill Social and Behavioral Sciences, 29, 1549–1554.
increase students’ ability to automatically and Feuerstein, R., Feuerstein, R. S., Falik, L. H., & Rand, Y.
(2002). The dynamic assessment of cognitive modifi-
rapidly apply them in their daily lives.

ability: The learning propensity assessment device, the-
ory, instruments, and techniques. Jerusalem, Israel:
RE ERENCES ICELP Press.
Feuerstein, R., Klein, P. S., & Tannenbaum, A. J. (1994).
Anderson, V., Jacobs, R., & Anderson, P. J. (Eds.). Mediated learning experience (MLE): Theoretical,
(2008). Executive functions and the frontal lobes: A psychosocial and learning implications. London:
lifespan perspective. New York: Taylor & Francis. Freund.
Anderson, L. W., Krathwohl, D. R., Airasian, P. W., Foundation for Critical Thinking. (n.d.). Defining criti-
Cruikshank, K. A., Mayer, R. E., Pintrich, P. R., . . . cal thinking. Retrieved from http://w ww.criticalth-
Wittrock, M. C. (2001). A taxonomy for learning, inking.org/pages/defining-critical-thinking/766
teaching, and assessing: A revision of Bloom’s taxon- Fox, E., & Riconscente, M. (2008). Metacognition and
omy of educational objectives (Abridged ed.). New self-regulation in James, Piaget, and Vygotsky. Ed-
York: Longman. ucational Psychology Review, 20(4), 373–389.
Begeer, S., Dik, M., voor de Wind, M. J., Asbrock, D., Heyl, V., & Hintermair, M. (2015). Executive func-
Brambring, M., & Kef, S. (2014). A new look at the- tion and behavioral problems in students with
ory of mind in c hildren with ocular and ocular- visual impairments at mainstream and special
plus congenital blindness. Journal of Visual schools. Journal of Visual Impairment & Blindness,
Impairment & Blindness, 108(1), 17–27. 109, 251–263.
Ku, K. Y. L., Ho, I. T., Hau, K., & Lai, E. C. M. (2014). Rosenshine, B. C. (2012). Principles of instruction:
Integrating direct and inquiry-based instruction Research-based strategies that all teachers should
in the teaching of critical thinking: An interven- know. American Educator, 36(1), 12.
tion study. Instructional Science, 42(2), 251–269. Rosenshine, B. C., & Meister, C. (1992). The use of
Marzano, R. J., & Kendall J. S. (2007). The new taxon- scaffolds for teaching higher-level cognitive strat-
omy of educational objectives (2nd ed.). Thousand egies. Educational Leadership, 49(7), 26.
Oaks, CA: Corwin Press. Siu, A. M. H., & Shek, D. T. L. (2009). Social problem
Matthews, R., & Lally, J. (2010). The thinking teacher’s solving as a predictor of well-being in adolescents
toolkit: Critical thinking, thinking skills, and global and young adults. Social Indicators Research, 95,
perspectives. New York: Continuum International. 393–406.
Miyake, A., & Friedman, N. P. (2012). The nature and Sternberg, R. J. (1987). Teaching critical thinking:
organ iz at ion of individual differences in execu- Eight ways to fail before you begin. Phi Delta Kap-
tive functions: Four general conclusions. Current pan, 68, 456–459.
Directions in Psychological Science, 21, 8–14. Stone, V. E., Baron-C ohen, S., & Knight, R. T. (1998).
Moll, L. C. (2013). L. S. Vygotsky and education. New Frontal lobe contributions to theory of mind. Jour-
York: Routledge. nal of Cognitive Neuroscience, 10, 640–656.
Orlich, D. C., Harder, R. J., Callahan, R. C., Trevisan, Tools of the Mind. (2014). Play plans. Retrieved from
M. S., & Brown, A. H. (2007). Teaching strategies: A http://w w w .t oolsofthemind .o rg /c urriculum
guide to effective instruction (8th ed.). Boston: /preschool/
Houghton Mifflin. Vygotsky, L. S. (1978). Mind in society: The development
Paul, R., & Elder, L. (2009). The miniature guide to critical of higher psychological processes (M. Cole, V. John-
thinking concepts and tools (5th ed.). Dilton Beach, Steiner, S. Scribner, & E. Souberman, Eds.). Cam-
CA: The Foundation for Critical Thinking Press. bridge, MA: Harvard University Press.
20
C H A P T E R
Social and Emotional Learning:

Recent Research and Practical
Strategies for Educators
Kimberly A. Schonert-Reichl
and Shelley Hymel
Success in school is not exclusively based on students’ ac- lings. His stepfather has been out of work for
ademic abilities. Increasingly, educators are recognizing more than a year and no one in Frank’s family has
that students who struggle with social and emotional ever graduated from high school. Frank wears
well-being fail to meet academic goals. Students with a thick glasses and often comes to school wearing
disability such as blindness or visual impairment may clothes that do not fit properly because they are
face additional hurdles related to self-esteem and social hand-me-downs from his older siblings. The
relationships. Professionals in visual impairment who school administrators are concerned about Frank
have an understanding of the components that facilitate because his attendance record is sporadic—he
social and emotional prosperity can more readily recog- often misses school for weeks at a time.
nize when students are struggling with aspects of social According to Frank, he does not attend
and emotional learning. If deficits related to social and school because of the frequent teasing and bul-
emotional learning are noted early, remediation can be- lying that he receives from his classmates. He
gin earlier, and the risk that students will suffer academ- states that his classmates exclude him from
ically as a result of these deficits is reduced. This chapter activities and call him names, and he reports
will provide important general information to help profes- that his teachers never intervene in t hese situ-
sionals working with students who are blind or visually ations, even when it was happening right in
impaired support the educational team and the student front of them. He feels that his teachers simply
in regard to social and emotional learning. —Eds. do not care about him. Frank does not seem to
have the confidence to defend himself, and the
taunting and exclusion by classmates have be-
V GNETTE come commonplace within the classroom. His
classroom teacher reports that she really has no
Frank is 12 years old and in the sixth grade. He idea how to help Frank, and that many of her
lives with his mother, stepfather, and five sib- students just seem to lack empathy. She believes
471
that her role is to teach the academic subjects and the public at large are also beginning to call
to her students, not social and emotional skills. in increasing numbers for such a focus. In the face
of current societal, economic, environmental,
INTRODUCT ON and social challenges, the promotion of these
“nonacademic” skills in education is seen as more
The prospects for Frank’s future success seem critical than ever before, with business and po
rather bleak—both in school and in life. His litical leaders urging schools to pay more atten-
home situation is troubling and at school he f aces tion to equipping students with what are often
bullying and exclusion. Frank’s schoolwork and referred to as “21st c entury skills” (Heckman,
his ability to learn are undeniably compromised 2007; National Research Council, 2012), such as
because of the social problems that he encoun- problem solving, critical thinking, communica-
ters on a daily basis in school and at home. Frank tion, collaboration, and self-management. In or-
also does not have a supportive, caring relation- der for c hildren to achieve their full potential as
ship with his teacher. Perhaps she feels that she productive adult citizens in a pluralistic society
lacks the knowledge and skills to help Frank and and as employees, parents, and volunteers, t here
her other students to develop their social and emo- must be explicit and intentional attention given
tional competence, and create a classroom context to promoting c hildren’s social and emotional
that is safe, caring, and collaborative—a context in competence in schools (Schonert-Reichl & Weiss-
which all students feel that they belong. Does it berg, 2014; Weissberg & Cascario, 2013).
have to be this way? Are students such as Frank This chapter focuses on one approach for
destined for a predictable path that leads to more enhancing c hildren’s success in school and in
risks and subsequent failure? Or are there ways life through universal, school-based educational
in which teachers could design schools and class- practices designed to promote students’ social and
rooms to nurture both the academic and the social emotional learning (SEL). It begins by providing a
and emotional competence and well-being of stu- rationale, definition, and description of the vari
dents without compromising academic process? ous dimensions that compose social and emo-
In conversations about the f uture of educational learning. Next, a brief review of recent
tion in North America and around the world, research that offers strong empirical support for
questions such as t hese are being raised—in dia- an SEL approach is provided. Following this, spe-
logues between policy makers and educators de- cific strategies are provided that can be used to
ciding whether to integrate the promotion of promote SEL in a variety of educational contexts.
students’ social and emotional competence into The chapter ends by offering some conclusions
learning standards (see, for example, Illinois State on how an understanding of SEL has implications
Board of Education, n.d.; British Columbia Min- for thinking about education in schools, along
istry of Education, n.d.). Indeed, t here is a grow- with some resources for educators.
ing consensus among educators and educational
scholars that a more comprehensive vision of ed-
ucation is needed—one that includes an explicit HE CASE OR A OCUS
focus on educating “the whole child” and one ON SOC AL AND
that fosters a wider range of life skills, including EMOTIONAL LEARNING
social and emotional competence (Association
for Supervision and Curriculum Development, The increased emphasis on the role of schools in
2007; Bushaw & Lopez, 2013; Greenberg et al., promoting students’ social and emotional com-
2003; Rose & Gallup, 2000). Parents, students, petence and well-being reflects, in part, growing
Social and Emotional Learning 473
concerns about the prob lems facing students annually on the treatment of m ental illness.
today, such as declining academic motivation By 2020, it is estimated that m ental illness w ill
(Eccles & Roeser, 2009; Roeser & Eccles, 2014), es- represent the leading health care cost in the
calating school dropout rates (Battin- Pearson country.
et al., 2000), increasing school bullying and ag- In this regard, SEL is increasingly recognized
gression (Hymel & Swearer, 2015; Swearer, Es- as foundational to the promotion of positive
pelage, Vaillancourt, & Hymel, 2010), and the mental health (Greenberg, Domitrovich, & Bum-
number and intensity of stressors experienced by barger, 2001; Sklad, Diekstra, de Ritter, Ben, &
today’s young p eople (for example, see Caspi, Gravesteijn, 2012; Wells, Barlow, & Stewart-
Taylor, Moffitt, & Plomin, 2000; O’Connell, Boat, Brown, 2003). Mental well-being is not a static
& Warner, 2009). Epidemiological reports high- condition that exists only within a child; it is also
light increased childhood m ental health prob affected by the interactions the child has with his
lems, with an estimated one in five c hildren and or her environment. Creating supportive, safe,
youths experiencing psychological disorders se- and respectful school environments in which all
vere enough to warrant mental health serv ices c hildren feel they belong can not only reduce the
(US Public Health Serv ice, 2000). Longitudinal stigma of m ental health difficulties, but also en-
studies indicate that, between the ages of 9 courage help-seeking when c hildren need it, pro-
and 16, over one-t hird of youths have been diag- moting mental well-being in all c hildren. From
nosed with one or more psychiatric disorders a cost-benefit perspective, schools are one of the
(Jaffee, Harrington, Cohen, & Moffitt, 2005), and primary settings in which promotion of social
follow-up studies indicate that the prevalence of competence and prevention of unhealthy behav
psychiatric disorders grew to 40 to 50 percent by iors can occur (Zins, Bloodworth, Weissberg, &
age 21 (Arseneault, Moffitt, Caspi, Taylor, & Silva, Walberg, 2004). In other words, in addition to
2000). Currently, a large proportion of students promoting knowledge and skills in reading, writ-
who require m ental health services do not receive ing, and math, schools play a critical role in pre-
them (Malti & Noam, 2008). As well, by high paring students to graduate with the capacities to get
school, as much as 40–60 percent of students be- along with o thers in socially and emotionally skilled
come chronically disengaged from school (Klem ways, to practice healthy behaviors, and to make re-
& Connell, 2004). sponsible decisions (Jones & Bouffard, 2012).
As mental illness and youth problem be
haviors are increasingly recognized as signifi- WHAT S SE ?
cant predictors of overall health and long-term
adjustment, the cost of addressing such prob SEL involves the processes through which indi-
lems is staggering. A 2009 US Institute of viduals acquire and effectively apply the knowl-
Medicine report on mental, emotional, and be- edge, attitudes, and skills necessary to understand
havioral disorders of young people estimated and manage their emotions, feel and show em-
the cost of these disorders to be $247 billion pathy for o thers, establish and achieve positive
annually, and emphasized the need for preven- goals, develop and maintain positive relation-
tion and intervention efforts as essential for ships, and make responsible decisions (Collab-
reducing mental illness and promoting social orative for Academic, Social, and Emotional
and emotional health. Such extraordinary costs Learning, 2013; Weissberg, Payton, O’Brien, &
are not limited to the United States; a 2001 re- Munro, 2007). That is, SEL teaches the personal
port by Stephens and Joubert, for example, in- and interpersonal skills humans all need to
dicated that Canada spends about $14.4 billion handle themselves, their relationships, and their
work effectively and ethically. As such, social- Since 1994, the Collaborative for Academic,
emotional competence is viewed as a “mastery Social, and Emotional Learning (CASEL) (www
skill” underlying virtually all aspects of h uman .casel.org), a nonprofit organization in the United
functioning. States, has been at the forefront in North Ameri-
Historically, SEL has been characterized in a can and international efforts to promote SEL in
variety of ways, often being used as an organizing schools. Since its inception, CASEL has defined
framework for an array of prevention and inter- SEL more specifically and has served as a guide
vention efforts in education and developmental to school- based SEL programming (CASEL,
science, including conflict resolution, cooperative 2005). CASEL’s mission is to advance the science
learning, bullying prevention, and positive youth of SEL and expand evidence-based, integrated
development (Devaney, O’Brien, Resnik, Keister, SEL practices as an essential part of preschool
& Weissberg, 2006; Elias et al., 1997). SEL builds through high school education. Based on exten-
from work in child development, classroom sive research, CASEL (2013) has identified the fol-
management, and prevention, as well as emerg- lowing five interrelated competencies that are
ing knowledge about the role of the brain in self- central to SEL (also see Weissberg, Durlak, Domi-
awareness, empathy, and social-cognitive growth trovich, & Gullotta, 2 015):
(for example, see Best & Miller, 2010; Carter,
Harris, & Porges, 2009; Diamond, Barnett, 1. Self-awareness: The ability to accurately rec-
Thomas, & Munro, 2007; Diamond & Lee, 2011; ognize how thoughts, feelings, and actions
Gallese & Goldman, 1998; Goleman, 2006; are interconnected, including the capacity to
Greenberg, 2006; Singer & Lamm, 2009). It fo- accurately assess one’s strengths and limita-
cuses on the skills that allow c hildren to calm tions, and have a positive mind-set, a realis-
themselves when angry, make friends, resolve tic sense of self-efficacy, a well-g rounded
conflicts respectfully, and make ethical and safe sense of confidence and optimism, and an
choices. Moreover, SEL offers educators, families, understanding of one’s emotions, personal
and communities relevant strategies and practices goals, and values.
to better prepare students for “the tests of life, not
2. Self-management: The skills and attitudes

a life of tests” (Elias, 2001, p. 40). In short, SEL
that facilitate the regulation of emotions and
competence comprises the foundational skills for
behaviors, including the ability to delay grat-
positive health practices, engaged citizenship,
ification, manage stress, control impulses,
and school success.
motivate oneself, and work toward achieving
SEL is sometimes called “the missing piece,”
personal and academic goals.
because it represents a part of education that is
inextricably linked to school success but has not 3. Social awareness: The ability to take the per-
been explicitly stated or given much attention spective of and empathize with o thers from
until recently. SEL emphasizes active learning
diverse backgrounds and cultures, to under-
approaches in which skills can be generalized stand social and ethical norms for behavior,
across curriculum areas and contexts when op- and to recognize family, school, and commu-
portunities are provided to practice the skills nity resources and supports.
that foster positive attitudes, be haviors, and 4. Relationship skills: The ability to establish
thinking processes. The good news is that SEL and maintain healthy and rewarding rela-
skills can be taught through nurturing and car- tionships with diverse individuals and
ing learning environments and experiences (Elias groups, including skills in communicating
et al., 1997; Greenberg, 2010). clearly, listening actively, cooperating, resist-
ing inappropriate social pressure, negotiating Indeed, effective SEL interventions and skill de-
conflict constructively, and seeking help velopment should occur in such an environ-
when needed. ment, one that is safe and well managed,
5. Responsible decision making: The knowl- supports a child’s development, and provides
edge, skills, and attitudes needed to make opportunities for practicing the skills. Commu-
realistic evaluation of consequences and con- nication styles, high performance expectations,
structive choices about personal be hav
ior classroom structures and rules, school orga
and social interactions based on consider- nizational climate, commitment to the aca-
ation of ethical standards, safety concerns, demic success of all students, district policies,
and social norms across diverse settings, and teacher social and emotional competence (Jen-
to take into consideration the health and nings & Greenberg, 2009), and openness to pa-
well-being of both self and o thers. rental and community involvement are all
important components of an SEL approach.
SEL programs and approaches are founded

RECENT RESEARCH FINDINGS
on a variety of theoretical perspectives, including
social learning theory (Bandura, 1977), social- Centuries ago, Aristotle contended that “educat-
cognitive (Coie & Dodge, 1998) or cognitive- ing the mind without educating the heart is no
behavioral approaches (Tobler et al., 2000), and education at all.” The same sentiment rings true
theories of emotional intelligence (for example, today. The aim of education should not only be
Goleman, 1995; Mayer & Salovey, 1997). All of to help students to master essential subject con-
t hese are predicated on the notion that the capac- tent areas such as reading, writing, math, science,
ity to process, reason about, and use emotion and social studies, but should include an explicit
can enhance cognitive activities, such as thinking and intentional focus on teaching students the
and decision making, facilitate the development competence to understand and manage emo-
and maintenance of social relationships, and pro- tions, set and achieve positive goals, feel and
mote personal growth and well-being (Brackett, show caring and concern for others, establish and
Rivers, Reyes, & Salovey, 2012). SEL program- maintain positive relationships, and make re-
ming also draws from theories that emphasize sponsible decisions (CASEL, 2013). What is dif
the primacy of relationships (Ainsworth & Bowlby, fere nt today from Aristotle’s time, however, is
1991) and are based on the understanding that that there is now strong scientific evidence to
learning is a social process—that is, students’ back up this claim.
learning occurs in collaboration with their teach-
ers and in interactions with their peers, and that Skills in Childhood
the best learning emerges in the context of sup-
portive relationships that make learning chal-
Predict L ater Success
lenging, engaging, and meaningful. A growing body of literature supports the prem-
Many SEL approaches include both an envi- ise that c hildren’s social and emotional compe-
ronmental focus and a person-centered focus (Zins, tence not only predicts success in school (for
Bloodworth, et al., 2004). Hence, in addition to example, see Oberle, Schonert-Reichl, Hertzman,
focusing on specific instruction in social and & Zumbo, 2014; Wentzel, 1993), but also predicts
emotional skills, SEL is a process of creating a a range of important outcomes in late adoles-
school and classroom community that is caring, cence and adulthood, including physical health,
supportive, and responsive to students’ needs. substance dependence, and overall well-being
(Moffitt et al., 2011). Recognizing the interrela- ment test scores in math and reading in grade
tionships between social-emotional competence seven. As hypothesized, teachers’ reports of stu-
and academic success, researchers have argued dents’ social-emotional competence significantly
that fostering positive social and emotional de- predicted higher scores in math and reading in
velopment may be key to enhancing academic seventh grade. Self- reported social- emotional
growth (see Greenberg et al., 2003; Zins, Weiss- competence in grade six was a significant predic-
berg, Wang, & Walberg, 2004). In a study of 423 tor of grade seven reading scores for boys but not
sixth and seventh graders, Wentzel (1993) found girls. Although more research is needed regard-
that students’ prosocial classroom behaviors, ing the link between SEL and academic achieve-
such as helping, sharing, and cooperating, were ment, t here is a confluence of empirical evidence
better predictors of academic achievement than suggesting that, if students’ success in school is
were their standardized test scores, even a fter desired, efforts should be made to intentionally
taking into account academic behavior, teach- and explicitly teach SEL.
ers’ preferences for students, IQ, family structure, In addition to playing a crucial role in pre-
sex, ethnicity, and days absent from school. dicting academic success, recent longitudinal re-
Similarly, in a longitudinal study of 294 Italian search also documents links between c hildren’s
children, Caprara, Barbaranelli, Pastorelli, Ban- social and emotional skills and later success in
dura, and Zimbardo (2000) found that prosocial adulthood. Jones, Greenberg, and Crowley (2015)
behavior in third grade (average age 8.5 years), as examined the degree to which late adolescent and
rated by self, peers, and teachers, significantly early adult outcomes were predicted by teacher
predicted both academic achievement (explain- ratings of c hildren’s social competence measured
ing 35 percent of the variance) and social prefer- many years earlier, when c hildren were in kinder-
ence (explaining 37 percent of the variance) five garten, following 753 kindergarten c hildren lon-
years later, when c hildren were in eighth grade. gitudinally 13 to 19 years later. Kindergarten
Most interestingly, this “prosocialness” score, teacher ratings of c hildren’s prosocial skills (get-
which included cooperating, helping, sharing, ting along with o thers, sharing, cooperating)
and consoling behaviors, significantly predicted were found to be significant predictors of w hether
academic achievement five years later, even a fter participants graduated from high school on time,
controlling for third- g rade academic achieve- completed a college degree, obtained stable em-
ment. In contrast, early academic achievement ployment in adulthood, and were employed full
did not contribute significantly to later achieve- time. Moreover, kindergarten c hildren who w ere
ment a fter controlling for effects of early proso- rated by their teachers as high in prosocial skills
cialness. in kindergarten were less likely as adults to re-
In a more recent short-term, longitudinal ceive public assistance, live in or seek public
study of 441 sixth- g rade Canadian students, housing, be involved with police, be placed in a
Oberle et al. (2014) examined the association juvenile detention fac ilit y, or be arrested. Early
between social and emotional competence and social competence inversely predicted days of
academic achievement in early adolescents.
binge drinking in the last month and number of
Social-emotional competence in grade six, oper- years on medication for emotional or behavioral
ationalized in terms of both self-reports of so- problems during high school. Given these find-
cial responsibility goals and teacher assessments ings, the authors emphasized the importance of
of frustration tolerance, assertive social skills, assessing young c hildren’s social and emotional
task orientation, and peer interaction, were eval- competence early on. They contended that t hese
uated as predictors of student academic achieve- “softer” skills can be more malleable than IQ or
other cognitive measures and, hence, important tioning, are both profoundly affected by emo-
contenders for intervention. tion and in fact subsumed within the processes
In another recent and notable longitudinal of emotion” (p. 7). Hence, how individuals feel
study, Moffitt et al. (2011) followed a cohort of affects how and what they learn.
1,000 c hildren from birth to age 32 in New Zea- Perhaps the most compelling evidence for
land, assessing c hildren’s self-control across the the importance of SEL programs in promoting
ages of 3, 5, 7, 9, and 11 years via reports from students’ social-emotional competence and aca-
researcher-observers, teachers, parents, and the demic achievement comes from a recent meta-
children themselves. Self-control in childhood analy sis conducted by Durlak, Weissberg,
was found to predict outcomes in physical health, Dymnicki, Taylor, and Schellinger (2011) of 213
substance dependence, personal finances, and school-based, universal SEL programs involving
criminal offending in adulthood, even after tak- 270,034 students from kindergarten through
ing into account intelligence, social class, and high school. Students in SEL programs, relative to
problems the c hildren had in adolescence (for ex- students who did not receive an SEL program,
ample, smoking, school dropout, unplanned were found to demonstrate significantly im-

pregnancy). The authors concluded that focus- proved social-emotional competence, attitudes,
ing on the promotion of c hildren’s self-control and behavioral adjustment (increased prosocial
“might reduce a panoply of societal costs, save behavior and decreased conduct problems and
taxpayers money, and promote prosperity” internalized problems). SEL students also outper-
(p. 2693). Thus, results from several recent lon- formed non-SEL students on indices of academic
gitudinal studies examining the association be- achievement by 11 percentile points. Durlak et al.
tween early SEL skills and l ater adult adjustment (2011) found that classroom teachers and other
suggest that, in the long run, higher levels of so- school personnel effectively implemented SEL
cial and emotional competence can increase the programs. Thus, SEL programs can be easily in-
likelihood of high school graduation, financial corporated into routine school practices and do
success, mental and physical health, and re- not require staff from outside the school for
duced criminal behavior. successful delivery. Taken together, t hese results
provide strong empirical evidence for the SEL

Social and Emotional Skills programs as “value-added” in fostering students’
social and emotional skills, attitudes, and behav
Can Be Taught iors, and also c ounter the claim that taking time
SEL is grounded in research from developmental to promote students’ SEL would be detrimental to
cognitive neuroscience (for example, Diamond, academic achievement.
2012) that indicates that social and emotional Similar results w ere obtained in a more re-
skills can be taught across the life span and are cently conducted meta-analysis by Sklad et al.
viewed as more malleable than IQ. Moreover, the (2012) of 75 recently published studies of SEL
research that informs SEL indicates that emotions programs. Sklad et al. found that universal,
and relationships affect how and what is learned school-based SEL programs had significant posi-
(Hymel, Schonert-Reichl, & Miller, 2006; Izard, tive effects on seven outcomes: social-e motional
2002; Spinrad & Eisenberg, 2009). As Immordino- skills, prosocial behavior, positive self-image,
Yang and Damasio (2007) assert, “The aspects of academic achievement, antisocial be havior,
cognition that are recruited most heavily in edu- mental health problems, and substance abuse.
cation, including learning, attention, memory, Not surprisingly, the most positive effects were
decision making, motivation, and social func- found for social-emotional skills, with an effect
size of .70. In other words, students participating SEL Is Important to Educators

in SEL programs had social- emotional skills 7
standard deviations higher than comparison stu- Recent research indicates that the myopic focus
dents, indicating that the average SEL program on academics as the sole purpose of education ap-
student had better social- emotional skills than pears to be shifting, at least among teachers and
76 percent of non-SEL students. Moderate effect the general public. A nationally representative
sizes (program effects of nearly a half of a standard survey published by Civic Enterprises and Pe-
deviation) emerged for four of the outcomes: aca- ter D. Hart Research Associates of more than
demic achievement, positive self-image, prosocial 600 teachers (Bridgeland, Bruce, & Hariharan,
behavior, and antisocial behavior. As for follow- 2013) illustrates this point. Their report showed
up effects, the largest effects were found for that the vast majority of preschool to high school
academic achievement, followed by substance
teachers believe that social and emotional skills
abuse. are teachable (95 percent), that promoting SEL
w ill benefit students from both rich and poor
backgrounds (97 percent), and that it w ill have
SEL Skills Are Durable positive effects on their school attendance and
Do students maintain their SEL competence a fter graduation (80 percent), standardized test scores
the SEL program has ended? Findings from Dur- and overall academic performance (77 percent),
lak et al.’s (2011) meta-analysis provide additional college preparation (78 percent), workforce readi-
support for the durability of effects of SEL pro- ness (87 percent), and citizenship (87 percent).
gramming on students’ social and emotional Additionally, these same teachers reported that,
competence. Among a smaller group of 33 inter- in order to effectively implement and promote
ventions that included follow-up data (an average SEL in their classrooms and schools, they need
follow-up period of 92 weeks), the positive effects strong support from district and school leaders.
remained statistically significant, although the These findings are important b ecause they dem-
effect sizes w ere smaller. onstrate that, although t here is a readiness among
Research by Hawkins, Kosterman, Catalano, teachers to promote SEL, there is a need for sys-
Hill, and Abbott (2008) documented the long- temic supports for implementation at the district
term positive effects of multiyear SEL program- level.
ming on student outcomes. Specifically, Hawkins Results from the 2013 PDK/Gallup Poll of
et al. found significantly reduced diagnosable the Public’s Attitudes t oward the Public Schools
mental health disorders (for example, major de- indicate that sentiments of the general public
pression, generalized anxiety disorder) at age 24 echo those espoused by teachers (Bushaw &
and age 27, 12 and 15 years after their SEL inter- Lopez, 2013). The report found that most
vention had ended. Their results also showed in- Americans agree that public schools should
tervention effects indicating better educational teach students a full range of social, emotional,
and economic achievement among those indi- and cognitive competence, including how to
viduals who received the SEL intervention in set meaningful goals (89 percent), communica-
contrast to those who did not. Although more tion skills (94 percent), how to collaborate on
research is clearly needed, Hawkins et al.’s (2008) projects (84 percent), and character (76 percent).
research provides important evidence about the Despite the strong consensus among educators
potential long-term benefits of well-designed and and the public regarding the enormous potential
well-implemented SEL interventions. of SEL as a fundamental component of school re-
form, it is essential that policy makers take action tors, teachers, school staff, and students and their
in order to make SEL a national priority. approaches to teaching and learning (Gottfredson,
Gottfredson, Payne, & Gottfredson, 2005). There-
fore, any approach to promoting SEL needs to take
NECESSARY NGRED ENTS into account both school culture and climate and
FOR PROMOT NG SE systematically and intentionally embed SEL into
the fabric of a school.
Imagine schools where c hildren feel safe, valued, SEL interventions and skill development
confident, and challenged, where they have the
should occur within supportive classroom and
social, emotional, and academic skills to succeed,
school environments, as well as help to create
where the environment is safe and supportive,
and where parents are fully engaged. Imagine such a climate. Additionally, successful SEL-
this not as the exception in an elite or small related school and classroom activities foster an
school but in every school and for all children. active student voice in decision making, problem
Imagine the integration of social and emotional solving, and engagement in lifelong learning. Re-
skills as a part of education at e very level, from search also has shown that effective programs
preschool to high school. Imagine it as part of provide repeated opportunities to practice new
district, state, and federal policies. (O’Brien, skills and behaviors within the program structure
Weissberg, & Munro, 2005/2006) and to apply them in real-life situations. That is,
providing opportunities to practice within class-
How can this dream be moved to reality? What room lessons is important, but opportunities to
can educators do to promote their students’ so- practice in real-life situations are likely to have
cial and emotional skills? The authors posit three even more impact (Durlak et al., 2011; Nation
necessary ingredients: creation of caring, safe, et al., 2003; Weare & Nind, 2011).
collaborative, participatory, and inclusive school A caring teacher can transform the school ex-
environments; explicit teaching of SEL skills; and perience, especially for students who face enor-
caring for teachers. mous difficulties, such as dysfunctional home
lives. The quality of teacher-student relationships
is critical for c hildren’s academic achievement, as

School Environments illustrated by the work of Maldonado-Carreno
Classrooms and schools operate as systems, and and Votruba-Drzal (2011). Using data from the
decades of research suggest that the unique culture National Institute of Child Health and Devel-
and climate of classrooms and schools affects how opment Study of Early Childcare involving
and what students learn (for example, see Thapa, 1,364 c hildren from kindergarten through fifth
Cohen, Guffey, & Higgins- D’Alessandro, 2013). grade, they found that increases in the quality of
School culture refers to a general set of norms, be- teacher-student relationships w ere associated with
liefs, and practices, or “the way things are done concomitant improvements in teacher- reported
around here” (Hemmelgarn, Glisson, & James, academic skills. Although their study was correla-
2006), whereas school climate “reflects norms, goals, tional and hence cannot provide direct evidence
values, interpersonal relationships, teaching and that changes in teacher-child relationships cause
learning practices, and organizational structures” improvements in children’s academic skills, the
(National School Climate Council, 2007, p. 4). study does illustrate the interrelation between
Culture and climate in combination influence the teacher-student relationships and students’ school
interactions and relationships among administra- success.
Some explicit strategies for fostering positive Explicitly Teaching SEL Skills
student-teacher relationships and caring class-
rooms include the following: here is no one way to promote SEL, as t here are
T
many different approaches to fostering student
• Greeting students e very day as they enter social and emotional competence, including
the classroom, with intentional efforts to such t hings as utilizing collaborative or coopera-
have a brief positive conversation with them tive learning structures in the classroom, teach-
(for example, noticing their new backpack ing c hildren how to resolve conflicts peacefully
or shoes). or how to solve social problems effectively, ad-
dressing bullying and discrimination in schools,
• Getting to know each student and the lives
promoting emotional literacy and moral educa-
they live, learning about their strengths, chal-
tion, and fostering positive teacher-student and
lenges, interests, and dreams. This could be
student-student relationships. (Re-
done at the beginning of the school year,
sources for obtaining information about
through individual interviews with each stu-
specific programs appear in the Re-
dent. Teachers can also ask students about
sources section of the online AFB Learning Cen-
what they, as teachers, can do to help students
ter; see also CASEL, 2005, 2013.) Indeed, a large
learn and thrive in school.
number of SEL programs have been developed in
• Actively listening to students to show you recent years that vary considerably in terms of
care. Aut hent ic listening is demonstrated by the scope of SEL skills addressed, the content of
hearing your students and then checking the curriculum, the target audience (for example,
back with them to make sure you under- elementary versus high school teachers), and the
stand. Such interactions help to develop a empirical evidence supporting the program’s ef-
trusting relationship between teachers and fectiveness. Whereas some SEL programs include
students. lessons that focus on explicit instruction in SEL
• Asking students for advice and feedback as well competence, others integrate SEL content into
as help when needed. For example, teachers core academic subject areas, such as language
can ask for help in setting up the classroom arts or social studies. T here are also SEL pro-
(for instance, what to put on the classroom grams and approaches that target teachers’ in-
bulletin boards, how to arrange the seating, or structional practices and pedagogy to create safe,
how to organize activity centers), giving stu- caring, engaging, and participatory learning en-
dents a voice in the nature and organization of vironments that foster students’ attachment to
their physical environment. Through regular school, motivation to learn, and school success
class meetings, teachers can engage students in (Zins, Weissberg, et al., 2004). Research has
developing the rules for the classroom and in shown that the most beneficial school-based pre-
creating a positive classroom environment. By vention and promotion programs are rooted in
considering student feedback, teachers demon- sound theory and research, and provide sequen-
strate that student opinions and experiences tial and developmentally appropriate instruction
are valued, and help to create a classroom cul- in SEL skills (Bond & Hauf, 2004). They are im-
ture in which students feel safe to ask questions plemented in a coordinated manner, and are
and take chances, enhancing the development preferably school-wide, from preschool through
of their SEL skills as well as their academic high school. Lessons are reinforced in the class-
success. room, during out- of-
school activities, and at
home. In effective SEL programs, educators re- the complexity of teaching with that much more
ceive ongoing professional development in SEL, highly rewarded profession, “doing medicine,” I
and families and schools work together to pro- concluded that the only time medicine even ap-
mote c hildren’s social, emotional, and academic proaches the complexity of an average day of class-
success (Nation et al., 2003). In short, SEL can be room teaching is in an emergency room during a
seen as a template for effective school reform. natural disaster. (Shulman, 2004, p. 504)
In their meta-a nalyses, Durlak, Weissberg,
and Pachan (2010) and Durlak et al. (2011) pro- Recent evidence indicates that efforts to improve
vided evidence that SEL programs promote bet- teachers’ knowledge about SEL alone are not suf-
ter student outcomes when program implementers ficient for successful SEL implementation. Indeed,
incorporate four elements represented by the teachers’ own SEL competence and well-being ap-
acronym SAFE: pear to play crucial roles in influencing the infu-
sion of SEL into classrooms and schools (Jones,
• Sequenced: Connected and coordinated set of Bouffard, & Weissbourd, 2013). Reviewing the
activities to foster skills development evidence linking teachers’ own SEL competence
• Active: Active forms of learning to help stu- and student outcomes, Jennings and Greenberg
dents master new skills (2009) pointed to the importance of quality
teacher-student relationships and effective stu-
• Focused: A component that emphasizes devel-
dent and classroom management skills (as well
oping personal and social skills
as implementation dosage and fidelity) in obtain-
• Explicit: Targeting specific social and emotional ing the best outcomes for students. Accordingly,
skills they recommended the development and imple-
mentation of interventions designed to specifi-
The effective implementation of an SEL pro- cally address teachers’ SEL competence, reduce
gram plays a crucial role in influencing student teacher stress and burnout, and improve teacher
outcomes. Unfortunately, some well-designed SEL well-being.
programs do not promote positive student out- Although limited, the past few years have
comes, often owing to variability in the way the seen the emergence of interventions specifically
program is implemented in the real-world setting targeted at improving teachers’ SEL and stress
of a school or classroom. When implementing an management. For example, two programs de-
established SEL program that has been shown to signed to promote teachers’ SEL competence by
be effective, it is important for educators to recog- incorporating mindfulness- based approaches
nize the importance of completing all lessons and are CARE (Cultivating Awareness and Resil-
activities in the program (dosage) and doing so as ience in Education) and SMART (Stress Manage-
designed by the program developers (fidelity) in ment and Relaxation Techniques) in Education.
order to maximize the likelihood of success of the (Sidebar 20.1 summarizes a number of programs
program in their own classroom environment. designed to promote teachers’ SEL.) Both pro-
grams aim to increase teachers’ mindfulness,
Care for Teachers job satisfaction, compassion and empathy for
Classroom teaching . . . is perhaps the most com- students, and efficacy for regulating emotions
plex, most challenging, and most demanding, and decreasing stress and burnout. Mindfulness is
subtle, nuanced, and frightening activity that our typically described as an attentive, nonjudgmen-
species has ever invented. In fact, when I compared tal, and receptive awareness of present-moment
S I D E B A R 2 0 . 1
Social and Emotional Learning Programs Designed for Teachers
The following are some of the social and educators, schools, and the general public
emotional learning programs designed on how to inspire and act in kindness. The
specifically for teachers: RAK Kindness in the Classroom Course,
offered in collaboration with the University
CARE for Teachers (w ww.care4teachers
1. of Colorado, Boulder, explores ways to
.com), from the Garrison Institute in New cultivate a caring classroom culture and
York, is a professional development school climate by learning about SEL and
program for educators teaching integrating it into the classroom and
emotional skills, understanding, and curriculum.
emotion regulation and recognition 5. SEL Resource Finder (www.selresources
through stress reduction techniques such .com), developed in the Faculty of Education
as mindfulness, self-reflection, and at the University of British Columbia, is an
breathing exercises. online collection of social and emotional
2. FuelEd (http://fueledschools.com) is a (SEL) and mental health resources for
program that trains teachers to meet the educators and other adults who work with
social and emotional needs of c hildren in children and youths.
the classroom, based on research from 6. Six Seconds (w ww.6seconds.org),
developmental and counseling psychology established in 1997, is a nonprofit orga
and social neuroscience. nization that provides training and
The Greater Good Science Center (http://
3. assessment tools on emotional
greatergood.berkeley.edu), established intelligence for both business and
in 2001 at the University of California– education, offering training for both
Berkeley, focuses on understanding students and teachers in skills related to
individual happiness, compassion, strong emotional intelligence.
social bonding, mindfulness, and altruism, SMART in Education (http://passageworks
7.
with the dual goal of conducting and .org/courses/smart-in-education), or Stress

disseminating research to the public. Management and Relaxation Techniques in
4. The Random Acts of Kindness Foundation Education, is a program for teachers and
(w ww.randomactsofkindness.org) is a adults working in education. The program
nonprofit organization that seeks to inspire aims to improve emotional health and
people to spread kindness, providing mental well-being through mindfulness
activities, lesson plans, and ideas for exercises.
experience in terms of feelings, images, thoughts, see Benn, Akiva, Arel, & Roeser, 2012; Roeser
and sensations or perceptions (for example, see et al., 2013) programs in promoting teacher SEL
Kabat-Zinn, 1990). Initial research to date has competence and well-being. Nonetheless, fur-
supported the effectiveness of both the CARE ther research is needed to examine whether such
(Jennings, Frank, Snowberg, Coccia, & Greenberg, positive changes in teacher well-being spill over
2013; Jennings, Snowberg, Coccia, & Greenberg, into the classroom and lead to improvements in
2011) and the SMART-in-Education (for example, students’ SEL competence.
that intentional efforts be made to devise the

SUMMARY most effective preventions and educational prac-
tices that promote SEL in all students. Such ef-
Although much has been learned in the past de forts must be based on strong conceptual models
cade about SEL programs and their effects on and sound research. Only then w ill the advance-
c hildren’s social and emotional competence and ment of the development of the world’s c hildren
academic success, the field has further to go be- and youths be possible.
fore firm conclusions can be made about the spe-
cific ways in which an SEL approach advances
c hildren’s short-term and long-term school and REFERENCES
life success. Indeed, many questions still remain
Ainsworth, M. D. S., & Bowlby, J. (1991). An ethologi-
regarding the ways in which programs and prac-
cal approach to personality development. Ameri-
tices designed to promote children’s SEL skills can
can Psychologist, 46, 333–341.
forecast c hildren’s f uture success. For example, Arseneault, L., Moffitt, T. E., Caspi, A., Taylor, P. J., &
what are the processes and mechanisms that lead Silva, P. A. (2000). Mental disorders and violence
to successful improvements in c hildren’s social in a total birth cohort: Results from the Dunedin
and emotional competence across programs? study. Archives of General Psychiatry, 57, 979–986.
Which programs work best for which c hildren? Association for Supervision and Curriculum Devel-
And under what conditions is optimal develop- opment. (2007). The learning compact redefined: A
ment fostered? call to action. A report of the Commission on the Whole
One of the biggest challenges that confronts Child. Alexandria, VA: Author. Retrieved from
the field of SEL is the translation of knowledge http://w w w.a scd.o rg /A SCD/p df/ W hole%20
garnered from rigorous research on the effective- Child/ WCC%20Learning%20Compact.pdf
Bandura, A. (1977). Social learning theory. Englewood
ness of programs into policy and widespread prac-
Cliffs, NJ: Prentice Hall.
tice (Greenberg, 2010; Shonkoff & Bales, 2011).
Battin-Pearson, S., Newcomb, M. D., Abbott, R. D.,
Clearly, t here is a need for greater efforts to trans-
Hill, K. G., Catalano, R. F., & Hawkins, J. D.
late science for practice and policy so that SEL ap-
(2000). Predictors of early high school dropout: A

proaches can be better integrated into schools and test of five theories. Journal of Educational Psychology,
communities. Such efforts can help build the pro 92, 568–582.
cesses and structures needed to foster high-quality Benn, R., Akiva, T., Arel, S., & Roeser, R. W. (2012).
implementation and promote sustainability (see Mindfulness training effects for parents and educa-
Elias, Zins, Graczyk, & Weissberg, 2003). tors of c hildren with special needs. Developmental
Greater collaboration between researchers Psychology, 48, 1476–1487.
and educators is also needed so that research not Best, J. R., & Miller, P. H. (2010). A developmental
only informs practice but is also informed by it. perspective on executive function. Child Develop-
Indeed, to create a world characterized by the ment, 81, 1641–1660.
Bond, L. A., & Hauf, A. M. C. (2004). Taking stock and
values and practices that illustrate caring and
putting stock in primary prevention: Characteris-
kindness among all people, it is essential that
tics of effective programs. Journal of Primary Pre-
educators, parents, community members, and vention, 24, 199–221.
policy makers work in concert to achieve long- Brackett, M. A., Rivers, S. E., Reyes, M. R., & Salovey,
term change. In today’s complex society, special P. (2012). Enhancing academic performance and
care needs to be taken to encourage and assist social and emotional competence with the RULER
young people to reach their greatest potential feeling words curriculum. Learning and Individual
and to flourish and thrive. It is therefore critical Differences, 22, 218–224.
Bridgeland, J., Bruce, M., & Hariharan, A. (2013). The Diamond, A. (2012). Activities and programs that im-
missing piece: A national survey on how social and prove c hildren’s executive functions. Current Di-
emotional learning can empower children and trans- rections in Psychological Science, 21, 335–341.
form schools. Washington, DC: Civic Enterprises. Diamond, A., Barnett, W. S., Thomas, J., & Munro, S.
British Columbia Ministry of Education. (n.d.). (2007). Preschool program improves cognitive
Personal awareness and responsibility. Retrieved control. Science, 318, 387–388.
from https://c urriculum.gov.bc.c a/competencies Diamond, A., & Lee, K. (2011). Interventions shown
/personal-awareness-responsibility to aid executive function development in c hildren
Bushaw, W. J., & Lopez, S. J. (2013, September). Which 4 to 12 years old. Science, 333, 959–964.
way do we go? The 45th annual PDK/Gallup poll Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Tay-
of the public’s attitudes t oward the public schools. lor, R. D., & Schellinger, K. B. (2011). Enhancing
Phi Delta Kappan, 95(1), 8–25. students’ social and emotional development pro-
Caprara, G. V., Barbaranelli, C., Pastorelli, C., Bandura, motes success in school: Results of a meta-analy
A., & Zimbardo, P. G. (2000). Prosocial founda- sis. Child Development, 82, 474–501.
tions of c hildren’s academic achievement. Psycho- Durlak, J. A., Weissberg, R. P., & Pachan, M. (2010). A
logical Science, 11, 302–306. meta-analysis of a fter-school programs that seek
Carter, D. S., Harris, J., & Porges, S. W. (2009). Neural to promote personal and social skills in c hildren
and evolutionary perspectives on empathy. In J. and adolescents. American Journal of Community
Decety & W. J. Ickes (Eds.), Social neuroscience of Psychology, 45, 294–309.
empathy (pp. 169–182). Cambridge, MA: MIT Eccles, J. S., & Roeser, R. W. (2009). Schools, academic
Press. motivation, and stage-e nvironment fit. In R. M.
Caspi, A., Taylor, A., Moffitt, T. E., & Plomin, R. (2000). Lerner & L. Steinberg (Eds.), Handbook of adoles-
Neighborhood deprivation affects c hildren’s cent psychology (3rd ed., pp. 404–434). Hoboken,
mental health: Environmental risks identified in a NJ: John Wiley & Sons.
genetic design. Psychological Science, 11, 338–342. Elias, M. J. (2001). Prepare c hildren for the tests of life,
Coie, J. D., & Dodge, K. A. (1998). Aggression and antiso- not a life of tests. Education Week, 21(4), 40.
cial behavior. In N. Eisenberg (Ed.), Handbook of child Elias, M. J., Zins, J. E., Graczyk, P. A., & Weissberg,
psychology: Vol. 3. Social, emotional, and personality de- R. P. (2003). Implementation, sustainability, and
velopment (5th ed., pp. 779–862). New York: Wiley. scaling-up of social-emotional and academic in-
Collaborative for Academic, Social, and Emotional novations in public schools. School Psychology
Learning. (2005). Safe and sound: An educational Review, 32, 303–319.
leader’s guide to evidence-based social and emotional Elias, M. J., Zins, J. E., Weissberg, R. P., Frey, K. S., Green-
learning programs (Illinois ed.). Chicago: CASEL. Re- berg, M. T., Haynes, N. M., . . . Shriver, T. P. (1997).
trieved from http://static1.squarespace.com/static Promoting social and emotional learning: Guidelines for
/513f79f9e4b05ce7b70e9673/t/5331c141e4b0fba6 educators. Alexandria, VA: Association for Supervi-
2007694a /1395769665836 /s afe - a nd - s ound -i l sion and Curriculum Development.
-edition.pdf Gallese, V., & Goldman, A. I. (1998). Mirror neurons
Collaborative for Academic, Social, and Emotional and the simulation theory of mind-reading. Trends
Learning. (2013). 2013 CASEL guide: Effective so- in Cognitive Science, 2, 493–501.
cial and emotional learning programs—Preschool and Goleman, D. (1995). Emotional intelligence. New York:
elementary school edition. Chicago: Author. Re- Bantam.
trieved from http://w ww.casel.org/g uide Goleman, D. (2006). Social intelligence: The new science
Devaney, E., O’Brien, M. U., Resnik, H., Keister, S., & of human relationships. New York: Bantam.
Weissberg, R. P. (2006). Sustainable schoolwide so- Gottfredson, G. D., Gottfredson, D. C., Payne, A. A., &
cial and emotional learning: Implementation guide Gottfredson, N. C. (2005). School climate predic-
and toolkit. Chicago: Collaborative for Academic, tors of school disorder: Results from a national
Social, and Emotional Learning. study of delinquency prevention in schools.
Journal of Research in Crime and Delinquency, 42, Institute of Medicine. (2009). Preventing mental, emo-
412–444. tional, and behavioral disorders among young people:
Greenberg, M. T. (2006). Promoting resilience in Progress and possibilities. Washington, DC: National
c hildren and youth: Preventive interventions and Academies Press.
their interface with neuroscience. Annals of the Izard, C. (2002). Translating emotion theory and re-
New York Academy of Sciences, 1094, 139–150. search into preventive interventions. Psychological
Greenberg, M. T. (2010). School-based prevention: Bulletin, 128, 796–824.
Current status and future challenges. Effective Jaffee, S. R., Harrington, H., Cohen, P., & Moffitt, T. E.
Education, 2, 27–52. (2005). Cumulative prevalence of psychiatric dis-
Greenberg, M. T., Domitrovich, C., & Bumbarger, B. order in youths. Journal of the American Academy of
(2001). The prevention of m ental disorders in Child and Adolescent Psychiatry, 44, 406–407.
school-aged c hildren: Current state of the field. Jennings, P. A., Frank, J. L., Snowberg, K. E., Coccia,
Prevention & Treatment, 4, 1–62. M. A., & Greenberg, M. T. (2013). Improving class-
Greenberg, M. T., Weissberg, R. P., O’Brien, M. U., room learning environments by Cultivating
Zins, J. E., Fredericks, L., Resnik, H., & Elias, M. J. Awareness and Resilience in Education (CARE):
(2003). Enhancing school-based prevention and Results of a randomized controlled trial. School
youth development through coordinated social, Psychology Quarterly, 28, 374–390.
emotional, and academic learning. American Psy- Jennings, P. A., & Greenberg, M. T. (2009). The proso-
chologist, 58, 466–474. cial classroom: Teacher social and emotional
Hawkins, J. D., Kosterman, R., Catalano, R. F., Hill, K. competence in relation to student and classroom
G., & Abbott, R. D. (2008). Effects of a social de- outcomes. Review of Educational Research, 79,
velopment intervention in childhood 15 years 491–525.
later. Archives of Pediatric and Adolescent Medicine, Jennings, P. A., Snowberg, K. E., Coccia, M. A., &
162, 1133–1141. Greenberg, M. T. (2011). Improving classroom
Heckman, J. J. (2007). The economics, technology, learning environments by Cultivating Awareness
and neuroscience of h uman capability formation. and Resilience in Education (CARE): Results of
Proceedings of the National Academy of Sciences, 104, two pilot studies. Journal of Classroom Interaction,
13250–13255. 46, 37–48.
Hemmelgarn, A. L., Glisson, C., & James, L. R. (2006). Jones, D. E., Greenberg, M. T., & Crowley, M. (2015).
Organi zat ional culture and climate: Implications Early social-e motional functioning and public
for serv ices and interventions research. Clinical health: The relationship between kindergarten
Psychology: Science & Practice, 13, 73–89. social competence and f uture wellness. American
Hymel, S., Schonert-Reichl, K., & Miller, L. (2006). Journal of Public Health, 105(11), 2283–2290.
Reading, ’riting, ’rithmetic, and relationships: Jones, S. M., & Bouffard, S. M. (2012). Social and emo-
Considering the social side of education. Excep- tional learning in schools: From programs to
tionality Education Canada, 16, 1–44. strategies. Society for Research on Child Development
Hymel, S., & Swearer, S. M. (2015). Four decades of Social Policy Report, 25(4), 1–22.
research on school bullying: An introduction.
Jones, S. M., Bouffard, S. M., & Weissbourd, R. (2013).
American Psychologist, 70, 293–299. Educators’ social and emotional skills vital to
Illinois State Board of Education. (n.d.). Illinois learn- learning. Phi Delta Kappan, 94, 62–65.
ing standards: Social/emotional learning. Re- Kabat-Zinn, J. (1990). Full catastrophe living: Using the
trieved from http://w ww.isbe.net/ils/social_emo wisdom of your body and mind to face stress, pain, and
tional/standards.htm illness. New York: Bantam Doubleday Dell.
Immordino-Yang, M. H., & Damasio, A. (2007). We Klem, A. M., & Connell, J. P. (2004). Relationships
feel, therefore we learn: The relevance of affective matter: Linking teacher support to student

and social neuroscience to education. Mind, Brain, e ngagement and achievement. Journal of School
and Education, 1, 3–10. Health, 74, 262–273.
Maldonado-Carreno, C., & Votruba-Drzal, E. (2011). bilities. Washington, DC: National Academies
Teacher-c hild relationships and the development Press.
of academic and behavioral skills during elemen- Roeser, R. W., & Eccles, J. S. (2014). Schooling and the
tary school: A within-and between-c hild analy mental health of c hildren and adolescents in the
sis. Child Development, 82, 601–616. United States. In M. Lewis & K. Rudolph (Eds.),
Malti, T., & Noam, G. (2008). The hidden crisis in Handbook of developmental psychopathology (3rd ed.,
mental health and education: The gap between pp. 163–184). New York: Springer.
student needs and comprehensive supports. New Roeser, R. W., Schonert-Reichl, K. A., Jha, A., Cullen,
Directions in Youth Development, 120, 13–29. M., Wallace, L., Wilensky, R., . . . Harrison, J.
Mayer, J. D., & Salovey, P. (1997). What is emotional (2013). Mindfulness training and reductions in
intelligence? In P. Salovey & D. Sluyter (Eds.), teacher stress and burnout: Results from two ran-
Emotional development and emotional intelligence: domized, waitlist-control field trials. Journal of
Implications for educators (pp. 3–31). New York: Educational Psychology, 105, 787–804.
Basic Books. Rose, L. C., & Gallup, A. M. (2000). The 32nd annual
Moffitt, T. E., Arseneault, L., Belsky, D., Dickson, N., Phi Delta Kappa/Gallup poll of the public’s atti-
Hancox, R. J., Harrington, H., . . . Caspi, A. tudes towards the public schools. Phi Delta Kap-
(2011). A gradient of childhood self-control pre- pan, 82, 41–58.
dicts health, wealth, and public safety. Proceed- Schonert-R eichl, K. A., & Weissberg, R. P. (2014).
ings of the National Acad e my of Sciences, 108, Social and emotional learning during child-
2693–2698. hood. In T. P. Gullotta & M. Bloom (Eds.), Ency-
Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. clopedia of primary prevention and health promotion
L., Seybolt, D., Morrisey-K ane, E., & Davino, K. (2nd ed., pp. 936–949). New York: Springer.
(2003). What works in prevention: Principles of Shonkoff, J. P., & Bales, S. N. (2011). Science does not
effective prevention programs. American Psycholo- speak for itself: Translating child development re-
gist, 58, 449–456. search for the public and its policymakers. Child
National Research Council. (2012). Education for life Development, 82, 17–32.
and work: Developing transferable knowledge and Shulman, L. S. (2004). The wisdom of practice: Essays on
skills in the 21st century. Washington, DC: National teaching, learning, and learning to teach. San Fran-
Academies Press. cisco: Jossey-Bass.
National School Climate Council. (2007). The school Singer, T., & Lamm, C. (2009). The social neuroscience
climate challenge: Narrowing the gap between school of empathy. The Year in Cognitive Neuroscience, New
climate research and school climate policy, practice York Academy of Sciences, 1156, 81–96.
guidelines and teacher education policy. New York: Sklad, M., Diekstra, R., de Ritter, M., Ben, J., & Grave
National School Climate Center. steijn, C. (2012). Effectiveness of school-based
Oberle, E., Schonert-Reichl, K. A., Hertzman, C., & universal social, emotional, and behavioural pro-
Zumbo, B. (2014). Social-e motional competen- grams: Do they enhance students’ development
cies make the grade: Predicting academic success in the area of skill, behaviour, and adjustment?
in early adolescence. Journal of Applied Developmen- Psychology in the Schools, 49, 892–909.
tal Psychology, 35, 138–147. Spinrad, T. L., & Eisenberg, N. (2009). Empathy, pro-
O’Brien, M. U., Weissberg, R. P., & Munro, S. B. social behavior, and positive development in the
(2005/2006, Winter). Reimagining education: In schools. In R. Gilman, E. S. Huebner, & M. J. Fur-
our dream, social and emotional learning—or long (Eds.), Handbook of positive psychology in schools
“SEL”—is a household term. Green Money Journal, (pp. 119–129). New York: Routledge/Taylor &
14(2), 57. Francis Group.
O’Connell, M. E., Boat, T., & Warner, K. E. (Eds.). Stephens, T., & Joubert, N. (2001). The economic bur-
(2009). Preventing m ental, emotional, and behavioral den of mental health problems in Canada. Chronic
disorders among young people: Prog ress and possi- Disease in Canada, 22, 18–23.
Swearer, S. M., Espelage, D., Vaillancourt, T., & Hymel, (Eds.), Handbook of social and emotional learning: Re-
S. (2010). What can be done about school bully- search and practice (pp. 3–19). New York: Guilford.
ing? Linking research to educational practice. Weissberg, R. P., Payton, J. W., O’Brien, M. U., &
Educational Researcher, 39, 38–47. Munro, S. (2007). Social and emotional learn-
Thapa, A., Cohen, J., Guffey, S., & Higgins- ing. In F. C. Power, R. J. Nuzzi, D. Narvaez, D. K.
D’Alessandro, A. (2013). A review of school cli- Lapsley, & T. C. Hunt (Eds.), Moral education: A
mate research. Review of Educational Research, 83, handbook: Vol. 2. M–Z (pp. 417–418). Westport,
357–385. CT: Greenwood Press.
Tobler, N. S., Roona, M. R., Ochshorn, P., Marshall, Wells, J., Barlow, J., & Stewart-Brown, S. (2003). A sys-
D. G., Streke, A. V., & Stackpole, K. M. (2000). tematic review of universal approaches to mental
School-based adolescent drug prevention pro- health promotion in schools. Health Education
grams: 1998 meta-analysis. Journal of Primary Journal, 103(4), 197–220.
Prevention, 20, 275–337. Wentzel, K. R. (1993). Does being good make the
US Public Health Serv ice. (2000). Report of the surgeon grade? Social behavior and academic competence
general’s conference on c hildren’s m
ental health: A na- in m iddle school. Journal of Educational Psychology,
tional action agenda. Washington, DC: US Depart- 85, 357–364.
ment of Health and Human Serv ices. Zins, J. E., Bloodworth, M. R., Weissberg, R. P., &
Weare, K., & Nind, M. (2011). M ental health promo- Walberg, H. J. (2004). The scientific base linking
tion and problem prevention in schools: What social and emotional learning to school suc-
does the evidence say? Health Promotion Interna- cess. In J. E. Zins, R. P. Weissberg, M. C. Wang,
tional, 26, i29–i69. & H. J. Walberg (Eds.), Building academic success
Weissberg, R. P., & Cascarino, J. (2013, October). Aca- on social and emotional learning: What does the re-
demic + social-emotional learning = national pri- search say? (pp. 3–22). New York: Teachers Col-
ority. Phi Delta Kappan, 95(2), 8–13. lege Press.
Weissberg, R. P., Durlak, J. A., Domitrovich, C. E., & Zins, J. E., Weissberg, R. P., Wang, M. C., & Walberg,
Gullotta, T. P. (2015). Social and emotional learn- H. J. (2004). Building academic success on social and
ing: Past, present, and f uture. In J. A. Durlak, C. E. emotional learning: What does the research say?
Domitrovich, R. P. Weissberg, & T. P. Gullotta New York: Teachers College Press.
G L O S S A R Y
COMPILED BY DAWN SOTO
Abacus A device used for performing mathematical Adaptive physical education teacher An educator who
computations by sliding beads along rods. has been specially trained to work with c hildren who
need individualized instruction to improve motor
Academic literacy skills The basic reading and writing skill development and participation in individual
skills taught in a conventional literacy medium (print and team sports.
or braille) during the elementary and m iddle school
years. See also Emergent literacy skills; Functional Adaptive technology See Assistive technology.
literacy skills; Literacy skills.
Adventitious visual impairment Loss or impairment of
Accommodation The ability of the eye to adjust its fo- vision that occurs a fter birth, usually as a result of an
cus for seeing at different distances by changing the accident or disease. Used to refer to the loss of vision
shape of the lens through action of the ciliary muscle. a fter visual memory is established. See also Congeni-
tal visual impairment.

Achromatopsia A congenital defect or absence of
cones, resulting in the inability to see color and re- Affective communication A social skill that enables
duce clear central vision. individuals to communicate nonverbally, that is,
through actions, gestures, visual expression, and body
Acquired Immune Deficiency Syndrome See AIDS. language.
Activities of daily living (ADLs) The routine tasks that AIDS (Acquired Immune Deficiency Syndrome) A
an individual must be able to perform to live inde chronic disease of the immune system that is caused
pendently. by infection with the human immunodeficiency virus
(HIV). As a result of a compromised immune system,
Acuity See Visual acuity. individuals with AIDS may develop eye conditions
leading to visual impairment, such as cytomegalovi-
Adaptation The modification of instructional materi- rus retinitis, the most frequent opportunistic intraoc-
als or the environment to the needs of students with ular infection among individuals with AIDS.
visual impairments. See also Auditory adaptations;
Nonoptical adaptations; Tactile adaptations; Visual Albinism See Ocular albinism; Oculocutaneous
adaptations. a lbinism.
489
490 Glossary
Ambylopia Reduced vision without observable changes Arena assessment A form of observation in which a
in the structure of the eye, caused by eyes that are not group of observers, often with different specialties,
straight or by a difference in the refractive errors in observe one or two people interacting with a student.
the two eyes, sometimes formerly called lazy eye; not
correctable with lenses b ecause the cause of vision Assessment In education, the process through which
loss is the brain’s suppression of the image. present needs and skill levels of a student are deter-
mined and achievement is documented.
Americans with Disabilities Act (ADA) of 1990 An act
granting civil rights to individuals with disabilities. Assistive technology Equipment used to help individ-
The ADA prohibits discrimination against individu- uals compensate for the loss of vision or a visual im-
als with disabilities in the areas of public accommo- pairment, such as speech, braille, and large-print
dations, employment, transportation, state and local devices that enable a person with a visual impair-
government serv ices, and telecommunications. It is ment to use a personal computer and software pro-
the most far-reaching civil rights legislation ever en- grams. Also known as access technology.
acted in the history of disability policy in the United
States. Assistive technology assessment A method of deter-
mining the most appropriate technological tools for
Amsler Grid A pattern of horizontal and vertical lines current and f uture education tasks.
used to monitor central field losses, as in macular de-
generation. Assistive technology specialist A professional who as-
sists the student in identifying which assistive de-
Anecdotal record A method of assessment involving vices most effectively meet a specific need.
brief notes about observations of a behavior of inter-
est. Also known as anecdotal observation. Astigmatism A refractive error that is caused by an ir-
regular curvature of the cornea and that prevents light
Angular gyrus A region on the left side of the brain rays from coming to a point or focus on the retina.
where the occipital, parietal, and temporal lobes meet;
involved in the process of identifying a word as a Auditory adaptations Modifications of educational
whole word during reading. materials by providing an aural version using a
human reader, recorded version, or assistive tech-

Anisometropia Different refractive errors of at least 1 nology.
diopter in the two eyes.
Augmentative and alternative communication (AAC)
Aphakia The absence of the crystalline lens, usually Techniques for the comprehension or production of
resulting from the removal of a cataract. communication used by individuals with little or no
functional speech.
Applied behavior analysis A systematic approach to
learning that incorporates the principles of behavior Aural reading The gathering of information from au-
modification and structured reinforcement to change dio materials and books.
a desired behavior.
Autism spectrum disorder A developmental disability
Aqueous The clear fluid in the space between the back that affects verbal and nonverbal communication
of the cornea and the front of the lens, produced by and social interactions.
the ciliary processes, that bathes the lens and nour-
ishes the iris and inner surface of the cornea. Also Autosome Any non-sex-determining chromosome, of
called aqueous humor. which t here are 22 pairs in a h
uman.
Glossary 491
Backward chaining An instructional strategy used to areer education skills The ability to function in the
C
teach sequential tasks by teaching one step at a time work environment by interacting with others, having
in reverse order, so the student first learns to com- appropriate O&M skills, and managing the tasks of
plete the task. See also Chaining. daily living.
Binocular vision Vision that uses both eyes to form a Case manager An individual designated by a team to
fused image in the brain and that results in three- assume primary responsibility for compiling all in-
dimensional perception. formation relevant to educational program planning
for a student.
Biomicroscopy The examination of the eyelids and an-
terior portion of the eyeballs with a slit lamp (biomi- Cataract A clouding of the lens of the eye, which may
croscope) for magnification. be congenital, traumatic, secondary to another visual
impairment, or age related. When a cataract is surgi-
Blind spot See Scotoma. cally removed, an intraocular lens implant, contact
lens, or spectacle correction is necessary to provide
Blindness The inability to see; the absence or severe the refractive function of the absent lens.
reduction of vision. See also Adventitious visual im-
pairment; Congenital visual impairment. Cerebral palsy A nonprogressive disorder of voluntary
movement and posture that is caused by damage to
Bold-line writing guide A handwriting guide for stu- the brain before or during birth or within the first few
dents with low vision that uses highly visible lines years of life; classifications of the types of cerebral
to give some measure of visual guidance for writing. palsy include monoplegia, hemiplegia, diplegia, para-
plegia, and quadriplegia.
Braille A system of raised dots based on a structure of
six-
dot cells that enables individuals to read and Cerebral visual impairment/cortical visual impairment
write using their tactile sense. (CVI) A neurological visual disorder, typically indi-
cated when t here is a normal or close to normal eye
Braille embosser A computer printer that produces examination that does not explain visual perfor
embossed braille by using software to convert from mance, a medical history that typically includes neu-
print to contracted or uncontracted braille. rological problems, and the presence of unique visual
or behavioral characteristics. Cerebral visual impair-
Braille literacy A student’s proficiency in using braille ment is generally considered to be broader in scope
to accomplish reading and writing tasks. and encompasses cortical visual impairment. The
definition of CVI continues to evolve as more is learned
Braillewriter A machine used for embossing braille about the brain and sensory processing.
by pressing combinations of keys. Also known as a
brailler. Certification A formal approval that indicates that an
individual is recognized as meeting all the criteria
Brain injury A physical injury or impairment that af- necessary for practice within a profession.
fects the brain, resulting from such causes as anoxia,
trauma, tumors, or stroke. The effects range from Chaining An instructional strategy used to teach se-
little to no visual impairment to a combination of quential tasks by teaching one step at a time in se-
poor visual acuity, visual field loss, diplopia, distor- quential order. See also Backward chaining.
tion, glare sensitivity, and such visual perceptual dif-
ficulties as visual agnosia (in which objects are seen CHARGE syndrome A genetic condition caused by a
but not recognized). mutation in a single gene; major characteristics include
492 Glossary
coloboma, atresia of the choanae (nasal passage), cra- Code of ethics A standard, typically consisting of
nial nerve abnormality, and ear abnormalities; minor guidelines, intended to ensure that those who have
characteristics include heart defects, cleft lip or cleft entered a profession have appropriate preparation
palate, kidney abnormalities, growth deficiency, and and practice in accordance with acceptable and re-
genital abnormalities. spected principles.
Checklists List of skills of increasing difficulty or re- Cognitive abilities Those operations of the mind by
lated to a set of objectives that are used to monitor which individuals become aware of objects, thoughts,
student prog ress. or perceptions, including understanding and rea-
soning.
Child Find system A legal mandate of IDEA that re-
quires each state to have a plan to locate and evaluate Coloboma A congenital cleft in some portion of the eye
all children (including infants and toddlers) with caused by the improper fusion of tissue during gesta-
disabilities and refer them for serv ice. tion; may affect the optic nerve, ciliary body, choroid,
iris, lens, or eyelid.
Choroid The vascular layer of the eye, between the
sclera and the retina, that nourishes the retina; part Color perception The perception of color as a result of
of the uveal tract. the stimulation of specialized cone receptors in the
retina.
Ciliary body Tissue inside the eye, composed of the cili-
ary processes and ciliary muscle; the former secretes Color vision The ability to discriminate different hues
aqueous, and the latter controls and alters the shape of and saturations of colors.
the lens.
Common Core State Standards (CCSS) A proposed set
Clinical low vision evaluation An evaluation of an indi- of national K–12 academic standards in mathematics
vidual’s use of vision, generally occurring in the office and Eng lish language arts and literacy, history and
of a licensed eye care specialist, including optome- social studies, science, and technical subjects a dopted
trists and other eye care professionals. The evalua- by many states around the country that outline
tion includes assessment of low vision, prescription what a student should know and be able to do at
of low vision devices, and training in the use of de- the end of each grade and the skills and concepts
vices and adaptive techniques to enhance visual required for college and c areer readiness in multi-
function. ple disciplines.
Clinical low vision specialist An ophthalmologist or Communication notebooks Records of events at school
optometrist who specializes in low vision care. and home made by teachers, parents, and students.
Closed-circuit television (CCTV) See Video magnifier. Compensatory education Unique knowledge and skills
that make it possible for the student with a visual im-
Clues Bits of temporary sensory information that can pairment to achieve educational objectives at a rate and
be used in orientation and mobility to tell where one level similar to that of his or her sighted classmates.
is or the direction in which one wants to go.
Comprehension The ability to read and understand
Cockayne syndrome An autosomal-recessive progres- the meaning of text.
sive disorder, characterized by retinitis pigmentosa
(RP) with optic atrophy, deafness, dwarfism, and in- Comprehensive assessment An evaluation of all the
tellectual disability. skills that are specifically related to the student’s vi-
Glossary 493
sual impairment, including the functional vision as- Content validity A determination of how clearly the
sessment, the learning media assessment, braille items sampled on the test represent the content that
reading and writing, potential for using assistive tech- the test purports to measure. See also Validity.
nology and other aids, academic achievement, and so
forth. Contrast sensitivity The ability to detect differences in
grayness and background.
Comprehensive, integrated, three-tiered (CI3T) model
Model of educational support that focuses on aca- Convergence The movement, as an object approaches,
demic, behavioral, and social domains; incorporates of both eyes toward each other in an effort to main-
response to intervention (RTI) and positive behavior tain fusion of separate images.
interventions and supports (PBIS) through a three-
tiered approach to prevention and intervention based Convex lens A lens that bends light rays inward and is
on measurement of an individual student’s needs. used to correct hyperopia. Also called plus lens. See
also Spherical lens.
Concave lens A lens that spreads out light rays and is
used to correct myopia. Also called minus lens. See also Core curriculum General education curriculum and
Spherical lens. state content standards that all students are expected
to master, including reading and writing, language
Concept development The development of m ental arts, science, mathematics, and social studies.
ideas and understanding of things, which is one of
the building blocks for independence and an essen- Cornea The transparent tissue at the front of the eye
tial element in orientation and mobility training. that is curved and provides approximately 66 percent
of the eye’s refracting power.
Concurrent validity A type of criterion-related validity
that compares a student’s performance on two or more Cornelia de Lange syndrome A genetic syndrome that
tests within a short period. If the student performs results in visual impairments, including hyperopia;
similarly on both tests, the accuracy of the results is sensorineural hearing impairments; and intellectual
considered more reliable. See also Criterion-related disability.
validity; Validity.
Co-teaching A form of instruction in which two or

Cones Specialized photoreceptor cells in the retina, more professionals jointly deliver substantive instruc-
primarily concentrated in the macular area, that are tion to a diverse, blended group of students, primar-
responsible for sharp vision and color perception. See ily in a single space.
also Rods.
Criterion-referenced tests Formal or informal instru-
Congenital visual impairment Loss or impairment of vi- ments that compare the student’s performance to the
sion that is present at birth or prior to the establish- overall mastery of the skill being evaluated. They are
ment of visual memory. See also Adventitious visual judged against a predetermined level of mastery that
impairment. is often expressed as a percentage.
Conjunctiva The mucous membrane that lines the eye- Criterion-related validity A determination of how accu-
lids and part of the outer surface of the eyeball. rately a test measures what it purports to measure
by comparing the scores with other criteria that are
Conjunctivitis An inflammation of the conjunctiva considered indicators of the same trait or skill as that
that is viral, allergic, bacterial, or fungal in origin, being measured. See also Concurrent validity; Pre-
some var iet ies of which are contagious. dictive validity; Validity.
494 Glossary
Curriculum-based assessment (CBA) Assessment of stu- Diplopia A vision disorder in which two images of a
dents using the classroom curriculum for testing and single object are seen b
ecause of unequal action of
documenting prog ress, such as a spelling test, end-of- the muscles in the eyes. Also called double vision.
chapter test, or teacher-made test to check for braille
contraction acquisition. Also known as curriculum- Disability A condition that exists when, in a part icular
based measurement (CBM). setting, an individual cannot independently perform
a specific set of functional activities.
Deafblindness Concomitant hearing and vision im-
pairments, the combination of which may cause such Distance education Academic or other learning pro-
severe communication and other developmental and grams to accommodate students by offering instruc-
educational needs that they require accommodation tion off campus, such as at satellite locations or using
beyond those provided in special education pro- the Internet.
grams solely for c hildren with deafness or c hildren
with blindness. Dog guide A specially trained serv ice dog that assists a
person who is blind or visually impaired in orienta-
Deafness A loss of hearing that is so severe that the tion and mobility. Dog guides learn to respond to
individual’s sense of hearing is nonfunctional for the commands and to judge when d oing so would en-
ordinary activities of daily living. danger the owner.
Developmental assessment An evaluation of motor and

Double vision See Diplopia.
personal-social skills. In the case of students who are
blind or visually impaired, the evaluator must take into
Echolocation The use of reflected sound (including
account the extent to which such development in pre-
ambient sound) to detect the presence of objects such
school c hildren depends on the extent of useful vision.
as walls, buildings, doors, and openings.
Developmentally delayed Functioning at a level below
Ecological assessment A structured way of observing a
one’s chronological age.
student’s interaction with his or her environment.
Diabetes mellitus A metabolic disorder related to
faulty pancreatic activity and an inability to oxidize Education for All Handicapped Children Act Federal legis-
carbohydrates, resulting in the inadequate produc- lation enacted in 1975 that guaranteed f ree appropriate
tion or utilization of insulin; it results in an elevated public education in the least restrictive environment,
blood sugar level and presence of sugar in the urine. with special education, related serv ices, and Individu-
alized Education Programs mandated for each child
Diabetic retinopathy A noninflammatory disease of needing special serv ices. Now known as the Individu-
the retinal blood vessels caused by diabetes; a leading als with Disabilities Education Act (IDEA), it is the
cause of blindness in the United States. most significant legislation on behalf of students with
disabilities.
Diagnostic teaching The use of reflective instructional
strategies to systematically analyze the immediate ELL Eng lish language learner.
impact of teaching to support learning and targeted
instruction to minimize or eliminate difficulties Embosser A printer that renders text as braille cells by
identified. using translation software to convert from print to
contracted braille.
Differentiated instruction A model of instructional de-
sign centered on the need for flexibility in content, Emergent literacy skills The earliest attempts by young
process, and product. c hildren to bring meaning to reading and writing. See
Glossary 495
also Academic literacy skills; Functional literacy Eyelids Structures that cover the front of the eyes to
skills; Literacy skills. protect them, control the amount of light entering
them, and distribute tears over the cornea.
Enucleation A surgical procedure consisting of re-
moval of the entire eyeball. Fading Scaling back prompts to less intrusive assis-
tance as soon as possible to allow a student to com-
Environmental assessment An analysis of the student’s plete a task independently. See also Hierarchy of
school environment to see how it affects his or her prompting.
functioning.
Farsightedness See Hyperopia.
Environmental modifications Changes in the environ-
ment to maximize the use of vision. Field of vision See Visual field.
ESL Eng lish as a second language. Fixation The ability to keep the eyes steady on a target
of interest.
Esotropia A form of strabismus in which one or both
eyes deviate inward.
Fluency Reading accurately, smoothly, rapidly, and
with comprehension.
Event records An observational method of assessment
in which the number of occurrences of a specific
Focal distance The distance between a lens and the
targeted behavior is recorded as it occurs within an
point at which parallel light rays are brought to a fo-
observational period. See also Observational meth-
cus.
ods.
Executive functions A group of cognitive skills that Formal tests Evaluations that require careful adher-
contribute to successful problem solving and critical ence to directions for their administration and scor-
thinking; refers to cognitive processes such as plan- ing, may have time limits, and result in a numerical
ning, organi zing, creative problem solving, and criti- or quantitative score that is compared to the scores of
cal thinking. a part icular group. See also Informal tests; Norm-
referenced tests; Standardized tests.

Exotropia A form of strabismus in which one or both
eyes deviate outward. Formative assessment Ongoing assessment used to
monitor how learning is progressing over time so that
Expanded core curriculum (ECC) The body of knowl- changes in instruction can be made as needed.
edge and skills, beyond the core academic curricu-
lum, that students with visual impairments need to Fovea A depression in the center of the macula that
learn in order to lead full, independent lives; includes provides the sharpest vision and contains a high con-
the nine areas of compensatory access, sensory effi- centration of cones and lacks blood vessels.
ciency skills, assistive technology skills, orientation
and mobility (O&M), independent living skills, so- Functional behavior assessment (FBA) An assessment
cial interaction skills, recreation and leisure skills, used to identify the communicative intent behind a
career education skills, and self-determination skills. behavior.
Experiential learning An approach to teaching in which Functional blindness A condition in which some use-
the environment is arranged to motivate c hildren to ful vision may or may not be present but in which the
explore, investigate, ponder, and question so they individual uses tactile and auditory channels more
can construct knowledge for themselves. effectively than vision for learning.
496 Glossary
Functional literacy skills The application of literacy Graphicacy The ability to correctly read and interpret
skills and the use of a variety of literacy tools (such as graphic information.
listening and technology) to accomplish daily tasks
in the home, school, community, and work settings. Group tests Evaluations designed to be administered
See also Academic literacy skills; Emergent literacy to more than one individual at a time. See also Indi-
skills; Literacy skills. vidual tests.
Functional vision The ability to use vision in daily liv- Gustatory system The sense of taste, involving recep-
ing and routine environments for planning and per- tor cells in the taste buds that are connected through
forming a task. a synapse to a sensory neuron leading back to centers
in the brainstem.
Functional vision assessment (FVA) An assessment of
an individual’s use of vision in a variety of tasks and Habilitation The process of supporting an individual
settings, including measures of near and distance vi- to keep, learn, or improve skills and functioning for
sion; visual fields; eye movements; and responses to daily living, especially assisting a child with achieving
specific environmental characteristics, such as light developmental skills when impairments have delayed
and color. The assessment report includes recommen- or blocked initial acquisition of the skills. Specifically,
dations for instructional procedures, modifications the education of c hildren and youths with congeni-
or adaptations, and additional tests. tal or early onset visual impairments. See also Reha-
bilitation.
General education teacher An instructor in an inclu-
sive environment who is not specifically trained to Hand-over-hand guidance Placement of a teacher’s
modify instruction for students with visual impair- hand over a student’s hand to guide the student or
ments. See also Teacher of students with visual help the student understand the movement of a task.
i mpairments. Used sparingly, when hand-under-hand guidance is
not feasible.
Geocaching An activity in which individuals access
GPS coordinates on a mobile device (for example, a Hand-under-hand guidance Placement of a teacher’s
cellular telephone or tablet) to find a geocache (con- hand underneath a student’s hand in order to explore
tainer) that has been hidden at a specific location. objects together, guide a child through a fine motor
task, or teach a person with deafblindness a new sign.
Glare An uncomfortable sensation produced by too Usually preferred to hand-over-hand guidance.
much light in the visual field that can cause both dis-
comfort and a reduction in visual acuity. Hemianopsia The reduction or total loss of peripheral
vision in half of the visual field, usually the result of
Glaucoma A disease in which increased intraocular brain damage caused by stroke or trauma.
pressure results in the degeneration of the optic disk
and eventual reduction in the visual field. If not Hierarchy of prompting Degrees of assistance, ar-
treated, the outcome may be total blindness. ranged from most to least intrusive, provided so that
a student can complete a task that he or she has not
Goalball A competitive sport in which all players, in- yet completely mastered. See also Fading.
cluding players who are totally blind, wear blindfolds
to ensure that everyone participates with equal lack uman guide A technique for giving appropriate as-
H
of visual input. Goalball is played on a court the size sistance to a person with a visual impairment when
of a volleyball court, the floor is marked tactilely traveling together safely and efficiently. Also, a per-
with duct tape, and a bell ball is used during play. son who walks with an individual with a visual im-
Glossary 497
pairment using the human guide technique. Previously Individuals with Disabilities Education Act (IDEA) The
known as sighted guide. amendments to the Education for All Handicapped
C hildren Act, the federal legislation that safeguards
Hyperopia (farsightedness) A refractive error in which a free appropriate public education for all eligible
light rays have not yet converged when they arrive at c hildren with disabilities in the United States, reau-
the retina, resulting in vision that is better for distant thorized in 1990, 1997, and 2004 (the last is referred
than for near objects; corrected with a plus (convex) to as the Individuals with Disabilities Education Im-
lens. provement Act).
Hypertropia The upward deviation of one eye. Informal tests Evaluations that allow flexibility in the
manner in which they are administered (as compared
Hypotropia The downward deviation of one eye. with formal tests) and have no time limit. See also
Criterion-referenced tests; Formal tests; Portfolios.
Inclusion A philosophy that promotes the meaningful
placement of a student with a disability in a general Integration The placement of children with impair-
education classroom for all or part of the school day; ments in regular classrooms with c hildren who are
previously used interchangeably with mainstreaming. not disabled. See also Inclusion.
Independent living skills Skills for performing daily Interdependence. A socioemotional status in which
tasks and managing personal needs, such as t hose for an individual does some tasks without assistance and
self-care, planning and cooking meals, maintaining a other tasks with various levels of assistance.
sanitary and safe living environment, traveling inde
pendently, budgeting one’s expenses, and function- Interdisciplinary team Professionals from various dis-
ing as independently as possible in the home and in ciplines who conduct and share the results of as-
the community. sessments and jointly plan instructional programs.
See also Multidisciplinary team; Transdisciplinary
Individual tests. Evaluations administered on a one- team.
on-one basis. See also Group tests.
Interoception system An internal body sense involv-
Individualized Education Program (IEP) A plan of in- ing information from one’s internal organs about
struction, compiled by a transdisciplinary educational basic comfort needs such as respiration, hunger, di-
team, that includes a student’s present levels of edu- gestion, body temperature, and elimination of body
cational performance, annual goals, short-term ob- waste.
jectives, specific serv ices needed, duration of serv ices,
evaluation, and related information. Under the Indi- Intervention strategies Plans for instructional inter-
viduals with Disabilities Education Act (IDEA), each ventions for students with visual impairments and
student receiving special serv ices must have such a disabilities that follow the changing needs of the in-
plan. dividual.
Individualized Family Service Plan (IFSP) A plan for the Interviews and questionnaires Assessment techniques
coordination of early intervention serv ices for infants based on open-ended questions asked orally and re-
and toddlers with disabilities, similar to the Individ- corded by the examiner or presented in written for-
ualized Education Program (IEP) that is required for mat and recorded by the respondent.
all school-age children with disabilities. A require-
ment of the Individuals with Disabilities Education Iris The colored, circular membrane of the eye that
Act (IDEA). is located between the cornea and the lens and that
498 Glossary
expands or contracts to control the amount of light tively about events in his or her life based on life
entering the eye. e xperiences.
Iritis An inflammation of the iris that may cause Learning media assessment (LMA) A systematic pro
blurred vision, a constricted pupil, pain, and tearing. cess for examining a child’s use of sensory informa-
Iritis must be treated medically. tion and gathering data to be used by educational
teams when selecting appropriate learning and liter-
Itinerant teacher An instructor who moves from place acy media.
to place (for example, from home to home, school to
hospital, or school to school) to provide instruction Learning media The assortment of materials available
and support to students with special needs. in classrooms, schools, communities, and homes that
contain information, including books, magazines, post-
Juvenile rheumatoid arthritis Chronic inflammation of ers, flyers, felt boards, whiteboards, and a wide array
the joints that affects c hildren and youths under the of options for information produced in braille or
age of 17; sometimes called Still’s disease. Also known print.
as juvenile idiopathic arthritis.
Least restrictive environment Placement of a child
Landmarks Objects in homes, schools, or the commu- with a disability in a classroom environment that is
nity that are easily identified, permanent, and unique adapted only to the extent necessary to maximize
to their part icular setting and thus can be used in ori- learning.
entation and mobility to tell where one is.
L egal blindness Visual acuity for distance vision of
Language-experience approach A method of instruc- 20/200 or less in the better eye a fter best correction,
tion that uses the child’s actual experiences as the or a visual field of no greater than 20 degrees in the
basis for written stories that are then used to teach better eye.
reading.
Lens The transparent biconvex structure within the
Large print Print that is larger than that commonly eye that allows it to refract light rays, enabling the
found in magazines, newspapers, and books (6–12 rays to focus on the retina; also called the crystalline
points). Recommendations for minimum size for large lens. Also, any transparent material that can refract
print vary, and the optimum size of print depends on light in a predictable manner.
the needs of the individual with low v ision.
Lifestyle plan A four-step plan that includes initial
Laurence-Moon-Bardet-Biedl syndrome An autosomal considerations, a personal profile, the creation of a
recessive disorder that is characterized by a range of desirable vision of the f uture, and the development of
impairments or abnormalities, including intellectual strategies to enhance accomplishments.
disability, pigmentary retinopathy, and spastic para-
plegia. Listening skills The ability to hear specific sounds, to
understand the main idea and specific facts presented
Learned helplessness A form of dependence that oc- by lecturers and readers, and to recall auditory infor-
curs when an individual learns to become reliant on mation and critically interpret the material.
others for support and assistance, usually b ecause
few expectations are placed on him or her to achieve Literacy The ability to read and write.
independence.
Literacy medium or media The form(s) of the printed
Learned optimism An outlook based on positive word (print, braille, or both) that an individual uses
thinking that occurs when an individual thinks posi- to read and write.
Glossary 499
Literacy skills The ability to use reading, writing, and gation of the extremities, partial dislocation of the lens,
other literacy tools to gather and understand impor cardiovascular abnormalities, and other disorders.
tant information and to convey information to one-
self or others. See also Academic literacy skills; ental math skills The ability to calculate mentally
M
Emergent literacy skills; Functional literacy skills. with efficiency and without the use of such instru-
ments as the calculator, abacus, or braillewriter.
Locus of control An individual’s belief about the ex-
tent to which he or she can influence events, affecting Microphthalmia An abnormally small eyeball.
them and their outcomes.
Minus lens See Concave lens.
Long cane A mobility device used for safe and effi-
cient travel by individuals with visual impairments. Mobility The act or ability to move from one’s present
position to one’s desired position in another part of
Long-range goals The measure of performance to be the environment. See also Orientation.
obtained by the end of the educational program.
Mobility skills The skills used by a person to travel in
Low vision A visual impairment, even a fter best correc- differe nt directions to move from one location to
tion, that is severe enough to interfere with an indi- another.
vidual’s ability to learn or perform tasks of daily life
but with the potential to use vision for some tasks Modeling A form of instruction in which the teacher
along with multisensory approaches and compensa- provides a model or demonstration of a task or skill
tory strategies and devices to support visual input. for the student to use as a guide in attempting to per-
form the task or skill.
Low vision device An optical or nonoptical tool used
to enhance the visual capability of persons with vi- Monocular vision Vision in one eye, typically caused
sual impairments. by injury or enucleation.
Macula A small portion of the retina, containing a Motility The coordinated movement of the eyes in
concentration of cones for sharp central vision, that conditions in which irregular eye movements occur.
surrounds the fovea.

Motor skills Skills related to fine and gross physical
Macular degeneration Deterioration of central vision movement. See also Orientation and mobility.
caused by a degeneration of the central retina.
Multidisciplinary team A team made up of profession-
Magnifier A device used to increase the size of an image als from differe nt disciplines who work indepen
through the use of lenses or lens systems; a magnifier dently to conduct assessments of a student, write
may be used at any distance from the eye (for example, and implement separate plans, and evaluate the stu-
stand, handheld, or spectacle mounted). dent’s prog ress within the parameters of their own
disciplines.
Mainstreaming The placement of a student with a dis-
ability in a general education classroom with c hildren Multiple disabilities Two or more concomitant disabili-
who are not disabled for all or part of the school day; ties (physical, cognitive, behavioral, or emotional)
this term is generally out of favor today in preference that have a direct effect on the ability to learn or in-
to inclusion. teract with the environment.
Marfan syndrome An inherited congenital disorder of Multisensory learning approaches A learning strategy
the connective tissue, characterized by abnormal elon- that encourages students to use all their available
500 Glossary
senses in exploring and learning and results in a rich and vocal sounds, that do not involve spoken words
learning experience. or manual signs. See also Symbolic communication.
Myopia (nearsightedness) A refractive error resulting Norm-referenced tests Tests in which the student’s
from an eyeball that is longer than “typical”; corrected results are compared to those of a larger group on
with a concave (minus) lens. which the test was standardized. See also Standard-
ized tests.
National Instructional Materials Access Center (NIMAC)
The electronic file repository managed by the Ameri- Numeracy The ability to attach meaning to numbers
can Printing House for the Blind (APH) that makes and number relationships; to understand the magni-
NIMAS files available for download to authorized us- tude of numbers, as well as the relativity of measuring
ers through an online database. numbers; and to use logical reasoning for estimation.
National Instructional Materials Accessibility Standard Nystagmus An involuntary, rapid movement of the
(NIMAS) A technical standard used by publishers to eyes, usually rhythmical and faster in one direction,
produce source files for the development of multiple that may be side to side, up and down, or rotary.
specialized formats (digitized text, braille, or audio
books). Observational method An informal method of assess-
ment that involves watching and recording a student’s
Nearsightedness See Myopia. behaviors, including such methods as anecdotal rec
ords, running records, and event records. See also
Nemeth Braille Code for Mathematics and Science Anecdotal record; Event records; Time sampling.
Notation The braille code developed by Dr. Abraham
Nemeth to transcribe symbols in math and science Occipital lobe The primary processing region of the
literature, officially adopted in the United States in brain for visual information.
1956.
Occupational therapist A professional who focuses
Night blindness A condition in which visual acuity is on maximizing an individual’s potential for age-
diminished at night and in dim light. appropriate functional behaviors, particularly in daily
living activities, through purposeful activities.

Nonoptical adaptations Devices or techniques, such as
lamps, filters, bold-lined paper, and writing guides, Ocular albinism A hereditary condition that results in
that alter the visual environment by adjusting the pigmentation loss in the retinal pigment epithelium,
space, illumination, color, contrast, or other physical iris, and choroid.
features of the environment.
Oculocutaneous albinism The congenital lack of pig-
Nonparallel instruction The teaching of braille skills at ment in the iris, choroid, hair, and skin that results in
some point a fter students have acquired basic print reduced acuity, light sensitivity, and nystagmus.
literacy skills. See also Parallel instruction.
Olfactory system The sense of smell, which involves
Nonstandardized tests Informal assessment tools that chemical receptors high in the nose that respond to
do not have rigid procedures for administration and airborne chemicals. The input is transmitted along the
do not provide norms for comparison or interpreta- olfactory nerve to the emotional center of the brain.
tion. See also Standardized tests.
Ophthalmologist A physician who specializes in the
Nonsymbolic communication Methods of communica- medical and surgical care of the eyes and is qualified
tion, such as laughing, bouncing, limb movement, to prescribe ocular medications and to perform sur-
Glossary 501
gery on the eyes. May also perform refractive and low Orientation and mobility (O&M) The field concerned
vision work, including eye examinations and other with the systematic techniques by which persons
medical vision serv ices. who are blind or visually impaired orient themselves
to their environments and move about in de
pen
Ophthalmoscopy A test that allows the eye care profes- dently. See also Mobility; Orientation.
sional to inspect the internal structures of the eye; per-
formed with or without the use of dilating eye drops. Orientation and mobility (O&M) assistants Paraeduca-
tors who are trained and certified to practice specified
Optic atrophy An ocular condition characterized by skills under the direction of orientation and mobility
degeneration of the optic nerve and resulting in loss specialists.
of vision and construction of the visual fields.
Orientation and mobility (O&M) specialist A profes-
Optic disk The point at which the nerve fibers from sional who specializes in teaching travel skills to per-
the inner layer of the retina become the optic nerve sons with visual impairments, including the use of
and exit the eye; the “blind spot” of the eye. canes, dog guides, sophisticated electronic traveling
aids, and human guide technique.
Optic nerve The sensory nerve that carries electrical
impulses from the eye to the brain. Orienteering Traveling over unknown terrain with the
aid of a map and compass to locate specified landmarks.
Optic nerve hypoplasia A congenitally small optic
disk, usually surrounded by a light halo and repre- Orthoptics The techniques of treating problems in eye
senting a regression in growth during the prenatal movement and coordination, binocular vision, and
period; may result in reduced visual acuity. functional amblyopia through nonsurgical means, us-
ing lenses, prisms, or exercises; the orthoptist usually
Optical character recognition (OCR) The conversion of works under the supervision of an ophthalmologist.
an image of text into computer-readable print charac-
ters, using a scanner and software, that can be recog- Paired reading A technique in which a proficient
nized and saved as computer files and manipulated reader models reading a passage and then a novice
electronically. reader reads the same passage.
Optical device Any system of lenses that is used to en- Paraeducator An individual who works u nder the di-
hance visual function. rection and supervision of a qualified educator to as-
sist teachers in the classroom or work with students
Optometrist A health care provider who specializes in who have special educational needs. When working
refractive errors, prescribes eyeglasses or contact with students with visual impairments, typical duties
lenses, and diagnoses and manages conditions of the may include transcribing print to braille, preparing
eye. May also perform low vision examinations. educational materials in braille, large type, and other
accessible media; assisting a student with practicing
Orbits Two pyramidal cavities in the front of the skull skills that were taught previously by the teacher of
that contain the eyeballs, eye muscles, and fatty cush- students with visual impairments or other qualified
ioning layers, as well as nerves and blood vessels. educator; and assisting in the classroom and school
as directed. Also known as paraprofessional, teacher’s
Orientation The knowledge of one’s distance and di- aide, or instructional assistant.
rection relative to t hings observed or remembered in
one’s surroundings and the ability to keep track of Parallel instruction The teaching of braille and print
these spatial relationships as they change during lo- concurrently and with a consistent level of focus on
comotion. See also Clues; Landmarks; Mobility. each medium. See also Nonparallel instruction.
502 Glossary
Partial sight A term formerly used to indicate visual Positive behavior interventions and supports (PBIS)
acuity of 20/70 to 20/200 but also used to describe Model of educational support that focuses on behav-
visual impairment in which usable vision is present; ioral domains.
low vision.
Predictive validity A type of criterion-related validity
Performance tests Evaluations in which students actu- that refers to a test’s ability to predict a student’s suc-
ally carry out activities to demonstrate their abilities. cess in a related area at a later time. See also Criterion-
See also Verbal tests. related validity; Validity.
Peripheral vision The perception of objects, motion, or Presbyopia A decrease in accommodative power (fo-
color outside the direct line of vision or by something cusing at near) caused by the increasing inelasticity
other than the central retina. of the lens– c iliary muscle mechanism that occurs
a fter the age of approximately 40.
Personnel preparation programs University programs
that offer college and university courses to prepare Print literacy A student’s proficiency in using print me-
specialized teachers to educate students with visual dia, with or without adaptations, to accomplish read-
impairments. ing and writing tasks.
Phonemic awareness Knowledge and understanding Prism lenses Special triangle-shaped lenses that are
that words are made up of separate sounds and that incorporated into regular eyeglasses to redirect the
t hese sounds can be manipulated in spoken words. rays of light entering the eye, resulting in a realign-
ment of the eyes or, in some cases, a shifting of image
Phonics Knowledge and understanding of the rules to permit binocular vision.
that govern the relationship between written letters
and the sounds of spoken language. Progress monitoring Frequent data collection over an
extended period of time, which yields multiple data
Photocoagulation The use of a laser to burn or destroy points that can be analyzed to document student per
selected intraocular structures, such as intraocular formance; often daily, weekly, or bimonthly.
tumors or abnormal blood vessels, and to create
chorioretinal adhesions in retinal detachment surgery. Prompting Provision of assistance so that a student
can complete a task that he or she has not yet com-
Photophobia Light sensitivity to an uncomfortable de- pletely mastered. See also Hierarchy of prompting.
gree; usually symptomatic of other ocular disorders
or diseases. Proprioception system Sensory receptors in the skin,
muscles, tendons, ligaments, and joints that give in-
Play-based assessment A method of evaluation in formation about the position of one’s body in space.
which a student is observed at play, interacting with
materials and p eople in situations that provide op- Psychological assessment A professional determi-
portunities for choice and initiative. nation of whether an individual possesses the emo-
tional stability to handle stresses associated with
Plus lens See Convex lens. performing a part icu lar job or learning a part icu lar
skill.
Portfolios Collections of the results of various assess-
ments and samples of the student’s work that are Psychosocial Of or relating to the interaction between
used to evaluate and provide a comprehensive over- the internal psychological development of each person
view of the student’s prog ress. and the h uman need for external social interaction.
Glossary 503
Pupil An opening in the iris that allows light to enter Rehabilitation counselor A rehabilitation professional
the back of the eye; the size of the pupil is controlled who serves as a case manager, usually at a state agency,
by muscles that increase or decrease the size of the and may provide therapeutic counseling.
iris.
Reliability The consistency with which a student’s per
Questionnaires See Interviews and questionnaires. formance on a test is repeated in multiple administra-
tions over time.
Radial keratotomy A surgical procedure in which a se-
ries of deep radical cuts are made in the cornea to Resource room A serv ice delivery option designed to
shorten the eye optically to reduce myopia. support students with visual impairments who are
enrolled in a general education classroom by provid-
Reading efficiency The speed at which an individual ing specialized instruction and support from a quali-
reads with comprehension. fied teacher who is h
oused on site.
Recreational and leisure skills Abilities, which are part Response to intervention (RTI) A model of instruc-
of the expanded core curriculum, that enable the stu- tional support that uses early identification of learn-
dent with visual impairments to participate in recre- ing problems, frequent prog ress measurement, and
ational activities. progressively more intensive interventions for c hildren
who are having difficulties in the classroom.
Refraction The bending of light rays as they pass
through a substance. Also, the determination of the Retina The innermost layer of the eye, which receives
refractive errors of the eye and their correction with the image formed by the lens, containing light-
eyeglasses or contact lenses. sensitive nerve cells and fibers connecting with the
brain through the optic nerve.
Refractive disorder Defects in the ability of the eye to
appropriately focus light rays that cause visual acuity Retinal degeneration A classification of a number of
loss if uncorrected. conditions in which retinal cells break down, such as
retinitis pigmentosa and macular degeneration.
Refractive errors Conditions, such as myopia, hyper-
opia, and astigmatism, caused by corneal irregulari- Retinal detachment The separation of the retina from
ties, in which parallel rays of light are not brought the underlying choroid, nearly always caused by a ret
in focus on the retina b ecause of a defect in the inal tear, which allows fluid to accumulate between
shape of the eyeball or the refractive media of the the retina and the retinal pigment epithelium. It usually
eye. requires surgical intervention to prevent loss of vision.
Refreshable braille display An electronic device that Retinitis pigmentosa (RP) A hereditary degeneration
provides braille in the form of electronically driven and atrophy of the retina, of unknown etiology; causes
plastic pins that pop up to form braille characters. night blindness and results in optic atrophy and ob-
struction of the peripheral visual fields.
Rehabilitation The process of supporting an individ-
ual to return to a normal or optimum state of health Retinoblastoma An intraocular malignant tumor of early
or level of constructive activity by means of medical childhood, often hereditary or caused by a mutated
treatment and physical or psychological therapy; gene. Symptoms include redness, pain, inflamma-
specifically, the relearning of skills already acquired tion, or a gray or white pupil. Treatment options in-
prior to the onset of a visual disability. See also clude chemotherapy, cryotherapy, radiation, and
Habilitation. enucleation (surgical removal of the eye).
504 Glossary
Retinopathies Diseases of the retina as a result of brain in one cerebral hemisphere; generalized sei-
vari
ous c auses, including diabetes mellitus and zures occur in both hemispheres or begin in one and
hypertension. travel to the other.
Retinopathy of prematurity (ROP) A series of retinal Self-concept The collection of thoughts and feelings
changes (formerly called retrolental fibroplasia), from one has about oneself.
mild to total retinal detachment, seen primarily in
premature infants, that may be arrested at any stage. Self-determination An area of the expanded core cur-
Functional vision can range from near normal to to- riculum that is a combination of skills, knowledge,
tal blindness. and beliefs that enable a person to engage in goal-
directed, self-regulated, autonomous behavior.
Rods Specialized retinal photoreceptor cells that are
located primarily in the peripheral retina, responsi- Self-efficacy A person’s judgments of his or her capa-
ble for seeing form, shape, and movement; the cells bility to organize and execute courses of action re-
function best in low levels of illumination. quired to attain designated types of performances.
Rubella A common, mild, viral infection that, when Self-esteem The affective dimensions of one’s self-
contracted by women during the first trimester of concept.
pregnancy, has a likelihood of generating fetal abnor-
malities, such as m ental retardation, heart disease, Sensory channels The senses through which the stu-
hearing defects, and eye disorders. dent acquires information.
Saccadic eye movements A rapid, jerky shifting of the

Shaping An instructional procedure in which a teacher
eye from one fixation target to another.
permits a student to move gradually toward master-
ing a task by accepting and reinforcing student behav
Scaffolding The provision of varying instructional
ior at each successive approximation of the task.
supports to help students learn new concepts or en-
gage in difficult tasks.
Shared reading An instructional strategy in which the
teacher and child read together in a risk-f ree environ-
Scanner A device that uses a moving electronic beam

to convert visual images, such as printed text or ment with no predetermined expectations.
graphic images, into an electronic format that can be
transmitted or converted into other formats. Short-term objectives Specified measurable outcomes
that, combined together, form the basis for achieving
Sclera The tough, white, opaque outer covering of the eye a long-range goal.
that serves to protect the inner contents from injuries.
Sight The capacity of the visual system to receive orig-
Scotoma A gap or blind spot in the visual field that inating or reflected light from objects.
may be caused by damage to the retina or visual path-
ways. Each eye contains one normal scotoma, corre- Sign language A system of communication that uses
sponding to the location of the optic nerve head, which manual signs and gestures.
contains no photoreceptors.
Signature writing skills The ability of a student with a
Seizure disorder A sudden, involuntary contraction visual impairment to develop a basic level of print
that disrupts the functioning of the nervous system writing so that he or she has a legal signature.
and may result in changes in awareness, motor activ-
ity, and general behavior that occur alone or in com- Slate and stylus A portable device for writing braille
binations. A partial seizure occurs in one area of the by hand, consisting of a slate (a metal template with a
Glossary 505
series of braille cells) and a stylus (the implement ences to overcome the limitations imposed by the vi-
used to press braille dots into the paper). sual impairment.
Snellen chart The traditional eye chart, whose top line Speech-language therapist A professional trained to eval-
consists of the letter E and which is used to determine uate and improve the student’s ability to understand
visual acuity in routine eye examinations. what another person is conveying to him or her and to
express his or her own thoughts, ideas, and needs.
Social and emotional learning (SEL) The processes Also known as speech-language pathologist.
through which individuals acquire and apply knowl-
edge, attitudes, and skills related to self-awareness, self- Spherical lens A lens whose shape is a segment of a
management, social awareness, relationship skills, sphere. A convex (plus) lens is thicker in the center
and responsible decision making. and is used to correct hyperopia; a concave (minus)
lens is used to correct myopia. Other types of spheri-
Social competence The ability to demonstrate a reper- cal lenses are biconvex (both surfaces curve out-
toire of behaviors and actions that lead to positive ward), plano-convex (a single-sided curve), biconcave
relationships. (both surfaces curving inward), and plano-concave
(only one surface curves inward).
Social skills assessment An evaluation, usually infor-
mal, of the student’s ability to interact with others. Standardized tests Formal instruments that have been
Skills in this area may include taking turns, paying standardized with regard to the manner in which they
attention to others, initiating conversations, and un- are administered and the population to which they
derstanding and using common age-appropriate ex- relate and have already been administered to large
pressions and behaviors. groups of individuals with similar backgrounds to es-
tablish the norms against which other results w
ill be
Social studies and science skills assessment An evalua- compared. See also Nonstandardized tests; Norm-
tion of the student’s mastery of compensatory skills referenced tests.
necessary to achieve educational objectives in social
studies and science at a rate and level commensurate Stargardt disease A condition transmitted in an auto-
with sighted peers. somal recessive manner, in which the macular pig-
ment epithelium slowly degenerates, leading to loss

Somatic system A system that allows stimulation to of central vision.
reach the central nervous system from receptors in
and on the skin, which is the body’s largest sensory Strabismus An extrinsic muscle imbalance that causes
organ; also referred to as the tactile system. misalignment of the eyes; includes exotropia, esotro-
pia, hypertropia, and hypotropia.
Sound localization skills The ability of the student to
use sounds to pinpoint the location of objects. Summative assessment Evaluation of learning at par
ticular moments in time, such as high-stakes school-
Specialized assessments An evaluation of the student’s wide assessments or end-of-unit exams.
efficiency in using sensory information and the impli-
cations for instructional programming, as determined Symbolic communication A method of communication
by the functional vision assessment, the learning media that involves the use of a spoken-word, object, pic-
assessment, and the assistive technology assessment. ture symbol, or written code. See also Nonsymbolic
communication.
Specialized instruction The teaching of the student
with a visual impairment by emphasizing concrete Tactile Related to or experienced through the sense of
experiences, learning by doing, and unifying experi- touch.
506 Glossary
Tactile adaptations Modifications of educational mate- Tracking The ability of the eyes to follow a moving ob-
rials mainly by the transcription of text, handouts, ject; also, the skill used to visually follow a line of
tests, and other written materials into braille and type or tactilely follow braille across a page and to
conversion of graphics into tactile formats. locate the next line.
Tactile defensiveness A strong aversive reaction to or- Transdisciplinary team A team of professionals from
dinary tactile exploration or input. differe nt disciplines who cooperate and collaborate
regarding assessments by teachers or specialists,
Tactile skills The ability to explore objects systemati- with the team choosing a primary programmer to
cally to observe all the features of an object by using be responsible for implementing the intervention
the available senses. program. Team members perform their related tasks
interactively and through a process known as role
Tactile symbols A form of communication, often used release. See also Interdisciplinary team; Multidisci-
when a student cannot learn braille because of phys- plinary team.
ical or cognitive difficulties, that uses concrete and
abstract symbols to teach students to gather infor- Transition IEP A program, written for a student
mation. beginning at age 14, that addresses the need for
transition serv ices in the areas of employment, ed-
Talking Book Program A f ree national library program, ucation and training, leisure and recreation, and
administered by the National Library Serv ice for the living arrangements and details the proposed ac-
Blind and Physically Handicapped (NLS) of the Li- tivities to achieve desired outcomes, establishes
brary of Congress for persons with visual and physi- timelines for reaching t hese goals, and assigns re-
cal limitations, in which books and magazines are sponsibility for providing support to the agencies
recorded and produced in braille and distributed in a and individuals responsible for following through
variety of formats, including on cassettes, as digital on each activity.
files on cartridges, as downloadable audio or braille
files, or in Web-Braille, through a cooperative network
Traumatic brain injury See Brain injury.
of regional libraries; the program also lends the de-
vices on which the materials are read.
Unified English Braille Code (UEB) The braille code cur-

rently a dopted for use in English-speaking countries
Teacher of students with visual impairments A specially
around the world; includes symbols that unify the
trained and certified teacher who is qualified to teach
code across literary, mathematics, science, and com-
special skills in areas of the core and expanded core
puter science subject matter.
curricula to students with visual impairments.
Universal design for learning (UDL) A framework imple-
Technology device See Assistive technology.
menting principles of Universal Design related to full
access for individuals who have disabilities, includ-
Telescope An optical device that makes small objects
ing the need for and importance of allowing flexibil-
appear closer and larger.
ity in learning options.
Time sampling An observational method in which the Usher syndrome An inherited disorder that includes
presence or absence of a behavior is recorded at speci- the major symptoms of both hearing and vision loss;
fied intervals to provide information on the frequency hearing loss is either congenital or progressive begin-
of the behav ior. See also Observational method. ning in middle childhood, while vision loss is the re-
sult of retinitis pigmentosa, often beginning in late
Tonometry The measurement of intraocular pressure. childhood or the teen years.
Glossary 507
Validity A determination of how accurately a test mea the eye’s ability to distinguish the details and shapes
sures what it purports to measure. See also Concur- of objects at a designated distance; involves central
rent validity; Content validity; Criterion-related (macular) vision.
validity; Predictive validity.
Visual acuity test An assessment of detailed central
Verbal tests Evaluations that rely on verbal presenta vision; infants are tested by ascertaining pupillary
tions of questions, problems, or directions and require responses to light and, later, light-fi xation reflexes;
verbal responses from the student. See also Per for assessments at subsequent ages include the standard
mance tests. Snellen chart and other charts.
Vestibular system An internal body sense that is com- Visual adaptations Modifications of educational mate-
posed of three structures in the inner ear that register rials by enlargement, increased clarity and contrast,
the speed, force, and direction of movement; the ef- increased illumination, decreased glare, and decreased
fect of gravity on the body; and the position of one’s visual clutter so that a student with low vision is
head and body. more successful in using his or her vision to complete
a task.
Video magnifier An electronic low vision device that
provides electronic magnification by using a video Visual capacity An individual’s potential to develop
camera to capture and project a magnified image on a visual efficiency.
screen for viewing; available in desktop and portable
units. Formerly known as a closed-circuit television sys- Visual disability A disability that c auses a real or per-
tem or CCTV. ceived disadvantage in performing specific tasks us-
ing sight.
Videotaped protocols A method of preserving obser-
vations for members of the educational team that Visual efficiency The degree to which specific visual
provides a visual journal of a student’s behaviors that tasks can be performed with ease, comfort, and mini-
can be used as a baseline for assessing f uture skills. mal time, contingent on personal and environmental
variables; the extent to which available vision is used
Vision The ability to interpret what is seen. effectively.
Vision rehabilitation therapist A professional whose Visual environmental awareness The extent to which
primary goal is to teach the adaptive skills that en- c hildren and adults with low vision are aware of ob-
able p eople with visual impairments to live inde jects in their environment.
pendently and perform the activities of everyday life,
primarily in the areas of communication, personal Visual field The area that can be seen when looking
management, home management, leisure time, and straight ahead, measured in degrees from the fixation
movement in familiar environments. Formerly known point.
as a rehabilitation teacher.
Visual functions The abilities of the visual system,
Vision screening Initial assessment of a student’s vi- such as visual acuity, visual field, color discrimina-
sual acuity and general observation of his or her eyes tion, dark adaptation, and contrast sensitivity, as
to determine the need for referral to an eye care spe- measured by performance on standardized tests of
cialist or other specialist. sight.
Visual acuity The sharpness of vision with respect to Visual impairment Any degree of vision loss that af-
the ability to distinguish detail, often measured as fects an individual’s ability to perform the tasks of
508 Glossary
daily life, caused by a visual system that is not work- Vocabulary Knowledge and understanding of words
ing as typically expected or not formed correctly. and their meanings.
Visual memory The retention of mental imagery of en- Vocational rehabilitation A system of serv ices that eval-
vironments or objects in one’s environment gained uates personal, work, and work- related traits, de-
through original visual input. signed to result in optimal placement in employment.
Vitreous The transparent physiological gel that fills War of the Dots Professional arguments over the use
the vitreous cavity, the back portion of the eye be- of various braille dot systems in the United States, in-
tween the lens and the retina; it is 99 percent water cluding British Revised Braille, New York Point, and
and serves to maintains the shape of the eyeball. Also American braille.
called vitreous humor.
Working distance The distance from the eye of the
Vitreous cavity The third chamber of the eye, located viewer to an object or surface being viewed, as with a
behind the lens and filled with vitreous gel. low vision device.
I N D E X
Page references followed by f , t, or s indicate figures, tables, or sidebars, respectively. Entries followed by “online content”
indicate material found in the online AFB Learning Center.
A ABA (applied behavioral analysis), books, 36

AAC (augmentative and alternative 117, 349 braille writing machines, 35
communication), 376–384 ABC Braille study, 201 computers and, 37–38
artificially associated symbols, abducens nerve (CN6), 75 accommodation process, 79, 152
379 abduction (eye movement), 76 accommodative dysfunction, 88
auditory scanning, 381 Abel, Georgie Lee, 6s, 25 accommodative esotropia, 90
defined, 377 absence (petit mal) seizures, 217, accountability of educational
graphic symbols, 381–383 219t programming, 309–311
line-drawing symbols, 383 abstract concepts acculturation stress, 269
near, intermediate, and distance difficulty acquiring, 162 achievement motivation, 368
vision difficulties, 382 effectance concept, 362 achievement values (expectancy-
overview, 381–382 least restrictive environment value model), 369, 370–371
visual complexity difficulties, concept, 15, 16, 31 achromatopsia, 83
383 readiness concept, 348–349 acquired immunodeficiency
visual field differences, 382–383 self-concept, 197 syndrome (AIDS), 229

visual novelty, 383 unique needs concept, 325 acquired nystagmus, 91
identical object symbols, 378 academic competence, psychosocial ACS (American Community Survey)
manual sign systems, 380 development and, 200–201 prevalence and incidence of
overview, 376–377 academic domain (CI3T models), individuals with visual
partial object symbols, 379 416 impairments, 65
real object symbols, 378–379 academic screenings, 421 racial and ethnicity identity of
speech-generating devices, 384 academic success individuals with visual
tablets, 384 expectancies for success, 369–371 impairments, 253, 253t
tactile signing, 380 middle childhood and active learning, 356–357
tangible symbols, 378, 379–380 adolescence, 161 active listening, 392
textured symbols, 379 social and emotional learning ACVREP (Academy for Certification
AAIB (American Association of and, 475–477 of Vision Rehabilitation and
Instructors of the Blind), 10 Academy for Certification of Vision Education Professionals), 43,
AAIDD (American Association on Rehabilitation and Education 328, 339–340
Intellectual and Professionals (ACVREP), 43, adduction (eye movement), 76
Developmental Disabilities), 328, 339–340 adolescence. See middle childhood
212 ACB (American Council of the and adolescence
AAPOS (American Association for Blind), 341 adult service agencies
Pediatric Ophthalmology and ACCESS for ELLs 2.0 proficiency test, defined, 449s
Strabismus), 86s 265, 267 interagency collaboration,
AAWB (American Association of accessible media, 35–38 450–451
Workers for the Blind), 20 auditory materials, 36–37 adult service providers, 449s
509
510 Index
advanced fluency stage (second angle-closure glaucoma, 93 atonia cerebral palsy, 223
language development), 266 angular gyrus, 81 atresia of the choanae (nasal
adventitious loss of vision aniridia, 91, 155s passage), 231
defined, 53–54 annual goals (IEP), 291 attribution theory (motivation),
psychosocial development and, antecedent event (stimulus), 349 365–367
189–190 anterior chamber (eye), 78, 79f causal dimensions, 366–367
AER (Association for Education and anti-epileptic medications, 217 controllability dimension, 366

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FOUNDATIONS

Printed in the United States of Amer­i­ca

Library of Congress Cataloging-­in-­P ublication Data

ISBN 9780891287711 (mobi)

Dear reader of Foundations of Education, Third Edition,

PART ONE History and Theory

CHAPTER 6 Psychosocial Needs of ­Children and Youths 185

PART TWO Connecting to the Broader Context

Kimberly A. Schonert-­Reichl and Shelley Hymel

2002 C. Warren Bledsoe Award from the Associ-

at the University of Pittsburgh and a con­sul­tant

students with disabilities, and early childhood

California College of Optometry, Fullerton. Dr. Council for Exceptional C ­ hildren.

impact on students and teachers in the low-­

ticultural perspectives. Chapters 9 and 10 focus

History and Theory

To hear an audio introduction to ♦ Formal, university-­based personnel preparation

ties in general education classrooms involved in­de­pen­dent lives.

Pioneer in education of ­children who ­were

(continued on next page)

Helen Keller TWENTIETH-­CENTURY LEADERS WHO

American Foundation for the Blind

Arkansas School for the Blind 1859

(continued on next page)

School Date of Founding

Public School Programs The RLF Epidemic and the Move

­children and also a resource room. The regular

less than 20/200 w ­ ere considered blind, they

and ­those who built on it, c­ hildren t­ oday are given

American Printing House for the Blind

New York Point and American braille. William

American Foundation for the Blind

reading rates. The dividing line between ­whether Curriculum

­until ­after high school graduation. 5. Orientation and mobility

­ isabilities following the passage of legislation

Educating Students with Deafblindness

During the mid-19th ­century, Howe supported

American Foundation for the Blind

1956). tempt educational efforts with deafblind stu-

dents to one that included a significant number Federal Legislation

Federal Quota Program.

for students who ­were blind and some local

(continued on next page)

WHAT IS THE RELATIONSHIP BETWEEN into accessible formats and distribute

students with visual impairments u ­ nder IDEA

Production of Books in groups was instrumental in supplying materials

Modern technology now provides high-­

American Foundation for the Blind

braille, print, or large print or in an auditory

NASDE Guidelines c­ hildren who ­were blind received an education,

impaired. When communicating about and with Partly b

Visual Impairment, Disability,

blackness or light or dark. Some im­por­tant in their waking lives. The

(continued on next page)

is a ­great deal of background noise. visual impairments should have many

information available through the Internet. socioeconomic development and improvements

The Visual System

Figure 3.1 Schematic Section of the ­Human Eye

Figure 3.2 Schematic Repre­sen­ta­tion of Nasolacrimal Excretory System

regions of the brain to perform vari­ous actions

The angular gyrus is involved in the pro­cess of

Use of Peripheral Vision

ripheral fields typically have what is referred to

depth perception is not the only way that we per-

Printed in the United States of America

Library of Congress Cataloging-in-P ublication Data

CHAPTER 6 Psychosocial Needs of Children and Youths 185

Kimberly A. Schonert-Reichl and Shelley Hymel

at the University of Pittsburgh and a consultant

California College of Optometry, Fullerton. Dr. Council for Exceptional C hildren.

impact on students and teachers in the low-

To hear an audio introduction to ♦ Formal, university-based personnel preparation

ties in general education classrooms involved independent lives.

Pioneer in education of children who were

Helen Keller TWENTIETH-CENTURY LEADERS WHO

children and also a resource room. The regular

less than 20/200 w ere considered blind, they

and those who built on it, c hildren t oday are given

reading rates. The dividing line between whether Curriculum

until after high school graduation. 5. Orientation and mobility

isabilities following the passage of legislation

During the mid-19th century, Howe supported

for students who were blind and some local

students with visual impairments u nder IDEA

Modern technology now provides high-

NASDE Guidelines c hildren who were blind received an education,

blackness or light or dark. Some important in their waking lives. The

is a great deal of background noise. visual impairments should have many

Figure 3.1 Schematic Section of the Human Eye

Figure 3.2 Schematic Representation of Nasolacrimal Excretory System

regions of the brain to perform various actions

The angular gyrus is involved in the process of

ficulty recognizing the f aces of people. and educational materials accurately.

Vision therapy is a non-evidence-based Often teachers of students with visual

iesel performed experiments on kittens with

here are many c auses of visual impairment that

Optic Nerve Hypoplasia of vision. The central vision of people with RP

supply blood to the various regions of the retina distance.

• Bring samples of the types of t hings your child

the smallest print possible with each eye at a typ-

TA B L E 3 .1 various distances. Thus, if a person is not able to

High-addition bifocal eyeglasses and high-

Anchor Center for Blind Children

by crawling, walking, or r unning). Therefore, a

Figure 4.1 Battelle Age-Equivalent Scores at Project End, by Degree of Visual Function,

Figure 4.2 Battelle Age-Equivalent Scores at Project End, by Additional Disability Status, at

Psychoanalytic Model each of t hese stages that had to be resolved for

and white, with little room for compromise. By

At best, teenagers experience acceptance, school can be painful. Further, as underscored

vision is absent or distorted in any way, it is statements or behaviors challenging, their

By adolescence, many behaviors and patterns Comparative Study of Adolescent