CHAPTER III

The Visually Handicapped

BERTHOLD LOWENFELD

S I N C E the publication of Lende's (1953) Books About the Blind, various

reviews have appeared, such as those by Meyerson (1957) and by Ash-
croft in the December 1959 REVIEW. The most comprehensive recent anno-
tated bibliography was compiled by Graham (1960), who covered the
literature from 1953 to 1960. It included a chapter on the young blind.

General Works
Besides those books to which reference will be made within this chap-
ter, there are a few general publications of importance and usefulness.
Hathaway's (1959) standard work on partially seeing children appeared
in a new and revised fourth edition. Spencer (1960) enriched the avail-
able literature by a socioeducationally oriented picture story about young
blind children. The visually handicapped also received attention in
Wright's (1960) outstanding treatise, in Kirk's (1962) newly published
textbook, and in Rusalem's (1962) book dealing with physically handi-
capped college students.

Identification and Classification

The reports of the American Printing House for the Blind provide a
valuable source for enrollment data in educational facilities for visually
handicapped (legally blind) children. During the period from 1959 to
1962, the number of blind children registered with the American Printing
House for the Blind has risen from 13,314 to 16,604, a 25-percent
increase.* Since the comparable increase between 1956 and 1959 was 69
percent, the enrollment figures indicate a considerable slowing down in
the increase of blind children. This was to be expected as a result of the
practical elimination of retrolental fibroplasia which had its peak years
of incidence between 1948 and 1953. The enrollment of children in the
primary grades already shows a marked decrease. An actual decrease in
the total number of blind children is to be expected only when the retro-
lental fibroplasia wave of children begins to be graduated from high
school; that is, after 1965. At that time, a small intake will coincide with

* Personal communication to the author.

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February 1963 T H E VISUALLY HANDICAPPED

a large output; hence, a decrease in the total number of visually handi-

capped children attending school probably will result.
Of the 16,604 children enrolled in 1962, 58 percent (9,564) were
enrolled in public school programs for visually handicapped children and
42 percent (7,040) were attending residential schools for the blind. The
National Society for the Prevention of Blindness reported that, as of
May 1962, approximately 9,400 partially seeing children were being
served in 273 cities and 55 counties in 40 states, the District of Columbia,
and the Canal Zone. Of these, 7,100 were placed in special classes or
resource rooms, and 2,300 were served by itinerant teachers.
Hurlin (1962) estimated the number of blind persons in the United
States at 385,000 with a rate of 2.14 per 1,000 population. In the school-
age population, a rate of 1 blind child for 2,000-4,000 public school
children has been variously estimated. Jones (1961a) expected that after
the graduation of the retrolental fibroplasia group "the incidence of blind-
ness will drop to about 1 child in every 7,000 or 8,000 of the school
population."
The legal definition of blindness by visual acuity (20/200 in the better
eye with correcting glasses or an equally disabling field defect) was a
fairly adequate tool in determining educational placement during an era
in which ophthalmologists considered the use of the eyes, particularly
for reading, as harmful for many types of visual handicaps. During the
last few decades, this opinion has been revised, and Milder (1960) and
other ophthalmologists now recommend that visually handicapped children
use their sight without any special restrictions. Since many "blind" chil-
dren can see well enough to read enlarged or even regular print by holding
it close to their eyes or by using magnifying devices, the visual acuity
definition has lost much of its educational significance. Jones (1962)
discussed this problem and stressed the necessity of using functional
characteristics in classifying and in placing visually handicapped children.
Fonda (1961), Graham (1959), and Rex (1962) further elaborated on
this problem.
Wallace (1959) reported the results of a survey of educational facili-
ties in urban areas in which 98 communities participated. She gave data
on the type and method of placement and recommended joint participation
by education and health personnel in placing and periodically reviewing
the placement status of visually handicapped children.
Jones (1961b) examined the data collected by the American Printing
House for the Blind in its annual registration of blind children enrolled
in public and residential schools for the 1959-60 school year. Of the 14,125
legally blind children, 6,407 attended residential schools and 7,718 attended
local schools. The ratio of children who were totally blind or who had
only light perception to those who had better vision was approximately
4 to 6 for the combined total, 3 to 7 for day schools, and 5 to 5 for
residential schools. As to be expected, there were more print readers in
local schools and more braille readers in residential schools. However, the
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REVIEW O F EDUCATIONAL RESEARCH Vol. XXXIII, No. 1

fact that, among children with a visual acuity of 20/200, 92 percent read
print in local schools and only 50 did so in residential schools indicated
that residential schools tended toward teaching braille while day schools
preferred to use print as reading media for their pupils.
Additional References: Gibbons (1961); Gibbons and McCaslin (1962).

Reading and Writing

The increased population of visually handicapped school beginners and

the medical approval of unrestricted use of the eyes and of low-vision
aids has revived interest in methods of teaching reading and writing and
in the printing of reading material for visually handicapped children.
Hanley (1961), Rawls (1961), and Rawls and Lewis (1961) reviewed
the literature and reported the status in this area. The American Printing
House for the Blind, which, under a federal grant, produces books, mate-
rials, and appliances for the education of blind children, has established an
educational research department, which was described by Nolan (1960b).
Nolan (1960c) and Nolan and Morris (1960a) reported research dealing
with discrimination of roughness; Morris and Nolan (1961) and Foulke
(1961) experimented with tactual patterns to be used as symbols in em-
bossed graphic communication, as in maps, charts, and diagrams. Ash-
croft (1961) analyzed the "type, frequency, and level of errors that occur
in children's oral reading of braille." Since the American Printing House
for the Blind also publishes large type books, Nolan conducted some studies
on readability of types (Nolan, 1959), illustrations (Nolan, l96Od), and
color combinations of ink and paper (Nolan, 1961).
Most of these studies deal with some facets of braille reading. Since
the publication of Maxfield's (1928) book, no comprehensive treatment
of braille reading and writing and of the methods by which it is taught
has been written. In view of the changes which have taken place since then,
such a work is long overdue.
Eames (1959) studied the importance of visual handicaps as causes of
reading failures. He also offered a valuable discussion of the physiology
of seeing to read and of the educational implications of various eye
conditions.
The slowness of braille reading puts blind children at a disadvantage
so far as quantity of reading matter is concerned. Even the reading rate
of talking books is slow as compared with visual reading. Enc and Stolu-
row (1960) studied the effects of "time compression" on learning and
retention with the encouraging result that, over the range of 160-233
words per minute, faster rates were more efficient than slower ones.
Typewriting is an important means of personal and educational com-
munication for visually handicapped students. Most schools for the blind
begin instruction of it on the fourth grade level. Cohoe (1961) provided
one of the few articles dealing with this topic. Morris (1960), the first
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February 1963 T H E VISUALLY HANDICAPPED

librarian for blind children in any public library in this country, described
this special service of the New York Public Library.
Ophthalmologists and optometrists gave increased attention to the use
of optical aids, as reported in Sight-Saving Review (1961). As a result
of this, many visually handicapped children are now able to attend regular
classes with or without the help of a resource teacher or an itinerant
teacher, as reported by the National Society for the Prevention of Blindness
(1961).
Additional References: Nemeth ( 1 9 5 9 ) ; Nolan ( 1 9 6 1 ) ; Nolan and
Bruce (1962).

Mobility

The rehabilitation of war-blinded service personnel, in which mobility

training techniques were developed, has resulted in increased attention to
this important aspect of education and of rehabilitation of the blind.
Finestone, Lukoff, and Whiteman (1960) thoroughly examined this area
for the adult blind population, and Whitstock (1960) discussed it for
blind children. Walker (1961) reported the results of a questionnaire
study that revealed that mobility training in residential schools and public
school facilities showed wide variations. Kenmore (1960b) discussed the
cane and its use and the training and functions of mobility instructors.
Garry and Ascarelli (1960) conducted training experiments in orientation
and spatial organization with a group of congenitally blind "good" and
"poor" performers with positive results, although untrained "good" per-
formers achieved better than trained "poor" performers.

Tests and Psychological Studies

The urgent need for the supplementation of verbal intelligence tests by

performance tests in order to gain a measure of the blind individual's
global intelligence has not yet been met. Newland (1961) assembled a
battery of potential items to test the learning capacity of blind children
through the use of tactually perceived embossed figures. Though the data
analysis of this study is incomplete, it has led to a number of questions
that invite further investigation. Nolan and Morris (1960b) achieved
satisfactory results by using object recognition as an estimate of concept
development and experience level for young blind children. Nolan (1960a)
repeated a study made by Cutsforth in 1932 and found that, in contrast
to it, the blind children of today showed a much lower proportion of
visual responses and are, therefore, not characterized by "verbal unreality"
to the extent indicated in Cutsforth's experiment. Davis and Nolan (1961)
found significant differences when a part of the Stanford Achievement
Test was either administered orally or read entirely in braille.
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REVIEW OF EDUCATIONAL RESEARCH Vol. XXXIII, No. 1

Projective tests that make use of stimulus situations that are auditory,
tactile-kinesthetic, or ideational-verbal were reported by Lebo and Bruce
(1960).

Social Psychology
Much has been written about attitudes toward the blind and toward
blindness. The latest studies in this field were those of Lukoff and White-
man (1961) and Whiteman and Lukoff (1962). The attitudes of several
groups of educators toward exceptional children as measured by a rating
scale were reported by Murphy (1960). Visually handicapped children
ranked second lowest, next to delinquent children. They also were ranked
as the group about which the respondents knew least. Because of certain
characteristics of this study, its results can be considered as only tentative,
and further exploration appears to be a fruitful field for research. Blind
children themselves considered blindness a much less severe loss than did
seeing children, according to a study by Bertin (1959). His sample, which
was limited in number, did not differentiate by age or intelligence. More-
over, it came from a single residential school.
The most important research study on adjustment to visual disability
was reported in the book by Cowen and others (1961) and was described
more briefly in a separate article by Underberg and others (1961). This
highly sophisticated work cannot be reviewed in the brief space available.
Its results indicated that there were no systematic or consistent differences
in the adjustment of sighted adolescents, of visually disabled adolescents
in residential schools, and of visually disabled adolescents attending public
schools; that there was no relationship between publicly verbalized ma-
ternal attitudes and child adjustment; and that parental understanding
correlated significantly with good adjustment of the child. The authors
applied a high degree of self-criticism in the appraisal of their research
methods and results, which makes their study a stimulating intellectual
exercise. Bauman and Strausse (1962) also reported that the difference
in social competency scores between blind children from day and from
residential schools, though favoring the latter, was not significant.
Jervis (1959) used the self-concept for a comparison of blind and
sighted adolescents. Though no significant differences were found, blind
subjects as a group indicated that they have greater difficulty in normal
adjustment.
Abel (1961) stressed the special needs of blind adolescents and made
suggestions about how they can be met, and Lowenfeld (1959) discussed
sex curiosity, dating, mobility, and concern for the future as four areas
where lack of sight creates specific situations.
The cumulative scientific evidence indicates that blindness does not
result in significant differences of over-all adjustment between blind and
seeing adolescents, though such differences may exist in some specific
characteristics.
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February 1963 T H E VISUALLY HANDICAPPED

The Multiply Handicapped

The education of deaf-blind children has in the past received a great
deal of public attention, but the professional literature dealing with it is
exceedingly meager. The Industrial Home for the Blind (1958-59) in
Brooklyn, New York, published a seven-volume report on the rehabilitation
of deaf-blind persons that was a result of a joint project with the Office
of Vocational Rehabilitation of the U.S. Department of Health, Education,
and Welfare. These volumes constitute the most detailed and comprehensive
description ever published in this field. It is fortunate that the Perkins
School for the Blind, which has the longest history in providing education
for deaf-blind children, published at practically the same time a pamphlet
by Robbins (1960), which was primarily intended as a guide for teachers
of young deaf-blind children. Burns and Stenquist (1960), members of
the Deaf-Blind Department of the Perkins School for the Blind, described
services for the deaf-blind in the United States. Root and Riley (1960)
reported on the diagnostic facilities of the Center for the Development
of Blind Children at Syracuse University as applied to the specific case of
a deaf-blind child.
Since most prematurely born children who became blind as a result
of oxygen therapy causing retrolental fibroplasia have by 1962 reached
school age, their problems increasingly occupied educators of the blind.
Prematurity by itself has been established as responsible for a greater
incidence of neurological damage, and there is every reason to conclude
that this must also hold true for prematurely born children who become
blind. Of course, environmental factors also play an important role in
causing additional problems for some blind children. Moor's (1961) article
provided a good general statement on this problem area. Blank (1959)
looked at it from the psychiatrist's point of view, and a symposium
reported in New Outlook for the Blind (1961) discussed the functions of
certain professional disciplines in serving these children and their families.
Parmelee, Fiske, and Wright (1959) reported on a follow-up of 10 retro-
lental fibroplasia children examined in 1955, when all were considered
developmentally normal. In 1959, three of the children functioned at a men-
tally retarded level and showed behavior difficulties suggestive of severe
emotional problems. Norris (1961) reported on the continuing follow-up of
the children included in the Greater Chicago Project on Blind Children,
whose preschool development was the subject of a previous publication.
Of the group of 62 children, more than two-thirds were making satisfactory
or above-average progress. Eleven of the 62 children had "severe learning
problems" requiring some type of special program, and seven others were
in the below-average group.
Zwarensteyn and Zerby (1962) discussed the inclusion of multihandi-
capped children in a residential school program and gave the principal's
and teacher's views.
Additional References: Kenyon (1959) ; Regler (1960).
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REVIEW O F EDUCATIONAL RESEARCH Vol. XXXIII, No. 1

Professional Preparation

The American Foundation for the Blind (1961) convened two confer-
ences on teacher education to discuss the professional training of teachers
of visually handicapped children. Kenmore (1960a) and Abel (1962) dealt
with the history and present status of teacher-education programs. The
status of houseparents, who are an important factor in a residential school
program, was described by Wilcox (1959) in a summary of a more exten-
sive study. Johnson (1961) gave practical suggestions to general classroom
teachers for integrating a blind child into their classes.
The American Foundation for the Blind, the American Association of
Instructors of the Blind, and the U.S. Office of Vocational Rehabilitation
joined in sponsoring a conference in order to develop principles and stand-
ards for industrial arts education of blind students. The report of this con-
ference was published with valuable additional materials by the American
Foundation for the Blind (1960).

Summary
About one-half of the items reported in this chapter deal with actual
research, while the other half are of a descriptive-experiential nature.
This could be taken as an encouraging sign in a field where research was
for a long time greatly neglected. However, many of the research items
included are of minor size and importance, while the more extensive
research studies are of a sociological or psychological rather than strictly
educational nature. Financial support for research in the education of the
visually handicapped similar to the grant program of the U.S. Office of
Vocational Rehabilitation is urgently needed.

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versity of Minnesota Press, 1960. 142 pp.
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Additional References
GIBBONS, HELEN. "Safety for the Child Who Is Visually Impaired." Exceptional
Children 28: 147-50; November 1961.
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