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VOLUME XX, ISSUE 1 JULY 2007

The Educator

A Publication of

ICEVIThe International Council for Education of

People with Visual Impairment

The Educator

LOW VISION

CONTENTSEditorHarry SvenssonSwedish Institute for SpecialNeeds EducationBox 12161SE- 102 26 StockholmSWEDEN

Editorial CommitteeHarry SvenssonLarry CampbellM.N.G. Mani

Publications CommitteeHarry SvenssonPeter RodneyCay HolbrookM.N.G. Mani

Our International Partners

Typesetting and PrintingICEVI SecretariatNo.3, Professors’ ColonyPalamalai RoadJothipuram PostCoimbatore – 641 047INDIAPhone : 91-422-2469104Fax : 91-422-2693414e-mail : [email protected]

1. Message from the President 22. Message from the Editor 33. Message from the Guest Editor 44. EFA-VI Global Campaign News 55. ICEVI Updates 116. Parents Column 13

- Paul Manning7. Low Vision Devices and Children with

Visual Impairments 14- Cynthia Bachofer

8. Education and Rehabilitation to Children withLow Vision in Special Schools in China 18

- Peng Xiaguang & Li Qingzhong

9. Education of Children with Visual Impairmentin Brazil 23

- Maria Elisabete Rodrigues Freire Gasparetto

10. Development of CBR Services for Children withLow Vision 26

- Sumrana Yasmin & Hasan Minto

11. Early Intervention in Hai Duong 30- Nguyen Duc Minh

12. Teacher Training in Low Vision - Polish andCentral European Perspective 34

- Antonina Adamowicz - Hummel

13. Professional Training, The University ofCosta Rica’s Experience 38

- Martha Gross

14. The Itinerant Teacher’s Role in EducationalInclusion of Children with Low Vision inLocal Schools in Africa 41

- Paul Lynch & Steve McCall

15. Efficacy of Optical Devices in Increasing the 45Reading Speed of Students with Low Vision

- G. Victoria Naomi & S.K. Tyagi

16. Content of a Vision-related Quality ofLife Questionnaire: the IVI_C 48

- Gillian Cochrane

17. DbI Awards 5018. International Institute for Social

Entrepreneurs (IISE) in Kerala, India 5119. International Congress for Blind and

Partially Sighted children 52

Christoffel-Blindenmission

VOLUME XX - ISSUE 1 �� 1

From July 2007, every issue of The Educator will focus on a specific theme. The current one is onLow Vision. The Educator will also contain updates of the EFA-VI Global Campaign and the currentactivities of ICEVI.

Guest Editor : Dr. Jill Keeffe Assistant Guest Editor : Collin McDonnell

Larry CampbellPresident

Message PRESIDENT

2 �� THE EDUCATOR

Jakarta, Indonesia

June 23, 2007

Dear Colleagues:

My letter for this issue of The Educator is being

written on a Sunday morning here in Indonesia

where our Secretary General, Dr. Mani and I have

been working for the past several days. This past

week we have been evaluating one of the first

active programs of the EFA-VI Global Campaign,

a pilot program that explores two models of

support for blind and low vision students enrolled

in higher education.

While the EFA-VI Global Campaign will largely

focus on reaching primary school children who

are without access to education, it is important

that the Global Campaign not ignore other areas

on the educational spectrum for children and youth

with visual impairment.

After meeting twenty of the one hundred visually

impaired university students served by this pilot

program I am convinced that this investment by

ICEVI, the Indonesia Union of the Blind and The

Nippon Foundation is not only an investment in

the future of these young people but a sound

investment in the future of the Global Campaign.

Let me tell you why I feel this way.

With training and access to the right assistive

technology these university students have had their

lives transformed. The self-confidence they have

gained and the respect they have earned from their

teachers, parents and fel low students is

remarkable. Having met many of these students

before this pilot program got underway, this week

I felt as though I was watching twenty flowers

blooming before my eyes.

We all recognize that creating demand for

education by making parents aware that education

for their visually impaired child is not only possible

but highly desirable must be a high priority of the

Global Campaign. This week here in Indonesia

we have met twenty young people whose life

stories and self-confidence will surely inspire and

provide hope to any parent with a visually impaired

child.

Our job now is to continue producing these role

models at all points on the educational spectrum

and to create strategies, with our colleagues at

the World Blind Union, to spread the word to

families of visually impaired children in every

country where the Global Campaign will promote

educational equity for all children with a visual

impairment.

I hope you enjoy this issue of The Educator. Let

me end this message with a word of thanks to our

1st Vice President, Dr. Jill Keeffe who served as

the Guest Editor for this issue on Low Vision and

to all whose contributions you will find on the pages

that follow.

As always,

Larry Campbell

President

Harry SvenssonEditor

Message EDITOR


Dear Reader:

Half a year ago I told you about our plan to give

The Educator a thematic appearance. The idea

was to have an experienced professional to serve

as a guest editor responsible for the thematic

section. Dr Jill Keeffe, a well-known low vision

expert and 1st Vice President of ICEVI, accepted

the challenge to become our first guest editor.

Jill and the assistant guest editor Collin McDonnell

have gathered authors from all over the world to

present their work and challenges.

With the limited space available in a journal like

The Educator it is not possible to cover all aspects

of a specific theme. This means you cannot expect

a “handbook”. What The Educator can offer you

is examples of how others have dealt with a specific

task. Look at The Educator as a source of inspira-

tion.

When the Publications Committee met earlier

this year four new topics were identified as

important for coming issues of The Educator – Self-

Esteem, Independence, Braille and Literacy.

The Publications Committee will welcome your

views on how to deal with subjects like these.

In the Publications Committee we have also

discussed the possibility to carry out a reader

survey. Before deciding to launch such a study it

is worth trying an easier and more informal

way – please send an e-mail or letter telling me

about your expectations.

Do not restrict your comments only to The Educator.

I’m also interested in having your opinion on our

website www.icevi.org. Earlier this year ICEVI

introduced a new site having two main sections –

ICEVI general information and information

about the Global Campaign on Education For

All Children with Visual Impairment (EFA-VI).

Our ambition is to have a website containing

valuable information for people involved in the

education or people with visual impairment all

over the world. If you translate an article

published in The Educator, or any other ICEVI

material, into any language, please let us have

the possibility to publish this material on our

website.

Sincerely,

Harry Svensson

Editor and 2nd Vice President of ICEVI

Message GUEST EDITOR

Jill KeeffeGuest Editor


Meeting the needs of children who are blind and havelow vision as part of Education for All 2015 – VisionImpairment presents challenges wherever in the worldwe live. This monograph on education of childrenwith low vision provides some insights from acrossICEVI’s regions.

In many countries enrolment in a school or servicefor vision impaired students has not included an eyeexamination to determine if vision can be corrected,restored or improved. A number of articles point outthe need for multi-disciplinary teams in the educationof students with low vision. The article by Nguyen fromVietnam discusses the importance of examinationsby eye specialists to determine the vision of potentialand current students. China has recognised thespecific needs for students with low vision which isevidenced by the enactment of legislation. While therehas been much progress, Peng and Li list among thechallenges the shortage of eye care and rehabilitationcentres, the involvement of families and society atlarge and the need for the systematic training of visualfunction to be integral to education, not just periodsof ‘vision training’. This is echoed by Bachofer in herarticle giving real life examples of the critical role ofprescription and training in the use of low visiondevices in enhancing the life experience of childrenof all ages. In her article she emphasises the need forthe involvement of a multi-disciplinary team in theassessment, training and education of children andyouth with low vision. Other articles also illustrate thispoint. Gasparetto describes the National Project forLow Vision Students which aims to identify, assess andprovide optical and non-optical devices for studentswith low vision to enhance their visual function.

The challenge of the unmet needs for education ofchildren with low vision is universal. The provision ofservices by community-based rehabilitation (CBR)workers and educators needs to be accepted as an

important solution if there is to be progress in meetingthe large proportion children currently without accessto education in underserved countries and in ruralareas especially in Africa and Asia. Yasmin and Mintoquote case studies to illustrate the needs of studentsand they outline the training and resourcing of CBRworkers in Bangladesh in a successful community-based initiative. Lynch and McCall have designed astudy to examine critical aspects of the work ofteachers in integrated education programs in EastAfrica.

Research into the needs of children with low vision isscarce, as it is into effective programs and their impact.Two short reports of research into reading (Victoria)and the development of a questionnaire to underst-and the scope of the needs of children with low vision(Cochrane) have been included in this monograph.

The need for trained educators is a theme whichruns through many of the articles in this monograph.Examples of innovation are given from LatinAmerica and Eastern Europe. As Adamowicz-Hummel points out ‘personnel preparation constitutesan indispensable part’ of the systematic approach tothe special educational and rehabilitation needs ofchildren and adults with low vision. She outlines therecently developed curriculum for Poland. Grossoutlines how the University of Costa Rica has trans-formed the curriculum to respond to the neweducational paradigms of inclusion, Education for All,and equality of opportunities. Like many others shepoints out the importance of partnerships –government, families, ‘special’ and ‘regular’ educatorin our progress towards Education for All.

Guest Editor:

Associate Professor Jill Keeffe

Assistant Guest Editor:

Collin McDonnell

EFA-VI Workshop for the Pacific RegionThe Global Campaign on Education For All Child-ren with Visual Impairment (EFA-VI) is gainingmomentum in various regions of ICEVI. The year2007 began with the workshop on this subjectorganized by the ICEVI Pacific Region on 4-5January 2007 at Perth, Australia for participantsfrom the Pacific region. More than 30 participantsfrom Fiji, Papua New Guinea, Kiribati, SolomonIslands, Australia, and New Zealand attended theworkshop. The workshop was coordinated byJill Keeffe, first Vice-President of ICEVI, FrancesGentle, the ICEVI Regional Chair of the PacificRegion, and Mani, the Secretary General. Mrs.Maryanne Diamond, Vice-President, World BlindUnion (WBU) and Mr. Cheng Hock, RegionalPresident, Asia-Pacific region of WBU werealso actively involved in the workshop. Theparticipants discussed in detail the strategies tobe adopted by the region in implementing theEFA-VI campaign. They unanimously resolvedthat the PRIDE (Pacific Region Initiative for theDelivery of Basic Education) project should beused effectively for implementing the EFA-VIcampaign in the region.

Global Task Force MeetThe Global Task Force (GTF) meeting of theEFA-VI Global Campaign was held in Oslo,Norway on 23-24 April 2007. This meeting hada special significance as the regional chairpersonsof ICEVI also attended and the plans for “focuscountries” in each region were discussed. TheGTF has already suggested ways to classifycountries within each region for implementationof EFA-VI activities and these strategies werediscussed further for operationalisation. The GTFis of the view that while some countries withineach region might be taken up as focus countriesto monitor the performance indicators of the

EFA-VI GLOBAL CAMPAIGN NEWS

Global Campaign, it feels that varied activitiessuch as awareness creation, capacity building,development of literature, etc., may also takeplace in other countries within each region sothat more countries take part in this campaignin one way or the other. The meeting craftedsuch a plan to implement various types ofEFA-VI activities for the quadrennium.

Launch of EFA-VI Global Campaign at theAfrica ForumThe Education For All Children with VisualImpairment (EFA-VI) Global Campaign for theAfrica region was launched at the 4th AfricaForum held in Nairobi, Kenya from 6 to 11 May2007. During the launch ceremony held on 8May 2007 in the presence of Mr. Larry Campbell,President, ICEVI, Dr. William Rowland, President,WBU, and more than 300 delegates from theAfrica region and international organisations,Mr. Karega Mutahi, Education PermanentSecretary of Kenya called for special initiativesto reach out to children with visual impairmentwho are currently un-reached. Here is theNewspaper report on the launch.

Allafrica.comThursday, May 10, 2007

Kenya: The Blind to Benefit From EducationPlanBy The Nation (Nairobi)Nation Correspondent, Nairobi

An initiative that will force African governmentsto provide education to visually impairedchildren has been launched.

The Education for All Children with VisualImpairment in Africa programme is in line withthe wider goal of ensuring education for all by2015.

EDUCATION FOR ALL CHILDREN WITH VISUAL IMPAIRMENT (EFA-VI)

GLOBAL CAMPAIGN NEWS


ICEVI availed the opportunity to conductworkshops on teacher preparation, teachingmathematics, and implementation of thecampaign activities at the Forum. Regionalmeetings for the delegates of the Forum were alsoorganized to network with each other forfacilitating synergy in serving persons with visualimpairment.

ICEVI is currently contacting major internatio-nal organisations working in the Africa Regionto come together for conducting a needs-assessment of the region and to work togetherto achieve the goals of education for allchildren with visual impairment.

EFA-VI Technical Task Force Meeting inVietnamVietnam is one of the Fast Track Countries forthe implementation of education for allmovement as identified by the World Bank andthis initiative is being used by ICEVI and theWBU to implement the Global Campaign oneducation for all children with visualimpairment. The East Asia Region has includedVietnam as one of the focus countries for theEFA-VI campaign. The country has alreadyformed a National Technical Task Force (NTTF)with Madam Mai, the Vice-Minister of Educationas its chairperson and Dr. Minh, Deputy Director,Department of Curriculum Development,Ministry of Education and Training as itsSecretary. The first meeting of the TechnicalTask Force was held in Hanoi, Vietnam on25-26 May 2007 wherein the members prepareda draft plan for the implementation of EFA-VIcampaign in the country from 2007 to 2010.The campaign will be officially launched in thecountry in the near future.

Education Permanent Secretary Karega Mutahilaunched the African initiative on Tuesday nightat a forum attended by representatives of blindand visually impaired people from 40 Africancountries.

In a speech read by the PS, Education MinisterGeorge Saitoti asserted that children withdisabilities deserved education to help them leadmeaningful lives.

The Minister said the Government would ensurethat the right to education for persons withdisabilities was included in all nationaleducation plans. The move would also ensureequal distribution of resources to all learners.

Excerpts of his speech“Education and training opportunities help tofill in the gaps in economic and socialdevelopment that marginalise them.”

The Government, he added, was developing apolicy on special needs education. He said thepolicy would guide the inclusion of educationalservices for children with disabilities in natio-nal development plans.

“Many people with special needs have alreadybeen socially excluded through denial ofeducation. This needs to be addressed urgentlyby all concerned,” the Minister said.

He cited lack of clear guidelines and supportfor an education policy and lack of data onchildren with special needs, inadequate toolsand skills for their identification and assessmentas some of the challenges facing them.

“This means that special education has not beenabsorbed in all education sub-sectors andprogrammes as effectively as it should be.”

Many teachers have not been trained to handlechildren with special needs and the childrenare rarely placed in appropriate learninginstitutions.

Their teaching and learning materials are alsoexpensive and inadequate.


The next meeting of theGlobal Task Force will be heldin London on 1-2 October 2007

With the feedback obtained from regional chairsand members of the Global Task Force of theEFA-VI campaign, guidelines were drafted forpreparing national plans for the implementationof Education For All Children with VisualImpairment campaign. The participants whoattended the EFA-VI workshop at the AfricaForum reviewed the guidelines and endorsedthem with minor changes. Following are theguidelines which may be useful for the countriesin preparing national plans.

1. PRESENT SCENARIO IN THE COUNTRY:(Provide as much information as possiblein this section to ensure a birds-eye-view ofthe current educational services availablefor children with visual impairment in thecountry.)

This section may cover the following keyaspects:

1.1 The magnitude of the problem: What isthe percentage of persons with visualimpairment in the country? Whatpercentage constitutes children of schoolage group? How many currently haveaccess to education? How many overaged children need education, etc?

1.2 Policy of the Government: Is the policyof the government conducive for thedevelopment of educational services forchildren with visual impairment? Arethere active organisations of and forpersons with visual impairment?

1.3 What are the impediments at present forexpanding educational services for child-ren with visual impairment – such as lackof teacher preparation facilities, lack ofmaterials, lack of awareness, etc.?

2. GOALS FOR THE QUADRENNIUM(This section may include targets thecountry is aiming to achieve in termsof increasing services for children withvisual impairment. Avoid listing activitiesthat emerge out of wishful thinking.Please mention what is achievable duringthe years 2007-2010 so that necessaryactivities may be planned to achieve thelisted goals.)

This section may include the following:

2.1 How many children with visualimpairment are likely to be providedaccess to education?

2.2 If projecting an absolute number isdifficult, the country may mention theprobable percentage of these children towhom education can be offered by theend of the quadrennium?

3. WHAT APPROACHES ARE APPROPRIATEFOR ACHIEVING THE DESIRED GOALS?(The country plan needs to include thecurrent service delivery approaches, and theapproaches to be adopted by the EFA-VIcampaign to achieve the desired goal.)


3.1 What service delivery approaches(special schools, integrated education,inclusive settings, etc.) are being appliedin the country at present?

3.2 What approaches are consideredappropriate in the implementation of theEFA-VI campaign in the country?

Guidelines for preparingNational Plans for the implementation of EFA-VI


3.3 If the suggested approaches are differentfrom the existing approaches, is thecountry prepared to adapt them?

3.4 What measures are necessary to executethe suggested service delivery models inthe country?

4. WHAT NEEDS TO BE ADDRESSED TOACHIEVE THE DESIRED GOALS?(In order to achieve the targets fixed above,many issues such as the human resourcedevelopment, curriculum, materials,monitoring, etc., need to be addressed.Providing these details may help inpreparing the financial requirement for theimplementation of the campaign.)


4.1 What type of personnel and profession-als are required to achieve the desiredcoverage of children with visualimpairment every year of theimplementation?

4.2 What preparations such as conductingorientation programmes, teacher trainingenrichment courses, etc., are necessaryin each year?

4.3 What facilities at present are availablefor human resource development?

4.4 What type of learning materialsare necessary for human resourcedevelopment?

4.5 What additional arrangements need tobe made for addressing the humanresources issues?

4.6 Does the country have necessary trainersfor addressing human resourcedevelopment? If not, what type ofassistance is required from the EFA-VIcampaign?

4.7 Who are the major stakeholders whoshould constitute the national task forcefor the EFA-VI campaign?

4.8 What should be the terms of referencefor the EFA-VI global campaign?

5. WHAT MECHANISMS WILL BE ADOPTEDTO ENSURE SUPPORT SERVICES?(One of the guiding principles of the EFA-VIcampaign is that appropriate services shouldbe ensured for children with visualimpairment. The country plan needs toinclude information on how Braille booksand assistive devices may be made availablefor children with visual impairment enrolledin schools.)

The plan may include how the existingcentres will play a role in the above.

The following aspects may be included in theplan:

5.1 What mechanisms are available / will beuseful in the early identification andassessment of children with visualimpairment for making appropriateplacement in educational services?

5.2 What is the existing mechanism forprovision of learning materials andassistive devices to children with visualimpairment enrolled in schools?

5.3 Assuming that the campaign will enrollmore children, what mechanism isavailable to ensure provision of suchservices to all children with visualimpairment enrolled?

5.4 Is there a support system to provide earlyintervention services in order to facilitateeffective inclusion of the child in themainstream schools?


5.5 Is there an institute in the country thatcan serve as a centre of excellence forpreparing human resources, providingsupport services, etc.?

5.6 If such a single institute is not available,is there a possibility of developing anetwork of institutions to provide therequired services?

5.7 What will be the requirement in termsof additional human resources,equipment, materials, etc., to make thecentres of excellence highly efficient inthe country selected?

6. HOW WILL THE COUNTRY ENSUREDOCUMENTATION OF DATA?(The impact of the EFA-VI campaign will bemeasured against the parameters of successsuch as increased enrolment of children withvisual impairment, reduction of dropoutrate, ensuring provision of support services,and creation of alternative service deliverysystems wherever appropriate. The planneeds to spell out a detailed plan of howdata would be collected to address the aboveparameters.)

The following key components may beincluded in this section.

6.1 What mechanisms will the countrymake use to document data regardingenrolment of children with visualimpairment, dropout prevention, etc?

6.2 What types of tools will be used todocument this information?

6.3 What is the periodicity to document theinformation?

6.4 What types of human resources arerequired to document such data?

6.5 How will the project record qualitativeinformation regarding the impact of thecampaign?

7. WHAT TYPE OF CAPACITY BUILDINGPROGRAMMES WILL BE ORGANISED?(In order to implement the campaign thecountry may organise a number of capacitybuilding programmes for many stakehold-ers such as teachers, parents, students,public, etc. The year-wise plan for theconduct of such programmes may also beprovided along with budget information.)

The following issues may be addressed in thissection:

7.1 What type of advocacy programmeswill be organized in each year of thequadrennium?

7.2 What type of impact these programmeswill have on the overall conduct of thecampaign?

8. BUDGET REQUIREMENT FOR THECAMPAIGNWhile preparing the budget, the country needsto provide information on how the expensestowards the implementation of the EFA-VIcampaign activities will be met from varioussources. The budget expected from thecampaign may be prepared under thefollowing categories. The amount for eachitem may be prepared in local currency andthen converted into US dollars using thecurrent exchange rates.


Though there are differences betweencountries, the National Plans for

EFA-VI will try to address all the majorheadings listed in these guidelines

1 Formation of National Task Force and one meeting during the year

2 General orientation programmes on the EFA-VI campaign

3 Capacity building activities for general classroom teachers

4 Advocacy and capacity building programmes for parents

5 Creation of Centres of Excellence - equipment, literature, etc.

6 Teacher preparation activities for special teachers

7 Preparation of teaching-learning materials

8 Human resources cost for monitoring the EFA-VI project activities(National Coordinators, if necessary)

9 Travel within the country

10 Telephone, fax, etc.

11 Programme monitoring at local (provincial) levels

12 Printing/translation of campaign literature into regional languages

13 Honorarium to secretarial staff of the regional chairs / national levelcoordinators

14 Budget for media awareness activities and also for documentationof best practices

TOTAL

Sl.No.

Budget Item Year 1 Year 2 Year 3 Year 4

9. EXPECTED OUTCOMES OF THECAMPAIGNThe single goal of the EFA-VI campaign is toincrease access to education for all childrenwith visual impairment. The Governmentsand funding agencies will naturally like toknow to what extent the EFA-VI campaign isable to facilitate such access to thisun-reached population. Therefore, the coun-try plans need to include expected outcomesat the end of each year of the implementationof the campaign. This information will alsobe useful for conducting research activitiesto assess the efficacy of the campaign.


9.1 Number of children with visualimpairment expected to be benefited bythe campaign.

9.2 How many teachers, parents and otherpersonnel would have been trained by

the end of each year to expand servicesto these children?

9.3 What types of qualitative impact thecampaign is expected to bring in on thequality of education of children withvisual impairment?

9.4 What impact the campaign activities willhave on the overall education system ofthe country?

The above list is not exhaustive and therefore,country specific expectations may be listed.The research team connected with theEFA-VI campaign may conduct an objectiveoriented evaluation to find out to what extentthe above expectations are met in thecampaign.

The framework provided in this plan is justsuggestive based on minimum requirementsand the country may add additional points ifrequired.


Meeting of the Executive Committee(EXCO) of ICEVIThe Executive Committee meeting of ICEVI washeld on 25-26 April 2007 in Oslo, Norway. Hereis the strategic update of the meeting.

1. The EXCO appointed a Task Force to prepareregulations for membership. Core committeeshave been appointed to review the currentstrategic plan of ICEVI and also to develop astrategy paper for resource mobilization,particularly in the context of the implemen-tation of the Global Campaign.

2. With regard to the implementation of theEFA-VI campaign, there was generalagreement that the campaign should addressissues at three levels, viz.,

• Advocacy at the international level to getsupport for the campaign in terms ofrecognition and resources.

• Implementing the campaign activitiesgradually in various regions of ICEVI, whichare considered ready by the Global TaskForce.

• Creating awareness in countries thathave not yet evolved strategies to promoteservices for children with visualimpairment.

3. The EXCO suggested that ICEVI publicationsavailable in languages other than English beposted on the website.

4. It was decided to establish a section relatedto the area of research on the website andmotivate those interested to undertakeappropriate researches.

5. Members unanimously approved the proposalto celebrate the Louis Braille Bicentennial in2009 in collaboration with the World BlindUnion. Detailed plans will be worked out inthe course of time.

Evaluation of the Higher Education ProjectThe ICEVI-Pertuni (Indonesian Union of theBlind) pilot project on higher education whichis currently providing support services toapproximately 100 blind and low vision studentsenrolled in 16 higher education facilities inBandung and Jakarta with the assistance of theNIPPON Foundation, Japan was evaluated inJune 2007. The evaluation team includedMr. Yaz and Ms. Maki Honda from the NipponFoundation, Mr. Larry Campbell and Mani fromICEVI and Ms. Aria Indrawati from the Pertuni.The team interviewed visually impaired learners,teachers, fellow students, administrators, etc.,and observed their skills in applying technologyfor their learning. The results are veryencouraging and the impact of the project isevident from the fact that more visually impairedstudents are enrolling for higher education studiesand their academic performance is improving.Recognizing the success of the project, theNIPPON Foundation has expressed its willingnessto expand the project in other regions of Indonesiaand also launch in Vietnam and Philippines.The visually impaired adults of the highereducation programme are becoming role modelsand they are certainly the ambassadors forcreating a demand globally for the education ofchildren with visual impairment. The report ofthe project will soon be posted on the website ofICEVI. ICEVI and Pertuni profoundly thank theNIPPON Foundation for its assistance in thisendeavour.

ICEVI UPDATES

ICEVI UPDATES


Meeting of the Publication Committee ofICEVIThe Publication Committee meeting of ICEVIwas held in Copenhagen, Denmark on 18-20March 2007 with Harry Svensson, 2nd VicePresident, ICEVI as its chairperson. Thecommittee has prepared a distinct plan ofaction for publication during the currentquadrennium. The committee discussed waysto better disseminate publications in order tospread the vision and mission of ICEVI. One ofthe key decisions of the Publication Committeeis that the future issues of The Educator, theofficial magazine of ICEVI will deal with specifictopics pertaining to the EFA-VI Global Campaign.The committee will also constantly update thecontent of ICEVI’s website.

President, ICEVI in WBU’s OfficersMeeting in TorontoLarry Campbell, President ICEVI attended theofficers meeting of the World Blind Union heldin Toronto, Canada on 3-4 April 2007 andprovided the WBU Officers with a progressreport on the EFA-VI campaign. He highlightedthe importance of the effective involvement ofthe World Blind Union in creating a demand foreducation of children with visual impairmentthroughout the world, particularly in thedeveloping regions.

Fasten seat belt to SydneyThe 13th World Conference is likely to be held inSydney, Australia. Fasten your seat belt to visitthis exotic place. More information on theconference will be posted on the website soon.


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May 2007

Greetings to you all,

I have been given this wonderful opportunity to regularly write a

column for “The Educator”. As a parent of a child with complex

needs, this is a wonderful opportunity. First, I would like to

introduce my family to you. I have been happily married to Marie

for 33 years, and together we have 6 children, 5 daughters and

a son, and 3 wonderful grandchildren. I am a lucky man! Our

4th child Jessica has special needs.

The first two years of Jessica’s life were a living hell for us all.

Jessica was born 3 months premature and weighed 800 gms…

Marie and I were only just coping, no, we were not coping.

It was horrible. No-one understood how we were feeling.

Another parent advised us to attend a weekend meeting of

parents called Parents of Vision Impaired. We were encouraged

this would help. You will be amongst friends, amongst parents

who understand. I thought, “What have we to lose, anything

will be better than what we are going through at the moment”.

I went, and they were right. I returned home changed, inspired,

and with hope - hope for Marie and I, hope for Jessica.

I learned that education for Jessica was not a dream but a

reality that she will go to school and learn just like her sisters.

I also learned how to cry and not feel ashamed etc. I felt

passionate for the first time about Jessica’s future.

Some 23 years ago, a small group of parents approached the

Royal New Zealand Foundation of the Blind (RNZFB) seeking

seed funding for an annual meeting of Parents raising Blind

and Vision Impaired (VI) children in New Zealand (NZ). 3 years

later Parents of Vision Impaired N Z (PVI NZ) was formerly

constituted.

One needs to be very clear why parents value coming together.

The commonality of shared experiences of their Blind or VI

children is a very strong bond. Parents learn, inspire and

empower each other when given opportunities to be together.

Here in New Zealand I call it “the knowing”. The ability to connect

and understand where another is coming from cuts across many

cultures. It gives natural authority to speak without fear of

judgement, without fear of having to explain, of being

listened to. It is an acceptance that for many of us we find very

healthy. Some explain it is as a “fix” like no other.

For many years, PVI NZ existed successfully as a voluntary

parent model. As the PVI membership grew, it was necessary

to become more professional. We decided to employ someone,

a paid position that would move the organisation forward.

Looking back this has been our single most important

undertaking. We urge other developing parent groups to follow

this path more quickly than we did.

Today PVI NZ is seen as a credible parent organisation in our

country. We work collaboratively with our educators and health

officials at local, regional and national levels. We now work

in the International arena through the ICEVI/WBU EFA - VI

Global Campaign.

Here in New Zealand, we have an education network called

BLENNZ (The Blind and Low Vision Education Network of New

Zealand). BLENNZ has been a joint venture with our Ministry

of Education, Resource Teachers Vision, the Royal New Zealand

Foundation of the Blind and PVI NZ. It has one employer, one

set of national standards and guidelines ensuring consistent

work practice. Although BLENNZ is still in its infancy, we are

expecting in the Government Budget announcement further

allocation of funding and resources. I shall explain more in the

next issue; hopefully it will be good news!

Please support parents in your communities to come together

and learn from each other. Let them learn at their pace. Let

them be “for parents by parents”. Self determination is a

wonderful thing provided it takes people with it.

Until the next time, take care.

Best Wishes

Paul ManningExecutive Officer, Parents of Vision Impaired NZ Inc

PO Box 21141Hamilton 3249

NEWZEALANDEmail: [email protected]

Parents ofVision Impaired (NZ) Incorporated

For Parents, by Parents

“The Knowing”

PARENTS’ COLUMN


Articles GENERAL ON EDUCATION

arina was a kindergartener who kept meawake at night. Sometimes I found myself tryingto fall asleep and thinking about what activity Icould come up with to keep her attention andentice her to use her vision. Karina was an intel-ligent, curious five year old who had retinitispigmentosa, an estimated acuity of 20/400 and aprescribed 4x telescope. Occasionally she wasable to identify letters on a large sign in front ofher school. Seeing these letters was not importantto her. I was struggling to convince her that shecould gain helpful information by using her eyes.Karina taught me valuable lessons aboutchildren and use of optical devices. The followingparagraphs focus on three primary points inhabilitation of children with low vision and theuse of devices from my perspective as a teacherof students with visual impairments (TVI). Thethree principles include: 1. Work with a team ofpeople to provide care; 2. Listen to the student’smessages and goals; and 3. Integrate device usethroughout daily routines. Giving attention topsychosocial issues is at the center of eachprinciple.

IntroductionChildren who are born with a visual impairmenthave a very different response to their conditionthan to adults who acquire a visual impairmentlater in life. Unlike adult rehabilitation, learningto function with a visual impairment anddevelopment of the child are taking place at thesame time. Secondly, these adults have led a lifeof visual independence, while children withvisual impairment have no memory of typicalvision use. Rehabilitation is taking a person to aprimary level of functioning. Habilitation is theprocess of helping children to build a belief inthe value of using the vision they have tocomplete tasks and to acquire skills formaximizing their potential to use vision. Theseneeds are unique to the learning process.

Low Vision Devicesand Children with

Visual Impairments

Cynthia BachoferProviding Access to the Visual Environment (PAVE)

Vanderbilt University691 Preston Building, Nashville

TN 37232-6838USA

[email protected]

K


Device use at a young age, even for children asyoung as three, is primarily about curiosity andexploration. Learning materials are larger andlessons typically happen within arm’s lengthwhere the item can be brought close to thechild’s eyes and examined through both visionand touch. Building early awareness of the toolthat “helps me to see more by making thingsbigger” is a critical lesson. By using a magnifier,the student can share in the vivid descriptionsof common items such as an insect held in ashallow dish, the color and texture variationsof the surface of many fruits and vegetables orthe dials and gauges with moving parts thatindicate equipment is functioning. Using atelescope, the student can mimic, along withclassmates, the flowing movements of a brightlycolored fish seen through the side of a large glasscontainer. From a safe distance, the student canstudy and copy the facial expressions of animals.Taking turns with classmates, the student canpractice tracking skills by watching theirmovement in the distance and describingchanges in body position. Using devices inactivities that take place within the classroomand beyond, the student is able to fullyparticipate with peers and sometimes even addadditional details missed by impatient eyes.

Two influences have shaped my current under-standing of this specialization. Having grownup with low vision and having managedresponsibilities in the competitive workplace, Iam aware of the necessity of visual efficiency andvisual independence. As a teacher with the projectProviding Access to the Visual Environment(PAVE) at the Vanderbilt Eye Institute, VanderbiltUniversity Medical Center, I have benefittedfrom exposure to a multidisciplinary model ofcomprehensive low vision care. This modelsupports follow-up instruction in the use of opticaldevices for students in their education andcommunity setting. To be successful, profession-als in low vision care must listen to the student as

well as the multiple voices that impact thestudent’s world.

What is success for my students? Success takesdifferent shapes based on a student’s needs andabilities. Cassidy, a 16 year old who useseccentric fixation for near viewing, had chosento rarely read menus in a restaurant. Success isher willingness to explain to a restaurantemployee who questions how she performs hertask, “I am visually impaired and this is the bestway for me to read.” Success for Carlos, a threeyear old, is willingness to use wide head turns toscan the floor for a wanted toy rather than cryingfor help. Success for Vincent, a 12 year old, iswillingness to grab a telescope before heading tothe school assembly and sitting with friends inthe gymnasium bleachers. These are examplesof personal confidence and visual independencefrom students who are finding their own style ofliving with low vision.

Principles of Low Vision Care

Multidisciplinary TeamLow vision is personal, emotional andunpredictable. This disability is poorlyunderstood by the general public, includingschool systems, and frequently a family feels lefton its own to figure out how to raise a child whosevision is somewhere between blindness andtypical sight.

Low vision services entail problem solving.Problem solving is best accomplished with a teamapproach. The members of a low vision teammust understand the subtle and direct influencesof various professionals’ perspectives on thestudent. A parent or guardian knows the childbest while a doctor understands the effects of acondition and educators can describe the impactof visual factors on learning. The meeting toreview Karina’s report from the low visionspecialist established communication among her


parents, classroom teacher, school principal, TVI,orientation and mobility specialist and PAVEteacher. This allowed us to determine commonmessages of visual efficiency for Karina. Inresponse to Karina’s questions such as “What ismy teacher holding?” during classroom demon-stration time or “What is that noise?” withconstruction equipment operating in theneighborhood, adults around her said, “Let’s grabyour telescope and find out.”

A collaborative approach is demanding of timeinitially but when members are able to coordinatetheir roles, habilitation for the child with lowvision is most effective. Prompting from a parentin an unhurried moment for the child to readnutrition information on a food package using amagnifier or find a pedestrian’s bright coloredoutfit through the telescope is a valuable lesson.Teachers can be supportive by helping parents toidentify such occasions in children’s daily routine.

Student Messages and GoalsLow vision defies explanation from a student’sdeveloping vocabulary. Learning first to underst-and how one sees differently than peers and thenfinding the words to explain the condition aretwo unclear tasks. Learning to voice one’s owngoals for using vision is a further step in thiscontinuum. Malcolm, a nine year old learningto use a 4x telescope, fiercely stated, “I want towrite my own spelling words from the whiteboard.” Previously, other students or the teacherhad provided written lists to him. Hence hadgiven his declaration of independence.

Low vision devices are not a magic solutionresulting in typical vision. Comments fromstudents give honest feedback of theirfrustrations. “But what if I can’t find the wordson the map during class tomorrow?” or “Don’tmake me use that thing. I don’t want atelescope!” Willingness by the teacher to explorethese versions of “I don’t want to be a kid with

low vision” can be very instructive. ForKadeesha, this meant “It’s too hard to use myvision when people are staring.” For Tobias thismeant, “I can use the thing but I won’t take thechance of being made fun of in front of myfriends.” For Karina it meant “Your tool is notgiving me enough information that is valuableto make the struggle of using my telescope worthit.” All of these messages are valid and areexamples of growth toward independence.Unfortunately, I may hear these messages in theclosing moments of a lesson. “Sometimes,” Itell a student, “my job is not to help you see, butto help you see choices.”

Case Study: BridgettBridgett wanted to see the batter at a baseballgame and her sister on horseback at the horseshow. She was a 20 year old student withoptic atrophy secondary to severe cerebralpalsy. She used a wheelchair and hadinvoluntary, spastic reflexes and a cognitivedelay. A team of 12 people including familymembers, teachers and support services staffcame together to review her low vision report.Bridgett’s persistence in wanting to see morepushed me to listen and to attempt anunconventional device mounting system. Afterseveral months of experimenting with spectaclemounted and head bourn systems, we settledon a telescoping rod from the back of herwheelchair that placed a clip in front of hereye for telescope positioning. Her field throughthe telescope is very restricted and requiresadult assistance but Bridgett was able to spother batter and her sister on horseback.

Integration of Device UseUsing vision efficiently and use of low visiondevices are not automatic skills to a student whohas low vision. Students who have gainedproficiency in device use may not recognize theinstances in which the device can be helpful.They may even be disinterested in the


information that others acquire visually becauseaccess is out of their reach. Too often as teachers,we focus so tightly on one environment that weneglect to extend visual reach into active settingsbeyond a classroom. Successful low visionhabilitation is truly found when strategies andtools are integrated across environments andactivities.

Case Study: TadejTadej’s doctor described him as exhibiting“tremendous visual curiosity” in the reportfollowing his low vision evaluation. He firstcame to clinic at age five with a diagnosis ofoptic atrophy and an estimated visual acuityof 20/700. His family had recently moved tothe United States and Tadej’s first task was tolearn English without a reading medium. Inhis first years of school, the closed circuittelevision was his tool for learning print lett-ers; this was an inefficient medium for him.Tadej fiercely resisted Braille. Early teammeetings occurred, but communication amongnew team members was difficult with hischanging program. We started with a 2.8xtelescope, with a final goal of his using an 8x.By age 8, Tadej’s interest in finding distanceinformation had increased. Holding the 6xtelescope, he motioned with his hand and said,“It’s not going far enough. I want to push itout.” With youthful clarity, he illustrated hisappreciation for range of telescope power.Today, at age ten, Tadej wants to seeclassmates’ facial expressions across the roomand identify what a speaker on Career Day isholding. He wants to find his buddies in theparking lot after school and take the telescopeto his brother’s soccer game. Tadej’s successis an unfolding story.

ConclusionTeachers must sometimes work as predictors ofthe future. They can help their students anticipate

life beyond the school setting and home. Canthe student find travel information such as busnumbers or building signs? Can the student checka grocery receipt or bank statement for accuracyusing high plus lenses or a magnifier? Whatvisual tasks is a peer three years older managing?We must remember, we’re not just helping astudent use a magnifier or a telescope, we’rehelping this young person to gain independencewith visual tasks for life.

Pediatric low vision services are an evolvingdiscipline in low vision care. The characteristicsof this population vary widely, yet some princip-les hold true for all students. Communicationamong members of the team providing care iscrucial. Listening to the student’s messages andgoals can inspire lesson plans that lead tomotivating use of devices-even in school. Finally,prompting integration of device use acrossenvironments throughout instruction willsupport the development of self-reliance andindependence. Wondering if I’ve really listenedto my student during today’s lesson comes tomind before I sleep. Like rewinding a moviescene, I replay conversations in my head lookingfor clues to understanding a student’s feelingsabout being visually impaired. Our mostimportant goal as members of a multidisciplinaryteam is preparing students for lifelong learning.Support of device use is central to creating thisreality.

Keep your eyes to the

sunshine and you cannot

see the shadows- Helen Keller


Education andRehabilitation to

Children withLow Vision in

Special Schoolsin China

PENG XiaguangDeputy-Director, Associate Professor

Department of Psychology and Special EducationChina National Institute for Educational Research

No. 46 Beisanhuan Zhonglu100088 Beijing,

P. [email protected]

&LI Qingzhong

SupervisorBeijing School for Blind Children

Beijing, P. R.CHINA

1. BackgroundThe official definition of visually impaired intraditional Chinese law is similar with thatdefined by WHO in 1973, but it is simplified sothat people working in this field can grasp it moreeasily. According to the definition of visuallyimpaired in China, visual impairment means thatpersons who have visual acuity impaired orrestriction in the visual field who for any reasonwill not be able to work, study or do otheractivities as normal people. The official defini-tion for visual impairment includes lowvision as well as blindness. Blindness can bedivided into two categories, the first category isdefined as visual acuity of less than 0.02 (20/1000 or 3/150) in the better eye with correction,or restriction in the visual field of less than 5degrees, the second category is defined as visualacuity between 0.05 (20/400 or 3/60) and 0.02in the better eye with correction, or restriction inthe visual field of less than 10 degrees. Lowvision is classified into two categories. The firstcategory is defined as visual acuity between 0.1(20/200 or 6/60) and 0.05 (20/400) in the bettereye with correction and the other category definedas visual acuity of between 0.3 (20/60 or 6/18)and 0.1 (20/200) in the better eye with correction.

At present, some Chinese experts are urging thegovernment to adopt the definition of lowvision passed in the meeting on “Managementof Low Vision in Children” held in Bangkok,Thailand, 1992, which was attended by expertsof low vision from different parts of the world.This meeting defined low vision as those whohave visual acuity of less than 6/18 (0.3), butwith light perception, or restriction in the visualfield of less than 10 degrees, but he/she can stilluse, or potentially able to use, vision for theplanning and/or execution of a task.

According to the statistics released by the ChinaDisabled People Federation in 2006, there are12.33 million people with visual disabilities in


China, covering nearly one percent of the wholepopulation. Although the number of people withlow vision has not been projected, it is presumedto be large in size.

Traditionally, education in special schools for theblind aims at those people who lose their sight.All special schools for the blind put emphasis onhow to teach blind students to read and writeBraille, how to transform scientific knowledgeto them, and how to improve those students’ self-independence and living skills. They use Braillematerials and other tactile teaching-aids. Allteaching activities are designed and appliedmostly for totally blind children. Therefore,students regardless of total blindness or low vi-sion, learn Braille at the beginning. Braille, thespecial learning tool, is used to help studentsacquire knowledge, communicate feelings andunderstand the world. According to the statisticsreported by a Chinese Special School for the Blindin 1996, low vision students are 62 percent ofthe whole population at school, and they are evenmore than totally blind students in some clas-ses. The situation of other special schools for theblind is similar to this one. However, the studentswho still have some sight too had to learn Braillelike those who are blind. In the late 1970s, as thenumber of low vision students in schools forthe blind increased, some people realized theimportance of educational reforms in theseschools aiming at addressing the specificeducational needs of blind and low visionstudents. In 1985, Shanghai School for the Blindand Beijing School for the Blind beganexperiments of teaching low vision students andblind students in separate classes. That is, lowvision students no longer had to learn Braille butlearn general Chinese characters by wearingappropriate visual aids. From then on, blindschools in China began experimental programsof classified teaching in the case of low visionstudents. The Ministry of Education in China paidmuch attention to the program and extended the

experiences of classified teaching to dozens ofblind schools in China. In October 1989, theDepartment of Basic Education, Ministry ofEducation held a seminar in Shanghai aboutteaching low vision children, advocating theprinciples of classified teaching. In March 1990,“Classified teaching of blind children and lowvision children” became a very important aspectof educational reform in blind schools and is asignificant measure to improve educationalquality in blind schools as well. Schools that havenot carried out classified teaching should beactive, design experimental plans and carry outthem gradually” - indicates the Working Reportof Classified Teaching of Low Vision Students. Inorder to hasten the implementation of classifiedteaching, Department of Special Education,Ministry of Education held Training Workshopfor Teachers of Low Vision Education in BlindSchools in China in July, 1990 and allocated aspecial fund to schools implementing classifiedteaching to provide adequate teaching facilities.

2. Policy and PracticeFrom 1982 to 1995, the number of laws andregulations published by the government wasmore than the total number published over thefirst thirty years following the Founding of thePeople’s Republic of China. The Constitution,published in 1982, states in Article 45, that thenation and society should arrange employment,living and education for the blind, the deaf, andthe others with handicapping conditions. TheCompulsory Education Law of the People’sRepublic of China, passed in 1986, states that allchildren including those with disabilities havethe right to receive free education and that thegovernment at various levels should establishspecial schools or special classes for the blind,the deaf or mute, and mentally retarded childrenor youth. The Law of the People’s Republic ofChina on the Protection of Disabled Persons,passed in 1990, stipulated that all persons with


disabilities should have equal rights includingthe right to receive education.

In accordance with these laws and regulations,the government has developed a specific five-year Work Plan for Disabled Persons and policiessuch as Suggestions on the Development ofSpecial Education in China to guide and promotethe development of education for all childrenwith disabilities. Guideline of Disabled in EighthFive Year and Ninth Five Year Plan statescorresponding implementation plans forrehabilitation of low vision persons. A NationalExpert Team was also established in 1998 andsince then, rehabilitation of low vision hasalready been in the right track due to theleadership of China Disabled Persons Federation.During the past decade, leading organizations oflow vision and rehabilitation have beenestablished, training of rehabilitation workersaccomplished, and training materials andbooklets have been published under theleadership provided by the China Disabled Per-sons Federation and organizations of disabledpersons at provincial and city levels. At the sametime, all kinds of optical aids have been producedin specific places in order to assist a large numberof people with low vision and laudableachievements have been made in this direction.

Experimental Plan of Compulsory EducationalCurriculum Assignment in Blind Schools issuedby the Ministry of Education in 2007 stipulatesthat classified teaching should be implementedin blind schools and special classes should becreated for low vision students. If the number ofstudents with low vision is so small that aspecial class cannot be created, those studentscan be combined in the same class with blindstudents, under classified teaching in the classitself. Blind schools should create barrier freeenvironment for low vision students, allocatefacilities of visual aids, large print textbooks andappropriate lamps, learn and use printing words,

encourage low vision students to use theirremaining sight and establish skills of effectiveuse of remaining sight to improve their abilities.

Teaching in low vision classes follow thecurriculum for general schools with suitablemodifications. General schools can refer to theimplementation of special education to studentswith visual disabilities in mainstream classes.Though China has made great strides in lowvision education and rehabilitation, someproblems still exist and that require attention.

In addition, China Disabled Persons Federation,in China Guideline of Disabled EleventhFive Year Plan, aims to provide free visual aidsfor 0.1 million poor students with low vision,train 30 thousand parents whose childrenhave visual disabilities, and establish 300rehabilitation clubs for people with low vision incomprehensive centers for disabled peoplebeyond the city level.

At present, some children with low vision inChina can go directly to general schools. Forexample, 20 students with low vision in 20schools from four districts of Dongcheng,Xicheng, Chongwen and Xuanwu in Beijing wereselected for an investigation of “inclusive study”.Till now, some of them have not only been tohigh schools, some have been to universities andseveral have been to higher education institutesin other countries too.

3. Major Strategies and ExperiencesThe Ministry of Education has attached greatimportance to the needs of persons withdisabilities, including their right to education andhas adopted a number of measures to cater tothe educational needs of low vision children.

Classified teaching of low vision studentsin blind schools in China is different indifferent schools as described below:


3.1 Stratified and classified teaching: There aremany low vision students in blind schools and inthese schools, blind and low vision students studyin different classes. Blind students learn Braillewhile low vision students learn print charactersand use the same teaching materials that are usedin general schools.

3.2 Classified teaching in mixed classes: For thoseblind schools with insufficient students, blindstudents and low vision students are mixed inthe same class and students use Braille or printtextbooks suited to their needs. Most of specialclasses for blind and small-scale special schoolsin some counties in China adopt this type ofteaching. Since learning Chinese is more difficultthan learning Braille, the initial speed of readinggeneral textbooks may be slower than blindstudents’ speed of reading Braille. Low visionstudents whose vision is poor usually use Brailletextbooks supplemented by general textbooks asadditional curricular reading materials.

3.3 Classified and grouped stratified teaching:Some blind schools with insufficient studentsclassify blind students and low vision studentsinto grade 1 and grade 2, or grade 1, 2 and 3,and implement teaching suited to different groups.

3.4 Helping low vision students with their Chineselearning outside class: Students who have poorvision and have difficulty in reading generaltextbooks and can still read some Chinese char-acters mainly use Braille textbooks. But for theconvenience of their future work and life, schoolsarrange time for their Chinese learning inadditional curricular teaching so that they canread and write some Chinese words to improvetheir abilities to live in the society.

In addition, there are integration centers/roomsfor vision stimulation to train low vision studentsto maximize the use of their vision.

4. Current Problems and ChallengesAlthough China has seen significant developmentsin low vision education and rehabilitation, thefollowing still remain as challenges:

4.1 Many Blind schools still do not have sufficientunderstanding of low vision education.

Some administrators and teachers think that lowvision students can learn and live at school, andwork and live in the society after leaving schoolwithout learning Chinese, and so learning ofChinese by low vision students is not givenimportance. According to an investigation madein one blind school in China in 2003, one thirdof students who use Braille can walk in familiarsurroundings, identify big objects in theenvironment, such as the human faces and treeswith the help of their residual vision. While inteaching, teachers seldom provide opportunitiesfor them to use their remaining eyesight properly.Many school leaders and some teachers, evenparents think that it is more difficult for lowvision students to learn Chinese characters thanto learn Braille. Therefore, teachers feel that theycannot complete teaching the required contentof Chinese characters prescribed by thegovernment within the stipulated time. Someother teachers worry about the effect of usingvision in learning of Chinese characters onstudents’ remaining vision. In general, they thinkthat there is no use for low vision students tolearn some Chinese characters. Because of thesemisunderstandings, many low vision students“read” Braille visually and not through tactilemode.

4.2 Restrictions and Limitations of NationalUnified Teaching Outline and teaching contentsare regulated by the Ministry of Education. Allstudents who are enrolled are required to learnthe same task, reach the same level, and pass thesame examination. When low vision studentslearn Chinese characters, teachers’ teaching loadassigned for each term cannot be completed, and


in such circumstances the teachers are subject tocriticism. In order to avoid such an embarrassment,many teachers encourage low vision students tolearn Braille. Therefore, developing effectiveteacher assessment system in blind schools mayhave an influence on the quality of education oflow vision students too.

4.3 There is a lack of professional teachersengaged in the field of low vision education inblind schools. Most teachers of blind schools comefrom general schools. Although some of them workin blind schools for many years, they do not receivesystematic training and education and thereforethey lack knowledge of low vision educationand rehabilitation. Through investigation, wefind that teachers themselves have manymisconceptions about education of low visionchildren.

4.3.1 Teachers think that low vision studentscan have visual training for a period of time andthere is no need for them to spend a lot of time inlong-term systematic training of their visualfunctions.

4.3.2 Teachers think that education and trainingof low vision students are only the job of thoseteachers who are in charge of training, and otherteachers do not have to understand or care aboutvisual training and rehabilitation of low visionstudents. Therefore, many teachers who teachlow vision students are just like those teacherswho teach blind students, not using blackboard,and even if they do so, they do not pay attentionto the factors that influence low vision students’learning, such as contrast between word andbackground, the size of characters, and theambient of light.

4.3.3 Teachers think that they only need to adjustand improve surroundings in the classroom,and do not have to adjust and improve allsurroundings in which low vision students studyand live, such as the first step of stairs, turning

point, door, wash room, poles that can be easilyencountered, electrical outlet, furniture, stepsoutside the room and equipment for sports.

4.3.4 Teachers think that it is enough for lowvision students to have training at school, and donot realize that low vision students also needsupport and cooperation of both families and thesociety.

Teachers’ knowledge and skills need to bestrengthened and improved to guarantee thequality of low vision students’ education.

4.4 Many schools for the blind and schools forblind and deaf do not have sufficient students.At present, there are not many students in eachclass in some blind schools, so specific classes oflow vision students cannot be organized. Mixedclasses of blind and low vision students bringgreat challenges to teachers.

4.5 Facilities needed for classified teaching arescarce. Classified teaching of low vision studentsneeds certain facilities such as good lighting inclassrooms, lamps for some students, effectivevisual aids, magnifiers, typewriters, adjustabledesks, etc. Since there is inadequate attention tolow vision students’ Chinese learning, thesenecessary facilities are not ensured. Therefore,difficulties are also evident in classified teachingof low vision students in schools.

4.6 The limited number of eye clinics andrehabilitation centers are not able to meet theregional needs of the country. There are somedesignated factories producing all kinds of opticalaids in China, but the number needs to beincreased, the quality needs to be improved andthe variety needs to be enriched.

In summary, education of children with lowvision is gaining momentum in China but thereis a long way to go...


Education ofChildren with

Visual Impairmentin Brazil

Prof. Dr. Maria Elisabete RodriguesFreire Gasparetto

Center of Study and Research in RehabilitationMedical School

Campinas State UniversityUNICAMP

[email protected]

ccording to Haddad (2006), in the Brazilianpopulation of 170 million people, 30% are in the0 to 14 age bracket (51 million children). Forthis group, the prevalence of blindness inchildren is 51,000 and of low vision, 153,000(214,000 children with visual impairment).

Data presented by the Special EducationSecretariat (SEESP) of the Brazil’s FederalMinistry of Education (MEC) show that therewere 55,046 new registrations of students withlow vision in the Brazilian public schoolsystem in 2005, with 60,632 in 2006, whichmeans an increase of 10%. For blindness, theincrease was 9%, as there were 8585 blindchildren registered in 2005 against 9206 in 2006.

The history of education for people withdisabilities in Brazil is marked by three periods(MAZZOTTA, 1996). The first period began in1854, going up to 1956 and was characterized byclinical services for the disabled in special institu-tions, many of which were residential schools. Thesecond period, from 1957 to 1993, was markedby official policies that regulated special educationclassrooms within the regular schools. The onsetof the third period began in the nineties, spanningthrough the twenty first-century, with the proposalof schools that aim for the inclusion of childrenwithin the regular system.

The founding principle of inclusive education isthat all children should learn together, no matterthe difficulties or differences they may have. TheFederal Regulations for National Education (LDB)is the official document that has stipulated theNational Education Policy for the last fourdecades. The LDB nº 9394/96, the most recentOfficial Education Law defines Special Educationin the 58th article:

“it is a modality of school education offeredpreferentially in the regular school system forstudents who have special needs.”

A


In order to guarantee access and continuity tochildren with visual impairments in regularschools, SEESP – MEC developed importantguidelines for national school systems, in theform of the publication Saberes e Práticas daInclusão, which includes strategies andeducational orientation for teaching children withvisual impairments. Besides publications, otheractions meriting mention are:

1) The creation of 34 Support Centers (Centrode Apoio Pedagógico aos Deficientes Visuaisl-CAPs) as resource centers for students withvisual impairments and 13 Support andBraille Production Nuclei (NAPPBs), aimingto offer specific and technological resourcesfor students with visual impairments. Themain purpose of these services is to preparepedagogical material, such as books and textsin Braille, as well as large print and talkingbooks for distribution to students who are inthe regular school system.

2) The National Program for Didactic Work-books (PNLD) made available to all blindchildren registered in elementary school, 40thousand workbooks in Braille.

3) Material: Totally 15,000 kits were madeavailable for students with visualimpairments, 7,500 being kits for the blindstudents including a satchel, slate and stylus,abacus, white cane, adaptive signature guide,and special paper for Braille. The other 7,500kits for low vision students included asatchel, double-lined paper, notebookswithout lines, soft pencils, porous felt-tippens (black and colored), erasers, and handmagnifier. The Ministry of Educationdistributed these materials to the registeredstudents in public schools.

4) The Brazilian Braille Commission wasconstituted through the Ministerial Statutenº319/99, presided and maintained bySEESP; the duties of this commission are

determining the rules for use and teachingof the Braille System in Brazil. Anothercommission was founded in order to establishguidelines for use and teaching of soroban(abacus) in Brazil through the MinisterialStatute 657/02.

5) Teacher Development: SEESP offers supportfor ongoing education courses on specificsubjects pertaining to the education ofstudents with visual impairments. Thefollowing courses are being offered in theCountry:

a) Braille system and unified mathematicscode system courses

b) Orientation and mobility courses

c) Braille adaptation and transcription

6) The aim of the National Project for LowVision Students was to identify, assess andprovide optical and non-optical devices forstudents with low vision, in order to enhancetheir visual functioning in the classroom(2001).

7) An important support for teachers ofinclusive schools was the preparation of aDVD, an audiocassette and a book called Theinclusion of students with low vision inregular schooling published recently in 2007.

Other governmental initiatives include theproposal for accessing books through thepublishing houses that should make availablethe books to people with special needs.

Since the eighties, several low vision serviceshave been rendered in universities, such as theState University of Campinas (UNICAMP), theUniversity of São Paulo (USP), the FederalUniversity of São Paulo (UNIFESP) and theFederal University of Minas Gerais (UFMG). TheBrazilian Society for Subnormal Vision wasfounded in 1995, as part of the BrazilianOphthalmology Council.


Brazil participates in international venturespromoted by the International Council forEducation of People with Visual Impairment -ICEVI and the Christoffel-Blindenmission - CBM,offering continuing education courses for thedevelopment of professionals who are workingor will be working with students having visualimpairments.

Another important achievement in the field oflow vision is the decision that made residentalrequirement definite for those studyingophthalmology. This certainly means that a morefavorable educational environment is beingmade for early assessment and educationalopportunities for children with low vision.

Service restriction for low vision results in adetection difficulty of visually impaired childrenand consequent lack of ophthalmologicassessment to investigate the need for optical aidsand orientation for efficient use of vision eitherin or off school.

Sampaio et al. (apud Haddad 2006), investigatedto know how many ophthalmologists work withpeople with low vision in Brazil, using a surveyform sent to Brazil’s 10,000 ophthalmologists.Only 205 (2.05%) replied, with 58 (28.3% out ofthe 205) declaring to work with low vision

persons and the 147 (81.7%) of the respondentsdeclared intentions to work with low vision.

Because Brazil is a large country with widediversity and contrasts, all the actions describedcannot cover educational needs of visuallyimpaired students especially those with lowvision.

Strong efforts are being undertaken to attainEducation for All. But it is also recognized thata lot more has to be done because this process ofchange demands big challenges and actionswhich take a long time.

References1. Mazzotta, M.J.S. – Educação especial no

Brasil: história e políticas públicas. São Paulo,Cortez, 1996.

2. Brasil – Secretaria de Educação Especial –SEESP- Ministério da Educação- MEC. Dadosda Educação Especial. [cited 2007 may 27]Available from: http://portal.mec.gov.br/seesp.

3. Haddad, M.A.O. – Habilitação e reabilitaçãovisual de escolares com baixa visão: aspectosmédico-sociais. São Paulo, 2006. [Tese-Doutorado- Universidade de São Paulo].

Dr Keith Watkins, former President of the ICEVI Pacific Region, and Foundation Chairman of

the International Association for the Education of the Deaf-Blind died at Wooli, New South

Wales on 25 June 2007. He was born in Newcastle, NSW and trained at Armadale Teachers’

College. Most of his career was spent with the NSW Department of Education. He was

Principal of the North Rocks School for Blind Children, Inspector of Schools for Special Education;

and Assistant Director, Special Education. He was also a Fellow of the Australian College of

Educators, and retired in 1988. In 2005 he authored ‘Education for people with impaired vision:

From Antiquity to the Antipodes in 2000’, which was based on his Macquarie University PhD

thesis “Towards systematic education of the Blind in Australia “.


OBITUARY

Development ofCBR Services for

Children withLow Vision

Sumrana YasminProject Officer

[email protected]

&

Hasan MintoRefractive Errors and Low Vision Advisor

[email protected]

Sightsavers InternationalPAKISTAN

Articles SERVICES

ccording to surveys carried out over the lastten years in various parts of the world, there area number of children who are either attendingspecial schools or special integrated educationprogrammes in mainstream schools. Also thereare children who could benefit from surgical orrefractive interventions and are needlessly blind.The main reasons for this are lack of coordinationbetween eye care and education services and alsothe unavailability of personnel trained to workwith children who have visual impairment.

The children with visual impairment can bedivided into three sub-categories. Those withmoderate visual impairment i.e. between 6/60to >6/18 can manage well in the mainstreameducation with some support from teachers;parents and provision of optical and non-opticallow vision (LV) devices. Almost all the childrenin Pakistan in this category can manage withoutadditional support.

The second group i.e. children with severe visualimpairment 3/60 to >6/60 need higher level ofintervention and here the prescription and othersupport required is more complex. The degree ofsuccess with mainstream education dependsmore upon the parents and teachers and variesfrom case to case. Almost 50% children still cancope in mainstream schools.

Those with vision less than 3/60 often havedifficulty in mainstream education withoutsupport from itinerant teachers, however a certainnumber about 10%-20% can still manage well,especially in higher grades. The remainingchildren in this category require more intensivesupport from the itinerant teacher, tactilematerials including Braille, assistive technology,and teaching aids.

The total number of people with low vision donot need low vision care. Internationalexperiences suggest that 30% of the people with

A


LV can be effectively served at the primary level,50% at the secondary level, while 20% wouldneed tertiary level care. However, there are veryfew good models which demonstrate theeffectiveness of primary level interventions andhow these are integrated with the health care andeducation sectors. Low vision services can beoffered at primary/community, secondary, andtertiary levels. At primary level services are offe-red by community based workers, primary healthworkers, teachers, volunteers etc. The mainresponsibility at the community level is detectionand referral of the persons with visualimpairment, simple low vision devices, andadvice on environmental modifications.

In most community based rehabilitation program-mes, the role of CBR workers has been limited toprovision of rehabilitation to the blind includingorientation and mobility (O&M), daily living skillsand vocational training. Normally the techniquesused by CBR workers are geared towardsnon-sighted methods and their training in lowvision is inadequate to offer effective services tolow vision clients. On the other hand, childrenwith visual impairment usually do not fall underthe responsibility of CBR workers and theireducation is primarily seen as the responsibilityof specialist or itinerant teachers. The educationservices for the children with visual impairmentcentre around Braille and other non-sightedtechniques often ignoring the presence of residualvision. Although there are not enougheducational services for the visually impaired,even these are not fully utilised. And also thereis a weak link between education, rehabilitationand clinical services (less than 5% of the childrenwith visual impairment have access to education).

Adding low vision services to the terms ofreference of the CBR workers can help overcomemost of the issues discussed above. Thishypothesis was tested in a pilot project onprimary low vision services in Bangladesh.

BackgroundAccording to a population based survey conductedby the National Institute of Ophthalmology andInternational Centre for Eye Health and supportedby Sightsavers in 1999-2000, the prevalence ofblindness is estimated to be 1.2% -1.4% in thepopulation 30 and above. This means that thereare nearly 650,000 blind people in Bangladesh.The Bangladesh national survey also identifiedthat there are 250,000 persons over 30 years whocould potentially benefit from LV services. Inanother study undertaken on the prevalenceof childhood blindness in Bangladesh, theprevalence of childhood blindness was estimatedas 0.75/1000 children, i.e. there are about 40,000blind children in Bangladesh. The estimatednumber of children who could benefit fromLV care in Bangladesh is 144,760.

In Bangladesh, CBR pilot-projects have beenset-up and have made marked progress in thepromotion, implementation and evaluation ofCBR, and have achieved good results. To promotebetter education and work for the integration ofthe persons with low vision in the community,CBR deals with different programmes in thecommunity and institutions.

This article presents a synthesis of the activitiesand outcomes of a project on “The Developmentof Low Vision Services at Primary/CommunityLevel” which was initiated by SightsaversInternational to test the feasibility of CommunityBased Rehabilitation (CBR) and CommunityApproach to Handicap and Development(CAHD) workers in prescribing simple opticaland non-optical low vision devices and byproviding training and low vision kits. This wasa pilot project (September 2003-December 2005)which was implemented to gauge howeffectively LV services could be provided by localNGOs’ rehabilitation workers working at thegrass root level for disability development.


This project was implemented by the Centre forDisability in Development (CDD), a nationalNGO, which had long-term experience inproviding training on disability. The goal forthis pilot project was the “rehabilitation andinclusion of persons with low vision in thecommunities of Bangladesh for mainstreamdevelopment”. The specific objectives set toachieve this goal were (i) capacity building ofthe NGOs involved in providing training on lowvision management at primary level, (ii)material development for low vision services,(iii) establish low vision resource centre fordemonstration and learning as well as managingsmall LV devices inventory for dispensing,and (iv) capacity building of developmentorganisations through training of field workersand equipment/devices support for creatingservice provision on low vision.

A core team of 6 trainers on LV was formed whichreceived the training of trainers (TOT) in lowvision. The team then developed training curri-culum and translated the low vision manual forrehabilitation worker (originally available inEnglish), into Bengali, for the field staff of thepartner organizations.

In total, 50 CBR workers (32 male and 18 female)from 29 partner organizations participated in thesix-day basic training on LV services at theprimary level, which took place in two batches.Later a refresher training was organized whichwas attended by 37 (25 male and 12 female)previously-trained field staff. This trained staffbecame the main force for implementing the LVprogramme. All trained staff were providedwith an LV toolkit bag that contained 14 diffe-rent tools (E chart, steel tape, pinhole, 3x, 4x,5x, 7x stand magnifier, 2x and 3x handheldmagnifier, binoculars, monoculars, spectacles,sunglass, torch light, bold line note book, felt tippen, reading stand, typo-scopes and a cap).

Two Low Vision Resource Centres (LVRC) wereestablished to provide clear knowledge on opticaland non-optical devices, the use of such devices,and to encourage staff to be creative in developingnon-optical devices using local resources. Thesecentres also display the domestic items withcolour contrast, which is essential in the dailylives of LV persons.

Each CBR worker was assigned a target to identify50 persons with low vision and support 20including children with low vision. This was inaddition to their regular work load. Afteridentification, the CBR worker referred the clientto the secondary eye care facility where adetailed eye examination and refraction wasundertaken. Those clients whose vision couldimprove with optical or surgical means wereprovided these services and referred back to thecommunity while those with incurable eyeconditions were referred back to the CBR work-ers who then undertook a functional assessment,prescribed appropriate optical and non-opticaldevices, and provided the necessary follow-up.In case of children, the CBR workers preparedguidelines for the family and the school on howbest to support the child. They also visited theschools to carry out necessary environmentalmodifications and worked with the teachers tofacilitate the classroom management of the child.

During the three years of this pilot project, atotal of 702 persons (35% of the total target) wereinitially identified for assessment, of whom 397(39.7% of the total target; 126 adult men, 74 adultwomen, 133 boys and 64 girls) were confirmedas LV during the tenure of the project. Thepersons with LV were provided mobility training(33%), vision training (35%) as well as opticaldevices (41%) and non-optical (39%) devices foradaptation of lifestyles. In some cases, objectslike doors and windows, which come into dailyuse by persons with LV, were coloured for betteridentification by the concerned individual.


Case study 1:Md. Faruque Mia, 14 year old boy, was diagnosedwith nystagmus since birth. His father is anunderprivileged rickshaw-van driver. Despite theirpoor financial condition and his poor eyesightFaruque struggled and continued his study, now ingrade 10 in mainstream school. Faruque’s youngerbrother also has low vision. He was identified duringa survey conducted by ABC under the CBR projectsupported by Sight Savers International. In school,he was not able to see the black board, he had totake the book as close as possible to his eyes, andhe had difficulties in writing. After assessment, CBRworker provided him with some non-optical andoptical devices, like reading stand, writing frame,big liner pen/signature pen, exercise books/khata,big printing papers, envelop card, signature card,7x stand magnifier, and 3x telescope. He alsoadvised him to use a cap and sunglasses as Faruquehas problems with bright daylight. Someinterventions were made to modify his environmentsuch as to always let him sit in the first row, writelarge letters on the blackboard and simultaneouslyarticulate what was written on the board. In home,a table lamp was arranged for his reading. Theyalso arranged bright colored comb and brush, andother colored objects to provide good contrast. Afterthese interventions, Faruque’s current condition isquite good. With the devices provided he has beenable to see much better and he is sure that he’ll beable to complete his studies and establish himselfas an important member of the society. Aftercompletion of study, he wants to work for thebetterment of the disadvantaged people.

Case Study 2:Rashida Akter is 11 years old and has micro corneaand nystagmus. Her father is a small-scale business-man from lower-middle class background. Due toher poor eyesight Rashida was struggling with herstudies. Currently, she is in class five. She wasidentified having low vision during the surveyunder the CBR project. Mr. Shakhwat Hossain, theCBR worker started to work with her 4 months ago.In school, Rashida was facing the similar problemsas Faruque. She could not even recognize a personfrom a little distance. After assessment, Shakhwatarranged some non-optical and optical devicesincluding a 4x telescope and a 5x Stand Magnifier

and a reading stand. He convinced the teachers tomake some environmental modifications in herclassroom. After these interventions, Rashida ismanaging well in school and is very excited withthe facilities. With the devices provided, her qualityof life improved tremendously. Now, she can seemuch better and has become more confident withher studies. She wants to be a doctor.

Conclusion:Nearly 200 children, who due to their visualimpairment had either left education or werestruggling to continue, could re-enter mainstreameducation with interventions to create anenabling environment and motivate the teachersand the families for the education of thesechildren. The results of this pilot project clearlyindicate that with limited inputs in the form oftraining and provision of basic materials CBRworkers can play an effective role in rehabilitationof persons with low vision in general and childrenin particular.

Low vision is a part of the spectrum of visionimpairment and thus low vision services shouldnot be separate from services to people who areblind. Essentially the same people and existingorganizations can provide care. Similarly in theprovision of eye care, low vision is part of thatcare utilizing the same personnel (with trainingin low vision) and often using the same facilities.What is needed to ensure low vision care for allwho need it, is trained personnel to assess needsand provide specialized skill training for peoplewith low vision and simple low vision devicesand materials.

References:1. http://www.lowvisiononline.unimelb.edu.au/

2. WHO Low Vision Kit

3. Minto, Hasan (2004). Establishing low visionservices at secondary level. Community Eye Health/ International Centre for Eye Health, Volume:17, Issue: 49, Page: 5


Early Interventionin Hai Duong,

Vietnam

Dr. Nguyen Duc MinhNational Institute for

Educational Strategy and Curriculums101 Tran Hung Dao, Hanoi

[email protected]

1. The target of Early Intervention forVisually Impaired ChildrenEarly intervention for visually impairedchildren means identifying eye diseases andtheir impact on the development of childrenand providing suitable intervention services.Early intervention services aim to treat orcompensate for impaired visual function anddevelop the specific skills to help visuallyimpaired children attend school at theexpected age. Early intervention also aims toimprove the circumstances of the familieswith visually impaired children and set up afriendly environment that is comfortable forthe care and education of visually impairedchildren in close cooperation with families,schools and the community.

Early intervention for visually impairedchildren aims to implement the VietnameseNational Education Strategy 2010 and relatedregulations of Government, Ministry ofEducation and Training on ensuring equalschooling opportunities for children withdifficult circumstances in general and visuallyimpaired children in particular.

2. Early intervention for visuallyimpaired children in Hai DuongThe importance of early intervention forvisually impaired children has been assertedby local and international experts. However,until now we have only had small programsand projects on the early interventionspecifically for visually impaired children anddisabled children in general.

In 2001, studies were conducted on provincialmodels of early intervention for visuallyimpaired children in Danang by the NationalInstitute of Educational Strategy andCurriculums (NIESAC) with the sponsor ofKommittee Two- Holland. Due to low funding


and a long distance from the project site, onlya survey for teachers who work directly withvisually impaired children and parents wasconducted. It is regrettable that the KommitteeTwo- Holland dissolved and NIESAC could notfind another sponsor for the project. However,at Nguyen Dinh Chieu special school for theblind, NIESAC has retained early interventionactivities.

NIESAC has assigned the task of researchingearly intervention for visually impaired child-ren to the Research Centre for Special EducationStrategy and Curriculum. Despite the limitedbudget for research, support from both localand international individuals and organizationshas been a welcome feature. Ms. MyrnaEijsenring (VISIO - Holland and NIESAC) anexpert on special education with many yearsof experience and a deep understanding ofVietnamese education, set up a VISIO sponsoredresearch project from 2005 to 2007.

2.1. Choosing project siteWe chose Hai Duong to implement theprovincial model of early intervention forvisually impaired children for the followingreasons:

- Hai Duong has a large population. For thisreason, there are children with a range ofdifferent visual impairments

- Hai Duong includes city, delta andmountain areas

- Hai Duong has a high level of educationwith experience providing education fordisabled children

- Hai Duong has been helpful aiding NIESACin many activities

- Hai Duong is close to Hanoi, providingsavings on travel and accommodationcosts. It is also possible to organizeadditional activities from this distance

2.2. Early intervention activities in Hai DuongOn the 26th of March 2005, NIESAC, Depart-ment of Education and Training (DOET) HaiDuong signed the contract with a detailedactivities schedule “Some early interventionmethods for visually impaired children”. Thisis Ministerial project coded B2005-80-26 withthe participation of the Department ofPreschool Education- Hai Duong DOET.

- NIESAC cooperated with the Departmentof Health in Hai Duong in trainingkindergarten teachers and local medicalstaff to identify early eye diseases in child-ren from 0 to 6 years old. Trainers went tohamlets and small villages to find visuallyimpaired children. After two weeks ofinvestigations 385 children with eyeproblems were spotted.

- All 385 children were screened using thefollowing steps:

� The first step: Doctors of Hai Duongperformed a preliminary hospital checkand screening. All children with eyediseases received a prescription, ifnecessary, and were guided for treatment.Of these, 164 children with eye diseaseshad a comprehensive eye examination.

� The second step: Doctors at the Natio-nal Institute for Ophthalmology andexperts from NIESAC screened and speltout necessary interventions.

After the second step, of the 120 childrenpresented with different visual impairments,43 children needed special care and education.Of these children, 6 were totally blind, 34 hadsquint and eyelid problems, 2 children hadtrachoma and one child had albinism.The other children were prescribed glassesand suitable care to improve vision at homeand at school.


- A workshop on the current situation andto make a perspective plan for the firstand second years was organized byNIESAC and DOET Hai Duong.

- Training and guiding skills courses werepresented to teachers and parents oncaring visually impaired children: Teacherswho work with visually impaired child-ren and the parents of the 120 visuallyimpaired children attended these trainingcourses.

- Advising skills directly for teachers andparents: advise is provided at home forall visually impaired children who needspecial care and education. Teachers whowork with visually impaired children havebeen given responsibility for children andhence they provided advice directly athome or school quarterly or whenevernecessary. This action has been organizedpermanently.

- Improving knowledge after applyingtraining and skills for the first time. Duringthe advanced training course, parents andteachers had a chance to share andexchange their experiences.

- Providing glasses and teaching materialsfor visually impaired children needingspecial care and education as well askindergartens with visually impairedchildren.

- Operating on children with squint oreyelid problems and cataract surgery(sponsored by ORBIS and NationalInstitute for Ophthalmology).

- Organizing dialogues to share andexchange experiences between teachersand educational managers of Hai Duongand Danang.

2.3. Results

- All visually impaired children from 0 to 6years old in Hai Duong were identified,screened and supported with early inter-vention.

- Most visually impaired children are 6 yearsold moving to grade 1.

- All visually impaired children neededmedical intervention:

� Doctors of the National Institute forOphthalmology examined in 4 stagesand operated in 2 stages

� All the children with eye diseasesneeding optical devices received them

� 31 children with eye diseases wereoperated on. The majority did not requirespecial care or education. These child-ren also did not need glasses whenparticipating in activities with peers.Only one child had no change in visionafter the operation. Further observationswill be conducted to find out the bestsolution for this child.

� 120 teachers and parents of visuallyimpaired children participated intraining courses on care of visuallyimpaired children. 30 key teachers havebeen trained in 3 stages (6+3+3 days)on early intervention for visuallyimpaired children.

� 35 parents have gained skills on earlyintervention at home.

� 16 kindergartens have been equippedwith teaching materials for activitieswith sighted and visually impairedchildren. Sixteen visually impaired child-ren have been provided sets of toys forrehabilitation, to develop specific skills,and play with peers. Visually impairedchildren have been guided to use


natural materials, utensils at home, andtoys of sighted children to aid inrehabilitation and play with others.

� Kindergarten teachers and parents ofvisually impaired children who attendedtraining courses received informationpackages on caring visually impairedchildren.

� The community has been educated onprotecting children’s eyes and to improveawareness on the capacities and needsof visually impaired and disabledchildren. They comprehended theirown responsibility for caring andeducating these children.

� 22 kindergarten teachers andeducational managers in Hai Duonghave shared and exchanged experienceswith special schools in other provinces(Quang Tri, Danang and Nghe An) onvisually impaired and disabled children.

� In cooperation with the Blind Associa-tion in Hai Duong, Manuals on Brailleand specific skills teaching for blindchildren are being prepared for someprimary schools that will begin acceptingblind children.

3. Lessons LearnedEarly intervention plays an important role inthe care and education of visually impairedchildren. Early intervention needs to beimplemented directly for visually impairedchildren and their families, setting upfriendly environments that are suitable forrehabilitation and development.

- Families, especially the parents, of visuallyimpaired children need to be informed ofthe results of early intervention.

- Kindergartens – Preschool teachers,educational managers, families and thecommunity need to know that the earlyintervention for visually impaired childrenwill be advantageous and supportive.

- Early intervention for visually impairedchildren has to be implemented as earlyas possible to provide the best results atthe least expense.

- Early intervention for visually impairedchildren will show better results whenthere is cooperation between stakeholdersof education, health, society, and if theyare flexible in finding additional sponsors.

- Sharing and exchanging informationbetween parents and teachers who workwith visually impaired children is alsovery important.

Using pinhole to test for refractive error


Articles TRAINING

Teacher Trainingin Low Vision

- Polish and CentralEuropean Perspective

Dr. Antonina Adamowicz-HummelAssistant Professor

Coordinator of Low Vision ProgramsAcademy of Special Education

Warsaw, [email protected]

PolandAlthough no systematic statistical andepidemiological information on the low visionpopulation in Poland has been collected, it isestimated that there are approximately 350,000individuals with low vision, out of a total popu-lation of almost 40 million. The 2005 statistics ofthe Polish Association of the Blind (PAB) reportthat among its members aged 16 and over, only7.02% are totally blind.

In 2005, the number of visually impaired studentsin Polish regular schools was three times higherthan in the ten residential schools for the visuallyimpaired. Research findings show, however, thatthe students in regular schools get insufficient -professional support.

Recognizing the special educational andrehabilitation needs of the low vision population,the Polish Association of the Blind, in cooperationwith the Academy of Special Education, has beenpromoting a systematic approach to the servicedevelopment since the early 1980s [Adamowicz-Hummel, Walczak, 1989]. Personnel prepara-tion constitutes an indispensable part of theproject.

Teacher training in Low Vision has been carriedout at the Academy of Special Education inWarsaw since 1987 – initially it was done at thepost-masters level only. Currently it is alsoincluded in the curriculum of the full-timeprogram for teachers of the visually impaired. Inaddition, short courses (10-40 hours) on LowVision are run as part-time programs and atpostgraduate programs at the Academy, as wellas at summer schools and workshops for teachersfrom regular schools, psychologists and otherrelated professionals.

The curriculum of Poland’s first (1987) programin vision rehabilitation was drawn primarily fromthe competency-based Master of Science Program


in Vision Rehabilitation at the PennsylvaniaCollege of Optometry, USA. It was establishedas a 3-semester, 350-hour, postgraduate trainingfor persons who were employed in the field ofvisual impairment and blindness. Two otherprograms followed to meet the growing demandfor Low Vision specialists.

In 1991-1993, I conducted a research study toevaluate the effectiveness of training of ourPrograms’ for graduates. The results showed thatthe graduates of the Program were competent invision rehabilitation and their interventionactivities were effective, the impact beingobserved both in functional and in psychologicalareas. The competencies developed for theProgram, as evaluated by the graduates from thepoint of view of their work experience, got ratedas basically sufficient and useful.

As of low vision intervention effectiveness, theresults of the study showed that there was notenough transfer of acquired visual skills into reallife situations of the low vision clients.

It was recommended that instructors should workoutside specific individual vision rehabilitationactivities, together with parents, other familymembers, peers, teachers, house parents, andother specialists in the settings that are mostimportant for the students’ functioning. Theinstructors should be more sensitive to andeffective in teaching the students to control theirphysical environment.

The data obtained in the study were used to verifythe competency based teacher training modeladopted for the Program in Vision Rehabilitation.The curriculum has been modified accordingto the findings of the study. Low VisionRehabilitation has been introduced at theAcademy for Special Education in Warsaw as afull time program at graduate level. TheAcademy is the only higher education faculty in

Poland that offers training for low visionspecialists.

In 2005 the 4th Postgraduate Program in LowVision Rehabilitation was launched. The Programlasted three semesters and ended in February2007. The curriculum included 350 hours. Twosemesters were devoted to academic studies (310hours), the third semester had individualpracticum supervised by the experienced LowVision therapists (40 hours of providing directservice per student) and to independentinternship (30 hours per student).

Taking into consideration that the students wereadults with a job and a family, the Program wasimplemented on a part-time basis, i.e., thestudents would come to 3-4-day training sessionsheld around weekends, once in 3-4 weeks. Weintroduced elements of distance training, i.e., partof the curriculum was implemented via electronicmedia, mainly e-mail and internet. It was apioneer step in personnel training in the field ofblindness in Poland.

The goal of the Program was to prepare teachersand instructors to work with low vision personsof all age ranges, and with their family membersand significant others. However, focussedemphasis was put on disruptions of normal visualdevelopment and their lifelong consequences,and on assessment and intervention methodsrelated to children, especially those of age 0-6years.

There were 15 participants in the Program. Theyincluded teachers and house parents fromresidential schools for the visually impaired, aninstructor from the Polish Association of theBlind, and employees of the educational-vocational counseling centers, special andintegrated kindergartens and early interventioncenters. This number of participants made itpossible to work in small groups (observationclasses) and individually (practicum).


The Program was implemented in cooperationwith the Center for Early Intervention of the‘Têcza’ Parents’ Association in Warsaw, the LaskiSchool for the Blind near Warsaw, the School forthe Partially Sighted in Warsaw and the PolishAssociation of the Blind.

The teaching was conducted by the facultymembers of the Academy, of other academies anduniversities (including ophthalmologists from theMedical Academy in Warsaw and Psychologistsfrom the Warsaw University and the Jagiellonian

University in Cracow) and practitioners fromagencies providing services for the visuallyimpaired.

The costs of the Program were met to the tune of70% by the participants and the rest 30% by theNew York Committee for the Blind of Poland.Committee’s assistance has made it possible tokeep the fees at a level comparable to fees inother postgraduate programs in the field, whilemaintaining a small study group and high qualityof instruction.

Postgraduate Program in Low Vision Rehabilitation, Academy of Special Education, Warsaw,Poland. September 2005 – February 2007: Curriculum Outline

Goal: Preparing the participants to provide rehabilitation services to the persons with low visionand their significant others that will enable them to use their impaired vision most efficiently andincrease their independence in the home and community.

Central and Eastern Europe (CEE), and… the rest of the worldI had the privilege of teaching and co-teachingLow Vision courses and workshops at theinvitation of colleagues from Lithuania, CzechRepublic, Slovakia and Hungary. We hosted suchspecialists in Low Vision as Dr Audrey Smith,Dr Lea Hyvarinen, Dr Silvia Veitzman, Dr DuaneGeruschat, Maureen Duffy and Dr OrjanBackman.

To my knowledge, the Charles University,Department of Special Education, in Prague,Czech Republic, is the only other institution ofhigher education in CEE that offers programs inLow Vision. They are preparing to launch theirsecond postgraduate program in Low Vision in2007-2008. The first Program was run asPostgraduate 3-semester training in 2004-2005.The curriculum was adapted from the 2nd semes-ter International Low Vision Program run byOrjan Backman at the Stockholm Institute of

# Course No of hours

1 Human development over lifespan 26

2 Early support of development of child with visual impairment 30

3 Anatomy, physiology and pathology of the visual system 40

4 Psychological and social implications of low vision rehabilitation 20

5 Professional issues in rehabilitation 14

6 Methods of vision assessment and training in young children andchildren with multiple impairments 90

7 Methods of vision assessment and training in older children, youths and adults 90

8 Practicum (working with LV persons under individual supervision) 40

TOTAL 350

Internship 30


Education in 1995-1996. The coordinator ofthe program was Dr Lea Kvetonova and the LowVision methods courses were taught by MarketaSkalicka, graduate of the Swedish Program.

The other European graduates of the SwedishInternation Program in Low Vision were: MartaGado from Hungary (a faculty member of the ElteUniversity in Budapest), Ene Kelk from Estonia(currently working in Norway as Low Visiontherapist), Teresa Audukiene from Lithuania(currently not working in the field of Low Vision)and Thorun Gunardotir from Island (no informa-tion on her current professional status).

In August 2004, Sweden launched a renewedMaster’s Degree Programme in Visual Impairmentat the Stockholm Institute of Education (atpresent, the only University in Sweden providingcourses in this field). The programme is run aspart-time study and takes five semesters (two anda half year) to complete. One semester is equalto 20 study weeks. The studies are a combinationof course meetings (three days), taking place 4-5times per semester in Stockholm, and distanceeducation via Internet. The programme addressesdifferent professionals. The main focus is to prov-ide specialised knowledge of visual impairmentsupplementing professional qualifications alreadyacquired. The programme considers educators(teachers at different levels), occupationaltherapists, physiotherapists, ophthalmic nurses,orthoptists, optometrists, social welfare officersand psychologists. The entrance qualification istraining at B.A. degree-level. The students shouldhave worked for at least three years in their basicprofessions before joining the programme in visualimpairment.

The recent/current programs in Poland, CzechRepublic and Sweden are taught in nationallanguages. However, both Poland and Swedenhave the experience of conducting internationalprograms in English – Sweden in Low Vision(1995-1996), and Poland in Orientation and

Mobility (four Programs over the period 1995-2005). A highlight of the Academy of SpecialEducation in Poland (2003-2004) was executionof a custom-designed postgraduate program inOrientation and Mobility, with a strong LowVision component, for a group of Hungarianteachers. The Program was sponsored by theHungarian Ministry of Health and Social andFamily Affairs and implemented partly in Polandand partly in Budapest.

We are open and willing to learn from the others,as well as to share our expertise, both in Poland,the region, and beyond.

Bibliography1. Polski Zwiazek Niewidomych. Sprawozdanie za rok 2005.

PZN, Warszawa 2006.2. Palak, Z., Integracja szkolna uczniów niewidomychi

slabowidzacych w oewietle badañ empirycznych. PrzegladTyflologiczny 1-2/1993, Polski Zwiazek Niewidomych,Warszawa 1994.

3. Witczak, J., Wplyw wybranych czynników na osiaganieumiejêtnooeci szkolnych przez

4. slabo widzace dzieci uczace siê w I klasie w szkolachogólno dostêpnych. Unpublished Ph.D. dissertation,Warszawa 2003.

5. Adamowicz-Hummel, A., Walczak, G., The Developmentof Low Vision Services in Poland. Journal of VisualImpairment and Blindness 1, 1989, pp. 64-66.

6. Pennsylvania College of Optometry. Prospectus: Master ofScience Degree Program In Vision Rehabilitation – Pro-gram and Course description. PCO, Philadelphia, PA, 1983.

7. Adamowicz-Hummel, A., Evaluation of Low VisionCompetencies for Teachers of the Visually Handicapped inPoland. Unpublished M.Sc. thesis, PennsylvaniaCollege of Optometry, Philadelphia, 1986.

8. Adamowicz-Hummel, A., The Graduates of Poland’s FirstProgram in Vision Rehabilitation - a Follow-Up Survey.In “Low Vision Research and New Developments inRehabilitation”. Ed. by A.C.Kooijman, P.L. Looijestijn, J.A.Weeling and G.J. van der Wildt, IOS Press, Amsterdam1994, pp. 592-594.

9. Adamowicz-Hummel, A., Effectiveness of Training VisionRehabilitation Specialists -

10. Evaluation of Their Professional Competence andEffectiveness. A Follow-Up Study of the Graduates of TheProgram in Vision Rehabilitation in Poland. Unpublishedmanuscript based on Ph.D. dissertation, 1996.

11. Skalicka, M., e-mail communication, 2007.12. Backman, O., Master’s Degree Programme: Visual

Impairment. Interdisciplinary perspectives and professionalcooperation. Presentation at the International Conferenceon Low Vision, London 2005.


Professional Training,The University of

Costa Rica’sExperience

Martha GrossApartado 26-2070

San JoséCOSTA RICA

[email protected]

he support and education services for visuallyimpaired children require that the teachers haveprofessional training according to the students’educational needs.

In this context, professional training represents aneed in developing countries, where universitiesdo not offer sufficient training in the field of visualimpairment. On the other hand, governmentpolicies do not consider this as a priority or aprincipal aspect in their agenda, and theeconomic situation does not give opportunitiesto develop and continue appropriate training forspecialists and professionals. Therefore, schools,parents and teachers of the visually impairedchildren have to find out different ways toaccomplish their need for training and improvingthe way they teach.

The demand in professional training hasincreased with the adoption of inclusion whichhas changed the responsibilities and priorities ofthe programs, but support given to the teachersis still not gratifying. The support throughprofessional training has been identified to bean important factor in the way teachers andparents teach their children.

It has been demonstrated that there is a need forspecialists with special education training toprovide for the development of pedagogic proces-ses in the blind and low vision population.

Currently, professional training in the specialeducation field has experienced a change in theway it is approached in Costa Rica. TheUniversity’s curriculum in special education hasincorporated classes that prepare the students inseveral areas such as low vision, mobility, anduse of braille and abacus. In this way, it isexpected that this generation of special educationteachers will be ready to work with visuallyimpaired children regardless of the locationbecause the educational system holds to the

T


principle of Education for All and educationalinclusion. This approach allows the itinerantprograms to support a variety of students withspecial education needs, especially in remoteschools where this kind of help has provedsignificant educational support for the children,parents, and regular teachers.

Local schools have identified several problemsin the field of education that are very similar,which have provided a frame of reference thatguide and focus more on daily educationconcerns. Suitable recommendations to improvethe work of teachers are offered through trainingin specific areas. Wherein local teachers gainsignificant knowledge as they assist in training.

The support of government staff has beenimportant in this kind of training program,because it ensures new ways to approacheducational matters for the visually impairedchildren and it is useful for teachers to gaincertification that reinforces their work. Anothercomponent that is crucial to this kind of approachis that it must be continuous and regular toaccomplish the best results. When schools andgovernment institutions support the continuoustraining provided to staff working with visuallyimpaired children, it reinforces their capacity toachieve their goals with positive attention andmeaningful efforts.

Yet the question remains, how can support staffbe professionally trained? Since continuousprofessional training has resulted in enhancingskills of visually impaired children incommunication, interchange of information andexperience, no doubt, these results havereinforced the work and future goals of supportstaff too.

The University of Costa Rica has been adjustingthe curriculum in special education over thepast years to respond to the new paradigms,which include attention to the diversity and the

equality of opportunities for all. The professionaldevelopment includes subjects to give new anddifferent insights to their approach with visuallyimpaired students.

One of the priorities is that the new profession-als have mastery over the techniques that can beeasily approached in a regular school with theitinerant services. Wherever there is a school thathas these services, it is assured that our newspecial education teachers can approach thevisually impaired children, and respond to theirspecific needs.

Integration has been applied in our educationalsystem for twenty five years and even thoughthere is much to do, recent advances have givenmore opportunities to the visually impairedpopulation to continue their education inspecial schools.

Currently, support services estimate that 87% ofthe visually impaired students are literate (Censo2000) compared with the 95.2% literacy rate ofthe general population in Costa Rica.

In the last decade, visually impaired studentshave been breaking attitudinal barriers, andcreating and developing different ways to teachand learn. The University of Costa Rica has beentransforming the curriculum to suit to the neweducational paradigms: Inclusion, Education forAll, and Equality of Opportunities. With theseparadigms new concerns have emerged. Newgeneration of teachers (regular and special)would develop new ways to teach, and wouldalso discover wholesome models of educatingthe visually impaired.

The goal of inclusion is a reality for Costa Rica’sstudents, it has come to stay, to enrich the senseof living in a fair society, respecting the diversityand the differences that allows us to identify withourselves, and join others in the quest for theequality of opportunities.


These efforts have been used as a commitmentto the visually impaired population in need ofeducational support. The University of Costa Ricaaccepts these challenges, modifying theprofessional curriculum to meet the changingneeds in the field. It is crucial to support inclusionand the idea that academic achievement is areal and challenging goal. Even in a developing

country, the possibilities of having professionalcareer programs is an effort that requires workingtogether by supporting the individual needs ofeach component. This goal will be for each andeveryone of the visually impaired students whobelieve in their capacity to change and facilitatean effective inclusion in regular schools.


Eye Examination

The ItinerantTeacher’s Role in the

Educational Inclusionof Children with

Low Vision in LocalSchools in Africa

Dr. Paul LynchResearch Fellow

[email protected]&

Dr. Steve McCallSenior Lecturer

[email protected]

VICTAR, School of EducationUniversity of Birmingham, Edgbaston

Birmingham BI5 2TTUNITED KINGDOM

IntroductionThis article describes initial findings from aone-year research study investigating the role ofthe itinerant teacher in Uganda and Kenya whichis being undertaken by the Visual ImpairmentCentre for Teaching and Research (VICTAR),University of Birmingham and sponsored bySightsavers International. The aim of this studyis to produce evidence that will increase under-standing of the practices, needs and goals ofitinerant teachers (ITs) in Kenya and Uganda. Thesample groups were drawn from three districtsin Uganda (54 ITs) and five districts in Kenya(52 ITs). Data were collected in two phases; thefirst consisted of a questionnaire sent to all ITsrequesting details of their training, methods ofassessment of children’s vision, and difficultiesfaced in teaching children with visualimpairment. The second phase included a seriesof workshops in Uganda (2) and Kenya (1) thatintroduced a ‘tool’, in the form of a journal forITs to complete, to help monitor the impact ofinterventions carried out with children havingvisual impairment. The following discussiondraws on an analysis of a mixture of quantitativedata obtained from the questionnaires andqualitative data collected during semi-structuredinterviews with various professionals working inmainstream schools, including class teachers,head teachers and parents of children with visualimpairment.

Traditional solutions based around specialschools and resource centres can cater for only asmall number of children who are blind or havelow vision. Many countries are seeking asolution to the challenge of educating childrenwith visual impairment by promoting inclusiveeducation. Some East and Central Africancountries e.g. Uganda, Tanzania and Kenya, haverecently introduced free Universal PrimaryEducation (UPE) as part of their commitment toEducation for All (EFA). Class teachers in thesecountries are expected to provide the minimum


necessary facilities and resources to enable everychild to enter and remain in school until theprimary cycle of education is complete. As partof the drive to encourage all children to attendschool, the Kenyan and Ugandan governmentsare paying attention to the needs of childrenwith the greatest barriers to learning includingchildren with visual impairment.

The introduction of Universal Primary Educationfor all children of primary-school age hasdramatically increased the number of childrenattending school. Most recent enrolment figuresin Uganda show this increase to be from 2.5million in 1996 to 6.5 million in 1999 (UNESCO,2001), with teacher: pupil ratio standing at 1:110for lower primary (classes 1-3), and 1:55 formiddle and upper primary (P 4-7). Theseincreases in class sizes pose a huge burden onclass teachers in local schools and on their abilityto provide support for children with visualimpairment. To address the challenges ofsupporting children with visual impairment inlocal mainstream schools, some African countriesoperate a support system provided by itinerantteachers with some specialist training in the areaof visual impairment.

Defining the role of the itinerantteacherThe itinerant teacher is generally a qualified classteacher who has undertaken some formal trainingin the education of children with visualimpairment either through a residential courseor distance education programme (e.g. a Diplomain Special Needs Education). Their work involvesproviding educational support for children withvisual impairment who have been placed in theirlocal primary school, as well as identifying child-ren and referring them to eye clinics for furtherassessment. They also play a role in providingearly intervention at home through teaching dailyliving activities (e.g. toileting, washing) andpreparing children for school. Another aspect of

their work is sensitising communities about theimportance of sending children with visualimpairment to school as a requirement ofUniversal Primary Education (UPE) in Kenya andUganda.

The IT normally works under the direction of thefull-time District Co-ordinator and is usuallygiven responsibility for a cluster of mainstreamschools and homes covering between 8-12 schools,but sometimes up to 30 schools, depending ontheir geographical or administrative spread withinthe area. ITs are usually released from theirnormal class teaching duties for up to two days aweek to carry out their itinerant duties.

There is currently a lack of formal job descriptionsfor ITs in both Uganda and Kenya. There ismounting pressure from ITs and theirCo-ordinators for a clearer definition of their roles.The common duties that ITs perform in bothcountries are:• Sensitisation

• Assessment, referral and intervention forchildren with low vision

• Teacher training

• Caseload management

• Record keeping

• Collaborating with eye care services

These duties will be briefly described here:

SensitisationThe sensitisation involves visiting localcommunities, seeking to change attitudes towardsdisability and informing them of the possibilitiesfor children with visual impairment to attendlocal schools. They will try to encourage thecommunity to identify and bring forwardchildren with visual impairment for assessmentand support.

Part of this process also includes collaboratingwith local primary schools and raising awareness


of the signs of visual impairment so teachers canidentify children with visual impairment alreadyin their schools. When children who are not atschool are identified the IT will help prepare theschool staff to accept them.

Assessment, referral and interventionfor children with low visionItinerant teachers are often the first specialists tocome into contact with low vision children.During their visits to schools they will follow upchildren that teachers have identified as havingproblems with their vision, which will ofteninclude obvious conditions such as eye infections,that result in itchy or red eyes. After conductinga preliminary assessment, the IT will then referthe child to an ophthalmic clinical officer (OCO)for a clinical assessment.

In the case of preschool children, ITs may carryout a preliminary functional visual assessmentin the home, e.g. finger counting, and distinguish-ing and matching everyday objects at variousdistances. ITs are often an important linkbetween families and clinicians (ophthalmicclinical officers or ophthalmologists) and canprovide health professionals with usefulbackground information about the child’scircumstances and functional vision that willsupplement information gained in the clinicalassessment. ITs also help follow up of childrenwho have been prescribed glasses or other lowvision aids (LVAs) e.g. hand held magnifiers, andprovide parents with information on where tobuy the glasses and aids that have beenprescribed by the health services. In cases whereparents are unable to afford glasses or LVAs theIT may seek funding to assist with the purchase.ITs can also train children on how to use andcare LVAs both at home and in the classroom.However earlier research carried out by the ICEVIin Uganda (2005) suggests that LVAs are in shortsupply and only few children have access to themin school.

Due to the scarcity of ophthalmologists and eyecare specialists, many children with low visionhave to wait for a long time for treatment evenafter their condition has been identified. In thecase of children with cataracts for example, somemay wait for months before surgery can beorganised at one of the few suitably equippedeye clinics in the country. Even after the opera-tion, they can wait up to 3-4 months for pre-scribed spectacles and LVAs to arrive. When theLVAs do arrive, lack of training on how to usethem in the classroom and at home can lead totheir incorrect use and abandonment. All ITstherefore require training on how to use lowvision devices and have a key responsibility inensuring children know how to use themeffectively.

Teacher trainingThere is a wide variation between ITs in theirability to carry out preliminary assessment ofvision in both Kenya and Uganda, and not all ITsfeel sufficiently confident to carry out theseassessments. Although all ITs receive sometraining on measuring visual acuity usingE charts, the training is often theoretical and notall teachers have access to these instruments inthe field. Findings from a recent workshop inUganda (May 2007) indicated that many ITs lackthe required knowledge and practical experienceto conduct screening and functional assessmentthemselves, or to interpret acuity measurementstaken by other professionals.

The level of training available to ITs varies greatlyand there is a lack of agreement among educationand health services about the ITs role in visualassessment. Current training seems to provideteachers with an understanding of theoreticalinformation such as the structure and functionsof the eye, but does not provide teachers withsufficient practical skills and understanding toassess the vision of children in the field. Forexample none of the teachers in one district of


Uganda appear to have received training in theprinciples of administering a ‘pinhole’ test – asimple method to identify children with refractiveerrors.

A total sample of 106 ITs (54 in Ugandarepresenting three districts and 52 in Kenyarepresenting five districts) were asked to statewhat materials/equipment they used to test achild’s vision. The following methods werementioned:

Uganda Kenya

E-Chart 48 47

Counting Fingers 14 28

Writing letters on chalkboard 12 31

Pinhole 0 20

Caseload managementManaging workload is a key skill that needsfurther investigation. ITs often have bothchildren who have low vision and children whoare blind on their caseload or ‘programme’. Lackof understanding in relation to assessment meansthat some teachers are found to be regularlyvisiting children who have only refractive errorsand whose vision would be corrected to normalif they had glasses. This deprives blind childrenand those with severe visual impairment of muchneeded support.

Record keepingAn important part of the role of the ITs ismonitoring the progress of children on theircaseload. There appears to be huge variation inthe quality and quantity of the records kept byITs. The evidence to date suggests that ITs donot have a systematic approach to monitoringtheir own interventions or a reliable method ofrecording children’s needs or monitoring theirprogress over a period of time. The collectionof data needs to be incorporated into the role ofthe IT both to help them improve their own

performance and to allow their managers todeploy them effectively.

Collaborating with eye care servicesEmerging evidence from this research suggeststhat ITs face many challenges in their work butthey offer a range of skills that can complementthe skills of other professionals in eye care toensure that children with low vision enjoy thebenefits of participation in education and training.Greater emphasis should be placed onencouraging health professionals (both eye careand paediatricians) to work closer with ITs inthe districts and sub-counties. ITs can play anessential part in ensuring children with lowvision receive the essential care and skill trainingthey need provided they are given adequatesupport from their school and other profession-als. Health workers should be able to draw onthe ITs’ skills and knowledge of the community,family and children when making key decisionsabout intervention programmes or prescribingLVAs or other equipment.

ConclusionThe education of children with low vision in localschools can only be successful when the medi-cal, education and rehabilitation sectors worktogether. ITs can play a vital role in identifyingchildren and carrying out initial assessmentsbefore referring them to the eye care services.This would ensure that children with low visionwould receive timely and quick medicaltreatment, proper check-ups and appropriateglasses and/ or LVAs, thus enabling them to fullyparticipate in an inclusive class setting andaccess all curriculum materials, and to maximisetheir progress.

References• ICEVI (2005) An Investigation into the educational

inclusion of children with a visual impairment in Uganda.

• UNESCO (2001) Education for All, the Year 2000Assessment, Report of Uganda.


Efficacy of OpticalDevices in Increasingthe Reading Speed of

Students withLow Vision

Dr. G. Victoria NaomiLecturer in Special Education

Avinashilingam University for WomenCoimbatore - 641 043, INDIA

[email protected]

&

Dr. S.K. TyagiProfessor in Education

Devi Ahilya Vishwa VidyalayaIndore - 452 001

INDIA

INTRODUCTIONStudents with low vision represent the largestsub-group of students with visual impairmentand their intensive instructional needs have notbeen clearly understood. The ability of the lowvision children to read print is crucial to integratethem into the mainstream education.

A problem that faces many teachers of visuallyimpaired students is determining and facilitatingthe appropriate use of low vision devices. Thisstudy conducted in an Integrated EducationService set up in Tamil Nadu, India was an effortto determine the efficacy of optical devices inincreasing the reading speed of low visionstudents. Sophisticated equipment and devicesfor reading are not available in India and hencethe indigenous low cost optical devices were usedand their efficacy was determined.

OBJECTIVESThe objectives of the study were:

1. To compare mean reading speed and meancritical print size before and after introductionof optical device(s).

2. To study the effect of visual acuity onreading speed and critical print size

3. To study the effect of varying magnificationon reading speed and critical print size forstudents with low vision

METHODSThe subjects comprised of 190 boys and girls inGrades 6 to 9. The subjects were classified onthe basis of their vision loss namely blurredvision (BV) (n=76), central vision loss (CV)(n=63) and peripheral vision loss (PV) (n=51).The ability to read either normal print or largeprint was the only criterion for the selection ofthe sample.

Articles RESEARCH


A preliminary evaluation was done to classifythe subjects on the basis of their vision loss. Thisevaluation included: i) visual acuity to assessdistance vision and to identify the viewingposition using the Tumbling E chart. ii) The fieldof vision was assessed using the Confrontationmethod. This test involves the student lookstraight ahead and signal by raising his handwhen he first sees the assessor’s finger or hand.iii) Amsler Grid test to map the central scotomato know the subject’s central vision loss.

Being an experimental study, it was designed onthe lines of pre-test and post-test single groupdesign. The treatment for all subjects wastraining in the use of optical devices for reading.

Reading speed and critical print size of thesubjects were assessed with the help of the tooldeveloped by the investigators.

A passage from age appropriate text in theregional Tamil Language was borrowed andedited with the help of a linguistic expert. Thetext had three hundred words. Each sentence hadthree lines with an average of ten words persentence. The passage was in twelve point printsize which is in the text books prescribed by theState of Tamil Nadu.

Experiment I: Assessment of Reading SpeedThe subjects were asked to read each sentencealoud, as quickly and accurately as possible tomeasure reading speed. The pre-test wasadministered to subjects who could read at least12 point print size, hence the pre-test wasadministered only to 145 subjects. Then thetreatment (training) in the use of optical deviceswas assigned to all (190) subjects. Optical devicesincluded hand held, stand and spectaclemagnifiers. The duration required for trainingeach subject ranged from 20 minutes to 60minutes. The subjects were instructed to practisefor at least 20 minutes every day for two months.

The post-test was administered to all 190 subjectsusing the same tool.

Experiment II: Assessment of Critical Print SizeCritical print size of each subject was assessedin print sizes ranging from 8 point to 20 point.No reading distance or time was prescribed.

Experiment IIIThe subjects were prescribed optical deviceswith their required magnification which included2x, 2.5x, 3x, 3.5x, 4x, 5x, 6x and 7x and thehand held, stand and spectacle magnifiers. Thedifferent powers of magnifiers were groupedinto four as (i) 2x & 2.5x, (ii) 3x & 3.5x, (iii) 4x &5x and (iv) 6x & 7x. The effect of magnificationwas identified by calculating the mean readingspeed and mean critical print size with the useof different powers of magnifiers.

RESULTS

Experiment IOptical devices enhanced the reading speed ofstudents with blurred vision, central vision lossand peripheral vision loss (Figure 1).

Fig. 1. The mean reading speed of the subjects beforeand after introduction of optical devices. The score inthe post-test was significantly higher than the pre-testscore in the three types of vision loss.


Experiment IIIntroduction of optical devices was found to besignificantly beneficial to subjects with the threetypes of vision loss to read smaller print size incomparison with the print size before training.There was a significant impact of optical deviceson critical print size of low vision students (Figure2).

Fig. 2. The critical print size of subjects before and afteruse of optical devices. There was a significant reductionin critical print size after the use of optical devices.

Experiment IIIThe reading speed of students using lower powermagnification was greater than the reading speedof students using higher power magnification.The effect of varying magnification was analy-sed with one way ANOVA (Analysis of Variance)followed by t-test.

The mean reading speed of subjects using2x &2.5x was higher than that of subjects usinghigher power magnifiers (Figure 3).

Figure 3. The effect of magnification power on meanreading speed.

CONCLUSIONThe results of the study indicate that low visionstudents on the whole benefited with the use ofoptical devices in increasing their reading speed.The findings indicated that the type of vision lossand visual acuity are poor predictors of thereading speed. A range of pathologies, eyemovements, the shrinking of visual span, typeof vision loss and use of monocular or binocularvision interact on the reading of persons withlow vision. This study has demonstrated that lowvision persons can benefit from use of opticaldevices for reading.

References:1. Bevan, J., Lovie-Kitchin, J., Hein, B., Ting, E., Brand,

P., Scott, M. & Fotkou, P., “The Effect of RelativeSize Magnification Versus Relative DistanceMagnification on the Reading Performance of Child-ren with Low Vision”. Envision : A Publication forParents of Children with Impaired Vision,Lighthouse International, New York, USA, 2000.

2. Corn, A., Wall, R. & Bell. J., “Impact of OpticalDevices on Reading Rates and Expectations forVisual Functioning of School Age Children andYouth with Low Vision”. Visual ImpairmentResearch, Vol. 2, (33-41), 2000.

3. Dandona, R., Dandona, L., Srinivas, R., Giridhar,M., Nutheti, P. & Rao, G.N., “Perception of Qualityof Vision Among Those with Clinically Defined LowVision in a Population-based Study in India”.Ophthalmology, Vol. 109(10), (1871-1878), 2002 .

4. Keeffe, J., “Vision Assessment and Prescription ofLow Vision Devices”. Community Eye HealthJournal, Vol. 17(49), (3-4), 2003.

5. Keeffe, J.E., “Assessment of Low Vision inDeveloping Countries, Book 1 Screening forImpaired Vision”. The University of Melbourne,1994.

6. Legge, G.E., Ross, J.A., Maxwell, K.T. & Luebker,A., “Psychophysics of Reading VII. Comprehensivein Normal and Low Vision”. Clinical Vision Science,Vol 4, (51-60), 1989.


Content of aVision-related Qualityof Life Questionnaire:

the IVI_C

Gillian CochranePhD Student

Centre for Eye Research AustraliaThe University of Melbourne

MelbourneAUSTRALIA

[email protected]

t the Centre for Eye Research we havedeveloped the Impact of Vision Impairment forChildren (IVI_C), a quality of life questionnaireto assist in determining individual support needsof vision impaired children. It does not requirehighly trained personnel to undertake them orinterpret the results.

The IVI_C was developed from 15 focus groups(n=102 participants). The 4 focus groupsincluded children with low vision aged11-18 years: and one in-depth interview with auniversity student. The other focus groups werefor parents of children with vision impairment(4 groups), class teachers who had worked witha student with vision impairment in theirclassrooms but had no formal training to assiststudents with vision impairment (3 groups), andspecialist instructors including visiting teachersfor the vision impaired, orientation and mobilityinstructors and occupational therapists (4 groupsplus 3 in-depth individual interviews withspecialist educators for children with visionimpairment).

The overall theme for the discussions was,“What has been the greatest impact of lowvision on every day life in the home, in school,within the community and socially”. Questionswere asked within the topic areas that werebrought up for discussion in each of the focusgroups; these being “home”, “travel & transport”,“sports and work”, “social”, and “emotional”.Sixteen themes emerged, which were Teacherknowledge, Access (teacher-facilitated), Specia-list support, Orientation & Mobility, Fitting-in,Social skills, Peer acceptance, Self-confidence,Personality, Communication skills, Communityunderstanding, Family well-being, Parental input,Mainstream/Special, Varied experiences, VI peersupport/integration, and VI role model. Thethemes reflected five domains: School/Specialist


A

Instruction, Social Interaction, Community,Family, and Vision impairment peer interaction.Interestingly, the focus of concern for each focusgroup type differed: the students’ perspectiveconcentrated more toward social/communicationand orientation & mobility skills, the parents’concentrated instead on the importance of familyand support for the family, the class teachers’were equally concerned with the students’academic and social development whereas theexperts targeted academic skills and specialistinput. However, for each focus group it was thedevelopment of good social skills that wereconsidered absolutely crucial for the children’sfuture success in life. Having information frommore than one perspective provided a broad rangeof issues from which content could be derived.The relevance of each perspective was conside-red to be equally important when items werebeing identified as content for the questionnaire.

From the information gathered, 30 questions(items) were initially tested for wording andlayout. To validate the 28-item questionnaire, itwas administered to students aged 8 to 18 yearsand following further analyses, the number ofquestions was reduced to 25. The average time

to administer the IVI_C, whether via telephoneor in a face-to-face interview, was 7 minutes. TheIVI_C has proven to be reliable betweeninterviewers as well as between mode ofadministering the questionnaire (telephone andface-to-face).

Further analysis revealed three domains (the-mes); school and social inclusion, mobility andindependence and lastly, community acceptance.The sub-structure represented by the domainspresents the possibility for assessment ofparticipation in particular areas of everyday life.

In real terms, these results translate to verypractical uses. Mean scores for each domain cangive an indication of individual support needsand highlight areas of concern. The IVI_C can beused to evaluate the outcomes of interventions.

Although the tool kit and questionnaire have beendeveloped in a resource rich country, certainaspects will be universal although other aspectswill be socially and cultural specific. To addressthese issues, further research is being done toassess how applicable the IVI_C will be for usein under-resourced countries.


SCHOOL DIRECTOR: OVERBROOK SCHOOL FOR THE BLIND, PHILADELPHIA, PAOverbrook School for the Blind seeks a dynamic, focused and accomplished educator to assume the position

of Director as soon as possible, no later than July 2008. The successful candidate will be an inspiring leader and

communicator, have significant hands-on school administrative experience in special education focused on

blind and visually impaired students, an accomplished background in school management, budgeting, school

leadership and be enthusiastically aligned with Overbrook’s philosophy, mission and values. The ideal candidate

must be passionately committed to children, possess strong organizational, operational and interpersonal

skills, have a strong commitment to diversity, possess excellent public relations skills, be a flexible and creative

problem-solver, be able to communicate effectively in writing and orally, and demonstrate an ability to focus

on attainable goals for all students.

This is an extraordinary opportunity for an exemplary educator and school leader. A highly competitive

compensation and benefits package (commensurate with qualifications and experience), and relocation assistance

will be provided to the successful candidate. Potential candidates are invited to the school website

www.obs.org . A full position description is available from the consultant listed below.

Qualified candidates interested in this opportunity are invited to submit a cover letter and resume to:

BARRY ROWLAND

Senior Search Consultant, Carney Sandoe and Associates, Boston, MA

Examples of work in the deafblind field or within DbI

• Examples of contributions when thinking about a possible nominee for the Distinguished Services Award: 1) overall professional

experiences; 2) innovative practices; 3) unique or extraordinary contributions to DbI; 4) professional publications, researchand/or staff training activities; 5) leadership on the international level which has promoted or improved services to deafblindindividuals and their families.

DbI Lifetime Achievement Award Eligibility RequirementsThe Lifetime Achievement Award will be made to an individual/individuals who has/have made a distinguished contribution toservices for deafblind people on a national and international level.

• This award is recommended to be given towards the end of one’s working life.

• Distinguished contributions could be in the area of: publications, research, development of new techniques or procedures,

practical application of teaching techniques, training staff and parents, advocacy; and dynamic leadership.

Instructions for Nomination for the DbI Distinguished Service Award and the Lifetime Achievement

Award1. Complete the nominations form.

2. Attach a 500 to 1000-word essay, which describes the nominee’s contribution to deafblind individuals.

3. Attach at least three (3) letters, which support the nomination. These letters can be from colleagues, parents, deafblindindividuals, employers or others who can comment on the nominee. The letters should present information that conveys anaccurate picture of the nominee’s achievements and contribution to the field of deafblindness.

DbI Distinguished Service AwardNominee Eligibility Requirements

This award recognizes a DbI member who has significantly contributedto the deafblind field or DbI, internationally.

DbI Distinguished Service and Lifetime Achievement Awards

NOMINATION FORM

Please type the following information so that it can be easily read or scanned. Forms or letters not presented in this manner will bereturned.

I would like to nominate: (Please complete a separate nomination form for each award/nominee)

Name of nominee :

Address :

Telephone Number : E-mail :

Is this individual a current or past member of DbI? Yes No

For the following award: (Please check one)

Distinguished Service Award Lifetime Achievement Award

Name of nominator:

Address:

Telephone Number: E-mail :


INTERNATIONAL INSTITUTE FOR SOCIALENTREPRENEURS (IISE) IN KERALA, INDIA

IISE - Construction underway

The participants of the 12th World Conference of ICEVI held in Kuala Lumpur,

Malaysia in July 2006 still remember the thunderous and thought provoking

presentation made by Sabriye Tenberken and Paul Kronenberg on empowering

persons with visual impairment. In continuation of the establishment of a successful

Rehabilitation and Training Centre for the Blind in the Tibet Autonomous Region

(TAR) from 1999 to 2005, Braille without Borders is developing an International

Institute for Social Entrepreneurs (IISE) in Trivandrum, Kerala, India. It offers a

one year training course to persons with visual impairment from all over the

world to make them leaders in the developmental field. The curriculum of the

training includes personality development, communication skills, institution-

building and management, application of technology, entrepreneur skills, fostering

disability movements, etc. The training is fully residential in nature and the

training activities will commence from June 2008. Visually impaired adults falling

in the age group 20 to 50 who are wishing to become leaders may apply for this

intensive course. The Centre is also proposing to organize management training

for administrators of institutions for visually impaired persons and capacity

building training activities to improve the competencies of teachers. More details

of this training may be obtained from www.braillewithoutborders.org


“Listening to the Children”INTERNATIONAL CONGRESS FOR BLIND

AND PARTIALLY SIGHTED CHILDREN

The World Blind Union (WBU)Children’s Committee and the SpanishNational Organisation of the Blind(ONCE), in partnership with UNICEF,ICEVI and Save the Children, will hostthe 1st International Congress forBlind and Partially Sighted Childrenfrom March 25th–29th 2008 at theONCE Educational Resource Centre“Santiago Apóstol” in Pontevedra,Spain.

The aim of the congress is to providea forum and meeting place for blindand partially sighted teenagers fromall over the world to reflect, in a groupsetting, on their current status andput forward their demands and needsto decision and policy makers in thefield of care and attention for visuallyimpaired children and those responsiblefor representing their interests.

Twenty-four boys and girls, betweenthe ages of 14 and 16 and representingall six regions of the world, will takepart in the congress.

The thematic programme will bedeveloped in morning plenarysessions, focussing on one of the threekey themes each day and drawing upconclusions and recommendations tobe adopted in an assembly, workshopsin which the children will take part inrecreational activities in theatre,music and sport, and leisure and freetime activities, including trips to

recreational areas and culturalexcursions around Pontevedra.

The congress is open to teenagers whoare actively involved in regional,national or international children’sinitiatives and have an interest,personal experience or knowledge inthe key issues to be addressed in thecongress (the family, education andrelating with peers). They should alsobe in a position to speak on behalf ofa wide cross-section of children fromtheir home country. The selectionprocess will take into accountgeographic and gender balance as wellas the degree of visual impairment.

Teenagers who wish to take part mustalso:1. Obtain written authorization from

their parents or guardians.2. Be able to travel alone (no need

for accompanying person).3. Have sufficient autonomy for

personal care and basic orientation.4. Have a working knowledge of either

English or Spanish.5. Be in good health and not require

medical care (a medical report willbe requested).

Participants will be chosen through acompetition open to blind andpartially sighted children from all over

the world. Participants will be askedto submit an essay on one of thefollowing themes:• Your life as a visually impaired

teenager (in a creative form,perhaps a poem, a letter or anewspaper article);

• Your experience with children’srights in your community, countryor region;

• One of the three areas to beaddressed during the congress (thefamily, education and relating topeers).

Entries (up to 1500 words) may besubmitted in English or Spanish andin print, braille (grade 1), electronicformat, mp3 or any other suitableformat by post, fax or E-mail untilDecember 31st 2007. Entries shouldbe sent to:

Enrique PérezWBU Secretary General

C/o ONCEC/ Almansa 66, 28039 Madrid

SPAINTel: + 34 91 589 45 33Fax: + 34 91 589 47 49E-mail: [email protected]

Two teenagers will sit on theCongress Technical Committee andparticipate in organizing the congressand selecting participants.

The World Blind Union Children’sCommittee asks everyone to circulateand disseminate this information aswidely as possible and encourages allvisually impaired boys and girlsinterested in attending to enter thecompetition.

For more information contact the WBUSecretary General.

Ana Peláez NarváezCongress Organizer


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