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Visual Impairments

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Silvana Melo

on 20 June 2013

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Transcript of Visual Impairments

Visual Impairments
Denise Washington
Tim Anderson
Silvana Melo

Etiology of Visual Impairment
Visual Impairment: When parts of the eye, or elements of the brain that process images, is diseased or damaged enough to result in the impairment of sight.
Visual Impairments
When parts of the eye, or elements of the brain that process images, is diseased or damaged enough to result in the impairment of sight.
Visual Impairment
Visual impairment can develop for a variety of reasons including genetic factors, complications during birth, drug/alcohol use of parents, and physical injury.

Common sources of world wide visual impairments such as Cataracts, Diabetic Retnopathy, and Tachoma, are not often seen in first world countries due to early detection, proper nutrition, and access to medical technologies.

For the purposes of this class it should be noted that the youth of children also make other causes of vision impairment, such as Cataracts, rare.

Causes of Visual Impairments
Leading Causes
The five leading causes of visual impairment in the United States in children:

1. Cortical Visual Impairment
2. Optic Nerve Hypoplasia
3. Retinopathy of Prematurity,
4. Albinism
5. Optic Nerve Atrophy

Childhood Glaucoma, while rare, will also be explored.
Presently, Cortical Visual Impairment (CVI) is the most common cause of permanent visual impairment in children (1-3). The diagnosis of CVI is indicated for children showing abnormal visual responses that cannot be attributed to the eyes themselves therefore brain dysfunction must explain the abnormal visual responses.

-With the assistance of trained teachers and medical professionals vision can improve throughout the early years. Multiple conditions, such as mental retardation, can severely impact the success of these early efforts but CVI does not indicate that a student will have multiple diagnosis.
Retinopathy of Prematurity
(ROP) is an eye disorder that results from complications due to premature birth. Light overexposure, infection, and high levels of oxygen are examples of such complications. These complications negatively impact the development of blood vessels in the retina.

Trained teachers can help individuals work with visual limitations brought on by ROP. Surgery is an option however, it is not a cure all and is not applicable to every case.

Optic Nerve Hypoplasia
Optic Nerve Hypoplasia (ONH) refers to the underdevelopment of the optic nerve during pregnancy. ONH is not progressive, is not inherited, and cannot be cured. ONH is one of the three most common causes of visual impairment in children.

Albinism refers to a group of inherited conditions. People with albinism have absent or reduced pigment in their eyes, skin or hair. They have inherited genes that do not make the usual amounts of a pigment called melanin which is essential for the full development of the retina.
Ranges from low severity (near/far sighted) to blindness

Common sources of world wide visual impairments such as Cataracts, Diabetic Retnopathy, and Tachoma, are not often seen in first world countries due to early detection, proper nutrition, and access to medical technologies.

For the purposes of this class it should be noted that the youth of children also make other causes of vision impairment, such as Cataracts, rare.
World Wide Causes
Evaluation Process
Vision personnel provide specialized assessments:
Provides assessments that help determine strategies and modalities for learning and communication and appropriate media for literacy and access to the general education curriculum.

Licensed Teacher of Students with Visual Impairments
Eye Care Professional
Determines the degree and type of vision loss, and evaluates to determine the need for optical aids and low vision devices
Conducts an orientation and mobility evaluation in the areas of: body image, motor coordination skills, visual and listening abilities, understanding of environmental concepts, analysis of traffic controls, street crossing skills, use of public transportation, use of low vision devices, and potential for mobility device or long cane
Certified Orientation and Mobility Specialist (COMS)
Evaluate and implement assistive technology needs for students with visual impairments.
Assistive Technology Personnel
Assesments Include:
Information from the eye doctor
Parent/Guardian Interview
Classroom Teacher/Related Service Provider/Staff Interview
Student Interview
Functional Vision Assessment
Learning Media Assessment
Assistive Technology Assessment
Orientation & Mobility Assessment
Curriculum Implications & Adaptations
All kids with visual impairments are different and even skills within each child with visual impairments may vary
Don't judge a book by its cover: not all children with visual disabilities have the same level of significant cognitive impairment.
Successful intervention for children with visual impairments isn't just facilitating opportunities for sight, but also providing meaningful contexts for associative learning.
Adapting materials and the environment is not a one size fits all solution for kids with visual disabilities it depends on their diagnosis, needs and abilities.
Children with visual impairment often require adaptations to access the regular educational curriculum.
For the student with low vision, these may include increased contrast and color highlighting, lighting adaptations, varied time requirements, use of optical devices, and auditory materials.
A student who is blind may use Braille, tactile adaptations such as raised maps, speech access, use of real objects and materials, and auditory descriptions.
Mobility Instruction
Students with visual impairments may also benefit from specialized instruction in skills that are not part of the standard curriculum.

Students with visual impairments may also benefit from specialized instruction in skills that are not part of the standard curriculum. Orientation and mobility instruction is vital to teach students to use all senses to identify their position in space and to move to a destination. For many students, efficient travel will include instruction in the use of a long cane to provide information on the immediate environment. Professional orientation and mobility specialists should teach skills in orientation and mobility.
Other curricular areas important for students who are visually impaired include instruction in daily living skills, career development, communication including literacy, use of assistive technology, use of functional vision, and social skills. Teachers with certification in visual impairment can work with the classroom team to plan for instruction in these areas.
Early Childhood Teacher preparation for students with visual impairments entering school:

•Obtain information regarding the child’s functional vision before making adaptations to the classroom.
•Whenever possible visit child at home prior to the start of the program.
•Invite the child to visit the program for the first time when no other children are present. Give a multi-sensory tour of the room and play yard. Talk about the daily routines.

Optic Nerve Atrophy
Optic Nerve Atrophy (ONA) is a permanent visual impairment caused by damage to the optic nerve. Genetics and disease play a major role in the development of ONA therefore the severity ranges from almost normal sight to total blindness. Once present ONA is largely untreatable.
Childhood glaucoma is usually diagnosed within the first year of life. This is a rare condition that may be inherited, caused by incorrect development of the eye’s drainage system before birth. Surgery can correct structural defects in uncomplicated cases. Both medication and surgery are required in some cases.

As noted not all of these conditions can be cured, however, with training individuals lead independent and full lives.

New technology, such as GPS and speech recognition software, and proven aids, such as service dogs and eyeglasses, are some of the tools that make this possible.

The American Foundation for the Blind estimates that 10 million people in the United States are visually impaired

490,420 children with vision difficulty (The term “vision difficulty” refers only to children who have serious difficulty seeing even when wearing glasses and those who are blind.)

42,000 children with a severe vision impairment (unable to see words and letters in ordinary newsprint)

59,341 children who are legally blind
Communication Strategies
•When you great or talk to a child, identify yourself by name: “Hello, Olivia. It’s Ms. Washington. How are you? Gently touch the child’s shoulder or arm to further indicate you are speaking to her. Encourage all staff and children to do so.

•Warn the child before you do something to her. It’s Ms. Washington I need to guide you over to the water table. This way the student can anticipate and prepare for what is about to happen.

•Verbally identify new sounds for the child. Do you hear that sounds? What is it? That was a pencil sharpener sharpening a pencil.

•During an activity or game, motivate the child by animatedly reporting what is happening and who is involved.

General Adaptations
•Pay attention to light sources in the classroom and play yard.
•Depending on diagnosis, the child may need a dark visor or sunglasses to reduce glare.
•Slow down the pace of songs to allow the child adequate time to do gestures and hand motions. (Provide guidance)
•Send words to songs, as well as a tape of songs, home so family can learn and sing them at home. For children who speak a different languages at home, tapes in both languages are appropriate.
•Young children who are blind sometimes display mannerisms like rocking back and forth, eye pressing and poking. Keep them physically active and engaged in hands- on activities to reduce this type of behavior.
•Keep circle time short so the child stays engaged with the activity. Give her tactile object related to activity to help her feel included.

General Adaptations :
•Tape circle time for the child. Send the tape home for the child to share with the family.
•Describe any visual aids or pictures used in the classroom or provide a tactile substitute (i.e. offer a miniature version/ this is a toy horse.)
•Encourage independence at whatever the level the children can do something for themselves.
•Children with visual impairments depend on their families to act as environmental mediators for their world. Family involvement in the classroom is important. Have clear defined roles for them in the classroom, and provide a space for them to keep their things or wait while their child participates.
•It takes more staff time to facilitate a visually impaired child’s participation in activities and promote meaningful social interaction between the child who is blind and typical developing children in the program. More staff in the classroom is needed.

General Adaptations

An interview with Ms. Bress- The Vision Resource and Braille Teacher

Curriculum: Reading Street ( Reading), Terc ( Math) and Tactile Treasures/ Math and Language Concepts for Young Children with Visual Impairments

Assistive Technology: Braille writer, CC-TV, Talking Word Processing Program, IntelleTalk, and Duxbury

Materials: foam paper, felt book with manipulatives

Family Resources
The Carol Center for the Blind:
The National Federation for the Blind:
Blind Children's Resource Center: http://www.blindchildren.org/
Braille Curriculum
Braille FUNdamentals
Perkins School:
http://www.perkins.org/resources/scout/early- childhood/

Orientation and Mobility
•A simple uncluttered, well-defined classroom layout works best.
•Use floor surface as cues to which activity happens in what area-carpet means the dress up area, vinyl the kitchen.
•Create clearly defined pathways to each area or centers.
•Furniture placement in the room should stay constant so the child can develop an accurate internal map of the room.
•Make sure the location of the playground equipment is kept the same, and the swing zone is clearly marked (texture or leveled change or sharp contrast in surface.)
•The child should start the day with he same person greeting her each morning. This creates a sense of security and allows the child to understand the rhythm and rituals of the day.
•Set up a permanent place where the child can keep and always find her things- a hook of cubby for belongings.

“ In the classroom environment, the help of a consultant trained to work with children who have visual impairments is essential. The resource person can assist teachers in arranging classroom and curriculum activities to ensure effective learning experiences.” ( Allen & Cowdery, 2012)
Teaching students with Visual Impairments at the Early- Learning Center West Zone:
Common Signs a Child May Have a Visual Impairment
Common signs that a child may have a visual impairment include the following:

Eyes that don’t move together when following an object or a face
Crossed eyes, eyes that turn out or in, eyes that flutter from side to side or up and down, or eyes that do not seem to focus
Eyes that bulge, dance, or bounce in rapid rhythmic movements
Pupils that are unequal in size or that appear white instead of black
Repeated shutting or covering of one eye
Unusual degree of clumsiness, such as frequent bumping into things or knocking things over
Frequent squinting, blinking, eye-rubbing, or face crunching, especially when there’s no bright light present
Sitting too close to the TV or holding toys and books too close to the face
Avoiding tasks and activities that require good vision
Vision Screening
Some vision screening may occur at birth, especially if the baby is born prematurely or there is a family history of vision problems
Baby wellness visits as early as six months should also include basic vision screening to ensure that a baby's eyes are developing and functioning as might be expected.

Vision Assessment
-Visual Reflexes: involuntary responses to stimuli. This provides information about the pupil's response to light and the visual pathway and how the optic nerve is working.

-Ocular motility: the muscles of the eye and their effect on eye movements. Provides information about what the child responds to visually, how well she can locate and follow objects in the environment, and whether both eyes are working together.

-Visual motor ability: the coordination of sight with other parts of the body. (Ex: Visually Directed Reaching)

-Object/Pattern Recognition: the ability to discriminate details, color and shape of an object or pattern. These tests also give information about how well the child can see objects against different backgrounds.

-Field of Vision: the entire area that can be seen without shifting the head or the eyes, including central and peripheral fields.
The Environment
Lighting and Illumination:
-Type of light, the intensity and position of the light and glare
-Some children require strong bright lights and can see better when the light is positioned at specific angles.
-Others may be sensitive to light and perform better when light is diffused

-The color difference between an object and its background.

Position of the child:
-Particularly if a child has multiple impairments, an evaluator will assess the most comfortable position for the child's best use of vision

Position of Materials:
-The visual diagnosis provides clues to an evaluator about how toys and materials can be shown or given to the child for maximum visual response.
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