Technological Impact - Meeting the Educational Needs of a Low Vision Child
Focus: School Years
Topic: Low Vision
Scientist - Grade I
Vision Rehabilitation Centers
L.V.Prasad Eye Institute
Hyderabad 500 034
Definition - Low vision:
A person with low vision is one who has impairment of visual function even after treatment and/or refractive correction, and has a visual acuity in the better eye of <6/18 to light perception, or a visual field of <100 from the point to fixation, but who uses or is potentially able to use vision for the planning or execution of a task (WHO, 1996).
Low vision is a major problem, especially among the children of school going age group. Assistive devices helps the children with low vision children to develop the use of residual vision optimally so as to attain their goal of vision independence and regain the ability to read even small print. Low vision rehabilitation in children is rewarding for the practitioner, the child, and the family. It is a team effort that requires patience, understanding and good communication.
Steps involved in the management of low vision children
To plan appropriately for low vision therapy, it is important to know the cause of the visual impairment. Families should be advised when a hereditary disease is suspected. When indicated siblings with potential visual loss should be examined as early as possible. Medical and surgical treatment should be undertaken when indicated. Every effort to maximize vision should be considered
Functional vision is usable residual vision, which enables to carry out the daily routines successfully. The goal in low vision rehabilitation is to maximize the remaining vision and to make it as functional as possible. Informal assessment of child's visual performance in various situations such as play ground, classroom, home, crowded areas helps to identify the functional use of residual vision for indoor and outdoor activities.
As children grow older, the needs and goals changes hence the assessment must be modified according to the developmental age of the child. Goals and objectives should be realistic and attainable. It is important to make contact with children's classroom and special education teachers and to maintain open communication with everyone involved in their care to decide the goals.
It should be emphasized that low vision rehabilitation in children is an ongoing process, which takes place over many years. Vision should be checked at the beginning of each year to make teachers aware of possible limitations.
Low vision devices should be evaluated according to the child's developmental stage, because a device that may be appropriate for a preschooler may be unacceptable to a teenager. However early introduction of devices helps to use them without peer pressure. It is extremely important to consider the factors viz., age, and cause of low vision, residual vision, academic needs, functional needs of a child before prescribing a particular device.
The most effective use of subnormal vision aids, usually there is need for a special training to supplement services provided by the ophthalmologist. After prescription and fitting, the special aid should work with the children to make certain he/she is able to make maximum use of the special lenses. Training instructions related to the visual skills such as fixation, scanning and instructions related to the maintenance of the aid are crucial in low vision service delivery.
6 - Follow-up
Successful completion of low vision management ends with periodical follow-up. Feed back received from the school teachers, parents, especially by the children who utilized the services ensures the quality of management. Regular follow up ensures the change in the vision and the need for adapting new devices.
Major Areas of Vision Loss
Different eye conditions affect different parts of the eye and hence the visual problem varies from child to child. The common areas of loses are
Impact of low vision - Educational aspects
Role of optical and non-optical devices in the education of a low vision child
The various types of low vision devices have specific uses, advantages and disadvantages. The most commonly used educational aids are Spectacle magnifier, Stand magnifier, Hand held magnifier, Pocket magnifier, Close Circuit Television, Minifiers and Telescope
Hand and Stand magnifier:
Hand and stand magnifier allows for magnification of near objects. They are used for reading, spotting phone numbers, product labels, dictionary print and foot notes. These are simple to use and easy to carry. Most children can use these devices without difficulty and without much instruction. Reduced vision from a central scotoma or generalized blurring or the field can be helped with magnification. Because most stand magnifiers have an image pane below the surface of the page, children with high accommodative amplitude cannot take full advantage of their close - focusing ability.
Children like a close working distance, but often reject high plus spectacles because accommodation already gives them a clear image at the close distance without the spectacles. For children who have motor difficulties and cannot hold a magnifier, a high add spectacle lens may be preferable. High adds can come as a bifocal or a full lens.
Telescopes can offer magnification of distant objects. They can be used either monocularly or binocularly. Hand held monocular telescopes often flexibility and can be used to see the chalkboard or the scoreboards. Focusable telescopes can be attainted to spectacle frames for viewing objects in midrange distances, such as a computer screen
These helps in reducing glare and improving contrast. The lenses come in a variety of absorptive properties and can enhance the quality of image.
Close circuit Television:
Provides greater magnification from 3X to 80X depending on monitor screen size. Helps to work at relatively normal working distance and reading position. Option of white on black and black on while symbols, enhances the contrast. The major disadvantages are bulky and expensive.
Non optical aids often enhance the use of vision with or without optical aids. Generally, non optical aids increase illumination, increase contrast or provide greater physical comfort. The commonly used educational non optical aids are Adjustable Reading Lamp, Adjustable Reading Stand, Typoscope, Bold lead pencils, Enlarged printed materials, Braille, Talking book and Talking calculator.
Is a piece of black cardboard with slit in it blocks out all but the line of print viewed through the slit, thus helps the person keep his or her place while reading, writing and signing.
Adjustable wooden reading stand helps to hold the reading material in a comfortable position so the patient can maintain a close working distance without straining the neck and back muscles or tiring the arms.
Bold line papers and notebooks:
Paper with bold lines will increase contrast and makes it easier both to write and to read
Adjustable reading lamp:
A goose-necked lamp of a flexible arm lam helps to adjust light on the printed materials and non on the eyes.
Felt tip pen, bold soft lead pencils:
Black felt-tip pens instead of blue ball point pens enhance the contrast while reading. It also helps to get magnified image, it letters are written larger.
Modification of the classroom for the child with visual problem
Citizens of all ages have come to rely increasingly on technology
in every aspect of life. For most people technology makes life
easier, broadens horizons, or for the young provides an earlier start
to learning. However for people with disabilities, technology
changes the most ordinary of daily activities from impossible to
possible. In an ideal climate, no person with a disability should be
denied the opportunity to obtain assistive technology and transfer
its inherent potential into viable, life fulfilling endeavor.
Conclusion: Today equal opportunities to all disabled person have become mandate for all welfare states. The dreams of a visually impaired child's education come true only if the professionals from various fields such as rehabilitational, medical, technological fields works together.
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