MODULE DESCRIPTION:

Vision is one of the primary distance senses that are responsible for how learners gather information about events occurring in their environments. This module is an introduction to learners who have low vision or blindness. It is divided into six sections including (1) the federal and stated definitions of learners with low vision and/or blindness; (2) the visual system; (3) common types of vision losses; (4) common causes and conditions of vision losses and/or blindness; (5) medical and functional vision assessments; and (6) environmental adaptations for learners who have low vision and/or blindness. Each section contains brief descriptions about particular focus areas for learners with vision losses.

Factors That Impact Visual Input

Understanding the nature of low vision and/or blindness has many implications for learners, their family members, and their educators. The impact that vision losses have on their learners becomes more evident especially when team members collaborate in planning their learners¹ individualized education programs (i.e., IEPs). The more information the team members have about the nature of their learners' vision loss, how their learners' vision is assessed both educationally and medically, and how to use the assessment results will better equip team members in determining the necessary adaptations, modifications, and accommodations for their learners' needs in home, school, work, or in the community.

Additional Considerations That Impact Visual Input

Vision losses vary in degree and severity. The learner may be identified as "totally blind" or identified as "low vision." If the learner is identified as "totally blind," it usually means that the learner has such a significant vision loss in both eyes, the use of his or her residual (i.e., remaining) vision (if there is any) is so limited that the learner is unable to obtain an accurate picture (i.e., input) of the environment even with correction (i.e., glasses). (Refer to Instructional Events Section in this module.)

If the learner is identified as "low vision," it usually means the learner's residual vision is less severe. The leaner has the ability to obtain more accurate input from the environment with correction. (Refer to Instructional Events Section this module.)

The cause and type of the vision loss, and the age of onset of the vision loss will provide further information about how often the learner's vision should be tested, what type (if any) glasses or optical devices should be used, and what environmental adaptations, modifications, and accommodations are needed for the leaner to see events, activities, and people more clearly in the immediate environment.

Learners with Vision Losses and Additional Disabilities

Learners who have vision losses often have additional disabilities, such as physical involvement, health care conditions, and cognitive difficulties. These conditions often will impact their ability to use residual vision. For example, learners with cerebral palsy most likely will have ocular motor difficulties (e.g., moving both eyes together) since cerebral palsy affects the muscles in the body. Learners with health care needs often will have fluctuating vision losses because of medications, medical treatment, or syndromes. Learners who have low vision and/or blindness with cognitive disabilities may have difficulty in processing what is seen. This limits their ability to understand what is being presented or communicated to them.

Mental Retardation Is Not the Cause of Vision Losses

What is most important about learners with vision losses and cognitive difficulties is that MENTAL RETARDATION IS NOT THE CAUSE OF THEIR VISION LOSS. Unbelievably, there are many physicians who think that some learners' vision loss is caused by mental retardation. The physicians who believe this typically do not recommend glasses for refractive errors (e.g., myopia, otherwise known as nearsightedness; see question three of this module) because they do not believe it would make any difference in their ability to receive and act on visual input. Therefore, it is essential that the learners' family members and educators locate an ophtalmologist or optometrist who (1) understands how to test learners with vision losses, and (2) provides information about modifications, adaptations, and accommodations for the learner's specific visual needs including those learners with additional disabilities.

National, State, and Local Resources

There are many national, state, and local resources for learners with low vision and/or blindness and their family members, such as:

• Indiana State School for the Blind and Visually Impaired
• Blind Babies
• The National Family Association for Deaf-Blind (NFADB)
• Helen Keller National Center (HKNC) regional offices
• The National Technical Assistance Consortium for Deafblind (NTAC)
• The Hilton Perkins Project
• American Printing House for the Blind (APH)
• The American Foundation for the Blind (AFB)
• The Indiana Deafblind Services Project
• Indiana's Project Vision
• Indiana Vocational Rehabilitation Services, Blind and Visually Impaired Services

Any of the above organizations are good resources to locate medical and educational professionals who can provide both medical and functional vision assessments. Additionally, these resources will provide family members and educators with information, such as how to adapt the environment, how to determine if some learners with low vision need to be restricted from contact activities (e.g., playing soccer), and how to make referrals to assistive technology centers that will assist learners to perform activities at home, school, and work. (Refer to the module on Assistive Technology for Learners Who Are Deafblind.)

Key Elements of Module 2: Learners with Low Vision and/or Blindness

The key elements of this module are: 1) the federal and state definitions of blind and low vision; 2) the structures and functions of the visual system; 3) the common conditions, causes, and impact that vision loss and/or blindness has on learning for learners who are blind or have low vision; 4) the common conditions, causes, and impact that vision losses and/or blindness has on learning for learners who are deafblind; 5) the common types of medical and functional vision assessments; and, 6) the environmental adaptations, modifications, and accommodations for learners with low vision and/or blindness

These key elements correspond with Indiana Department of Education (IDOE), Division of Professional Standards Instructional Proficiencies and objectives from the Competencies for Teachers of Learners Who Are Deafblind that were developed by members from the Perkins National Deafblind Training Project published in 1997. (Refer to IDOE Division of Professional Standards Instructional Proficiencies and Objectives 28 through 32.2 from the Competencies for Teachers of Learners Who Are Deafblind listed below.)

Module Requirements

While it is encouraged that you complete all of the Tasks for Completion in this module, persons who would just like to have a basic understanding of learners with low vision and/or blindness only need to read or look through resources included in Module Two. Individuals who are planning on teaching others about learners with low vision and/or blindness or who may want to receive CRU's or Points for the Professional Development Plans need to complete all of the tasks and activities included Module Two.

IDOE Division of Professional Standards Instructional Proficiencies
and Competencies for Teachers of Learners who are Deafblind

• Standard 3. The educator of students with exceptional needs has an in-depth understanding of the unique characteristics and specialized needs of students and the implications for academic, social, and emotional planning necessary to support continuous skill development and to maximize independence thoughout life: Performances #4, #5; Knowledges #8, #10; Dispositions #6

• Standard 4. The educator of students with exceptional needs possesses a repertoire of evidence-based instructinal strategies and knowledge of technology, and selects, adapts, and uses these strategies and technologies to promote positive learning results: Performances #7, #8, #14, #15; Knowledges #3, #5
• Standard 6. The educator of students with exceptional needs understands typical and atypical language development and uses individualized strategies to enhance language development and teach communication skills: Performances #3, #6
• Competency Objective 1 - Knowledge: The critical roles of vision and hearing in all learning (e.g., communication, concept development, motor development, and/or movement).
• Competency Objective 28 - Knowledge: The structure and function of visual systems and how it interrelates in the learning process.
• Competency Objective 29 - Knowledge: Impairments in the structure and the function of the visual system.
• Competency Objective 30 - Knowledge: Legal definitions of blindness/low vision.
• Competency Objective 31 - Knowledge: Functional and clinical assessments of vision.
• Competency Objective 32 - Knowledge: Clinical assessments of vision that are used by learners who are deafblind (e.g., evoked responses, preferential looking, electroretinography).
• Competency Objective 32.3 - Skill: Appropriate positions, and accommodations, modifications, and adaptations to optimize the learner's visual functioning (e.g., learner in an adapted chair, learner's location in a room, and light sources).

INSTRUCTIONAL OUTCOMES:

After completion of this module, Learners with Low Vision and/or Blindness, you will:

• gain knowledge about the legal definitions of blindness and low vision.
• gain knowledge about the structure and function of the visual system.
• understand the common causes and conditions of vision losses.
• understand the common causes and conditions of vision losses for learners with deafblindness.
• recognize clinical and educational assessments for vision losses.
• gain knowledge about environmental adaptations, modifications, or accommodations that are needed for learners who are blind and learners with low vision.

INSTRUCTIONAL EVENTS:

To complete this module, you will need to:

1. Study the module: Learners with Low Vision and/or Blindness.
   
2. Study other resources and report on additional information related to the module   topics. (See the section, "For More Information" listed after every question in this   module.)       
3. Complete the "Tasks for Completion and Discussion" included in this module.

Tasks for Completion and Discussion

There are six "Tasks for Completion and Discussion" activities that you will be asked to respond to throughout Module Two. These tasks are designed to assist your understanding and to provide opportunities for you to implement what you have learned, give you additional practice implementing what you have learned, and let you reflect on the topic content. Additionally, if you would like more information about the content of each of the questions included in the Module Index, resources are listed at the end of each question in the Module Index under, "For Further Information," and included in the Bibliography at the end of this module.

MODULE INDEX:

1. What are the legal definitions for learners with low vision and/or blindness?
   (Task for Completion #1)
2. What are the different sections and parts of the visual system?
   (Task for Completion #2)
3. What are the common types of vision losses?
   (Task for Completion #3)
4. What are some of the common conditions and causes of vision losses?
   (Task for Completion #4)
5. What are the some of the common clinical and educational vision assessments?
   (Task for Completion #5)
6. What are some informal environmental assessments that would help my learners with low vision and/or blindness use their residual vision or other senses to learn best and be safe?
   (TASK for Completion #6)
7. Bibliography