An all-round plan is usually a complicated one and may require the services of several agencies, both public and private. In many instances, the visually handicapped child will need long and intensive help from a number of sources. His ultimate adjustment will be largely dependent upon the extent and integration of these services. There are essential elements in such a program, and every community should make certain that its program includes: (1) Finding the child; (2) medical care; (3) education to fit the child's needs; (4) broad personal and vocational guidance leading to the best possible life adjustment; and (5) cooperation in institutes and workshops for parents. FINDING THE CHILD WITH A VISUAL DEFECT The first step in the program is to find the child with a handicap. The main responsibility for discovering eye defects in children is borne by the family physician, the pediatrician, and by other specialists and private physicians. In large cities, many people are seen in clinics and hospitals, which afford a splendid opportunity for finding eye deficiencies, even though the patient may be in the hospital or clinic for other tyes of examinations. Agencies in some communities have a designated responsibility for aiding in the identification of visually handicapped children, such as the commissions for the blind. (Most of the States have commissions for the blind.) Still other agencies conduct services which provide them the opportunity to discover eye defects in children who come to them for other types of treatment. The Crippled Children's agencies, for example, through their widespread clinics and other services, offer a means for finding eye defects in children who are brought to their clinics usually because of other conditions. Any agency known to have facilities and resources to help handicapped children will have cases referred to it and will, to some extent, become a casefinding agency. The more services an agency offers, the more complete will be the register in any kind of case-finding program. In addition to the work of physicians and agencies, persons such as the public health nurse, the classroom teacher, the social worker, and other representatives from childserving agencies are likely to discover eye defects in children. The classroom teacher, because of close association with children, may be the first to suspect that a child has partial vision. If she is alert, she will make full use of available community resources in helping the child secure proper examinations. It is important that the schools have a close working relationship with agencies and individuals serving handicapped children. Blind and par Under the provisions of the Social Security Act, every State now has a public program for crippled children assisted by Federal grants-in-aid administered by the Children's Bureau, Social Security Admin. istration, Federal Security Agency. (See p. 18.) 953684-51-3 tially seeing children may be known to departments of health even before they enter school. On the other hand, the school may suspect the presence of a vision defect in a child before one has been found by a private physician, a health agency, a clinic, or a social worker. The school as a case-finding agency will increase its effectiveness by cooperating with private physicians, health departments, and other agencies concerned with children. MEDICAL CARE Basic to any sound plan for physically handicapped children is a thorough medical examination and follow-up by a competent physician. As suggested in preceding paragraphs, the visual defect in a child may be dis covered by his parents, by his teacher, by the family physician, by a hospital or clinic, or by a welfare agency. Regardless of who discovers the condition. the child should be referred to a specialist for accurate diagnosis. The terms "ophthalmologist," "oculist," "optometrist," and "optician," are sometimes confused. The ophthalmologist, also called oculist, is a physician who specializes in the study and treatment of defects and diseases of the eye. He uses the initials M. D. after his name. The optometrist is a nonmedical practitioner who is skilled in the measurement of vision. He uses the the initials O. D. after his name. The optician is one who is trained to make and supply eye glasses and optical instruments. EDUCATION TO FIT THE CHILD'S NEEDS One of the major worries of the parent of a blind or partially seeing child centers on the concern for the child's education. This is not surprising since so much of the educational program involves the use of the eyes. The parent naturally wonders how this problem is to be overcome. He wonders how knowledge is to be acquired, how social participation is to take place; he may even wonder if it is possible for his child to get an adequate education. The child's total adjustment to life will depend to a large extent upon the kind of educational opportunity he has. The public school is an agency to which the parents of a visually handicapped child should turn as soon as they know that their child has an eye defect. Fathers and mothers, especially of partially seeing children, could often be saved unnecessary worry and hours of fruitless searching for help if they would explore the services their schools provide. Many communities provide day classes for partially seeing children; others through supervision help these children in regular classes. In some of the larger population centers, there are day-school classes for the blind. A few communities provide special classes for children under the age of 6. In some communities, advisers, supervisors, or consultants work on State or local levels and give the help that enables visually handicapped children to get all or a part of their schooling in the local school systems. It may be that the local school system can make all the necessary adjustments for the child so that he can continue to live with his family and still get his education. When this is not possible the local school systems working within the State department of education may be able to help plan the child's education elsewhere. All States make provisions either by maintaining a school or by making arrangements with a school in a neighboring State-for residential school care for their blind children and admit them as resident or as day students. Several States and some school systems provide counseling services for parents of visually handicapped children. Under such a plan, parents receive help in the specialized training of their child so that the child will be ready to enter school at the normal age. Such service helps to put parents in touch with other parents who have similarly handicapped children and to aid them as a group as well as individuals. All of this leads to the consideration of personal and vocational guidance as a necessary element in a well-rounded program for the visually handicapped. PERSONAL AND VOCATIONAL GUIDANCE All those who come in contact with the child have a share in his guidance the parents, the teacher, the social worker, the physician, and fellow classmates. A good guidance program should be in effect throughout a child's life and should permeate the efforts of the home, the school, the clinic, and agencies and individuals working with the child. However, as the child with a visual handicap approaches adolescence he may need special help. He may need help from the guidance counselors in planning further education, in meeting personal or social problems, in finding desirable recreation, or in developing hobbies. Special encouragement may be essential. Most people with serious handicaps need assistance in planning for a lifetime occupation. Fortunately State and local governments have made provisions to help these young persons through the services of the "vocational rehabilitation" agencies. (See p. 18.) COOPERATION IN INSTITUTES AND WORKSHOPS FOR PARENTS Much attention has recently been given to the problems which mothers and fathers face when they discover they have a blind or partially seeing child. This new focus of attention has come about partly because of the rise in incidence of blind babies. Parents of visually handicapped children need information and instruction to help them make plans for their children. To meet this need at least to some extent, a number of workshops have been conducted for mothers and their young blind children. Many of these have been sponsored by and held in residential schools for the blind. They may, however, be fostered by several agencies and housed wherever a convenient place can be found. Such institutes supplement the services rendered to blind preschool children in many States by visiting teachers. The pattern of such institutes or workshops is usually something like this: A series of lectures and discussion groups is arranged for the parents, and a nursery school situation is provided for the children. Mothers and children usually live in dormitory fashion with the children sharing quarters with their mothers. During the day the children engage in good child-developmental activities while the mothers are free to attend lectures and participate in discussion groups. Lectures may include such topics as causes and treatment of visual defects and theory of child development. More and more the fathers, as well as the mothers, are being brought into these programs. Fathers who cannot participate in the entire program sometimes come for evening or Sunday lectures and discussions. There are many values to be gained from such institutes or workshops. Through participation in such activities, parents may be helped to see that their children have many possibilities for normal development and begin to provide an environment for the child based on good principles of child growth and development. By sharing in the experiences of an institute, the parents may be freed from their frustration; they get better factual understanding of the conditions; they see hope for their child; they find that other fathers and mothers are bearing burdens similar to their own. To promote a greater cooperation between teachers and parents, some residential schools for the blind have organized parent-teacher groups. The meetings of these organizations offer opportunities for the exchange of experiences and observations which result in improved treatment of the children both at home and at school. Sources of Aid to Visually Handicapped Children At present not every community will have the elements essential to an adequate program for children who are blind or partially seeing. When such children live in commnnities affording little or no specialized help, the parents and teachers will still be able to find assistance. This will come most often from agencies and organizations at the national or State level. Individual help, or printed materials at little or no cost, can usually be obtained through correspondence. WHAT SOME NONGOVERNMENTAL AGENCIES DO Private agencies have played a very important role in getting better services for various types of children who have physical handicaps. In many instances they have put the problem before the public in a dramatic and effective way. They have disseminated facts, sponsored demonstrations, rendered individual and group services, and stimulated public agencies to action. In the field of the blind and partially seeing, private agencies have been especially active on the national level. Such agencies as the National Society for the Prevention of Blindness, the American Foundation for the Blind, and the American Printing House for the Blind, have done much toward bringing opportunities to the visually handicapped. 4 6 The National Society for the Prevention of Blindness, Inc., was founded in 1908. It works closely with official and unofficial agencies (such as education, health, welfare, industry, and safety organizations) in developing and promoting activities for the prevention of blindness and the preservation of eye health. The Society carries on original research to determine * 1790 Broadway, New York 19, N. Y. 15 West Sixteenth Street, New York, 11, N. Y. € 1839 Frankfort Avenue, Louisville, Ky. |