Visually Handicapped Children: who they are and what they need EVERY CHILD has characteristics, interests, abilities, and desires of his own. This is true of a child with a visual handicap whether the handicap is a mild one, correctable with glasses or treatment, or one as severe as blindness. A physical limitation, however, may adversely affect an individual's development, especially if proper help is not given him. It is for this reason that special consideration must be extended to children with such handicaps as low vision or blindness. If suitable educational facilities, proper medical care and good environment are provided while these children. are still in the formative years, much can be done for them. In this bulletin, the term "visually handicapped" will refer to both the partially seeing and the blind. The bulletin is not concerned with children whose vision can be brought to normal either through medical care or by properly fitted glasses. Instead it is concerned with children who have severe vision defects even after all possible correction has been made. From the standpoint of treatment, education, and general care, the needs of partially seeing and blind children are quite different. A brief consideration of some children will perhaps show the differences. Some Children Jane is partially seeing; John is blind; Mary has an eye defect, but it is correctable with eyeglasses. Jane and John have real visual handicaps, but the handicaps of partial vision and blindness affect them differently. Their life adjustments in various situations will also differ accordingly. Jane, a partially seeing child, lives in a small town on the outskirts of a large city. When she entered school, she did not get along well: She was shy and retiring; she seemed to occupy herself well with most types of desk work, but she did not follow directions written on the chalkboard. Both her parents and the teacher were baffled. They thought Jane was intelligent, and yet her behavior was "peculiar," so the teacher and the mother had a conference with the school principal and the school nurse. The nurse suggested that the parents take Jane to a pediatrician for a thorough physical examination. The parents followed this advice. Through medical examination, it was discovered that Jane was extremely nearsighted. The pediatrician referred her to an eye physician (ophthalmologist) for a thorough eye examination. Glasses were prescribed, but even with these Jane's vision was found to be considerably below normal. The eye specialist, the school principal. and the teacher conferred, and they recommended that Jane attend a sightsaving class in a nearby city. Within a few months after entering this special public-school class, Jane became well adjusted and at present takes more interest in other children and has developed as an individual in her own right. (For further information concerning sightsaving classes, see pages 20-30.) John, on the other hand, has a more severe handicap. He is blind-and has been so since birth. His training and schooling are of necessity quite different from Jane's. Life for John must be planned so that he will learn through the senses of touch, hearing, smell, and taste. Because of his blindness, John had many problems in early childhood. He was in danger of being left out of child activities at a time when it is important for any child to be accepted by his peers. He was accustomed to sharing in family matters but also wanted to be included in the play of boys and girls. His eyes, however, could not show him what the children were doing. This limitation in vision threatened to become a barrier between him and his seeing companions. He was not able, for example, to learn to "skip a rope" by watching other children. Someone had to teach him what was meant by skipping a rope and then how to do it. To learn this, as well as countless other activities, it was necessary for him to depend upon his senses of touch and hearing. John was fortunate, for his parents and little friends showed him how to skip a rope, how to roll a ball, how to play with toy trains and toy animals, and how to move about safely. When John was small, he lived in a community where there were no day-school facilities for the education of blind children. He therefore attended a State residential school for the blind and secured his elementary education there. If John had lived in a large city such as Los Angeles, Cleveland, Chicago, or Detroit, he could have attended a special day-school class in a regular public school. (Such classes are usually referred to as Braille classes.) By the time John reached high-school age, the State school had given him so much help that he had mastered both Braille reading and Braille writing and typing. He had developed reasonable independence in getting about and learned grade by grade what other children learn in day-school classes. With the help of a reader he was then able to attend a regular high school in his own home town and live at home with his family. John is now in college in one of the Western States. The local newspaper recently commented as follows concerning him: "His fellow students believe he has what it takes courage, determination, a wholesome The present adjustment of this young man to college is possible because of special training given to him as a young child in the home, continued and supplemented by the work of the school and other public and private agencies. * outlook, and a will to succeed * * Then there is Mary, a little 8-year-old girl, whose disposition was happy and cheerful until she started to school and had trouble with reading. At first, she appeared to be a "handicapped" child. Fortunately, however, it was found by testing her vision that all Mary needed was a pair of glasses. As soon as these were supplied, she began to read and to perform the usual activities of children. With glasses, she was no longer handicapped. Children like Mary, if correctly fitted with eyeglasses, can function as normal people. They are not, for one moment, to be thought of as handicapped. This bulletin will be concerned with boys and girls like Jane and John, and not with children like Mary. The Child in the Family The first needs of the visually handicapped child, whether he is partially seeing like Jane or blind like John, should be met by his family. A child with a vision defect requires the love and care of his parents just as his 953684-51-2 brothers and sisters do. He may have an even greater need for evidence of their affection and understanding because his visual defect creates special problems for him. If teachers, social workers, and medical specialists are to give adequate help to mothers and fathers of such children, they need to recognize and consider both the parents' feelings and emotions, and the practical aspects of problems which these parents face. In looking forward to the arrival of a baby, parents think of a normal child and not of one who may be blind or partially seeing. When they discover that their baby has a severe handicap, they often cannot help being disappointed, bewildered, or even resentful. Frequently they do not know what to do for the child. Many times they cannot even see the possibilities for normal development. These emotions may be expressed in various ways. Fear of doing the wrong thing, for example, often complicates the thinking of the parents; it may even overshadow their ability to plan for the child. Some parents not only are plagued by their fears, but also blame themselves or their families for the condition of the child. They may even try to hide the child from their relatives and neighbors. These attitudes profoundly influence the child. Even though the parents' anxiety or despair is not verbally expressed, the child can sense it and is negatively affected by it. The handicapped child's chances for adjustment in the community are not good unless he can achieve a normal and satisfactory place for himself within the home circle. THE YOUNG CHILD Some parents, because of their own attitudes, do not give the young handicapped child opportunity to develop normally. They may overprotect him or reject him, perhaps without realizing it. They sometimes do things for him which he could do for himself, such as continuing to dress him or feed him when he is old enough to learn such skills. In other cases, the parents and grandparents shower material things on a child who is blind or partially seeing, but fail to give him the normal affection or the opportunity to develop responsibility-because they reject him as a personality. In contrast are the fathers and mothers who, almost from the birth of the child or the onset of the handicap, are mature and realistic in their attitudes toward life and toward the child. When the ophthalmologist tells these parents that the child's eye condition cannot be improved, they begin to gather reliable facts concerning his condition. They study possibilities for care and education of the child. Such parents are able to make constructive plans for him. The adjustments to be made in the home for the blind child are different from the adjustments to be made in the home of a partially seeing child. If he is blind, he will need to be taught many things which partially seeing children can learn independently by visual imitation. A blind child will have to learn what a spoon is by feeling and handling it. Then he will have to be shown how to hold it and how to put food on it. Lacking sight, he cannot learn by watching others. If, on the other hand, a child is partially seeing, different types of adjustments will have to be made for him. His storybooks must have large pictures with a minimum of detail. He should have better lighting conditions than the average when he is looking at these books. His eyes should be protected from glare. When he takes part in children's games, he will probably need extra instruction. After he enters school, there will be other adjustments needed which will involve both the school and the home. THE OLDER CHILD As the child approaches adolescence, his parents and teachers need to give him intensified help. In order to do so, they may require assistance from agencies prepared to advise him and render special service to him. While the principles of child development are the same for all, each age group does have its own particular needs and interests. As the young person grows up, many of the interests of earlier years will persist and expand, and new ones will develop. The adolescent, however, will be more immediately concerned with those interests and activities which are related to his future vocation and to social participation with his young friends. During adolescence and youth, fear of vocational or social failure sometimes appears in a handicapped person who has previously seemed to be well adjusted. As he thinks of the choice of a life occupation, this fear may express itself in worry over the effect of his physical limitation. When he thinks, for example, of applying for a job, he may ask himself, "What will my visual handicap prevent me from doing? Will it close the door of opportunity against me?" When this is true, parents and teachers should work closely with visiting teachers, counselors, vocational rehabilitation agents, and appropriate agencies to help the young persons avoid these fears. Classification According to Visual Handicaps The Children with visual defects are classified for purposes of education on the basis of several factors. One of these is acuteness of central vision. visual acuity findings alone, however, are not considered to be an adequate basis for educational classification, especially if such classification is used to determine the child's placement in school. The findings of the visual acuity must be studied along with other factors. They serve as a guide in planning for the child when supplemented by medical diagnosis and prognosis and other information about the individual, such as his ability to adjust to his handicap and to compensate for it. The environment of the child, both past |