Kay Alicyn Ferrell
Early education
services for young children with visual impairments have had a long and proud
history in the
In the 1950s, as
the number of children with retrolental fibroplasias (RLF; now known as
retinopathy of prematurity (ROP)) reached almost epidemic proportions, parents
themselves organized to provide services for their children. Such private, often volunteer, agencies
sprung up across the
Services for young children with visual disabilities in the
The Individuals with Disabilities Education Act (IDEA), initially
enacted in 1975, mandates special education services for preschoolers (ages 3-5
years) and provides incentives for states to provide early intervention
services for infants and toddlers (ages birth-2 years). Although early intervention services are not
mandated by the law, every state participates in the program in an effort to
ameliorate the effects of disability on early development. Early intervention services are coordinated
through either the health department or the education department in each state,
while preschool services are the responsibility of the public school
district. The law recognizes “vision
services” as one component of early intervention services, and “orientation and
mobility” (O&M) is identified as a related service (an ancillary service
that assists a child to benefit from special education).
On the surface, the legislation has improved existing services and
created new services for all children with disabilities. By creating universal early education
services, families are less dependent on the location of private agencies, and
high quality services are now available regardless of where one lives. The infant and toddler provisions are
particularly significant, since they require an individualized family service
plan (IFSP) that incorporates family as well as child needs and is reviewed
every 6 months. The law also requires
states to develop comprehensive early intervention programs and to assure that
those services are provided by highly qualified personnel. IDEA promises that all children, including
those with visual disabilities, will receive the services they need to optimize
their early growth and development.
Unfortunately, the promise is not always kept for young children with
visual disabilities. Visual impairments
may be one of the most severe disabilities, but in the United States it affects
such a relatively small proportion of children (1/2 of 1% of the school-age
population) that it is often simply overlooked in discussions that may affect
policy and implementation. In some ways,
the law that has served other young children with disabilities well may create
injustices for young children with visual impairments. Some of the ways this has occurred are
discussed below.
As the early education system has evolved over the years, several
issues have developed that seem to place young children with visual impairments
at a disadvantage, at least in terms of where and how services are
delivered. These can be simplified into
two main categories of concern: (a)
homogenization of services, and (b) natural environments.
Labeling has been an issue since
The difficulty with this approach is that children with very
specialized needs, such as sensory impairments, are homogenized into the group
without regard to the individual characteristics that may make learning
different. A needs-based approach might
correctly identify a fine motor skill as an objective for a child, but it does
not acknowledge that visual impairment necessitates a different style of
learning. Following brain theory,
teaching strategies focus on repetition, practice, and play, but all from a
visual perspective. In a non-homogenized
environment where visual impairment is acknowledged, teaching and learning can
be analyzed from a tactual, auditory, or kinesthetic perspective that would
better address alternative learning styles.
The problem is that we tend to do what we know best – and people who
have always had vision tend to teach from a visual perspective. Without training, they have difficulty
understanding that visual impairment or blindness is more than simply closing
your eyes. It is both natural and
understandable, and it happens sometimes even with folks who are trained not to
do so. But it is not an excuse.
There is nothing inherently wrong with the way early education services
have become homogenized. Developmentally
appropriate practices endorsed by the National Association for the Education of
Young Children and the Division for Early Childhood of the Council for
Exceptional Children (Bredekamp & Copple, 1997) are excellent guidelines
that truly represent best practice for all children. But it is false to think that children with
visual impairments can experience events in the same way as children without
visual impairments. While the learning
of children without visual disabilities is often reinforced by visual input,
whether repetitious viewing of the act itself or the expression on an adult’s
face, children with visual impairment often miss out on both the visual
feedback and the visual reinforcement.
Learning occurs too often by chance, and it occurs in discrete, fleeting
pieces that cannot easily be combined into concepts. Learning for young children with visual
impairments has to be more deliberate – not a structured, stimulus-response
approach, but a thoughtful and planned use of the time available to increase
the chances for success by mediating an environment that cannot be experienced
visually.
The issue of homogenization suggests that in the effort to avoid
labels, use a needs-based approach, and provide universal early education, we
run the risk of teaching to the lowest common denominator. The only thing we are sure about is that
children with visual impairments are extremely heterogeneous (Ferrell, 1998,
2000). Predictions about outcomes are
difficult enough when the environment is optimum; they are much more difficult
when the environment does not address differences in learning styles. While homogenization is a good thing,
sometimes it is better to let the cream rise to the top.
We thus know very little about how many young children with visual
disabilities are served in early education programs. The Department of Education does report that
8,735 infants and toddlers received “vision services” in 1998 (Office of
Special Education Programs (OSEP), 2002), which comprises approximately 4.3% of
all infants and toddlers served under the law.
But this is a greater proportion than reflected in the school-age
population of students with disabilities (0.5%). These data suggest that (a) more infants and
toddlers receive specialized services in infancy than they do at school age; or
(b) infants and toddlers who do not meet the definition of visual impairment
are actually receiving vision services; or (c) many more school-age students
with visual impairments exist but are not receiving services. Unfortunately, we have no way of verifying any
of these equally pessimistic scenarios.
Personnel Training. We also have no way of knowing the types of
personnel who provide services to young children with visual disabilities. The IDEA legislation requires personnel to
meet the highest standard of teacher certification in the state. We know from the OSEP report (2002) that 457
orientation and mobility specialists provided services to infants and toddlers
in 1998, but we do not know how many of the 6,964 special educators who
provided early intervention services were actually trained to work with
children with visual impairments, or, indeed, what type of professional
actually provided “vision services” to 8,735 infants and toddlers. If all the
“vision services” were provided by the orientation and mobility specialists,
then each served 19 infants and toddlers on average. However, this is clearly not the case, as 84%
of the orientation and mobility specialists nationwide were reported in one
state (most states reported no O&M specialists at all). Just who is providing early education
services to visually impaired young children across the nation is unknown.
Yet, this should be of concern. A study conducted by Stratton (1991)
indicated that early childhood special educators knew very little about the visual
disability and the pedagogy of blindness and visual impairments, while teachers
of students with visual impairments knew very little about family-center
practice, early child development, and early intervention strategies. The primary difference between children with
and without visual disabilities is not what they learn, but how they
learn. We cannot expect personnel who
learned visually themselves to fully appreciate or make accommodations for a
non-visual learner without specialized training. There is very little evidence that the
personnel working in early education settings hold this fundamental
competency. Even the orientation and
mobility specialists who provide services to infants and toddlers receive a
traditional type of professional preparation that is focused on the individual
(usually adults), without knowledge or application of family systems theory,
family-centered practice, or early intervention principles and strategies. Who is providing early education
services is just as important as who is receiving them.
Efforts to bridge this gap in personnel preparation
are now under way at the
IDEA 1997 added a requirement that, to the maximum extent appropriate,
early intervention services are provided in natural environments. Natural environments are defined as “settings
that are natural or normal for the child’s age peers who have no
disabilities.” While this clearly
includes services in the home, it seems to exclude the many center-based
programs that have provided early education services to young children with
visual impairments and their families for years. Since this legislation went into effect, many
agencies have reported pressure either to change their services to conform to
the legislative mandate (by serving children without disabilities), or to risk
losing government funding for their programs.
The concept of natural environments is not without precedent in the
field of visual impairments. Most
private agencies would define the natural environment for an infant as the
home, and services are in fact routinely provided there. What seems to be an issue across the country
is that these home services are augmented by traveling to the agency for
additional services, and it is these arrangements that are deemed
“unnatural.” The issue may seem trivial,
given the long history of providing services in the home and creating home-like
environments at center-based programs (which has been advocated by Fraiberg
(1977) since the late 1960s), but many agencies with long histories of serving
young visually impaired children and their families are struggling to
survive. In the past their expertise was
valued and sought after by other early intervention programs; today these
agencies are viewed as reactionary and territorial.
There is some concern that these turf battles are based on economics
rather than philosophy, but often they are argued under the mantle of best
practice. There is no evidence that
infants and toddlers with visual impairments are best served in the definition
of natural environments in use today.
There is research demonstrating that children with other disabilities
are well served in these environments, but the low prevalence of children with
visual impairments makes it highly unlikely that they were included in any of
these studies. Generalizing the results
of studies to a population not included in the research is neither best
practice nor ethically defensible.
Furthermore, this misapplication of the concept of natural environments
fails to account for parent choice. It
assumes that all families want (and perhaps need) the same type of
services. It is very possible that some
families might not want home visitors, or that they might want to observe other
children with visual impairments, or that they might want to spend time with
adults who have similar concerns and interests.
They might even want to receive services from personnel trained to meet
their children’s specialized learning needs.
Rather than advancing the early intervention field, the natural
environments initiative may be nothing more than another example of
paternalism, where services are imposed on parents under the guise of
“professionals know best.” Natural
environments should be interpreted in the same context as least restrictive
environment: Parents should have a menu
of options from which to choose what they deem best for their children.
The
1. Being proactive. One
thing we have learned is that in the political context, policy makers are
generally not concerned about children with blindness or visual
impairments. It is simply outside their
experience, and they cannot be expected to remember about the specialized needs
of such a minute proportion of the population.
We cannot take policymakers (either legislative or professional) for
granted, and we cannot let them take us for granted. They need reminders.
2. Keeping
current. After setting the standard for early
education, we have in some ways been eclipsed by generalists working for the
common good. Had we been more involved
with the fields of early education and early intervention, we might have been
able to forecast and cut off the homogenization process. It is incumbent on us not only to follow
developments in early childhood education, but to anticipate them and suggest
alternatives.
3. Documenting
what we do. Educational reform in the
These
same issues may arise in other countries, too, as UNESCO (2002) reports that
“developing and developed countries alike are expanding [Early Childhood Care
and Education] provision” (p. 38).
American poet Robert Frost wrote,
The woods are lovely, dark, and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.
Some
of the promises the
References
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