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As a pioneer in Spain in the field of early attention, I have dedicated almost twenty years of my professional life to the developmental care of babies and infants who are blind, visually impaired and who have multiple disabilities. I have also had extensive experience in guidance for parents and families, besides supervising the work of other specialists in this field.
I graduated in Psychology from the University of Barcelona, and also hold a diploma from the University of Harvard validating my qualification for the performance of the NBAS test (the Brazelton newborn assessment scale). I have participated in the teaching of several Master's and Postgraduate degrees in different Spanish Universities specializing in this particular professional field.
I have a working knowledge, both written and spoken, of English, French and Italian.
I have designed a Development Assessment Scale for Blind Children from 0 to 2 years of age, which is currently undergoing approval for use throughout Spain, as well as a Visual Stimulation Kit for visually impaired children from 0 years upwards.
I have published several brochures and other booklets covering the training of babies who are born blind or visually impaired, and guidance for the parents of such babies.
My work "The blind baby" was published in 1992, as were the results of research studies entitled "Introduction to the study of stereotypes in the blind child", for which I was team leader.
Two further books, for which I also acted as coordinator, are currently in the process of publication. The first of these concerns "Early attention for the blind and visually impaired child", and the second, which is based on research findings, discusses the topic "The initiation of blind children into language. A focus on preventive measures".
In the course of my career, several of my articles have been published in American journals - one of them for the American Foundation for the Blind - as well as in French, Italian and Spanish journals.
In addition to the
above, I was contributor to "Newborns within a culture", a book about the
child in different cultures, which was published by the eminent American
paediatrician Dr. T.B. Brazelton. My contribution was in Vol. 3, "The Cultural
Context of Infancy", in a chapter covering the language of the blind child,
which was coordinated by Mª José del Río, from the University
of Barcelona.
I have given papers and
spoken at several national and international congresses and conferences
(Madrid 1994 and 1996, Hungary, Bad Berleburg, Montpellier, Brussels, s'Hertogenbosch,
etc.), and was appointed by the Social Services Management Section of the
ONCE to be a member of the International Commission for Early Training
for the ICEVI..
I was awarded one prize by the Complutense University of Madrid for the video "The blind baby", and another by the Gerona College of Psychologists and College of Journalists for an article on blind babies which was published in the Gerona newspaper.
I was invited by the government of the United States to spend one month becoming acquainted with various institutions and methods of working with disabled persons in five American states.
By way of conclusion,
I would mention that I have carried out a great number of studies on the
early stages of development of children who are blind, visually impaired
and have multiple disabilities, and have created different methods of working
with them.
ICEVI - 10th WORLD CONFERENCE
INITIATION INTO LANGUAGE
FOR BLIND CHILDREN
AUTHOR: Mercè Leonhardt
Psychologist.
Coordinator for the Early Attention Service and Coordinator for this research.
The Joan Amades Educational Resources Centre. ONCE. Barcelona.
The research findings which we are about to present are the result of a study performed over a period of four years at the Joan Amades Early Attention Centre - ONCE -Barcelona, on blind babies just a few days old and infants up to the age of two years. This study was carried out by Dr. F. Cantavella and Dr. R. Tarragó, in conjunction with the Early Attention Team, whose members were Mª A. Esteban, M. Morral, M. Alvarez and M. Leonhardt. We also received the valuable assistance of J.J. Tolosa, M. Ruiz, and Prof. M. Siguan and Prof. C. Trevarthen, both of whom are internationally-known figures in the research world.
The aim of our study
The assessment of the needs and progress of blind children, from the early stages of development, concerning their understanding of other people and their environment, requires the need for such children to recognize the immensely rich patterns of motivation which prepare the human mind for the shared learning process: to share meaning through action and speech. This means grasping the meaning that objects and actions have for other people, at the same time as learning to be - in the words of Trevarthen - an attentive and understanding partner in the use of meanings. This necessarily implies the use of a particularly flexible imagination and a close attention link with others in a subtle exchange where mutual adjustment is the common denominator.
Language is the most valuable element in this process of mutual understanding, but it can only be learned because human beings have many pre-linguistic ways of penetrating the minds of others, especially when they are motivated to read non-verbal expressions which can take many and varied forms. For the blind baby, language is not only a motivating force, but also provides a means of access to a whole universe that opens up ideas and possibilities for action, thought and meaningful relationships with others.
The nucleus of the theme which is to be developed here comprises a knowledge of the first language-promoting signs and signals which occur within the relationship, together with a recognition of how this begins.
First of all, however, we wish to provide a brief summary of the scientific characteristics of the study, as this will make it easier to understand the results of the research. CHARACTERISTICS OF THE STUDY:
1. Hypothesis
Blind children do not demonstrate any special difficulty in developing language. Some are early language learners, but there are also others who are very late talkers. Some children, regardless of whether they use speech or not, experience communication difficulties, while others live in a world of their own and do not communicate.
The mother-baby nursing relationship appears as the protype of all forms of ulterior exchange. The mother interprets the signals given by the baby and translates them into words, which is what gives the exchange its structure. Exchange through play and the pleasure shared in the exclusive code being used fulfil a structuring role. The mother acts as a mirror for the child. When she makes a sound, the child reproduces it. When the mother teaches a gesture and the blind child copies it, the child will enter into the communicative phenomenon "if I make a body movement, always the same one, my mother will respond in the same way".
Communication necessarily precedes language, and for the child, gestures are a bridge or support which give access to communication. The child has an interest in language and makes an effort to come to grips with it as a privileged means of participating in this communication as it becomes more familiar to him, at the same time as he becomes more aware of his surroundings. For the blind child, this also means the possibility of understanding and amplifying his world in a progressive and unlimited way, as it allows him to gain knowledge of the sighted person's world and use the information he receives.
On the basis of the above, we drew up the following hypotheses:
- The interaction established between mother and baby will determine the emergence and level of language in the child.
- The different kinds of communicative interaction between blind babies and their mothers evolve according to the age of the child.
- To analyze the processes
which lead to the organization and acquisition of language or its failure
to appear.
2. Choice
Five children who were
blind from birth were chosen. They had no other associated disabilities.
They attended our Early Attention Service from birth up to the age of two
years.
3. Family variables
The following variables were taken into account: the presence of the mother and the father. The type of family (nuclear or otherwise). Type of habitat. Financial situation. Cultural level. Emotional stability. Number of brothers or sisters. 4. Variables in the subject
Sex. Number of older and/or younger brothers and sisters. Whether or not born prematurely. Psychomotor development. Intellectual level. Personality.
The development of
the children was monitored and assessed on the Leonhardt Development Scale
for blind children from 0 to 2 years of age.
5. Methods and materials used
A large amount of video material (VHS system) was used for filming the babies from the early days after their birth up to the age of two years. Every two weeks, a session of approximately thirty minutes was filmed in the family home. The basis for these sessions was the interaction of the child with one or both parents. The best interactive sequence from each session was chosen and timed.
Two types of files were set up for analysis of each sequence. The first covered an interpretation of interrelated conduct between the parents and the child and was divided into five categories:
1. Non relevant
2. Synchronous, Contingent,
Symmetrical
3. Interactive
4. Gestural dialogue
5. Dialogue through
speech
while the other recorded the conduct observed in the child: vocal, gestural, expressive and linguistic, and that of the mother, father, or the carer.
All the information
thus obtained was entered into the database of a computer programme for
subsequent statistical analysis.
DIFFERENTIAL MODALITY OF THE BLIND CHILD. PECULIARITIES THAT AFFECT SPEECH
The study of the blind child requires the adoption of a basic standpoint: an understanding of his own specific nature without unfortunate comparisons with the development of sighted children. The perspective which we consider appropriate is oriented towards the resources at the disposal of the individual and the way in which he uses these to face the demands of his psychosocial surroundings, bearing in mind the fact that child development is a dynamic and evolutive process which continues throughout life.
However, we have taken into consideration difficulties which constantly arise both for the child and his adult partner in early interactive processes such as, for example, the absence of eye contact which is a powerful, socially binding instrument that controls and encourages interpersonal relationships. Early warning signals produce confusion, as in the case of the child turning its head away from the source of the sound, or placing its ear and not its face against the face of the mother (Leonhardt 1989), this behaviour pattern ususally becoming manifest in the first month of the baby's life. For this reason, the blind baby will need to receive a great deal of specific help in the early stages of development in order to discover his own ability to communicate and interact in the context of his environment. This help takes the form of an additional effort on the part of the mother in her organizing and structuring function.
Emotional development is threatened by unforeseen and dangerous situations which can result in unexpected pain, and these can produce in the child sensations of fear and apprehension in his contacts with the world around him. In comparison with the sighted child, the blind child needs a prolonged period of time in which to build up a feeling of trust and self-confidence.
However, the blind child not only has a perfectly sound sense of hearing, but one which is hypersensitive, and we believe that language arises on the basis of phonetic imitation and a discrimination of sounds. Anzieu points out the way in which "personal identity is formed as a sonorous wrapping round of experience in a bath of sounds", and the human voice occupies a preferential place in the emotional world of the blind child. The different variations in shrillness, intensity, tone and inflection all produce very varied and individualized combinations, which will produce a sensation of coolness, acidity, calm, anger, etc. The blind person develops an intense "phononomy" which takes over from the "physionomy" which he is unable to capture. The mere listening to one voice can produce feelings of anger or hatred. In addition, the absence of sight deprives him of a multitude of possibilities for controlling situations and achieving a rapid recovery while experiencing them.
These and other considerations
lead us to believe that the blind baby needs to receive a different type
of organization in his development: the creation of a world of realities
which are different but have a highly significant value.
ANALYSIS AND COMMENTS ON THE RESULTS
A brief explanation of the results obtained from the research groups studied will now be given and explained under the following guidelines:
a) Communication and language
We observed the importance of interactive conduct in the first year of infancy, although towards the end of this period dialogue through gestures begins to appear. To begin with, the babies show progressive responses which commence through synchronic, contingent, symmetrical forms of conduct, demonstrating how the child responds to an action performed by the mother or father by trying to copy it. The infants prove to be attentive and receptive during such interaction and, in addition, the gestures made by the parents towards the child allow him to enter into an understanding of communication meanings as pre-symbols, which act as a kind of prosthesis in the language development of the blind child. After a few months, the use of gestures disappears quite rapidly (given the fact that the blind child has little use for them as compared to the use of the spoken word) and the linguistic symbol takes over. The production of words increases progressively and, usually, quite rapidly. From the age of one year onwards, speech becomes the principal instrument of communication used by the parents.
b) Forms of communication
Among the different
forms of communication used between the mothers and their children, we
observed how the curve of the three main groups under study - vocal, gestural
and linguistic - in children whose language skills developed well, was
always in parallel with the curve observed concerning the conduct used
by the mother and that used by the child.
(colour slide)
Harmony of conduct between parents and their children appears to provide the best basis for understanding the subsequent development of good language skills on the part of the child.
c) Categories of the mother's language
This section draws attention to the significant fact that mothers who do not use stimulation to a high degree but who, on the other hand, achieve a great capacity for interpreting the baby's conduct and, especially, for attributing responses to the child, are those who most favour the development of language. The child is seen as an individual with the ability to interact and evolve.
d) The time at which language appears and its use at the age of two years in our study sample
Children who developed a good use of language generally started talking between the ages of 13 and 18 months, sometimes very quickly and sometimes very slowly, but we also observed that from 18 months onwards, there was a significant increase in language development.
e) Two prototype cases. Differing development
Let us examine two cases which we consider to be prototypes because in one, good and rapid use of language occurred, and in the other, the use of language not only barely occurred, but the few words that the child learned to say were lost after a period of time. In this paragraph, we shall present the conduct patterns involved.
In the first case, we observed that although the mother was affected by deep depression, she was able to identify with her baby at the right times and give him satisfactory communication nourishment through her movements, contact and words, all of which are essential for the formation of the basis on which early development depends. Therefore, it is not the depression itself which is responsible for the absence of emotional expression which may occur between a particular diad, but the specific effects that depression exerts over each individual mother; in other words, when the internal vacuum interferes with the genesis of the bases on which the relationship is founded. When this occurs, it usually results in an abnormal development of thought and language. In this case, the child's mother was not only able to nourish his emotional and cognitive needs, but was also able to perform the appropriate organizing, structuring function which her psychism demanded. The child developed good, all-round language communication abilities at the right age.
In the second case,
the mother demonstrated severe difficulty in relating to her baby. We know
that the demonstration of affection prefigures the representation of the
object, and so it is not difficult to understand how any change, inadequacy,
unforeseen truncation of the interactive style between the diad for reasons
of maternal or paternal difficulties, can produce harmful repercussions
upon the representative potentialities of the baby and the developing child,
especially as regards the commencement of symbolic representation of words.
In this case, the child experienced difficulty in producing his first words,
and even then their number was limited; these words were lost and were
not recovered subsequently.
CONCLUSIONS
The research work summarized above enabled us to learn about early processes and to define the elements which encourage interaction, relationships, communication and language in the blind child.
We were also able to consider the importance of paralinguistic elements, as well as the contents of the language used by the parents, which will enable their child to develop communication and language skills.
In addition, we gained
a better knowledge of the elements which encourage early interaction, besides
also learning of different, new warning signals indicative of possible
disturbances in the relationship in its early stages, and these factors
provide an important degree of guidance for the preventive and clinical
work performed in Early Attention services for blind children.
Appendix
PROTOCOL OF CONDUCT CLASSIFICATION CREATED THROUGH THIS RESEARCH WORK
COMMUNICATION AND LANGUAGE CONDUCT
1. NON RELEVANT CONDUCT
When the conduct observed does not fit into any of the other categories because it falls outside the framework of the direct relationship between the child and his partner. Examples of such behaviour on the part of the child are: kicking movements when the child is not focusing his attention on anything in particular, or a state of sleepiness or actually falling asleep. On the part of the adult: when he or she talks to a third person and forgets all about the child, or performs a task unrelated to the baby.
2. SYNCHRONOUS, CONTINGENT, SYMMETRICAL CONDUCT
When the response to one partner's action is followed by a similar action on the part of the other partner, although this has no interactive or communicative purpose. It can mean that the imitating partner is attentive and that the action being copied causes a response, and may be considered to be the first step towards interaction: the father speaks and the infant opens and shuts his eyes, or opens and closes his hands.
3. INTERACTIVE CONDUCT
In response to an action performed by the mother, the baby performs a related action, or vice versa. For example, if the mother speaks, the baby explores her mouth and smiles. This is a shared situation in which sequences of interrelated actions and responses between the two participants occur. This process includes rhythm, pauses, withdrawals and approaches, imitation, smiles, and all kinds of vocalization and varied intonations harmonize within an atmosphere of shared affection.
4. GESTURAL DIALOGUE CONDUCT (Secondary intersubjectivity)
Both participants understand one another through gestures, and an exchange occurs by means of established codes. The child opens and closes his mouth, while making clicking movements with his tongue; his mother pours water into a glass and lets the child drink from it. Then the mother asks him if he wants more and the child gives a negative response by shaking his head. This means that she understood the child's initial action.
5. DIALOGUE CONDUCT INVOLVING SPEECH
This requires the presence of linguistic symbols, even though these may not appear in the normal, idiomatic vocabulary of a given culture, but are accepted as being part of what we call baby language. A good example of this is when the child says "Yummy, yum, ooh" (I like this food), and when the mother asks the child: "Do you want some yummy, yum?".