Home| Keynote Speeches| Workshop Papers| Other Documents
SUMMARY
This paper presents the results of the work with low vision children at the Low Vision Service-UNICAMP, their insertion into regular school and the continuing atendance aiming their complete integration. the best optical aid directed to school work is devised only through a low vision trained examination considering the coupling of individual vision and learning environment. Necessary strategies to operate this integration embrace the instrumentalization and instruction of family, children and instructors. Examination must evaluate, besides acuity, contrast, field, color and binocular vision. Recommendations to enhance visual efficiency include proper ilumination, use of contrasts and procedures to decrease visual fatigue. Half (52.14%) of the patients attended at the LVS-UNICAMP (Kara-José et al., 1988) had corrected visual acuity within 20/60-20/200. They were prescribed with conventional specs and maintained or directed to the regular school, along with family and school guidance. Only 29.28% needed special optical aids to be engaged into regular school, and 18,58% were driven to rehabilitation programms. Therefore 81.42% of the patients are integrated into the regular school. Practically half of all cases considered could have been resolved in a conventional ophtalomologic clinic with a training in children" low vision.
INTRODUCTION
Low vision or Subnormal Vision
designates a severe vision loss, unable to be corrected either by clinical
treatment, cirurgical intervention or conventional spectacles. It can also
be described as any degree o visual impairment cansing functional loss
and dismimishing visual capacity. However, functional ability is not related
only to visual factors but also to the individual reaction to visual loss
and to environmental factors wich interfere on visual performance (Carvalho
et alii., 1994).
According to Spungin (1990),
public education is to be available to all children, including those with
visual deficiency. The Statute for Infant and Teenager, in the Brazilian
Constitution (1990 edition) says "the infant and the teenager have the
right to education, aiming full development of the individual, preparing
them for the exercise of citizienship and qualifying to work, assuring
equal conditions for the access and stay at school; the right of being
respected by their educators".
But the insertion of low
vision children into regular school may give cause to a conflict regarding
the integration of someone that is different and has special needs. Such
conflict may drive parents and social service professionals to delay the
engagement of the viually impaired children to the regular school. This
usally occurs because they are convinced that special schools will provide
all necessary conditions to supply the special needs of the child.
The Salamanca Declaration,1994,
proposes "individuals with specil needs should have access to regular school
which should integrate them into a child centered pedagogy able to fill
their needs.
In Brazil, the present educational
policy is the inclusion of the impaired child into the normal School, in
a joint programm by the Ministry of Education (MEC), the SORRI and the
UNICEF.
The necessary Strategy to
conduct such integration involves the instrumentalization and guidance
both children and school teachers. Teachers must understand that a wide
variety of parameters do interfere with visual efficiency. According to
Crespo (1980) tehse parameters include: the eye pathology, other impairments,
motivation, intelligence, overall health, reading seekness, self-image,
envinonmental coditions and the circumstances of the learning process.
All these variables make each child a unique individual thus needing to
be specifically evaluated.
Usually when the teacher
at the regular school faces this situation he feels unprepared, thus refusing
the insertion of the impaired child into mainstreaming.
The present work reports
a program of insertion and effective inclusion of low vision children into
regular school aimingat their integration. The program is conducted through
the Low Vision Service (SVSN) and the Rehabilitation Center (CEPRE), both
at the Medical School of the University of Campinas (UNICAMP).
MATERIALS AND METHODS
Key factors for the success
of effective inclusion of low vision children into regular school are:
specialized ophtalmologic examination, instrumentalization and guidance
to children, parents and (very important) teachers.
The specialized ophtalmologic
examination detects if the child is having the adequate optical correction.
Complete examination includes, (beyond acuity) visual field, color vision
and binocularity.
The need for optical or
non optical aid is also evaluated, and if a special aid is recommended
a corresponding trainning is applied. The child with low vision receives
orientation according to the qualitative and quantitative results from
the visual evaluation, the prescribed aids and the analysis of the school
material that will have to be dealt with by this child.
Parents or any person accompanying
the child during the process of visual evaluation are active participants.
During the first intervew an anamnesis is developed were both child and
family are argued about their knowledge on the child"s visual deficiency
which include pathology, extension of visual impairment and miths about
low vision. Through the answers received and doubts presented an elucidation
is provided aimingat a better visual performace.
The application for engagement
and insertion into the regular school is conducted by the professionals
from the CEPRE and SVNs Services by directly visiting the school or by
mail in case of far location. The school receives all information available
about the child who is to be inserted as well as the enviromental arrangements,
aids, aptitudes, visual abilities and deficiencies.
A follow up assistance to
the child"s family and school personee is provided during the academic
period.
RESULTS
Brazilian educational policy
is supporting and enhanciang the integration of the the impaired children
into regular school. Data regarding low vision patients under SVSN care,
indicate that 81,4% are included into regular school and only 18,6% had
to be directed to special school (Kara-José et alii, 1988 and Gasparetto
et alii, 1996)
A campaign enhancing the
integration of the impaired child into regular school is undoubtedly the
most efficient way to go against discriminative behaviour and therefore
helps his acceptance and development. This action surely helps the relation
cost x benefit of all educational system. This will be attained if three
points are observed: 1) Professional must be trained; 2) Less students
in classroom and 3) The school must receive a previous preparation to receive
such population.
From all patients addressed
to the SVSN with complaints of low school yield and problems of adaptation
to regular school, it was verified that 52,1% showed visual acuity between
20/60 to 20/2000 which, according to the visual deficiency classification
proposed by the World Health Organization (Carvalho, 1993), corresponds
to Group III - Moderate Subnormal Vision. Those patients were analysed
and received the adequate optical aid or had their aids confirmed and all
were trained for an effective utilization. Training also provided to parents
and school personnel dealing with the handicaped children.
Optical aids are necessary
and important but prescription must be carefull in considering visual acuity
and also the academic stage of the child because the beginner in reading
has different needs as compared to more advanced student. From all patients
of SVSN only 29,3% were prescribed with telescopes to improve near and
far vision.
CONCLUSION
Up to now the efforts applied
to integrate children with low vision into regular school showed very promising
results even considering that a large scale action has to be developed.
From patients at school
age coming to SVSN 52,1% showed visual acuity in the range 20/60 to 20/200,
which means a Moderate Subnormal Vision - Group III, according to W.H.O.
Patients had prescriptions
maintaning or adapting their original optical aids and were oriented towards
a more effective use of it.
Only 29,3% of patients showed
the need for prescription of telescopes to improve near and far vision
and with this aid were capable to continue in regular school.
From all patients received,
81,4% are included into regular school and 18,6% were addressed to specialized
institutions.
The relation cost x benefit
of the educational system can be increased through an active action that
must cover from the patient to the school, including family and all professsionals
and this action is a complimentary part to the ophtalmologic procedure.
REFERENCES
BEATY, L. A.; Psychological
Factors an Academic Sucess of Visually Impaired College Students. RE. view,
Vol. 26(3) 131 - 139 1994, Chicago (EUA).
CARVALHO, K. M. M. - Visão
Subnormal: Apresentação de um modelo de Atendimento e Caracterização
das Condições de Diagnóstico e Tratamento de umServiço
Universitário do Brasil. Tese de Doutorado apresentada à
Faculdade de Ciências Médicas da Universidade Estadual de
Campinas, 1993, UNICAMP.
CARVALHO, K. M. M.; GASPARETTO,
M. E. R. F.; VENTURINI, N. H. B.; KARA-JOSÉ, N. - Visão Subnormal:
Orientações ao professor do ensino regular. Campinas, Editora
da UNICAMP, 1994, Segunda Edição.
CRESPO, S. E. - La escuela
y niño ciego. Manual práctico. International Council for
Education of the Visually Handicapped - ICEVH. Región Latinoamericana.
Córdoba (Argentina), 1980.
GAMBARDELLA, A. - Coferência
"A Declaração de Salamanca". Anais do II ciclo de Debates
em Educação Especial: "Educação para Todos",
Secretaria Municipal de Campinas.
GARCIA, J. N. & ALONSO,
J. C. - Actitudes de los Maestros hacia la Integracion Escolar de Niños
con Necesidades Especiales, Integracion, n 30(1): 51-68, 1985, Spain.
GASPARETTO,M.E.R.F.; KARA-JOSÉ,N.;
MOREIRA, D. and CARVALHO, K. M. M. The use of telescopes in children at
school age. VISION 96, Madrid - 1996.
KARA-JOSÉ, N.; CARVALHO,
K. M. M.; PEREIRA, V. L.; GASPARETTO, M.E. R.F.; VENTURINI, N.H.B.; GUSHIKEN,
M.T. - Estudos Restropectivos dos 140 Casos Atendidos na Clínica
de Visão Subnormal do Hospital de Clínica da UNICAMP. Aquivo
Brasileiro de Oftalmologia. 51(2): 65-69, 1988.
SPUNGIN, S.J. - When You
Have a Visually Handicapped Child in Your Classroom: Suggestions for Teachers.
Preface to the Original Edition, American Foundation for the Blind, New
York, 1990, Second Edition.
TORRES, I. & CORN, A.L.
- When You Have a Visually Handicapped Child in Your Classroom: Suggestions
for Teachers. American Foundation for the Blind, New York, 1990, Second
Edition.
BIODATA
M. ELISABETE R. F. GASPARETTO
She is an active member of
the Low Vision Service and the Research Center "Gabriel Porto" both at
the Medical School - UNICAMP, since 1978. Is engaged in a programm to support
mainstreaming of low vision children. Has been teaching courses throughout
Brazil on Low Vision. Is co-author of the book Low Vision - Directions
to the Teacher of Regular School, and co-author of a book chapter Low Vision
Pegagogy. Is an active participant of scientific meetings on the subject.
Works on Low Vision clinics at the University Teaching Hospital and at
the Instituto Penido Burnier.