Severe Vision Impairment

Severe Vision
Impairment

 Jennifer Singh
300481784

1

Content
 Meeting Laila
 Severe Vision Impairment
 How Does Our Vision Work?
 Vision Chart
 Children and their Enviornment
 Modifying the Environment
 Guidelines for Teachers
 Areas of Development
 Possible Ideas for Activities
 Resources & Agencies in Local Area
 Final thoughts
 Biblography

2

Meet Laila
 Laila is a 15 month old infant. She has been
diagnosed with severe vision impairment. Her
parents are concerned about her safety and how
she will form friendships. The family has been
living in Toronto all their lives

3

Meet Laila

What Laila and her Family Will Need:
 Resources to understand Severe Vision
Impairment
 Inclusive Environment
 Support from child care center
 Agencies and programs in the community that
will Laila and her family

4

Severe Vision Impairment
 A visual impairment takes place when a portion of the optical system is
defective, diseased, or malfunctions. If the visual impairment is caused
by a defective part, it is usually present at birth. The eye specialist
(ophthalmologist/optometrist) is qualified to identify or diagnose these
concerns. A visual impairment can also occur when the central nervous
system is damaged. The brain controls and coordinates the optical
system as well as interprets the visual stimuli sent to it by the eyes.

5

How Does Our Vision Work?
 Our vision is an structured process. It is composed of the optical system (eyes, eye
muscles, optic nerve) and the perceptual system (brain). Perfect vision requires all
systems to be in order. Optical components (eyes, eye muscles, optic nerve) collects
visual stimuli and sends them to the brain. The brain identifies, classifies, and files
stimuli in memory. The brain sends instructions to the body regarding how to
respond to an object or situation. In order for the optical system to function
properly, the brain must be capable of detecting the adjustments (the eye
alignment, pupil response, lens adjustment). It must also be able to process
information it has already received. Brain malfunction can cause failure in both
optical and perceptual systems. This results in a visual impairment.
 Light rays move through the cornea (where they are bent slightly, or refracted),
they continue on through the aqueous, then through the lens (which makes
additional refractive adjustments) and finally through the vitreous, where they are
focused on the macular area of the retina.
 The retina starts the sorting process and sends the images (by electrical impulses)
through the optic nerve to the brain. Any defect or malfunction at any point of the
visual process can result in impaired vision.

6

How Does Our Vision Work?

7

Vision Chart
• This chart reflects the development of Laila’s vision
Age Normal Vision Development
1 Month Follows moving object; regards face
2 Months Eyes fixate, converge and focus. Child can follow vertical movements; prefers faces, attends
to objects up to 6 feet away. Child becomes aware of bright lights and colours (yellow,
orange and red)
3 Months Eye movements become smoother
4 Months Eyes begin to shift focus; recognize familiar faces, visually explores surroundings, capable of
horizontal, vertical and circular eye movements but uncoordinated
5 Months Eye hand coordination developed. Child can gaze at objects close to eyes

6 Months Eye movements are coordinated and smooth, child can shift visual attention easily. Child can
recognize faces up to 6 feet away. Begins to anticipate position of falling object. (20/200
vision)
7 Months Manipulates objects, depth perception begins to develop
8 Months Turns objects in hand and observes them visually
9-10 Months Can see tiny objects nearby, observes facial expressions and tries to imitate. Child looks for
objects hidden. Visually alert to new environments
12 Months Near and far acuity is good, binocular vision is strong. Child has focus and good depth
perception.
8
12-18 Months Vertical Orientation (walking, building block towers) develops, points to pictures in books,
matches identical objects

What Does This Mean for a
Child and Their Environment?
 Psychological factors play a meaningful role in vision. Sensory integration
(the ability of the brain to make sense out of all sensory input) is extremely
important. If the child has optical aids (e.g. magnification, telescopes, glasses)
visual perception (the ability to make sense of visual information) is critical.
Cognitive skills can motivate children to learn, and understand abstract
concepts. Personality characteristics such as curiosity, motivation, and
perseverance can play a part towards the developing a child’s understanding of
their vision.
 Environmental factors color, contrast, time, space, and illumination. Some
children may rely on color cues, while others need variation of printed or
graphic materials. Many children need good lighting. Some children may
require extra time when using vision for tasks, and others might find it easier
when pictures, words, or numbers are displayed differently. The ECE and
teachers in the room can make suggestions for visual comfort and efficiency,
based on each child's individual needs.

9

Modifying the Physical
Environment
 Modifying the Physical Environment
Safety:
Modify stairs such as adding non-slip rubber mats. Add different colours and stripes to
the areas with stairs. Position rubber covers or rubber stoppers on sharp corners.
Decrease the amount of obstacles present in room - make sure the room is always kept
tidy and free of unnecessary objects and clutter.
 Modifying the Physical Environment
Sensory Cues:
Use a varieties and different types of shelving that have textures. Have specific textures
to define certain toys. Use auditory cues to associate with specific transitions. All of the
signs and labels around the room should also have a raised image, braille, or a texture.
Outline spaces with specific textures on the floor such as carpets, tiles, wood. Lighting
should be placed behind the child.
 Teaching Strategies should incorporate toys and activities that stimulate the child’s other
4 senses. For example, when reading a book make sure you allow the child to hold
objects that are in the book. Direct the child’s body when singing active songs like head
and shoulders and rolleypolley.

10

Teacher’s Guidelines for
Visually Impaired Children
1. Lack of vision, in itself, does not inhibit learning, but lack of opportunity to
function does.

2. The less interaction (socially, and with objects) there is, the less cognitive growth there will
be.

3. The child must act upon, not be acted upon.

4. If you can't take the child to the world, bring the world to the child.

5. Critical to the visually impaired child is his/her inability to observe the results of actions
("what happens when..."). Help to alleviate this potential problem by providing verbal, tactual and
concrete experiences.

6. Motoric experience/development teaches spatial orientation and spatial imagery.

7. "Motor" the visually impaired child through actions, to teach him/her the imitation of movement.
Use hand over hand, arm to arm or leg to leg motion to help communicate.

11 Bishop, Virgina,"Preschool Children with Visual Impairments by Virginia Bishop." Texas School for the Blind
and Visually Impaired (TSBVI). N.p., n.d. Web. 4 Apr. 2013. <
http://www.tsbvi.edu/curriculum-a-publications/3/1069-preschool-children-with-visual-impairments-by-virginia-bish
>.

Teacher’s Guidelines for
Visually Impaired Children
8. Use play as a teaching technique. Use real things; manipulate objects; structure experiences to
permit the child to discover for himself/herself "what happens if..." You can't play
until you have mental imagery, which is acquired through experience.

9. Representations of things (eg. pictures) must follow concrete
experience, and they precede mental imagery.

10. Language is the manipulation of symbolic representations (words). Echolalia is
speech without language; verbalisms are a kind of echolalia.

11. Concrete reasoning precedes abstract thought.

12. When internalization of things/objects (mental imagery) occurs, the child is ready to begin to think, and
NOT BEFORE!

13. Provide an explanation of what will happen next; because the child cannot see
visual cues, she/he may be unaware of activities to follow.

14. If there are visitors (e.g.observers) in the classroom, make a casual statement to this effect (e.g. "We
have some visitors today who want to see how nicely we work.
12 Bishop, Virgina, "Preschool Children with Visual Impairments by Virginia Bishop." Texas
School for the Blind and Visually Impaired (TSBVI). N.p., n.d. Web. 4 Apr. 2013. <
http://www.tsbvi.edu/curriculum-a-publications/3/1069-preschool-children-with-visual-im
>.

Role of the Teacher

 This video shows the role and functions of a teacher of
students with visual impairments. It helps show
teachers what they can expect and how to plan
activities. This video also shows different techniques
teacher use in the classroom and can offer parents
ideas to use at home.
 http://www.youtube.com/watch?v=ofIt3So1dJU

13

Critical Areas of
 Motor:
Development
- Mobility (encourage exploration)
- Body Image (play body games)
- Body in Space (MOVE to learn spatial concepts such as up, down, over, under,
on top, underneath, above, behind, in front, in back, etc.
 Cognitive:
- Object Permanence (that objects continue to exist even though they are not
visible)
- Cause/Effect (use toys, blocks, etc.)
- Environmental Events ("motor" the child through the motions)
- Sensory Awareness/Discrimination (developed through manipulation)
- Seriation (nesting toys, rows or "lines" of objects)
- Comparisons (size, shape, height, weight, etc.; grouping and classification)
- One to one Correspondence ("one for you and one for me")
 Self Help: (VITAL)
- Eating (it's messy; be patient)
- Dressing (practice with large fasteners first)
- Grooming (washing/drying hands; combing/brushing hair)

14 Bishop, Virgina, "Preschool Children with Visual Impairments by Virginia Bishop."
Texas School for the Blind and Visually Impaired (TSBVI). N.p., n.d. Web. 4 Apr. 2013.
<
http://www.tsbvi.edu/curriculum-a-publications/3/1069-preschool-children-with-visu
>.

Critical Areas of
Development
 Social/Personal:
-Social Interactions ("me" vs "notme")
- Imitation (gestures; manners)
- Play (experience with real things first)
- Conversation as a Social Skill.
 Language:
- Nouns and Verbs (must have meaning! Provide labels for things and
experiences.)
- Pronouns (separation of "me" from "notme")
- Adjectives/Adverbs (concepts and comparisons can help here)
 LOTS OF CONCRETE EXPERIENCES! Words need meaning. Meanings may not
be observed automatically and labeled incidentally.

<
>.

Possible Ideas for Activities
 Motor Activities

Gross motor:
• marching, running, jumping, hopping, climbing, rolling, stretching, twisting
• Games at circle (where children hold hands, follow directions, do directed
movements, e.g., "The Hokey Pokey") action songs
Fine motor:
• finger plays (e.g., "Where is Thumbkin," "Two Little Blackbirds," "Eensy,
Weensy Spider," etc.)
• pounding (play dough, clay, bread dough) and kneading
• block play (cubes, Lego, etc.)
• finger painting and "pudding painting"
• "school skills:" coloring, cutting, pasting, tracing stencils (both with fingers
and with a writing tool)

16
http://connectability.ca/category/kids/workshops-kids/


 Sensory Activities
Using Vision:
• Treasure Hunt (using large or brightly colored objects)
• talking about what things look like (shape, size, color, weight, texture)
• looking for things in the environment that resemble circles, squares,
triangles, rectangles

Using Hearing:
• listening games (e.g., "Simon Says“ “Eye Spy”)
• singing songs
• listening for sounds in the environment (e.g., birds, traffic, airplanes, voices,
motors) “eg. Sound bingo”

17 http://connectability.ca/category/kids/workshops-kids/

Using Touch:
• sorting by touch (e.g., texture blocks, cloth samples)
• talking about what things feel like (e.g., smooth, rough, soft, hard, furry,
"picky," bumpy, etc.)
• guess what's in the box, purely through touch)
• tracing raised lines
• sorting shapes blindfolded (GOOD EXPERIENCE FOR ALL CHILDREN)

Using Smell:.
• talking about how things smell
• pointing out particular and specific smells
• used film cans, filled with things that have unique smells, e.g.,
chocolate, vanilla, vinegar, orange peel, mint, licorice – helps child identify and
remember



 Cooking Activities – Great way to demonstrate physical changes.
• Make: popcorn, Jello, fudge, applesauce, meatloaf, hamburgers, hard-boiled
eggs, cookies, s'mores, Rice Krispies squares
• Bake: a cake, gingerbread, potatoes, cookies
• Stirr dry beans, macaroni, rice, mud
• Fine Motor: placing one M&M on each cookie
• Setting the table as one-to-one correspondence practice and self-help
training.

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 Science Activities – Great way to demonstrating physical change and concept of
matter.
• Plant seeds and watch them grow, record daily observations.
• Check the weather
• Boil water – feel water vapour, encourage dialogue
• Freeze water into ice, melt ice into water.
• Talk about temperature; relate it to weather, personal comfort, needs of
plants and animals.


 Play
• Dress-up
• Use a toy telephone for conversation, play house etc
• Use a sand table or water table for "messing" and pouring.
• Perform housekeeping activities with real but small-sized implements (e.g.,
broom, iron & iron board, dishes, etc.)
• Make a "mailbox" from a cardboard box and paint it to look like a real comer
mailbox; "send letters." ("Letters" should be identifiable, and "delivered" to
the right recipients.)
• Act out stories; devise original dialogue when needed.
 Field Trips and Visits – Experiences should be as practical and "hands-on" as
possible.
• Visit as many community resources as much as possibe (e.g., grocery
store, bakery, firehouse, airport, post office, farm where children can touch
the animals)
• Nature walks – allow child to touch and feel surroundings (with interaction
with the environment, such as putting arms around a tree trunk, wading
in a stream, collecting leaves or shells or stones, comparing the shapes
of leaves, smelling pine trees, etc.)
21

Resources & Agencies in Local
Area Educational & Medical
 Ophthalmologist: a medical doctor who has specialized in the treatment of eye
defects/diseases. Are capable of performing eye surgery and prescribing drugs.
 Optometrist: a nonmedical but licensed practitioner who can measure refractive errors and
prescribe glasses. Can prescribe optical devices in special cases.
 Optician: A trained technician who makes glasses; creates the lenses to prescriptions, fits
them into frames, and adjusts frames to the wearer.
 Early Childhood Educator: “observes, participates in creating and implementing IPP’s,
making adaptations in the environment, supports families, links with other professionals,
and much more”
 Special Education Teacher: “Specialty teacher who overseas and may also implement the
education and development of children with special needs”
 Resource Teacher or Consultant: “promote the inclusion of children with special needs in
the childcare community, gather information in relation to children with special needs, assist
families and childcare staff in identifying strengths, needs and goals for the child with
special needs, access and coordinate resources to support children, families and childcare
staff, develop appropriate strategies and service plans to support inclusion of the child with
special needs and interact with related professionals in the community”
<
>.

Area
 The Early Intervention Program (CNIB)
1929 Bayview Avenue
TORONTO, ON
M4G 3E8
HELP LINE: 1-800-563-2642
PHONE: (416) 486-2500 - Ext. 7616
FAX: (416) 480-7028
WEBSITE: http://www.cnib.ca

Central Contact: Office of Beverley Ginon - Ext.7616 who will direct you to
the service nearest you
Sponsoring Agencies: Canadian National Institute for the Blind (CNIB)
Area: Ontario Division
Population Served: Families and their children up to 6 years who are blind or
visually impaired
 Services: rehabilitation and support. CNIB’s shop offers products that can
help make tasks easier. Has one of the worlds largest libraries designed for
people who have challenges with reading traditional printed books. Provides
workshops, support classes and group meetings.

23

 Area
Family Support Network
1645 Sheppard Avenue West
TORONTO, ON
M3M 2X4
PHONE: (416) 633-0515
FAX: (416) 633-7141
WEBSITE: http://www.oaicd.ca
E-mail: bpowell@hincksdellcrest.org
E-mail: rfine@hincksdellcrest.org

Contact: Barbara Powell/Rochelle Fine
Sponsoring Agency: The Hincks-Dellcrest Centre/Community Prevention Program
Area: North York West of Bathurst
Population Served: Isolated families and/or children (0 to 7 years) with or at risk
of, developmental delas, and/or parents requesting parenting support
 “We provide approach to infant and young child development in family-centred
intervention that is responsive to parent strengths, competencies and priorities,
and is based on up-to-date research data regarding evidence-based practices.
Infant and child development consultants provide the expertise needed to assist the
family to make informed decisions regarding goals and objectives for their child
that will support optimal development and functional outcomes.”
 Services: formal and informal assesments, interventions, help families find
community resources, support children in transitions, programs in place to support
family and child’s specific needs, supportive counciling

24

Area
 COTA Health
700 Lawrence Avenue West, Suite 362
TORONTO, ON
M6A 3B4imgres
PHONE: (416) 785-9230
FAX: (416) 795-9358
WEBSITE: http://www.cotahealth.ca

Contact: Carey Lucki, Manager of Client Services Ext. 1103
Sponsoring Agencies: Community Care Access Centres
Area: Toronto Central LHIN, Central LHIN, Mississauga Halton LHIN, Central
West LHIN, Central East LHIN
Population Served: Families with infants and children with physical,
functional, and/or sensory motor needs
 Services: provider of mental health and community support services; case
management, supportive housing, short-term residential beds, an adult day
program, court and justice-related services and outreach to individuals who
are homeless or living in shelters.

25

Final Thoughts
 It is important to remember thateverything and
anything is possible. We (parents and teachers) should
have great expectations, we should provide infinite
training and education, and keep every door of
opportunity open for our children. Nothing should stop
a person from accomplishing goals and fulfilling their
dreams and it is important to teach that in our children

 It is our job to assist children in becoming independent
and knowledgeable adults who will have the same
oppertunities as every other child out there in the
world.
 Remember, there are no limits
 http://www.youtube.com/watch?v=sZu1CwSfm0g
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Area
 North York General Hospital - Branson Division
555 Finch Avenue West
5th Floor
TORONTO, ON
M2R 1N5
PHONE: (416) 632-8703
FAX: (416) 632-8704
WEBSITE: http://www.nygh.on.ca/
E-mail: smfrost@nygh.on.ca

Executive Director: Clara Will
Sponsoring Agencies: Adventure Place Child & Family Centre
Area: North Quadrant Toronto (formerly North York)
Population Served: Children birth to 6 years of age who are experiencing (or
are at risk of experiencing) difficulties in one or more of the following areas:
behavioural, social, emotional, communication and/or developmental
 Services: medical support to families, address concerns and share resources
in the community, provide additional support with follow up care

27

Biblography
 Bishop, Virgina, "Preschool Children with Visual Impairments by Virginia
Bishop." Texas School for the Blind and Visually Impaired (TSBVI). N.p., n.d.
Web. 4 Apr. 2013. <
http://www.tsbvi.edu/curriculum-a-publications/3/1069-preschool-children-with-visual-impai
>.
 Supporting children with visual impairments. (n.d.). Education articles,
resources and products. Retrieved April 4, 2013, from
http://www.teachingexpertise.com/e-bulletins/supporting-the-child-with-visual-impairment-1
 Apple: How iPads could help children with severe vision impairments 'see the
light' | Mail Online. (n.d.). Home | Mail Online. Retrieved April 4, 2013, from
http://www.dailymail.co.uk/health/article-2045948/Apple-How-iPads-help-children-severe-vis
 Parenting and Child Health - Health Topics - Vision impairment. (n.d.). CYH
Home. Retrieved April 4, 2013, from
http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=306&id=1873

28

Biblography
 Vision Impairment Or Blindness - Circle of Moms. (n.d.). Circle of Moms -
Online mom groups, mom blogs, and parenting resources around
motherhood, new.... Retrieved April 4, 2013, from
http://www.circleofmoms.com/mothers-of-special-needs-children/vision-impairment-or-blin
 About Us. (n.d.). The National Coalition for Vision Health. Retrieved April 4,
2013, from http://www.visionhealth.ca/about-us.htm
 Ages & Stages Hand Book
 McCaie, L. Connectability-inclusion workshop, 2013
 McCaie,L. Adaptive learning environment, 2013
 McCaie, L. The role of the early childhood educator,2013
 McCaie, L. Connectability-giving instructions, 2013
 McCaie, L. Inclusion of children with special needs, 2013

29

Biblography
 1, L. E. (n.d.). CDC - Kids Quest - Vision Loss - NCBDDD. Centers for Disease
Control and Prevention. Retrieved April 4, 2013, from
http://www.cdc.gov/ncbddd/kids/vision.html
 Porter, P. (n.d.). blind children | Lighthouse for the Visually Impaired and Blind.
Lighthouse for the Visually Impaired and Blind | Helping the Visually Impaired
and Blind. Retrieved April 4, 2013, from http://lvib.org/tag/blind-children/
 http://www.aph.org/prodpics/8-00070-00_achde.jpg
 Visual Impairment in Children: Identifying Causes, Signs & Symptoms and
Learning How To Support Them. xixi12 on HubPages. Retrieved April 4, 2013,
from http://xixi12.hubpages.com/hub/visual-impairment-in-children
 Holiday Guide for Parents of Children Who Are Visually Impaired -
FamilyConnect . (n.d.). FamilyConnect . Retrieved April 4, 2013, from
http://www.familyconnect.org/parentsite.asp?DocumentID=4882
 Lighthouse International - Services for Children & Youth. (n.d.). Lighthouse
International. Retrieved April 4, 2013, from
http://www.lighthouse.org/services-and-assistance/services-for-children-youth/
 Round Rock ISD : Teaching Students with Visual Impairments. (n.d.). Round
Rock ISD : MAIN SITE HOME. Retrieved April 4, 2013, from
http://www.roundrockisd.org/index.aspx?page=2256

30

Bibliography
 Rubber Tiles & Pavers. (n.d.). Rubber All. Retrieved April 4, 2013, from
http://www.rubberall.ca/page12.html
 http://www.thepickyapple.com/blog/2010/07/10/sensory-bin-extravaganza/
 Pre-School for Blind Children | Education for Blind Children. (n.d.). Welcome
to Resources for the Blind. Retrieved April 4, 2013, from
http://www.blind.org.ph/projprog/projprog_efbc_psbc.html
 Paths to Literacy | for students who are blind or visually impaired. (n.d.).
Paths to Literacy | for students who are blind or visually impaired. Retrieved
April 4, 2013, from http://www.pathstoliteracy.org/

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