Teachers Curriculum 1

Low Vision CurriculumTeachers

IAPB Low Vision Work GroupInternational Agency for the Prevention of BlindnessNovember 2016

Curriculum for Teachers

The Curriculum for Teachers can be used for training of teachers involved in different levels and types of education of children with vision impairment but focussing on low vision. The focus of the curriculum is on inclusive education but can also be used where teachers are involved in special education but need training in low vision. The course can be taught by a team given all the areas covered but needs to have a teacher involved in working with children with low vision with experience in inclusive education.1. The basic curriculum can be used with classroom teachers without any

special training in vision impairment who have a student with low vision in their classroom. It introduces low vision, the eye and visual development, screening and testing vision and a lesson on orientation and mobility. The course can be taught in about 17 hours over 2-3 days.

2. The second level is designed for teachers who have some background in special education and vision impairment but seek training related to low vision. In addition to the basic curriculum this level covers the causes and epidemiology of low vision, functional assessment of children with low vision, selection and training to use low vision devices, accessibility of the environment, learning methods and materials, and the impact of low vision for a child. This course can be taught in 1 week (48 hours of instruction).

3. The third level is designed for teachers who have the role of a specialist teacher in inclusive education settings and who might have a role in training of teachers, programme planning and management related to low vision services in education. The course includes all 24 lessons. It is designed to provide information and skills for comprehensive models of service, the role of teachers, curriculum content, counselling, advocacy and management of programs. The course spans 60 hours and can be taught in 10 days.

Ideally during all these courses, observation in a classroom should be arranged so that teachers attending the course can observe the teachers and children with low vision.

The Curriculum in its 3 versions has been used extensively for training teachers but has recently been updated with references to provide current information and data.

The Curriculum has been developed by a team from the IAPB Low Vision Working Group:

Dr Haroon AwanMr Joseph ChoProfessor Jill Keeffe (lead writer)Mr Hasan MintoDr Ramachandra PararajasegaramMs Sumrana Yasmin

Cover photo: David de Wit, Netherlands (from the #StrongerTogether Photo Competition)

Teachers Curriculum 2

Session No. Session Title Duration

1. Introduction to the course and low vision 2 hours

2. ** Global, national and local policies 1 hour

3. Anatomy and function of the eye 2 hours

4. * Causes and implications of visual impairment and prevention 2 hours

5. * Refractive error 1 hour

6. * Epidemiology 1 hour

7. Normal visual development 2 hours

8. Testing distance vision, near vision, assessment of visual fields, and other clinical assessment 4 hours

9. Vision Screening 2 hours

10.* Functional assessment of low vision and case studies 8 hours

11.* Selection and use of optical low vision devices 4 hours

12. Adaptations to the environment and non-optical devices 4 hours

13.* Training in the use of vision, visual skills, and training in the use of low vision devices 10 hours

14.* Accessibility 2 hours

15. Orientation and mobility for people with low vision 4 hours

16.** Models of low vision care 2 hours

17.* Selection of learning methods and materials 4 hours

18.* Inclusive education for children with low vision 4 hours

19.** Role of the special education teacher 1 hour

20.* Psychosocial impact of low vision 2 hours

21.** Counselling 4 hours

22.** Core and expanded core curriculum 3 hours

23.** Community attitudes, advocacy and awareness 2 hours

24.** Management of low vision: review and conclusions 2 hours

Classroom teacher: 17 hours basic (2 - 3 days); * 48 hours (1 week)

** Specialist teacher: 60 hours (10 days)

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Session Plan 1

Introduction to the Course and Low VisionTime 2 hours

Outcome At the end of the session participants will know the overall objectives of this course, be familiar with one another and have an overview of the significance of low vision.

Objectives Understand the objectives of this course

Understand the effects of low vision

Session PlanStage Content Method Material

Stage-1 Introduction of participants Discussion in pairs

Stage-2 Objectives of the course Discussion

Stage-3 Assess expectations Discussion

Stage-4 Develop an understanding of low vision through simulation

Practical Materials for low vision simulators

Process:Stage-1: IntroductionIntroduction of course leaderPrepare an orientation exercise to have participants work in pairs to get to know one another. Select participants to work in pairs. Give participants five minutes to introduce themselves to their partners. After the time is up, have them introduce their partner to the group.

Stage-2: Course ObjectivesShare the objectives of the course with the participants and follow this with a question and answer session about the overall course. Use the objectives of the curriculum as a guide.

Stage-3: Assess expectationsAsk the participants about their expectations of this course and write these on a board or flip chart on view for the length of the course. At intervals during the course check that the listed expectations have been met.

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If there are any expectations that are relevant to the subject matter and have not been included as part of the training curriculum/schedule, consider adding them where appropriate.

Stage-4: Develop an understanding of low vision through simulationProvide instruction on the creation of low vision simulators and have the participants create their own simulators.

Once the participants have completed their low vision simulators provide them with exercises to complete while wearing the low vision simulators.

ExamplesViewing PowerPoint slides, reading notes, moving around the room in pairs.

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Session Plan 2

Global, national and local policiesTime 1 hour

Outcomes: At the end of the session participants will have an awareness of global, national and local policies and statutory benefits for people with vision impairment

Objectives: To introduce major global programs and policies relevant to people with vision impairmentTo discuss regional and local programs and their benefits for people with vision impairment

Session Plan

Stage Content Method MaterialStage-1 Global programs and

policiesDiscussion Websites (see

references)

Stage-2 National and local policies Discussion Websites (see references)

Stage-3 Preparing submissions and applications

Practical Sample forms

Process:

Stage-1: Global programs and policiesShare the global programs and policies with the participants:

VISION 2020 – IAPB & WHO EFA –VI - ICEVI, WBU UN Declaration of Human Rights UN Declaration of Child Rights UN Declaration on the Rights of People with Disabilities UN Sustainable Development Goals WIPO Marrakesh Treaty

Discuss the local country’s involvement in these agreements and implications for the country and region.

Stage-2: National and local policiesOutline national welfare schemes, education support, employment opportunities, pensions, and other benefits provided for people with disabilities. Also discuss

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funding and benefits provided to non-government organisations working to support people with disabilities.

Discuss the roles and activities of disabled peoples’ organisations.

Describe the responsibility and advocacy roles of a Teacher for a child with low vision and effective ways to advocate for their access to appropriate education.

Stage-3: Preparing submissions and applicationsCase StudyPresent a case study outlining a national or local situation where a teacher has gained support for a student with vision impairment.

PracticalSelect submission forms and applications from available sources of support and funding. Discuss the process of completing these forms and have the participants complete a sample form.

REFERENCESUniversal Declaration of Human Rights. http://www.un.org/en/documents/udhr/

UN Convention on the Rights of the Child. http://www.ohchr.org/en/professionalinterest/pages/crc.aspx

UN Convention on the Rights of Persons with Disabilities. http://www.un.org/disabilities/convention/conventionfull.shtml

Sustainable Development Goals. https://sustainabledevelopment.un.org/topics/sustainabledevelopmentgoals

Vision 2020 – The Right to Sight. http://www.iapb.org/vision-2020

WHO Global Action Plan – Towards Universal Eye Health 2014-2019. http://www.who.int/blindness/actionplan/en/index1.html

International Council for Education of People with Visual Impairment. http://www.icevi.org

Nordstrom, K. (2007). Convention on the rights of persons with disabilities. The Educator, 20 (2). http://www.icevi.org/january_07/educator_january-07.html

UNESCO. (1994). The Salamanca Statement and Framework for Action on Special Needs Education. Salamanca, Spain: UNESCO and Ministry of Education and Science Spain. http://portal.unesco.org/education/en/ev.php-url_id=7939&url_do=do_topic&url_section=201.html

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World Blind Union. http://www.worldblindunion.org/English/Pages/default.aspx

Marrakesh Treaty to Facilitate Access to Published Works for Persons Who Are Blind, Visually Impaired, or Otherwise Print Disabled (2013) www.wipo.int/ treaties /en/ip/ marrakesh

UNESCO. (2015) Education for All http://www.unesco.org/new/en/education/themes/leading-the-international-agenda/education-for-all/

International Council for Education of People with Visual Impairment: http://www.icev.orgUN Sustainable Development Goals. https://sustainabledevelopment.un.org/topics/sustainabledevelopmentgoals

Low vision care: the need to maximise visual potential. Community Eye Health Journal. (2004). 17(49). www.cehjournal.org/0953-6833/17/jceh_17_49.html

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Session Plan 3

Anatomy and function of the eyeTime 2 hours

Outcome At the end of this session the participants will able to describe the characteristics of the normal eye, and they will understand common visual defects.

Objectives Understand what vision is and the importance of

vision Understanding of at least six characteristics of the

normal eye. Understanding of at least ten parts of the eye and

their functions. Understanding of how the healthy eye functions Knowledge of common visual defects

Session Plan

Stage Content Method MaterialStage-1 Explanation of vision and

the importance of vision for learning and functioning

Instruction, Discussion

Diagrams

Stage-2 The parts of eye and their functions

Instruction Model eye, Handout, Websites

Stage-3 Visual defects Demonstration, Discussion

Handout, Websites

Process: Stage-1: Explanation of vision and the importance of vision for learning and functioningExplain the visual system referring to the eye, brain and the environment. Discuss how the visual system receives and interprets information

visual mechanism, image forming mechanism

Outline the importance of vision in functioning particularly during early learning.

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Stage-2: Parts of the eye and their functionList the primary parts of the normal eye using the model eye. Use diagrams of the eye (external and internal components). Discuss the function of the anterior and posterior segments of the eye.

Discussion using simple questions such as: “How do you think the iris controls light?” or, “How does the lens help to see near and distant objects?”

Ask the participants to label a diagram of the eye, identifying the parts of the eye and describing the function.

Stage-3: Visual DefectsExplain examples of how abnormal functioning of the different parts of the visual system lead to specific visual defects.

Examples Blurred vision – refractive system, ocular media, central retinal function Dark-Light adaptation – anterior segment (iris), retinal function Visual Fields – retinal function, cortical function

o Central and para-central scotoma - retinao Generalized loss such as peripheral - retinao Hemianopia and quadrantanopia – cortical

Colour Vision – retina, ocular media Eye movements – extra-ocular muscles, cortical, visual deprivation Contrast sensitivity – everything

REFERENCES

http://www.lowvisiononline.unimelb.edu.au/

http://www.md-health.com/Parts-Of-The-Eye-And-Its-Function.html

National Eye Institute https://nei.nih.gov/health/examples

CNIB http://www.cnib.ca/en/your-eyes/eye-conditions/eye-connect/Pages/EyeSimulator.aspx

Perkins http://www.perkinselearning.org/scout/simulation-vision-conditions

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Session Plan 4

Causes and implications of visual impairment and preventionTime : 2 hours

Outcomes : Participants will be able to describe the causes, symptoms and implications of visual impairment and will have knowledge of prevention strategies.

Objectives : Present the most common causes of visual

impairment Explain parts of the eye and symptoms associated

with the causes of visual impairment Outline prevention and interventions for common

causes of vision impairment

Session Plan :

Stage Content Method MaterialStage-1 Common causes of visual

impairment in childrenDiscussion, Demonstration

WHO website, Model of the eye

Stage-2 Common causes of visual impairment in adults

Discussion, Demonstration

IAPB website, Model of the eye

Stage-3 Signs and symptoms of common causes of visual impairment

Discussion ICEH and WHO posters, Model of the eye

Stage-4 Parts of the eye and implications of the common causes of visual impairment

Discussion, Practical

Simulators, Model of the eye

Stage-5 Treatment and prevention Instruction, Discussion

Model of the eye

Process:Stage-1: Common causes of visual impairment in childrenCongenital, hereditary, later onset, trauma

Stage-2: Common causes of visual impairment in adultsIntervention measures for all of the relevant diseases should be discussed in detail during this session. Emphasise the diseases that are prevention and treatment priorities.

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Stage-3: Signs and symptoms of common causes of visual impairmentDistribute handouts on the list of eye diseases.

Blindness due to malnutrition and its symptomsThrough the discussion, cover the following points:

a person with malnutritional blindness will not see well after dusk or in dimly lit places, they may also stumble and fall, and have difficulty finding food on a plate.

the eyes will gradually become dry; the sclera gradually becomes frothy, as if it has a cover of soap bubbles; the cornea will become scarred and damaged.

Once a person experiences these symptoms and it leads to corneal damage, the damage is permanent and cannot be treated.

Causes and prevention of malnutritional blindness; Vitamin A rich foods and Vitamin A supplementsAsk the participants if they know the causes of malnutritional blindness? Why does this problem arise at dusk?

Teaching pointThe principal cause of malnutritional blindness is lack of Vitamin A. Vitamin A deficiency leads to physical changes in the eye that can lead to visual impairment. The rod cells of the eye allow us to see in dim light and aid in the perception of motion. In the primary stage of the deficiency, the rod cells cease to function and as a result it becomes difficult to see in dim light. Gradually the deficiency leads to lesions that harm the cornea.

Rich sources of vitamin A include:

green and coloured vegetables; all kinds of coloured fruits and roots; milk and milk derivatives; animal livers; some fish (depending on local availability).

Treatment of night blindness and when vitamin A is not recommendedAsk the participants if they know the treatment for night blindness due to vitamin A deficiency. Explain the recommended dosage information for vitamin A supplements.

Apart from the children identified with Vitamin A deficiency, any children that are recovering from measles or severe diarrhea should also be given vitamin A supplements in the above dosage. Measles and severe diarrhea can lead to being malnourished and a severe vitamin A deficiency if not treated.

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In young children, vitamin A dosage should also not be exceeded as it can result in numerous side-effects such as sensitivity to sunlight, rough skin and rashes.

Use slides/transparencies to show examples for different eye diseases from case studies. Distribute handouts on the causes, signs, prevention and interventions for eye diseases.

Cataract - its definition and symptomsExplain the topic and objectives of the session. Ask the participants what they know about cataracts. Ask them if they have ever seen a patient with cataracts? If so, then ask what it looks like? Show photographs of a cataract affected eye. Ask the participants the difference between a normal eye and a cataract-affected eye. Which part of the eye is white? Why? Explain that cataract is a partial or complete opacity of the lens. Ask what kind of problems patients with cataracts face?

The following problems should be mentioned:

vision may seem cloudy and blurry; glare, where light sources appear too bright, and halos around lights. double vision; poor night vision; in the final stages, sight diminishes to the extent that the patient cannot

see.

Causes and precaution of cataractAsk the participants if they know some of the causes of cataracts? Explain the different causes of cataracts are:

Age Diabetes Chronic exposure to UV Oxidative stress Medications Smoking Genetics

Types, stages and treatment of cataract Cataracts can be divided into two types; congenital and acquired. Acquired cataracts can be further divided into 3 types, age related, injury and other eye diseases. Other eye diseases can lead to difficulties in two ways. One is due to the prolonged intake of steroid or other medicines and the second is a prolonged infectious condition. The typology is seen below:

Cataract

Congenital Acquired

Age related Traumatic Other eye diseases

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Explain that although doctors prescribe spectacles in the primary stage, the ultimate treatment is surgery. Generally, the decision for surgery is decided in two ways.

1. The patient decides it is emergency considering his/her occupation and the severity of the cataracts and undergoes surgery accordingly.

2. With immature cataracts it is also possible to operate, which is becoming more common. In the past many ophthalmologists would wait for cataracts to mature before they operated. Children born with cataracts should be taken to an ophthalmologist as early as possible. Currently the best treatment available for advanced cataracts is surgery.

IOL (Intra Ocular Lens operation): An artificial lens is inserted into the eye.

Some patients will often require contact lenses or spectacles after the surgery.

Stage-4: Parts of the eye and implications of the common causes of visual impairmentGroup workDivide the participants into 4 or 5 small groups and ask each group to draw and label a diagram of the eye. Ask the participants to point out which parts of the eye are affected by each disease. This task should take around 25 minutes.

diseases of the eye lid, cornea, lens, retina, optic disc have each group present their findings and assist with any problems.

REFERENCES

World Health Organization. Refractive error and low vision. http://www.who.int/blindness/causes/priority/en/index4.html

World Health Organization. (1992). Management of low vision in children. WHO/PBL/93.27. http://apps.who.int/iris/bitstream/10665/61105/1/WHO_PBL_93.27.pdf

http://www.icoph.org/resources/260/Childhood-Blindness--Public-Health-Presentation.html

http://www.cehjournal.org/do-vitamin-a-deficiency-and-undernutrition-still-matter/

http://www.cehjournal.org/low-vision-we-can-all-do-more/

http://www.cehjournal.org/the-visually-impaired-child/

Vitamin A Supplementation. http://www.who.int/vaccines/en/Vitamina.shtml

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Gilbert, C., & Foster, A. (2001). Childhood blindness in the context of VISION 2020 – The Right to Sight. Bulletin of the World Health Organization, 79(3), 227-232.

WHO Prevention of Blindness and Visual Impairment. Causes of blindness and visual impairment. Global Data on Visual Impairment 2010. http://www.who.int/blindness/causes/en/

West, S. (2007). Epidemiology of Cataract: Accomplishments over 25 years and Future Directions, Ophthalmic Epidemiology, 14 (4). 173-178.

What is low vision. http://www.aao.org/eye-health/diseases/low-vision

Smart Sight. http://www.aao.org/smart-sight-low-vision

Low Vision – essential guide for ophthalmologists. https://www.rcophth.ac.uk/wp-content/uploads/2014/08/2012_EXE_225_Low_Vision_BookD5-v4.pdf

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Session Plan 5

Refractive ErrorTime : 1 hour

Outcome : Participants will understand refractive errors and have knowledge of referral for refractive error.

Objectives :

describe myopia and its correction; describe hypermetropia and its correction; describe astigmatism and its correction; describe presbyopia and its correction; knowledge of referral pathways for people with

refractive errors.Session Plan

Stage Content Method MaterialStage-1 Causes, symptoms and

correction of myopia Demonstration, Discussion

Cross-sectional diagrams of the eye

Stage-2 Causes, symptoms and correction of hypermetropia

Demonstration, Discussion

Cross-sectional diagrams of the eye

Stage-3 Causes, symptoms and correction of presbyopia

Demonstration, Discussion, Practical

Cross-sectional diagrams of the eye

Stage-4 Astigmatism Discussion

Stage-5 Referring people with refractive errors

Discussion

Process: Stage-1: Causes, symptoms and correction of myopiaDiscussion and IntroductionAsk the participants what they know about refractive error and if they know how refractive error leads to visual impairment?

Describe the concept of refractive error, explaining that refractive errors occur when the image of an object does not reach the proper position on the retina. Refractive error can hamper the regular lifestyle of the affected person as it can lead to impaired vision.

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If there is a person with spectacles in the session, ask her/him why s/he wears glasses and if they know the powers of the lenses?

Ask the participants if they have seen any young children wearing glasses? Most young children who wear glasses have refractive errors.

Explain that refractive errors are corrected by using different types of lenses depending upon the specific error.

Show the structure of the normal eye and an eye with myopia, using websites. In a myopic eye the rays of light converge before the retina rather than

focusing on the centre of the retina. This creates a problem with distance vision. A person with myopia can see clearly when objects are closer to their eyes. Therefore, this condition is also known as nearsightedness.

Explain that using a concave lens can focus the rays of light on the correct area of the retina and correct for myopia. Show the diagram demonstrating a concave lens used to correct myopia.

Stage-2: Causes, symptoms and correction of hypermetropiaAsk the participants what they know about hypermetropia. Explain that hypermetropia is the opposite problem to myopia.

Show the structure of the normal eye and a hypermetropic eye using a website. Ask the participants what differences they can see. In a hypermetropic eye, light is not focused on the retina and converges on a point beyond the retina. This leads to a problem seeing close objects. Therefore, this condition is also known as farsightedness or hyperopia.

Explain and demonstrate with diagrams how convex lenses can be used to correct the problem.

Stage-3: Causes, symptoms and correction of presbyopiaAsk the participants if they are familiar with presbyopia.

Instruction and description of presbyopiaExplain that usually around the age of 40 years people often start having difficulty seeing closer objects clearly. With age the lens gradually loses the capacity to change shape to adjust focus for close objects. This can lead to a problem with near vision.

This condition can be corrected using an appropriate lens. Draw or show a diagram of an affected lens and show how the plus lens creates a wide image.

Stage-4: AstigmatismExplain that astigmatism is different from the other refractive errors discussed earlier. Astigmatism occurs due to an irregular shaped cornea or lens. Astigmatism can also occur in conjunction with the refractive errors mentioned above.

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It is possible to correct for astigmatism using cylindrical lenses. Demonstrate this with diagrams.

Stage-5: Referring people with refractive errorsDescribe where to refer people with refractive errors in the local area. Provide contact details.

Explain how to determine whether the person needs referral to a specialist. Give a brief explanation of how to detect refractive errors.

Explain to the participants that problems due to refractive errors should be corrected. It is important that whenever they meet someone (or identify them during a screening programme) with refractive error they should be referred to a person trained in refraction who has access to a supply of spectacles.

REFERENCES

http://www.iapb.org/resources/who-documents-other-avoidable-blindness-and-vi-main-causes-data-and-surveys-global-data

Primary Eye Care Course at http://www.brienholdenvision.org/education/academy.html

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Session Plan 6

EpidemiologyTime : 1 hour

Outcome : Participants will have an understanding the World Health Organization (WHO) terminology of visual impairment, and the prevalence and causes of visual impairment

Objectives : Understand the definitions and classification of visual

impairment, low vision and blindness Understand the sources of data and their limitations Able to present data on global epidemiology of visual

impairment Able to present data on national epidemiology of

visual impairment

Session Plan :

Stage Content Method MaterialStage-1 Describe and compare the

ICD-10 and ICFInstruction, Discussion

ICD-10, ICF handouts

Stage-2 Definitions and classification of visual impairment, low vision and blindness

Instruction, Discussion

WHO website

Stage-3 Global epidemiology of visual impairment

Instruction, Discussion

IAPB website

Stage-4 National epidemiology of visual impairment

Instruction, Discussion

IAPB website, publications, National websites

Stage-5 Sources of epidemiological data and their limitations

Instruction, Discussion

Process:

Stage-1: Describe and compare the ICD-10 and ICFDescribe and explain the epidemiological and functional definitions of visual impairment as stated by the World Health Organization (WHO). Describe the ICF

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and compare the implications of the medical and social models of health for the assessment and understanding of low vision.

Stage-2: Definitions and classification of visual impairment, low vision and blindnessRefer to the 2008 WHO definition of visual impairment. Highlight the importance of presenting compared to best corrected vision. Outline and discuss the critical differences between visual impairment, low vision and blindness.

Explain the differences between none, mild, moderate, severe, and profound visual impairment categories.

Stage-3: Global epidemiology of visual impairmentShare information regarding the global prevalence and causes of visual impairment. Highlight the regional differences and their importance for planning of prevention, treatment, correction, and rehabilitation programs.

Explain the differences between avoidable, preventable and treatable causes of visual impairment.

Discuss the following standard references:

Bulletin of the World Health Organization 2008 - Refractive Error WHO website

Stage-4: National epidemiology of visual impairmentExplain how prevalence data can be applied to a country to establish the number of people with visual impairment and how this will vary across regions of a specific country.

Discuss the common problems related to lack of accurate and recent data on the causes of visual impairment. Discuss possible solutions, such as the use of regional data.

Stage-5: Sources of epidemiological data and their limitationsDiscuss the following:

Sources of data need to be critically reviewed to establish if the data is truly representative of a region or country.

Differences in the methodology of data collection that affect its accuracy:o Categorisation of visiono Age and location of the population studied. o The size of the sample studiedo The sources of the sample (particularly in children)

Do the data give information on the disadvantaged and under-served populations.

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REFERENCESGlobal Burden of Disease Study.http://www.globalvisiondata.org/ http://www.iapb.org/sites/iapb.org/files/IAPB%20position%20on%20GBD%20data.pdfhttp://www.iapb.org/assembly/course-10-global-burden-disease-impact-vision-loss

Global Vision Database Maps. http://www.iapb.org/maps

Cama A, Sikivou B, Keeffe J. Childhood Visual Impairment in Fiji. Archives of Ophthalmology 2010;128(5):608-12. doi: 10.1001/archophthalmol.2010.54.Gilbert, C., & Foster, A. (2001). Childhood blindness in the context of VISION 2020 – The Right to Sight. Bulletin of the World Health Organization, 79(3), 227-232. http://www.who.int/bulletin/archives/79%283%29227.pdf

World Health Organization. Refractive error and low vision. http://www.who.int/blindness/causes/priority/en/index4.html

World Health Organization. (1992). Management of low vision in children. WHO/PBL/93.27. http://apps.who.int/iris/bitstream/10665/61105/1/WHO_PBL_93.27.pdf

Bourne RRA, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, Jonas JB, Keeffe J, Leasher J, Naidoo K, Pesudovs K, Resnikoff S, Taylor HR. Causes of Global Vision Loss: 1990-2010. The Lancet Global Health 2013. Open Access. http://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(13)70113-X.pdf

Gilbert CE, Ellwein L. Prevalence and causes of functional low vision in school-age children: results from standardized population surveys in Asia, Africa and Latin America. Invest Ophthalmol Vis Sci 2008;49:877-881. http://iovs.arvojournals.org/article.aspx?articleid=2184425

Understanding Low Vision. Gilbert C. Journal of Community Eye Health 2012;25:2. http://www.cehjournal.org/wp-content/uploads/low-vision-we-can-all-do-more.pdf

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Session Plan 7

Normal Visual DevelopmentTime: 2 hours

Outcome: Participants will be able to detect visual development that differs from normal.

Objectives: - describe normal visual development

- explain how visual development that relates to functional visual assessment

Session Plan

Stage Content Time Method MaterialStage-1 Normal visual development 40 min. Brainstorm,

individual exercise, instruction, discussion

Matching exercise, Barraga handout

Stage-2 Comparing normal visual development and functional assessment of vision

30 min. Discussion, instruction

Functional Vision Assessment form

Stage-3 Effect of low vision on normal visual development

30min. Instruction Reference materials

Process:

Stage-1: Normal visual development children Use visual development exercise. Ask participants to fill match visual responses and skills to age groups using their own experiences and observations. For example: name the age at which you would typically expect a child to start to: 1) follow moving objects and lights, 2) watch movements and scribbling, 3) match geometric forms, 4) fit objects together, 5) reach towards objects, 6) play looking games, 7) imitate facial expressions

Provide participants with a handout of normal visual development skills and ages adapted from Barraga “development of efficiency in visual functioning. Rationale for a comprehensive programme” (available at lowvisiononline). Participants to compare their responses to the handout.

Provide movie / photographs of various stages of visual development.

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Stage-2: Comparing visual development and functional assessment of visionDescribe that functional vision assessment and training is based on a comparison of normal visual functioning to the functional level that a person who is vision impaired achieves. Provide participants with a Functional Assessment form.

With the participants, relate the normal visual skills to the visual skills assessed in the functional assessment:

near and distance visual acuity: Fixation 1-2 follows slow moving objects: Tracking 0-1 Awareness of outlines of familiar objects, simple pictures: Awareness 2-4 Fixates on mothers face: Fixation 0-1 Walks around freely in own environment and similar places: Mobility 2-4 Inspects objects with eyes only: Fixation / focus 1-2 Moves eyes to search and explore visually: Scanning 0-1 Response to light: Awareness 0-1 Identifies actions, objects in complex pictures: Awareness 5-7 Glances at small objects of 2cm : Attention 0-1 Copies symbols, starts writing; Attention 5-7 Follows rapidly moving objects in all directions: Tracking 1-2

Stage-3: Effect of low vision on normal visual developmentBrainstorm how low vision may affect the normal visual development.

Describe common visual effects based on current literature.

Discuss effects of congenital, early and late onset of low vision.

Highlight main areas of development that low vision may affect, eg no imitation, eating, concepts, body image, movement, dressing, washing, latrine, playing, use of senses like hearing, smell, taste; use of residual vision; communication, language; social skills.

REFERENCES

http://www.aoa.org/patients-and-public/good-vision-throughout-life/childrens-vision/infant-vision-birth-to-24-months-of-age?sso=y

http://www.lowvisiononline.unimelb.edu.au/Assessment/development.htm

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Session Plan 8

Testing distance vision, near vision, assessment of visual fields, and other clinical assessmentTime : 4 hours

Outcome : Gain the skills to test distance and near vision and visual fields, and understanding of the components of a low vision clinical assessment.

Objectives : To test distance vision To test near vision To conduct a visual field assessment

To know the components of a clinical low vision assessment

Session Plan

Stage Content Method MaterialStage-1 Aspects of vision

Functions of vision to be tested in low vision assessment

Discussion ,

Demonstration

Low vision screener, visual fields by confrontation, Functional colour vision assessment, simulators, table light and light filter

Stage-2 Assessment of visual acuity (distance vision)

Discussion, Demonstration, Practical exercise

Low vision screener, measuring tape, low vision simulator

Stage-3 Assessment of near vision

Discussion, Demonstration, Practical exercise

Near vision charts and examples of reading materials, functional colour vision assessment

Stage-4 Assessment of visual field

Discussion, Demonstration,

Visual field by confrontation,

Teachers Curriculum 24

Practical exercise occluder, visual field defect simulator

Stage-5 Review Question and Answer

Handout 4.1: screening of near & distant vision & visual field.

Process:

Stage-1: Aspects of visionThere are several aspects of vision that are important for daily life. Explain their functions with the session’s materials and discuss their importance in everyday activities.

Visual acuityo distance visiono near vision

Visual fields Colour vision Contrast sensitivity Sensitivity to light

Demonstrate disability glare with table light and light filter, colour vision deficiency and poor contrast sensitivity with simulators and tests.

Describe the difference between screening for / identifying a vision impairment and clinical assessment of low vision (comparison, rationale for using either, when performing these).

Describe the purpose of low vision screening.

Outline the steps of a low vision assessment1. Observation2. Interview3. Visual acuity testing (distance)4. Near acuity testing5. Assessment of visual fields by confrontation

Steps-2: Assessment of distance visionAt the beginning of this session display a distance visual acuity chart in front of the participants and ask if they are familiar with this chart?

Explain briefly the principle of visual acuity measurement with reference to the design of tumbling E chart.

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Familiarise the participants with the chart regarding its use. Explain the measurement of vision using the indicated symbols and the distance at which the chart should be used.

Describe how to conduct and score this test, starting from the largest symbol and moving to the smallest symbol. Explain to the participants that they should introduce the chart to the patient before performing the test.

DemonstrationAsk one of the participants to wear low vision simulation spectacles and record his distance vision.

Practical exerciseHave the participants practice giving the test until they are comfortable performing it.

Steps-3: Assessment of near visionExplain the properties, including the recommended viewing distance and the applications of near vision charts of different designs, and why they can be used at different viewing distances.

Instruct how to use the near vision chart.

To perform the near vision test the person must be seated in a place with sufficient light. Hand the chart to the person and ask them to read the chart from the biggest to the smallest symbol or word they can see, allowing them to move the chart as close as they need. Record the distance of the chart from the client and the last line that they can read.

Demonstrate with one participant, then participants repeat in pairs.

Steps-4: Assessment of visual fieldExplain to the participants that the visual field test requires the person have a good understanding of test procedure before commencing.

Demonstrate the confrontation testSelect one of the participants to help demonstrate the test. Stand approximately one metre away face to face with the participant who has one eye occluded. Ask him to look into your eye right opposite to his unoccluded eye, and do not move his neck or eyes during the test. Take your hand and slowly move it back until he cannot see your fingers moving. Demonstrate the blind spot and extent of monocular visual fiend in the superior, inferior, temporal and nasal principal merdians. Do the same procedure for the other eye with your other hand, to measure the extent of visual field. (Low Vision Kit and lowvisiononline)

Practical exercise

Teachers Curriculum 26

Participants to repeat the confrontation test in pairs with occluders and with or without visual field defect simulators.

At the end of the session ask participants questions about the tests to make certain they understood all of the test procedures. Discuss the clinical assessment of visual function and provide feedback to participants.

EvaluationThe participants will be assigned an individual case study of a person with low vision. They are to independently list the test that they would conduct for the case study and write a report on the assessment for their case study.

REFERENCEShttp://www.lowvisiononline.unimelb.edu.au/Assessment/index.htm

http://www.cehjournal.org/article/measuring-vision-in-children/

Gilbert C, van Dijk K. When Someone Has Low Vision. Journal of Community Eye Health 2012;25:4-14. http://www.cehjournal.org/wp-content/uploads/low-vision-we-can-all-do-more.pdf

Keeffe J. Low Vision Assessment. Journal of Community Eye Health 2004;17:3-5WHO Low Vision Kit Book 2. http://apps.who.int/iris/bitstream/10665/58719/1/WHO_PBL_95.48_book2.pdf

Van Dijk K. Low Vision: The Patient’s Perspective. Journal of Community Eye Health 2012;25:3. http://www.cehjournal.org/wp-content/uploads/low-vision-we-can-all-do-more.pdf

Gilbert C. Making Life Easier for People with Low Vision. Low Vision. Journal of Community Eye Health 2012;25:12-13. http://www.cehjournal.org/wp-content/uploads/low-vision-we-can-all-do-more.pdf

Teachers Curriculum 27

Session Plan 9

Vision ScreeningTime : 2 hours

Outcome : The ability to plan and conduct a vision screening programme

Objectives : To outline the criteria for vision screening To introduce the critical elements of a vision screening

programme

Session Plan

Stage Content Method MaterialStage-1 Identification of

population to be screened

Discussion

Stage-2 Selection of suitable tests for vision screening

Discussion, Demonstration

Vision charts

Stage-3 Guidelines to plan vision screening programs in communities and schools

Discussion, Exercise

Stage-4 Write a plan for a local vision screening programme

Practical exercise

Process:

Stage-1: Identification of population to be screened

Demonstrate how to use epidemiological data for identification of population groups for screening. This would include determining if; vision impairment is common in a particular group, treatment is available in the country for what is found...

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Give an example of population groups that could be selected for screening, such as older people, school age children, or areas where nutritional vision impairment is likely to be high.

Stage-2: Selection of suitable tests for vision screening

Determining a test that is easy to use and can be administered after minimal training. Discuss the range of visual acuity tests that may be suitable for vision screening.

Stage-3: Guidelines to plan vision screening programs in communities and schools

Use example from the epidemiology data to choose a disease or causes of vision loss that are common.

Select a suitable test given the age group to be screened. Determine the key stakeholders and approvals that need to be completed

(MoH, MoE, schools) Describe the personnel to conduct the screening. Set criteria for referral, i.e. visual acuity. Design forms for data collection. Outline report for planning of subsequent intervention

Stage-4: Write a plan for a local vision screening programme

Form small groups of participants to write a plan for a local vision screening programme using the above guidelines. Assign each group a specific topic such as school screening or screening of older people for cataract and refractive error.

REFERENCES

WHO Low Vision Kit

http://www.aao.org/eye-health/tips-prevention/children-eye-screening

https://www.mja.com.au/journal/2014/200/4/vision-screening-preschoolers-new-south-wales-statewide-eyesight-preschooler

Teachers Curriculum 29

Session Plan 10

Functional Assessment of Low Vision and case studiesTime : 8 hoursOutcome : The knowledge to assess the functional vision of a person with

low vision and identify needs for vision training programme Objectives : To train participants in the methods to assess functional vision

of people with vision impairmentTo train participants to use the results of the functional vision assessment to design an intervention programme such as the training of visual skills To write a functional vision assessment report.

Session plan :

Stage Content MaterialStage-1 Why conduct a functional

visual assessment?Stage-2 Observing, interviewing and

recording the history and current observations of a person with low vision

Form to record functional vision assessment

Stage-3 Apply the stages of normal visual development to the context of functional vision assessment

WHO Low Vision Kit

Stage-4 Testing the eight areas of functional vision

Example of materials to use

Stage-5 Functional vision assessment Assessment form, collection of materials for functional vision assessment

Stage-6 Analysing the functional vision assessment results for development of a training programme

WHO Low Vision KitRNIB Low Vision Toolkitwww.lowvisiononline

Stage-7 Reporting the findings of a functional vision assessment and training programme

Assessment form

Process:

Stage-1 Why conduct a functional visual assessment?

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Discuss the limitations of visual acuity testing and refer to the International Classification of Function (ICF) for the contextual factors that influence functioning, ie the environment and personal factors.

Stage-2 Observing, interviewing and recording the history and current observations of a person with low vision

Outline the prerequisites of a functional assessment, to ensure that treatment refraction and vision has been formally assessed.

Observe how the person uses vision in an informal situation, coming into the room Provide instruction for interviewing a person with low visionTake a history related to eyes and vision. Ask the person or family questions such as:When was poor vision first noticed?Does anyone else in your family have poor vision? What is the cause?Have you had any treatment for poor vision?Do you have glasses or contact lenses? When should they be used?What can you tell me about your vision?

Practical exercise.In pairs, participants practise interviewing each other and recording information.

Stage-3: Apply the stages of normal visual development to the context of functional vision assessment Revise the contents of session 7 “Normal Visual Development”. Discuss methods to informally assess each of the stages. Introduce the process of assessment of functional vision.

Stage-4: Testing the eight areas of functional vision

Ask participants to name and define the areas of functional vision that they are aware of. Prompt participants if they are having difficulty. Identify and describe each area.

Response to light and reflected light (accommodation) Response to approaching objects (fixation) Response to moving objects (track, saccade) Response in visual fields Response to contrast Response to large, medium and small objects Response to faces Vision for mobility

Explain that each test should be administered to measure the functional vision of a patient.

Demonstrate all of the tests to the class, using one of the participants wearing a low vision simulator.

Teachers Curriculum 31

The participants should be confident that they understand all of the tests by the end of the session.

Demonstrate the tests for the detection of light, colour and contrast on a participant wearing a low vision simulator.

PracticeDivide the participants into groups to practice each test. Each participant should practice all of the tests. Observe the participants and help if required. Ask the participants to write an assessment report of their test results. Provide feedback to class - discuss the results of the tests and any difficulties experienced.

Arrange a visit to a vision clinic, or organize participants to meet with people who are willing to participate in a functional vision assessment. With supervision, participants to conduct a functional vision assessment with a consenting client. Participants to write the functional vision assessment report.

Stage-5: Practical functional assessment

Use the instructions in the Low Vision Kit for participants to collect materials for the assessment of functional vision. Only use materials that are available in the training room or immediately outside. Discuss the materials collected and compare with instruction in the Low Vision Kit. Use the questions in the instructions in Low Vision Online section on Functional Assessment to observe visual behaviour. Examples:

Is vision used to find out about the environment and what activities are happening or does the person wait to be told what to do?

Are other senses such as hearing and touch used instead of, or with vision? Which sense is used first to get information - vision, hearing or touch?

Are objects inspected as a whole object or in small parts or sections?

Participants practice conducting assessment in pairs without and then with simulators.

Arrange a visit to a school or have children with low vision available for participants to work with.

Stage-6: Analysing the functional vision assessment results for development of a training programme

Discuss the results of the assessments conducted. Relate results to the stages and expectations of normal visual development according to the age of the child. Discuss the results in terms of the eight areas of functional vision and the implications for the content of a training programme.Use references such as the Low Vision Kit, Low Vision Online and the Low Vision Toolkit to identify content areas and examples of the content of a training programme. List resources needed for a training programme.

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Stage-7: Reporting the findings of a functional vision assessment and training programme

The record form in the Low Vision Kit can be used as a guide for the content of the findings from a functional assessment. The Low Vision Toolkit has examples of materials to explain, for example the effects of poor contrast that can be attached to a report for teachers, parents or other who work with a child. The content of the training programme should be arranged under headings used in the functional assessment.

Select results from a child assessed and compile a report from the group on the contents of a training programme.

REFERENCES Low Vision Online. www.lowvisiononline.unimelb.edu.au/LVO.htm

World Health Organization Low Vision Kit.

Focus on Low Vision. http://www.cera.org.au/wp-content/uploads/2013/12/CERA_FocusLowVision.pdfor http://catalogue.nla.gov.au/Record/4587925

Teachers Curriculum 33

Session Plan 11

Selection and use of optical low vision devicesTime : 4 hours

Outcomes : The ability to select optical low vision devices and teach people with low vision how to use optical low vision devices.

Objectives : Aware of the different types of optical devices that are

available for people with low vision and their uses Able to select optical low vision devices for people

with low vision Able to develop a training programme for people with

low vision in the use of optical low vision devices Able to explain the use of near vision optical devices Able to explain the use of distance optical devices.

Session plan :Stage Content Material

Stage-1 Description of optical low vision devices

Example optical low vision devices

Stage-2 Selection and use of near vision optical devices

Examples near vision optical devices

Stage-3 Selection and use of distance vision optical devices

Examples of distance vision optical devices

Stage-4 Development of a training programme in the use of low vision devices

Sample training programme

Stage-1: Description of optical low vision devices Ask the participants if they know the types of optical devices available for people with low vision?

Describe the types of optical low vision devices

Teachers Curriculum 34

a) Near vision devicesb) Distance vision devices

Stage-2: Selection and use of near vision optical devices Discuss near vision optical devices. Ask participants to brainstorm the advantages and disadvantages of the different near vision optical devices (i.e. uses, field of view, lighting conditions, age groups, co-morbidities).

Demonstrate how to use near vision optical devices and explain the different situations where a person would require a specific near vision device.

Reading spectacles Hand held magnifiers Stand magnifiers Finding the enlargement ratio for a stand magnifier Near vision telescopes Tints

Practical exerciseAsk participants to split into pairs. Have the participants practise teaching one another how to use the near vision optical devices.

Describe how optical devices affect reading speed for people with low vision.

Discuss the pros and cons of using low vision devices vs. non-sighted techniques (such as Braille) for the education of children with low vision.

Also discuss the pros and cons of using optical devices versus large print in education services for the children with visual impairment.

Stage-3: Selection and use of distance vision optical devicesDiscuss distance vision optical devices and explain the difference between monoculars, binoculars and telescopes. Discuss the advantages and disadvantages of the different distance vision devices (i.e. procedures, field of view, image brightness, and client groups).

Telescopes Galilean telescope Astronomical telescope

Practical exerciseAsk participants to split into pairs. Have the participants practise teaching one another how to use the distance vision optical devices.

Teachers Curriculum 35

Case studyAssign the participants cases studies of people with different visual problems, ages and functional levels. Ask participants to prescribe suitable optical low vision devices for each of these individuals.

Stage-4: Development of a training programme in the use of low vision devicesDiscuss the development process and key components of training programme. Share the aspects which need to be considered and develop a sample format of training programme including objectives, activities, duration, timeframe, and outcome.

REFERENCEShttp://www.cehjournal.org/article/low-vision-devices-for-children/

http://www.cehjournal.org/article/when-someone-has-low-vision/

http://www.cehjournal.org/article/low-vision-devices-and-training/

http://www.lowvisiononline.unimelb.edu.au/Assessment/index.htm

All about low vision. http://www.lighthouse.org/about-low-vision-blindness/all-about-low-vision/

All about vision. http://www.allaboutvision.com/lowvision/

Teachers Curriculum 36

Session Plan 12

Adaptations to the environment and non-optical devicesTime : 4 hours

Outcomes : Able to adapt the environment to assist people with low vision and demonstrate the use of non-optical low vision devices

Objectives : Understand environmental adaptations to assist

people with low vision Selection of non-optical materials for people with low

vision Session plan

Stage Content MaterialStage-1 Adapt or modify the

environment

Stage-2 Description of non optical low vision devices

Non-optical low vision devices

Stage-3 Selecting non-optical devices

Case studies and non-optical materials

Stage 4 Visit a class room

Stage-1 : Environmental adaptation Discuss the key fundamentals of environmental adaptation and consideration to make the environment accessible. Share suggestions for adaptive techniques and materials that will help people with low vision function more effectively.

Environmental modification can include; changing the size, distance, color and contrast of things being used in daily living activities, and the use of suitable light. Simple placement of furniture and other items in the house can also be very helpful for a person with low vision in everyday life.

Stage-2: Description of non-optical low vision devicesAsk the participants what they know about non-optical low vision devices and why a person would use non-optical rather than optical devices?

Teachers Curriculum 37

Review the elements of vision (light detection, colour, shape, form, and position). Explain how non-optical devices are used to modify the different elements of vision to assist people with low vision.

Demonstrate the following materials. Ask participants to brainstorm their uses and advantages.

lighting: adjustable table lamps, wall lamps, globes reading: enlarged and high contrast print, typoscopes (reading guides),

reading stands (fixed, adjustable, illuminated), tape recorders, reading material in Braille, flash cards, tactile cards, cards with enlarged and high contrast alphabets, numbers, pictures.

writing: bold-line papers (English and Math), writing guides (letter, signatures, cheque, envelope), markers, stencils, writing pens with light

activities of daily livingo Time: large print and regular high contrast clocks (wall clocks, table

clocks, wrist watches), talking clocks and watcheso Date: large print calendaro Pouring liquids, identifying and labelling

domestic activities: o cooking: contrast handles and borders, large print and high contrast

labelling o sewing: needle threading devices, blind needles, frames, washing

clotheso gardening: high contrast

recreation: chess, high contrast playing cards, footballs, audible balls self-care activities: magnifying mirror, lipstick, nail polishes, health care:

Electronic Devices In cases of severe visual loss where optical visual devices do not provide adequate help, electronic devices can be helpful. These are two basic types of electronic low vision device. One type displays the task in a magnified or enhanced form on a monitor, and the other type is used to convert text into speech. Discuss how these work and demonstrate usage.

Stage-3: Selecting non-optical devicesExplain the assessment process used to decide when to prescribe non-optical materials:

Explain the interview process to determine the activities that the client performs or would like to perform, and areas of difficulty. Participants should practice their interview technique and determine important activities in a patient’s life. They should also attempt to solve any problems the persons with low vision encounter in daily life due to their visual impairment and consider other physical or cognitive impairments that may impact on their ability to use the materials.

Teachers Curriculum 38

Discuss availability of non-optical materials in the local areas and methods of accessing or purchasing materials.

Group workBreak the class into groups and assign person in each group to act out a case study. Group members should interview the person with the case study to determine meaningful activities, strengths and areas of difficulty. Each group should brainstorm devices that would be useful to help this person with low vision participate in daily tasks. Members of the group should teach the ‘client’ how to use the non-optical device. Groups should swap case studies and have another person from the group act out the new case study.

At the end, distribute a written work plan card to every participant and ask them individually what materials will be needed for a person with low vision to finish that particular plan, and how that will help them.

Stage 4: Visit a class roomArrange a class room visit and ask participants to make environmental adaptations - modifications for a case study to maximize the use of vision, i.e. changing lighting, contrast, color, distance, and size of object in the environment.

REFERENCES

http://www.lowvisiononline.unimelb.edu.au/Assessment/index.htm

http://www.cehjournal.org/article/low-vision-and-rehabilitation-for-older-people-integrating-services-into-the-health-care-system/

Creating a comfortable environment for people with low vision. http://www.afb.org/info/low-vision/living-with-low-vision/creating-a-comfortable-environment-for-people-with-low-vision/235

Organizing and modifying your home. http://www.visionaware.org/info/everyday-living/home-modification-/12

Making life easier for people with low vision. http://www.cehjournal.org/article/making-life-easier-for-people-with-low-vision/

Tips for Modifying the Learning Environment for Children with Visual Impairments and Additional Disabilities. http://www.perkinselearning.org/activity-bank/tips-modifying-learning-environment-children-visual-impairments-and-additional

Household tips for people with low vision. http://www.environmentalgeriatrics.com/pdf/handouts/household_tips_low_vision.pdf

Teachers Curriculum 39

Session Plan 13

Training in the use of vision, visual skills, and training in the use of low vision devices

Time : 10 hours

Outcomes : Able to assist people with low vision to best utilize their vision.Objectives :

identify the concepts of low vision training describe general training (learning/teaching) concepts

and strategies to motivate clients development of visual skills training programme demonstrate training of basic visual skills

Outcomes : Participants will be able to use, and provide training on, the appropriate materials for people with low vision.

Session plan

Stage Content Method MaterialStage-1 Factors affecting vision Discussion,

instructionPictorial

Stage-2 Visual skills required to perform functional tasks

Instruction

Stage-3 Training on how to optimize the function of the areas of deficiency

Instruction

Stage-4 Development of visual skills training programme

Discussion Training programme format

Stage-5 Training of visual skills Discussion, instruction, brainstorm, small group work

Completed functional assessment form

Optical low vision devices

Teachers Curriculum 40

Process:

Stage-1: Factors affecting vision Describe and discuss the concepts of vision. Discuss myths about using vision (e.g. clarify with participants that people’s vision will not deteriorate if they use it).

Discuss why it is important for people to use vision.

People must be acquainted with how to make best use of their vision. Use of vision can be explained using; guidance, counselling, rehabilitation, training on special tips, techniques to perform different tasks, and environmental modification.

Discuss the features that affect how well a person can see and recognize objects:

Familiarity Distance Size Details or simplicity Light Contrast Colour Mobility Complication Position Time given

Ask participants, how can we adapt features to enable people to make better use of their vision?

Stage-2: Visual skills required to perform functional tasksDescribe that in order to encourage the use of vision, vital information needed about a person with low vision is h/her:

Visual Acuity (near and distance) Visual Field Colour Vision Day Vision Night Vision Contrast Sensitivity Illumination preferred Visual skills - how the person is able to use vision for a particular purpose

Define and describe the visual skills which are used to enhance functional vision:

Awareness Attention Visual Fixation Peripheral Vision Tracking

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Scanning Contrast Sensitivity

Define and describe the perceptual skills used to enhance functional vision:

Visual Identificationo Matchingo Identification (of patterns, numbers and words)o Classificationo Colour Concepto (Pre-reading skills and reading skills)

Perceptual Constancy Discrimination (discrimination of details of the objects and pictures) and

figure-ground Visual Memory Visual Closure Visual Spatial Relations Perception Visual-motor Coordination – gross and fine motor skills Pre-writing skills and Writing Skills

Stage-3: Training on how to optimize the function of the areas of deficiencyWith a completed functional assessment form:

participants to write down the problem the case study client demonstrated identify the specific areas where they may face problems in daily living

activities. Based on these areas, the next course of action should be considered.

Stage-4: Development of visual skills training programmeProvide an overview for developing a visual training programme based on the functional assessment.Participants to identify different types of activities according to the different functional problem and write a plan (e.g. task analysis) for teaching the activity (this may be training in visual skills or an activity of daily living).

Skill can be improved through practice and increasing everyday use gradually.

Each group will present their activity to the class.

Stage-5: Training of visual skillsDiscuss the purpose of visual skills training – write a list of aspects (e.g. attention, visual acuity, visual field, scanning etc.). Ask participants to correctly identify aspects which can be modified and those that cannot be changed (e.g. visual acuity).

Identify the three aspects of vision training

1. Encouraging use of vision (early intervention)2. Visual efficiency – how vision is used, interpreting meaning of shapes, using

vision in combination with other senses3. Changing the environment

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Revise the key components of training programme.

1. Look at the results of the functional vision assessment2. Identify areas – 7 areas of visual skills

a. Is there a particular area that stands out? E.g. Problems with areas 7 (a and c). 7a is only outlines, so is easier, therefore train this first.

b. In the areas identified, what is the particular problem?3. Set objectives

a. Start with easy to more difficult. E.g. change fixation – horizontal, vertical, diagonal. Scanning – is general, speed or distance scanning the problem?

b. Set a clear objective4. Select activities

a. Age-appropriateb. Related to tasks person needs to learn

5. Traininga. Set time limitsb. Relate training to objectives. You may want to break the long term

objective into shorter term ones.6. Evaluation

a. Assess the results of your programme. Decide how and how often to assess results.

Provide an overview of intervention for training visual skills

General principles (e.g. simple to complex) Four stages of training (touch, touch and vision, vision confirmed by touch,

vision only) Activity and environmental hints for increasing attention and motivation

BrainstormBrainstorm with the participants a sequence of simple activities for one of the skill areas (e.g. attention and awareness), using the sequence outlined (four stages).

Group workIn small groups, discuss the functional assessment results of two children or case studies with low vision. Provide the group with completed functional assessment forms. Provide each group a selection of primary school books and/or other relevant materials to assist in identifying useful training activities. Participants to:

Choose two different areas of difficulty for vision training Set objectives Select activities in a good sequence for each area on a flipchart. Relate

activities to what the child does and how she lives e.g. classroom, ADL, farm work. Include one children’s game

Set a time limit for the training and details of evaluation.

Teachers Curriculum 43

Discuss each flipchart Is the problem correctly identified? Is the sequence of activities correct? Are the activities appropriate?

Low vision devices: Divide participants into groups. Ask each group to examine a case study of someone with low vision using the completed assessment forms. Participants to:

Determine what type of optical low vision device the case-study would need, and what prescription.

Determine what type of non-optical materials would be needed after providing information on light, colour and contrast vision.

Provide a rationale for these decisions. In order to determine the best materials for someone, a person’s age, profession and condition are important factors to take into account. For instance, age, and if a person is in school are important factors for determining the approach for education. If the client is involved in a job, the nature of the work should be a major factor in determining the appropriate materials.

REFERENCES

http://www.lowvisiononline.unimelb.edu.au/Assessment/index.htm

http://www.cehjournal.org/article/low-vision-and-rehabilitation-for-older-people-integrating-services-into-the-health-care-system/

Teachers Curriculum 44

Session Plan 14

Accessibility Time : 2 hours

Outcomes : Understanding of adaptive daily living skills and practical techniques for training people with low vision. Knowledge on how to adapt an environment to promote independence.

Objectives : aware of the impact of low vision on activities of daily

living; able to train a person with low vision in adaptive daily

living skill techniques; aware of modifications that can be made to the

environment and building design to assist people with low vision.

Session Plan :Stage Content Method Material

Stage-1 Independence / activities of daily living and low vision

Practical exercise, discussion

Low vision simulators, bowls, cups, food, drink, utensils

Stage-2 Evaluating independence / adaptive skills

Practical exercise, discussion,

Stage-3 Teaching and learning strategies

Instruction, practical exercise

Stage-4 Adaptive living techniques Instruction, demonstration, practical exercise

Clothes, coins, food,

Stage-5 Physical access and environmental modifications

Instruction, group work

Photographs or community visit

Process:Stage-1: Independence / activities of daily living and low visionDiscuss the concept of independence taking into the consideration of “Culture for All” and activities of daily life.

Teachers Curriculum 45

Practical demonstrationHave participants attempt to complete some daily living tasks using low vision goggles. For example: eating a meal, pouring a drink.

Discuss the activity with the group. Ask the participants questions about:

Was the task difficult? What effect can low vision have on independence? What difficulties may exist with different eye conditions and types of vision

loss (e.g. peripheral, central vision loss, glare)? What other factors may impact upon performance? For example age,

habit, motivation, co-existing disabilities, cognitive impairment/ memory.

Stage-2: Evaluating independence / adaptive skillsDescribe how to obtain information about the person’s independence / safety:

1) Interviewing

Obtain a client history – find out about the client’s meaningful activities, social support, financial situation, access to services, age/developmental stage.

Determine activities where they currently experience difficulty or cannot participate in, but want to. Discuss different attitudes (e.g. some people may be satisfied with receiving assistance from other people, whilst others may want to do most things for themselves).

2) Observation of tasks – observe areas of difficulty, safety precautions.

Stage-3: Teaching and Learning strategiesDescribe concepts of learning and training skills:

Task analysis – breaking the skill down into small steps Chaining – forward chaining: teaching the skill from beginning to end; and

backward chaining: teaching the skill from the last step to the first step Removing assistance when the client is learning – reducing the physical

or verbal assistance, reducing visual, verbal or situational cues, increasing the complexity of the task (e.g. reduce the size of the objects)

Motivating the client to continue practice – reinforcement (what is motivating to the client e.g. colour, sound, reward, completion of the task), meaningful activity, learning in context, practicing in the environment.

Stage-4: Adaptive living techniquesTo promote independent living in people with low vision some basic factors should be considered and implemented. Describe and demonstrate key strategies and techniques to facilitate independence:

Routine activities: e.g. eating, identifying and accessing money, signing name, using telephone, accessing and recoding information,

Educational activities: e.g. learning concepts, recording work Employment activities: e.g. needlework, farm work, desk work

Teachers Curriculum 46

Domestic activities: e.g. laundering clothes, cooking, cutting, serving, organizing cupboards, using appliances

Recreational activities: e.g. modifying rules games, sports, watching TV. Self and health care activities: e.g. choosing clothes, applying makeup,

shaving, identifying medicines Outdoor activities: e.g. gardening, transport or mobility.

Practical demonstrationIn pairs, participants practice implementing the adaptive daily living training techniques by teaching each other e.g. folding clothes, serving rice, selecting the correct money for payment, selecting a particular object from several objects.

Stage-5: Physical access and environmental modificationsDiscuss the essential elements of physical access. It is pleasant and easy to move around in an accessible environment. Physical access means accessible parking spots, level passageways, large enough elevators and toilets and comfortable rest places. Works of art and other objects, as well as texts, are placed so they can be looked at from different heights. There are places for wheelchairs in halls with audience seating, and chairs are available in exhibition halls. Emergency plans take account of visually impaired, wheelchair users and others.

Small changes that make a big difference: minor improvements can be done without delay: remove thresholds; add seats, handrails and mini ramps, high contrast signs, etc.

Review the concepts of environmental facilitators for low vision:

Bigger (e.g. large print signs) Brighter or reduce glare (use of general lighting or daylight and task

lighting) Bolder and contrast (e.g. contrasted coloured door frames to identify

where the door is) Simplified layout (e.g. uncluttered environment, clear pathways) Use of tactile or audio features (e.g. door mat at front door, personal

assistance).

Group workIn groups, have participants to describe and assess the following of a building:

The facilitators that are present in the building (interior and exterior) for people with low vision considering the five factors above.

Environmental barriers of the building that reduce access for people with low vision

Make recommendations for improving the design, layout or features of the building.

REFERENCES

Teachers Curriculum 47

http://www.lowvisiononline.unimelb.edu.au/Assessment/index.htm

Creating a comfortable environment for people with low vision. http://www.afb.org/info/low-vision/living-with-low-vision/creating-a-comfortable-environment-for-people-with-low-vision/235

Organizing and modifying your home. http://www.visionaware.org/info/everyday-living/home-modification-/12

Making life easier for people with low vision. http://www.cehjournal.org/article/making-life-easier-for-people-with-low-vision/

Tips for Modifying the Learning Environment for Children with Visual Impairments and Additional Disabilities. http://www.perkinselearning.org/activity-bank/tips-modifying-learning-environment-children-visual-impairments-and-additional

Household tips for people with low vision. http://www.environmentalgeriatrics.com/pdf/handouts/household_tips_low_vision.pdf

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Session Plan 15

Orientation and mobility for people with low vision Time : 4 hours

Outcomes : Ability to assess and provide basic orientation and mobility training for a person with low vision.

Objectives : list the problems a person with low vision may have in

orientation and mobility discuss how to assess O&M function and the need for

training describe the important areas of O&M training for

clients with low vision teach basic orientation and mobility skills for people

with low vision appropriately refer to an orientation and mobility

instructor in the region

Session Plan :

Stage Content Method MaterialStage-1 Principles of O&M in low

visionDemonstration, discussion, instruction

Stage-2 Assessing O&M for people with low vision

Review, instruction

O&M assessment form,

Stage-3 O&M training for people with low vision

Discussion, instruction, demonstration

Telescopes, canes, O&M training handout

Stage-4 Practical session Practical training

Simulation spectacles, telescopes, canes,

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Process:

Stage-1: Principles of Orientation and Mobility in low vision Provide a description of orientation and mobility specialist role and orientation and mobility theory.

Practical demonstrationParticipants needs to work in pairs. One partner should wear a blind-fold or simulator. Under the supervision of their partner, participants should attempt to find their way around the class/outside and determine certain landmarks. Their partner should provide directions/instruction to orient partner wearing the blind-fold/goggles.

Group discussion What was difficult? What effect did it have on your mobility? Difficulties with different eye conditions and vision loss (e.g. peripheral,

central vision loss, glare). What strategies did the blind-folded person use for safety, orientation? What strategies did the supervisor use to orient their partner?

Discuss common O&M problems among people with low vision. A person with low vision not only gets sounds, smells, tactual information, but also visual cues which are often incomplete of blurred. Most commonly reported problems are:

Changes in light levels Glare Contrast Night travel Recognising faces Crowded situations Depth perception Unfamiliar areas

Stage-2: Assessing Orientation and Mobility for people with low vision Review the functional assessment and discuss the relevance of these to mobility. Ask participants to rate which skills are more important for O&M (e.g. seeing details or scanning, contrast sensitivity or colour vision).

List key areas to observe during an O&M assessment:

Size, colour, texture ad distance of objects Familiarity with objects Identification of stationary, moving objects Size of objects identified, is bigger or smaller easier? Bumping into objects of same colour as environment? Looking directly to the side/above/below an object?

Provide instructions for how to conduct a low vision mobility assessment and evaluate signs of orientation and mobility difficulty (see Low Vision Online).

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Describe the process for referring to an orientation and mobility specialist. Discuss orientation and mobility providers in the region, and how to make a referral to access specialist advice (if available).

Stage-3: Orientation and Mobility training for people with low visionDiscuss the important aspects of an O&M training programme for people with low vision. Special attention should be paid to their general health conditions, the presence of other physical or sensory impairments and their individual learning difficulties.

Motivation and positive reinforcement are of paramount importance during this stage of training. Training should be conducted outdoors to enhance awareness and utilization of environmental clues and landmarks. This is an appropriate period to develop basic cane skills and to consolidate concepts of sidewalks, blocks, streets and intersections. It is also advisable to take different weather conditions into consideration.

Provide a lecture on the different techniques used in mobility training. Demonstrate the practical techniques discussed.

1. When to use and when not to use vision2. Learning orientation concepts (important for client and description by

instructor) Positions – left, front, close sideways Directions – forward, top, down Size – small, wide, thin, high Shape – round, triangle, semi circle

Define O&M terms such as trailing, squaring-off, directional cues3. Learning how to identify and use visually useful landmarks and cues. For

example: landmarks in upper visual field, church steeple, large boab are useful for maintaining orientation

4. Visual skills training Train skills like tracking, scanning, blur/shape interpretation first Practice fixation using favourite objects Introduce LV devices (if used) after these skills have been developed.

For example: using a Telescope, using a cane.5. Learning where things are supposed to be, e.g. street signs, latrine behind

house6. Distance and depth perception concepts

Closer objects look bigger than those far away Far objects seem higher If an object is partly hidden behind another, the partly hidden one is

further away When reversing a route, visual landmarks look different

7. Lighting and glare8. Safety – protective mobility techniques9. Use of other sensory cues (e.g. tactile markers or audio cues if appropriate)

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The following activities will enable the people with low vision to use the different means of public transport while travelling independently, so that they can integrate into society:

1. Implications of traffic rules and regulations;2. Auditory analysis of traffic patterns;3. Development of advanced cane skills;4. Selection of appropriate means of transport;5. Use of good judgment under changing conditions;6. Transfer of acquired skills to new situations;7. Effective interactions with the public.

Stage-4: Practical sessionConduct a practical session in pairs. One participant to wear simulation spectacles.

Assess the person’s vision and O&M skills Teach a short new route using the training suggestions

Discuss remarks and questions after practice.

How useful was vision? Other sense needed? How does training of visual skills fit with training O&M

REFERENCESICEVI (2006). Orientation and mobility for persons with visual impairment: Steps to independence. The Educator, 19 (1). http://www.icevi.org/publications/educator/July_06/Educator_July-06_part1.html  

Low vision online http://www.lowvisiononline.unimelb.edu.au/Mobility/index.htm

http://www.tsbvi.edu/general-orientation-and-mobility-recommendations-for-functional-programs

References for participants to use:Look out Marcus. https://www.guidedogsvictoria.com.au/uploads/pdf/LookOutMarcus/LookOutMarcusWeb.pdf

Gabby’s Going Places https://www.guidedogsvictoria.com.au/uploads/pdf/GabbysGoingPlaces/GabbysGoingPlacesAccessible3.pdf

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Session Plan 16

Models of low vision careTime : 2 hours

Outcomes : An understanding of different models of low vision care

Objectives : aware of the elements and objectives of a low vision

programme Know effective resource and human resource

strategies required to implement a low vision service Be able to develop a model for a low vision service

and recommend short and long term actions for it’s

Session Plan

Stage Content Method MaterialStage-1 Inclusion/ exclusion of low

visionInstruction Journal articles/

reference books

Stage-2 Essential elements of a Low Vision Programme

Brainstorm

Stage-3 Models of Low Vision Service

Community consultation & group assignment

Process:

Stage-1: Inclusion / exclusion of low vision in Community Based Rehabilitation (CBR) programsDescribe the disadvantages of non-inclusion of low vision in traditional CBR programs:

techniques used by CBR workers are geared towards non-sighted methods

training in low vision is inadequate to offer effective services to low vision clients.

children with visual impairment usually do not fall under the responsibility of CBR workers and their education is primarily seen as the responsibility of specialist or itinerant teachers

Describe the potential effects of adding low vision services (refer to Yasmin & Minto, 2007):

children with low vision could re-enter mainstream education

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interventions to create an enabling environment and motivate the teachers and the families for the education of these children

provision of basic materials CBR workers can play an effective role in rehabilitation of persons with low vision in general and children in particular.

Stage-2: Essential elements of a Low Vision ProgrammeFor tertiary, secondary, primary levels of low vision care and community rehabilitation, brainstorm with the class:

objectives of a low vision programme personnel involved roles and functions of personnel (including teachers)

o For example, case finding and referral, assessment, advocacy, provision of basic needs, skills training, medical services, equipment provision, monitoring, eye health education, health promotion, early intervention and visual stimulation, employment, welfare

equipment required personnel training/ human resource requirements

Stage-3: Models of low vision service Participants to conduct a community survey/ field visit to determine the needs of the local community and assess how people with low vision are identified, assessed and provided with intervention or training in the local area. Participants are to propose the implementation of a low vision model in their local area, identifying the roles of personnel, training, referral procedures and services provided to people with low vision.

Participants to make recommendations for plan of action

Short term Medium Term Long Term

REFERENCESYasmin, S. & Minto, H. (2007). Development of CBR Services for Children with Low Vision. The Educator, 20 (1), 34-41. http://icevi.org/pdf/educator_july_2007.pdf

Guidelines for setting up a low vision programme for children. http://www.cehjournal.org/article/guidelines-for-setting-up-a-low-vision-programme-for-children/

Establishing low vision services at secondary level. http://www.cehjournal.org/article/establishing-low-vision-services-at-secondary-level/

Low vision and rehabilitation for older people. http://www.cehjournal.org/article/low-vision-and-rehabilitation-for-older-people-integrating-services-into-the-health-care-system/

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Asia Pacific Regional Low Vision Workshop, Hong Kong 2001. http://apps.who.int/iris/bitstream/10665/67744/1/WHO_PBL_02.87.pdf

Pizzimenti JJ. The Low Vision Rehabilitative Service Part One: Understanding Low Vision. The Internet Journal of Allied Health Sciences and Practice. July 2003. Volume 1, Number 2. http://ijahsp.nova.edu/articles/1vol2/pizzimenti-Low_Vision.pdf

Inclusion made easy in eye health programmes. Disability inclusive practices for strengthening comprehensive eye care. CBM, 2013. www.worldblindunion.org/English/resources/Documents/CBM%20Inclusion_Made_Easy_in_Eye_Health_Programs.pdf

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Session Plan 17

Selection of learning methods and materialsTime : 4 hours

Outcomes : The ability to select learning methods and materials for people with low vision

Objectives : Apply learning theories to describe the role of vision in

development and learning Identify and describe the impact that low vision has on

learning and classroom participation Be able to use learning theories and learning style

theories with individual children according to need Identify instructional and curricular techniques for

teaching children with low vision

Session Plan

Stage Content Method MaterialStage-1 Myths and facts about low

visionDiscussion and instruction

Stage-2 Learning theories and their application to low vision

Brainstorming, instruction, group work

Reference theory books, journals

Stage-3 Teaching methods for working with children who have low vision

Instruction, group work, practical

Jug, bowl, cup, soap.

Process:

Stage-1: Myths and facts about low visionMythsDiscuss common myths that exist in the community about the learning and development of children with low vision. Examples of myths include:

Children with low vision cannot learn or do not have the capacity to learn the general education curriculum

Children with low vision have intellectual impairment Children with low vision must be educated in a specialized environment

using similar strategies used for teaching blind students

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Children with low vision should be educated exactly the same as sighted children.

All children with vision impairment perform at lower levels to sighted children

All children with vision impairment need to read Braille rather than print.

Facts about development, learning and low visionProvide instruction regarding current knowledge about learning and development of children with low vision. Stress the variance amongst people with low vision – many students function at high levels and demonstrate good academic competence. However, there are potential risks and barriers to participating in the curriculum and these may impact adversely on concept development and learning.

Low vision has potentially adverse effect on development (the rate and sequence of milestones): emotional development and early attachment to parents, concept, motor, perceptual and spatial development, social development, self care and independence skills

The variation among children with low vision (difference amount of functional vision, vision condition, presence of additional disabilities, development) means that there is a great variation in the skills of children with low vision.

Potential academic achievement of students with low vision. Provide examples of people with low vision and their potential to succeed.

Other children with low vision struggle academically e.g. reading, mathematics, grade averages.

Children with low vision experience barriers to participation and learning in the classroom. Modifying the environment, instruction or using optical aids can reduce these barriers and promote access to learning.

Stage-2: Learning theories and their application to low vision Revise major theories of learning. Ask participants to contribute names and explanations of theories that they are aware of. Provide instruction on the main aspects of relevant theories. For example:

Constructivism: by reflecting on our experiences, we construct our own understanding of the world we live in. Each of us generates our own "rules" and "mental models," which we use to make sense of our experiences. Learning is the process of adjusting our mental models to accommodate new experiences.

Behaviorism (Pavlov): focuses on objectively observable behaviors and discounts mental activities. Learning is defined as nothing more than the acquisition of new behavior. Conditioning – classical, operant and conditional

Piaget Theory of Cognitive Development: the developing child builds cognitive structures (mental "maps,") for understanding and responding to physical experiences within his or her environment.

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Social learning theory (Bandura): learning occurs when an observer's behaviour changes after viewing the behavior of a model (can be affected by the positive or negative consequences of a model's behavior).

Social Cognition: culture is the prime determinant of individual development. A child's learning development is affected in ways large and small by the culture, including the culture of family environment, in which he or she is enmeshed.

Learning Style Theory: how much individuals learn has more to do with whether the educational experience is geared toward their particular style of learning. Different individuals have a tendency to both perceive and process information differently:

1. Concrete vs. abstract perceivers. Absorb information through: direct experience, by doing, acting, sensing, feeling vs. analysis, observation, and thinking.

2. Active vs. reflective processors- Make sense of an experience by immediately using the new information vs. by reflecting on and thinking about it.

Group taskAssign each group a theory.

Groups to apply the theory to explain how low vision may impact upon learning and development. For example: reduced interaction with the environment, fewer opportunities to participate in typical activities, decreased ability to visually observe and model behaviour, adult expectation of achievement.

Re-group and share with the class.

Group taskAssign groups a different theory. Participants to answer the following:

1. Apply the theory to explain the barriers children with low vision face to participating and learning in the classroom. For example:

Much learning is visual rather than verbal or tactile (child with low vision may miss concepts or learning as they are unable to see and model visual instruction).

Concrete examples where possible may promote learning of abstract concepts.

Teachers and students may have lower expectations of what children with vision impairment can achieve.

2. Describe how can aspects of the learning theories can be used in the classroom to promote learning for children with low vision. For example:

modifying the observed behaviour (encouraging verbal instruction and discussion in the class), encouraging interaction with the environment (providing concrete examples, performing tasks rather than discussing)

3. How does the theory of learning impact upon the curriculum, instruction and assessment? For example:

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Learning styles - the traditional schooling heavily favours the verbal-linguistic and logical-mathematical intelligences. A more balanced curriculum may incorporate the arts, self-awareness, communication, and physical education. Traditional schooling tends to favour abstract perceiving and reflective processing.

Stage-3: Teaching methods for working with children who have low visionDescribe behavior modification techniques (adaptations) to stimulate learning and instructional methods appropriate for children with low vision. Discuss and demonstrate each concept.

Reinforcement / reward: internal and external reinforcement; developmental differences; individual interests and motivations;

Task analysis: breaking the task into small steps; Chaining: forward and backward chaining e.g. putting on a sock; Shaping: different types of prompts and cues (physical, verbal, visual,

tactile); emphasize the importance of reducing prompts to promote learning and independence. In particular discuss the merits and disadvantages of using ‘hand-over-hand’ (teacher puts hands on top of child’s hands to direct) or ‘hand-under-hand’ (teacher puts hands under child’s hands to encourage exploration) techniques. Hand-under-hand is generally preferred as it allows the child to be in control of actions.

Age and developmentally appropriate material and instructions; Language: clear verbal instructions, direction or descriptive; Co-active teaching e.g. holding a pen, cutting a slice of bread; Time: providing more time to complete tasks; Use of residual vision and other senses.

Task analysis exercise In pairs, participants write a task analysis for a given activity (e.g. pouring water from a jug, washing hands from a bowl, eating soup etc.). Another pair then demonstrates the task, using only the steps that have been written. Provide feedback to the groups regarding the uses and importance of task analysis.

Small group exerciseEach group to prepare a session on how to teach a young child to do one of the following tasks:

1. Crawl and walk2. Put on shirt3. Peel a banana4. Wash a towel using soap bar

Participants can use any or all of the teaching methods, but in particular encourage use of co-active teaching, chaining, task analysis, clear verbal instructions).

Teachers Curriculum 59

REFERENCEShttp://svrc.vic.edu.au/supporting-students/learner-with-low-vision/

Ek, U., Fellenius, K., & Jacobson, L. (2003). Reading Acquisition, Cognitive and Visual Development, and Self-esteem in Four Children with Cerebral VisualImpairment. Journal of Visual Impairment & Blindness, 92(12), 741-754.Wall, R., & Corn, A. L. (2004). Students with visual impairments in Texas: description and extrapolation of data. Journal of Visual Impairment & Blindness, 98(6), 341-350

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Session Plan 18

Inclusive education for children with low visionTime : 4 hours

Outcomes : Understanding of inclusive education and application of inclusive education to low vision

Objectives : Understand the components of inclusive education Understand the philosophy and aims of inclusive

education Awareness of the evidence regarding outcomes in

inclusive classes Identify barriers and facilitators to inclusive

education in the region Identify teaching and curricular strategies to

facilitate inclusive education

Session Plan

Stage Content Method MaterialStage-1 What is inclusive

education?Instruction, debate

Handouts

Stage-2 Inclusive education in the region

Instruction, discussion

Stage-3 How to provide inclusive education services

Instruction Case studies of inclusive education

Stage-4 Observation of inclusion education

Observation of student class

Process:

Stage-1: What is inclusive education?Describe the brief history of the inclusive education movement and the philosophy, principles and aims of inclusive education. Provide a handout.

Children with disabilities learn from positive role models of typically developing children

Increased expectations in regular school lead to increased performance amongst children with disabilities

Children attend school and make friends with children in their local area

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Equal opportunity access to all educational experiences by all children Benefits to the community: promotes acceptance and tolerance of

differences

Describe the difference between inclusion and integration

Integration: occurs when students with disabilities who have been in a special school or class are educated for some or all of the day in regular programs. In many cases additional support is provided, although some students manage without formal assistance. Also, it is generally not the school or programme the student would have attended if they did not have a disability, as specialist teachers and supports are often available at specified locations.

Inclusion: education programs, which are designed both physically and in curriculum to provide appropriately for all students. It involves an unconditional commitment to: designing programs which fit children with disabilities rather than the child fitting the programme; instructional practices which are designed to cater for all children and diverse learning characteristics; all children belonging and learning together regardless of differences; and opportunities for students to form friendships in their local school (Gale, 1998).

Describe the evidence regarding outcomes for children with and without disabilities in inclusive vs. segregated classes. Evidence (reviews and meta-analyses) for the effectiveness of inclusive education is unclear, but equally there is little evidence for the superiority of specialized education settings. There is no evidence for negative effects of inclusive education on the child with disabilities or on other students.

DebateHave a class debate regarding the pros and cons of segregated vs. inclusive education for children with low vision. Provide 5 minutes for the groups to plan their argument. Examples of pros and cons are detailed below.

Advantages inclusive education include: Exposes the student to the ‘real’

world Curriculum is less limiting, offering

wider subject choice Provides opportunities for social

interaction with a diverse peer group

Exposes students to a broad range of ideas and concepts

Sighted peers are role models Philosophical and human rights

issues Lower instruction costs when

compared to segregated

Disadvantages of inclusive education include:

Can be socially isolating – difficult for students to form true friendships

Pace of class and physical activities may be difficult for the students to attain

Lack of opportunities for true and fair competition

Lack of understanding by school staff / perception of staff

Need for adult assistance can lead to dependency and isolation

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Advantages of segregated inclusion include:

Specialist teachers and awareness of curriculum requirements

Greater opportunities to access specialist needs

Easier achievement of balance between academic and independence skills

Access to specialized equipment

Disadvantages of segregated Often travel away from home and

local area Perception of students as being

segregated and different No opportunity to interact with

sighted children (reference: Gale & Cronin, 1998)

Stage-2: Inclusive education in the regionDescribe current educational practices regarding special education and general education of children with disabilities and vision impairment in the region. Describe any changes that have been occurring regarding inclusive education and evidence regarding inclusion and participation within the general classes.

Discuss the impact of inclusive education on the role of various personnel: general education teachers and support personnel, specialist teachers, itinerant teachers.

BrainstormBrainstorm with the class the potential in the region for true inclusive education in the region for students with low vision:

Barriers to inclusion in the region (financial, historical, infrastructure, geographical, social, resources)

Facilitators of inclusion in the region Potential ways to overcome barriers. What is required from government,

community, personnel to achieve inclusion?

Stage-3: How to provide inclusive education servicesProvide instruction regarding the theory and practice of the ‘Multi-level Curriculum’ or ‘Differentiated Instruction’ (adapting activities to target a wide spectrum of abilities of children with and without disabilities: above average, average and below average performing children). Discuss the aspects to consider in inclusive education: instruction, assessment, environment, equipment, attitude, play time or independence.

Describe strategies to determine how to meet individual student needs, particularly using an ‘Individual Education Plan’ to target specific educational and therapy (speech, physical, behavioural) objectives.

Describe the process of developing an Individual Education Plan. Discuss how to arrange a plan to meet mutual goals among parents, therapists, teachers and the school.

Discuss aspects of the Individual Education Plan:

1. Setting appropriate objectives

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2. Assigning strategies and activities within each daily subject area to meet objectives

3. Assigning personnel to provide the experiences or promote achievement of the objectives

4. Monitoring performance and achievement of goals and modifying strategies and objectives as required.

Describe classroom strategies to promote social participation among students with low vision and typically developing students e.g. buddy systems, cooperative group work.

Discuss the role of Special Educator and support personnel in supporting the Class Teacher.

Play a video to the class or examples of case studies / reports of children with disabilities (including low vision if possible) being included in regular classes.

Stage-4: Observation of inclusive educationParticipants to attend an inclusive classroom to observe a student with a disability (student with vision impairment if possible). Observe the level of involvement in activities and participation with other children, teaching strategies utilized, curriculum methods to promote inclusion.

REFERENCES

http://svrc.vic.edu.au/supporting-students/learner-with-low-vision/

Gasparetto, M.E. (2007). Education of Children with Visual Impairment in Brazil. The Educator, 20 (1), 31-33. http://www.icevi.org/pdf/educator_july_2007.pdf

Xiaguang, P. & Qingzhong, L. (2007). Education and Rehabilitation to Children with Low Vision in Special Schools in China. The Educator, 20 (1), 24-30. http://www.icevi.org/pdf/educator_july_2007.pdf

D'Allura, T. (2002). Enhancing the social interaction skills of preschoolers with visual impairment. Journal of Visual Impairment and Blindness, 96(8), 576-584.

Diane P. Bryant, Brian R. Bryant, Deborah D. Smith. Teaching Students With Special Needs in Inclusive Classrooms https://books.google.co.in/books?id=eeuECgAAQBAJ&pg=PT887&lpg=PT887&dq=www+svrc+vic+edu+au&source=bl&ots=dcHNFz6ob1&sig=cdRkPTUAvk1P-OH785TI550gDPg&hl=en&sa=X&ved=0ahUKEwi70r-hz5rLAhUUwY4KHX2TB1gQ6AEIRTAJ#v=onepage&q=www%20svrc%20vic%20edu%20au&f=false

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Session Plan 19

Role of the special education teacherTime : 1 hour

Outcomes : Understanding the dynamics of new and changing role for special educators

Objectives Awareness of the new role and responsibilities of

special educators with regards to wider aspects of education

Understand the dynamics of linkages with other stakeholders

Understand the effectiveness of cross-referral mechanism

Session Plan

Stage Content Method MaterialStage-1 Role of special education

teacherDiscussion.

Instruction

Case scenario; Presentation

Stage-2 Development of linkages and networks

Discussion

Stage-3 Development of cross-referral mechanism

Discussion, Group work

Sample referral forms, Flip charts

Process:

Stage-1: Role of Special Education TeacherDiscuss the traditional role of special education teachers and emergence of more inclusive approaches that has led to a new or changing role. The special education teacher specialty is not just a kind of education or teaching method. This job is more habilitation and rehabilitation than teaching. It is not "only" a teaching (to transfer suitable knowledge and information to students), it translates into independence and life-style.

Ask participants to share the difficulties they experience in their professional practice, and the barriers for moving towards a more inclusive model of intervention in their job. Analyse these difficulties and barriers at a personal-professional level, at an organizational and political level, because these three levels could be useful in order to explain the fundamental contradictions that are affecting professional practices. The transformation of special schools and institutes into resource centres

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is an emerging trend. In general, the following tasks are distinguished for these schools as resource centres:

provision for training and courses for teachers and other professionals; development and dissemination of specialized materials and methods; support for mainstream schools and parents; short-time or part-time help for individual students.

The presentation needs to cover the above-mentioned responsibilities of special educators and provide the basis of further discussion.

Stage-2: Development of linkages and networksAsk participants to identify the key stakeholders involved in the education process. Discuss the level of support required from these in the delivery of quality education.

Describe the most fundamental pre-requisite for inclusion - reform and restructuring of mainstream schools and of the education system itself. The other key themes are; prioritise training, collaborative working, improving quality and resources as the key areas for development. To improve the collaborative working, well established and good links need to be established with the all key stakeholders especially special and mainstream education. The linkages, developed at all levels, actively encourage and support teachers and school management to value inclusion as a challenge which has positive outcomes for all students. These also address the management issues and provide support to schools to commit towards a guiding set of principles:

all children matter; barriers to learning are identified; positive action is taken to remove them; a sense of community prevails through collaborative schools-community

relationship.

Give examples of various activities which can develop and foster effective linkages and networks within community such as networking meetings, orientation sessions, IEC material etc.

Stage-3: Development of cross-referral mechanismDescribe the effective cross-referral mechanism in the context of educational setting including the key stakeholders. Ask participants to chalk down the various departments, organisations, individuals which can be part of the process.

Discuss the factors which influence the consideration of a referral - if neither the teacher's adaptations nor the recommendations of consultants or problem-solving teams are effective, then referral to certain service should be considered. The right and timely referral increases mainstream education's capacity to accommodate student diversity and to increase the meaningful participation and the achievement outcomes of students with LV within the structure of the school. Some key dimensions of an effective referral mechanism are:

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supports the collaborative planning mechanism; provides on-going technical assistance; facilitates reintegration process; modifications in education and family support plans; main-stream information.

Sample referral forms and process to complete these should be shared with participants.

Group workDivide participants into groups. Ask each group to examine the case studies and recommend the appropriate referral by completing the referral form and advice on follow-up procedure.

REFERENCES

http://svrc.vic.edu.au/supporting-students/learner-with-low-vision/

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Session Plan 20

Psychosocial Impact of Low VisionTime : 2 hours

Outcomes : Understanding of the psychosocial impact of low vision and strategies to manage coping difficulties

Objectives : able to identify and describe potential psychosocial

effects of low vision at developmental stages aware of the signs and symptoms of psychosocial

problems and disorders aware of appropriate intervention and referral

strategies to promote healthy psychosocial development and coping

Session Plan

Stage Content Method MaterialStage-1 Social and emotional

development and effects of low vision

Instruction, group work, class sharing

References on child development

Stage-2 Awareness of psychosocial problems and psychological disorders

Instruction DSM-IV (book, handout or internet site).

Social skills assessments

Stage-3 Intervention strategies to promote healthy psychosocial development

Discussion and instruction

Intervention programs or manuals. Local referral information

Stage-4 Case study Group work Case scenarios

Process:

Stage-1: Social and emotional development and effects of low visionDescribe current knowledge regarding the psychosocial impact of low visionHighlight that differences exist between people with low vision; while many people function at high levels and demonstrate good social competence, develop strong, meaningful friendships and do not experience psychological problems, others can experience difficulties coping.

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Explain how low vision can lead to problems with the psychosocial well-being of students and adults with low vision. Describe these to the class, based on current literature.

Social impact of vision impairment it is more common for children with vision impairment to interact with adults in

classes rather than peers and spend less time interacting with peers. Sighted children more often choose sighted peers to interact with;

breakdown in communication with peers (particularly for younger children) is common;

isolation and or rejection by peers due to differences in appearance; stereotypical behaviours, social behaviours or specially adapted equipment.

potential for overprotection by peers and adults; difficulties learning social norms. Children with vision impairment often lack

skills to appropriately enter groups, hold conversation and negotiate conflicts;

difficulties in locating peers for play.

Potential psychosocial impact of low vision a feeling of difference to others; adjustment difficulties. Often children with low vision have greater difficulties

than those who are blind. Because their impairment is not obvious, adults often impose similar expectations for children with low vision as they do for sighted children. Unlike blind children, children with low vision are often not afforded modifications or support they require;

loneliness or isolation; adjusting to vision loss later in childhood, grief regarding the loss of vision; vision impairment is associated with depression amongst adult populations often receive distorted and unreliable visual information, and as a result, may

grow up lacking confidence or develop a poor self-image or behavioural difficulties;

adolescents with vision impairments have significantly lower self-concept than their sighted peers. Feelings of inferiority and inadequacy caused by vision impairment could be a significant factor behind the problem of poor self-image (Beaty, 1991).

Adolescents who cannot conform to group norms are prone to peer rejection. Peer rejection and acceptance is a predictor of later academic success, social success and behaviour problems.

Stage-2: Awareness of psychosocial problems and psychological disordersDiscuss the range of normal emotions and difficulties faced in life and potential difficulties faced by students with low vision. Instruct the class on the difference between a typical or developmentally appropriate psychosocial problem / difficulty and a psychological disorder. Discuss psychological classifications for disorders

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(ICD-10, DSM-IV) compared to the range of normal experiences that people may face in their daily life.

Class discussionAsk participants to name childhood / adolescent experiences and the spectrum which exists among these experiences. Provide cues and additional information regarding disorders. For example:

sadness through to depression Periods of sadness are common aspects of life and should not be diagnosed as a Major Depressive Episode unless criteria are met for severity (see ICD-10, DSM-IV)

developmentally appropriate separation anxiety through to Separation Anxiety Disorder.

worry and anxiety through to generalized anxiety disorder. social shyness or embarrassment through to Social Anxiety. problem behaviours through to Conduct Disorder.

Instruct the class about the signs and symptoms of disorders discussed above using the DSM-IV or ICD-10 classifications and diagnostic criteria. Provide a handout of the signs and symptoms.

Instruct the class regarding identification and assessment of psychosocial disorders:

awareness of signs and symptoms allow the teacher to monitor a child’s well-being;

if any concerns are raised, discuss with parents; assessment and diagnosis is required by a professional (psychologist,

psychiatrist or counselor). Referral is important if signs are noticed; do not hesitate to refer them to a mental health professional for assessment;

if immediate assessment is needed, contact parents and take the child to the hospital emergency room;

discuss the procedure for referring to health professionals in the local area;

specialists may implement interventions such as counseling, medication and/or cognitive behavioural therapy.

Social skills deficits Discuss the signs of social skill deficits that are common among children with low vision. For example: difficulties interacting with peers and adults, inappropriate verbal or non-verbal communication skills, inappropriate social behaviours, overly assertive, aggressive or submissive behaviours.

Discuss ways to assess social skills Informal observation of social interaction.

o observe the frequency of interaction with peers, o the nature of the interactions,

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o does the child initiate interactions? o does the chid respond to other’s interactions? o are their interactions appropriate?

Standardised assessments. Teacher and parent questionnaires can be completed to measure the child’s social skills relative to the expected skills of the age range. Examples included the Matson Evaluation of Social Skills with Youngsters (MESSY), Social Skills Rating System, Vineland Adaptive Behaviour Scale. Demonstrate the procedures to administer, score, and interpret the assessments. Allow the participants to practice using the assessments.

Stage-3: Interventions strategies to promote healthy psychosocial developmentDescribe interventions to promote healthy psychosocial development.

Building social competence early exposure to social interaction is important. Encourage parents to mix

the child with other children from an early age.

Teaching social skills children with vision impairment may require explicit instruction regarding

social norms, as well as suggestions for improving social competence. This may take the form of social skills groups (a good chance to put the social skills into practice) or one-on-one training. Provide an example of a social skills training programme, manual or video.

topics may include: interpersonal communication skills; awareness of appropriate and inappropriate verbal and non-verbal behaviours, assertive communication; consideration of the perspective of others; joining groups; beginning and maintaining conversations.

using trained peers or adults to reinforce social skills and provide feedback has been shown to be effective for some children with vision impairment and other disabilities.

involve parents in teaching and reinforcing appropriate social skills.

Strategies to increase interaction between peers balance of adult involvement in promoting interaction ‘Cooperative Learning Activities’ and group games in class Buddy systems teaching peers and educators about vision impairment adapt activities to increase participation in class and increase a sense of

belonging

Strategies to deal with stress relaxation and meditation techniques,

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diversion techniques such as going for a walk, exercise rational and non-rational thoughts. teaching compensatory techniques for a realistic understanding of visual

problems

Strategies to increase confidence and self esteem mastery of skills, achievement and having positive experiences developing interests / hobbies, extracurricular activities rewards and praise in class, setting achievable goals in class

Strategies to deal with bullying or isolation instruction regarding assertive, aggressive and submissive behaviour

styles involvement in extra-curricular activities, groups and developing interests

Family relationships and role of the family discuss the importance of parent involvement, encouragement and

positive, healthy relationships with the child family barriers (expectations, poor family relationships, sibling rivalry) family facilitators (support, rewards and praise, listening and discussing

problems, stability and safety for the child) referral to counselors, psychologists, or psychiatrists. Who to refer to, when

to do so. Provide details of mental health specialists in the local area and how to find details

Stage-4: Case studyGive participants a case study regarding a student with low vision who is experiencing adjustment problems. Group members to examine and suggest:

Signs and symptoms the student is displaying How to identify the severity of the problem Suitable coping strategies Referral to specialists, local community organizations and groups

REFERENCESUCL Working Papers. Psychosocial implications of blindness and low-vision ISSN 1467-1298 https://www.bartlett.ucl.ac.uk/casa/pdf/paper114.pdf

Sharon Z Sacks Psychological and Social Implications of Low Vision in Foundations of Low Vision. Anne Corn and Jane Erin. ISBN: FOLV2, AFB Press, 2010

Focus on low vision. http://trove.nla.gov.au/work/32458520?selectedversion=NBD43720160 or

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http://www.cera.org.au/wp-content/uploads/2013/12/CERA_FocusLowVision.pdf

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Session Plan 21

CounsellingTime : 4 hours

Outcomes : Ability to use basic counselling skills as part of teaching methodology

Objectives

List the characteristics of teachers who effectively use counselling skills

Articulate the benefits of using counselling skills

Understand the concepts of counselling and techniques

Session Plan

Stage Content Method MaterialStage-1 Characteristics of teacher /

counsellor Discussion, group work

Presentation

Stage-2 Benefits of using counselling skills

Instruction Handouts

Stage-3 Counselling techniques Discussion, group work

Group exercise, handouts

Process:

Stage-1: Characteristics of teacher / counsellor Ask participants to list down the characteristic of an effective teacher and share these with the group. Discuss the key traits of an effective teacher that are:

Friendly and understanding Organized Personable Generous in their appraisal of others Child-centered in their educational approach Positive about students Fair Emotionally adjusted And students are successful when they have effective teachers

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The combination of these characteristics results in quality education and impacts on the quality of life of students with LV. The teacher/counselor:

is trained in interpersonal skills and models them for students; understands the basics of helping skills and applies them in the classroom; is attentive, genuine, understanding, respectful, and knowledgeable of

culture; assists students with self-exploration; assists students with understanding problems and making a commitment

to change; guides students in decision making to alleviate problems;

Above all, the teacher/counselor listens and helps without controlling or judging.

Stage-2: Benefits of using counselling skills Ask participants to list down the benefits of counselling and share these with the group.

Discuss the reasons why people with LV need counselling. Often, clients have encountered distressing or stressful experiences or situations which they'd like to talk about and get some advice to cope with it. In addition to help with specific goals or difficulties, clients who undertake counselling may experience general improvements in their quality of life, including:

increased self-esteem; decreased defensiveness; increased ability to express themselves; improved relationships with other people.

Stage-3: Counselling techniques Discuss the basic techniques of counseling by learning which a teacher can become an effective counselor as well.

Getting the environment right Create a space to talk which is private and quiet and where you know you will be free from interruptions (always seek the advice of a colleague about the safety and appropriateness of this action).  Where possible, make sure the seating is comfortable. Get the message across that you have time to attend to the issue that you want to address.  

Getting the listening rightOne way of encouraging a person with low vision is to make sure that they know you are listening.  You can do this by just being attentive that you are listening.  Try not to interrupt when the child/young person with LV is talking.  By occasionally saying "yes" or "aha" the child/young person should be encouraged to open up.  Make sure you look and sound calm, unhurried and caring.

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Asking the right questions Try to ask more open questions than closed questions.

An open question is one which cannot be answered with yes or no and which encourages a more detailed answer, for example:

“What are your feelings about this?” “What are the advantages of doing things the way you have suggested?” “What are the disadvantages?”

Avoid closed questions such as:

“Are you sad?” “Are you managing your work?”

Another disadvantage of closed questioning is that the desired answer might be implied within the question and you might inadvertently steer the person with LV to give an answer that they wouldn’t otherwise have given.  An example of this would be:

“Are you going to stop speaking to that boy who has been upsetting you?”

The implied expected answer here is quite clearly “yes”.

Being affirmingTo encourage the flow of conversation, it is important that you show respect by taking an accepting attitude.  The message you are trying to get across is "I have respect for your opinions and your view of the world at this present time".  This is not the same as saying that you agree with the child’s opinions or actions and it is okay for you to make it clear that your opinions and moral view are different, as long as this is done in a respectful way.

Limiting the adviceTry to limit the direct advice that you give during your conversation.  This is more important for older than for younger children who clearly need more guidance.  This is especially the case at the beginning of a problem-solving conversation.  For example, it is usually better to start with "What do you think is the best thing for you to do next?" than to say, "What you should do next is..."

Involving the familyTo ensure the success of any counselling plan, it is critical to involve families especially parents. Assess the situation and see to that the family gets all the support needed. Be especially worried if the parents are 'fine'. It means that they still deny the situation and need more than usual amount of counselling to even start thinking on their child's way of experiencing them and the world. Continuous engagement and spirited follow-up will play a vital role in the emotional well-being of children and their families.

Group exercise: Ask participants to work in groups and demonstrate the counselling techniques for a particular case scenario.

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REFERENCESHerbert, M. (2005). Developmental problems of childhood and adolescence prevention, treatment, and training /  1st ed. Malden, MA: BPS Blackwell Pub.

Peavey, K. O., & Leff, D. (2002). Social acceptance of adolescent mainstreamed students with visual impairments. Journal of Visual Impairment and Blindness, 96(11).

Sacks, S. Z., Kekelis, L. & Gaylord-Ross, R. The Development of Social Skills by Blind and Visually Impaired Students: Exploratory Studies And Strategies. New York: American Foundation for The Blind.

Focus on Low Vision or http://catalogue.nla.gov.au/Record/4587925

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Session Plan 22

Core and expanded core curriculum

Time : 3 hours

Outcomes : Participants will understand the need for an expanded curriculum for students with low vision

Objectives : Understanding of the implications of low vision for the content of the school curriculumOutline the areas and content of the expanded core curriculum for students with low visionList the human resources and equipment needed to implement the expanded core curriculum

Session Plan

Stage Content Method MaterialStage-1 Implications of low vision for

the school curriculumDiscussion

Stage-2 Areas of the expanded core curriculum and the content

Instruction

Stage-3 Human resources and equipment needs for the expanded core curriculum

Discussion

Process:

Stage-1

In addition to the core curriculum, students who are blind or have low vision have need for areas of instruction not required by their peers. The number of areas and the content of them will be related to their needs as a person with low vision.

Discuss the implications of low vision on psychosocial development, communication, mobility, independence, leisure and recreation, employment and technology.

Stage-2

List areas of the expanded core curriculum: Access to materials in the general education curriculum. Ensure skills

acquired to access print materials with or without devices; organisational skills; spatial awareness

Career education. Awareness of range of employment and ability to make personal independent decisions

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Independent living skills. Skills presented in a suitable manner and format related to financial management, personal hygiene and food preparation.

Orientation and mobility. Decisions as to methods and assistive devices to be used; training in orientation and mobility in various settings.

Recreational and leisure skills. Exposure to the range of possible activities and any training needed for participation.

Social interaction skills. Training in skills for social interaction that may not be acquired due to lack of incidental learning.

Self-determination skills. Exposure for students of choices that are available to them and how to make age- appropriate choices.

Assistive Technology. Information on low and high technology devices for education and general functioning.

Sensory efficiency skills. Assessment of needs and training for effective use of use vision, auditory and tactual skills.

Stage-3

Discuss the cadre of workers, ie teachers, rehabilitation workers or specialists needed for training of skills needed for expanded core curriculum.

REFERENCEShttp://svrc.vic.edu.au/wp-content/resources/PLlvbooklet.pdf

Sapp W, Hatlen P. The expanded core curriculum: where have we been, where we are going, and how can we get there. Journal of Visual Impairment & Blindness, 2010; 338-348

Kelley P & Gale G (Eds.) Towards Excellence: Effective Education for Students with Vision Impairments. Sydney: North Rocks Press.

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Session Plan 23

Community attitudes, advocacy and awarenessTime : 2 hours

Outcomes : Understand the role of advocacy to create community awareness and behaviour change

Objectives Understand the dynamics of community and

culture Awareness of the basic advocacy techniques Recognition of the effectiveness of community

engagement to foster the positive change

Session Plan

Stage Content Method MaterialStage-1 Engaging community Discussion

Group work

Handouts

Stage-2 Community perceptions and advocacy techniques

Discussion;

Scenario planning

Group exercise guidelines

Stage-3 Awareness leading to change Discussion;

Community fair

Flip charts, markers etc

Process:Stage-1: Engaging community

Start the session with a group exercise and ask participants to define community. Discuss the group work feedback. Community is defined as a group of people living in a particular local area and having common interests. Discuss what community engagement is, how it works, the impact that it can have, and why is it important in the educational context?

The importance of community engagement is emphasised everywhere – it is set out in law and a range of best practice guidance is available. But before beginning community engagement activity, it can be useful to look at the basics. Put simply, community engagement is the process of involving people in decisions that affect them. This means involving communities in the planning, development and management of services. It is only by listening to the experiences and ideas of

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people who live in these communities that we can find solutions that will make a lasting difference.

Discuss the role of parent teacher association (PTA). The benefits of family-school-community partnerships are many: higher teacher morale, more parent involvement, and greater student success are only a few. Interactions among teachers, students, parents and others set the tone for everything else. This is the only way to ensure the involvement of key stakeholders.

Discuss how to create a welcoming climate: When families walk into the school building they should feel they belong. Can families develop personal relationships with teachers and staff? Is the atmosphere family-friendly and accessible for everyone? Are there many ways to volunteer for parents?

Stage-2: Community perceptions and advocacy techniquesCommunity engagement activity can take place in many different ways. It can mean supporting a group of people to set up their own community group, or get involved in a local partnership. Or it can involve simply asking people to fill in a survey, or take part in a focus group. Outline different ways to understand the community perceptions about education of children with disabilities. Discuss the roles of key stakeholders and activities they can carry-out.

Some of the methods which can be used to engage with communities are: Discussion groups Public events Surveys Regular involvement of families Peer support groups Self help groups Capacity building Using art and innovation

Case studies are practical examples of organisations or techniques which have worked to improve community engagement. Share some examples that highlight both the achievements, and the lessons learned from a particular approach.

Scenario planning is another technique that tests out a number of "future scenarios" for the development of a community. Ask participants to work in small groups to envisage what things will be like in the future with regards to education of children with disabilities.

Stage-3: Awareness leading to change

Discuss the various aspects of changing community attitude and raising the level of awareness on different issues related to visual impairment, disability and right to education. It is critical to build a respectful, inclusive community - policies and programmes should reflect and respect the diversity of the families in the community. Families should be empowered to be advocates for their own and other children, to

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ensure that students have access to learning opportunities that will support their success. School staff and PTAs/parent groups can make a critical contribution to student success by ensuring all students have an advocate, whether it’s a family member, teacher, or community volunteer. Parents must know how the local school and district operate and how to raise questions or concerns about school and district programmes, policies, and activities. They also must understand their rights and responsibilities under provincial and national law and local ordinances and policies. Discuss to understand that how the school system works:

Do parents know what school staffs do and who to contact for information? Do parents know the legal rights of students? Do parents know how to get a problem resolved? Are parents offered opportunities to learn how to make the best choices for

their children's education? How often do counselors and advisers meet with each student?

Empowering families and communities is important to facilitate the children’s success in school. Explain that parents must be prepared to monitor students’ progress and guide them toward their goals so students can be ready for postsecondary education and a career. Discuss what can be done to:

Help the children set goals and plan for the future; See that the student gets assistance, such as tutoring, medical attention, or

counseling; and  Make sure after-school time is spent in constructive, enriching activities

Explain the importance of information, education and communication (IEC) material. Divide the participants in four groups to organize a community fair including the elements of information material i.e. posters; street play to highlight the importance of education of children with disabilities; PTA meeting; and role of religious and community leaders. Discuss the feedback.

REFERENCESInclusive consultation: A practical guide to involving people with disabilitiesAuthor: Commonwealth Disability Strategy; Publisher: Commonwealth Disability Strategy

http://www.eenet.org.uk/about.php

http://www.communitiescommittee.org/fsitool/Chapter2.pdf

http://www.allfie.org.uk/

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Session Plan 24

Planning and Managing a Low Vision ServiceTime : 4 hours

Outcomes : Knowledge for effective planning and management of a low vision service

Objectives

Understand the essential elements of a low visions service

Knowledge about referral pathways

Managing case files and records

Social protection

Session Plan

Stage Content Method MaterialStage-1 Elements of a low vision

service – human resources, infrastructure, technology

Discussion

Practical exercise

Various standard checklists

Stage-2 Referral pathways

Who are the service providers

How to write a referral letter and ensure follow-up

Discussion

Practical exercise

Referral forms

Stage-3 Managing case files and records

Discussion

Practical exercise

Sample case records

Stage-4 Understand social protection mechanisms

Discussion

Question and answer

Case studies

Process:

Stage-1: Describe what are the essential elements of a low vision service and explain how this is relevant to rehabilitation services.

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Low vision services are made up of 3 main elements:

Human resources – mainstream teachers, itinerant and special needs teachers, rehabilitation professionals. Understand the roles and responsibilities of each of these cadres and equip them with the necessary skills and resources to perform their roles effectively. Explain the linkage with eye health and education systems

Infrastructure – remind them about accessibility and environmental modification

Technology – essential learning and education materials for children (e.g. reading stands, lamps, optical and non-optical low vision devices), mobility devices like white cane, adaptive living devices, accessibility to information

Explain the use of various standard checklists and identify mechanisms on how to ensure that the client with low vision has access to the appropriate materials to facilitate inclusion.

Stage-2: Explain how a mapping exercise can be undertaken to identify service providers and available resources and roles and responsibilities of various stakeholders according to local context.

Demonstrate with examples of how referral pathways work and their importance to facilitating care of clients with low vision.

Explain with examples on how to write referral letters and ensure the follow-up necessary.

Stage-3: Explain the importance of maintaining proper and standardized client record sheets.

Demonstrate how data from the service can be analysed and used for planning and research. Explain how to keep copies of referral forms or letters and use these for follow-up of progress of clients.

Stage-4: Explain what is meant by social protection mechanisms and how one can access them in the local context.

Discuss various viewpoints about social protection and encourage participants to identify possible social protection options using different case studies.

REFERENCESJournal of Community Eye Health article on low vision http://www.cehjournal.org/0953-6833/17/jceh_17_49.html

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