Showing papers in "Journal of Visual Impairment & Blindness in 2010"

Sensitivity and Specificity of the Montreal Cognitive Assessment Modified for Individuals Who Are Visually Impaired

Abstract: Evaluating the cognitive status of individuals who are visually im- paired is limited by the design of the test that is used. This article presents data on the sensitivity and specificity of the version of the Montreal Cognitive Assessment for people who are visually impaired. The original validation data were reanalyzed, excluding the five visual items. The results indicated that the specificity was excellent, while sensitivity was reduced; however, the recom- mended proportionally adjusted cutoff values showed better sensitivity.

The Expanded Core Curriculum: Where We Have Been, Where We Are Going, and How We Can Get There.

Abstract: Although teachers consider the Expanded Core Curriculum (ECC) critical for students’ success, they do not provide their students adequate instruction based on principles of the ECC. A minimum level...

Health-Related Fitness of Youths with Visual Impairments.

Abstract: This study analyzed the passing rates on five health-related fitness items on the Brockport Physical Fitness Test of youths aged 10–17 with visual impairments. It found that the youths had low pass...

The Treasure in Leisure Activities: Fostering Resilience in Young People who are Blind:

Abstract: Because leisure activities are often viewed as optional, their value to people with disabilities may not be recognized. This study explored the benefits of leisure activities for eight young people...

The Social Lives of Canadian Youths with Visual Impairments

Abstract: This survey of the social and leisure experiences of Canadian youths with visual impairments found that, in general, youths with low vision experienced more social challenges than did their peers w...

Factors Related to the Employment of Visually Impaired Persons: A Systematic Literature Review:

Abstract: The aim of this systematic review of the literature is to increase understanding of the factors that influence the labor force participation of persons who are visually impaired. Labor force participation was associated with many factors, such as communication training and education. Future research should focus on high-quality studies of labor force participation and underemployment in more countries.

Assessment of Indoor Route-finding Technology for People Who Are Visually Impaired

Abstract: This study investigated navigation with route instructions generated by digital-map software and synthetic speech. Participants, either visually impaired or sighted wearing blind folds, successfully located rooms in an unfamiliar building. Users with visual impairment demonstrated better route-finding performance when the technology provided distance information in number of steps rather than walking time or number of feet.

The Reliability of the CVI Range: A Functional Vision Assessment for Children with Cortical Visual Impairment.

Abstract: Children who are identified as visually impaired frequently have a functional vision assessment as one way to determine how their visual impairment affects their educational performance. The CVI Ra...

Charles Bonnet Syndrome: A Review of the Literature

Abstract: Charles Bonnet syndrome (CBS) commonly occurs in older adults with visual impairments, particularly those with age-related macular degeneration It is characterized by complex visual hallucinations in individuals without mental disorders The authors explore diagnostic criteria, demographic characteristics, clinical features, theories of pathogenesis, and management options for people who are diagnosed with CBS ********** A substantial number of older adults without mental disorders but with age-related visual impairments experience formed visual hallucinations that are due to a condition known as Charles Bonnet syndrome (CBS; Teunisse et al, 1999) CBS is particularly common in people with agerelated macular degeneration (AMD) (Kahn, Shahid, Thurlby, Yates, & Moore, 2008; Lannon et al, 2006) and has been reported in persons with diabetic retinopathy (Holroyd, Rabins, Finkelstein, & Lavrisha, 1994; Teunisse, Cruysberg, Verbeek, & Zitman, 1995; Teunisse, Zitman, Cruysberg, Hoefnagels, & Verbeek, 1996), glaucoma (Nesher, Nesher, Epstein, & Assia, 2001), and cataract (Teunisse, Zitman, & Raes, 1994; Teunisse et al, 1995) Historically, visual hallucinations have been associated with the negative stigma of mental disorders Menon, Rahman, Menon, and Dutton (2003) stated that individuals who grasp the unreality of the visual hallucinations may be disturbed by the possibility of imminent insanity, and because of their fears, they may be reluctant to discuss their experiences with physicians or allied professionals It is important for clinicians and those in allied professions to be knowledgeable about CBS in order to avoid misdiagnoses and consequent unsuitable therapies or recommendations It has been suggested that informing a client that the hallucinations are not a result of mental illness may have a therapeutic effect (Lannon et al, 2006; Menon et al, 2003; Nadarajah, 1998) Origin of CBS In 1936, Georges de Morsier, a neurologist, coined the eponym Charles Bonnet syndrome in recognition of Charles Bonnet, who was a Swiss naturalist, philosopher, and biologist Bonnet had documented the experiences with visual hallucinations in 1769 of his 89-year-old grandfather, Charles Lullin, who had cataracts Lullin was fully aware that the hallucinations were not real because the images of buildings and landscapes would spontaneously appear, disappear, and increase or decrease in size (Hedges, 2007) Lullin was further convinced of the unreal nature of the images because they never made noise He reported seeing people, buildings, carriages, and birds Bonnet, like his grandfather, experienced visual hallucinations early in his life because of deteriorating vision (Hedges, 2007; Menon et al, 2003) De Morsier defined CBS as visual hallucinations that occur in older people with otherwise intact mental functioning, but unlike Charles Bonnet, did not emphasize that visual impairment is a possible cause of the visual hallucinations (Hedges, 2007; Menon et al, 2003) The discrepancy regarding the inclusion or not of visual impairment as part of the CBS diagnosis has resulted in a vagueness of diagnostic criteria that has led to the assumption that the condition is rare (Teunisse et al, 1996) Diagnostic criteria Various criteria exist for diagnosing CBS (Menon et al, 2003; Terao, 2002) Schultz and Melzack (1991) described previously identified core features of CBS hallucinations as (1) a clear state of mind, (2) normal perception, (3) the absence of additional auditory or olfactory hallucinations, (4) the absence of other unusual sensations, (5) the absence of control over hallucinations, and (6) the disappearance of hallucinations upon closing the eyes They believed that an additional requirement should be the presence of reduced vision Teunisse et al (1995) isolated CBS from other psychiatric disorders by requiring the hallucinations to be (1) complex, repetitive, and persistent; (2) with full or partial insight, meaning awareness that the hallucinations are not real; (3) with no additional delusions; and (4) present in the absence of additional hallucinations in the other senses …

The Employment and Postsecondary Educational Status of Transition-Age Youths with Visual Impairments.

Abstract: A limited amount of information is available about the employment and postsecondary educational status of transition-age youths with visual impairments. The National Longitudinal Transition Study (NLTS) provided valuable information about this population, but its data are now more than 15 years old. The NLTS2, a follow-up to the original NLTS, is updating information on the current status of all transition-age youths with disabilities, including youths with visual impairments. SRI International, the organization responsible for conducting NLTS2, publishes comprehensive reports on the employment and postsecondary education results of the study. However, these reports tend to focus on overall results and usually do not provide detailed analyses by disability groups. The purpose of this article is to present the most current data available on the employment and postsecondary educational status of youths with visual impairments. Detailed information about the employment experiences of these youths while in high school; the percentages employed, by educational status; and the percentages attending postsecondary schools are provided. The results are presented for the entire population of youths with visual impairments as their primary disability and with this group divided on the basis of the presence of additional disabilities. Previous research documented that the majority of youths with visual impairments have one or more additional disabilities (65%, including youths with deaf-blindness; Kirchner & Diament, 1999). METHOD Source of data The NLTS2, the source of the data presented here, contains restricted-use data that are available from the Institute of Education Sciences. It is an ongoing longitudinal study, funded by the U.S. Department of Education, that documents the experiences of a nationally representative sample of students with disabilities as they move from secondary school to adult roles. Data are being collected on a wide range of topics, including high school course work and grades, extracurricular activities, postsecondary education and training, employment, independent living, and participation in the community. At the time of this writing, data were available from Wave 1 (collected in 2000-01) through Wave 3 (collected in 2004-05), and data from all three waves were used in these analyses. Sample The sample used for this study was limited to students whose primary disability was visual impairment. Data on employment were available for 518 students from at least two waves. The following number of observations were available at each wave: 507 at Wave 1,503 at Wave 2, and 423 at Wave 3. Longitudinal analyses of work experience during the entire first three waves included all students, regardless of their educational status or age. Analyses of work experience in high school were conducted with students attending school who were aged 16 or older during Wave 2 (n = 358). These analyses were conducted with Wave 2 data because this wave provided the largest sample of students who were still in high school. Demographic information for this subsample is presented in Table 1. The data from Wave 3 were used to determine the current employment and postsecondary educational status of this population, since the youths were older during this wave, and these data were the most recent. Variables The variables of interest to this study were the employment-related (all waves) and current educational status variables (Wave 3). These variables were all available from the interviews with the parents or youths. The primary employment variable that was used for the longitudinal analysis was a question answered at each wave by either the youth or the parent about whether the youth had worked during a preceding period (12 months for Wave 1 and 24 months for Waves 2 and 3). Six different work-related items from Wave 2 were used to provide the data presented in Table 2. …

Conceptual Understandings of Seasonal Change by Middle School Students with Visual Impairments.

Abstract: The purpose of this study was to understand and describe the misconceptions of students with visual impairments about seasonal change. Students who participated in traditional instruction exhibited...

Do People Who Became Blind Early in Life Develop a Better Sense of Smell? A Psychophysical Study

Abstract: Using a set of psychophysical tests, we compared the olfactory abilities of 8 persons who became blind early in life and 16 sighted persons in a control group who were matched for age, sex, and handedness. The results indicated that those who became blind early in life developed compensatory perceptual mechanisms in the olfactory domain that involve basic sensory processes, such as the detection of odors.

Attitudes toward Everyday Odors for Children with Visual Impairments: A Pilot Study:

Abstract: The question of how the processing of stimuli from the external world is organized or reorganized when a sensory modality is altered or missing has been the subject of numerous studies, although the studies have mostly been on tactile and auditory abilities (Hatwell, 2003). In contrast, olfaction has been poorly investigated in people who are visually impaired, despite the increasing evidence that humans have a keen sense of smell (Schaal & Porter, 1991). Odors influence mood; well-being (Ehrlichman & Bastone, 1992); and social interactions, such as the choice of partners (Herz & Inzlicht, 2002). Emotional and social implications of odors go back to the earliest periods of development (Schaal, 1988). Olfaction should thus be considered a significant source of environmental information and emotions in persons with visual impairments. Most, if not all, studies of the relationship between olfaction and blindness aimed to test the intuitive hypothesis of increased sensitivity of the unimpaired senses (for a review, see Ferdenzi, Holley, & Schaal, 2004). The comparison of olfactory detection thresholds in participants with and without visual impairments first led to inconsistent results (Boccuzzi, 1962; Griesbach, 1899). More recent studies that have used more reliable methods found no difference between the two groups in olfactory sensitivity, discrimination, or cued identification (that is, the choice of the name of an odor from among several alternatives) (Diekmann, Walger, & von-Wedel, 1994; Schwenn, Hundorf, Moll, Pitz, & Mann, 2002; Smith, Doty, Burlingame, & McKeown, 1993). Conversely, more ecological perceptual tasks, such as noncued odor identification, revealed better performances by participants with visual impairments (Murphy & Cain, 1986; Rosenbluth, Grossman, & Kaitz, 2000; Wakefield, Homewood, & Taylor, 2004). This advantage was interpreted as reflecting higher attention to olfactory stimuli, resulting in deeper knowledge and the better ability to reactivate associated information. Thus, possible differences in favor of people with visual impairments may be a result more of advantages in attentional strategies than of enhanced sensitivity. This view was advocated by Tilney (1929), who examined Helen Keller: "[Her] olfactory sense shows nothing above the normal average.... Her sensory supremacy is entirely in the realm of intellect" (pp. 1242, 1254). Outstanding olfactory abilities of individuals with visual impairments have repeatedly been reported in everyday life contexts. For instance, Julia Brace (James, 1890) and an anonymous young boy (Hinds, 1984) were able to sort the freshly washed linen of acquaintances by smell alone; Willetta Huggins was able to identify the color of fabrics according to the odor of the dyes (Gault, 1923). Describing children with visual impairments sniffing out objects, people, or themselves, Hinds (1984) interpreted these frequent behaviors as an unrestrained seeking of information. Odors seem to help build representations of the environment, as Rosenfeld (2001) also suggested. In Rosenfeld's survey, respondents with visual impairments declared more often than their sighted counterparts that odors provide useful information to characterize or identify places and people. These sparse observations stimulated us to investigate olfaction-blindness interactions in everyday settings. The purpose of our study was to conduct a pilot investigation of the self-reported awareness and reactivity to odors of children with visual impairments and sighted children. A questionnaire related to relevant everyday contexts involving food and social cues, as well as the general environment, was used to determine whether, and in which conditions, odors would constitute salient cues for children with visual impairments. METHOD Participants Six boys and two girls with visual impairments, aged 8 to 11, were recruited from a specialized center in Dijon, France (see Table 1 for the characteristics of the participants). …

Interaction Coaching with Mothers of Children with Congenital Deaf-Blindness at Home: Applying the Diagnostic Intervention Model

Abstract: This article describes the application of the Diagnostic Intervention Model and its effects in two case studies of 3-year-old boys, Rolf and Ruud, using individual interaction coaching with their mothers. Positive effects were found for all the target categories in both cases, although an interaction that used materials appeared to be more complex.

Interaction of Dual Sensory Loss, Cognitive Function, and Communication in People Who Are Congenitally Deaf-Blind.

Abstract: Being congenitally deaf-blind dramatically affects a person's ability to communicate. It is well known that the development of social interaction and communication is important for the development of children and adults who are congenitally deaf-blind, and the development depends on the skills of a partner (such as a teacher of students with visual impairments, a teacher of students who are deaf and hard of hearing, and parents) in deaf-blind communication (Janssen & Rodbroe, 2007; Nafstad & Rodbroe, 1999; Rodbroe & Souriau, 1999). It can be hypothesized that cognitive function is related to the communicative abilities of the person who is congenitally deaf-blind and his or her communication partner. Limited communicative abilities may affect the cognitive function of the person who is congenitally deaf-blind. No research has been conducted on congenital deaf-blindness and cognitive function, but research on people with acquired deaf-blindness has reported a decreased cognitive function compared to people without or with only a visual or hearing impairment. Laforge, Spector, and Sternberg (1992) found, after adjusting for age, sex, and cognitive status, that persons who had visual impairments or both visual and hearing impairments were 2.5 and 3.5 times, respectively, more likely to experience a functional decline than were unimpaired older adults. In a large study of 6,112 women aged 69 and older, Lin et al. (2004) found similar odds of reduced cognitive function (2.19) for women with combined visual and heating impairments compared to women without impairments. The odds of reduced cognitive function for women with visual impairments alone were only 1.78, and hearing impairment was not associated with reduced cognitive function. No studies have investigated if the higher rate of reduced cognitive function is related to communicative abilities. The purpose of this study was to investigate the relationship, if any, between communicative abilities and cognitive function among persons who are congenitally deaf-blind. In 2003, the Danish Resource Centre on Congenital Deaf-Blindness published Aging Processes and Late Manifestations in Adults Who Are Congenitally Deaf-Blind in Denmark using questionnaires distributed in 2000 to 58 persons with congenital deaf-blindness. Different hypotheses of specific medical and psychosocial symptoms were discussed, but evaluating cognitive function was not the aim of the study, and no conclusions could be made. This study is a new and updated version of the 2003 publication, including a larger number of participants and new clinical experiences about cognitive function among people who are congenitally deaf-blind. This article focuses on cognitive function among people who are congenitally deaf-blind, in general, not on delayed manifestations in any group with a specific etiology, such as rubella syndrome (see Sever, South, & Shaver, 1985, for a review). Delayed manifestations among individuals with rubella syndrome constituted a separate aspect of the study and will be published in a separate article. THE STUDY Participants All 123 people in Denmark aged 18 and older who were known to be congenitally deaf-blind were included in the study. The Scandinavian definition of deaf-blindness was used: "a combined vision and hearing disability [that] limits activities of a person and restricts full participation in society to a degree that requires that society compensates by means of specific services, environmental alterations and/or technology" (Nordisk Lederforum, 2007). The participants were recruited from an updated national survey from 2004 (Danish Resource Centre on Congenital Deaf-Blindness, 2004; see also Dammeyer, 2010) using a screening method devised by Andersen and Rodbroe (2000). Questionnaires were distributed to all 123 individuals by mail. Six persons were omitted from the study because they (or their guardians or committees) did not want to participate. …

A Survey of Parents of Children with Cortical or Cerebral Visual Impairment.

Abstract: This article summarizes the results of a survey of 80 parents of children with cortical or cerebral visual impairment (CVI) regarding how a CVI diagnosis is received and supports that are provided ...

Profile of Personnel Preparation Programs in Visual Impairment and Their Faculty

Abstract: This survey of university personnel preparation programs in visual impairment in the United States and Canada investigated the demographic characteristics of faculty members and programs, instructi...

Tactile Functioning in Children Who Are Blind: A Clinical Perspective.

Abstract: This study of 48 children with congenital blindness who attended mainstream schools focused on the tactile and haptic skills they needed in typical academic and everyday tasks The results showed that, in general, the children mastered such tactile tasks, but some items posed special problems

The Competencies, Roles, Supervision, and Training Needs of Paraeducators Working with Students with Visual Impairments in Local and Residential Schools.

Abstract: Paraeducators who were employed by local school districts and residential schools for students with visual impairments were surveyed to determine if there are differences in their roles, training n

Exploring the Relationship between access Technology and Standardized Test Scores for Youths with Visual Impairments: Secondary Analysis of the National Longitudinal Transition Study 2:

Abstract: This article presents the findings of a secondary analysis of the National Longitudinal Transition Study 2 that explored the predictive association between training in access technology and perform...

A Best-Evidence Synthesis of Research on Orientation and Mobility Involving Tactile Maps and Models.

Abstract: A review of the literature from 1965 to 2008 on tactile maps and models in orientation and mobility yielded four pre-experimental and three experimental articles The articles were analyzed via best-evidence synthesis--a combined narrative and statistical approach--allowing for recommendations for the most effective use of tactile maps and models ********** The No Child Left Behind (NCLB) Act of 2001 places increased emphasis on evidence-based practice in the educational system by calling for the use of high-quality research methods that include rigorous and systematic procedures, rigorous data analysis, reliable and valid measures, and random assignment It also stresses that studies that are presented should be clear and detailed enough for replication and should have been approved or accepted by experts in the field This call for evidence-based practice pertains not only to subjects in the core curriculum, such as English and math, but to skills in the Expanded Core Curriculum for Students with Visual Impairments (ECC) The ECC consists of nine disability-specific skill areas that students who are visually impaired (that is, those who are blind or have low vision) need in order to gain the full benefit of the standard educational curriculum It serves as a framework that guides the provision of specialized services and skills that are necessary to compensate for the loss of or reduction in vision (Corn, Hatlen, Huebner, Ryan, & Siller, 1995; Huebner, Merk-Adam, Stryker, & Wolffe, 2004) Orientation and mobility (O&M), one area of the ECC, is defined as the ability to understand one's position in space in relation to the exterior world and to travel independently (Blasch, Welsh, & Wiener, 1997) A substantial portion of O&M instruction consists of the student physically navigating paths in a variety of settings to gain experience with travel and safety techniques (Ungar, Blades, Spencer, & Morsley, 1994) Tactile maps and models are also important O&M teaching tools, for two primary reasons First, individuals who are sighted are able to scan areas to be traveled and to create cognitive maps with relative ease (Sapp, 2003), whereas those who are visually impaired cannot do so because their visual impairments prohibit them from exploring the environment at a distance greater than their canes (Golledge, 1991, 1993, cited in Ungar, Blades, & Spencer, 1996) The rich variety of environmental information that is available to a person who uses vision cannot be fully replicated--even using the most advanced and modern Global Positioning Systems (GPS) and other mapping technologies In the case of a person who cannot adequately preview an environment using vision, tactile maps and models and other accessible mapping technology may be the best-available alternatives to visual preview Second, with standardized achievement tests continually growing in importance because of the accountability standards outlined in NCLB, students in typical classrooms are increasingly asked to demonstrate proficiency in the use of maps This is a standard that students with visual impairments must also meet if they are to achieve on the same level as their sighted peers in inclusive settings (Budd & La Grow, 2000) With the call for evidence-based practice, we posed the following question: What studies exist in the area of O&M tactile maps and models that meet the criteria of "scientifically based" research on educational practice as stipulated by NCLB? The purpose of the best-evidence synthesis presented here, which is a combination of statistical and narrative analysis, was to examine the use of tactile maps and models related to O&M and to review evidence on the effectiveness of these assistive devices for individuals with visual impairments to gain more independent and efficient access to the environment The studies allowed us to measure maps and models as explanatory variables and independence and efficiency as response variables …

Statement on Cortical Visual Impairment

Abstract: In August 2008, the American Printing House for the Blind (APH) brought together an advisory group to provide guidance and clarity on a range of issues related to cortical visual impairment (CVI) as those issues relate to the development of products The internationally drawn CVI Advisory Group, with members suggested by APH ex officio trustees and consultants, represents a continuing effort by APH to serve the growing group of students with CVI who are registered for Federal Quota funds Previous activities conducted by APH on behalf of these students have included improving the Federal Quota registration process by better defining eligibility criteria; hosting a CVI Synergy meeting in Louisville, Kentucky; identifying existing APH products that serve the unique needs of this population; developing and manufacturing new products for students with CVI; creating a CVI web site; and providing information on APH products that are related to students with CVI through workshops of the APH National Instructional Partnership DEFINITION OF CVI: A WORKING DEFINITION FOR EDUCATIONAL SERVICES CVI is defined as impaired vision that is due to bilateral dysfunction of the optic radiations or visual cortex or both It can coexist with ocular and ocular motor disorders and can be the result of perinatal brain dysfunction or be caused by trauma Approximately 30%-40% of children with visual impairments have CVI (see Figure 1, which can be viewed in an area dedicated to CVI on the American Foundation for the Blind's web site at ) One concern of professionals in the field of education of students with visual impairments is to establish a standard definition of CVI Accordingly, the purpose of this article is to clarify the differences between children who qualify for services from vision educators and those who have visual processing difficulties that are not considered visual impairment Our perspective is that all children who have CVI should be classified as visually impaired and receive the necessary services, regardless of the severity of the degree of CVI or additional disabilities A child with CVI is distinguished from a child with learning disabilities or developmental disabilities by the following criteria: (1) an eye examination that cannot fully explain the child's use of vision; (2) a history or presence of neurological problems, even when the child's brain-imaging studies may appear normal (Dutton, 2008); and (3) the presence of the behavioral or visual responses that are collectively associated with CVI In most North American jurisdictions, low vision is defined as a reduction in visual acuity no better than 20/70 (6/21) but better than 20/200 (6/60) in the better eye with the best correction Legal blindness is defined as visual acuity no better than 20/200 (6/60) in the better eye with the best correction Legal blindness is also defined as a central visual field that is no greater than 20 degrees Using this framework, CVI should be defined, albeit arbitrarily, by a reduction in visual acuity, in the visual fields, or in a child's ability to see compared to other children of the same age Unfortunately, traditional methods of precisely determining acuity or visual field function in children with CVI are problematic Because children with CVI frequently have additional disabilities, it is often difficult to measure visual acuity When it is possible to do so, standard visual acuity testing should be performed Electrophysiological measures, such as visual evoked potential acuities, may also be used When warranted, visual acuities should be measured using forced-choice preferential looking acuities or estimating visual function through the identification of sized objects at specific distances Dutton (2008) and others have proposed a theoretical construct for classifying higher-level visual processing This framework considers the effects of damage to the dorsal and ventral streams of the brain to explain visual dysfunction …

Sexual Health Education for Children with Visual Impairments: Talking about Sex Is Not Enough.

Abstract: This study investigated problems that children with visual impairments experience with sexual health education. The participants identified themes that affected their knowledge of sexual health and...

Visual Search Training and Obstacle Avoidance in Adults with Visual Impairments

Abstract: This study assessed the effect of visual search training on the avoidance of obstacles by adults with visual impairments. A significant reduction in contacts with obstacles under mesopic conditions was found in individuals who received search training. This finding suggests that search training had a positive effect on mobility performance. ********** Mobility is the ability to move independently, safely, and efficiently through the environment. In the context of a visual impairment (that is, blindness or low vision), this movement is achieved primarily by walking. In a previous study, we found that visual search ability, assessed on a feature search task, was strongly associated with mobility performance in persons with severe visual impairments (Fuhr, Liu, & Kuyk, 2007). Specifically, reaction times on the feature search task were found to explain up to 67% of the variance in mobility performance in persons with visual impairments. We also found that although the participants with visual impairments searched more slowly than did the sighted participants, their reaction times were independent of the number of distracters, suggesting that the search was done in parallel (Kuyk, Liu, & Fuhr, 2005). Last, we found that, like the performance of sighted persons, the performance of persons with visual impairments on the search tasks improved with training (Liu, Kuyk, & Fuhr, 2007). Since the visual search performance of persons with visual impairments can be improved with training and is strongly associated with their mobility performance, an obvious question is: Will improved visual search result in improved mobility performance? The findings of several studies suggest that this may be the case. Dodds and Davis (1987) found that persons with visual impairments who received training in visual attention tasks that included detecting motion as a result of textural shearing, searching for a familiar shape embedded in an array of lines, and detecting a parafoveal target while monitoring a foveal one, improved not only their performance on the tasks, but their mobility performance. Virtual reality training of stroke patients with unilateral spatial neglect has also produced some encouraging results. After training in a virtual environment obstacle course, the patients looked more toward the neglected side (Katz et al., 2004), were less likely to bump into obstacles (Jaffe, 2004), made fewer errors in wheelchairs on a real obstacle course, and reported fewer falls and accidents during hospital stays (Jaffe, 2004; Webster, Szeto-Wong, McFarland, & Abadee, 2000). Some of the effects of training persisted after training had stopped. In such training, the virtual environment was comparable to a real environment in terms of visual content, and the patients were learning a set of visual skills in the virtual environment that was specifically related to mobility. The fact that the patients performed better in the real world after being trained in a virtual one suggested that their task-specific virtual experiences were partially transferable to real-world environments. In another study, 29 stroke patients with homonymous visual field defects without neglect were given 20 daily training sessions in visual search tasks (Pambakian, Mannan, Hodgson, & Kennard, 2004). The training resulted in a significant shortening of reaction times while searching and a small but significant improvement in activities of daily living (coin collecting, post box, bead threading, bead placing, and nut sorting), indicating that specific daily living skills may benefit from visual search training. Although the results of these studies are interesting, for different reasons they do not answer our question about the visual search training of persons with visual impairments. The improved mobility found by Dodds and Davis (1987) is more suggestive than definitive because changes across their three performance measures were not consistent. …

Cerebral Visual Impairment in Children: A Longitudinal Case Study of Functional Outcomes beyond the Visual Acuities.

Abstract: Damage to the areas of the brain that are responsible for higher visual processing can lead to severe cerebral visual impairment (CVI). The prognosis for higher cognitive visual functions in children with CVI is not well described. We therefore present our six-year follow-up of a boy with CVI and highlight intervention approaches that have proved consistently effective. ********** Cerebral visual impairment (CVI) is the most common cause of visual impairment in children in the developed world (Gronqvist, Flodmark, Tornqvist, Edlund, & Hellstrrm, 2001). When damage occurs anywhere along the visual pathway (the anterior visual pathway, the lateral geniculate bodies, the optic radiations, and the occipital cortices), the resulting visual impairment can be obvious, with a clear restriction in the visual field or a reduction in visual acuity. However, visual impairment can also arise from perceptual and cognitive visual dysfunction that is due to damage to the areas of the brain that are responsible for higher visual processing. The inferior temporal lobes and the ventral stream pathway that connects them to the occipital lobes are responsible for recognition, orientation, and navigation. Children with ventral stream dysfunction can have difficulty recognizing people and shapes and can become easily lost even in locations that they know well (Dutton, 2003). The posterior parietal lobes and the accompanying dorsal stream pathways enable a child to analyze complex visual imagery, to apply selective visual attention to elements in the environment, and to guide his or her own movement by means of vision. Dorsal stream dysfunction is perhaps the most common symptom complex that has been identified in children with CVI. These children have difficulty extracting information from crowded visual scenes, lack visual attention, and have inaccurate visual guidance of motion of their lower and upper limbs (optic ataxia), which may be accompanied by lower visual field impairment (the term visual field loss is not used because it has not been lost; it has not developed) (Dutton et al., 2004; Fazzi et al., 2004; Steirs, De Cock, & Vandenbussche, 1999). Both lower visual field impairment and optic ataxia may contribute to difficulty walking over uneven ground, problems crossing floor boundaries, and difficulty with steps and stairs. Children with periventricular whitematter pathology can present with severe perceptual and cognitive visual dysfunction despite relatively normal visual acuities (Jacobson & Dutton, 2000). This dysfunction can sometimes lead to a delayed diagnosis of their visual problems. Although the level of vision of adults with CVI on long-term follow-up has been well described and improvements have been reported (Casteels et al., 1997; Huo, Burden, Hoyt, & Good, 1999; Roland, Jan, Hill, & Wong, 1986), the prognosis for higher cognitive visual functions in children with CVI has been poorly described. We therefore present the results of our six-year follow-up of Quentin (a pseudonym), a 9-year-old boy who had a delayed diagnosis of CVI at age 3 when he was first referred to our clinic. His difficulties are described in detail to enable a full understanding of his problems. Informed consent for the publication of the details of the case was obtained from Quentin's parents. Case report Quentin is a 9-year-old boy who has marked CVI. We first met him when he was referred by his local ophthalmologist at age 3. Quentin was initially being followed up with a left convergent squint and nystagmus. He was also being seen for regular screening for retinoblastoma because of a family history of the condition. Quentin was referred to our unit at the request of his mother. BIRTH HISTORY Quentin's birth was uncomplicated and was induced at 39 weeks and 5 days because of concerns regarding his mother's pre-eclampsia in a previous pregnancy. …

The Inclusive Educational Process of Students with Visual Impairments in Spain: An Analysis from the Perspective of Organizations:

Abstract: The research was funded by CIDE (Centro de Investigacion y Documentacion Educativa [Educational Research and Documentation Center]), Ministerio de Educacion (Spanish Ministry of Education), supervi...

The Selection of Tangible Symbols by Educators of Students with Visual Impairments and Additional Disabilities

Abstract: Tangible symbols are objects or partial objects that can be physically manipulated and that share a perceptual relationship with what they represent, known as the referent (Trief, 2007; Westling & Fox, 2009). They make fewer demands on memory and representational ability, making them an appropriate expressive form of communication for individuals with visual impairments and additional disabilities who communicate at the presymbolic level (Rowland & Schweigert, 2000). Although other communication forms, such as sign language, braille, and line drawings, have been standardized, little has been done to establish a standardized set of tangible symbols (Trief, Bruce, Cascella, & Ivy, 2009). Tangible symbols may be individualized or standardized. Individualized tangible symbols represent an experience of an object, person, or activity that is highly idiosyncratic to one child. Standardized tangible symbols often represent a dominant feature of an object, person, or activity that could be recognized by many children. It is possible to use the same tangible symbol for multiple children if they interact with the referent in the same way (Downing, 2005), making standardized symbol systems particularly relevant for experiences that are similar to a number of individuals. This article discusses the tangible symbols that special education teachers, paraprofessionals, and speech-language therapists (collectively referred to as educators) selected (from a standardized set of commercially produced symbols), the characteristics of the symbols that were selected, and implications for the development of a starter kit of standardized tangible symbols for use in schools. The selection of tangible symbols by educators is important to investigate because it highlights the topics that educators regard as important to the classroom context, giving insights into the kinds of communications that are expected from children at different ages. METHOD Participants The participants were 29 educators in four urban public schools in one large city on the East Coast that serve children who are visually impaired (that is, those who are blind or have low vision) aged 3-21. At the four schools, parental permission and approval from the institutional review board at Hunter College was obtained for 51 children to participate in a larger field-based study in which tangible object symbols were introduced over a seven-month period. The educators in this study were the persons who were directly responsible for communication-based programming for the 51 children, including the selection of which symbols to introduce throughout the school year. These children had both intellectual disabilities (severe and profound) and visual impairments with normal or aided hearing that allowed them to access auditory information for learning. They communicated at the preintentional to early symbolic level (that is, five or fewer words, signs, or pictures). Procedure The participants were given a commercially produced standardized set of 48 tangible symbols, manufactured by the Adaptive Design Association in New York City. These 48 whole-and partial-object symbols were developed on the basis of data from a survey of 29 special education teachers and speech-language therapists, coupled with input from a focus group of 14 advisory board members (school directors, speech-language therapists, the designer and manufacturer of the symbols, a representative of the Perkins School for the Blind, 3 college professors, and a graduate research assistant) (Trief et al., 2009). These commercially produced tangible symbols were designed to be representations for commonly occurring words in school vocabularies. In addition, this team of professionals assigned each tangible symbol to one or more of the following categories: transition (T), location (L), choice making (Ch), and conceptual skills (C). It is critical to note that these standardized symbols were not intended to replace existing individualized symbols but, rather, to augment individualized symbols that were already in use or would be needed in the future. …

Language and Play in Students with Multiple Disabilities and Visual Impairments or Deaf-Blindness:

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An Assessment-for-Learning System in Mathematics for Individuals with Visual Impairments.

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