22 | Addendum: TVI Guide

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Guide for Providing AT for Students with Visual Impairments

According to annual disability statistics, fewer than .9% of children ages 5 through 17 in the United States have a vision disability. While children with visual impairments represent a small proportion of the population of students served, their needs can be quite challenging. This addendum was developed to provide educators with an understanding of some differences among children with visual impairments, as well as tools and resources available to help them to learn and thrive. This document is not meant to be comprehensive, or to duplicate existing training materials and documents.

Visual Impairment Defined

Under IDEA, visual impairment including blindness means an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness. [§300.8(c)(13)] Learn more at: https://sites.ed.gov/idea/

Diseases and Disorders

There are multiple conditions which may lead to visual impairment. These abnormalities may impact visual functioning, and by extension, education of the student, in a variety of ways. The effects on a child’s development depend on the severity, type of loss, age at which the condition appears, and overall functioning level of the child. Many children who have multiple disabilities may also have visual impairments resulting in motor, cognitive, and/or social developmental delays.

The following selected terms include only a few of the many visual disorders found in children:

  • Amblyopia (condition in which one eye fails to develop clear vision; commonly called lazy eye)
  • Cataracts (clouding of the lens impacting visual clarity)
  • Convergence Insufficiency (eyes drift outward when reading or doing close work)
  • Cortical Visual Impairment (visual dysfunction caused by damage or injury to the brain)
  • Glaucoma (damage to the optic nerve, usually caused by fluid build-up and increased pressure inside the eye resulting in peripheral vision loss, and difficulty seeing in dim light)
  • Hyperopia (distant objects are seen clearly, but close objects are blurred; commonly called farsightedness)
  • Infections, malformations, optic nerve defects, and trauma to the eye (various causes and results)
  • Retinoblastoma (cancer that begins in the retina and may result in loss of the eye)
  • Myopia (close objects are seen clearly, but objects farther away are blurred; commonly called nearsightedness)
  • Nystagmus (repetitive, uncontrolled eye movements, often resulting in reduced vision)
  • Strabismus (eyes are not both directed toward the same point simultaneously; commonly referred to as crossed-eyes)

Additional information about conditions which cause visual impairments is available from the following sources:

Educational Implications

There is not a “one-size-fits-all” solution for working with students who have visual impairments; educators must take the student’s individual needs into account when designing the education program. For instance, Albinism is a condition characterized by lack of pigment in the hair, skin, and eyes. The functional impacts on vision may include low vision, nystagmus (involuntary, rapid and repetitive eye movements), and photophobia (extreme light sensitivity). A student with photophobia must take care to limit exposure to bright light. Conversely, students with other eye conditions, such as retinitis pigmentosa, may benefit from increased lighting to be able to perceive printed materials and objects in their environment.

Children with visual impairments should be assessed as soon as possible following identification to benefit from early intervention programs, when applicable. Technology in the form of computers, braille equipment, and low-vision optical and video aids enable most children with visual impairments to participate in regular class activities. IDEA also requires that schools provide AEM to all students who need them—this can include audio, braille, digital, and large print materials.

Determining Optimal Mode of Learning

The way a student learns, and the accommodations needed, vary from student to student. Tools such as a Functional Vision Assessment and a Learning or Reading Media Assessment can help in determining the optimal mode of delivery for textbooks and other curricular materials, possible accommodations, and AT.

The following assessments should be conducted by a qualified professional such as a TVI. The Oklahoma School for the Blind, http://osb.k12.ok.us/, provides outreach services including conducting assessments and a limited number of site visits for consultation.

Examples of Assessment Tools

If assessment results indicate that the student will benefit from the use of braille, the IEP team should also consider the braille code(s) a student will learn such as Unified English Braille (UEB), UEB plus NEMETH Code, and/or Music Code. Note: Oklahoma public schools were scheduled to complete the transition from English Braille American Edition (EBAE) to UEB in 2019.  Find information about online UEB transition courses at: http://brailleauthority.org/ueb.html#learn.

Assistive Technology

AT includes devices and services that help a person accomplish a task that might otherwise be difficult or impossible to do without it. Many types of AT are available to help students who have visual impairment. AT for vision ranges from low-tech to high-tech and from free to high-cost. Many times a person will need multiple devices depending on the tasks they wish to accomplish, the locations or environments, and the degree of vision loss/amount of usable vision.

During consideration and selection of AT devices for vision needs, educators should consider whether the individual could comprehend materials or access the environment better if materials were enlarged or visually enhanced, auditory feedback were provided, or braille and/or tactile feedback were provided. The findings should guide educators in determining which types of devices to try with a student.

 Examples of AT Devices for Vision

  • Adapted learning aids (Adaptations may include enlarged display, high contrast colors, auditory feedback, haptic feedback, and tactile feedback.)
    • Calculators
    • Games
    • Tactile graphics tablets
    • Recreational/sporting equipment
  • Audiobook readers
  • Braille displays/notetakers
  • Electronic text readers
    • Screen reading software
    • Text reading apps and software
  • Magnification tools
    • Optical magnifiers
    • Electronic video magnifiers
    • Screen magnification software
  • Printers
    • Braille/tactile graphics embossers
    • 3D printers

AT Services

In addition to AT devices are the services needed to help a person select, acquire, and use the AT. Oklahoma ABLE Tech offers the AT Device Loan Program, https://www.okabletech.org/guide-to-all-services/device-loan-program/, to assist with selection of devices. For links to information about specific products available for trial, see the ABLE Tech Vision AT Discovery web page, https://www.okabletech.org/at-discovery/vision/.

ABLE Tech provides AT Support Team Training, https://www.okabletech.org/education-services/at-services-for-pk-12/at-support-team-workshops/, to schools through a contract with OSDE. ABLE Tech training materials and opportunities assist schools in helping consider and assess students’ AT needs as well as help educators with implementing the AT into the students’ curriculum. An additional resource for assessment information is the textbook "Assistive Technology for Students Who are Blind or Visually Impaired | A Guide to Assessment" by Ike Presley and Frances Mary D’Andrea published by AFB Press. The book is available for purchase from the American Printing House, aph.org

AT Training

Training is an AT service that must be provided to students to enable them to successfully use AT to meet their educational goals. TVIs and other educators may also require professional development in preparation to assist students. With the wide variety of devices and frequent technological advances, it is difficult for any one person to be an expert on all devices. Oftentimes, it is necessary for schools to obtain training from multiple sources depending on needs.

Below are a few training sources to consider:

AT Funding

Under IDEA, LEAs must provide AT devices and services to students at no cost to families; however, schools do not always have to bear the entire cost. Federal and state governmental agencies provide funding for select devices for use by and with students with visual impairments. The AIM Center at the Oklahoma Library for the Blind and Physically Handicapped, http://olbph.org/AIM, provides specialized educational materials and equipment for students who qualify for the Federal Quota Program administered by the American Printing House for the Blind. Liberty Braille, http://libertybraille.com/, provides textbooks and other curricular materials in large print and braille, in addition to select devices, free of charge to students through a contract with OSDE. Find additional funding information in the online guide OK Funding for Assistive Technology, https://www.okabletech.org/resources/at-funding-guide/.

For more information on the provision of AT, including documenting AT in the IEP, please see Assistive Technology Technical Assistance (AT-TA) Document, Part B, https://okabletech-docs.org/homepage/at-ta-document-part-b/.

Teaching Tips and Instructional Strategies

Students with visual impairments need to learn the same information that students without disabilities learn and be held to the same high standards; however, in addition to learning core subjects such as math, English/language arts, history, and science, students with visual impairments may also need to learn specialized skills such as:

  • Braille literacy (reading and writing in braille using a variety of tools)
  • Auditory literacy (reading with audio format)
  • Strategies and techniques for using AT
  • Activities of Daily Living i.e. “blindness skills” such as cane travel, cooking, self-care, and dressing

Many of these skills must be taught explicitly, as students with visual impairment are frequently unable to learn through visual observation. Whatever the degree of impairment, students should be expected to participate fully in classroom activities. Although they may confront limitations, with proper planning and adaptive equipment, their participation can be maximized.

Following are tips for maximizing participation.

The Classroom:

  • Select optimal seating position based on student’s lighting needs
  • Allow space for seeing eye/guide dog if applicable
  • Assist student in using and storing adaptive equipment
  • Keep aisles clear and drawers and cabinets closed

The Teacher:

  • Face the class while speaking
  • Permit lectures to be recorded
  • Provide classroom materials in accessible format(s) used by student
  • Be flexible with assignment deadlines
  • Consider alternative assignments (based on IEP team decisions)
  • Consider alternative measures of assessing achievements
  • Be specific with directions
  • Provide “hands-on” learning experiences
  • Make sure materials are properly scaled, i.e. enlarged to the student’s optimal font size
  • Ask the student if they have any suggestions
  • Keep communications open

The Rest of the Class:

  • Instruct others to yield the right of way
  • Instruct students to help when asked
  • Instruct students to ask if help is needed
  • Instruct students to be considerate of the seeing eye/guide dog

Accommodation Resources

For information regarding accommodations, see the following:

Instructional Settings and Staffing Considerations

Instruction may be provided to students with visual impairments in a variety of settings, including the general education classroom, pull-out for individualized instruction, resource room, self-contained special education classroom, or in a residential program such as the Oklahoma School for the Blind, http://www.osb.k12.ok.us./. Schools may provide educational and related services to students with visual impairment by employing or contracting with itinerate service providers. Service and staffing time must be considered on an individual basis by the IEP team. The responsibility for providing such services rests with the LEA; however, the Oklahoma School for the Blind may provide a limited number of site visits to schools as a support measure.

A TVI is the primary educator who provides specialized instruction to students with visual impairment. The TVI provides lessons in the use of braille and tactile graphics, strategies and use of assistive technology, and many other skills.

Services may also be provided by a Braille Transcriber, who may prepare worksheets, tactile graphics, and other necessary instructional materials for students to use. Additional professionals who may be involved include Orientation and Mobility Specialists (OMS) and Paraprofessionals.

Students with visual impairment may have co-existing disabilities which require additional services such as speech, occupational, or physical therapy. Deaf-blindness is a category of disability which includes students who have sensory losses in both vision and hearing. For assistance in serving students with deaf-blindness, please contact the Oklahoma Deaf-Blind Technical Assistance Project at: http://www.ou.edu/education/edpy/special-education/deaf-blind-project.html.

Pre-Certification Training for TVIs

TVI Training for Oklahoma teachers is available through the TVI Institute, a collaboration of OSDE and OSB. For information email Karen Reed, kreed@osb.k12.ok.us. (Note: Educators may request to update their Oklahoma Teaching Certificate after receiving a passing score on the Oklahoma Subject Area Test (OSAT) for Blind/Visual Impairment (028) provided by the Certification Examinations for Oklahoma Educators (CEOE™)), http://www.ceoe.nesinc.com/.

No institutions of higher education in Oklahoma are currently offering pre-certification training for TVIs; however, out-of-state programs are available. Educators wishing to enroll in university training programs can find reviews from the Association for Education and Rehabilitation of the Blind and Visually Impaired (AERVBI), https://aerbvi.org/resources/career-center/university-review-program/.

Conclusion

Education of students with visual impairments can be challenging, but the impact on the future employment and personal success for students can be enormous. The information and resources included in this addendum are provided to help. For additional information contact Kimberly Berry at: Kimberly.Berry@okstate.edu, or call: 1-800-257-1705 (toll-free & v/tty) or contact OSDE— Education Services at: http://sde.ok.gov/sde/special-education.

Background information for this document was excerpted from the OSDE Visual Impairment Fact Sheet, http://sde.ok.gov/sde/sites/ok.gov.sde/files/Visual Impairment_3.pdf. Other sources and links are included within the document.

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