University of Edinburgh

Prematurity and Vision

Friday 3 March 2006

Mairi Graham, VTSS Edinburgh

For the Teacher for Visual Impairment

three immediate reactions:

1. Have not previously considered these pupils as a group with common characteristics:
we deal with every child as an individual but it has been a useful exercise to investigate similarities displayed. Not authoritative - based on experience.  

2. Assessment takes time and involves partnership:
to discover all the implications for learning especially of CVI  gives an ideal 'excuse' for 'playing' with the individual child; necessitates working closely with parents; collaborating with teachers and learning assistants -all in many different settings over a period of time - a one off assessment not appropriate.

3. Privilege of seeing progress:
continuity of involvement means we have the pleasure of seeing the development of the child/young person from birth through primary and secondary school and can be genuinely encouraged and encouraging.

Three Main Stages
VTVI always in a 'supporting' not a lead role
Parent involvement crucial throughout

Stage 1
Promote Learning preschool by playing together.
Support for the Parent who has the key role
All about creating a positive approach for the Parent whois emerging from the stressful 'Clinical period'; modelling play; helping them to relax and enjoy their child; learning together; informal assessment going on.

Stage 2        
Promote Learning by working and collaborating with teachers and other professionals and parents.
Support for the Class teacher who has the key role.
All about raising teacher awareness of the issues for child with VI; giving inservice training, involvement in IEPs; teaching additional skills; advising on approaches and adaptations. 
Addressing parent anxieties.

Stage 3
Promote Learning by helping the young person to have confidence in themselves, giving them an appreciation of their own skills and contribution, enabling them to 'manage' their impairment
Young person takes the leading role.
All about developing self awareness and increasing independence; preparation for the world of work.

Advice on special exam conditions; work experience placement; creating time to talk; opportunities to socialise with peer groups; excursions to widen experience eg RNIB young people's conference.

Three Stages to some extent corresponding with Preschool, Primary and Secondary stages.

Stage 1 Preschool
This involves working with parents as they emerge from the 'Clinical Period'.  Coming from a state of high anxiety it is a major task to build mutual confidence, and inject a sense of normality.  If a relationship of trust can be created at this stage it is vital for the rest of the child's time at school. 

As school approaches the anxiety levels rise again particularly if the premature child is showing signs of delay. 

At school the focus is on the group, the community; there is peer pressure and parental pressure and it is sometimes difficult for parents to rejoice in their child's own rate of development  and achievements if it is not in line with the majority or compares unfavourably with a sibling.  On the other hand there are at times very low expectations for their learning.

To quote one parent:
"my advice to a visually impaired child's parents is not to underestimate what your child is capable of."

(This from a useful book written by the Canadian Institute for the Blind 'Finding a new path' full of helpful and practical advice for the early years. Available from the SSC library)

Stages 2 & 3 approached as case studies

Are there Common Characteristics?
From experience:-

1. Social strengths
2. Remarkable progress often unexpected
3. 'Dyslexic' type reading difficulties
4. Mobility Issues ("topographical agnosias"!)
5. Dispraxic difficulties
6. Immaturity and Global Delay
7. Respond well to rote learning and close supervision
8. Difficulties with mathematical concepts
9. Lack of time to develop fully at school
10. Limited Independence

Approaches  for Learning and Teaching

1. Visual Enhancement is helpful: clarity, contrast, size, colour


2. Avoid overstimulation: overcrowding, complicated backgrounds, overdescription.

3. Develop visual skills as part of the literacy and numeracy programme: eg;

  • developing visual memory
  • visual imagination
  • prediction
  • pattern recognition

4. Use a multi sensory approach: using sound and rhythm, rote learning, tactile and real materials.

5. Enrol pupil in Motor Skills class to develop gross and fine motor skills and spatial awareness.

6. Develop Listening Skills

7. Give 'real experiences'

8. Allow for slower acquisition of reading skills.

9. Use drama to develop self awareness and social skills.

10. Discourage passivity:in conversation, making choices, exploring.