Dr. Rosenblum is an Associate Professor of Practice in the Department of Disability and Psychoeducational Studies at the University of Arizona. She prepares teachers to work with children with visual impairments (TVIs) and currently coordinates a project to prepare TVIs for the state of Nevada. As a person with low vision Dr. Rosenblum is able to share first-hand information with future teachers about the impact of a visual impairment on the lives of children and adults. She is especially interested in the social aspects of having a disability and in how best to prepare teachers to meet both the academic and social needs of children.
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Presented by L. Penny Rosenblum, Ph.D.
Length of time to complete: approximately 30 minutes
CHAPTER 1: Introduction
ROSENBLUM: For people who live in industrialized countries, the automobile is really considered to be, you know, the mainstay of how people get around in most parts of most countries. And, especially when we’re talking about the United States and Canada, children really live for that day when they’re going to get that driver’s license, get their independence from Mom and Dad, be able to go where they want to go, when they want to get there.
And when we’re talking about children and youth with visual impairments, they don’t get to have that opportunity. That key to independence, that key literally to the car that leads to that independence is going to be really different for a youth who has a visual impairment. And it’s never too early to really start to think about how can we help that young person develop into as independent a nondriver as they possibly can be?
NARRATOR: We see photographs of a young girl in a pink shirt and a pink cap practicing using a public bus. In her hand, the young girl clutches her cane and a transit pass.
ROSENBLUM: Many folks who are supporting young people with visual impairment themselves are drivers and they may not be thinking about the intricacies that you need to be a successful nondriver in today’s day and age. It’s more than being able to take your cane and cross the street. We’re talking about things like social skills, we’re talking about communication skills, problem solving skills, planning skills. There’s a lot more in it than just orientation and mobility of getting from point A to point B.
CHAPTER 2: Early Development of Navigation Skills
ROSENBLUM: The first thing when you’re a parent is obviously you want to keep your child safe, you want to make sure that they are not going to come in harm’s way, and you don’t want to put your child in an unsafe situation. At the same time, children need to build some independence from parents, and you can start when a child is three or four years old. Nobody’s going to say to their child as they arrive at the park in the family vehicle, “Oh, go play on the swings.” Parents are going to be right there making sure that their three- or four-year-older is going to be safe on the swings.
But, once you get out of the car and you get onto the sidewalk, to say to your child, “Okay, show me the way to the swings,” or, “You’re leader today, let’s go to the swings,” and for that parent to stay back, you know, two or three steps so, yes, if you need to reach and grab, you can get that child and make sure they’re, you know, stopped before something comes up. But, encouraging your child to use his vision to look. So if your child knows that the slide that he likes to go on has a blue mat underneath it, encouraging him to look for the blue as he walks up towards it.
NARRATOR: We see a photo of a young boy who is blind visiting a harvest fair. He has made his way to a patch of bright orange pumpkins. There is also a large bouncy house in the background. In another photo the young boy is playing in a large red and yellow toy car.
ROSENBLUM: The other thing parents can do starting when children are preschoolers is to get them in the car, okay, and the car to a young child is basically a moving couch. So, you want to help them realize that there are things going on that Mom or Dad is responsible for doing as a driver, but also that there’s this whole outside world out there that Mom and Dad are having to look at and make judgments in. So it might be, if your child is really excited that we’re going to be going to Grandma’s house, having them have to look for the house with the big tree out front that lets us know that this is the street that we turn on that goes to Grandma’s house.
Or asking them to call a business — even though you, the parent, know exactly the address of that business, you know exactly what the building looks like, and you know exactly where it is — but having your child have to call and ask the business, “What color is your building, and what side of the intersection are you on?” So that children start to get aware, long before they are going to be independently traveling a route by themselves in the community, that there are things that you have to know, environmental cues you have to pick up on.
NARRATOR: In a series of photos, we see a teenaged girl wearing sunglasses and holding a cane, getting out of an SUV. Next we see her navigating around some curbs which project onto the walkway. The final shot shows her about to enter a shop.
ROSENBLUM: I think a great suggestion for families is for that family of five, even though Mom and Dad drive, to once a month plan an outing where the family takes a taxi. So that gives their visually impaired child an opportunity to start seeing, “Hey, you can take taxis places. “Here’s an alternative method of travel that we can use as a family.” And when we’re going to go do that, to really encourage the visually impaired child to be the one who calls and gives the information to dispatch, who gets to pay for the taxi, tell the driver where the family wants to go. I think that’s a really important thing.
NARRATOR: In a series of photos, we see a young girl in her driveway, approaching a bright green cab. In the next photo, she is reaching for the handle of the rear door and preparing to enter.
ROSENBLUM: The same thing, I really encourage families to ride public transportation as well as a family when the child is young so that they start to get some exposure to the different types of transportation, the different social skills that you need to have when you’re out interacting with the community as well.
CHAPTER 3: Social Skills and the Successful Non-Driver
ROSENBLUM: To be a successful nondriver doesn’t mean that you have to go everywhere all by yourself with absolutely nobody around you. We’re all interdependent, meaning we all take things from people, people give us things and we… nobody acts in a vacuum, so to speak. But to be a successful nondriver, you can’t be so needy that you can’t get anywhere on your own. And you have to be able to negotiate with people, and I think this is a really big part of nondriving and why we need to address social skills with children from a young age.
It’s not uncommon sometimes to see children with visual impairments — especially children who have additional disabilities besides the vision impairment — to engage in what we call stereotypical behavior. So you might see a child rocking back and forth or you might see a child flicking their hands in front of their face to stimulate off of the pattern of the light. Or the child might flap their hands, especially when they get really excited. And a lot of times these behaviors develop because the child is lacking stimulation.
Okay, they don’t see all these things that are going on in the world that catches other children’s attention. And also they don’t get the feedback of seeing that other people aren’t rocking. And so a lot of times if you sit down and you have a conversation with a child on their level and explain to them, “You look funny when you do this. “People don’t want to play with you on the playground. “That little boy walked away. “He didn’t want to slide with you “because you were waving your hands “and that looks scary to him.”
We often don’t give our kids information that really lets them know how they’re being perceived by other people. And since they can’t see what other people are doing well, or they can’t see it at all, they need a way to get that information. And even though that’s a social skills thing that we typically think about in the realm of social skills, social skills and nondriving really go hand-in-hand. You have to be able to interact, and people don’t want to interact with somebody who is acting in a strange way.
Let’s say we have a young person who’s traveled, be it by walking, by bus, by bicycle, to a downtown area and they decide, “Hey, I’m hungry. I want something to eat.” So they walk into a restaurant and they need to order. And they see that in order to order your food, you have to look up at a board above the cashier. There’s lots of choices up there. You have to pick your choice. You have to pick your choice and then order. Well, they have a couple of options. They could pull out a monocular, a telescope that allows them to see at a distance what’s written up on that board. They can go up to the cashier and say, “I want a burger,” because almost every place you walk into you can get a burger, but they’re missing out on all these great opportunities of food.
They can ask for a “to go” menu and stand off to the side and read that “to go” menu, because they’ll be able to potentially see that easier if they get it closer to them or they have a hand-held magnifier they want to use, or they can say to the cashier, “Hey, I don’t see really well. “Could you tell me what sandwiches you have with chicken in them?” So, they have choices, and part of being social when it comes to nondriving is figuring out what choice works in what situation and being able to verbalize to people what you want.
NARRATOR: Inside of a smoothie shop, we see a young woman holding a monocular telescope up to her eye to read the choices on a menu, which is mounted on a wall.
ROSENBLUM: Being able to call and talk to a taxi dispatcher to explain what I want, you know, “I need a cab to come pick me up at this address.” More importantly, when I need to be picked up from the mall, letting them know what entrance I’m going to be at. Being able to explain to somebody in the community… it happens to me all the time. I’ll be standing right near a sign which is huge as can be, you know, that says, “B Terminal to your left,” in the middle of the Dallas airport and I’ll stop somebody and say, “Excuse me, where is the B Terminal?” And they’re, like, pointing to the sign. Like, “Come on, lady, the sign’s right there.” And being able to say to somebody when I stop them instead, “I don’t see really well. Can you tell me the way to B Terminal?” That’s going to get a much different reaction from people when you’re comfortable enough in your own skin to be able to let people know why you need what you need.
A big part of being a nondriver is recognizing that there are going to be times when you’re going to need to work with other people and get their support and you are going to need to let them… or have a way to acknowledge that they helped you. And sometimes that’s money. You pay for somebody’s gas. You give them ten bucks because they’re giving you a ride home from your job site. And, you know, you basically pay for a service. But a lot of times, especially with people that know you, maybe it’s more infrequent. People might not be comfortable taking money from you. Or you may be a teenager and you may not have money to give them. But we all have things that we can do in exchange for transportation, ways that we can reciprocate. It may be that I really like to bake, and so I bake people brownies as a way of thanking them. It may be that I’m really good at music and so I’ll be willing to teach somebody guitar lessons in exchange for transportation.
NARRATOR: We see a young man who is blind, sitting and playing his guitar.
ROSENBLUM: And I think teaching our children from a young age about the importance of reciprocation is really important. If I’m always the child in school who everybody is helping me, and I never have the opportunity to be in a leadership role and help other people and everything is just always given to me or done for me, I’m going to be much less likely to have the skills as a teenager or young adult to reciprocate.
CHAPTER 4: Low Vision Aids
ROSENBLUM: Many people with low vision, meaning people that have some usable vision but don’t have typical vision, can use low vision aids to assist them in traveling. First, it’s really important for families and professionals to recognize that you just cannot go into a store and buy a magnifier and have the right one for a child or for a young adult or a monocular telescope for that person.
NARRATOR: A young woman with long brown hair stands in front of a display of greeting cards. She is using a low vision aid to read a card that she has selected.
ROSENBLUM: These really need to be prescribed by a low vision specialist who has expertise in how to get the right aid for the right person — so, an optometrist or an ophthalmologist who has training. And there needs to be consideration given to what task the person needs to do and what aid might be helpful to them. So, for example, if somebody needs to see signage, okay. They’re walking through a neighborhood and they need to see what the street signs are, or they need to see the numbers on a building, or they’re at a bus area where buses pull in in the community and they need to see which one is the number 15 bus going east towards Grant Road, they could use a monocular telescope to aid them in doing that.
And a monocular telescope — this is one example, okay — is like, think of a pair of binoculars where you hold it up to your eye, and there’s a mechanism for focusing. And it allows you to bring information into focus at a distance. So this, for many people, will help them get near normal acuity, meaning visual acuity is the clarity with which you see an object. However, the field of vision, the amount you can see through the telescope, is very limited. So, you use it typically more for spotting.
NARRATOR: In a video clip, we can see a young woman standing at a busy intersection. She uses a monocular telescope to spot the street sign. The camera swings to the sign, which reads, “Tucson Drive,” and then back to the girl, who announces the location to her orientation and mobility instructor.
ROSENBLUM: So there are low vision aids that people can use for near. One of them is this hand-held magnifier. And this one I really like because it’s small, and it’s portable and the lens can be protected. So if I went to a restaurant, and I was with my friends, and we were talking about what kind of pizza we wanted to order, I could get my hand-held magnifier out and I could read the different things that are here for pizza — and find out that I could get chicken, portabella mushrooms, that I could get roasted red peppers, eggplants or black olives — without having to say to my friend, “Hey, you know, what do they have on that menu that we can get on the pizza?” This gives me independence as a person who is a nondriver.
NARRATOR: In a photo, we see a teenaged girl using a low vision aid to read a restaurant menu. A second photo shows her at the table with her mother, enjoying the meals they just ordered.
ROSENBLUM: The earlier we can make low vision aids a habit for children with visual impairments, the more they’re going to become a part of their life. So if your child is used to taking a magnifier to look to see what’s on the menu when she’s seven or eight years old, then when she’s 14 or 15 years old and peer pressure hits and she doesn’t want to look any different, that magnifier is really going to be a part of her and she’s not going to be thinking about, “Oh, this is something that makes me different. This is just something that’s a part of me.” And so, the earlier you can start with low vision aids with children, the more they can become a part of them.
NARRATOR: A young woman with albinism is using a monocular telescope as part of her orientation and mobility training. Her O and M instructor stands behind her and observes.
ROSENBLUM: Another option for folks with low vision who want to use an optical aid would be to use what we call a portable video magnifier. And this is my personal one. This is an Optelec Mini. And what I really like about this is it’s real small, I can put it in my purse and I can see the print through it.
NARRATOR: The camera angle shifts to a shot looking over Penny Rosenblum’s shoulder as she scans a line of text and changes the text and background colors.
ROSENBLUM: I can also adjust the size of the print — make it bigger, make it smaller — or I can change the color. So I can do yellow on black, yellow on blue, black on white. Probably my favorite reason for buying this particular device was because it has the ability to do what’s called a freeze frame. So, for example, if I wanted to see this up close, I push the button at the top and then I can bring it to my eye and I can really take a look at it and see what it says.
I use this personally when I’m shopping. Especially when there’s items up high on the shelf and I want to see what’s the cost of them. I’ll take and I’ll hold this up, I’ll take a picture and then I’ll bring it down and I’ll take a look at it. And I really have enjoyed that particular feature of this particular device for me.
NARRATOR: In a photo, we see a woman who is visually impaired using a portable video magnifier in a supermarket. The woman, who is shopping with two of her children, uses the magnifier to read the label on a bottle of laundry detergent.
ROSENBLUM: That may not work for your child or for your student. A different device may be more appropriate. And that’s why it’s so important when we’re thinking about optical devices for children and youth with low vision that that child gets to a low vision specialist to have what’s called a clinical low vision evaluation. That you just don’t order one of these out of a catalog, that you really have the device prescribed to the child.
CHAPTER 5: Strategies and Resources
ROSENBLUM: When it comes to education of a child with a visual impairment, that IEP team, that Individualized Education Program team, has that long-term goal of getting this child as far along in the education process as we can to be as independent as possible. And it’s really important that that team works together for many, many reasons, but when we’re thinking about later independence after school, what skills is that child going to need to live out on his or her own? You ask a parent when the child is seven, eight, nine years old, you know, “Where do you see your child in the future?” “Oh, you know, she’s going to go to college, and she’s going to live on her own,” and yet that parent won’t let that child walk next door to the neighbor’s house.
So we’ve got a big gap that we need to try to traverse between the time this child is eight and isn’t allowed to walk to the neighbor’s house and this child is 18 and the parents envision this child going off to college and living in a dorm and taking college classes. And so, getting everybody together as a team and having a shared image is really important. And professionals can really support families in doing this by talking about, “Where do you see your child in two years? “Where do you see your child in five years? “Okay, now let’s look back and see what steps do we need “to get to that goal, and how can we work together “for you to do stuff at home and us to do stuff at school so that your child can reach that goal?” And of course, getting input from the child as the child gets older.
NARRATOR: In a series of photos, first we see a young man holding a cane while boarding a bus. Next, we see him at the counter of a restaurant taking money from his wallet to pay for his order. In a third photo, he is preparing to get his change from the cashier.
ROSENBLUM: One thing I really suggest we do with families, and it doesn’t necessarily tie to teaming specifically, but is to help families and young people with visual impairment meet others who are nondrivers and to find out the strategies and the techniques that they use to get around. Because one thing that one nondriver does may not necessarily be effective for another nondriver. Finding wheels is a curriculum that myself and Dr. Anne Corn developed.
NARRATOR: We see the cover of the book Finding Wheels. The cover illustration shows a man who is visually impaired getting into a taxi. The cab is stopped in front of a dry cleaner and the man has the clothes he has just picked up in his hand.
ROSENBLUM: It’s not a cookbook. It’s a curriculum to guide people — primarily people who themselves are drivers and may not think about all these skills that you need to know about nondriving. But the curriculum is not a cookbook, and the idea with it is, is it exposes children — primarily it’s geared towards teens — but it exposes teens to what you need to know to be a successful nondriver. So in the first section, we introduce four fictitious nondrivers, some of whom use different methods of transportation. One young man named Jason who doesn’t want to go anywhere unless somebody takes him.
NARRATOR: As Dr. Rosenblum describes some of the nondrivers, we see photo illustrations that are used in the book to depict them. In a black and white photo, Jason is shown walking down the sidewalk and holding on to the elbow of a sighted companion. He also has a mobility cane.
ROSENBLUM: Another young man named Pablo, who’s, like, “Give me that transit pass and I’m good to go,” has lots of strategies. You know, treats the band to pizza in exchange for one of the guys in the band giving him a ride home after practice.
NARRATOR: Pablo is shown in the open doorway of a transit van. In one hand he holds his mobility cane. The other hand rests on the seat of the van. To Kisha, who, if she can’t walk somewhere, doesn’t want to be bothered because buses run on a schedule and that’s just, you know, too annoying for her.
NARRATOR: The title of Kisha’s chapter is, “The Power of My Own Two Feet.” And she is shown walking down a sidewalk.
ROSENBLUM: So they meet these nondrivers, do some activities around them, then we have a chapter that helps them explore their own visual impairment. It is amazing to me how many children and adults with visual impairment don’t even know the cause of their own visual impairment, but more importantly, how to articulate to others what it is they need. I myself have congenital cataracts and nystagmus and it’s not important for me to tell a taxi driver that. But what is important for me to tell a taxi driver is, “I may not see your taxi pull up, so you need to come in and get me.” Or, “Can you please make sure that the taxi driver…” I’ll say to the dispatcher, “Can you please make sure “that the taxi driver pulls up at the north entrance, close to the door so I can see him.” So, I don’t have to give my life history to a taxi driver, but I do need to let them know what I need from a visual standpoint.
In the second section of Finding Wheels, we look at the different transportation options. Personal wheels — walking, biking, skateboarding. Ways that you can use your feet to get to the places you need to go. Then we look at public wheels, things like buses and trains and subways that may or may not be available in the community in which the family is living in. And then we look at hired wheels. I can hire a taxi, I can hire somebody to drive me places. And finally we look at specialized wheels. And by specialized wheels, I’m talking about paratransit, which is federally mandated services that if a person cannot ride the public transit in the community the community provides that go the same places that the public transit goes. So, it’s door-to-door service that takes a person with a disability, often elderly people as well, from point A to point B.
The final thing we look at in that section is bioptic wheels — being able to drive with low vision and using specialized glasses called bioptic telescopic systems, BTS, to help you see what’s out there on the road. Not every person with low vision is going to qualify to use a BTS, and not every state in the United States allows you to drive with a BTS. But for some people with low vision, driving with these specialized glasses after getting instruction can be a really effective means of transportation.
The next section of Finding Wheels looks at how to make it work. How do you budget for nondriving? What do you do when the driver doesn’t show up or is running late? So you’re kind of… your wheels are kind of spinning. So it’s a curriculum where families or teachers, orientation or mobility instructors can pick different parts of the curriculum to work on with different children.
CHAPTER 6: Planning and Outlook
ROSENBLUM: When young people are getting into the teenage years and we’re really starting to get serious about what’s going to happen after high school graduation — is this young person going to go to work, are they going to go to community college, vocational school, are they going to go to a four-year college — that’s when we really need to get real serious. First off, if that young person knows what community they’re going to go to or they have a pretty good idea, starting to learn about that community is really important, and this can happen on their own, with the teacher of visually impaired students, the orientation and mobility specialist, the family. The Internet is a great tool.
Another really important piece for teens and their families to understand is that educational services are an entitlement. If your student, if your child has a documented disability, such as a visual impairment, that child is entitled to services under the Individuals With Disability Education Act. But in adult services, it doesn’t work that way. And that’s a big wake-up call to a lot of youth and families. You have to seek out services. So if you need orientation and mobility to learn about using the metro and getting around George Washington University’s campus, you’re going to have to arrange for those. Some teacher is not magically going to appear every Wednesday at 2:30 for your O and M lesson, your orientation and mobility lesson. You’re going to have to make that happen. And that’s a big piece of learning how to be an adult out there in the world and what do I need to do to be able to maximize my independence.
NARRATOR: In a photo, we see a young woman holding a page of directions close to her eyes as she reads an orientation and mobility assignment. The second page contains a large map which shows and names cross streets as well as the location of a bus stop.
ROSENBLUM: Being a nondriver is not an easy thing. As a nondriver — I’ve been a nondriver all my life — there are days where I just want to throw in the towel and say, “I don’t want to do this anymore. Where’s my driver’s license?” You’re going to have ups and downs. Your child, your student is going to have ups and downs as being a nondriver. But, there’s a silver lining to just about everything, and I think helping young people see that is important.
For example, because I ride my bike more and I walk more, I see more of my community. I meet more people because I’m out and about more. Because I often have to negotiate for rides with people, I get a ride home from somebody that I may just at the end of a college class be like, “Bye, see you next week,” and instead, you know, like, “Hey, can you give me a ride home?” And “I’ll pay you for some gas.” I get to get engaged with another person who ultimately ends up becoming a friend of mine that I still have 30 years later from when I was in college.
So everything has a silver lining, and I think that’s really important to focus on. It’s real easy to look at the negativity, and there will be negativity. There’s no getting around this. This is a tough thing to be a nondriver in today’s society. But there also can be positives, and that is something that is going to vary for each individual. But you can find the positives as a nondriver, and part of that is going to come from within you.