Does My Child Have Additional Disabilities?

It is a fact that children who are blind or have low vision can develop into fully capable adults who work and live in their communities despite their vision loss. Vision loss, regardless of its degree, does not prevent the development of skills, but it can impact how and when they are learned. An infant who is blind or has low vision may need encouragement in learning to move and may resist activities such as crawling. Seeing a desired toy is what often motivates learning to move. By introducing toys that produce noise, the block to development for a child who is blind is overcome.

Learning motor skills is one of the areas that need direct instruction and intervention. Most children learn this through visual imitation of movements. This is often not possible for children experiencing vision loss. This can cause a deviation in the "normal" childhood development of skills for some children but can be overcome with appropriate intervention and opportunities for movement. For each of us, the ability to be the super star athlete is a mix of innate ability, instruction, and practice. Without innate ability, the instruction and practice will most likely not result in a person becoming a professional athlete. The same is true for children experiencing vision loss with some tending to be good at a certain skill and others not. Our goal is to provide the intervention and opportunities that let each child get to the level that suits their ability and personality and is not influenced solely by their lack of sight.

Many of our children have several disabilities in combination with their decreased vision. This presents an even greater challenge to discover the correct combination of intervention. A child with cerebral palsy and blindness will need to overcome both the influence of the cerebral palsy and the lack of sight. Combinations such as deafness and blindness create such an environment of isolation that precise intervention strategies need to be created and provided. Each potential combination of disabilities sets the need to put together a team of professionals who can give guidance in creating the approach to overcome the barriers created by each disability.

Intellectual Developmental Disabilities (I/DD) create a separate challenge for families and professionals. The fact that children who are blind or visually impaired tend to develop at a slightly different pace and acquire skills in different fashion present challenges in identifying I/DD. It is certainly possible for a child who is visually impaired to also have Learning Disabilities (LD). The standard tests used for I/DD and LD have visual components to them that make their use difficult if not impossible for children with visual impairment and create the need to carefully analyze the findings to determine if the student’s performance is due to the evaluated skill or the student’s ability to interact with the visual components of the test. The diagnosis of these disabilities that are unseen such as orthopedic and blindness/low vision is often delayed and again is very difficult to assess and diagnose.

So how can we go forward without a diagnosis?

  • Establish the current level of skills in whatever area (motor, language, etc.)
  • Find the best approach considering the vision loss
  • Develop the next step or skill in the sequence

The team can proceed to work on the skills. This process is usually fine-tuned as the child’s best learning style and rate is discovered. If no progress is made on a particular skill, are there underlying skills that need to be taught first? An important thing to remember is children with I/DD may need more time to acquire skills, practice them, and master them for completion of tasks. A better curriculum will not push the child through any faster.

What does this mean for my child’s program? The focus is on the attainment of skills. If adaptations are made, then progress can be made at their personal rate of attainment. The child who struggles with learning new skills can make progress but may need more time to master the skill. In many cases, attention must be made to the sequencing of skills to achieve success. Tasks may need to be broken down into smaller steps with focus on how they are presented to the child experiencing vision loss. Children with I/DD who are also experiencing vision loss may need additional time and practice to acquire some skills.

What is the impact of a learning disability? This is another example of where the teaching method and skill acquisition will need adapting or modifying. As previously mentioned, the diagnosis of a child who is blind or visually impaired with a learning disability is a challenge to those who usually provide the assessments. The hallmark of this child is the vast difference in certain academic areas. When reading is a challenge, but math and verbal skills are excellent, it does indicate a problem. However, we all vary in how well we do in certain "subjects" in school, but these cases are often dramatically different with the student functioning at a level two or three years different. It may take several years of school before the pattern emerges that leads to the speculation of the existence of a learning disability. The important component is to find strategies that work for the child and assist them in overcoming their particular challenge. For the child with a reading learning disability, they may read (braille, large print, or use a magnifier) for some things but "heavy" reading may be best done by listening if that is their "best" mode.

The important point is for the team of professionals who are working with your child (along with your input) to establish the way in which your child learns. With blindness or visual impairment, the adaptions are well known and relatively easy for the professionals to apply them. When problems with learning occur, it is difficult to diagnosis in all children but especially in our children who cannot see well enough for standardized tests to be used. However, regardless of the diagnosis, the strategies that work best for your child are the eventual goal regardless of achieving an accurate diagnosis. Does a certain child have a learning disability, or do they just struggle with math? The important answer may lie in mastering the use of a calculator.

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JVIB Special Issue on Critical Issues in Visual Impairment & BlindnessJVIB Special Issue on Critical Issues in Visual Impairment & Blindness

JVIB Special Issue on Critical Issues in Visual Impairment & Blindness

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