Abstract
The purpose of this inquiry was to identify a number of children with multiple disabilities and visual impairments (MDVI) within the public and private special schools of Crete, the biggest island of Greece with approximately 600,000 inhabitants. According to the official information there was no social provision for these children as there was no child with visual impairments in Crete (Koutantos, 1998). It is not helpful to divide up a school population according to dry categories of impairments. That is why teachers experience about the daily educational practice can contribute to better educational intervention. The headteachers and classroom teachers of 18 special educational placements filled in a questionnaire (n=59). Contrary to the official information, the results of this study reveal an important number of these children in these schools (n=58), or out of any educational placement (n=18), a total of 76 children and young people with MDVI, and at least 12 children with visual impairments. Furthermore, the current educational provision concerns more traditional techniques rather than contemporary technological and educational approaches.
This study could be an example of an alternative and complementary option to the individual model of disability. It concerns both personal aspects (impairment), environmental factors (home, school, human resources, equipment resources), and their combination and interaction (attitudes, state's responsibility).
Reference
Koutantos, D. (1998) The Role of the Peripatetic
Teacher in Working with Families of Children with Visual Impairments,
Unpublished Dissertation for M.Ed. University of Birmingham.
The problem
Collective social developments in different aspects of human activity including educational activity, have recently made applied researchers internationally increasingly interested in the relationship between parents and educationalists. In particular, there has been a profound interest in examining the relationship and activity of parents of children with SEN and the staff of special schools. An understanding of this relationship may be of considerable value to educationalists, parents and managers concerned with the special educational provision for these children in Hellas.
I worked in a school for children with multiple impairments for three years in Hellas. During my work in this school I realised that often we did different things at school and different things in the school. For instance, part of our educational programme at school was children's self-independence included the preparation of a table, eating properly and doing the washing up. All children ate at school together but because sometimes I could not support my students individually, I decided to carry out this activity in my classroom giving me additional work for half of each week. I did this for three months. Among my students there were three siblings and during the summer vacation I visited them at home. I was disappointed when I realised that the children were not doing anything of what we had done at school. Their parents did not believe that their children could prepare the table or do the washing up. In my third year at this school, these contradictions between home and school practice made me develop a fortnightly programme for one year of visiting children' families with the agreement of the social worker, the educational psychologist, a professor at the University of Crete, and the head of the school. Parents who had earlier refused to co-operate or be at home when the social worker and the psychologist of the school visited them, gradually took part in our visits and in the educational programme. There has been very little research in this working with families of children with SEN and in particular of children with VIMI in Hellas.
There has been very little research in this working with families of children with SEN and in particular of children with VIMI in Hellas. I have tried, to an extent, to overcome the lack of research in Hellas by taking into account the international literature and drawing parallels of theory and practice to the special educational provision in my country. However, whilst parental involvement is internationally a widely researched area there has been little research to investigate the relationship between parents of children with SEN and/or VIMI with educationalists in a holistic way as it occurs in reality. Most researchers internationally and in Hellas have investigated aspects of this complex and dynamic interaction.
From my experience I often felt that the meetings with parents were just the tip of the iceberg. In fact, I had experience of the fact that the structure of the school, the individual family and its members, the assessment, transport etc. influenced both the parents and the educationalists. However, I had enormous difficulty in making sense of this complex relationship and this exactly is the aim of my study, to:
The context
For practical reasons this study was carried out in one region of Hellas, Crete. The population of Crete is 540,054 (National Statistical Service of Hellas, NSSH, 1994). The Hellenic educational system is organised according to the 1975 constitution and the principles of Article 16. "All Greeks have a right to free education at all levels in state schools. The state shall support distinguished students and those deserving of assistance or special care, according to their abilities" (MNER, 1994). Nevertheless there are still many difficulties facing an efficient educational provision for children with SEN including those with VIMI, because of historical, economic, social and cultural factors. The main development of special education has only taken place the last 30 years! Most students with SEN (94%) are integrated 'by accident and by chance' within the regular classes without receiving any special help and support (Polychronopoulou, 1996). Under these circumstances the MNER supports the view that the situation today is clearly integration-orientated and the "basic strategy, is to change the attitude and thinking of teachers and parents towards children with special needs" (MNER, 1994: 265). However, as O'Hanlon (1995) asks, does this conclusion suggest that the problem is not in the passing of enabling legislation which will ensure resources and policy, but rather that attitudes of teachers and parents are preventing this ideal from being achieved? This statement shows that special education in Hellas is influenced by an individual model of disability. In the same way that disability has to do with the pathology of the individual, an inclusive policy is problematic because of the individual parent's and teacher's attitude rather than because of socio-political-economic structures. Within this context I carried out my investigation. When I started my investigation there was no any information concerning children with VIMI in Crete. There was no any school for these children in the whole island or any other information where these children could be.
The literature review
Traditionally, people with multiple impairments received services based on answering the question: "Which appears to be the most serious impairment?". However recently, this practice for people with VIMI starts changing with the development in medical sciences and technologies and the educational political and legislative framework (Aitken, 1997; McLinden, 1997). Approximately 70 conditions have been found which cause severe or profound learning difficulties of these conditions 25 can cause severe visual disorders. The most frequent causes of severe visual impairment are cortical visual impairment/cerebral visual dysfunction (Grossman, 1992; Jan, 1993; Dutton, 1994), optic atrophy, retinal disorders, cataract, malformation of eyes (Warburg, 1986).
In Hellas according to the Law No. 958, 23.8.1979, people with blindness are those with visual acuity in the best eye 1/20 (=3/60) of the normal vision. There is no law which defines the limits of partial sight but some researchers suggested that people with partial sight are those between 1/20 and 4/10 of vision without problem (Papadimitriou, 1995). It is estimated that in Hellas 1.5%oo of the total population concerns people with visual impairments, while in the UK the latest figures suggest that VI affects 2.1oo children up to age of 16. Therefore a visual problem is considered a 'low incidence' disability which does not have a high profile in the national debate about educational planning; poses problems for those planning provision at local level (Kirkwood & McCall, 1997).
In Hellas there are no studies about children with VIMI. Even the estimation of children with VI is poor which might influence their educational provision. In one of my previous investigations I found out that there was no social provision for children with VI 'as there was no child with a visual impairment in the whole island!' (Koutantos, 1998; Koutantos, 1999a). My hypothesis was that there was a big number of children with VIMI in special schools for children with SEN because of their multiple impairments or because there were not schools for children with VI in Crete.
Moreover a number of studies in different countries disclosed that, within the population of children with VI there was a big number of children with additional impairments who needed a different educational approach. In a summary of different surveys, Erin and Koenig (1997) indicated that, between 14% and 65% of students with visual impairments also had learning difficulties. Similarly a number of surveys all over the world estimated a big number of children with VIMI in special schools for children with learning difficulties (Thomson, Budge, Buultjens & Lee, 1985; Gates, 1985; Bone & Meltzer, 1989; Walker, Tobin & McKennell, 1992; Griffiths & Best, 1995; Clunies-Ross, 1997).
For the identification of a student population assessment is an essential and crucial part of the whole procedure. There are two main types in assessing vision, one which is clinical and measures the amount of vision children has and another, which assess functional vision that is how well children use the amount of vision they have (Hritcko, 1983; Mason, 1997). In the past, assessment was a result from one single vision eye test but current practice stresses a more comprehensive approach to pupil assessment, by assessing levels of functional vision and providing a programme of vision training (Barraga, 1983). Furthermore, the limitations of clinical examination reinforce a holistic approach. These limitations include:
The above limitations of the clinical testing were confirmed in several studies (Aitken & Buultjens, 1991; Bozic, 1995; Erin & Koenig, 1997). After stressing the value and importance of teachers' views, the main problem for my inquiry was: How to collect this information from teachers who were not specialised for children with VI? The literature review suggested that observation often used by researchers in the classroom (Jose, 1983; Aitken & Buultjens, 1992; Mason, 1995; 1997). All these observational procedures, however, demanded from myself as researcher to assess children's functional vision which was difficult because of time and resource limitations. Nevertheless these empirical approaches disclosed that I could adopt a simple definition according to which I could ask teachers to identify children with VIMI in their classroom (Thomson et al, 1985). Now my new research questions were:
The definition I adopted was: From the children in your classroom, identify those who have any type of impairment and a visual impairment which can influence their performance and learning in the classroom. Visual impairment which influences their performance and learning in the classroom even with correct vision-glasses.
The other questions concerned the assessment of the current educational practice for these children.
Research methodology
There are certain difficulties which make 'the absolute identification of a student population', difficult. These difficulties could be: different samples; lack of standardised tests (Porter & Pease, 1998b); the risk of merely statistical categorisation of a population with an impairment; varying research philosophies and tools; the fragmentary special education in Hellas which causes difficulty for the researcher to gain to the field. Besides, the purpose of educational research should not only be to compare children with sight with children with visual impairments but also to investigate the development of children with visual impairments on its own terms (Warren, 1994; Koutantos, 1999b).
In March 1999 I carried out a pilot study for the questionnaire in two special schools, one private and one public. It was clear to me that the eight participants did not have any major problem in replying to this questionnaire and it served the purpose for which was designed. Some changes with the modification/clarification of some questions, some new questions or deleting some others improved it. A total of 81 questionnaires were sent out and 59 came back from 18 special schools, private and public. More information was collected from the service of Social Provision of each prefecture, and the association of parents prior- and school age children of children with VI of Crete.
The findings
A considerable majority of the participants, 49 out of 59, adopted a definition based on an individual approach to disability, which considers disability = impairment. Only 5 informants gave a definition with elements of a social model of disability which considers disability = social obstacles. One participant gave a theological explanation while 4 educationalists did not give any answer.
I wanted to examine some dynamics of the educationalists, personal and professional, which might influence their work. These dynamics concerned personal experience of disability, training, inter-personal relationships and collaboration with other educational placements. From the total number of 59 informants, 40 had no personal experience of disability and only 14 informants had direct knowledge of a relative or a close acquaintance with some disability. It was very interesting to realise that this personal experience with disability influenced educationalists in their work in a positive way. From the total of 59 educationalists, only 15 educationalists had attended a postgraduate course in special education, and 2 had a master's degree in the subject. Seventeen participants answered that they worked in a special school because of their professional orientation and 37 mentioned some more altruistic and personal reasons. This suggested that being in a special school is both occupation and social function and raises a question of professional skills and personal sensitivity.
All participants could make some suggestions about ways to improve parental participation in their children's education. None talked directly about structural changes such as legislation. This raises the big question of teachers' involvement in central planning and decision making. Moreover, although all participants were happy with their job, quite a number of them (n=20) still talked about some difficulties which made them feel tired and frustrated such as satisfaction with their attempts, the achievement of their aims, lack of training, physical tiredness and stress, lack of money and the educational curriculum in itself.
It is difficult to identify the exact number of children with VIMI in schools for children with LD for a number of reasons I discussed above. Another difficulty was that there was no homogenous team of teachers to deliver the questionnaire to. Fifteen educationalists responsible for a classroom were qualified as social workers, gymnastic teachers and psychologists; the remaining 46 had a degree in education.
Twelve special schools out of eighteen had children with VIMI. The results of this study disclosed that, contrary to the official information, stating that there were no children with a VI in Crete, according to the definition I gave, there are 58 children and young people with VIMI. From the Social Provision in four prefectures there were 17 children aged 0-20, and 1 young person aged between 20 and 30 with VIMI. The Association of Parents prior- and school age children, mentioned that there were 12 children with VI. All these different sources gave a number of 76 children and young people with VIMI between birth to early adulthood and at least 12 school age children with VI.
Teachers and headteachers used a variety of additional criteria along with the given definition in identifying these children. Most of them included difficulties in mobility, reading and writing. A few (n=5) mentioned the distance from books and other materials, understanding their self-image and lack of will to take action. Only one participant mentioned the use of spectacles along with some other criteria for identifying these children. This element gave evidence that the informants understood the given definition which largely excluded children with corrected vision. Most participants replied that students had additional educational needs because of their visual impairment. These needs concerned slowness in school activities and work, i.e. reading, writing, in mobility, in self-service. Only three informants said that there were no additional educational needs because the VI was not so serious. It was optimistic to record that most educationalists believed that they meet these additional educational needs in their school. The educationalists put in order of importance the following educational methods/ materials/ programmes which were found useful for children with VIMI.
| enlargements 15 lighting 13 colour 11 integration of senses 9 time 9 real objects 9 listening skills 8 motor experience 7 space 7 illumination 6 task analysis 6 |
recorded materials 5 basic representation of ideas 5 contrast 4 maps 4 structured practice 4 providing graphs 3 talking calculators 2 word processors 2 Braille 0 other: relaxation of muscles, reinforce self-esteem 1 |
The adjustments which made in teaching materials for use by children with VIMI were mainly also enlargements while five informants did nothing. As far as it concerned management changes for children with VIMI, such as the number of pupils in the class, the teacher/student ratio, environment and programme, six educationalists said that they made some and six that they made no adjustments. In the question about who they contacted to ask for advice about visual problems and education, materials and classroom management, in connection with the VI, eleven informants mentioned some person or organisation while five knew nobody.
A contemporary educational approach
A contemporary approach should provide a suitable environment enabling the individual with VIMI to negotiate effectively tasks in that environment (Laffan, 1997). This interest in children with VIMI was also reflected in the educational policy of the European Union (de Jong & Neugebauer, 1996; Buultjens, 1997). The main centre for children with VI in Hellas, is 'K.E.A.T'. It is a centre for children with blindness and partial sight aged 5-22. There is no teacher training for students with VI or VIMI. Most teachers have developed a practical knowledge or have attended some seminars abroad.
An essential educational intervention starts with a full assessment of the needs and abilities of students with VIMI. From a medical perspective assessment is important for treatment if possible, genetic counselling and informing parents. From an educational perspective it is important for advice to inform parents of the support and services they use to maximise residual vision, to make use of low vision aids and equipment and for educational support and provision. For children with VIMI what is important during assessment, which is difficult to identify by standardised tests, is the inter-relationship between cognition, perception and sight (Miller, 1996). None of the participants mentioned a systematic assessment of children and young people with VIMI. However, the analysis and literature review pointed out that assessment of students with VIMI should examine:
The educational intervention and adjustments of the participants of whom nobody had training for teaching children with VI, mainly relied on traditional approaches such as lighting, colour, contrast, time, recorded materials, listening skills, real objects rather than on more sophisticated approaches such as integration of the senses, motor experience, Braille, task analysis, structured practice, space, illumination, talking calculators, word processor, providing graphs, charts, maps and basic representation of ideas. Similarly the main educational adaptation was making enlargements. The environmental adaptations such as the number of students in the classrooms and the student/teacher ratio had also low application; the number of children in the classrooms was not high in any case (5.4). A contemporary educational approach for chidden with VIMI should include:
It is disappointing that there were no organisations to help these educationalists or the organisation from which people asked help were not a suitable one, but for instance an organisation for deaf people. This, in connection with the spread of these children over a large geographical area makes their support more difficult. An inclusive programme in mainstream schools could resolve, the management but not the educational aspect of this problem. If a teacher who is working in a special school cannot meet the needs of these children then neither can a mainstream class teacher. An alternative proposal concerns visits to these children by a peripatetic teacher trained to work with children with VI and VIMI (Koutantos, 1999a; 1999c). A peripatetic teacher can, in collaboration with parents and class teacher design, a programme for children with VIMI.
The questionnaire concerned only teachers and this was the main limitation. The only reason for this was that I was in Britain and I could not ask the staff of these schools to deliver and collect the questionnaires from parents. This could have made them too tired and bored to fill in their own questionnaires. The time and resource limitations of my study did not allow a thorough approach to identifying and providing for children with VIMI in whole Hellas. Future research could concern early intervention for students with VIMI and parent teacher collaborations.
After this survey I chosen two special schools, one public and one special, as case studies for a deeper investigation. In these two schools 93 semi-structured interviews were taken from parents, staff and students. Additional information was collected by observing parents' and staff's meetings, the schools' documents and 16 interviews from headteachers in mainstream schools. The preliminary analysis shown that the collaboration between parents and educationalists in special schools depended on multiple levels rather than single variables: (1) the intrapersonal level of the partners; (2) the interpersonal level of the parents (children, community, marital relationship) and the staff (team work, headteachers, colleagues from other schools); (3) the positional level of the partners (age, education, economic-social level, role and power); (4) the ideological level (beliefs of disability, ethnicity, culture, religion); (5) and the organizational level of the family (structure, resources, employment, service provision) and the school (charities, private or public school, accommodation, staff, educational practices). Most parents wanted to participate in the procedure of the assessment, the curriculum, the vocational training but educationalists were not in favour. Individuals with their actions simultaneously transformed their own circumstances and the institutional realities. Further analysis is needed.
References
Aitken, S. (1997) Visual and additional impairments: social perspectives and attitudes, The British Journal of Visual Impairment, 15(3), 93-97.
Aitken, S. and Buultjens, M. (1991) Visual assessment of children with multiple impairments: a survey of ophthalmologists, Journal of Visual Impairment and Blindness, 85, April 1991, 170-173.
Aitken, S. and Buultjens, M. (1992) Vision for Doing. Assessing Functional Vision of Learners who are Multiply Disabled. Edinburgh: Moray House Publications.
Barraga, N. C. (1983) Visual Handicaps and Learning. Austin, Texas: Exceptional Resources.
Bone, M. and Meltzer, H. (1989) OFCS Survey of Disabilities in Great Britain, Report 3: The Prevalence of Disability Among Children. Office of Population Censuses and Surveys. London: HMSO.
Bozic, N. (1995) Look and think users in the early nineties, British Journal of Visual Impairment, 13(2) 59-64.
Bozic, N. and Vickers, C. (1994) Choice and control: introducing a new operating system to give children with multiple disabilities improved access to software, Eye Contact, Summer 1994, 9, 25-27.
Buultjens, M. (1997) Where are we now? A personal perspective on educational provision in Scotland for children and young people with multiple disability and visual impairment, The British Journal of Visual Impairment, 15(3), 105-108.
Clunies-Ross, L. (1997) Where all the children gone? An analysis of new statistical data on visual impairments amongst children in England, Scotland and Wales, The British Journal of Visual Impairments, 15(2), 48-53.
de Jong, C. G. A. and Neugebauer, H. (Eds.) (1996) Timely Intervention: Special Help for Special Needs. Wurzburg: Edition Bentheim.
Dutton, G. N. (1994) Cognitive visual dysfunction, British Journal of Ophthalmology, 78, 723-726.
Erin, N. and Koenig, J. A. (1997) The student with a visual disability and a learning disability, Journal of Visual Impairment and Blindness, 30 (3), 309-320.
Farrell, K. A. (1986) Working with parents. In: T. Scholl (Ed.) Foundations of Education for Blind and Visually Handicapped Children and Youth, Theory and Practice. New York: American Foundation for the Blind Inc.
Gates, C. F. (1985) Survey of multiply handicapped, visually impaired children in the Rocky Mountain/Great Plains region, Journal of Visual Impairment and Blindness, 78, November 1985, 385-391.
Griffiths, J. And Best, T. (1995) Survey of Visually Impaired Children in Schools for Children with severe Learning difficulties. Shrewsbury: RNIB Condover Hall School.
Griffiths, M. I. (1979) Associated disorders in children with severe visual handicap. In: V. Smith and J. Keen (Eds.) Visual Handicap in Children. London: William Heinemann Medical Books.
Grossman, H. L. (1992) The Royal New South Wales Institute for Deaf and Blind Children, Monograph Series-Number 3. Cortical Visual Impairment Presentation, Assessment and Management. Australia: North Rocks Press.
Hall, A, Scholl, G. T. and Swallow, R. (1986) Psychoeducational assessment. In: T. Scholl (Ed.) Foundations of Education for Blind and Visually Handicapped Children and Youth, Theory and Practice. New York: American Foundation for the Blind Inc.
Hritcko, T. (1983) Assessment of children with low vision. In: J. Rose (Ed.) Understanding Low Vision. New York: American Foundation for the blind.
Jan. J. E. (1993) Neurological causes of visual impairment and investigations. In: A. R Fielder, A. B. Best and M. C. Bax (Eds.) The Management of Visual Impairment in Childhood. London: Mac Keith Press.
Jose, R. T. (1983) Minimum assessment sequence: The optometrist's viewpoint. In: J. Rose (Ed.) Understanding Low Vision. New York: American Foundation for the Blind.
Kirkwood, R. and Mccall, S. (1997) Educational provision. In: H. Mason and S. McCall with C. Arter M. McLinden and J. Stone (Eds) Visual Impairment: Access to Education for Children and Young People. London: David Fulton Publishers.
Koutantos, D. (1998) The Role of the Peripatetic Teacher in Working with Families of Children with Visual Impairments, Unpublished Dissertation for M.Ed. University of Birmingham.
Koutantos, D. (1999a) Peripatetic teachers: A challenge for special education in Hellas, Pedagogic Review, 29, 127-145.
Koutantos, D. (1999b) The social and emotional development of children with visual impairments and educational research, Contemporary Education, 109, 43-50.
Koutantos, D. (1999c) Training for special education teachers, Mobility for children with Visual impairments, Issues of Special Education, 5, 48-58.
Koutantos, D. (2000) Disabled people or disabled society; An alternative, holistic, ecological approach, Pedagogic Review, (accepted for publication).
Mason, H. (1997) Assessment of vision. In: .H. Mason and S. McCall with C. Arter M. McLinden and J. Stone (Eds.) Visual Impairment: Access to Education for Children and Young People. London: David Fulton Publishers.
Mason, H. L. (1995) Spotlight on Special Educational Needs: Visual Impairment. Tamworth: NASEN (National Association for Special Educational Needs).
McLinden, M. (1997) Children with multiple disabilities and a visual impairment. In: .H. Mason and S. McCall with C. Arter M. McLinden and J. Stone (Eds.) Visual Impairment: Access to Education for Children and Young People. London: David Fulton Publishers.
Ministry of National Education and Religion (MNER) (1994) Bulletin of Information in Special Education: Educational and Social Integration. Athens: Instructional Books Publications.
Miller, O. (1993) Out of Sight, Special Children, 69, October 1993, 24-26.
Miller, O. (1996) Supporting Children with Visual Impairment in Mainstream schools. London: Franklin Watts.
Muldoon, J. and Pickwell, D. (1993) Optometric needs of multiply handicapped children. In: T. Buckingham (Ed.) Visual Problems in Childhood. Oxford: Buttwerworth-Heinemannn Ltd.
National Statistical Service of Greece (1994) Population of Greece According to the Census of the 17ths March 1991. Athens: National Statistical Service of Greece.
O'Hanlon, C. (1995) A Comparison of Educational Provision in Europe. In: P. Mittler and P. Daunt (Eds.) Teacher Education for special Needs in Europe. London: Cassell. CDDI
Papadimitriou, D. ?. (1995) Education for blind children. In M. Kaila et al (Eds.) People with Special Needs, Volume B', Second Edition. Athens: Hellenic Letters.
Polychronopoulou, S. (1996) Legislative Trends in Special Education. In: MNER (Eds.) Legislation on Educational Integration in Europe: Trends and Changes. Athens: Ministry of Education and Religious.
Porter, J. and Pease, L. (1998a) Framework for Inspecting School Provision for Pupils with Multiple Disability and Visual Impairment. London: Royal National Institute for the Blind.
Porter, J. and Pease, L. (1998b) Developing Whole School Policies to Meet the Needs of Pupils with Multiple Disability and Visual Impairment. London: Royal National Institute for the Blind.
Silberman, R. K. (1986) Severe multiple handicaps. In: T. Scholl (Ed.) Foundations of Education for Blind and Visually Handicapped Children and Youth, Theory and Practice. New York: American Foundation for the Blind Inc.
Thomson, G. O. B., Budge, A., Buultjens, M. and Lee, M. (1985) Meeting the Special Education Needs of the Visually Impaired: The Process of Decision Making. Edinburgh: University of Edinburgh.
Thomson, G. O. B., Budge, A., Buultjens, M. and Lee, M. (1985) Meeting the Special Education Needs of the Visually Impaired: The Process of Decision Making. Edinburgh: University of Edinburgh.
Walker, E., Tobin, M. and McKennell, A. (1992) Blind and Partially Sighted Children in Britain: the RNIB Survey, Volume 2. London: HMSO.
Warburg, M. (1986) Medical and ophthalmological aspects of visual impairment in mentally handicapped people. In: D. Ellis (Ed.) Sensory Impairments in Mentally Handicapped People. London: Croom Helm.
Warren, D. H. (1994) Blindness and children: An individual Approach. Cambridge:
 |
 |