Vision Therapy for Children Who are Blind
by Jessica Kovacs
We found out my son Thomas was blind at birth so we were able to get him started with Early Intervention services right away. He was evaluated in our home by a vision therapist from Early Intervention when he was just two weeks old.
Early Vision Therapy
Our first vision therapist was a sweet lady. She visited us weekly and was so gentle with Tommy. As a newborn, we worked on stimulating him with textures and teaching him to turn to sounds. We often used toys with sound and textures to encourage him to reach out for toys. After many surgeries, Tom had the ability to see light, so we began using light up toys to try to engage him. Our vision therapist encouraged us to explore non-traditional sources for toys: feathers and bells from craft stores, gummy glow worms and light up toys from dollar stores or party stores, dollar bin finds at other stores. We really worked on using his other senses to stimulate and teach him about the world.
We also had Thomas evaluated at our local school for the blind, the Western Pennsylvania School for Blind Children (WPSBC). It was so amazing to step foot in a school just for children who are blind. There are so few kids who are blind that it can be very lonely for parents; I felt like no one else really understood. To see happy children who are blind running around and playing at the school gave me so much hope for the future. It was just what I needed to see.
His evaluation was a part of outreach services by WPSBC called the Toddler Program, which offers free assessments, therapy and playgroups. Tom participated in several playgroups at WPSBC and will attend preschool there once he turns three.
I got to enjoy a very long and cuddly "baby stage" with Thomas. He was delayed in sitting up and many of his early milestones but they all came eventually. Once he could stand up, he spent months and months taking first steps until he actually began to walk. As a child who is blind, I am told that it is unique that Thomas is so bold physically. He loves to move and dance and go, go, go!
Orientation and Mobility Therapy
Once Thomas started walking, there was no stopping him, but it also meant lots of bumps and bruises as he explored. I began to wonder if he needed orientation and mobility training. I had no idea when it would be time for him to start learning to use a cane. I thought he needed a cane now since he was walking. So I went to my program coordinator at Early Intervention and asked about getting an evaluation for orientation and mobility services for Thomas. I found out that he would have to give up his current vision therapist and get a vision therapist who was also certified in orientation and mobility.
So when Thomas was about two years old we said goodbye to his old therapist and started working with a new teacher of the visually impaired who is also certified in orientation and mobility. The first couple visits were very hard on Thomas because it was so different! This teacher was much more demanding and Tom had to WORK! He had toys to work on his fine motor skills, finger strength and finger isolation, all in preparation for Braille someday. I noticed that this teacher came with a huge case of toys and books to work with. Some of the items he brought to therapy were homemade toys and wooden puzzles; others were purchased from the American Publishing House for the Blind catalog and were designed for children who are blind.
Tom and his therapist do a lot of shape identification and location drills. For example, they use three aluminum bowls to sort balls and squares. He puts the bowl of balls and squares between Tom's legs and a bowl on either side. Then they put all the balls on the left and all the squares on the right. This teaches him to identify shapes and left and right. It's important to know up, down, left and right for orientation purposes. If you are in an unknown area, people use location words to direct you, and kids who are blind need to know those words early.
I was impressed with the techniques and resources our new therapist had. It made me realize that maybe Thomas hadn't been getting all he needed from our first therapist. She had been excellent with Thomas when he was a baby, but as he grew her therapy style did not grow. I was very glad that I spoke up and requested a new therapist. At the same time, I realize that our new therapist might not have been so good for Thomas when he was a baby and was having so many surgeries.
Thomas, however, was less glad about the change in therapists. He cried and pouted when his new therapist began working with him. He wanted to be cuddled and played with like his old therapist had done. But after a couple sessions Thomas learned that his tantrums weren't getting him anywhere, so he began to accept his new therapist and participate.
This therapist also encouraged me to step back and let Thomas work on his own. I found that Thomas often did more work and stayed on task longer when I wasn't hovering. Then he told me that Thomas had made a big mistake. Thomas had showed him how much potential he had so his therapist wanted to increase his visits to twice a week! I hadn't even known that was an option.
I asked his therapist when we would start cane training and he said that Thomas needed to use pre-cane toys first and then eventually he could work up to a cane. I said that Thomas has been using "pre-cane toys" like riding toys and push toys for quite a while and that I wanted to start now. His therapist believed that at two and a half Tommy was too young to understand and he would use the cane as a weapon. Well, any toy can be used as a weapon so that didn't sound like a good argument to me.
Now I don't expect Thomas to use his cane with perfect form. He is just a little guy. But I do think it's better to introduce the cane to him now, before he really develops other ways to move about on his own. I don't want him to create a system he is comfortable with and then take it away from him and say, "Now use this cane!" I would rather the cane be there so he can grow and learn with it.
Since Tom was walking well, it just seemed natural to me to give him the tool he needed to walk safely and confidently--a long white cane. I went online and ordered a cane for Tom and showed it to his therapist. Eventually, his therapist warmed up to the idea of cane training for Tom. Now we have two therapy sessions a week: one session on pre-Braille skills and one session where we go to the mall and work on orientation and mobility.
The mall is a great place for working on orientation and mobility! It's not very crowded during the workday and has nice long, safe hallways. Once a week you will see my son at our local mall practicing with his little cane. We get lots of stares, but that is OK with me. Seeing my little guy learning to use a cane really is a unique and special sight. I would stare too.