Education for Learners with Visual Impairment

This article presents an overview of special education in the United States for learners with visual impairment (VI), which includes children who are blind or who have low vision. It provides a historical perspective on the continuum of educational settings (i.e., specialized schools for the blind vs. public schools) and curricula that have been available for children with VI. The controversy over Braille literacy is explained. The challenge of providing learners' with VI access to the common core curriculum while still teaching the expanded core curriculum (eight specific skills and strategies necessary for individuals with VI to succeed in school and in life) is addressed. A description of various assistive technologies is provided. Finally, issues related to employability after graduation, multimedia accessibility, and testing accommodations are discussed.

Keywords Assistive Technologies (AT); Blind; Braille; Common Core Curriculum; Expanded Core Curriculum; Low Vision; Special Education; Visual Impairment (VI)

Overview

About one in 1,000 school-aged children has a visual impairment, or VI (Council for Exceptional Children, n.d.). The Individuals with Disabilities Education Act (IDEA) of 1997 defines VI as "an impairment in vision that, even with correction, adversely affects a child's educational performance" (20 U.S.C. §1401). The term includes both low vision and blindness. Approximately 90% of individuals with VI have low vision while 10% are functionally blind (American Federation for the Blind, 2007). Throughout history, students with VI have been referred to as blind, visually handicapped, visually disabled, partially sighted, partially blind, visually limited, or sight impaired (Jackson, 2005).

Curriculum for Visual Impairment

In 1879, the United States Congress acknowledged the importance of improving the learning experiences of students with VI. During the 19th and early 20th centuries, these students were primarily educated in residential schools for the blind. Instruction in these specialized schools consisted primarily of the common core curriculum (e.g., language arts, math, science, social studies), while teaching students to read and write by using Braille. Interestingly, the use of Braille has been controversial throughout the history of American education. It took more than a century-a period known as "the war of the dots"-for Braille to be established as the preferential reading method for blind learners (Jackson, 2005).

In the early 20th century, there was a widespread belief that extreme nearsightedness would become worse through eyestrain; therefore, curriculum materials for nearsighted students were enlarged and supplemented by oral reading. This "sight saving philosophy" persisted well into the 1960s until it was discovered that efficiency of vision improved through use rather than by disuse (Jackson, 2005). The resulting "sight utilization philosophy" then persevered into the 1980s, when

“. . . declining Braille literacy rates among blind students were observed to correlate with unemployment. Concurrent with the sight utilization philosophy was an increase in public day school attendance by blind students. Children who may have learned Braille at residential schools were now using enlarged print or print with optical magnification. From the perspective of many special educators, this overemphasis on the importance of sight utilization deprived many severely visually impaired students of the opportunity to learn Braille. Hence, the 1990s brought on a new era of curriculum emphasizing Braille literacy” (Jackson, 2005, p. 38).

Today, IDEA (2004) presumes that all students with Individualized Education Plans (IEP's) who have VI shall use Braille as their primary literacy medium unless the IEP team determines that print is more efficient for a particular student with usable vision. According to Jackson (2005), the following factors must be taken into account when considering the needs of visually impaired learners:

Age at onset of visual impairment,

Degree of impairment,

Site of impairment,

Prognosis for improvement or degeneration in condition,

Day-to-day stability of condition,

Individual tolerance for visual fatigue, and

The extent of any co-existing additional impairments (Jackson, 2005).

Educational Setting

Historically, specialized schools for the blind were the only option available to students with VI. Curriculum design for low-vision students began to emerge in the early part of the 20th century when children with VI were removed from residential schools for the blind and placed in public schools. Chicago was one of the first public school districts to intermingle blind children with sighted children. This arrangement, which was referred to as the "Chicago experiment," established separate classrooms for blind students while allowing them to spend some time in classrooms with their sighted peers (Ely, 2006).

Jackson reports that,

“During the 1950s and 1960s, public day school programs for blind and visually impaired students expanded rapidly. Resource models, itinerant teaching services, and teacher-consultation models emerged and soon overtook residential school placement as the preferred approach for meeting blind students' educational needs. With the enactment of IDEA (1997), special education is no longer considered a place but rather a network of services and supports designed to enable students to derive full benefit from a public school education” (Jackson, 2005, p. 39).

The International Council for Education of People with Visual Impairment and the World Blind Union

“. . .supports inclusive education as one of the alternative models of service delivery, on condition that all necessary steps are taken to first put in place the required number of teachers trained in the special needs of blind and low vision children and the essential support systems, the necessary equipment, Braille books, and low vision devices to guarantee true inclusion” (ICEPVI/WBU, 2003).

Unfortunately, in the United States, there is an estimated shortage of more than 5,000 teachers of trained students who are visually impaired--a shortage that is especially acute in rural areas (Johnson & Lawson, 2006). Therefore, in some cases, an IEP team determines that an “alternative and highly specialized setting” is the best choice, and therefore the “least restrictive,” placement for meeting the needs of a student with VI, especially if the local public school “is not sufficiently equipped to provide a safe and successful educational experience for that student” (Jackson, 2005, p. 13). Therefore, for some students with VI, the road “toward the greatest access to the general education curriculum may be pursued more appropriately in a separate setting” such as a residential school for the blind (Jackson, 2005, p. 13).

What is most important when considering appropriate educational settings for learners with VI is that the placement or location of services is the last decision an IEP team should make during the assessment and planning process. Previously, the disability label itself would dictate the setting, and that placement would then define the treatment or nature of the instruction (Jackson, 2005, p. 15). Today, the individual needs of a student are of more importance than a categorical label.

Expanded Core Curriculum

Prior to IDEA (1997), advocates for public school settings tended to de-emphasize the special challenges of students with VI when immersed in the general educational environment. According to Jackson (2005), they believed that these students “needed the same curriculum as every other student and that teachers should supply just a few additional skills and resources” (p. 39). Such supplemental skills and knowledge areas became known as the “plus curriculum.” Today, the plus curriculum is known as the “expanded core” curriculum, emphasizing that it must correlate with the “common core” curriculum (Jackson, 2005). Although the concept of a disability-specific curriculum has been present in the field of VI since its inception (Ely, 2006), the term "expanded core curriculum" has reached a level of general acceptance in recent years.

According the American Federation for the Blind, the expanded core curriculum includes eight areas of instruction “specific to students with VI. Intervention from a teacher for students with visual impairments is necessary to provide direct instruction in the expanded core” (AFB, 2007). The Federation’s website outlines the areas of the expanded core as follows:

1. Compensatory or Functional Academic Skills, including communication modes-skills that a student with a visual impairment must acquire to access the regular curriculum. These skills include learning Braille, study and organizational skills, spatial understanding, and any adaptation of the existing curriculum.

2. Orientation and Mobility -skills involved in independent travel and the concepts that underlie spatial reasoning and navigation.

3. Social Interaction Skills -acquisitions of the subtle modes of interaction that people develop by watching, imitating, and reacting to each other.

4. Independent Living Skills -can include cooking, personal hygiene, money management, time monitoring, and organization. These are often skill areas that children with visual impairments do not develop because they do not observe them in others and they are often not explicitly taught.

5. Recreation and Leisure Skills -while physical fitness is generally addressed in the regular curriculum, activities that can be used to actively fill leisure time are often not addressed. Without direction instruction, it is not likely that a child will be exposed to the range of activities possible.

6. Career Education -as in many of the other areas listed, children with visual impairments are often not exposed to a large variety of career options. This is both because of a lack of prior visual experiences and because of a perception that the range of options is severely limited for children with visual impairments. Unemployment and underemployment is one of the biggest problems facing adults with VI in today's society.

7. Use of Assistive Technology -technology can be a great tool for providing access to information for people with visual impairments. Whether it is through speech, Braille, or large print output, the use of technology gives a person with a visual impairment access to information at approximately the same time as a person who is sighted.

8. Visual Efficiency Skills -although the amount and type of vision varies greatly among individuals, a common requirement is instruction in using what vision they have efficiently. For a student with a field loss, it might be viewing print eccentrically to maximize clear perception of the print. For another student it might be paying attention to objects in their peripheral field when walking to get as much advance warning of impending obstacles as is possible (AFB, 2007 http://www.afb.org/section.asp?sectionid=44&topicid=189&documentid=2646).

A person who is visually impaired and who has a command of expanded core curriculum skills as well as knowledge of common core subjects is fully equipped to be competitive in the workforce. This person is then in a position to contribute to the economy, rather than being dependent on governmental assistance. However, the average national unemployment rate for people who are blind or visually impaired is a disappointing 70% (McDonough, Sticken, & Haack, 2006).

Parents and special educators have been lobbying for formal support of the expanded core curriculum since the 1990s. Toward that end, the 2003 Senate bill S1248 included language that addressed the need for instruction in a handful of areas of the expanded core curriculum (McDonough, Sticken, & Haack, 2006). Unfortunately, this language was not included in the most recent reauthorization of the IDEA in 2004. Despite an established place in the education of children with VI, the expanded core curriculum has not yet been fully embraced by some administrations, state education departments, and the federal government (McDonough, Sticken, & Haack, 2006).

Since the purpose of education is to equip children with the skills and knowledge they need to succeed in school and to eventually contribute to society, special education advocates emphasize the importance of the expanded core curriculum as a necessary element of the educational experience of children with VI. However, mastering the expanded core curriculum takes time. Even for students who are high academic achievers, the expanded core curriculum is difficult to complete within 12 years of education (Hatlen, 1996). The tension between achieving the NCLB mandates of accountability in the common core curriculum while still addressing the unique needs of the expanded core curriculum is evident in a survey study conducted by Lohmeier (2005), in which she found that even specialized schools are falling short in covering all areas of the expanded core. The most frequently taught areas were recreation and leisure, orientation and mobility, and career education, while social interaction development and visual efficiency were the areas least emphasized (Lohmeier, 2005). She concluded that the schools' primary goal was to ensure literacy, but many overlooked unique skills and strategies which are necessary in order for individuals with VI to be employable and independent at the conclusion of their K-12 schooling (Lohmeier, 2005).

Jackson (2005) suggests that regular classroom instruction

“typically relies on the visual/motor channel of communication and depends upon social mediation for student achievement. Because students with VI cannot access the visual channel of communication and are often socially isolated, they generally have limited opportunities for incidental learning. This places them at a disadvantage when attempting to participate in classroom activities. Often, gaps exist in concept development, making it difficult for classroom teachers to activate prior knowledge, or leads teachers to make false assumptions about the fundamental understanding these students have of the world around them. Moreover, the need for Braille as an alternative to print creates a challenge for general classroom teachers to provide corrective feedback, since very few general education classroom teachers can read or write Braille. Lack of eye contact and the impossibility of visually-based social recognition can have a profound impact on a student’s opportunity to form meaningful and cooperative relationships with peers. Such barriers must be carefully examined and skillfully addressed by practitioners in order to provide genuine and valid access to the common core curriculum for students with VI” (Jackson, 2005, p. 19).

Applications

Access to the Common Core Curriculum

In addition to a focus on the expanded core curriculum, a strong emphasis in contemporary education for students with VI is access to the common core curriculum (sometimes called the general education curriculum). It is essential to provide students with VI access to educational information and communication. The Office of the United Nations High Commissioner for Human Rights (OUNHCHR, 1993) supports the use of Braille, tape services, large print, and other appropriate technologies so long as they are accompanied by appropriate support services by trained personnel. The American Federation for the Blind suggests that students be provided with optical devices such as magnifiers, microscopes, and tele-microscopes for “accessing near information and monocular telescopes and bioptic lenses for accessing distance information. Preferential seating and paper handouts containing pertinent information are other ways that information can be more easily accessed by” students with VI (AFB, 2007).

Access, participation, and progress in the common core curriculum “depend on the development and implementation of high-quality Individualized Educational Plans (IEP’s). The IEP is a regularly-updated document that makes explicit the components of a particular student’s educational program by specifying necessary services, supports, ancillary aids, instructional accommodations, and curricular modifications” (Jackson, 2005, p. 67). Typically, a Learning Media Assessment (LMA) is conducted by a qualified teacher in order to determine which media (e.g., Braille, large print, and tape recordings) are most efficient for a particular student with VI. However, research has not yet offered simple or conclusive answers to questions about the effects of specific instructional accommodations, such as Braille editions of printed materials, large print editions, regular print editions accompanied by optical devices, dictating responses to a scribe, extended time to complete assignments, or providing interpreters for instructions (Thurlow & Bolt, 2001). In addition, Jackson (2005) cautions educators to avoid "over-accommodations" that can deprive students of the opportunity to establish independent learning strategies.

Assistive Technologies

As a result of recent technological advances, assistive technologies (AT's) have come to the forefront of the discourse surrounding the education of students with VI. Computer technology has made possible some of the following AT solutions:

1. Braille Embossers: A Braille embosser is a printer that places Braille over regular text. It uses special translation software to easily create the document, making Braille production more efficient and cost-effective.
2. Refreshable Braille Displays: A refreshable Braille display is an electro-mechanical device for displaying Braille characters, usually by means of raising dots through holes in a flat surface. The display usually sits under the computer keyboard. Students with VI who cannot use a regular computer monitor use it to "view" the text. Speech synthesizers are also commonly used for the same task, and a learner may switch between the two systems depending on circumstances.
3. OCR (Optical Character Recognition) Software: OCR software allows educators to scan and digitize printed materials that can then be printed out or read onscreen in larger fonts for students with low vision.
4. Screen Magnifiers / Large Print
5. Screen Readers / Talking Web Browsers
6. Braille Music Translation Software
7. Adaptive Keyboards & Mice
8. Cursor Enlargers

Increasingly, special educators are embracing a Universal Design for Learning (UDL) theoretical framework (Rose & Meyer, 2002), which combines AT's with the flexibility of web-based and software computer technologies to enhance access to the common core curriculum for learners with a wide range of disabilities.

Issues

Three issues that are unique to the education of children with VI include employability after K-12, multimedia accessibility, and testing accommodations.

Employability

Although individuals with VI have the highest employment rate of any other low-incidence disability group (e.g., deaf/hard of hearing, autistic, multiple-disabilities), the 30% national employment rate for individuals with VI is still regrettably low (Jackson, 2005; McDonough, Sticken, & Haack, 2006). As Kirchner & Smith (2005) state:

Education is not enough. Perhaps it is not blasphemy, but it is still a shocker to hint that visually impaired people are not necessarily helped in finding employment simply by piling on years of education after high school--that is, without gaining work experience while still in school (online document).

In addition to ensuring that the expanded core curriculum is fully taught alongside the common core curriculum and offering relevant work experience during the later grades, educators suggest that children with VI be provided with early intervention and preschool experiences (ICEPVI/WBU, 2003). Current research suggests that VI children should be exposed to Braille literacy at an early age and that audiotape materials not be stressed until the later grades in order to ensure that students develop requisite basic literacy skills (AFB, 2007). Statistics show that proficient Braille users are the most frequently employed sub-group of visually impaired adults (Jackson, 2005). In fact, IDEA (2004) encourages U.S. states not to categorization for disability until age nine. The more common term developmental delay is used instead, to avoid the stereotyping and lowered expectations that tend to follow disability-specific labeling” (Jackson, 2005, p. 17).

Multimedia Accessibility

A new potential barrier to educational accessibility for children with VI has resulted from the increased use of classroom multimedia presentations (computers, videotapes, television programming, filmstrips, etc.) that are not fully accessible to students with visual impairments (Ely, Emerson, Maggiore, O'Connell, & Hudson, 2006). Teachers are increasingly augmenting the curriculum with multimedia resources specifically designed by publishers to align with state standards and curriculum frameworks, all of which rely on visual presentation of content (Ely et al., 2006). This obviously presents an accessibility challenge for individuals with VI.

Since the vast majority (93%) of people with VI believe they are missing information from the video programming they watch, many seek out programs that provide formal audio descriptions (Ely et al., 2006). This has been shown to have a positive psychological, social, and cognitive impact on adult viewers who are blind or severely visually impaired (Ely et al., 2006). Younger children with VI also benefit from well-designed descriptions of visual material because of their need for explicit instruction in concepts that their sighted peers develop through incidental observation of the world around them. Since children's developmental transition from concrete operations to abstract thinking depends on the perceptual process, students with VI are slower to establish a sufficient base of information, most notably in the 7-to-11 age range (Ely et al., 2006).

While the benefits of audio description are generally acknowledged for individuals with VI as well as for those learning a second language or who have learning disabilities, descriptive video as currently provided is most often conducted post-production. As a result, descriptions can only be inserted in the natural gaps allowed, and few programs offer sufficient time in the narration to do so effectively. Further, not all visual information easily lends itself to description (Ely et al., 2006). A Universal Design for Learning (UDL) approach offers a promising solution to this problem due to its emphasis on creating flexible curricular materials pre-production rather than attempting to retrofit them after the fact (Rose & Meyer, 2002). Although educational publishers are now required by law to provide alternative versions of printed materials, publishers have been slow to adhere to the National Instructional Materials Accessibility Standard (NIMAS), which is intended to facilitate timely access to alternate and consistent formats of all instructional materials, including multimedia materials. One problem is that the market for students with VI and other low-incidence disabilities is extremely small, which provides little motivation for educational publishers to expend time and effort toward developing fully accessible materials.

Testing Accommodations

In this era of high-stakes testing, researchers (Erin, Hong, Schoch, & Kuo, 2006; Thurlow & Bolt, 2001) are beginning to investigate the validity of testing accommodations for students with disabilities, including those with VI. The most common testing accommodations for students with VI are Braille editions of the test, large print versions, and oral administration. Each accommodation offers distinct benefits and challenges.

Braille editions of tests are a frequently used accommodation for students who are blind and those with severely low vision. There is some agreement among researchers that students who are competent Braille readers should be tested in Braille whenever possible if their peers are being tested in their written medium (Erin et al., 2006). However, Thurlow & Bolt (2001) caution that some test items that are difficult to translate into Braille (e.g., pictures, charts, tally items) should be avoided during initial test development. They also suggest that students using a Braille version of a test should be given extended time to complete the test, perhaps as much as twice the time.

Large print editions of tests are often used for students with low vision. It is important to note that “students receiving the large print accommodation should have adequate practice taking tests in this format to be familiar with the extra page turning that may be required” (Thurlow & Bolt, 2001, Recommendation). Learners should also be evaluated in advance to determine the best font size for their needs. Thurlow and Bolt also suggest that “tests that are translated into large print should be checked to make sure no inappropriate line breaks occur and that the items are grouped as much like the original as possible (CEC, n.d.). Students who use the large print accommodation may also require additional time due to visual processing challenges” (Thurlow & Bolt, 2001, Recommendation).

Educators tend to assume that oral tests yield equivalent scores to those on print or Braille tests, but there is little empirical support for this assumption (Erin et al., 2006). For example, Thurlow and Bolt (2001) found that variations in whether students are entitled to hear the material several times, whether they should be offered a written copy during the read aloud, whether group administration is viable, and whether students may receive unintentional cues through the reader's voice are all relevant when considering the validity of the read aloud option. Further, Meloy, Deville, and Frisbie (2000, cited in Erin et al., 2006) found that both students with disabilities and those without disabilities benefited from the read aloud accommodation, which raises a serious concern about whether reading a test aloud "levels the playing field" (as accommodations should do) or actually gives students with VI an advantage over their sighted peers.

Conversely, in a study conducted by Erin et al. (2006), it was found that oral tests did not provide any advantage over written tests for three groups of secondary students who were blind, low vision, and fully sighted. Interestingly, while most participants in all three groups correctly predicted their fastest reading medium, fewer participants were able to identify the medium that resulted in their best test score (Erin et al., 2006). This was especially true for the low vision group, most of who believed that they performed better on printed tests than on oral tests, but in this study, they performed similarly in the two media. This suggests that careful assessment is particularly important with this group, especially because the effects of duration and fatigue in testing for students with low vision have not yet been researched (Erin et al., 2006). Thus, for many reasons, the read aloud accommodation is highly controversial and is only allowed in four U.S. states without limitations (Thurlow & Bolt, 2001).

Terms & Concepts

Access to the Core Curriculum: The notion that students with disabilities should, whenever possible, participate in the same general education curriculum (e.g., math, language arts, social studies, science) as their peers rather than taught in a specialized class with different learning objectives.

Assistive Technologies (AT): Any equipment or product system, whether acquired commercially, modified, or customized, used to increase, maintain, or improve the functional capabilities of a disabled person.

Common Core Curriculum: Subjects that most children study in public schools, such as language arts, math, science, social studies, health, physical education, fine arts, and foreign languages. Synonymous with the term "general education curriculum."

Expanded Core Curriculum: Additional skill areas needed by students with VI to succeed in school and in life, as follows: compensatory academic skills, social interaction skills, independent living skills, recreation and leisure skills, orientation and mobility, assistive technology, career education, and visual efficiency skills.

Individuals with Disabilities Education Act (IDEA): A law passed in 1997 and reauthorized in 2004 that is designed to protect the rights of people with disabilities and mandates how, what, and where students with identified disabilities should be taught.

Individualized Education Plan (IEP): A set of specific instructional objectives created by a team of educators based on a thorough evaluation of an individual student's needs who qualifies for special education services. IEP's are typically updated every 1-3 years.

Least Restrictive Environment: The concept that students with disabilities should have the opportunity to be educated with non-disabled peers to the greatest extent possible. The less opportunity a student has to interact and learn with non-disabled peers, the more that the setting is considered to be restricted.

No Child Left behind Act (NCLB): An extensive set of laws passed in 2001 that aim to improve student achievement and accountability through mandated instructional programming and high-stakes testing.

Special Education (SPED): Specialized instruction for students with a wide variety of special needs, including sensory, motor, emotional, and linguistic disabilities. A visual impairment is considered a sensory disability.

Universal Design for Learning (UDL): An approach to initial curriculum design that emphasizes flexible goals, methods, assessments, and materials so as to decrease the barriers that typically limit student access to learning.

Visual Impairment (VI): Blindness or low vision.

Bibliography

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Ely, R., Emerson, R. W., Maggiore, M., O'Connell, T., & Hudson, L. (2006). Increased content knowledge of students with visual impairments as a result of extended descriptions. Journal of Special Education Technology, 21 , 31-40. Accessed April 24, 2007, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=23788252&site=ehost-live

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Huebner, K. M. (2006). Achieving equality in education: New challenges and strategies for change: The 12th world conference and general assembly of the International Council for Education of People with VI. Journal of Visual Impairment and Blindness, 100 , 693-696. Accessed April 24, 2007, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=23485874&site=ehost-live

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Individuals with Disabilities Education Act Amendments of 1997, 20 U.S.C. §1415 et seq.

International Council for Education of People with Visual Impairment and the World Blind Union (2003). Joint position paper on inclusive education of children with visual impairment. Retrieved April 24, 2007, from http://www.icevi.org/publications/ICEVI-WBU_joint_policy_paper_on_inclusive_education.html.

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Jackson, R. M. (in preparation). The need for progress monitoring to support the participation of students with visual disabilities in standards-based reform. Unpublished manuscript.

Johnson, L., & Lawson, H. (2006). Teachers of visually impaired students as providers of related services? "Supportive services" versus "specially designed instruction." Journal of Visual Impairment and Blindness, 100 , 595-596. Accessed April 24, 2007, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=23057195&site=ehost-live

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McDonough, H., Sticken, E., & Haack, S. (2006). The expanded core curriculum for students who are visually impaired. Journal of Visual Impairment and Blindness, 100 , 596-598. Accessed April 24, 2007, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=23057196&site=ehost-live

Office of the United Nations High Commissioner for Human Rights (1993). Standard rules on the equalization of opportunities for persons with disabilities. Retrieved April 24, 2007, from http://www.ohchr.org/english/law/opportunities.htm.

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Thurlow, M., & Bolt, S. (2001). Empirical support for accommodations most often allowed in state policy (Synthesis Report 41). Minneapolis, MN: University of Minnesota, National Center on Educational Outcomes. Retrieved April 24, 2007, from http://education.umn.edu/NCEO/OnlinePubs/Synthesis41.html.

Suggested Reading

Blasch, B., Wiener, W., & Welsh, R. (Eds.). (1997). Foundations of orientation and mobility (2nd Ed.). New York, NY: AFB Press.

Chen, D. (Ed.). (1999). Essential elements in early intervention: Visual impairment and multiple disabilities. New York, NY: AFB Press.

Corn, A. L. (2000). Overview, assistive devices and technology. In Silverstone, B., Lang, M., Rosenthal, B., & Faye, E. (Eds.), The lighthouse handbook on visual impairment and vision rehabilitation, 903-906. New York, NY: Oxford University Press, Inc.

Ferrell, K. A. (2005). The effects of NCLB. Journal of Visual Impairment & Blindness, 99 , 681-683.

Ferrell, K. A. (1985). Reach out and teach. New York, NY: AFB Press.

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