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A Publication about Visual Impairments and Deafblindness for Families and Professionals

By: Excerpts from Family Engagements, NCDB

Abstract: In this article NCDB provides a list of children books on deaf-blindness and general disabilities

Keywords: Deaf-blindness, blind, visually impaired, National Center on Deaf-Blindness (NCDB), disability, books about the disability experience

NCDB recently received an inquiry about where to find children’s books on deaf-blindness and disabilities in general.  They put together a list of resources, focusing on books for preschool through 6th grade.

A great source for children’s books on disability in general is the Schneider Family Book Award, given annually by the American Library Association to books about the disability experience. They give the award in three categories—birth through grade school, middle school, and teen. Go to the link below and select a year to see the winners:
http://www.ala.org/awardsgrants/awards/1/select

Probably easier to navigate is their bibliography of books about the disability experience (organized by age range):
http://www.ala.org/awardsgrants/sites/ala.org.awardsgrants/files/content/awardsrecords/schneideraward/2009_schneider_bio_children.pdf

As far as books specifically about deaf-blindness, there are a TON of Helen Keller biographies for kids out there. Just search Amazon or a library catalog to find one that’s at the reading level you want.

Helen's Eyes: A Photobiography of Annie Sullivan, Helen Keller's Teacher
http://www.amazon.com/Helens-Eyes-Photobiography-Sullivan-Photobiographies/dp/1426322224/ref=sr_1_1?ie=UTF8&qid=1443837563&sr=8-1&keywords=helen%27s+eyes

Helen Keller: Her Life in Pictures
http://www.amazon.com/Helen-Keller-Her-Life-Pictures/dp/0439918154/ref=sr_1_1?ie=UTF8&qid=1443837713&sr=8-1&keywords=helen+keller+her+life+in+pictures

This next one is a biography of Laura Bridgman (slightly fictionalized). It’s out of print but available on Amazon:

Child of the Silent Night
http://www.amazon.com/Child-Silent-Night-Fisher-Hunter/dp/0395068355/ref=sr_1_1?ie=UTF8&qid=1443838656&sr=8-1&keywords=child+of+the+silent+night

Here’s a more recent children’s biography of Laura (higher reading level):

She Touched the World: Laura Bridgman, Deaf-Blind Pioneer
http://www.amazon.com/She-Touched-World-Bridgman-Deaf-Blind/dp/0618852999/ref=sr_1_2?ie=UTF8&qid=1443838917&sr=8-2&keywords=laura+bridgman

Aside from Helen biographies, there are not many children’s books out there that deal with deaf-blindness. Here are two more:

Can You Feel the Thunder?
Thirteen-year-old Mic Parsons struggles with mixed feelings about his deaf and blind sister and his new neighbor. (Grades 4-8)
http://www.amazon.com/Can-Feel-Thunder-Lynn-McElfresh/dp/068982324X/ref=sr_1_1?ie=UTF8&qid=1443839504&sr=8-1&keywords=Can+You+Feel+the+Thunder%3F

A Dog Called Homeless
Fifth-grader Cally Louise Fisher stops talking, partly because her father and brother never speak of her mother who died a year earlier, but visions of her mother, friendships with a homeless man and a deaf-blind boy, and a huge dog ensure that she still communicates. (Grades 4-7)
http://www.amazon.com/Dog-Called-Homeless-Sarah-Lean/dp/0062122266/ref=sr_1_1?ie=UTF8&qid=1443840903&sr=8-1&keywords=a+dog+called+homeless

Here are two bibliographies of children’s books that include blind characters:
http://www.aph.org/museum/BooksBlindness.pdf

https://www.dcmp.org/caai/nadh264.pdf

Here’s a bibliography of picture books organized by disability:
http://guides.libraries.wright.edu/childrensbooksdisabilitythemes

Here’s a nice, concise bibliography of children’s books on disability from the San Francisco Public Library:
http://sfpl.org/index.php?pg=2000152701

And last but not least, Connie’s New Eyes. It’s the true story of a woman getting her first guide dog, starting when the dog is a puppy and following the two of them through their training and back to Connie’s home and career. It’s illustrated with beautiful full-page black and white photographs. Unfortunately it’s no longer in print, but you can get it from Amazon:
http://www.amazon.com/Connies-New-Eyes-Bernard-Wolf/dp/0397316976/ref=sr_1_1?ie=UTF8&qid=1443845351&sr=8-1&keywords=connie%27s+new+eyes

 

By: Sharon Nichols Outreach Assistive Technology Specialist

Keywords: accessible comics, accessible books

 

Comics Empower http://comicsempower.com/about-us . An excerpt from their website: Comics Empower is the online comic book shop that makes comics for the visually impaired! You will finally be able to take part in the comic book conversation! You can finally experience what has become a basic part of life and of the growing experience for so many!

What Are Comic Books for the Visually Impaired? The comics are translated into audio form. Pages, panels, and texts are described in a way that doesn't break the rhythm of the story. Twenty-two to twenty-four pages of comics are translated into thirty to thirty five minutes of audio recordings. Readings include the letters pages, where the editors, writers, or publishers interact with the readers.

More Accessible Comics and Books

Holly Cooper, Outreach Deafblind Early Childhood Specialist

photo of stuffed animal

Dr. Strange battles a Giant Teddy Bear in Marvel Comics Dr. Strange #1, 2015. Displayed on an iPad

 

Did you know many public libraries have websites which include downloadable audio books and e-books? Audio books can be downloaded from your computer to an iPod, or directly to a phone or tablet. MP3 players such as the iPod have the advantage of being small and having long battery life for audio files. E-books can be downloaded to tablets or reading devices such as the Kindle. These devices allow users to enlarge the font size for people reading visually. Monochrome screens such as the Kindle have a very long battery life, and the backlight feature can be brightened or dimmed. Some new reports indicate using dimmer monochrome screens are less likely to keep readers awake when used before bedtime. Color screens can be easier to see for people with visual impairment and illustrations in the books are bright and clear. Graphic novels on a large color screen are lots of fun to read when enlarged on a tablet. The new iPad Pro has a screen which is 12.9 inches diagonally. Never have more books and literacy resources been more available to people who are blind and visually impaired.

The Texas Fellows program acknowledges the individual recruiters (Texas Fellow) and welcomes the new VI professional (Candidate) to the field.  You are eligible to be a Texas Fellow if you were a significant person in the candidate’s recruitment. Candidates must have started their training program, seeking their first certificate (TVI or O&M), after May 15, 2014. 

Texas Fellows and Candidates receive additional recognition and incentives. For more information, and an application go to the following link:

http://www.tsbvi.edu/how-do-i-become-a-vi-professional.
For more information about becoming a Texas Fellow or working as a VI professional contact Mary Shore at .  

Texas Fellow

  • Shelly Gonzales
  • Lonnie Fortner
  • Tashia Ellington
  • Deborah Thompson
  • Janiel Hayes
  • Charlotte Simpson
  • Marcia Hopkins
  • Kandice Burke

Candidate

  • Katie Nash
  • Judy Martinez
  • Heather Gill
  • Kelly Bevis Woodiel
  • Irma Garza
  • Cindy Holifield
  • Jennifer Brown
  • Cassidy Sherwood
  • Alecia Jarrett
  • Jennifer Gillispie
  • Michelle Peacock

By:  Megan Morgan, Policy Fellow for The ARC of Texas
Article reprinted from Texas Parent to Parent Newsletter, Winter 2015

Abstract: This article reviews the new legislation that recognizes supported decision-making as an alternative to guardianship for adult with disabilities and provides links for additional information.

Keywords: Supported Decision-making, guardianship, individuals with disabilities, The Arc of Texas, blind, visually impaired

<p>During the most recent legislative session, Texas made history by becoming the first state to legally recognize supported decision-making as an alternative to guardianship for adults with disabilities. At the heart of supported decision-making is a simple premise: all people use help to make important life decisions.&nbsp;Supported decision-making allows individuals to make their own decisions and stay in charge of their lives, while receiving any support they need to do so. To use a supported decision-making agreement, a person with a disability chooses an adult they trust to serve as their supporter. This may be someone like a parent, friend, or former teacher. It is important to know that the supporter cannot make a decision for the person with a disability. The supporter can, however, help the person with a disability understand the options, responsibilities, and consequences of their decisions. The supporter can also help the person obtain and understand information relevant to their decisions and communicate their decisions to the appropriate people.</p>

 After an individual with a disability asks someone to be their supporter, they should explain to the supporter what types of decisions they need help making. When both parties feel ready, they will fill out a written plan called a supported decision-making agreement, which explains what decisions the supporter can help with and what information the supporter can access. Doctors, service providers, educators, and others are legally required to accept the agreement. This means that if the person with a disability so desires, his or her supporter can do things like talk to doctors about private medical information, discuss service coordination with providers, and participate in Individualized Education Plan (IEP) meetings. Supported decision-making agreements are an excellent self-advocacy tool that people with disabilities can use to make their own decisions while having the support they need.

Through legally recognizing supported decision-making as an alternative to guardianship, Texas is providing individuals with disabilities and their families with another option to consider as individuals transition into adulthood. To download a blank supported decision-making agreement form, please visit The Arc of Texas website at http://bit.ly/1NuTCYE

For more information on supported decision-making, visit the websites below or contact
Megan Morgan, Policy Fellow for The Arc of Texas, at
or 1-800-252-9729 ext. 7753.

National Resource Center for Supported Decision-Making
http://supporteddecisionmaking.org/

Texas Guardianship Reform and Supported Decision Making

www.grsdm.org

By: Texas Parent to Parent Pathways to Adulthood Staff
Reprinted from Texas Parent to Parent Newsletter, Winter 2015

Abstract: This article answers frequently asked Medicaid Waiver and related program questions

Keywords: Texas Parent to Parent, Medicaid Waiver Program, Medicaid, Consumer Directed Services, Community First Choice

What are Medicaid Waivers?

Medicaid Waivers are long-term supports and services provided by a state/federal partnership for people who need assistance with daily living. The purpose of the Waivers is to keep someone living in the community rather than an institutionalized setting. The same income and resource limits apply as for SSI, but Waivers are the one program based on the assets of the child even under age 18 rather than a family's.

Why is there such a long waiting list? Are there new programs?

The State of Texas has been slow to fund these programs; however, in the Legislative session of 2013, the state added waiver-type services to STAR+PLUS for people at age 21 who are nursing-home eligible. If your child receives Medicaid, she should receive a letter at age 21 directing her to select a STAR+PLUS MCO (Managed Care Organization) for health services. Another new funding source is Community First Choice (CFC) (June 2015) for people with disabilities of all ages; check with your Local Authority for more information. Additional information on CFC is below.

What happens when my child's name comes up on the interest list?

He or she will receive a registered letter from the funding agency. You will be given information about the programs and choices available. You will have to choose a case management provider. If your child proves to be eligible for that waiver, you will create a budget with the assistance of a case manager. Medicaid Waivers give choices to the recipient and family about how to use the program and which services to use from a list of available services.

What is CDS (Consumer Directed Services)?

One of the choices for Waiver services is the CDS model, which empowers the person receiving the service (or someone given that authority) to be the employer of record for attendant care and respite providers. Choosing CDS provides more control over who will work with your child than if you use care providers employed by an agency; you will also be able to pay them at a higher rate. Note that this model requires more effort on your part.

What happens when my child is receiving one waiver service and his name comes up on another waiver?

You can only use one Waiver at a time; you'll need to do the research to decide which Waiver will best suit your child. It might help to talk to other parents whose children receive Waiver

services; call the TXP2P office to connect with community wisdom. See this chart for a comparison of all Waivers: http://www.dads.state.tx.us/providers/waiver_comparisons/index.html

What is Community First Choice?

The following information about CFC is taken from this website: http://www.hhsc.state.tx.us/medicaid/managed-care/community-first-choice/

A federal option, called Community First Choice, allows states to provide home and community-based attendant services and supports to Medicaid recipients with disabilities. This option provides states with a 6 percent increase in federal matching funds for Medicaid for these services. To be eligible for Community First Choice services an individual must:

  • Be eligible for Medicaid
  • Need help with activities of daily living, such as dressing, bathing and eating
  • Need an institutional level of care

Community First Choice Services include:

  • Activities of daily living (eating, toileting, and grooming), activities related to living independently in the community, and health-related tasks (personal assistance services)
  • Acquisition, maintenance, and enhancement of skills necessary for the individuals to care for themselves and to live independently in the community (habilitation); providing a backup system or ways to ensure continuity of services and supports (emergency response services); and
  • Training people how to select, manage and dismiss their own attendants (support management).

Texas began the Community First Choice program on June 1, 2015. This means:

  • Individuals on a 1915(c) waiver interest list who meet eligibility and coverage requirements may be eligible to get Community First Choice services.
  • Individuals already getting services through a 1915(c) waiver will continue to get those services as they do today from their existing providers.

 

To access CFC, go to your Local Authority for people over 21. (To find your Local Authority, go to https://www.dads.state.tx.us/contact/search.cfm)

For those under 21, go to the Department of State Health Services (call the Texas Medicaid & Healthcare Partnership (TMHP) PCS Client Line toll free at 1-888-276-0702

 

For more information, go to http://www.dads.state.tx.us/providers/cfc/ 

General information about CFC

 http://www.hhsc.state.tx.us/medicaid/managed-care/community-first-choice/docs/cfc-faqs.pdf  

CFC Frequently Asked Questions

http://www.dads.state.tx.us/providers/communications/2015/letters/IL2015-29.pdf 

For more information, go to http://txp2p.org/parents/pathwaysSevvices.html#ptaServMediWav

By: Tammy Martin, Program Manager, Blind Children’s Program

Abstract: In this article, Mrs. Martin provides information on the Blind Children’s Program transition from DARS to HHSC

Keywords: blind, visually impaired, Blind Children’s Vocational Discovery and Development Program, Department of Assistive and Rehabilitative Services (DARS), Health and Human Service Commission (HHSC)

By now you are probably aware that the Department of Assistive and Rehabilitative Services (DARS) no longer exists. You may be wondering why the change occurred and what does that means for the services your child/family receives. Will the program continue to provide services and how will you find/contact your Blind Children’s Specialist?

 

Why the change?

The 84th Texas Legislative session’s goal was to make the system more efficient and easier to navigate for the people who rely on state services and, Senate Bill 200 was approved to re-align the five agencies that make up the health and human services enterprise. This brought changes to the programs that made up the Department of Assistive and Rehabilitative Services. In order to serve Texans more efficiently and effectively, the DARS programs were transferred to either the Texas Workforce Commission (TWC) or to Health and Human Services Commission (HHSC). The Blind Children’s Vocational Discovery and Development Program was transferred to HHSC.

The Programs that are now a part of TWC are:

  • all Vocational Rehabilitation programs, including Transition, divisions (there are two, one for the blind and one general) and services (including the Criss Cole Rehabilitation Center - CCRC)
  • the Business Enterprises of Texas (BET) program
  • Independent Living services (IL)-Older Blind

The Programs that moved to HHSC are:

  • the Blind Children’s Program (BCP)
  • Blindness, Education, Screening and Treatment (BEST)
  • Early Childhood Intervention (ECI)
  • IL- Part B
  • Autism
  • Deaf and Hard of Hearing Services
  • Comprehensive Rehabilitation Services
  • Disability Determination Services

 

How does this change effect the services my child receives from the Blind Children’s Program?

The services provided by the Blind Children’s Program have not changed.

While the Blind Children’s Program now lives in the newly created department within the HHSC Medical and Social Services Division, the fundamental values and goals of the Blind Children’s program remains the same. We are committed to providing quality services to assist your child in reaching their fullest potential and becoming a successfully employed adult. We will continue to assess the barriers that prevent your child from having a level playing field and work with you to plan, develop and deliver services that will provide the tools and training they need to overcome obstacles.

How do I find my Blind Children’s Specialist?

Most of the Blind Children’s Specialists have moved to a HHSC office/ location. They have new addresses, emails and phone numbers. Hopefully you have received their new contact information. If not, here are some ways to contact them.

As we embark on these changes and learn our way around the HHSC system our number one priority remains meeting the needs of our consumers and their families. Your feedback, ideas and concerns are always welcome. Please let us know how we are doing.

By: William Daugherty, Superintendent of Texas School for the Blind and Visually Impaired

Abstract: In this article, Superintendent Daugherty discusses the importance of White Cane Day and how it celebrates a person’s abilities and independence.

Key Words: White Cane Day, blind, visually impaired, mobility, independence

White Cane Safety Day was enacted into law in 1964 by President Lyndon Johnson. The “Safety” part of the law was intended to inform motorists that they must yield to a person with a white cane crossing the street. In 2011, President Barack Obama also named the day celebrated annually on October 15, as Blind Americans Equity Day. As you can see, the day has become symbolic for more than a simple tool used by people who are blind or visually impaired to safely walk from place to place. It has become a symbol for independence and capability.

This year the Austin White Cane Day Celebration will be held on the campus of the Texas School for the Blind and Visually Impaired, not on the 15th, but on the 12th of October. The Austin event is often thought to be the largest in the U.S., with crowds ranging from 500 to 700. Typically, it is held downtown, and there is a march by the entire group along Congress Avenue in the brightly colored t-shirts that are custom designed each year to commemorate the celebration. When this happens, the Austin downtown shoppers and office dwellers get an up-close lesson in how cane users apply their skills. As a former instructor of cane travel (Orientation and Mobility specialist, or O&M) who has walked a lot in urban areas under blindfold with a cane, I can tell you that it is a highly skilled activity that requires focus, sensory awareness, courage and problem solving abilities of the highest order. Put another way, when you see someone walking around town with a white cane, you are looking at a very capable person. This is at least one way to look at the meaning of White Cane Day.

People have a range of responses to seeing a person walking around using the cane. Some see it as miraculous that anyone could do that. But it is not because of an individual’s miraculous abilities. Instead, it is the result of hard work, overcoming fears, and continuous practice. Some see it as sad that a person has to tap their way through the environment. But it is not sad. Instead it is a strong symbol of independence; of not having to rely upon a sighted person to go from place to place. The more we see people with the white cane out in our communities, the more all of us will begin to see it as part of the normal fabric of the neighborhood. In Austin, I see the white cane in use practically everywhere I go. Add to this the folks who are using dog guides, those with low vision using telescopes, smart phones with navigation apps, and new technologies coming on-line all of the time. White Cane Day becomes a symbol of the many ways individuals who are blind or visually impaired are achieving independence.

Many teenagers who would benefit greatly from the use of a cane or a low vision device such as a telescope, will fight against it because they feel it makes them look different. As more and more people are out in our communities using the cane or other devices, I can see a time when teens will begin to think differently about it. One day soon, I’m almost certain, there will be a blockbuster movie that comes out featuring a cool, leading character that uses a white cane with great style and ability. Not like some cheesy guy that is scripted to have super-human powers, but like real-life people I personally know; like many among those who will be marching in celebration on White Cane Day. That will be a cultural tipping point worth looking forward to.

By: Holly Cooper, Ph.D. deafblind educational specialist,
Texas School for the Blind and Visually Impaired Outreach

Abstract: A discussion of toys appropriated for children who are in the early childhood years and have visual impairment, deafblindness, and additional disabilities

Keywords: toys for visually impaired children, toys for deafblind children

People often me ask what to get as a gift for Christmas or birthday or other special occasion for a child who has a visual impairment. Every child is unique and has their own interests, preferences, and abilities so any advice must be considered with the in light of what the particular child would like. Having said that, ideas are always good, and we who work in schools get a first-hand look at what makes our students excited and happy.

Infants

Infants who are visually impaired may be premature or medically fragile, and so may have had as much experience or interest in reaching out and exploring the world at the same age as other babies. Sometimes friends and family members give them visually cute soft plush toys because they are soft and safe. For little ones with vision this is fine, but babies who are blind may not like such toys. An occupational therapist once told me that it’s the indistinct tactile boundaries of such toys that is aversive to them. For a tactile explorer, reaching for and knowing where the object is when it’s furry and soft is confusing. Having soft things around is fine, but look for variety. 

Another issue for infants and kids of all ages is plastic toys. Plastics are good, they’re generally safe, sturdy, brightly colored, and easy to clean. But being surrounded by items which are virtually all plastic doesn’t provide the developing mind with enough variety. Lilli Nielson in her Active Learning literature tells us to look for items of different sizes, weights, and types of materials. Having more than one item of a kind is also good. So look for safe, sturdy items made of metal, wood, and cloth. As babies gain more fine motor skills, look for items with internal movement, parts that twist, bend or spin. Most people know to look for toys that make noise, but also look for noise producing toys which are not electronic, to provide different experiences and fine motor challenges.

photo of toy rattles

Photo of wooden rattles and teething toys that encourage exploration

 

Because our babies with visual impairment may have spent much time in the hospital and may be at risk of health problems at home, they may have spent a lot of time on their backs. So look for blankets and baby items that they can lay on to have “tummy time” where they practice pushing up against gravity and reach for toys and interact with people. These pushing up movements are the first steps to sitting independently and later to walking.

  • Wooden toys
  • Plastic links to keep dropped toys nearby.
  • Wind up or battery operated musical toys
  • Cloth books, board books
  • Safe everyday objects
photo of a sheep an mouse
Photo of a fabric book for babies made with textures and shapes of animals.

Toddlers

Typical children reach the age and have the motor coordination to begin to walk around 12 months of age. Our students with visual impairment may reach this stage later due to medical issues, additional disabilities or delays due to the unique effects of blindness on the developmental milestones of early childhood. As youngsters begin to move about more independently, gross motor play dominates their time and their fine motor and communication skills may plateau for a while. Toddlers with cortical visual impairment may make rapid gains in their visual processing skills as they move about more and gain more experience interacting with objects in space. To encourage functional gross motor skills such as crawling, cruising and walking, avoid prolonged use of devices such as baby “walkers” or standing play stations. Also avoid over use of equipment that confines them to a space such as the “Johnny Jump Up” or “Sit ‘n’ Spin.” These devices may keep a young child safely contained, and safety is important, but experienced vision professionals have had many experiences trying to break self-stimulatory habits such as jumping and spinning that young children with blindness may have. So look for items such as riding toys that the young child can self-propel, and toy grocery carts or lawn mowers which give youngsters some support in standing and a “bumper” to provide good experiences to build on for cane use.

photo of a toy lawnmower
Photo of a lawn mower push toy which has balls that rattle as it rolls
  • Push toys
  • Riding toys
  • Nesting/stacking cups or blocks
  • Safe small blocks
  • Duplo blocks
  • Balls: koosh balls, nerf balls
  • Large cars and trucks
  • Buckets, shovels, scoops for playing in a sandbox, water table, or outside in the garden
  • Toddler books

Ages 3 to 5

Around the third birthday, children usually begin to focus somewhat less on gross motor play and settle down with longer attention spans and more imaginative play. More significant gender differences are evident at this age, with many boys interested in vehicles and things that move, and many girls interested in imaginary play, dressing up, playing family roles, and socializing.
Move away from the push button light and music show toys, instead provide:

  • Blocks and Legos
  • Smaller cars and trucks
  • Fire trucks
  • Trains or cars on a track
photo of wooden trains
Photo of a wooden train that a child can push on the track

 

  • Dolls (for both boys and girls)
  • Play dishes and tea sets: made of tin, plastic, or ceramic if you dare
  • Metal pots and pans
  • Real food on a temporary basis: apples, pears, carrots, potatoes, onions,
  • Crackers, cookies
  • Wearable accessories such as purses, tote bags, coin purses, hats, jewelry, cell phones, make up mirrors, combs, belts, scarves
  • Baby dolls and child dolls
  • Play characters and props such as Play Mobile sets, doll houses with small dolls
  • Recorded music and musical instruments
  • Books
photo of clothes on a rod
Photo of child-sized dress-up clothes with hats, bags, and accessories

 

The early years of childhood are a time of great learning. Babies and toddlers and older children with additional disabilities are in the sensory-motor stage of learning. Choose toys which encourage sensory-motor exploration and play. For children who have advanced to the next stage learning, concrete operations, choose toys which give opportunities for social interaction, expressive language, imaginary play and learning about society and culture. Most of all, allow plenty of unstructured free time for play. One of my greatest concerns about family life as it is now is how little free, unstructured time children have. Unstructured time allows children to daydream, imagine, fiddle and be bored. Boredom pushes us all to be inventive, creative, and curious.

Thanks to Terra Toys of Austin for tolerating me while I stalked around taking photos of their many wonderful toys.

Edited from an article originally published in Texas SenseAbilities, Fall 2012

By: Holly Cooper, Ph.D., Early Childhood Specialist, Texas Deafblind Project,
Texas School for the Blind and Visually Impaired

Abstract: Media and methods for adapting mass market books to tactile and braille books, and experience books which include real objects.

Keywords: braille literacy, tactile books, experience stories

 It is amazing how early little humans show an interest in books! Typically developing children widely show an interest in children’s books by 12 months of age, and reading together with an infant is an enjoyable activity for the adult and child at age 9 months or even earlier. Experiences with books and literacy can vary widely in infancy. As with language and many other things, children from economically and educationally disadvantaged homes often have less access to books and literacy experiences. Children with disabilities are also at a disadvantage. Many of our children with visual impairment are born in very critical medical condition and remain so for a long period of time. They may be hospitalized or very fragile and have minimal opportunities to interact with people, toys, and books, or to have stories read to them. Children with severe and multiple disabilities are at a special disadvantage. Infants who are totally blind or functionally blind even without additional disabilities also have limited experiences with books, since most printed books are not meaningful and accessible to them.

Approaches to Literacy Experiences for Very Young Children

There are two good approaches to offering literacy experiences to infants with blindness and visual impairment including those with additional disabilities: adapting books and creating books. Either approach to literacy must be based on a foundation of real experiences with real objects and people. Families, caregivers and educators must give children with disabilities a variety of experiences in the community and in nature to build a foundation of language and concepts for literacy. Children who are isolated indoors with limited opportunities to interact with others, especially other children, may not understand what many stories are about. Children who are isolated due to medical difficulties may still enjoy books with an entertaining language component such as songs and finger plays, rhythmic language and rhymes. When I select books for very young babies, I look for books related to topics with which they have direct personal experience, such as body parts, feelings, routines of the day or activities of daily living. You can often find such books, or you can create them yourself.

watercolor picture of childrens hands
Here Are My Hands Softback: disassembled, laminated, brailled, and bound with comb binding

 

When should braille be introduced in books?

For a child who is blind or has a significant visual impairment, it is good to add braille to the book, or use a book with braille already in it. Even if the young child is not talking yet, having the text in braille helps build literacy awareness. When I’m reading to a child I also like to pretend to “read” the braille with my fingers, because that is the way the child will read, and reading tactually provides a good model for them to imitate. Braille can be added to almost any print book by brailling on adhesive braille products such as American Printing House for the Blind’s Braillables. (Available: https://shop.aph.org/webapp/wcs/stores/servlet/Product_Braillable%20Labels%20and%20Sheets_1054977P_10001_11051) or in a pinch, clear contact paper. Braillable sheets can be inserted into an electronic or manual braille writer, or purchased in tractor feed sheets that can be used with a braille embosser. Then they can be trimmed and attached to the book’s pages. Clear contact paper is not as durable, and will not stick as long. Another alternative is to purchase a paperback book and cut the spine off and the pages apart and laminate it. The laminated pages can be brailled on, and the embossed dots are very durable. The book can then be re-assembled with a plastic comb binding or spiral binding. Unfortunately, most books for infants and toddlers are printed on heavy cardboard for durability, so can’t be put in a braille writer. For board books, Braillables are usually the best option. I also suggest using simple uncontracted or Grade 1 braille. This may be a suggestion some teachers disagree with, but I think simplifying the braille makes it more accessible to new readers because there are fewer characters and special rules.

picture of a frog on a braille book
One Green Frog, Board book with braille added using Braillables

 

Adding tactile features to a book

Tactile features can be added to a book, similar to some mass market children’s books such as Pat the Bunny. Some stories are easier than others to illustrate tactually. Look for stories with simple concrete references to objects with texture which you can add, such as blankets, washcloths, spoons, combs, and similar items. Avoid more abstract tactile illustrations such as rain, snow, ice, peanut butter, and other things which aren’t practical to add to a book.

Creating an experience book

An alternative to finding a book and adapting it, is creating one especially for the child’s use. One beneficial approach is the use of “language experience books” or “experience books.” To create a book like this, an adult teams with the child and does an activity or participates in a special event with them. Perhaps it is going to the beach and swimming. The adult should explain to the child what will happen, then do the activity, then talk about it afterwards and write a short book about it. For a child who doesn’t yet have expressive language, using an activity that is repeated on a regular basis (such as going to bed) can help build language skills. For a child who is sighted, the adult and child can take photographs of the event, for a child who is blind or very young, small objects (sometimes referred to as “artifacts”) can be collected and glued in the book. Such a book might include something like this:

  • We went on a trip in the car. I like to shake mommy’s keys when we go to the car.
    (glue a key to the page)
  • We drove all the way to the beach. There was sand everywhere.
    (glue some sand or sand paper to the page)
  • We went swimming in the water. It was cold!
    (some things don’t have an object to go with them)
  • I liked to float on the noodle
    (or play with the beach ball, etc.) (Include a piece of noodle or ball)
  • I got really tired. Mommy dried me off with a towel.
    (glue a piece of towel to the page)
  • When we got home I fell fast asleep.

Below is a book from our library at Texas School for the Blind and Visually Impaired. It is about going horseback riding. The book’s creator went to considerable effort to collect real items to be included in this book.

four pictures of tactile symbols
Horses By Carolina, former student at TSBVI
This book is part of a collection of object and tactile symbols books at the TSBVI library

 

Clearly some experiences are easier to illustrate with tactile items glued to the page than others. Going to the rodeo might be more difficult. One farm animal feels much like another if you glue a fur sample to the page. Another way to make books is to use objects mentioned in the story, but not attach the objects to the book. If you make a trip to the farmer’s market, you can’t glue a tomato and a cucumber to the page, but you can read the story and explore real tomatoes and cucumbers together. It is also possible to find children’s books about simple familiar daily experiences and find objects to go with the story. It is important when doing this to use real objects as much as possible. Using a plastic cucumber and tomato for the farmer’s market story is not nearly as meaningful, since the weight, odor and texture of the vegetables is significantly different than toy food. Likewise, using miniature models such as toys is also usually not a good practice. Illustrating a trip to the rodeo with toy horses and cows does not give the child relevant information since toy horses bear little resemblance tactually to a real horse. In some cases, some creative license can be used, but it’s good to get some advice from your child’s teacher of students with visual impairment.

photo of spot the dogs toys
Spot's Toys by Eric Hill
book with objects mentioned in the story:
a plastic dog bone, baby’s shoe, wooden circle shape and ball

 

Building a foundation of life experiences

The most important part of literacy is to build a foundation of life experiences, talk or communicate with your child in their preferred communication mode (it might be sign language) about what you are doing together, and read stories together. Take time every day to read to your child. Reading specialists recommend reading aloud to children long after they have skills to read themselves, such as up to the middle school grades. Reading aloud gives them access to information they can’t read themselves and provides a skilled reading role model. Reading together also helps to build a special bond between yourself and your child supported by a shared experience of storytelling.

Resources

In addition to the resources on this site, some other good ideas for creating tactile experience books and adapting books include:

Creating and Using Tactile Experience Books for Young Children with Visual Impairments
Sandra Lewis, Ph.D.
Texas School for the Blind and Visually Impaired See/Hear newsletter
http://www.tsbvi.edu/seehear/spring03/books.htm

Experience Stories for Functionally Blind Pre-Readers
Millie Smith
Texas School for the Blind and Visually Impaired
http://www.tsbvi.edu/independent-living-skills/64-graphics/1735-experience-stories-for-functionally-blind-pre-readers-1

Experience Books
Washington Sensory Disabilities Services
http://www.wsdsonline.org/video-library/deaf-blind-videos/experience-books/

Teaching Emergent Literacy Skills To Kindergarten Students in a Braille/Print Program
http://www.tsbvi.edu/preschool/66-teaching-emergent-literacy-skills-to-kindergarten-students-in-a-brailleprint-program
AER International 2002 conference
Duncan McGregor, Ed.D. & Carol Farrenkopf, Ed.D

Typhlo and Tactus book contest
http://www.aph.org/research/tactile-book-contest/
American Printing House for the Blind

Guidelines for Making Tactile Books
http://www.tactus.org/guidelines.html
Typhlo & Tactus, THE International Tactile-Illustrated Book Prize

On the Way to Literacy: Early Experiences for Visually Impaired Children
https://shop.aph.org/webapp/wcs/stores/servlet/Product_On%20the%20Way%20to%20Literacy:%20Book%20Set%20I:%20Early%20Experiences%20for%20Visually%20Impaired%20Children_6-77500-00P_10001_11051
American Printing House for the Blind

Guide to Designing Tactile Illustrations for Children’s Books
http://www.aph.org/research/illustration/
American Printing House for the Blind Louisville, KY
Suzette Wright

By: Ann Adkins, Education Specialist, TSBVI Outreach Program,
and Debra Sewell & Jeri Cleveland, TSBVI Curriculum Department

Abstract: This article provides information on the development of tactile skills in students with visual impairments, including those with low vision. It explains the importance of the Hierarchy of Tactile Skills and includes suggestions for activities and resources

Keywords: tactile skills, tactile learning, Hierarchy of Tactile Skills, tactile development, braille reading, tactual

 

Although we may typically think that only blind children need instruction in the development and use of their tactual skills, research suggests that students with low vision may also be missing crucial information about their world. This can affect concept development, language acquisition, orientation and mobility skills, the development of independent living skills, and many other skills that impact a student’s ability to acquire the information he needs about his environment and the world around him. A visual impairment affects the entire process of information gathering. Far too often we expect blind or visually impaired children to base their knowledge of the world on verbal descriptions and very limited “hands-on” experiences. This cannot compare to the almost constant barrage of incidental information that fully sighted children have received before they go to school. It is imperative that teachers of students with visual impairment understand tactile learning in order to provide the experiences and instruction needed by all of their students with visual impairments.

Tactile learning, by its very definition, is not the same as visual learning. Tactile learning involves the acquisition of information about the tactile qualities of objects, such as their texture, weight, or temperature, and the composition of objects, their shapes, the materials from which they’re made, etc. This requires immediate proximity to the object. Tactual information cannot be gathered from a distance - if a student can’t touch the object, his perceptions of that object may be wrong, incomplete, or dependent upon information from someone else. For students with low vision, being able to tactually explore an object can provide the additional information needed to confirm an impression gained visually.

Tactile learning also requires that information be gathered over time by systematically exploring an object one aspect at a time. This may require multiple explorations. The inability to simultaneously perceive all parts of an object means that the entire image of the object must be built-up out of an understanding of each of its components. This is clearly not as simple a task as gathering information in a single glance. A higher level of cognition may also be needed for the integration of sequential information, and without an understanding of “the whole”, or the gestalt, future learning may be impaired. Research shows that while the development of tactile skills follows the same general progression in the blind child as it does in the sighted child, the blind child must develop his tactile skills to a much higher degree than his sighted peer, and blind children need more stimulation and motivation over a longer period of time (The Blind Child in the Regular Kindergarten, 1977).

Tactile learning simply takes more time. There are additional concerns for tactile learners as well, including limited incidental learning, fewer opportunities to share information that is learned tactually with others (reduced peer learning and interactions), and difficulty understanding the relationships between objects. Tactile learning also necessitates a lot more touching than society may accept, affecting a child’s social skills, rec/leisure skills, and self-esteem.

In the best of all worlds, the development of tactile skills happens simultaneously along with concept development and language acquisition. Before children know they can reach out and touch things, the adults in their lives must intentionally create opportunities for tactile exploration and interaction. This needs to start in infancy by increasing movement, stimulation, and access to interesting and motivating people and objects. If children do not become actively engaged in experiences and exploration at an early age, their approach to gathering information can be passive and they may not fully develop their sense of touch and their ability to learn tactually. Historically, by the time students with visual impairments enter school, they have not received enough instruction in the development and use of their tactile skills or had enough opportunities to touch and explore their world. Therefore, they may be behind in concept development, which has a long-term impact on their ability to benefit from traditional instruction. Further, if they haven’t had enough opportunities to be tactile learners, they won’t choose to do things tactually, and teachers may assume that they will be auditory learners. Children with visual impairments must learn to be active seekers of information about their world, and it is the role of the teacher of students with visual impairment (TVI) to guide educational teams in ensuring that appropriate instruction is provided for the development of tactile skills.

There are three important components of tactile skills. In order to be an efficient tactile learner, a student must have all of the following skills:

  1. Motor skills (mechanical skills & hand development)
  2. Cognitive skills (an understanding of the Hierarchy of Tactile Skills)
  3. Sensory skills physiological tactual development (levels of tactual learning)

All of these skills are equally important and should become more integrated as the student becomes a more proficient user of his tactile skills. In 2009, Jeri Cleveland and Debra Sewell addressed the importance of sensory skills in their article, “Early Tactile Learning” (Texas SenseAbilities, Summer 2009, http://www.tsbvi.edu/resources/3096-early-tactile-learning). The information below on the first two components, motor skills and cognitive skills, is also derived from their work.

Motor Skills - Mechanical Skills and Hand Development

  • Grasp and release
  • Rotary motion
  • Finger isolation
  • Bilateral hand use
  • Hand and finger strength
  • Tactile discrimination
  • Light touch
  • Proper finger position for Braille
  • Tactile tracking skills

(Sewell & Strickling, 2004)

Activities to Promote Motor Skills:

  • Using Thera-putty
  • Opening doors with door knobs
  • Finger puppets
  • Stress balls
  • Scooping and stirring
  • Dressing skills - buttoning, snapping, zipping
  • Rolling cookie dough or playdoh into balls
  • Stringing beads
  • Finger painting
  • Games on Talking Tactile Tablet (TTT)

Functional Applications of Tactile Skills:

  • Locating - randomly finding or intentionally searching for an object
  • Exploring - getting information about the tactual properties of an object (by moving hands or by moving the object)
  • Manipulating - intentional movement of an object
  • Recognizing - associating an object with a memory of the object
  • Comparing - discovering similarities, differences, and preferences; matching and sorting
  • Communicating - using objects to request, refuse, comment and question; for choice-making, calendars
  • Organizing - finding objects in their usual place; returning them to their usual place; sorting or categorizing by placement, function, attribute; gathering materials for a task

(Smith and Levack, 1997)

Cognitive Skills - Hierarchy of Tactile Skills: Concrete to Abstract

It is important to note that each level of the Hierarchy of Tactile Skills is equally important and that students must move through the hierarchy in order, mastering skills at each level before moving on to the next level. If students aren’t provided with a variety of meaningful experiences at each level, braille and/or print will have little meaning to them. We often discover that students who are struggling with tactile skills, especially tactile discrimination of braille letters, have moved too quickly to succeeding levels of the hierarchy, not spending enough time at the beginning levels to completely master them. The Hierarchy moves from concrete, real objects to the most abstract of tactile concepts and skills, braille symbols and letters.

The Hierarchy of Tactile Skills (adapted from Kershman, 1976):

  • Real Objects
  • Object Representations
  • Graphic Representations
    • Two dimensional objects
    • Solid embossed shapes
    • Outlines of objects
    • Raised lines (solid and broken)
    • Symbols/letters

 

Activities for Real Objects:

  • Touching, exploring and using familiar objects in the environment
  • Exploring objects in object bags
  • Creating Objects Books
  • Exploring Story Boxes

Resources for Real Objects:

Activities for Object Representations:

  • Side-by-side comparisons
  • Real objects to toys
  • Real food to play food
  • Real animals to stuffed animals
  • Using parts of objects to represent the whole item
  • Tactile symbols

Resources for Object Representations

  • Real objects and things used to represent them (e.g., playdoh cookies, doll, toy dishes)
  • Setting the Stage for Tactile Understanding (APH)
  • Tactile symbols

Activities for Graphic Representations (two-dimensional objects, solid embossed shapes, outlines of objects, raised lines, and symbols/letters/numerals):

  • Making hand-prints and foot-prints in plaster
  • Making faces out of playdoh
  • Creating Thermoform representations with the student
  • Puzzles and color-forms
  • Yarn or string art

Resources for Graphic Representations:

  • Setting the Stage for Tactile Understanding (APH)
  • Picture Maker: Wheatley Tactile Diagramming Kit (APH)
  • Chang Tactual Diagram Kit (APH)
  • Velcro and magnet boards

Because it takes more time to amass tactile information for building concepts, educators and parents should expect to continue instruction in these areas throughout the students’ educations. The development of tactile skills is too important to wait until students begin formal schooling and is important for students who are functionally blind and those with low vision. Parents, caregivers, teachers, and all members of the educational team of a student with a visual impairment must work together to promote the development of tactile skills - and a love for the information that can be learned tactually.

References

Kershman, S. (1976). A hierarchy of tasks in the development of tactual discrimination: Part one. Education of the Visually Handicapped, 5(3), 73-82.

Sewell, D., & Strickling, C. (2004). “Motor activities to encourage pre-braille skills.” http://www.tsbvi.edu/early-childhood/1927-motor-activities-to-encourage-pre-braille-skills.

Smith, M. & Levack, N. (1997). Teaching students with visual and multiple impairments: A resource guide. Austin, TX: Texas School for the Blind and Visually Impaired.

Stratton, Josephine. (1977). The Blind Child in the Regular Kindergarten. Springfield, IL: Charles C. Thomas Publisher, Ltd.