Falls and fallinjuries are very common in peoples own homes in various institutions. Hospital inpatients often fall during daytime in connection with their visit to the toilet. Visual impairment such as cataract, glaucoma, macular degeneration and diabetic retinopathy can cause falls. The purpose of this study was to examine patient´s records where falls and fallinjuries were documented at an emergency clinic and to examine if they were registered to visual impairment. The records from 68 hospital inpatients from the age of 65 years and older who did fall during the year of 2004, were examined. In spite of different preventive actions that were taken, falls and fallinjuries often happened when the patients were on the move and left on their own. The number of patients who have any visual impairment and a record at an eye clinic, were 41. Thirtytwo of the patients who have any visual impairment did fall between 18:00 - 06:00. In the emergency clinics records, there were no records about how the patients experienced their visual ability. Objective and subjective visual impairment were only registered in the eye clinics records. When risk assessments are made, visual impairment should be considered as a riskfactor for falling. It should be considered as an independent riskfactor as well as in addition with other riskfactors. When the patient gets to the ward, the nurse should ask the patient and register if he or she has any visual impairment. The nurse can therefore use strategies to plan the caring and prevent falls and fallinjuries during the patients stay at the emergency clinic. Visual impairment as well as the natural ageing affects the visual ability and therefore the wards environment should contain sharp colours and bright lightening.

Denne masteroppgaven fokuserer på særtrekk eller vanskeområder ved CVI som kan komplisere sosial samhandling med jevnaldrende. Utgangspunktet for undersøkelsen har vært en antagelse om at noen særtrekk som kan vise seg ved CVI, kan komplisere sosial samhandling med jevnaldrende. Undersøkelser viser at blinde og svaksynte kan ha utfordringer knyttet til sosial samhandling, og at de ofte føler seg sosialt isolerte (McAlpine & Moore, 1995; Huurre & Aro, 1998; Huurre & Komulainen, 1999). Kanskje er det også slik for barn med CVI? Mestring av sosial samhandling er viktig for å bli bedre sosialt integrert, og for å få anledning til å tilegne seg sosial kompetanse. God sosial kompetanse og skolefaglige prestasjoner henger sammen (Utdanningsdirektoratet udatert, a). Det er derfor viktig at elevene trives og kjenner seg sosialt integrert i klassen og på skolen. Masteroppgaven tar utgangspunkt i en kvalitativ undersøkelse, hvor lærere og foreldre til tre barn med CVI er intervjuet om barnas utfordringer knyttet til sosial samhandling. Datainnsamlingen er gjort gjennom semistrukturerte intervjuer våren 2012. Intervjuene ble tatt opp som lydfiler, og er i etterkant transkribert fra lydfiler til tekst. Gjennom undersøkelsen kommer det frem at alle tre barna har utfordringer knyttet til sosial samhandling, dog i ulik grad. De har vansker med identifikasjon av kjente, med tolkning av ansiktsuttrykk og non-verbal kommunikasjon, samt orienteringsvansker. Det er sannsynlig at dette bidrar til å gjøre samhandling med andre vanskelig. Det er imidlertid umulig å si at det er disse særtrekkene ved CVI alene som forårsaker samhandlingsvanskene foreldre og lærere rapporterer om, men det er ikke usannsynlig at trekkene kompliserer samhandling med andre mennesker. Den store utfordringen er å finne ut hva vi skal gjøre for å tilrettelegge godt for denne gruppen barn, og ikke minst hvem som har ansvaret for å gi dem den hjelpen de trenger.

The Picture Exchange Communication System (PECS) is an augmentative and alternative communication program (Frost & Bondy, 2002). Although PECS has been effectively used to teach functional requesting skills for children with autism, mental retardation, visual impairment, and physical disabilities (e.g., Anderson, Moore, & Bourne, 2007; Chambers & Rehfeldt, 2003), there are limited studies examining the effectiveness of PECS to teach requesting skills for children with multiple disabilities including visual impairment (Lund & Troha, 2008).This study explored the effectiveness of combining tangible symbols and other adaptations with PECS to teach requesting skills to students with multiple disabilities. Specifically, the participants were four students with multiple disabilities including visual impairment who also had many challenges in communication skills. The research design was the multiple probe design across subjects, a variation of a multiple baseline design. A notable benefit to this design is that there was no need to collect continuous recordings of baseline measures, because a strong a priori assumption of stability and the possibility of causing strong participant reactions existed before introducing the intervention. Instead, the researcher made periodic recordings of baseline levels to insure no significant changes have occurred before introducing the intervention.The study included four parts: (a) the assessment of reinforcers, (b) baseline, (c) the implementation of the intervention, which was teaching the three PECS phases and conducting generalization sessions, and (d) the maintenance condition. Three important research questions were posed:1. Can students with multiple disabilities including visual impairment learn to make requests for preferred items using adapted PECS materials and procedures?2. Can students with multiple disabilities including visual impairment generalize requesting skills for preferred items using adapted PECS from training rooms to classrooms?3. Can students with multiple disabilities including visual impairment maintain requesting skills after training?The results indicated that all four participants learned requesting skills using adapted PECS, generalized the newly acquired skills to their classrooms, and maintained the requesting skills after training. Results of this study provided preliminary evidence that PECS with adaptations could be used effectively to teach requesting skills for students with multiple disabilities including visual impairment.

This thesis looks at social scientific and disability related research on visual impairment and education. It starts from a historical perspective, and outlines the radical change of emphasis in research and thinking brought about by the Disabled People's Movement. After showing how this movement has developed, it looks at various aspects of visual impairment, concentrating on rehabilitation, personality research and the symbolism of the eye. The next section looks at the development of education for visually impaired people. It starts from a historical perspective, and relates this to mainstream Sociological research on classroom interaction and school culture. All of these sections highlight the importance of attitudes and social factors, whilst not denying the undoubted impact of visual impairment in itself. 23 visually impaired school pupils were interviewed, each individually, in a wide range of schools, and from a variety of social and educational backgrounds although an age range of 14 to 18 years seemed most suitable, for various reasons, the ages of those interviewed range from 13 to 19 years. For more detail see Chapter 7. The results highlighted a lack of understanding amongst educational establishment and society at large, especially with regard to partial sight. They showed that generally people can live normal lives, but that it is difficult for them to become fully part of groups which include sighted people, mainly due to problems in sighted people's attitudes and the effects of not seeing who and what is around. Varying levels of confidence were found in both mainstream and special schools, and these often related to the level of encouragement given by staff for the visually impaired people to mix with sighted people. 10 sighted colleagues of the visually impaired respondents at three of the schools were also interviewed, again individually. They were aged 15 and 16. Again, see Chapter 7 for more details. They highlighted issues including looking different, not "knowing how to act" around a visually impaired person, and in some schools, a lack of information about visual impairment. It was these issues, along with the availability of more mainstream information for visually impaired people, (especially "top shelf" material) that concerned respondents the most.

The effect of exercise programmes on psychosocial characteristics, namely self-esteem, of people with visual impairment (VI) is limited. Martial arts practice has been found to improve global self-esteem among different age groups and among people with different abilities, but not for people with VI. This presents a notable gap in the research literature on people with VI. This thesis conducted three studies with the aim of investigating whether martial arts practice improves self-esteem in people with VI, including martial arts mechanisms and strategies for self-esteem improvement. Study one (n = 5) investigated the effect of a martial arts (karate) 10-week programme on the exercise and self-esteem model components (EXSEM) in young adults with VI (age range 19-40 years) following a non-concurrent multiple baseline approach. Visual inspection and graphical approach analysis showed that four participants improved their global self-esteem. Physical self-worth improved for all five participants. Exercise self-efficacy was improved in three participants whereas the other two had high exercise self-efficacy before participation in the karate programme. Exercise self-efficacy and physical self-worth maintained higher scores than the baseline for all five participants for 3 months upon completing the programme. The 3-month follow up results of global self-esteem were lower than the baseline scores for two participants whereas the other three participants achieved higher global self-esteem scores than the baseline scores. Study 2 (n = 12) aimed to identify the mechanisms for self-esteem improvement from the perspective of martial artists with VI following a narrative approach. Results identified two main factors that contributed in the improvement of self-esteem found in this group. Firstly, social self-esteem impacted global self-esteem as instructors unconditionally accepted the martial artists with VI, motivated them and created relationships based on trust. In addition, participants reported that team work in the dojo, trustful relationships among martial arts peers, and feeling respected impacted their social self-esteem. The resultant was improved global self-esteem of the martial artists with VI. The second factor identified showed that global self-esteem improvement was related to intellectual self-esteem, as the martial artists increased their self-achievement awareness and body and spatial awareness and thus helped martial artists in achieving their maximal potential. Study 3 (n = 6) aimed to provide strategies that martial arts instructors utilize to improve self-esteem of their students with VI using an interpretative phenomenological approach (IPA). Participants reported that the first step for global self-esteem improvement of martial artist with VI was social inclusion which needed to be rooted in a personal perception about the abilities of individuals with VI. Most of the strategies that were utilized by the instructors were focused either on social relationships, for example peer tutoring, or martial arts philosophy such as teaching real situations. Furthermore, instructors reported that improvement of the other cognitive and psychological characteristics, namely body awareness and self-confidence improvement, positively affected global self-esteem of individuals with VI. Supporting the multidimensional hierarchical construct of self-esteem, this thesis reports a positive influence of martial arts styles on social self-esteem, physical self-worth, intellectual self-esteem, and consequently global self-esteem in people with VI. Therefore, it is recommended that instructors focus on these three domains to improve global self-esteem of people with VI.

Language and communication difficulties of young children with visual impairment (VI) may be ascribed to intellectual disability, multiple disabilities and autism spectrum disorder (ASD) rather than sensory impairment. As a result, the impact of VI on communication development has been underestimated and undertreated. Speech-language therapists should be included on the early intervention team for children with VI. There is a need to review and critically appraise recent peer reviewed research to examine the strength of the evidence and to describe the language and communication developmental characteristics in young children with VI. A literature review regarding the developmental characteristics of children with VI was compiled as a foundation of information. A systematic search of recent literature (2003-2013) was then completed using the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Primary and secondary search phrases were used in three databases and 1661 articles pertaining to language and communication developmental characteristics were identified. Once the inclusion criteria were applied, the level of evidence of the nine remaining publications was determined. Thematic analysis was used to describe the early language and communication characteristics of children with VI. All the studies were from developed countries and participants from seven of the nine articles had congenital VI. Five studies received an evidence level rating of III while four articles were rated as IIb. Two main themes emerged from the studies, 1) early intervention and 2) multiple disabilities and ASD. Language and communication development is affected by VI especially in the early stages of development and speech-language therapists should therefore be included in early intervention for children with VI. Recent evidence on the early language and communication difficulties of children with VI is stronger than in the past where studies were mostly on evidence level IV, i.e. descriptive research and expert opinion. Language and communication difficulties are missed or not prioritized in children with VI due to the co-occurrence of multiple difficulties such as intellectual disability, ASD and multiple disabilities. Six articles attempt to address this problem. The impact of VI itself on communication remains unclear because the effect of VI on language and communication development cannot yet be separated from the primary conditions. Children with VI are a hidden population for speech-language therapists. This systematic review motivated the need for speech-language therapists to become involved in early intervention for children with VI from the perspective of prevention of further delay, intervention for existing delays and advocating for the awareness of the possible communication problems. Children with VI, specifically those in developing countries within Sub-Saharan Africa with acquired VI, need to receive greater focus not only within research but also in clinical practice. The identified language and communication developmental characteristics and early intervention guidelines by ASHA (2008) provide the framework for improved service provision by speech-language therapists to young children with VI. / Dissertation (MComm Path)--University of Pretoria, 2015. / Speech-Language Pathology and Audiology / Unrestricted

Thesis (Ed.D.)--Boston University / Research suggests that web-based education increases opportunities for underserved populations to be integrated into educational activities (Schmetzke, 2001; Burgstahler, 2002; Opitz, Savenye, & Rowland, 2003). This may be true for students with disabilities because they have more flexibility to participate in formal education. However, Moisey (2004) found that people with disabilities had lower rates of enrollment and educational achievement than people without disabilities. These findings raise the question of whether or not web-based = education helps increase students with disabilities' access to learning opportunities and improve their learning outcome. This study investigated the degree of difficulty blind persons had in accessing and using web-based educational resources provided by Thailand Cyber University (TCU). Based on a mixed methods design, the data were collected in two phases. Quantitative data were collected first, in order to identify accessibility problems and conformance levels reported by automated web accessibility evaluation tools. Qualitative data was collected from interviews with blind participants in the second phase to expand the understanding of the accessibility problems and usability issues that were not discovered in the quantitative phase by the automated web accessibility evaluation tools. The findings indicate that all of the 13 selected web pages failed to meet a minimum requirement of WCAG 2.0. This means those selected web pages would be inaccessible for the blind. However, the findings indicate blind participants rated only one of the 13 pages as inaccessible. Moreover, their ratings of difficulty on "usability" were higher than their ratings of difficulty on "accessibility" on the same web page. On six out of 22 tasks, blind and sighted user groups agreed on the ratings. Nevertheless, the time that it took to complete each task varied greatly between the two user groups. / 2031-01-01

Barn med funktionsnedsättningar upplever mer problem med hälsan och lägre livskvalitet än barn utan funktionsnedsättning. En integrativ litteraturstudie användes för att beskriva och belysa barns upplevelser av att leva med synnedsättning. En analys av 13 artiklar utfördes. Barn med synnedsättning beskrev bland annat hur de undvek sociala situationer där problem relaterat till synnedsättningen kunde uppstå.Många barn deltog tillsammans med sina familjer i fritidsaktiviteter anordnade för barn med synnedsättning arrangerade av olika organisationer. Barnen beskrev både positiva och negativa upplevelser av sina möten med vården. Några av barnen beskrev en frustration över att behöva förklara sitt tillstånd för vårdpersonal som inte var insatta i deras hälsohistorik. Fysisk aktivitet och skola var ett återkommande ämne i flera studier och barnens självkänsla och självförtroende påverkades av möjligheterna till att delta inom dessa områden. Barnen upplevde besvikelse och frustration över den stigmatisering som en synnedsättning innebar. Studien belyser ett relativt outforskat ämne där forskning inriktad på att mäta välbefinnande hos barn och ungdom som lever med synnedsättning är sparsam både utomlands och i Sverige. Genom att samla den befintliga forskningen kan kunskapen öka och leda till en mer individanpassad vård och omvårdnad. / Children with disabilities experience more problems and difficulties with their health and decreased quality-of-life conditions than other children. An integrative litteraturestudy was used to describe the experiences of children with visual impairment and their everyday-life. This study includes an anlysis of 13 articles. The children described scenarios in which social settings were avoided due to problems or concerns that may arise involving the visual impairment. Many of the children with visual impairment and their families attended leisure services that were arranged by different childrens organisations. The children described both positive and negative experiences when meeting with their caregivers. Some of the children described a frustration of having to explain their medcial and health condition to caregivers who were not familiarwith their medical and personal history. A recurring theme in several studies was physical activity and school and how self-esteem and confidence of the children often depended on opportunities to participate in these subjects. Children experienced disappointments and frustrations over the stigmatisation that visual impairment involved. The study encompasses a topic that is relatively unexplored and in need of further research to provide greater understanding. Research that focuses on evaluating the well being of children and youth living with vision loss is sparingly both in Sweden and abroad. By summarizing the existing research, increased knowledge could lead to a more individualized nursing care for these children.

BACKGROUND: Visual impairment impacts over 15% of Americans over the age of 65, roughly 7.3 million people. Currently there is no statewide model for low vision rehabilitation services that serves individuals across the visual impairment continuum. This dissertation sought to examine the existing eye care service delivery models, identify best practices, and explore perceived barriers and facilitators to access low vision rehabilitation services for older adults in order to inform the development of a revised service delivery model. The model will guide practice and policy change for existing and future services. METHODS: A mixed methods convergent approach was used to achieve the study’s overarching objectives. First, quantitative data from a synthetic estimation, was used to categorize high and low resource communities, which informed the purposeful sampling of focus groups and provided essential data to guide model development. Next, focus groups and one-on-one key stakeholder interviews were held to understand stakeholder perspectives on access to low vision rehabilitation services in both high and low resource communities. Further, one-on-one interviews with focus group participants provided additional quantitative data on individual prioritized barriers. Taken together, qualitative and quantitative research was conducted concurrently and then merged and expanded to inform a low vision rehabilitation focused care delivery model grounded in the Institute for Health Improvement’s Chronic Care Model. RESULTS: Key findings indicate the need for a model of service delivery that provides the full continuum of care, beginning with a low vision eye exam, which is coordinated throughout the community and health systems and addresses the chronic nature of visual impairment. Care should be client-centered and provided when the client is ready to accept services. Lastly, ongoing education to health care providers, consumers, and society will facilitate productive interactions and positive health outcomes. CONCLUSION: The stakeholder-driven low vision rehabilitation focused care delivery model grounded in the Chronic Care Model will provide a structure for service delivery throughout the state. This collaboration with community and health systems, as well as case management, will assist with program sustainability and reach to all adults throughout the state living with VI. / 2020-06-30T00:00:00Z

Students with Visual Impairment (VI) s5ll experience barriers to educa5on despite the right to educa5on s5pulated in the United Na5ons Conven5on on the Rights of Persons with Disabili5es (UNCRPD). Challenges such as delays in the conversion of curriculum content to accessible formats, inaccessible online course sites and teaching and learning that is mostly visual. With the University of Cape Town (UCT) going fully online due to COVID-19 pandemic, it became necessary to explore how equitable access to the curriculum is understood. The research topic is: How do staff and students at UCT understand equitable access to the curriculum for students with VIs? Four conceptual framework components were used. The hidden and enacted curriculum was used to explore hidden curriculum aspects and their effect on the enacted curriculum. Universal Design for Learning (UDL) framework was used to explore enablers such as assis5ve technology (AT) and challenges such as inaccessible content. Eight elements of digital literacies were used to explore access to opportuni5es to acquire digital literacies and the UNCRPD to ensure alignment with the right to educa5on. A Q methodology study was conducted which is a hybrid of both quan5ta5ve and qualita5ve methods. It sta5s5cally groups viewpoints that are significantly similar to or dis5nct from each other, quan5ta5vely into factors, then qualita5vely interprets these factors thema5cally to reveal par5cipant views about the research topic. Data was collected from students with VI, lecturers, staff from Disability Services, ICT Services, Library Services, and the Centre for Higher Educa5on Development using Q sor5ng where par5cipants ranked sixty statements into disagree, neutral and agree. Focus group discussions were used to support the interpreta5on of the factors. Findings revealed that: accessible curriculum is also a technical issue which is not priori5sed at UCT, and lecturers struggle with compe5ng demands such lack of 5me, need for promo5on and research. Accessibility design from the start both for curriculum development and support services is not valued. The right to educa5on for students with VI is par5al, varying their experience of the curriculum. Tes5ng of a course site for accessibility and lack of AT nega5vely affects right to educa5on. This study argues that students with VI do not yet enjoy full par5cipa5on in the curriculum due to lack of understanding of the complexity involved. UDL can help academics move from a deficit view to an asset view of students with VI. UCT should change its opera5onal model to accessibility from the start. Then UCT will move closer to equitable access to the curriculum for students with VI.