Clinical profile and error of inclusion and exclusion in schools for the blind in Bangalore and a review of literature.

Purpose: To determine the causes of severe visual impairment and blindness in children in schools for the blind in the city of Bangalore, Karnataka and to determine the error of inclusion and exclusion from these schools. Methods: This was a cross-sectional study. Children in four schools for the blind were subjected to a detailed ophthalmic evaluation. The World Health Organization Program for Prevention of Blindness low-vision form was used to collect data. To know the educational background of children with visual disability of 40% or more (best-corrected visual acuity of ≤6/24 in the better eye), not in schools for the blind, we collected data by telephonic conversation after procuring their phone numbers from our low-vision clinic. Results: One-hundred-seventy-eight children were examined. The major site of anomaly causing blindness in 31% of children was optic nerve, followed by retina (24%), cornea (23%), and whole globe (22%). Avoidable blindness was 35.42%. Thirteen percent of the children with no visual disability were incorrectly enrolled in blind schools. We were able to contact 92 children with a visual disability of ≥40%. Seventy-eight children (84.78%) attended regular schools; these schools were bereft of a specially trained teacher to look after the needs of the blind. Conclusion: Avoidable blindness is still a cause for concern. Children should undergo eye-examination before being enrolled in schools for the blind to avoid errors of inclusion. Though integrated education for children with vision disability is a good approach, it requires teachers trained in teaching skills particular to blindness. Education for the visually impaired in India needs a major revision.

Avaliação educacional por meio do teste iar em escolares com cegueira / Scholastic achievement assessment of blind students using the iar test

Com o objetivo de verificar a aplicabilidade do Teste IAR em escolares cegos, foram realizados estudos de casos, mediante avaliações de três escolares de oito anos de idade, com cegueira, por retinopatia da prematuridade ou catarata congênita (A.M., D.A.C., T.A.M.), atendidos no Centro de Distúrbios da Audição, Linguagem e Visão (CEDALVI), do Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) da USP, Bauru/SP/Brasil. Durante um período de seis meses, os escolares foram avaliados por meio do Instrumento de Avaliação do Repertório Básico para Alfabetização (IAR), adaptado ao Sistema Braille e contando com recursos em relevo. Os resultados da aplicação do IAR mostraram que T.A.M. alcançou 100,0 por cento em acertos em todos os conceitos; A.M. e D.A.C. obtiveram 100,0 por cento de acertos em esquema corporal, lateralidade e verbalização de palavras; D.A.C. apresentou 50,0 por cento nos conceitos posição, tamanho e quantidade; A.M. apresentou 50,0 por cento em discriminação auditiva; D.A.C. apresentou menos de 50,0 por cento de acertos nos conceitos de direção, espaço, forma, discriminação tátil, discriminação auditiva, análise/síntese e coordenação motora fina; A.M. também alcançou menos de 50,0 por cento de acertos nos conceitos de direção, discriminação tátil, análise/síntese e coordenação motora fina. Com relação à aplicabilidade, o teste IAR mostrou-se eficaz para avaliar os escolares cegos, oferecendo instruções úteis para que profissionais e familiares adotem estímulos e estratégias que favoreçam o desenvolvimento dos mesmos.

Three case studies were undertaken in order to assess the applicability of the IAR Test in blind students; three eight year old blind students, whose impairments were caused by retinopathy of prematurity or congenital cataract (A.M., D.A.C., T.A.M.), who went to the Center for Hearing, Language and Vision (Cedalvi) of the Hospital for Craniofacial Anomaly Rehabilitation (HRAC), USP, Bauru/SP/Brazil, participated in the study. During a six month period the students were assessed using the Instrument to Assess Basic Literacy Repertoire (IAR); the instrument was transcribed in Braille, also having raised images when applicable. Results of the IAR application showed that T.A.M. achieved 100 percent accuracy for all concepts; A.M. and D.A.C. achieved 100 percent accuracy for body scheme, laterality and word verbalization; D.A.C. achieved 50 percent for the concepts of position, size and quantity; A.M. achieved 50 percent for hearing discrimination; D.A.C. obtained a rate of less than 50 percent for concepts of direction, space, shape, tactile discrimination, hearing discrimination, analysis/synthesis and fine motor coordination; A.M. also achieved less than 50 percent success rate for direction, tactile discrimination, analysis/synthesis and fine motor coordination concepts. As to applicability, the IAR Test was shown to be effective in assessing blind students; it offers useful orientation to professionals and family members who wish to adopt stimulation and strategies that enhance their development.