Illuminating conference shines light on vision education

The biennial event, held in January at the Royal International Convention Centre, attracted keynote speakers from around the world to present on a range of topics, including Cerebral Vision Impairment, the role of 3D printing in the lives of the visually impaired, and SPEVI’s recent initiatives.Keynote speakers included; Then SPEVI president Dr Frances Gentle, UK-based Reader in Paediatric Ophthalmology Ms Cathy Williams, Professor Greg Downey, and Associate Professor Paul Pagliano – a life mber and former president of SPEVI.Other stars of the show included sometime MC and ‘housekeeping’ announcer Ms Leanne Smith and the entertaining, Ms Julee-Anne Bell, managing director, World Access for the Blind Australia – an organisation for the blind, run by the blind.The programme properThe conference opened with Mr Paul Grevell, Executive Director of Disability Services in Queensland, who lauded the NDIS as the most significant advance in community care since the introduction of Medibank in 1975.The NDIS provides a much larger choice with regard to support services, and Grevell noted it would create an increased dand for quality staff and new jobs within the sector. He also expects a greater uptake of assistive technology, helped in some part by decreasing prices as the technology matures.The Queensland department of Communities, Child Safety, and Disability Services is introducing the sche in stages, beginning with 15,000 in 2017 before ramping up to 60,000 by 2018/2019.CVI a recurring ths Cathy Williams, a consultant at Bristol Eye Hospital who is a specialist in visual development in children, opened her first presentation with a brief overview of the visual syst. She divided the presentation simply into the dorsal or ‘where’ syst (ie, spatial processing) and the ventral or ‘what’ syst (object processing).The senior research fellow at the National Institute for Health Research described CVI as an umbrella term, which covered multiple impairments including VA, visual fields, contrast sensitivity, eye movents, and visuocognitive/perceptual aspects. Williams said children at risk of CVI are those with congenital or acquired-early conditions related to prature birth, cerebral palsy, epilepsy, disorders of brain development, and syndromes such as Williams syndrome (a developmental disorder) or chromosomal deletions.CVI can also be acquired from infection (eg, meningitis), severe epilepsy, trauma – especially head trauma – hydrocephalus, or an episode of significant hypoxia such as near drowning. The final group are those that exhibit developmental delays, learning difficulties, and behavioural disorders.Unfortunately, because of some overlap with other disorders such as ADHD and autistic spectrum disorders (ASD), differentiating CVI from other conditions is not always straightforward. Currently, it’s not known how much recovery is possible and what might minimise the impact of established CVI.{{quote-A:R-W:450-Q: Mr Paul Grevell lauded the NDIS as the most significant advance in community care since the introduction of Medibank in 1975. }}Barriers already identified include a lack of a robust definition of CVI, a limited understanding of the condition among professionals and parents, and apathy toward its significance in cases where near normal VA can be achieved but probls still exist.Willams’ second presentation covered CVI in the classroom, where any VI is a barrier to effective learning. Learning requires good accommodation, visual fields, and eye movents, before even getting to its visuocognitive aspects. Therefore, the role of eye care professionals is an obvious, albeit singular, piece of a complex puzzle.Difficulties that involve higher brain centres include poor maths skills, symbol-recognition difficulties, an impaired ability to differentiate between target and surrounding distracters, poor visual recognition, the inability to recognise faces, and word and number ‘blindness’.In some cases, especially ASD, social communication is hampered by the inability to recognise faces or interpret facial expressions and otions. Additionally, the dangers on the street and in the playground are obvious if the effects also encompass impaired motion thresholds.While those with an abnormal focus on details can be incredibly good with ‘Where’s Wally?’ type tasks, overall they are at a significant disadvantage because they have difficulty differentiating the ‘wood for the trees’.Establishing suitable standardsDr Frances Gentle – convening editor of SPEVI’s annual journal – detailed some of their recent initiatives, specifically, the second editions of SPEVI Principles and Practice (Guidelines for quality education of learners with VI) and Professional Standards Elaborations for Specialist Teachers (Vision Impairment) Career Stages.The guidelines are intended to assist SPEVI mbers, ployers, governments, and service providers to establish suitable standards of care and services. They also help with assessments of the providers (teachers) for the purposes of career planning and promotion.Another driving force was the relevance of, and difficulty in applying, general teaching standards to specialist teachers – especially of the VI and hearing impaired – for the purposes of in-service assessment, promotion, and hiring.Low vision aids in Australian schoolsNew elected SPEVI President Ms Carly Turnbull reported on her 2015 Australia-wide survey of optical low vision aids (OLVAs) in use in metropolitan schools. The survey was partly motivated by the perception that older, simpler and more affordable optical technologies were being ignored, sometimes detrimentally, in favour of newer technologies. Figures show that only about a third of people who have been recommended optical aids actually use th.Benefits of OLVAs include their use on an incidental or fallback basis, their low cost, as a tool for promoting functional vision, and their utility as a good introduction to low vision aids in general.However, there are some barriers to OLVA usage, which include a reluctance to look or behave differently, insufficient instruction time available, and earlier decisions to use other aid types.Role of 3D printingWhile the development of 3D printing has many potential uses, Dr Matthew Butler from Monash University’s Immersive Analytics Group donstrated some real-world applications specifically produced for the visually impaired.He created a low profile, 3D layout of the conference venue, onto which Braille labels had been added. The models allowed those with a VI or blindness to orient thselves adequately and understand the multi-room layout for break-out sessions, toilet locations and ergency exits.One of the highlights came when Bell, who has been blind since birth, was able to assess the Sydney Opera House’s real shape in some detail thanks to another of Butler’s 3D models. In the past, she had been given the poetic description of ‘sails’ to help picture the Opera House’s most obvious external, aerial features. However, to the blind, ‘sails’ conjure-up a completely different mental image, one that is totally irrelevant.Therefore, for the first time in her life, Bell understood the actual shapes and complexities of the iconic structure thanks to Butler’s 3D model.Anthropologist provides a different perspectiveAmong other research activities, Macquarie University’s Head of Anthropology, Professor Greg Downey, studies elite sportspeople, with a particular interest in what sets the elite from the also-rans.But, he is also interested in the VI, especially their heightened abilities that amount to adaptations. Curiously, in almost all cases, the actual measured performances related to hearing, touch, smell, etc. are normal or nearly so.{{quote-A:L-W:450-Q: When the sighted are communicating with the blind or VI regarding navigation matters, difficulties arise because most of the directions from the sighted are so personal that they’re not transferrable. }}However, what has changed is what the VI do with their senses. Downey asserted that all sensory perception is shaped by culture. As we grow, people direct our attention, encourage us to notice aspects of our environment, and shape our perceptions.Using an anthropological analogy, Downey likened that process to scaffolding sensory learning. He said a child’s sensory development is shaped by culture (including family) but as the child learns, the level of support is reduced in the interests of the development of independence.But, for the VI, the environment is different. Worse, if society regards one as being ‘disabled’, the probl becomes about more than just the disability itself.Learning is a two-way process, with teachers assessing progress along the way. As Downey pointed out, the blind and the VI have much to teach the sighted as well as the newly VI.The perceptions of the blind rely on heat (the sun), smell, noise, sound, airflow, and traffic noise. When the sighted are communicating with the blind or VI regarding navigation matters, difficulties arise because most of the directions from the sighted are so personal that they’re not transferrable.The blind understand the sighted much better than the reverse, and it has also been shown that an adapted blind person is much more capable compared with a blindfolded sighted person due to their adaptations and skills.The technique of echolocation – using reflected sounds itted by white canes, tongue clicking, and other noises – has also been studied by Downey.His particular interest lies in the technique taught worldwide by Mr Daniel Kish of the US, who lost both eyes at just 13 months of age. His technique, called FlashSonar, uses tongue clicking as the ‘illumination’ of his environment, augmented by head movents to reorient the ears.Kish has donstrated his ability to identify environmental features with surprising accuracy, even from afar. Incredibly, he is able to ride a mountain bike in most circumstances despite his total lack of eyes using just his echolocation technique.However, according to Downey’s research, only about 20% of the VI are good echolocators.The probl of infantilisationThe probl of infantilisation – the act of prolonging an infantile state in a person by treating th as an infant – likely commences early in the educational life of the blind and VI, when an additional layer of disability is added by way of lowered expectations and enforced by others.It is probable that the person’s maximum performance is set by those early experiences.However, Bell’s presentation challenged this kind of thinking with a donstration of her teaching techniques. She blindfolded the able-sighted Ms Jo Minniss and used her as the sensory ‘student’ for the donstration.According to Downey, society generally teaches us what we cannot do, rather than what we can. Further reinforcent of disabilities occurs at transport hubs and other situations where the VI interact with officialdom or the uninformed general public.Bell told a story, confirmed to be common by many present, of well-intended strangers grabbing th by the arm to assist their perceived navigation difficulties.However, not only is this attention often not welcome, but the VI person can be displaced some 15–30° from their original direction – enough to disorient th from a situation they probably had in hand.Instead, the light-dependent (a description used only half-jokingly to describe the majority of us) should ask, “Can I help you in any way?”, “Do you need any assistance?”, or “What can I do to help?”.Bell reported that, on occasions, she has had to tell the ‘helpful’ in no uncertain terms to “get lost” as their insensitivity is often compounded by persistence. She also donstrated the undesirability of the so-called ‘hand-over-hand’ sensory teaching technique on the blindfolded Minniss, when she guided Minniss’ hand with her own to touch a chunky necklace in an attpt to teach her what she was handling.Not much was achieved. However, when Minniss was left to her own devices while still blindfolded, it took her little time to assess what she was holding. It was concluded that the hand-on-hand technique resulted in no, or very little, learning.SummaryThe densely packed programme was full of relevant information, with specialist teachers and industry partners presenting concurrent, breakout sessions of various assistive technologies.* The next SPEVI biennial conference will be held in Perth in early 2019.