Basic rehabilitation programs are for all groups of visually impaired people. From those with total blindness to those with low vision, those with normal intellectual development, those with intellectual retardation, from children to the elderly, the visually impaired persons with just a visual disability to visually impaired persons with multiple disabilities. In their identity, these groups are heterogeneous in composition. With the loss of vision, some psychological processes occur that need to be identified and taken into account by the teacher in basic rehabilitation. Impariment is not always immediately accentuated, and mistakes may occur. At first the visually impaired can not adapt to the surrounding reality. When a visually impaired person starts to accentuate his / her disability, his / her readiness for active perception of the environment is increased, training on the subjects included in the basic rehabilitation programs may be started. During the diagnostic period, the personal qualities, the interests and tendencies, the physical and mental state, as well as the concomitant conditions, if any, must be clarified. This is of great importance for choosing the right method of training and preparing individual rehabilitation programs. The following physical factors must be taken into account when preparing the programs:
- Condition of the vision
- Movement of upper and lower limbs
- Condition of the cardiovascular system
- Diseases of the respiratory system
- Consequences of chronic illnesses (for example: impaired sense of touch, diabetes burden, reduced hearing, etc.).
In addition to these factors, age, gender, marital status, occupation and others should also be taken into account. A very important factor is the attitude of the relatives to the disability and the personality of the visually impaired. In the training of older people, some characteristics of their behavior must be taken into account. Character traits are permanently formed for many years, they are stable and inviolable.
- Decreases the memory capabilities, which particularly affect memorizing the new material.
- There are sclerotic phenomena and other destructive changes that lead to difficult storage of new and important information.
- Hearing and touch impairments are usual and they impair the perception and analysys of information, making it slower.
- Communication ability is noticeably reduced, but these people sometimes demonstrate hyperverbalism, which can mislead the teacher during the diagnostic period.
- Motor discoordination and underestimation or overestimation of physical capabilities are common.
If one or more of these signs are present, the teacher must comply with them and use the most appropriate method for conducting mobility training. In this case, the individual characteristics determine the measure of the necessary and useful in the rehabilitation process. The training of elderly individuals gives good results.
Although slowly, this category of visually impaired people assimilates long-lasting habits after a number of purposeful lessons. In persons with low vision, its effective use depends to a large extent on the attitude of the rehabilitated person towards his / her own impairment. To this group of visually impaired trainees, the teacher has to be very careful – on one hand, he must constantly motivate the client for effective use of residual vision, and on the other hand carefully monitor not to cross the border and the trainee to tend to overestimate his / her vision. For people with retinal pigmentation degeneration, it is appropriate to conduct part of the classes in the evening. In visually impaired people, hearing plays a major role in their skillful and unimpeded movement into space. When this sense is damaged, the client falls into the group of the deafblind. According to the definition of colleagues from Sense International, a deafblind person is considered a person who has lost sight, and hearing is unable to compensate for lost sight or a person who has lost his hearing and vision is unable to compensate for lost hearing. For this category of persons we have to comply with the following requirements:
- The diagnostic period for this group should be significantly longer.
- At first, poor vision and hearing should be assessed and optic and auditory tools recommended, and only then be evaluated.
- In older people, adaptation is more difficult, younger ones are more irritable and reactive.
- It is easier to get information than to be given to them.
The teacher should be able to communicate with this category, showing a lot of patience and tact during the training. As a separate group, we can also note the visually impaired people with intellectual disabilities. The teacher has to assess whether the client is at a mental level where he / she can use the familiar process. In the case of retarded mental development, central nervous system damage, mental illness or any other disability, the client may not be able to develop good spatial concepts and be unable to navigate unobtrusively in space. In this group, the classes should be of low intensity and new knowledge should be taught only after good absorption of the previous ones. A strictly individual approach to each case is mandatory. Sometimes the individual elements can be explored in the form of a game. They need to be stimulated even with little achievement. A teacher’s reply, „You do not do it well“ or „That’s wrong,“ would discourage most of the visually impaired people in this group. In order to achieve good learning results, when a mistaken task is done, the teacher can say, „You are doing it well, but if you do it (it shows the right way) it will get even better.“ This would stimulate clients and encourage them to further absorb the material. In summary, the following conclusions and recommendations can be made:
- Training programs should provide equal access to rehabilitation and the right to education of all groups of visually impaired people, regardless of their education, ethnicity, physical and mental status.
- Programs should be open and flexible.
- Programs can be creatively adapted to the specificities of each individual group and each particular case.
As a conclusion, it should be noted that, despite the difficulties encountered in training these groups of visually impaired people, greater efforts should be made to their early detection, motivation and inclusion in the rehabilitation process in order to optimally integrate them into society.
Stefan Danchev
