2020 June

Professor Emeritus, Miyagi University of Education
Mari Inohira

1. Current Status of Early Support

In Japan, special schools for children with visually impairments (including schools for the blind, hereinafter abbreviated as special support schools) in each prefecture are mainly in charge of preschool support and education for children with visual impairments who either face difficulties with vision or who cannot see at all. Educational instruction for infants is primarily provided at the kindergarten and preschools of special support schools. In addition, early support activities such as consultation and guidance for raising infants from birth are also carried out at each school.

Visual impairment is a type of disability that affects very few children. For children with disabilities, there are nearby support facilities such as day-care centers at welfare and medical institutions, but there are only a few facilities in Japan that provide specialized support for children with visual impairments. In addition, consultation organizations such as developmental support centers have difficulty providing specialized consultation services for visual disabilities.

According to a basic survey by the Ministry of Education, Culture, Sports, Science and Technology, the total number of students enrolled at special support schools in FY 2019 was 144,000, marking a remarkable increase. Of these, approximately 2,700 students are enrolled at special support schools for visual impairments, demonstrating that visual impairments are increasingly becoming a minority type of disability.

The special support schools for visual impairments provide support and education for preschool children at 65 schools nationwide. However, of Japan’s 47 prefectures, 37 have only one special support school for visual impairments. In order to receive professional support for visual impairments, it is often necessary to commute from a remote location, which is a heavy burden for parents and children.

Many children who receive early consultation support and education and guidance for infants have not only visual impairments but also multiple disabilities such as delays in intellectual development and physical disabilities. Such children represent 70% of children with visual impairments enrolled in kindergartens, a percentage which is even higher among infants aged 0 to 2 who are brought to childcare classes.

On the other hand, the acceptance of children with visual impairments by non-specialist general nurseries and kindergartens has been increasing nationwide, because children with multiple disabilities require the support of rehabilitation facilities, the number of children going to both special support schools for visual impairments and general kindergartens has been increasing significantly.

2. Support and Guidance for Infants

People use their five senses to obtain information about the outside world, but humans tend to be vision-dominant, with over 80% of information coming from sight.

Image 1 presents an overview of the effects of visual impairments on child development*.

Image 1: The Effects of Visual Impairment on Child Development

When children have difficulties seeing or cannot see at all, they lack visual concepts, images, and spatial information. This makes it difficult to immediately understand what is occurring around them, and limits movement and behavior. This also entails difficulties in visual imitation, and these factors, alone or in combination, place restrictions on learning.

This article outlines the considerations and supports that address the characteristics of visual impairment in infancy and early childhood in a list of fundamental items.

Support for Parents

Parents can often be greatly troubled by their child's visual impairment, which, in combination with medical treatment, increases their anxiety about child rearing. Children who lack visual information and are less likely to have a spontaneous interest in people, objects, and the environment will expand their interest in the outside world with people who interact with them and enjoy time together with them. It is necessary for parents to feel secure and to be able to proactively engage with their children in a cheerful and warm way.

Interaction between parents of children with the same disabilities is a unique source of support, and the meetings of parents of children with visual impairments, who rarely have the opportunity to meet, are an important part of our support activities.

Improvement of Exercise Ability and Physical Development

Children with visual impairments have difficulty confirming their own safety, and they have trouble initiating exercise induced by physical movements and actions. For this reason, safe and secure environments are created in everyday life to encourage physical development by allowing children to enjoy jumping, leaping, and moving themselves. These environments enable children to engage with adults and other children in whole-body movements such as rolling around, and the use of playground equipment also increases motivation to exercise.

Music rhythm also promotes understanding and movement, and combining music with physical movement makes it easier to visualize actions and provides a fun and proactive way to engage in exercise.

Learning Daily Movements and Acquiring Autonomy

In early childhood, most children learn many basic movements in life by watching the people around them.

Teaching children who cannot see how to do something involves doing that action along with the child in the same direction. To show how to use a spoon, for example, it is important for the adult to put the child’s hand on top of their own hand, which is holding the spoon, and allowing the child to feel how the overall movement of the hand works. On the other hand, children with limited vision are shown the action clearly in close proximity. When assisting, contact is made in advance and considerations are taken to enable learning in the form of concrete experiences in a variety of situations.

Use of Tactile Perception

Children who are blind use a technique called seeing with the hands. It is also a tool for children with limited vision to compensate for their lack of vision. Information from touch is obtained not only by placing fingers on objects, but also by consciously moving the fingers and palms as one reaches out and touches the object. In order to make use of this tactile perception, children's desire to explore is essential, so effort is made to instill a desire to learn and to confirm. In addition, sufficient time is given to allow children to touch objects with both hands carefully and provide explanations of words.

Promotion of Visual Function in Children with Limited Vision

Vision develops by seeing clear images of objects during infancy when a child’s visual function is sensitive. While children with limited vision vary greatly in their ability to see, early support is needed to help them use their eyes consciously. To this end, care is taken to make the child’s environment easy to see by choosing toys and playground equipment with clear colors and showing picture books with thick outlines, large designs and letters, etc. This boosts the child’s motivation and encourages them to get a good look at their surroundings. At the same time, it is important to develop hand-eye coordination.

3. Toward the Expansion of Future Support

While there are many challenges in early support activities for children with visual impairments, I would like to focus on two proposals for future expansion.

One is to expand outreach. One of the activities that can be a starting point for support is in-hospital consultation at medical institutions. These consultations are carried out in cooperation with special support schools via visits by staff, and these are complementary to medical treatment at a hospital. There are some areas that already have a long track record of this type of consultation. In addition, there is a strong demand for visiting support, such as accompanying visits of public health nurses to the homes of individual infants. Both methods can provide help to parents during their times of greatest concern.

On the other hand, with progress being made toward an inclusive society of co-existence and an increase in the number of dual-income families, the number of children with visual impairments in regular local nursery schools and kindergartens is on the rise. It will therefore be necessary to focus on carrying out regular consultation visits to childcare facilities. In addition, it is necessary to deepen exchanges with rehabilitation and daycare facilities where children with multiple disabilities go.

In some areas, support for infants is provided at satellite facilities of special support schools. I think that remote support via online consultation will expand from now on. Outreach in the form of providing support can be said to be a key initiative for early support.

My second proposal is to enhance the guidance system for early support. In order to provide appropriate support and guidance for preschool children at special support schools, it is essential to allocate teachers with specialized guidance skills to children with visual impairments and to secure a place for support. However, as there are still nine prefectures in which special support schools for visual impairments do not have kindergarten or preschool sections, which are the core of support and guidance, the support system for children with visual impairments is weak.

Support for children with visual impairments is limited due to the small number of affected children. Additionally, despite difficulties in commuting to special support schools, these schools often do not meet the needs of those they serve, with the system of preschool education based on the number of children enrolled, among other issues. In order to enrich the guidance system of special support schools, it would be desirable to improve the policies to adapt to the characteristics of students.

References

Inohira, Mari. “Supporting the Growth of Infants with Visual Impairments” Keio University Press, 2018, pp.20