Overcoming the Barriers to Including Students With Visual Impairments and Deaf-Blindness in Physical Education

Lauren J. Lieberman and Cathy Houston-Wilson

RE:view, Overcoming the barriers to including students with visual impairments and deaf-blindess in to physical education. Lieberman, L.J. & Houston-Wilson, C. 31(3), 129-138, 1999. Reprinted with permission of the Helen Dwight Reid Educational Foundation. Published by Heldref Publications, 1319 18th Street, NW, Washington, DC 20036-1802. www.heldref.org. Copyright © 1999."

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Today more Americans are participating in physical activities than ever before. Activities like tae-bo, in-line skating, and martial arts have fostered participation by people of all skill levels and abilities. Physical activity is defined as "movement of the human body that results in the expenditure of energy at a level above the resting metabolic rate" (Anshel et al., 1991, p. 113). Benefits associated with involvement in physical activity include reduced risk of heart disease, diabetes, high blood pressure, high cholesterol levels, and decreased stress levels (Surgeon General, 1996). Furthermore, the social and psychological benefits of increased physical activity are tremendous. Many individuals involved in daily exercise report better ability to sleep, improved self-esteem, increased stamina, and decreased stress levels, attributes that lead them to have a better attitude about life (Martinsen & Stephens, 1994; McAuley, 1994). Research also indicates that when students are involved in daily physical activity, their inappropriate behaviors as well as their self-injurious or self-destructive behaviors decrease (Craney, 1994).

Unfortunately, students who are blind or deaf-blind are not afforded the same opportunities to participate in regular physical activity and do not attain the same psychological, social, and physical benefits as their sighted peers (Sherrill, 1998). That situation occurs in part because having to devote more time to academic subjects than their sighted peers hinders their ability to engage in leisure and physical activity (Sherrill, 1998). Psychologically and socially, people who are more sedentary tend to have negative affect, anxiety, depression, low self-esteem, low confidence, and poor self-efficacy (Morgan, 1994). Physically, individuals who are blind and deaf-blind tend to possess higher levels of body fat and lower levels of cardiovascular endurance, muscular strength, and muscular endurance than their sighted peers (Jankowski & Evans,1991; Lieberman & Carron, 1998; Skaggs & Hopper, 1996; Winnick & Short, 1985). Winnick (1985) has also determined that students who are blind are less adept at activities such as throwing, catching, balancing, striking, and body and spatial awareness. Those various delays are attributed not to genetic limitations of performance but rather to the overprotective and discouraging attitudes of parents or teachers who do not allow individuals who have visual impairments or are deaf-blind to participate in physical activity (Nixon, 1988; Winnick, 1985).

These deficits in physical and motor fitness are especially alarming because in almost every daily activity individuals who are blind expend more energy than sighted individuals (Buell, 1973). Activities of daily living require additional attention to directions, safety, and location of everyday objects and need more strength, balance, and coordination (Buell, 1973). Kobberling, Jankowski, and Leger (1989) determined that individuals with visual impairments expended significantly more energy in running and walking than did sighted individuals. In addition, individuals with visual impairments have increased metabolic demands for most motor tasks because of heightened tension and stress from lack of visual feedback (Buell, 1973; Hladky et al., 1996; Shephard, 1990). Often, increase in metabolic demand, energy expenditure, and mechanical inefficiency rather than the visual impairment lead to their inactive lifestyle (Auxter, Pyfer, & Heuttig, 1997; Winnick, 1985).

Individuals with visual impairments have the same potential for developing motor skills and fitness as their peers, yet lack of opportunities, limited expectations, and lack of training lead to developmental delays and decreased fitness levels (Adelson & Fraiberg, 1976; Shephard, Ward & Lee, 1987; Sherrill, 1998). Researchers have clearly demonstrated that children with visual impairments who engage in general physical activity programs demonstrate improvements in fitness performance or levels of fitness comparable to sighted peers (Blessing, McCrimmon, Stovall, & Williford, 1993; Gleser, Margulies, Nyksa, Porat, & Mendelburg, 1992; Ponchillia, Powell, Felski, & Nicklawski, 1992). It is imperative to encourage individuals who are blind to participate in physical activity. The physical, social, and psychological benefits of physical, activity increase the likelihood of independence and improve their quality of life.

Students attain physical activity in many ways. One that is available to all of them is physical education, which is designed to enhance the development of the psychomotor, affective, and cognitive domains of learning (Rink, 1998). Activities in the psychomotor domain develop and improve physical and motor skills, sport-specific skills, and lifetime activities. In addition, programs may include adventure activities, aquatics, and dance. Promoting team work, cooperation, and appropriate social interactions throughout the program address the affective domain. Finally, activities that require problem solving, critical thinking, and basic understanding of rules and procedures of play enhance the cognitive domain. (Rink, 1998).

Physical education is required by law regardless of a student's ability level. PL 94-142, the Education for All Handicapped Children Act (1975) first cited the inclusion of physical education as a core content area when it defined special education as "specially designed instruction, at no cost to the parent, to meet the unique needs of a handicapped child, including classroom instruction, instruction in physical education, home instruction, and instruction in hospital and institutions." Although PL 94-142 has been reauthorized and amended since 1975, physical education has remained a core content area that must be provided to all students with disabilities. Thus physical education is considered a direct service (Winnick, 1995) as opposed to a related service and therefore cannot be replaced by physical therapy, occupational therapy, Braille class, orientation and mobility training, or speech therapy.

The law also stipulates that each student served under special education must have an Individualized Education Program (IEP) and that physical education be addressed on every IEP. The extent to which physical education is addressed, however, will depend on the unique needs of the student (Houston-Wilson & Lieberman, 1999). Some students with disabilities can participate in unrestricted general physical education and their IEPs reflect "regular" physical education, but the programs of students with visual impairments typically need some modifications for them to be successful (Sherrill, 1998). These modifications may include a guide or peer tutor, beeper or bell balls, or various textured items that would be specifically addressed on the IEP under the accommodations section (Lieberman, 1996). In cases where students possess unique needs that cannot simply be met through modifications, a specialized or "adapted" physical education program must then be developed and provided. Goals and objectives related specifically to physical education would also need to be developed and presented on the IEP. An adapted designation on the IEP does not necessarily mean that the student receives separate physical education. Adapted physical education is a service, not a placement. The environment in which adapted physical education is provided will vary depending on the needs of the student (Winnick, 1995). Least restrictive environment applies to physical education settings. Students with disabilities are to receive the same amount of physical education as their peers of the same age. Other services that students with visual impairments may need cannot conflict with their scheduled physical education time. Although legislation to protect the rights of individuals with disabilities has been n in place since 1975, students with visual impairments are still being denied access to appropriate physical education experiences (Sherrill, 1998).

In this article, we plan to highlight major barriers that impede the inclusion of students with visual impairments in physical education and to provide strategies for overcoming those barriers. We primarily address students with visual impairments, but the barriers and solutions presented are also applicable to students who are deaf-blind. We collected data about the barriers from surveys completed by more than 170 physical education teachers throughout New York state, who attended workshops on how to include children who are blind in physical education. The New York Commission for the Blind held the workshops in five cities throughout the state. On the basis of the results of the surveys, we have identified attitudes held by teachers, by students with visual impairments, and by school administrators that raise barriers to including visually impaired students in physical education programs.

Teachers' Barriers

Lack of Professional Preparation

Most respondents felt that lack of professional preparation hindered them from appropriately including students with visual impairments in physical education. Preservice physical education teachers receive only limited information about blindness. Typical content on blindness in their course of study includes a simulation, a video, a short lecture, and participation in a game of goal ball. In addition, the amount of information about physical activity given to preservice teachers of the visually impaired usually centers around orientation and mobility, transition, and recreational activities. Such minimal amounts of information in professional preparation programs are simply not enough.

The solution to removing this barrier is to improve professional preparation and inservice training for practicing teachers by providing information about strategies for including students with visual impairments into the main content of the curriculum. Information should include ways to modify physical and fitness activities, instructional strategies, and sports and recreational activity resources.

Curriculum and Activities

A second barrier is the curriculum and activities provided in general physical education classes. Activities like basketball, soccer, football, hockey, lacrosse, volleyball, tennis, and badminton in the traditional format are not conducive to independent participation by students who are visually impaired. These activities require visual-motor coordination (i.e., tracking the ball and the opponent) to be successful. These activities should not be prohibited because they can be modified to meet the needs of all students (Lieberman & Cowart, 1996). Examples of those modifications include using auditory balls and goals, slower moving balls, and changing-the rules of the game to accomplish the same or similar goals (Lieberman & Cowart, 1996). An even better approach would be to incorporate activities that are independent in nature such as golf, swimming, track and field, martial arts, aerobics, tae-bo, wrestling, gymnastics, weight training, and inline skating (Lieberman & Taule, 1998). Those choices enhance the independence and opportunities for students who are visually impaired to participate successfully in physical activities.

Pace of the Lessons

Another barrier that impedes the successful inclusion of students with visual impairments in general physical education relates to the pace of the lesson. Teachers may unknowingly move along at a pace that is conducive to learning for sighted students but not for students with visual impairments. Those students need specific explanation, demonstration, physical guidance, and feedback regarding skill or activity performance (Lieberman & Cowart, 1996). By the time they understand and elicit the desired movement, the class may have already moved on to another activity.

A solution to removing this barrier would be to change teaching styles from a more teacher-directed (i.e., command style) to a more student-centered teaching style (i.e., problem solving, cooperative learning, and guided discovery) (Pangrazi, 1995). Additionally, the use of trained peer tutors or guides may promote a quicker understanding of and response to the desired task and better skill performance (Barfield, Hannigan-Downs, & Lieberman, 1998; Houston-Wilson, Lieberman, Horton, & Kasser, 1997).

Fear Overprotection, and Limited Expectations

Teachers may see students with visual impairments as incapable of performing various motor tasks and as a threat to the safety of themselves and others within the class. As a result, these youngsters may not be given the same opportunities to perform the same tasks as their sighted peers. Additionally, because they lack training and exposure to students with visual impairments, teachers may be unaware of the potential of those students for physical activity.

In trying to resolve these barriers, teachers should be assured that students with visual impairments are as capable of performing motor tasks as their sighted peers (Norris, Spaulding, & Brody, 1957) and should, therefore, be given the same opportunities for involvement in activities. Although modifications may be needed, such as task analysis, students with visual impairments can be successful in most physical activities. For example, during a gymnastics unit a teacher may be fearful that the student may be injured on the uneven bars. Analyzing the tasks involved in the skill into basic components such as a simple mount, front support, and skin-the-cat would demonstrate that the student has sufficient upper body strength to participate in the gymnastics activities. This approach does not differ significantly from teaching sighted students; it merely demonstrates that given the proper psychological orientation teachers can feel confident about allowing students who are visually impaired to participate in activities similar to their sighted peers. Using the same or equivalent objectives and assessments for students with visual impairments as with sighted students ensures appropriate expectations and adequate challenges to achieve their full potential. Rubrics provide hierarchical levels of skill performance and allow instructors to examine each student individually and determine immediate goals and objectives on the basis of current levels of performance (Block, Lieberman, & Conner-Kuntz, 1998).

Students' Barriers

The attitudes of students with visual impairments can also be a major barrier to their successful inclusion in general physical education. Students may or may not control these barriers. Many of them arise solely from lack of knowledge and opportunities and from the attitudes of peers, teachers, and parents.

Parental Overprotection

Parental overprotection (Sherrill, 1998) is the first factor that contributes to lack of involvement in physical activities and physical education by students with visual impairments. It is understandable that parents want to ensure their child's safety at all costs, but they may thereby limit their child's ability to interact freely with the environment or their peers. Parents may also assume that their child is unable to perform various motor tasks because of a visual impairment and may-request that their child not participate in physical education.

Lack of Opportunities

Opportunities and resources in physical activity programs for these children may be limited. For example, in the early years children who are visually impaired may not have the opportunity to interact with their environment and learn basic fundamental motor skills like climbing, jumping, and skipping or basic object control skills such as bouncing, throwing, or batting (Ferrell, 1984). This early lack of opportunity affects later involvement in typical age-related activities such as gymnastics, soccer, and little league programs.

Lack of Confidence

The lack of opportunities may cause these students to lack confidence and be fearful of participating in typical physical activities. Interviews with 35 students with visual impairments participating in a developmental sports camp revealed the following reasons for refraining from participation in physical activities: low skill levels and fear of ridicule, of losing the game for their team, or of hurting themselves or others (Stuart, 1998).

A solution to those problems includes providing developmental activities at an early age so that children who are visually impaired maintain the developmental skill level of their typical peers. These activities include crawling, rolling, pulling to a stand, walking, and running and should be attained in natural environments such as parks and daycare settings (Drouillard & Raynor, 1977; Ferrell, 1984). Those setting should offer clear pathways with objects to explore at ground level to allow children who are visually impaired to interact with their environment (Drouillard & Raynor, 1977). Schools and recreational programs should have available adaptations to typical sport-related activities so that students who are visually impaired may successfully participate with their same-age peers. Examples of these adaptations are providing sighted guides and making minor modifications of rules for soccer games, peer tutors and task analyses for a gymnastics program, and the use of beeper balls and bases for beep baseball (Lieberman & Taule, 1997). Providing activities that require little or no modifications such as tandem biking, swimming, martial arts, and goal ball will help to increase independence as well as confidence levels.

Administrative Barriers

Administrative barriers involve variables that affect the successful inclusion of visually impaired students in physical education. These include time, equipment, lack of physical education on the IEP, and blanket medical excuses by doctors.

Time

Finding time in the child's schedule for physical education may be a problem. Many children with visual impairments have Braille class, orientation and mobility training, and occupational or physical therapy. Their full schedules may unintentionally deny these students the opportunity to participate in physical education. That practice is unacceptable. Physical education is a direct service required by law under special education (IDEA Amendments, 1997). Activities such as orientation and mobility and physical and occupational therapy may supplement the student's daily motor program, but they may not supplant physical education. Students with a visual impairment must have physical education in an amount of time equivalent to that of their same-age peers. Activities may be adapted to meet the unique needs of the student in either an inclusive physical education class or in an appropriate alternative physical education class. If a student receives modified or alternative physical activities, then those activities must be addressed in the student's IEP, with specific goals and objectives for those activities written on the IEP (Houston-Wilson & Lieberman, 1999). When students with visual impairments participate in unrestricted physical education activities, the IEP should state that the student receives regular physical education with no modifications (Houston-Wilson & Lieberman, 1999).

Lack of Appropriate Equipment

Some students with visual impairments may benefit from beeper balls and goals, bell balls, larger and brighter equipment, equipment that may be costly and prohibitive within the current school budget. However, when this equipment is requested and agreed on during IEP meetings, the school district must provide it. Therefore, it is imperative that either the physical education teacher or a knowledgeable representative speak to the physical education needs of the student at IEP meetings (Sherrill, 1998).

Blanket Medical Excuses

The last variable is blanket medical excuses from physicians or ophthalmologists that prohibit the student from any involvement in physical education or physical activities. Retinal detachment, glaucoma, or other visual conditions often cause doctors, parents, and school administrators to be fearful and to restrict a student's participation in physical education. These blanket medical excuses, by denying students the opportunity to participate in the same or equivalent activities as their peers, may impede the quality of life for the visually impaired child. Physical education exposes students to the values of physical activity for life-long health benefits and the pursuit of life-long recreational and sporting activities. Blanket medical excuses are unnecessary because adapted physical educators are trained to consult with doctors, teachers, administrators, and parents to develop a safe, successful, and appropriate program to meet the unique needs of a student.

Summary

In this article we have identified the major barriers associated with teachers, students with visual impairments, and school administrators that impede the inclusion of visually impaired students in physical education and physical activity programs. We have also offered solutions to remove those barriers. It is imperative that students with visual impairments be afforded opportunities to participate in a variety of age-related physical activities that are the same or equivalent to those of their sighted peers. Having those opportunities enhances their quality of life. Through the combined efforts of parents, teachers, administrators, and the individuals themselves, major barriers can be overcome to make those goals achievable.

References

Adelson, E., & Fraiberg, S. (1976). Sensory deficits in motor development in infants from birth. In Z. Jastrzembrska (Ed.), The effects of blindness and other impairments on early development. (pp. 1-15). New York: American Foundation for the Blind.

Anshel, M. H., Freedson, P., Hamill, J., Haywood, K., Horvat, M., & Plowman, S. A. (1991). Dictionary of sport and exercise sciences. Champaign, IL: Human Kinetics.

Auxter, D. A., Pyfer, J., & Heuttig, C. (1997). Principles and methods of adapted physical education and recreation. St. Louis: Mosby.

Barfield, J. P., Hannigan-Downs, S. B., & Lieberman, L. J. (1998). Implementing a peer tutor program: Strategies for practitioners. The Physical Educator, 55, 211-221.

Blessing, D. L., McCrimmon, D., Stovall, J., & Williford, H. N. (1993). The effects of regular exercise programs for visually impaired and sighted school children. Journal of Visual Impairment & Blindness, 87, 50-52.

Block, M. E., Lieberman, L. J., & Conner-Kuntz, F. (1998). Authentic assessment in adapted physical education. Journal of Physical Education, Recreation, & Dance, 69, 48-56.

Buell, C. E. (1973). Physical education and recreation for the visually handicapped. Eric Document Reproduction Service No. E.D. 079288.

Craney, D. M. (1994). The influence of physical activity upon the stereotypical behaviors of a 15 year old female who is blind. Unpublished Master's Thesis, SUNY College at Brockport, Brockport, NY. Department of Health, Education, & Welfare. (1977a). Education of handicapped children. Federal Register, 42(163), 42434-42516.

Drouillard, R., & Raynor, S. (1978). Move it! A guide for helping visually handicapped children grow. Reston, VA: American Alliance for Health, Physical Education, Recreation and Dance.

Ferrell, K. A. (1984). Parenting preschoolers: Suggestions for raising young blind and visually impaired children. New York: American Foundation for the Blind.

Gleser, J. M., Margulies, J. Y., Nyska, M., Porat, S., & Mendelberg, H. (1992). Physical and psychosocial benefits of modified judo practice for blind, mentally retarded children: A pilot study. Perceptual and Motor Skills, 74, 915-925.

Hladky, A., Blazkova, V., Frantik, E., Hlavkova, J., Kozena, L., & Prochazka, B. (1996). Cardiovascular response indicates a higher stress from the journey to work in blind people. Homeostasis, 37, 204-208.

Houston-Wilson, C., & Lieberman, L. J. (1999). The Individualized Education Program in physical education: A guide for regular physical educators. Journal of Physical Education, Recreation, & Dance, 70, 60-64.

Houston-Wilson, C., Lieberman, L. J., Horton, M., & Kasser, S. (1997). Peer tutoring: A plan for instructing students of all abilities. Journal of Physical Education, Recreation, & Dance, 6, 39-44. Individuals with Disabilities Education Act, 1997 amendments. 20 U.S.C.A. (West 1990).

Jankowski, L. W., & Evans, J. K. (1981). The exercise capacity of blind children. Journal of Visual Impairment & Blindness, 75, 248-251.

Kobberling, G., Jankowski, L. W., & Leger, L. (1989). The relationship between aerobic capacity and physical activity in blind and sighted adolescents. Journal of Visual Impairment & Blindness, 85, 382-384.

Lieberman, L. J., & Carron, M. F. (1998. April). The Health-Related fitness status of children with visual impairments. Poster Session presented at the annual meeting of the American Alliance for Health, Physical Education, Recreation and Dance, Reno, NV.

Lieberman, L. J., & Cowart, J. F. (1996). Games for people with sensory impairments. Champaign, IL: Human Kinetics.

Lieberman, L. J. (1996). Adapting games, sports and recreation for children and adults who are deaf-blind. Deaf-Blind Perspectives, 3, 5-8.

Lieberman, L. J., & Taule, J. (1997, May). Adapting activities for individuals who are deaf blind. Paper presented at the National Conference on Deaf-blindness, Washington, DC.

Lieberman, L. J., & Taule, J. (1998). Including physical fitness into the lives of individuals who are deaf-blind. Deaf-blind Perspectives, 5, 6-10.

Martinsen, E. W., & Stephens, T. (1994). Exercise and mental health in clinical and free-living populations. In R. K Dishman, (Ed.), Advances in exercise adherence. (pp. 55-72). Champaign, IL: Human Kinetics.

McAuley, E. (1994). Physical activity and psychosocial outcomes. In C. Bouchard, R. J. Shephard, & T. Stephens, (Eds.), Physical activity, fitness and health: International proceedings and consensus statement. (pp. 551-568) Champaign, IL: Human Kinetics.

Morgan, W. P. (1994). Physical activity, fitness and depression. In C. Bouchard, R. J. Shephard, T. Stephens, (Eds.), Physical activity, fitness and health: International proceedings and consensus statement. (pp. 851-867). Champaign, IL: Human Kinetics.

Nixon, H. L. (1988). Getting over the worry hurdle: Parental encouragement and sports involvement of visually impaired children and youth. Adapted Physical Activity Quarterly, 5, 29-43

Norris, N., Spaulding, P., & Brodie, P (1957). Blindness in children. Chicago: University of Chicago Press.

Pangrazi, R. P. (1998). Dynamic physical education for elementary school children. Needh Heights, MA: Allyn and Bacon.

Ponchillia, S. V., Powell, L. L., Felski, K. A., & Nicklawski, M. T. (1992). Journal of Visual Impairment & Blindness, 86, 174-177.

Rink, J. E. (1998). Teaching physical education for learning. Boston: McGraw-Hill.

Shephard, R. J. (1990). Fitness in special populations. Champaign, IL: Human Kinetics.

Shephard, R., Ward, R., & Lee, M. (1987). Physical ability of deaf and blind children. In M. E. Berridge & G. R. Ward (Eds.), International perspectives on adapted physical activity, (pp. 155-362). Champaign, IL: Human Kinetics.

Sherrill, C. (1998). Adapted physical activity, recreation and sport cross-disciplinary and lifes. pan. Boston: McGraw-Hill.

Skaggs, S., & Hopper, C. (1996). Individuals with visual impairments: A review of psychomotor behavior. Adapted Physical Activity Quarterly, 13, 16-26.

Stuart, M. E. (1998). Socialization into sport: An investigation of children with visual impairment. Unpublished manuscript, SUNY Brockport, Brockport, NY.

Surgeon General. (1996). Physical activity and health. U.S. Department of Health and Human Services.

Winnick, J. P. (1985). Performance of visually impaired youngsters in physical education activities: Implications for mainstreaming. Adapted Physical Activity Quarterly, 3, 58-66.

Winnick, J. P. (1995). Adapted physical education and sport. (2nd ed.). Champaign, IL: Human Kinetics.

Winnick, J. P., & Short, F. X. (1985). Physical fitness testing for the disabled: Project UNIQUE. Champaign, IL: Human Kinetics.

Lieberman, L.J. & Houston-Wilson, C. (1999). Overcoming the barriers to including students with visual impairments and deaf-blindess in to physical education. Re:View, 31(3), 129-138.

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