Developing Self Without Sight: The Psychology of a Blind Child

DEVELOPING SELF

WITHOUT SIGHT

The Psychology of a Blind Child

By

William F. Cavitt

AuthorHouse™

1663 Liberty Drive, Suite 200

Bloomington, IN 47403

www.authorhouse.com

Phone: 1-800-839-8640

AuthorHouse™ UK Ltd.

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Central Milton Keynes, MK9 2BE

www.authorhouse.co.uk

Phone: 08001974150

© 2010 William F. Cavitt. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

First published by AuthorHouse 1/8/2010

ISBN: 978-1-4259-3284-8 (sc)

ISBN: 978-1-4678-0538-4 (ebk)

Printed in the United States of America

Bloomington, Indiana

The profits from the sale of this book will go to a college educational trust fund for Cavitt.

Dedicated to:

The Izon family from who Cavitt gets his rich Filipino heritage. Especially to Papa Damaso and Mamma Petra Izon for their hard life making America their home and building a foundation for Cavitt to develop on.

Acknowledgements

In Cavitt’s first book I’m Cavitt, I’m Two, and I’m blind there were so many people to thank. He still has many of the same professionals working with him who helped him so much during his first two years of his life. Paula Nelson of Pediatrics Plus Corporation is still his primary physical therapist and Kathy Majka gives him speech therapy. Now Cavitt has entered the public school system at Springfield Elementary. His teacher in the Exceptional Student Education (ESE) program is Mary Jon Crawford and she has four assistants. Although we are cautiously watching Cavitt’s progress in the public school system the professionals he is exposed to are very pleasant and Cavitt seems to be adjusting well to the classroom environment. My special thanks must be given Cavitt’s father and my son-in-law Philip Breeze who patiently did all computer layouts, arranged all the photographs and developed the graphics. Without his computer expertise and dedication to Little Cavitt this book would have been impossible. To Nana Cavitt for proof reading, correcting and making telephone calls to relatives looking for the Izon family historical data, I express my love and devotion. Again I am sorely indebted to Dr. Bob Smith a friend and intellectual jouster for his insight and encouragement while writing this book. My thank you goes out to Reverend Ben Howard, Lt. USN Chaplain Corps. for his many suggestions and ideas shared during late evenings at work concerning spiritual values important in the development of moralistic well-being. Finally, I thank Naomi Tuttle RN, coauthor of Self-Esteem and Adjusting with Blindness who not only facilitated my learning about the self during a distance learning course with Hadley School for the Blind but gave me some personal suggestions for enhancing Cavitt’s self-esteem. Her instruction is deeply appreciated.

Contents

Introduction

Chapter One:

Self, Self-Concept, and Self-Esteem

Introduction to Discovering the Self without Sight

Using the Holistic Approach

Developmental Aspects of a Child Who is Blind

from a Holistic View

Holistic View of the Aspects of Well-Being

Chapter Two:

Physical Aspects of Developing Self

without Sight

Developing Physical Aspects of Well-Being of a Child

without Sight

Developing Body Image Without Sight

Developing Motor Skills without Sight

Developing Eating Skills Without Sight

Mastering Toilet Training without Sight

Developing Sleep Patterns without Sight

Chapter Three:

Psychological Aspects of Well-Being of a Child without Sight

Development of Personality without Sight

Developing Emotions without Sight

Developing Motivation without Sight

Chapter Four:

Cognitive Aspects of Developing

Self without Sight

Cognitive Aspects of Well-Being of a Child without Sight

Developing Intelligence without Sight

Transition into the Public School System without Sight

Public School Promises and Deliver

Chapter Five:

Social Aspects of Developing Self without Sight

Social Aspects of Well-Being of a Child without Sight

Language and Social Development without Sight

Learning to Play without Sight

Cavitt’s Filipino Heritage

Chapter Six:

Moral Aspects of Developing Self without Sight

Moralistic Aspects of Well-Being of a Child without Sight

Epilogue

Bibliography

About the Author

Introduction

Cavitt is a happy well adjusted three and a half years old who easily adjusts to his environment and bonds to his caregivers. He was born September 17, 2002 with bilateral micropthalmia causing total blindness. Cavitt was born five and one-half weeks early which we believe was the cause for him having reflux apnea. He wore a respiratory monitor for his first six months of life. During his early months his family provided him with as much physical therapy as possible, within their knowledge and ability. However they soon realized that he needed a regimented program designed to address physical, occupational, orientation and mobility, speech and cognitive problems. The Florida Children’s Services Representative was consulted and a list of all physical therapist in his area was provided. The family chose Pediatric Plus Corp from the list and Paula Nelson was assigned to make one home visit a week to treat Cavitt. Cavitt’s first two years of life is well documented in Cavitt, W. F. (2005) I’m Cavitt, I’M Two, and I’m blind. Bloomington, Indiana: AuthorHouse, Pub. Updated information on Cavitt Izon Breeze can be found on his Website at www.cavittsworld.com. This site is updated and added to on a monthly basis.

Cavitt has been evaluated and followed by a number of specialists since his birth. He has the following diagnoses: Bilateral Micropthalmia (absent right eye and a scant remnant of the left eye resulting in no vision at all), Hypotonic Cerebral Palsy (diminished muscle tone), Under-developed corpus callosum, and developmental delays. He was most recently seen by Dr. Charles A. Williams of Shands Children’s Hospital at the University of Florida. It was found that he possess a trisomy thirteen chromosome. This condition may be a predisposition for his blindness and other physical problems. Later research is required to determine any genetic causation.

It became evident during the first six months of physical therapy treatment that Cavitt required more professional help than physical therapy was providing. Paula Nelson conducted a complete evaluation of his range of movement, transition abilities, cognitive awareness, upper body strength and motion, along with his verbal ability. Her findings were substantiated by an independent Early Intervention Specialist from the Florida Health Department and a professional team was developed to address the physical, emotional, cognitive, and social issues addressed in Paula’s findings.

The members of this team consisted of Paula providing one to two sessions a week of physical therapy working on gross motor skills, body transition from lying to sitting, and much later in the program sitting to standing and eventually standing to assisted walking. Each transitional act took hours of repetitive therapeutic intervention that was very difficult for the family members to master. It is important to note that physical therapy for a totally blind child is much different than that provided for a child who is sighted. The sighted child sees others performing desired movements and merely copies them. For a child who is blind, it takes much effort to first develop a confidence level, place your hands in just the right location on the child’s body, with just the right amount of pressure, and then rotate the limb or body in the desired direction. Unlike a sighted child, a blind child can more easily be taught the wrong movement and therefore will become apprehensive to certain movements and require the therapist to start all over. Even with weekly instruction, Cavitt’s highly educated parents and grandparents found it difficult to duplicate the required exercises needed for his physical development and ability to transition.

Cavitt’s weak upper body strength and his inadequate use of the hands indicated a need to bring in an occupational therapist. Stacy Thomas was authorized one thirty minute home visit a week to work on his use of hands, fingers, and arms. During every session, Stacy would instruct the family members on how to get Cavitt to properly use his upper limbs during practical life skills. During feeding time he was encouraged to search for items on his tray, rake food items toward him, palm and later finger grasp items and feed himself using the pincer method. Feeding time also afforded an opportunity to observe developmental functions such as permanence of objects, turning toward a sound, and turn taking which are very important to a child who is blind. Cavitt’s family members were also encouraged to make his feeding time a social event with much verbal exchange. In fact every natural event in Cavitt’s life was made an opportunity to talk, talk, talk.

During his physical and occupational therapy, three more basic needs were discovered: speech, social opportunity with other children, and orientation and mobility. He was not progressing through the normal speech pattern of babbling, single word sentences, and asking for what he wanted, so the need for speech therapy was indicated. Once a week Cavitt was brought to Pediatrics Plus Clinic to play with other children and receive thirty minutes of speech therapy from Kathy Majka. At first this included teaching him to chew properly, feeding him different textures of food, and exercising his tongue with lollypops and other devices; then later actual word pronunciation was included working on a different phoneme a week. During these visits Cavitt was given the opportunity to interface with other children his age and he is slowly learning to socialize. At this point however, he does not initiate social interchanges, even though he will respond to them.

Pat Wilson was brought in to complete the team. She is both an Orientation and Mobility Specialist and an Educational Specialist for the blind. Working with the other members of the team she immediately started locating toys that would stimulate both his cognitive and fine motor ability. These were push button musical and animal sound making toys where different textures of material could be glued over the switches. It was not long until Cavitt could randomly locate any switch to make the desired sound.

The next innovation was an ingenious setup, conceived by the entire team, requiring Cavitt to exercise his gross and fine motor skills, his transition skills, and his cognitive skills. This contraption consisted of a circular pen made of hard plastic panels. The sound making toys were attached at different locations on the fence. Cavitt soon learned to walk around the fence locating the toys and sitting down to choose any sound requested of him. He would tire of one toy and move on to the next. This gave him frequent exercise of his transitional skills. It was not long until he was not only exercising his legs, arms, hands, and fingers using this play pen, but he was singing, in his babbling way, some of the songs learned from the toys. This singing, along with his memory of where each sound switch was located on each toy was an indication of his cognitive ability. The therapy pen with all its devices was demonstrated at the 2005 Florida Families of Children with Visual Impairment (FFCVI) Conference held at Gulf Coast Community College, Panama City, Florida. Experts in the field of blindness were amazed at Cavitt’s physical and cognitive progress using this professionally structured device.

It is extremely evident that Cavitt’s development during his first three years was aided by dedicated professionals in the areas of physical, occupational, speech, educational, and orientation and mobility therapy. Each member of the team displayed patience, ingenuity, and a caring desire to help Cavitt become all he can be at this age. Then at the magical age of three he was required to transition into the public school system with an entirely different treatment philosophy. This transition has caused much concern and some doubt about the approaches used by the school system.

After an Individual Education Plan (IEP) was developed Cavitt’s parents were convinced to give the public elementary school a chance. Even though the school is an one-hour drive away from Cavitt’s home, Kim and Philip were told that he would receive more and better therapy at Springfield Elementary School than any other school in Bay County Florida. Initially, Cavitt’s parents had doubt but they have agreed to give this school a chance to meet his required physical, emotional, cognitive, and social needs for one year. Therefore, it was agreed that he would attend Springfield Elementary School four hours a day, three days a week. This schedule was determined because of his relatively short attention span and the necessity for a family member to drive him to the school.

However, it was surprising to learn that limited professional therapy would be provided by the school. Cavitt would be evaluated during the normal school process and any intervention would be provided by one Special Education Teacher. Although she has three other full time helpers, she is the only certified teacher in the classroom and her attention is spread very thin. This very caring teacher tries to give Cavitt the needed attention but with eight special needs children, some with behavior problems, she cannot provide the one-on-one support required by a blind child. The family has requested a full time paraprofessional mentioned in both Federal and Florida State Statue for the Blind but this request has fallen on deaf ears. Therefore, Cavitt often sits wondering what is going on around him.

It was made clear to Cavitt’s family that the medical model was not used in the public school so full time corrective therapy was not expected, but more was expected than what is presently being provided. He is getting social interaction with other children much older than him, some with behavioral problems who could easily become negative role models for a totally blind child. The special education teacher is wonderful with children and has displayed exceptional expertise educating special needs children, but would be the first to admit that a blind child has individual needs that are hard to provide in a public school group sitting. She has made progress in getting Cavitt to transition from his walker to a two step stand to brush his teeth. To see him accomplish this fete is heart warming but Cavitt needs much more.

Cavitt’s speech therapy consists of one or two weekly classroom visits by a speech therapist who has not yet worked with Cavitt one-on-one. She merely repeats what is done by the special education teacher; reads a book and tells the child in a group what she is reading. It was amusing to note that she makes statements like Cavitt, see the elephant, or Cavitt do this, without explaining what this is. He is slowly making progress in speech but it is a family concern that he may approach a critical period in this developmental ability before adequate personal attention is given. Adequate speech therapy is not being provided by the public school system. Research has shown that if this critical period is reached without proper intervention he will never develop the neglected skill. The area of speech therapy in the public school has been a complete disappointment to the family.

This introduction addresses the absolute success of the services provided via the Early Step (First Step) program administered by the Florida Health Department and the professional support provided by Pediatrics Plus Corp. It in no way is intended to pass negative judgment on the Public School System. There is, however, the need to report sincere concern about the schools failure to provide the needed therapy for a child who is totally blind. It defies the No child left behind concept, and makes each child an element of the budget process. It is also surprising that one arm of the Florida government (Health Department) recognizes the absolute need for early intervention for a child who is blind. They advertise that, if we don’t pay now we will pay much later when the blind child becomes an adult totally dependent on society, whereas the Public School System seems to take a different approach. Their philosophy is that if it does not concern an educational process or need then it is not our responsibility to provide it. The news is out, all physical, emotional, and social needs are also cognitive needs. The Florida Education Department needs to take a close look at this prevailing attitude because any detected double standard may have later financial and legal consequences.

Chapter One:

Self, Self-Concept, and Self-Esteem

Introduction to Discovering the Self without Sight

Using the Holistic Approach

When I write about the holistic approach to mind, body and spiritual development, I realize that many of the readers may have more experience in this relatively new philosophy of development than I. This situation reminds me of a story. President William Taft’s eleven year old great grand-daughter was accepting an award. She said, Amy great grand-daddy was President, my grand-father was Secretary of State, and my daddy is a Senator, but, I’m a Brownie!" I always feel like a brownie when I write about the holistic development field.

I was asked to write my ideas about holistic, comparative, or integrative human development by some members of The Society for the Advancement of Integrative Healthcare in Pensacola, Florida well before our little grandson Cavitt was born totally blind. Rest assured, I am not an expert in this area but I can share my personal beliefs which have evolved over many years of teaching developmental psychology at the college level. I also had the opportunity to put some of these beliefs in to practice while working with Psychologist Jack Moser, Ph.D. and our Psychiatrists Gene Masankay, M.D. and Martha Sarasua, M. D., Ph.D. at the Center for Holistic Rational Living, Pensacola, Florida. This Center operated with the belief that development and healing is the function of the entire being: Mind, Body, and Spirit. Therefore, complete and healthy physical, psychological, cognitive, social and moralistic well-being is developed and maintained by using the holistic approach.

Every developmental aspect and element of a child who is blind from birth must be considered. Each caregiver must believe in both contemporary and traditional approaches to development and treatment of physical, emotional, intellectual, social, and moral aspects of development that is not progressing on a general schedule, taking in consideration any particular disabilities the child may have. For example, without the sense of sight, by which 80% of incidental learning occurs, Cavitt cannot expect to develop in his physical, psychological, cognitive, social, and moral aspects of well-being at the same pace as a child who is sighted. However, this does not mean that Cavitt’s caregivers are not extremely concerned about any lack of study progression in all aspects and elements of his development.

There is a relatively extensive paradigm (psychological schematic) for addressing the development process of a child in need. A complete paradigm is necessary to ensure no developmental need falls through the crack and when detected it is not too late for corrective action. Therefore, a paradigm to observe Cavitt’s overall development was put together so constant observation will occur. Vigilant observation is necessary to eliminate the fear of missing something that may require immediate attention by a medical doctor, a neurologist, occularist, physical therapist, occupational therapist, orientation & mobility specialist, or an education specialist for the blind. This more extensive paradigm is the over-riding theme of holistic care giving. I believe that every therapist regardless of their specialty, should have a well developed paradigm of observation and treatment for Cavitt. This section describes my approach to holistic treatment of a child who is blind.

Assessment–The first objective is to be aware of how affectively the child is developing his self-concept. When dealing with a child who is blind, observation