2000 Conference Proceedings

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A MODEL OF AN INTEGRATED LOW VISION AND ADAPTIVE TECHNOLOGY ASSESSMENT SERVICE

Dennis Moir
Manager, Low Vision Services
Royal Society for the Blind of South Australia
Email: dmoir@rsb.org.au

Finding out that you have a vision impairment could be likened to losing a member of your family or a close friend. It certainly creates a change in your life but it does not have to mean a change in quality of life.

The immediate question is ‘where to from here, what is life all about, is it worth living?’

Unfortunately that is the probelm that often confronts those individuals who experience a sudden sight loss or are told that their sight loss is permanent and that they may, in some instances, lose all sight.

All too often, the individual is left scared, disillusioned and frightened with no where to go. More often than not they have not asked or had all their questions answered about their vision loss or what the future holds for them because they may be in a state of shock.

It is fortunate that more and more are referred to a low vision assessment service and then, an adaptive technology assessment and training service.

At the RSB, clients are able to access an integrated low vision and adaptive technology service. This enables them to receive a full functional vision assessment, adaptive technology and training service.

The low vision and adaptive technology services are housed in one central location in Adelaide, together with the majority of the RSB’s other services, which include vocational, community outreach services and print alternatives.

Services provided

The Low Vision Centre (LVC) is often termed the gateway to the RSB’s services.

Individuals referred to the LVC by an eye care professional receive a full low vision functional assessment provided by skilled staff, including ophthalmologists and optometrists experienced in low vision care. Other services provided by the LVC include eccentric viewing training and a low vision and daily living aid service.

The LVC staff are also very familiar with the adaptive technology which is available in the adjacent Adaptive Technology Centre.

This enables clients to be made aware of alternative available technology aside from the traditional magnifiers and lighting aids that are generally prescribed for low vision clients.

Today, we have the situation where ophthalmologists and optometrists are keen on the adaptive technology and readily refer clients across the passageway or indeed will often take the client over and show them some of the lesser, such as the closed circuit televisions.

Three years ago the number of clients accessing adaptive technology was minimal, the number today approximates some 300 per annum. Clients include children, tertiary students, the employed and unemployed and the elderly and retired.

Even for a City with only 1.3m people the Low Vision Centre sees some 1,000 new clients each year. Of these, approximately 75% of them are low vision at the time of referral. The other 25% are legally blind.

The RSB made a conscious decision several years ago that those persons experiencing a significant loss of vision that was likely to lead to legal blindness are entitled to receive a service.

In providing this service the individual is being afforded every opportunity to adapt to their sight loss with as much remaining vision as possible, little recompense really for the traumatic circumstances they often find themselves in.

There is no doubt though that many clients have been able to continue with their employment or course of study, due to the assistance afforded them through an integrated low vision and adaptive technology service.

The Adaptive Technology Centre (ATC) is equipped with examples of the latest available technology, including closed circuit televisons, reading machines, Braille equipment, computers with speech and large print and other equipment.

Of note, the ATC does not generally sell the adaptive technology, instead preferring to offer an unbiased service to clients.

The range of equipment held enables those with varying vision loss to be fully assessed and recommendations made as to the equipment that best suits the individual’s needs.

An example of the benefit of having these two centres together is the fact that during the past year alone, there has been an average of 3 clients each month purchasing closed circuit televisions. This is in direct contrast to the situation three years ago when clients did not have the opportunity to be exposed to adaptive technology.

I can still recall the day, just prior to the renovations to establish the ATC, when we placed a CCTV in the LVC’s waiting room and the discussions that it created, even amongst the RSB’s own staff. There was an immediate acceptance and requests for assessment on adaptive technology equipment by clients.

Clients now also obtain computers with speech and large print and other associated technology.

The ATC is not only a display and assessment centre but also a drop-in centre for those clients who do not wish to obtain their own equipment but instead take advantage of the RSB’s adaptive technology. It is not uncommon for the centre to have persons in on a daily basis utilising the closed circuit televisions, computers and associated scanners, braille and associated equipment. This includes those persons who might be retired and those undertaking tertiary studies.

The ATC also provides an advisory service to employers and tertiary institutions on adaptive technology for their employees and students.

Of significance, the ATC is now a facilitator for student support rather than a direct provider.

Three years ago the tertiary institutions (and even clients) expected the RSB to hold examinations on their behalf and provide equipment in an ongoing manner. The RSB at the time did little to discourage or change the practice.

Over the past three years, the RSB has worked with the tertiary institutions to assist them to meet their responsibilities to provide equipment and other facilities to meet the needs of persons with a disability, in particular those with a vision impairment. 

Training

The ATC also provides keyboard, computer and Braille training for persons with a vision impairment.

This service has provided clients with the capacity to learn a new skill or re-learn how to use computer technology aided by adaptive technology, including large print and speech.

The range of clients accessing the training is unlimited, ranging from the young to the elderly, the employed and unemployed and the student. Age knows no barrier and discounts the theory often espoused that the elderly cannot learn computing. It generally means that it takes a longer period.

Similarly with Braille, there appears to be no bounds to the age of people learning, rather it is limited more by their dexterity and ability to comprehend. 

There also needs to be a degree of lateral thinking, due to the various multiple disabilities that can be encountered. If one adheres rigidly to mainstreaming then many people will often miss the opportunity to develop and enjoy life that little bit better. For example, we had a client, vision impaired and illiterate. It was not the RSB’s role to educate the person, however we were able to assist by introducing the client to Braille per medium of training them in music Braille with the assistance of a client skilled in music Braille. 

What does it all mean?

To the RSB, it means that we must ensure that the ATC is fully staffed at all times when the LVC is open, to facilitate the connection between the two mediums of assistance able to be offered clients.

The success of this integrated service is that the Low Vision Centre staff are able to talk about the adaptive technology, including Braille and indeed make recommendations to the client and ATC staff as to which mode of technology might suit the individual.

The acceptance of the service is further amplified by the fact that the LVC’s staff optometrists will often demonstrate the CCTV’s if ATC staff are not available and they have the time. At this stage the optometrists have not ventured to demonstrate the value of the reading machines, computers and other equipment but they certainly refer them for such.

To gain an appreciation of the extent of success, I should point out that the ages of clients range from the very young (5 years) to the very old (in excess of 100).

There are many elderly clients who learn Braille, computers with large print or speech and in some cases all three. The training offered depends on the capacity of the individual and generally ranges from one on one to a group of three. The RSB is fortunate in being able to offer individuals what best suits them rather than specific periods each year for particular programs.

What’s new ?

Just prior to last year’s CSUN, the RSB launched its Adaptive Technology website (html//at.rsb.org.au). This was in addition to its other website at html//www.rsb.org.au and CD which contained the latest demos and downloads on the world wide web.

This year, the RSB has launched its latest innovation, an educational CD schools program. This program developed with the assistance of the State and private schools is an educational tool to inform primary students about vision impairment is and how people adjust to live life as independently as possible. The schools have included the program in their curriculum for this year. My colleague Theo Schaftenaar will tell you more about this,

The message

Based on the experiences of the RSB over the past three years, it is extremely beneficial to the individual if low vision and adaptive technology areas can be co-located and work together. There is no doubt, that had the RSB not made the decision three years ago to integrate the low vision and adaptive technology services, then many persons with a vision impairment would not have had the benefit of the enhanced services. The RSB will continue to further develop the two services to provide the best possible service to persons with a vision impairment so that they are to be able to live life as independently and as successful as possible.


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