Identifying the Needs of Adolescents With Visual Impairments in a Nonurban Setting

PURPOSE: Adolescents with visual impairments face unique challenges compared with sighted peers. The purpose of our study was to assess the unique needs of adolescents with visual impairments and associated perceptions of service needs.

METHOD: A phenomenological qualitative approach was used to capture detailed information from participants’ personal experience. Participants were associated with Greater Wilkes-Barre Association for the Blind (GWBAB). GWBAB recruited participants via purposive sampling among attendees of a summer camp. Participants were recruited by mail and digital information included with camp registration and services documents 3–6 wk before the camp. GWBAB identified 13 participants for the study, who were interviewed until data saturation.

The qualitative methods used to collect data were semistructured interviews and demographic information forms. The semistructured interview instrument was developed by four researchers and evaluated by two reviewers with an average of 27 years of experience in research and by GWBAB. Questions centered on how visual impairments affected participants’ ability to participate in everyday activities, including home activities (e.g., interactions with family members, daily self-care), school activities, relationships with others, mobility from place to place, feelings about their visual impairment, and any assistive devices used daily. The demographic form, completed by the parent or guardian, was distributed to parents by GWBAB on the first day of camp, and completed forms were returned to GWBAB by August 1, 2017. Questions included participants’ age; gender; race or ethnicity; type, cause, and length of visual impairment; and any additional medical conditions.

Interviews were digitally recorded and transcribed by the researchers. The researchers reviewed all the transcriptions individually and met to discuss the identified themes. Specific quotes to highlight the themes were identified and verified by all researchers for inclusion in the data. To maintain confidentiality, all digital audio recordings were labeled with a number to code the interview. All data were secured on a password-restricted and encrypted computer.

RESULTS: Participants included seven boys and six girls; 12 identified as White and 1 as other. The majority identified as legally blind from birth because of a medical condition. Four themes were identified from the data: (1) use of assistive technology, both in school and in the community; (2) typical teenage hobbies; (3) social participation; and (4) services. Driving was not identified as a theme but was embedded in the themes as discussed by several participants in related contexts. Participants also indicated they were mostly independent in their morning routines, needing assistance only to match clothing, tie shoes, and style hair and to make changes to the routine.

CONCLUSION: Occupational therapy practitioners working with adolescents with visual impairments are aware of their needs from a social, assistive technology, and integration perspective. Practitioners teach foundational skills essential to independence and self-determination, leading to increased success and higher achievements. Practitioners also promote adolescent development with coordinated care to ensure access to schools and communities through needed services and assistive technology. Adolescents with visual impairments must receive sufficient training in assistive technology to ensure success with the devices. Additionally, health care providers should assist these adolescents in identifying leisure pursuits that will also engage them in social participation with both sighted and nonsighted peers to minimize depression and assist with the transition to adulthood.

Occupational therapy practitioners should work with a team of care providers to identify accessible transportation options, conduct or refer adolescents for driving evaluations, and provide both on- and off-road services to teach adolescents the skills needed for driving. The lack of identified services indicates that services do not meet the needs of adolescents with visual impairments. Thus, an opportunity exists to improve client outcomes through expansion or emergence of new occupational therapy practice areas with this population.

References

Sacks, S. Z., & Rosenblum, L. P. (2006). Adolescents with low vision: Perceptions of driving and nondriving. Journal of Visual Impairment and Blindness, 100, 212–222.

Salminen, A.-L., & Karhula, M. E. (2014). Young persons with visual impairment: Challenges of participation. Scandinavian Journal of Occupational Therapy, 21, 267–276. https://doi.org/10.3109/11038128.2014.899622

Tsai, L.-T., Meng, L.-F., Wu, W.-C., Jang, Y., & Su, Y.-C. (2013). Effects of visual rehabilitation on a child with severe visual impairment. American Journal of Occupational Therapy, 67, 437–477. https://doi.org/10.5014/ajot.2013.007054