Review on Interdisciplinary Rehabilitation of Visually Impaired and Blind People

Abstract

Developments.During the last decades, several developments have led to a change in care and assistance for blind and visually impaired people. Due to insight into the complexity of visual problems, there has been a development in the disciplines that become involved in rehabilitation. Another development is the increase in types of assessment and rehabilitation methods and increased technical possibilities. In addition, the range of visual problems has become larger. Originally restricted to ocular-caused types of visual impairments, now also visual problems caused by cerebral problems (or a mixture of the two types) have come into focus. These developments have led to a need for coordination and cooperation with respect to administration (planning appointments, keeping track of who was doing what with the client) and also with respect to content of the work, namely, treatment has become interdisciplinary. Interdisciplinary Rehabilitation.Need for a conceptual framework by the several disciplines led to the development of an interdisciplinary model. This model consists of three elements: (a) the main principles of interdisciplinary teamwork, (b) a scheme of the rehabilitation process, and (c) use of the International Classification of Impairments, Disabilities and Handicaps (ICIDH) as the common conceptual framework. From the perspective of visual rehabilitation, adaptations were neccessary, mainly in the classifications of ocular and visual impairments, the classification of other sensory impairments, and in classifications of disabilities. “Handicap” became regarded as the consequence in terms of changes in the fulfillment of social roles. With the elaborations mentioned, it is possible to apply the ICIDH concepts in rehabilitation for visually impaired and blind people. During the whole path of rehabilitation, practitioners must take into account the three dimensions of impairment, disability, and handicap, including the eye disease or disorder. Interdisciplinary Teamwork in Practice.At several regional rehabilitation centers in The Netherlands (part of the foundation Visio), it appears that the model, and especially the concepts, of the ICIDH is a major tool in specifying and integrating the diagnostic findings of different disciplines in a “visual profile.” It has also become the basis for further development in assessment instruments. Implementation of the interdisciplinary model has meant a clearer understanding of each professional's own viewpoint (and limitations) regarding clients' visual problems and request for help. As a result, compared to prior rehabilitation processes, a more structured and better qualitative way (interdisciplinarily) in which providers help clients during the rehabilitation process has emerged. Still in the near-future it will be necessary to evaluate the interdisciplinary process in a quantitative way. It is our hope that with this theoretical basis, it will become possible to evaluate the quality and effect of offered rehabilitation to our clients. It is our expectation that this model and, especially, the concepts of the ICIDH can contribute to further development and exchange of knowledge in the field of visual rehabilitation, both nationality and internationally.