Vision Rehabilitation Services at a Crossroads

Abstract

Following World War II, troops who were blinded in combat returned home. At that time, Veterans Administration (now Department of Veterans Affairs) lacked specialized services to provide rehabilitation for these veterans. Although these services existed through army and civilian agencies, this was a time of change, and a controversy developed over who would provide services to those who were blinded in war (Bledsoe, 1997). Civilian agencies, military, and Veterans Administration all wanted to serve these blind veterans. Even American Association of Workers for Blind appointed a committee to advise government about care and training of the war as they were known at time. Although much of controversy was fueled by a genuine desire to provide services to newly blinded veterans, issues of funding, prestige, and rivalry undoubtedly played a role. In end, as Bledsoe so aptly chronicled, existence of blind troops returning from war became catalyst for dramatic change in services to all individuals who are visually impaired, in professional training and in society's view of people with visual impairments. These changes were accompanied by heated discussions, and Bledsoe (1997, p. 587) noted that Part of undoubtedly was generated by fact that it was an impassioned time. The program began in a war and because of a war. Yet from this heat evolved first university-based training programs for orientation and mobility (U.S. Department of Veterans Affairs, 2010), and although impetus focused on blind veterans, impact spread throughout profession to include not just adults, but children who were blind. The result was a fundamental restatement of goals and methods of blind rehabilitation. As Zambone and Suarez (2000, p. 1155) noted, What emerged, too, was a new perspective on capacity and role of persons with vision impairments in their homes and communities. The changes included dramatic expansion of services to include not just individuals who were blind, but individuals with low vision and those with multiple impairments. As controversy over who would provide services to veterans who were blinded in war unfolded, a major medical calamity changed face of services for blind children in United States. From early 1940s to early 1950s, number of premature infants who had visual impairments that were due to retrolental fibroplasia (now called retinopathy of prematurity, or ROP) increased in epidemic proportions (Silverman, 2000). According to Silverman (2000), ROP was induced when preterm infants who were placed in incubators were exposed to increased levels of concentration of oxygen because this practice was thought to promote regular breathing patterns. Unfortunately, this procedure also affected eyes and led to visual impairments in some infants. Once this practice was identified as a cause of ROP epidemic, it was modified, but estimated 10,000 children who were already affected needed educational services. ROP remains a concern, and debate surrounding one of causes of ROP, saturation of oxygen necessary to prevent or minimize its occurrence in relation to saturation necessary to preserve life, continues (Study Group of Eunice Shriver NICHD Neonatal Research Network, 2010). When it came time to educate children with ROP, families did not want to send their children to residential schools away from home. It was then that initial push for civil rights of children with visual impairments began as parents called for services for their children alongside typically sighted peers. A subsequent shift ensued that resulted in an increase in local school programs for students with visual impairments and a change in population of children who were served in residential schools for students with visual impairments (Hatlen, 2000). …