Some issues of The New RE:view will include legacy articles, which are reprinted from the past issues of RE:view. This first legacy article, originally written by rehabilitation teacher and Florida State University faculty member Lynda Jones, encourages teachers to apply the author's Least Restrictive Adaptation Theory in solving problems or teaching task.Introduction by author Lynda Jones: The need for this article came to my attention several years before it was written. While I was providing training to staff for a state agency in the 1990's, I observed a number of VRT's (called rehabilitation teachers then) who used a task-centered approach rather than a process-approach to instruction. Often this left the consumer unable to generalize the adaptive techniques to other tasks, therefore, remaining dependent on the knowledge of an instructor. In addition, too frequently the instructor overlooked the consumer's skills, interests, and preferences when developing the consumer's rehabilitation plan, limiting consumer choice. It was during that time I developed the principles and categories of the Least Restrictive Adaptation Theory. It became the foundation of almost everything I taught when I joined the Florida State University (FSU) faculty as the coordinator of the VRT graduate program. At times over the past 26 years, I have chatted with former FSU students at professional conferences. The most frequent topic has been the “Have You Looked in the Kitchen Drawer” philosophy, the name the students always used.As you read this article, you will notice that some of the examples provided within each category are outdated. This is especially true under Category #4. Today, Google and a Smart Phone can handle multiple tasks and problems. Newly visually impaired consumers familiar with lots of electronic devices will be thrilled to know they can continue to use them as well as all of the specialty gadgets available to make life easier.Keep in mind there are still many tasks that fall under Categories #1 and #2. Crucial is the need for training in the consistent use and reliability of the ten other senses. It's equally important that consumers can generalize techniques to a variety of old and new tasks, even tasks utilizing a specialty product or electronic device, whenever possible. For example, the same techniques are used for cleaning a mirror, applying make-up, and sweeping the deck. Throughout this article are at least ten principles for effective vision rehabilitation instruction. Most important? The teacher's number one objective must be teaching consumers an array of techniques they can generalize to every area of life so they can solve their own problems after completing their rehabilitation.Original article: Assisting consumers with visual impairments to achieve their optimum level of independence in the home and in the workplace should be the goal of the rehabilitation teacher. Independence rests on the premise that each consumer is a unique, self-determining person who can and should be able to have control in shaping every area of his or her life. (Gray, 2003). Consumers can discover the path to independence more quickly when they are encouraged to couple personal resources and problem solving behaviors with newly learned concepts and skills transferable to life activities.From the time the consumer enters the rehabilitation center or the rehabilitation teacher first arrives at the consumer's home, the teacher's fundamental objective must be to implement a generic approach to adaptation that the consumer can apply to an array of tasks and can generalize to every aspect of his or her environment (Roberts, 1990). In this article, I describe a teaching approach called the Least Restrictive Adaptation Model that I have developed over the past 12 years and that is similar to ideas developed by Kapperman and Koenig (1996) and Roberts (2001).The Least Restrictive Adaptation Model may be better understood through its more illustrative label, “the Kitchen Drawer Philosophy.” Like the author, many readers probably grew up in homes where kitchens had a designated “junk drawer”, which contained rubber bands from the daily newspapers, twisty ties from bread wrappers, string from packages, or anything that looked as if it might have a future involving a household problem. In this article, the author applies the “kitchen drawer” philosophy to teaching individuals with vision loss the adaptations they can use to solve problems or perform tasks after the rehabilitation agency has closed their case.The Least Restrictive Adaptation Model divides adaptations for daily living skills into four categories. Category 1 involves changing one's approach to a task. Category 2 requires altering the environment either to make a task easier or to make movement within the environment safe. Category 3 discusses familiar tools or devices that consumers can purchase in a local department or variety store or find in a kitchen drawer. Category 4 adaptations are the most restrictive, involving special devices or tools designed for a general task for a specific disability and purchased from a specialty company.The least restrictive environment for performing a task requires modifying the way it is done. For visually impaired people whose vision is no longer efficient or functional, training the remaining senses for consistent reliability is critical. This strategy, known as sensory integration or “sense shifting,” relies on sensory compensation by using a more effective sense for successful performance of daily activities (Roberts, 2001). This method of adaptation follows the laws of assimilation: The original task is unchanged but accomplishing the activity successfully requires substituting another sense or senses (Cameron-Ballard, 1985; Roberts, 2001). A familiar example of this theory is using the tactile sense to identify coins. Other obvious illustrations of the law of assimilation in which a person's performance could be improved by shifting senses includeDeveloping and maintaining good habits of organization is another example of a least restrictive adaptation. Consistency inorganization may help reduce frustration or save time or both. Arranging cans in a pantry in alphabetical order can make it easier to grab a can of corn instead of peas. Color coordinating file folders in a file cabinet may help the individual with residual vision to locate a specific document quickly. As Watson (1996) confirms, practicing the principle that everything has a place and everything in its place reduces frustration. Eventually, the consumer's kinesthetic memory allows him or her to locate items without searching for them.All of these techniques for monitoring and performing daily tasks described in Category 1 involved little more than a change of behavior. The rehabilitation teacher's objective is to train the person with a visual impairment to conceptualize familiar tasks from a new perspective, thereby eliminating the need to consult the teacher each time the consumer encounters a novel situation.This category also necessitates using sense shifting and the law of assimilation, but the focus is on manipulating the environment rather than on specific tasks (Roberts, 1990). Again, the consumer is making the least adaptation to a procedure that will enable efficient functioning (Kapperman and Koenig, 1996). The category is especially beneficial to individuals with varying amounts of residual vision. Individuals with low vision may improve visibility by adjusting the type, amount, and angle of lighting in the kitchen, bathroom, office, or closet (Watson, 1996). Properly placed lighting can reduce shadows that often create false information or obscure stairs and other safety hazards. Eliminating visual clutter or avoiding patterns in wallpaper, carpets, tablecloths, or ironing board covers can enhance depth perception and make dropped objects easier to find. Increasing contrast and minimizing glare can make life more comfortable and safer for many consumers. Some specific examples of modifying or altering the environment to improve the visual functioning of people with residual vision areFor the individual whose vision is unreliable, environmental modifications are dependent on the consumer's ability to use auditory and haptic systems. A radio left on in a room or a loud, ticking clock may help a consumer maintain orientation in an indoor environment such as the home. Keeping room arrangements stationary allows an individual to develop kinesthetic and proprioceptive skills for traveling freely within the environment.As with category 1, consumers should learn how to generalize these techniques to new situations. The practitioners must always keep in mind that here, as in all education, the goal is not the retention of all the facts presented by the teacher but the acquisition of resources and strategies for managing routines and creatively solving problems throughout life.Although in Categories 1 and 2 the individual shifts from vision to a multisensory system for monitoring and evaluating task performance, the kinesthetic aspects of a task change very little (Cameron-Bandler, 1985). For example, the movements involved in ironing a shirt are not different for someone who can see or someone who cannot: the person who cannot see will use the sense of touch to evaluate success in ironing out all the wrinkles.On the other hand, when a tool or device is needed to complete a task, such as using a threader to thread a needle, the task becomes more complex because performing it requires more steps. What once required only good eye-hand coordination to guide a thread through the eye of a needle, now includes guiding the threader through the eye of the needle, placing an adequate amount of thread through the threader, and removing the threader with the hope that the thread follows the threader through the eye of the needle. Threading a needle without a threader may be impossible, but as Robert‘ (2001) explains, the additional steps needed to complete the task may shift the focus of learning from a generic process of adaptation to a task oriented or even a device oriented approach. Suddenly, the focus of the lesson shifts from developing a series of skills that can be transferred to several situations to learning how to use one, two, or three types of needle threaders.Applying the concept of “situation forecasting” (Roberts, 2001) to the task of needle threading can refocus the lesson on its original objective. The object of situation forecasting is to guide the consumer to name several tasks or situations that could also be performed by applying the compensatory techniques described for needle threading. For example, a technique similar to needle threading is used for lacing shoes, making jewelry, crocheting, and inserting dymo tape into a Braille labeler. Eventually, whether a task is simple or requires a tool or device, the consumer begins to generalize from one task to another and to associate the task at hand with stored memories of solutions for similar situations (Cameron-Bandler, 1985; Kapperman,& Koenig, 1996; Roberts, 1990, 2001).If a consumer chooses to use a familiar tool or device as an adaptive aid to make a task easier, using items commonly found at home or in local stores helps the consumer maintain a sense of normalcy. Relating the learning of adaptive solutions for everyday problems and using household items common to the adventitiously blinded consumer's previous visual reference system enable the association of new information with proven and trusted visual memory (Roberts, 2001).Furthermore, the model of rehabilitation adheres to a key principle of adult learning (Knowles, 1984), namely the more similar the new activity is to past experience, the more motivated the individual is to learn. In other words, the adventitiously blinded consumer will be more eager to accept and experiment with adaptations that use familiar items and known skills. A few examples are the following:Remembering to consider the “kitchen drawer” approach first will help consumers to become more independent and also to realize that when assistance is needed, family members, friends, and neighbors can help with such needs. In the future when a new appliance is purchased, the consumer will be prepared to make the necessary adaptations either independently or with assistance from someone other than a rehabilitation professional.At times, a special adaptive product developed for people with visual impairments and purchased from a specialty company may be the best and only choice for solving a problem, For example, the individual who cannot tell time with a print watch may choose to use a tactile watch. Another individual, blinded by diabetes, may also experience neuropathy and, for safety reasons, need to use a liquid level indicator when pouring beverages. Some individuals, like the author, may have proprioception problems and need the Magna Wonder Knife to make even slices when cutting vegetables, fruits, breads, or meats. No professional in the field of rehabilitation in this age of high tech equipment would expect a consumer with little or no vision to use a computer without the necessary adaptive software and hardware.Nonetheless, the necessity for such products does not minimize the restrictions that a consumer encounters. For example, the consumer must purchase these products through a mail-order company or a store that specializes in products for people with visual impairments. As most practitioners in the field know, these companies and stores are limited. Product availability is dependent on the manufacturer and the vendor. Manufacturers may stop producing devices because of low sales, design problems, or cost inefficiency.When the individual's tactile watch needs repair, it either must be returned to the manufacturer or taken to a private watch repairman. When the visually impaired employee's adaptive software is incompatible with the employer's new application software, an appointment must be arranged with an assistive technology specialist to remedy the glitches. Not being able to find parts to repair a device that is no longer made can render a much-needed tool unusable. Probably the best example of that illustration concerns the Optacon. Many people who learned to use the Optacon years ago still find it irreplaceable for some tasks, but it is no longer manufactured, and repairing one still in use is virtually impossible.If a consumer chooses to use a special adaptive device, a teacher must provide training for that device and an alternative method of doing the task should the specialty product fail, its battery die, or the device not be available for use in the present environmentAlthough a special product will sometimes meet the need, too often the consumer is not given the opportunity to make an informed choice. Devices are provided or recommended before more generic adaptations are fully explored. Frequently, an elaborate system is recommended for labeling clothing, food products, or settings on the appliances when simpler methods that can be readily generalized could be implemented. For example, instead of adding a special manufacturing tag to clothing for easy identification (Category 4), clothing might be identified according to texture, buttons, collars, pockets, belts and so on (Category 1). Clothing that is similar except for color and design can be marked by notching the manufacturer's label. Different shaped notches cut at different places on the labels make it possible to mark several similar items without adding anything to them. The consumer who chooses to add a label could do so by putting a safety pin or sewing a small knot (Category 3).Marking appliances with a specialty product is more restrictive than some other methods of identifying dial settings. Employing the law of assimilation and visual memory by relating the settings on stove dials to positions on a clock face may work more efficiently than tactile markings. For example, medium temperature may be at the 6 o'clock position and medium low at 8 o'clock. This adaptation may be especially effective for a consumer who has used the stove for years. Notching a dial with a file or using tape or glue may be less conspicuous and locally more available than a specialty product.Many specialty companies offer a variety of adapted versions of well-known games—Scrabble, Monopoly, Clue, checkers, Bingo, Uno, and others; unfortunately, these adapted versions are 3 to 5 times more expensive than the original versions sold in game and toy stores. With some ingenuity most commercially available games can be adapted with limited modifications and at little or no expense. Few projects for practicing problem-solving skills are more fun than adapting a game that can be enjoyed by family and friends. For example, Twister ($15) can be created with a shower curtain liner, remains from sewing projects, a cardboard box, puff paint, dymo tape, and a push pin.Learning is the expected outcome of effective teaching, and how we teach is as important as what we teach. With independence as the goal, the teacher's priority objective must be teaching consumers to solve their own problems. Consumers who can create their own adaptations and find their own resources will be more independent at home and on the job.As the rehabilitation teaching profession moves into the twenty-first century, the need to improve and refine teaching methods and service delivery systems is paramount. An increasing number of consumers face the challenges of social, economic, and technological change complicated by age, multiple disabilities, and new technological advances. Growing populations of consumers, personnel shortages, and shrinking funds add to the dynamics for change.One key to reducing the effects of some of these problems is to create a paradigm shift from a task-oriented program model to a process-oriented system, a system that defines successful rehabilitation in terms of a consumer who can meet everyday challenges by functioning within his or her own lifestyle and whose primary resource is the kitchen drawer filled with ordinary useful items.