The incidence of visual impairment among young and old people alike is on the rise, and is expected to increase in the future. The purpose of the paper is to provide an overview of the problems that typically confront families when one or more of their family members has a visual impairment. The background of the problem is followed by a discussion of how visual impairments affect the individual child, followed by an analysis of how such conditions affect other family members. A summary of the research is provided in the conclusion.
Physical impairments can assume a variety of forms, such as a loss of limbs or a paralysis due to accident or disease. When one family member becomes disabled in one fashion or another, it will naturally have profound consequences for other family members, but it is important to remember that every family is unique. Each family member will bring certain attributes (and perhaps liabilities as well), to the family unit mix that can help (or harm) other members, for example, and each family member will likely react to physical impairments in others in different ways. It just makes sense that a family member with a severe visual impairment will have a more pronounced effect on other members of the family.
According to Marshak, Prezant and Seligman (1999), "The nature, characteristics, and severity of the physical impairment may determine the type of adjustment the child and the family must make" (p. 57). A young child with only minor visual impairment, then, may have dramatically different needs than the adolescent who is a mainstream entering high school, for instance. Furthermore, the point in time at which another family member becomes disabled may have an effect on how others in the family react; for example, family members who experience the birth of an infant born with a disabling condition will have the child's entire life to become accustomed to the condition and to help the child overcome these obstacles.
By sharp contrast, a child that suffers an eye injury or disease that affects their sight later in life will require an entirely different set of coping skills, just as other family members will as well (Featherstone, 1980). Whatever the degree of visual impairment though, the fact remains that visually impaired children, including those who have become completely blind, routinely succeed in life despite their disadvantages. At the same time, their limitations will touch the lives of their siblings and parents, as well as other family members depending on a wide range of cultural and socioeconomic factors (Featherstone, 1980, p. 4). Adults who experience a loss of sight or other visual impairments later in life may experience a completely different set of challenges from their younger counterparts, but the impact on other family members may be just a pronounced (Feinberg, 1990). The challenges and opportunities associated with young visually impaired family members are discussed further below.
Impact of Visual Impairment of Young Children and Adolescents on Other Family Members. Visual impairment is on the rise among young children in the United States today and is expected to increase in the future (Dodson-Burk, Hill & Smith, 1989). One of the unexpected consequences of improvements in neonatal care has been an increase in the incidence of visually impaired preschool children in the United States. "Perhaps medical advances in saving premature infants and the development of better child find programs have contributed to this increase" (Dodson-Burk et al., p. 47). Visually impaired children may be prone to additional disabilities; for instance, a child with congenital rubella can also have hearing problems, mental retardation, congenital heart disease, and oral-facial defects. Family members may also be required to become more actively involved with visually impaired children because visual impairment can have an adverse impact on intellectual and may delay social development (Mallett & Palenik, 1990). It is only reasonable to assume that parents and siblings would be required to devote an inordinate amount of time to helping these children manage their disabilities, with the expectation that resentment and anger could potentially result over the long-term if these feelings were left unresolved (Marshak et al., 1999).
Researchers have reported that the degree of visual loss in blind children has important implications for the child and the family's reaction to the child: "Just as children with low vision try to pass as normally sighted, parents, too, are caught in the dilemma of not wanting to identify their children's differences" (Marshak et al., 1999, p. 57). Young children who are visually impaired may naturally struggle to overcome the challenges associated with their disability; studies to date, though, suggest that there is some evidence of delayed and immature social behavior associated with the condition. Nevertheless, Marshak et al. point out that the visually impaired child can think, communicate, and carry out the daily tasks of living, features that may make visual impairment less stressful to the child and the entire family than other types of disabilities.
Family members may also be compelled to play an important role, at least early on, in helping visually impaired children learn how to cope with the routine requirements of living in a modern society. For example, Sauerburger (1989) reports that all family members can help visually impaired children learn how to safety cross a busy street by following some key clues in the environment, but very young children, of course, should continue to be supervised by an older family member even when these skills have been sufficiently mastered. At a certain point, family members will be unable to assist young children with visual impairments without professional assistance.
According to Bailey and Head (1993), children with severe visual disabilities will also frequently experience difficulties in a number of developmental areas, including motor skills, communication and language abilities, vision, hearing, and behavioral and intellectual functioning. These children will require services from a team of specialists, each of whom is responsible for a different area of need. "An orientation and mobility (O& M) instructor may be part of such a team if the child has a visual impairment or is handicapped in travel situations and is able to benefit from O& M. training" (Bailey & Head, 1993, p. 57). In these instances, family members may be able to play an important role in helping the child accept and master the O& M. techniques.
Impact of Visual Impairment of Adults on Other Family Members. If the family member with the visual impairment is an adult, there are of course other considerations involved. Just as the incidence of visual impairment is increasing among the very young, blindness is particularly prevalent among the aging. "Frequently, the elderly will have lost their sight or have become seriously visually impaired because of retina deterioration, diabetes, glaucoma, cataracts or accidents" (Feinberg, 1990, p. 10). As the number of older people continues to increase, the visually impaired will naturally continue to grow in number as well. Today, there are about 30 million elderly people in the U.S.; by the year 2030, there will be 64 million. "Of these, according to conservative figures, 8% will become either seriously visually impaired or legally blind" (Feinberg, 1990, p. 11). Unlike their younger counterparts, though, adult family members may be income-providers and their visual impairments may have economic consequences for the entire family unit. Furthermore, adults will either be unable to continue to drive a vehicle, or will be forced to accept the fact that they are going to require some type of assistance if they are to do so (Corn, Lewis and Lippmann, 1990).
On a final note, it should be pointed out that geographic proximity to healthcare facilities and economic status are other considerations involved in this analysis. According to Gorospe (1999), impoverished or rural Americans are faced with a completely different set of challenges in providing assistance to their family members than their urban counterparts. "Isolation is another problem. "Emergency services may take much longer, so that vehicle accidents result in more disabilities than accidents in urban areas would. If obtaining health care is inconvenient, it is also less likely to be sought" (emphasis added) (p. 95). Clearly, then, there are a number of factors involved in how the visual impairment of one family member will impact other members of the family.
The research showed that the incidence of visual impairment among the young and old is on the rise, and is expected to continue to increase in the future. The American family has already been subjected to fundamental changes over the past 50 years or so, and the impact of these increases in disability levels will likely have some unforeseen consequences in the future. Nevertheless, there are a number of professional, educational, and consumer-related organizations such as the American Council of the Blind, the National Federation of the Blind, the Blinded Veterans Association, and the National Association for Parents of the Visually Impaired available for families to help them help each other (Giesen & Johnson, 1997). In…