Strategies Menu
The strategies described in this guidance material have been divided into the sections listed below. To access the strategy section you are interested in, click on its title.
Categorising the strategies
Categorising most of the strategies was straightforward. However, some of them have relevance across several sections. This meant it was difficult to decide on the most appropriate way to categorise them. Some examples follow.
Schedules / timetables are described in Promoting learning because they are a key element of the TEACCH approach which is best described there. But schedules / timetables are used to inform the young person, and therefore contribute to Supporting receptive communication. They can also contribute to Promoting positive behaviour and Promoting emotional wellbeing.
The low arousal approach is described in Addressing sensory needs, but it contributes to Promoting positive behaviour and to Promoting emotional wellbeing.
Transitions are discussed in Underlying principles and in less detail in Promoting mobility and independence, but the topic is also relevant to Promoting positive behaviour, Promoting emotional wellbeing, Supporting receptive communication and Promoting learning.
Minimising clutter is discussed, with different emphases, in Supporting receptive communication, Managing the environment, Promoting learning and Promoting mobility and independence.
No single strategy area is more important than any other and no area should be tackled in isolation. It is essential to address all the needs of young people with visual impairment and autism. It may be thought that music is an "add on" and of less importance than other strategy areas. But for a young person with special musical abilities or interests, it may be crucial: if those abilities and interests are not developed, it may not be possible, for example, to promote positive behaviour and emotional wellbeing; expressive communication may also be compromised.
The need for an individual approach
Young people with visual impairment and autism vary enormously, so an individual approach is crucial. In selecting the strategies to use with a young person, practitioners need to use their knowledge of that individual as well as their experience of what they have found effective in the past. They should constantly review each strategy to monitor its suitability. What works for one young person with visual impairment and autism will not necessarily work with another; what works at one time with an individual will not necessarily work at a later time.
The origin of these strategies
These strategies were identified in a survey carried out by members of the Visual Impairment and Autism Project team. They visited 17 educational settings and observed 23 young people with visual impairment and autism. The team members also met key practitioners involved with each of the young people and discussed how they were meeting their needs.
An attempt was made to include as wide a range of young people as possible, so individuals were visited in a variety of settings, including:
The observations of the young people, and the discussions with their practitioners enabled the project team members to identify numerous strategies. The project did not have the resources to carry out any research to establish that those strategies were effective, nor to compare any one strategy with any other. Once all the survey work had been carried out, the team members discussed the strategies that had been identified. They did so in the light of their own experience, the available literature and contemporary beliefs and values regarding good practice. The discussions resulted in descriptions of the vast majority of the strategies being included in this material.
It must be pointed out that many of the strategies described here are also used with young people who have special needs other than visual impairment and autism. Indeed, some of the strategies constitute what is widely considered to be good practice for all learners. Nevertheless, it was considered important to include them here in order to provide as wide a range of guidance as possible.
Evidence based practice
Practitioners are increasingly expected to adopt an evidence-based approach to their work. This is very difficult for those who support young people with visual impairment and autism, as there is very little evidence available. The kind of evidence regarded as the "gold standard" is that obtained from randomised controlled trials. However, there appears to be little prospect of obtaining such evidence with respect to supporting young people with visual impairment and autism.
The material provided here is offered as evidence on which practitioners can base their practice. This evidence is necessarily of a different kind from that obtained from empirical research: it is evidence obtained from the current practice of a range of experienced workers, reviewed by a group of experienced practitioners in the light of their own experience, the available literature and contemporary beliefs and values regarding good practice.
Practitioners who use this guidance material and who are subject to inspection (e.g. teachers) may wish to cite the material as evidence that their practice has a sound evidence base.
The conflict between the needs arising from the visual impairment and those arising from the autism
The overall impact of visual impairment and autism is not a simple matter of adding the impact of the two disabilities together. It is likely to be greater than the sum of the two parts. In addition, as discussed in the following sections, there is potential conflict between meeting the young person�s needs which arise from the visual impairment and those which arise from the autism, and there is a need to re-think some strategies commonly used with visually impaired young people and, for those with very little or no vision, some that are commonly used with autistic learners.
Re-thinking strategies commonly used with young people who have visual impairment
It is worth noting here that some strategies commonly used with visually impaired young people who have no additional needs are not recommended for use with young people who have visual impairment and autism.
Communication is, of course, important for all learners. For most young people, spoken language and, later, written language, are crucial. For visually impaired young people, language has an even greater significance than for sighted learners, as it provides them with access to many aspects of the world that are otherwise not available. However, young people with autism have difficulty understanding spoken language, and individuals with visual impairment and autism need practitioners to augment their spoken language. Practitioners typically use a good deal of spoken language when working with most young people who have visual impairment. However, this is not appropriate when working with young people who have visual impairment and autism. These learners require practitioners to reduce their spoken language.
Visually impaired young people are denied access to much of the information about what is going on around them. Practitioners sometimes provide them with a verbal commentary about who else is in the room and what is happening. However, because of the need to reduce spoken language for young people with visual impairment and autism, verbal commentaries should be avoided.
Practitioners quite commonly re-cast their spoken language when communicating with a young person who has visual impairment. This occurs when the young person fails to understand something: the practitioner finds another way to put the question, instruction, description or explanation. But re-casting language is not appropriate for young people with visual impairment and autism: if they fail to understand, it is important to repeat what was said in exactly the same form as the original.
Another strategy commonly used with visually impaired young people is to maintain contact through touch. For example, a light touch on the arm may serve to re-assure the learner that the practitioner is still present, or to gain the learner's attention. However, many young people with visual impairment and autism find light touch aversive. This is certainly true of Cecily and Bob. Indeed, touching Cecily lightly typically triggers an outburst from her, so the staff who work with her avoid this trigger.
Re-thinking strategies commonly used with young people who have autism
In general, when supporting a young person with visual impairment and autism who has some useful vision, it is not necessary to re-think the strategies commonly used with sighted autistic young people. This is because most autistic learners do best when information is presented in a visual form.
However, practitioners supporting a young person with visual impairment and autism who has very little or no useful vision must certainly re-think the strategies commonly used with sighted autistic young people. For example, when augmenting spoken language for such a learner, it is necessary to employ non-visual means; according to the individual's skills and needs, one or more of the following might be appropriate
Overlapping practice
Some strategies commonly used with young people who have visual impairment are also employed with sighted autistic learners. An extremely important one is minimising clutter, which (as noted above) is discussed in:
CCTV is provided for some young people with visual impairment and can be helpful for those with visual impairment and autism. Indeed, it could be supportive for some sighted autistic learners. This is because, in effect, CCTV minimises clutter.
Not surprisingly, mobility is an important area of need for young people with visual impairment. Getting from one place to another also presents major difficulties to some sighted autistic learners, who can benefit from visual landmarks on frequently used routes. Providing landmarks for young people with visual impairment and autism can therefore be very supportive.
Further sources of guidance
Users of this guidance material may also wish to consult the following sources of guidance:
Some brief comments on the above follow:
The items by Gibbons (2005) and Jordan (2005) are brief and rather general and are unlikely to provide any specific additional guidance of value. They are chapters in an edited book (Pring, 2005) which users may wish to refer to as it provides further material on visual impairment and autism that is of interest and importance.
The book by Gense and Gense (2005) is much more comprehensive and detailed than the Gibbons and Jordan items. However, many of the ideas in the book may not translate well to the UK; for example, their approach is rather behavioural in character. They also they fail to address the needs of the most disabled young people.
Howley and Preece (2003) and Taylor and Preece (2010) briefly describe only one possible approach, which is based on the TEACCH approach.
Bahar et al. (2003) do not specifically mention autism, but their paper, again very brief, nevertheless contains some valuable advice. Despite the title, it does not apply only to preschool children; the recommendations provided are appropriate for many older individuals, probably including adults.
The book by Hagood (2008) is intended to provide guidance on building relationships with young people who have visual impairment and autism. Users of this guidance material may find that the book fails in this respect. It certainly fails to address the needs of the majority of young people who have visual impairment and autism as the activities provided seem to depend on the individual having good cognitive skills as well as sound verbal skills.