Independent living skills

Introduction

Factors often driving parents to place their children or young people in special residential, sometimes independent schools or colleges, are under developed independent living skills. Too often, mainstream placements and local authority services are not adequately addressing this area of need.

Meaningful inclusion

Underdeveloped independence has a major impact on meaningful inclusion. When your child is young you can take him or her with you when visiting friends and family. S/he can then play in the garden or in other safe controlled environments. But later, can s/he ride his or her bike on the street, go to town unsupported or keep up with friends when out doing what teenagers do?

An indicator of independence and inclusion could be to ask yourself how many children invite your child home? Compare this to the number of invites received by fully sighted peers.

Consider therefore the age related skills fully sighted peers have when compared to your child or young person’s.

• Can your child get his or her school dinner and eat it unsupported?
• Can s/he tie shoelaces when peers are able to do so?
• Can s/he go to the playground unsupported and find friends if arriving late?
• And, although the list could be huge, does s/he have close friends both in and out of school

Appropriate behaviour

If your child or young person does not behave appropriately when interacting with peers s/he will not fully integrate. For example, does s/he understand communication well enough to know when to disengage during conversation and are peers avoiding your child or young person as a result?

These issues not only affect your child or young person’s integration and quality of life but they can also impact on academic progress and later employment.

No child or young person should need to leave mainstream provision because these issues are not being addressed.

Developing skills begins with assessment

Every child and young person needs to learn independence skills in order to shop, eat and drink out, socialise and travel independently. This involves developing the confidence necessary to do things for themselves. Fostering self-confidence also has an effect in other areas of development.

Suggestion

Independence can often be best achieved when activities are designed to combine a supported learning experience whilst trying something new and fun.

Teenagers and professional support

When children reach their teens many parents find that professional support is necessary as a demand for independence increases. This can mean needing information and advice about the best way to progress and avoid being over-protective. To begin, a comprehensive assessment is often required followed by innovative methods to address the development of skills at home and in the local community. All of this is necessary to develop practical skills and achieve a realistic standard of personal independence.

Emotional wellbeing, motivation and self-determination

The level of independence an individual possesses is often connected to emotional well-being and motivation. Self-determination can also play a major part in developing independence.

Disabled children and young people can encounter challenges which impact on self-determination. These include:

• Personal autonomy
• Feelings of competence
• Social inclusion

Evidence shows that many would like to develop independence but find it frustrating not being able to do so.

Meaningful choices and well-being

Opportunities to make meaningful choices helps to foster feelings of control and self-motivation. A child who is constantly supported experiences a different world from someone who is allowed to socialise in unsupported situations absorbing first-hand the perspectives of others.

Suggestion

Having the opportunity to support others can also build confidence, well-being and happiness.

Building autonomy

We all must learn how to deal with frustration and disappointment. However, allowing the individual freedom to make meaningful choices and learn whilst maintaining support can be difficult. For example, when out and about,

• Allowing your child or young person to use his or her mobility skills when crossing a road
• When your child or young person is accessing information in a shop stand back and let him or her do it independently
• When s/he is trying to find a bag of peas at the bottom of a freezer give her or him time and space to do so independently

At times like these you, your child or young person may notice dependence, experience anxiety, frustration and even anger.

Mobility training to develop independence and confidence

Your child or young person may want to visit shops independently or with a friend. However you might not be confident in their skills. It is likely at this time that professional help will be useful.

A mobility specialist can:

• Assess your child or young person’s skills and involve you in the process
• Teach fundamental techniques
• Teach a route of meaning which could be to and from the local shops
• Involve you in the development of these skills
• Show you that your child or young person is managing

During these sessions your son or daughter can also be shown techniques to find for example peas at the bottom of a freezer and then pay for a list of shopping. That is, during mobility training teach more general independent living skills.

A structured programme

Independent living skills sessions can potentially develop your child or young person’s feelings of control. To best achieve this sessions should be well structured. It is recommended therefore that targets set are SMART. That is:

• Specific
• Measurable
• Attainable
• Relevant
• Time-specific

Developing independence - a few suggestions

When the young person becomes older encourage him or her to:

• Learn and practice new independence skills
• Manage his or her time
• Learn to be proactive

As s/he becomes more independent, reduce your control over situations and allow the individual to:

• Regulate him or herself more
• Trust his or her own ability and judgment

Provide opportunities for your child or young person to make choices and encourage questioning but also make it clear where s/he can get support.

In a specific and quantifiable way encourage your daughter or son to take responsibility for his or her diary involving appointments, coursework and deadlines in order to develop:

• Organisational skills
• Problem solving skills

If necessary, enlist the support of a professional to advise you about letting go and allowing the development of independence.

The demands of the National Curriculum and developing ILS

The demands of the National Curriculum make finding time to develop independent living skills during the school day difficult. If the individual isn’t in a residential placement the family should be supported to develop these skills during out of school hours.

Skills should be age appropriate and, after assessment, taught and practiced in the environment in which they are required.

Suitably adapted or specialist equipment is also required with the young person also encouraged to problem solve and find his or her own solutions so that transferable skills can be developed.

Interpersonal skills

Age appropriate interpersonal skills should also be covered. Under developed interpersonal skills might strongly affect social interaction. Input may be necessary in the following areas:

• Appearance
• Dress
• Facial expressions
• Body posture
• Personal body space
• Gestures
• Appropriate eye contact

Addressing these can be difficult. However, if you don’t do it who will?

The young person should be made aware, if necessary, that there are unwritten rules to appropriate behaviour. Important conventions may be missed if the young person has low vision with social inclusion and employment affected along with confidence and self-esteem.

Aspects of sexual health and sexuality may also need addressing with advice from a professional again necessary.

All of this should be designed to ensure that a young person can manage his or her own care needs and make informed decisions.

If you feel isolated, in need of professional support and information see what Families and Special Educational Needs can offer.

Independence, loss of freedom and autonomy

It is commonly believed that if a person isn’t independent then this represents a loss of freedom and autonomy which undermines the individual as a human being. However, the relationship between helper and helped can become restricting. If constantly having to express gratitude or at best not complain this can result in a feeling of loss of power in the individual.

The notion of independence can be taken too far leading to restricts in the individual’s life. For example, a standard exercise for well-meaning life skills teachers is to get disabled learners to make, for example, a pizza. Whereas, it might be more of a help to show the learner how to use a mobile phone and order a pizza already made then allow the individual the free time to do something s/he actually enjoys. Similarly, a lot of time is often spent getting a learner to tie shoe laces whereas it might be better to buy slip on shoes.

Consequently, the notion of self-help which is second nature to a fully sighted person might become frustrating to someone with a disability.

The fundamental notion of basic skills here impedes the quality of life and inhibits the disabled learner’s self-expression and independence.

Increasing slowness

Disability can also make the individual slow which can be made worse if forced into doing something which is very difficult. The helper is, in fact, restricting the individual’s freedom of thought and action.

Pressure and independence

Closely associated with the pressure to be independent is the pressure to appear ‘normal.’ This can lead to inefficiency and stress through the disabled individual being subjected to the pressure of adopting a ‘normal’ image which will never happen.

Technology, a mixed blessing

Technological aids can be a mixed blessing too. Visual aids, for example, give the impression that a visually impaired individual is able to perform in the same way as a fully sighted person. When actually, low vision aids can make the person less efficient. When using the aid the individual is often slow, makes visual errors and is also less likely to be helped by others.

Independence undermining self-esteem

Consequently, striving for independence can lead to frustration and low self-esteem and the over-emphasis on basic independence can rob the individual of true independence by restricting freedom of choice and action. Appropriate support, therefore, represents a very difficult balancing act.

If you feel isolated, in need of professional support and information see what Families and Special Educational Needs can offer.

Introduction

The skills most fully sighted children learn incidentally and by imagination are more complicated to learn for those with low vision. Families and professionals should work together from early years so that your child can learn and then internalise skills. This requires a comprehensive assessment and programme.

In the beginning

Importantly, to begin, your child should develop effective motor skills, appropriate behaviour and an understanding of words like:

• Left and right
• Up and down
• Front and back
• Top and bottom
• Inside and outside

S/he should also know the parts of the body before trying to gain full independence washing, feeding and dressing.

Time to teach and time to learn

You must have time to teach independence and your child must be given time to learn. For example, it is often of little use developing skills when trying to get the whole family ready for school along with your visually impaired child. Similarly, if a teacher is trying to manage a whole class making scones it is unlikely that enough quality time will be available for the visually impaired child to do things independently. The tendency often is to take over and move things along at a faster pace.

Therefore, not only should the learning experience be fun it also requires sufficient time to complete tasks.

Be careful though, a child soon learns to go slow so that you take over. This could mean not dressing your child in the morning when s/he is capable of doing it. Or, helping your child to eat breakfast when similarly capable. If this is allowed to continue you may arrive with a 10 year old unable to dress or feed independently.

Dressing

Children often find it easier to begin taking clothes off before learning to put them on. When helping your child to dress, use precise consistent language and guide from behind.

Suggestions

Choose:

• Clothes which are easy to put on and take off
• Slip on shoes or ones fastened with Velcro
• Clothing with zips as opposed to buttons
• Large buttons rather than small buttons
• Clothes with an obvious front and back

Feeding

Meal times should be relaxed and pleasurable. However, in the beginning, eating with your disabled child might be difficult. To avoid a stressful and possibly embarrassing situation try teaching your child to eat on his or her own. Then, include your child at the table afterwards as part of the social occasion.

Suggestions

• Plan the meal
• Cover the floor so that any mess can easily be cleaned up
• Place a Dycern mat under a bowl to prevent the bowl from slipping
• At first, use bowls with a rim and cups which are not easy to mishandle or knock over
• Ideally, meals should be at the same time each day
• Avoid snacks between meals
• Use precise and consistent language
• Keep the session relaxed

Also:

• Encourage your child to enjoy the smells, tastes and textures on offer
• You might find it best to start with finger feeding
• Serve small portions
• Use colour contrast between different foods and the plate or bowl
• Support your child from behind
• Gradually reduce involvement

Avoid distractions; for example,

• Conversations with others
• The TV or radio playing
• Phone calls

Generally speaking,

• Make the meal time a special occasion
• Praise success

Later, share the occasion with others who are perhaps a little older and more developed in this area.

Conclusion

Strategies must be consistent. Those employed in the family should be shared with school and visa-versa.

Meal times provide great opportunities for the development of social skills. Remember though, meals are full of cultural conventions with basic skills learned over time and for many by sight.

if you feel isolated, in need of professional support and information see what families special educational needs can offer.

Introduction

The level of mobility skills can, to a large extent, determine a visually impaired person’s quality of life. The ability to move around can affect the individual both physically and emotionally in relation to confidence and self-esteem. Although these points are recognised by many, it is estimated that only a quarter of children or young people needing mobility training receive it.

Two fundamental skills

The two skills necessary for independent travel are:

• Orientation, which means having an awareness of space and an understanding of your body within that space
• Mobility, which is the ability to move without harming yourself

To develop the necessary skills mobility and orientation needs to be an integral part of your child and young person’s learning. It is not simply a process of mastering a few skills which can be taught in a few weeks or months.

Aspects of vision affecting mobility

These include:

• Reduced distance acuity
• Field of vision loss
• Difficulties adapting from light to dark or visa-versa
• Bright sunlight or a cloudy day
• Strong sunlight causing confusion
• Poor depth perception
• Poor contrast sensitivity

Understanding the world

We develop an understanding of the world by moving around. Disabled children and young people who find it hard to move around can be severely restricted. The variety and quality of opportunities to experience and explore the word independently is missed. Consequently, knowledge of the world can be second hand and only perceived via what they read, receive via TV, the internet or are told.

If children or young people are able to move independently their world develops. Through being exposed to a wider range of real experiences learning is stimulated.

Social understanding

Mobility also helps to develop social understanding. It is in the wider community that new social interaction and contacts are made. Through this, confidence and self-esteem are potentially developed.

Risk taking, self-esteem and confidence

Moving around independently involves problem solving and risk taking. Assessing risks and taking responsibility for your own actions is an important part of development.

Moving around independently can also raise self-esteem and confidence.

Posture and muscle tone

A visual impairment can impede relaxed and quick movement. A lack of movement undermines good physical development. It is this type of movement which develops posture and builds muscle tone especially in legs and feet. Walking gait is improved this way too.

Poor physical development also restricts the development of coordinated movement.

Early mobility training

Being born visually impaired can undermine the forming of correct body concepts. It can also significantly impact on developing a mental map of the world. As a result, your child or young person’s position within her or his world can be limited and confusing. Concepts such as distance and direction may be difficult to grasp. Then, if not addressed, these underdeveloped concepts will continue throughout school life and beyond.

Mobility and employment

Independent travel is extremely important in finding, securing and maintaining employment.

Without being able to travel independently journeys are expensive. This is especially the case when taxis are constantly necessary.

If you feel isolated, in need of professional support and information see what Families and Special Educational Needs can offer.

Introduction

When pushing your child or young person in a wheelchair consider the following:

• Tell your child where s/he is going
• Use symbols and objects if necessary to help highlight features
• Put your hand on your child or young person’s shoulder if appropriate when pushing
• Don’t leave your child or young person in the middle of a room unattended. Place her or him near a wall or table
• Tell your child or young person when you’ve reached a destination
• Talk to your child or young person about the route but don’t over load with information
• Be aware of your child or young person’s limbs which can hang over the edge of the wheel chair when going through narrow spaces
• Take your time, don’t rush the journey, your child or young person
• Don’t let other children or young people push the wheel chair especially if unattended
• Don’t use your child or young person’s wheel chair to open doors

If you feel isolated, in need of professional support and information see what Families and Special Educational Needs can offer.

Introduction

It is often primarily through sight that our understanding of the world develops. It,

• Makes your child want to reach out and explore his or her environment
• Encourages your child to walk towards a favorite toy or person
• Enables your child to imitate the movement of others and to feel reassured by what s/he sees

However, possessing low vision need not be a barrier to learning as children have a great capacity to develop skills and make up for reduced vision.

What can you do to help?

Your baby may have difficulty seeing how others move. Consequently, you will need to spend more time showing your child what his or her body can do. Do this gradually so that s/he gets used to new movements and is not frightened by the experience.

It is important to give your baby warning about what is about to happen. Your baby may have difficult seeing your hands coming. Therefore, tell your child what you are going to do before touching or picking him or her up.

The smile in your voice will encourage and reassure your child. Your close contact will give him or her pleasure and help your baby feel secure.

Remember, the more stimulating your baby’s environment, the more incentive there is to move.

Compensating for low vision

A baby with low vision can compensate for a lack of sight, to a large extent, by using other resources. S/he can learn about him or herself through being touched and talked to. This can all take place during the first few weeks of life whilst being carried.

Suggestions

• Cuddle your baby because this is when s/he learns how the body works
• During songs like for example, ‘This little piggy went to market ...’ your child further learns about body parts
• Ask your baby ‘Where are those little ears Tom, where are those eyes, toes and hands Molly?’ This way your baby can be further taught about him or herself

Baby and very low vision

Blind babies can appear more passive than sighted children of a similar age. They may feel safer lying down. Unfamiliar movement can cause upset and therefore may be resisted.

Your baby may need encouragement to change position. S/he may need help to roll on to the tummy or lift the head. Some babies do not crawl, progressing from sitting to bottom-shuffling to standing and walking.

A few points to consider:

• Babies with low vision differ from each other just as much as sighted babies do, and their development will be just as varied
• Experiencing a range of different movements early on will help later as s/he learns to walk and run
• Be sensitive to your child’s body language. For example, sometimes s/he may keep still through worrying about moving. At other times this may result through listening to what is going on around

Encouraging movement

Encouraging baby to reach out for objects, especially if they make a noise, can stimulate movement. Then, in due course, baby can learn about other surrounding objects.

Suggestion

Lie baby on a fur or shaggy rug so that s/he can grasp the fur and pull him or herself over.

Reaching out

A baby with low vision may need to be shown the connection between sound and an object. Then, after discovering and understanding what is causing the sound baby should be encouraged to reach out for it.

Suggestions

• Place baby in a large low sided box or laundry basket. Pad it out with cushions for support and comfort. This will enable baby to sit up safely even if not possessing the strength to do so independently. This way, baby gets a different view of the world in a safe controlled environment whilst giving you peace of mind
• To encourage reaching out, tightly fasten toys which are shiny or noisy to the side of a box or laundry basket
• Always try to use toys of different textures and not always made of plastic; for example, offer items made of wood, cloth, fur or metal
• By introducing more textures and sounds of interest, baby is stimulated along with experiencing, exploring and making connections with the outside world

Try the following,

• Bang things like saucepans, cans and spoons
• Choose toys which reward baby with a pleasant light and sound
• Collect a variety of containers made of plastic, tin and wood. Fill them with sugar, rice, pebbles or pasta to shake and make a variety of sounds
• Decorate homemade shakers and make them more visually interesting
• When ready, music and movement can be introduced using toys which require a button to be pressed or lever pulled to trigger music or animal sounds
• Having learned to connect these objects with sounds, more is discovered by mouthing. Baby can then be encouraged to find for example his or her own bottle.

More suggestions

• Put her or his feeding bottle against baby’s hand then gradually touch and move it away. This will encourage your child to look and reach for the bottle
• Encourage your child to hold the bottle with both hands while you balance it with your hand under its base

Developing confidence

Developing confidence will help your child begin exploring furtheraway. This will help baby make sense of the world. These early experiences are vital for developing mobility.

Suggestion

• Try introducing obstacle games. Encourage your child to place his or her body in positions which helps teach about the body in relation to an object

Through bending, stretching, climbing and wriggling your baby is exercising and developing muscle strength and stamina. Exercise helps develop self-image and confidence along with knowledge of strengths, weaknesses and limitations.

Suggestions

• To encourage movement further away hang a beaded curtain somewhere safe in the house. Its texture, sound and colour may be interesting and rewarding to touch, smell, taste, hear and see
• A beaded curtain will encourage your child to grasp using both hands together and stimulate co-ordination. Its sound may also provide a useful orientation tool
• Mobiles and chimes may further stimulate interest whilst again helping orientation

Exploring further afield

After getting used to one small area in one room your child may then begin to explore and find routes around the house. At this stage, if necessary, some parents may wish to encourage their toddler to put his or her hands out for protection when moving around.

Having learned to crawl, bottom-shuffle or walk, s/he will start finding a way around the house. Children tend to choose their own routes. They will be interested in places with characteristic smells and sounds, like the kitchen.

Learning about the house prepares your child for an unfamiliar nursery or playschool and then later a primary school class.

Suggestions

• Fridges, washing machines and vacuum cleaners can be fascinating. Talk to your child about all the sounds around but avoid information overload
• Show your child how s/he can use sounds to help find a way around

S/he will have learned to explore by using other senses too. For example, the smell of food cooking or a bag of compost in the garden will help your child make sense of different stimulating smells and sounds. Their position will help open up the wider world too.

Suggestion

Let your child go barefoot where safe both indoors and outdoors and feel,

• Gravel, leaves, sawdust and sand
• Cold lino and tiled flooring, carpet, rubber mats, cork tiles and leather upholstery

Safety

Supervising the use of a climbing frame may be necessary. It is important, though, not to be over-protective - a difficult balance.

The confidence to move about independently is gained from first-hand experience which sometimes involving an element of risk. Help your child to understand why some things might be dangerous so s/he can learn to avoid problems.

Initially, parents often worry about safety at home and feel that they should make changes. Some things, like unguarded fires are a danger to all children but for those with low vision there are additional hazards such as doors left ajar.

Suggestions

• Keep drawers and cupboard doors closed
• Cover and protect any sharp corners or edges
• Keep the floor clear. Toys can be stored in drawers and cupboards that are set aside for your child to use. Ideally they will be independently accessible by your child
• Encourage your child to be organised and independent
• Keep environments consistent and if changed, ensure that your child is aware of this

If you feel isolated, in need of professional support and information see what Families and Special Educational Needs can offer.

Introduction

For children with low vision mobility is an educational necessity. They need independent access to the learning environment, curriculum, social environment and wider community.

Personality, confidence and independent travel

Personality greatly affects attitudes towards independent travel. Getting lost for some might be fun whilst others might find it upsetting. Even setting out might be accompanied with positive or negative thoughts.

As a result, simulating visual impairment is of limited use. If you are wearing simulation glasses and get lost you can simply take them off. For someone visually impaired, this isn’t an option.

Other personality factors affecting mobility and its development include:

• Shyness
• Assertiveness
• Having a sense of humour

Motivation

Motivation is a major factor in learning. You can unintentionally discourage your child from moving around. Unless children are encouraged to move early in life motivation can be difficult later. Conversely, the child who has been actively encouraged to move, explore, develop and satisfy curiosity is more likely to face challenges in an outgoing way.

Transferable skills

Mobility skills need to be transferable so that your child or young person can become independent. It would be silly to say that a child or young person only learns numeracy for use in school. Numeracy is taught and designed for application in the wider world outside school. Therefore, the same principle applies to mobility.

Mobility skills to aid inclusion and general development

A mobility programme should include the wider community and involve your child or young person’s home environment. These skills will not only build confidence and self-esteem but also assist integration and help the removal of isolation experienced by many. Consequently, mobility should be seen as part of your child or young person’s general development and necessary for future employment.

Assessment and an appropriate programme

As with all targeted skills time must be made available for individual tuition in key areas. Each skill must be clearly assessed by a relevant person before moving from supported and semi-supported to independent execution.

Undermining your son or daughter must be avoided. Setting expectations too high will set a learner up to fail.

Underpinning skills

A functional grasp of the following is required:

• Sighted guide techniques
• Knowledge of environmental clues
• Indoor orientation and safety clues
• Appropriate cane skills

Then, dependent on age and assessed ability the individual can then learn to:

• Travel safely and independently indoors and outdoors
• Follow instructions, use maps and access travel information
• Negotiate shopping areas
• Use public transport
• Interact appropriately with the general public
• Recognise and handle money

If you feel isolated, in need of professional support and information see what Families and Special Educational Needs can offer.