WHY SEPARATE AGENCIES FOR THE BLIND?
THE PROBLEM
Because of the myths and stereotypes of blindness, rehabilitation
agencies for blind persons must take a different approach than
agencies that serve persons with other disabilities. Agencies
serving the blind must deal with two problems. Of course, they
must address the physical loss of vision by teaching specialized
skills and techniques. But, they must also address the
misconceptions. The second aspect involves creating attitudinal
changes in their clientele and in society. This requires that
rehabilitation professionals working with blind persons possess in-
depth knowledge about the abilities of blind people. In addition,
they must possess the ability to teach blind persons how to deal
positively with public attitudes, and must be prepared to deal with
those attitudes themselves.
BACKGROUND
Throughout history, people have feared blindness more than almost
any other physical disability. In the last few years, AIDS, cancer
and Alzheimer's Disease have become more feared in industrialized
nations because massive publicity has brought them to the
forefront. For most of the world, however, blindness is still the
most feared.
The fear of blindness is based largely upon two elements: the
extent to which we rely upon vision as our primary sense, and the
negative images about blindness which are almost universal
throughout the world. These negative images are pervasive and
deeply entrenched: If you can't see, you can't do; blind people are
dependent and not able to meet their own needs; they cannot work,
travel, enjoy recreation or maintain households. These two
elements represent myths and stereotypes which constitute a
dangerous and misleading view of blindness. They lead the general
public to assume that visually impaired persons lead cloistered,
sterile lives. They deny the essential truth of the normality of
blind persons. They deny the fact that many, many blind people
lead successful, fulfilling lives.
All those concerned with the welfare of blind persons, plus blind
persons themselves, must understand that the myths and stereotypes
held by the general public are the single most difficult obstacle
to assisting blind persons to achieve success in life. Whatever
other elements are involved, rehabilitation staff and their clients
are always confronted with the need to overcome these perceptions.
WHAT'S AT STAKE?
For years many states have examined the feasibility -- even the
desirability -- of merging specialized agencies for the blind with
other human service agencies. Even with the attractive idea of
saving money by creating a massive bureaucracy, many states reached
a different conclusion. They determined that true cost
effectiveness, efficient and timely service delivery, focused
management, and competent targeted leadership are best accomplished
in a separate agency, or in an identifiable department or bureau
with competent, qualified and trained staff.
Research to compare outcomes of rehabilitation services for people
who are blind according to specialized or general settings has been
limited. The best designed study (conducted for the U.S.
Rehabilitation Services Administration by a neutral research firm -
- JWK International) had two major findings.
First, most state agencies, even those not identified as providing
rehabilitation services solely for persons who are blind or
visually impaired, chose to serve blind people either:
via a specialized unit within the agency, or via counselors in
a specialized unit within the agency, or via counselors with
specialized caseloads.
Second, specialized caseloads, regardless of agency type, produced
better rehabilitation outcomes for blind clients.
This and other studies have supported the advantages of separate
agencies.
WHY SPECIALIZED SERVICES?
Nowhere is the need for specialized, intensive services more
required than in dealing with the consequences of blindness. The
basic skills and techniques to overcome blindness are many and
varied and teaching these basic skills requires discrete knowledge,
a thorough understanding of blindness and the problems attendant to
it.
Unique skills related to this disability:
1. Traveling with the long cane or the guide dog. Such
training must encompass how to assess the environment and
move about efficiently in it.
2. Braille, a system of reading and writing which depends
upon the tactile identification of raised dots. Braille
will vary in complexity from a simple alphabet to
specialized notations for computers, foreign languages,
music, math and other disciplines.
3. Assistive technology, including the use of synthetic
speech for computers, closed circuit television
magnifiers, Braille computer terminals and reading
machines or scanners. This includes assessment of the
need for specific devices to accomplish specific tasks.
4. Independent living, including all the skills for personal
and home maintenance -- from grooming, to how to cook, to
how to get to work. In short, all those things sighted
persons take for granted in daily living.
5. Personal adjustment, which is a blind person learning how
to deal with the effects of total or partial loss of
vision and how to respond to negative thinking about the
abilities of blind people.
The efficient, effective transmittal of all the skills required to
cope with blindness requires the specialized attention of experts
whose own unique training and experience has been focused on those
who are visually impaired.
WHAT STRUCTURE IS MOST CONDUCIVE TO DELIVERY?
Several considerations must go in to determining which
administrative structure is most appropriate to deliver effective
services:
1. Savings or Service -- Does the consolidation of
administrative functions result in meaningful savings?
Are larger units of government efficient, considering the
inherent problems of complex bureaucracies in terms of
slowness and lack of focus?
2. Consolidation or Specialization -- Are there things to be
learned from big business which, because of hard lessons
learned from unhappy past consolidations, is moving to
decentralize and adopt the practice of smaller, more
specialized units.
3. Ease or Difficulty of Access -- How can blind and
visually impaired persons best access services?
Accessing service delivery systems always presents
problems for consumers, especially for persons who are
blind or visually impaired because they are a minority
among the total disability population. aren't their
specialized needs likely to be lost in a combined setting
which attempts to deal with the needs of persons with all
types of disabilities?
4. Generic Skills or Relevant Knowledge -- Can persons
trained to provide general rehabilitation services
furnish the kinds of services visually impaired persons
require?
5. Generalized or Specialized Focus -- Can senior managers
of generalized rehabilitation agencies bring to bear
adequate specialized training and experience to develop
the most effective service programs for blind and
visually impaired persons?
WHAT DO CUSTOMERS WANT?
A paramount issue in deciding upon the structure of a service
delivery system for blind and visually impaired persons must be the
view point of the consumers of the services. All major
organizations of and for the blind agree on the need for
specialized services. They overwhelmingly believe that the optimal
way to deliver such services is through a separate agency.
Reasons for agreement include the following:
Access to decision-makers -- not buried in a bureaucracy.
Specially-trained personnel who can use their skills and
abilities to facilitate the acquisition of vocational and
independent living skills.
Appropriate representation on advisory councils, task forces,
and other work groups so that their specific needs can be
addressed.
An agency that advocates for blind persons to overcome the
myths and stereotypes so evident in our society.
WHAT HAS THE EXPERIENCE OF EDUCATION SHOWN US?
Time and experience have demonstrated that forcing the integration
of blind persons has not served them well. For example, those
concerned with the education of blind children have found that
"mainstreaming" as a rule has not worked for visually impaired
children. In too many cases, it has resulted in inferior education
for them. Many states, under the pressures of inadequate funding
and resources, have abdicated responsibility for providing special
education programs for visually impaired children. An
unanticipated harmful effect has been the loss of many special
education personnel and teachers. All of this has had disastrous
effects on blind students, who, in many cases, had to fend for
themselves in integrated, mainstream classrooms. This experience
of the educational system should serve as a warning to those who
advocate integrated rehabilitation agencies for adults.
CONCLUSION
The skills of blindness are markedly different from the skills
required by other disabled persons. The methodology of instructing
the blind and confronting the issues of blindness in our society
require the development of specialized service programs, with
service delivery by specialized personnel. Therefore, the National
Council of State Agencies for the Blind (NCSAB) supports the
concept of a separate service delivery system and organizational
structure for the blind to maximize the success of blind persons
served by rehabilitation agencies.