Encouraging independence

Mobility, for children with vision impairment, means helping them to learn to move safely and independently, learning routes and strategies for getting around familiar and unfamiliar places, and using supports like a sighted guide, long cane and a guide dog, if that becomes appropriate or desirable in teenage years or adulthood.

Habilitation refers to the fact that children are learning life skills for the first time, and are not getting used to a new set of skills having performed them as a sighted person first. It consists of teaching and learning daily living skills with increasing independence. For example: dressing, washing, eating and drinking, finding and taking responsibility for belongings, and generally learning all of the everyday skills and abilities that children acquire as they grow and develop.

Rehabilitation more commonly refers to the learning of everyday living skills for adults and/or people who have acquired a sight impairment.

Your child will benefit from access to a Habilitation Specialist (sometimes called Mobility Officer) who can support in these areas.

Different local authorities provide mobility and habilitation services in different ways. Your child may need more intensive support from a Habilitation Specialist when they are learning particular skills, for example in the early years or starting school, and then need further periods of intensive work if they are changing settings, between primary and secondary school for example. There may be times of less frequent or intensive work with a Habilitation Specialist in between. A programme of mobility and habilitation work should be developed by your local service depending on your child's needs.

Your Qualified Teacher of (children with) Visual Impairment is the best place to start regarding setting up mobility and habilitation support for your child.

Get the right support

Doing things for your blind or partially sighted child may be easier or faster for both of you but takes away an opportunity for them to learn and develop. Try to balance your support and help by enabling them; allowing them to learn to do things for themselves. Your son or daughter will get a lot of happiness and reward from developing his or her own skills, and this is essential for their well-being and self-esteem.

Learning is best practised through doing, being unafraid of making mistakes or mess. Focusing first and foremost on successfully completing the activity will build your child’s confidence. After a few times of them successfully completing a given task, you can then start thinking about how that task can be done more neatly or with fewer mistakes.

Letting them explore the activity and try out their own ideas will also build their confidence and skills. Copying someone else is an important part of learning, so you may need to describe what you are doing while you are doing it. Allow them to guide you when it’s their turn in the same way that you guided them when it was your turn.

As a general approach, it’s helpful to:

• Be consistent: follow the same pattern and use the same language each time you go through an activity.
• Support and guide your child from behind unless walking: it is easier for children to feel movements from behind and it feels more natural to be moved from behind than to be pulled forward.
• Use the right equipment: there are lots of gadgets out there that could help so it’s worth looking around in the shops. We’re always happy to help if you’re looking for something particular or need to find a grant.
• Practice! Encourage your child to do something by themselves, only helping them if they’re stuck after a few tries.
• Allow your child to make accidents, messes and mistakes while they do a task, helping them to clear up only after they’re finished. They don’t have to be neat straight away and learning to clean up after themselves is just as important as anything else.
• Talk to other parents and professionals if any difficulties persist. All parents have to deal with the same issues and hearing from those who have been through it before or who deal with it every day could give you a new perspective.

Start with undressing (it’s easier to take things off than to put them on). Here are some more helpful tips:

• Putting their clothes away properly helps with tidiness and memory – good organisational skills are essential for blind and partially sighted people so that they keep track of where their belongings are.
• Choosing clothing that is easy to put on and take off.
• Zips are easier than buttons, but both skills are important.
• Starting with large buttons rather than small fiddly ones.
• Choosing garments that have obvious fronts and backs – tangible collars, logos, fastenings and decorations help just as much as locating the labels.
• As image becomes important as your child gets older, shaped buttons (slate colour) can be sewn inside garments to ensure that, for example, blue tops match blue bottoms.
• Fastening shoes – start off with velcro fasteners until your child has learned the necessary manual dexterity for buckles and then shoe laces. Teach your child to tie shoelaces in stages, with your support from behind, co-acting each movement.
• Asking what shall I wear? It is helpful for your child to learn about appropriate clothing – for example, when to wear jeans and strong shoes, when not to wear a party outfit, etc.

Bath time is a great opportunity for babies and young children to learn about body parts as well as keeping clean.

• If your baby is afraid of water (wet, or unfamiliar substances can be upsetting for blind and partially sighted children), you may want to put him in a small baby bath, or use a sponge insert or baby bath seat to make things easier.
• Scented soap and bubble bath make bath time more interesting.

Breaking this down into several smaller tasks may help. Some children don’t like the sensation of the brush or the toothpaste in their mouths, so making a song or a story that says what’s about to happen could give them a more enjoyable experience:

• Putting the toothpaste onto their finger and letting them rub it onto their teeth directly is a good way to measure the right amount. This way, you avoid the problems of coordinating the end of the toothpaste tube with the toothbrush and they can feel what the correct amount is.
• Helping them to get the correct action while doing the more difficult bits, then encouraging them to brush for themselves makes sure everything is done. This is also a great time to be talking to them about all the parts of their mouth.
• When your child is older, flossing may also take some practice. Try getting the right length and encouraging them to use their sense of touch to make sure they’ve done everything. Dental tape might also be easier to use than dental floss.

Talk to your dentist and your local sensory services if you have any issues that stick around.

Children learn to use the toilet at different ages and stages and it is important that you and your child are both comfortable to embark on this project. Accidents will happen and may require patience on your part as a parent or carer. There are lots of children's books that have stories about using the toilet. It's worth asking a few questions if any issues keep popping up:

• Have you got a potty with a solid base?
• Can you put it in a permanent place where it’s easy to locate, for example, within reach of a wall?
• Have you got a toilet seat for when they are older?
• Does your child know that Mum and Dad go to the toilet?
• Are they happy to be in the bathroom?
• Have you got the time to sit and talk to your child while they are on the potty so that they feel more secure?
• Can they wipe themselves properly and know that they are completely clean?
• Can they find and use toilet roll, flush and find the sink to wash their hands when they're finished?
• Do they know how to wash their hands properly?
• Talk to the teachers at playgroup or nursery if you attend one and agree on a routine which works at home and at nursery.

Eating is an important daily living skill to teach your child. Mealtimes should be fun and are a good opportunity to develop social skills, although eating can be a difficult or stressful experience for some. The tips below may help to set in some healthy eating habits:

• Prepare the eating area and protect carpets and floor coverings with plastic sheeting or newspaper.
• Your child may like to practise eating skills with you in private rather than learn 'on the job' at family meal times.
• Use a non-slip mat under the dish to prevent it from slipping or use anti-spillage bowls and cups.
• Ensure that children understand the words you are using, being consistent in what you say.
• Give children an opportunity to enjoy different smells, tastes and textures.
• Start with finger feeding and then work from behind, at first guiding the child’s hand from the dish to the mouth and then gradually reducing your involvement.
• Choose dishes with a rim at first and cups or mugs which do not easily tip over.
• Give small portions.
• Praise success, particularly new achievements or something that was particularly tough.
• Tell your child what they are going to eat for their meal and keep eating times consistent whenever possible.
• With older children, use the points of the clock to explain the position of foods on the plate. For example carrots at three o’clock, potatoes at six o’clock.
• Cooking and baking make great afternoon activities and are good ways to learn about food and different textures.

Children are naturally inquisitive and it is important to put safety precautions in place before they reach the next stage in their development.

• Do not leave a baby on a high surface – today might be the day your child learns to roll for the first time.
• Put up stair gates before your child can crawl and climb.
• Use childproof locks on cupboards and drawers containing medicines or poisonous substances such as bleach, breakables such as glass or china, or sharp objects such as knives, graters or blenders; keeping these items in high cupboards and drawers that are out of reach if possible.
• Protect your children from hot ovens, hobs, kettles and irons.
• Make sure that they know which area of the house they are in and what to think about in that area: "the oven in the kitchen is hot!"

If someone in the family is blind or partially sighted there are additional safety measures that you can take:

• Learn about your house from your child’s height and size. A parent suggested crawling round it on your hands and knees to get a child’s perspective and discover any safety hazards.
• Different floor coverings (carpet, textured rugs, laminate or wood floors) will help a young child understand different rooms and locate herself in the house.
• Encourage tidying of toys into plastic crates to avoid tripping hazards. One blind Mum has a rule that no toys are to be left in the kitchen, where she could trip over while carrying something hot. Putting things away will develop organisational skills that are also helpful for a blind or partially sighted child in locating items they want to use again.
• Leave doors fully open or fully closed to prevent head injuries.
• Open doors slowly if your child is in a room but you don't know which part.
• Pin back and cover trailing wires from telephones or computers.
• Pad sharp edges of furniture, shelves or fireplaces.
• Some blind parents find it helpful to attach bells or a charm bracelet to children to help with locating them.

Accidents are always going to happen – it’s one of the ways that we learn and it’s a natural part of growing up. Your role as a parent is not just to minimise the risk for your child, but to teach them about the world around them and how to minimise those risks for themselves. That way, they can explore the world and do the things that they want and need, knowing that they can support themselves and that you are there for them too:

• Make sure you and your child know what to do if one of you is hurt or there is a different type of emergency.
• If an accident does happen, talk with your child and think of ways to stop it from happening again together.
• Make sure they have enough supervision and support, particularly if the same type of accident keeps happening.
• Bumps and scrapes on furniture or other obstacles can be common, your habilitation specialist might be able to help with these.