Interview #16: Greg Hansen (OT to Students with Visual and Hearing Impairments)
An occupational therapist shares his perspective on what it’s like working with children with visual and hearing impairments.
Greg Hansen has been an occupational therapist for over 20 years. For the last decade, he has worked with the pediatric population at the Virginia School for the Deaf and Blind (VSDB). Greg is also a full time assistant professor at Murphy Deming College of Health Sciences (MDCHS), where he teaches pediatric courses as well as foundations of research and motor learning.
During his lectures, Dr. Hansen will often challenge students to think about disability and function on a deeper level by presenting case scenarios and examples of instances from his experiences at VSDB. Because of these examples, I was curious to observe what it was like working with students who had visual or hearing impairments, so I arranged to shadow Dr. Hansen for a day at VSDB to enrich my understanding. After the experience, I developed a deeper appreciation for the work Dr. Hansen did at VSDB, and continue to be mindful about the ways in which the environment influences individuals with such impairments to function optimally.
I was glad when Greg agreed to have a sit-down interview to discuss how the role of occupational therapy can be beneficial to individuals with visual and hearing impairments, as well as share his perspectives on how the community can be adapted to better support their independence.
Here is Greg’s perspective.
The Role of Senses in Development
During the interview, Greg describes ways in which sensory input influences development, and how the lack of input may have a significant impact on motor and social development. The key concepts referenced are:
- Motor Learning: The process of acquiring the ability to produce skilled actions. Vision plays an important role in the process of motor learning, including planning, control, and evaluation of movements.
- Incidental Learning: Everything we learn through informal interactions we have with others. These interactions may be kinesthetic, visual, or auditory.
- Social Learning: Bandura’s Social Learning Theory proposes that people learn from one another through observation, imitation, and modeling. With the absence of vision, a child lacks the necessary input needed in order to mimic what is being modeled.
Greg provided several examples to enhance the understanding of these concepts. With regard to kids who are blind:
“So, if you think about a typically developing child, he or she is very visually engaged with the environment from a young age. They see things that attract their attention, and seeing that and being attracted facilitates the development of motor skills. ‘I want to see what that object is…I want to crawl….I want to scoot…I want to grab that object…I want to explore it.’ So, in the absence of vision, a lot of those stimuli aren’t there, so the impact on motor development is significant. Now, that doesn’t mean the kids don’t eventually overcome the absence of that stimuli, but it does impact motor impairment. At least that’s certainly been my experience.”
“Going back to the motor skill perspective, if you think about how much motor skills are modeled by peers… ‘I see little Jimmy running…I want to run like little Jimmy’, or ‘I see Sally climbing the monkey bars and I’m learning from her performance, how to do that better.’ Kids without vision are denied that… those learning opportunities.”
With regard to kids who are deaf:
“What I think many folks don’t recognize is the lack of incidental learning that takes place. So, kids learn so much implicitly; from overhearing adults conversations, from overhearing the conversations of peers. And, typically kids who are deaf or hard of hearing miss that content.”
“All of these things that are often developed just through relationships in the home, and through overhearing siblings, etc., these kids often miss.”
Because of some of these missed opportunities, the role of occupational therapy in conjunction with educational efforts at VSDB is vital to the success of students in developing the skills needed to support independence.
The Role of Occupational Therapy
Greg highlighted some of the key ways in which an occupational therapist works with individuals with visual and hearing impairments at VSDB. OTs primarily address self-care skills, ranging from the basics of dressing (e.g., shoe tying, zipping, buttoning) to more advanced independent living skills as the children get older (e.g., laundry, meal preparation, and community navigation). They also lead groups to help facilitate independent living skills by using role-playing. An OT may use a series of pictures to help a deaf student understand the required steps for emergency management, as well as go through the steps verbally with a student who is blind.
OTs might incorporate tactual cues in the environment to make meal preparation easier for students who are blind. Braille markings may be incorporated on different labeling to make the identification of objects and kitchen items easier, as well as other tactual markings to aid in the identification of correct buttons on microwaves to increase independence.
Having relatively inexpensive modifications in environments allows children to gain valuable skills in which they can use or transfer over into different environments, so they can remain successful as they transition out of VSDB’s program.
Social Barriers
One of the anecdotal observations Greg has made while working with individuals with visual impairments is that they sometimes tend to have significantly smaller social circles when compared to typically developing peers. For example, students with visual impairments may lack the ability to participate in sports that require vision to play. In addition, the lack of driving may make it difficult for an individual who is blind to attend events with their friends independently out in the community. Fortunately, VSDB embodies a culture of students and educators who share similarities, which ultimately provides the opportunity for individuals to network and connect with others who have similar experiences.
In regard to the deaf population, Greg has hypothesized that the emergence of texting may be a contributing factor in tearing down some of the communication barriers. He gives the example of how a deaf student who uses an iPhone to text now has an advantage of communicating with a student without a hearing impairment who does not communicate via American Sign Language (ASL).
Advice to the Community
Greg also lends advice to business owners for interacting with individuals with visual and hearing impairments in the community. His advice:
“I guess if someone came in into your place of business with a visual impairment…just be very hospitable toward that person, greet that person, try to provide a visual or verbal description rather of this stores layout, what some of your items are. Ask… ‘How can I help you?’ Because if you think about the shopping experience of someone who’s blind, it’s gonna be quite challenging. And that individual is most likely gonna need considerable assistance, so be willing to provide that. Assist the person through the store, or help the person understand what products you have.”
“With regard to a person who would be deaf, gosh…Learning sign language is always good. Even just a couple of basic signs. If communication becomes more complex, always offer to write things down, or communicating that way, gesturing [using basic ASL signs].”
Greg shared valuable insight from his experiences working with individuals with visual and hearing impairments. As we expand our knowledge on some of the more “invisible” impairments, we become more familiar with ways to increase inclusion within social contexts as well as within the community. I hope you enjoyed Greg’s perspective!
P.S.: If you’d like to share your story, contact Sarah at sarah@universaldesign.org to set up a time to talk!
