Future Reflections         Convention Report 2010

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REHABILITATION TRAINING: THE STATE OF THE ART

by Dr. Edward Bell

Dr. Eddie BellIntroduction by Carol Castellano: Dr. Eddie Bell has been in this field for roughly fifteen years, working hard for the benefit of teachers, rehabilitation counselors, and other professionals, and also for the benefit of their blind students and clients. It is a great pleasure for me to introduce Dr. Eddie Bell.

As I was thinking about the state of the art in education, rehabilitation, and research, it occurred to me that the best way for me to talk about where we are is by looking through the lens of a paradigm. A paradigm is basically a model or framework, a set of practices and principles for looking at the things we do. In 1970 Thomas Kuhn talked about how a new paradigm can only replace an older, existing one when it has demonstrated enough success to point the way toward more effective strategies. What paradigm governs the world of education, rehabilitation, and research that we know today? Over the past sixty years or more the field of rehabilitation has been under a paradigm that we might call the traditional approach. This approach was developed in the army hospitals of the 1940s and in the schools for the blind. This paradigm has grown over the past sixty years. It includes the entire methodology and philosophy that determine the way professionals view education and rehabilitation. All of the aspects of blindness education and research that have driven the field over the past six decades have come through this traditional approach--the university O&M and teacher training programs, the certification processes, the professional organizations such as the Association for Education and Rehabilitation of the Blind and Visually Impaired.

The traditional paradigm has not been dominant because it's a perfect model or because we agree with it. Way back in the 1940s and 1950s the National Federation of the Blind was not very satisfied with the way rehabilitation was being done in this country. Members of the organization tried to work with agencies and universities to educate them and to say, "There's a better way to encourage independence. There's a better way to train individuals." They weren't very well received. For the most part universities thought blind people had very little to offer to the blindness professions. We continued to push from the outside, trying to convince the universities to change, to see the value of the consumer perspective.

In 1958 Dr. Kenneth Jernigan took over the Iowa Commission for the Blind. Within a short time he turned it into one of the most successful rehabilitation programs in the country. He demonstrated that the consumer perspective in rehabilitation is a powerful agent for change.

You might think that was enough to convince some of the more traditional folks that this idea was worth looking at, but it didn't happen right away. More than twenty years passed before the Nebraska Commission for the Blind adopted Dr. Jernigan's method and philosophy. By that time the debate over which programs were most effective was in full swing. It was discussed heavily in research literature and at professional conferences, but that research and those conferences were all governed by followers of the traditional approach. The new approach was mocked and ridiculed. It was seen as militant, dogmatic, outside the realm of what was realistic.

After another fifteen years or so, in the 1980s, the NFB centers were founded in Minnesota, Louisiana, and Colorado. Based on the consumer perspective, they began to train blind adults to become independent. Within a very short time these centers were recognized nationwide and internationally as being among the world's most effective training programs for blind adults. Shouldn't that be enough to change the field? Well, no. The field continues to view this approach as a fringe effort, an anomaly inconsistent with the values and philosophy of the existing paradigm.

Another ten years went by. We began to produce professional literature. The first book on our approach was Cognitive Learning Theory and Cane Travel Instruction by Richard Mettler. It explained how cane travel through structured discovery works. The book argued for a paradigm shift, and showed that these ideas were not just an anomaly, not an erosion of existing law, but something different and substantively better than what was used previously. In 1997 Maria Morais and others created a book on techniques used by blind cane travel instructors.

Those two small pieces of literature formed a body of knowledge in nontraditional mobility that was used in the development of the orientation and mobility program at Louisiana Tech University. It is the first and only program anywhere in this country based on a consumer perspective and philosophy.

Things started moving a little more quickly. In 1999 the Professional Development and Research Institute on Blindness was founded as a collaborative effort between Louisiana Tech University and the Louisiana Center for the Blind. Its purpose was to oversee the orientation and mobility program, to build new programs, and to begin to do research on blindness. That research is meant to deepen and clarify an understanding of blindness and to lead to better methods and techniques for increasing the effectiveness and efficiency of blind individuals. The National Blindness Professional Certification Board was founded to credential our graduates as they went out into the work world. The NFB created the Jernigan Institute as a world-class leader in rehabilitation and education.

All of this was still not enough to change the field. There was still lots of mockery and ridicule. But within the past ten years the National Development and Research Institute on Blindness has become one of the leaders in the field of training individuals who are blind.

By 2004 we had created a monograph on the orientation and mobility field that, for the first time, put structured discovery cane travel on a par with the conventional approach to teaching. We created a series of books called Critical Concerns in Blindness to get the truth about blindness from the consumer perspective into the literature and out into the field. The ninth book in the series has just been released and it is at this conference, a book by our very own Carol Castellano.

Within the past two years the Professional Development and Research Institute on Blindness has taken a leading role in training individuals to work in the fields of rehabilitation and research. The National Blindness Professional Certification Board continues to be strong with its orientation and mobility certification. It has also launched the National Certification in Literary Braille for credentialing of teachers who work with blind kids. Both of these credentials are becoming viewed as the gold standard across the country for teachers who work with blind kids.

Research done at the Institute on Blindness is finding its way into the professional journals--not just the Journal of Visual Impairment and Blindness, which has governed the field for so many years, but growing and expanding beyond it. Research is starting to show that mentoring is valuable, and that literacy for blind kids is attainable.

In collaboration with the Jernigan Institute we helped to create the National Reading Media Assessment, an assessment designed to help identify kids with low vision who need Braille. We're gathering hard data so we can show administrators that if these kids aren't given Braille instruction they will fall behind grade level within just a year or two.

This is the ninth conference of rehabilitation professionals, and now we're working together with parents. There are over two hundred people in this room today working and learning together. We're working to design the future direction of rehabilitation, the direction we will follow in the next generation.

While we've done professional research and conducted professional discourse, we've had no way to get it published in peer-reviewed journals. As we've done with everything else in our field, if we can't convince the professionals, we create it ourselves. The NFB Jernigan Institute, in collaboration with Louisiana Tech University and Butler University, is launching, at this convention, the first ever peer-reviewed research journal on blindness that is based on a consumer perspective. [Applause.] The Journal of Blindness Innovation and Research is now live! It is an online journal based on the perspective of consumers who know about blindness. All of you should sign up as readers. Parents and professionals should sign up to be peer reviewers. Go to <www.nfb-jbir.org> and find the journal.

The paradigm has shifted. The new state of the art in education and rehabilitation is here in this room. Look around at the professionals sitting next to you. If you want to know where rehabilitation and education are headed in the coming decades, it's all here at this convention.

A good friend of mine said at a conference a couple of weeks ago, "We've already taken over the field. The problem is they just haven't figured it out yet!" I think he's right. It's due to you professionals who are figuring out the right direction, and to you parents who want the best for your kids. It's due to all of you coming together with the attitudes and expectations that are needed to move forward.

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