[PHOTO/CAPTION: Dr

[PHOTO/CAPTION: Dr

The Braille Monitor

October,

2003

(back)(next)(contents)

The Truth about Choice

by

Fredric K. Schroeder, Ph.D.

Dr.

Fredric Schroeder

From the Editor: Last

spring, long before Resolution 2003-101 on rehabilitation choice caused great

discussion at our convention, I asked former commissioner of the Rehabilitation

Services Administration, Dr. Fred Schroeder, to write an article for the Braille

Monitor discussing his understanding of what the concept of informed choice

as laid out in the Rehabilitation Act means. After all, when the choice language

was written into the act, Dr. Schroeder was RSA commissioner. Who better was

there to articulate what was meant and what was not. This is the article he

wrote:

Perhaps no more misunderstood

provision of the Rehabilitation Act exists than the requirement that individuals

receiving rehabilitation have the opportunity to exercise "informed choice"

in all stages of the rehabilitation process. While many issues have arisen surrounding

the real meaning of the language that makes choice a fundamental value of the

rehabilitation process, the most hotly debated question in the blindness field

today is the proper application of informed choice in the selection of and participation

in orientation-and-adjustment-center training.

The

definition of effective orientation and adjustment training for blind people

has been a topic on which people in the blindness field firmly disagreed long

before the informed-choice provisions were enacted into federal law. In the

mid 1980's the National Federation of the Blind began establishing orientation

and adjustment centers modeled on the program Dr. Jernigan had created in Iowa

years earlier.

The

Federationists who established these programs did so because they believed the

existing orientation and adjustment programs in the country did not offer training

that challenges blind people to come to terms with their blindness, nor did

the training encourage blind people to develop fully the skills necessary to

live and work productively. In short, these Federationists assessed the existing

training commonly available and came to the conclusion that it was rooted in

low expectations mirroring society's stereotypic view of blindness--producing

training that moved people from dependency to lesser dependency with no real

goal, no real belief in the attainability of a normal, productive life. In other

words, existing training pretended the training model based on lowered expectation

was a virtue called respect for the individual. Federationists came to reject

both the model and the training based on it, and founding centers of their own

was the logical next step.

The

essence of the NFB model is its assumption that blind people are capable of

full participation in society. Of course all programs maintain that their training

is based on the same assumption, but those who have attended training at one

of the NFB centers know that, while all programs say they believe in blind people,

at NFB centers that claim is supported by actions.

So

what are these actions that make such a difference? First, in NFB centers skills

training is not viewed as separate or apart from confidence building. Blind

people are helped to believe in themselves and acquire the necessary skills

to put their newfound confidence into practice. The fundamental connection between

skills training and confidence training is explained and emphasized, both in

words and in the students' progress through the center, during which they are

taught and drilled on all basic blindness skills while simultaneously being

taught the confidence to problem-solve throughout life. This combination of

skills and confidence, of first learning and then practicing to routine mastery

gives students a firm foundation on which to stand throughout all life's challenges.

Participants

in NFB centers are referred to as students, not clients. The distinction between

student and client is followed systematically throughout Federation training

center practice. Being a student is an active task. Students take responsibility

for their own learning and progress. Being a client on the other hand means

that the person waits more or less passively for something to be done to him

or her. Next, students take the full range of courses which, taken together,

are designed by training center staff to complete both skills and confidence

training to routine mastery. On the other hand, clients at more conventional

centers, new to blindness or to grappling effectively with it, are nonetheless

encouraged, in a mockery of the real meaning of choice, to pick and choose from

available classes--even, or especially, those of which the client is most afraid,

leading to the absurd result that the client who understandably knows little

about blindness is made to feel empowered, while he or she is declining to learn

the fundamentals needed for true empowerment.

Moreover,

students are viewed as blind people regardless of whether they have some remaining

vision, in contrast to the client model which allows clients to reject this

training method without really even knowing what they are rejecting. Accordingly,

students with some sight wear sleepshades all day--five days a week--in all

classes and during after-hour activities. Why? First, because sustained use

of the blindfold allows students to achieve routine mastery of the essential

nonvisual skills that they will need to function safely and effectively after

training. Second and equally important, because it is the most effective way

to help students reshape their beliefs about blindness.

Third

and as important as the other two is the profound belief at NFB centers that

students must learn to see themselves as part of the community of blind people--part

of the struggle of blind people to achieve true equality and full integration

into society. NFB centers teach their students that students must not simply

take but give back as well, that they have an obligation to pass on what they

have been given and to be a part of the movement of blind people toward true

integration. They become a part of the National Federation of the Blind--the

family of blind people, giving and receiving support, giving and receiving encouragement,

giving and receiving hope for the future.

There

are other differences between NFB centers and the more conventionally designed

ones--use of rigid canes that are longer than customary in conventional programs,

for example; but the fundamental difference is one of expectations--believing

in blind people and helping them to believe in themselves.

So

where does informed choice come in? It may seem obvious that blind people can

choose to attend an NFB center or they can attend more conventional programs.

After all, the concept of informed choice is based on the assumption that an

individual has options from which to choose. Nevertheless, some agencies and

individuals subscribe to a misguided, even corrupted concept of informed choice

which they have then used like a club to try to force NFB centers to operate

like conventional centers. These misguided proponents of choice argue that the

law forces NFB centers to be just like other centers in allowing participants

to choose for themselves which classes to take, whether to wear sleepshades,

and which type or length of cane to use. These misguided proponents claim to

be upholders of the law and seek to enforce their opinion upon NFB centers despite

the fact that such practices are incompatible with the underlying NFB-center

philosophy and despite the fact that, rather than showing respect for the individual,

such practices are widely recognized by blind people to be ineffective and,

all too often, harmful.

Perhaps

the most absurd application of this misguided version of informed choice came

to my attention when I was commissioner of the Rehabilitation Services Administration.

An NFB center was routinely accepting students from a state rehabilitation agency

under a contract with that agency that allowed agency clients to choose the

NFB center and thereby save the rehabilitation agency the trouble of doing the

same paperwork over again for every new student attending that center. The rehabilitation

agency told the center that, as a requirement for continuing its contract with

the NFB center, the center was not to assign students canes.

Instead,

according to this misguided version of choice, the NFB center was simply to

show new students a selection of all available canes and allow the student to

select a cane of any type and length without comment from the instructor--as

though professional judgment and expertise had somehow been repealed in the

name of choice. In other words, the rehabilitation agency was so drenched in

the choice language that it was willing to break a contract with a training

center offering a genuine alternative to its clients because of what it perceived

as a lack of choice when in fact the fundamental choice was between approaches

to training and not between specific canes to be used by a newly blind person.

Once,

while I was attending a blindness-related meeting in Washington with Dr. Maurer,

another misguided proponent of informed choice floated the idea that people

attending NFB centers should not be required to participate in NFB activities.

This person maintained that orientation and adjustment training should be neutral

and went on to make it plain that, in his view, neutral meant neutral in the

sense of not promoting any particular philosophy, by which he obviously meant

the NFB's approach to blindness. Dr. Maurer quite reasonably asked the person

why someone who disagreed with NFB philosophy would want to attend an NFB center.

The person replied that it was well known that the NFB centers offer the best

training in the country. Dr. Maurer pointed out that participation in NFB activities

is a key part of the training, not an add-on or extraneous activity.

The

suggestion that our centers be philosophy-neutral would be like demanding, in

the name of choice, that parochial schools not insist on providing religious

instruction because it might be offensive to some students. If NFB centers are

forced to give up the characteristics that distinguish them from other programs,

blind people will again be limited to one homogeneous model of rehabilitation

training, the training Federation centers seek to replace, forbidding the very

training the misguided proponent himself admitted was the most effective.

During

my term as commissioner I made it clear when I issued policies and provided

technical guidance to rehabilitation agencies that informed choice must be practiced

at the program level or, in other words, at the time an overall program is chosen.

For informed choice to be real and effective, blind people must really have

the right to learn about available options and differences among programs and

then to exercise their right of informed choice in selecting a training program.

However, it is not reasonable to ask and is most certainly not required by law

to force a program to change its fundamental nature in the name of informed

choice.

Consider

this analogy: a person wishing to pursue a professional career may find that

it is necessary to obtain a college degree. The individual may, after reviewing

the curriculum, make a choice among the various options and attend a particular

college or university, exercising the right to choose among such differences

as more or fewer required classes; more or fewer requirements outside the major

field; presence or absence of foreign language, math, or science requirements;

and presence or absence of strict rules about alcohol on campus. But, once the

choice of college is made, the student cannot then insist on being exempted

from an otherwise required class simply because he or she does not believe that

it will have relevance in his or her professional life.

Similarly,

a student cannot simply decide that he or she would prefer a different textbook

from the one the instructor has selected or simply decide not to attend class

without suffering consequences from such decisions. Once the choice has been

made to attend a particular college or university, the student is bound by the

requirements of that institution and the decisions of its faculty. The student's

choice is to attend or not to attend. By simply making that choice, the student

is not then endowed with the power to dictate that the program change its curriculum,

teaching methods, or for that matter its philosophy at the whim of that one

student.

Similarly

training programs providing orientation and adjustment for blind people also

have differences. Some orientation and adjustment centers permit their participants

to choose which classes they will take and whether they will wear sleepshades

for all classes, some classes, or not at all. Some programs allow participants

to choose how long they will attend. But other programs--those at NFB training

centers and those modeled on our centers--believe in a much more structured

approach to training. Individuals have the right to exercise informed choice

in deciding which type of program they wish to attend, but they do not by reason

of having chosen a particular program then have the right to demand that the

program alter its structure or programming for them.

That

is the law. That is the technical answer--blind people can choose to attend

an NFB center, or they can choose to go somewhere else.

Yet

in a real sense the legal or technical content of informed choice sidesteps

the most important question. To say simply that people can make a choice leaves

the impression that both options are equally good, that they are equal in quality,

that both are effective in assisting blind people to gain the confidence and

skills to live normal, productive lives. Treating informed choice as a neutral

concept suggests that the choice is one of style, not quality--like choosing

between chocolate and vanilla ice cream or choosing whether to vacation in Boston

or Yellowstone--a choice based on preference and individual interests. The truth

is that the differences are not gratuitous or unimportant, not simply a matter

of style, not the casual choice between ordering a steak and a piece of fish

for dinner.

When

a blind person seeks training from a rehabilitation program, that training is

likely to be the person's single formal opportunity to acquire the skills he

or she will need to live productively. If the blind person receives training

rooted in the stereotypic belief that blind people are inevitably limited to

lives of marginal participation, he or she is likely to internalize such beliefs.

On the other hand, if the training is rooted in the belief that blind people

can learn to take charge of their own lives and can master the skills to work

competitively, then blind students are much more likely to develop confidence

and pursue personal goals and interests. To hold high aspirations, blind people

must believe that they have at least a reasonable chance of attaining those

aspirations. To have hope, blind people must believe that they have the possibility

of living a normal life.

The

misguided idea that blindness should be viewed as nothing more than a sort of

clinical challenge--a condition requiring skills taught by professionals who

will always know more than the blind person can ever learn, skills which can

help the blind person function a little better but which can never allow him

or her to compete on terms of equality with the sighted, and with no expectation

of true normalcy, true equality, or true fulfillment, dignity, and self-respect.

The prevalence of such a view is a sorry commentary on the failure of the blindness

field to understand the social dimension of blindness and its impact on blind

people and society as a whole.

We

have been told in the form of a criticism that NFB training centers are a one-size-fits-all

approach to training. In one sense, this is true, but not in the way that the

general public assumes that all blind people are the same, regardless of age,

education, health, or ability. NFB center staffs recognize that, to be successful,

all blind people must come to understand that they are blind, that blindness

means they will face discrimination, that blind people themselves are often

one source of that discrimination in the form of lowered personal expectations,

that to combat discrimination from within or without they need a broader perspective

on blindness coupled with confidence and skills, and that the best way to gain

perspective, confidence, and skills is through a concentrated training program

and ongoing involvement in the National Federation of the Blind.

What

is the alternative to this so-called one-size-fits-all model? It is what we

have always had--the conventional training system based on low expectations.

When people become blind, they do not know what they need, what is possible,

or even what training will best serve them. So to use choice as an excuse for

justifying low expectations is unconscionable.

Not

every blind person who has attended an NFB center is a success; not every blind

person who has received conventional training or, for that matter, received

no training at all is a failure. Yet NFB training is not more or less the same

as other training. Yes, the same skills are taught: cane travel, Braille reading

and writing, cooking, and computer technology. But it is not true that the outcomes

are the same. NFB orientation and adjustment centers do in a concentrated way

what the Federation has done for blind people for all of its sixty-three-year

history: give blind people the means to challenge society's and, all too often,

their own, low expectations. As with the Federation as a whole, NFB training

centers help the blind person learn that life is not limited by the physical

characteristic of blindness as much as it is by low expectations. Training gives

the blind person the confidence to believe in a future in which he or she will

face discrimination yet will have the skills and the strength to meet and overcome

it.

NFB

centers do not teach skills in isolation from philosophy. In fact the life-changing

dimension and extraordinary vitality of NFB centers arise from their imparting

of the philosophy of the National Federation of the Blind. Therefore to encourage

blind people to believe that any training center is pretty much like any other

goes far beyond a factual mischaracterization and is fundamentally misleading

to people who have not been truly informed about the differences.

How

then does an individual exercise informed choice in selecting a training center?

To be truly informed, the blind person must meet graduates of training programs--not

just one or two, but many. The blind person needs to learn what these graduates

are doing with their lives. Are they in school? Are they working? Are they married

and raising families? Are they active in their communities? Are they pursuing

hobbies and social interests? Are they going to the theater, the ball game,

restaurants, shopping, and movies? Or are the graduates mostly spending time

at home, explaining that they really prefer quiet, are not people persons, haven't

quite decided what to do with their lives, and are often considering maybe getting

a little more training in some aspect of blindness skills that they didn't quite

master or keep up with after their training--good as they assure everyone it

certainly was.

So

where can a blind person go to meet normal blind people, the ones getting out

and doing things and getting jobs and moving ahead with their lives? The easiest

way is to attend the convention of the National Federation of the Blind. At

our national convention one has an opportunity to meet blind people from throughout

the country. Some will have received training from NFB centers; some will have

received training from conventional programs; and some will have received no

training at all. What blind people with all three backgrounds at an NFB convention

have in common is the commitment to the Federation's approach, to the combining

of skills and confidence, whether they received this knowledge through an NFB

training center or more broadly through contact with the National Federation

of the Blind.

The

collective experience of blind people distilled and focused by the Federation

enables the blind individual to begin to gain a perspective broader than his

or her own experience and begin to see what is possible for blind people, given

training and opportunity. One cannot attend a national NFB convention and fail

to be impressed by all that we have achieved. One also cannot attend a national

convention and fail to be moved by all that remains to be done. At national

convention one meets young blind children and their parents and learns of their

hopes. One meets blind college students preparing to assume future leadership,

blind adults working in every conceivable job or occupation, and blind seniors

determined not to sit quietly in the shadow of nonparticipation.

True

choice can be exercised only when a person has real information--perspective

on which to base his or her choices. Selecting orientation-center training is

the foundation on which one can base either future achievement and success or

a future of genteel occupancy of the quiet sidelines of life. Choice is not

the simple selection of a long or short cane--rigid or folding; not the choice

of one class and not another; not the choice of training nearby rather than

in a distant city. These things are only the trappings of choice, not its substance.

How

then does one begin the process of making an informed choice? Those who are

serious about embracing informed choice might begin by calling their NFB state

presidents to learn when and where the local Federation chapter meets. If none

exists in the area, they can ask for help in starting one. Going to Federation

state and national conventions to meet people and become involved is also an

excellent early step. Such actions commit one to the movement of blind people

working toward first-class citizenship. Contributing time, money, and talent

to help build a future in which blind people are judged by their ability and

not by their blindness can be a powerful step in learning to believe in blind

people.

Having established this

foundation, any blind person can eventually decide that the time has come to

call the director of one of the NFB centers and ask for help in working with

the state rehabilitation agency to support individual participation in training.

Everyone has the right to exercise the right of choice, but the most important

right is to exercise the opportunity to make an informed choice based on information

and perspective--a choice that will serve the individual for a lifetime and

provide the training and confidence to live life exercising personal interests

and ability rather than living a life of limited participation based on low

expectations.

(back)(next)(contents)