Inclusion of visually-impaired children in special and regular schools: the family's perceptions


Aline Campelo PintanelI; Giovana Calcagno GomesII; Daiani Modernel XavierIII; Glaucia Dal Omo NicolaIV; Tânia Cristina Schafer VasquesV; Mara Regina Santos da SilvaVI

IPh.D. in Nursing. Professor at the Nursing School and the Graduate Program of the Federal University of Rio Grande. Rio Grande do Sul, Brasil. E-mail: acpintanel@hotmail.com
IIPh.D. in Nursing. Professor at the Nursing School of the Federal University of Rio Grande. Rio Grande do Sul, Brazil. E-mail: giovanacalcagno@furg.com.br
IIIPh.D. in Nursing. Federal University of Rio Grande. Fellow of the Higher Education Personnel Improvement Commission and the National Scientific and Technological Development Council. Rio Grande do Sul, Brazil. E-mail: daiamoder@ibest.com.br
IVMaster in Nursing. Federal University of Rio Grande. Rio Grande do Sul, Brazil. E-mail: glauianicola@hotmail.com
VPhD in Nursing. Federal University of Rio Grande. Rio Grande do Sul, Brasil.E-mail: taniacristina9@yahoo.com.br
VIPh.D. in Nursing. Professor at the School of Nursing and the Graduate of the Federal University of Rio Grande program. Rio Grande do Sul, Brasil.E-mail: marare@brturbo.com.br

DOI: http://dx.doi.org/10.12957/reuerj.2015.7617




The objective was to discover families' perceptions of the inclusion of visually-impaired children in regular and special schools. This qualitative study was conducted in the second half of 2011 with ten mothers of children attending a special school for the visually impaired. Data were collected by semi-structured interview and subjected to thematic analysis. The families recognized the special school as a source of support, an adapted facility where the children are helped to develop their skills and prepared for entry into regular school. Regular schools are perceived as unprepared to meet the children's special needs and to educate the blind. It was concluded that schools need to incorporate inclusion as a philosophy and goal, and that teacher training is fundamental to these children's education. Nurses can be enablers in this process by bridging between child, school and family.

Keywords: Education; visually impaired; child; family; nursing.




Visual impairment (VI) is defined as the partial or total loss of the ability to see, either by a deficit in an organ or the visual system1. The VI can bring numerous limiting consequences for the performance of activities in childhood such as walking difficulties, understanding and spatial orientation, limitations in communication and household tasks, such as limitation for self-care2.

It is observed that the orientation of the child with VI is hardly developed when this is not addressed properly and not worked in educational spaces 3. For the educational inclusion of children with VI, it is necessary to propose teaching methods based on student interaction by using appropriate content to different types of learning. Some acquisitions take longer to be understood, needing constant stimulation. Inclusion is a constant, gradual and iterative process that requires the participation of the student in the construction of a school environment that is favorable to him 4.

Regular education is aimed at children without noticeable limitations and special education for those who need special intervention5. It is understood that regular and special school can interfere positively on identity´s construction of children with VI. From the integration between different social groups from those of their family environment, it is possible that the children acquired greater adoption of possibilities for healthy and independent development, improving their communication and socialization6.

The inclusion of children with VI at school is guaranteed by the Federal Law 9.394, of December 20, 1996, which establishes the guidelines and the rights to education of people with disabilities7. This law ensures that children with VI have supported the rights to education and literacy 6.

Decree 3298, which regulates Law 7.853/89 is about the national policy for the social integration of these people. Its Article 25 states that special education services will be offered in specialized schools exclusively when education in regular schools cannot meet the educational or social needs of the student8. This decree recognizes the regular school as the best educational environment for this type of student, reserving special education only for those deemed incapable of integration into regular education. However, there are many obstacles for the regular school not being prepared in practice to receive this type of student, becoming a polemic issue. The insertion of a disabled child in the school environment may favor the testing of a wider range of activities, promoting their global development, improvement of skills and capabilities, overcoming difficulties and the discovery that it is an integral and active part of society9.

Special schools for the visually impaired children are establishments where all students have VI. In Rio Grande, southern municipality of Brazil, there is the Special Education School José Alvares de Azevedo, also known as the School for Blind People. In this place, different activities are developed, especially literacy by Braille method, motor and cognitive stimulation, acting classes, and physical education, self-care education and activities of daily living as well as monitoring the child with VI by educators, physical educators, psychologists, physiotherapists, social workers and doctors. They have a place in which the children with VI can live with trained professionals to special education as an important source of support and encouragement 10.

These children are included in regular schools after being literate by the Braille method. The process of inclusion of children with VI, both in especial and regular schools, is favored as there is family involvement as a supporter of the student in this new trajectory11. The integration between school and family is crucial in the inclusion process, minimizing barriers considered as obstacles in getting the children´s independence in this environment12.

The nurses can act in the process of social integration of children with VI, being an active part of the rehabilitation team, increasing educational activities that help in acquiring skills for self-care and developing a critical awareness which facilitates their social integration. They should guide the family of the children with VI to become the core of child stimulation, promoting their education.

For this, it is necessary to know their perceptions about the inclusion of blind children at school. In this context, the guiding question was: how do the family notice the inclusion of children with VI both in special and in regular schools? From this questioning, it was aiming to meet the family´s perceptions of the inclusion of visually impaired children in special and regular schools.



The family is essential for the disabled children to be at school. It is the direct contact of the child with the inclusion, as it experiences the realities and the changes needed to the independence of the child13.

For the children with disabilities have a good performance in school, changes in the education system as the qualification of teachers training are needed 14. Without professional´s training, they cannot meet the needs of children with VI, not enhancing their independence capabilities13.

It is noticed that many achievements have been made by people with VI. However, the commitment to improving education must continue. It is up to the professional direct their attention to the capabilities and the development of children´s skills, redirecting attention before focused only on disability 14. The needs arising from the visual impairment must be corrected, understanding the differences as positive challenges, and professional actions to maximize children´s potential of the children with VI6.



It is a descriptive research with a qualitative approach. The descriptive research investigates the phenomenon under investigation, enabling its understanding through the experiences15. It is qualitative because it works with a universe of meanings, reasons, aspirations, beliefs, values and attitudes16.

The research was held in the second half of 2011, in a Special Education School for the Visually Impaired, located in southern Brazil. This school has classrooms, where students have the first to fourth grade of elementary school, as well as resource rooms, sensory stimulation, computer, library, crafts, pottery and physical education, with sports such as futsal and judo, dancing and performance of activities of daily living (ADLs), such as making a bed, cooking and others.

There were ten relatives of children with VI participating that meet the inclusion criteria: take care of the blind child in the family environment and be continually together their activities in special and regular schools. The caregivers who do not provide continuous care for children with VI were excluded. Of the ten children, eight attend a special school for the visually impaired and to attend both the special and the regular schools.

Data were collected through semi-structured interviews, previously scheduled. This questionnaire had a script with questions concerning their perceptions about the inclusion of children with VI in a special school and regular school. The data were analyzed using thematic analysis15 operationalized through three stages: pre-analysis, which were identified reporting units that guided the analysis; exploitation of material, the initial data, and aggregates were classified into categories; and treatment of the results, data interpretation of correlating them with scholars of the thematic.

All provisions of Resolution 196/96 of the National Health Council for research on human beings were considered17. The project was sent to a Research Ethics Committee and approved under number 105/2011. The speeches of the family members were identified by the letter F, followed by the interview number to ensure their anonymity.



Thematic analysis of the data generated two categories that are analyzed below.

Family perceptions: inclusion of children in special school

One of the essential sources of support in the family for the care of children with VI is the existence of the Special School for the Visually Impaired. Being able to have a place where the child with VI lives with qualified professionals for special education and other children with VI, is an important support and encouragement for the development of children's potential.

One of the purposes was to come here to school because it is a place for it, teaching to live with others. Here we live with other blind children, and trained professionals teach blind children. (F1)

She was a teacher here at the school, who taught her how to walk without getting hit in things, like making clothing. [...] She began testing her, to see that she's smart, and it facilitates everything. Teachers help her to develop. (F4)

The inclusion of children with VI in special school helps the family caregiver to engage in the care of the children. It makes the family be prepared to help and learn how to lead with everyday tasks and interaction with these children.

Here she lives with other blind children and lives with trained professionals to teach. [...] Being here as a volunteer I learn a lot to take care of my son day by day. (F1)

Here, at school, I had the support I needed to take care of her. Seeing my daughter treated well by teachers, it help me. Here at the center, everyone strives because it is a place for it, prepared to teach to live with others. (F2)

The participation of children in special school activities allows the coexistence of the family with the qualified professionals to teach children. Thus, the acquisition of knowledge about the VI is a facilitator for family childcare.

The teacher helped me to learn to take care of him [...] I was trying, but with school support I learned a lot. (F10)

Here, at school, I was directed learning. It is not only good for children. We learn to stimulate the child. (F3)

They mentioned that in the special school the child interacts with other children with VI. They play calmly and slowly, and the child with VI is happy to be understood and can develop his skills gradually feeling secure and confident.

Here, in the school of blind children, they children help and lead into the school and play. She feels happy to play with who is understanding her, in her rhythm. Here she learns gradually, without rush and she feels confident. (F4)

Here, the games with the children are slower, calmer. In his time. He feels safe. (F5)

The family realizes that the special school is adapted to the education of the blind people, enabling children with VI having their special needs care and education met.

The school is prepared for the education of the blind. It is an institution for the blind children, there are handrails for easy moving, all works are in high relief, they teach how to read by the Braille method, there are adapted computer rooms. So, it's a special school, prepared for the blind people. (F10)

The special school is recognized by the family as the preparation for the children with VI for entry into the regular school. It also offers enhanced content to follow children without VI and support for the family.

Get a place for my daughter to study here was important because it is a preparation for regular school. She has left here knowing to read and write in Braille and to relate to other children. Here she has extra hours to study the subjects she learns there. This supplement will enable able her to keep up with other children. (F4)

Family perceptions: inclusion of children in regular schools

The family perceives the regular education as important for the development of their children.

The next year he leaves here. He is already literate. He will go to regular school. There special children get along. I think he is well prepared and he will not have problems. It is important the inclusion in the world of people without VI. (F3)

Attending regular school makes the children live with children without VI, being challenged to follow them, developing new skills and competencies.

In the early days, he was slow to let go and go playing. […]. Then, when the children realized that he played regular, they begun to call him. But that took a few days. Now he is used to it, she plays together, he has to do the exercises fast. [...] It's a new challenge every day. (F3)

She goes to regular school and she even likes more than the school of blind people. Because there children are excited. She tells me she likes running and swinging. And she does not want to stand still just listening to others playing. (F4)

The family fears that in the regular school the child's needs are not considered because it is not a specialized school. They believe that this transition will require the child with VI to be adapted, but it will be important for the acquisition of independence.

It's a fear of all mothers here because here, at school, everything is adapted. But one day she has to get out of here [...]. Then, it begins another problem. Did the other school will be like this one? (F7)

I do not know how she will be adapted, but I think the normal school is a test of independence. (F2)

The family fears that professionals working in regular schools unaware of how to act with the child with VI, not being ready to receive them. The family states that the regular school teachers have not received a prior preparation to raise a child with VI.

When he print his works in Braille, he will give it to the teacher. But will she know to correct Braille? Without having a previous preparation? (F9)

Some families do no believe the possibility of their children successfully attending this school, seeing inclusion as something difficult and that will bring suffering to the children because of the prejudice that may suffer by being blind. Some of them reported the experience for the children of bullying situations.

There are prejudiced colleagues. They laugh at her. Now there is a name for it [bullying]. If without such situations is no longer easy, imagine that every day. She says she does not want to go. (F6)

In regular school, she is called four-eyed, blind child. Then she cries! [...] I talked to the teachers, but they never do anything. They do not know how to handle the situation. (F8)

Although they believe the interaction of the children with VI with children without VI is beneficial, they apparently realize that they have no patience with the slow pace of the child with VI.

Lack of patience of the other children who see because they have to play in their time and that they do not always accept. They have to wait for him to understand the game and be prepared. (F5)

Family members feel limited in their choice of regular school, in which their children will go because they believe that many schools are reluctant to have children with VI.

The only school that I know having Braille is the [...]. But it ends up limiting. And if I do not want to send her there? What if I want a private school. I know that schools have a resistance in receiving them. (F3)



Although the children with VI have the right to education and literacy, with legal support, it depends on the family to exercise it. It is indicated a rehabilitation centers for the child with VI and training for visually impaired and for regular school2. They are supported for the family in the development of this child.

Parents of children with VI may have doubts and difficulties in their educational stimulation, needing effective guidelines. The special school is presented as a place where the child interacts with other children with VI, teachers and family members, in which the family finds support and guidance 11.

It is a suitable place in which the child with VI lives with qualified professionals to be assisted in developing their skills10. The special education stands out and is recognized as an important way of education to support of the regular school system18.

This type of education used a dialogic process, facilitated by customized features, updated content and specific information, with playful and communicative character. The child and family live with specific professionals who understand about the best ways of communicating with these children 19. The educator in special school has the task of assisting in the learning process of children with VI, considering their own pace. The use of differentiated teaching strategies can be thought as a resource that enables students' access to knowledge and is described as a facilitator to effect quality with the process of school inclusion of children with disabilities in regular schools20.

As for regular school, the proposed educational inclusion of disabled students in this school system provides answers to the specific needs and special education in the school routine. To this end, it is essential that these needs are properly identified and met21.

It is believed that the coexistence of blind children with children without VI can contribute to their adaptation in school, feeling similar ability and potential. During the interaction with these children, the children with VI can build their idea of relationships, being challenged and tested for their ability to adapt and tolerance.

A study found the importance of pretending for the visually impaired child development. The authors observed that blind children developed different actions that developed in daily life. Various skills, not previously disclosed, emerged during the interactions with other children, enabling them to become safer22,23.

The family, by placing the child with VI in a regular school, is concerned that the school and the teachers are not prepared for their education. In a study of the point of view of mothers for school inclusion of children and adolescents with special educational needs, it was observed that only 17% of them identified the regular school as a welcoming place and suitable for the special needs of children. While 60% reported that school had no preparation because of the lack of qualified professionals, an appropriate structure, and resources that facilitate children's learning13.

By including children in the school, the family fears to suffer because of the difficulties they will face because of VI. Mother of children with VI reported that their children are victims of prejudice and exclusion in regular school, compromising their learning13. Realizing that they are being discriminated, students may have feelings of rejection and humiliation, which hinder their psychosocial development24. Thus, there is the need for the school to become a context of overcoming stigmas, prejudices and attitudinal barriers and teaching for inclusion19.

Another difficulty pointed out was the impatience of teachers and students with the slower pace of the child with VI. A study found that the child´s development with VI follows the same sequence of children without VI, only with a change of pace, leading to a slower learning. Such a condition requires patience and attention, at all levels of learning24.

The family realizes that the regular school teachers do not have preparation to teach children with disabilities. Research on school inclusion of students with VI showed that the greatest difficulty inclusion is the lack of availability of teachers to detect the school needs and adapt to them, looking for resources and other strategies to teach them. Teachers reported difficulty teaching the student with VI, failing to transmit the knowledge necessary to the other students. This posture can cause the feelings of frustration and failure for the children with VI6.

It is noticed that many achievements have been made by people with VI. However, the commitments to improving education must continue. It is up to the professional the direction of attention to the capabilities and the development of children´s skills, redirecting attention before focused only on disability14.



The study data show that the family needs to be prepared to assist the child with VI in the process of education, being instructed on correct ways to circumvent the limitations caused by the VI. The nursing professionals need to look carefully for the family of children with VI, seeking to assure their information, enabling the care of children for their independence. It is necessary to help the family in choosing care of effective strategies to develop their potential, being stimulated at home or at school.

Nurses should play the role of facilitator in the educational process of children with VI, carrying out consultations, discussions, workshops, study groups with teachers on issues involving health and limiting condition of this children. The nurse also must perform individual assistance to children with VI, enabling the exhibition of their difficulties faced during their inclusion in the school, as a bridge between the child with VI, the school and the family in the search for solutions.

Despite the existing legislation, it is concluded how important the help of the special school to prepare children with VI to be inserted in regular school, more instrumented, being a source of support and reinforcement to children with VI and family. Further studies should be undertaken to identify effective strategies for facilitating the inclusion of these children in school.



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