Abstract
High-quality education for students with visual impairments starts with service intensity determination based on the needs of students by teachers of students with visual impairments (Lewis & Allman, 2017; Spungin et al., 2016). Even though the Individuals with Disabilities Education Improvement Act (IDEA) emphasizes addressing students’ needs for service delivery (United States Department of Education, 2004), some teachers of students with visual impairments continue taking other factors such as caseload size into account for service intensity determination (Pogrund et al., 2019). Similarly, The Michigan Vision Services Severity Rating Scale (Michigan Department of Education, 2017) does not focus on the individual needs of the students to recommend service time. For example, it considers teachers’ availability such as travel time while determining service intensity. It also uses students’ visual condition as a criterion, which may not always accurately reflect the needs of the students for service delivery time.
High-quality education for students with visual impairments starts with service intensity determination based on the needs of students by teachers of students with visual impairments (Lewis & Allman, 2017; Spungin et al., 2016). Even though the Individuals with Disabilities Education Improvement Act (IDEA) emphasizes addressing students’ needs for service delivery (US Department of Education, 2004), some teachers of students with visual impairments continue taking other factors such as caseload size into account for service intensity determination (Pogrund et al., 2019). Similarly, The Michigan Vision Services Severity Rating Scale (Michigan Department of Education, 2017) does not focus on the individual needs of students to recommend service time. For example, it considers teachers’ availability such as travel time while determining service intensity. It also uses students’ visual impairment condition as a criterion, which may not always accurately reflect the needs of students for service delivery time.
The Visual Impairment Scale of Service Intensity of Texas (VISSIT, 2014) was created to provide guidance to teachers of students with visual impairments (i.e., those who are blind or have low vision) on how to determine appropriate service type and amount of time to address the needs of students. The VISSIT follows the categories of the expanded core curriculum (ECC) (Sapp & Hatlen, 2010). It focuses on students’ needs for direct instruction and collaborative consultation in the nine areas of the ECC to determine appropriate service type and amount of time. In the initial validation study (Pogrund et al., 2015), validation and reliability of the VISSIT were examined, and the instrument was found to be a moderately valid and reliable. A large-scale national validation study on the VISSIT (Pogrund et al., 2019) showed high validity and reliability and supported social, consequential, content, and construct validity.
Since the VISSIT is a recently developed and validated tool, there has been no study exploring effects of the VISSIT in practice. Therefore, there was a need for further research to deeply understand practical implications of using the VISSIT. The purpose of this study was to examine the educational impact of the use of the VISSIT on students with visual impairments by proposing the following research questions: 1. Is there any change in the type and amount of service provided after the use of the VISSIT? 2. Is there any change in the goals and objectives in the ECC areas in a student’s Individualized Education Program (IEP) after the use of the VISSIT? 3. How does the use of the VISSIT by teachers of students with visual impairments affect the education of students with visual impairments?
Methodology
A multiple-case study research design was utilized in the present study (Yin, 2014). Each teacher of students with visual impairment and her student was considered as a single case, then compared to determine similarities and differences across cases. Once approval from the Institutional Review Board of the Southwestern University was obtained, recruitment of the participants began by using a purposive sampling technique (Creswell & Creswell, 2018). The selection criterion was being a teacher of students with visual impairments who had not used the VISSIT before and who had a student with an upcoming IEP meeting. As a result, two teachers of students with visual impairments and one student of each teacher who met the participation criterion participated and provided informed consent and assent forms. Teacher A had worked in the field of visual impairment for 18 years. She had 12 students and served in rural areas of a Southwestern state in the United States. Her student was 8 years old and in 2nd grade in a general education classroom. He was diagnosed with retinoblastoma, and his left eye was removed. Visual acuity in his right eye was 20/150 for distance and 20/30 for near. He also had auditory impairment. Before entering the study, he received 50 minutes of direct vision service four times a week. His vision–related current IEP goals focused on two ECC areas: compensatory skills and assistive technology. Teacher B was in her first year of teaching. She served five students in rural areas of a Southwestern state. Her student was a five-year-old kindergartener in a life skills class. He was born with schizencephaly. He was functionally blind and had significant low vision. In addition, he had been diagnosed with an intellectual disability, orthopedic impairment, health impairment, and speech impairment. Before entering the study, he received 30 minutes of direct vision service twice a month. His vision–related IEP goals focused on compensatory skills and sensory efficiency areas of the ECC.
Data sources included interviews, observations, and document reviews. First, the teachers of students with visual impairments were asked to fill out a current student information sheet for their student asking about the student’s age, degree of visual impairment, additional disabilities, service setting, learning medium, previous service type and amount of time, and IEP goals. Second, the teachers conducted a functional vision evaluation (FVE), learning media assessment (LMA), and evaluation in all ECC areas for the students. The teachers were allowed to utilize their preferred evaluation and assessment tools. Then, they used the VISSIT to determine recommended service type and amount of service time for the students. Third, the completed VISSIT forms along with evaluation documents were collected. Later, the researchers interviewed the teachers about effectiveness of the VISSIT. Last, the researchers attended the students’ IEP meetings and observed conversations about the students’ IEP goals and service type and amount of time.
By within-case analysis, the researchers became familiarized with data and worked on detailed descriptions of individual cases. Specifically, constant comparison analysis technique was utilized. Glaser and Strauss (1967) defined constant comparison as “chunking” data into meaningful smaller portions, labeling them as codes, and then grouping those codes as themes. Cross-case analysis was used to determine similarities and differences between cases and draw conclusions (Yin, 2014).
Results
Results for each teacher and her students are first discussed as separate cases. Then, common themes and differences between cases are reported.
Results for Case A
Teacher A completed the VISSIT for the student and came up with a score of 60 for direct service, which fell within 180–270 mins per week suggested time range. This result supported her continuing recommendation of 50 minutes of direct vision services four times a week. For the consultation, the total score was 56, which fell within the 30–70 minutes range per week. At the IEP meeting, she proposed providing 30 minutes of consultation services a week to the student’s educational team. Regarding the first research question, the student’s direct service hours did not change after using the VISSIT, since the recommended service time range was similar to what the student used to receive. During the interview, teacher A pointed to this similarity as an indicator of reliability of the tool. More importantly, after use of VISSIT, the teacher proposed, and the IEP committee approved, adding consultation hours for the student. The teacher reported, “I used to do consultation informally, but now I am putting those hours on the paper after using the VISSIT.” Regarding IEP goals and objectives for the student, teacher A did not propose any changes to the IEP committee, since her scores on compensatory skills and assistive technology areas on the VISSIT showed the same priorities as her previous IEP goals.
In response to the third research question, service times and types for the student in this case became more precise and based on data. The responses to the interview questions of Teacher A supported that the VISSIT is an effective tool for teachers of students with visual impairments to determine appropriate service type and amount of service time. For instance, she said that she was planning to use this tool with her other students in the future. According to her, when she started working in her district last year, she realized that some of the students were receiving more service hours than they should be. She added, “I know that if I want to change that, parents would probably disagree. But, if I use this tool, I would justify my decision and tell them it is based on this tool, not my own decision. . . . I like having flexibility in the time range”.
Results for Case B
Teacher B utilized the VISSIT for the student and came up with a total score of 25 for direct service, which fell within 30–60 minutes per week as the suggested amount of service time. Previously, the amount of direct service provided was 30 minutes twice a month. Thus, she proposed to increase direct service time to 30 minutes 5 times per 6-week grading period. The student’s IEP committee approved her proposed changes to direct service time. Regarding consultation hours, the total score on the VISSIT was 20, which fell within the range of 5–10 minutes a week. Before this IEP meeting, the student did not receive any consultation services. Therefore, she proposed to add 15 minutes twice per 6-week grading period. Consequently, the student’s IEP committee approved this addition. Overall, using the VISSIT helped this student receive more direct service and start receiving consultation services. Regarding changes in IEP goals and objectives, the vision–related IEP goal remained the same, which was obvious on the completed VISSIT form, which had higher scores on compensatory and sensory efficiency skills areas.
Regarding the third research question, the student in this case started receiving educational services that are more aligned with his assessed needs due to use of the VISSIT. Teacher B’s responses to the interview questions supported this argument. For instance, she stated, “As a new TSVI [teacher of students with visual impairments], I think it is a great way to give you the outline to follow. It is a great tool because otherwise my decision would be subjective. It is a great way to be more objective about your decision with service time and be able to have research-based evidence that you can show parents and IEP committee to back up your decision”.
Cross-Case Analysis
There are some similarities seen between case A and B. First, both teachers found the VISSIT to be an effective tool to determine service type and amount of service time for students with visual impairments. In addition, they both stated that they were planning to use this tool in the future to be more objective in their recommendations. Second, in both cases, the teachers followed the suggestions that the VISSIT gave them and added collaborative consultation hours for their students. In case B, the teacher also increased direct service time for the student, while it remained the same in case A. Lastly, both teachers kept IEP goals and objectives the same for their students. This finding showed that scores on the VISSIT forms were parallel to the current IEP goals.
Discussion
The findings of this study showed that using the VISSIT can result in changes in the education of students with visual impairments. Specifically, the amount of time recommended for provision of services became more aligned with what the teacher was already providing, with the addition of collaborative consultation hours and increases in direct service time. It was also observed that scores on the relevant ECC areas on the VISSIT forms were aligned with the current IEP goals. Therefore, the VISSIT can help teachers of students with visual impairments determine appropriate service type and amount of time for their students. Teachers’ perceptions about the usefulness of the VISSIT supported this argument. For instance, both teachers found this tool effective and were willing to use it in the future for their students. They also reported it was better to use this tool when determining service type and amount of service time because it is more objective and based in research. These findings showed close similarities with the results of initial and national validation studies on the VISSIT (Pogrund et al., 2015; 2019). For instance, in both studies, the vast majority of the participants were willing to use the VISSIT again for service intensity determination purpose in the future, 96% and 93%, respectively. Similarly, most of the participants in these studies found the VISSIT better than any other tools available, 78% and 86%, respectively.
Limitations and Implications for Future Research
This study had some limitations. Although it provided a rich description of the context of the study for possible transferability, the results are not generalizable to the larger population of students with visual impairments due to a small sample size and a lack of randomization of participants. Therefore, further research with a larger number of participants is needed. Second, since this study solely focused on teachers who used the VISSIT for the first time with their students, it would be good to conduct a research study that seeks the experiences of teachers who have been using the VISSIT for their students over time to better understand the educational effects of the VISSIT.
Another limitation of the study is that the teachers of students with visual impairments who were involved knew the purpose of the study and were likely familiar with the authors of the VISSIT. Thus, they may have been more inclined to provide supportive findings. Lastly, since the VISSIT is a self-completion tool, and its accuracy depends on proficiency of its users, the results of the VISSIT may be biased in practice. The recommendations of the VISSIT may not always be implemented because of teachers’ caseload sizes and a lack of visual impairment professionals that can be hired to provide necessary services, but it does provide a less subjective and more data-based way to determine the type and amount of service time recommended for students with visual impairments.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.