Friday, 15 November 2013

Overview of Daily Living Skills for Children with Visual Impairment

Daily Living Activities & Demonstration Lesson

Mr. Rajnish Kumar Arya

We have come across the limitations of blindness or the losses due to blindness. One of the major limitations due to blindness is the limitations is the basic skills in which the activities of daily living become a major part.  Daily Living Activities is one of the important pre – requisite for successful rehabilitation of the Persons with Visual Impairment.  Owing to absence of sight, the persons are deprived of gaining information through eyes. Medical experts and specials educationists agree that about 85 per cent of the information are received through our eyes and remaining 15 per cent of the information are form other senses.
Activities of Daily Living (ADL) comprise everything entailed in human life and relationships. These are the basic activities necessary during an ordinary day. There are hundreds of activities which a person performs from the moment he wakes up in the morning till he goes to sleep at night.

Note: Daily Living Activities and Daily Living Skills are having the same meaning. Here after Daily Living Activities will be used as Daily Living Skills. Daily Living Skills usually termed as DLS.  In this paper DLS will stand for Daily Living Skills.
Relevance of the DLS for Persons with Visual Impairment
As it is well known that the sighted persons normally learn to perform these activities by themselves by observing other persons. A large part of daily living activities are learnt by observation and imitation.  Only when a person does something in wrong way the elders or others correct them. Mostly these skills are acquired from childhood onwards.
However the environmental deprivation and lack of opportunities also block the development of these daily living activities in the persons with visual impairment. As visual discrimination is involved in these activities, a visually impaired person cannot learn the same on his own. Through his other senses, he / she may get an idea of what is going on but he / she cannot learn the exact procedure.
Hence these skills are very important for a person with visual impairment if not one has to depend upon others for each and everything.
Definition of DLS
The activities a person does daily from the moment he / she wakes up in the morning and till he/she goes to bed are considered as DLS or DAILY LIVING SKILLS. Activities of daily living include all those that people do every day like getting dressed, bathing, using the toilet, washing clothes, shopping, cooking, eating etc.
In other words: The basic activities that a person employs daily to maintain and keep himself / herself on par with the other and certain activities that are must for a person to live and does on a day to day basis are called “DAILY LIVING SKILLS / ACTIVITIES OF DAILY LIVING or quite recently they are known as SURVIVAL SKILLS.”
Objectives of Teaching DLS
Ø  To carry out day to day activities on his/her or with minimal assistance and safety;
Ø  To be independent or to be self sufficient in all functional activities;
Ø  To develop self – confidence;
Ø  To be socially integrated;
Ø  To develop healthy personal and family relationships;
Ø  To learn scientific management of self and home;
Ø  To become aware of safety precautions to be taken inside / outside of the home;
Ø  To become a well groomed person;
Ø  To reduce dependence upon the care-takers as well as family members;
Ø  To expedite comprehensive rehabilitation including economic independence; and
Ø  To develop a positive self image.
Pre – Requisites for Training of DLS
Most of the DLS are of routine nature. One does not need to learn any special techniques for performing these skills. Lack of stimulus leading to absence of imitative learning makes one to realize that each and every skill has to be taught to the persons with visual impairment in a formal way after careful planning. It is essential to train one for the particular procedures involved in performing the activity.  The following should be considered before teaching the DLS.
Ø  Adaptation
Ø  Assistive Devices
Ø  Identifying the difficulties faced by the individual
Ø  As per need, age, occupation and other personal issues.
 Procedure for Designing the DLS
 There is the following procedure which should be followed while designing the DLS:
1.    Observe daily living skills of sighted persons of different age groups.
2.    Identify the difficulties faced by individual with visual impairment in performing such activities and learning the skills.
3.    Develop specific procedures for each skill with suitable modification.
4.    Must have the following things in the mind while evolving the training schedule:
i)        individual felt needs
ii)      physical potentials
iii)     age
iv)     age at the on-set of visual impairment
v)      family background, economic status and occupation
vi)     environment and
vii) Past experience
5.    Explain the procedure orally followed by sighted persons in performing a particular activity to person with visual impairment.
6.    Provide appropriate devices and adaptations
7.    Impart essential training in orientation and mobility associated with the effective performing of a particular activity.
8.    Must develop a system of monitoring and evaluation of the training programme.
9.    Follow up for sustaining the abilities to perform the activities.
Specific Rules for Teaching the DLS
1.     Gather the relevant and needed following things before initiating the training:
a.      All materials needed;
b.      Essential equipment;
c.      Special assistive devices and adaptations; and
d.      Embossed diagrams and tactile adaptations

2.        Perform task analysis for:
a.        Evolving the proper sequence;
b.        Deciding the procedure of performing the activity and
c.        Finalizing the lay-out and positioning of the material and equipment.

3.       Orient the person regarding
a.    Location of the materials;
b.    Procedure of taking and replacing the same;
c.    Hand co-ordinations;
d.    Sequence of various operations;
e.    Safety measures; and
f.     Use of equipment and adaptations.

4.      Ensure
a.    Appropriate use;
b.    Safety of the individual;
c.    No damage to equipment; and
d.    Least possible wastage.

5.      Supervise during the performance of the procedure and provide instruction whenever essential.

6.      Follow-up, evaluate and appreciate good performance.

Precaution during Teaching Daily Living Skills

  • Select age appropriate activities. Observe the sighted person of the same age and then list out the activities for person with visual impairment.
  •  Work closely with the family of person with visual impairment. So that they must take a regular follow up of the activities which she/he has practiced.
  • Remember person with visual impairment will master these activities by practice and not by lectures.
  • Don’t try to teach more than one skill at a time.
  •  Must divide a skill into a number of sub skill; it will be helpful in teaching and learning.
  •  After the activity is completed; be sure that one who is your pupil cleans itself.
  •  Equipments if used during the teaching must be cleaned and return for the correct storage space so they can be easily located as well as used later.

List of Daily Living Skills
It is very difficult to list out all the DLS. Here is some given under some broad category for understanding:

Self-help skills
  • Eating
  • Getting Fresh (Using Toilet/ Brushing Teeth)
  • Taking Bath
  • Combing and Washing Hair
  • Cutting Nails
  • Shaving
  • Personal Hygiene and Grooming
  • Dressing and Undressing
  • Identification of Clothes
  • Choice and Care of Clothing
  • Applying Make-Up

Home skills
  • Home Management
  •  Using Electrical and Electronic Devices
  • Sweeping and Mopping the Floor
  • Dusting
  • Washing Utensils
  • Washing-Drying-Folding-Ironing Clothes
  • Sewing
  • Polishing
  • Feeding Cattle
  • Cutting Grass
  • Cleaning Yard

Cooking skills
  • Cleaning
  • Buying Food-stuffs
  • Correct Storage of Food-stuffs
  • Identification of Fresh/ Stale Fruits and Vegetables
  • Peeling Fruits and Vegetables
  • Safe use of Knives
  • Lighting Stove/ Gas Stove
  • Measuring Food items
  • Preparing Food
  • Cooking

Other Skills

  • Socially appropriate behavior
  • Etiquette
  • Self-esteem
  • Communication [Oral/ Writing (Braille, Typing etc.)]
  • Handling Money
  • Shopping
  •  Using Public Utility Services such as Bus, Post office, Banks etc.

Task Analysis
It is nothing but listing out the sub skills in an activity. To exemplify let me take a skill: Combing hair for girl
This skill can further be made into many sub skills. It means that any activity may be further divided into sub skills.

  1. Identifying Comb
  2. Identifying Oil
  3. Applying Oil
  4. Holding the Comb
  5. Brushing the Hair/ Combing
  6. Making Plaits
  7. Using Ribbons/ Back-Pin
  8.  Different Styles of Plaits

1.    Books
Drishitibadha-Sikshan; All India Confederation of the Blind, Delhi
Learning through Doing; Blind People Association, Ahemdabad
Sikshak Prashikshak Lekmala;
Training Module on Visual Impairment; Sarva Siksha Abhiyan
Visual Impairment Handbook; Blind People Association, Ahmedabad
2.    Websites

Per-forma of Lesson Plan for DLS

1.    General Information

a.   Name of the Pupil          Sonali Kumari
b. Age             12 years                                c. Gender      Female
d. School        Model School                        d. Class          Six
e. Date           4th July 2013             f. Time          12:30 pm
g. Skill to be Developed      Combing Hair
h. Assistive Devices/ Things to be needed
CombComb, Hair Oil, Clip, Ribbon etc

2.  Objectives
a.         To hold the comb properly
b.         To apply the Hair properly
c.         To comb the Hair
d.         To bind the Hair properly with the help of Clip, Ribbon etc.

3. Skill Development
a. Explanation          At first whole process will be narrated in descriptive way step by step.  
      b. Demonstration    Each and every step will be demonstrated to the Student
c. Practice                 There will be separate practice session for every objective and in different day

4. Check List
S. No.
Skills / Sub Skills
To hold the comb properly


Difficulties  Faced by the Pupil
Some problem in fine motor skill
Things to be Focused in the Further Practice Session
Grip of the hand

5. Remarks of the Teacher/ Spl. Educator/ Int. Teacher

As it was the first day of this skill, she was a bit nervous but after conversation with me it reduced, but still something left. It is challenging for me that how would I be able to get rid of nervousness.

Name of Teacher/ Spl. Educator/ Int. Teacher …………………………………………..
Signature ………………………………………………………………………………………………

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