Issue 24 Spring 1998 Physical Disabilities and Children's Reading Needs Desmond L Spiers	Collections under which this       article appears:       Reading       Special Needs Related Articles or Resources Other Articles by Author

Though many children and adults with a physical disability never end up in a wheelchair, the first image that springs to mind for most people when they hear the words 'physically disabled' is a wheelchair. This image is so strong, that the wheelchair is the international symbol for disability.

CAUSES

There are many causes that can result in either a temporary or permanent disability. The former can include broken limbs or paralysis as a result of an accident, or recovering from an operation or illness. Permanent problems can be divided into those:

• originating in the brain or nervous system, for example, Cerebral Palsy and Hydrocephalus.
• resulting from damage to the spinal cord, for example, Spina Bifida, paraplegia and quadriplegia.
• resulting from muscle wastage, for example, Muscular Dystrophy.
• resulting from inflammation of the joints, for example, arthritis.
• relating to heart, chest and kidney problems.
• asthma.

It would be as unwise to make a generalisation about the abilities of the physically disabled as it is with any other disability or learning problem. Every child is unique. However, some of the following problems are more likely to be encountered:

• Schooling can be missed because of ill health or hospitalisation, leading to the child falling behind in reading and language ability.
• Gross motor control may be poor so that the child cannot pick a book from a shelf.
• Fine motor control may be lacking, e.g., the ability to turn over pages.
• The child may have difficulty with visual tracking and find it hard to focus on pictures or words on the page.
• Spatial awareness can be impaired - the child takes his eyes off the page and cannot refocus.
• Pictures can be too fussy, so the child finds it difficult to distinguish key characters or elements of the picture.
• Visual perception may be difficult leading to problems in recognising letter shapes.
• Conceptual problems can occur which may result in an inability to relate to everyday experiences and situations.
• Children can be easily distracted from the task in hand and have difficulty maintaining concentration.
• An active mind in a body that is dysfunctional, can lead to immense frustration and sometimes cause emotional problems.
• Children having difficulty controlling hand and arm movement can have problems with writing.
• Some children may have difficulty transmitting information orally.
• Accessing information through touch can be difficult. As very young children learn much about the world through the tactile senses, children with physical disabilities may not have had access to the same range of experiences.
• Body language plays an important part in communication. These children may have problems transmitting and or receiving such kinesthetic information.

ACCESSIBILITY TO THE LIBRARY

Getting into a library may be the first barrier that children encounter. If making any structural alterations, it is advisable to adhere to British Standards and guidelines published by relevant national bodies. Contact the local planning office for assistance. Additionally the Disability Discrimination Act of 1995 will have relevance to services provided. The Government Literature Line 1 can provide a range of relevant publications. Two other national organisations who will be able to give information are RADAR 2 and the Centre for Accessible Environments 3.

The following are some of the points that should be addressed, including liaising with wheelchair users and local disability groups before any alterations are made:

• Access should preferably be flat; check to see if a ramp will need to be installed.
• Having reached the library door, difficulties can be encountered in opening it; the door can be too heavy, open the wrong way, have the handle at the wrong height. Consider installing automatic doors, or one that can be operated by a touch pad. Wider doors that accommodate wheelchair users will also benefit people using crutches, or those who are unsteady on their feet, as well as users pushing prams and buggies.
• There should be enough room between shelves to manoeuvre a wheelchair or move with a pair of crutches. A wheelchair user requires a turning space of over four feet by four feet, some eight times the space required by a fully ambulant person on foot.
• The majority of shelves should be at a height that wheelchair users can reach.
• If a public toilet is provided, it should be adapted for the disabled.
• Some, if not all of the library guiding needs to be duplicated at a lower level. Keep it plain, simple and bold.
• Floors should be kept clear of obstacles, which would impede movement. Children and adults need to feel confident that there will be no loose carpet tiles, rugs or objects lying around over which they can trip.
• Corridors of movement could be clearly defined, and if edged in a different colour would also assist those with a visual loss.
• Sharp edges and corners should be avoided if possible. For those with no control over involuntary movements, these could cause injury.

ACCESS TO MATERIAL

For children with physical disabilities, books need to be viewed as a range of items containing literature, rather than just printed materials. Reading can be life-changing, opening up areas of interest that might otherwise be denied to the child. Certainly the majority of children with physical disabilities are able to use print, though some will have problems. For these children and those who will not be print users, it is important that the frustration of not being able to use print is replaced by a more accessible method of reading. If this happens the child will see reading not as a chore, but as way of entering other 'worlds'. Print will probably still be required for curriculum work, but with the use of electronic equipment this can be made more accessible.

Children read with their eyes, ears, hands and fingers, and children with physical disabilities are no different.

• Books can be read with the ears using sound tapes, and if the child can wear earphones it remains a private occupation. If providing cassette recorders in the library, have a range of earphones available from 'in the ear' types to large 'professional' cans. It is important that sound tapes are not abridged, so if possible, the child can read with their eyes and ears at the same time. Chivers Press 4, Cover to Cover 5 and Harper Collins 6 are a few of the companies that produce unabridged fiction story cassettes for children. Tracking down non-fiction material is a little more difficult. However, Morley Books 7 on request, can produce a catalogue of fiction and non-fiction cassettes available. Charities such as the National Listening Library 8 and Calibre 9 provide story cassettes for children. The Talking Newspapers Association 10 can supply tapes of daily and Sunday newspapers, television listings and other items for a small fee. Sound cassettes are also an invaluable resource for those with a visual loss, and children with language, and learning problems.
• Videos of books are also useful, both for individual reading and for class use. They are visually stimulating and can lead the child into reading the print edition. Subtitled videos will have a place for those who need additional language input. The European Captioning Institute 11 (formerly the National Captioning Institute) is providing an increasing number of videos with Close Captions. A special Decoder is required and is available from Sarabec 12. Though a decoder is needed to see the captions, the videos are available to buy or rent in most high street shops or video stores. Availability is biased towards adult material. Close Caption videos can be recognised by a small television shape speech mark that usually appears on the spine and back of the video. A catalogue is available from the European Captioning Institute. Open captioned videos do not require a decoder and are available from the National Subtitling Library 13. All subtitling is a précis of what is spoken. Some language will be simplified and the subtitles may not match the spoken word. This is a disadvantage only when the viewer is reading and listening.
• Large print material will benefit those children who have problems with visual tracking. The larger print and increased line spacing can make it easier for the child to focus his eyes and also allow for less effort in following text with a finger or hand. Problems with spatial awareness can also be eased, allowing the child to refocus on the correct word if he should take his eye off the page, either voluntarily or involuntarily. For junior and lower secondary level Chivers Press publishes a range of fiction material. Additionally they also sometimes produce unabridged cassettes to accompany the books. For the teenager HarperCollins, ISIS 14, Magna 15, Portway 16, and Ulverscroft 17 are companies that publish large print material that may be suitable.
• Large format books (45cm x 36cm), both fiction and non-fiction, will be viable for those with poor fine motor skills in fingers and hands. The large pages lie flat on a table or floor and do not have to be held down to stop them accidentally flicking over. The extra thickness of the paper means that the pages are less liable to be torn when clutched and turned over. The very large print, pictures and photographs allow for easier focusing of head and eyes and refocusing if the reader loses concentration. Companies that produce such material include: AMS Educational 18, CollinsEducational 19, Ginn & Co 20, Heinemann Educational 21, Kingscourt 22, Longman Education 23, Thomas Nelson 24, Oliver & Boyd 25, Oxford University Press 26 and Scholastic 27.

BLISSYMBOLS

This is an international system of semantographics/hieroglyphics used as a communication system by a number of children with physical disabilities, as well as those who have speech and language disorders. A Bliss user can communicate with a non Bliss user because the relevant word is attached to each symbol. These symbols consist of either ideographs that represent ideas, e.g., before |· , after ·|, or pictographs representing words, e.g., house. Symbols can be combined to create new expressions, so that a basic core of symbols can be used to create a language with most of the nuances of standard written speech.

Blissymbols can be presented in a variety of ways depending on the physical and intellectual ability of the user. The simplest way would be a series of flash cards on particular subjects with a core vocabulary. These could sit on the tray of a wheelchair to be touched by the user with either a finger, fist or hand. Some users may use their eyes to point to the required symbol. If they do not have enough control over hand and arm muscles, then a helper will be required to find the relevant set of symbols that the child wishes to use. There is a standardised search procedure to ascertain what the child is communicating. Others may use electronic aids to point to the correct symbol. Special computers are available with a full array of symbols divided into chapters or sections. The user can access these on their own either manually or using a variety of switching devices to control the computer. In some cases these computers can also speak.

Bliss is in fact the only truly international language system, and in this country development is controlled by Bliss Symbol Communication U.K. 28, from whom advice and information can be obtained.

Only one commercially produced book containing Blissymbols has been published in English - Spot's Big Book of Words/Blissymbols 29.

REBUS BOOKS

These books, which have existed since the middle ages, replace a word with a picture. They are fun books, but have an important role in helping to expand a child's vocabulary, whether spoken or signed. For example, could be replaced by a number of words with a similar meaning (see end of article for suggestions). Many of the signs we use in everyday life can be classed as Rebus images, e.g.,
Some children use a very sophisticated version of Rebus as their communication device, and a complete programme entitled COMPIC that originated in Australia is now available from Winslow Press 30.

This Rebus image could be replaced by the words: trees, wood, forest grove, spinney, copse, jungle, weald, thicket, arboretum, orchard, plantation.

HIGH INTEREST/LOW ABILITY BOOKS

For those children with additional learning problems high interest/low ability material will be of use. The annotated bibliography KICK-START 31 contains over 250 titles, both fiction and non-fiction and gives both interest and reading levels.

DIFFERENTIATED TEXT

To enable a range of children with differing abilities to read some publishers produce two editions, both with the same photographs, but one has simplified text. These series have started to appear in increasing numbers over the past few years. Publishers include Belitha Press 32, Franklin Watts 33 and Wayland 34.

SPECIAL AIDS AND EQUIPMENT

Some children with physical disabilities and motor problems need specialised equipment to access print, use language, write independently, and communicate. For those interested in exploring this area in more detail, most education authorities have a unit devoted to information technology that includes computers (hardware and software) and microelectronic equipment. The following two organisations can also give advice and information SEMERC 35 and the ACE CENTRE 36.

The range of intelligence quotients for children with physical disabilities is no different from able bodied children, nor is the range of material that they use. An outstanding example is Professor Stephen Hawking whose mental capabilities have not been lessened by his physical disabilities.