Sumara Shakeel, MA, NOMC
Rehab teachers are known as “the bump dot people.” We’re seen as the people who mark appliances with raised stickers (called bump dots) and hand out nifty gadgets for people who are blind or have low vision. That’s a nationwide problem, not just limited to my home state of New Jersey.
Certainly no rehab teacher would want a blind person to believe that he or she cannot be independent, but that’s the very thing that our system teaches. How can we expect blind people to go back to the kind of life that they had before losing their vision if they can’t get beyond adjusting their own oven’s temperature?.
Today, there’s an emphasis on technology, so the gadgets are fancier (sometimes installed on smartphones) yet we are still looking at the same, fundamental problem. In my work, I keep trying to bring the focus back to techniques, because the blindness skills are going to serve people regardless of how technologically complex or simple they wish to be.
When people lose their vision, many counselors direct them to a rehab teacher first. Before these blind folks can find a job, they have to be able to survive in their own homes, cook meals, and take notes in an accessible format. Instead of empowering these people to label their own homes, though, we rehab teachers are sent to do the labeling. Several times per year, a referral comes across my desk because somebody has moved and needs their appliances re-labeled. At the same time, counselors are sending orientation and mobility instructors to folks simply because they’ve moved. “This person has to be taught their new neighborhood and routes to the grocery store, pharmacy and their favorite restaurant,” we hear.
In my work, and as much as I can influence the work of my colleagues, I try to look at these situations from a different perspective. A blind person has moved out of an area that is comfortable and maybe even the only neighborhood he has ever known. “What a unique opportunity!” I say, for this person can now learn how to explore and orient himself. I will certainly go visit with a person after he moves into a new apartment, but I’ll teach him—rather than do for him—how he might work with a sighted friend, family member, or paid reader to help him to label his appliances.
I see a lot of people who are drawn to professions like rehab teaching because they like to do for people. I see very few who enjoy slowly stepping back and disappearing into the shadows, as their consumers begin to be empowered. The best rehab teachers are not those who aren’t looking to “help people;” the best teachers are the ones who want to eliminate a consumer’s need for a rehab professional.
Before we go any further, let me say that addressing immediate needs is not all bad. Braille and large print watches, clocks, calendars, check writing guides, and monoculars are helpful for people. In addition, though, we must teach the skills of daily living that will suit a person for the rest of his life. I have a student who relocated to the United States from Ireland. She is so incredibly brilliant that her employer, a well-known leader in the research field, paid for her relocation. Sadly, she has really poor to no blindness skills.
Because of the way that our country’s rehab system is organized, the agency is focused only on one goal: achieving a “status-26 closure,” which the Rehabilitation Services Administration calls “closed and rehabilitated.” In order for a counselor to achieve this coveted status for a consumer, he has to have documentation that the agency provided services in a multitude of areas. While some agencies—such as mine—reward high-quality services, the system rewards quantity first and foremost. Some agencies would be perfectly happy if you purchased some household gadgets, showed the consumer how to take shortcuts in cooking, and answered a few questions. Without going too far into the weeds of federal regulations, the state agency pays my salary and can be reimbursed for the time that I spend with a consumer once she achieves “rehabilitated” status. There is little impetus for agencies to spend more time with consumers than necessary if it can prove the consumers have met their employment goals.
The system does, however, reward orientation and mobility instructors and rehab counselors because their work is seen as leading directly to employment. Just like my student from Ireland, whether she can cook a meal at home or not, she still has a job and that is all the system needs to close a case. Not all agencies view rehab teachers as important parts of the training experience, because you can always eat frozen foods and pay someone to come clean for you. How sad!
Change takes a long, long time and it doesn’t feel like you are making a difference. Unless you push back against the system, no change will happen. I’ve been with the New Jersey Commission for the Blind for nine years. I’ve gone from being the “bump dot lady” to one who goes out, pushes people and holds them accountable, eventually helping them move forward in life. The best thing that rehab teachers can do is get out there and do what you know to be right, good and effective. Eventually, your successful training will speak for itself and people will start to notice.