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Integrating infants; a playgroup for both visually impaired and sighted infants provides a well-structured model for mainstreaming preschoolers with disabilities.

Integrating Infants

Since the passage of PL 94-142 with its emphasis on "least restrictive environ-ment," mainstreaming and integration of students with special needs into regular education and community settings has grown steadily. Recently, this interest has extended downward as children with special needs have been integrated into pre-school and day care programs developed for non-impaired children. This trend toward providing more integration experi-ences for young children can be expecteded to grow as a result of the recent passage of PL 99-457.

Infants with visual impairments have specific developmental needs that require the specialized services of infant/visual impairment specialists working simultaneously with the infant and the parents. As with any highly diverse, low incidence group, it is very difficult to provide practical, cost-effective solutions to these service needs. Integration into community infant programs facilitated by specialists is an easily developed, cost-effective component of intervention for children with disabilities.

To date, there is essentially no literature on the integration of infants with visual impairments into parent-child playgroups designed for non-impaired infants. This may be the next frontier of the integration movement, as there are reasons to expect that integration experiences may be more easily achieved and more effective the earlier they are initiated. Some of these reasons are: 1. Parents of all infants have a common interest in the basics of physiological growth and development. During the period of infancy parents of all children share the same primary, concern with eating patterns, sleep patterns, growth, skill development, socialization and physical health. This provides the parents with a more common set of priorities related to the child than might be true later. 2. Differences between children with visual impairments and their sighted peers may be least obvious in infancy. The adaptive behaviors of infants with visual impairments are likely to be most similar from their sighted peers while both sets of infants are working to master the developmental tasks of the sensory-motor period. 3. The only prerequisite for participation in an integrated playgroup is sufficient medical stability. In a playgroup setting, adults provide guidance and support for the behavior of the infant that is attuned to the individual infant's skills and needs. Most infants require considerable assistance with activities, so there is no stigma for the infant with a visual impairment who may require extra assistance. 4. Involving the parents in integration is more effective than involving the children alone. Infant playgroup integration simultaneously impacts the attitudes of the parent and the child. The parents of sighted children, having participated in integrated infant settings will be more accepting of their children's peers with visual impairments and more willing to entertain them at home than parents who have not participated in such a program. 5. By beginning integration in infancy, an expectation of integration is developed that can then be maintained throughout school and life. Attitudes developed early carry through life; acceptance is more easily learned from the outset than later in life. It should prove true that children (both visually impaired and sighted) who have partici-pated in an integrated infant setting are easily transitioned into integrated preschools, integrated elementary schools, inte-grated secondary schools and finally integrated work places.




The process for developing an integrated playgroup involves three steps: 1) locating a suitable program in the community and enlisting its cooperation, 2) providing inservice training to the staff, and 3) providing information to the parents of participating infants (both sighted and visually impaired) upon registration for the playgroup.

Collaboration with existing programs is the most cost-effective approach. Some programs that are widely available and appropriate are: a) community college parent education programs; b) kindergymtype programs; c) community center infant-parent classes and programs. Infants with visual impairments can be integrated into situations such as these without major revision of the existing program.



Existing community resources should be evaluated on the basis of prerequisites (if any) for infant participation, physical environment, schedule and personnel. There should be no prerequisites for participation in the program (such as that the infant be ambulatory) that might disqualify some infants with visual impairments. The physical environment should be clean, cheerful, orderly and well-lit. An orderly lay-out aids orientation and mobility. Good lighting is also critical to the infant's functional use of residual vision. The schedule should be structured in an age-appropriate manner which provides the opportunity for a breadth of experience for infants. Personnel must be sensitive, flexible, willing to learn and interested in the integration experience.


In 1985 the PAVII (Parents and Visually Impaired Infants) Project was funded by the Handicapped Children's Early Education Program as a Model Demonstration Project to develop an early intervention model for infants (birth to three years) with visual impairments and their families. One aspect of the model was an integrated playgroup for both infants with visual impairments and sighted infants. This program, which ran for three years, provides a model for integration of all infants with disabilities into community programs.

In the case of PAVII Project, the San Francisco Community College Parent Education Center Child Observation Classes presented the best opportunity for integration. These classes were open to parents and infants at locations throughout the city. They were free of charge; the parent enrolled in a community college class and was listed as the student. The behavior and development of the children was observed informally, with the guidance of the instructor, during a loosely-structured play, music and snack time.

The site of the the weekly integrated plagroup was chosen because of its setting, instructor and schedule. The setting was clean and spacious and offers a wide variety of gross and fine motor activities. The instructor had a long-standing interest in children with special needs and was very committed to their integration. The schedule was flexible but predictable; parents and children were free to choose activities for one and a half hours, followed by a short music circle and then snack time. After snack time the parents and children went home.

Participation in the integrated playgroup was facilitated by certified teachers of the visually impaired with extensive experience working with infants and young children with visual impairments (members of the PAVII Project staff). Their activities included providing in-service training to the community program personnel, adapting activities to ensure their appropriateness for infants with visual impairments and acting as a resource to the parents of all the children in the program, as well as the community program personnel.


It was impractical to provide significant pre-training to the parents of sighted children in a loosely structured community infant-parent class. At the beginning of each semester, when parents enroll in the class, they receive information sheets explaining the structure of the class and that the class will include some infants and toddlers who are visually impaired. Throughout the semester, project staff respond to parent requests for information as they arise.

Observed interactions between the project parents and parents of sighted infants indicate the attitudes of non-project parents have been positively impacted. The parents of sighted infants share concerns over sleeping and feeding issues with the parents of infants with visual impairments and take a genuine interest in the development of project infants. No parent has expressed concern that sighted infants might learn inappropriate behavior patterns as a result of exposure to infants with visual impairments.

The sighted infants have been largely unaware of the exceptionality of the project infants and treat them as any other peers. They have, on occasion, responded with interest to facial anomalies, sensory aids (especially hearing aids), and unusual behavior patterns of the project infants. One or two toddlers imitated the behavior of a child who mouthed tires placed on the floor for climbing, as if to investigate its attraction. This imitation was transitory and did not persist.



None of the project infants had an opportunity to explore a rich diversity of activities with a group of nondisabled peers outside the playgroup. Several participated in other infant programs, but none were in an integrated setting. In the integrated playgroup they had the opportunity to encounter explore and imitate their non-disabled peers.

Project parents, especially first-time parents, have been reassured to learn that many of the problems they encounter are common to all parents. Regular observation of the development of infants without disabilities gives parents a realistic view of development.

Transition from infant to preschool programs is typically a very difficult time for parents. Participation in the playgroup has made this transition easier, because parents have the opportunity to experience a preschool-like setting with their child and see that their child has developed many of the skills needed in preschool (e.g. sitting with a group, participating in a song, eating snack at a table). "Modeling" by project staff and "practicing" fielding questions about the children's visual impairment in the playgroup helps prepare them to move into new settings.

Experiencing the integrated playgroup helps parents develop the skills needed to observe and evaluate preschool programs for their children. They become able to envision their child in a particular setting and to anticipate how adequately that setting would meet their child's needs.


For each of the first two years, the PAVII Project Playgroup was evaluated by consumer satisfaction questionnaires filled out by parents of the infants with visual impairments. Most of these parents reported that they felt comfortable at the playgroup (86 percent the first year and 88 percent the second year). The integrated playgroup was rated "Very Useful" (the highest rating on a three-point scale) by 85 percent of the participating parents the first year and 63 percent the second year. Both years there were parents who reported the playgroup was what they liked most about participation in PAVII Project.

At the end of PAVII Project, parents of sighted and visually impaired children were asked to complete an evaluation. This consisted of a questionnaire on effects of integration of infants with visual impairments into the playgroup, as well as general questions on the integration experience. Completed questionnaires were returned by 12 parents of visually impaired infants and by 30 parents of sighted infants.

The questions on which there was highest group consensus were: . "Helps parents and their sighted children understand and accept people who are visually impaired." Parents of 91.7 percent of visually impaired and 96.7 percent of sighted infants agreed. . "Helps to prepare children with visual impairments for the real world." Parents of 91.6 percent of visually impaired and 96.7 percent of sighted infants agreed. . "Helps parents of toddlers with visual impairments learn more about how sighted children develop." Parents of 91.7 percent of visually impaired and 83.3 percent of sighted infants agreed. . "Helps toddlers with visual impairments learn play and social skills from sighted toddlers." Parents of 83.3 percent of visually impaired and 86.7 percent of sighted infants agreed.

Responses to general open-ended questions gave more insight into differences between the two groups of parents. Parents of visually impaired infants indicated repeatedly that what they wanted for their babies was to interact with sighted peers, but what they wanted for themselves was 1) to interact with other parents of visually impaired children and 2) to observe the development of other visually impaired babies. The integrated playgroup model met both of these needs simultaneously.

The responses of parents of sighted infants indicated a strong commitment to the value of the integrated experience in building their child's values, sensitivity, tolerance and acceptance of individual differences. For themselves, they indicated an appreciation of the development of the visually impaired babies and an interest in more information about visual impairment and PAVII Project.
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Author:Friedman, Clare Taylor
Publication:The Exceptional Parent
Date:Jan 1, 1989
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