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Origins of conflicting professional and consumer images of blindness.

The conflict and sometimes resulting hostility between consumer organizations of persons who are blind and some rehabilitation agencies is a source of concern and puzzlement to many outside observers. The growth of such organizations in terms of legislative efforts, self-help groups, education of the public, and the efforts to develop human potential would appear to be consistent with the frequently stated goals of rehabilitation programs. In most areas of disability, consumer organizations are flourishing; however, many people who are blind are now questioning the value of some programs and, indeed, the very assumptions about blindness held by many occupational groups who provide rehabilitation and educational services. Some of the ideas and images they have encountered from them now undermine the formerly assumed unity of interests between professionals and their clients.

Consumer complaints and opinions about rehabilitation programs are on the rise. Some organizations of persons who are blind are challenging many aspects of rehabilitation such as sheltered workshops, mobility training, techniques for teaching independent living, and the teaching of braille. Effective service delivery is jeopardized when agencies are picketed, boycotted, sued, and publicly criticized. In addition, such actions threaten funding sources. Today's service delivery systems have the greatest potential for success when clients and professional have compatible expectations since mutual respect is a minimal condition for all successful client-professional relationships.

R.A. Scott observed in The Making of Blind Men (1969) that blindness is a learned social role which is acquired through ordinary processes of social learning. Attitudes about blindness are learned in early childhood and are acquired both through daily interaction with other people and from organizations established to help them. Both Scott and the leadership of major organizations of people who are blind consistently affirm that the amount of visual stimulation available to individuals is not an "objective" condition; that is, success depends not upon the degree of blindness but upon the availability and quality of educational programs and opportunities. In Constructing Social Problems (1977; 1987) Spector and Kituse claimed that the process of defining social problems and the activities that promote this process actually constitute social problems. Agreement and consensus concerning social problems become established within interest groups who then provide explanations, definitions, research, and solutions.

Along these same lines, J. Gusfield has devoted a series of articles to the organizational ownership of social problems and the production of supportive scientific claims about them (1975; 1982; 1989). When institutions and programs for the disabled and disadvantaged were first established in the United States, welfare, protection, and education were the most commonly stated goals.

The sense of mission of workers for persons who were blind was based on a definite understanding of the seriousness of blindness as a condition. According to Gusfield, such understandings "constitute vital sources for a sense of professional esteem, client respect, and the ability to maintain legitimate occupational place. They constitute the source of belief that knowledge base has been buttressed by the methods and expertise of scientific and technical professionals" (1989). In short, he points out that interest groups claim to own problems and are possessive of their turf. However, what is good for interest groups is not always good for consumers who are blind.

This paper analyzes the development of the symbolism and discourse about blindness from the asylum movement for the blind in the United States up to the current age of "mainstreaming". Its particular focus is the advent of imagery which found symbolic legitimation in "science" and the activity or work of individuals who claimed that blindness was a field requiring training for professionals. To date, sociological interest concerning the blind has focused on how claims about social problems are created, documented, and extended. However, according to J.W. Schneider, previous research has overlooked the origins of definitional activities that preceded professional and related bureaucratic developments (1985). This paper examines the sources of the conflict between consumer organizations and rehabilitation professionals. Understanding the origins of their opposing views is an important first step to a dialogue that will enable them to combine their resources, energy, and talent, and thus contribute to more effective rehabilitation services.

Asylums and Welfare

Several scholars locate the origins of public care for the blind in the poor laws of Elizabethan England (French, 1932; tenBroek & Matson, 1959; Koestler, 1976; Katz, 1986; Matson, 1990). Distinctions between indoor relief and outdoor dole were established at this time. Indoor relief referred to asylums, residences or institutions intended to house the poor and infirm, while the outdoor dole was aid provided to individuals and families in non-institutional settings.

During the period 1830 through 1860 many asylums were established in the United States. "Removing deviants, including the poor and infirm, from society, placing them in an institution and providing a strict regimen was the best approach for solving social problems that were associated either with prisons, insane asylums, or almshouses" (Rothman, 1971, p. 191). Welfare was now the primary responsibility of the state, and individual and religious group charity declined in importance (Katz, 1986).

In addition to the widespread growth of asylums, special purpose institutions were also established to educate and otherwise care for special categories of people who were disabled. Schools developed in almost every state during this period, and the Perkins School became a model for educating children who were blind. Such schools did not replace the welfare asylums, but reflected a special niche for educable children. These schools were influenced by those which had arisen earlier in Germany, France, and England. In Austria, Johann Wilhelm Klein started the first program that was oriented around education, not charity. His was a school, not an asylum. He established the Vienna Institute for the Education of the Blind in 1808, and by 1816 his program attracted so much attention that his school was elevated to a state institution receiving royal support (French, 1932, p. 103). "Certain categorical programs were set up at a state level in recognition of the fact that numbers of blind and deaf children or other specialized groups were too few in local areas to warrant proper facilities" (tenBroek, 1948, p.45).

Whether in general asylums or specialized schools, many persons who were blind were "cared for" in the general context of charity and welfare. Neither almshouses nor specialized schools resulted in significant economic and social improvement of the lives of inmates or students (tenBroek & Matson, 1959). Regardless, programs proliferated and new agencies were created. Almost every major city developed a "light house" supported by private philanthropy. Funds available from state and federal sources also grew steadily. Those in charge organized themselves as teachers (American Association of Instructors for the Blind) and, later, as comprehensive welfare workers (American Association of Workers for the Blind).

Commenting on the failure of the asylum movement, Rothman observes that the founders of the almshouses lacked special training. In addition, they frequently lacked formal education. "There was nothing very interesting, let alone exotic, about decrepit and unemployed men, and nothing that would confer a special status on those who managed them" (Rothman, 1971, p.193).

Educators of the blind argued that their unusual needs and condition required dedicated teachers with specialized skills for educating and otherwise helping them. Despite sympathy for veterans blinded in World War I and the first distribution of federal funds for state programs, the understanding of blindness and the potential of people who were blind changed very little.

In 1932 The American Foundation for the Blind published From Homer to Helen Keller. This widely acclaimed social history of blindness was written by Richard French who, until his retirement in 1946, had been director of the California State School for the Blind for twenty-two years. Dr. French's seminal work illustrates what were widely held opinions in the 1930's. Not a single article or comment criticizing the ideas of this prestigious educator and administrator appeared in the Outlook, the dominant journal of workers for the blind. For French, one hundred years experience in educating the blind had led to an accumulation of facts. These facts were "conceded" by those who had given the subject thought:

(1) Music is overestimated as a vocational area.

(2) The blind can do first class work only in a few handicrafts -- basketry, weaving, knitting, broom -- and brush-making, and chair-caning.

(3) The blind cannot compete equally with the sighted in quantity or quality of items produced.

(4) Crafts pursued by the blind are best done in workshops, supervised by government officials or officers of benevolent associations.

(5) Apprenticeships and commercial education can help prepare blind persons for work. Sales and shopkeeping are promising fields for those "sufficiently fortified in soul" to handle failure.

(6) Among the "higher" callings, piano-tuning and, under favorable conditions, massaging are fields with the greatest possibility of success.

(7) Teaching and other learned professions are on the whole only for those with superior talent.

(8) "To argue from individual successes is not to show what the 'blind as a class' can do, and that therefore many notable examples of success, whatever their moral worth may be, cannot be taken as other than exceptional and therefore as practically valueless in the formulation of general guiding principles" (1932, pp. 200-201).

Later in the same book French asserted that women who were blind and of normal intelligence and good health should have the right to marry and bear children. He stated that many were charming, and that a man able to support a wife and children might well choose to marry one. However, two individuals who were blind ought not to marry: "For two helpless blind persons to be mated as public charges and to bring children into the world, whether congenitally defective or not, is the height of folly: worse than that, it is a crime and one that ought to be made impossible by law and law-enforcement" (1932, p.320).

Enter Science

Unfortunately, the 1930's brought forth further proliferation of negative images concerning people who were blind. About the same time that French's book was published, presentation were made at meetings of educators and workers for the blind, and articles appeared in Outlook for the Blind reflecting appeals to new knowledge based on science and psychoanalysis. The conference proceedings and publications of this decade came in answer to French's hope "that practice could be rationalized, that scientific method and a logical critique could successfully be applied" (1932, pp. 250-251). In 1931 Dr. Holsopple, a clinical psychologist at New Jersey State Hospital, published an article entitled "Psychological Problems of the Newly Blinded Adult." In describing their condition, he frequently drew analogies from the behavior of young children.

As the child tired from a long day's play, fails to recognize his desire for sleep, cries for attention and gets it only to burst into tears a moment later when he discovers attentions is not so satisfying after all, as the adult newly blinded may reach for one satisfaction after another only to find disappointment with all attainment (Holsopple, 1931, p.37).

Infantilizing was to become a frequent theme in describing the behavior of people who were blind. Holsopple cited Freud concerning the importance of sexuality to people who were blind. However, he recommended that competent psychological advice be sought. Even though sexual relations were becoming legitimized, repression still seemed to be the best policy: "The satisfaction of desires other than sexual and the cultivation of these other satisfactions may lead to a happy substitution" (1931, p.36).

On a more positive note, psychologists, particularly Dr. Samuel Hayes, adapted existing intelligence, achievement, and vocational aptitude test for use with students who were blind. The Perkins School for the Blind became the showcase for these "new psychological services" (Farrell, 1934). In addition to using the Binet-Simon and other tests, Hayes wrote more than twelve articles in Outlook for the Blind. The first, published in 1933, was "Problems in the Psychology of Blindness" in which he tried to correct misconceptions about blindness. He identified "the best experimental work upon the blind thus far published" and "the many interesting unsolved problems which await the patient application of reliable scientific methods for their proper solution" (1933, p.209). In his second article, he reviewed an array of empirical studies from experimental psychology which indicated that people who were blind, contrary to public opinion, were not superior in hearing, touch, taste, and smell. For example, he reviewed studies in which they were rotated on barrels to show that their sense of balance was not extraordinary (1934). The experimental psychology which Hayes reviewed for readers of Outlook for the Blind dealt with physiological and psychological reactions -- thresholds of perception, rather than with their social lives or personalities. In all that he wrote, he argued that they were ordinary. He used science to dispel myths about blindness, but his narrow focus only dispelled those about physiological responses. To his credit, he did not contribute to stereotypes about the personalities of blind people.

However, this was not true of other writers. Their comments often reinforced stereotypes about the inherent limitations of people who were blind and the resulting consequences in their personalities. For example, in 1934 H. Sidis, a sociologist from Carlton College, Minnesota, observed that students who were blind were both opinionated and stubborn. They could not see both sides of a question; they were either right or wrong (1944). Her generalizations were based on observations remembered from her experiences as a teacher of high school students who were blind.

Most influential of all, however, was Dr. Berhold Lowenfeld, who was Director of Educational Research for the American Foundation for the Blind and later was a successor to Dr. French as head of the California School for the Blind. He named three basic ways in which blindness restricted the individual, and these same assumptions were repeated in almost every article and public presentation that he made from 1944 through 1952. Unfortunately, no one stepped forth to question his claims about the basic differences between people who were blind and those with sight. First, he said that a visual sensation cannot be adequately replaced. The person who is blind is limited "in the range and variety of his concepts.... These limitations in the perceptual field cannot but result in a restriction of the range and variety of ideas and concepts in blind individuals" (1944, p.32). Second, blindness limits one's mobility. It makes one "dependent upon the aid of others, thus afflicting his social relationships and attitudes in varying degrees" (1944, p.32). Third, because a person who is blind cannot experience the world visually, he has less control over his environment. He cannot learn appropriate social behavior through observing and imitating others. This trouble in conforming to accepted behaviors leads to social isolation. "The isolating effect of this detachment restricts the blind individual in his control of the environment and results in increased feelings of insecurity and in a state of higher nervous tension" (1947, p. 33).

Lowenfeld's three propositions about blindness were related to many other characteristics of persons who were blind. "The effects of blindness also tend to drive the blind individual into a world of unreality and fantasy where he may find compensation for his real or supposed failures" (1947, p. 34). He argued that sight is essential in order to carry on the ordinary activities of life (1947, p.31). Furthermore, he accepted the results of intelligence tests showing that there were fewer persons who were blind of average and superior intelligence and many more than the general population that were dull, border-line, and feeble-minded (1947, p.35). Concerning achievement, although children who were blind began on a similar level, they fell increasingly behind with each year of education. In his articles he overlooked the quality or appropriateness of the education received by students who were blind as a possible explanation of their relatively poor performance on achievement and intelligence tests: "Besides blindness as such -- which affects particularly the information component of the tests -- heredity, poor environment, illness, emotional conflicts and late admission to school are some of the factors which contribute to the unfavorable distribution of IQ's and to the educational retardation" (1944, p. 35). Individuals who were congenitally blind were, he thought, worse off than the partially sighted or those who lost their eyesight in later life.

Lowenfeld was still discussing his "three limitations of blindness" as late as 1963. In a review of psychological studies of blindness, Kirtley mentioned the same ideas in 1975. In 1977 Santin and Simmons, in "Problems in the Construction of Reality in Congenitally Blind Children," reflected and cited Lowenfeld's "limitations" of thirty years earlier and claimed that sight is our chief contact with the objective world. "Therefore, the input from the remaining senses is intermittent, elusive, sequential, and necessarily received in fragments" (1977, p. 425). In all, Lowenfeld published more than one hundred books and articles about blindness. To his credit, his perspective broadened in some later publications such as The Changing Status of the Blind. In this book, he focused on factors associated with the integration of blind people into society, and he presented important historical material on the origins of self-help organizations. Unusual for writers in his field, he wrote favorably about the importance of consumer organizations such as the National Federation of the Blind. Dr. Jacobus tenBroek, founder of the NFB, is one of the people to whom he dedicated this book.

In summary, Lowenfeld provided a group of ideas that defined blindness, particularly congenital blindness, as a condition which separated people who were blind from others in their access to "reality". Such people required assistance and could not adequately control their own environments. Furthermore, almost any vision was better than no vision. Also, persons who were congenitally blind were worse off in any area he discussed than those who became so adventitiously. Unfortunately, he repeated these ideas, as did other people, numerous times in the dominant professional journals, and they remain prominent today in the minds of workers for the blind.

Professional Self-Understanding

Although workers for the blind (this was their self-appellation) had published a journal since 1907, their annual meetings and literature did not discuss the occupation as a profession until the late 1930's. In the period from 1939-1942 several presentations were made and articles were published extolling the virtues of professionalization and standardization. In the twenties and thirties workers were lauded as humane and involved in a "noble calling". Now claims were being made that this work was not only a profession, but a specialized activity due to the peculiarity of the problems of people who were blind. Wilensky observes that an occupation will not be granted professional status if its claims are based on common sense or easily codified procedures (1964).

Harry Best, a sociologist at the University of Kentucky, was one of the featured speakers at the 1939 annual meeting of the American Association of Workers for the Blind (A.A.W.B.) where he decried public misunderstanding concerning the profession:

It is our solemn obligation to make the public understand that we are engaged, not in a formless, shapeless, disorganized, straggling enterprise, and one reeking with sentimentality, but one that can be, and is being, carried on in an efficient, businesslike manner, and according to the fullest principles of commerce or industry or other pursuit known to man. The circumstances that we are engaged with, the noblest of all human causes, should not bar us from proving that we are likewise engaged in an undertaking that can meet the strictest standards of professional and scientific endeavor (1939).

In 1941 Samuel Hayes referred to social work for the blind as a fast developing new profession (1941). The "News and Views of the A.A.W.B." in The Outlook for the Blind reported That home teaching was the first area needing special attention concerning professional standards (1941). Committees had been working and resolutions passed as early as 1939. The June 1942, "News and Views of the A.A.W.B." reported "that progress was made in setting up standards for home teachers and preparing for certification of workers in this field" (1942).

Partly because of increased federal funding for vocational rehabilitation programs, Robert Irwin, nationally prominent as head of the American Foundation for the Blind, focussed attention on the specialized nature of the profession. In "Why Rehabilitation of the Blind is a Function of a Special Agency for the Blind" he argued that "unusual special services" were necessary. Because of the severity of the handicaps of people who were blind, their rehabilitation was more difficult and called for special knowledge. The best results came from agencies specializing in services to the blind.

Because blindness affects all phases of an individual's life -- even such simple matters as eating, dressing, reading one's personal mail, walking down the street alone -- and also because the psychological effects of blindness are probably more severe than for any other type of physical handicap, vocational rehabilitation of the blind is as much a matter of social case work as it is of vocational training and placement. Therefore the rehabilitation of the blind is more appropriately a function of a social agency, such as the commission for the blind or the department of welfare, than of a department of education (OB; 37:10).

Critiques of existing ideas and the work of other professionals were still rare in the professional literature; in fact, I found only two examples of such articles. Foulke did say that Metler not only examined previous ideas, but also provided new ways to view the adequacy of sensory information available to the blind. He claimed that different modes of sensory perception need not result in significant social differences (1987).

Consumer Resistance

The first national organization for people who were blind, The National Federation of the Blind, was organized in 1940. Dr. Jacobus tenBroek and many others continually maintained that with proper education and enlightened public attitudes, people who were blind were as ordinary as anyone. In his 1948 Presidential Address to the Ninth Annual Convention, tenBroek expressed this philosophy as he argued for a bill of rights. Articles by Dr. Kenneth Jernigan and many others calling for a reinterpretation of the significance and meaning of blindness appeared in the widely circulated consumer journal The Monitor (Jernigan, 1982a). In 1976 Dr. Hanan Selvin, a prominent sociologist reflecting on his own experience with late life blindness, wrote that with proper training it could be viewed only "as a nuisance." Ideas about blindness were, he noted, more important than the physical condition itself (1976).

However many professionals began to counter consumer claims of "normality." Soon thereafter, Paul Schulz published "Who Says Blindness is Just an Inconvenience?" Individuals who denied the severity of blindness were not mature, he said, and sight is the best sense receptor and source of information and has no equivalent (Schulz, 1977). Many rebuttals appeared in both consumer and professional journals (Cobb, 1977; Olson, 1977; Jernigan, 1982b). Changing what it means to be blind became a major theme as the National Federation of the Blind worked to present "more positive" images of blindness.


A professional ideology has developed from early images about the philanthropic care of the blind to later claims which appealed to "science" for legitimation. The later claims are typified by Lowenfeld's frequently repeated "three limitations" of blindness. This symbolism defined blindness as a severe condition which separated people who were blind from reality as experienced by others. They required not merely philanthropy, but highly specialized workers for their rehabilitation and education.

At almost the same time those understandings of blindness were being diffused, arguments appeared for the "professionalization of the field." Professionalization included licensing and accreditation requirements, and the American Foundation for the Blind coordinated developments. This new occupational group defined itself as distinct within the broader profession of rehabilitation. It now has its own journals, professional organizations, national and state funding sources, and in most states, separate niches in either the welfare or education bureaucracies. National organizations including the National Council of State Agencies for the Blind, the National Council of Private Agencies for the Blind, and the federally coordinated program involved with channeling government contracts to sheltered workshops have emerged and make major contributions to the continuing development of this profession. This professionalization and its accompanying imagery about blindness, along with the publication outlets and professional networks, were heavily influenced by the American Foundation of the Blind.

Beginning in 1940, professional interests encountered a well organized and rapidly growing consumer movement The National Federation of the Blind argued for the equality of blind people, competitive employment and full consumer participation in programs for people who were blind. With a more informed public understanding and proper education, they could be both independent and as "normal" as others. Although there are several additional consumer groups, none have received the notoriety of the NFB for its consistent philosophy and willingness to challenge programs and interest groups which it finds either harmful to persons who are blind or wasteful of resources.

The conflict between consumers of services and providers mentioned at the beginning of this paper is more than symbolic. Critics of the "blindness system" argue that it is harmful to individuals who are blind because it creates dependency and the internalization of negative self-images, and because it sustains stereotypes about their capabilities on the part of the general public. Educators and rehabilitation workers have interests to protect -- agencies, endowments, programs, and anticipated increases in federal and state government funding. Shepherding the growth of career opportunities is important in a narrowly defined work arena. For example, minimizing competition by excluding individuals who are blind and who are judged incapable to teach mobility helps protect the opportunities for the existing pool of workers as well as prospective new employees being trained in a small group of university centers.

The conflict has many and complex sources, not the least of which are the interests of workers who provide rehabilitation and educational services. Organizations of people who are blind have also become interest groups. The diametrically opposed symbolism reflected in this paper is one indicator of the gulf between them. This paper intentionally emphasizes the historical origins of two different views of blindness. Many professionals share the opinions of, and are even members of, the most critical consumer groups. Likewise, many individuals and organizations of people who are blind are seldom critical of existing rehabilitation programs. The historical material reflects a consistent tendency to ignore consumer criticism. Only in recent years has there been some attention to it at national and regional professional meetings of the Association for the Education and Rehabilitation of the Blind and Visually Impaired. Additional dialogue is a necessary condition for improved relationships. The leadership within this profession is in the best position to open formal channels of communication because of its influence over professional journals and national meetings. Improved communication should increase mutual respect and trust, minimizing unnecessary barriers to positive client-professional relationships in the rehabilitation process.

C. Edwin Vaughan, Ph.D., Department of Sociology, 202 Sociology Building, University of Missouri, Columbia, MO 65211.


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Author:Vaughan, C. Edwin
Publication:The Journal of Rehabilitation
Date:Jan 1, 1993
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