EATT
Equal Access to Technology Training
A project aimed at increasing computer literacy among people with vision impairments.
EATT is part funded under the
EU Leonardo da Vinci Programme
The Employment Support Practices for Visually Impaired People (ESP) Transnational Partnership acknowledges the financial support of the European Union's HORIZON Programme.
The Partnership is made up of the following organisations:
The transnational editor for this document is Bob Greenhalgh. His background is in social work, vocational rehabilitation and the training of rehabilitation workers - all of these in the context of people with a visual impairment.
Currently he is an independent specialist in visual disability, Honorary Chairman of the Partially Sighted Society and Low Vision Consultant to the Guide Dogs for the Blind Association.
This document is an Editorial Summary of comprehensive research conducted by the Partner Organisations represented in this Transnational Project. Original reports, on five key themes, Job Creation and Support, Job Retention, Vocational Guidance Practices, Rehabilitation and Assessment and Professional Training and Development, were presented to the Editor, who had full editorial control.
The original reports which are fully referenced and acknowledged can be found on the Transnational Website. (www.aaa.dk/jobvision)
2.1.1 In Denmark practical blindness is defined as being present when there is a visual acuity of 1/60 or less in the better eye, or a field of view reduced to 10 degrees or less. Social blindness occurs when the visual acuity in the better eye is between 6/60 and 1/60 or when the field of view is reduced to between 10 and 20 degrees. Partial sight is defined as being present when there is a visual acuity of 6/18 or less in the better eye.
2.1.2 It is thought that in Denmark there are approximately 45,000 people with a visual impairment, about 1% of the adult population.
2.1.3 In the 1960s Denmark started a policy of integration. Children who are visually impaired are now educated in the mainstream system. At the end of their education the objective is to gain social and economic integration within the workforce, preferably under conditions which are as near to normal as possible.
2.1.4 Unemployment among people with a visual impairment is higher than the national average.
2.1.5 The Danish Institute for the Blind and Partially
Sighted (IBS) was originally established to provide traditional education and training for blind people.
Today IBS is in charge of specialised guidance and
counselling.
2.1.6 In 1992 the County of Århus established The County Resource Centre for the Visually Impaired. The centre operates under the Department for Disabled Adults and the objective is to offer services and counselling to people with a visual impairment and be consultative to institutions and municipalities within the County.
2.1.7 The County Resource Centre for the Visually Impaired offers a broad spectrum of services dealing with children, families, youths and adults. The services include low vision and general rehabilitation.
2.1.8 The Rehabilitation Clinic is operated by the Department of Education and Labour Market, the County of Århus. Its function is to deal with rehabilitation issues which are particularly complex and which cannot be resolved at a local level. It is a non-residential unit. The unit is staffed by a multi-disciplinary team of specialists.
2.1.9 When the County Resource Centre for the Blind and Visually Impaired was established it quickly became clear that there was a need for a project dealing with the employment problems of people with a visual impairment in a new way. Thus the collaboration started between the County Resource Centre for the Visually Impaired and the Rehabilitation Clinic.
2.1.10 There was EU funding for the pilot stage, and subsequently for the current programme which is called "Labour Market Network for the Blind and Partially Sighted".
2.1.11 There is a detailed description of the financial situation in the submission from Denmark. It is important to note that all kinds of economic support, training daily living skills and mobility, compensatory courses and compensatory aids are paid by government, county or municipality funding.
2.1.12 The current government in Denmark has tried to establish schemes to ensure that people with disabilities receive the same employment opportunities as any other citizen. They have developed a strategy which involves establishing contact with companies following two themes. Firstly, "it concerns us all". Secondly, the "social commitment of companies". Through dialogue and by making the issues more visible it is hoped that companies will be motivated to create a more accommodating labour market with room for everybody.
2.1.13 Already there seems to be a greater willingness to retain employees when they acquire a disability.
2.1.14 It is hoped that a change of general attitudes can be achieved through the provision of appropriate information. Integration might then be achieved voluntarily rather than introducing legislative measures such as quota schemes and fines.
2.2.1 Current support systems for people with a visual impairment started in the 1970s. Integration into employment is organised through specialist rehabilitation centres. There are clearly defined areas of employment including telephonist, chair stacker, piano tuner and so on.
2.2.2 Since that time rehabilitation centres and retraining centres have emerged. These are funded by the state.
2.2.3 The Inter-regional Support Service for Visually Deficient Adults (SIADV) was formed in October 1995 through a merger of two existing organisations. Currently it has three establishments which provide technical assistance for integration for people with a visual impairment. It has a small, flexible and mobile team.
2.2.4 Services include raising the awareness of the problems associated with visual impairment amongst a range of organisations. It provides a functional assessment of people with a visual impairment with a view to integration into the workforce. It also provides rehabilitation and training for individuals along with the appropriate adaptation of the work place. There is a comprehensive programme of research and innovation.
2.2.5 The organisation's objective within this European project is to exchange ideas and practices with Partners in order to better the opportunities for people with a visual impairment.
2.3.1 The National Council for the Blind of Ireland (NCBI) was formed in 1931 and is a non-profit, voluntary organisation offering a service nation-wide to persons experiencing problems with their eye-sight. Over the years its structure and its approach to service provision have developed to take account of current 'best practice'.
2.3.2 In Ireland, blindness is legally defined as being present when there is a visual acuity of 1/60 or less in the better eye or where a field of vision is limited, the widest diameter of vision subtending an angle of 20% degrees or less.
2.3.3 The original emphasis on home visiting and the teaching of craft and communication skills has gradually matured through the development of a social work service to the present community resource service.
2.3.4 The direction and development of the services provided by the NCBI has been influenced by developments in the United Kingdom. Indeed, whilst a rehabilitation service was developing in Ireland provision was made for funding people with a visual impairment to travel for services in England.
2.3.5 NCBI is now able to satisfy demands within the country for rehabilitation services and has an effective and continuing in-service training programme as well as sponsoring workers to conventional training agencies.
2.4.1 The Partners from Italy are the Italian Union of the Blind (UIC) and the Institute of Research, Training and Rehabilitation (I.Ri.Fo.R).
2.4.2 The legal definition of someone who is "blind" include those who are totally blind and those who are "partially blind". The partially blind consist of two groups. With regards to the first group, the definition says that the individual should have a visual acuity of between 1/10 (6/60) and 1/20 (3/60) with the best available correction. The second group is defined as being those with a visual acuity of 1/20 or less with the best available correction. No account is taken of the visual field of view, colour perception or contrast sensitivity. No definition of weak sightedness (low vision) exists in Italian legislation.
2.4.3 People with a visual impairment are categorised into four groups. Firstly those impaired through war, secondly through the performance of a public service and thirdly through industrial injury. The fourth group contains those impaired through any other cause. Each category has its own set of regulations. This prevents any standardised assessment processes. Each category is entitled to a specific range of benefits and these are outlined in the submission from Italy.
2.4.4 There are approximately 370,000 people in Italy who are "legally" blind, the majority of whom live in the north of the country.
2.4.5 The UIC was formed in 1920 and represents and protects the "moral and material" interests of people with a visual impairment with all of the public and private organisations concerned with assisting them. The UIC's primary objective is to assist people with a visual impairment to become integrated into society.
2.4.6 It is an association of people with a visual impairment and only those who are "legally" blind are entitled to membership. Management positions within the organisations must be held by people with a visual impairment.
2.4.7 The UIC collaborates with public and private agencies in order to develop the opportunities for education, training, employment and rehabilitation for people with a visual impairment.
2.4.8 I.Ri.Fo.R was formed by the UIC in 1992. Its function is to carry out research in the fields of education, rehabilitation and vocational training. It is charged with identifying new employment opportunities for people with a visual impairment, organising vocational training courses and providing advice and information to public and private agencies.
2.4.9 I.Ri.Fo.r has a central structure with branches throughout the regions. The chair of the organisation at national and local levels is taken by the appropriate chair of the UIC. Other positions within the organisation may be taken by people not having a visual impairment.
2.5.1 The Royal National Institute for the Blind (RNIB) is one of the biggest and most diverse charities in the UK and provides a wide range of services for about one million visually impaired people.
2.5.2 These services include information and advice about financial benefits, housing and health, specialist products and equipment, accessing information in various formats and training for visually impaired people, employers and others.
2.5.3 RNIB is recognised as providing the most comprehensive and well developed employment related service for people with a visual impairment. Specialist establishments and colleges provide vocational training with qualified staff offering vocational guidance, advice and advocacy services.
2.5.4 The RNIB has established the Employment and Student Support Network (ESSN). It aims to meet the educational, training and employment needs of people with a visual impairment. Currently more than three thousand people access the ESSN. The submission from the UK gives further details about this initiative.
2.5.5 The Institute of Employment Studies found that from a random sample of organisations people with a visual impairment, compared to other disabilities, were the most difficult to employ. About 51% of respondents stated that it would not be possible for them to employ someone with a visual impairment.
2.5.6 The submission from the UK gives a comprehensive background to the employment situation.
3.1.1 In Denmark individuals have always had an obligation to support themselves and their family. Consequently it is the responsibility of each individual to seek the basis of that support, and this includes employment.
3.1.2 Several "safety nets" are in place to facilitate this principle. One is taking out insurance with an unemployment fund. Another is the "social safety net" which provides state support when all other avenues have been explored. The rate of unemployment is currently about 7.4%. (31-4-98).
3.1.3 It is difficult for people with a visual impairment to gain and retain employment. The employer has an absolute right to organise work, divide work and recruit. Frequently the employer will not elect to employ someone with a disability.
3.1.4 There is a reducing need for unskilled workers and an increasing number of opportunities in the information technology sector.
3.1.5 Unemployment registration cannot be categorised according to disability, religion, race and so on. There are therefore no useful statistics to identify how many people are unemployed in each category.
3.1.6 The establishment of good student guidance and trainee periods with companies is necessary to allow people with a visual impairment to broaden their occupational knowledge and allows employers to gain more knowledge about visual impairment.
3.1.7 People with a visual impairment who undertake occupational training or further education often find that they receive support materials up to several months after the term has started. One result of this is the number of people who terminate their training or rehabilitation. Support materials are not available for every training course and the result of this is that people are forced to choose courses which are not their primary interest.
3.1.8 The state employment service (AF) has a number of regional centres. Each centre has an advisor for people with a disability who is notified of job vacancies in the public sector and has a right to attend interviews with the applicant. Frequently, people with a disability do not use this system as they feel that it is not competition on "equal terms".
3.1.9 Among employers there is a raising of social responsibility and they prefer to have voluntary employment practices rather than a stringent legal framework.
3.1.10 In common with other European nations people who are considered as "blind" have traditionally been in occupations such as basketry, telephony, upholstery, brush making, music and so on. There has been no typical occupations for people who are considered as "partially sighted" nor has that group received the same kind of support in employment.
There is an increasingly lowered emphasis on what have been seen as "traditional" jobs for people with a visual impairment. For some years guidance has been particularly directed towards academic subjects but now there is a heightened awareness of possibilities in trade.
3.1.11 There is in general a reducing need for workers in some of the more "traditional" areas of employment. Much emphasis is therefore placed on the enormous growth of opportunities within the information technology sector. This sector has opportunities for people with a visual impairment. There are also difficulties in terms of the speed of technological change. This does not always allow specialist technologies to be developed to suit the needs of people with a visual impairment.
3.1.12 There are some financial supports both for the individual and the employer. These are detailed in the submission from Denmark.
3.1.13 Currently in the County of Århus the project Labour Market Network for Blind and Visually Impaired is developing a structure linking the services for people with a visual impairment with the established statutory agencies. This is a real attempt to develop a support network which is multi-disciplinary and multi-sectorial. Again, full details are contained in the submission from Denmark.
3.1.14 Employers are increasingly developing strategies to recruit people who are visually impaired. This has been stimulated by the spread of information about visual impairment and the increasing general awareness of the problems and potentials.
3.2.1 It is not helpful to try to identify specific jobs which can be done by people with a visual impairment. Rather, it is essential to identify the skills, aptitudes and interests of the individual and then apply those in the job seeking analysis. A job which might be possible for one person with a visual impairment is not necessarily possible by another.
3.2.2 Unfortunately, the public in general still consider that people with a visual impairment are particularly suited to some specific jobs. These include telephonist, physiotherapist... This public misconception increases the problems in successfully identifying new opportunities.
3.2.3 Physiotherapy is an occupation entirely adapted to people with a visual impairment and the rate of unemployment is very low. Such is not the case with telephony.
3.2.4 There is a long history of legislation related to the employment of people with a disability. This is well chronicled in the submission from France. Recent legislation means that every business with twenty or more employees must have 6% of the workforce being people with disabilities. In businesses which operate from more than one site, the ruling applies to each site.
3.2.5 The 6% is calculated in a rather complex way. It is measured in "units". Each person with a disability may be "worth" one or more units. Further details are contained in the submission from France. Employers can meet their obligation in a number of ways. For instance through the direct or indirect employment of people with a disability, or by contributing to a Development Fund. The purpose of the Fund is to provide facilities for the integration of people with a disability into the mainstream workforce.
3.2.6 The legal obligations are strictly monitored and the Development Fund (AGEFIPH) provides money for carrying out action plans for the employment of people with a disability. Action plans might include such things as the adaptation of work premises.
3.2.7 The government has job placement and follow-up teams (EPSR). These teams are geared to ease the path of people with a disability into employment. There is now at least one EPSR team in each county.
3.2.8 The integration and placement organisation (OIP) has the functions of canvassing employers, providing information about disability and searching for candidates to fill specific vacancies. The organisation will assist in the compilation of a CV, arrange mock interviews and so on.
3.2.9 The county-based programme of integration (PDI) is responsible for managing the route to integration for people with a disability.
3.2.10 The services outlined above are general services. There are more specific services geared to particular disabilities. The Inter-regional Support Service for the Visually Impaired (SIADV) provides considerable support for the generalists. This is a successful partnership which works to the advantage of people with visual impairment.
3.2.11 There are 60,000,000 people in France and of these 1,500,000 have a visual impairment according to the World Health Organisation's classification. One third of these people are blind and two thirds are partially sighted.
3.2.12 The analysis of visual impairment is no longer a standardised approach, but a personalised approach. In other words there is no longer a uniform guidance, rather it is a case by case analysis. It takes into account the nature and degree of disability, the personality and experience of the individual as well as the motivation and limitations. Thus it is a positive rather than a negative approach to the analysis.
3.2.13 A thorough skill analysis and personal assessment is therefore the cornerstone of job seeking.
3.2.14 There are some professionals who are new to the field of employment. One of these is the Integration Liaison Officer. This worker will provide the link between the employer and the person with a disability and will generally have a background in social work. Another is the ergonomist. It is only recently that the skills of the ergonomist have been used extensively to assist people with a disability. This is becoming an increasingly important role. Considerable detail is given in the submission from France.
3.2.15 The change of approach in France towards the analysis of the individual rather than of the disability is likely to improve the employment position of people with a visual impairment.
3.3.1 According to a recent report by the Commission on the Status of People with Disabilities, it was estimated through surveys carried out by organisations concerned with disability that the unemployment rate is as high as 70-80% among people with disabilities in Ireland. Hence, the task of job creation and support for people with a visual impairment is challenging.
3.3.2 Currently, Ireland does not have a compulsory quota system for the employment of people with disabilities. However, in 1977 the Government set the objective of the employment of people with disabilities in the public service to a minimum of 3% of total staff. While this has not been achieved in all areas of public service, it has served to emphasise the importance of the employment needs of people with disabilities.
3.3.3 The Irish Employment Equality Act 1998 has recently been introduced to outlaw direct and indirect discrimination in employment conditions on nine grounds including that of disability. It covers all aspects of employment including equal pay, access to employment, vocational training, conditions of employment, work experience, promotion and dismissal. The Act makes provision for the development of two bodies to implement and monitor the legislation.
3.3.4 The National Rehabilitation Board (NRB) is the government body which provides services to people with disabilities, advises the Minister for Health and other service-providing organisations and works to create an awareness of disability issues. Currently it has approximately fifty advisors providing guidance, assessment and information relating to employment. It also runs 'job clubs' which offer job seeking skills and support.
3.3.5 The NRB has responsibility for monitoring and setting standards for a range of vocational training programmes, largely funded by the European Union (EU) and targeted specifically at the open employment market.
3.3.6 The NRB has recently launched a new initiative, 'Positive to Disability' to assist employers in adopting equal opportunities practice and to make their companies 'positive to disability'. Employers can use the 'Positive to Disability' logo in company promotions and advertising once they have satisfied the NRB that they have an equal opportunities policy in place and meet specific criteria in the recruitment, training, promotion and retention of disabled staff.
3.3.7 It is proposed that the NRB is to be replaced by the National Disability Authority (NDA) with many of its existing functions being assimilated into other Government bodies.
3.3.8 Other mainstream agencies provide training in a number of skill areas. They are aimed at school-leavers and the unemployed. People with disabilities can generally gain access to these programmes through the NRB. These agencies also provide short and long-term work placements alongside supportive training.
3.3.9 Various voluntary organisations provide employment-related services specifically tailored for people with disabilities such as the National Training and Development Institute (NTDI). The primary service provider for people with a visual impairment is the National Council for the Blind of Ireland (NCBI) which runs courses to promote their independence. They include modules on basic skills training, personal effectiveness, job development, independent living skills as well as work skills sampling.
3.3.10 The NCBI is an important source of advice and support to people with a visual impairment who are seeking assistance with employment related problems. It also provides direct assistance through assessing equipment needs.
3.3.11 Developing from an ad hoc service the NCBI has moved towards an integrated multi-disciplinary employment and advisory service. As this service matures it is hoped that it will meet the complex needs of both employers and people with a visual impairment.
3.3.12 The new Employment Support Service deals with people as individuals, responding to their particular needs. It includes a comprehensive assessment, appropriate guidance, assistance with relevant training and provision of the necessary assistive technology. Support is available on an ongoing basis for individuals and the whole service is delivered by a multi-disciplinary team of professionals.
3.3.13 In the submission from Ireland there is a detailed description of this service and it serves as a helpful model.
3.3.14 There are a number of financial incentives available to encourage employers to recruit people with disabilities. These include grants for productivity shortfalls and the cost of adaptations to the premises or equipment making the workplace more accessible. There is also a grant available for Personal Readers to facilitate employees with a visual impairment.
3.3.15 Those registered with the NCBI as being legally blind are entitled to free travel on all public transport services. They are also entitled to the additional Blind Person's Tax Free Allowance.
3.3.16 While there is a wide range of agencies and services involved in job creation and support, NCBI are in the process of formulating policy recommendations on the creation of employment for people with a visual impairment.
3.4.1 The Italian constitution recognises the equal dignity of all citizens regardless of individual differences and aims to remove all barriers to the full personal development of human beings. It establishes the safeguarding of work in all its forms and states its duty to provide for the training of workers. Finally, to qualify for entry into the protected employment system, the individual must be under 55 years of age, have a 46% disability and enrol in one of the Compulsory Employment Registers at a Provincial Employment Office.
3.4.2 Public and private employers with more than 35 employees are legally obliged to employ people with a disability to make up 15% of their workforce. Public bodies are required to draw 40% of ancillary staff from the Compulsory Employment Registers.
3.4.3 Companies that do not have a statutory obligation to employ people with a disability are those with less than 35 employees, maritime or aeronautical companies, state railways and the driving and travelling sectors of public transport companies.
3.4.4 Inspection and control is based on six-monthly declarations which must be handed in to employment offices. These declarations must include the total number of employees and the list of those drawn from the Compulsory Employment Register.
3.4.5 Failure to comply with the regulations results in a fine followed by an obligation to comply. Sanctions are not yet in place to deal with the public sector and consequently this is where there is the largest area of non-compliance. Compliance is monitored by Provincial Boards for Mandatory Employment which is made up of representatives from organisations of and for people with a disability.
3.4.6 Currently there is a review of the compulsory employment system. It is thought that any changes will mean even more stringent measures to protect the employment rights of people with a disability.
3.4.7 The central government and other public bodies are required to employ people with a visual impairment as switchboard operators. Health service bodies must employ one or more osteopaths and rehabilitation therapists who have a visual impairment. Both of these occupations employ special registers which require applicants to have the appropriate professional qualifications.
3.4.8 People with a visual impairment are entitled to take up 2% of teaching posts in primary and secondary schools providing they hold the appropriate qualifications. Computer operators and physiotherapists also have some mandatory rights.
3.4.9 The Italian Blind Union (UIC) offers the main support for the professional placement of people with a visual impairment. I.Ri.Fo.R provides support through training courses.
3.4.10 Currently there is little financial incentive for employers who recruit people with a disability. However, there is proposed legislation which should offer some financial support.
3.4.11 Although the mandatory employment system has much to recommend it, there are problems. The system does not necessarily take into account the individual's skills, aptitudes and interests. People with a visual impairment are often employed at a "lower" level than their ability suggests.
3.4.12 Changing technology, particularly in switchboard work and some computer related occupations have increased the range of problems encountered by people with a visual impairment seeking entry into the workforce. At the same time as creating initial problems, this communication sector also holds a wide range of opportunities for the future.
3.5.1 Job creation and support can be defined as economic co-operation and regeneration on a community, regional and national basis involving the public, private and voluntary sectors.
3.5.2 The government department with responsibility for job creation and support is the Department of Education and Employment (DEE).
3.5.3 The government's "New Deal" programme includes initiatives which offer some time limited financial incentives to employers to employ people with disabilities.
3.5.4 Part of the "New Deal" is aimed at people aged between 18 and 24 years who have been unemployed for six months or more. There is an element of on-the-job training or educational development. Another section is aimed at people over the age of 25 to ensure inclusion into society at the earliest possible stage.
3.5.5 Although the "New Deal" is a new concept in the UK, there are other state initiatives to meet some of the needs of people who are unemployed. Some of these are aimed at the individual and some at the employer.
3.5.6 Much of the recent legislation is geared towards providing opportunities for people who are disabled to become economically active. The Employment Service's Disability Employment Advisors are a major source of advice for people with a disability.
3.5.7 Newly introduced tax concessions will ensure a minimum weekly income for a family with a wage earner. Other new economic incentives include provision for child-care.
3.5.8 One of the continuing problems in discussing job creation and support is the changing pattern of the job market and the workforce. A steady decline in manufacturing processes, the rapid improvements in technology and the increasing age of the employable population are examples.
3.5.9 There will need to be a close examination of technical, professional and managerial opportunities if the employment needs of people with disabilities are to keep pace with current change.
3.5.10 Within the UK there is a history of involvement from the charitable sector in developing employment opportunities for people with disabilities. Over the years the role of charities has changed considerably, but many are still very active in the pursuit of equality of opportunity. There are now strong partnerships between the charitable, public and private sectors within the employment market.
3.5.11 Despite the many services and incentives currently available, employment opportunities for people with a visual impairment are still unacceptably difficult.
3.5.12 Appropriate training and support will allow many jobs to be undertaken by people with a visual impairment. There still needs to be a proper programme of public education because of the lasting stereotypical image of people with a visual impairment. The image leads to discriminatory behaviour despite enlightened legislation.
3.5.13 However it would seem, for the first time, that people with a visual impairment will be able to demand that employers treat them equally with others and that reasonable adjustments are made to the workplace to allow them to apply and secure appropriate paid employment.
3.5.14 Developments in computer technology, either with or without special adaptations, are assisting people with a visual impairment to compete on an equal footing in the labour market. However, general developments using a pictorial interface produce an equal number of disadvantages.
3.5.15 It is becoming increasingly apparent that the "traditional" employment opportunities for people with a visual impairment must fade into the past. The employment services must use imagination in identifying opportunities which are more in keeping with modern market trends.
4.1.1 The Nordic countries have traditionally been thought of as benevolent "welfare" states. One of the most important features is the collective social security system which is based on a deep and wide financial safety net.
4.1.2 Various government committees recommended a more structured approach to job retention and supported corporate social responsibility. There was encouragement for job retention rather than making early retirement or other benefits an easy alternative option. It is now stated by law that an employee has the right to receive help from the municipality to make an effort to stay employed.
4.1.3 Labour market responsibility has in general been decentralised to the regions in the hope of providing a more responsive service. To support this devolution the project Labour Market Network for the Blind and Visually Impaired is established to stimulate the integration of people with a visual impairment into the mainstream labour force. Full details of this project, which has European Union (EU) funding, are contained in the submission from Denmark.
4.1.4 Employers and employees are encouraged to contact the project at an early stage, when a visual impairment is identified or progressed. This will allow early intervention and be more likely to result in job retention.
4.1.5 Companies are increasingly developing job retention policies, but it is completely voluntary. It is therefore essential that a good deal of work is undertaken by agencies for people with a visual impairment in developing appropriate attitudes and removing negative prejudices.
4.1.6 The submission from Denmark gives a detailed description of the projects three phase model of job retention. This is an attempt to apply a more formal and systematic planning process bringing together the employer, the employee and the expert resources available to both.
4.1.7 There is a conscious attempt to develop a more flexible labour market and this is partly because of the need to reduce the amount paid in state benefits. Again, this is not uncommon among the Nordic countries.
4.1.8 The key seems to be a timely and rapid response, as little interference as possible, dialogue, professionalism, an interdisciplinary approach, clarity, economically viable solutions with employee and managerial responsibility.
4.2.1 Every employee in the public or private sector must undergo a compulsory medical examination on recruitment. The company doctor will establish fitness for the job. Should redundancy be considered then the results of a further medical examination takes precedence over all other factors. This is a legislative measure.
4.2.2 The company doctor is the official legal expert who can distinguish whether a person with a visual impairment should be retained with an employer or not. He will be involved in all evaluations by other bodies.
4.2.3 If redundancy is being considered then a range of external specialists and internal representatives can be brought in to offer an opinion. The Inter-regional Support Service for the Visually Impaired (SIADV) plays an important part in recommending techniques for intervention in order to ensure that an employee with a visual impairment is kept in post.
4.2.4 The development of partnerships between workers and organisations has already shown considerable success. It is envisaged that these partnerships will continue to develop with the result that more professionals are aware of the opportunities for employing people with a visual impairment.
4.2.5 It is through the development of an action plan at an early stage in job seeking or job retention that people with a visual impairment will have the best chance of integrating into the mainstream workforce.
4.3.1 Job retention in Ireland has developed in an ad hoc way between the statutory and voluntary agencies with a dependence on the goodwill of employers.
4.3.2 The issue of job retention arises when an employee encounters problems in executing their duties due to the onset of a disability. When this occurs, the job retention options are adaptation , partial redeployment or redeployment or as a last resort, early retirement.
4.3.3 One of the main disincentives to job retention is that individuals can sometimes find themselves better provided for financially by accepting state benefits.
4.3.4 A continuing problem in job retention was the reluctance of people with an acquired visual impairment to declare their problem until a very late stage because of the lack of a legislative framework to support them.
4.3.5 However, under Ireland's new Employment Equality Act 1998, employers will be required to do all that is reasonable to provide special treatment and facilities for people with disabilities, both in their employment and for those applying for employment. Employers will only be exempt from these provisions where the cost of providing reasonable accommodation is other than of a 'nominal' nature.
4.3.6 The support structure for job retention is provided by the National Rehabilitation Board (NRB) and the National Council for the Blind of Ireland (NCBI). Both provide assessment, training and advisory services in supporting job retention.
4.3.7 The NCBI is currently participating as a partner in the EU funded project entitled 'Developing Instruments to support the process of vocational guidance for newly Disabled Employees' (DIDE). This is testing a model involving checklists which was developed by the Royal National Institute for the Blind (RNIB) in the United Kingdom (UK). Full details are in the UK submission. This model is also being tested in Holland and Italy. It facilitates the clarification of issues when an employee acquires a disability and offers options for intervention. Initial results from using the model suggest that it offers a more coherent and structured approach to the service.
4.3.8 There are also financial incentives available to employers to retain people with a disability/visual impairment in their job as set out in 3.3.14.
4.3.9 The involvement of many agencies in Ireland in the Employment Initiative under HORIZON has led to a number of national meetings where discussion has taken place on the main issues regarding the employment and retention of people with disabilities. It is hoped that this will lead to the proposition of policy on job retention to be adopted by the Government. Overall, there is a need to create realistic awareness of the needs and abilities of people with a visual impairment among the public in general and the employers in particular.
4.4.1 Job retention is assisted by the laws relating to the mandatory employment of people with a disability. However, there is little clarification about the job retention rights of people acquiring a disability.
4.4.2 There is a legal framework which means that a person who acquires a disability may not be dismissed from employment unless s/he proves incapable of fulfilling the duties required. Prior to dismissal there will be negotiation to determine whether the individual can partly fulfil the job requirements. The dismissal process still can not be initiated unless it is shown that the arrangements necessary for the retention of the individual would involve considerable restructuring of the employer's business. This framework gives substantial protection to people with a disability. The process is discussed in detail in the paper from Italy.
4.4.3 The legal procedures tend to allow people with a disability to retain employment. There are implications for pension rights and job grading for the individual.
4.4.4 The paper from Italy gives comprehensive details of the legislative framework.
4.4.5 It is envisaged that further legislation will lead to the setting up of locally based technical committees to advise on job retention. The committee will include a doctor, a social worker, a professional training expert, a rehabilitation expert and a health and social services representative specialising in employment training and job preparation. Hopefully, such a committee will become the key player in job retention.
4.4.6 Assistance in job retention is provided by the Italian Blind Union (UIC) and the Rehabilitation, Research and Training Institute (I.Ri.Fo.R). The former organisation ensures that appropriate procedures are followed and that there is adequate support for the individual. The latter organisation ensures that appropriate training is in place for the individual.
4.4.7 In many cases when an individual becomes visually impaired whilst in employment, redeployment will be as a switchboard operator. Other likely options are discussed in the section on Job Creation.
4.4.8 Attention is given primarily to ensuring the legislative framework is adhered to rather than on optimising the skills and abilities of people with a visual impairment.
4.4.9 Research has indicated that despite significant efforts at making employers aware of the problems associated with visual impairment and the potential input of workers with a visual impairment there is still a great deal of misconception and misinterpretation.
4.4.10 The lack of a cohesive rehabilitation service tends to be a limiting factor in improving the employment potential of people with a visual impairment.
4.5.1 In the UK, job retention is the attempt to keep those already in employment in their existing jobs when their working capacity has been impaired or reduced, temporarily or permanently, due to illness or disability.
4.5.2 The Disability Discrimination Act 1995 and related codes of practice acknowledge job retention as a priority issue and provides support for employers.
4.5.3 The statutory service is the responsibility of the Employment Service (ES). Services are provided through Placing, Assessment and Counselling Teams (PACTs), Disability Employment Advisors (DEAs) and the Access to Work (ATW) programme.
4.5.4 PACTs were established in 1992 and are locally based. It is mainly accessed by individual disabled job seekers and small to medium sized businesses. The Major Organisation Development Unit (MODU) provides a similar service for larger organisations.
4.5.5 DEAs work through the PACTs to provide information and advice on employment related issues for unemployed people with a disability. DEAs can arrange special equipment, occupational assessment and training. They can also provide information on recruitment and are responsible for placing people with a disability into employment.
4.5.6 The ATW was set up in 1994 and provides the channel through which the ES delivers or subsidises assistance for the employment of disabled people. Advice and information is also offered through this programme, and services are intended to be flexible and tailored to suit individual needs.
4.5.7 ATW grants can help to off-set the higher employer costs of recruiting someone with a disability. The programme can also pay for the costs of facilitators, such as readers, special equipment or modifications to the employment environment, such as additional lighting.
4.5.8 The ES has a disability symbol which sets standards of practice for the employment of people with a disability. It now includes the words, "positive about disabled people".
4.5.9 The initiatives outlined above have had only a limited success. There is still much work to do in raising awareness among employers and publicising the services available.
4.5.10 Supported Employment, formerly known as Sheltered Employment, is a programme for people with disabilities who are unable to secure or retain a job in the open labour market. Primarily this involves supported placements and workshops run by local authorities and voluntary organisations.
4.5.11 Currently there is a programme called the "New Deal" which is aimed primarily at people who are currently unemployed, but also at those who are in danger of moving out of employment on to the benefit system. A number of dangers are anticipated with this programme including a low budget, plans to tax disability benefits and an element of compulsion to join the programme.
4.5.12 Local Authorities play only a small part in job retention. Generally they are concerned with helping people with disabilities to obtain or retain employment within a Local Authority setting.
4.5.13 The Employers' Forum on Disability (EFD) consists of about 300 major employers and has a range of action points designed to be sympathetic to the support of employees with disabilities.
4.5.14 Apart from the ES, help and advice is available from a number of voluntary organisations.
4.5.15 The Disability Working Allowance, a state benefit, is paid on top of low wages or self-employed earnings to encourage people with disabilities to return to, or remain in, employment. In late 1999 this will be replaced by a Disabled Persons' Tax Credit.
4.5.16 Despite the services and benefits outlined above, there is relatively little "real" support and encouragement aimed at job retention.
4.5.17 46% of blind people and 14% of partially sighted people left their last job because of a sight problem. This is part of the case for concentrating services towards job retention rather than job replacement.
4.5.18 The UK paper on job retention provides considerable information on the occupational statistics and the political environment. It makes the case that concerned action is necessary from individuals and organisations in order to raise the profile on the political agenda. The RNIB is leading a number of initiatives to move the situation forward.
4.5.19 To conclude on a more optimistic note, the Disability Discrimination Act which came into force in 1996, is now being strengthened by the present Government, and now has a Code of Practice. This aims to eliminate discrimination against people with a disability in the field of employment. The Code says that employers must take every possible step to ensure that people who acquire a disability are helped to retain their employment.
5.1.1 Educational and vocational guidance in Denmark dates back as far as 1886. However, a formal counsellor training programme did not exist until September 1998.
5.1.2 Unfortunately, the terms guidance and
consultancy are often used rather loosely. There is no clear definition of the terms nor has there been a methodical approach towards the two services.
5.1.3 The great Danish philosopher Søren Kierkegaard's (1813-1855) comment seems to be the ideal starting point. "When one, truthfully and successfully, is to guide another person to a certain place, one must first and foremost make sure to find him at the place where he is, and start from there."
5.1.4 Guidance as a specialist area of work can be traced back to 1886 when Alfred Georg Ludvig Lehmann founded his Psychophysical Laboratory. His model was based on the concept of a counsellor as the "diagnosing" expert.
5.1.5 Lehmann's student, Poul Portefeé Bahnsen, had a
great influence on vocational guidance from the 1920s for thirty years.
5.1.6 There is a fascinating account of his work in the
submission from Denmark.
5.1.7 In the 1940s, pioneering workers began to
undertake programmes to prepare students for
vocational choice, this included vocational guidance, and latterly work experience.
5.1.8 Gradually, the number of teachers providing
vocational guidance increased typically it was the form teacher who took on the job. In 1958 vocational guidance was introduced in all schools. In 1976 the educational counsellor scheme was established. The educational counsellor became a support to the form teacher who was the link between school and parents. This continued until 1996.
5.1.9 Since 1970, a student counselling body has been
established at most educational institutions. Indeed, we now talk of integrated counselling.
5.1.10 Vocational guidance is now carried out primarily
between the specialist, the educational counsellor and the form teacher. The role of the counsellor is now often considered that of a "catalyst".
5.1.11 The development at the labour market has increased the need for adult vocational guidance. As the demand for qualified workers increases, more and more unskilled workers are taking targeted courses. A new adult guidance scheme has therefore developed.
5.1.12 Vocational guidance has expanded and now every
educational institution and every project offers an integrated guidance scheme as part of their service. However, many counsellors have never received formal training other than perhaps participating in short courses. The counties have set up short courses and study days to offer them support.
5.1.13 A national counsellor's society has been established, The Society for Adult Counselling (SEFOVO). One of SEFOVO's major objectives is to create an expert forum for adult counsellors. SEFOVO organises various study activities.
5.1.14 The starting point is dependent upon the individual's familiarity with the labour market, life experience, and so on. To ensure that the individual person makes the right choice, guidance in connection with the project Labour Market Network for the Blind and Visually Impaired will include a visit, together with a project counsellor, to relevant educational counsellors, and result in
the establishment of a practical training/work experience scheme. This is the same method that is used in primary and lower secondary schools.
5.1.15 For people who are visually impaired guidance
should also include elements such as an analysis of the visual problems, the difficulties predicted in terms of the choice of training or career, an analysis of the need for training in the use of compensatory aids, information on relevant legislation and so on.
5.1.16 The first serious attempts to integrate children with a visual impairment into mainstream education took place in the 1960s. Since then there has been a complete decentralisation of guidance and counselling services both for children and adults with a visual impairment.
5.1.17 There is now a number of consultants employed
by the counties and the county resource centres. Their function is to limit, as much as possible, the effects of a visual impairment and to give both children and adults with a visual impairment the opportunity of functioning within the mainstream through appropriate training and guidance.
5.1.18 Experience has shown that general counselling will not suffice for people with a visual impairment. It is necessary to associate the educational and vocational expertise with vision specific knowledge of such things as diagnosis, prognosis, visual function and training in the use of equipment.
5.1.19People with a visual impairment need to be given a
realistic choice and have an analysis of their
equipment needs.
5.1.20 A co-ordinated, interdisciplinary service will help to develop and improve the individual areas of expertise and ensure closer co-operation in providing a coherent guidance and counselling service to people with a visual impairment.
5.1.21 The service must be local, visible and capable of
swift and flexible action.
5.1.22 The County of Århus provides such a service offering support and advice on a continuing basis.
5.1.23 There is a comprehensive account of the current
service structure in the submission from Denmark.
5.2.1 Vocational guidance refers to a process which
leads the individual to identify a job taking into account motivation, functional visual ability, skills, academic level, current career path and the training required to enable to job to be undertaken successfully.
5.2.2 It is the characteristics of the individual which take the primary place rather than the visual impairment.
5.2.3 In France there is no specialist vocational guidance service for people with a visual impairment.
5.2.4 People under the age of twenty years receive guidance through the education system and the family. This applies equally to young people without impairment. In other words it is a conventional system which involves discussions between the student, the parents and the teachers. It is the responsibility of the teacher to ensure that the student has the appropriate academic prerequisites.
5.2.5 In the case of young people who do not have any specific direction, or possibly motivation, for employment the teacher might suggest some routes worthy of exploration. The student and the family may elect to take this route or follow a different one.
5.2.6 In seeking a new vocational direction the family can seek help from an Information and Vocational Guidance Centre, there is one in each large town, which is directly answerable to the National Education Department. Here, the student will receive professional assistance.
5.2.7 Visually impaired students benefit from a specialised structure which gives support within mainstream education.
5.2.8 All adults, including people with an impairment, can be supported through the vocational guidance process by a specialised organisation and may be referred to COTOREP once a disability is officially recognised.
5.2.9 The submission from France gives comprehensive details of the conventional vocational guidance process for adults who do not have impairment.
5.2.10 In the case of a person with a visual impairment when referral is made to COTOREP the file is studied by a team of professionals including medical practitioners, a social worker, and an occupational psychologist. Generally the team will interview the individual who will then be directed to a Vocational Guidance Centre, a Skills Assessment Centre or any other local service which appears to meet individual needs. When referral is from COTOREP the service is carried out free of charge.
5.2.11 Children and young people with a disability might be able to attend a work experience project. This scheme has been developed over the past few years. This combines a work setting with some skills development in terms of orientation, mobility and daily living skills. The scheme is helpful in identifying positive directions for employment.
5.2.12 Some people with a visual impairment may be referred to a Vocational Rehabilitation Centre which specialises in problems of visual impairment. The work in these Centres will be similar to the work experience schemes. Generally the people referred will be those who are for some reason not able to take up mainstream options.
5.2.13 There are two functional rehabilitation centres for people who have recently acquired a visual impairment. These are primarily directed at assisting with independence skills rather than engaging in vocational guidance.
5.2.14 The general vocational guidance system is well established. However, there is still considerable work to be done to provide input on the more specialised aspects of visual impairment. This will almost certainly result in a partnership between the centres and SIADV. As with many other aspects of services available to people with a visual impairment it is likely that the best results will be achieved by working with a team of professionals each with different relevant skills.
5.3.1 People with a visual impairment find it hard to access employment due to the existence of structural and attitudinal barriers, although a number of employment support services currently exist.
5.3.2 FÁS is the Government organisation, responsible for providing career advice and a training service to job seekers and a recruitment and advice service to employers. It has the responsibility for employment placement for unemployed people in Ireland. Until recently it had no specific policy for dealing with people with a disability.
5.3.3 Priority has been given on Community Employment Schemes run by FÁS to unemployed people registered as disabled with the National Rehabilitation Board (NRB). These schemes take people from the unemployment register and provide employment in non-profit making organisations without loss to state benefits. The schemes give people with a disability the opportunity to work alongside colleagues without a disability and consequently promote 'inclusion'.
5.3.4 FÁS has received European Union (EU) funding for a project called 'Action for Disability' which is piloting the 'inclusion' of people with disabilities on courses in three of their training centres.
5.3.5 A local employment service called Obair has been launched by FÁS to provide a service to unemployed, including those registered as disabled with the NRB. The local centres provide a contact point for those seeking work and for potential employers. Service users are referred to the relevant statutory and voluntary services for training, education, job information, job clubs and other social services. They are also able to access guidance counselling, job placement and recruitment and post recruitment services. They can also access customised education, training and temporary employment programmes.
5.3.6 The NRB employs advisors whose function is to
assess the abilities and needs of people with disabilities who have registered with the NRB and place them in further training and/or employment. The advisor can receive advice from NCBI when necessary.
5.3.7 The NRB monitors programmes with an employment focus using European Social Fund (ESF) money.
5.3.8 There is a detailed description of the mechanics of provision related to ESF funding in the submission from Ireland.
5.3.9 All universities employ both Career Guidance Counsellors and Disability Liaison Officers. Neither has specific expertise in dealing with the problems of visual impairment. However, the Association for Higher Education Access and Disability (AHEAD) promotes access to, and full participation in, third level education for students with disabilities. The NCBI through the Employment Support Unit also provides support to students attending third level colleges and Disability Liaison Officers.
5.3.10 Vocational guidance practices dedicated to people with a visual impairment are relatively new. The NCBI has established an employment support service over the course of a number of EU funded projects.
5.3.11 The 'Into Work' Project headed by an employment specialist took responsibility for providing a comprehensive employment service for people with a visual impairment. It sought new job opportunities as well as putting considerable effort into job retention.
5.3.12 The Vocational Opportunities in Creating Employment (VOICE) project focused on creating a support resource to all vocational training centres. Towards the end, it included people with a visual impairment on its courses. The project has resulted in extending the range of professionals who have expertise in the problems of visual impairment.
5.3.13 A Diploma in Professional Studies was piloted in partnership with other European nations to provide a qualification in technology training and employment of people with a visual impairment. The resultant worker is multi-skilled and can provide a service at a local level. Prior to this initiative people with a visual impairment had to travel in order to access support services.
5.3.14 The NCBI's MATE project seeks to develop a multi-disciplinary employment support service to empower people with a visual impairment, employers and potential employers to develop skills to create an integrated work environment. Within this project there is considerable emphasis on vocational guidance. The objective is not to duplicate existing services, rather to complement them.
5.4.1 Job recruitment is largely government controlled and dealt with through local employment offices. People who are unemployed are graded into various categories, for instance, according to length of time unemployed, qualifications and age.
5.4.2 Vocational guidance and skills evaluation are generally dealt with on a regional basis by various organisations. The training of workers within these bodies is through specialist organisations such as the Research, Rehabilitation and Training Institute (I.Ri.Fo.R).
5.4.3 Staff in the local employment offices do not have specialist training in work with people with a visual impairment.
5.4.4 Regional Orientation Units provide advice and support for people who have to make vocational decisions. The service is primarily directed at people wishing to take up university education.
5.4.5 Local Job Enterprise Centres (LJECs) provide a service to guide people seeking information regarding job and training opportunities within a particular region.
5.4.6 University Study Entitlement Agencies (A.Di.S.Us) provide various services for university students. These are not specifically directed towards people with a visual impairment.
5.4.7 The funding for professional training is through the government. People with a visual impairment are entitled to seek the services of all of the vocational guidance practitioners.
5.4.8 Once trained, a visually impaired person may be helped to achieve employment status through a system of protected jobs. For instance, 2% of university teaching posts are reserved for blind people specialising in certain subject areas.
5.4.9 Job selection for people with a visual impairment is generally based on getting a "protected" job rather than on an analysis of skills and abilities.
5.4.10 Although there is a minimal vocational guidance service for blind people, there are no such arrangements for people who are partially sighted.
5.4.11 With the move towards decentralisation, a likely development will be the emergence of private companies in recruitment rather than the current governmental monopoly. It is hoped that these agencies will provide more efficient solutions to job seeking and offer a greater range of alternative opportunities.
5.5.1 Vocational guidance involves a series of activities which are undertaken with the purpose of helping people to select a suitable job. These activities will include an examination of the aptitudes, abilities, personality characteristics and interests of the individual which must be contrasted with the particular demands of the job being considered.
5.5.2 In the UK the term "guidance" is widely used and different organisations mean different things by the same term. The Adult Guidance Network in Glasgow uses the following definition. "The process of enabling individuals to understand their current situation, identify their options for the future and decide on a course of action that will enable them to achieve their goals in education, training or employment."
5.5.3 Traditionally, people with a visual impairment have had more restriction in vocational choice than their sighted peers. They are likely to have had less experience of the world of work; access to guidance services may have been more difficult; guidance practitioners may not have an understanding of visual impairment and its implications; and society as a whole has limited expectations of people with a visual impairment.
5.5.4 In the 1980s there was a growth of guidance bodies. There was also a growth in joint support and general professionalism.
5.5.5 There are numerous services available through the charitable sector, but many people with a visual impairment still access vocational guidance through mainstream services.
5.5.6 In the private sector more employers are recognising the benefits of vocational guidance in the workplace. Staff development and training programmes are on the increase and more employees are working towards vocational qualifications.
5.5.7 Research has shown, not surprisingly, that standards of vocational guidance for people with a visual impairment vary over the country. Some practitioners merely adapt conventional vocational guidance materials. Many simply do the best they can with limited knowledge, experience and resources.
5.5.8 Most practitioners use one of the following three models. Firstly Rogers' client centred approach. This approach is based on an open relationship between practitioner and client. The client can be "put in the driving seat" with this approach, and this is unusual in this field when working with people with a visual impairment.
5.5.9 The second model is Egan's skilled helper approach. This involves a three stage process of clarifying issues, exploring possibilities and formulating plans. The practitioner facilitates the process and encourages the client to discuss and evaluate their own circumstances and options.
5.5.10 The third model is Rodger's seven point plan. Here the interview is seen as a means of gathering information, providing information and making recommendations. Seven areas are considered. These are physical make-up, attainments, general intelligence, special aptitudes, interests, disposition and circumstances. This approach can be difficult for people with a visual impairment who may have had limited experiences of life and work.
5.5.11 Further sources of information and support include the Careers and Occupational Information Centre, Occupational Psychologists, low vision specialists and technology consultants. Research has indicated that the best results occur when interventions involved a combination of the different approaches and resources.
5.5.12 Careers Advisers from local Career Service Companies provide vocational guidance for school age visually impaired people. The process starts at the age of fourteen.
5.5.13 Within colleges of further education the student support services provide guidance and counselling for visually impaired students. Several colleges have Visual Impairment Centres where staff are available to discuss options and courses of study. In most cases a Learning Support Plan, an action plan, is agreed with the student highlighting additional support measures which may be required.
5.5.14 In higher education there is usually a relationship between the person with a visual impairment and a "named" member of staff who will act as mentor and advisor. Usually there are strong links with the charitable sector which can supply specialist support and advice.
5.5.15 Within the Employment Service's Disability Service Teams (DSTs) a number of practitioners are available to help people with a visual impairment in their job search.
5.5.16 Through the New Deal people with a visual impairment are offered guidance, support and advice on employment or training options by a Personal Advisor. This Advisor will be the contact throughout the guidance process.
5.5.17 Training Enterprise Companies (TECs) and Local Enterprise Companies (LECs) can also provide advice, guidance, and counselling. This is part of the process of assisting people with a visual impairment to access employment support programmes and in turn employment.
5.5.18 The onus is very much on the individual to access and take-up vocational guidance and other employment support services. A free national guidance telephone help line is now in place and this should help individuals to identify appropriate local providers.
5.5.19 One development which will improve guidance standards for people with a visual impairment is the implementation of the Guidance Council's Quality Standards for Learning and Work. These now have national accreditation and national recognition. They will shortly be adopted by guidance organisations throughout the UK.
5.5.20 RNIB has produced Best Practice Guidelines to supplement the Guidance Council's Standards. These are aimed at practitioners who are likely to provide a service for people with a visual impairment and cover such issues as accessibility of information, equipment and access to technology, the built environment and psychometric testing.
5.5.21 An additional Government initiative is the National Adult Guidance Strategy which aims to encourage partnership working, strategic planning and joint development of policy and practice.
6.1.1 Elizabeth Kampmann Hansen, Vice-Director of the Danish Centre for Technical Aids for Rehabilitation and Education, suggests the following definition of rehabilitation. "From the point of view of the person involved, the aim of rehabilitation is an optimum level of activity and participation (social integration). The goal of rehabilitation is set by the person himself on the background of relevant information and counselling."
6.1.2 It is pivotal for individuals to define the objectives for their own rehabilitation. "Rehabilitation" should mean that a person's life is viewed and respected as a coherent whole and is the starting point for progress.
6.1.3 The rehabilitation process is presented in different forms depending on the situation. For instance, in the case of congenital impairment, the services within the public service sector will join together to intervene at a very early stage. Support will be provided to ensure that the child is facilitated in developing at the optimum level.
6.1.4 In many ways, the best service is provided if contact with service providers is made early and there is thus continuing contact until integration to the labour market as an adult has taken place and even after. These include such things as adaptation of the workplace, a personal reader, payment for training and so on. All of the benefits are paid from public funds and any professional advice is provided by staff within the public sector.
6.1.5 To optimise rehabilitation it is necessary to have a "key worker", with a broad knowledge base about the general concept of rehabilitation, to follow the progress of individual visually impaired people. However, for various reasons this is not always possible.
6.1.6 It is hoped that in the future there will be acceptance of cross-sector agreements. Equally it is hoped that the same kind of agreements can be made across disciplines.
6.1.7 Multi-disciplinary teams are being formed in some areas, and it is in those areas where there is more likely to be a holistic approach to rehabilitation.
6.1.8 In the team one person will be appointed "contact" worker and will follow the process through. Should it be necessary at a later stage it will also be the responsibility of that person to ensure an efficient hand-over to the next "contact" person.
6.1.9 Employment service workers are important in the rehabilitation process and will be introduced to the individual at the earliest appropriate time. It is vital for these services to be involved as they will need to liaise with the employer to ensure a smooth transition either into employment or to retention of employment.
6.1.10 Many of the organisations, both public and private, e.g. trade unions, which impinge on the rehabilitation process employ social workers. These workers can often be helpful in giving advice and information to individuals with a visual impairment.
6.1.11 Currently the rehabilitation system involves so many different parts of the "care" complex that it is very difficult to negotiate a way through without there being annoying delays and repetition of information. The person with the visual impairment can lose motivation when going through the various bureaucratic processes. They frequently report it as being moved from one box to another with the boxes having no contact with each other! There are undoubtedly similar examples in other European nations.
6.2.1 There are generally different rehabilitation options for people with a visual impairment.
6.2.2 Functional rehabilitation is carried out at two residential centres. Courses vary in length from one to four months and recruitment is national.
6.2.3 Some areas have a service at a county level offering rehabilitation sessions.
6.2.4 Some rehabilitation is carried out within professional training courses. However, in this case the time spent with the individual will be less than in the other two examples mentioned above.
6.2.5 It is only recently that an interest has been taken in the problems of rehabilitation of people in the older age group. A number of initiatives to deal with this are currently under way.
It is hoped that initiatives can be developed which allow rehabilitation to be taken to the individual's home as an alternative to attending national centres. On a local basis, centres should offer the same quality of rehabilitation than national centres in:
6.3.1 The National Council of the Blind for Ireland (NCBI) exists to optimise the intellectual, social and economic independence of people with a visual impairment and to minimise the handicapping effects of visual impairment. NCBI offers a wide range of general services for people with a visual impairment.
6.3.2 Interventions are made with the objective of inclusion in the terms of the social model of disability.
6.3.3 Rehabilitation exists at two levels. Firstly, medical rehabilitation which includes the diagnosis and treatment of visual disorders, the clinical assessment of vision and the assessment and treatment of any secondary physical, sensory or psychological condition.
6.3.4 The second level involves functional rehabilitation where services are provided to meet identified needs in the areas of orientation and mobility, independent living skills and communication skills. In addition, a number of employment support/training initiatives will have a rehabilitation element.
6.3.5 The Commission on the Status of People with Disabilities produced a report called 'A Strategy for Equality' in 1996. This recommended changes to promote the inclusion of people with disabilities into all aspects of Irish life. The guiding principles within the report are equality, maximising participation and enabling independence and choice.
6.3.6 The use of the term 'rehabilitation' is avoided in the Report as in Ireland it is typically linked with the medical model of disability. The report stresses the importance of providing quality services to meet individual needs at all stages in the life of a person with a visual impairment so that they might have the opportunity to realise their potential.
6.3.7 Referrals to the NCBI for rehabilitation services are received from a wide range of sources. Eligibility for entry into the service is restricted to those who are named on the official register of blind people. The primary criterion for entry onto the register is falling within the legal definition of blindness as set out in 2.3.2.
6.3.8 NCBI's Rehabilitation Service provides a general assessment to establish overall needs followed by a more specific assessment to establish rehabilitation needs. The person with the visual impairment must agree the statement of need and the subsequent programme of intervention. This ensures that the individual is an integral part of the process of rehabilitation and retains choice and control over the desired outcomes.
6.3.9 The programme will be reviewed by the person with the visual impairment and the worker at regular intervals. When the programme is complete it is evaluated and the case is closed. A reassessment will take place if new needs are identified either at the closure stage or subsequently.
6.3.10 Funding for the rehabilitation service comes partly from the Health Boards and partly from fund raising activities on the part of the NCBI.
6.3.11 Currently NCBI are in the process of seeking accreditation for their existing staff who have already received in-house training in rehabilitation and an accredited package for those staff awaiting training.
6.4.1 In Italy the concept of rehabilitation was introduced at a relatively late stage in comparison with other European nations. It is an educational and problem-solving process.
6.4.2 Rehabilitative medicine has become recognised from an ethical, cultural and legal view. Social rehabilitation, which includes employment rehabilitation, is still striving to find its own identity and recognition as a professional skill.
6.4.3 The Italian Blind Union (CUI) and the rehabilitation, Research and Training Institute (I.Ri.Fo.R) have both made significant contributions to the development of social rehabilitation.
6.4.4 Rehabilitation is considered to be a part of the health sector. This is a part of the legislative framework.
6.4.5 An expert working party produced a paper for the Health Ministry to identify what should be involved in social rehabilitation for people with a visual impairment. It was a complex document which particularly identified mobility and orientation, activities of daily life, communication and the use of vision as major rehabilitative issues. Thus far there has been no official recognition. The lack of recognition creates considerable problems in the current funding of rehabilitation.
6.4.6 At present rehabilitation specialists for people with a visual impairment include the following.
Low vision instructors
Orientation and mobility specialists
Daily living skills specialists
Information technology teachers
Computer literacy assistants
6.4.7 There is currently no professional recognition of any of these rehabilitation specialists and consequently there is a lack of workers, insecurity within the sub-specialisms and a tendency for experienced workers to leave for more recognised posts.
6.4.8 Various bodies organise general rehabilitation courses, or more specialised ones such as in braille, for people with a visual impairment.
6.4.9 There are a number of special training courses for people with a visual impairment trying to gain entry into employment. These include switchboard operating, physiotherapy, computer programming, composition and the teaching of musical instruments, journalism and so on. Not all of these courses have a component of social rehabilitation, some are purely job oriented.
6.4.10 Only people under the age of 45 and with vision no better than 6/60 can enrol for these training/rehabilitation courses.
6.4.11 The diverse national and local bodies providing rehabilitation and training creates a continuing funding problem.
6.4.12 There is a move to clarify what is meant by rehabilitation in terms of people with a visual impairment. It is hoped that it will develop to involve the individual's "total" being and be the responsibility of a team of practitioners, each with different but complementary skills.
6.4.13 In terms of the child the aim is to help to avoid the visual impairment interfering with growth and development. Adult rehabilitation is aimed at facilitating the individual to restore or retain the skills and lifestyle to which s/he is accustomed.
6.4.14 There is a significant shortage of professional rehabilitation staff. Some local areas have no suitable worker.
6.4.15 Funding priorities still tend to be towards the medical aspects of rehabilitation rather than the social aspects. The financial burden on non-governmental organisations is therefore considerable.
6.4.16 The recent emergence of social rehabilitation means that there is not an appropriate system of linking to other professionals. It also means that there is a very uneven spread of services throughout the country. In general terms there is a reluctance on the part of medical practitioners to become involved in the social rehabilitation process.
6.4.17 As the rehabilitation culture develops the person with a visual impairment must be placed firmly at the centre of the process rather than seen as an element which needs to be "done to"!
6.5.1 The United Nations describes rehabilitation as being a process aimed at enabling people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological and/or social function levels, thus providing them with tools to change their lives towards a higher level of independence.
6.5.2 SIADV in France describes it as the totality of the means at the disposal of a person with an impairment to be able to achieve or regain the independence that he or she considers necessary to accomplish the activities which he or she wishes to carry out.
6.5.3 In order to understand the fundamental principles behind the concept of rehabilitation in the UK it is necessary to explain the unique funding mechanisms that exist.
6.5.4 In the UK rehabilitation is described as the reinstatement to former privileges that in some way one has lost. In the case of visually impaired people the loss suffered is not only sight but also the ability to do things for which sight is needed. The process of rehabilitation is one of coming to terms with the sight loss both by accepting what has gone and cannot be regained, but also by learning new ways of doing ordinary things like reading, walking down the street, or performing household tasks.
6.5.5 A recent survey conducted by the Guide Dogs for the Blind Association (GDBA) showed that 38% of local authorities in Scotland did not employ a Rehabilitation Officer.
6.5.6 The Royal National Institute for the Blind (RNIB) provides specialist employment rehabilitation to less than 300 people each year. It employs specialist rehabilitation staff in its specialist centres, but probably employs no more than ten staff in total who specialise in rehabilitative skills.
6.5.7 There are two separate kinds of rehabilitation acknowledged in the UK. These are social rehabilitation and employment rehabilitation.
6.5.8 Social rehabilitation is characterised by the use of rehabilitation professionals in its delivery. Great use is made of Mobility and Orientation specialists and Rehabilitation Workers. This service is largely the responsibility of Social Services Departments funded through local and national taxation. Local authorities can elect to contract-out of these services by delegating them to local agencies for the visually impaired. This situation is most prevalent in Scotland.
6.5.9 The service includes independence skills, daily living skills and communication skills and mobility and orientation skills. Services are normally triggered when an individual is registered as blind or as partially sighted by an ophthalmologist. In the UK registration is entirely voluntary.
6.5.10 Rehabilitation services are focused almost entirely on the elderly population as approximately 75% of all services are delivered to people over the age of 60 years.
6.5.11 Rehabilitation training in the UK is not at degree level at this stage. Most workers will have been trained at one of three centres receiving what is now the Higher Education Diploma in Rehabilitation Studies. Funding is not readily available and sponsorship is by a Social Services Department, Employment Service or a government agency. Currently, for rather obscure reasons, employment rehabilitation must not contain any more than 25% of so-called social rehabilitation, meaning daily living skills, mobility and communication skills.
6.5.12 It is this rather strange division which is probably
the biggest problem in the rehabilitation field in the UK.
6.5.13 Social rehabilitation is essential in any re-skilling
of a person with a visual impairment who wants to enter or re-enter employment. For instance, mobility skills within the workplace are just as important as those necessary to travel independently to and from work. Yet in the UK these two vital components are funded by two separate and totally independent agencies.
6.5.14 Employment rehabilitation includes skill development and training in alternative vocational areas. Employment rehabilitation is undertaken in two quite different ways.
6.5.15 The RNIB has two skills development centres, the primary aim of which is to provide specialist employment rehabilitation. The centres deal with about 250 people each year between them and the average length of a programme is between nine and eleven weeks.
6.5.16 In addition to this specialist residential provision, local training organisations can provide agency rehabilitation. This concept was developed in the early 1990s to contract out provision from government agencies to other businesses. Rehabilitation services are provided in this way by a variety of other organisations including training providers, colleges and other disability organisations. They are focused entirely on employment rehabilitation.
6.5.17 There are no specific qualifications for rehabilitation professionals in the field of employment. Usually workers will have one of the established qualifications and simply transfer skills.
6.5.18 The government agency, the Employment Service (ES) funds most of the employment rehabilitation. The ES supports the RNIB by using either one of its rehabilitation centres or one of its two colleges.
6.5.19 Social Services Departments deal with rehabilitation at a local level. Most rehabilitation teams are organised into specific disability units, for instance visual impairment.
6.5.20 Local societies for the visually impaired act as agents for Social Services Departments and are charitable organisations. Contracting of services by competitive tender is being introduced gradually and this could change the emphasis of charitable provision.
6.5.21 There is a large number of charitable organisations and these provide a wide range of specialist services. The RNIB focus is on the provision of rehabilitation services.
6.5.22 There is surprisingly little consultation with service users about the services provided.
6.5.23 In the social rehabilitation model following a diagnosis of the visual impairment, the individual will receive a clinical assessment by an ophthalmologist. Registration as blind or partially sighted may follow. Registration gives immediate access to appropriate services, but there is still a reluctance on the part of younger people to agree to registration.
6.5.24 Those who register are often faced with long waiting times for their first contact with a professional. Up to one year is not uncommon. Rehabilitation services may then be brought into play. However, the provision of rehabilitation services is very uneven throughout the country. In a recent survey in Scotland, 20% of service users described the rehabilitation services they received as "poor".
6.5.25 In the employment rehabilitation model rehabilitation usually takes place locally in the first instance. Once contact is made with the ES the full range of employment rehabilitation services may be made available.
6.5.26 The main difficulties stem from the lack of distinction between social rehabilitation and employment rehabilitation, the lack of a unity of purpose between the two, the voluntary nature of registration as a visually impaired person, funding anomalies, differing levels of staff competency and a lack of communication between government departments.
6.5.27 Innovation has come with initiatives establishing close links between the health and social service sectors in order to provide a "seamless" service. Such partnerships have led to frameworks for minimum standards in education, social care and vocational rehabilitation being drafted.
6.5.28 If the service is to be truly successful and meet the real needs of the service users there must be co-ordination between the medical, educational, social and employment related professionals. People with a visual impairment must be allowed to make choices and facilitated in making them in an informed and realistic way.
Ann Tversted
Lene Sørensen
Hans Carl Matthiesen-Juhl
Erik Knudsen
Maja Frahm Oue
Jean-Yves BOUVIER
Guillemette DE NANTOIS
Denis GAGNER
Francis GUITEAU
Loïc HAFFRAY
Gaëtane LEROUX
Sophie PINEL
Bertrand TESSIER
Bláithín Gallagher
Aideen Collard
Fiona Lawlor
Emer Mulhall
Geraldine Neill
Martin McConnell
Stefan von Prondzinski
Kate Storrow
Egon Walesch
Frances McManus
Translation by Cathy Chaussepied
Ó ESP 1999
