Including People with Severe Visual Impairment in your Aquatic Fitness Class

By Katherine Hevener Certified WaterART Fitness Instructor & Anita Beauchamp WaterART Master Trainer

According to The World Health Organization (WHO), adults age 18 years and oldershould get a minimum of 150–300 minutes of moderate-intensity aerobic physical activity per week to enhance physical fitness and to reduce the presence of chronic diseases such as obesity, hypertension, diabetes mellitus, coronary artery disease, osteoporosis, and reduced life expectancy.  (WHO, October 5, 2022). People with vision impairments and other disabilities are not receiving this kind of recommended daily exercise. Studies show that one reason for this is that fitness professionals feel ill prepared to meet the unique needs of people with visual impairments. What follows is a general overview of this population, best practices for interacting with them, and proven teaching strategies.

The information is based on professional literature and personal experiences of Katherine Hevener, who was born blind and struggled with physical fitness for years. Scott Perry, a former professional football player with the Cincinnati Bengals used water exercise to show Katherine that she could have success in exercise. As she says, he gave me “the gift of health”. Now, Katherine is a Certified Aquatic Arthritis Instructor with WaterART Fitness International. For over twenty years, she was also credentialed to teach people with visual impairments to function independently at home, work and in academic settings.

Sighted people often associate the term “blindness” with people who can’t see anything- no light or shadows. While this association is accurate, total blindness is rare. Many people, have some usable vision. What they can see will depend on environmental factors and the eye condition that caused the vision loss. Some may have trouble seeing what’s in front of them (central) while others may have trouble with their side(peripheral vision). Furthermore, persons with vision impairments will typically have difficulty performing everyday tasks such as reading, writing, driving, etc. Additionally, their sight can not be corrected to “normal” with standard lenses or eyeglasses. 

Complete blindness or low vision may occur at birth(congenital) or later in life (adventitious.) While sighted children typically learn skills such as running, jumping, swimming, by watching others, children with visual impairments must specifically be taught how to do these skills . Even with such specialized instruction being provided at a very early age, visually impaired children often cannot get even a rough idea of the motions used in throwing, running, or swimming (Pogrund and Fazzi, 2002; Ponchillia, 2008).Thus, their motions may be more mechanical than those of their sighted peers. On the other hand, people who experience changes in their vision later in life already have these skills readily available.  Adults who experience late stage vision loss, discover that the biggest challenge they face is emotionally adjusting to sight loss.

People who are blind or visually impaired often face limited resources and negative attitudes from family, peers, and fitness professionals, which often result in them not wanting to participate in physical activities. In light of the wide range of visual impairments at the age of onset, the one way you can help this population benefit from your class is to simply ask “how can I help you best?”.

As a fitness instructor, try to incorporate their feedback and the teaching strategies covered in this article. Here are some communication tips that may make this critical conversation more natural and comfortable.

  • Remember that people who are blind or visually impaired are people first. They just do not see as well as you. So, treat them as you would like to be treated.
  • Speak clearly and state your name. Voices are not always easy to identify, especially in crowds or where sounds may be compromised by environmental factors.
  • Talk directly face to face with people who are blind or visually impaired, not to friends who may be with them.
  • Speak in a normal tone. It is not necessary to talk loud unless you know the person with whom you are speaking has a hearing impairment.
  • Your mood is conveyed through your tone of voice as facial expressions may not be seen.
  • Feel free to use everyday words such as look, see, watch, etc.
  • Let people know when you are leaving or returning to the area where they are located.

 

People who are blind/visually impaired may navigate environments, such as the pool area, by using their remaining vision, guide dog, white cane, sighted guide, or any combination thereof. 

Good lighting and color contrast are especially important for people who are relying on their remaining vision to travel. 

When guide dogs are in harness, please remind class participants to never distract these trained service animals by feeding, petting, or talking to them without the handler’s consent. This type of distraction can undo costly specialized training that the dog has been given, thus jeopardizing the handler’s safety.

People who travel with white canes often move them along landmarks such as walls, doors, pool edges etc. To help them reach their destination.  While it may look like they are going to run into something or fall, they typically will not.

If people put their canes, guide dogs and any other personal belongings in an inconvenient area,  tell them and offer to assist in finding a more appropriate location. Occasionally, you may be asked to physically guide people to the pool entrance or surrounding areas.  This may seem daunting, especially if you have never done it before. Simply, allow people to hold on to your arm, just above the elbow, and walk about a half step ahead of them. For more specific information about navigating steps, narrow spaces, etc., visit

https://visionlossresources.org/resources/how-to-be-a-guide/

Participants with a visual impairment cannot learn movement skills by observing and imitating the motions of others. So, it will be necessary to use their sense of touch, hearing, and any remaining vision, to teach these skills. Here are some basic instructional tips:.

Be aware of the environment. Most indoor pools have a lot of echo, which makes it difficult for the participant to hear and/or understand you. Try mitigating the effect of the echo by lowering the volume of any music you may be using , move the music to other parts of the pool where there may be less echo, lower the pitch of your voice by speaking from your diaphragm, and stand close to participants when talking to them.

Using contrasting colors, (light color on a dark surface or vice versa) can help participants with low vision more easily see exercises being demonstrated and/or locate equipment.

 Noodles may be marked with waterproof tape to help the participant more easily find specific hand positions such as “shoulder width apart”.

 It is quite easy for participants to lose their orientation when performing exercises while traveling. Lane lines, pool wall, depth of water against their body, slope of pool surface, and the location of music and/or your voice will likely mitigate this problem. However, they may still need a little help to get back to their space. When providing this assistance, give left right directions according to the way the participant is facing.

Verbal instruction is a powerful tool for some lessons in which the exercise is simple or in which students have a good deal of previous experience. One element of verbal instruction is the use of consistent terminology. For example, the term “jump” should only be used when leaping from one foot and landing on two feet. The use of several different terms for the same exercise is confusing. So, do not use “hop” or “step” when you really mean “jump”.

 Another element of verbal instruction is analogies or comparisons. For example, jumping is like hopping except that you are going to land on two feet rather than just the one you started the hop with. Analogies are especially useful when working with adults who acquired vision loss later in life. This is because they have a great deal of life experience on which to draw comparisons.

People who became blind or visually impaired early in their lives have very limited motor skill experiences. So as an instructor you will have to break the exercise down into smaller steps teaching each one separately and then combining them. This process is known as task analysis.

Tactile modeling and Physical guidance are more effective than verbal instruction for teaching exercises to people who are blind or visually impaired with limited movement experience. During tactile modeling, students touch or observe a person who is demonstrating that particular skill. In physical guidance, you actively touch and move the students through the motions of that particular exercise. Prior to using these techniques, make sure participants are comfortable with touching and being touched. Furthermore, let the participant know when you are about to enter their space to physically put them through a motion.

The use of partner exercises may be a great way to break the ice between sighted classmates and participants who are blind or visually impaired However, do not rely on these classmates to teach exercises. This will only cause confusion for people with vision impairments as they are forced to listen to two people saying the same thing differently or something altogether different.

To conclude, visual impairments do not directly cause poor physical skills or fitness. Rather, the lack of ability to perceive movement visually can affect the normal development of physical skills. This coupled with the reduced opportunities to learn to perform sports and fitness activities that may result from psychosocial barriers can lead to below-average physical abilities for an individual. However, effective interventions can remove barriers, increase skills, heighten a desire for physical activity, and improve fitness and the individual’s self-esteem. So, how will you include people with visual impairments in your class so they too can live a healthier lifestyle?

References:

 Physical Education and Sports for People with Visual Impairments and Deafblindness: Foundations of Instruction: Lieberman, Lauren J., Ponchillia, Paul E., Ponchillia, Susan V.: 9780891284543: Books oct 25, 2012

https://visionlossresources.org/resources/how-to-be-a-guide/

https://www.aph.org/tips-for-inclusive-interactions