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Restricted or repetitive behavior (RRB) is common for individuals with visual impairment (VI), autism spectrum disorder (ASD), and intellectual disability. Previous reviews have suggested that VI may moderate the effectiveness of behavioral interventions to decrease RRB. A search of the single case literature resulted in 30 studies and 40 experiments involving participants with VI to test behavioral interventions to reduce RRBs. Nearly all participants had significant intellectual disability, half were deafblind, and only two had an ASD diagnosis. Success rates were higher for participants with low vision (88.9%) than for participants with blindness (68.4%) and to reduce non-self-injurious behavior (81%) than for self-injurious behavior (68.4%). Although most interventions in this review involved punishment and more research on reinforcement-based interventions is needed, multi-component interventions combining differential reinforcement with brief restraint or specific response contingent on RRB appear to hold the most promise for reducing RRBs for individuals with VI.

Introduction: Constant time delay is an evidence-based practice to teach sight word recognition to students with a variety of disabilities. To date, two studies have documented its effectiveness for teaching braille. Methods: Using a multiple-baseline design, we evaluated the effectiveness of constant time delay to teach highly motivating words to three beginning braille readers with developmental disabilities. Procedural variations included a pre-teaching and assessment tool, a higher criterion for mastery, an increased number of trials per session, and remediated instructional feedback. Results: A functional relation was established for all three participants. Students reached mastery in four to 12 sessions in less than one hour of instruction. Although the number of correct responses decreased over time, long-term maintenance was demonstrated. Discussion: Results suggest that constant time delay is a promising strategy for teaching highly motivating words to early braille readers. Replication is required to establish constant time delay as an evidence-based practice for braille literacy. Implications for practitioners: Practitioners are encouraged to incorporate constant time delay into a comprehensive literacy program with opportunities to generalize word reading to other contexts.

This article describes and evaluates a technological approach to support a preservice teacher of visually impaired students with extremely low vision to conduct essential assessments for a learner with multiple disabilities and visual impairment with limited distraction to the child and classroom. The selected technology discussed here was purchased with funds provided by a departmental grant, but it would be relatively affordable to an individual living on the average salary of a teacher working in the United States. In addition, as the demand for streaming sports cameras and tablets rises, basic economics indicate that the cost of such items should continue to reduce. Experimental research is needed to address whether the technology described in this paper can be used to decrease distractions and increase the quality of assessments completed by teachers of students with visual impairments who are visually impaired themselves. Concurrently, other uses of live-streaming video and bug-in-ear communication could prove beneficial for other pre-service or professional teachers with visual impairments who may need assistance in working with learners with or without visual impairments and with or without additional disabilities for assessment, classroom management, or academic instruction.

Introduction: Little is known about the effects of specific behavioral strategies to reduce stereotypy and self-injury for learners with sensory impairments and additional disabilities. Method: A single-subject, multi-treatment withdrawal design was used to test the isolated and combined effects of physical prompting to engage in object manipulation of preferred items, contingent reinforcement, and response blocking on target hand-related stereotypy and object manipulation for one 9-year-old boy with deafblindness and additional disabilities. Results: A functional relation was observed to show that hand-related stereotypy decreased due to prompting and reinforcement of object manipulation. Adding response blocking had inconsistent positive effects on stereotypy, and a functional relation was not observed. Prompting alone did not appear to increase object manipulation until contingent reinforcement was added, and response blocking did not appear to have an additive effect to increase object manipulation. Discussion: Results contradict findings of the replicated study and indicate need for further research, including research carried out in natural environments. Implications for Practitioners: Practitioners can use this research to justify the application of differential reinforcement of incompatible behavior using functional activities that result in meaningful reinforcement for students.

Introduction: Many students with adventitious vision loss or progressive vision loss need to transition from print to braille as a primary literacy medium. It is important that this transition is handled efficiently so that the student can have continued access to a literacy medium and make progress in the core curriculum. For this study, we used constant time delay to teach literary braille contractions and Nemeth Code for Mathematics and Science Notation (hereafter, Nemeth Code) braille symbols to learners with visual impairments who were making the transition from print to braille. Methods: A single-subject, multiple-probe research design was used to test the effectiveness and efficiency of constant time delay to teach literary braille or Nemeth Code. Three female students, aged 13 to 15 years, participated at a specialized school for students with visual impairments. The students' braille and math instructor delivered interventions in the classroom. Procedural fidelity and interobserver agreement data were collected. Results: Two students each learned 40 short-form literary braille contractions, and one student learned 28 Nemeth Code symbols throughout the study. Students appeared to generalize learning after instruction with the first word set to identify similar contractions. Students maintained learning throughout the study at high levels. Visual analysis of the data suggests a functional relationship between constant time delay and contraction identification. Discussion: This study replicated previous work (Hooper, Ivy, & Hatton, 2014) to expand understanding of the scope of the usefulness of time delay in braille education. Implications for practitioners: For students making the transition from print to braille, constant time delay may be an efficient method to help students acquire braille. The efficiency itself may increase students' confidence and motivation to learn braille.

Introduction: This article describes the most prevalent visual conditions and other demographic characteristics of 5,931 young children with severe visual impairments in 28 states in the United States, the largest sample reported to date. The information presented in this article can assist in planning and implementing programs. Method: The data were collected at the time of entry into specialized early intervention programs for young children with visual impairments through reviews of records, interviews, and direct observations. They were sent to Babies Count: The National Registry for Children with Visual Impairments, Birth to 3 Years at the American Printing House for the Blind. The data were collected and entered between January 2005 and April 2011. Results: Cortical visual impairment, retinopathy of prematurity (ROP), and optic nerve hypoplasia were the three most prevalent diagnoses. Approximately 60% were identified as being legally blind, and 65% had disabilities in addition to visual impairments. The mean age of the children at the time of diagnosis was 4.9 ("SD" = 5.7) months, referral to specialized programs was at 10.5 ("SD" = 7.8) months, and entry into specialized programs was at 11.6 ("SD" = 8.0) months. There was an average lag of 5.6 months between the diagnosis and referral. Discussion: Cortical visual impairment, ROP, and optic nerve hypoplasia continue to be the leading causes of severe, uncorrectable visual impairments in children in the United States. ROP appears to be decreasing in prevalence; however, more children with ROP appear to have additional disabilities. The lag of 5.6 months between diagnosis and referral, a longer lag than was previously reported, is of concern. Implications for practitioners: Information about the characteristics of children with severe uncorrectable visual conditions is valuable for communicating with families, planning and implementing early intervention and educational programs, and collaborating with medical professionals.

Children's skill level in using a spoon facilitates increased independence during mealtimes and greater control over the pace and quantity of food intake, which has important implications for health and self-determination. Children with severe multiple disabilities, including cognitive and visual impairment (VI), require intensive instruction to achieve independence using a spoon. We used graduated guidance and verbal prompting to teach spoon use to three children with severe multiple disabilities, including cognitive and VI, in a pullout setting during afternoon snack at school. Efficacy of the intervention was tested using a multiple probe design across participants. Results show that the intervention was associated with an increase in participants' independent, accurate spoon use; although, in the time allotted, participants did not reach full independence with all steps of spoon use. Implications for practice and future research are discussed.

Students with visual impairment (VI) lack access to the same models and reinforcers as students with sight. Consequentially, behaviors that children with sight acquire through observation must be explicitly taught to children with VI. In addition, children with VI have difficulty maintaining such behaviors. Therefore, interventions that promote self-management of students' own behavior are desirable. In this study, three adolescents used self-talk to increase chewing with a closed mouth during mealtimes. We used explicit instruction to teach students the target behavior and to use a small vibrating device as a reminder to self-talk during mealtimes. Prompts were faded as participants increased chewing with a closed mouth. Following mealtimes, performance feedback and reinforcement were provided. All students increased percentage of intervals chewing with a closed mouth immediately at the start of intervention and maintained this behavior for up to 1 month post-intervention. Implications for practice and directions for future research are discussed.

Students with visual impairment (VI) were taught to request using the Picture Exchange Communication System (PECS) and tangible symbols. Participants were four males with additional disabilities, 5 to 11 years old, who had little to no functional vision. A functional relation between PECS Phase 1 and requesting was established using a multiple baseline single subject design. All students learned to request independently within 7 to 14 sessions in Phase 1. Students maintained requesting above criterion for 1 to 5 months. All students generalized requesting to a new communication partner (CP); however, only two students reached criterion during generalization sessions. Two students learned to seek out a CP 5 feet away to request; however, no functional relation was established for Phase 2. More research is needed to establish PECS as an evidence-based practice for children with VI.