What is habilitation?
Habilitation involves one-to-one training for children and young people with a vision impairment. Starting from their existing skills, it aims to develop their personal mobility, navigation and independent living skills. At whatever age the training is started, the overriding goal is to maximise the child or young person’s independence, opening the way in the future, to further study, employment and an independent life.
Why is habilitation training necessary?
Habilitation training by a suitably qualified and registered practitioner is necessary for children with impaired vision because a child who can see would typically develop these personal independence skills as they grow up in their family. They would observe what other family members and other people around them did on a day-to-day basis. Typically sighted children would then go on to imitate what they had seen, repeatedly practising and modifying it, until the skills and strategies they were using became automatic. Children with a vision impairment cannot observe and watch others to the same extent (if at all). They cannot see what others do and so learn from what they see.
What exactly do habilitation specialists do?
Habilitation specialist’s work with individual children and young people, their parents and carers and the educational and other settings they work and live in. Habilitation Specialists, supported where possible by Habilitation Assistants, train children and young people with a vision impairment in the use of alternative independence strategies. They support and advise carers on alternative skill learning as the child grows up, using a range of strategies customised to the age, needs and development of the child.
The strategies the habilitation practitioner uses involve using the other senses: hearing, touch, taste, smell and balance in a coherent, planned and systematic way to provide the child with information about their world. As the child reaches school age, the habilitation specialist works increasingly with school staff as part of the transition process, along with other professionals, to develop the child’s independence when travelling to, being at and returning home from school. This includes developing their independence skills in many areas of personal life such as dressing skills, personal care and eating, safe travel, shopping and leisure activities.
As the child progresses through the different educational stages, the habilitation specialist supports them and their families through the various transitions between schooling stages and ultimately their progress to college, university, apprenticeships or employment.
What guides the work of Habilitation Practitioners?
The Quality Standards (QS) for Habilitation (1) specify the knowledge, understanding, skills and strategies that a trained habilitation worker needs to have to be able to train and support a child or young person with vision impairments in the age range 0-19 and up to 25. These have to cover the wide range of vision and vision related impairments from blindness to low vision. It is defined as:
- ‘…any level of visual impairment that has an effect on education, mobility and the ability to live independently.’ (QS, Section 1, p6)
The range of skills to be taught to children and young people includes age and maturity appropriate personal mobility, independent navigation and independent daily living skills (e.g. eating, washing, buying food, cleaning and banking).
Habilitation training is not a form of therapy or care support: it is a way of accessing the world, maximising learning strategies through specific learning and experiential approaches and skills (in the absence of vision) with the aim of maximising a person’s independence and ultimately, their employability.
Habilitation professionals are of two types in the Quality Standards: the Habilitation Specialist and the Habilitation Assistant (QS: 9-11). They have different roles and responsibilities.
An Habilitation Specialist (HS) observes, assesses, plans, implements, trains, reviews and monitors a child or young person’s habilitation programme (in liaison with parents, carers and other key professionals from education, health and social care). In particular, the HS undertakes the teaching of all the practical habilitation skills (from the development of body and spatial awareness to long cane use) and independent living skills (e.g. cooking, personal care, social skills and purchasing goods).
An Habilitation Assistant (HA), in contrast, works under the direct supervision and responsibility of the HS. HAs support individual children and young people to practice their habilitation skills and strategies: this may be inside and/or outside of school or other educational settings. They also contribute to the monitoring of habilitation progress.
How is habilitation training organised?
Habilitation training takes place in four key contexts (QS: p12-13): at home (including where children and young people are ‘looked after’; In educational settings (from nursery all the way through to university and post graduate study); In public spaces (such as on the pavement, in public transport, in the high street or in a shopping centre) and in the transitions between these spaces (from home to school, school to college or university, from school to work). The QS specify (Sections 3 :p12-13 and 4: p 14-21 how the training in these four contexts should be organised. This includes who else is involved (e.g. parents, school staff and key professionals from Health and Social Care); the key practices and procedures involved such as assessing a child’s working vision, receiving and using feedback from children and parents; auditing environments where children will be working; assessing and managing risks during practical skills work and the training of others (parents, carers and other professionals).
The QS have a series of Annexes which further specify the habilitation practitioner’s roles and working contexts:
- Annex A gives a sample specification for setting up a habilitation service (QS: p22-26);
- Annex B gives detailed job descriptions for the HS and HA roles (matched against National Occupational Standards for work in the Sensory Support area) (QS: p27-31);
- Annex C states the expected specific knowledge, understanding, practical skills and strategies, ways of professional working, and standards of professional practice to be demonstrated by an habilitation worker at the two levels of practice, HS and HA (QS: p32-40).
Annexes A and B are particularly significant for those preparing to offer habilitation training provision and for commissioners of services.
The QS, as a whole, define and specify what children and young people with visual needs, and their parents, carers and supporters, should expect from the habilitation workers involved in their training.
- Miller, O., Wall, K.R. and Garner, M. (2011) Quality Standards: Delivery of Habilitation Training (Mobility and Independent Living Skills) for Children and young people with visual impairment. London.M21/IOE/RNIB/DCSF/DfE. Developed by the government funded Mobility 21 Project (2007-2010: Director Dr Olga Miller; Principal Researcher, Dr Karl Wall) drawing on extensive, UK wide, consultations with existing practitioners, parents, children and young people with visual needs, vision professionals and providers of VI-related support. It also drew on contemporary worldwide research and practice.
Dr Karl Wall BSc(Hons), PGCE, MA(Psych & Edn for SEN), PhD, FHabVIUK, MBPsS.
Lecturer in Psychology and Habilitation Studies (Visual Impairment)
UCL Institute of Education
Telephone: 020 7612 6282
- Programme Leader for the Specialist Qualification in Habilitation and Disabilities of Sight (Children and Young People) Graduate Diploma at UCL-IOE
- Programme Leader: Masters in Special and Inclusive Education at UCL-IOE
- Senior Research Fellow, UCL Centre for Inclusive Education