Abstract

The study intended to search the role of mothers in rehabilitating their children with adventitious visual impairment. The design of the study was qualitative and exploratory. Mothers (N=15) of visually impaired children from various age groups were the sample of the study. A convenient sampling technique was used for sampling procedures. A self-developed semi-structured interview was the tool of this study. Instruments validity was confirmed through expert opinion (N=03). An extensive literature review guided the researcher towards the reliability of the instrument. A coding & thematic analysis approach was done for Data analysis. Three major themes emerged from interview transcription including mother's understanding, problems of mothers, and educational support. The study's findings show that mothers remain worried about their children's future. Although, mothers face many difficulties in accepting the acquired blindness of children. This study recommends particular orientation & training sessions for mothers of visually impaired children and adequate social support.

Key Words

Role, Rehabilitation, Mothers, Visually Impaired Children, Visual Impairment

Introduction

Visual Impairment which transpires in adulthood or in midlife of individuals by an accident is called Adventitious impairment of Visual (AVI) (Bajaj, 2019). According to Lupón et al.,  (2018), to manage or adjust the situation families need awareness or guidance about the diagnosis of the defects in their children. Past studies indicate that individuals who experience post-traumatic tension lose their vision in an accident (Brunes et al., 2018; Kim and Yoo, 2018; van der Ham et al., 2021).

When the vision of the children is lost due to disease or accident, this situation is so critical for children and their families. In this critical situation, the mother's role is much more important. Mothers are the major personalities in the rehabilitation of their visually impaired children to spend a normal & healthy life. Visually impaired people can live at the same degree as normal people because, in the case of visual impairment, they can actively use their other sanities especially auditory sense (Park, 2017). So, mothers have a significant role in rehabilitation. Children become emotionally and mentally strong due to only the efforts of the mothers. The self-efficiency is enhanced as well and depression can be reduced in individuals with adventitious visual Impairment by the activity of music (Park et al., 2020). Mothers of visually impaired children work with their children with visual impairment and get them out of stress. 

Research proves that dependency is increased in leisure activities due to restricted participation. Additionally, parental control, neurological problems, and increased dependency are common issues concerned with vision loss (Augestad, 2017). Mothers help them by focusing on their abilities rather than their disabilities.

Therefore, mothers are the main actors in the rehabilitation of their children with visual impairment. Visually impaired children face social maladjustment and become fearful about the behaviours of people. In this case, mothers play an important role to get them out of stress. They teach them about social moves. So, mothers are the main supporters behind the rehabilitation of their adventitious visually impaired children. Adventitious visually impaired individuals need to adapt to internal and external factors because they require to face many challenges which are different from the challenges they face before the visual Impairment (Jaleel et al., 2019).

This study is intended to seek the role of mothers while bringing back their children with visual impairment to ordinary life. It contains the challenges and efforts which are concerned especially mothers of visually impaired children. 




Statement of Problem

Rehabilitation of visually impaired children who are having acquired blindness becomes a hurdle for the mothers. It requires mastery to cope-up with the situation. Therefore, the mother's role becomes so important as well. 




Objectives of the Study

The study’s objectives were to:

1. Explore the mothers' perspective on the rehabilitation of their acquired visually impaired children.

2. Investigate the problems faced by mothers while guiding their children in daily living skills.

3. Highlight the efforts delineated by educated and uneducated mothers to their children with visual impairment in their rehabilitation. 




Research Questions

The questions of the study were:

1. What is the mothers' perspective on the rehabilitation of their acquired visually impaired children?

2. What are the problems faced by mothers while guiding their children in daily living skills?

3. Is there any difference in the rehabilitation efforts of educated and uneducated mothers

Significance of the Study

The study is important in its nature. The study is beneficial for the mothers of visually impaired children. It will give an explicit concept to uneducated mothers to learn from the techniques of educated mothers. Teachers of the visually impaired field will get benefit from this study to collaborate with the parents for the well-being of the visually impaired children. Additionally, this study will guide community stakeholders to make visually impaired children the active member of society with the help of supporting their mothers. A comprehensive understanding will be delivered through this study to the state authorities to support the families of children with visual impairment in their social, emotional, moral and educational life. 




Limitations & De-Limitations of the Study

? This study was limited to the province of Punjab only due to time and financial constraints. 

? Only mothers of visually impaired children were included as a sample of this study. 

Literature Review

Childhood and adolescence are the life stages dispense to parents for the purpose of learning development and education of their child (McClelland et al., 2022). Positive support from family members and society plays a tangible and effective role to enhance the experience of active participation by a visually impaired individual (Bassey, Ellison, (2022).

Visual impairment at an early age has lifelong implications for the child, family and society as a whole. Effective rehabilitation programs are offered to children at an early age, in order to aim for the global development of such children in a comprehensive manner for ensuring apex life quality (Dhillon et al.,2022).

Mothers enhance the relationships which rely on unsociable infants to nurture pro-social behaviour. Parents hide their children from others and educate them in special settings but they feel proud of the achievement of their child's performance (McKillop et al., 2006). In the future, the value will be increased and all devices will be used for training and rehabilitation for visually impaired students. (Virgili et al., 2022)

Individuals with visual impairment may engage in physical activity and exercise through the professionalism of rehabilitation.  (Kirk et. Al., 2019).

Rehabilitation professionals should enhance the participation among the visually impaired and heterogeneous groups for maintaining a social network (Bassey Et al., 2019).

Nowadays in the world, there is the main cause of acquired blindness is diabetic retinopathy.( Calderon et al., 2017). Acquired vision loss adults have less economically, productive life and adventure. they gain less opportunity to get an education and participation in jobs and social work. Because of that, they are suffered from psychological issues (Bassey et al,.2019).

In children's life, mother and father play an important role in education, caring, and encouraging. Mothers bring up their children and also they sharpen the children's personalities and educate them (Aziza, 2020).

Visual-impaired rehabilitation depends on the way to balance the loss of vision, and their understanding of the factors which help rehabilitation (Nakade et al., 2017).

Visually impaired children are not reinforced by their parents to have relations with sighted children and for this reason, visually impaired children avoid peer relations (Willings, Carmen 2019).

Psychological factors affect the care of others for visually impaired children (Lupóna et al., 2018). Education rehabilitation includes learning Braille (Raju et al., 2020).

Research Methodology

Research Design

This was exploratory research which is qualitative in nature.

 

Study’s Population

The populations of the study were the mothers of acquired visually impaired children from various cities of province Punjab.

 

Sample of the Study

The Sample of the study included mothers (N=15) of acquired visually impaired children with a purposive sampling technique.

Table 1

Sample Detail

District	Sample
D.G Khan	03
Faisalabad	01
Multan	02
Khanewaal	03
Waah Cantt	01
Bahawalnagar	01
Lahore	04
Total	15

 

Instrument

For the purpose of data collection, a semi-structured interview protocol was administered. After obtaining the expert opinion (N=03) for the purpose of ensuring validity, eleven open-ended questions were finalized for the collection of the most relevant data.

 

Data Collection Procedure

All the mothers of visually impaired children were requested for the collection of data before starting the procedure. Then, the responses of the mothers were recorded and transcribed for the purpose of thematic analysis.

 

Analysis of the Data

After interview transcription, the data were analyzed by applying the technique of thematic analysis. The thematic analysis contained categories and sub-themes to represent the collected information. From this, major themes were drawn for reaching towards the 

Findings and Conclusion

Ethical Consideration

The participants of the study were informed accordingly before the start of the data collection as a part of the ethical consideration of the study. The participants were also assured that the information they are sharing will be kept confidential and will be used only for research purposes.

 

Qualitative Data Analysis

Coding & Thematic Analysis

Interview transcription of the data helped the researchers to produce codes & themes. This part of the article contains two parts. One is the demographics of the participants and the other is concerned with the coding and thematic analysis. Initially, categories emerged from the interview transcription. There are sub-themes which are the detailed description of the categories. Then, the major themes were drawn from the categories.




 

Table 2

Districts of the Participants

District	Sample	Frequency
D.G Khan	03	20%
Faisalabad	01	6.6 %
Multan	02	13.3%
Khanewaal	03	20%
Waah Cantt	01	6.6 %
Bahawalnagar	01	6.6 %
Lahore	04	26.6%
Total	15	100%

 




Table 2 shows that DG Khan contained 20% of the participants, 6.6% were from Faisalabad, 13.3% from Multan, 20% from Khanewaal, 6.6% from Waahcantt, 6.6% from Bahawalnagar and 26.6% from Lahore. It means that the maximum number of participants belong to the Lahore district i.e. 26.6% of participants.




 

Table 3

Family Settings

Single-Family	Combine Family
10 (66.6%)	05 (33.3%)

 




Table 3 shows that participants belonging to single families were 66.6% while participants belonging to combine families were 33.3%. It means that the maximum number of participants belong to single families (6%).




 

Table 3

Educated & Uneducated Parents

Parents	Below Matriculation	Above Matriculation
Father	11 73.3%)	04 (26.6%)
Mother	10 (66.6%)	5 (33.3%)

 




Table 3 depicts that 73.3% of the fathers of visually impaired children were below matriculation. Only 26.6% of fathers of visually impaired children were above matriculation. It shows the great difference in education. Additionally, the major participants in the study were 66.6% of mothers of visually impaired students who were below matriculation. However, only 33.3% of the mothers of visually impaired students were above matriculation. It means that there is a great difference between educated and uneducated parents.  Moreover, as for study concerns with educated or uneducated mothers, mothers of visually impaired students were found more below matriculation 66.6% as compared to educated 33.3%.

The data analysis of the semi-structured interviews was based on interview transcription. There were a total of five major themes which have been emerged from various categories and the categories were drawn from the interview transcription of the responses collected from the participants.

 

RQ 1: What is the understanding of mothers of acquired visual impairment?

 

Theme 1: Mother’s Understanding

This theme has emerged from the perception of the mothers. It includes the mother's worriedness, life goals, acceptance and non-supportive society. Diverse perceptions were attributed to mothers (Duminda et al., 2022).

 

Category 1: Mothers' Worriedness

The thematic analysis of the category reveals that there were half of the participants responded that they are much worried about the present and future of their child with visual impairment. Worriedness for mothers also include imagining the difficulties of the child with visual impairment which he or she will face in future. It means that around half of the participants were worried about the future of their child with visual impairment. One of the mothers said,

“I am much worried when I think about the future of my Blind child.”

 

Category 2: Life Goals

The sub-theme of this category depicts that few of the participants expressed that they have set goals for the child with visual impairment to get an education in life. According to these mothers, education is the best way to spend good and happy life. As one of the participants narrated that

“I am working hard to provide education to my child with visual impairment.”

 

Category 3: Mother’s Acceptance

This category shows that only a few of the mothers responded that they did not accept the visual impairment of their child. It was very difficult for them to accept this reality. Even one mother narrated that "I have no courage to see my son's face." One more participant expressed that

“I think that it is the result of my sins.”

Category 4: Non-supportive Society

The thematic analysis of this category reveals that few of the participants responded that society is not supportive at all. It creates many difficulties with regard to the visual impairment of my son. My son became isolated because of various social behaviour. It means that only a few participants agreed on the effect of social behaviours on the visual impairment of the child.

 

Theme 2: Rehabilitation Aspects

This theme has emerged from the mother's perception regarding the most important aspect of rehabilitation for children with visual impairment. Society should pay attention to improving the visually impaired children's life quality (Hu et al., 2022).

 

Category 1: Motivation

This category shows that few of the participants narrated that motivation is the major aspect of rehabilitation. It is related to both mothers and children with visual impairment. As one of the participants expressed that

“I am much hopeful that my son will grow up well in life.”

 

Category 2: Awareness

This category shows that only a few mothers responded that awareness for mothers is a significant aspect of rehabilitation for children with visual impairment. Awareness helps mothers deal with the visual impairment of their children. One of the participants narrated that

"I try to be involved in various conferences, workshops and such positive activities to get awareness about the rehabilitation of my blind daughter."

 

Category 3: Attention

This category shows that only the majority of the mothers narrated that attention is an important aspect of rehabilitation for their children with visual impairment. These participants stated that Attention helps their children to develop in life. One of the participants expressed that

"I give much attention to my blind son as compared to my sighted children."

 

Category 4: Guidance

This category depicts that only a few of the participants responded that guidance for their children with visual impairment is an important aspect of rehabilitation. These participants also narrated that guidance is the best technique to guide children with visual impairment to decide best for themselves. As one of the participants described that

“I guide every single step and every small thing to my visually impaired children.”

Category 5: Social Interaction

This category depicts that only a few of the participants stated that social interaction for their children with visual impairment is an important aspect of rehabilitation. These participants expressed that social interaction helps the child with visual impairment to be a part of society. One of the participants narrated that

"I take my blind children into every function that is held in or out of the family so that they could get interaction with the people around them."

 

Category 6: Education

This category reveals that half of the participants responded that education for their children with visual impairment is an important aspect of rehabilitation. These participants also described that education can bring positive change in life. However, one of the participants stated that

"I took complete information firstly about schools for visually impaired students in my city, then I made my child get to study there."

 

RQ 2: What are the problems faced by mothers while guiding their children about daily living skills?

 

Theme 3: Mothers’ Problems

This theme reflects the problems of the mothers while handling their children with visual impairment experiencing acquired visual impairment. It includes the answer to the research question that what are the problems which mothers of children with visual impairment experience while rehabilitating their children in daily living skills. Psychosocial factors influence mainly the experiences of caring for the visually impaired child (Marta et al., 2018).

 

Category 1: Parent’s Irritation

This category displays that half of the participants responded that there is an irritation for them to deal with the visual impairment of their visually impaired children. These mothers a the problem of irritation which rehabilitating their children with visual impairment in learning daily living skills. One of the participants described that

“I was not ready to deal with the visual impairment of my child because there is no such problem in my family.”

 

Category 2: Non-cooperative Society

The sub-theme of this category reveals that only a few of the participants narrated that society is non-cooperative to the visual impairment of their child. These participants also described that society creates a problem for them because of their child's visual impairment. As one of the participants expressed that

"I found no cooperation from the people around me regarding supporting my child with visual impairment."

 

Theme 4: Encouragement for Daily Tasks

This theme reveals the encouraging behaviour of the mothers of visually impaired children about the performance of their daily tasks. To reduce the growing challenges of visual impairment or visual-intellectual problems, sheltered relations of parent-child can help (Ellen et al., 2016).

 

Category 1: Supportive behaviour

The thematic analysis of this category displays that more than half of the participants narrated that they encourage their children with visual impairment to perform their daily tasks on their own. This encouragement is based on the humble and kind behaviour of the mothers. One of the participants described that

"I speak mostly my son to perform his daily tasks on his own."

 

Category 2: Mother’s Belief

This category reveals that half of the participants believed that their children with visual impairment have the ability to do their tasks on their own. These participants narrated that there is no need of encouraging the child. One of the participants expressed that

"My son never disappoints me when he is supposed to perform any task."

 

Category 3: Explicit Direction

This category depicts that Only a few of the participants articulated that she has set everything for her son with visual impairment in its proper place. These participants also added that there is appropriate encouragement for the child to pick up the object from the place. As one of the participants narrated that

"My son knows well that his things are always put in their proper place at home."

RQ 3: Is there any difference in the rehabilitation efforts of educated and uneducated mothers?

 

Theme 5: Educational Support

This theme has emerged from two categories which are support by educated mothers and the role of uneducated mothers. Both categories have their different perspective. Children's education is mattered by the involvement of parents including for their motivation, well-being and achievement at school (Adri et al., 2010).

 

Category 1: Support by Educated Mothers

This category reveals that the majority of the participants responded that they do their best to educate their Child with visual impairment. These mothers also encouraged and prepare their children for their education. One of the participants stated that

"I teach my daughter at home in the evening mostly because I think if parents focus their attention towards their children in education then their children can get success in life."

 

Category 2: Role of Uneducated Mothers

This category shows that half of the participants narrated that they wish to educate their visually impaired children but due to their poor skill in learning Braille, they feel much difficulty to support educationally to their child. These participants also described that their child with learning at their own or special education school will guide their child properly. For this reason, they have nothing to do. As one of the participants narrated that

“I have no idea to teach and it is quite difficult to learn and then teach Braille to my child.”

 

Findings

The following were the findings of the study:

 

Mothers Worriedness

Mothers of visually impaired children are worried about their children with visual impairment regarding their mobility, education and future etc. Worriedness is a constant condition of mothers of visually impaired children.

 

Mother’s Acceptance

The majority of the mothers of visually impaired children do not accept the visual impairment of their children with visual impairment. They say that they consider normal their children with visual impairment.

 

Positivity

The majority of the mothers of visually impaired children revealed that the visually impaired children show positivity when they depict their affection towards them or their siblings.

Attention

Attention is a significant rehabilitation aspect for children with visual impairment. Attention helps their child to develop in life. It means that few of the mothers responded that attention is an important aspect of rehabilitation.

 

Parent’s Irritation

Mothers have irritation to deal with the visual impairment of their children with visual impairment.

 

Non-cooperative Society

The mother depicted that society is non-cooperative with the visual impairment of their child. Society creates problems for them because of their child's visual impairment.

 

Relatives Support

Mothers revealed that the behaviour of the relatives becomes problematic for the mothers. This is also contemplated as challenging social behaviour. For example, the grandfather or aunt spoke negatively to the mothers about the visual impairment of the children with visual impairment.

 

Mother’s Guidance for O & M

Mothers guided their children with visual impairment to move here and there without any training.

 

Support by Educated Mother

Educated mothers do their best to educate their visually impaired children. These mothers also encouraged and prepare their children for their education.

 

Support by Uneducated Mother

Uneducated mothers wish to educate their children with visual impairment but due to their poor skill in learning Braille becomes a hurdle for them to support educationally to their child.  It also includes a supposition that their child with learning at their own or special education school will guide their child properly and for this reason, they have nothing to do.

Discussion

Acquired visual impairment brings various challenges for mothers of children with visual impairment. It includes Worriedness for mothers. This worriedness is regarding the future of the child and mobility problems in the child's matrix. 

Mothers of visually impaired children are worried about their children with visual impairment regarding their mobility, education and future etc. Worriedness is a constant condition of mothers of visually impaired children. Parents are worried about the future of their children, and the performance of the school. It also includes showing concerns regarding psychosocial problems of their visually impaired children with various aspects of family matters (McKillop et al., 2006).

However, acceptance by mothers regarding the visual impairment of their children is another fact in Pakistan's society. Most mothers do not accept the visual impairment of their children. Visually impaired children are not reinforced by their parents to have relations with sighted children and for this reason, visually impaired children avoid peer relations (Willings,  Carmen 2019).

Visually impaired children require only attention from their parents, especially mothers. Attention is the only aspect of rehabilitation which motivate visually impaired children. During childhood and adolescence, the learning development of the child is the only concern of parents (Lenes et al., 2022). 

There are challenges for the mothers of visually impaired children by the society but these problems can be addressed through positive change in the social settings. With the change in economic trends and especially in social settings, alternative personal objectives have given rise to intentions of bearing the child (Spéder, Kapitány, 2014).

 Mothers of visually impaired children experience different problems while learning daily living skills for their children with visual impairment. These problems include poor handling of the mothers and non-cooperative society. Put a sentence here with a citation.

There is a difference in providing rehabilitation to children with visual impairment between educated and uneducated mothers. Educated mothers do their best to educate their Children with visual impairment. Mothers bring up their children and also they sharpen the children's personalities and educate them (Aziza, 2020).

However, uneducated mothers only wish to educate their visually impaired children but due to their poor skill in learning Braille becomes a hurdle for them to support educationally to their child.  

Conclusion

To conclude the study with the fact that education of the mothers of visually impaired children is important. The difference in education between educated and uneducated mothers influences the life of their children with visual impairment. Mothers perceive their children with visual impairment may feel difficulty in their life but education can bring change in the lives of their children. The role of the mother is significant as she has to bring positivity to her child with visual impairment by accepting his or her needs and providing her child with eternal support. Although, mothers of visually impaired children face various problems while rehabilitating their children. Challenges from society for any visually impaired child discourage the mothers but it is significant to deal with the social challenges with sensibility. Therefore, educated mothers think well about the life of their children with visual impairment. It is also concluded here that uneducated mothers feel difficulty with regard to dealing with their children as compared to the educated mother. 

Recommendations

The recommendations of the study are:

1. Mothers of children with visual impairment should be motivated & guided appropriately for dealing with the visual challenges of their child. 

2. Counselling services should be promoted in society for parenting children with visual impairment. 

3. Community-based awareness programmes must be carried out to eliminate negative perceptions of visual impairment. 

4. Educated mothers should be given training and provided with proper guidelines by the 5. Government to deal the children with visual impairment. 

Uneducated mothers should be given the necessary understanding of dealing with the visual challenges of their children with visual impairment.

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