As it was a hundred years ago, a thousand years ago, five thousand years ago, the key that will unlock the final gate to freedom for blind people lies not within their own grasp but in the hands of the rest of society.
The twentieth century has seen giant strides toward integration in education, in the economic sphere, in the social and communal aspects of life. Yet pockets of prejudice linger. The frontal attack—exhorting the public to abandon its fears and misconceptions—has thus far made little headway. Far more has been accomplished by subtler, if slower, forms of persuasion: by the ever more common spectacle of blind people matter-of-factly going to school or working at jobs, traveling unescorted on the streets and public conveyances, maintaining households, participating with neighbors in social and recreational pursuits, fulfilling their roles as citizens in communal and political movements.
The thought, persistence, and devotion—not to mention the uncounted millions of dollars—invested in achieving such gains have been documented in preceding chapters. As the last quarter of the twentieth century approaches, the field of work for the blind, evaluating its unfinished business and sorting its priorities, ponders a series of urgent questions. How are these gains to be safeguarded? Where do they need to be shored up? In what directions should new advances be attempted?
Indispensable to any kind of planning is the need to know the dimensions of the overall blindness problem. Estimates of the visually handicapped population in the United States that range from under 500,000, according to some authorities, to as many as 1,700,000, hardly constitute a sound base for realistic deployment of resources. More than 40 years of effort to arrive at a uniform definition of blindness which would take into account functional factors other than mere visual acuity, of attempts to develop uniform diagnostic techniques and to secure nationwide regulations for compulsory reporting of visual impairment, have not brought satisfactory results. The job remains to be done.
Allied with the demographic dilemma is the need to know and do more about the causes of blindness and the measures that can prevent or mitigate them. Many people continue to suffer needlessly from visual limitations that can be overcome, partially or even totally, through medical intervention or through proper prescription and use of low-vision aids. This is true even in cases where loss of vision is caused by the degenerative diseases of advancing age. New impetus is needed for extending medical and low-vision services to all population groups, for training professional and paraprofessional practitioners in these services, for expanding the operations of existing low-vision clinics and establishing new ones, for publicizing their availability and encouraging use of their facilities.
Renewed vigilance is needed, too, to head off future epidemics of blindness among children. Public health authorities are currently expressing concern over the failure of many low-income families to observe infant inoculation precautions. Reliable vaccines to shield children from measles, polio, rubella, scarlet fever, and other disabling diseases are readily available, but alarming numbers of young parents are neglecting to provide their infants with these protections. The rising incidence of venereal disease among all groups in the population is another potential cause of blindness that cannot be ignored.
As of 1972 the children severely damaged by the rubella epidemic of the mid-Sixties had reached school age. For at least the next decade or two, they will constitute a continuing challenge. Some will need extended, perhaps lifelong, custodial care. For others, existing programs of education, rehabilitation, and vocational preparation are largely inadequate. New thinking, new resources, and new techniques will have to be created. It is an open question (but one not yet universally faced) whether the residential schools for the blind will gradually phase out their traditional programs of academic and vocational education and serve exclusively as treatment centers for children with additional impairments.
Fresh thinking is also needed for the benefit of children whose sole impairment is blindness. Although six out of ten are already being educated in the public schools, and the proportion seems likely to increase, the quality of instruction is uneven and, in many places, leaves much to be desired. Too many teachers, never indoctrinated in how to cope with the special needs of blind pupils, handle the problem ineptly, showing overindulgence at one extreme or neglect at the other. Intensified efforts to achieve more enlightened teacher preparation remain high on the priority list. Equally urgent is the need for a new surge in parent guidance so that preschool blind children will be more adequately prepared for functioning in educational programs.
Even in many of the better public schools, blind students are not getting the benefits of a rounded education when they are automatically excluded from physical education classes, shop work, or home economics courses. Questions are beginning to be raised in educational circles about resource rooms. Is over-reliance on them becoming an expedient way of ghettoizing blind children?
More serious yet is the paucity of realistic vocational preparation and guidance services for teenagers. In 1972 the Foundation established a Task Force on Career Education to seek new solutions, both in the school systems and in the state vocational rehabilitation agencies, whose sometimes stultified thinking about career options for blind persons constricts the range of guidance and placement services offered young people. Questions are being raised about the unusually high proportion of visually handicapped youth enrolled in college programs. Does this represent sound planning for future careers, or is it merely a postponement of reality?
The basic thrust of vocational rehabilitation is also in need of reshaping. The product of wartime conditions, when the nation's consciousness was focused on manpower needs, the amended Vocational Rehabilitation Act of 1943 has been administered to accentuate the vocational rather than the rehabilitative aspect of its mandate. Today, thirty years later, technology has altered the need for manpower, and there are legitimate reasons for questioning whether emphasis should not be shifted to rehabilitation per se, so that the Act's provisions may also encompass persons outside the labor market, such as the elderly or the severely impaired, for whom improved functioning can result in less social and economic dependency.
Increasing attention to older Americans has been a dominant theme in the overall socio-political thinking of the Sixties and Seventies. At the beginning of the century, only 4 percent of the United States population was sixty-five or older. By 1960, increased longevity had raised this proportion to nearly 10 percent, and elderly men and women, better educated and more aware of their rights as human beings and their power as voters, began to make themselves felt as a significant force. A profusion of organizations, voluntary and governmental, arose to deal with the needs and demands of the aging.
In contrast to the one-in-ten ratio of the elderly in the general population, more than half of America's blind persons are in the over-sixty-five bracket. But at best, according to some sources, only 9 percent of the total resources for help to blind persons is directed to the needs of the elderly. The reasons are complex but stem from the same basic factor that accounts for the neglect of all aging persons: America's emphasis on a youth- and achievement-oriented culture. On top of this is the inertia induced by traditional patterns of social service delivery and the absence of any strong incentive to alter them.
In an effort to supply such incentive the Foundation, in 1968, assigned a program priority to the cause of the aging and appointed a Task Force on Geriatric Blindness to assess the dimensions of the problem and initiate steps to deal with it. In its four-year tenure the task force moved out in a number of directions. To ascertain whether blind persons could be assimilated into the programs of "golden age" centers and the like, it sponsored pilot projects in which five different cities in New York State tried out a variety of approaches. The results were uneven, but the overall experience indicated that, given enough time, motivation, and funds for such special services as transportation, this kind of integration with sighted peers could help overcome the major burden of social isolation among the elderly blind.
Another step took the form of a grant to the Community Service Society of New York to test the feasibility of including blind persons in that agency's Project SERVE (Serve and Enrich Retirement by Volunteer Experience), in which elderly men and women worked as volunteers in mental hospitals. Here, too, results were promising.
On a national scale the task force established links with other organizations concerned with aging, among them the American Geriatrics Society, a body of physicians specializing in treatment of the elderly. It participated in the effort to gain Congressional passage of the bill introduced in the Senate in 1971 by Jennings Randolph under which elderly blind persons would become eligible for rehabilitation services through the Vocational Rehabilitation Act. The effort failed because of a Presidential veto, but undoubtedly it will be renewed in the future.
The task force also contributed ideas toward the documentation of blind persons' needs in the deliberations of the 1971 White House Conference on Aging. It stimulated the convening of six regional symposia on the problems of the aging blind and the production in 1972 of an illustrated handbook, An Introduction to Working with the Aging Person Who Is Visually Handicapped, designed to serve as a practical guide for families and for those whose jobs bring them into daily contact with the elderly blind. The task force was replaced in mid-1972 by a standing Advisory Committee on Aging to ensure continuing advocacy on a national scale in this area.
Inevitably, lacunae exist between advocacy and action. How well geared are the providers of service to reorganize their programs or realign their priorities? How convinced are these agencies of the necessity or validity of making fundamental changes? In the late Sixties, two severe jolts to complacency seemed to have only transitory effects. One, the publication in 1969 of Professor Robert A. Scott's The Making of Blind Men, accused the agencies making up the "blindness system" of concentrating on only a small and select portion of the nation's blind people—the young, the employable, and the educable—and of holding these persons in captive dependency for needlessly long periods. By squeezing clients into a kind of Procrustean mold that fit their own concepts of attitudes and behavior patterns of blind people, the agencies were shaping those they served into "a learned social role." Moreover, Scott charged, agencies competed with one another for preferred types of clients and were unwilling to surrender any of their prerogatives, even in the face of unmistakable duplication of services.
Scott's accusations were reiterated in an even more sweeping body of criticism incorporated in a document prepared by the Organization for Social and Technical Innovation (OSTI) for the Subcommittee on Rehabilitation of the National Institute of Neurological Diseases and Blindness. Based on a one-year study of "blindness, its prevention and management, including rehabilitation," the OSTI report echoed and elaborated Scott's theme.
Not unexpectedly, many of the Scott and OSTI assumptions, as well as much of their data, met with indignant rebuttals. But however faulty the data, or exaggerated the implications, the basic philosophic issues reflect valid problems to be faced in the years to come. The "blindness system" assailed by these documents is a literary fiction; the "system" concept implies a degree of structure and an agreement on common goals and standards that has yet to exist. If an overall strategy for change is ever to develop, it will have to be preceded by a virtual revolution in social thinking—a revolution that discards the "cost-benefit" yardstick, which measures service costs against return on dollar investment, in favor of the human-benefit criterion that the function of society is to serve its members. In the American political and economic climate of the early Seventies, such a turnaround in values seems a long way off.
This is not to say, however, that the need for change is being ignored. The accreditation process, though advancing more slowly than was hoped, is producing critical self-examination and reevaluation of programs among the more progressive agencies and schools for the blind. As the base of accredited organizations broadens, pressure will inevitably be exerted on the weaker agencies to upgrade their practices. Liquidation or merger is the prospect faced by organizations whose programs, however useful they may once have been, no longer warrant continuation.
Accreditation, while serving to improve the performance of individual agencies, cannot supply the complete answer. There remains the problem of autonomous, sometimes superfluous services for particular religious or ethnic segments of the blind population, for special occupational groups, for different sexes and age groups. How to coordinate the activities of these free-standing organizations, how to end program duplications at the one end and bridge gaps in service at the other, will be a complex and long drawn-out piece of business, and the need for it is as yet barely acknowledged.
A logical source of strength in tackling such problems might seem to be blind persons themselves, who have to shuttle from one agency to another for an array of services. Most large cities have loosely organized groups of blind persons affiliated with one of two national associations, but their energies are more often focused on broad global concerns than on specific local issues. The larger and older national group, the National Federation of the Blind (NFB), currently centers its efforts on strident but largely unproductive attacks against long-established agencies and organizations in work for the blind. The younger and more moderate association, the American Council of the Blind (ACB), concentrates on a variety of self-help projects, both independently and in concert with national and local agencies.
The one arena in which both organizations have ever realized any real degree of their potential is that concerned with federal legislation, where their numbers could make an impact. Here, however, even the dissident NFB has been able to make itself felt only when it joined forces with the very groups it might be simultaneously attacking on other grounds—the American Foundation for the Blind, the American Association of Workers for the Blind, the Association for the Education of the Visually Handicapped, the Blinded Veterans Association, and the National Council of State Agencies for the Blind. Over the years, the NFB has made a number of efforts to go it alone in legislative campaigns, but it has yet to achieve a single-handed victory.
The most conspicuous experience of this kind took place beginning in 1957 in relation to a legislative proposal the NFB persuaded then Senator John F. Kennedy to introduce: "A Bill to Protect the Rights of the Blind to Self-Expression through Organizations of the Blind." This innocuously-titled measure, ostensibly designed to safeguard blind employees and clients of agencies benefiting from federal funds, contained a sleeper provision proposing that "the Secretary of Health, Education, and Welfare shall to the fullest extent practicable consult and advise with authorized representatives of organizations of the blind" and that policies and procedures should be formulated to "encourage" state agencies to do likewise.
As NFB's president rightly said, that last provision would give his organization "tremendous leverage," a fact which caused the principal spokesmen in work for the blind to voice strenuous objection to the bill. Their added reservations were on the broader philosophic grounds that such a law, by strengthening separatism, would impede the more desirable goal of integrating blind persons into general society. A resolution adopted by the AAWB at its 1957 convention charged that the bill "embodies a completely unsound and retrogressive concept of the responsibilities and privileges of blind persons as citizens."
The Kennedy bill, and its companion House measure introduced by Nevada Congressman Walter S. Baring, were the subject of extensive hearings conducted by the Subcommittee on Special Education of the House Committee on Education and Labor in March 1959. The hearings also took testimony on several collateral bills calling for the appointment of a Presidential study commission to examine the nation's services for blind persons. About half of the 50 witnesses who testified over a five-day period were NFB representatives urging adoption of the "right to organize" measure, while most of the remaining witnesses, representing the major organizations in work for the blind, testified in opposition to the Kennedy-Baring bill and in favor of a Presidential study commission.
A solo position was taken by one witness, Dr. Merle E. Frampton, whose testimony skirted the "right to organize" issue and centered on opposition to the study bills. That Frampton had a hidden agenda in so doing became clear two months later when the House subcommittee decided that instead of recommending any of the bills discussed at the hearings, it would set up its own staff study with Frampton as director. Virtually the sole accomplishment of this two-year exercise was to deflect the naming of a Presidential body and arrest the momentum of the "right to organize" bill. The latter could easily have been reintroduced by the NFB, were it not for an internal upheaval which saw the resignation of its founder and president, Jacobus ten Broek, and the split-off of some of its member groups into the separate American Council of the Blind. By the time the intramural squabbles had been settled and ten Broek resumed the NFB presidency after a five-year hiatus, his organization was zeroing in on new targets.
A brilliant legal scholar, impressive in appearance and commanding in manner, Jacobus ten Broek was graduated from the California School for the Blind and went on to secure a law doctorate, a graduate degree in political science, and a post as instructor at the University of California. He gained stature in California welfare circles through his appointment, in 1950, to that state's Social Welfare Board and his ascent to its chairmanship ten years later. He was an authority on constitutional law as well as on welfare legislation, and a prolific writer on these subjects.
Ten Broek first tasted the satisfactions of group action when he participated in the formation of the California Council of the Blind in the mid-Thirties. In 1940 the council joined with six other state organizations of blind people to form the National Federation of the Blind as a protest against what ten Broek called "the oppression of the social worker and the arrogance of the governmental administrator." (This was during that early period of the Social Security Act when blind people harbored legitimate grievances against the arbitrary manner in which Title X, Aid to the Blind, was being administered by many public welfare bureaus.) The NFB grew rapidly; by 1960 it could claim affiliates in 47 states and attract 900 delegates to its 20th anniversary convention.
Ten Broek's initial goals were not in conflict with those of others in leadership positions. In 1948 he said that all he asked was that qualified blind people "be given an equal chance with the sighted." The early activities of Federation members were concentrated on demolishing what they regarded as the barriers to this goal. Working with other groups, they played helpful roles in the struggle to force civil service commissions to end discrimination against employment of physically handicapped persons, in the campaign to open more vending stand opportunities for the blind in public buildings, and in the drive to gain more equitable treatment for blind persons in state vocational rehabilitation programs.
The real rift between the Federation and its erstwhile partners began in 1953, when the AAWB adopted its Code of Ethics and labeled as unacceptable the practice of raising funds through the mailing of unordered merchandise. This hit NFB squarely in the pocketbook, since its principal means of support came through the mailing of remit-or-return boxes of greeting cards. In 1957 the United States Post Office's Fraud Division issued a complaint against the NFB, charging that the letters accompanying the greeting card mailings falsely implied that all or most of the $1.25 asked for the merchandise would be used to assist the blind, whereas in fact the NFB's yield from each sale was only 15 cents. The complaint was dropped when the NFB agreed to amend its future literature to specify the exact amount accrued from each sale.
This incident, and the fact that it was fully reported in both the nation's press and in the major communication channels of work for the blind, gave the Federation the sense of being embattled; its list of "enemies" grew to embrace virtually the entire field of work for the blind. Such extremism gave way, in turn, to insurrection among some of its state affiliates; NFB conventions in the late Fifties and early Sixties saw bitter floor fights on motions to censure, suspend, or expel state chapters that objected to the autocratic structure which centered all organizational and fiscal power in the person of President ten Broek.
A report in the September 1958 issue of the New Outlook, describing the heated atmosphere of that year's NFB convention in Boston, drew a furious attack against the Foundation for publishing it and the Foundation promptly rose to the top of NFB's enemy list. However, the factional rivalry disclosed in the report was real enough. It came to a head in 1961 when ten Broek resigned as NFB president, blaming "internal strife and chaos." He returned to the presidency in 1966, and held the post until his death from cancer two years later at the age of fifty-six. He was succeeded by Kenneth Jernigan, a graduate of and former teacher at the Tennessee School for the Blind, who had moved ahead professionally to become director of the Iowa State Commission for the Blind.
Under Jernigan, the NFB entered a heightened phase of militancy, targeting its opposition first at the Commission on Standards and Accreditation of Agencies for the Blind (COMSTAC) and then at COMSTAC's successor, the National Accreditation Council (NAC). Against the latter it employed many of the same tactics used by other "rights" groups during the Sixties—mass picketing staged for maximum media coverage, along with a mail campaign addressed to senators and congressmen demanding that the federal funds which helped support NAC's budget be withheld because the council had inadequate consumer representation. This was accompanied by an unremitting barrage in NFB's house organ, the Braille Monitor, demanding that half of the accreditation council's board of directors be appointed by, and subject to the control of, the Federation. None of these devices had achieved their aim as of the end of 1972.
Paradoxically, at the same time as this warfare was being waged against the youngest (and presumably the most vulnerable) national body in work for the blind, NFB's Washington office continued for the most part to work in harmony with the established agencies on legislation affecting blind persons. In 1970 an informal group, consisting of the heads of the seven major organizations for and of the blind, began a series of semi-annual meetings to seek common ground in policy matters. One of the seven was the NFB, represented by Jernigan; another was the American Council of the Blind, represented by its then president, Judge Reese H. Robrahn of Topeka, Kansas. The ACB had 34 affiliates in 1971. Like the NFB, it had a blind lawyer as its Washington representative. Durward K. McDaniel worked in close cooperation with both NFB's John F. Nagle and Irvin Schloss, the Foundation's Washington man; the trio constituted the principal spokesmen for blind persons in the nation's capital.
The future course of these organizations of blind persons is difficult to predict. If they follow the developmental sequence of other dissident groups which emerged in the Sixties, they may sooner or later conclude that the surer, if slower, road to reform lies in working within the system rather than through attempts to tear it down, and in joining forces with the sighted community rather than marching under separatist banners.
For their part, most agencies for the blind have been slow to recognize legitimate demands for consumer representation in their policy-making bodies, but this, too, may well see change in the years ahead as collateral community organizations give way to pressures for a broader base. A true and equal partnership between blind and sighted persons in work for the blind remains a milestone yet to be reached.
At the same time there is no dearth of intramural problems. To cite just a handful:
The merest beginning has been made in affording orientation and mobility training to all who can benefit by it. There is an ever more pressing need to redefine the role of the workshop as a therapeutic agency or as a place of terminal employment for those unable to function in competitive jobs. There is an equally urgent need for vigorous action to end exploitative workshop practices where they exist. The impasse on vending stands in federal and state buildings must somehow be broken, and new opportunities actively pursued in factories and commercial buildings. Psychological tests truly applicable to the rehabilitation needs of blind people must be devised, and a more effective counseling role found for the psychologist. Agencies for the blind must be helped to end their isolation, build two-way working relationships with other community service organizations, and expedite the integration of blind persons into programs serving the sighted. Similarly, there needs to be a much greater degree of interdisciplinary exchange and cooperation, so that staff members who provide social, educational, recreational, and health services in these general agencies are better geared to work comfortably and constructively with blind persons. The technologically sophisticated sensory aids already available must be made more accessible, and there must be encouragement for continuing research on simpler, better, and lower-priced devices to mitigate the handicaps of blindness.
In the closing decades of the twentieth century, these and comparable challenges require at least as much creativity and clear-eyed leadership as those with which the century began. The cardinal difference is that there now exist tested and tempered agents of change which can mobilize the needed resources of brains, boldness and financial investment.
We in the United States … are today at the beginning of a movement which will not rest until all preventable blindness has been prevented, until the competent blind have found a recognized place of usefulness in the community, and until the condition of the rest, the aged and otherwise handicapped, has been truly ameliorated.
A worker for the blind in Massachusetts sounded this call to action in 1908. It echoes still.
