How far have we come?

1967 photo of preschooler who is blind and his teacher

This black and white photo was published in New Outlook for the Blind in September 1967.The picture is of a preschooler boy who is blind and his teacher. The teacher is behind him smiling and she is bent over. She is holding both of his hands as he walks. His head is bent down and she is holding his hands above his shoulders.

This was thirty years before orientation and mobility (O&M) was listed in the Individuals with Disabilities Education Act (IDEA) Part B (1997) as an essential support for children in preschool who are blind or visually impaired.

Why is the sighted teacher being led by the blind preschool student? He can’t see where they are going. He shouldn’t be the leader because he has no tactile path information. In fact, by grasping the child by both hands, she is exposing him to further risk, because he has no way to protect his body at all. Yet, this is not an outdated preschool human guide method. A week ago, I witnessed an O&M specialist using this same ‘guiding’ technique with a blind preschool boy.

Last week, the teacher had the three-year-old boy hang up his long cane at the classroom door, from there they walked like this to his chair. Her behind him, grasping both of his hands as he led the way. It was his chest that contacted the back of his chair first.

Who among us wants to locate a chair we can’t see with our chests?

I am concerned that in the fifty plus years since this black and white picture was published, we have not come very far in improving the safety of blind preschool children moving about inside classrooms.

The boy I observed last week was being taught to use a rod-shaped cane.

The O&M teacher stated that he was using the rod-shaped cane correctly for a child his age. The three-year old boy was observed walking very slowly as he held the cane tip off the ground. Although his cane tip was off the ground and behind him most of the time, his O&M instructor alternated between prompting him to re-position his cane and praising him for doing a good job.

His O&M instructor told me that his learning to hold the rod-cane briefly during O&M lessons put him on the road to one day becoming a terrific cane user. She indicated that the fact that the rod-shaped cane was not yet providing him with safety was not a problem, because for his age; it was an “acceptable outcome”.

Yet, once he located his chair, he sat like a lump and licked a toy, his language was non-existent as was his interest in anything beyond his tongue. A three-year-old boy who was physically able to walk, remained stationary in his chair, in his own world mouthing a plastic toy. This is not age-appropriate behavior for three-year olds.

Typically developing two- to three-year-old children walk about seven hours a day; and, on average, they walk as fast as 31 steps a minute for five minutes at a time (Bjornson, Song, Zhou, Coleman, Myaing, & Robinson, 2011).

Thus, instead of finding a better way for a blind three-year-old boy to independently navigate his world with safety, his O&M teacher has lowered the motor and play standards for her student. Early education professionals suggest the reason blind children remain stationary and don't play with any sophistication is they lack visual motivation. Lowry & Hatton (2002) wrote "...the motivation to move decreases in relation to the degree of vision loss" (p. 125).

They suggested that the children’s blindness kept them stationary, but they have never tried to provide them with developmentally appropriate mobility tools that kept them from being exposed to sudden bodily collisions.

Children born blind do learn to walk, but the stop walking- not because they can't see, but because they wish to avoid hurtful collisions.

Consider:

Children with correctable eye conditions are provided child-sized corrective lenses. Children with correctable hearing impairments are provided with child-sized hearing aids. Children who are paralyzed are provided with wheelchairs that fit their height and manual dexterity.

Why do we look at blind three-year-old children and say, they are not motivated, even when we all watch them routinely walk into walls, fall down the stairs and trip over obstacles? Why are O&M specialists taught that nothing can be done or needs to be done to prevent harmful collisions of blind toddlers until these blind babies grow up and finally learn to swing a rod-shaped cane for safety?

A child wearing his belt cane with a physical therapist behind him.

How far can they go?

To find a solution, we must first understand the problem. The problem children who are blind have is the need for mobility tools that match their physical and cognitive abilities.

Essential facts about toddlers and preschoolers:

1. Preschool children don’t run, because they are unsafe running with a long cane.

2. Preschooler’s lack the manual dexterity and cognition needed to operate a rod-cane arc for safety.

3. Preschool children who are blind don’t run, because they are unsafe running.

Preschool children who are blind do run when they feel safe and they feel safe when they wear their belt canes.

Jojo runs for the first time ever, wearing belt cane

Thus, the reason preschool learners who are blind are idle is that they lack a developmentally appropriate mobility tool. Having no tactile path information causes blind children to be afraid to move independently. They don’t move because they don’t have enough information about the path ahead.

Blind children can’t see the path, but when adults fit them with pediatric belt canes and allow them to wear their canes everywhere- they learn to feel the path ahead. When you give them consistent tactile path information – they do run, they do explore, they do move – even those who have never seen anybody else move before; because the mind wants to learn, the body wants to move, you don’t have to be sighted to have these basic human abilities.

Just like the child I met last week; wearing his belt cane he began to move freely about his classroom with great interest. What a triumph - it took less than thirty minutes of wearing his belt cane for him to begin to feel safe enough to follow his natural, preschool curiosity. He began to propel himself around his classroom wearing his belt cane. He was eagerly exploring everything he encountered.

His confidence was growing every time his cane contacted obstacles instead of direct body collisions. He got to decide what he wanted to touch with his hands and what he wanted to ignore.

Yet, as soon as I left, his teacher, O&M specialist and the classroom aids conspired to take his belt cane away from him. His brief encounter with safe mobility ended as soon as I walked out the door.

Many families and professionals are allowing their children/students who are blind to run and freely explore wearing canes. When blind children have consistent tactile path information that enables them to gain self-confidence needed to explore independently.

Pediatric belt canes are a wonderfully simple solution, an innovation that makes sense for children age five and younger who will one day be long cane users. Blind children do successfully transition from belt cane to rectangular cane to rod-shaped cane. They have no difficulty in learning to employ hand-held canes as they get older, because by wearing their belt canes they learn the benefits of consistent tactile path information for locating a clear path ahead.

In 2020, it's time to provide blind toddlers and preschool learners with the tools they need to develop to their potential. Pediatric belt canes are an essential first step to learning, because we all need safe mobility to learn.