In the early 1900s, children with a mobility visual impairment or blindness (MVI/B) were educated at their state residential schools for the blind by well-meaning matrons and headmasters, or homeschooled. A mid-century epidemic in premature births and forward-thinking changes in United States (US) education law caused a dramatic shift to how and where the US educated its children with a MVI/B.
By the end of the 20st century, most were taught in their home school districts by university educated teachers certified in the field of blindness and visual impairment. An educator who bridged the first and the second half of the 20th century was Thomas Cutsforth, whom the 1963 New Outlook for the Blind necrology said was “the most often-quoted author in the entire field of blindness” (p. 114).
Cutsforth was born sighted in 1893 and became blind in 1904. In his book, The Blind in School and Society he declared, “No one as yet has adequately understood how to educate the blind” (1951, p. 2). His influence on educating children with a MVI/B can still be felt today.
The misunderstanding of the role of incidental learning & walking.
Cutsforth's first edition of his book was published just prior to the retinopathy of prematurity (ROP) epidemic, in 1933. A time when only those children with a visual impairment who were deemed 'educable' were allowed to attend their state residential schools for the blind. Although educated separately, they were held to the same educational standards as their sighted peers.
Cutsforth's education theories were based on his understanding of the concept of incidental learning. He understood incidental learning to be restricted to a purely visual experience, resulting in his assertion that sighted infants only learned to walk "...by watching" people walk (Cutsforth, 1951, p. 5).
Thus, despite of, or perhaps because of Cutsforth's own history of having had sight his first eleven years; he concluded that congenitally blind infants didn't walk because, they were "...aware of nothing, objectively, outside the arcs described by his unsteady hands and feet (1951, p. 5)”.
Yet, the converse of his statement is also true, which is they have no ability to protect themselves from being touched by obstacles. They have limited to ability to visually anticipate what lies in the path ahead, which is why holding on to a sighted person is a very effective adaption for blind babies.
In 1904, when Cutsforth lost his vision, he continued to travel independently with only the length of his arms and legs to protect him. His ability to get about without a long cane was something he was incredibly proud of, even after long canes were invented (Koestler, 1974). He did not use one and, like many others, worried they would result in 'soft blind kids' (Bledsoe, 1967).
When Cutsforth declared again in his 1951 printing, that "no one as yet has adequately understood how to educate the blind", he was speaking to the continued failure by educators to achieve the goal of getting otherwise healthy blind infants to walk independently on par with their sighted peers.
Especially the blind infants who looked the picture of health. They had good strong legs, and healthy torso, rosy cheeks and a great attitude. As they grew to be ten months old, they loved to laugh and play, and began weightbearing and walking holding on to furniture, even taking a few unaided steps. But after their first two years of life...they still would not walk very far, very fast, or very often, and they weren't talking much either.
Thus, the rationale given as to why blind infants were developmentally delayed is that sight was essential to early development. What is not mentioned by Cutsforth is the primary role vision plays in safe mobility, and the importance of safety in child development.
Walking is a sensorimotor skill, meaning it requires both 'physical' motor skills and 'sensory' motor skills working together to walk. Infants need both the physical ability to use their body to bear weight and propel themselves forward, they also need to rely on their senses to plan a route that avoids danger.
Infants with a MVI/B were simply expected to grow up accepting a life of walking into the unknown. The educators who could not achieve this goal were perplexed. Perhaps because they failed to understand the difference in walking ability specific to children who acquired blindness after they learned to walk and someone born blind.
Walking is a sensorimotor skill: Motor AND Sensory skills are required
Travel ability differences in children with adventitious and congenital blindness.
Having had vision during the first eleven years of life, Cutsforth's early experiences were very different from an infant born with a MVI/B. By age 11, he had learned to walk. He was able to bring all his walking skills and concepts into his new life as a blind child.
In 1904, for children like Cutsforth, going blind meant they had to learn to endure, even welcome, the bodily collisions they could no longer visually avoid. He attributed his success in life to this blunt method of adjustment, akin to a father throwing his son into the pool to teach him to swim. Those who succeeded believed it to be the best system of education, those who didn't... became developmentally delayed.
Cutsforth believed the only path to independence for blind children was the one he endured, one that was trod without a guide or white cane protection. Cutsforth’s second edition of The Blind in School and Society was published six years after the invention of the long white cane, in 1951. His advice on independent walking remained unchanged from the first edition, in 1933, to the final printing in 1972, reprinted nine years after his death.
Although he recognized touch as the child's connection to the world, he characterized the blind child’s need to stay in physical contact with the world as a bad habit that needed to be broken. Cutsforth's advice to parents was to withhold their helping hand when their child with MVI/B needed it most.
He wrote:
“When the child has once learned to walk, it is well to omit any form of
manual guidance about the house and to permit the child to become
oriented himself, even at the expense of minor injuries and emotional
distress of both the children and the other members of the family…"
(Cutsforth, 1951 p. 21)
Cutsforth's advice in this influential text included the well-known thesis that it was perfectly natural for blind children to get injured when they walked independently. His contribution was to oppose providing children with a MVI/B with any hand-held assistance, and later; he opposed the use of the long cane by children with a MVI/B (Koestler, 1976).
It was obvious from his advice to parents that there was still no successful method for getting infants with a MVI/B to walk. The only possible reason Cutsforth would have us consider was the child's natural inclination to walk was being held back by a parent who did not 'permit their child to walk...'
Cutsforth also felt the problem resided in residential schools. He advocated for children with a MVI/B to attend their local public school. While being educated close to home is an advantage, his evidence of this being the preferred educational placement was the accomplishments of "so many prominent blind men not educated in institutions, such as Gore, Pulitzer, Person, Schall, Irvine, Scapini..." (p. 203).
Each of these men became blind as teens and adults. As blind men in the early 1900s, their accomplishments in life are to be admired, but none of the men on this list were born blind.
This blurring of lines of the real life differences among men who became blind as beacons of what is possible for children born blind was all too common. Men like Cutsforth had great conviction that their experiences as children served them well to educate the next generation. Twelve-year-old Tommy Cutsforth believed his bruises earned his independence and, like Blacklock, believed his parents had been overprotective.
Their insistence that parents 'permit the child' with a MVI/B to walk freely appears to be a reflection of their personal experiences. They wanted more permission to move about independently, but their parents were no doubt trying to prevent harm. They had to witness to their sons' countless collisions, falls, and the affected walking posture that results from unprotected blind navigation.
Cutsforth and Blacklock were certain that all blind babies wanted to be set free. They believed blind babies were equally unaffected by bruises as they were. They blamed the parents that blind babies didn't walk.
The use of the word permit is intentional.
The reader should not assume that the often-repeated phrase ‘permit the child to become oriented...’ was based on published outcomes showing its success. It appears more likely to be a form of rebellion only available to adults looking back and repairing the perceived wrongs of their childhood.
'Permit the child' also fits neatly into the theory that he, Howe and Blacklock proposed, that mothers were preventing their children with a MVI/B from walking freely, because they wanted to protect them. 'Permit the child to walk' is based on the assumption that the blind child's tendency to sit quietly is driven by an external force (e.g., being prevented from walking), not an internal one (e.g., self-selecting to avoid the danger of walking without visual or tactile anticipatory control).
This narrative serves to "easily" explain the cause of children with a MVI/B's developmental delay, 'it is the mother's fault' (Hatton, Ivy, & Boyer, 2013; Howe, 1841; Huffman, 1957). Howe (1841) wrote “the mother runs and fetches whatever the child requires, and pets and humors it continually. The consequence is that he is unfitted for the rough arena of the world…” (p. 6).
The permit the child narrative places blame on external forces (e.g., the mother) for the consistent delays found in infants with a MVI/B early walking attainment. The child feels unsafe theory espoused by Ambrose-Zaken focuses on the internal, self-protective forces that prevent children with a MVI/B from moving into danger without effective protection. Adults control the external forces they provide children with a MVI/B. Unfortunately, the mothers' natural fear for the safety of their children with a MVI/B; and their children's clear fear of walking independently did not inspire innovation in safety tools for blind babies.
By not developing tools to improve blind babies safety, the families were left with improvising external forces to improve the safe mobility of their children, like holding their hands, pushing them in strollers, and shouting verbal warnings. These external forces impact the child's internal feelings of confidence.
In the picture, on the left, the physical therapist (PT) applies the external force of her position and readiness to intercept danger on behalf of the child with cortical visual impairment (CVI). The child is wholly unaware of what her therapist is doing to keep her safe. Thus, there is no internal feeling of safety directly resulting from the adult's actions.
On the right, the same child's PT provided the external force of a Belt Cane. The touch feedback from the Belt Cane child gives clear indicators that she is protected from obstacles in her path. Her internal feelings are easily measured in her outward confidence, improved quality, and amount of walking (Ambrose-Zaken, 2022, 2023; Ambrose-Zaken, et al., 2019; Penrod, Burgin, Ambrose-Zaken, 2024).
It should be very easy to understand there is a serious problem with any educational philosophy regarding infants that recommends bruises as an instructional method. In these often repeated phrases 'the permit the child to walk' and 'allow them to sustain injury' we see blind infants being treated very differently from sighted infants.
Teachers began reporting their experiences and offering how-to guides to assist other teachers in following this advice. In these publications, the walking intervention of having no protection is again and again shown to be the basis upon all educational initiatives for children who had no insider's knowledge of the seeing world.
18th century beliefs perpetuated in the 20th century.
In the 1960s, one of the foremost educators in special education reviewed the book, “Fun Comes First for Blind Slow-Learners”. He wrote, Huffman's text "...for classroom teachers, written by a classroom teacher..." was an instructional guide that had “been awaited with eagerness by teachers from Maine to California” (Goldberg, 1958, p. 65).
Huffman's (1957) gives us an inside look at the difficulty teachers had implementing these independent walking theories in real life. She was guided by the principle that blindness restricted her students' opportunities and the “lack of these experiences was… responsible for much the emotional disturbance and asocial behavior found in the children under the writer's supervision” (p. 3).
Huffman's remedy for lack of experience was to fill her students' days with experiences of roller skating, rock climbing and other thrilling challenges.
Huffman believed the teaching of safety was “…the same for all children. The only “…difference in teaching being that emphasis was placed on sound rather than sight” (Huffman, 1957, p. 76). Huffman gave the following example of how she employed a referee's whistle to protect her pupils with a MVI/B including those with physical and cognitive delays:
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“Any hazards or danger-spots in the school environment were utilized as a means of teaching objective lessons in realistic problems. Among tangible factors used to teach safety habits were: Steep steps, retaining walls with rough protruding rocks, roadways over which maintenance or delivery trucks frequently traveled; construction areas, deep and wide ditches…
For acquiring prompt group responses, a referee’s whistle was found to be convenient when used as a definite means of signaling. A long, shrill blast meant “Danger! Stand still! Listen!” The children were taught that this danger could be anything from an unexpected appearance of a car to the possibility of a child’s walking in front of a swing, stepping off in a ditch, or walking into some obstacle in his path.”
…When there was danger of an approaching car, one long shrill blast was blown, followed by the assembly signal of three short blasts repeated twice in succession. Next, I stepped to a safe place off the side of the roadway where the group collected in a compact unit until the car had passed” (pp. 76-77).
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Huffman made clear the difficulty she had supervising students who were unable to independently detect and avoid hazards. Contrary to the recommendations of Blacklock, Moyes, Howe, and Cutsforth no teacher could, in good conscience, allow her students to get hurt on her watch. Her detailed whistle types and their descriptions of communicating danger was a page long. She was on constant guard.
A side note: The problem with shouting general warnings is bind people are unable to see who the target of the warning is. When you shout “watch out”, what is the blind man supposed to do? You may have been warning your child from stepping into on coming traffic. Or you may have been warning him that he was about to step into a ditch. Sound is an inferior warning system when compared to touch (see Seatbelt safety).
Consider the problem of the "assembly signal" for a child with a MVI/B - what if there is a drop-off between the child and the assembly location. Without a safety tool, the blind child still doesn't know exactly where the drop begins or how deep it is. Those are the jobs of the white cane. 
Huffman intended for ALL her students within earshot of the whistle blast to stop what they were doing. All had to stop so they could find out which one of them was in danger. Huffman’s whistle was her unique solution to her very real problem caused by the lack of a white cane solution for her students.
Huffman began teaching children with a visual impairment TEN YEARS after the white cane had been invented. A white cane is a tool that enables the user with a MVI/B to use their touch sense to safely feel/detect “…steep steps, retaining walls with rough protruding rocks, and roadways... a ditch, or ...some obstacle in his path” two steps ahead (1957, p. 76). The next blog in this series will discuss the slow introduction of the long cane in schools.
Suffice to say, Cutsforth and Huffman were both right in their intensions, they wanted their students to be independent. They were misled from the beginning about the actual causes preventing their students with a MVI/B from walking freely. Their students had not been held back by their mothers, they were simply trying to protect themselves.
The blind child is aware of things he is in contact with through his hands and feet, and it makes a difference how he learns of objects. A Belt Cane is a white cane for blind babies, it gives them a two-step safety buffer, preventing most direct body collisions and gives clear indicators of objects and drop offs. The Belt Cane extends the reach of infants with a MVI/B in many meaningful ways.
References
Ambrose-Zaken, G., (2023) Beyond Hand’s Reach: Haptic Feedback is Essential
to Toddlers with Visual Impairment Achieving Independent Walking. The
Journal of Visual Impairment & Blindness, 117(4), 278-
Ambrose-Zaken. (2022). A Study of Improving Independent Walking Outcomes
in Children Who Are Blind or Have Low Vision Aged 5 Years and Younger.
Journal of Visual Impairment & Blindness, 116(4), 533–545.
Ambrose-Zaken, G. V., FallahRad, M., Bernstein, H., Wall Emerson, R., & Bikson,
M. (2019). Wearable Cane and App System for Improving Mobility in
Toddlers/Pre-schoolers With Visual Impairment. Frontiers in Education, 4.
Cutsforth, T. D. (1951). The blind in school and society; a psychological
study. (New ed.). American Foundation for the Blind.
Goldberg, I. (1958). Book Review: Fun Comes. First for Blind Slow-Learners.
Journal of Visual Impairment & Blindness, 52(2), 65-68.
Hatton, D. D., Ivy, S. E., & Boyer, C. (2013). Severe visual impairments in
infants and toddlers in the United States. Journal of Visual Impairment &
Blindness, 107(5), 325–336. https://doi.org/10.1177/0145482X1310700502
Howe, S. (1841). The Ninth Annual Report of the trustees, of the Perkins
Institution and Massachusetts Asylum for the blind 1841 from Boston:
Huffman, M. (1957). Fun comes first for blind slow-learners. With a foreword by
Samuel A. Kirk. C. C. Thomas.
Penrod, W., Burgin, X., & Ambrose-Zaken, G. (2024). Study Result: Pediatric
Belt Canes Improved Children with Mobility Visual Impairments Safety and
Independence. The Journal of Visual Impairment & Blindness, submitted for
publication.
The New Outlook for The Blind (1963). Necrology. 57(3), 113-114.
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