Ambrose-Zaken’s theory “Safe Mobility is Essential to Achieve Developmental Potential” helps us to understand the psychological reasons unavoidable collisions cause children who are blind and mobility visually impaired harm. When toddlers who are blind and mobility visually impaired are not provided safe mobility, any independent walking achievement predictably regresses to the 12-month walks with assistance or crawling, the 11-month milestone cruising or 10-month milestone stands, that is they stop all walking activity (Ambrose-Zaken, 2021).

​

Children who are blind or mobility visually impaired who have been encouraged to walk independently, have experienced unavoidable collisions, because unavoidable collisions are the only dependable consequence of independent walking when blind or mobility visually impaired. Ambrose-Zaken’s theory is that children who are blind and mobility visually impaired walk very slowly or request to walk with assistance because they have become afraid of walking independently.

​

Ambrose-Zaken’s theory combined Maslow’s Hierarchy of Needs with the Expanded Core Curriculum’s “nine areas of instruction children with visual impairments (both those who are blind and those with low vision), including those with additional impairments, need to be successful in school, the community, and the workplace” (Sapp & Hatlen, 2010, p. 338) to demonstrate that safe mobility, the ability to independently detect collisions before they impact the body, is essential to achieving one’s developmental potential.

​

The first rung of Maslow’s hierarchy is Physiological Needs. Physiological needs were defined as biological requirements for human survival, e.g., reliable access to food, shelter and good health.

None of the expanded core curriculum areas are included in that rung. A child who lacks food, shelter and good health can learn, but if nothing changes to improve access to these necessities they are not going to develop to their full potential. If these needs are not satisfied the human body cannot function optimally. Maslow considered physiological needs the most important as all the other needs become secondary until these needs are met. Children’s learning cannot be as robust when much of their energy and mental focus is diverted to solving these more pressing concerns.

 

The next rung is Safety Needs defined as stability, order, freedom from fear including safe mobility. Once an individual’s physiological needs are satisfied, the needs for security and safety become salient. People want to experience order, predictability and control in their lives. These needs can be met external supports derived from family and societal structures.

 

Toddlers who are blind and mobility visually impaired lack the visual ability to gain control over their independent movement essential to improving their internal feeling of safety. This lack of control that results in living in a constantly unsafe state driven by an inability to independently improve their safety (e.g., reduce accidents and injury while moving freely) is detrimental to toddlers who are blind and mobility visually impaired independent walking progress, which prevents their age-appropriate exploration of the environment.

 

In the expanded core curriculum (ECC) “orientation and mobility” were listed together as one of the nine areas of instruction. We see these as two areas. The first area is safe mobility and is listed in the safety rung, the term “orientation” has been replaced with the terminology “independent travel skills” and located within the Love and Belonging rung. Early independent walking is awkward, unbalanced. The toddler can harness this skill into purposeful, intentional, directed way finding only through daily practice.

 

Increasingly safe independent walking is fundamental to learning. The onset of independent walking triggers immediate, significant acceleration in language growth; a pattern that is stable and is evidenced across cultures. Infants’ walking experience significantly predicts both receptive and expressive language growth with walking infants having significantly larger vocabularies than their age‐matched peers who are not yet walking. The ability to walk affords new opportunities and experiences that bolster infants’ language development.

​

Children who are blind and mobility visually impaired need access to safe independent mobility most of the day in order to obtain similar amount of walking practice as their sighted peers. The areas of the expanded core curriculum that are included on this rung are self-determination, compensatory functional, and sensory efficiency. Children who feel safe enough to independently explore develop self-confidence. Children who possess self-confident independence can acquire self-determination. The practice of independently moving about also develops their sensory efficiency.

​

The importance of safe mobility to toddlers who are blind and mobility visually impaired is equal to that of a sighted child or adult. All toddlers need adults to protect them. Adults turn on the light switch for sighted toddlers, otherwise they would be left in the dark as they cannot reach the switch. Toddler who are blind or mobility visually impaired need adults to ensure their safety by providing them with effective tools. Toddlers who are blind and mobility visually impaired cannot secure effective mobility tools for themselves. They also cannot make sure their belt canes are fastened to them. Toddlers are not responsible enough to oversee their safety.

​

Once adults have secured safe mobility and made room for all the changes that a pediatric belt cane brings to the environment- children born blind and mobility visually impaired will be able to feel safe when independently mobile, a feeling needed to reach their developmental potential.

Each rung on this pyramid relies on the lower rungs. Children who know only collisions, cannot benefit fully from the next rung entitled Love and Belonging nor can they seek it out. After physiological and safety needs have been fulfilled, the third level of human needs is social and involves feelings of belongingness. 

 

Belonging and Love refers to a human emotional need for interpersonal relationships, affiliating, connectedness, and being part of a group. Two belonging and love needs which are at risk in children who are blind and mobility visually impaired are trust and acceptance. It is inherently unsafe to walk and run if you cannot see where you are going. The trust of children who are blind and mobility visually impaired is challenged each time they are encouraged by another to move about freely into harm’s way.

​

A child who is blind and mobility visually impaired without pediatric belt canes who knows only unavoidable collisions resulting from their desire to walk independently may build a protective shell, wall themselves off from the pain caused by independent exploration and the failure of those around them to protect them. Children who are blind and mobility visually impaired may develop a protective shell from experiencing a world that seems bent on harming them and the knowledge that they can do nothing to avoid the harm except to stay in one place, which results in developing self-stimming activities, echolalia and tactile defensiveness.

​

Toddlers equipped with the pediatric belt cane can achieve “independent travel skills”. The ability to be oriented when walking safely is the basis for development of complex travel skills, navigating home environments, neighborhoods, indoor shopping and greeting every environment with confidence.

​

Preschool learners who are blind and mobility visually impaired and are eager to walk independently can learn how to stay with the family, the rules of store etiquette, movie theaters, playgrounds. A child who is blind and mobility visually impaired who is happy in the knowledge that the cane frame will prevent most bodily collisions, eagerly runs into the world to discover and begin to acquire independent travel skills, recreational and leisure skills and social interaction skills through experience and direct instruction.

​

Consider the contrast of achieving the next rung Esteem.  Esteem needs are the fourth level in Maslow’s hierarchy and include self-worth, accomplishment, and respect. Maslow classified esteem needs into two categories: (i) esteem for oneself (dignity, achievement, mastery, independence) and (ii) the desire for reputation or respect from others (e.g., status, prestige).

Compare the esteem of children who are blind and mobility visually impaired growing up knowing every step for them is uncertain. Yet their siblings (including younger children), parents, teachers, can move and avoid colliding with obstacles. From the very beginning of understanding children who are blind know only that they are unable to be like others in this important respect but can’t understand the abstraction that they are not all the same sensory-wise.

​

Self-actualization needs are the highest level in Maslow's hierarchy, and refer to the realization of a person's potential, self-fulfillment, seeking personal growth and peak experiences. Maslow (1943) describes this level as the desire to accomplish everything that one can, to become the most that one can be.

​

Some children who are blind indeed do grow up and graduate high school despite these difficulties. The question to ask of any child who is blind or mobility visually impaired who achieves success, despite of these tremendous odds, is what they could have achieved given a life of predictable, reliable, independent safe mobility during their sensorimotor period of development.

There are many children who are blind and mobility visually impaired with developmental delays, how many of them could have, if not held back by unsafe mobility, been on par with their development? How much did a constant risk of unavoidable bodily collisions exacerbate or even cause additional disabilities?

​

What is the true price of developmental delay? What is the price of fear of independent walking?

We can celebrate those blind children who can make it despite a lifetime of unavoidable collisions, but it is the development of self-worth, through self-reliance and self-confidence that enables us to consider career, living independently and adopting assistive technology. Consider the unemployment rate of adults with visual impairments has remained consistently above 70 percent. One major reason is orientation and mobility concerns. How many of the academically successful high school students who are blind are afraid to independently travel? The key is not to celebrate the few notable children who may succeed despite hardship, but instead to provide children with nurturing environments so that they can thrive.

​

Toddler’s who are blind and mobility visually impaired experience with unavoidable collisions causes them to fear natural inclination to run and explore. Children who are blind and mobility visually impaired who grow up without an independent means of safe mobility are at greater risk. Resilience among children and adults may account for those who “beat the odds” but given the reality of the need to see where you’re going- either visually or tactually- it is common sense to solve for safe mobility as early as possible, rather than risk the outcomes of developmental delay, and poor employment that befall so many children who are congenitally blind and mobility visually impaired.

​

Instead of celebrating those children who “beat the odds” we would do better to help all blind toddlers achieve their true potential by providing them the tools they need to develop on par with their peers.

​

If you are willing to turn on the light switch for a sighted toddler, then perhaps you would be willing to secure a pediatric belt cane for a blind toddler.