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October is Equal Access to Path Information Month!


In 1964, President Lyndon Johnson signed the first proclamation declaring White Cane Safety Day in recognition of the passage of the federal White Cane Law. Every October 15, the United States (US) president signs a White Cane Safety Day proclamation. Over the past 55 years, the meaning of White Cane Safety Day has evolved from the commemoration of the new law, to the broader observance of the white cane as a symbol of independence for people who are blind and visually impaired. In 2011, President Barack Obama added the name Blind Americans Equality Day to the White Cane Safety Day proclamation.

The advantage of the long white cane is that when used properly it provides the user with consistent tactile path information. Yet, consistent tactile path information is more important than any one type of mobility tool. For example, guides dogs were the first independent mobility

tool, introduced in 1923 and they are still used today, by blind adults. Children are not mature enough to employ guide dogs, that’s why it is very rare that a high school student would have a guide dog before graduation.

In 1932, the Lions Club disseminated a short, white cane with the express purpose of helping blind adults get the attention of drivers when they wanted to cross streets. In 1945, it was the blinded veterans who demanded and got better mobility tools. The US Army made the white canes longer, lighter and more durable.

The long white cane began to be introduced to high school students in the 1960s. By 1997, education law entitled the Individuals with Disabilities Education Act (parts A, B and C) listed and defined orientation and mobility (O&M) services for students birth to 22 years of age with visual impairment and blindness. Orientation and mobility are the specialized skills and techniques for teaching travel with a visual impairment (including teaching the use of the long cane).

Yet, there was still no effective solution for consistent tactile path information for children five and younger born severely visually impaired and blind. Skellenger and Sapp (2010) wrote that “a major overriding role of O&M specialists working with learners in the early childhood years will be the facilitation of the child’s typically innate enjoyment of exploration, which is so often thwarted by absent or impaired vision” (p. 168). The authors stated the role of the practitioner was to continue with enrichment activities until such time as these students with visual impairment demonstrated “higher developmental skills that indicate readiness to begin long-cane instruction” (p. 190) and lack of competence with the long cane was considered probable through age five.

In the same O&M Foundations textbook, Rosen stated that children born severely visually impaired or blind were typically 3-6 months behind in gross motor skill development, and reasons for delays included "…apprehensions about moving in space without vision." The concern, Rosen explained, was that gross motor skills, "the ability to move about and explore is essential to global development and forms the foundation for cognitive development."

Children age five and younger do not benefit from long canes, because the long cane is only useful when used correctly (one step, one swipe, no prompts).

Yet it is hard to follow the logic that suggests that ‘because blind toddlers are unable to physically and cognitively use the long cane correctly to achieve consistent tactile path information, that they don’t need consistent tactile path information. Therefore, it is only when they are able to use the long cane correctly, that they need consistent tactile path information.’ This is not logical, because everybody needs path information to move about safely, especially children aged five and younger.

The expert advice of the O&M Foundations textbook is that children who are congenitally visually impaired and blind should be taught to explore their environment with damaged or no path information, despite their reluctance to move about free of an adult’s hand and that moving freely with impaired vision caused developmental delays.

Yet, in 2019 children born blind and visually impaired are asked to navigate their first five years without access to consistent tactile path information and it is causing them harm. That is why Safe Toddles has declared October to be Equal Access to Path Information Month.

We need a full month of awareness on behalf of children born severely visually impaired and blind, because path information is not optional hence the light bulb and specialized mobility tools.

Children born severely visually impaired and blind who are age five and younger demonstrate their need for mobility tools through their poor motor skills such as developing a slow, halting gait, delay in walking free of an adult’s hand, and bruises from colliding with unseen obstacles. In fact, Wyver and Livesey (2003) review of motor skill research on children with visual impairment concluded, “…findings are generally consistent despite the studies being conducted in a wide range of settings, in a variety of countries and with children with varying degrees of visual disability... there is strong evidence of an adverse impact of visual impairment on motor development” (p. 25).

Bakke, Cavalcante, De Oliveira, Sarinho, and Cattuzzo (2019) reviewed 1113 articles on motor skills with visual impairment. They stated that, “… motor development in children with visual impairment is expected to be different from that in typically developing peers” (p. 1). The studies focused on changing the environment and/or offering adapted physical therapy training to address the motor skill impact on this population. Yet, none of the research reviewed sought to investigate whether these motor skill deficits could be avoided.

Instead, researchers overwhelmingly agreed that severe visual impairment and blindness resulted in motor skill delays. The delays were due to a lack of anticipatory preview of the environment and the consensus has been that for children five and younger who are severely visually impaired and blind nothing can prevent these “inevitable motor skill delays”.

Yet, although blind adults have successfully thrived using tactile path information (the long white cane) for almost 80 years, none of the 1113 studies investigated the use of mobility tools for providing path information to congenitally blind learners aged five and younger. Why have researchers failed to hypothesize or propose a method to apply what is understood to be the benefits of white canes for blind adults in order to propose a developmentally appropriate mobility tool for blind babies, toddlers and preschool learners?

It is true, children five and younger with severe visual impairment and blindness are unable to employ rod-shaped canes or any mobility tool that is employed by hand, but it is also true that they need consistent tactile path information for effective, safe ambulation. The provision of consistent, tactile path information would prevent these motor skill delays.

Safe Toddles says celebrate equal access to path information month by learning more about wearable canes because wearable canes provide learners five and younger with path information in an easy to interpret tactile form (Ambrose-Zaken, FallahRad, Bernstein, Wall Emerson, & Bikson, 2019). Children five and younger who are blind and visually impaired benefit from wearing their canes every day all day, because they need path information and wearable canes provide them with tactile path information in a developmentally appropriate mobility tool.

We celebrate October as Equal Access to Path Information month because we are committed to improving families and professionals’ understanding of the urgency of supplying appropriate mobility tools to children age five and younger who are born severely visually impaired and blind and we have the tool that helps them -a wearable cane (see photo).

References

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. doi.org/10.3389/feduc.2019.00044

Bakke, H., Cavalcante, W., De Oliveira, I., Sarinho, S., & Cattuzzo, M. (2019). Assessment of Motor

Skills in Children With Visual Impairment: A Systematic and Integrative Review. Clinical

Medicine Insights. Pediatrics, 13, 1179556519838287.

Skellenger, A. C., & Sapp, W. K. (2010). Teaching orientation and mobility for the early childhood

years. In W. R. Wiener, R. L. Welsh, & B. Blasch (Eds.), Foundations of orientation and mobility

(3rd ed., Vol. II, pp. 163-207). New York: American Foundation for the Blind.

Wyver, S. R., & Livesey, D. J. (2003). Kinaesthetic sensitivity and motor skills of school-aged

children with a congenital visual impairment. British Journal of Visual Impairment, 21(1),

25–31. https://doi.org/10.1177/026461960302100106


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