The origin story of the field of orientation and mobility (O&M) is the stuff of Hollywood movies. It stars the blind heroes of WWII who returned home with an absolute belief in democracy for all. Once again on American soil, they fought for and won their right to be equally as safe when they walked as their sighted army buddies.
Our movie might open on a scene of young blind men in uniform being taught to use their short white and red colored wooden canes, called Lions Club canes, to signal to sighted drivers and pedestrians that they were, in fact, blind. "When the blind person crosses a street let him extend it so that everyone can see and be aware of his blindness" (Martin & Kleinfelder, 2008, p. 33).
The drama would juxtapose the sighted teachers being satisfied with their blind students' proficiency in using the Lions Club cane telling them they were ready to return to a full civilian life; with a group of brave, blind WWII veterans candidly admitting to each other that they were afraid to walk alone without more protection.
The blinded vets disliked the Lions Club cane because its only function was to identify them as blind. The Lions Club cane was not a mobility tool that provided the user with independent safe mobility.
Pictured below, a man and a woman demonstrate the Lions Club 'street crossing technique'. Note that by holding the short white cane in the air, they will be unable to know the exact location of the up-curb until they find it with their feet, a tripping hazard.
In the picture note the height and make up of the down-curb behind them:
Question: How did they know how deep that curb was before the stepped into the street?
Answer: They didn't.
Correct reaction: YIKES!!! That is unacceptably dangerous.
The origin story of Early Intervention O&M is not as well known, and yet it is equally compelling and classified under "I couldn't make this %#*! up" genre. In his autobiography, Russell (1962) described his experiences traveling the streets of Bronx, New York independently as a child. Born sighted, he lost his vision at age five. The first time he left the protective walls of his residential school, the New York Institute for the Blind, by himself was in 1936 when his parents gave the school their permission.
As he exited the school gates for the first time onto the busy streets of a major city, Russell didn't even have a Lions Club cane to wave at the sighted drivers to alert them that he was blind. Instead, he had only his visual memory and his twelve-year-old boyish enthusiasm to safeguard himself with, which really isn't at all safe. Russell remembered...
“With trembling hands, I took my first slip from the principal's office to my housemother and made a dash for the gate. I had nowhere to go; but to stand outside the fence was enough...Fortunately, there was another boy in the same predicament. Together we mustered the courage to explore the wilderness of the Bronx. Stumbling over curbs and running into lampposts, we finally covered the seven blocks to the business section of White Plains Road. After banging into nine hundred baby carriages, asking countless questions, and receiving much help, we made our way to the dime store..." (Russell, 1962, p. 62).
He describes stumbling and crashing into everyday objects as inevitable. He accepted every collision and disorientation on his way to the dime store as just a natural part of being an independent child, because the adults in his life told him so. As described in two prior blogs, unsafe mobility has long been viewed as an insurmountable outcome of congenital blindness.
Unsafe mobility has long been viewed as an insurmountable outcome of congenital blindness.
The most alarming concern is the institutionalized lack of recognition that walking blind without sufficient physical protection is incredibly dangerous and humiliating. Walking is fundamentally a sensorimotor activity and requires both sensory information and motor skills working together. In sighted people, the sensory information needed to walk is vision. In blind people its touch, which is where the mobility tool comes in.
The contact between the tip of the mobility tool and a surface transmits tactile feedback for the user to interpret and respond to. Its like reading a page of braille dots, only when they misread a cue from a mobility tool, it can cause life-threatening injury, such as falling into an open manhole.
Judy Dixon was born with a mobility visual impairment in 1952. She recalled, "...I never had a device until I lived in New York, and I was going to graduate school; I started using a cane" (Ambrose tapes, 2000).
In the late 1980s she, a long cane user and her husband, a dog guide user, both blind, were walking down a busy Washington DC street on their way to lunch. His dog avoided the manhole, as trained. But, as Judy explained,
A. I had a serious accident a few years ago. I fell down an open manhole and was really very seriously injured. And, and it was sort of interesting because uh it was open. I mean it was. It was. There were no barricades and I walked up to it and knew that it was there. You know, knew that it was a drop off, because I felt it with my cane. And I put my cane down and it encountered something. I thought it was a driveway. And I stepped down and swept out with my cane. Simultaneously as I believe I was taught to do. Well when I stepped down I, I stepped down on the top rung of a ladder that went down the side of this manhole. They called this thing an electric vault. It was 36 inches in diameter. And I started to ff —my foot slipped off the ladder and started going down bing, bing, bing down the ladder. Anyway started falling freely and fell all the way down twenty-four--a little over 24 feet. And I was really nervous about traveling after that. It was about 7 weeks before I, I could, could travel, or walk or do anything (Ambrose tapes, 2000).Instead of improving safety devices for blind babies health and well-being, as described in Parts I & II of this history of early intervention O&M, children born with a MVI/B have always been taught to be proud of their bruises gained through walking independently, no matter how much they hurt.
For example, below is a picture of a blind High School Senior approaching a descending stair without a long cane filmed in 1966. This film was intended to highlight the progress in teaching safe mobility to blind teens, yet they show multiple examples of blind children approaching stairs without any independent, physical means to detect the exact location of the drop off. As Judy's story illuminates for us all, it is unsafe not to know exactly where and how deep the drop-off is.
Sighted or blind falling hurts!
Blinded WWII vets in their twenties were not as gullible as children who were born blind. These men did not accept the precarious "stumble and crash" strategy of getting about town (Bledsoe, 2010).
When told that overcoming fear of injury was the only path to independence as blind men, they resoundingly and emphatically rejected this ending to their heroic tale. The men who had helped to defeat Hitler, Mussolini, and Hirohito had absolute faith in American ingenuity to overcome every obstacle, including this one.
The heroes of WWII refused to walk independently with a Lions Club cane because it did not protect them.
Bledsoe (1952) remembered that "upwards of fifty blinded soldiers had been transferred to Valley Forge, and the more articulate and vigorous of these were pounding the commanding officer's desk regularly, demanding that something "be done for them..." (p. 5).
At the highest levels of policymaking there was a deadlock, both inside the Army and outside. As the inaction of indecision wore on, "...far down underneath, as a buck sergeant, Dr. Hoover took over and started investigating foot travel and teaching blinded veterans how to get around" (Bledsoe, 1952, p.5).
Gilbert & Levy (1872) invented the constant contact cane technique.
United States Army Sergeant Richard Hoover is regarded as the father of the Lightweight Long Cane Technique. Hoover credited William Hanks Levy, a man who was blind since infancy, with the discovery. Like Hoover, Levy did not invent his long cane methods alone.
Elizabeth Gilbert, blinded at age two from scarlet fever, together with Levy, crafted and refined their long cane safe mobility technique through daily use. In 1854, Gilbert & Levy co-founded a vocational training program called "The Association for Promoting the General Welfare of the Blind". In 1872, they published their treatise on blindness under his name.
Their book contained a detailed description of how blind people can use a long stick for safe mobility. They described its shape, how to determine the correct length, and their system for systematically checking the surface
"...about six to nine inches from the feet, the ground will always be examined before being actually trodden (p. 70). They called it a "stick" but, please do not picture a branch off a tree.
Their stick was a well-crafted, elongated walking stick that was repurposed for safe mobility. It had a handle "somewhat like a hook, and sufficiently large to be grasped firmly, so that it may not easily be knocked out of the hand..." and "...suited to the height of the individual, but it should be longer than what would be used..." as a support cane. And "...it should always have a good ferrule*..." (Levy, 1872, p. 70). (*a ferrule is a metal cap or band placed on a wooden pole to prevent splitting) .
Gilbert & Levy described their long cane technique as "waving the stick alternately from right to left to correspond with the movements of the feet.” They explained that they made sure the width of the arc checked the ground ahead of the leading foot with each step (Levy, 1872, p. 70). There is no film of their cane technique, but they described the easiest, most natural way to syncopate the swinging of a long cane with one's pace.
In 1944, Hoover famously altered Gilbert & Levy's cane technique in two important ways. The Hoover technique, also known as the two-point touch cane technique, requires the user to tap the long cane back and forth drawing a small arc in the air between the taps. His most celebrated change was that he taught the men to control their long cane movements so that the tip checked the surface in front of the trailing foot as they walked.
Bledsoe (1977) explained on John Chester's radio show “Dialogue Today,” that the two-point touch cane technique is actually quite difficult to learn to use correctly as:
"Long cane use has to be taught and carefully taught in conditions and situations in which blind travelers go. One of the first things we discovered is that no one picks up a cane and touches in front of the trailing foot naturally. In fact, it takes hours and hours of training to get blind people to do it that way. It seems to be the opposite of conditioned reflex."
Videos of the two-point touch cane technique give the impression of a soldier marching in an army parade of one.
The Hoover technique was a product of good Army training. The originators of the field of O&M had all served in the US Army and endured endless hours of drilling, learning to walk with precision. When faced with the task of training blind soldiers to use a long cane to walk independently, what resulted resembled a long cane 'marching' technique; taping the cane with the precision sufficient to befit the uniform.
Tapping the long cane back and forth is less safe than keeping the cane tip in constant contact with the ground as it is swept back and forth, known as the constant contact technique (Kim & Wall Emerson, 2018, Levy, 1872; Sauerburger, 2024). Gilbert & Levy described the action of waving the cane from side to side which sounds more like a description of the constant contact cane technique, than tapping.
The constant contact cane technique recommends the essential protective arc be traced on the ground instead of in the air. It is easier to learn than two-point touch, safer, and still currently in use today.
US Army adopts Walk First Instructional Sequence
Hoover & Bledsoe, both sighted, and Russ Williams, blinded by enemy action in France in 1944, worked together with a small unit of men to create what they dubbed orientation and mobility (O&M) training for the blinded vets beginning in 1945.
The major problem with sighted and newly blind people inventing O&M is that the emphasis, concern, and worry most sighted people express is in getting lost, the orientation part. That's why it is first in the name and first in the sequence of instruction.
Yet for real blind people, such as Russell, Levy and Gilbert; not newly blind or sighted people wearing blindfolds, such as the originators of O&M and O&M graduate students; the real problem they write about most are the collisions. The lack of safety due to not being able to detect the obstacles in their path.
Russell described some of the perils he and his New York Institute for the Blind classmates experienced learning to ride the New York City subway on their own without any protection from or ability to detect mobility hazards, he remembered learning orientation was easy:
"We learned on which side the doors opened at each stop, where the curves in the track were, and at what stations we would hear a bell and what it meant" (Russell, 1962, p. 66). For them, sudden injury was harder to contend with.
Despite it being impossible to avoid injury when you can't see where you're going; these boys insisted it was their fault for falling into the gap between the train floor and the platform:
"Sometimes we made mistakes. Fortunately, they were usually unimportant, such as getting off at the wrong station to make connection with another line. But some times they were more serious. Some fellows, for example, either did not know how, or were simply careless about stepping off the Seventh Avenue at 177 Street. In some places there was a gap of ten or twelve inches between the train and the platform, and ignorance or carelessness frequently resulted in a bruised shin or a twisted ankle...Sometimes, though, accidents were the result of just plain bad luck (Russell, 1962, p. 66).
The purpose of a safe mobility tool for blind people is to feel the ground before each step. Today, blind people use long canes find the gap and step over it.
If the US Army knew how truly important the "simple" invention of long cane was to independent travel for blind adults, perhaps they would NOT have begun the sequence of teaching independent travel with pre-cane skills, first.
Pre-cane skills, as the name implies, are ways to walk about without the safety of a long cane. Pictured below are two people using a pre-cane skill.
The army's primary method and sequence for teaching O&M thus became first walk using pre-cane skills followed by learning long cane skills. Pre-cane hand gestures do not detect drop offs, tripping hazards, or surface changes. The army taught soldiers to orient inside the barracks calmly, efficiently and erectly without the safety of a mobility tool, first. The inadequacy of the protection from these "skills" causes them to be more like a fraternity hazing ritual, than a useful defense.
Most blind children rejected using pre-cane skills; a refined version of protective hand gestures like raising the hand to protect the face, or extending the arm to grope and feel along walls and furniture. These are hand gestures used by anyone who is sighted when they suddenly can't see where they're going, and feel unsafe.
Blind infants who grow up never having the ability to protect themselves when moving about lack any concept that safe mobility exists. Hand gestures do not change their safety in any meaningful way.
Blind infants who grow up never having the ability to protect themselves when moving about lack any concept that safe mobility exists. Hand gestures do not change their safety in any meaningful way.
In the 1960s, pre-cane skills were taught to school-aged children. In the picture below, we see a high school boy who is blind walking down the middle of a school hallway without any protection at all. The caption of the picture indicates that this blind high schooler's ability to walk unaided was heralded as safe and confident moving by a blind child. The terrible irony is that no matter how safe it looks to sighted people, there is nothing safe about a blind child who can't see moving through space unprotected.
The guide dog and the long cane demonstrated that blind travel could be safe and efficient. These were the first tools that could replace two functions of vision necessary for independent walking: obstacle preview and balance. Yet, in the 1960s when this photo was taken, the leading profile of a 'mobility tool user' had always been and adult with an adult-onset MVI/B who was smart and physically able.
The next blog will explore why the long cane was purposely kept out of schools in the 1960s and 1970s.
References
Ambrose, G. (2000). Judith Dixon Oral history transcript (Interviewed on
1/6/2000).
Bledsoe, C.W. (2010). Originators of orientation and mobility training. In W.
Wiener, R. Welsh, & B. Blasch, (Eds). Foundations of Orientation and Mobility:
Volume II Instructional Strategies and Practical Applications (3rd Ed) (pp.434-
485). AFB Press.
Bledsoe, C.W. (1952). Resistance. C. Warren Bledsoe Manuscript Collection, AER
O&M Division C. Warren Bledsoe Archives, museum of the American Printing
House for the Blind, Louisville, KY.
Chester, John, (1977). “Dialogue Today” C. Warren Bledsoe Manuscript
Collection, AER O&M Division C. Warren Bledsoe Archives, museum of the
American Printing House for the Blind, Louisville, KY.
Hatlen, P. & Wurzburger, P., Collins, R, & Kellis, T. (1966). Film entitled From
Here To There. https://www.youtube.com/watch?v=X58hWwXd8XI&ab_channel=annetucson (Accessed May, 21, 2024).
Kim, D. S., & Wall Emerson, R. (2018). Obstacle detection with the long cane:
Effect of cane tip design and technique modification on performance. Journal
of Visual Impairment & Blindness (Online), 112(5).
Levy, W. H. (1872). On the Blind Walking Alone, and of Guides” (pp. 68-76) in
(W. H. Levy) Blindness and the Blind: A Treatise on the Science of Typhlology.
London : Chapman and Hall
Russell, R. (1962). To Catch an Angel: Adventures in the World I Cannot See.
Vanguard Press.
Sauerburger, D. (Accessed May, 19, 2024) www.sauerburger.org/nodetect.htm