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 so that she can hold both 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, he is exposed to further risk, because he has no way to protect his body with his arms. Yet, this, sadly, is not an outdated preschool human guide method.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? Not me.

Since this picture was published, we have not come very far in improving the safety of blind preschool children moving about inside classrooms. Very little has changed, except that in the 1960s it is doubtful that the little boy in the photo was expected to use a mobility aid other than this wonky version of human guide- wonky because the blind preschooler is the guide, even though he has no visual or tactile path information needed to confidently find a clear path to lead the way.

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, the teacher alternated between prompting him to re-position his cane and praising him for doing a good job.

In the opinion of his instructor, holding the cane briefly during O&M lessons put him on the road to one day becoming a terrific cane user. His teacher 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 and 'stimmed' on a toy. A three-year-old boy who was physically able to walk, remained stationary in his chair. 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, his O&M teacher has lowered the standards for him. Rather than identify and fix the cause of the problem, they dumbed down the standards.

Some professionals suggest the reason blind children remain stationary 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, not the fact that the children were being provided with inadequate mobility tools that left them exposed to sudden bodily collisions. Yes, they are stationary because they can't see, but not for lack of motivation.

In first world countries we do not have the same answer for other children who have correctable visual impairment, hearing impairment or for those who are paralyzed. 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 did Lowry and Hatton look at blind three-year-old children and say, the problem is their brains are different?

- Why do O&M specialists suggest, that nothing can be done until 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?

There is an alternative solution, when you understand the problem. The problem a child who is blind has is the mismatch of mobility tool and their immature physical development.

Simple fact: preschooler’s lack the manual dexterity and cognition needed to operate a rod-cane arc for safety.

Preschool children don’t run, because they are unsafe running with a long 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 wearable 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; he began to move freely about his classroom with great interest when wearing his belt cane. 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.

Children who are blind are running and freely exploring, right now, because they are wearing their canes and have consistent tactile path information that enables them to feel safe enough to explore independently. 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.

Several children have successfully transitioned from belt cane to rod-shaped cane. They had no difficulty in learning to make a consistent arc with a rod cane, because by wearing their belt canes they understood the benefits of consistent tactile path information for locating a clear path ahead.