Until now there was no mobility device for children under the age of two and there is a lack of funding for early intervention services holding children who are blind back from achieving their developmental potential.
Pediatric Belt Cane Solution
The pediatric belt cane addresses the problem of independent walking with safety which is critical for development. The first 1000 days of life from conception to age 2 are the most critical for brain and body development (Likhar & Patil, 2022). The last 365 of those days are the focus of this blog.
By age two, toddlers’ walking should be rhythmic and relaxed with a minimum of conscience effort. Yet, infants born blind or mobility visually impaired (B/MVI) without a pediatric belt cane are not able to walk effortlessly by this important milestone. Instead, they fall behind in their motor development when they reach the stage of independent walking that depends on vision for balance, between 12 and 18 months.
Sighted toddlers must rely upon their vision to let go and balance without holding on to objects or people. In the absence of vision, blind toddlers must rely on haptic feedback (touch) for balance (Ambrose-Zaken, in press; Hallemans & Aerts, 2009). ). For the first six years, blind children’s reliance on haptic feedback is their strongest, most effective means of achieving effortless, relaxed balance.
For every child for whom independent walking is a goal, the most important outcome of the first 365 days after a child’s first birthday is independent, relaxed walking that requires a minimum of conscience effort. That is because effortless independent walking is the necessary building block upon which concept, language, and social skills develop (Clearfield, 2011).
Toddlers who are congenitally or early onset B/MVI face several roadblocks to obtaining the tools they need to combat delays in independent walking.
The first roadblock is the lack of a mobility tool for toddlers who are blind. The pediatric belt cane solved that problem. The second roadblock is the lack of funding.
Follow the “LACK” of Money!
One of the key reasons there is a lack of money for blind toddlers is that the Individuals with Disabilities Education Act (IDEA) Part C defines early intervention services as “voluntary” for parents. The outcome of that provision is that States, public and private companies, and agencies have little incentive to fully fund and staff early intervention services.
Parents who do want to obtain services to assist them in supporting the needs of their disabled infants’ quickly find out whether they live in a good State or not.
A good State engages in child find activities, has plenty of nearby agencies staffed with highly skilled professionals with specialization in blindness including O&M. These providers come to their homes, and they can also access specialized centers for additional enrichment opportunities.
In Part C early intervention services there is a lack of funding and lack of choice of mobility tools offered in IDEA’s definition of orientation and mobility (O&M) instruction which reads, “teaching children as appropriate to use a long cane or a service animal to supplement visual travel skills or as a tool for safely negotiating the environment for children with no available travel vision.”(see Sec. 300.34 (c)(7)).
Teachers have been attempting to teach long canes to infants, toddlers, and preschoolers who are B/MVI and have found that toddlers can no more learn to employ a long cane or service animal for safe travel as they can safely drive a car. The good news is you can request a Pediatric Belt Cane for your blind toddlers.
Yes, IDEA can be used to pay for the pediatric belt cane to “supplement visual travel skills and as a tool for safely negotiating the environment.”
Trying to teach toddlers to employ complex mobility tools is limiting their developmental potential. The pediatric belt cane is the best, most appropriate and proven mobility tool from 12 months through age 5 (and beyond).
Instead of futile instruction in long cane skills, what could we be teaching? For infants aged 12- to 24-months who are blind or mobility visually impaired, the focus needs to be achieving effortless and independent ambulation with safety. We can substitute these complex tools with one designed specifically for toddlers.
The only effective mobility tool for toddlers born blind or mobility visually impaired is the pediatric belt cane (Ambrose-Zaken, 2022, Ambrose etc, 2019). The belt cane is effective for two reasons it provides haptic feedback and safety.
The belt cane does not hold a child up, it provides 12- to 15-month-old toddlers the essential haptic feedback they need to let go without visual feedback and still achieve independent balance on time. Independent balance is a prerequisite to independent ambulation. The belt cane also provides the wearer with an effective safety barrier. When children wear their cane frame, they learn to rely upon it to be in the right place at the right time.
The belt cane also provides toddlers with an important introduction to long cane skills. They learn to hold onto the side of the frame, to free it to locate a clear path, to respond to the cane, for example, learning to stop when the path is blocked or when they detect a drop off. The belt cane develops a child’s ability to be independently safe as they move about freely to explore to learn concepts, language, and social skills.
There are two published studies demonstrating the efficacy of belt canes with blind toddlers, there are no studies showing the efficacy of teaching blind toddlers or preschoolers to use the long cane for the purpose of safely negotiating their travel environment.
Prior to the belt cane, teachers have done what they could to attempt the impossible with these long cane (but not service animals) as named in IDEA Parts B & C, but these tools have been proven ineffective as essential mobility tools during the first 365 days of ambulation as well as the second 365 days and the third and fourth 365 days of ambulation.
Now that we have the Safe Toddles Belt Cane, the world’s only effective mobility tool for early intervention and preschools supported by research and readily available, it is time to build a coalition to rewrite Parts B & C of IDEA. For example, we need to make early intervention mandatory rather than voluntary so that States fully fund early intervention educational services. We also need to innovate and create more appropriate mobility tools and have them listed and funded through IDEA including the pediatric belt cane. It is our intention to continue innovating mobility tools that positively impact their early childhood development outcomes. Innovate. Facilitate. Legislate.
Ambrose-Zaken, G. (2022) A Study of Improving Independent Walking Outcomes
in Children Aged Five and Younger who are Blind and Visually Impaired. Journal
of Visual Impairment & Blindness.
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.
Clearfield, M. (2011). Learning to walk changes infants’ social interactions. Infant
Behavior and Development, 34(1), 15-25.
Hallemans, A., & Aerts, P. (2009). Effects of visual deprivation on intra-limb
coordination during walking in children and adults. Experimental brain
research, 198, 95-106.
Likhar, A., & Patil, M. S. (2022). Importance of Maternal Nutrition in the First 1,000
Days of Life and Its Effects on Child Development: A Narrative Review. Cureus,
14(10), e30083. https://doi.org/10.7759/cureus.30083