Guide Before and With Pediatric Belt Cane

Updated: Jun 22, 2021

Children who are blind lack the functional vision needed to aid in their safe mobility. Two-year-old children who are blind are unable to use hand-held mobility tools to achieve consistent path information (such as white canes), however they are able to walk with a human guide (HG) to achieve orientation and mobility assistance.

HG is a term used to identify when a person who is blind holds onto another person when walking. It is recommended that the guide be positioned a half-step ahead of the person she is guiding. Guiding is a great way to increase speed and direction of travel.

It is very difficult for an uninformed guide (someone who is not a certified O&M specialist) and challenging for informed guides (O&M specialists) to provide effective mobility protection when guiding someone. That means even when guided by the best guide, two-year-old children who are blind do not experience adequate, consistent, or reliable tactile path information.

Tactile path information is essential for someone who is blind. They need cane arc safe mobility to assist them in discovering or avoiding obstacles, drop-offs, and surface changes that occur naturally within the environment. A blind toddler walking without reliable tactile path information collide with obstacles even while being guided (see photos below).

It is easier for a guide to walk correctly to a location (provide orientation), than it is for them to provide consistently safe path information (safe mobility) to a person who is blind. It is very challenging for a person acting as a HG to provide safe mobility, because people develop individual path avoidance strategies to achieve personal safe mobility and these individual strategies do not translate well to protecting two people walking together.

Sighted object avoidance strategies rely on sight and are so second nature, that it can be very difficult for sighted guides to remember that a blind person cannot visually avoid obstacles. Toddlers who are blind and encounter collisions when being guided are of great concern, because three-year-old children born blind, with no additional disabilities have been found to be eighteen months behind in gross motor skills (Ambrose-Zaken, 2021).

When children who are blind experience unavoidable collisions when being guided by an adult, it confirms to them that all walking strategies are inherently unsafe, and this fear prevents them from attaining effective guided and self-locomotion strategies. Ambrose-Zaken, Mcallister, & FallahRad (2020) suggested use of the term mobility visual impairment (MVI) to identify those children who require consistent tactile path information. They defined MVI as an inability to visually avoid obstacles. When children with MVI are being guided they may exhibit a tendency to pull away from the guide, have an uneven pace, and collide with obstacles.