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Stunning Outcomes of the 2-year Belt Cane Project Led by NIU Professor Bill Penrod

Updated: Dec 16, 2023

Executive Summary

Results of The Northern Illinois University

2-Year Pediatric Belt Cane Study

 

The same boy is inside a school. On the left he is walking with a teacher behind him stretching her hands out to his shoulders. On the right side his is stopped because his belt cane frame is blocked in the hallway by furniture.

Photo: (left) 3-year-old boy with mobility visual impairment walks with safety assistance from his teacher (right) same child walks with safety assistance from his belt cane.

Dr. William Penrod, Orientation and Mobility Professor at Northern Illinois University (NIU) led a 2-year study to evaluate 50 blind children under the age of 5 before and after being introduced to wearing a pediatric belt cane. This research project was funded by a grant from the Lavelle Fund for the Blind. This Executive Summary reports the major findings of the study.

Fifty children (60% boys) with blindness or mobility visual impairment with an average age of 2 1/2 years participated in the study. The children resided in 22 states in the United States and 7 countries. They were blind (52%), mobility visually impaired (44%), or dual sensory impaired (4%). Mobility visual impairment was defined as having impaired vision such that they cannot visually avoid obstacles (Ambrose-Zaken, 2022).

Most of the children were described as requiring adult assistance when standing and walking. Walking with assistance is a 12-month motor milestone. Yet, 98% of participants were above the age of 12 months. The children had no physical impairment that explained their delayed walking.


Key Findings

Before belt cane, the children were inactive. They spent 65% of their time sitting or standing still while holding on to someone or something. They walked solo (without any help) only 13.8% of the time. Only 16% of the children were observed using any form of mobility tool and their average mobility tool usage time was 62 seconds.

When wearing the belt cane, the children were active. They spent 60% of their time solo walking and running and 18% solo standing. The belt cane significantly improved independent motor skills of blind or mobility visually impaired children under the age of 5. The children changed from passive, quiet, idle babies, to engaged, active little kids.


Figure 1

Percent of Time Engaged in Specific Motor Skills Pre-and Final-Belt Cane Video (n=50)


Final Post Belt Cane Video	Pre Belt Cane, Sitting final 0.041; pre 0.456; Standing with Assistance final 0.040; pre 0.208; Walking with Assistance final 0.106 pre 0.135; Standing Solo final 0.184, pre0.045, Walking Solo final 0.597, pre 0.139, Running/Hurried Walking Solo final 0.033, pre 0.002

Families and teachers cited a major problem was their children could not use their mobility tools (e.g., long canes) without full adult assistance. NIU found after the parents put the belt cane on the child, the children required little to no adult assistance to use the belt cane. This contributed their ability to be safe independent walkers. This is the only mobility tool that allows them to be fully independent. 

Providing blind toddlers with easy access to safe mobility made a significant difference in the amount and quality of their independent walking. Achieving independent, effortless walking is directly correlated to toddler gains in receptive and expressive language skills and the ability to engage socially with family and peers (He, Walle, & Campos, 2015; Oudgenoeg‐Paz et al., 2016).


Conclusion

NIU’s findings are consistent with previously published research on the motor skill delays, limited mobility tool usage in young learners with blindness and visual impairments, and the positive outcomes associated with belt cane use (Ambrose-Zaken, et al., 2024, 2023, 2022, 2019; Warren, 1994, Penrod, et al., 2023). Belt cane studies show children born blind or mobility visually impaired were safer and they consistently improved their independent walking when they wore their belt canes.

Safe Mobility is Essential to Blind Toddler Development. The photo below is of a 3-year-old boy who is mobility visually impaired. The two pictures demonstrate two methods of providing him safety information when walking. On the left, the adult provides safety information by clasping the child’s shoulders from behind and steering him towards the clear path. On the right, the child’s belt cane prevents him from walking into the obstacle. He can simply move his cane frame to locate the clear path. One method is passive, the other is active and engaged. The belt cane design makes safe independent mobility easy for blind toddlers.


Blind toddlers provided with an easy-to-use mobility tool demonstrated improved activity levels, safety, and independence. The belt cane enables blind toddlers to safely move about on their own and gain confidence in their ability to keep themselves safe. No other mobility tool has shown similar, positive outcomes for blind children.


References

Ambrose-Zaken, G., (2023) Beyond Hand’s Reach: Haptic Feedback is Essential to

Toddlers with Visual Impairment Achieving Independent Walking. The Journal

of Visual Impairment & Blindness, 117(4), 278-

Ambrose-Zaken. (2022). A Study of Improving Independent Walking Outcomes in

Children Who Are Blind or Have Low Vision Aged 5 Years and Younger. Journal of Visual Impairment & Blindness, 116(4), 533–545.

Ambrose-Zaken, G. & Anderson, D. (2024). Teaching Orientation and Mobility to

Learners who are Blind or Visually Impaired and have Cognitive Impairments.

in Foundations of Orientation and Mobility, Fourth Edition: Volume II,

Instructional Strategies and Practical Applications Chapter 19 (in press).

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.

He, M., Walle, E. A., & Campos, J. J. (2015). A cross-national investigation of the

relationship between infant walking and language development. Infancy, 20,

Oudgenoeg-Paz, O., Volman, M. J. M., & Leseman, P. P. M. (2016). First steps into

language? Examining the specific longitudinal relations between walking,

exploration and linguistic skills. Frontiers of Psychology, 7, 1—12.

Penrod, W., Burgin, X., & Ambrose-Zaken, G. (2023). Study Result: Pediatric Belt

Canes Improved Children with Mobility Visual Impairments Safety and

Independence. The Journal of Visual Impairment & Blindness, submitted for

publication.

 

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