History of Early Intervention O&M: The First Half of the Twentieth Century

At the dawn of the 20th century, most children with a mobility visual impairment or blindness (MVI/B) in the United States were educated at state residential schools for the blind. There, well-meaning matrons and headmasters — often with little formal training — supervised their daily lives. Others were homeschooled, depending on parental initiative and access to community resources.

A mid-century convergence of factors — an epidemic of premature births leading to retinopathy of prematurity (ROP) and sweeping changes in U.S. education law — would radically reshape how children with MVI/B were educated. By the century’s end, most were learning alongside peers in local districts, taught by university-trained educators certified in blindness and visual impairment.

Among the influential voices bridging the two eras was Thomas Cutsforth, whom New Outlook for the Blind described in 1963 as “the most often-quoted author in the entire field of blindness” (p. 114). Born sighted in 1893 and blinded at age 11, Cutsforth became a leading philosopher of blindness education. Yet his most quoted line, “No one as yet has adequately understood how to educate the blind” (1951, p. 2), reflected a truth he himself could not resolve.

A Century-Old Misunderstanding: Incidental Learning and the Act of Walking

Cutsforth’s first edition of The Blind in School and Society (1933) was published just before the ROP epidemic expanded the population of congenitally blind children. At the time, only “educable” blind students were admitted to residential schools, and even then, they were expected to meet the same academic standards as sighted peers — without equivalent access to safe mobility.

Cutsforth believed that infants learned to walk by watching others walk, concluding that congenitally blind infants “are aware of nothing, objectively, outside the arcs described by [their] unsteady hands and feet” (1951, p. 5).This statement, grounded in his own experience of once having sight, ignored the core difference between adventitiously and congenitally blind children: the ability to protect oneself from unseen obstacles.

A sighted infant or a child who once saw learns to anticipate hazards visually; a blind infant cannot. Holding a parent’s hand, hugging a wall, or moving cautiously are intelligent adaptations, not developmental deficits.

Yet, having lost his vision at 11, Cutsforth learned to navigate through trial and impact — collisions were his classroom. He took pride in traveling “with only the length of his arms and legs” as protection, even after long canes were invented (Koestler, 1974). Like many peers, he feared canes would produce “soft blind kids” (Bledsoe, 1967). His philosophy was endurance over safety — and he taught generations to follow suit.

The Invisible Difference Between Adventitious and Congenital Blindness

Cutsforth’s independence came from visual memories, spatial concepts, and confidence developed before blindness. But those born blind had none of these. Expecting them to walk unaided was like expecting a sighted child to walk blindfolded toward unknown sounds.

For children like Cutsforth, independence came through surviving collisions. For those born blind, it often never came at all. Yet educators failed to grasp this difference. The enduring mantra — “permit the child to walk” — placed blame on protective parents rather than on unsafe conditions.

Cutsforth’s advice to parents was explicit:

“When the child has once learned to walk, it is well to omit any form of manual guidance about the house and to permit the child to become oriented himself, even at the expense of minor injuries and emotional distress...”(Cutsforth, 1951, p. 21)

This sentiment echoed the 18th-century writings of Blacklock, Moyes, and Howe, who urged parents to allow bruises as “good influences” on blind children’s development. Across centuries, the core idea remained unchanged: pain builds independence.

Cutsforth's opposed providing children with an MVI/B with hand-held assistance, and later; he opposed the use of the long cane by children with an MVI/B (Koestler, 1976).

Cutsforth wrote the problem resided in residential schools. He advocated for children with an MVI/B to attend their local public school. While being educated close to home is an advantage, his evidence of this being the preferred educational placement was the accomplishments of "so many prominent blind men not educated in institutions, such as Gore, Pulitzer, Person, Schall, Irvine, Scapini..." (p. 203).

Gore, Pulitzer, Person, Schall, Irvine, Scapini became blind as teens and adults. As blind men in the early 1900s, their accomplishments in life are to be admired, but none of the men on this list were born blind.

This blurring of lines of the real life differences among men who became blind as beacons of what is possible for children born blind was all too common. Men like Cutsforth had great conviction that their experiences as children served them well to educate the next generation of congenitally blind children.

Twelve-year-old Tommy Cutsforth believed his bruises earned his independence and, like Blacklock, believed his parents had been overprotective.

Their insistence that parents 'permit the child' with a MVI/B to walk freely appears to be a reflection of their personal experiences. They wanted more permission to move about independently, but their parents were no doubt trying to prevent harm. They bore witness to their sons' countless collisions, falls, and the affected walking posture that resulted from unprotected blind navigation.

Cutsforth and Blacklock were certain that all blind babies wanted to be was set free. They believed blind babies were equally unaffected by bruises as they were. So they blamed the parents that blind babies didn't walk.

The “Permit the Child” Myth and the Mother’s Blame

The phrase “permit the child to walk” became a convenient explanation for why blind infants failed to walk on time. It suggested overprotective mothers were the problem. Howe (1841) had written the same a century earlier:

“The mother runs and fetches whatever the child requires… The consequence is that he is unfitted for the rough arena of the world.”

This theory — that parental overprotection, not sensory limitation, caused developmental delay — endured well into the 20th century (Hatton, Ivy, & Boyer, 2013; Huffman, 1957). It ignored what Ambrose-Zaken and colleagues later termed the “child feels unsafe” theory: that blind infants limit their movement because they lack a reliable method of protection.

Without tools for safety, families relied on “external forces” — holding hands, guiding, shouting verbal warnings — that managed risk but did not create internal confidence. A shouted “watch out!” is useless to a child who cannot see where “out” is. The only reliable warning system for someone who cannot see is touch.

Mother accidently guides her blind son into heavy wooden toy.

In the picture, on the left, the physical therapist (PT) applies the external force of her position and readiness to intercept danger on behalf of the child with a cortical visual impairment (CVI). The child is wholly unaware of what her therapist is doing to keep her safe. Thus, there is no internal feeling of safety directly resulting from the adult's actions.

On the right, the same child's PT provided the external force of a Belt Cane. The touch feedback from the Belt Cane child gives clear indicators that she is protected from obstacles in her path. Her internal feelings are easily measured in her outward confidence, improved quality, and amount of walking (Ambrose-Zaken, 2022, 2023; Ambrose-Zaken, et al., 2019; Penrod, Burgin, Ambrose-Zaken, 2024).

Educators Confront the Reality of Unsafe Mobility

The writings of Elizabeth Huffman (1957) reveal the enormous practical challenges teachers faced. In Fun Comes First for Blind Slow Learners, she documented the constant vigilance required to keep children safe in environments full of unseen hazards:

“Steep steps, retaining walls with rough protruding rocks, roadways… deep and wide ditches…”

To prevent injury, Huffman developed an elaborate whistle-code system — one long blast for danger, three short for assembly — to stop all students until she could determine which child was in harm’s way. Her method was creative but reactive, a desperate attempt to compensate for the absence of a proper mobility tool.

Ironically, Huffman began teaching a decade after the invention of the long white cane. Yet, even then, canes were viewed as adult tools. Blind children, especially those with cognitive or motor delays, were expected to rely on adult supervision and auditory warnings — methods that kept them dependent.

Huffman believed the teaching of safety was “…the same for all children. The only “…difference in teaching being that emphasis was placed on sound rather than sight” (Huffman, 1957, p. 76). Huffman gave the following example of how she employed a referee's whistle to protect her pupils with a MVI/B including those with physical and cognitive delays:

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“Any hazards or danger-spots in the school environment were utilized as a means of teaching objective lessons in realistic problems. Among tangible factors used to teach safety habits were: Steep steps, retaining walls with rough protruding rocks, roadways over which maintenance or delivery trucks frequently traveled; construction areas, deep and wide ditches…

For acquiring prompt group responses, a referee’s whistle was found to be convenient when used as a definite means of signaling. A long, shrill blast meant “Danger! Stand still! Listen!” The children were taught that this danger could be anything from an unexpected appearance of a car to the possibility of a child’s walking in front of a swing, stepping off in a ditch, or walking into some obstacle in his path.”

…When there was danger of an approaching car, one long shrill blast was blown, followed by the assembly signal of three short blasts repeated twice in succession. Next, I stepped to a safe place off the side of the roadway where the group collected in a compact unit until the car had passed” (pp. 76-77).

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Huffman made clear the difficulty she had supervising students who were unable to independently detect and avoid hazards. Contrary to the recommendations of Blacklock, Moyes, Howe, and Cutsforth no teacher could, in good conscience, allow her students to get hurt on her watch. Her detailed whistle types and their descriptions of communicating danger was a page long. She was on constant guard.

A side note: The problem with shouting general warnings is bind people are unable to see who the target of the warning is. When you shout “watch out”, what is the blind man supposed to do? You may have been warning your child from stepping into on coming traffic. Or you may have been warning him that he was about to step into a ditch. Sound is an inferior warning system when compared to touch (see Seatbelt safety).

Consider the problem of the "assembly signal" for a child with a MVI/B - what if there is a drop-off between the child and the assembly location. Without a safety tool, the blind child still doesn't know exactly where the drop begins or how deep it is. Those are the jobs of the white cane. 

Huffman intended for ALL her students within earshot of the whistle blast to stop what they were doing. All had to stop so they could find out which one of them was in danger. Huffman’s whistle was her unique solution to her very real problem caused by the lack of a white cane solution for her students.

The Persistence of 18th-Century Ideas

From Cutsforth’s 1930s writings to Huffman’s 1950s classrooms, one belief persisted: blind children could and should learn to move independently without protection. The consequence was predictable — delayed walking, fear of movement, and generations of children growing up believing they were the problem.

Cutsforth and Huffman were compassionate, intelligent educators. Their intentions were right; their tools were wrong. They could not solve a problem that required an innovation they didn’t have: a way to restore safety through touch.

Reframing the Problem: Safety Enables Independence

Walking is a sensorimotor act. It demands both physical ability and sensory feedback to navigate safely. For children with MVI/B, the absence of visual feedback must be replaced by tactile feedback — a safe, consistent signal about the environment ahead.

The Belt Cane provides that missing signal. It extends touch two steps ahead, protecting the child’s body and creating the internal feeling of safety required for movement. When safety is restored, mobility and communication follow naturally (Ambrose-Zaken, 2022, 2023; Ambrose-Zaken et al., 2019; Penrod, Burgin, & Ambrose-Zaken, 2024).

For the first time in history, blind infants can experience the same feedback-driven exploration that sighted babies enjoy. This is not merely progress — it is correction.

Brayden, age 6 - it took him 6 months of Belt Cane to feel safe enough to let go and walk in the middle of the hallway.

Conclusion: A Century Late, but Finally Right

The first half of the 20th century was marked by sincere but misguided efforts to teach blind children independence through exposure to danger.Cutsforth’s enduring words — “No one as yet has adequately understood how to educate the blind” — still rang true in his day, but not because blindness was an educational mystery. It was because safety had never been made the starting point.

Today, with innovations like the Belt Cane, we can finally answer him: To educate the blind child, begin with safety — and independence will follow.

References

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to Toddlers with Visual Impairment Achieving Independent Walking. The

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

291. https://doi.org/10.1177/0145482X231188728.

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.

https://doi.org/10.1177/0145482X221121824

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.

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Goldberg, I. (1958). Book Review: Fun Comes. First for Blind Slow-Learners.

Journal of Visual Impairment & Blindness, 52(2), 65-68.

https://doi.org/10.1177/0145482X5805200208

Hatton, D. D., Ivy, S. E., & Boyer, C. (2013). Severe visual impairments in

infants and toddlers in the United States. Journal of Visual Impairment &

Blindness, 107(5), 325–336. https://doi.org/10.1177/0145482X1310700502 

Howe, S. (1841). The Ninth Annual Report of the trustees, of the Perkins

Institution and Massachusetts Asylum for the blind 1841 from Boston:

Eastburn https://play.google.com/books/reader?id=0JoyAQAAMAAJ&hl=en&pg=GBS.PA36

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The New Outlook for The Blind (1963). Necrology. 57(3), 113-114.