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

A Brief History of Blindness Education

At the start of the 20th century, most children with a mobility visual impairment or blindness (MVI/B) in the United States were educated in state residential schools for the blind. There, their daily lives were overseen by matrons and headmasters who were well intentioned but often lacked formal training. Other children were educated at home, depending on their families’ resources and initiative.

By mid-century, two forces dramatically changed this landscape. First, an epidemic of premature births led to a sharp rise in retinopathy of prematurity (ROP), increasing the number of children born blind. Second, sweeping changes in U.S. education law shifted responsibility for educating children with disabilities to local school districts. By the end of the century, most children with an MVI/B were educated alongside their sighted peers by university-trained, certified teachers of students with a visual impairment.

One influential figure who bridged these two eras was Thomas Cutsforth. In 1963, The New Outlook for the Blind described him 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 famous statement—“No one as yet has adequately understood how to educate the blind” (1951, p. 2), revealed the clarity of understanding that the real cause of devastating delays seen in early childhood congenital blindness had yet to be identified or solved.

A Century-Old Misunderstanding: Walking Without Safety

Cutsforth’s first edition of The Blind in School and Society (1933) appeared just before the ROP epidemic expanded the population of congenitally blind children. At the time, only the very small group of blind children who appeared “educable” by school age; were admitted to residential schools. Those blind children were expected to meet the same academic standards as their sighted peers—without comparable access to safe mobility.

Cutsforth believed that infants learned to walk primarily by watching others. He concluded that congenitally blind infants "are aware of nothing, objectively, outside the arcs described by their hands and feet" (1951, p. 5). His belief, rooted in his own experience of having once had vision, overlooked a crucial difference: children who are born blind never experienced the ability to visually anticipate and avoid unseen hazards.

Holding a parent’s hand, hugging a wall, or moving cautiously are not signs of delay; they are intelligent adaptations to an unsafe environment.

Cutsforth himself learned to travel unaided by sight or mobility tool through trial and impact. Collisions were his teachers. He wrote with pride of his traveling "with only his arms and legs" for protection, even after the long white cane was invented (Koestler, 1974). Like many of his contemporaries, he feared that the introduction of long canes to school aged children would make “soft blind kids” (Bledsoe, 1967). Endurance was valued over safety, and generations of children were taught accordingly.

Adventitious vs. Congenital Blindness: A Critical Difference

Cutsforth’s independence rested on visual memories, spatial concepts, and self-confident travel developed before he lost his sight. Children born blind have none of these advantages. Expecting them to walk blind and unaided by mobility tools causes harm, not the least of which is growing up having zero confidence in themselves to judge the soundness of their next step, before it is too late.

For those who became blind later in childhood, independence often emerged through surviving collisions. For those born blind, it frequently did not. Yet educators failed to distinguish between these experiences. Instead, a familiar refrain took hold: “permit the child to walk.” When children did not walk, parents, especially mothers, were blamed for being too overprotective.

Cutsforth advised parents:

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

This view echoed 18th- and 19th-century writers who argued that bruises were beneficial. Across centuries, the message remained the same: pain builds independence.

The Myth of “Permit the Child” and Blaming Mothers

The idea that blind children failed to walk because parents did too much for them persisted well into the 20th century. Samuel Howe wrote in 1841 that "The mother runs and fetches what her blind child requires. The consequence is that he is unfitted for the rough arena of the world.” Later researchers repeated this claim, suggesting that overprotection, not the obviously unsafe travel due to blindness, caused developmental delays.

What these theories ignored is what later scholars described as the “child feels unsafe” explanation. Seen through this lens, an alternate explanation is that blind infants limit their movement because they lack a dependable way to protect themselves. Without a tool that fills in the visual gaps with touch feedback providing advance information about obstacles, movement causes pain and uncertainty, and is to be avoided.

Families have tried many ways to compensate for the challenges their child's blindness caused them when navigating including using external supports such as holding hands, guiding, and shouting warnings. But verbal alerts like “watch out” are meaningless to a child who cannot see where the danger is. Sound is an inferior warning system.

Touch is the only reliable warning sense for blind children, that is why holding hands, guides, and long canes are effective means to help navigate a blind person navigate various environments. Yet, Cutsforth 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 of delays resided in residential schools that routinely used guides to move their blind students from place to place. 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 an 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.

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).

Teachers Facing Unsafe Reality

Educators knew the risks were real. In Fun Comes First for Blind Slow Learners (1957), Elizabeth Huffman described the constant hazards her students faced: steep steps, ditches, roadways, construction areas. To manage danger, she developed a complex whistle system—one long blast for danger, three short blasts for assembly—forcing all children to stop while she identified who was at risk.

Huffman’s system was creative but reactive. It existed because children had no mobility tool of their own. Although the long white cane had already been invented, it was viewed as an adult device, and no attempt to create a child's centered mobility tool was embarked upon. Blind children, particularly those with additional disabilities, were expected to depend on supervision and sound cues.

Huffman openly described the burden of this responsibility. No teacher could ethically allow children to be injured on her watch. She was thrilled to see a blind child climb rock walls and used those photos of proof of her methods. Yet, her whistle was not a philosophy—it was an emergency solution to an unsolved problem.

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 an 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 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.

Why Sound Is Not Enough

General verbal warnings fail because blind individuals cannot tell who the warning is for or what action to take. An “assembly signal” is equally flawed if a drop-off or obstacle lies between the child and the gathering place. Without tactile information, the child still cannot judge where danger begins. That is the role of a mobility tool.

The Persistence of an Old Idea

From Cutsforth’s writings in the 1930s to Huffman’s classrooms in the 1950s, one belief endured: blind children should learn to move independently without protection. The predictable result was delayed walking, fear of movement, and generations of children who believed they themselves were the problem.

Cutsforth and Huffman were compassionate, thoughtful educators. Their intentions were right. Their tools were wrong. They were attempting to solve the safety problem caused by blindness without a safety solution for blindness.

Reframing the Problem: Safety Enables Independence

Walking is a sensorimotor act. Walking requires not only physical ability but continuous feedback about the environment. For children with an MVI/B, missing visual feedback can be replaced with constant tactile feedback.

The Pediatric Belt Cane provides that feedback through a unique design. The belt holds the lightweight rectangular cane in place. By extending touch several steps ahead, it protects the child’s body and creates an internal sense of safety. When safety is established, confidence, movement, and communication emerge naturally (Ambrose-Zaken, 2022, 2023; Ambrose-Zaken et al., 2019; Penrod, Burgin, & Ambrose-Zaken, 2024).

For the first time in history, blind infants can explore their environments with the same feedback-driven confidence as sighted babies. This is not simply progress—it is a long-overdue 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 Few Centuries Late, but Finally Right

Early 20th-century educators sincerely believed that exposure to danger would teach blind children independence. Cutsforth’s famous observation—that no one had yet understood how to educate the blind—was true, not because blindness was mysterious, but because safety was never the starting point.

Today, with innovations such as the Belt Cane, we can finally answer him. To educate a blind child, begin with safety. Independence will follow.

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-

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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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

Huffman, M. (1957). Fun comes first for blind slow-learners. With a foreword by

Samuel A. Kirk. C. C. Thomas.

Penrod, W., Burgin, X., & Ambrose-Zaken, G. (2024). Study Result: Pediatric

Belt Canes Improved Children with Mobility Visual Impairments Safety and

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

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