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Wearing pediatric belt canes encourages independent walking in Blind 2-year-old

Toddlers who are blind need effective mobility tools for safe mobility, because safe self-locomotion skills are essential for language development (Rosenbaum, 2005; Adolph et al., 2010; Iverson, 2010). For example, Oudgenoeg-Paz et al. (2016) suggested that exploration via self-locomotion measured at twenty months predicted later spatial language, yet children born with mobility visual impairment or blindness exhibit delays in self-locomotion due to lack of access to independently safe mobility (Ambrose-Zaken, 2021).

Children who are born blind grow up with unsafe self-locomotion and this inhibits their willingness of to freely ambulate and contributes to developmental delays (Ambrose-Zaken, 2021). The goal of independent walking is important, because walking freely is tied to language outcomes. Particularly, walking is important for building vocabulary, the most common measure of language development (Oudgenoeg-Paz et al., 2012, 2015, 2016; West et al., 2017).


Matias' family reached out to Safe Toddles to obtain a pediatric belt cane (PBC) for him, a nineteen-month-old boy who was blind due to Leber's Congenital Amaurosis. His family provided a video record of his self-locomotion during play activities before and after receiving the PBC. The purpose of this study was to compare the number of steps per second taken by Matias when playing indoors and outside in three conditions; without a mobility device, with a push toy and wearing his PBC.


Method

Participant Matias was a two-year-old boy who was blind with no light perception. He was typically developing and able to walk, however prior to obtaining the PBC he walked only when he was in contact with objects or people, including pushing a chair or pushing a toy. His language skills were also delayed. He repeated words and sentences out of context and he did not engage in conversation or seek out others for social interaction.

Procedures The researcher employed a single-subject repeated measures design. Sixteen videos of Matias before obtaining a PBC and nine videos of him wearing his PBC were analyzed. The videos selected were those of him playing alone inside and outside his home. Ten videos documented Matias' typical play activities without a mobility tool (six inside and four outside). Six videos observed him when used a push toy during play time. Nine videos were taken when wearing his PBC during play activities (three inside and six outside).

Measurement Visible steps caught on camera were counted. Steps were defined as purposefully moving his foot forward or backwards, walking up or down stairs, anytime the foot moved to change his location. Steps not counted were those considered stamping in place or to adjust his balance. Steps per second was obtained by dividing the number of total steps taken during the video by the number of seconds of the video.


(Title) Steps per second with no mobility tool (A), push toy (B), and pediatric belt cane (C). A room w/no device 0.11, 0.01, 0.53, 0.03, 0.09, 0.60, (B) room w/push toy 0.09, 0.01, 0.05, 0.06, 0.01, 0.00, C room w/PBC 0.78, 2.14, 2.78, A outside no device 0.00, 0.00, 0.00, 0.00, C ouside w/PBC 0.31, 0.30, 1.40, 1.37, 1.64, 1.64
Chart shows number of steps per second in three conditions

Discussion The chart indicates that when he was playing without a mobility tool or with a push toy he took very few steps per second. When he was playing while wearing his PBC the number of steps increased over time. The more he wore his cane, the greater number of steps taken.


Matias walked many more steps per second wearing his PBC than under the condition of playing without a mobility tool and with a push toy. Therefore, two-year-old children who are blind may also benefit from wearing PBCs most of the day. This is because PBCs provide the benefits of safe mobility and consistent tactile path information. When children who are mobility visually impaired or blind wear PBCs they take independent steps with greater frequency than without a mobility tool or when encouraged to use a push toy.


Children who are blind wearing PBCs show improved self-locomotion which provides them with new learning opportunities to interact with objects, their environment, and with caregivers. When children who are blind feel safe enough to increase self-locomotion, it allows them to travel independently throughout their environments, traversing long distances to encounter objects and caregivers and builds opportunities to increase concepts and develop language and social skills.


Conclusion

Tactile path information is a known entity, since 1945 adults who are blind have benefited from using a long cane. Most physically and cognitively able adults learn to use a long cane in less than an hour. Toddlers who are blind are not able to employ a long cane for safety, after several years of instruction, many can only hold the long cane for a few steps. Children need safe mobility all day, every day.



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