The Ambrose-Zaken Theory that Safe Mobility is Essential to Achieve Developmental Potential explains why "walk first, safety later" has not worked and will not work for blind toddlers. Her theory is expressed in the below triangle. The colors and words that fill this figure combine to explain why toddlers need to feel safe, independently safe, to learn and grow to their full potential. The Ambrose-Zaken model combined Maslow's Hierarchy of Needs with the nine areas of the Expanded Core Curriculum. The colors represent nature.
Physiological Needs-Food, shelter and health.
We begin with the earth: The solid beginnings that all creatures need. This post is about thriving, about achieving one's developmental potential. The best start for toddlers is their never having to worry about food, shelter or health.
Safety Needs- stability- order, freedom from fear and Ambrose-Zaken added safe mobility
Upon the well nourished earth the grass can grow - what grows from our feelings of well-being is the individual interest in independently seeking adventure and learning.
Safe Mobility is such an important aspect of life - that sighted people fill their world with lights of all kinds to ensure they have a good view of what lies ahead of them. The industrial revolution was made possible because of the lightbulb. Light allowed factories to expand, and also allowed travel at night. Because no sighted person wants to walk around not being able to see to avoid collisions.
Piaget called the ages 0-2 the Sensory Motor stage. By age 2 a child is expected to walk and run with the ability to deftly and expertly visually avoid obstacles. The ability to walk and run is necessary for the next stage of life- Preoperational Stage - the hallmark of that stage is developing independent play, exploration, language and social skills. Preschoolers need to have confidence in their ability to run towards and away from activities independently, at will.
In one year, most toddlers transition from fully assisted walking to independently running away from the adult - with increasing skill, grace and zest for life.
Current practice asks families of blind toddlers to have their children skip over the Safety Rung. They say encourage your toddlers who are blind and mobility visually impaired to walk first, and seek safety later. This advice puts blind toddlers in harm's way and this explains why they want to be held, carried, pushed in strollers and otherwise need assistance to go anywhere.
Blind children walk slowly with poor posture or jump in circles instead of standing still. Blind toddlers do not quickly walk straight across the room like their peers. This is not because they are unaware, it is because they are aware of the risk this poses to them- unavoidable collisions.
The plain safe mobility facts are:
Turning on the lights doesn't provide blind toddlers with the same safety as it does for sighted toddlers.
Holding a hand does not provide toddlers with independent safe mobility.
Holding on to a couch does not provide toddlers with the ability to explore freely across open space.
Holding a long cane does not provide toddlers who are blind and mobility visually impaired with consistent detection of a clear path.
Independent safe mobility cannot wait for a child to get old enough to use a long cane correctly. Toddlers need safe mobility to walk freely, quickly and to run and explore
WE KNOW THIS
Degree of vision impairment negatively impacts a child’s development (Hatton, et. al,. 2013). According to the World Health Organization (WHO), “Young children with early onset severe visual impairment can experience delayed motor, language, emotional, social and cognitive development, with lifelong consequences” (WHO, 2019, p 1).
The 15-month independent walking milestone definition is ‘inability to avoid obstacles’ (Sharma, 2011). Some have suggested that blind 15-month-old toddlers’ collisions are age-appropriate (Chamberlain, 2017). Yet, a study of 151 sighted toddlers (aged 11 to 19 months) found that after a few months they fell less and demonstrated better gait, pace, and obstacle negotiation skills in cluttered settings (Adolph, et al., 2012). A study of 330 learners with visual impairments with an average age of 3 years found that over half (52.4%) were walking only with adult assistance (a 12-month milestone), over thirty percent (33.3%) walked with slow, unsteady, wide-based gait (a 15-month milestone), and the remaining subjects had motor impairments (Ambrose-Zaken, 2021b).
While attending a sports camp for the blind, visually impaired teens were given positive feedback about their athletic abilities. At the end, they were asked to rate their physical abilities and their motor skills were evaluated. The teens reported relatively high self-perceptions about their physical abilities. The group’s motor skills measured significantly below age norms (Stribling, et.al., 2021).
These teenage participants had received the best of current instructional practices (see table 1). Since early childhood, they had been taught to walk and run independently in all environments without mobility tools (figure 1). For those born blind, the outcome of the current best practices that emphasize walking and running without safe independent mobility tools is a growing avoidance of independent walking and developmental delay (Ely, 2014).
Figure one shows the most current practices and their shortcomings- it is clear that in 2021 - people still taught that blind toddlers need to walk first, safety later.
What about the rest of the pyramid? When a child has safe mobility all day every day, the rest of life is flowers, sunshine and the sky's the limit.
Wearing a pediatric belt cane is a big departure from centuries of walk first, safety later- this is NOT about wearing the belt cane during a hour of O&M instruction.
This is about
When the lights are on the belt cane is on. Safety First, everything else will follow.
Pediatric Belt Canes Improve Safe Mobility - and safe mobility improves toddler development.