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Grace Ambrose-Zaken, Ed.D., COMS


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 (accepted).


Ambrose-Zaken, G. V. (2022). A Study of Improving Independent Walking Outcomes in Children Aged Five and Younger who are Blind and Visually Impaired. Journal of Visual Impairment & Blindness, 114(4).


Ambrose-Zaken, G. (2021, March 25-27). Importance of Safe Mobility to Achieving Developmental Milestones: 2021 Rocky Mountain Early Childhood Conference. US.


Ambrose-Zaken, G.V. & Anderson, D. (2022). Teaching O&M to Learners with Cognitive Impairments and Vision Loss. In W. Wiener, B. Blasch, R. Wall-Emerson (Eds.), Foundations of Orientation and Mobility (4th Ed., Vol. 2. Chpt 19). Louisville, KY: APH.


Ambrose-Zaken, G., 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, 01.

A Study of Improving Independent Walking Outcomes in Children Who Are Blind or Have Low Vision Aged 5 Years and Younger

Summary of article published in the Journal of Visual Impairment & Blindness:

This study examined independent walking in thirty-five children with blindness or mobility visual impairments (B/MVIs) aged fourteen to sixty-nine months. Before obtaining a Belt Cane, they had limited to no ability to walk independently with safety. Wearing the Pediatric Belt Cane provided them with consistent, haptic tactile feedback and safety from colliding with objects in the environment.


Thirty-five participants with B/MVIs’ independent walking milestones were analyzed using pre- and post-video recordings provided weekly one month before and the three months after obtaining the Belt Cane. The Belt Cane consisted of a rectangular frame that connects to a custom-made belt with magnets. The Belt Cane provided no weight support. While none of the participants had motor impairments, 80 percent of them were receiving physical therapy services prior to obtaining a Belt Cane. Fifty-four percent were receiving orientation and mobility services, and half were equipped with hand-held mobility tools (e.g., long canes). 

Results: Visual impairment
   Twelve participants had optic nerve hypoplasia Septo optic dysplasia (35.3%), eleven had cortical visual impairment (29.4%). Three participants had retinopathy of prematurity. Two participants each presented with Norrie’s disease, microphthalmia with retina coloboma, Leber Congenital Amaurosis and traumatic brain injury. The cause of one participant’s congenital blindness was listed as unknown. Seventeen of the participants were blind (NLP) and eighteen were visually impaired, they responded to visual stimuli but the result of the severity of their visual impairment meant they were unable to visually avoid collisions, or MVI. 

mean age and walking skills (Ambrose 2022). four lines top left dashed with black dots show mean (x) age in months before (from left) Stand (x-21) cruises (x=21.5), walks with assistance (x=35.4), walking wide gait (x=35), top long dashed line with four dots is mean (x) age in months with PBC walks with assistance (x=34), walking wide gait (x=30), walks well (x=39), runs (x=36), lower dotted line shows number of participants at milestone before stands (n=3), cruises (n=4), walks with assistance (n=18), walking wide gait (n=10), walks well (n=0), runs (n=0), fourth line solid with dots at stands (n=0), cruises (n=0), walks with assistance (n=2), walking wide gait (n=10), walks well (n=18), runs (n=5).

Independent Walking Ability 

 Before Belt Cane, the children spent 65% of their time sitting and standing with assistance and only 14% of their time solo walking. With the Belt Cane they spent 60% of their time solo walking and running and 18% solo standing. The Belt Cane caused a complete, positive change in these children. They changed from passive, quiet, idle babies, to engaged, active little kids. Both post-evaluations agreed that the children with MVI/B demonstrated significantly improved independent motor skills due to wearing the pediatric Belt Cane. 


Pediatric Belt Cane skills and motor outcomes

There were instances where adults chose to limit the amount of time their children walked with the Belt Cane. For example, they would provide the Belt Cane during a particular therapy or for just a few minutes a day. Children under the age of five are entirely dependent on adults to outfit them with what they need to participate in their day. This study has shown that blind children can succeed in walking independently when adults provide them with the white canes they need for safe mobility. 

research report
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