Braille Monitor                                                   March 2010

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Exploring Blindness: Questions yet Unanswered

by Michael Bullis

Michael BullisFrom Barbara Pierce: Michael Bullis is a certified orientation and mobility instructor and currently the executive director of the Maryland Technology Assistance Program. In the following article he raises questions and explores research options, discussion of which we usually find uncomfortable. He welcomes comments on these ideas at <bullis.michael@gmail.com>.

As members of a minority striving for acceptance, we spend much of our time emphasizing our normality and our capacity to compete. When people say, "You must have wonderful hearing," we usually reply that blind people don't hear particularly well. When they say, ”You must have a phenomenal memory to recall where you're going," we respond, "Not really. My cane gives me the information I need, but I probably don't have much more capacity for memory than you do." And so it goes. Because we live in a sighted society, we strive to seem to be part of it. Yes, we're blind, but we strive to minimize the differences and emphasize the things we have in common with the sighted society around us.

All of this is quite understandable. We compete for jobs, the romantic attentions of others, the interest of potential friends, etc. People fear or at least shy away from that which they perceive as weird.

But, though we are much like our sighted family members, friends, and colleagues, we are also different. We cannot see. This means we take in most of the information we gather about our surroundings through touch and sound. Sighted folks more often than not take in information visually. Yes, there are taste and smell, but these are not primary sources of information unless we're at a restaurant.

Although we are surely more alike than different from our sighted colleagues, our differences are certainly worth understanding. I keep a list of topics I wish we understood better. Some items are obvious and require little explanation. Others require some discussion. Some will lead to inventions, while others will lead to research and new training techniques. Here then is my list of blindness issues that we should explore.

1. Although hearing tests show that blind people do not hear better than others, do we hear differently? Magnetic resonance imaging (MRI) has shown that the blind process audible information using the visual cortex. Can this processing capacity be enhanced? Could we take in more audio information through the development of new and heretofore unconsidered techniques? Daniel Kish of World Access for the Blind teaches active echolocation, which he calls "flash sonar." Watching his students, it is clear that they can define the characteristics of a room, playground, or mountain trail far better than those of us who simply rely on the echoes produced by our canes.

Discussion of whether tongue clicking is weird puts the cart before the horse. First we should research a method to determine its benefits. Then blind people can decide whether the gains outweigh the social idiosyncrasy. That's what we do with the cane. We decide that the benefits of the cane outweigh the disadvantages of being different from others. So, even though many of us pooh pooh the tongue-clicking method as weird, shouldn't we try to understand and assess the information it conveys and try to incorporate it into our lives and those of our students? Perhaps the richer tapestry of detail that flash sonar allows would help newly blinded folks frustrated by the limited picture the cane provides. Canes are effective at creating a picture of the immediate area where we are traveling, but they are not so good at helping us formulate images at thirty or forty feet. Although the echoes from a crisp metal cane tip can fill in some blanks in the environment, they cannot create nearly the detail that active echo-location does.

As I said, I do acknowledge that we're uncomfortable with the idea of blind people being defined as "clickers." But, let's be honest. We already stand out in a crowd by virtue of using a cane--something we've been working for seventy years to get the public to understand. When I was a young man, I observed some blind clickers. I thought they were weird, and, quite honestly, they were usually blind people who exhibited other less than socially normal behavior. My mom wouldn't have tolerated my clicking. She explained, more often than I care to remember, "You live in a sighted world." This meant that I should try to blend in--not be different. That's why, in some ways, using a cane was so difficult for me. Doing so meant a readjustment of thinking that I thought had served me pretty well up to that point.

So I'm not advocating clicking during a job interview. I'm simply suggesting that after investigation we might decide it is one of the many tools we could use in the right situation and at an appropriate time. What we have not yet done is give it a very serious look rather than a cursory glance. Could flash sonar be an answer to detecting quiet cars?

2. Can some hear far better because they use techniques that could and perhaps should be taught to others? I've met people who could hear animals in the woods that I simply couldn't hear. Are they better at discriminating than I am? Could I learn the skill?

3. Can we improve our hearing? It seems to me that there are two ways to improve hearing. Either we improve our ability to interpret what is already coming into our ears, a technique that we teach to some extent in cane travel instruction. Then there is the improvement of our ability to hear what's out there through mental training or mechanical means. Hearing aids improve people's hearing but often interfere with directionalization and discrimination. Can we create devices that actually improve our hearing? Is the shape of the human ear optimal? Could it be improved? Are the liquid in the ear canals and the hairs that register sound as efficient as they might be? Could we improve their function?

4. Can we improve our ability to directionalize sound? Could the shape of the ear or some external device improve our ability to focus on distant objects, thus providing a more accurate sound picture of them?

5. Can we find ways to dampen loud sounds that overwhelm softer ones in order to increase our information-gathering ability at, say, very noisy intersections or when a neighbor is mowing the lawn?

6. Improving touch. It is said that Jacob Bolotin could feel Braille through eighteen handkerchiefs. I don't know if that was true or not, but I have certainly met both blind and sighted people with very sensitive touch. Can touch be improved in us all? Could we develop techniques? Similarly, can nerves damaged by age, diabetes, or overuse be reinvigorated? What do people with incredibly sensitive touch have that the rest of us don't, and how can we spread it around?

7. The ability to map a physical environment mentally is stronger in some folks than in others. Certain parts of the brain are activated in good mental mappers and not in those who aren't. Could we enhance the skill through focused training? We already improve it somewhat through travel training, but could we develop more focused abilities?

8. Using residual vision. One primary approach to using residual vision is to occlude it during training and then assume that it will be useful once the person has sharpened alternative techniques. But I have noticed that some people, with or without training, use their residual vision more effectively than others. Yes, yes, I know that the profession clings to residual vision like an alcoholic to the bottle, but can we put all that aside and determine whether we can develop better techniques to help people benefit more effectively from their residual vision? The immersion method taught by NFB helps retrain the brain to process nonvisual information. It works better with some folks than with others. That is, some people seem naturally able to redirect their brains to use alternative techniques. Others, although they study for up to a year in an NFB center, don't seem to make the switch easily. Why? What can we learn from these folks about how to teach them?

9. Braille literacy. Let's set aside the issue of whether Braille is taught effectively or often enough to children and adults. Braille is difficult for many adults to learn. Sighted learners who did not learn to read or write as children have similar difficulties with print. What can we do to fix this? Far too often we continue Braille instruction when, whether through lack of finger sensitivity or for other reasons, it is obvious that the student is not going to be an effective Braille reader.

Beyond the literacy problems this creates, these folks are unable to take notes efficiently. How about developing a truly effective audio management system for people—a portable device that quickly allows the digital recording and indexing of information and the retrieval of that information? Suppose you could record something like "phone number for Bob Jones, 361-2273." Then, when you wanted the number, you simply say, "Bob Jones" and are immediately presented with information under that name. No such product is currently on the market. One can record information on a multitude of devices, but there is no elegant and simple way to find it quickly and easily. Suppose we could combine voice-recognition technology with a voice recorder and make the information truly indexable? The technology for such a device exists.

10. Blindness counseling. Historically, blind people have been counseled to death. Psychologists and psychiatrists were the first stop in rehabilitation through the 1970s. Over the past thirty or forty years we have for the most part discontinued that practice. But perhaps we've thrown out the baby with the bath water.

Some people really do have difficulty adjusting to blindness. With the right professional counseling they could benefit from therapy. This doesn't mean that they're broken or that blindness necessarily requires the intervention of psychiatrists because of its complexity or trauma. It does mean that professional counseling techniques have something to offer professionals in the blindness field.

Those who conduct group discussions at centers for the blind could truly benefit from some training in ways to engage in group counseling. No, the groups would not turn into group therapy sessions. They would simply be managed by a professional who understood at a deeper level how to spot and understand group interactions and the messages being sent and received. Psychiatrists, psychologists, and other therapists really do have a vast and useful body of knowledge that could be helpful. We need to find ways to incorporate that knowledge into professional work with the blind while not sending negative messages. Yes, most counselors focus far too often on blindness when the cause is something else. I well remember the fellow who said when told that he was angry about his blindness, "What you don't understand, sir, is that I was a jerk before I became blind." We ignore at our peril the broader knowledge about human personality and the personal counseling skills being developed today. In the long run, not knowing leads to less effective rehabilitation for the more challenging people we face.

11. Cane improvements. We’re still in need of improvements in the long white cane. It doesn't protect against upper body objects. That's a big deal for many who don't enjoy knocks on the head or wet branches in the face. We also need to increase the capacity of the cane to detect objects at a distance. Numerous methods have been tried, but nothing yet meets the test of affordability and ease of use.

12. Audible balls. We need a method of making balls of all types audible so blind kids and adults can learn the joys of ball playing. The goal is a ball that is audible and has the same bounce and weight as regular balls.

13. A paradigm shift. Perhaps the lack of sight itself needs a bit of discussion. Humans cannot fly independently. Birds can. Because of this disability, humans have invented aircraft and rocketships. Whether we would have done so if we had had wings and the capacity to fly, I don't know. But I think the argument can be made that blind people may be uniquely positioned to invent a new form of sight--and perhaps, one that goes beyond that used by naturally sighted people. What would such sight be?

14. Things left out. I do not include in this list anything having to do with creation of synthetic eyes, restoration of the optic nerves, or sight restoration. That subject is being adequately addressed by the medical field and will be a constant focus of those who seek to prevent blindness.

Conclusions

Blindness excites me. It is a fascinating and rich experience. I like fascinating and rich experiences. If somebody offered me the opportunity to see tomorrow, with several caveats, I would take it. I would take it precisely because it too would be exciting and rich. In the meantime, though, let's explore and engage this experience and learn from it, perhaps enriching the world for the sighted and blind alike.

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