Future Reflections          Fall 2007

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Functions of the Cane
and the Bottom-Up Approach to O&M for Children

Excerpts from
Independent Movement and Travel in Blind Children: A Promotion Model
A Volume in Critical Concerns in Blindness

by Joseph Cutter


Introduction and Review
by Barbara Cheadle, Editor, Future Reflections
President, National Organization of Parents of Blind Children

Independent Movement and Travel in Blind Children: A Promotion Model
A Volume in Critical Concerns in Blindness
by Joseph Cutter
Includes bibliographical references
Copyright 2007 IAP--Information Age Publishing, Inc.
ISBN 13: 978-1-59311-603-3 (paperback)
ISBN 978-1-59311-604-0 (hardcover)
331 pages, large print font, black and white photos.

Joe Cutter demonstrating the benefits of the long white cane.Hardback and paperback editions are available for purchase from IAP at <www.infoagepub.com> (search by author, Cutter). Paperback copies are also available from the NFB Independence Market: <IndependenceMarket@nfb.org>, fax (410) 685-2340, phone (410) 659-9314, extension 2216.

Joe Cutter has finally done it. He’s written a book with answers to the questions that parents have been asking ever since the NFB revolutionized orientation and mobility (O&M) for blind kids by being the first to produce and promote kid-size canes for toddlers on up. For years, parents have been asking: When is a child ready for a cane? What kind of cane should she use? How long should the cane be? What if my child has additional disabilities? Our traditionally trained O&M instructor is using techniques and strategies that don’t work with our three-year-old; is she just too young or is there a different approach that will work?

The last question is key to understanding the unique breakthrough that Cutter’s book represents. This is more than a book about cane techniques and teaching strategies (although there is enough of that to satisfy the most detail-oriented parent or instructor), it is a guide that lays out a whole new way to think about and approach the facilitating of normal--yes, normal--movement and independence in young blind children.

That’s what has made it so hard to select a segment to reprint from the book. If we only print the practical tips and strategies, then the reader will not fully understand the vital conceptual underpinnings; and if we only print segments about principles and philosophy, then we lose the practical-minded who are looking for specifics. So, as editor, I determined that to do this properly, it required printing a segment from two different sections of the book. Going in reverse order, the first segment is reprinted from chapter 4, “Cane Travel for the Blind Child--From the Bottom Up.” This is a very practical discussion of the specific functions, uses, and characteristics of the cane, with special attention to its functionality and adaptations for the very young child. Last is a segment reprinted from chapter 1, “The Promotion Model.” This segment is a short explanation of the philosophy behind the practices that are described in the book, with specific attention to the bottom-up concept that Joe Cutter has pioneered in the development of the Promotion Model.

Having said all this, it still does not do justice to the importance of this book. Since movement is essential to all aspects of development and growth for every blind and visually impaired child, the value and scope of this book goes far beyond questions related to the use of the white cane. In fact, I can say--without hesitation--that if the parents, caregivers, or instructors of blind/visually impaired children between the developmental ages of birth to kindergarten could only have one book or one resource to consult--this is the one they must have.

With permission of IAP--Information Age Publishing, here are pages 149-160 as reprinted from Independent Movement and Travel in Blind Children: A Promotion Model:


Functions of the Cane

The cane is a handheld tool used for independent movement and travel. It performs many functions. Under the blind child’s direction, it can inform, explore, inspect, detect, protect, and most of all, facilitate getting to know and moving in the world.

To illustrate, the cane is more than a windshield wiper on the world. It is the steering wheel that can be manipulated to where the traveler wants to go and gives direction for whenever the traveler wants to circumvent an obstacle. It is the headlights giving preview of what’s ahead. It is the bumper protecting from unexpected encounters. It is the antennae receiving resonance information about the sound space world. It is the tires, adjusting to the terrain and providing a smoother safe ride. Like the car, the cane is as effective as the driver who must obey the laws of the road. The cane gets children where they want to go.

Below is a list of the basic functions of the cane.

Characteristics of the Cane

The characteristics of the cane can affect the safety, effectiveness, and efficiency of the traveler. As travelers, blind children and blind adults have the same requirements for the characteristics of the cane. These main characteristics that need to be considered when choosing a cane are: composition, weight, length, grip, tip, flexibility of the shaft, resonance affordability, and one piece or folding.

As blind children mature and develop appropriate posture, balance, hand-functioning, height, and size, they will use a proportionately larger cane. Over the years, I have experimented with a variety of types of canes, grips, and tips. I have found that the straight, hollow, flexible, lightweight, metal-tipped canes, such as those available through the National Federation of the Blind, possess the most advantages for the blind traveler. These canes start at about 24 inches and, as their length increases, the overall proportions of the cane are scaled larger. The design of the cane is not altered. This creates a seamless continuity for the child and makes it unnecessary to adapt to a different type of cane.

The characteristics of the long cane can either afford the traveler advantages in use of this handheld tool or not. Below is a list with a brief explanation of the characteristics that have the most significant effect on the independent movement and travel of blind children.

Eventually, a telescoping or folding cane might be an option as a back-up cane, or when the child has developed efficient reaction time and a light touch with using the cane. However, in the early movement of blind children, adults must promote what is known to be best to facilitate independent movement and travel, and which affords a rich and valuable experience in using the cane.

When these characteristics of the cane are considered carefully, we are more likely to choose a cane that places the blind child at an advantage. The bottom line is this: any cane is better than no cane. However, if we are to promote the independent movement and travel of blind children, we should consider the characteristics outlined above. We should be placing blind children at an advantage by using what we know has worked successfully when learning to use the cane.

When these characteristics are considered and built into a cane, this becomes the cane of choice for the blind child. There are blind adults who use this cane of choice every day and blind children should have the opportunity to use it too. The Resources chapter gives contact information for purchasing this cane through the National Federation of the Blind.

Ideas for Adapting the Cane for the Child

To better meet the needs of the child, it may be necessary to adapt the cane. The cane may need to be adapted for various reasons--hand and finger functioning, keeping the tip oriented down, and differences in the child’s developmental level to grip and use the cane. Below are some ways to adapt the cane.

These modifications can be removed as the child develops more advanced hand-functioning and control over inadvertently lifting the cane, or when personal preferences for griping the cane change.

[The following segment is reprinted from chapter one, pages 10-12, of Independent Movement and Travel in Blind Children--A Promotion Model, with permission of IAP--Information Age Publishing.]

The Building Blocks of the Promotion Model

Below are the building blocks of the Promotion Model. First, the philosophy, which is its essence and spirit. Second, the principles, which are the foundational truths that support the model. Third, the developmental perspectives, which are the fundamental beliefs to fuel and guide the model. Fourth, the strategies, which put the philosophy, principles, and developmental perspectives into a plan for action. And fifth, the practices and techniques, which facilitate and put the strategies into action in the everyday learning and development of life skills for the independent movement and travel of blind children.

The Philosophy

Philosophically, we must acknowledge that child development is built on gain and not loss. The adult-centered approach of conventional O&M gives significant consideration to the loss of vision that adults experience later in life. When looking at child development, however, the Promotion Model recognizes that loss of vision does not factor significantly in the developmental gains that children make every day. Children born blind or who lose vision in the first years of life do not experience the type of loss associated with adults who lose vision. These children have not acquired years of developing visual skills nor do they possess a visual orientation to the world that has a long-standing integration into their personality.

For blind children, success is not measured by how much vision they have, but rather is built on how many skills are developed for independent movement and travel. With one skill built upon another, the goal of development is mastery over the environment to move and travel safely, confidently, and independently.

In the Promotion Model, the child leads the way, and if we are willing to learn from the child, many possibilities emerge. As an O&M professional service provider, I have connected with parents of blind children, incorporated them into my service delivery plan, and learned much from their experiences with their blind children. I have partnered with the organized blind that have provided me with positive, skilled blind role models for independent movement and travel. The building blocks of the Promotion Model have been developed from years of such learning from blind children, their parents, and skilled blind adults (the organized blind). Together, they form the fabric of the “nature and nurture” of independent movement and travel. Together, they present a formidable, alternative program of O&M to promote the independent movement and travel of blind children.

Bottom-Up

The child is not born with concepts of the world. The baby is born with sensory systems, like “fingers of the brain,” that gather information. With sensory and motor experiences the child matures over time and gives purposeful thought to what is experienced. One way to describe this process is bottom-up, which means that out of the experience comes the concept. If the experiences we give blind children are developmentally sound they will experience independent movement and travel age/stage appropriately. Blind children will develop the concept or self-perception of themselves as travelers.

Historically, conventional O&M was developed as an adult-centered approach. Its protocols were developed from an adult point of view for adult learners. For instance, the adult was given the concept of a new skill and the skill demonstrated for him/her. Then the newly blinded adult would perform the skill. This can be described as a top-down approach, which means that out of the concept comes the experience. This is a very different approach than bottom-up, which is the perspective of the Promotion Model.

Bottom-up is driven by the sensory and motor experiences of the child, and top-down driven by the cognitive concepts directing the movements of the adult. For example, when blind children under three years of age are learning to use the cane, they will need to be amused, explore, and have fun with their cane. Their movements will be more exaggerated and less refined. On the other hand, these are not the behaviors or the goal of the adult learning cane travel for the first time; adults will be ready to perform at a different cognitive level of understanding.

When promoting independent movement and travel in blind children we need to approach skill acquisition from the bottom-up, making sure our intervention and practice is suited to the developmental ability of the child. Imposing a top-down approach at a developmentally inappropriate level will meet with frustration and disappointment for both the child and the teacher. As a result, the conventional O&M instructor often assesses that the child is not ready for O&M instruction or ready for using a cane. In the latter case a pre-cane device is often used. Within the Promotion Model, however, the blind child is ready for instruction, just not from the top-down but rather from the bottom-up.

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