by Jeffrey T. Altman
From the Editor: Jeff Altman is a proud Federationist living in the state of Nebraska. He works as a cane travel instructor for the Nebraska Commission for the Blind and Visually Impaired, and in that capacity he was asked to address a convention of the American Council of the Blind’s Nebraska affiliate to discuss the topic of Structured Discovery. These remarks explain the concept with refreshingly simple language and convey the enthusiasm many of us feel about the concept and the liberating affect it can have in the lives of those who receive it. Jeff’s presentation also underscores the need to take our message to those who may not have heard it or may have heard a distorted version of why we use Structured Discovery. Here is what he said:
First of all I want to thank all of you for inviting me to speak at your state convention this year. As most of you likely know, I am the cane travel instructor at the Nebraska Center for the Blind, which is located in Lincoln. I’ve been teaching travel in the center for approximately fifteen years, and I’ve been working in this profession for nearly twenty-five years. Cane travel instruction is also known as orientation and mobility, and I have both a master’s degree and national certification in this field. In other words, I have papers and letters after my name. Now, if you’re not impressed by letters and papers, don’t worry about it, most people really aren’t, and that’s okay, because that’s not what’s actually important about learning independent travel.
While it is important for an instructor to know how to travel, and of course, to know how to teach these skills, what is more important is knowing the best way for human beings to learn cane travel. There is a Native American saying, “Tell me and I will forget, show me and I may not remember, involve me and I will understand.” Almost everyone learns better by doing, and this is a key aspect of good instruction. I am convinced that the greatest respect a cane travel instructor can show his students is to expect them to be able to draw upon their existing knowledge and to independently gather information from the environment in order to solve the problems that come up when they are traveling. In the center students often joke and sometimes complain that the only thing they ever hear from instructors is, “What do you think?” Well, they’re right; we ask that question a lot, and it is because we respect them enough to expect them to be able to answer it.
Perhaps I should explain a little about the instructional methods that we use in the center. You have probably heard of Structured Discovery and the fact that we use a longer type of cane and sleepshades in our training center. Not everyone is comfortable with this approach to teaching, and, without having these things explained, they can seem a bit strange, maybe even a little scary at first. Structured Discovery isn’t just one way of teaching, but rather it is a continuum between two very different methods of providing instruction, each of which has important benefits and some limitations that can actually make learning more difficult in certain situations.
Let me begin by asking you folks some questions and have you answer by applauding. How many of you have taken a foreign language in school? How many of you would consider yourselves to be fluent in that language? For argument’s sake, let’s say it was Spanish you were learning. Let me see if I can guess what your class experience was like. You took Spanish in a classroom, along with approximately twenty-five to thirty other students. You probably had a book or maybe a workbook, possibly a few “cultural experiences,” and likely there were some quizzes and tests. You had a teacher who stood at the front of the room, and that teacher would say something in Spanish, and you’d repeat it back. Or perhaps the teacher would say something in Spanish, and you had to give the correct response. Maybe you had some conversations with your classmates in Spanish. This is called structured learning, and while it works well for some of the things you need to learn, for many things it doesn’t work well, such as learning a foreign language.
Now at the opposite end of the continuum, there is discovery learning. So, let’s say you wanted to learn Spanish through discovery learning. We’d put you on an airplane, give you a parachute, throw you out over someplace like Lima, Peru, and say “See you in a year.” If you live through the experience, well, you might just learn some Spanish!
On the other hand, if you wanted to learn Spanish through Structured Discovery, it would go something like this. You would hire an instructor who is fluent in both English and Spanish and very familiar with one of the cultures where Spanish is spoken—let’s see, maybe somebody like Carlos Serván, who might be very willing to work for you for a year in Peru with a nice salary and all expenses paid. Then the two of you would fly to Lima, and on the way your instructor would review some basic words and phrases in Spanish, just enough for you to get by the first day or so. Once you land, your instructor tells you that you are going to go to a restaurant for dinner that night, and he just happens to have a copy of the menu. He says that you and he will go through the menu together, he’ll help you to understand what the various items are, and, when you find the items you want, he will help you learn how to order them in Spanish, because you are going to order your own dinner that night. He is going to be there with you and will help you out should you run into any difficulty, but you are going to order your own dinner in Spanish.
So you go to dinner that evening, and even if you struggle and need a little extra help, you will make it through the experience. Perhaps the next morning your instructor says that the two of you need to go to the marketplace to get a few things. He tells you what the items are, how to ask for them, and how to get directions to the booths where the items are sold. He also explains how the local money works and how to bargain with the merchants to get the best price. He tells you that he will be there with you should you need some help but that as much as possible you will be doing the talking. So you go to the market together and make your purchases.
That night your instructor tells you that the two of you are going to stay in for dinner, but that you are going to walk to the local pizza parlor on your own. The establishment is a couple of blocks away, and you will order and pay for the pizza. You will then bring it back to the hotel. You go and do this on your own, even though you are a bit nervous doing it.
After dinner your instructor tells you that tomorrow the two of you will be going to a museum, and the tour will be given by docents who speak only Spanish. This is pretty complicated, so he will be there to help you out. But, as much as you can, you will be doing your best to understand the tour information with as little help from him as possible. You will need to ask some questions about the displays, so he will help you to come up with the questions in Spanish, but you will be asking them.
Each time a new experience is introduced, your instructor will be there to help you, although he will often ask you questions so that you are figuring it out for yourself, and just at the point that you are able to handle things for yourself, he will back off and let you work it out on your own. You will find that more and more he is speaking with you only in Spanish and expecting you to answer in Spanish as well. What’s more, you are now finding yourself having to go places on your own and use your Spanish to complete your assignments. You’ll be meeting lots of people who speak only Spanish, and you will be expected to start conversations with them. How do you think your Spanish would be after a year in this environment and with this instruction?
Switching from our language example now, that longer white cane tends to raise some questions for folks who are not used to this type of cane, but it’s really not all that complicated. A longer cane allows you to have the necessary preview of the environment in front of you so that you have time to react, and at the same time you are able to keep your arm in a comfortable position. The longer cane also gives you greater upper body protection when you are traveling using the pencil grip, especially in a congested or unfamiliar situation. It is lightweight and somewhat flexible, so it is relatively easy to handle, it doesn’t wear you out as quickly as a shorter heavier cane, it absorbs impacts and remains straight afterwards, and it gives you some extra reach when you need it. The metal tip provides very good tactile and auditory feedback that makes it much easier to identify surfaces and to use echolocation.
Next, what about these sleepshades? This is one of those things that can cause folks to have uncomfortable feelings about this type of training, and in my experience many times it is a matter of not understanding the reason we use the sleepshades in our program. There are many very good reasons for using the sleepshades, but for now, I’ll just touch on a few of them.
First of all, no matter how many letters you have after your name or what papers you have hanging on your wall, you simply cannot get inside another person’s head and know what works best for that individual. It is the individual who experiences a vision loss that is going to know what works best for him or her in a given situation. Our agency believes very strongly in “informed choice.” This may seem a bit obvious, but if you are going to make an informed choice, then you really need to be informed. Otherwise the only thing you have to base your decision on is an emotional reaction. If you are going to make an informed choice between using a low-vision technique and a nonvisual technique, you truly need to know how to use the nonvisual technique. Most folks are so concerned about losing their eyesight that if you introduce a low-vision technique first, they’ll likely think it is the best possible solution to their problem and be unwilling to learn the nonvisual technique. If you approach training by addressing the possible low-vision solutions first, then the folks being provided these services are not being given the opportunity to make an informed choice.
When you have limited eyesight, sometimes the best use of your vision is not to use it at all. What I mean is that, if you are truly struggling to see to do something and you could accomplish the same task using a nonvisual technique just as well or even better, using your eyesight simply isn’t the best choice in that situation. You already know what is possible with eyesight, so using the sleepshades for an extended period of training gives you the opportunity to discover what is truly possible without it. Only then can you make a genuinely informed choice.
We tend to use the term blind most of the time in our center and not visually impaired. This concerns some folks as well. We often hear from new students in the Center who say, “I’m not blind. I can see pretty good, so I consider myself to be visually impaired.”
I think it may help to understand the reason we most often use the word blind by considering how the term legally blind came to be and what it really means. Back when Congress was considering expanding Social Security benefits to help provide an income to people with disabilities, they recognized that, aside from people who were totally blind, a lot of folks out there had very limited eyesight and that they needed this help too; however, how would the law determine who was eligible, and who wasn’t? They approached the eye care professionals with this question. The professionals talked about it among themselves and realized that people below 20/200 or with a visual field of less than twenty degrees found it very difficult to function in the world if they attempted to do things using their vision, so this became the standard or what we know today as the federal definition of blindness. Now this is more important than you may realize; this meant that blindness really wasn’t about how much a person could see, but rather how that person functioned based on having a certain level of vision. In reality being blind means that you do not have reliable eyesight, to the degree that you need to develop effective nonvisual techniques in order to carry out the majority of your daily activities as effectively, efficiently, and safely as would a person with normal vision.
If you are going to function on an equal level with your sighted neighbors, you have to master the nonvisual skills you need. Yes, your vision may work perfectly fine for certain things or in the right conditions, but what about those times in which your vision can’t get the job done?
We must always train for those situations that are less than optimal. As an example, our daughter, who is not blind, has been driving for about a year now, and before she got her license, we made sure that she got lots of driving lessons. If she had only taken driving lessons on nice days with dry streets and very little traffic, what would it have been like for her the first time it rained or snowed or she encountered heavy traffic? You have to be able to function in adverse conditions, and for folks with limited eyesight this means those situations and times when their eyesight doesn’t work well. An instructor teaching the skills of blindness cannot really know or create those conditions often enough or in enough places to assure that the person with limited eyesight has enough experience with the nonvisual skills truly to master them unless the sleepshades are used as a primary tool in this training.
The fact that being blind means a person does not have reliable eyesight leads to another important reason for the use of the sleepshades, and it is directly related to learning nonvisual skills. If I never expected my cane travel students to do anything other than to sit in my office and talk with me about being independent travelers, would they learn very much about cane travel? Or suppose that on the first day of class I expected my new student to walk to the biggest, busiest intersection in town and cross it independently. What would that person likely learn? In the first case I’m obviously teaching nothing, and in the second case, I am very definitely teaching something: fear and frustration. Of course, these are silly examples at two extremes, but they demonstrate one important point: that between the point at which someone is completely comfortable and the point at which that person would be overwhelmed, there is an area in which that person will learn. If a person is going to learn, that individual has to be challenged, but not to the point where it is beyond his or her skills and ability. So as an instructor, it is my job to keep my students challenged but not push them too far, and there is some room in this learning zone to meet the individual’s unique needs. The closer the challenge is to the student’s comfort zone, the less involved the instructor should be, and the closer the challenge is to overwhelming the student, the more involved the instructor should be.
Going back to a couple of things I mentioned earlier, a blind person with some eyesight doesn’t have reliable vision, and I can’t get inside that person’s head, right? So, other than an educated guess, I can’t really know how effectively the person can use his or her eyesight, nor can I know when and for what purpose the person is using his or her vision. All I can do is observe the person’s performance, and since it is my job to keep the student challenged, based on these observations I make my decision as to how much more of a challenge the person needs to continue learning. If the student is doing well, I increase the challenge, and if the person continues to do well, I continue to increase the level of challenge. All of this sounds fine, but without using the sleepshades there is a problem. Remember that the person’s eyesight isn’t reliable, which means it doesn’t work well enough to meet the demands of everyday activities in many places and situations. Also remember that I can’t get inside the person’s head, so I don’t know when or in what situation the person is using his or her eyesight. This means I don’t have any way of knowing whether or not the student is actually learning the nonvisual techniques or simply doing what comes naturally and depending on his or her unreliable eyesight.
As I push this student forward into more challenging situations, sooner or later the student is going to run into one in which his or her eyesight cannot provide the information to effectively, safely, and efficiently deal with the challenge. In a Braille or computer class, that could prove very frustrating and might lead the student to feel that it is only possible to read or word process when he or she can see. However, in my cane travel class, finding yourself in a situation where you can’t see well enough to complete a task and discovering that you haven’t learned the nonvisual techniques that would allow you to stay safe could be a lot more than frustrating.
When it comes down to it, orientation and mobility is really about being able to get from point A to point B, and the skills a blind person develops through this training are especially important when point B is some place you’ve never been before. First of all, being highly skilled with whatever type of mobility device you choose to use is very important. Be it cane or dog, you have to be effective in gaining information from the environment and be able to avoid the possible dangers the environment can present. You also have to be able to use the information that is available to you effectively. For example, you probably shouldn’t be attempting to travel across town if you haven’t figured out how to locate curbs, cross streets at the correct time, and recognize familiar places. Once these things are in place, understanding how to use a street pattern and address system in general, as well as knowing more specific information about the town in which you are traveling, is critical. You are going to have a pretty tough time planning how to get somewhere you haven’t been before if you don’t have some basic concepts about how the world is put together. Of course, if public transportation is going to be involved, then you would probably be well served to have received some training in how to use the system. If you are going to be going somewhere new, then being able to ask relevant questions and access a variety of sources of information regarding the transportation system is vital. The good news is that, if you have ridden a bus in one town, you’ll find they work pretty much the same way everywhere else, and the same can pretty much be said for subways and other types of rail transit systems. There may be some small differences, but the basic mechanics tend to be the same. Some simple things I would tell you are: when you are first learning the system, make sure you have some extra time built into your schedule, be prepared to ask questions, and once you have become comfortable with the system, don’t become complacent. Surprises can happen, and you have to be able to respond and adapt.
When I was asked to talk with you, it was suggested that I address some of the current trends that may affect the lives of blind people, so I will attempt to give you my point of view on these issues. Some folks in recent years have been promoting the idea that orientation and mobility should be considered therapy. The proposition is that it is similar to physical therapy (PT) or occupational therapy (OT) and should be viewed in a medical context. There are even some in the field of physical and occupational therapy who believe they should be considered qualified to teach these skills and that those without their qualifications should not.
I would dispute these notions for two important reasons. PT and OT are primarily focused on human beings from the neck down. Yes, they teach some skills, but for the most part their role has to do with restoring an individual’s physical capacity. In other words, the job of these therapists is helping a person regain physical strength, reestablish normal joint movement, and promote the relief of pain to allow them to return to their previous state of health or to come as close as they can to total restoration. If that can’t be accomplished, the goal is to develop some physical techniques or use devices that will allow the person to complete the tasks that their physical limitations would otherwise prevent. PT and OT are also providing techniques that allow the individual to return to interacting with the environment or conducting tasks with which the individual is already familiar and well oriented.
Orientation and mobility, while it involves the development of some physical techniques, is primarily focused on developing skills related to orienting and interacting with the environment through a less familiar set of sources of sensory information. In other words it focuses on the person from the neck up. For example, an individual injured in a car wreck may have to undergo extensive physical therapy to restore enough movement and strength to be able to reach items stored on an upper shelf. If that individual cannot develop enough strength and movement to do so, then an occupational therapist may teach the person to change the way things in a work area are arranged or provide the person with a device that allows him or her to reach and grab things off a high shelf. On the other hand, a person who has recently become blind may not have any physical difficulty reaching items on that upper shelf; however, this person may find it very difficult to locate the shelf, the place on the shelf where the desired item is stored, and then may not know how to determine which item on the shelf is the desired one. Therefore, in terms of orientation the person must learn how to use information available in the environment to locate the shelf, locate the items on the shelf, and determine how to identify the differences among the items. She or he may even need to create a nonvisual label to identify the item. Therefore, orientation and mobility is not therapy per se, but rather an educational experience.
At the opposite end of the spectrum, there is emerging a class of professionals calling themselves “travel instructors.” I am a cane travel instructor or travel instructor, but that is not what these folks are talking about. As I understand it, some of the centers for independent living, (CIL’s) and some transit authorities are hiring these folks, or people with similar training, to provide orientation to blind people and other disabled people so that they can go to their jobs or use regular fixed-route public transportation systems rather than relying on paratransit. I can’t speak to what these folks are doing for people with other types of disabilities, although the whole notion seems a bit confusing to me personally. However, I can speak as a professional regarding the needs of blind people when it comes to the need for these kinds of services. Frankly, a blind person who is only dealing with mobility issues related to blindness and is relying on paratransit where regular public transportation is available has simply not received proper orientation and mobility training. Therefore, the proper person to be working with such a blind person is an orientation and mobility instructor and not somebody that has been given a brief training in a set of general travel-related skills that are apparently designed to address the needs of the full range of disabled people. I would further say that a blind person who does not have other relevant disabilities and has received proper orientation and mobility training does not need a professional at all in the majority of situations and in fact should probably not have been using paratransit to begin with. To clarify, I am talking about those situations in which a regular public transportation system is available and can meet the individual’s transportation needs. You will observe that I said I was referring to blind people who are not experiencing secondary conditions such as a physical disability that may restrict his or her mobility or a significant hearing loss or a cognitive condition that limits the ability to maintain one’s orientation and safety. In these situations, the limitations these characteristics involve may well necessitate the use of paratransit. For these people, attempting to have these individuals change to a fixed-route public transportation system may not be appropriate, and even if it is appropriate, it is certainly not something an instructor with limited knowledge of blindness should be attempting to introduce. Blind people in these circumstances are in need of very specialized skills, and they are only going to learn them from someone who knows them and how to teach them.
Of course we are experiencing a serious shortage of O&M instructors right now, and with many state governments looking to cut spending, proper orientation and mobility training can be a real challenge to obtain. The National Blindness Professional Certification Board, of which I am a member, is making a strong effort to meet this challenge, but we need people willing to make the commitment to obtain the training and education necessary to perform this important work. If you know someone with the interest and character to become an O&M instructor, please send them our way; we’d love to help them reach this goal.
I hope I have answered some of the questions you have regarding independent travel and perhaps have given you some additional understanding of Structured Discovery. Thank you again for inviting me to be a part of your convention, and I’ll be happy to attempt answering any questions you may have.