I’m starting to walk – I can use a cane!

I’m Starting to Walk – I Can Use a Cane! Bronwen Scott Orientation & Mobility Instructor/Visiting Teacher Vision Education Service Department of Education and Training, Western Australia [email protected] In Western Australia, children who are blind or have a severe vision impairment are starting Orientation & Mobility (O&M) training as soon as they begin to walk. This means learning how to use sighted guide, basic body protection skills, and beginning to use a long cane from around 14 – 18 months of age. The Department of Education and Training’s Vision Education Service (VES) is a team of Visiting Teachers, including an Orientation & Mobility Instructor/Visiting Teacher, who work with children from birth until they leave school (usually around the age of 17 or 18 years). Part of the service is an Early Intervention/Early Childhood Service, which works with children aged 0 – 6 years. O & M is an integral part of the Early Childhood Service, and is an important aspect in a weekly group called “Braille Nest”. This group meets once a week at a centrally located Primary School in Perth, and caters for children whose primary communication mode will be Braille, or who will be dual Braille/print users. The students are aged between 8 months to 8 years, and there are between 4 and 8 students attending each week. The program fosters the development of social skills, social competence, independence, Braille literacy, life skills and concept development. “Braille Nest” also provides the children with peer support and role models for using the long cane. How do we start? Once a very young child is referred to the Vision Education Service, a Visiting Teacher (who is qualified in vision impairment as well as early intervention) will begin to make home visits, and lets the family know of what other services may be appropriate. If O & M is required, the child is referred to the O & M Instructor/Visiting Teacher who works with the team, and O & M training begins as soon as the child is walking. I begin by introducing sighted guide – with the child holding on to my ring and little fingers as they are walking. I use the term ‘sighted guide’ right from the beginning. Much of this early work is based on building trust and a rapport with myself, and to develop confidence in moving through the environment. As the child’s balance improves, I spend a lot of time encouraging the child to walk freely towards sound sources (under close supervision to avoid any accidents!), ‘cruising’ (using two hands whilst walking sideways around furniture, along walls), and generally becoming confident in themselves with movement. As soon as the child has good balance and is moving independently (no matter how small the distance), I introduce the long cane. Using the cane Using a long cane as a small child is very different to using it as an older child or an adult. Teaching of formal cane skills, such as touch technique, are not introduced by myself until the children are around 6 years of age and are starting to develop the strength and motor skills to learn these techniques. When working with young children, developmental levels need to be considered. When first introducing the long cane to very young children, I initially let the children ‘explore’ the cane – they are all interested in putting it in their mouths! – and to find out all about it. They bang it on the ground, sometimes on the walls, feel it from one end to the other – in other words, just what they do with every other object that comes into their world – play with it! We also choose a name for the cane – usually I will encourage the families (especially siblings) to see if they can think of a name, or the child themselves if they are able to. This helps to ‘personalise’ it for them, and the cane becomes another member of the family who accompanies them wherever they go. Currently we have “Tinkerbell”, “Candy”, “Spike”, “Nemo” and “Miss Polly” to name a few! After the initial ‘exploration’ of the cane, I don’t let the children lift the cane up into the air, other than if they are ‘tapping’ it. This rule is strongly reinforced by families, other teachers, and everyone who may be working with the child whilst they have their cane. One of my initial concerns about introducing the cane at such a young age was that they would use it inappropriately and that it might be dangerous to other people! However, I have to say that this has not been an issue at all. The children I teach learn very quickly that the cane is most useful when it is on the ground. The only other hard and fast rule is to have the index finger pointing down the grip of the cane (the hand position they will use as an adult). In other words, the children are learning to use a basic diagonal technique. If they are walking with the cane independently, they are closely supervised to ensure that they don’t contact an obstacle – I usually find a verbal warning is enough for them to stop, and I can then show them how to use the cane to find and avoid the obstacle. They may choose to use sighted guide whilst using the cane in the other hand – and families are all taught early on how to do this. If they decide not to use the cane, that is fine too – we reinforce that they can choose to walk independently in safe areas if they wish, as long as they use ‘safe hands’ (modified body protection techniques). In this way, the children begin to see independent mobility skills as empowering, and as their choice. General Guidelines Once a child is walking with good balance, they are ready to begin to use a long cane. Encourage the students to explore with their canes, to enjoy the freedom of movement it gives them, and to have fun with them! Incorporate other aspects of O & M training – sound localisation skills, trailing, squaring off, body protection, concept development – into your ‘explorations’. Use the correct language – from the first day use the terms sighted guide, trailing, squaring off, long cane and ‘safe hands’ (I use the term ‘body protection’ once we introduce the more formal skills as the child gets older) Team work is essential! The child’s family, teachers, and other early intervention professionals involved must be strong believers in, and advocate for, the development of early O & M skills. Reinforce the correct techniques at all times. Inappropriate cane use should not be tolerated, and my students know the cane will be taken away temporarily if they use it irresponsibly. I have rarely had to enforce this rule. In my experience, children are more responsible than we give them credit for - they don’t want to lose the freedom that the cane is giving them! There is a growing amount of professional literature in relation to early long cane use, and I encourage people to research the issue further. I have just commenced Doctoral studies in early intervention O & M, and would be interested in hearing from anyone working in the area. SOME USEFUL BEGINNING REFERENCES Bessen. N.E.L. (2004) Everyone has a Cane, just like me! Future Reflections, Volume 23, Number 2, 57 – 58. Cutter, J. (2004) “Parents: Blind Children’s first Mobility Teachers”. In Future Reflections, Volume 23, Number 2, pp 45 – 58. Pogrund, R.L. & Rosen, S.J. (1989) The Preschool Blind Child Can be a Cane User. Journal of Visual Impairment & Blindness, November, 431-438.