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Issues
in O&M: Early Intervention, Preschool, Transition
to Kindergarten
Reprinted from
In Touch, the newsletter of Parents of Blind
Children-NJ
Joe
Cutter, Early Childhood O&M specialist with the NJ Commission
for the Blind and guest speaker at our January meeting,
began this look at issues in Orientation & Mobility
with an overview of O&M. Joe explained that the field
developed after World War II to provide blinded veterans
with a way to move about independently. The techniques
that were developed were being taught to formerly sighted
adults who already had well-developed concepts of space
and movement. Terminology such as "arc," "in-step rhythm,"
and "alternating sides" made sense to them. Joe calls
this standard method of teaching O&M skills a "top down"
approach.
When
O&M instructors began to experiment with giving canes
to younger children, they found that the adult "top
down" approach was not appropriate. Joe believes a better
approach with children is "bottom up," an approach which
takes into consideration the way children develop.
Here
are some of the core ideas of the "bottom up" approach:
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Just
because a child is lacking eyesight, s/he is not
lacking the "drive to move and the need to know."
We don't see with the eye and hear with the ear;
rather we see and hear with the brain! A young blind
child simply needs assistance in learning how to
move and in finding out what there is to know. |
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One
of the things a child must do in order to make sense
of the world is to put together, or integrate, the
information s/he takes in through the senses ("sensory
integration"). But a child cannot integrate information
that s/he does not have! So one of the keys is making
sure the child is receiving information about the
world. |
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How
does a blind child get information about the world?
Largely through movement. Movement brings the child
into contact with objects and people in the world.
If a child is restricted in movement, s/he will
be restricted in information about the world. |
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The
goal is for the child to initiate movement him/herself.
Parents and other adults in the child's life can
facilitate movement by showing the child that the
world is a safe place where s/he can find fun and
enjoyment. First the adults bring the world to the
child; then we help the child go to the world him/herself.
Movement experiences in the early stages, however,
must be provided in ways that the child can take
in. We must feed the child from an appropriate,
meaningful "menu" in order for the child to thrive
and grow. |
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Infant
Movement Experiences
Much
of the literature on the development of blind babies
states that they are delayed in pushing up on their
arms in the prone position (on the belly) as much as
six months compared to sighted babies. Is this noted
delay an inevitable result of blindness?
No,
says Joe Cutter. If we enrich the prone experience for
the baby with parent-baby play, for example, the baby
will have reason to push up, and we can begin to close
the gap. For example, instead of letting a baby lie
on a blanket on the floor, let the baby lie on the parent's
chest The baby then gets a reward for pushing up—closer
contact with mom or dad's face and voice. We can think
of such interventions as alternative techniques of blindness
suitable for babies.
Other
important aspects of early movement are "midline" experiences.
A crucial time in the development of sighted babies
occurs when they discover their hands and then the rest
of their bodies. When the hands come together at the
center of the body (the midline), the baby begins to
break out from reflexive movement and begins to make
purposeful movements. This purposeful, body-discovering
play leads to the ability to integrate information gained
through the senses.
How
can we facilitate midline experiences and, therefore,
body discovery for blind babies? By "furnishing the
midline space," again providing reasons for the blind
baby to touch his/her hands together. On-body play—hands
together, hand to foot, foot to mouth, etc.—is
the way the child begins to know his/her body and how
it can move. These are the components needed for eventual
sitting and walking.
A third aspect parents can explore is the sound-touch
relationship. Early on, sound not related to a touchable
object will not have meaning to the blind baby. For
a sighted baby, things to look at are things to touch,
and things to touch are things to look at. How can we
create an equivalent experience for the blind baby?
By making sure that things to hear are things to touch
and by adding a touch experience to whatever vision
the child might have. Even visually directed reaching
is tactually directed at first. What can facilitate
sound-touch understanding and reaching? The parent's
voice and body is the logical place to start.
Early
Intervention Experiences
What
does a blind baby need? To move in and learn about the
world. A toddler with normal eyesight would be running
around "visiting the world." The young blind child should
have this opportunity, too. An early intervention program
for a blind child should be about movement and discovery;
movement should be built into the structure of the program.
A
large part of the EIP day is often circle time-type
activities with the desired behavior being "sitting
quietly and waiting your turn" This kind of activity
is often overemphasized and inappropriate for toddlers
who need experience in visiting the world (and was,
in fact, a program design borrowed from the preschool
model meant for older children). If the needs of the
child dictated the program, then sitting quietly would
not be a top priority for children who need movement
and exploration. Programs should be facilitating and
encouraging movement. (A more meaningful and appropriate
alternative to the typical circle time for a blind child
might be a small circle made up of the child, the parent,
and a teacher or aide.)
The
Role of the Classroom Aide
The
role of the aide in the classroom is another critical
aspect of early programming. Joe feels classroom aides
should be there to facilitate movement and independence
in the child. The aide must not be a shadow hovering
over the child! The aide must learn what the child can
do and allow the child to do it. She should be an available
but not interrupting helper. She should not be a personal
bodyguard!
Use
of the Cane
When
should the cane be introduced? When it will facilitate
and not interrupt movement, says Joe. Usually this is
when the child has achieved stable walking. Some classroom
teachers and even professionals in the O&M field do
not as yet see the cane as a viable tool to facilitate
movement in children so young. As a result of these
reservations, sometimes the "sighted guide" technique
is emphasized because it supposedly gives the child
a quicker, more efficient way to get around. However,
this quicker, more efficient movement is at the expense
of the blind child's developing his/her own efficiency
and speed and observing his/her own movement, all of
which eventually lead to independent mobility. Of course,
guided walking is also at the expense of the child's
self esteem and confidence about his/her own knowledge
of and ability to get around in the world. If independent
mobility is the eventual goal, then the child must be
allowed and encouraged to develop it.
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