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O&M: A Process Towards Independence O&M: A Pediatric Perspective A Child-Centered Approach: Common Themes in the Early Years Some Thoughts About Vision, Visual Development, and Visual Efficiency Auditory Object Perception Issues in O&M: Early Intervention, Preschool, Transition to Kindergarten

O&M: A Process Towards Independence
by Joe Cutter

Society tends to underrate the importance of play. Since most children play adequately without parental help and since it is not easy to see how play develops the brain, most people think of play as mere entertainment or fooling around. However, the child-play before a child goes to school is just as important for his development as is his schoolwork. The essential ingredient in play is the child's expression of an inner drive toward self-fulfillment as a sensory-motor feeling. The end product of playfor example, a tower of blocks or some number of jumps over a jumpropeis not important in itself. What is important is that the child follows his inner drive to produce physical activity in which he masters his environment and his body. Physical activity produces sensory stimulation and adaptive responses that help to organize the brain. The external results may not mean anything to an adult but to the child they signify success in his own growth process.

-Dr. Jean Ayres, the "Mother" of Sensory Integration

Orientation and mobility is a way of life. It is a way of knowing and a way of moving, a process of reciprocal interaction motivated by a wish to know, a wish to "be there" or "out there," of being with the world instead of separate from it. This process of orientation and mobility during the early years of life enables the blind child to engage with the early years; a common thread will sew together the variety of experiences. It will be consistent with the fact that, as human beings, blind children will have a sense of order, a sense of organizing their experiences and the ability to improve upon these experiences. From the earliest sensorimotor schemes to the formation of intentional thought and complex problem solving, the drive to want more and to make more out of what reality at any given moment has to offer will be part of the foundation of getting to know the world.

So what we observe through the maturation of the blind child is this process unfolding over time, of getting to know and moving in the world, on life's terms. Over time, this progression toward independence becomes more safe, effective, and confident. Parents and other educators of blind children are facilitators and interpreters using touch, verbal, and visual cues when they may apply. This is done to lure their child into a safe, interesting space where "visiting the world" will take place. We will offer blind children a menu of experiences that will make sense to them. Where visual acuity is absent (or partially so), sensory acuity remains. Research has proven that there is an interconnectiveness to the sensory systems—touch, sound, taste, smell, vestibular, proprioceptive—not to mention the joy to move and the need to know! The human brain employs these senses to "get the job done!" It is an "equal opportunity employer" and does not discriminate between the modes which provide the sensory information. For example, the sense of touch is primary in integrating and relating to all other sensory systems. The largest area of the brain's surface is devoted to the hand. The skin is the largest organ of the body. The blind child is a "sensation" of information. This will be used to compensate and adapt in the process of progressing toward independence.

Of course the blind child will not do this alone. What child could? All humans enter the world dependent upon getting their needs met. Movement needs are no exception. In learning anything new there seems to be a pattern: we do it for the child, then with the child, and then allow the child to do it alone. With parental love and guidance, the alternative techniques of blindness (or adaptive strategies) and tools for success (the brailler, cane, low vision aids, etc.), the blind child will learn a "can do" attitude. We know we can do for blind children, and they are vulnerable to our doing what they can do themselves. In other words, we often continue to bring the world to them instead of investing our energies in getting them to go out into the world. Blind children, like all children, are more than a sum of their parts. What is essential is not visible to the eye, but more fundamental (adaptive and compensatory) and is driven from the inside. These alternative techniques and tools look different but the results are the same: functionality, enjoyment, having a life! Differences are not deficits! We must make this message clear to the blind child in what we do and how we do it.

So, as an orientation and mobility instructor, I am fascinated and educated by how blind children adapt and compensate (and of course their parents too!). For example, take the phenomenon of auditory object perception in the blind child. This is the use of reflected sound by the blind child to explore and manipulate an aspect of the sound world. When one looks at blind children crawling, one can observe their hands being slapped on the kitchen floor. They are doing this not only for play and amusement but also to utilize this feedback from the environment to avoid or go to objects. They are looking to hear. The blind child's hands perform extra movements not needed for the motor act of crawling per se. These additional movements are utilized for the same purpose as an older child or blind adult may use their feet or a cane when ambulating.

I am privileged to be a part of this process, adapting and compensating with the blind child as she or he—for the first time—sits, crawls, stands, walks, uses a cane, uses his or her partial sight effectively, and learns to explore interesting spaces, places, and things. I acknowledge the creator in them and their spirit and drive to go to the world. I respect the love and developmental guidance of their parents and other educators who, with them, creatively adapt and compensate, too.

And I am reminded again that what is essential is not visible to the eye.



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