Child-Centered Approach: Common Themes in the Early
orientation and mobility has been taught from adult
to adult with particular emphasis on cane travel. This
tradition can be referred to as a "top-down" approach,
adults already having the concepts and learning the
motor schemes to match their comprehension.
a pediatric perspective, however, the approach will
be "bottom-up." First, the child learns purposeful movement
and out of the relied-upon motor schemes will come the
concepts. During the first two years of life particularly
(known as the sensorimotor stage of development), the
child will come to know and master his/her environment
with a lesser or greater degree of competency. The orientation
and mobility specialist will be better equipped to assist
the blind child if knowledge is gained about how children
following list of concepts respects the "bottom-up"
approach. It's a peek at some of the ways blind children
will come to know and move in their world.
Holistic Nature of Child. The child is more than
the sum of his/her parts. The child perceives changes
in the world and responds to those changes. The baby
does not know, for example, that he/she is seeing or
hearing or touching, but rather experiencing a change
in the environment.
2. Development will be Head to Foot and Proximal
to Distal. This is quite significant, as the blind
child's hands and feet will be the last to develop control
in the first year of life. Foot travel and integrity
of hand use will be needed by the blind child for life
and yet the blind child is quite vulnerable in how he/she
develops control in them.
Play. Lorraine McCune states: "When play is defined
to include all of a baby's freely chosen encounters
with objects, a large proportion of the child's waking
time is play time!" When blind children are restricted
in the kind and amount of play they may be allowed to
perform, when they are limited by others in their free,
intentional movement, the context of their understanding
of people, places, and things will also be limited along
with their ability to reason, experiment, and create
a more functional understanding of their world.
Reflexive. Accidental. Intentional. There is
an integrative function to the brain, so that the child
learns progressively. The blind child is vulnerable
to not taking advantage of "accidental behavior" (example:
hands coming into view), which has an impact on developing
intentional thought. So, we must provide an appropriate
menu of nonvisual experiences that promote accidental
learning in the blind child.
Using Residual Vision. In the early years, residual
vision may be ignored because it is less than "print
vision." What may start out as light perception or projection
in the infant may, by two or three years of age, become
more useful. CAUTION: DO NOT PUSH VISION TO THE POINT
Active vs. Passive Use of Body. Blind children
are quite vulnerable in this area. Often, intentional
actions are interrupted by adults doing for the child.
Over time there is a subtle and potentially devastating
concept of the world "reaching to you" and you not "reaching
to it." The role of the orientation and mobility instructor
can be instrumental here, structuring the environment
to facilitate the child's movement.
7. Parental Interaction-Close In to Moving
Away. First through touch and sound, attachment
occurs, but often during the second year, parents move
to more verbal interaction with children. Blind children
may need a prolonged period of touch interaction here,
a period of infant-parent attunement.
8. Preview. Lacking sight, the blind baby does
not get a visual preview of the world. How can we provide
experiences that will give the blind baby a preview
of his body and the world?
Synchrony. In the early years, blind childrenthe
same as sighted childrenuse two senses at a time
instinctively to experience the world. For example,
when babies hear a voice, they turn, expecting to see
a face. What of the blind baby who turns, but does not
see a face? Would moving the arm to feel the face provide
a meaningful function? One 13-month-old baby, when hearing
a person's voice on the phone (and not being able to
touch the person), smelled the phone. Was this an attempt
to verify the sound? To synchronize?
Affordance. The structure and function of objects
have a lot to do with a child's interest, amusement,
and interaction with them. Giving thought to the child's
play environment can facilitate purposeful thought and