I made a lot of assumptions about how blind and mobility visually impaired toddlers would respond to belt canes. This is a list of ten assumptions that have been proven wrong since collecting videos of children wearing belt canes. The blue links take the reader to webpages containing specific example videos demonstrating the point made in that paragraph. I continue to learn about belt canes from the toddlers and preschoolers who are blind and mobility visually impaired wearing them. It won’t be long before I need to add part II of what blind and mobility visually impaired toddlers have taught us all about using belt canes.
1. Hands free – I thought hands free meant building a cane frame that never deviated from the path ahead. A major emphasis of the belt cane design was to make something that was completely hands free. The Safe Toddles’ team thought the belt cane should never drift from the path ahead. The belt cane design does stay ahead of the child on most smooth surfaces when walking alone (not holding a hand). Yet, on rougher surfaces and/or when walking in guide with an adult, the cane frame can drift off to one side, causing the need for either the child or adult to right the cane (put back into forward position).
When asked, parents were the first to allay my fears about this aspect of the belt cane. Charna’s mom and dad frequently responded by saying, “That’s not a problem for us. She doesn’t mind and Charna knows how to fix her cane.” In fact, when Charna, who was blind and two years old, wanted attention, she moved her cane around to her back, knowing her parents will say, “Charna, fix your cane.” and she did. And because they spoke, Charna now knew where her parents were located and went to them. She is so clever.
2. Push back – I worried that it would take time for children to learn to tolerate the intensity of tactile path feedback. Alilah put her first belt cane on when she was 20 months old. Right out of the box, she was filmed walking in the kitchen. We see her O&M specialist block her path with a chair. When the cane base contacted the chair legs, you see her get pushed back from the force of inertia. She remained standing. Several more times when the cane contacted something on the ground, she again withstood the impact. Once, she did fall back and she cried a little. However, mostly Alilah took it all in stride.
In her videos you can watch her gait and her pace improve. She walked much faster and further away from her parents with greater ease than she did in her “before” videos. She used her cane frame contacts to locate objects for further investigation.
3. Stairs- I thought the most important aspect of the belt cane would be that it performed like rod and rectangular canes on stairs. The first question that every O&M specialist asks about the belt cane is, “what about stairs?” We are O&M specialists, so we were the first people to ask that question. As we too want the belt cane to easily negotiate ascending and descending stairs. We have found that descending stairs, the cane works well. The method for ascending stairs wearing the belt cane has varied. However before we get too far ahead of ourselves, it is important to remember the value of knowing exactly where the stairs are. The belt cane tells the wearer exactly where the ascending and descending stairs begin. The problem that we see in children who are blind right now is that they can only guess at where the stairs begin, and can only find the stairs when their foot collides with the riser. Without consistent tactile path information, children under five have no warning before their body touches/falls down the stairs. We need to be reminded that currently, children five and younger without consistent tactile path information demonstrate highly inadequate outcomes of navigating stairs. The benefit of the belt cane is path information. I am sure that given time and opportunity, toddlers will figure out how to navigate stairs, in fact Matias has found that going up the stairs backwards is one way to go. Wyatt and Jack have both demonstrated great competence navigating the step up to wash hands at the classroom sink.
4. Free time – I thought that there was a benefit to being without a cane when you’re blind or mobility visually impaired. Many authors of early intervention articles have contended that blind children benefit walking without canes. However, there is overwhelming evidence that this is not true. When you cannot see where you are going, it is only a matter of time and distance before you collide with obstacles.
These unavoidable obstacle collisions cause developmental delays in children who are blind or mobility visually impaired.
The more children who can’t see the path ahead walk freely, the greater number of body collisions they experience. Blind and mobility visually impaired children have no way of veering away from these collisions or slowing down to reduce the impact. Therefore, children learn that walking causes pain and that causes them to avoid walking alone. Instead, they smartly ask to hold onto a hand, touch a wall, cruise furniture, but they do not want to walk across open space on their own. It isn’t the walking with assistance that causes delays, it is walking with fear.
There is no benefit to walking in the pitch dark and there is no benefit to walking while blind without consistent tactile path information (like lights for blind kids). When children wear their belt canes, they gain confidence in themselves. They walk across open space, they let go of the wall and they let go of the hands of adults. They become hands free, because they don’t need to walk with assistance anymore. Children who are blind or mobility visually impaired walk more, better and faster wearing their belt canes. The more they wear it the greater their self-confidence.
Just remember: lights on, cane on.
5. Cane sticks – I thought that canes getting stuck under furniture would cause children to reject the belt cane. The belt cane is a set of one belt with two cane frames. The two frames were created for children in order to reduce the amount of cane sticking. The daily cane is the correct length for children who are blind and mobility visually impaired to obtain two steps of warning. The tight spaces frame is ninety percent of the length and the cane tip is turned inward to reduce catching. However, the rectangular cane frames catch on chair legs and get stuck, and this is all a part of learning. Children who are blind don’t know that canes getting stuck are a different experience from sighted people, because when you are three-years-old you think everybody is the same. Canes get stuck and that’s a fact of life, and the more you wear your cane the better you get at getting unstuck. More experience adds up to better skills. There is a difference. A child who is blind and walks and experiences direct bodily collisions, has no way to “get better” at walking with collisions, except to stop walking. A child who wears her cane all the time develops confidence. A child with confidence whose cane gets stuck, can improve in her ability to get unstuck because her confidence in herself drives her to master this problem by finding an independent solution. One thing they don’t do is ask to take off the belt cane. They just work to free themselves.
6. Catchall – I thought the cane would need to be designed to locate all the objects all the time. After two months of wearing her cane, there is a moment when Charna’s cane glides over/misses little toys on the floor, and she steps on them. Charna reaches down and investigates what she stepped on and then continues on her way. This is not the first time her cane has allowed Charna to step on something. The difference is that the number of times Charna runs into walls, cabinets, chairs and people has been reduced by ninety-five percent. Thus, the five percent of the time the cane isn’t there is within acceptable limits. We can all tolerate little accidents that occur infrequently. Next time her cane signals little bumps, she will have learned to turn away, or to step carefully. She has already learned to pick up on many of the signals her cane provides, because she is walking and learning. This is very different from children who walk without any warning, they are walking with fear. You can’t learn anything when you’re walking with fear, all you can think about is how to protect yourself. You are motivated to find safety, not to learn. The belt cane removes fear and improves learning.
7. At arm’s length- I thought that the cane frame would need to collapse so that the child could get closer to objects. One noticeable difference between the belt cane and the rod and rectangular canes is that the belt cane frame does not retract. Although Charna can achieve cane retraction because of her size, her belt slips above her waist as she moves towards a bin when wearing her tight spaces cane frame, this is not a typical outcome when wearing the belt cane.
Our search continues for a magical cane frame material that can remain strong and straight during forward propulsion and yet, when enough pressure is exerted retracts to allow the user to step closer to explore objects blocking their path. The magic part is the expectation that the material will be able to spring back to straight, strong and extended into the path when freed from the blockage. We will keep looking for that material or design feature, but in the meantime, the children have shown us that they are able to figure out multiple strategies for getting closer to objects they find. Like Matias, who when playing with a water toy one summer, put his cane frame behind him. His cane is still there, ready to be returned in front when he is ready to move again.
8. Take on/off independently – We thought it would be important for children to learn how to take their belt canes on and off themselves. At first, the first belt cane was a bungee belt, and children stepped into the belt like a pair of pants. We thought that this would be a routine that would be easily mastered by very young children. The magnet belt is a much better design. It is much less cumbersome to put on the child, as there is no need for the child to step into or out of the cane frame. The belt is closed using a mushroom head fastener that requires an adult’s strength and dexterity to pinch close and pull open.
It turns out, that some highly capable three and four-year-old boys and girls do learn how to detach their belt canes. They don't discard them, they push them. They get to decide if they want to keep them attached or detached. So, while we intended to make the canes like car seats, we made them so well that kids can take them off, and still want to use them. This is helping them with the transition to the AMD and later the rod cane.
9. Mobility instruction – I thought the child would have to be taught how to employ the belt cane. The Audrina Series, documents a three-year-old girl wearing her belt cane and compares her wearing the belt cane to when she is using her rod cane. In the video series, we see clearly that she is not able to work her rod cane to achieve one step, one swipe. No matter how much she is prompted to do so by her teachers and O&M specialist. Yet, with no instruction at all, she is moves about freely and with greater speed and self-confidence with the belt cane.
When Audrina wears her belt cane, she becomes much more of a three-year-old (meaning less compliant). She begins to discuss, some might say argue, orientation and route planning. Her language is more interesting, and she begins to run and explore and have fun. The benefit of the belt cane is that now O&M lessons can be about concept development as the cane arc is built in and the children learn to confidently explore their world. Belt cane O&M lessons are more fun because it can focus on concept development, route travel, locating fund destinations, learning the rules of the road -just more learning period about important concepts can happen when you don’t have to worry about safe mobility.
10. I didn’t know blind children would run without prompting – The first child who was mobility visually impaired to run wearing the belt cane was Jojo and he was the first child with mobility visual impairment to wear the first ever 3D printed bungee belt cane in September 2017. Since then, almost every three- and four-year-old who wears the belt cane, runs. If they are physically able to run, they run.
Blind and mobility visually impaired children do want to run; they want to let go of the wall and they want nothing more than to feel safe and confident and to be independent.
Anybody who says the blind child prefers a sedentary lifestyle is asking that child who is blind or mobility visually impaired to walk/run without consistent tactile path information. When they have no path information, they are the smartest person in the room, as they know better than anyone else that running without path information is dangerous. Running with path information is fun (watch part five of the Audrina series).
Orientation and Mobility Blog 