According to the author, blind students are not developmentally ready to do a coordinated, complete touch technique until between the age of 12 to 14. Do you agree with this position? Why or why not?
Many students naturally drop the cane down and to the side rather than keep it centered. Should we continue to insist as a profession that centering is a major goal of training? Should we modify our approach or expectation?
How do you teach centering? Have you had great success teaching centering to students?
NFB and mobility colleges have a divergence of opinion about how long a cane should be. What is your position on this controversy?
The author puts forward the idea that "proper" cane skills might be part of a Saber Tooth Tiger curriculum? Do you think there is a proper set of cane skills or are we being too closed (professionally)?
At the end of this section, the author offers a list of outcomes (with the cane) that should be complete (or addressed) by certain grade levels. Do you concur with this assessment, or would you order the outcomes differently?
Comments (feedback to the above questions) by readers.
The concept of "independence" (doing things for and by oneself) should be introduced early. The word should be popping up in kindergarten, and old hat by the end of first grade. This is critical. Quality of life is at stake. Children who do well in school have strong support systems, and high expectations coming from teachers and parents (grandparents and care givers). This external set of high expectations becomes internalized over the elementary years if the child hears the message often enough: "Do things by and for yourself". The cane is the key tool for independent mobility.
Elementary school, as early as kindergarten, is the time to address bad cane habits, like whacking the cane off walls, lifting it to nose level and smacking the floor so loud the fire alarms go off, dragging the stick along behind and to the side; dropping the cane any old place any old time, using the cane as spear or bludgeon, and worst of all; tripping your mobility specialist just to hear the crashing sound. Poor cane techniques, using the diagonal and touch skills incorrectly, are not examples of bad habits. To expect graceful, exact cane skills at a young age is unrealistic and unfair. Young children have difficulty making small, refined movements.
Also, Motor delays are not uncommon with blind children. One adult may have become proficient with the cane after the 7th grade, while another may not have become graceful and efficient with the cane until high school. Another way to think about this is to consider athletic ability. Let's face it, some of us have bodies designed for sports excellence and some of us exercise everyday just to avoid looking like lawn Buddhas. Some people are good ball players because they have the genetics for it, and some people are good ball players because they stubbornly work at developing their skills. Some people find good coaches (teachers), while others never receive the formal training necessary to develop their potential. Cane skills require motor coordination. The more practiced and refined the skills, the more graceful, efficient and stress free the blind traveler.
Using the long cane in the manner designed by Dr. Hoover at Valley Forge Hospital, the touch technique, requires that a large number of developmental abilities be in place. Developmentally, (and age appropriately) most children do not acquire the neuromuscular coordination to learn advanced skills until about age twelve (12 to 15), in late middle school or early high school. It is at this age, the early teen years, when we begin to see young athletes perform complex neuromuscular skills similar to that of adults. Sports become a serious undertaking in high school because it is at this age that children develop advanced, adult neuromuscular abilities.
Some children develop good skills as early as 9 years of age, in late elementary school, but most do not. Many blind students have developmental delays, so the chances of good neuromuscular coordination developing before age twelve are unlikely. Therefore, it makes no developmental sense, nor is it age appropriate, to expect blind children to master the touch technique in elementary school or even in early middle school. Look to the 9th grade to begin expecting, or working hard on, coordinated cane techniques.
By the time a student exits the second grade they should know what the diagonal and touch techniques feel like, have some rudimentary understanding of the procedures, and have some preliminary practice with the skills (with assistance). By the time a student exits 5th grade, they should be skilled at using the diagonal technique. They should also know the correct usage for the touch technique (when and how to use the skills) and they should have experienced using the touch technique outside, and in unfamiliar (or infrequently visited) indoor settings.
Mike had a habit of drooping his head. When he was required to center the cane, his head came up. When I wasn't around to insist that the cane be centered, however, Mike let the cane rest at his side. My personal take on this issue is that you try to teach a student centering in late elementary school or (better) in early middle school, with occasional (but polite) requests after puberty. If the student continues to drop the cane to the side in early adulthood, I figure it's their choice (I get them a longer cane).
For some students, centering the cane can be painful. Women with large breasts find it hard or impossible to use the standard touch technique (another problem with the Valley Forge legacy was that it was based on males). Children with cerebral palsy, low tone, or with other neuromuscular impairments also are unable to smoothly perform the touch technique. A large number of students in special education have trouble crossing their midlines. Centering the cane may be painful or impossible for all these students.
I keep thinking of a book I read in college. It was called "The Sabertooth Tiger Curriculum." The author's contention was that once somebody wrote down a curriculum, a formula for correct behavior, it was virtually impossible to get it changed. Richard Hoover did a great service when he and his staff came up with a strategy for teaching safe travel to blind solders. But we need to be careful not to chisel his 1945 thoughts across the face of time. Centering the cane may be one of the ten commandments of mobility teaching, but God didn't write the rule. We can change the strategy (if we should), but we need to do more and better research.
The profession of ergonomics studies the natural fit between the human body and the instruments (tools) humans use to interact with the world. We need to submit our dilemma to human relation engineers and see what they come up with.
A discussion about proper cane length on the mobility listserve drew a comment from Dr. Bruce Blasch (Atlanta VA) that I copied and offer here as a clear headed summary of the issue. Dr. Blasch said: "I do not believe there is only one way or the "right way" to do the touch technique or measure for cane length. I have come to realize that the touch technique is far more complicated than I was taught or ever realized. The bottom line is there are trade offs . . . with the diversity of clients we now teach and with the abundance of experience and research we have in orientation and mobility, it is a mistake to argue over what is "the way" to teach various facets of cane position, measurement, and movement of the cane,. Rather, we should ask what combination of cane techniques and modifications is most appropriate for the individual client in the general environment they will be traveling." I found through experience that for the more active elementary aged students, it is best, at this early age, to use the constant contact approach; ie. to keep the cane on the floor and not try to lift it. Karen used her cane like a hammer, whacking it up and down vertically, from nose level to the floor with a crack and then back up to the hair line. This was not so good for the tiny kindergarten kids who happened to be the nail of the day. The constant contact approach worked best for Karen.
During the elementary years, students should be able to relate the twenty one uses of the long cane and be able to demonstrate them by the end of the third grade (if not sooner for the more capable kids). I have students hold the cane over their heads in a gesture of triumph when they tell me that the cane is a symbol of their independence. I start this routine in kindergarten. By the end of second grade, I expect my students to be able to label the parts of canes, differentiate rigid from folding canes, and be able to explain different types of cane tips, grips, reflecting materials, and shaft materials. I also expect them to know a support cane from a long cane, and to differentiate (by 4th grade) how canes are measured (contrasting NFB with rehabilitation techniques). I also expect blind students to know a little about the history of the long cane (by the 4th grade).
The original notion of using a white cane was started by Lions International in Peoria, Illinois in 1930. The Lion's wooden cane was short and fat, tapered toward the tip, with a knobby handle. The cane was painted white except for a 6" red tip. The purpose of the Lion's cane was to alert motorists that a blind individual was about to cross a street. Lions International was instrumental in getting the Peoria City Council to pass the nation's first "white cane law" requiring cars to stop when drivers spotted the white cane. The blind traveler would point the cane straight out in front, chest high, and march across the street. They still cross streets like this in some countries, but in the United States orientation and mobility specialists recoil in horror from the image.
Now the cane is given an exaggerated first movement as the blind traveler leaves the curb to begin crossing the street, after which the cane is used in the "proper" touch technique while the street is being crossed. Early canes were used to tap the pathway warning others that a blind individual was approaching. In the 1940's at Valley Forge Hospital, Richard Hoover devised strategies for teaching blind veterans to move around independently using a 46 inch standard, rigid cane. His teaching methods caught on, were documented, and became the foundation, not only for blind mobility, but for the profession of orientation and mobility, and the creation of college programs to teach the new professionals. Hoover's strategies evolved at Hines Veterans Hospital in Illinois, at the Universities, and at rehabilitation centers, into what we cautiously call "proper" cane skills today.
List eight uses of the long cane
Demonstrate how the cane is used to probe
Demonstrate how the cane is used as a bumper
Demonstrate how the cane is used to detect drop offs
Walk through school using a rudimentary diagonal technique
Know that there is a touch technique and that it is used mostly outdoors or in unfamiliar places
Raise the cane over their head and say that the cane is a symbol of independence
Label parts of a cane
Differentiate types of canes and cane parts
Cross streets in quiet residential neighborhoods with close supervision
Describe some bad cane habits (and what should be done to correct them)
Demonstrate and discuss twelve uses of the long cane