Teaching Strategies and Philosophies

Mobility specialists have a set of strategies and a guiding philosophy for helping children with impairments gain independence in the real world. Following is a summary of travel strategies.

Emphasis on Problem Solving

Visually impaired children need to be placed in situations requiring them to solve problems. During mobility lessons students are placed in situations that require them to perceive and think. Students also participate in group problem solving sessions.

Sequential Lessons

Lessons start in familiar surroundings (school or home) and slowly spin outward to more complex and challenging environments. Smaller, easier layouts are learned before more complex environments are introduced.

Orienteering

Orienteering is the process of learning environmental patterns, most of them man-made spatial patterns (the built environment). It often involves learning strategies to move efficiently through specific building layouts. Malls, grocery stores, residential areas, and so on, have logical designs. Knowledge of layout leads to competence when traveling. Orienteering outside often implies the use of orientation technologies like GPS systems, electronic compasses, and location-based services

Landmarks and Clues

Landmarks are chained together to teach routes. This is the strategy used to teach orientation to blind children. It is a system that is equally useful for teaching travel skills to other children in special education, particularly those with perceptual and/or vision anomalies.

Walking Behind

Mobility specialists are careful to walk behind their students. Walking ahead or beside allows the student to follow. It takes away the responsibility for self orientation. Mobility specialists do walk ahead when they are requiring students to follow the sound of a moving voice.

Fading

During beginning lessons, students stay close to their teachers. There is constant feedback and assistance. This builds confidence and overcomes insecurity. As students develop, mobility instructors fade their assistance. They give less help and provide less verbal feedback. The distance the instructor is from a student also increases with student ability (the teacher fades into the background). Final lessons occur with the instructor out of sight and out of range. Students are told that, having reached a high level of independence, the instructor is no longer available to them unless an emergency occurs.

Feedback

Mobility instructors use basic teaching strategies like positive feedback and prompting. Student questions are rarely answered directly. Instead, the teacher prompts the student to problem solve on their own or with the help of teammates.

Reorientation

Mobility specialists believe in letting students "get lost." At a high level of independence, students are allowed to wander while they attempt to reorient. The students understand that they are to solve their own problems. If instructors intercede it is only to suggest strategies for problem solving.

Daily Living Skills

Daily living skills taught in a classroom do not provide the motivation found in the community. In many cases, lessons learned in the classroom do not transfer to the real world. In the normal course of mobility lessons daily living skills are naturally addressed.

Independent Lessons

After students have mastered a set of lessons (or a layout), they are allowed to go on independent lessons. During these lessons teachers are out of sight and may not interact with students until the lesson is over. "Drop off sessions" are tests that show the student and the teacher that routes or layouts have been learned.

Impairments, Disabilities, and Handicaps

Carefully defining the words "impairment," "disability," and "handicap" clarifies the roles of different professionals, makes it easier for parents to put their child's problems in perspective, and helps to clarify murky terms (in the literature) such as "functional vision," "functional vision assessment," and "vision stimulation." The distinction also helps in the understanding of the new definition of public school mobility instructors as navigational specialists.

A child with an impairment has damage to a body part. Optic atrophy, for example, is an eye impairment. Spina bifida is a birth defect that can damage brain areas responsible for navigation.

Disabilities are tasks that cannot be accomplished because of impairments. For example, a child with optic atrophy often has a disability for reading standard print sizes from a standard reading distance. A child with spina bifida may have associated perceptual problems making it difficult for the child to use maps, use landmarks while traveling, or remember right from left.

A Handicap is a social role that is difficult to fulfill because of disabilities. For example, some jobs may require the ability to read small print. A person with optic atrophy would he handicapped for this job. Other jobs might require map reading skills, or the ability to stay oriented in space. The individual with spina bifida could be handicapped for this kind of job.

Disabilities and handicaps do not have to follow from impairments. The purpose of special education is to teach children to do tasks even without normal vision, or without normal spatial perceptual skills. We want children to gather information from a printed page, that is the task. This can be accomplished with a normal vision system, with an impaired system using magnification, or with braille for a blind student. The means a student uses to gather information is irrelevant, as long as the task can be accomplished at an appropriate age.

Impairment assessment is the job of medical personnel. They look for damage to the human body, and they are trained to remedy problems using medications, therapies, and surgery. These specialists can also make reasonable guesses about functional implications. For example, if a person has advanced glaucoma and shows field loses when tested, it is a safe prediction that this person will have some degree of night blindness.

Disability assessment is the job of rehabilitation and educational professionals (mobility specialists included). Our role is task analysis; measuring a students ability (in the real world) against age appropriate norms. Our job is to circumvent impairments so that disabilities are avoided.

Handicap assessment is a dual role, played by both disability specialists and by social service professionals. Handicap measurements assess quality of life, including the ability to interact socially so that life provides happiness, economic success, and social support. The job at hand is to teach social adjustment, to emotionally support students going through difficult psychological times, and to provide opportunities to improve quality of life. Whether or not an individual has a good quality of life is, of course, a personal matter, self-assessed and self-proclaimed.

Terms like "functional vision" can also be clarified using the distinction between impairment, disability, and handicap. For impairment specialists, the term functional vision refers to the range of motion of certain body parts. The ocular muscles have a normal range of movement left, right, up, down and obliquely. If damage has reduced the distance these muscles can move the eyes, then muscular function is impaired and a functional visual impairment is present. A functional vision assessment for a doctor would be the measurement of the range of motion of the impaired muscles. Vision stimulation can have a variety of meanings in this context. It can refer to the effort to "awaken" an amblyopic eye (to increase the eyes ability to resolve detail), to establish binocularity, to teach tracking or scanning skills, or to teach spatial/temporal visual skills. Vision stimulation for an impairment specialist could be orthoptic exercises to increase range of motion. The setting for vision stimulation for the impairment specialist is clinical.

For disability specialists the term "functional vision" has been borrowed from the optometric profession. Functional vision refers to visual performance on specific tasks. A functional vision assessment is a measure of degree of vision needed to do a task under real (not clinical) conditions. For example, does an individual have sufficient visual skills in the classroom to learn given all the lighting variables, noise, contrasts, and various distances to see the chalkboard, calendar, clock, etc.? Vision stimulation for a disability specialist simply means "practicing to use the eyes," employing a strategy for improving efficiency while performing a real life task under actual conditions.

Functional vision on the level of handicaps refers to the ability to use vision in social settings. One of the major roles of normal vision is to read and transmit body language. Success with dating, marriage, and family life can be affected by visual communication skills. The ability to get and/or hold a job can also be related to the sending and receiving of body signals. A functional vision assessment at the handicap level is a measure of the ability to use body language to send and receive social messages. Vision stimulation refers to training an individual to send and receive eye and body signals.

Finally, using the distinction between the three terms impairment, disability, and handicap, helps in the understanding of mobility as a navigational profession. In the rehabilitation model, mobility is the profession that teaches travel skills to visually impaired persons. In the educational model mobility is the profession that teaches travel skills to students with navigational problems.

Navigational problems are an obvious consequence when there is blindness or severe vision impairment. Less obvious is the awareness that navigational problems can and do arise from a variety of impairments to other parts of the brain besides the vision centers.

The Future of Orientation and Mobility

The profession of orientation and mobility, particularly regarding the training of children in special education, is in its infancy. In the 1995, March/April edition of the Journal of Visual Impairment and Blindness, Lance Potter summarized the current status of the field.

"Existing O&M practice, especially that dealing with children, does not yet have a coherent, commonly agreed-upon foundation for understanding orientation problems... The O&M profession developed around long cane techniques, yet the scientific basis of the technique is still poorly developed. Even now, more than 40 years after the advent of long cane training, O&M professionals do not have a systematic and scientific theory that they can consistently use to interpret their teaching efforts and training techniques, much less to discuss them one with another."

Dr. Potter is correct. We need to explore the science of human orientation in greater detail. Mobility specialists, particularly those working with children, need a comprehensive grounding in the theories and applications of environmental and developmental psychology, in the science of navigation, and in the theories and terminology of behavioral scientists studying navigation.

Dr. Potter is also correct about cane skill training. The standard approach for teaching blind students to use the long cane is controversial. It is not based on ergonomic research, doesn't take into consideration the developmental unfolding of human ability, and besides being uncomfortable is hardly ever used by blind travelers, even after training. The largest population of blind people, the multiply impaired and elderly blind rarely have the cognitive and/or physical abilities needed to accomplish "proper cane skills." Children don't have the neuromotor development to attain the skills until late in their school careers. When these students grow up and join consumer groups like the National Federation of the Blind, they do as they please with their canes, often abandoning the standards set by their mobility instructors. It may be time to work collaboratively with ergonomics experts and consumers to explore the use of a cane in finer detail. The old stand-by techniques need a fresh look.

Mobility specialists have also not addressed the complexity of vision in enough detail. A large group of individuals have 20/200 vision. This is a well defined population of individuals with specific needs separate from the problems of a scarcer population of people with more severe vision anomalies. Understanding the fascinating workings of vision holds a promise for better comprehending human navigation, and for better understanding human movement (kinesthetics).

If discussions on the orientation and mobility listserve (out of Michigan State University) are any indication, there is an identity crisis going on within the field. Federal and State governments are not recognizing the profession for third party billing. The message is that the profession is not on a par with the psychologists and the therapists. We are perceived as cane trainers, something anyone could do with a little effort. This has sparked a discussion on the internet. Should we be affiliated with environmental psychology? Ought our identity to be separated from that of education or rehabilitation? Should we change our title, call ourselves mobility therapists? Or should we, as I argue here become navigational specialists? The stakes are high and our future depends upon the decisions we make in the years ahead.

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