THE EDUCATOR
Volume XIX, ISSUE 1 JULY 2006
ORIENTATION AND MOBILITY FOR
PERSONS WITH VISUAL IMPAIRMENT
Steps to Independence
A Publication of
The International Council for Education of
People with Visual Impairment
Contents
3. Long Cane Training – A global approach
– Nurit Neustadt
4. Exploring the mobility and independence needs of children with visual impairment in the UK: the Steps to Independence project
– Sue Pavey
5. 40 Years of O&M – The Journey to Independence for People with Visual Impairment in Vietnam
– Le Dan Bach Viet
6. 12th World Conference of ICEVI – An Event to Remember
7. The Future of Training of Specialist Staff in Rehabilitation Services in the UK
– Robert Avery
8. Tribute Professor Allen Foster, new President of CBM
9. Executive Committee Meeting of ICEVI – Strategic Update
10. Post-conference workshops
11. Other Meetings
12. Orientation and Mobility Practices in India
– A.K. Mittal
13. Brailler Repair Program in Malawi
14. Tech-Talk: Victor Tsaran
15. Parents’ Column – Mobility The Hard Way
16. International Mobility Conference in Hong Kong
MESSAGE FROM THE PRESIDENT
Dear Colleagues:
As this issue of The Educator is readied for press its preparation is being done amidst much other activity in preparation for our 12th World Conference in Kuala Lumpur, Malaysia.
As this quadrennium draws to a close let me use this opportunity to thank you for the privilege and honor of serving as your president for the past four years. This has been an exciting time for ICEVI as we strengthened our organization, particularly our regional structures. We are happy to share with you the achievements of this quadrennium in a report that is enclosed with this issue of The Educator.
In a sense, I feel that that past four years have been a phase of ICEVI history that can be compared to a runner preparing for a great marathon. Our training routine has involved strenuous efforts to build a stronger regional base for our race and has also involved workout routines in the form of awareness raising and capacity building activities to strengthen our endurance for the most important race of our lives. This is a race to assure that educational equity is extended to all children and youth with visual impairment in the decade ahead.
The starting line for this marathon is now prepared at the Putra World Trade Center in Kuala Lumpur and the Deputy Prime Minister of Malaysia has the starters gun in his hand. On Sunday, July 16th the race for educational equity begins and so does an exciting new chapter in the long and proud history of ICEVI.
The race course ahead will be challenging with many steep hills to climb and weather conditions that will not always favor our efforts to reach the finish line by 2015. However, our race strategy has been developed through the collective experience of ICEVI, WBU and a Task Force composed of some very elite “runners and coaches” with many years of experience in international development.
Now the challenge before us is to work together as a team to implement our race strategy. We know, before we even hear the crack of the starters gun, that we can only win this race by working together to achieve our shared vision, a world in which all children with visual impairment have access to a quality education. Although this global campaign and program of action is being led by ICEVI we know that this is a race that can only be won with the full and active partnership of government and non-government sectors and the active support of our partners at UNESCO and UNICEF.
ICEVI and WBU believe that the race strategy developed by the Task Force is well crafted. If you, our colleagues around the world, will do your share we can reach the finish line and turn the dream of assuring that all children with visual impairment, no matter where they live, are no longer denied that basic human right, the right to education.
The Educator, our electronic newsletter and our newly designed website will regularly provide race updates. However, if we are to win this race we cannot afford the luxury of to many fans standing on the sidelines. This is a race in which all of us need to become runners so that by the year 2015 we can cross the finish line and know that all children with visual impairment have attained the right to education.
I look forward to being with many of you at the starting line in Malaysia and to running along side many more of you on the race course in the years ahead.
Sincerely,
Larry Campbell
President
MESSAGE FROM THE EDITOR
I am fully sighted but I have no sense of direction and I can get lost very easily even in relatively familiar environments. At conferences I am prone to spend much of the week wondering around hotels looking forlornly for my room - utterly confused by the corporate layout. I often make spectacular mistakes in navigation on car journeys, confusing (for example) north with south. Even the satellite navigation system I have recently installed in my car gets annoyed with me and the system’s synthesised voice adopts a tone that is far too judgemental for my liking.
I have a good friend in Liverpool called Frank. Frank is totally blind and is a very able independent traveller. He regularly comes to the University in Birmingham where I work to give lectures to teachers of the visually impaired and thinks nothing of travelling alone to the University. He often teases me about the fact that when we drove around our home town of Liverpool together in our younger days he used to have to give me directions about when and where to turn.
So, as you can imagine, when it comes to the abilities of people who are blind to travel independently. I have a great deal of healthy respect for their achievements (and no small degree of wonderment). Mildly amusing as my own inadequacies in orientation are to people who know me well, mobility and orientation is no laughing matter for people with a visual impairment. Over half a century ago Berthold Lowenfeld argued that blindness has the potential seriously to affect children’s development by imposing limitations in three key areas: the range and variety of the child’s experiences; the child’s ability to get about; and in interaction with the environment. I suppose we could go on to argue that as children grow, their ability to get about independently determines to a great extent what the range and variety of their experiences will be, and what opportunities they will have to interact with their environment. So there is no question that teaching children to get about efficiently and confidently needs to be taken very seriously.
Safety must clearly be a consideration. While there is an element of risk in independent travel, as a former colleague of mine, Juliet Stone, once pointed out “Understanding danger, assessing risks and taking responsibility for your own welfare is an important part of personal development and the raising of self esteem.”
The ability to walk briskly and independently constitutes a form of aerobic exercise that helps improves health, muscle tone, posture and coordination throughout the lifetime. Good mobility is often a prerequisite of employment and facilitates social interaction within the community. In short, independent mobility is a key to children’s present and future development.
In this edition of the Educator we explore different aspects of this multilayered topic. In articles from around the world we see that while there is a long historical tradition of people who are blind using canes to assist travelling, modern approaches to travel based around the long cane are directly descended from techniques developed in the USA for the rehabilitation of blinded war veterans after the second world war. While these techniques have stood the test of time, they were developed for adults and not children and were formulated with an assumption that travel would take place in an American city designed around regular grids of roads. How these techniques should be adapted for children and for rural areas is the challenge for educators around the world.
We see in the article by Bach Viet that systems of training introduced over 40 years ago to Vietnam are still too often applied rigidly and have not evolved to meet the country’s changing needs. We see too the sometimes tragic consequences that a lack of public acceptance of the adaptations required for independent travel can bring.
In the article by Nurit Neustadt we see how the shortage of trainers in the developing world has led to a re-appraisal of the traditional one to one teacher–client approach in skills training. Mobility specialists are most likely to trained in groups that are large and they need to be motivated to take responsibility for refining and developing their individual skills through practice. Because their scarcity, trained specialists will need to see themselves as the designers of programmes that are delivered by others. In order to reach the large numbers of children who require training they must enable parents and teachers to undertake a key role in developing their children’s mobility. A one-to-one trainer/client relationship is often a luxury of cannot be afforded.
In A.K.Mittal’s piece we see the challenges of providing mobility training to children with visual impairment in India and anxieties that movement towards inclusion is being hampered by the lack of professionals who can offer mobility and independence training.
Anxieties about the lack of mobility specialists are not limited to the developing world. Robert Avery describes how the profession of Rehabilitation Workers in the UK is under threat from lack of agreed national training standards, funding problems and uncertainty about the alignment of the profession - should it be seen as belonging to Social Services, Education or Health Services? .
Sue Pavey summarises the results of a major research project into the Mobility and Independence needs of children with Visual impairment in the UK and concludes that training in travel should be seen as inextricably linked with training in broader independence skills and proposes a Mobility and Independence curriculum. She also outlines a mobility online resource that emerged from the research – a free bonus for our readers!
Our Parents’ Column provides us with a valuable insight into what Mobility means to a child with complex needs and his family. It also highlights the issues of children with low vision and the importance of environmental adaptations in meeting mobility needs.
Finally, thanks as ever to all our contributors to an edition I hope you enjoy, and to Dr Mani and his staff for their patience and skills in bringing this edition to print. I am looking forward to seeing many of you in Kuala Lumpur – it’s not the long journies I have a problem with, it’s the short ones!
Steve McCall
Editor
LONG CANE TRAINING – A GLOBAL APPROACH
Nurit Neustadt, Ph.D
Peripatologist, CBM Adviser, Israel
Introduction
A human guide, a stick or bamboo pole have been used by persons who are blind for travel purposes throughout history and references to blind persons using such devices can be found in writings of many ancient civilizations. Although the systematic use of a cane as a travel aid was first described in England over 120 years ago (1) and there is evidence of some use of the white cane in England in the 1920s, its widespread use began in the United States in World War II in the rehabilitation of soldiers who had been blinded in action.
The process began in hospitals where an “Orientor” introduced methods of moving about that involved interpreting landmarks, layout, echo and changes of surface in the environment. Initially independent mobility was achieved using a cross-body protective technique but in June 1945 Richard Hoover introduced the methodology of the modern long cane as a protective and navigational tool (2).
After the early development of modern O&M instruction, the professional training of O&M instructors soon spread across North America and into Western Europe. But in most parts of the world O&M training for adults and children did not become available until the latter part of the 20th century with the emergence of social and political justice movements. In many countries training in O&M and rehabilitation skills had been rejected not just on grounds of cost but because of a lack of awareness of the capabilities of people who were blind and ignorance of the opportunities that independent travel could open up for blind individuals within their communities.
Training programmes
The uneven provision of O&M across the world possibly reflects historical differences in the development of services to people who are visually impaired. Currently O&M training programs range in length from a two year academic Masters degree in USA; 12-18 month Diploma training programmes in Western Europe; training by correspondence in some Eastern European countries and programmes of two weeks or less in remote developing regions of the globe.
It is widely agreed that O&M professional preparation programs must address the pre-cane foundations of O&M which include the development of sensory awareness; sound localization; spatial concepts; and independent movement to assure effective navigation and safe travel. In practice however, very little time is given to these fundamentals of holistic rehabilitation and the majority of training time is often focused on the development of simple basic technical skills in the use of the long cane and negotiating the travel environments and transportation systems which vary so much from country to country.
The classic model of O&M training comprises the teaching of theory, observation sessions, practical instruction and field work. The practical instruction is traditionally delivered on an individual basis with a one to one teacher-student ratio. However in the developing world, international organizations tend to provide short term courses in which a single instructor is expected to deal with all aspects of training for classes of 16-24 sighted trainees. Lessons are usually delivered through an interpreter and practical instruction becomes a group exercise. Success is dependent on the motivation of the trainee to continue to practice and fine-tune the skills introduced in the short training programme.
O&M in Schools
Unlike in US and Western Europe, participants in O&M training workshops from developing regions are usually already employed by an agency for the blind, most frequently in school settings. Their newly acquired expertise in O&M becomes part of their repertoire of work skills but not their major activity. It is common for a teacher of mathematics, computer science or geography to be designated by the school to teach O&M too.
At the former USSR Internats (residential schools for the blind), it was the afternoon care giver who was trained in O&M skills as the government did not allow the inclusion of O&M in the school curriculum. The implication in many countries is still that O&M skills should be taught in children’s free or recreation time.
O&M and parents organizations
Increased exposure to the media has enabled parents in developing countries to find out more about what is available to blind children in other parts of the world. As a result they are voicing their opinions and demanding that their governments supply O&M training. If their dialogue with the Ministry about O&M training for their children does not bear fruit, they often exercise their right to register as a Parent’s Organization. They then typically initiate contact with international organizations that can support their efforts to secure training in O&M and Activities of Daily Living (ADL). Once one group of parents are trained in O&M skills, they take responsibility for training other parents how to teach their children basic O&M skills and the use of the long cane.
The Parents’ Movement is often very influential in the development of good travel skills in blind children through the early years. During weekends and holiday workshops parents learn to teach their children how to navigate in space, to orient their bodies to landmarks, to formulate mental maps and use various long cane techniques. The process can be greatly rewarding both for the child and the parent.
There is a clear indication that parents are no longer dependent only on what the government system provides, but can be active partners in supplying the necessary O&M and life skills to their children. Parent Movements greatly expand the reach of the small core of trained professionals and semi professionals offering O&M training in their country.
Professional leadership training
The aims of the basic O&M skills training in the developing world should be to provide the first generation of professionals in a community who will themselves become leaders and trainers of other instructors, establishing a chain of local training for future generations.
In recent years in many agencies where the need for O&M instructors outstrips demand, the cascade model of training is being applied effectively to groups of new professionals. This new group approach makes the training of O&M instructors more affordable and increases the availability of instructors especially in the developing parts of the world where services for the blind are in their infancy.
In the majority of programs, the international organizations that support the training endorse the achievements of the trainees through a diploma or certificate. However for many people in developing countries, the certificate serves as a springboard to a higher administrative post and the initial investment in them is lost if they subsequently change their field of interest.
The Growing Need
90% of people with visual impairment live in the developing world (3), and can be roughly divided into children (10%), adults (25%) and the elderly (65%). Yet surprisingly 90% of trained O&M service providers are based at schools and only 10% serve homebound adults and the elderly.
With expansion of life expectancy (with the exception of HIV affected regions) it could be argued that the time has come to re-evaluate this uneven distribution of support and to build up a wider core of O&M professionals to respond to the growing needs of the majority of visually impaired people whose onset of blindness starts at later stage in life.
The concept of O&M as a paramedical discipline aligned to health care professions (which is how the profession initially started) should be reconsidered, after its journey through a full circle encompassing community, educational and social services.
No one questions the positive impact that O&M training can have on the life of visually impaired individuals of all ages and the closer to onset training is offered, the better the results in independent travel using the long cane (4). In order to expand the core of O&M specialist, this discipline should be looked at as an equally important contribution to one’s future as literacy is.
To fully achieve the goals of Vision 2020 “The Right to Sight” which aims to establish community eye health programs and to fully achieve the aims of “Education for All by 2015”, it is necessary to expand and further develop O&M services on a much larger scale than currently available through a combination of higher education, technical schools, short term workshops or parent education.
Reference
(1) Levy, W. H. (1872/1949). On the blind walking alone, and of guides. Outlook for the Blind and the Teachers Forum, 43, 106-110.
(2) W. R. Wiener & E. Siffermann, “The Development of the Profession of Orientation and Mobility,” in B. Blasch, W. R. Wiener, R. L. Welsh, Eds., Foundations of Orientation and Mobility (2nd ed.) (New York: AFB, 1997), pp. 570–579.
(3) http://www.who.int/mediacentre/factsheets/fs282/en/
(4) Neustadt, N. http://www.icevi.org/publications/ICEVI-WC2002/papers/keynote/resp-neustadt.htm