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SWOMA 2011-12Out of the Box and On a Shoe String

Happy TappingTeaching Beginning Case Skills to Toddlers

Friday, November 11, 2011

Presented byRuth Ann Marsh, COMS / O&M Consultant, Texas School for the Blind & Visually Impaired Outreach [email protected] Mary Tellefson, COMS / TVI / AAGG, Wisconsin Center for the Blind & Visually [email protected]

2011-12 SWOMA – Happy Tapping: Teaching Beginning Cane Skills to Toddlers 1

mailto:[email protected]


The Teaching Cane: Experiences, Ideas and Strategies

Ruth Ann Marsh, Texas Statewide O&M ConsultantMary Tellefson, Wisconsin Statewide O&M Consultant

Early Focus: Working with Young Children Who are Blind or visually Impaired and their Families, Rona Pogrund & Diane Fazzi“Use of Canes with Preschoolers: During the late 1980’s there was a shift in thinking and practice regarding the introduction of long canes to children as young as age 2. In current practice, long canes are routinely introduced by O&M specialists to toddlers and preschoolers.” p 389Developmental Guidelines for infants with visual impairmentAmanda hall Lueck, Deborah Chen, Linda Kekelis“Travel tools such as push toys with a secure base of support as well as long canes and other adapted travel tools probe the environment, provide information about the ground surface ahead, and serve as bumpers (Langham, 1995). Mobility devices are introduced to infants as they approach or have mastered independent walking (Anthony, 1993). P. 115OSEP Mission for Providing Early Intervention Services in Natural EnvironmentsPart C early intervention builds upon and provides supports and resources to assist family members and caregivers to enhance children’s learning and development through everyday learning opportunities.(http://www.nectac.org/topics/families/families.asp )OSEP Key Principles for Providing Early Intervention Services in Natural Environments

Infants and toddlers learn best through everyday experiences and interactions with familiar people in familiar contexts.

All families, with the necessary supports and resources, can enhance their children’s learning and development.

The primary role of a service provider in early intervention is to work with and support family members and caregivers in children's lives

(http://www.nectac.org/topics/families/families.asp )Independent movement and travel in blind children; a promotion model Joseph Cutter

“Initially, the baby, toddler or child will hold onto the parent with one hand and the cane with the other. Introduction of the cane should not mean “loss” of the parent or adult's hand but rather an addition to what is familiar to the child—the adult’s hand.”


http://www.nectac.org/topics/families/families.asp

http://www.nectac.org/topics/families/families.asp

“Gradually, with the stability that comes with balance and confidence in movement the child then moves away from the parent contact and ventures out more independently.” p. 173

Personal Applications At any given time we are influenced by the information available to us. As practitioners we consider information from the field, meld that with our own

preferences, beliefs, training, experience and intuition and plan a course of action. We do the best we can; our practices are transparent and we take data. We evaluate our approaches and re-adjust if necessary. The Teaching Cane” Strategy” is the result of my process. Photos were my data

collection; tells story. Ruth Ann’s application is similar and her results are valid. Video and observation were

her data collection. The result of your own process is equally valid whether or not it agrees with ours. Collect

data! Wisconsin is goofy. Constraints of our system: no requirement for B-3 agencies to

provide TVI/O&M’s. (Aargh…don’t get me started!) Cutter’s ideas about parent’s being the first O&M teacher suited my situation. So I went

with it. My position does not provide “direct service”. I trained others what to do (even OT and PT!) in my absence—with orders to call me.

AND, pleaded with B-3 to hire an O&Mer. I found a pattern which I described as stages; designed a brochure to leave with parents It worked well for its purpose. You are welcome to use it; change it; put your own contact info on it or use it to line your

bird cage. Download version: www.wcbvi-oandm.blogspot.com


http://www.wcbvi-oandm.blogspot.com/

Stage One: Child experiences cane in his/her environment

Figure 1 An adult, using a cane, holds the hand of a toddler as they walk.

Figure 2 Two adults using canes hold the hands of a toddler who walks between them.

Figure 3 Two adults using canes travel outside with the toddler between them.


Stage Two: Child expresses interest

Figure 4 A young girl touches the cane held by the adult as the adult explores a trash barrel.

Figure 5 A toddler holding a cane explores the bushes and surrounding area with support from the adult.

Figure 6 The adult squats next to the toddler and circles her arm around the child while holding the cane in front of her.

Figure 7 A young boy grips the adult's cane with both hands as the adult holds it in a travel position.


Stage Three: The child is given a cane

Figure 8 An adult holds a toddler in her arm as he explores a cane with his hands.

Figure 9 An adult squats down to allow a young boy to examine a cane.

Figure 10 A young child holds a cane upright and in front of himself.

Figure 11 A toddler mouths the strap of a cane as he holds it in front of himself.

Figure 12 A young girl explores the ground with her cane while the adult discusses it with her. 2011-12 SWOMA – Happy Tapping: Teaching Beginning Cane Skills to Toddlers 5

During Stage three the child experimentsThe cane informs, inspects and explores. Age/stage-appropriate behaviors are expected.

Figure 13 A little boy explores a long cane while his short cane lies alongside him.

Figure 14 An adult carries a little girl in one arm and the child hangs on to her own short cane.

Figure 15 A little boy sits in the adults lap and explores a plastic toy bin with his cane.

Figure 16 A young boy lets go of his cane and it drops in front of him.


Figure 17 A young girl pokes at the ground with her cane.

Figure 18 A little boy lies on the floor and plays with the strap of his cane while the adult looks on.

Stage Four: The use of the cane is shaped to approximate techniques.

Figure 19 A little boy uses his cane to explore under the teacher's desk.

Figure 20 The adult, traveling alongside the little boy, models the appropriate positioning of the cane as they walk on a sidewalk.

Figure 21 A group of adults walk along with an older girl down a hallway; they are all using canes.


Figure 22 A young girl explores the side of the family van with her cane. The word "Yikes" appears across the image.

Figure 23 Opening shot of a video of a child in the mall at Christmas time.

ELI

Figure 24 A picture of Eli traveling with his cane.

25 months < 20/200 Infantile glaucoma Nystagmus Corneal opacity Amblyopia OS


YIKES!

Figure 25 Eli walks between two adults who are using canes as they walk along a sidewalk.

Figure 26 Two adults walk along a sidewalk using canes. Mom carries Eli.

Figure 27 Dad and Eli’s sister walk with canes down the sidewalk.

Figure 28 Eli explores a long cane held by Mom.

Figure 29 Eli grasps the end of the long cane held by an adult to direct it to explore an electrical meter box near the sidewalk.


Figure 30 Eli explores a tree near the sidewalk with his hand.

Figure 31 Eli compares Mom’s long cane to his short one.

Figure 32 Eli carries his cane upside down and not touching the sidewalk.

Figure 33 His sister, Eli, and Dad walk along the sidewalk with their canes.


Figure 34 Eli uses his cane to explore the edge of the outdoor playhouse while mom offers support.

Figure 35 Dad shapes the position of the cane Eli uses and they move together along the sidewalk.

Five Months Later...

Figure 36 Eli, another young boy and an adult use canes to travel in the Mall.

Figure 37 Eli window-shops as he travels independently in the mall using his cane.

Figure 38 Eli walks quite independently through the mall using his cane. 2011-12 SWOMA – Happy Tapping: Teaching Beginning Cane Skills to Toddlers 11

Figure 39 Eli takes a tentative first step down the stairs with his cane in his right hand and holding the adult's hand. A second adult travels behind Eli and observes his progress down the steps.

Figure 40 Eli and the other child's canes cross as they come down the stairs in a line. The adult holds Eli's hand and carries her own cane.

Figure 41 Eli touches the stair rail as his right toe searches for the next step as he comes down the stairs.

Figure 42 Eli pauses on the stairs, holding to the rail as the adult reaches toward him to offer assistance.


Figure 43 Eli climbs the stairs hold the hand of the adult, but touching his cane to the next step up.

Figure 44 Eli holds his cane and reaches out with his left hand toward the adult.

Figure 45 Eli uses his cane to travel down the ramp in the library as his teacher walks along-side using her cane.

Figure 46 Eli and another boy walk down the ramp in the library. Eli holds the rail and does not touch his cane to the ground.


CECELIA

Figure 47 Cecelia stands on the sidewalk holding her travel cane.

18 mos. Approx. 20/70 Ocular Cutaneous Albinism

Figure 48 Two pictures show an adult who carries Cecelia on her hip and taps with her long cane.

Figure 49 Two pictures: the adult now holds Cecelia's hand while they travel together with the adult using the cane.


Figure 50 Cecelia is held on the adult's hip and plays with the strap of the cane.

Figure 51 Cecelia is held on the adult's hip as she grasps and explores the cane.

Figure 52 Cecelia is held by the adult; she holds the cane and taps on a white picket fence just off the sidewalk.

Figure 53 Cecelia stands on the sidewalk and moves the cane held by the adult to touch the fence.

Figure 54 Cecelia holds her own short cane and gazes at the adult's cane as it explores another fence near the sidewalk.


Figure 55 Cecelia holds her cane in her right hand and trails along the fence rail with her left hand.

Figure 56 Cecelia visually and tactually explores her cane; the adult stands beside her with her own cane.

Figure 57 Cecelia his carried by the adult and grins as she holds out her cane.

Figure 58 Cecelia uses her cane to explore a bed of flowers.

Figure 59 Cecelia grasps the adult's cane to move it toward a post.


Figure 60 Cecelia explores a step with her cane.

Figure 61 The adult and Cecelia walk through the mall; Cecelia carries her cane over her shoulder.

Figure 62 Cecelia uses her cane to explore a darker strip of tiles.

Figure 63 Cecelia walks in the mall using her cane.

Figure 64 Cecelia leans against the adult who has squatted and holds her cane.


Figure 65 Cecelia drops her cane on purpose.

Figure 66 Cecelia using her cane, grasps the adult's cane as they walk along.

Figure 67 Cecelia grasps the adult's cane to poke it through a chain-link fence.

Figure 68 Cecelia continues to grasp the adult's cane and adds her own cane to explore the chain-link fence.


Figure 69 Cecelia takes a break from her exploration of the fence to explore the handle of her cane.

Figure 70 An adult holds Cecelia up to look at a plastic statue of a man in a hardhat.

Figure 71 Cecelia turns her cane upside down to explore the base of a sign board.

Figure 72 Cecelia peers through a large donut shaped play-scape figure.

Figure 73 Cecelia plays inside a "fun bus" in the play-scape.


MARIN

Figure 74 A young girl, Marin, bends her knees as she holds her cane with both hands and explores the grass.

2 yrs. 9 mos. Light Perception Lebers Congenital Amaurosis

Figure 75 Two photos showing Marin and her mother walking down the sidewalk. Marin holds mom's hand and mom uses a cane.

Figure 76 Marin grips her cane with both hands and raises it as if to bang it on the sidewalk.

Figure 77 Marin holds her cane and reaches for the adult's cane held before her.


Figure 78 Marin tries the adult's cane.

Figure 79 Marin explores the adult cane with her hands.

Figure 80 Marin hangs on to the bottom of the adult's cane to direct it to touch a garbage can.

Figure 81 Marin squats in the grass and uses her cane to explore the area in front of her that is covered with mulch.

Figure 82 Marin reaches for the adult cane as she navigates the playground.


Figure 83 Marin climbs on the spring horse.

Figure 84 Marin rides the spring horse.


VAUGHN 2 years, 10 mos. < 20/200 Shaken Baby

Figure 85 A picture of Vaughn and his dad with the handle of a cane showing between them.

Figure 86 Two pictures show Vaughn being carried by his mother as his parents walk down the sidewalk using canes.

Figure 87 Dad lets Vaughn feel his cane while mom hold's Vaughn's hand.

Figure 88 Vaughn walks along-side mom and dad, holding her hand.


Figure 89 Vaughn is interested in the grass and mother squats down to discuss it with him.

Figure 90 The parents continue to stroll using their canes and holding Vaughn's hand as he walks between them.

Figure 91 Vaughn sits in his dad's lap as dad explores a chip bag and bowl placed on the floor using Vaughn's cane.

Figure 92 Vaughn looks at the handle of his dad's cane as dad holds him.


WYATT 13 mos. Less than 20/70 Complex non-synomomic Microphthalmia

Figure 93 Wyatt plays with a wooden spoon.

Figure 94 Wyatt walks between his parents, holding their hands as they travel in a parking lot using canes.

Figure 95 Wyatt and parents stroll in the grass.


BENNETT

Figure 96 A little boy, Bennett, stands with his cane.

22 mos. <20/200 Congenital Glaucoma

Figure 97 Bennett walks near his dad who travels, like his mom and older brother, with a cane.

Figure 98 Bennett checks out his brother's cane while they travel in a mall.

Figure 99 Two pictures show Bennett holding hands with his brother as his brother navigates the mall with his cane.


Figure 100 Bennett explores his mother's cane.

Figure 101 Bennett tries out his brother's cane.

Figure 102 Bennett is given his own cane.

Figure 103 Bennett, hands in the air, holds his cane.


Figure 104 Bennett walks using his cane.

Figure 105 A change in the floor tile is handled as Bennett uses his cane.

Figure 106 Mom kneels beside Bennett with his cane.

Figure 107 Bennett checks out large jars of candy.

Figure 108 Bennett moves towards a display window.


Figure 109 Bennett looks out a display window. The word "Justice" is painted above his head.

Figure 110 Bennett moves independently with his cane through the mall.

RAVON

Figure 111 A picture of Ravon and his mother, Mai as she holds him in front of a hassock.

2.5 yrs. oldRetinal Dysplasia; NLPCulture: Hmong

Figure 112 Two pictures show Mom pushing Ravon in his stroller while she travels with a cane.


Figure 113 Ravon's stroller is pushed up before a pole; his mom and brother look on and hold their canes.

Figure 114 Ravon's mom holds him while she and his brother travel with their canes.

Figure 115 Ravon, his mom and brother explore the trunk of a large tree.

Figure 116 Two pictures: Ravon plays with a large metal bowl and mom explores near his feet with her cane.

Figure 117 Ravon's mom holds him and smiles broadly.


My name is Mai. In my Hmong culture it is not common to ask for help with a special needs child. I’ve learned to honor my culture and take advantage of the help that is available to Ravon. I have learned much from people who come to my home to work with Ravon and those people have also learned from me. Best of all, it helps my son!

Evey

Figure 118 Evey sits on the ground her head tilted up to the camera.

20 mos. Optic Nerve Hypoplasia NLP

Figure 119 Evey and her mom step off the sidewalk and into the grass.

Figure 120 Mom uses her cane to explore the ground near the sidewalk.


Learning with whole body. On body-before off-body

Figure 121 Three pictures showing Evey exploring the trunk of a large tree with her hands.

Figure 122 Two pictures of Evey exploring the grass with her hands and feet.

Figure 123 An adult shows her cane to Evey who explores it with her hands.

Figure 124 Evey touches her mother's cane as they travel across a lawn.


Figure 125 Mom holds Evey as she walks along using her cane.

Figure 126 Two pictures of mom with Evey as she wades in a pool of water.

Figure 127 Evey lays her head on her mom's shoulder.

Learning with whole body. On body-before off-body

Mackenzie

Figure 128 MacKenzie plays with her cane as she stands in a yard.

16 mos. old Retinal dystrophy VEP flat to all intensities


Figure 129 MacKenzie travels along with her parents as they use their canes.

Figure 130 MacKenzie grabs hold of her mother's cane to explore the shadow.

Figure 131 Two pictures: MacKenzie and mom hold her cane.

Figure 132 Two pictures: MacKenzie notices dad's cane and then bends down to grab it.

Figure 133 MacKenzie sits down and holds the cane cross ways of her body. Dad reaches to get her to stand up.


Figure 134 MacKenzie holds dad's hand as they continue to travel.

Figure 135 MacKenzie looks at her cane as mom stands along-side.

Figure 136 MacKenzie holds the cane before her in both hands.

Figure 137 Mom assists MacKenzie with her grip on the travel cane.

Figure 138 MacKenzie explores the wooden deck outside her home.


Figure 139 MacKenzie looks at the German shepherd through the patio doors.

Figure 140 Dad offers MacKenzie her cane as she and her parents begin to step off the deck.

Figure 141 Mom guides MacKenzie's cane over the edge of the patio drop-off.

Figure 142 MacKenzie holds her cane up with both hands and gazes at it.


Terry 23 months Bilateral optic nerve hypoplasia

Figure 143 Terry wears a hooded sweater and hunting cap as he holds an adult's hand and looks down.

Figure 144 Terry lays on the floor holding a blanket.

Figure 145 Two pictures: Terry and his parents (mom holding his hand) walk down a road in the country.

Figure 146 Dad shows Terry his cane.


Figure 147 Dad holds Terry's hand and travels behind him using the cane.

Figure 148 Terry explores dad's cane with his hands.

Figure 149 Terry smiles as the cat strolls by him.

Figure 150 Terry and dad touch foreheads together.


Example:Classroom plan for use of Teaching Cane Strategy

Stage Target Behaviors: What it looks like

Adult Role Principals & best practice

recommendations from field of

Blind/Deaf-blind/O&M Child specific

info:

1. Cane exposure to promote awareness.

Child notices movementChild notices caneCane becomes object for mutual attention & conversation.

Model sound-rhythm, grip, movement of cane back and forth in front of child, use cane in front of child during daily travel routines, positively reinforce child’s interest; use cane in environments that would engage sensory awareness or interest (auditory, tactile, visual).o O&M oversight

Hand under handCo-active participationObservation is what is essentialJoint attentionUse of familiar people in relationship w child

Child Specific: The cane is a natural producer and conductor of resonance and vibration information. Cutter






info:

2. Encourage interest in the cane.

Reach for canePause while walkingTurn toward caneIncreased excitementStillness when exposed to cane.Child participate s by handing on while adult moves cane back & forth; or makes contact with object, child puts hand on top of adult’s; child’s hand follow shaft of cane to object for tactual exploration; child may desire to control cane

Recognize and reinforce child behaviors that indicate interest in the caneApply individualized strategies that facilitate child’s understanding and participation.Adult invites child to co-actively participate, follow up with hands on contact with objects/vibrationso O&M: reinforce mutual attention; demonstrate strategies that promote child’s participation; discuss using more than one sense to verify information.

Use of multiple senses to verify information; motivation = joint attention; use of sensory systems and relationship; reach off body; extension of reach; connecting sound to touch; active vs. passive movement; role of tactile system, promotes reaching and searching for objects, sensory before conceptual (out of the experience comes the concept); tool usage; child learns through own body movement

Child Specific:

Stage 3: Child is given own cane for independent use. This stage is introduced by an O&M specialist. The previous stages serve to prepare the child for formal O&M instruction. Role






info:

release to other adults for the purpose of reinforcing skills is decided by the O&M specialist and is individual to each student depending on many factors: O&M specialist’s relationship to the child (trust/bonding, etc.); child’s responses and behaviors with the cane, etc. The O&M specialist will work with the child, and through diagnostic teaching, determine whether a role release model is appropriate for emerging skills or applying known skills to multiple environments.“Promote movement that leads to exploration, discovery, experimentation, play and eventually mastery of the environment.” Cutter

Functions of the cane: Inform, explore, inspect, detect, protect and facilitate getting to know and move in the

world. Preview of what’s ahead Bumper to protect from unexpected encounters Antennae receiving resonance information about the sound space and vibration world Tool for action and sensory integration Tool for normalizing posture and gait Tool for play Low vision aid Tool for cognitive development Connects upper body to ground Hand held tool


Wisconsin Center for the Blind and Visually Impaired

Example of Teaching Cane Consult Report

Using the Teaching Cane Strategy with Children Who are Deaf-Blind

Mary Tellefson, M.A., M.S., COMS

World-renowned deaf-blind educator, Jan van Dijk, suggests four major developmental areas that are impacted by dual sensory impairments or deafblindness. They are 1) access to sensory information; 2) communication & movement; 3) incidental learning, including concept development & mental imagery; 4) emotional development including sense of self, motivation, perception of safety and isolation. The cane is a tool that addresses these areas of development by increasing the availability of sensory information through auditory, tactile, kinesthetic and vibratory feedback. Cane use promotes active movement, contact with the world, exploration and a sense of safety when used strategically to detect obstacles and preview the walking surface.

The “Teaching Cane Strategy” is an instructional approach to early cane use that is appropriate when working with children who are deaf-blind. It is a role-release approach in which an O&M specialist teaches the adults, including parents, who work most closely with the student to use a cane in the child’s presence. When the child expresses an interest in the adult’s cane and joins with the adult in handling it, then the child receives his/her own cane. In this strategy, the term “teaching cane,” which was first introduced by pediatric O&M specialist Joe Cutter, refers to the canes of both the adult and the child since both are used to teach the child. Rather than requiring a child to demonstrate the ability to use a cane before it is introduced, the teaching cane strategy promotes early cane use as a way to facilitate early fine motor, hand manipulation, cognitive and sensory skill development.

Early Cane UseLearning to use a cane is a process. In the teaching cane strategy, children as young as one year are introduced to the cane and only age/stage-appropriate behavior is expected. The child’s developmental level, abilities and personality determine the behaviors that are appropriate. As a child matures, so his/her use of the cane matures. Eventually, early play behaviors are “shaped” to approximate techniques that detect, protect, inspect, and inform.


The ability to walk is not a requisite to the teaching cane strategy. The only requisite is the ability to hold the cane in a manipulative grasp. Children transported in wheelchairs or strollers can use the cane for tactile and vibratory feedback, extending reach, previewing the walking surface and exploring.

The teaching cane strategy is a process in which individual differences are addressed and best practice applications from the field of deafblindness can be integrated into each stage of the teaching process. Stages of the strategy are illustrated with photos of children ages 13 months through 3 years, not all of whom are deaf-blind.

Stage 1: The child becomes aware of and/or experiences the cane in his/her daily environment. This is accomplished when the child becomes aware of the cane being used by a familiar adult. Awareness may come as a result of the child noticing the adult’s movement or noticing the object (cane) itself. Either way, the movement or cane becomes the mutual topic for conversation. In her book Remarkable Conversations, Barbara Miles explains that topics of mutual attention or conversation follow a typical sequence: people and objects as extensions of themselves or as things to be incorporated (put in the mouth); then in movements; then in people as distinct in themselves; and, after time, in objects themselves and what they feel like and can do (p.65).

Role of O&M SpecialistObjective: Those who will become role-models learn to use the cane and create the conditions in which the child will take interest.

Direct instruction to teachers and parents in the appropriate use of the cane with attention to sound-rhythm, grip, touch technique, and as extension of reach to make contact with environmental objects.

Demonstrate use of cane while carrying child, while pushing child in stroller or wheelchair or walking hand in hand. Explanation and modeling of how to use “joint attention” or “shared experience” to

positively reinforce and engage the child’s interest. Discuss the role of “cane walks” and the types of environments that will provide auditory,

tactile and visual interest to the specific child, without overwhelming.

Figure 151 Parents hold their child's hands as they walk along with their own canes.


Figure 152 Mom and dad walk along with canes and mom carries the child.

Stage 2: The child expresses interest in the cane. When the child expresses interest in the adult’s use of the cane, the child is encouraged to participate to the extent that s/he is motivated to do so. At no time is the cane forced on the student with “direct instruction.” The adult uses his/her knowledge of the child to facilitate interest and motivation.

Interest may be expressed in different ways. The adult must be a good observer of the child’s attention so that the behavior that indicates that the child has noticed some aspect of the cane use, such as a reach for the cane, a pause in walking, a turn of the head, increased excitement or stillness, is recognized. This is a critical moment of mutual attention in which the adult responds to the child’s interest. This may take the form of what Jan van Dijk calls “coactive movement.” The child may hang on to the cane while the adult moves it back and forth or bangs it on an object in the environment, or if the adult’s cane is long enough, walk in front of the adult using the cane together. The child can hold on to the cane or place his/her hand on top of the adult’s hand. Use hand-under-hand to invite the child to participate. Hand-over-hand (coactive manipulation), according to van Dijk and Miles, is often used in educational programming but should be systematically decreased.

When using vibration-sound induced strategies, always encourage the child to follow the shaft of the cane to any objects with which the cane makes contact because vibration or sound is meaningless unless the child knows the source of the feedback. When the child is a motivated participant s/he may indicate a desire to control the cane for himself/herself. This may be the indicator to move to stage 3.

Figure 153 A young child in a stroller grabs the adults cane as they travel together.


Figure 154 A toddler grasps his mother's cane with both hands.

Figure 155 Mother and daughter stand on the sidewalk; the child grasps her mother’s cane.

Role of O&M SpecialistObjective: The adult recognizes and reinforces behaviors that indicate the child’s interest in the cane and applies individualized communication strategies that facilitate the child’s understanding and participation.

Celebrate the event and reinforce how powerful “joint attention” is for the child. Demonstrate and discuss co-active participation/manipulation and turn-taking as defined

by van Dijk. Discuss the importance of providing multi-sensory experiences paired with language

(sign, voice, object) to verify sensory information received through the cane.

Stage 3: The child is given a cane. Avoid the assumption that the child will automatically know what to do with the cane or will be able to imitate what was done with the adult’s cane. The adult may need to begin again with coactive movement in which the adult follows the child’s movements or actions with the cane in a reciprocating fashion to establish a common movement sequence. Sequences are eventually expanded over time. This will be the foundation upon which the child’s interaction with the cane will be shaped into cane techniques.

The child may reject the notion of having his/her own cane for any number of reasons. The child’s cane, as a separate object from the adult’s cane may be perceived as a new or novel object. In typical development, novelty fuels the brain and creates interest. For a deaf-blind child or a child whose visual impairment is caused by cortical visual impairment (CVI), novelty can shut down the interactive behaviors or the child’s interest. Adults need to design a process


of scaffolding from the point at which the child was an active, motivated participant to higher level skills or the next behavior target.

Because of the cane’s ability to provide auditory, tactile and vibratory feedback and facilitate physical, cognitive and social growth, the child who is willing to interact with it is learning. The child who is able to use familiar tools, such as a spoon, toothbrush or comb, may be able to independently experiment with what the cane can do as a tool. If not, the teacher uses the cane along with other objects to teach the concept of tools.

Figure 156 A little girl holds her cane and looks as her mother uses her own cane to explore the surroundings.

Figure 157 A child in a stroller holds his cane as he is pushed along by an adult.

Role of O&M SpecialistObjective: The adult creates the condition in which the child experiments with and exhausts the possibilities of what the cane can do, using it to inform, inspect, extend reach, play and explore.

Provide appropriate cane for the child. Encourage continued modeling and co-active participation of the cane through “cane

walks” when appropriate. Discuss what age/stage appropriate behaviors look like for this child. Discuss the child’s preferences and sensory limitations. Discuss the types of environments that are most likely to provide and promote interest

and motivation for the child. Provide on-going support, observations and check-ins.


Stage 4: The child’s use of the cane is shaped.When developmentally appropriate, the child’s use of the cane is shaped towards its intended use as a travel tool. At this stage, the O&M specialist teaches cane techniques that detect and protect. This stage is on-going and travel becomes oriented towards a task, activity or destination. The child becomes increasingly mobile under his/her own power. When children use their own brains to engage in movement, they are learning (Cutter).

Figure 158 The adult guides the child's hand to help him find the fire hydrant with his cane.

Figure 159 A young girl holds her cane in front of her with both hands.

Figure 160 Dad helps guide his son's cane as they travel together.

Figure 161 The adult helps guide the child's cane as they descend the stairs.


Role of O&M SpecialistObjective: Through continued modeling and/or direct instruction from an O&M specialist, use of the cane increasingly approximates formal cane techniques in form and function, given modifications and alternatives as appropriate.

Observe child’s functioning periodically and coach adults to reinforce specific skills. Check the adult’s ability to identify behaviors that may indicate readiness for specific

techniques such as stairway travel, diagonal trailing, or touch technique. Discuss the likelihood that skills already mastered may not be accessible to the child

while mastering a new skill, especially if it includes a gross motor milestone. Build a relationship with the child as a requisite of providing direct instruction. If the child turns 3 and enters early childhood education during this stage, the O&M

specialist participates in transitioning and IEP development.

The teaching cane strategy is an approach to early cane use that facilitates all areas of development and has valuable applications for children who are deaf-blind. The decision about if or when to begin this approach depends on the child’s level of spatiotemporal development, physical ability, the support of the parents and an O&M specialist who is comfortable with a role-release model of service delivery. In this case, a role-release model does not necessarily imply fewer hours of O&M instructor time. It does suggest a majority of the instructor’s time spent observing and coaching the adults who, because of their consistent relationship with the child, are in a favorable teaching position. The O&M specialist, who is in a consistent and daily relationship with the child, may appropriately choose to retain, rather than release, the modeling role.

Cutter, J. (2007). Independent movement and travel in blind children, A promotion model, Charlotte, NC., Information Age Publishing.

Miles, B., Riggio, M., (1999). Remarkable conversations, a guide to developing meaningful communication with children and young adults who are deafblind, Watertown, Massachusetts, Perkins School For The Blind,.

van Dijk, J., (1999). Reaching our Students with Jan van Dijk, Conference handouts. November 4, Fort Worth, TX.


Wisconsin Center for the Blind and Visually Impaired

Example of Teaching Cane Consult Report

Teaching Cane Consult for: ____________________________________________________

The “Teaching Cane Strategy” was described to _____________________________________

An informational brochure was left on site.

1. This strategy is appropriate for small children because it relies on the parents to provide consistent and accurate modeling of the cane. It is best when an O&M specialist has direct contact and direct over sight with the process. Parents are taught to use a cane correctly themselves and how to encourage the child’s appropriate handling of the cane. This fits with the B-3 model because of the role of the parents and the involvement of the family structure. It is also developmentally appropriate as a teaching model because children learn to do what the significant adults in their lives are doing. This is how they learn to eat, talk and walk—by modeling after parents.

2. Only age-appropriate behaviors are expected from the child. A child will not handle a cane like an adult handles a cane. Over time, and when developmentally appropriate, the use of the cane is shaped to simulate adult techniques. This is similar to how children learn to write. They begin scribbling with crayons using a palmar grasp and eventually, this is shaped into handwriting using a pencil grip.

3. The major learning tool of a 2.5 year old child with low vision is his/her hands. Children learn accurate concepts through on-body contact and exploration. Therefore, any time the cane is used to extend reach toward objects; it should be followed up with hands-on contact with the object the cane has touched. This is a particularly poignant teachable moment.

4. Some of the skills promoted with early exposure to the cane are: keeping tip on ground; movement of cane back and forth; grips and the ability to use more than one grip; detecting drop-offs; exploring vibration and sound feedback from the cane; keeping it in a consistent location and taking it along on appropriate trips with parents.

5. Parents use family “cane walks” to model, support and co-actively engage the child.

6. Use of the cane needs to be positive—if unwanted behaviors are noted, a simple re-direction is used such as, “put the tip on the ground”. If a child’s behavior does not change, put the cane away but without negative or punitive intention. The child’s attention span with the cane is variable and getting into a power struggle over how it is handled is not productive. If 5 minutes in the amount of time the child can use—or—wants to use the cane then that’s it. Don’t push the time beyond his/her ability to respond positively regardless of the reason.


7. The environment in which the child uses the cane is carefully chosen to provide instantaneous, helpful and interesting feedback. Allowing the child to use the cane during non-instructional time is not recommended. Using the cane in indoor familiar environments is not recommended in the early-learning stage. When a child demonstrates consistent self-control in using the cane appropriately, then specific situations in which the cane is useful can be identified and the child can begin using the cane in indoor situations.

8. When parents are out on community cane walks, they should model appropriate use of the cane; get excited about what their cane finds and encourage their child to find it also; and help the child sequence interesting environmental features along a given route. So for instance, if walking a one block distance to a park (motivating destination), you pass a light pole, fence, park bench and fire-hydrant before reaching the next curb, teach your child to anticipate the sequence. Listening skills can be enhanced as well. Listen for birds and have him point in the direction he hears them; listen for the difference in motor vehicle engine sounds-s “is it a big car, a truck or a fire engine?” etc.

9. Do not start outside training in cold weather. Either wait for mild weather or use a mall.

10.Parents should receive weekly support if necessary and every other week at the very least.

For more information or collegial support for this project, contact Mary Tellefson, COMS 608.758.6147 or [email protected] .



Notes:


This conference is planned and sponsored by the Southwest Orientation and Mobility Association (SWOMA). This event is funded by conference registration fees, with additional support provided by Texas School for the Blind & Visually Impaired Outreach Programs. We appreciate the contribution of our speakers who generously donated their time to present at this event.

Texas School for the Blind & Visually Impaired Outreach Programs serves as the fiscal agent for this event.

Figure 1 TSBVI Outreach Programs logo.


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