How to Determine whether Your Toddler's White Cane Provides Safe Mobility
- Dr. Grace Ambrose-Zaken, COMS
- Jan 15, 2024
- 13 min read
Sighted toddlers learn to use the most powerful sense they have, vision, to artfully detect and avoid colliding with danger. Children with mobility visual impairment or blindness (MVI/B) have that same innate ability to make optimum use of their senses.
When adults provide children with MVI/B with the right mobility tool, their children can learn to use it as an extension of their sensory ability and become equally as artful in detecting and avoiding collisions. A white cane lights up the child's world with tactile, auditory, haptic, kinesthetic, proprioceptive, object perception, and echolocation sensory feedback.
Adults who provide children with MVI/B with white canes at 10 months are ensuring their child grows up always knowing safe mobility. Safe mobility is essential to toddlers' health and well-being, which is why adults are in charge of toddler safety, and the white canes they provide toddlers need to be both easy to use and effective.
Safe mobility is essential to toddlers' health and well-being
Families with blind toddlers have more to do. Adults raising children with MVI/B know that they don't just have to teach them to physically walk independently. They are doubly tasked with ensuring their children also learn to use their white canes for safe mobility.
Adults can teach children with MVI/B to physically walk without the safety of a white cane, but studies have shown this can delay the achievement of gross motor walking milestones.
Children ages 3 through 5 years need to be active throughout the day. Adults have reported this level of activity is achievable and fun when the white canes they provide their children with MVI/B are easy to use.
Safe mobility can be easy. Car safety is a perfect example of easy safe mobility. Adults select the correct child restraint according to children's size and ability and then they make sure their children use it correctly every time they are in the car. Some children will never be able to use a seat belt independently, but that does not make the child's car restraint optional. That is because safe mobility is not optional.
Safe mobility is not optional
The wonderful diversity of the population of learners born with MVI/B means there is great diversity in how children achieve walking and moving during their daily routines. For adults to trust their child with MVI/B's safety to a white cane when walking solo, they need to be sure the white cane meets the five requirements of an effective safety buffer for their child.
Adults have to trust the white cane they provide to their toddlers with MVI/B can keep them safe
Jasmine aged 3 years, pictured above, was born with optic nerve hypoplasia which resulted in her mobility visual impairment. In 1997, Jasmine's safety when walking solo down a preschool hallway was being overseen in several ways.
Her preschool kept the hallways clear of objects.
Her teacher walked backwards to prevent collisions.
Her teacher provided verbal prompts so Jasmine could follow her voice and walk down the middle of the hallway.
When her teacher causally replaced her verbal prompt with tapping on the wall so she could speak to a colleague, Jasmine unexpectedly turned towards the tapping sound and unexpectedly collided headfirst into the wall.
All accidents are unexpected, but the outcome of this one was easy to predict. Jasmine got hurt because she has a MVI, and adults taught her to walk solo without a safety buffer to protect herself.
Akira is the other girl in the title graphic. Akira was born blind with no other disabilities. At age 3, adults used a baby stroller to provide her with safe movement. In the next photo, the adults taught her to use a belt cane. Her teachers credit their decision to use the belt cane with Akira for finally achieving their goals for her independent walking. In the final photo, at age 7, her teachers have provided her with a long cane for her safe mobility.
Adults gain confidence in their children with MVI/B's independent walking when their white canes consistently prevent accidents. Adults lose confidence in their children with MVI/B's independent walking ability each time they see them have an accident.
At age 3, Jasmine needed a belted white cane like Akira's to improve adult confidence in her solo walking. A white cane designed specifically for a blind preschooler's size and ability, but belt canes did not exist in 1997.
To improve her safety, Jasmine needed the adults to provide her with a means of independent safe mobility - a white cane designed for a blind preschooler's size and ability, but belt canes did not exist in 1997
Two-step reaction distance. In 2024, adults have only three choices in white canes for children with MVI/B; the belt cane, the rectangular cane, and the long cane. Adults will want to choose a white cane that provides their child with MVI/B with a sufficient safety buffer between their child and any danger ahead of the child.
A safety buffer for a blind toddler is defined as a mobility tool that is in the right place at the right time to reduce unexpected body contacts with obstacles, and gives two-steps of reaction distance for impending collisions, surface changes, and drop offs. The purpose of this article is to aid professionals and families in evaluating whether the white cane they are currently providing their children with MVI/B is providing them with an effective safety buffer.
A safety buffer for a blind toddler is defined as a mobility tool that is in the right place at the right time to reduce unexpected body contacts with obstacles, and gives two-steps of reaction distance for impending collisions, surface changes, and drop offs.
Top Five Requirements to be an Effective White Cane Safety Buffer for Blind Babies
For adults to trust a white cane to keep their child with MVI/B safe, they need observable proof that it meets the five requirements to be an effective safety buffer. An effective safety buffer for toddlers with MVI/B is:
Independent safe mobility most of the day for confidence building.
Consistently used.
Reliable to be in the right place at the right time.
Path coverage.
Information easy to understand and respond to.
Independent Safe Mobility Most of the Day
Adults need to determine whether the white cane is providing their child with independent safety during recommended daily physical activity. Adults will want to begin using white canes with children with MVI/B when they are playing age-appropriate weight-bearing games (e.g., standing and bouncing while holding mom's hands) with them. Adults will want to evaluate how much help they need to provide their child to keep the white cane in the proper position for safe mobility.
Adults who employ the belt cane have the advantage with this age-group, as they are able to more easily hold the child's hands since the belt cane frame is connected to a belt secured around the child's waist. There are three recent studies that reported adults found belted white canes to be an easy, effective white cane for their young children with MVI/B to use independently.
Adults do teach toddlers with MVI/B to use long white canes. There are no studies showing any adults successfully teaching any toddlers with MVI/B to independently use their long canes for safe mobility, ever. Not one study, zero studies in the 2000s and zeros studies in the 1900s.
Independent means solo, the adult provides no help, partial assistance means the adult provides some help, and full assistance means the adult gives the most help to the child to complete any part of positioning the tool or accomplishing the mobility skills needed for safe mobility in that particular moment.
Adult instruction of a white cane for a child's physical safety when upright has a predictable instructional cycle, depicted below. The adult introduces a new cane skill with full assistance, provides the child with lots of practice time, and provides the child with diminishing verbal and physical prompts overtime.
Adults use hand-over-hand instruction with a singular focus on teaching the child to use the cane skill correctly. The adult's expectation is that, once the cane skill has been introduced to the child in this structured way, the adult will gain confidence that the child is able to use their cane skills solo.
When adults observe the child with MVI/B can use her white cane independently, that opens a world of fun and games. Adults can switch their focus away from teaching cane skills and towards relying upon the white cane to protect the child as they engage in fun activities that teach her concepts, language, and social skills.
Adults' confidence improves when they observe the child with MVI/B to be capable of independent cane skills
The type and amount of assistance an adult gives a child is based on adult confidence.
Adults provide:
Full assistance (e.g., hand over hand) when they have no confidence the child can complete any part of the safe mobility skill solo.
Partial assistance (e.g., verbal, physical cues) when they have confidence the child can complete only part of the complete cane skill for safety. They recognize the adult rather than the mobility tool is signaling to the child about the danger ahead.
Natural assistance when they have full confidence that the child can complete all parts of the safe mobility skill solo. Adults might say, "Slow down, no running in the hall." or "Please go wait for mommy by the door."
The more an adult's confidence grows in the white cane's effectiveness at protecting their child with MVI/B when walking, the fewer prompts they use
A strong indicator that adult confidence in the particular white cane remains low is when the adult consistently provides full to partial verbal and physical assistance to keep the white cane positioned for safe mobility. In the graph below, we see that week after week of daily white cane practice, the adult has no confidence the white cane she chose for her child with MVI/B is working.
The amount of adult assistance should be tracked and evaluated regularly
The amount of adult assistance with the mobility tool can be tracked by logging the number and type of verbal prompts and the length of time and type of physical prompts adults used to directly support the child’s safe mobility skills. Adults can then evaluate any visible trends such as the overall amount of assistance they are providing the child to use the cane skill correctly overtime.
When an adult sees they continue to provide the same level of physical assistance to correctly position the child's white cane for safety, this suggests that particular white cane is not a good fit for the child. Adults will notice that their child with MVI/B is unsafe when walking solo using that specific mobility tool.
When an adult sees they are providing less verbal and physical assistance to correctly position the child's white cane for safety, this suggests that particular white cane is a good fit for the child. Adults will notice that their children with MVI/B are getting the warning they need to be safe when walking.
Consistently Used
Adults need to determine whether they can consistently use the white cane most of the day, every day with their child with MVI/B during their recommended hours of daily physical activity. Childhood daily physical activity expectations are based on studies of typically developing children. A 2-year-old, on average, is physically active 6-8 hours a day.
Adult's white cane selection will heavily influence whether their toddlers with MVI/B can participate fully in their recommended daily activity hours needed to keep up physically, intellectually, and socially with sighted peers. Adults reported the belt cane made it easier to engage their toddlers with MVI/B in physical activities.
The safe mobility clock diagram helps adults to determine daily white cane usage for their child with MVI/B. Adults are directed to provide the white cane during all recommended daily physical activity hours when the child has the developmental potential to walk solo.
Adults whose children with MVI/B's motor impairments prevent them from walking outside of therapy sessions reported that including the belt cane during walking therapy improved their children's achievement of the movement goals set for them.
Reliably in the Right Place at the Right Time
Adults need to make sure the white cane is in the right place at the right time for their child with MVI/B. Adults know that to instruct their child with MVI/B to rely upon a white cane for safe mobility, it will take discipline and commitment. 'Right place right time' means adults make 'white cane safety' fully accessible for their child. They use careful planning and creativity to include the child's white cane in their daily routines. Adults who employ belt canes report they achieve this safety goal fairly easily, especially when compared to their experiences with a long cane.
Adults create time and space for the child's mobility tool. Adults need to recognize that their confidence in the white cane can only grow when they create time and space for it in their children's lives. Adults can keep track of the amount of time they are providing their child the white cane each day and track whether the number of hours is increasing over time to correspond with daily recommended physical activity.
The key is consistency, once the adult begins providing the child with a white cane, she must continuously reinforce the child's use of the white cane. When adults build the white cane into their daily routines, they make white cane use just another natural part of daily life.
Adults should consider creating:
A schedule that enables the adult to plan when and in what activities toddlers with MVI/B will be physically active and how to include the white cane as part of those activities.
Routes and play spaces conducive to children with MVI/B moving about with their white canes.
An atmosphere that prioritizes the children with MVI/B's safe, independent mobility most of the day.
The adult is responsible for remembering that toddlers with MVI/B need white canes for safe mobility. The adult is the driver of all thing's toddler-centric, e.g., dressing, meals, and safety belts. The white cane is no exception. It is important for the adult to consider how to best integrate the white cane into as many of the daily activities she has planned as possible.
The adult may need to slightly alter an activity to be purposefully inclusive of the white cane.
If the game usually requires the child to kick a ball with the foot, find a way for the child with MVI/B to kick the ball when also using the white cane
Path Coverage
Adults need to determine whether their choice of white cane provides sufficient path coverage for their child. White cane path coverage is when the safety arc explores the left and right side of the path in front of the child. The area adults need to make sure is being checked by the white cane arc is two-steps directly in front of the child's two feet.
The long cane safety arc is created by rhythmically sweeping the cane tip back and forth in sync with the footsteps, one step, one swipe, two-steps ahead. Sketched below is a diagram of the pattern made by plotting the path of the long cane safety arc and the user's footsteps; her cane tip checks the floor before she steps on that spot.
Adults who employ the belt cane with their toddlers with MVI/B report that it consistently and reliably checks the full path ahead of their toddler with MVI/B. Sketched below is a diagram of the pattern made by plotting the path of the belt cane safety buffer and the user's footsteps; her cane tips check the floor before she steps on that spot. The safety buffer of the belted white cane is in a fixed position; therefore, the cane frame just needs to be center front of the child's body to provide full path coverage.
This diagram shows the difference in reaction distance and path coverage with long canes and a belt cane.
The diagram above demonstrates the importance of two steps of warning and path coverage. In panels labeled A & C, the tip of the white cane locates the drop off and the footsteps stop. In panel B, the tip of the white cane is next to the right foot, which means the cane tip gave no warning that the drop off is a step away and the footsteps continue. Panel B also shows that the cane tip did not check the ground beneath the footsteps, this is unsafe mobility for toddlers with MVI/B.
The path coverage of the belt cane is measurably safer than the long cane for toddlers with MVI/B.
Adults may need to provide physical assistance to ensure the white cane they choose is providing complete path coverage for their child with MVI/B. Adults have reported that the belt cane's design makes it easier than the long cane for providing toddlers with safe path coverage. The rectangular safety shape of a belt cane plows forward to check 80-90% of the path ahead, compared to the 60-70% of the path checked by a perfectly in sync long cane.
Information Easy to Understand and Respond to
Adults need to determine whether the white cane they choose provides information their child can understand and respond to. The first-time toddlers with MVI/B touch a white cane they go from complete and utter silence about the path around them to a loudspeaker announcing every nook and cranny it touches. Yet, the information transmitted through the white cane is only helpful when it is communicated in a way the child can understand.
Adults may observe that the white cane is correctly positioned to provide two-steps of warning, but an accident still occurs. When this continues to happen after weeks of daily use, instruction in proper positioning, and plenty of practice responding to white cane information; it suggests that specific white cane is not a good fit for the safe mobility of that child with MVI/B.
Adults reported they found the belt cane provides concrete feedback in a way that is easy for toddlers to understand. The belt cane stops toddlers in their tracks before they trip over large cracks. The belt cane is much more effective than the white cane at preventing head-on collisions.
Adults reported that the belt cane's two cane tips made teaching the concept of staying on the preferred walking surface easier. For example, when there is one cane tip on the grass and one cane tip on the sidewalk simultaneously; it allowed the adult to have the child more easily compare the two textures and teach the child to make the safer walking choice.
Adults choose white canes for the safety they can provide their child, today. There is no advantage of using a seat belt with a toddler in the car thinking that is the only way the toddler will ever learn about seat belt safety. A seat belt is the wrong car restraint to use to keep a toddler safe during a car accident.
There is no benefit to providing the wrong white cane to a toddler with MVI/B, because the wrong white cane cannot keep the child safe when walking. Adults not only teach their blind children to walk, but also to use their white cane for safe mobility. There are three white canes to choose from.
Adult's choice and method for implementing white cane use will make a profound impact on their child with MVI/B's quality and amount of independent walking
Adults choose white canes for the safety their child needs today, because a baby that feels safe develops self-confidence. Adults have found that when they provide belt canes to toddlers with MVI/B they are more ready, willing, and able to learn through active fun and games.
Which white cane should I choose for my blind baby? Adult's choice and method for implementing white cane use will make a profound impact on their child with MVI/B's quality and amount of independent walking. In making the right choice, read the published studies to see if they included children like yours.
There are three peer-reviewed published studies in the Journal of Visual Impairment and Blindness and multiple self-published research studies on this blog page that demonstrate the effectiveness of the belted white cane to meet the five recommended safety buffer requirements for blind babies and improve solo walking. Since 1945, there has not been one study of blind toddlers using long canes.
There is not one study of blind toddlers using long canes since they were invented in 1945
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