D7 Mobility

Question 1

Exploring Objects / Drop Offs

Answer 1

When contact made traveller stops and holds position to objects and drop offs.
If don’t want to explore object or drop off,
Contact broken and move back
Area to side of drop off explored with cane sweep to locate clear path of travel.
If want to explore,
Cane remains anchored against object or drop off at point of contact
Cane inwardly rotated in hand to vertical position
Continue as for descending stairs, then
Push forward to determine height of object or dropped down to determine depth of drop off
Move side to side to side (horizontally) to determine width of object or edge of drop off from centre line.
Can use alternate cane to both hands to enhance exploration.
Can slide hand down cane shaft to further explore tactually

Hold cane against object to explore so orientation isn’t lost. If there is a change in surface level, the learner stops and determines characteristics. Slide hand down cane to contact and explore object, use upper protective technique while doing so.

Question 2

Stair / Escalator

Answer 2

Stairs: Position slightly below and to the side of the learner to fully view the technique and to provide stability to the learner in the event of a misstep. In a position in which it can break the fall of a learner. Ascending: behind traveller within arm’s reach. Descending: in front of traveller by 2-3 steps depending on traveller’s balance always within arm’s reach to catch fall if needed.
Escalator: Position close to learners to ensure that they are not separated when stepping onto a crowded escalator. Stay behind travellers within arm’s reach for both ascending and descending. Note difference to Australian technique!

Ascending
Tip of cane anchored against edge of first step.
Cane inwardly rotated in same hand,, bringing it to vertical position, modified pencil grip or,
Palm of hand outwardly rotated bringing cane to vertical position, as done when contact objects.
Cane brought to midline.
Toes to edge of riser/or back from stairs if preferred.
Can move cane side to side to determine,
- to determine position at stairway
- establish perpendicular to stairway
- can use handrail and change cane hand
- use cane to work out height of stairs
Arm flexed out and nearly parallel with floor.
Cane drawn up to riser.
Move hand down cane shaft.
Depending on height cane onto 2nd or 3rd riser, 1-2 inches below the steps edge.
Cane can be held diagonally if wanting more protection.
Move forward with tip touching the facing of each step.
Maintain position of arm.
Wait for cane to swing free at top.

Descending
Approach in perpendicular fashion.
Anchor cane tip against stair edge.
Rotate hand outward or inward until cane is positioned at midline and vertically against the stair, traveller walks toward stairs.
Step up to edge of stairs, or just behind, square off.
Use cane to check side to side, height & width of stairs.
Locate handrail which will determine hand to use cane.
Modified diagonal position with cane.
Cane tip in front of opposite foot of grip hand.
Cane extended out and down so it’s forward on the edge of the second step.
Cane should be no wider than width of body.
Lift cane from edge of step so it hovers just below the next step without contacting riser.
Avoid striking steps as descend and aim to contact landing.
Clear area before moving off.
Constant contact in preparation for next set of stairs if necessary.

Question 3

Analyse & Discuss Crossings

Answer 3

Approach intersection, stop at curb maintaining initial alignment. Check alignment by listening to traffic.

Determine starting point for crossing and tactile cues to use for realignment after pressing push button.

Evaluate patterns, geometry, locator tone.

Search for APS with systematic pattern.
Wait for perpendicular to start and press APS
Realign at crossing point.

Type - lights, 2 way stop, T
Features - lanes, kerbs,
Patterns - time of day and cycles, near and far.
Risks & Opportunities - visibility, sound, width, culture, TAMS
Alternatives - ,

1. Identify type of traffic control, (e.g. APS, give way/stop signs, left permitted turn on red, pedestrian crossing, shared zone)
2. Identify shape and features of intersection (2,3,4,5way, square, offset, speed humps, lanes and width, pedestrian refuge /islands, kerb, pram ramp, tactiles)
   3.Identify traffic pattern/direction of traffic flow (times of day, surges and cycles
3. Visit location at different times to determine variability

Identifies near/far lane perpendicular/parallel traffic, determines vehicles’ travel paths and estimates number of lanes.

Common risks
Turning vehicles
Bikes
Drivers running red lights, speeding
Undetected/unexpected vehicles (masking sounds, visual obstructions)
Driver doesn’t yield/give way to pedestrians
Drivers not following traffic laws, instead of going with surge they delay surge to watch individual with cane instead of going when green light turns green.
Wider streets to cross.

Visibility / Audibility
Situation of Confidence or Uncertainty
Alignment crossing
Indenting opportunity
TAMS Crossing

Make informed choices about given crossings, including where best to cross and when to find alternative crossing or ask for assistance if they deem it necessary
Discuss risks and possible consequences involved in each situation & how to reduce risks as much as possible
Teach alternatives when risk is not acceptable
Prepare to cross at intersections with good alignment, visibility, and the use of pedestrian controls
Cross streets at the safest times
Manage the crossing to reach the destination with consistency and confidence.

Traffic Lights
Fixed
Semi-actuated
Actuated
Protected left turn
Permissive left turn

Four leg right angle intersection
Plus intersection (cross road for us)

Three leg intersection
T intersection

Offset intersection
Proximity but not directly across

Skewed intersection
Two streets meet at an angle, significantly less than a right angle.

Multi leg intersections
More than two streets meet in five or six legs converging at intersection.

Roundabouts
Traffic travels in circle around central island moving counter clockwise in US.

Newer and alternate intersection types
Diverging diamond interchanges
Continuous flow intersections…
Single point urban interchanges
Median U-Turn

Continuous flow intersection …Vehicles attempting to turn across the opposing direction of traffic (left in right-hand drive jurisdictions; right in left-hand drive jurisdictions) cross before they enter the intersection. No left turn signal in the intersection is then necessary. Instead, vehicles traveling in both directions can proceed, including through vehicles and those turning right or left, when a generic traffic signal/stop sign permits.

Question 4

Crossing Alignment & Teaching Position

Answer 4

Traffic Flow.
Maintain line of travel, plant feet.
Physical features, (1) perpendicular alignment to curb or (2) Parallel alignment to path edge.
Tactiles, pram ramp least effective.

Positioned behind and away from parallel to not block sound or vision. Within arms reach.

Approach intersection, stop at curb maintaining initial alignment. Check alignment by listening to traffic.
Determine starting point for crossing and tactile cues to use for realignment after pressing pushbutton
Evaluate patterns, geometry, locator tone.
Search for APS with systematic pattern
Wait for perpendicular to start and press APS
Realign at crossing point.

If traffic available the learner listens to movement of parallel and perpendicular traffic, adjusting head as necessary to aligned with traffic movement on parallel street.
If no traffic available leaner maintains approach alignment and awareness of approach trajectory and projects mental line across street. May explore kerb and gutter to see if alignment is perpendicular in a residential or small business area where corners may be relatively square.
After aligning to cross the learner explores alignment of kerb, kerb ramps or detectable warning surface in relation to their feet, the nearby landscape strip or grass line (if present) and other potential cur for alignment to be used when preparing to cross.
Learner find the cue then turns slightly away from it, realigns with it and checks their alignment using parallel and perpendicular traffic or other techniques.

Parallel alignment with grassline/kerb
Perpendicular alignment with kerb
Note: Research found that travellers align more accurately with underfoot cues that are perpendicular to their travel direction (e.g. squaring off at kerb/TGVSIs rather than aligning along a crack in direction of travel)
Use of tactile guide strips if available
Use cobblestone/varied surface cross walks
Use perpendicular kerb edge to align
May need to use clockface

• auditory parallel alignment, requires tracking cars so that when the loudest car is equaling the 9 o’clock position (at left shoulder) when the parallel traffic has the green phase.
• auditory perpendicular alignment, requires traveller to square their shoulders to the traffics loudest point in front of aka, 12 o’clock position. When the perpendicular traffic has the green phase.

The OMS should be positioned behind and away from the oncoming near and perpendicular traffic

When instructing some NEW to street crossing O&M may stand in front of student in order to provide feedback about alignment and state where they think student is aligned.
When student has been street crossing for a while the O&M stand slightly behind and away from parallel street. This allows O&M to monitor traffic from all streets at the same without creating a sound shadow between traveller and parallel traffic.

When crossing the OMS should be positioned behind and toward the oncoming near perpendicular traffic

O&M moves behind and slightly away from parallel cars so the traveller is between the parallel and the O&M. The O&M needs to be within arms reach of traveller and adjust position so as to best monitor lanes of threat at all times.

Question 5

Uncontrolled Crossing & TMAD

Answer 5

Timing Method for Assessing the Detection of vehicles (intuitive understanding of road crossing time in quiet location, compare to vehicle ID time on road with frequent but intermittent gaps for SOC, SOU)
Visible/Audible position.
Alternatives: different crossing, assistance, ride, delivery, request road improvements.

Use TMAD: Timing Method for Assessing the Detection of vehicles.

TMASD - basically using a situation of confidence, trying to pick the last second you could leave to cross in before the vehicle arrives. X is crossing time. Basically X is the time required for crossing whole street. So from left 1x and from right 0.5x has you just need to get over half way. 1 second error margin is needed.

Dangers: bend in road, hill, restricted field scan fully and more slowly,

General:
Analyse Crossing.
Position for visibility, hearing.
Assess SOU, SOC and personal response.
Scan across field of vision of 180 degrees, more slowly with restricted field.

If there are regular detectable quiet periods in traffic on both streets, the learner can decide to cross in safe gaps.
If there aren’t consistent quiet periods on streets may choose to cross with a near lane parallel vehicle traveling straight through the intersection.
If prior 2 options are not available or are difficult to determine, and traveller feels risk is unacceptable the traveller needs to consider alternatives to crossing the location at that time.

Question 6

Yield

Answer 6

Yield signs (give way signs) are found in residential neighborhoods where a secondary street crosses a main thoroughfare.
Also at roundabouts.

Roundabouts.
Channelised turn lanes – often found in residential streets joining a major or heavy activity street.

Yield means – driver needs to slow down, defer to oncoming or intersecting traffic, stop when necessary, proceed when safe and remain aware of oncoming vehicles. A flashing yellow light has the same meaning as yield sign.

Question 7

4-way stop Crossing

Answer 7

Listen for surge of parallel vehicle after determining it isn’t turning. Then start crossing while listening to perpendicular vehicle to ensure they are not moving.

Both streets have stop signs and all vehicles must stop (AKA All Way). Characterised by sounds of traffic slowing and stopping on any of the 4 approaches, waiting briefly and then moving through the intersection in the intended direction of travel of any 4 directions.
traveller listens for surge of traffic in parallel street after determining that it will not be turning. Crosses while listening carefully to traffic in perpendicular street to ensure vehicles are not yet moving. Use visual and auditory scanning before and during crossing.

Question 8

T shape with 1 way stop on stem

Answer 8

Begin to cross when confirming all clear OR traveller listens for perpendicular traffic and travels with parallel surge.
Visual/auditory scanning before and during crossing.

Question 9

2 Way Stop

Answer 9

With perpendicular stop traffic.
Analyse intersection.
Walk with surge of parallel traffic
For beginner they may wait until traffic is All quiet, ALL clear to cross.
Use visual/auditory scanning before and during crossing

With parallel stop traffic.
At a stop sign on the parallel street, the learner gets into the ready position and listens for traffic to come to a complete stop. As a vehicle surges forward & learner determines by listening that it isn’t turning, initiate travel using traffic as a buffer.

If on perpendicular street, learner listens for traffic to completely stop, starts crossing immediately once determines there is no parallel traffic.

Traffic on one street (usually higher activity street) does not stop, except when waiting to make a turn onto perpendicular street. Traffic on other street (usually the street with intermittent traffic) stop and proceed when there are gaps of adequate length and available on the uncontrolled street.

.

Question 10

T shaped intersection

Answer 10

traveller crosses with parallel surge.
Determines right turn phase.
Use visual/auditory scanning before and during crossing.

Fixed T intersection crossing
Can count traffic cycles and flow to know from red light to red light.
Bottom of T traveling to top must turn. When travelling paralle with bottom of T headed to top traveller knows the parallel surge is a turn is it is a 50% chance they will turn toward traveller.
traveller has right of way once they step in cross walk, the turning vehicle must wait for traveller to cross.
traveller needs to go at start of phase to make car wait.
Don’t travel with other pedestrians crossing unless 100% sure pedestrians crossing at correct time.
If no parallel traffic to cross with for long periods of time traveller can used fixed automatic light controls to count and cross with perpendicular cars stopped.

Question 11

Fixed, Semi-actuated, Actuated, Permissive Turn, Protected Turn.

Answer 11

Semi Actuated - side street can trip it.
Fully actuated - both streets activate.
Plus APS press gives longer pedestrian phase.
Permissive - turn with parallel traffic when gaps available
Protected turns - only turn during the green filter phase (traveller can mistake filter for parallel surge, not walk phase. Recommend going with near lane parallel traffic)
Protected - Permissive - tr
Split Phasing - two opposing approaches, all traffic from north moves together (parallel and turning). E.g. Pedestrians on east (AU) walk when north traffic moves south
Exclusive pedestrian phase - all traffic stopped and pedestrians can cross in any direction.
Walk button / pedestrian detector button activities the walk phase in light cycles. Must be pressed.

Fixed
Length of traffic cycle is same every time and consistent.
Pre-timed signals run on predetermined cycle that gives predictable amount of time for each crossing. Amount of time may change depending on time of day. Need to observe at different times of day to determine.
Fixed traffic light signal: length of traffic cycle is always same and consistent. Predictable amount of time for each crossing. However, may have different fixed time for peak hours compared to off-peak.

Semi-actuated
Provides green signals on major street until there is a call to the signal by either pedestrian (via button) or vehicle (magnetic loops, video, weight sensors).
Usually longer to cross side/minor street but just barely enough time to cross the major road. There may not be time to cross major road if signal is activated by vehicles. Activating pedestrian push button with usually result in a longer crossing time.
Semi-actuated signal: Has vehicle sensor only on some approaches to intersection. Provides green signals on major street until there is a call to the signal, either by a pedestrian or a vehicle, for crossing that street. Signal then turns red.

Actuated – fully actuated
No specific time to cross. Lights wait until cars show up and change depending on when cars arrive, how many etc….signals change depending on the traffic at each cycle for all approaches to the intersection. This type of signal timing results in complex variations in the order and timing of traffic signal phases and often has protected left or right turns when pedestrians do not have right of way to cross, even though some of the traffic on the parallel street is moving. These signals may seem to act predictably at certain times of the day, such as rush hour when there is a lot of traffic in all lanes, but can vary greatly from cycle to cycle. Pedestrians usually need to press the push button to call a walk signal to have adequate time to cross the road.

Fully actuated: Completely influenced by traffic volumes, detected through sensors at all approaches to intersection. Mainly used at intersections of two main arterial streets. No specific time to cross, very variable depending on traffic flow, time of day. Pedestrians usually need to press the push button to call a WALK signal to have adequate time to cross the road.

Travellers may be able to discern traffic light intersections from stop sign controlled because signals are longer intervals between changes. traveller detects parallel surge and travels with it as a buffer. Travellers at new intersections are encouraged to listen through several traffic cycles to determine whether protected or permissive left turns are allowed.

Protective left turns – where traffic stopped at red light and allow cars with left green arrows a phase in the traffic cycle. The DON’T WALK phase will appear during this. Cars have right of way – not pedestrians.

Permissive left turns – occur when there is a gap in parallel traffic giving time for cars to turn onto perpendicular street during the vehicles green phase. Pedestrians in the crosswalk have right of way and turning cars need to wait for them to cross. Common for cars to make turns before and after pedestrians while they’re on crosswalk. These runs typically take place briefly after the parallel surge has begun due to vehicles traveling straight get to go before turning vehicles. Hence it’s important for traveller to initiate crossing when surge begins and delay unless there is a car turning right.

Important for travellers to learn to interpret and monitor traffic during each traffic phase within each cycle especially as they’re crossing.

Question 12

Signalised Crossing ( APS or not)

Answer 12

VISUAL CROSSING AT SIGNALISED CROSSING (NO APS?)
Accurate information about the functioning of traffic signals and push button pedestrian signals and crossing with near parallel traffic
While crossing understand traffic movements, discuss lane by lane analysis for potential cars that may be hidden
Can use waiting perpendicular cars as an alignment tool
Pay attention to right turning cars that may be planning on not stopping
Use alternatives at intersections where acceptable risks cannot be determined

Accurate info about functioning signals and pushbutton pedestrian signals.
Crossing with near parallel traffic.
While crossing understand traffic movements, discuss lane by lane analysis for potential cars that may be hidden visually by other vehicles.
Can use waiting perpendicular cars as an alignment tool.
Pay attention to right turning cars than may not plan on stopping.
Use alternatives at intersections where acceptable risk can’t be determined.
Look for crosswalk to align.
May be able to see the pedestrian and vehicular traffic and should confirm with crossing.

AUDITORY CROSSING AT SIGNALISED CROSSING (NO APS?)

As above plus…

• Accurate info about functioning signals and pushbutton pedestrian signals and flow of traffic sounds need to be confirmed prior to crossing.
• Crossing with near parallel traffic is preferred as a buffer.
• While crossing, understand traffic movements, discuss lane by lane analysis for potential cars that be hidden by the masking of other vehicles.
• Use of perpendicular sounds of cars as an alignment tool.

CROSSING AT SIGNALISED WITH APS

• Learner listens for and notes if there is a pushbutton locator tone or speech WALK indication from an APS.
• Leaner searches for pushbutton using systematic pattern. Beginning on side furthest from parallel street.
• Once pushbutton or APS locate explore button to locate button and find out other features if installed.
• Hold pushbutton down for 2 seconds or more to see if more info provided.
• Listens to APS, if available, and traffic at intersection for a full cycle to make sure that tones or speech correspond with traffic after the button is pressed to confirm info regarding traffic patterns determined earlier during the intersection analysis.
• As traffic on perpendicular street begins to move the learner presses pushbutton again, returns to predetermined spot at kerb, aligns with previously determined tactile cue and prepares to cross.

Use of pedestrian button determine length of walk cycle and may not give walk cycle without pushbutton press.
Emphasize that the signal states only that it says WALK, not that it is safe to cross.
Use as a supplementary aid to visual/auditory information.
The learner should always attend to traffic movement and information determined in intersection analysis and not rely on APS indication alone.
Approach intersection & stop at kerb/ramp.
Check for alignment of crossing via traffic.
Determine starting location for crossing & ID tactile cues to realign after pushing button.
Listen & evaluate intersection.
Leave the kerb & search for push button in an organized manner then explore device & function.
Listen to APS & traffic for a full cycle to correlate information.
Push button at beginning of perpendicular surge, realign & prepare to cross.
When the indicator is made, confirm perpendicular traffic has stopped & listen for surge of near parallel traffic
Cross street using typical technique while listening for turning cars.

Question 13

O&M Foundations - Kinesiology, Proprioception, Muscle Tone

Answer 13

Proprioception – position of body and includes balance, it is more subconscious and under the surface. Knowing left and right, touch nose, and balance (one’s own perception)
Kinesthesia – movement of body and does not include balance, it is more behavioural with conscious thought (e.g. learning and improving your golf swing). Knowing movement speed.

Make a safe space, advise what is going to happen.
Sequence skills, facilitate and encourage practice of new movements (long cane, interesting sounds, smells, tactiles to explore).

Combat Poor balance, Poor arm positioning, Poor gait, Poor posture, Poor skills.

Imagine that you put a blindfold on. Ah! You can’t see where your hands are now!

Yet, you would still likely be able to tell me where your hands are (eg, your left hand may be resting at your side). This would be referred to as proprioception (proprio- meaning “one’s own” and -ception meaning perception, thus together proprioception would mean perception of one’s own body). Note how I said resting at your side, this implies that your left hand is not moving.

Now imagine that I ask you to touch your nose with your left pointer finger (blindfold still on). To avoid smacking yourself in the face, you may slowly move your left pointer finger towards your nose. But wait, how do you know how fast your hand is moving without using your vision? The answer is kinesthesia, the sense of movement and speed (kine- meaning movement and -esthesia meaning feeling, sensation, or perception, thus together kinesthesia would mean perception of movement). In other words, you can sense that you are slowly moving your left finger towards your nose and thus will not have to worry about smacking yourself in the face.

If you successfully touched your nose while blindfolded, I must ask: how did you avoid poking yourself in the eye? How did you know that it was your left hand and not your right? How did you know that it was your pointer finger and not your ring finger? The answer to these questions is proprioception. You were aware of where your nose was, and you knew where your left pointer finger was, and then you were able to guide the finger to the nose using proprioception and with the correct speed to not hurt yourself using kinesthesia.

Kinesiology (movement) is study of movement. Children with vision impairment have difficult with prone position and often skip all fours crawling and don’t walk 18-24 months. A delay development may reduce opportunities for self-initiated exploration.

Proprioception (position) is body’s ability to sense where our body is in space using sensory receptors in muscles, tendons and joints of body. Awareness of body position and relationship of body parts to one another. Often develops poorly with congenital vision impairment. Especially with low muscle tone and no functional vision. There is lack of inceptive to play with hands, feet, objects in environment. may contribute to less movement and missed opportunities for proprioceptive input. Few opportunities for physical activities also contribute to less proprioceptive input. Contributes to laterality, directionality and spatial awareness. Motor output could be affected based on a delay in the development of this sensory system including: Balance or finding equilibrium, gait which iis a person’s pattern of walking, Posture which is the vertical alignment of body parts over the body’s centre of gravity, and, Coordination, which is the ability to use different parts of the body and muscles together smoothly and efficiently for purposeful movement.

Muscle Tone relates to readiness for movement. Many children who are congenitally blind have low muscle tone. Often related to a lack of a stable postural foundation from which to perform motor skills. Can affect gait development, posture, balance, and straight line travel.

Sensorimotor development. Vision loss impacts sensorimotor functions globally by limiting the integration of the 5 areas: predictability, sequencing, active movement, quality of movement, and timing of movement:
Advise for safe space. Advise what is going to happen, if someone or something is coming into their space or the environment is changing. Encourage practice of new movement skills to move confidently.
Building Blocks. Sequence motor development, consider what pre-requisite abilities they need and choose activities to develop.
Independent Movement. Facilitate active movement with long cane or adaptive mobility device for purposeful, self-initiated movement to develop foundations above.
Quality Movement. Refine for safe, efficient and graceful movement. acquisition of higher-level motor skills relies heavily on the development of lower-level skills and abilities. Improvisation and approximation at age appropriate level is good.
Timing sequence with age appropriate functioning.

If a VI in infant then baby must have other senses stimulated and used in order to gain the information for cognitive development. If blind baby not reaching for toys around them because can’t see them then the toys needs to be auditory, textured and/or olfactory so as to encourage the baby to explore them

Otherwise:
Poor balance: dynamic or static
Poor arm positioning
Poor gait,
Poor posture
Poor skills.

Question 14

Upper and Lower hand/forearm techniques

Answer 14

Upper protection used with cane for head and chest safety when overhanging objects/vertical objects above waist or when bending down to pick up objects

Lower protection used to locate known objects such as chairs, table edges, doorknobs, and other items at just below waist-level. When the cane is not being used, this technique should only be utilized in familiar areas without drop-offs, surface-level changes, or obstacles.
Taller people may miss more objects than shorter people with this technique. A newspaper or magazine can be held to extend the reach.

Crossing a hallway
Travelling under low-hanging branches or signs
Moving within a food court
Trailing a wall
Grid search within a room
Upper hand – vertical coat rack, fireplace mantle, overhanging branches, sinage.
Lower hand – waist level info, chairs, tables, doorknobs

Question 15

Trailing, Shorelining, Squaring off

Answer 15

For determining position in space, locating a specific object, to get or maintain parallel line of travel. Used for short distances

best used in conjunction with the long cane or other mobility device.
Trailing procedure – position body parallel to wall. Arm positioned parallel to floor, curl fingers so don’t get jammed into door hinge or obstacles on wall. Keep light contact with surface, mentally projecting line parallel to trailing surface.

Visually trailing – if sufficient vision, crosswalk line, rooftops of houses, hedges etc
Auditory trailing – parallel traffic outdoors or tailing a wall indoors listening for opening.

Shorelining or direction taking means travelling in the same line of direction by aligning with the wall or shoreline. May take direction from object or sound.

Squaring off
heels and back against a flat surface, project line from nose and then walk.

Question 16

Human Guide & Assistance

Answer 16

safely and efficiently travel with another person as a guide, interpret environmental info through movement of guide, develop skills in orientation, sensory awareness and environmental interpretation for later independent travel.
Guide touches back of hand to travellers hand
traveller trails up guides arm to find elbow
Grips just above elbow
Grip arm like a cup, slightly firm grip
Arm at around 90 degree angle
Upper arm tucked into side
½ step behind guide

Narrow spaces… guide arm being placed behind and across the back (bent at the elbow and out away from the body). The learner maintains grasp, steps directly behind, and at arm’s length to avoid tripping over heels.

Transfer Sides… Either for personal preference or because of change in environment.
If stationary,
- verbalise
- place back of free hand against back of guide, just above grip
- release grip
- turn 90 degrees
- trail across guide’s back until opposite arm contacted
- traveller restablishes grip and turns 90 degrees to assume basic guide position. ????

If dynamic,
- contacts guides arm with free hand
- extends his arm fully while stepping in behind guide, as done in narrow technique
- changes hands on guides arm while releasing initial grip
- trails his hand across the guides back to other arm
- establishes contact with that arm
- releases grip on original arm ????

Reversing Directions
The about-face procedure: the two execute two 90-degree turns: facing each other while grasping the guide arm, then the free arm which is extended for locating, then executing the second turn.

Doorways
explain door and concept of door
- guide approaches door squarely, describes door to learner, side of hinges and opening away or towards them
- leaner on hinge side
- single file as move through doorway

Ascending stairways
both approach the stairs squarely so the instructor’s toes are touching the first riser and the learner is about a half step behind in the basic guided position. The guide begins the ascent with the learner one step behind (holding the opposite handrail for balance). When reaching the landing, the guide gently pulls the guide arm forward to indicate there are no further steps on that flight.

Descending Stairways
While using human guide technique, the two approach perpendicular the stairs & stop with guide’s toes over the edge;
the learner is a half step behind, squaring off with head hips & toes pointing directly ahead.
The guide begins descent and learner follows one stair step behind.
When learner foot hits the landing, the guide pulls the guide arm forward to indicate no further steps.

Seating
guide approaches back of chair or positions traveller close to seat. traveller trails arm of guide to chair. traveller contacts side of chair with lower legs, moves to front, examines chair by moving back of hand down back and covers surface of seat by making wide circle to detect any objects. traveller places back of legs against front edge of chair, puts up upper protective technique, catches back of chair with free hand and sits down

Accepting / Refusing
responds by relaxing the grasped arm and pulling it across his body toward his opposite shoulder to accept.
Refusing – plant feet and shift centre of gravity back, the arm is pulled across body as a means of breaking contact with the would be guide. The traveller shifts his weight back to keep from being propelled forward or be turned. The feet are planted firmly to avert the possibility of an inadvertent change of alignment or disorientation while refusing assistance.

Hines break

Guided Responsibilities
Accurate communication (verbal & nonverbal), use sensory information for mental mapping & orientation. Adjust grasp depending on size and characteristics of guide. Adjust position when moving through doorways, narrow areas – follow movements and cues from guide. Position self on half a step behind the guide, 90 degree angle at the elbow of traveller.

Children
Depending on the student’s height/hand size will determine where the student will grasp the guide, e.g. wrist, or two fingers.
DO NOT hold the student’s hand unless necessary for safety reasons

Advantages:
guide ensures traveller’s safety
Allows the learner to focus on the task instead the navigating
Allows opportunity for an initial review of a new environment.

Disadvantages
Dependency can develop, incautious guide.

Question 17

Long Cane Pro / Con

Answer 17

Advantages
Auditory and tactile feedback
Independence
Detects drop-offs, terrain changes
Makes others aware of disability
Protects from obstacles in travel path
detects drop offs, terrain changes, gives traveller’s other hand free to carry belongings, multiple techniques in different environments.

Disadvantages
Length of cane can become unwieldy in close areas such as food courts
Frequent re-measuring for growing clients
Catching in uneven surfaces, need to change cane tip
Doesn’t protect from obstacles at head height
May contribute to veering

Considerations:
Will cane help them travel more confidently, safely, gracefully?
Motivated to use cane?
Can they hold cane?
Physical and cognitive ability to carry cane
Cross-midline cognition
Posture/gait
Mobile enough to travel (even if in wheelchair)

Regardless of the amount of usable vision a student has, will use a cane to help travel safely, more independently and more graceful manner.
Is student motivated to learn to use cane?
Can and will the student hold a cane?
If no useable vision and a need to travel in new and complex environments.
People with useable vision only in good lighting who may trip over obstacles/hazards in darker conditions.

Question 18

Diagonal Cane Technique

Answer 18

Used in familiar indoor areas or with guide in which cane held and positioned diagonally across and in front of body. Can’t reliably detect drop offs or equally preview across and in front of body.
Use with human guide or with persons with usable vision in uncontrolled and /or unfamiliar areas.
Used,
familiar and controlled environments
moving in congested environments
persons wishing to carry cane for identification.
Acts as a buffer between body and obstacles.
May be used with guide or outdoors by person with usable vision
Useful in congested areas or for identification purposes
Hold cane in front of you with it angled from one side of the body to the other.

Hand held forward just outside hip.
Arm flexed at shoulder until hand at waist height and forward of body by 20-30cm, 8-10 inches.
Forearm inwardly rotated until palm of hand facing down.
Slight bend in elbow, shaft of cane positioned diagonally across body.
Tip of cane positioned forward of grip and about 1 inch beyond outside shoulder.
Tip raised just above floor surface to avoid sticking in carpets/cracks.
Keep in contact with floor and slide if smooth surface.
Either hand.
Choice of hand may depend on placement of objects within environment.
Grip,
Standard index finger - Index finger extended and thumb up, remaining fingers wrapped around grip, best control when trailing along wall.
Thumb – useful when walking into open spaces with few pedestrians.
Pencil – easier to manipulate when around pedestrians feet. Cane grasped between finger and thumb as it rests on the middle finger. Remaining fingers curled down. Commonly used when going up stairs and narrow spaces.

trailing with the diagonal technique:
Enables the traveller to locate specific objectives along a wall or building line
Enables straight line travel
Allows to maintain contact with environment while travelling
Gives more sensory information
Determines door openings & hallways
Hold the cane in the hand away from the trailing surface and put the tip of the cane against the trailing surface
It crosses diagonally in front of the body
Disadv: restricted to familiar environments, doesn’t detect all drop-offs, only protects one side of lower body, no protection above waist.

Question 19

2 Point Touch

Answer 19

Allows to probe ground where foot will fall. Enables client to detect drop offs and objects in the vertical plane.
Used indoors/outdoors.

Side to side, touching ground at each end of arc.
Objective
Sufficient obstacle and surface preview to allow for travel in unfamiliar and uncontrolled environments.
Procedure
Cane grasped with had held forward as is done when shaking hands.
Index finger extended parallel along flat side of grip.
Thumb diagonally across top of grip.
Remaining fingers curled under grip to provide support.
Top of grip rests at top of palm.
Crook, if one, facing down.
Arm extended at shoulder until hand is waist height, elbow flexed slightly (not locked) so that arm is fully extended and in firm position. Upper arm may rest against body.
Had positioned at or near centre of body,
- Point of reference
- Symmetrical arc
- Equal preview of both sides
- Max frontal view
Wrist outwardly rotated so thumb bones facing upward and back of hand faces to side
Cane moved side to side by wrist.
Arc extends 2.5cm (1 inch) outside widest part of body.
Syncronise with feet, alternating foot strikes floor in sync with cane on other side. Cane touching ground just before where foot will be placed.
Allows for as much reaction time as possible.

Question 20

Touch and Slide Technique

Answer 20

Used as variation of 2 point touch (not required with constant contact).

Basically switch to touch and slide when want a little more info of subtle texture changes (e.g. curb cut).

When tap at 1o’clcok, let it slide 4-5inches with momentum of body.

Need to slow pace down to remain in step.

Used to detect subtle surface changes, such as blended curbs or narrow grates, by slowing the walking pace and sliding the tip further forward at each point of contact. Used to find terrain changes or sloping areas where terrain isn’t smooth enough for constant contact. Some use it to differentiate between dry & wet/muddy areas. Provides earlier warning of drop-offs than 2-point touch. Only used for a short time when looking for particular known landmark. Good in wet leaves, snow.

To detect subtle surface surface changes, such as blended curbs, expansion joints. Variation of 2 point touch.
Objective
Provide more continuous surface preview.
Provide earlier warning of drop offs.
Enhance detection of subtle changes in texture and other surface changes.
Good when terrain is a bit rough, such as outdoors, in snow, when there’s wet leaves – so traveller can poke into ground.
Procedure
Cane tip touched down at approx. 30 degrees past midline.
Tip remains in contact with walking surface as it slides20-25cm (8-10inxhes) to lateral extent of the arc – out to outer side….
Introduce at any time.
Value to traveller dependent on travellers ability to anticipate need, so mostly of benefit in familiar situations.
Use ascending, descending stairs, curb, tactile warning strips at corners.
Need good coordination.
Constant contact similar in function, easier to learn and requires less coordination to use.

Question 21

Constant Contact

Answer 21

Used when first learning 2-pt technique; gives earliest detection of drop-off; good for those with multiple impairments. Superior tactile feedback as cane tip always in contact with ground. Requires less coordination than touch-and-slide.

Variation of 2 point touch.
Keeping cane on ground surface all the time.
Gives superior tactual feedback, find small surface discontinuities and precise location of walkway margins.
Best used with mushroom tip or roller tip to reduce sticking.
Can result in being more out of step.

Question 22

Three Point Touch

Answer 22

Find object above level of walking, break in wall (e.g. steps).
Slow walk to integrate 3rd touch and stay in step.

used to detect objects on side and above level of walking; locating desired objective on a higher-level surface, e.g. kerb, hedge, storefronts. Primarily used to locate intersecting footpath after veering on road crossing.

Cane technique used to follow raised surface to locate a desired objective on a higher level surface, doors which open at a higher level than travel surface, intersecting sidewalks which are present above travel plane. Adding a 3rd point of contact to locate specific objectives.
Lifted over kerb and placed in grass above it to locate an intersecting side walk or during street crossing recovery.
Procedure
Parallel to vertical raised surface.
Move cane across body to trailing surface, contact trailing surface, lift up cane after striking surface and contact this third surface.
May need to slow to do this technique.
Experienced travellers may use hesitation stride with leg opposite the trailing surface, in order to remain in step.

Question 23

Touch and Drag

Answer 23

Trail shoreline and also good in rough areas I find.
Variation of 2 point touch.
Slow done to stay in rhythm

Trail a shoreline or remain parallel to drop-off. Good for rural areas without footpaths. Dragging the cane tip from the opposite side of the surface to a surface to be followed. Only needed for short time when generally using two-point touch.

Used to maintain a desired line of travel along a border or surface by dragging the cane tip from the opposite side of the surface to be followed. (aka – shorelining to detect parallel area). Used to trail edge of a drop off from a raised position, or detect a seam, ridge, texture change, parallel line of travel and is only needed when using 2 point touch as these functions are normally provided by touch and slide and constant contact techniques.
Also use to locate landmarks such as bus stop sign.
Procedure
Occasionally there may be situation to follow edge of drop off. ie train platform or other raised area.
Used with 2 point touch technique only.
Touch and drag modifies basic trailing procedure by leaving the tip in constant contact with walking surface as its dragged from the outside shoulder to the edge of the trailing surface.
traveller aligned to parallel surface to be followed.
Taps cane tip to opposite side of surface to be followed and drags tip until it reaches the surface to be trailed.
Maintain same rhythm and step.
Also works well when trailing a small ridge or seam perhaps in a passing driveway entrance to a petrol station.
traveller uses a low flat arc.
Considerations
May drift from trailing surface and uneven arc.
Can be difficult to stay in rhythm and lead to slower pace.

Question 24

AMD

Answer 24

Adaptive Mobility Devices

Adv:
Provide as much protection as cane but don’t need perfect cane technique, e.g. used by people who may not be able to use long cane because of physical disability or cane is painful to use or unable to use reliably
Customised for individual needs
Can detect obstacles, slopes, drop-offs
Client is more comfortable with additional support and barrier to obstacles
Transition to long cane is easier
Customised for individual needs, person more comfortable with additional support. May assist with transition to long cane later. Can provide as much protection or more, but don’t have to use proper cane technique. Can reliably detect drop offs, gradient changes and obstacles.
Can be used by children/adults who can’t use cane because physically not able to move the cane properly or unable to learn how to use it reliably or it’s too painful to use cane.

Disadv:
They don’t provide support, only a preview of environment
Large, expensive
Don’t allow for advanced techniques
Cost of materials/creation
Portability/cumbersome
Poor reaction time eg for dropoffs
Endurance/stamina for movement
Dependence, cost of materials, creation of device, portability, endurance, stamina for movement.
Traditionally designed and don’t provide support. Only provide info about what’s on ground ahead.
Larger and more expensive.
Restrict traveller from doing advanced techniques.
Bulky in large crowds.
Poor reaction time, especially for drop offs.
Inability to scan space above hands.

Considerations:
Ability to grasp, push/pull
Age-appropriate/socially acceptable
Physical or cognitive limitations
Kinaesthetic/proprioceptive/posture/gait problems
When used as a pre cane device.
For elderly who have short term mobility needs that don’t require a lengthy mobility program.
Student motivation.
Physical or cognitive limitations.
Kinesthetic or proprioceptive problems – info of one’s position in space received through muscles during movement.
Social appropriateness.

Question 25

Guide Dog

Answer 25

Adv:
Increased mobility, independence & speed
Approachability by public
Can handle obstacles more easily
Easier travel in bad weather
Navigate complex environments “find the way”
Companionship

Disadv:
Maintenance – need attention
Responsibility of looking after dog
Inconvenient or uncomfortable situations for dog
Quick motion and rapid mutual responsiveness required
Handler needs good health, coordination and balance
If too much vision may override dog decisions and decrease skills of dog
Dogs need regular work to retain skills
Can’t take dogs everywhere, or misunderstanding about access rights.
Managing public

Considerations:
Likes dogs and people
Active or employed (enough work for dog)
In good health (mental and physical)
Legally blind or worse
Good hearing
Responsibility (take ownership/leadership)
Out-of-house obligations
Maturity
Orientation/cane skills
Good O&M skills
Not too young or old
Don’t need reliance on tactile landmarks, lots of info
Fast walker
Good strength, balance
Good understanding of environmental and spatial r’ships, spatial updating

Question 26

ETA

Answer 26

Adv:
Electronic travel aides
Early warning of overhanging obstacles
Auditory/tactile cues
Can be hands-free
Give more sensory info along a route
Increase travel efficiency and confidence
Decrease reliance on tactile landmarks for ‘O’
Can help with veering or misalignment
Time-Distance Estimation

Disadv:
Overdependence
Cannot rely on ETA alone
Time estimation can be affected by elements in the environment (e.g. slower walking due to pedestrian congestion)
Does not take into account traffic or obstacles
Malfunctions (esp. during inclement weather)
Urban canyoning – tall buildings on both sides can affect GPS signal
Hard to pay attention to lots of info at once
Needs batteries - battery life of device used, may need to carry extra batteries or an external charger
May not be waterproof
High cost and limited availability
Reliability affected by access to satellites, cloudy days may impede use or tall buildings in city areas.
Differences between availability of apps accessed on iOS and android
High cost of stand alone devices

Question 27

Bus Travel

Answer 27

Before boarding bus traveller should confirm,
It’s the desired bus - name, number & suffix
It goes to bus stop choice – name destination, intersection, street names etc.
When boarding bus traveller should,
Approach bus directly until contact it with cane
Trail towards the front of bus using appropriate strategy as conditions dictate to locate door.
Ascend stairs using ascending stairs technique.
Trail front railing to pay station or card swipe.
Requests directions to nearest open seat near the door, preferably on opposite side of driver, so as to be visual reminder and close enough to verbally communicate.
Ask driver to inform when destination reached.
Request stop (push button/pull cord) when stop announcement is made for desired destination.
Maintaining orientation – keep track of direction of travel, time distance – unaided, GPS or asking driver.
Which direction is bus facing?
Name of street bus is currently traveling along and direction of desired intersecting street (in front and behind bus).
Exiting bus,
Ensure correct stop prior to exit.
Request orientation info, how far am I from kerk, am I exiting into driveway/sidewalk, which direction is name of intersection/place of business?
Descent stairs using descending stairs technique.

Download / text map information from website
Call the bus terminal for routes
Travel apps

What is paratransit and how does a learner become eligible to use the paratranist system.
Door-to-destination transportation on a call-in basis for a minimal fee
For people with disabilities
Supplement to usual mass transit systems
Individualised rides in US without fixed routes or timetables
Varying flexibility depending on region
Eligible via proof of disability

Question 28

Country, Snow, Rain

Answer 28

traveller takes position next to the parallel kerb, shoreline or edge of road.
Using 2 point touch or touch and drag traveller maintains parallel alignment with reference point.
traveller mentally projects a straight line of travel. Will facilitate the recognition of change (curve or cessation) in the reference line.

Under most circumstances traveller would walk the side of the roadway AGAINST traffic. If road sufficiently side or bike path is present this would not be necessary. Caution should be exercised when cresting hill as traveller obscured from driver’s view. Hill may also obstruct sound of approaching vehicle. Crossing road near crest of hill should be avoided.

If no sidewalk the traveller recognizes the perpendicular street by the curving of the reference line (shoreline) away from the parallel street. Follow curve until has turned 90 degrees.
Place reference line/kerb to back and squares off with edge of street
Project a straight line while crossing
When the edge of the road is less well defined, the touch-and-drag technique is most useful.

Snow
Constant contact or touch and slide

Rain
Most techniques won’t need to be altered unless rain is heavy or water is deep. If so, slow pace and shorten stride to allow for better reaction time, esp. if sounds are distorted/masked.

Question 29

Shops, Gas Station, Parking Lots

Answer 29

Shops
Shorten cane from typical placement
Constant contact
Self-protective techniques
Push the cart (trolley) to give preview and protection

Gas Station
Touch and drag to shoreline
Maintain traffic flow observation – cars turning in/out
Return to parallel surge to find sidewalk

Parking Lot
Listen for traffic in parking lot and bordering streets, walking towards traffic sounds and establish parallel until a sidewalk is found. As parked cars are detected the angle is explored with 2 point touch technique until square off, use self protective technique to avoid mirrors and other protruding objects.