Domain 6: Mobility Skills and Strategies

Question 1

3 skills taught after human guide

Answer 1

1. upper hand and forearm
2. alternate hand and lower forearm
3. Trailing a wall

Question 2

Sequencing of self-protection techniques instruction

Answer 2

1. start in open spaces using “follow my voice” technique and walking in front of student.
2. as student gains confidence, then add an obstacle, then move to walking behind or alongside student and observe position from 3 positions: front, side, and behind.

Question 3

Five-Point Travel System

Answer 3

1. Route pattern or shape
2. compass directions
3. names of hallways (later streets)
4. landmarks along the route
5. All previous elements in reverse order on the return trip

Question 4

Lesson sequencing of diagonal cane technique

Answer 4

• simple motor skills to complex
• give student time to master each grasp in either hand
• free arm should be relaxed by side, or in upper hand and forearm technique
• lessons progress from travel in open spaces to trailing while using diagonal with each hand, then mix of each

Question 5

3 ways to use a cane with human guide

Answer 5

1. learns to keep cane out of the way during human guide procedures.
2. uses cane in diagonal fashion.
3. uses cane using two-point touch technique.

Question 6

Advantages and Disadvantages of Diagonal Cane technique

Answer 6

Advantages:
- most basic technique
- enhances ability to travel in familiar, indoor environments
Disadvantages:
- cannot detect drop-offs or some obstacles outside cane protection.

Question 7

Advantages of Two-Point Touch

Answer 7

enables one to travel in all types of environments, both familiar and unfamiliar.

Question 8

Good environments to teach diagonal cane technique

Answer 8

• Indoor environments such as an uncluttered hallway
• same as self-protection
• as student learns skills, can use hallways with more furniture, or more congested rooms.

Question 9

Types of diagonal technique cane grasp and when to use each

Answer 9

1. Index finger grasp: affords best control when trailing a wall.
2. thumb grasp: best when walking into open spaces with little pedestrian traffic because it easily maintained and maneuvered.
3. pencil grasp: best when many people are present, because it may allow him to move the cane gently in and around feet. Can reduce length of cane by holding below the handle. Also good for ascending stairs.

Ultimately, student decides which grasp they like best.

Question 10

requisite skills to teach before teaching room familiarization procedure

Answer 10

1. human guide
2. self-protection
3. long cane techniques (diagonal and trailing)
   - understanding of laterality, directionality, and five-point travel system

Question 11

3 ways you can document how a student has mastered and transferred self-familiarization skills of a room.

Answer 11

1. ask student to walk through a room and describe it’s characteristics.
2. Student can create a tactile or low vision map that illustrates the layout of the room and its contents.
3. student can make an auditory map of the room, or verbal, digitized description of the layout.

Question 12

4 requisite skills student should master before room-familiarization

Answer 12

1. human guide
2. self-protection
3. long-cane techniques (diagonal, wall trailing)
4. understanding of laterality, directionality, and 5-point travel system

Can also be introduced at specialist’s discretion, maybe before diagonal technique or even after two-point touch (which is designed for use in unfamiliar areas).

Question 13

right. left, in front of, behind, above

Answer 13

lateral directions

Question 14

Sequence of teaching room-familiarization

Answer 14

1. perimeter familiarization
2. grid familiarization

Question 15

3 things a student learns about a room after thoroughly exploring its interior.

Answer 15

1. objects in room’s center
2. reaffirms relationships of objects along the walls (learns which objects are opposite each other on opposite walls)
3. learns about the shape of the room by completing the grid pattern of exploring.

Question 16

Which Cane Technique?
- suggested user: persons with no shoulder anomalies.
- environment: indoor, familiar areas with no unknown drop-offs

Answer 16

Diagonal with index finger grasp

Question 17

Which cane technique?
pros: good introduction to using the long cane; good buffer in familiar areas
cons: lacks ability to discern drop-offs

Answer 17

Diagonal Cane Technique
Index finger grasp

Question 18

Which Cane Technique?
- Suggested user: persons with shoulder anomalies
- environment: indoor, familiar areas; ascending stairs

Answer 18

Diagonal Cane Technique
Thumb grasp

Question 19

Which cane technique?
- pros: easy to learn
- cons: difficult to keep cane tip from getting behind used when trailing or contacting objects

Answer 19

Diagonal cane technique
Thumb grasp

Question 20

Which cane technique?
- suggested user: persons with good fine motor and finger dexterity
- environment: indoor, familiar areas; ascending stairs; crowded areas

Answer 20

Diagonal cane technique
pencil grasp

Question 21

Which cane technique?
- pros: fairly easily to learn
- cons: difficulty for some to maintain while walking

Answer 21

Diagonal cane technique
Pencil grasp

Question 22

Which cane technique?
- suggested user: persons of all ages
- environment: indoors or outdoors; familiar and unfamiliar

Answer 22

Basic two-point touch
whole hand

Question 23

Which cane technique?
- suggested user: persons with good manual dexterity and no neuropathy
- environment: indoors and outdoors; familiar or unfamiliar

Answer 23

Basic two-point touch
fingertip

Question 24

Which cane technique?
- suggested user: persons with neuropathy or poor dexterity
- environment: indoors or outdoors

Answer 24

Basic two-point touch
constant contact

Question 25

Which cane technique?
easier to learn at first; hard to monitor arc height/width; students tend to rotate wrist

Answer 25

Basic two-point touch
whole hand

Question 26

Which cane technique?
pros: hard to learn at first; arc height/width easy to maintain and monitor

Answer 26

Basic two-point touch
fingertip

Question 27

Which cane technique?
pros:
- easiest on smooth surfaces or rough surfaces if standard cane tip is changed to roller ball or marshmallow tip.
- do not need to walk “in rhythm” bc cane
- good for students with multiple disabilities and those who have difficulty detecting changes in terrain.
- quieter - does not draw as much attention.

Con:
- can get stuck easily in cracks or rough areas - would need to change out cane tip

Answer 27

Basic two-point touch
constant contact

Question 28

Which cane technique?
- suggested user: all cane users
- environment: indoors and outdoors; familiar and unfamiliar

Answer 28

Basic two-point touch
touch and slide

Question 29

Which cane technique?
pros: assists in detecting drop-offs

Answer 29

Basic two-point touch
touch and slide

Question 30

Three-point touch technique:
What are the suggested users, environments, pros/cons?

Answer 30

-suggested user: all cane users who have good coordination and dexterity
-environment: indoors or outdoors; familiar or unfamiliar areas
- pros: Assists in locating surfaces along one’s side and above the feet

Question 31

What is an advantage of three-point touch, touch and drag technique?

Answer 31

assists in shorelining and detecting drop-offs to one’s side.

Question 32

What is an advantage of three-point touch, one up/one down technique?

Answer 32

assists in locating surfaces along one’s side and above the feet.

Question 33

The traditional and preferred method (Hoover Method) of two-point touch

Answer 33

Whole hand

Question 34

In two-point touch, what is the preferred height of the arc at its apex?

Answer 34

1/2-2 inches

Question 35

What can happen if the hand drops below the waist in two-point touch?

Answer 35

• tip will probably rise higher off the ground
• harder to detect drop-offs
• cane tip can also poke into groin area

Question 36

What might happen if the dominant hand were held off to the side of the body during two-point touch?

Answer 36

• arc width would need to be wider to cover entire width of the body
• apex of the arc would be a shorter distance from the student’s feet, which can result in overstepping the cane tip which can lead to tripping over stairs or drop-offs.

Question 37

When is touch and slide technique used?

Answer 37

-two-point touch
- When student wishes to make as much contact with the ground as possible, but the terrain is not smooth enough to allow the tip to remain on the ground.
- used to detect drop-offs (when anticipating them)
- determine changes in terrain

Question 38

When is touch-and-drag technique used?

Answer 38

• trail shoreline outdoors or to remain parallel to a drop-off while walking along it.

Question 39

When is three-point touch cane technique used?

Answer 39

• Used to detect objects located off to the travelers side and above the level he is walking.
• also used to detect doorways along building storefronts bc it allows student to hear difference between elements.
• This is more advanced, and introduced later in O&M program.

Question 40

When is the one down and one up-and-over cane technique used?

Answer 40

• For same reason as the three-point touch - many students find it easier to accomplish.
• can be harder to maintain distance from shoreline, causing one to veer

Question 41

When teaching a student how to ascend stairs, do you teach with handrails first or without handrails?

Answer 41

without handrails, because its harder to teach without handrails if they have already learned with handrails, but not vise versa. Also, handrails are unreliable, as they can stop or curve at any point.

Question 42

Teaching-coaching-solo phases

Answer 42

1. teaching - in concert with O&M specialist
2. Coaching - minimal amount of assistance from specialist
3. solo - no assistance

Question 43

Limitations of two-point touch

Answer 43

• can miss detecting objects
• can miss a drop-off
• student can misinterpret information received from the cane

Question 44

Strengths of two-point touch

Answer 44

• is still most reliable technique despite its drawbacks.
• helps student concentrate on orientation without worrying about next foot placement

Question 45

Types of cane tips that work well on smooth surfaces, such as tile and some pavement

Answer 45

nylon pencil tip

Question 46

What cane tips work best for rough surfaces?

Answer 46

nylon roller ball, marshmallow, teardrop

Question 47

When is a student ready to learn how to cross the street?

Answer 47

Once she have learned to familiarize herself with an entire city block and has maintained orientation and become reoriented after when confused.

Question 48

Where are street crossing skills first taught?

Answer 48

in quiet residential neighborhoods (crossings controlled by stopsign) so specialist can control as much as possible situations that could compromise the student’s ability to gain the skills and confidence necessary for successful travel.

Question 49

which types of intersections are street crossing first taught at?

Answer 49

First two-way and then at four-way stop intersections where perdenpicular traffic must stop. One-way would also be a good place tostart if available bc student would only have to listen to traffic coming from one direction.

Question 50

Procedure for initiating a street crossing

Answer 50

1. approach corner with touch-and-slide (or constant contact) until student feels curb edge and then braces tip up against the edge.
2. studnet plants feet several inches from curbs edge, with dominant foot slightly ahead of nondominant foot.
3. student switches to diagonal cane technique, using index-finger grasp with cane tip against the curb edge and in the street with her hand at midline.
4. Check for obstacles - sweep cane in semicircle motion from nondominant side, to dominant side, and back.
5. Ready to cross position: tip is placed out of the street and up against the nondominant foot; use index-finger grasp
   5.