Domain 7: Mobility Skills Flashcards
Where should the instructor be positioned during stair travel?
descending: 2-3 steps in front of the traveler while walking backwards
ascending: behind the traveler walking forward
where should the instructor be positioned during escalator travel?
descending: 2-3 steps in front of traveler
ascending: behind traveler with feet on separate steps
Kinesiology
study of movement
provides structure for understanding sensorimotor skills
allows O&M to analyze performance of mobility and other motor skills
proprioception
awareness of position of the body
contributes to laterality, directionality, and spatial awareness
connected with muscle tone and balance
muscle tone
readiness for movement
children w/ VI lack stable posture
can alter or limit movement
predictability
personal: hypersensitivity to touch and tactile stimulation
O&M must inform student what what they are doing before doing it
environmental: modifications to the world around a VI person
(contrast tape on steps, lighting fixtures)
sequencing
motor development
coms must insure proper learning of sensorimotor skills in order to move to higher levels
active movement
purposeful, self-initiated, confident movement
quality of movement
child must crawl before walking to build muscles
timing of movement
VI infants who skip crawling have poor posture, poor gait, low muscle tone
vision loss and sensorimotor function
affects balance, posture, gait, muscle tone, coordination, stability and movement
static balance
maintaining posture while sitting or standing
dynamic balance
maintaining posture while moving
uses several sensory systems
upper hand and forearm
protect the learner from head-chest level obstacles
bending down
unexplored space
lower hand and forearm
protect learner from waist level obstacles
examples of protective technique use during daily travel
bending down to grab something
getting in and out of vehicles
classrooms or other crowded environments
TRAILING
useful to maintain a straight line of travel
learner is positioned parallel
palm slightly cupped with fingers and thumb relaxed, fingers pointing downward
squaring off
perpendicular surface alignment
enables learner to cross hallway or other open spaces
learner aligns back and shoulders and heels against a straight surface
parallel alignment
enables learner to use parallel surface to establish a straight line of travel
learner uses 1 arm or shoulder to position themself on a parallel surface
basic human guide
enables learner to participate while walking with a guide
guide verbally offers an arm and makes contact with the learners lower arm with the back of their hand
learner grasps guides arm above the elbow by trailing with their own arm
learners upper and lower arm is bent at 90 degrees
the learner remains 1/2 step behind the guide as they walk together
narrow spaces
guide moves their arm behind and toward their back
learner extends their arm and moves directly behind the guide
guide returns arm to side signaling the end of the narrow passage, learner returns to original position
transferring sides
enables learner to switch sides from one of the guide to the other
guide or learner indicates want to switch sides
learner releases initial grasp of guide and with the back of that hand, trails the guides back to find the other side
once contact is made with guide’s opposite arm the learner releases grasp from original arm and brings hand over to grasp new arm
reversing directions
enables learner to make a 180 degree turn in a limited space
guide indicates need to reverse directions
guide and learner turn 90 degrees towards each other
guide initiates contact with his free hand for the learner to grasp the guide’s free arm then releases initial grasp
guide and learner complete the remaining 180 degree turn until they are facing the opposite direction
doorways
enables guide team to safely negotiate through doorways
guide approaches doorway where doors open on the same side as the learner
guide opens door with a push or pull motion, learner places free hand in upper protective technique with palm facing out towards the door
doors that open on the opposite side of learner: guide opens door with push or pull motion, learner extends arm, moves behind the guide and grasps guides arm with freehand to switch hands before placing free hand in upper protective technique
learner passes through the door
ascending/descending stairs
guide approaches edge of stairs and aligns perpendicularly
guide pauses at the stairs allowing the learner to align alongside the guide
guide takes first step and continues to ascend or descend with learner one step behind
guide will verbally communicate with learner when they are on the last step
seating
guide team approaches desired seat
guide team describes type of seat and position
guide places hand on the back of the seat and learner releases grasp
learner repositions to face the seat and uses upper protective technique
bending at the waist learner clears the seat and places the back of the legs against the seat and sits down
accepting/declining assistance
learner relaxes arm that is grasped and raises it towards opposite shoulder, keeping her feet stationary
with free hand, learner grasps the person’s wrist while stating her intentions to accept or refuse assistance
responsibilities of learner when using human guide
learn techniques
interpret guide’s movements when navigating
remain oriented and aware of the environment
communicate with guide about pace
small children human guide
grasp wrist or finger instead of elbow
advantages of human guide
speed and efficiency
more information about environment
someone available for questions
disadvantages of human guide
dependent on someone to receive info
may be tempted to ignore landmarks and environemntal info
advantages of using a long cane
lightweight, durable, cheap
visibility to others
detect all obstacles below the waist
disadvantages of the long cane
no overhead protection
not efficient for travel
training time for use
will need to be replaced
advantages of dog guide
speed and efficiency
learn routes
companionship
disadvantages of dog guide
upkeep and cost
training
dog will die
responsibility
advantages of ETAs
can detect obstacles on both vertical and horizontal planes
some can detect drop offs
greater independence and travel confidence
disadvantages of ETAs
cannot detect traffic gaps
need to be used in addition to a cane
high cost
not commercially available
advantages of AMDs
gait improvement
provides full coverage across body
bridges gap between basic skills and cane skills
cheap to make
disadvantages of AMDs
large
not weight bearing
should not be used in unfamiliar environments
what is residual vision?
remaining vision someone has after they have become VI
environmental factor that can impact residual vision
glare
color
lighting
contrast
visual clutter
depth perception
qualities that a learner needs to be considered for a dog guide
responsibility
age
physical ability
cognitive ability
hearing
level of vision
needs and travel needs
orientation skills
qualities that determine use of an AMD
age
need
physical/cognitive ability
social appropriateness
qualities that determine use of a long cane
level of vision loss
travel needs/independence
physical/cognitive ability
basic diagonal technique
hand is positioned on grip so that index finger is extended along flat edge of grip, thumb is up and remaining fingers are flexed around grip so that cane rests comfortably in hand
upper arm and forearm slightly extended with grip of hand positioned 10-12 inches in front of hip, hand positioned waist high
cane lightly rests on the ground across the body so that it is 1-2 inches beyond the width of the opposite shoulder 2.5 feet in front of the learner
trailing with diagonal technique
enables learner to verify a location, establish a straight line of travel or locate a desired destination
cane is held using diagonal technique in the hand opposite the surface being trailed
cane tip lightly contacts the point where the floor and wall meet
learner moves forward while maintaining body position parallel and close to trailed surface
2 point touch
hand is positioned so that cane grip rests in the middle of the palm with back of the hand facing to the side away from the learner’s midline (same position as a handshake)
index finger is extended downward along the flat side of the grip with remaining fingers flexed
1 inch above the ground and covers the width of the learners body
constant contact
hand is positioned like a handshake
cane is centered at midline with the arm extended forward
wrist is flexed and extended out
cane in an arc from side to side
3 point touch
while standing on the lower surface the learner is positioned parallel to the vertically raised surface
3 taps of the cane fits into one complete two step stride sequence
learner moves the cane from just beyond shoulder to cover vertical surface
touch and drag
learner is aligned parallel to surface
learner taps can tip to the opposite side of the surface to be followed and drags the tip of the cane until it reaches surface to be trailed maintaining the same rhythm
cane on stairs
cane positioned vertically allowing the learner to walk toward the stairs
base of steps in vertical, learner lowers grasp on shaft and moves cane left and right along the base of the stairs
learner lifts cane until the tip moves over the edge of first step and pushes the cane forward so that the cane tip moves across step
arm extended and cane in pencil grasp, learner lifts cane slightly so tip rests on next step
when tip no longer contacts base of step, learner prepares for landing by clearing landing with cane prior to taking last step
procedure when detecting drop offs with cane
maintain orientation
use protective techniques
discuss possible dangers on sidewalk
clear area with cane
cane should remain anchored against object at dropoff
cane held vertically in front of body for protection
explore with cane on ground horizontally
concepts used to analyze intersections
spatial layout:
number of lanes
which direction cars are traveling in
sensory information
traffic controls
risk involved
common risks when crossing an intersection
cars
speeding
quiet cars
veering
complicated intersections
how can the O&M prepare the learners to make informed decisions
effective crossing strategies and making sure there is autonomy
risk determination
alternative routes when needed
solicit for assistance
2 way stop
one way has constant traffic and traffic is controlled
by stop sign in another direction
if parallel traffic is surging through intersections, begin crossing when traffic reaches half way point
if no parallel traffic, cross when perpendicular traffic is stopped
can cross when all quiet
4 way stop
traffic stopped in all directions
wait for surge of parallel traffic and begin crossing when traffic is halfway through the intersection
can cross on all quiet
T shaped intersection with one way stop
begin crossing after determining all clear
use visual or auditory scanning
when crossing the crossbar of the T, student initiates crossing when car begins to turn into the intersection- this is safer than waiting because the car should see the student wanting to cross
simple traffic light
student stops at the beginning of the cross and anchors cane tip diagonally
maintains alignment while moving up 2-6 inches from curb
analyzes parallel and perpendicular traffic, and light cycle
prepares to cross while maintaining straight line of travel
cross with parallel traffic surge
where are the most yield signs present
roundabouts
channelized turn lanes
what strategies should the O&M teach for situations of uncertainty
have students determine street width and crossing time
have student judge whether they can hear traffic well enough to cross
technique for crossing at uncontrolled crossing using visual strategies
check for obstructions
look for cars before stepping into the street
auditory strategies?
listen for cars
cross with the least amount of background noise possible
stop sign- visual strategies
look for cars
check crosswalk for visible danger
begin crossing
what strategies should be used when teaching a learner APS
learner listens for tone or speech WALK indication
learner searches for push button using s systematic pattern
learners holds push button
as traffic on the perpendicular street begins to move, learner pushes button again
describe a tactile method of alignment at street crossings
parallel alignment with grassline
perpendicular alignment with curb or truncated domes
describe auditory method for alignment of street crossings
align shoulders with parallel traffic
use perpendicular traffic to align shoulders at the loudest point
how can a learner obtain new information when planning a trip using public transportation
call customer service
websites
maps, route description, large print maps
talking signs
what is paratransit and how does a learner become eligible to use it?
drivers that work for a service for people with disabilities
what techniques should be used in the snow?
touch and drag
touch and slide
ice gripper shoes (yak tracks)
walk slower
rain techniques
umbrella
sounds of traffic may be exaggerated
should stay farther away from curbs and edges due to puddles
excessive heat conditions
sunburn
heat exhaustion
heat stroke
characteristics in a rural environment
no sidewalks
increased distance between intersections
few landmarks
few traffic
what procedure is used for travel without sidewalks
learner faces oncoming parallel traffic on the side of the road
constant contact or touch and drag
learner stops when vehicles approach and resume when they pass
what procedure and cane techniques should be used when crossing without sidewalks
follow curve until it is straight
square off with shoreline
cross in straight line
strategies for traveling a grocery store
become familiar with the perimeter of the store
and the aisles
travel to check out using auditory cues
ask for assistance
gas station travel
towards the parallel street using touch and slide
use shoreline as well/touch and drag
recovering from shopping mall parking lots
ask for assistance
work towards nearest traffic
trail as closely to cars as possible
