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By Melvin Marx, COMS, Houston ISD, Houston, Texas

This article was originally published in the Summer of 2004 edition of See/Hear newsletter.

Abstract: This article provides a sampling of modifications in O&M techniques for use with deafblind students.

Key words: programming, orientation and mobility, O&M, deafblind, modifications, orientation and mobility techniques

Do you have indelible memories of your collegiate experience? As a graduate of Stephen F. Austin State University in the field of rehabilitation, majoring in orientation and mobility, I frequently think back on many positive memories. I fondly remember the orientation and mobility practicum lessons under blindfold in downtown Lufkin, the chaotic noise of twenty five Perkins Braillers hammering out inharmonious melodic lessons in the Braille 301 class, or waking up at 8:10 for Dr. Weber's 8:00 Rehab classes. Do these memories ring a bell? These may be a few of your favorites as well. For me, each memory holds a special place in the journey of what makes me who I am.

I believe that for all orientation and mobility professionals one memory that makes a lasting impression in the field of O&M is the study of the "Blue Book." The "Blue Book" is officially entitled Orientation and Mobility Techniques: A Guide for the Practitioner. Written by Purvis Ponder and the late Dr. Everett "Butch" Hill, the "Blue Book" is chock-full of precise technological application on every pre-cane and cane technique known to the O&M field. This book is a point of reference for every O&M who has reached out to teach and empower the life of a visually impaired or blind student. If the O&M profession had a bible, the "Blue Book" would be it.

Full of confidence and success in my "Blue Book" knowledge and teaching strategies, I continued along teaching fellow coworkers and students in the utilization of proper O&M techniques. I continued on my daily crusade of furthering my students' independence until one day when I received a phone call from my supervisor. She instructed me to go and evaluate a new student who was entering our program. This particular student was totally blind and profoundly deaf and yet cognitively on target with his age. As I began working with this student, I quickly came to a shocking reality. My method for teaching the "Blue Book" techniques to this student was functionally impossible.

Needless to say I did continue working with this student and eventually had many success stories in relation to developing his understanding of O&M concepts and the purpose for their use. I have also discovered that, as the years have gone by, I have evaluated and picked up more of these students for O&M service. Tragically, however, I have come to find out that this population of students is highly underserved. Probably the largest reason has to do with the lack of preparation and schooling in this specific population. When it comes to teaching students with dual sensory impairments of vision and hearing, we in the O&M field must be willing to step out of the box of standardized teaching. Modification of what we have learned from the "Blue Book" must become our mantra.

The information that follows is a sampling of a few modifications to the O&M "Blue Book" techniques. I hope you find this material helpful as you assist your deafblind students in achieving the highest level of independence that they deserve to reach.

  • In teaching sighted guide the traditional method can be taught having the student holding on to the guide's arm just above their elbow. For younger students the grip will have to be modified to holding the guide's index finger or wrist depending on height and strength needs.
  • For more receptive communication to assist the student's knowledge of what is coming up in his/her environment, move the student's sighted guide position to a hand under hand guidance. This method will allow the guide to wrap his/her thumb on top of the student's hand for more proprioceptive feedback. The examples listed below should be given to the student right before the requested movement takes place:
  • Left turns: hand movement goes twice towards the left.
  • Right turns: hand movement goes twice towards the right.
  • Ramps: Angle hand 45 degrees in a descending or ascending direction depending on how you are traveling on the ramp. Give an upward or downward hand motion, in the 45-degree position, twice to indicate the direction of the ramp.
  • Straight ahead: a forward surge of the hand given in intervals depending on the length of the straight travel.
  • Stop: hand moves from a 0 degree position to a 90 degree position. Pause in the stopped position to relate the requested action to the student.
  • Advanced directionality: This is for students who are emerging in their understanding of sign language. The directions left and right can be signed with an "L" or "R" in the student's hand to communicate which direction they are being requested to take.
  • Up: hand movement goes twice in an upward elevation.
  • Down: hand movement goes twice in a downward elevation.
  • If some students need more proprioceptive feedback to grasp the concepts of up and down, have the hand under hand guidance also establish contact at the guide's waist. This will give additional communication to the student to the length of the step up or drop off.
  • Touch cues have additional communication benefits for students who are utilizing adaptive mobility devices or for those who are engaged in trailing activities. These examples should be given to assist the student in understanding movement they are being requested to initiate.
  • Left turn: Using your index and middle fingers, make a sweeping motion down the student's left upper arm.
  • Right turn: Using your index and middle fingers, make a sweeping motion down the student's right upper arm.
  • Straight: While standing behind the student, make a sweeping motion across the student's shoulder with the side of your hand. Your pinky finger should be the only finger of contact on the student.
  • Stop: Place your hand firmly on the student's upper shoulder.
  • Squaring off: You will need to have good rapport with your student for this modification. The reason for this is because you will be physically maneuvering his/her body into a correct positioning initially. After using the stop touch cue, drag your index and middle fingers down the middle of the student's back to indicate squaring off. Position the student so that their shoulders and feet are touching the wall in the correct squaring off position. Then give the student a positive "good job" touch cue by patting them on the shoulder.

For all of these modifications the key is repetition. Remember, Rome was not built in a day. Your students will need these modifications routinely in order to gain understanding of their purpose and meaning. May these initial modifications assist you in teaching your children to develop to the fullness of their O&M potential.

Editor's Note: Melvin Marx graduated from SFASU in 1991. He has worked both in the rehabilitation and educational fields. He has received specialized training in the area of deaf-blindness from The Helen Keller National Center in Sandspoint, New York. For the past twelve years Melvin has been employed by Houston ISD. His specialty areas of training include the multiply impaired and deafblind populations. You may contact Melvin by email: 

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Last Revision: September 1, 2010