Orientation and Mobility Skills: Audio Interview

Interviewer: Welcome to this Project Aspiro audio feature. Today we’ll be talking about Orientation Mobility with Mark Rankin, and Orientation and Mobility Specialist with the CNIB. So Mark, what does an Orientation and Mobility Specialist do?

Mark: Okay so, what we do is we teach blind or partially sighted individuals how to travel safely and independently. So as my title suggests, there’s really two components to this; the orientation component being figuring out where you are and where you need to get to and what the steps are in between to do that. And it’s a big component for people who have little or no sight. And the other is the mobility which is the sort of techniques most people are familiar with seeing somebody who uses a white cane. And that’s sort of, how to get those, complete that route by avoiding obstacles or obstructions or changes in elevation. Things that usually aren’t a problem for people who can anticipate these visually, but if you don’t have that sort of visual input are a lot more tricky. 

Interviewer: I see, so kind of the where you are part of it and the where you’re going part of it?

Mark: Yeah and then how I could be safe on that route once I figure that out. So it’s a lot of mental mapping, converting, maybe auditory input into sort of a picture in your mind that may not be the same one that a person with regular sight would have, but that allows you to sort of move through that space with almost the same level of efficiency

Interviewer: And what are the different ways that people with vision loss travel independently?

Mark: They’re usually using a combination of different things, we’ve talked a little bit about establishing landmarks and doing a mental map, using the vision they have left. If there is a bit of vision left, you’re always using that. But there’s also basic techniques, so sighted guide is one that a lot of people are familiar with, which is just using a sighted person to help you through a certain environment.

So what a sighted person would do is you just take their elbow and then as they’re walking, you sort of control how fast or slow you’re walking by sort of pressure on their arm to give that indication. You’d be able to tell whether someone is confident with you guiding them or not. But they help you to avoid obstacles and if it’s a place that you’re not going to going on a repeated basis, there’s a limit to how many groups and environments you can learn and go once someplace every six months or it’s a one off, it’s probably easier just to get someone to guide you than to figure it out on your own or to try to learn it ahead of time or that sort of thing.

So I know people that will even, even myself, someone who might be a really good traveller, but they’re learning their route for the first time. Well it might be easier to walk through that while I’m guiding them and then that way they don’t have to worry about every step or getting lost or anything like that, or bumping into things. What they’re doing is getting a sense of how long it’s going to take them to complete that route, they can listen to what sort of things they’re going to hear on the way, if they have some vision they can figure out what they’re going to be able to see on the way. And that way they get a sense of what it’s going to be like to travel the route eventually.

So they get a good overall, sort of, impression of what that’s going to be like, and then we start to go back to build on the individual skills and the skills they may end up working on might be using a cane, and a cane can be used kind of as a probe to feel around for different things, but also just to find obstacles or changes in elevation that your eyes would be able to alert you of otherwise. Some people after a period of training with an orientation and mobility specialist find that they’re quite independent, quite capable; they might want to get a dog.

The advantage of a dog, being that a dog is really good for avoiding obstacles because it can avoid them without actually contacting them, whereas the cane you have to soft of bump into something with the cane before you know it’s there often can get around it. So complex environments with a slough of obstacles, where there’s not a clear route through it, a dog can sort of get you through it in a less manner.

And then that’s how a process of applying to a school that’s and independent school that does the training and you go and usually it’s a residential program and you’re there and you get paired up with a dog and you get trained and then you get some follow up after, and you probably still continue to work with an orientation mobility specialist back in your community.

Sometimes even relearning groups, because they’re going to feel different now with the dog than they would with a cane. And the people will also sometimes, it’s a minority, but sometimes people will use electronic travel aids. There are some that give you indications of obstacles in advance. More likely, they’d use one that’s more like an orientation aid like a GPS or a talking GPS, as well a …………….. lately because they’re getting information about the environment that it would be difficult to obtain that otherwise. But, yeah, those are the main ones

Interviewer: And how does the talking GPS work, exactly?

Mark: Just like any GPS, only it, depends on the system right? So, you can use it in different ways, so some you can set so that it will, sort of, read out words. Some have a “Where am I?” function, so you can hit it…………… an indication of where you are. Others you have to actually travel a route. What it works really well for people with little or partial sight, you can look for landmarks or points of interest on your route, so you can customize a route that’s fast for you.

So maybe book marking Starbucks is fine and that’s what most regular GPS’s do, but maybe the route there you need to know four or five things on the way. Maybe there’s a tree branch that whacks you in the head every time you go down there because somebody doesn’t trim. So you can mark that so get an advance warning. “Approach tree branch” and you duck and wow, that’s like magic.

That’s something you were never able to do before, but I mean, for way finding. So you can put points in there that will help you to locate yourself on the route, so you know on the halfway because I’ve just hit that, whatever that is, right. I’ve hit that overhang with the awning that comes out of the building. I’m pretty sure that’s the one but just to be sure I’ve booked marked it now, it’s now so that it is that awning it’s not something else that I’m hearing so I know, I’m reassured that I’m on the right track and I’m half way there. 

Interviewer: And how do you decide what skills to teach someone who is blind or partially sighted in that area of orientation and mobility?

Mark: So it always starts with an assessment with the individual. Usually we sit down and we’re very goal based so we talk about, you know, what are the things you really can’t do that maybe you could do formally if you had sight? And then they sort of, they’ll go through a process of this is what I miss most, or this is what I need to do, most of all, and then you kind of build on that. So it can be simple so it might be a senior who’s maybe had macular degeneration, was able to do most little trips by herself, maybe a big thing for her is just to get across to the corner store, and she can’t cross because she can’t see the lights anymore.

She’s safe on the route otherwise and pretty much has it memorized because she’s been living there forever, but just needs a little bit of help there, so we’ll go and work on identifying the traffic flows and figuring out how she can cross the street safely. It’s pretty cut and dry. If you’ve got someone whose maybe had total vision loss, they can literally be lost in their own home, you know, getting from the bathroom back to bed. And I’m sure you’ve had this experience, you know, you get up in the middle of the night and its pitch black and you turn the wrong way going to the washroom, though you know quite well where it is.

So you work a lot more on sort of foundational skills, working on training hearing, anything you can do to compensate for that visual input that they lack, and I help put that picture together. You also have to, there’s always a few things that you would suggest anyway, right, based on safety assessments, so they’ve just moved into a new place, you want to make sure that they learn the emergency exits no matter what because that’s an essential. So that’s goals that we would ………… say well you know what? It would be one thing you’ve got to figure out how to do is this. And then you’ve also got to look at levels of independence, so crossing the street is one that you have to get right.

There might be other ones that they want to try and they’re not 100% sure. Maybe they’ve never travelled on the subway but they want to try it. So there’s a process of assessment, whether or not that goals going to be achievable, whether it’s what they really want. And they change as you’re going along. Sometimes people’s worlds start to open up a little bit, and they thing, “Well, you know what, maybe the corner stores not the level I may be at, can do more………. So you have to be open all the way through the process, it’s not like you decide on the first visit and then that’s that, it continues. And that’s part of the relationship, it evolves as people get a little bit more of a taste of what happens and what might be possible.

Interviewer: So it’s definitely more of an ongoing process and a kind of assessing things as you go process.

Mark: Yeah, definitely, and very different too, I mean if you’re working say, with a child, then it’s a totally different process, of they’re not going to have goals, but their parents may have some goals of what they want but, with a child with very little or no sight, then you’re going be working on sort of, developmental goals, which is, well you know that kids typically will want to end up doing this, and you want to keep them as close to normal development as possible, but for them conceptually, they don’t get the same input as their sighted peers so they develop concepts a lot slower.

So you want to work on environmental concepts, they might have an understanding of a door just based on the fact that someone every day opens a door and pushing them through, well they don’t really have a full understanding that their concepts tend to be very limited, so putting together a full picture based on the partial hands-on experience that they have or the partial auditory experience they have. So, in that sense it’s a lot of making sure that they develop as close to the way that their sighted peers do, as possible.

Directional concepts, so not just forward, backward, up, down, and cardinal directions. So many of things are spacial concepts when you don’t continually see things being placed in relation to each other then it’s a lot harder to get concepts of below, under, in front of, and relate your body to those things. So those things are really important too so with kids it’s a lot of directed playing, letting them get these experiences that maybe their sighted peers would because a bird flies by, they automatically track it.

They’re getting all these concepts they’re developing movement just naturally. With kids with very little or no vision then you’re going to have to sort of give them opportunities to try the same things, and their different motivations. So we’re working on a lot of, sort of, doing all these things to get them to get these experiences that are necessary to develop these concepts. And also to develop the actual physical ability to move through space, in a purposeful way.

Interviewer: did you say the term “auditory training” or hearing training”? Did you use that earlier?

Mark: Yeah, for sure, that’s a big component, especially if there’s very little or no vision. Mostly the way you orient to the world is by using sounds. You know, you take direction from sounds and the environment, so a good example is crossing streets. So you use the surge of traffic. When the traffic surges across the street, you know that that light has changed. You also use the sound of traffic to get a sense of how straight you’re walking, so you try to estimate that. But there’s a lot of work that goes on beforehand.

So you develop a sensitivity. Some sounds, some places just have sort of some ambient sounds. You walk in and you can, I know people who are totally blind who can walk into a room and snap their fingers and get a pretty good sense of how big it is and what the dimensions are like which seems like magic to us. But it’s the result of a lot of experiences, a lot of trial and error for them that allows them to put this together. So there’s been a lot of training and a lot of guided experience going on to get them to that point. 

Interviewer: Well that’s interesting. And so, I’m …………travel skills, is that a component of what you’re talking about now, or is that something different?

Mark: It’s all, I guess that’s the goal, is independent travel. What that looks like can be different for different people but you know, if you still have some functional vision then your independent travel might be finding visual landmarks that are going to help you. So you may be walking down the sidewalk, maybe your issue is finding a particular address. You’re not able to read the address numbers, or whatever, so you’re using landmarks on the street.

Maybe you’re using the fire hydrant, or maybe you’re using the shrubs and you can see those, or you can find them with the cane or something. So it’s different, but generally the less vision you have, the more you’re relying on something auditory, or something tactual, if you’re actually ……………… cane, or it could be, it’s actually several things usually at once; which one’s working better, so maybe here you’re going to be relying on hearing because you're walking by a bus shelter and there’s a bit of an echo and you know you’ve passed, and there’s another spot that might be where you know there’s a certain slope expecting street corners. Some people do it because there’s a slope; some people do it because they hear traffic.

What they do depends on preference, it depends on what works best in a different environment, it’s a whole mixture of things but that’s what in the end gives you an independent traveller and gives you the skills necessary for independent travel.

Interviewer: I see, and so given Project Aspiro is a career planning and employment website, what would you say are some, and obviously these kind of things you’re talking about are kind of building the foundation people need through life, and then in particular, then later in life when they’re doing whatever, as it might apply to a career, what are some of the more common orientation mobility skills that people might require for a workplace setting?

Mark: As you mentioned, there’s been a lot of foundation of the whole experiences and a lot of work so that the things that we’re talking about, in terms of let’s say someone who’s congenially blind or vision impaired that grows up without vision, hopefully we’ve gone through all these things where they can localize sound and they’re able to look at you when you’re talking, so there’s all those little components sort of are important for socialization have been put in place because there’s been a lot of opportunity for them to experience those.

And then for the actual terms of the workplace, it’s really important to be able to have really good orientation skills, so to be able to put together a mental map of your surroundings. And that’s mostly by a variety of experiences. So to be widely travelled helps you to quickly do that in a new environment.

Especially if you’re starting, or ready for a career, you don’t want to be highly dependent on others around the office, you want to kind of get up to speed as quickly as possible. So in terms of learning the routes and layouts in your own environment, that’s really the key thing. You want to get your orientation down so you’re not asking for directions. You’re not getting confused and you’re able to problem-solve your way out of it. And there’s a lot of specific things.

You want to be able to , inside the workplace, for instance, you eventually want to be able to organize your own workspace so that it’s not cluttered and you can move back and forth freely and not have to grab your cane and trail the wall and that sort of thing. But all the other things you can probably learn fairly quickly, and that depends on how accessible the building is too, but there’s always work to be done but hopefully the layout is conducive to you learning it quickly. It depends on how much you have to travel too. Some people have to travel for work and that’s a whole other thing, so you’re learning multiple routes to all the locations. It can be, vary, for………….. how much of them you use, right.

Interviewer: So let’s say someone who’s in a process of career planning, whether they’re starting to interview for a job, or that she starting in a new job, is there anything that you would recommend in getting ahead of time, in terms of, for these activities?

Mark: That I see, again, as much as possible, the orientation is going to be key. At this point, most of the skills that you’ve learned are going to be transferable, in terms of your basic mobility, so your travel skills. But what you want to do is get specifically prepared for where you’re going to be working or where you think you’ll be working. And that’s just kind of like preparing for any job, right? You want to learn as much about any place you’re going to be working as you can.

The added provision that if you have a visual disability is that you’re going to have to also do work about learning the actual environment that most people would be able to walk in the foyer, take a quick scan and figure out where things are. But again, you want to ideally present yourself as somebody that comes in with a lot of independence and who’s also done the work to learn as much as they can about the place they’re going to be working, so if you can get there ahead of time and it’s a public building and you can walk through and figure out things like how the elevator panel will work, where are the meeting rooms? Where are the washrooms? What’s the office space? And then establish landmarks for yourself so that, you know, if you do end up working there and you’re going to meet somebody somewhere you’re able to get exactly where it is.

Like right now if I want directions I’m more likely to call a blind person than I am a sighted person, because their directions will be extremely precise. They’ll say “Well if you want to be close to the elevators and Yonge, you know what, get at the front of that Bloor train, and actually if you’re at the middle door of that second train, you can come out there’ll be a phone booth, and then there’ll be this…” they’ll give me very precise directions because they orient themselves very precisely in space. In a job site you want to be able to do that too. So if I’m saying let’s go meet by the front, it’s not great for me, it’s great for a sighted person, but if I’m visually impaired I going to want to say to you, you know, let’s meet by the fountain at the north corner of the building.

I’d get you there so that learning those little bits so that you can get precise information or convey precise information to people you’re working with it’s going to save you a lot of problems-solving if you get very inefficient information you’ll find that people come, visually impaired people, as I said are really good at giving directions, so you’ll find people coming to you and saying “How can I explain to someone that’s coming to the building how to get to my office?” and they’ll be able to tell you lefts and rights and norths and souths and landmarks and those sorts of things. And then the other thing is if there’s a lot of common rooms or meeting rooms or multipurpose rooms and it’s good to go in and get a really good sense of the layout of those ahead of time so that you’re not going in and your chair is facing opposite of where the projector is going to be.

You know, you may not be able to see the projector; you don’t want to have your chair facing the other direction because socially you stand out. You want to fit in. So figuring out where you’re likely to be oriented in a room, figuring out if certain things work better for you, so maybe you want to have your back to the window, or you want to make sure ahead of time that the shades are closed if you have a sensitivity to glare.

A lot of little things in terms of what’s going to make things better for you. So there’s the meeting room that’s used frequently you might want to try and get there early or let it be known that you have a spot that’s best for you. Maybe a spot that’s close to the door so you’re not coming in and trailing around trying to find an open seat. You want to get in and be discreet, just like everyone else, and because of your vision, just fit in like everyone else. 

Interviewer: Sounds like preparation and practice are two big themes?

Mark: Yeah, the skills that we teach as orientation mobility specialists are not that difficult and not that complex but it’s putting the amount of practice so the whole process of becoming an independent traveller is a process of trial and error and building up problem-solving skills. So you’ve got this sort of bag full of techniques that work but they don’t work all the time and in every possible situation right out of the bag, you’ve got to adapt.

So our role is providing experiences that let you adapt those in a successful way so that your confidence increases and your ability to tackle different situations increase so eventually you’re probably not going to need that much help, you’re going to be able to figure out most things on your own because you’ve sort of had this gradual sense of independence and trying things in different circumstances and different challenges and certain……………… and succeeding ………

Interviewer: Well that’s great! Thanks so much, Mark, for coming in and talking to us about orientation/mobility!

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