Beyond Hand's Reach: Haptic Feedback Is Essential to Toddlers With Visual Impairments Achieving Independent Walking

Abstract

Introduction: A toddler's ability to stand alone in the middle of a room (static standing) is an essential skill for independent walking and is accomplished visually or through haptic feedback. Toddlers who are blind or mobility visually impaired (hereafter, “visually impaired”) use haptic feedback to attain static balance as evidenced by their continued use of cruising furniture and walking with assistance long after it is age-appropriate. Methods: This study analyzed demographic data, motor skills, learning ability, mobility tool usage, and the solitary play activities of 562 learners who were visually impaired and born between 2012 and 2021. Results: A cross-sectional analysis of learners aged 8- to 180-months, found motor skill delays began at 12 months. The most frequent walking method reported was “walks with assistance” (n = 274). The most frequent mobility tool provided was a gait trainer (n = 131). A major reason for obtaining the pediatric belt cane was the child “does not use other tools correctly” (n = 112). Discussion: The children received handheld mobility tools (e.g., long canes, gait trainers, push toys, and adaptive mobility devices) at 13 months of age. Adults were seeking belt canes for children aged 8 to 180 months because they did not benefit from handheld mobility tools. Physical therapists provided gait trainers to the children with visual impairments who had no motor impairments. PTs use gait trainers to provide the user with static and dynamic balance. Implications for Practitioners: Children who are born with visual impairments, as defined by the current study, acquire independent walking delays. These delays may be a function of how they learned to achieve static balance as toddlers, walking with assistance. Current instructional strategies and tools do not prevent these delays. The field of visual impairment must continue to search for new mobility tools and more effective strategies because the delayed achievement of independent walking appears to have long-lasting negative effects on development.