Does Mobility Performance of Visually Impaired Adults Improve Immediately After Orientation and Mobility Training?

Grace P. Soong et al. published a study in the September 2001 issue of Optometry and Vision Science entitled “Does Mobility Performance of Visually Impaired Adults Improve Immediately After Orientation and Mobility Training?”1 As an orientation and mobility instructor for nearly 30 years, I would like to draw attention to misconceptions about mobility instruction that are assumed in the methodology and implied in the outcome of this study. Individuals with severe visual impairment were scored on their ability to walk through an artificial environment indoors. Along this randomly winding artificial pathway, randomly sized obstacles were dangled and placed in random locations. Although hypothesizing increased speed and better obstacle avoidance in the study group after receiving instruction in orientation and mobility, the researchers found no difference in the performance of the control group and study group after instruction. In fact, the study claims that the control group did slightly better than the study group and attribute mental distraction from instruction as a probable cause. I would suggest that this outcome is instead due to the randomness of the task for both the control group and the study group despite instruction. In general, the intent of orientation and mobility instruction is to teach blind and legally blind people to navigate safely in their environments. The use of remaining vision, ambient sounds, and subtleties of hearing are emphasized, and often the use of a white cane is taught to help the blind person check for steps and other obstacles. The underlying assumption in the methodology of this study is that instruction prepares individuals for random encounters with randomly sized obstacles randomly placed in a random environment. However, what I really do as a mobility instructor is to teach people that familiarity with their environment is the primary safety factor—either knowing exactly where obstacles lie (which is why you can get to your bathroom in the middle of the night unscathed) or anticipating similarities in similar environments (which is why you can travel confidently down city streets in your car). The real environment is not random. You anticipate what you are likely to encounter, and mobility instruction aims to enhance that anticipation in blind individuals, not to prepare them for random events. What if you were driving around a corner and suddenly found a cement block dangling in front of you? Would your driver's education course have prepared you for that? Perhaps a study that has more accurately assessed the intent of instruction would produce more meaningful results. Christian J. Foy