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ACKNOWLEDGEMENTS

Text and Materials Development
Sandra Rosen

Project Leaders
Terrie (Mary T.) Terlau
Rosanne Hoffmann

Graphics and Photography
Sandra Rosen
Terri Gilmore
Bisig Impact Group

Production Team
Lila Adkins
Cary Crumpton
Darlene Donhoff
Anna Fox
Frank Hayden
David Hines
Karen Marshall
Lou Tingle
Phyllis Williams

Expert Reviewers
Nora Griffin-Shirley
Julie Hapeman
Donna Brostek Lee
Richard Long
Grace Ambrose Zaken

INTRODUCTION



Human Guide is one of the three primary modes of travel mentioned in the introduction. When performing human guide techniques, one person takes the lead and guides another person through an area. The guide's role is to identify obstacles and hazards in the travel path and to guide the other person safely around them.

In times past, this set of techniques was often referred to as "sighted guide" techniques based on the assumption that the guide would always be "sighted." However, because people who have visual impairments often serve as guides for others who have visual impairments, the term "Human Guide" has now been adopted.

The human guide techniques are often among the first mobility techniques taught to new travelers. Due to their cooperative nature, these techniques enable the new traveler to be mobile, but do not require the traveler to take full responsibility for safe or efficient travel. They also lay a foundation upon which the instructor and the traveler can develop a positive rapport and a relationship built on trust (Jacobson, 1993). Having said this, however, it must be emphasized that it is absolutely not necessary to teach human guide techniques before teaching other techniques of independent travel such as use of the long cane. In fact, many professionals who teach mobility feel that human guide techniques should be taught toward the end of a traveler's instructional program. It is felt that, by sequencing instruction in this way, the immediate experience of free and independent travel reinforces new travelers' self-confidence in their ability to travel on their own.

Human guide techniques are also not limited to use between the instructor and the traveler. There are several additional aspects to effectively using these techniques. For example, the traveler must be able to travel with others in his or her life. It is important, therefore, to teach family members, teachers, and significant others in the traveler's life how to perform these techniques.

The human guide techniques are the primary means of travel for some people who are blind. This might be the case for some new travelers and/or for those who, due to reasons other than visual impairment, lack the ability to travel using other techniques. Yet, even the most capable of travelers use the human guide techniques from time to time. Travelers who are experienced and skilled in the use of a long cane and/or a dog guide, for example, will often use the human guide techniques in situations when it is perhaps just more convenient to do so such as when trying to carry on a conversation with a friend while walking together.

Rather than implying a dependent mode of travel for people who are blind, the human guide techniques can be considered in themselves an independent means of travel. When traveling using human guide techniques, the guide does not pull the traveler passively along; the traveler is instead an active partner in the travel. The traveler takes on equal responsibility for safe and efficient travel by doing such things as properly grasping the guide's arm and proper positioning of her body in response to the guide's movement through different environments. Without equal participation of both partners, travel using the human guide techniques is far less effective.

Because most travelers are unlikely to have the luxury of always walking with a skilled guide, the traveler should know how to perform the human guide techniques when walking with an inexperienced guide. She should even know how to teach human guide techniques, when necessary, to inexperienced guides such as friends, co-workers, or even the helpful person on the street. Doing so may call for teaching a wide range of techniques. For example, when dealing with the Good Samaritan, all that may be needed is to tell the Good Samaritan that the traveler can follow the person's movement by simply holding onto his elbow. When teaching human guide techniques to family members or close friends with whom the traveler walks frequently, she may choose to instruct these significant others how to perform many or all of the human guide techniques including those used to negotiate narrow spaces, stairways, and doorways.

When teaching human guide techniques, there are a few principles that all instructors should keep in mind. While these are not necessarily given in any specific order, they are some of the most common teaching tips and suggestions that have been handed down from generation to generation of O&M specialists.

  1. Simple courtesies extended to the traveler should never be overlooked. For example, before touching a person who is blind to initiate physical contact for the BASIC HUMAN GUIDE technique, it is considered polite to ask the traveler if she would like to take your arm or to walk together using this technique. While this verbal introduction is sometimes omitted in familiar situations when the traveler expects contact to be made, it is always polite to ask when such an expectation may not exist.
  2. When entering a room or area in which there is a person who is blind, it is polite to speak to the person to identify yourself and to let her know that you are there. Some people may feel that their privacy has been invaded when they later find that someone was present in the area unbeknownst to them (LaGrow & Weessies, 1994). Similarly, if you or any guide need to leave a traveler alone momentarily, it is only considerate to tell the traveler when you are leaving and to leave the traveler standing next to a wall or similar physical object in the environment rather than in open space. Leaving the traveler in contact with an object can provide her with a point of reference for establishing her own orientation to the environment and will also avoid imposing upon her the uncomfortable feeling of standing alone in open space while waiting for someone's return.
  3. It goes without saying that consistency in performing Human Guide skills is essential in order to build the traveler's trust in the instructor. It won't take more than a few bumps into a door frame or missed curbs to instill doubt in a new traveler's mind about the safety of traveling with the guide or perhaps about the traveler's own potential for safe travel alone later on.
  4. In several of the human guide techniques, the guide gives verbal cues regarding relevant environmental features (e.g., telling the traveler on which side of her the door opens). This is almost always done in new teaching situations. As the traveler gains confidence and skill in responding to non-verbal signals and to the movement of the guide's body, these verbal cues are faded. Fading the verbal cues as soon as possible minimizes the traveler's dependency on verbal cues and shifts the focus to responding to non-verbal signals. The benefits of using non-verbal signals, whenever possible include
    • making it easier for the guide and traveler to carry on a conversation without interruption;
    • facilitating travel through areas where conversation might be disturbing to other people (e.g., when walking through a theater or through any area where it is important to minimize unnecessary noise);
    • facilitating the traveler's skill at interpreting the movements of an unfamiliar or inexperienced guide.
  5. The traveler should also know how to guide another visually impaired person. This is a very useful skill, and one that can also be used to facilitate the traveler's understanding of the guide's role. One effective way of teaching a traveler how to instruct others is using role play. Assuming the role of a naive guide, the O&M specialist provides opportunities for the traveler to receive guided practice in this very important skill.

The following module contains 12 human guide techniques, designed to enable safe and efficient travel in almost any environment. The techniques are divided into two sections, those for use when the traveler is not carrying a cane, and those for use when she is. While separated into two sections for clarity of presentation, the reader will quickly notice that every technique in the first section has a counterpart in the second section.

WITHOUT A CANE

BASIC HUMAN GUIDE

PURPOSE

To travel safely and efficiently with a guide in varying environments; this technique forms the foundation upon which all of the skills in the HUMAN GUIDE module are based. It is one that family, friends and significant others should also learn.

PREREQUISITE TECHNIQUES

None

TEACHING ENVIRONMENTS

Begin in a quiet, open, familiar area that is free of obstacles and that does not require the traveler and guide to ascend or descend any steps. Initially presenting this technique in an area in which the ground is level and smooth will also minimize the impact of any balance difficulties on learning this technique.

Progress to quiet, controlled, unfamiliar indoor and outdoor areas that have obstacles to walk around (e.g., chairs, benches, drinking fountains, poles, and trash cans). Walking around obstacles gives the traveler practice following the guide's movement as he changes direction.

Progress to areas that have an uneven or irregular walking surface (e.g., rugs, carpet, ramp, curbs, grass). Lead up to areas that are more congested (e.g., busy hallways, cafeterias).

Practice this technique in a variety of environments (e.g., residential, small business, downtown) and situations (e.g., while the traveler and/or guide are carrying items such as a cafeteria tray, grocery bag, books).

SKILLS

Unlike most mobility techniques, the BASIC HUMAN GUIDE technique is generally not taught or performed as a series of sequential steps. Rather, it is generally taught as a grouping of components that are performed simultaneously.

Standard

The most efficient method of walking with a guide. This skill can be used in all environments and it forms the foundation for all other human guide skills.

Initiating Contact

Guide initiated contact.

This is the most commonly used method of initiating contact.

  1. The guide and traveler stand facing the same direction, with their arms hanging comfortably at their sides. The guide touches the back of his hand to the back of the traveler's hand or to her forearm.
    • This facilitates contact in a non-verbal manner and eliminates any need for the traveler to search for the guide's arm.
    • Contacting the traveler with the back of one's hand is less intrusive and personal than contacting the traveler with the open palm.

      Note: As a matter of courtesy, the guide verbally invites the traveler to take his arm by saying something such as "Would you like to take my arm?" or "Would you like to travel using the Human Guide technique?" prior to making physical contact.
  2. The traveler slides the back of her hand up the guide's arm to a point immediately above the guide's elbow and grasps his arm. Her grasp should be comfortably firm, yet secure enough so that a sudden movement of the guide's arm will not cause her to lose her grasp. Unless there is a significant difference in height between the guide and traveler, this will position the traveler's elbow at approximately a 90 degree bend (see Figure 1.01).
    • Holding the guide's arm in this way will enable her to interpret the guide's movements most reliably as they travel. (To help the traveler verify that she is holding the guide's arm just above the elbow, the guide can momentarily bend and straighten his elbow.)

      Figure 1.01
      The traveler holds the guide's arm just above his elbow with a comfortably firm grasp. Her elbow is bent to approximately 90 degrees.

    • The traveler's grasp above the guide's elbow should be comfortably firm, but not tight. It should be just secure enough to maintain consistent contact with the guide (so that a sudden movement by the guide will not cause the traveler to lose his grasp). Holding the guide's arm above the elbow allows the guide to have free movement of his lower arm and hand for doing such things as opening doors or carrying packages.
    • Unless there are extenuating circumstances (e.g., a physical disability), the traveler should be able to walk on either side of the guide. Deciding on which side of the guide a traveler will walk generally depends upon safety, comfort, and convenience for both the guide and the traveler.
      • Some guides may have a preferred side on which they wish the traveler to walk.
      • If the guide is carrying something with one arm, he may wish the traveler to grasp his other arm.
      • Environmental and cultural situations occasionally dictate on which side of the guide a traveler should walk. For example, in some cultures, men walk on the street side of the sidewalk.

Modifications.

Children, or others who are much shorter than the guide, may hold the guide's arm at a comfortable point somewhere between the guide's elbow and wrist (see Figure 1.02). Very small children may even hold the guide's fingers (see Figure 1.03). When they do so, however, the guide may need to minimize his arm swing because a pronounced arm swing can make it confusing or difficult for some small children to follow the guide's movements.

Travelers who are significantly taller than the guide may find it more comfortable to hold higher on the guide's arm or perhaps even to hold the guide's shoulder if the difference in height makes a higher grasp on the guide's arm uncomfortable. Similarly, in certain cultures, it is customary for a male traveler to hold the shoulder of a guide. This position, however, can limit the traveler's ability to interpret signals from the guide in certain environmental situations such as when negotiating narrow spaces.

Figure 1.02
Very small children may find it most comfortable to hold the guide's wrist.



Figure 1.03
Toddlers may find it most comfortable to hold the guide's fingers.

Traveler initiated contact.

This method is commonly used when the traveler either walks with an inexperienced guide or simply wishes to initiate contact with the guide.

  1. The traveler may verbally request to be allowed to take the guide's arm.
  2. Localizing the guide's voice, the traveler locates the guide's arm by either
    • reaching her straight arm out to the side until she contacts the guide's arm, or
    • bending her elbow nearest the guide to 90 degrees and slowly rotating her arm outward toward the guide until the back of her hand touches the guide's arm. Contacting another person with the back of one's hand is often seen as less intrusive than contacting him with one's palm.
      • If the traveler contacts the guide's trunk, she can lightly trail with the back of her hand to the guide's arm and then assume the proper grip above the guide's elbow.

      These are natural and discreet movements that avoid the appearance of groping and minimize the chance of contacting the guide in an inappropriate manner.
  3. The traveler then moves the back of her hand up the guide's arm to the proper position above the elbow.

Grasp

  1. Forming a "C" with her hand (as if holding a drinking glass), the traveler securely grasps the guide's arm, positioning her thumb on the outside of the guide's arm and her fingers on the inside of the guide's arm; the fingers and thumb point forward (see Figure 1.01).
    • Forming a "C" enables the traveler to feel the direction of the guide's movement most reliably. It also provides a brace for stops, making it difficult for the traveler to incorrectly continue forward when the guide stops walking.
    • The traveler's grasp should be secure enough to maintain contact, but not so tight as to cause discomfort for the guide. An excessively tight grasp may indicate that the traveler is tense. A secure, yet not tight, grasp will
      • be comfortable and will not tire either the traveler or the guide;
      • reduce the possibility that the traveler's grasp may slip or that she may lose contact with the guide.

Modifications.

If the traveler has difficulty maintaining the proper grasp, the guide can gently press his upper arm and elbow against his side to keep the traveler's fingers pressed lightly against his rib cage for increased control and security.

If the traveler cannot grasp the guide's arm (e.g., due to bulky or slippery clothing) she can maintain a slight forward pressure on the back of the guide's arm. Another alternative is to lightly grasp the guide's sleeve, although this is discouraged unless absolutely necessary because it can decrease the traveler's ability to reliably feel the guide's movement.

If the traveler requires physical support from the guide during travel, the guide can hold his arm with his elbow bent to 90 degrees and his forearm parallel to the ground. The traveler loops her hand over the guide's forearm (see Figure 1.04) and can even interlock her fingers with the guide's fingers if she needs additional support. This position brings the traveler alongside the guide rather than having her walk in the typical position of a half-step distance behind the guide (see "Walking" on the next page). Because the walking speed is typically slowed when using this modification, the traveler will still have sufficient reaction time to respond to signals from the guide (LaGrow & Blasch, 1992).

Figure 1.04
If the traveler requires physical support from the guide during travel, the guide can hold his forearm parallel to the ground. The traveler can then loop her arm over the guide's forearm for physical support as needed. If the traveler requires even more physical support from the guide during travel she can interlock her fingers with the guide's fingers.

Arm Position

  1. The guide's arm should be relaxed, hanging naturally to his side. When walking, the guide holds his guiding arm relatively steady with only a minimal arm swing except for intentional signaling.
    • Keeping his arm close to his side facilitates the guide's ability to keep the traveler aligned correctly behind him, maintaining the proper overall body width of the guide and traveler.
  2. The traveler keeps her elbow close to her side and her forearm directed forward as she holds the guide's arm. She aligns the shoulder of her grasp arm directly behind the shoulder of the guide's guiding arm (see Figure 1.05). This position decreases the combined body widths of the guide and traveler while not restricting the movement of the guide. Most importantly, it enables the traveler to most accurately interpret kinesthetic signals that tell her about the guide's movement in the environment.

    Figure 1.05
    The traveler aligns the shoulder of her grasp arm directly behind the shoulder of the guide's guiding arm.

    • By keeping her elbow close to her side, the traveler especially avoids swinging wide on turns or moving laterally beyond the protection or control of the guide, potentially contacting obstacles outside of the travel path.
    • This position also helps her to maintain a proper half-step following distance behind the guide which allows her time to react effectively to signals from the guide (see "Walking" below).

Walking

  1. The traveler walks a half-step distance behind the guide. This positions the traveler for maximum safety by allowing her greater reaction time when starting, stopping or turning. Following too closely can decrease her reaction time and pose a safety hazard in the case of a sudden stop.

    The guide walks at a normal pace (unless the traveler or guide has an impairment that limits the speed of walking). In this way, a slowed pace becomes a definite cue to indicate an upcoming environmental change such as a descending stairway and makes it generally easier for the traveler to interpret non-verbal signals from the guide. A normal pace is also generally more comfortable for travelers and guides (Jacobson, 1993).

    • If the traveler tends to lag behind the guide, this may be an indication of insecurity, fear, or difficulty with balance; on the other hand, it may simply mean that the guide is walking at a pace that is too fast for the traveler's physical ability.
    • In rare circumstances, it might be helpful to initially walk at a slower speed than normal for a new and fearful traveler, increasing to a normal speed as soon as possible. Walking at a slower than normal pace, however, tends to alter gait patterns and may lower a traveler's confidence in the ability of the guide; hence, it is not recommended unless absolutely necessary.
    • The traveler's free arm should be moving in a natural, relaxed manner. If the traveler holds it stiffly, it may be an indication of insecurity or fear. Some travelers who are congenitally blind, however, may typically not demonstrate a relaxed arm swing and naturally hold their arms down at their sides.

      Figure 1.06
      The guide can verify that the traveler is aligned correctly behind him by turning his head to glance back at her.

  2. It is the guide's responsibility to watch for, and to appropriately navigate around, objects and hazards both at foot level and at head height (e.g., low tree branches). In addition, he must continually be aware of the combined widths of the traveler and himself and make any necessary adjustments in his guiding to ensure safe passage for both of them through any environment. The guide should periodically verify that the traveler is aligned correctly behind him by turning his head (with minimal rotation of his trunk) to glance back at her (see Figure 1.06). In turn, the traveler can verify that she is aligned correctly behind the guide by using her free hand to feel the guide's shoulder and then to feel her own (see Figures 1.07a and 1.07b).

    Figure 1.07a and 1.07b
    The traveler can verify that she is aligned correctly behind the guide by feeling his shoulder and then her own shoulder.

Breaking Contact

  1. The guide rotates his arm along its axis, signaling the traveler to release her grasp. This provides a non-verbal, discrete manner of signaling the traveler to release her grasp. If desired, however, the guide also can give a verbal cue.
    • If the guide is going to leave the traveler alone, he should tell her that he is leaving and let her know when he returns. It is also a courtesy to let the traveler stand out of the flow of traffic and, if possible, to be in contact with an object (e.g., a wall or seat) in the environment. Doing so generally makes the traveler feel more comfortable and provides her with either physical support and/or a landmark for orientation purposes. Additionally, the traveler may look less conspicuous than if she stands alone in open space.
  2. Upon feeling the guide rotate his guiding arm or give a verbal cue, the traveler releases her grasp on the guide's arm.

GENERAL MODIFICATIONS

Negotiating Changes in Elevation Other Than Stairs or Curbs

The guide approaches the elevation change perpendicularly. This ensures that the traveler will arrive at the change in elevation a half-step distance behind him, allowing her sufficient time to react to the guide's signal indicating the elevation change.

Taking Buses or Subways With a Human Guide

With all similar forms of public transportation (bus, subway, trolley, streetcar), the guide leads when boarding, locating seats, and disembarking. The traveler may have to lower or raise her grasp on the guide's arm in order to maintain contact while negotiating steep ascending or descending steps on buses or trolleys.

The guide and traveler should each hold onto hand railings, poles, or car walls for support and balance while standing in a moving vehicle.

Walking With an Uninformed or Inexperienced Guide

If the traveler anticipates walking with the guide through unfamiliar or complicated environments, she may wish to suggest that he specifically give a verbal warning of steps, doors, narrow areas, congestion, or any other changes in the environment that may affect how the traveler and guide perform the BASIC HUMAN GUIDE technique.

If the traveler does not feel completely confident in the guide, she may

COMMON ERRORS AND CORRECTIONS

Error:
The traveler fails to keep her grasp arm shoulder aligned behind the guide's grasped arm shoulder.

Correction:
Keeping her grasp arm shoulder aligned behind the guide's grasped arm shoulder enables the traveler to follow the guide and to respond to changes in his movement most effectively. This position also prevents her from overstepping the guide's position when he stops.

Error:
The guide walks at an inconsistent pace.

Correction:
Walking at a natural, consistent pace makes it easier for the traveler to follow the guide's movement.

Error:
The traveler loosely wraps her entire hand around the guide's arm with her palm and fingers resting against the front of the guide's upper arm.

Correction:
Holding the back of the guide's arm with her thumb and fingers pointing forward in a "C" shaped grasp enables the traveler to perceive and follow the guide's movements most effectively.

Error:
The guide rotates his trunk when he glances back at the traveler.

Correction:
Keeping his trunk facing forward when he looks back at the traveler prevents the guide from inadvertently moving the traveler out of alignment.

Error:
The traveler reaches with her palm or with her fingers extended to contact the guide.

Correction:
Rotating her bent arm outward or reaching her straight arm out to the side in order to contact the guide with the back of her hand reduces the possibility that the traveler will poke the guide inappropriately. Contacting another person with the back of one's hand is often seen as less intrusive than contacting him with one's palm.

Error:
The traveler walks directly beside the guide.

Correction:
Walking a half-step behind the guide gives the traveler sufficient reaction time to respond to signals from the guide. This position also decreases the combined body widths of the guide and traveler while not restricting the movement of the guide.

Error:
Traveler grasps the guide's arm too tightly.

Correction:
Grasping the guide's arm firmly, but not too tightly, enables the traveler to follow the guide's movements easily without causing discomfort for the guide.

Error:
Traveler grasps the guide's arm too loosely.

Correction:
Grasping the guide's arm firmly, yet gently, will ensure that the traveler does not lose contact with the guide.

Error:
The traveler does not walk with her trunk facing directly forward.

Correction:
Walking with her trunk facing directly forward enables the traveler to most accurately interpret signals from the guide and sometimes improves balance.

Error:
The traveler grasps the guide's arm below the elbow.

Correction:
Unless she is unable to reach the guide's elbow, grasping his arm directly above the elbow assists the traveler to most reliably interpret the guide's movements. It also leaves the guide's lower arm and hand free to carry something, if necessary.

Error:
The traveler fails to keep her elbow at her side.

Correction:
Keeping her elbow at her side enables the traveler to most reliably interpret signals from the guide.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Accepting/Declining Assistance When Not Carrying a Cane
Carrying a Cane When Walking With a Guide
Doors with a Guide
Escalators With a Guide
Narrow Spaces With a Guide
Reversing Direction With a Guide
Seating*
Stairs with a Guide
Transferring Sides

* The BASIC HUMAN GUIDE technique is prerequisite to Auditorium Seating and Seating With a Guide.

NARROW SPACES WITH A GUIDE

PURPOSE

To travel through areas that are too narrow or congested for the guide and traveler to pass through easily or safely using the HUMAN GUIDE technique. Such areas might include bus aisles, store and theatre aisles, and restaurant aisles.

PREREQUISITE TECHNIQUES

Human Guide

TEACHING ENVIRONMENTS

Begin in a quiet, open space in which there is room to practice this technique without contacting any obstacles.

Progress to a quiet, familiar area that has narrow spaces (e.g., narrow hallways, open doorways) through which to pass. Choose an area in which the ground is level and smooth and does not require the traveler and guide to ascend or descend any steps or to negotiate closed doors.

Progress next to areas that have an uneven or irregular walking surface (e.g., rugs, carpet, ramp, curbs, grass). Lead up to areas that are more congested (e.g., busy hallways).

Practice this technique in a variety of environments (e.g., narrow aisles, cafeterias, congested hallways or sidewalks, stores, theaters, restaurants, narrow stairways—after the traveler has learned the STAIRS WITH A GUIDE technique).

SKILLS

Standard

The standard method of negotiating narrow spaces when using the HUMAN GUIDE technique

Figure 2.01
The guide reaches his guiding arm backward with his hand centered at midline to signal to the traveler that they are approaching a narrow space.

  1. The guide signals the traveler that they are approaching a narrow space by reaching his guiding arm behind him as far as possible with his elbow straight and his hand centered at his midline (see Figure 2.01).
    • When the traveler is first learning this technique, it may be helpful for the guide to give a verbal cue that they are approaching a narrow space. Gradually this verbal cue would be faded as the traveler learns to respond reliably to the guide's signal.

      Modification.

      If the guide has difficulty extending his arm fully behind him as described above, he can reach his arm backward, bending his elbow and resting his forearm in the small of his back (see Figure 2.02).
  2. The traveler moves directly behind the guide, reaching her grasp arm across her body (see Figure 2.01). This places her directly behind the guide and far enough back to avoid stepping on his heels.
    • Travelers who have short arms and/or a long step length, or who cannot straighten their arms fully to avoid stepping on the guide's heels can slide their grasp hand down to the guide's wrist in order to increase their distance behind the guide (see Figure 2.03).

      Figure 2.02
      If the guide has difficulty extending his arm fully behind him, he can bend his elbow and rest his forearm in the small of his back.


      Figure 2.03
      The traveler slides her grasp down to the guide's wrist.


      Figure 2.04
      The traveler grasps the guide's arm with the "same side" hand.

    • If the traveler is unable to bring her grasp arm fully across her body, she can change her grasp to hold the guide's arm with the "same side" hand (i.e., she holds the guide's right arm with her right hand or holds his left arm with her left hand), then straighten her arm fully (see Figure 2.04).

    The traveler can verify that she is directly behind the guide by using her free hand to feel the relative locations of her shoulder and the guide's shoulder (see Figure 2.05).
  3. As they pass through the narrow area, the guide should glance back at the traveler, as needed, to verify that she is positioned directly behind him and will pass through the area without bumping into objects or people. In order to avoid inadvertently moving the traveler out of position to pass through the narrow space safely, the guide must be careful to minimize any rotation of his trunk as he glances behind him (see Figure 2.06).
  4. The guide returns his arm to his side, signaling that they have passed through the narrow space. He and the traveler then resume the HUMAN GUIDE technique.
    • For travelers who have difficulty proprioceptively identifying that the guide has returned his arm to his side, the guide can either give a verbal cue or can gently press the fingers of the traveler's grasp hand momentarily against his side to provide an additional tactile cue.

      Figure 2.05
      The traveler verifies that she is directly behind the guide by using her free hand to feel the relative locations of her shoulder and the guide's shoulder.


      Figure 2.06
      As they pass through the narrow area, the guide glances back at the traveler to verify that she is positioned directly behind him and will pass through the area without bumping into objects or people.


GENERAL MODIFICATIONS

In extremely narrow or congested areas (e.g., between rows of seats in an auditorium or in cafeteria lines), the guide and traveler can side-step.

COMMON ERRORS AND CORRECTIONS

Error:
The guide fails to look back at the traveler as they pass through the narrow space.

Correction:
Looking back at the traveler as they pass through the narrow space enables him to verify that the traveler is positioned correctly and is passing through the space safely.

Error:
The traveler fails to straighten her grasp arm fully when walking directly behind the guide.

Correction:
Straightening her grasp arm fully positions her far enough behind the guide to avoid stepping on his heels.

Error:
When the guide brings his arm behind his back to signal a narrow space, he fails to place his hand in the midline of his body.

Correction:
Bringing his arm sufficiently behind his back to place his hand in midline brings the traveler directly behind him. If the guide is unable to reach his arm behind him far enough to bring his hand to midline, a modified technique can be used (e.g., the traveler can hold the guide's arm with her "same-side" hand, making it possible to assume a position directly behind the guide as they walk through the narrow space).

Error:
The traveler fails to reach her arm fully across her body when walking behind the guide.

Correction:
Reaching her arm fully across her body when walking behind the guide best positions the traveler to walk directly behind the guide.

Error:
The guide fails to maintain his trunk facing forward when he glances back at the traveler.

Correction:
Maintaining his trunk facing forward when he glances back at the traveler prevents the guide from inadvertently moving the traveler out of the proper position to pass through the narrow space safely.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Doors With a Guide
Escalators With a Guide*
Narrow Spaces With a Cane and Guide
Stairs With a Guide*

* Knowing the NARROW SPACES WITH A GUIDE technique will be helpful if it is ever necessary to negotiate stairs or escalators that are only wide enough for one person.

REVERSING DIRECTION WITH A GUIDE

PURPOSE

To reverse direction when walking with a guide. This technique encompasses several methods for reversing direction in a variety of areas, both large and small. Selected methods are most commonly used in elevators, theaters, narrow store or restaurant aisles, or any place where space to turn around is limited. This technique also forms the foundation for the technique, REVERSING DIRECTION WITH A CANE AND GUIDE.

PREREQUISITE TECHNIQUES

Human Guide
Trailing*

* Knowing the TRAILING technique may assist in learning how to locate the guide's other arm by trailing across his back when reversing direction using either the Hand-Over-Hand or Scoop methods.

TEACHING ENVIRONMENTS

Begin in a quiet, familiar area that has plenty of room in which to turn around.

Progress next to areas that have limited room in which to turn around (e.g., the end of a narrow hallway).

Practice this technique in a variety of environments that require the use of this skill (e.g., crowded rooms, cafeterias, restaurants, theaters, elevators, narrow hallways).

Note: Do not perform this technique on stairs because it can cause the guide or the traveler to lose balance.

SKILLS

Pivot

This skill is the easiest to perform, but it requires more room than do the other methods; it is therefore only used in relatively spacious areas.

  1. Either the guide or traveler indicates a need or desire to reverse direction.
  2. The guide and traveler come to a complete stop.
  3. Without breaking contact, the guide and traveler make a U-turn; either the guide or traveler can serve as the pivot point.
    • Some travelers prefer to serve as the pivot point as they find it disorienting to swing around the guide who is acting as the pivot point.

Breaking Contact

An easy method for reversing direction that looks very natural.

  1. Either the traveler or the guide indicates a need or desire to reverse direction.
  2. The guide and traveler come to a complete stop.
  3. The guide rotates his arm to break contact with the traveler, or the traveler can break contact with the guide.
  4. The traveler and guide turn 180 degrees, turning toward one another.
    • Turning toward each other looks more natural than turning away from one another.
  5. The guide reestablishes contact by touching the back of the traveler's hand or forearm with the back of his hand.
  6. The guide and traveler resume the HUMAN GUIDE position.

Maintaining Contact

This skill is useful for travelers who require physical support from the guide or who become fearful or disoriented when separated from the guide.

  1. Either the guide or the traveler indicates a need or desire to reverse direction.
  2. The guide and traveler come to a complete stop.
  3. The guide and traveler turn 90 degrees toward each other. As they do so, the traveler reaches her free arm out slightly wider than body width, then brings it in slowly to locate and grasp the guide's opposite arm.
    • The guide can also reach out with his free hand to touch the traveler's free hand. She then trails up his forearm to grasp above his elbow.
  4. The traveler releases her original grasp on the guide's arm.
  5. The guide and traveler turn another 90 degrees to complete the turn, then resume the HUMAN GUIDE position.

Hand-Over-Hand

This skill is useful for travelers who require physical support from the guide or who become fearful or disoriented when separated from the guide.

  1. Either the guide or traveler indicates a need or desire to reverse direction.
  2. The guide and traveler come to a complete stop.
  3. As they begin to make a 90-degree turn in the same direction, the traveler grasps the guide's guiding arm with her free hand, then releases her original grasp. As they continue to turn, the traveler reaches out slightly wider than body width with her free hand, and then brings her hand in to locate and grasp the guide's opposite arm; or if she prefers, she can trail the guide's back with her free hand to locate his other arm (see Figure 3.01).

    Figure 3.01
    As they turn, the traveler trails the guide's back with her free hand to locate his other arm.

    • If the guide extends his elbow backward slightly, it will make it easier for the traveler to locate it.
    • If the traveler trails the guide's back, she should cup her trailing hand slightly to avoid snagging the guide's clothing or hair.
  4. The traveler releases her grasp on the guide's original guiding arm and moves that hand to grasp his opposite arm above her other hand.
  5. The traveler releases her original grasp on that arm. She and the guide each turn another 90 degrees and resume HUMAN GUIDE position.

COMMON ERRORS AND CORRECTIONS

Error:
The traveler and guide perform this technique while on the staircase.

Correction:
Reversing direction on a staircase should not be attempted because it can cause the traveler and/or the guide to lose balance.

Error:
When performing the Breaking Contact method, the traveler contacts the guide with extended fingertips.

Correction:
Contacting the guide with the back of her hand prevents her from accidentally poking the guide.

Error:
When performing the Hand-Over-Hand method, the traveler fails to release her original grasp on the guide's arm and simply reaches for the guide's opposite arm with her free hand while turning.

Correction:
The traveler should first grasp the guide's arm with her other hand, then release her original grasp and trail the guide's back (or simply reach out for his arm) with her now free hand in order to avoid twisting her arms.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Doors With a Guide*
Reversing Direction With a Cane and Guide
Stairs With a Guide**
Seating***

* Knowing the REVERSING DIRECTION WITH A GUIDE technique makes it easier for the guide and traveler to turn around to practice negotiating a door, especially when space on either side of the door is limited.

** Knowing the REVERSING DIRECTION WITH A GUIDE technique makes it easier for the guide and traveler to turn around on a landing to practice walking up and down the same staircase, especially when space on the landing is limited.

*** Knowing REVERSING DIRECTION WITH A GUIDE technique can be helpful, especially in theater seating when the guide and traveler may need to turn around to return via the same aisle by which they approached their row of seats.

TRANSFERRING SIDES

PURPOSE

To reposition oneself to stand or walk on the other side of a guide. Common situations in which this technique is used include transferring to the guide's other side in order to reach the handrail on stairs and positioning oneself to follow the guide into a narrow row of seats in a theater or auditorium.

PREREQUISITE TECHNIQUES

Human Guide
Trailing*

* Knowing the TRAILING technique may assist in learning how to locate the guide's other arm by trailing across his back when transferring sides.

TEACHING ENVIRONMENTS

Begin in a quiet, familiar area that has plenty of room in which to practice transferring sides.

Practice this technique in a variety of environments that require the use of this skill (e.g., when the traveler needs to transfer sides for ease in negotiating a doorway or stairway).

SKILLS

Hand-Over-Hand

This skill is perhaps a bit more cumbersome than the Scoop skill (described next), however some travelers find it more secure because they always have a firm grasp on an arm of the guide. For this reason, elderly travelers, those who have physical disabilities, or those with balance problems, may prefer this skill because it affords the most stability.

  1. Either the guide or traveler indicates a need or desire to transfer sides.
  2. With her free hand, the traveler grasps the guide's guiding arm above her original grasp hand. She then releases her original grasp.
  3. Extending her new grasp arm fully, the traveler steps behind the guide.
    • Extending her arm fully ensures that she does not step on the guide's heels as she transfers sides.
    • For smoother movement while walking, the traveler can extend her grasp arm by simply slowing her pace momentarily.
  4. As the traveler transfers sides, she reaches out with her free hand slightly wider than body width and then brings her arm in to locate and grasp the guide's opposite arm; or if she prefers, she may trail the guide's back with her free hand to locate his other arm (see Figure 4.01).

    Figure 4.01
    The traveler trails the guide's back with her free hand to locate his other arm.


    • Trailing gives more stability and security for travelers who are insecure and those who have balance or other difficulties.
    • The traveler's trailing hand should be cupped slightly to avoid snagging the guide's clothing or hair.
    • The guide may extend his elbow backward to make it easier for the traveler to locate his free arm.
  5. The traveler then releases her grasp on the guide's original guiding arm.
  6. Grasping his opposite arm with her now free hand, she releases her original grasp on that arm and resumes the HUMAN GUIDE position.

Scoop

This skill is easier to perform than the Hand-Over-Hand skill. Some travelers, however, find it difficult to maintain contact with the guide when performing this skill while walking.

  1. Either the guide or traveler indicates a need or desire to transfer sides.
  2. The traveler places the back of her free hand on the back of the guide's guiding arm, above her grasp hand; her fingers are pointed toward the guide's opposite arm, held together and slightly curled (see Figure 4.02).

    Figure 4.02
    The traveler places the back of her free hand on the back of the guide's guiding arm, above her grasp hand; her fingers are pointed toward the guide's opposite arm, held together and slightly curled.

    • This position of the fingers facilitates trailing across the guide's back and positions the traveler's hand to grasp the guide's opposite arm. Curling the fingers slightly ensures that the traveler's hand will not accidentally pull the guide's hair or clothing.
  3. The traveler releases her grasp on the guide's arm. Turning 90 degrees or extending her arm fully (to avoid stepping on the guide's heels), she then trails the guide's back with the back of her other hand to locate the guide's opposite arm (see Figure 4.03).

    Figure 4.03
    The traveler trails the guide's back to locate his opposite arm.

    • The guide may extend his elbow backward to make it easier for the traveler to locate his other arm.
    • In order to maintain contact with the guide, the traveler must be certain not to release her grasp on the guide's arm before she has her other hand positioned to trail. Travelers with good kinesthetic awareness, however, may omit trailing.
    • This skill is more difficult to do when walking than when standing still. If done while walking, it may help the traveler avoid losing contact with the guide if she moves quickly and even applies slight pressure against the guide's back as she trails. It may also help the traveler to perform the transfer more smoothly if the guide slows his pace slightly.
  4. The traveler grasps the guide's opposite arm just above the elbow.
  5. The traveler and guide resume the HUMAN GUIDE position.

GENERAL MODIFICATIONS

If there is insufficient room for the traveler to transfer sides, the guide can simultaneously side-step slightly in the direction opposite to the traveler's movement. The combined body width needed to perform this skill is then only two body widths instead of three body widths.

COMMON ERRORS AND CORRECTIONS

Error:
The traveler fails to extend her trailing arm fully before trailing the guide's back.

Correction:
Extending her trailing arm fully before trailing the guide's back positions her far enough behind the guide to prevent stepping on his heels.

Error:
When performing the Scoop method, the traveler fails to release her grasp on the guide's arm when starting to trail his back.

Correction:
Releasing her original grasp on the guide's arm when starting to trail his back prevents the traveler from crossing her arms uncomfortably and enables her to maintain a sufficient distance behind the guide to avoid stepping on his heels.

Error:
The guide and traveler perform this technique on stairs.

Correction:
This technique should be done only on level ground to avoid accidental loss of balance.

Error:
Guide fails to extend the elbow of his non-grasped arm backward.

Correction:
While not a serious error, the guide should, if possible, extend his elbow backward to make it easier for the traveler to find it as she transfers sides.

Error:
When performing the Hand-Over-Hand method, the traveler releases her original grasp on the guide's arm before she has grasped his other arm.

Correction:
Maintaining her original grasp on the guide's arm until she is able to grasp the guide's other arm prevents the traveler from losing contact with the guide.

Error:
The traveler fails to cup her trailing hand slightly while she trails the guide's back.

Correction:
Cupping her trailing hand slightly helps the traveler avoid snagging the guide's hair or clothing or poking him in an uncomfortable manner.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Doors With a Guide*
Escalators With a Guide**
Seating***
Stairs With a Guide**
Transferring Sides When Carrying a Cane

* Knowing the TRANSFERRING SIDES technique makes it easier for the traveler to learn how to position herself behind the guide in order to negotiate a door when she is on the latch side of the door.

** The traveler can use the TRANSFERRING SIDES technique to move to the other side of the guide in order to be next to the handrail of the stairway or escalator.

*** The traveler can use the TRANSFERRING SIDES technique to move to the proper side of the guide in order to enter a row of theater seats.

DOORS WITH A GUIDE

PURPOSE

To negotiate closed doors when traveling with a guide. This technique provides an efficient means of handling a variety of doors: self-closing and manual-closing, doors that open in or out, and doors that open to the left or to the right. This technique also forms the foundation for the technique, DOORS WITH A CANE AND GUIDE.

PREREQUISITE TECHNIQUES

Reversing Direction With a Guide**
Narrow Spaces With a Guide
Transferring Sides*
Upper Hand & Forearm

* Knowing the TRANSFERRING SIDES technique makes it easier for the traveler to learn how to position herself behind the guide in order to negotiate a door when she is on the latch side of the door.

**Knowing the REVERSING DIRECTION WITH A GUIDE technique makes it easier for the guide and traveler to turn around to practice negotiating a door, especially when space on either side of the door is limited.

TEACHING ENVIRONMENTS

Begin in a familiar area that is quiet and free from a lot of pedestrian traffic. For initial instruction, use indoor, lightweight, self-closing doors where wind and other weather factors will not interfere with teaching, and where there are no steps to walk up or down immediately before or after going through the doorway.

Gradually progress to areas that have heavier, self-closing doors, including those that lead to the outside. Give the traveler experience with doors of many different sizes and shapes. Introduce her to manual-closing doors as well as self-closing doors, to doors that open to the right and those that open to the left, to doors that present a variety of doorknobs and handles, and to doors that are placed closely in sequence (e.g., at entrances to some stores or hotels, especially in colder climates). Also introduce the traveler to doorways that have a step going either up or down immediately before or after the doorway.

Lastly, practice the technique in areas where there is heavier pedestrian traffic.

The following are some tips for making the initial teaching process easier:

SKILLS

Self-Closing Doors

To negotiate a self-closing door when walking with a guide

  1. The guide and traveler approach the door perpendicularly.
    • The guide may verbally indicate the direction in which the door opens (i.e., to the left or right).
  2. The guide places the traveler in the NARROW SPACES WITH A GUIDE position, if necessary, and opens the door.
    • If the traveler is on the hinge side, she straightens her grasp arm fully and places her free arm in the UPPER HAND & FOREARM position, ready to assume the weight of the door when the guide passes it to her (see Figure 5.01).

      Figure 5.01
      The traveler places her free arm in the UPPER HAND & FOREARM position, ready to assume the weight of the door when the guide passes it to her.

    • If the traveler is on the latch side, she assumes a partial-transfer position behind the guide.
      • The traveler grasps the guide's guiding arm with her free hand, then releases her original grasp.
      • The traveler straightens her new grasp arm fully, steps behind the guide, and places her free arm in the UPPER HAND & FOREARM position, ready to assume the weight of the door when the guide passes it to her (see Figure 5.02).

        Figure 5.02
        The traveler assumes a partial-transfer position behind the guide and places her free arm in the UPPER HAND & FOREARM position, ready to assume the weight of the door when the guide passes it to her.

    • Regardless of the side on which the traveler is walking (hinge vs. latch), note the following observations:
      • By straightening her grasp arm fully, the traveler can walk far enough behind the guide to avoid stepping on his heels as they go through the doorway. It also places her in the proper position to catch the door.
      • Placing her free arm in the UPPER HAND & FOREARM position enables the traveler to contact the door with her palm rather than with the sensitive bones on the back of her hand.
      • If the traveler mistakenly identifies her position as being on the latch side instead of the hinge side (or vice versa), she will identify the error when she does not contact the door in approximately one step for a "pull" door and one or two steps for a "push" door.

      If the traveler wishes to verify that her arm is in the proper UPPER HAND & FOREARM position, she can touch the guide's shoulder lightly with her free hand and then straighten her elbow to place her hand a few inches outside of the guide's body width. This helps to ensure that her hand is in the proper position to contact the door.

      Modification.

      Some travelers will prefer to use a modified UPPER HAND & FOREARM position in which the hand is held just above waist level. Other travelers will want to hold their hand at, or slightly higher than, shoulder height in order to have better leverage when they take the weight of the door from the guide (see step 4).
  3. The guide moves forward until the traveler's hand is positioned near the edge of the door and then pauses. The guide may need to either allow the door to close slightly, or open it slightly wider, in order to place the "stile" (the vertical border on the face of a door) into the palm of the traveler's free hand (see Figure 5.03). For optimum leverage (and to ensure that her hand is not near the hinge where it can be injured), the traveler should contact the face of the door on the latch-side stile.

    Figure 5.03
    The guide pauses and places the door "stile" into the traveler's palm.


    • As the guide moves forward, he looks over his shoulder (minimizing any rotation of his trunk) to verify that the traveler has her arm positioned correctly to assume the weight of the door, and that she is positioned to pass through the doorway without contacting the door jamb.
    • If negotiating a "push" door (one that opens away from the guide and traveler), the traveler may straighten her arm to reach out and contact the door. It is important that the traveler not reach for the door until the guide has moved forward and pauses.
      • The traveler generally takes one or two steps after sensing the opening of the door, or she can use the door threshold as a marker to indicate her position relative to the opened door. If she reaches too soon, she may catch her fingers in the hinge.
      • As a note, the traveler may also need to take an additional step or two before contacting the door when she and the guide are using the NARROW SPACES WITH A GUIDE technique.
    • If negotiating a "pull" door (one that opens toward the guide and traveler), it is important that the traveler keep her hand and forearm still and never reach out to contact the door. Reaching out would leave her trunk and face unprotected against accidental contact with the door edge. Doing so would also make it more difficult for the guide to position the door stile near the traveler's hand.
  4. The guide passes the weight of the door to the traveler. If the guide has had to close the door slightly in order to place the outside stile of the door where the traveler's hand would contact it, the traveler may now need to open the door slightly wider in order to pass through the doorway. The traveler should keep her thumb and fingers flat on the face of the door and not wrap her hand around the door edge. This minimizes the possibility of injury to her hand from any rough door edges.
  5. Once the traveler has assumed the weight of the door, the guide continues through the doorway. After passing through the doorway, the traveler releases the door, allowing it to close behind her.
  6. The guide and traveler resume the HUMAN GUIDE position.

Manual-Closing Doors

The procedure for negotiating manual-closing doors varies only slightly from that used to negotiate self-closing doors. For the sake of clarity, however, the skill is presented here in its entirety.

Steps 1-3 are the same as for negotiating self-closing doors.

  1. The guide positions the stile of the door to contact the palm of the traveler's raised hand. The traveler slides her hand down along the stile to the doorknob while the guide continues to hold the door steady (see Figure 5.04). The guide then passes control of the door to the traveler. If the guide has had to close the door slightly in order to place the outside stile of the door where the traveler's hand would contact, the traveler may now need to open the door slightly wider in order to pass through the doorway. The traveler should keep her thumb and fingers flat on the face of the door and not wrap her hand around the door edge. This minimizes the possibility of injury to her hand from any rough door edges.

    Figure 5.04
    The traveler slides her hand down the stile to the doorknob while the guide holds the door steady.

    • Some travelers may choose to trail gently down the guide's arm (with a familiar guide) to locate the doorknob more easily.
  2. Once the traveler has assumed control of the door, the guide continues through the doorway. After passing through the doorway, the traveler pushes or pulls the door closed behind her.
  3. The guide and traveler resume the HUMAN GUIDE position.

GENERAL MODIFICATIONS

Small children whose arms are not long enough to reach the door from a partial-transfer position might need to transfer sides in order to be on the hinge side before negotiating the doorway. Similarly, some adult travelers may also choose to transfer sides as a simple matter of personal preference.

When walking with an inexperienced guide, the traveler can get directly behind the guide (without stepping on his feet) to avoid being hit by, or to avoid being in the way of, the closing door. The guide simply lets go of a self-closing door or closes a manual door when both are through it. This modification may also be appropriate for use by travelers who are physically unable to hold the weight of the door.

Some travelers curl their fingers into a fist when catching the door so as not to jam their fingers when contacting the door. Other travelers may choose to do so simply as a matter of personal preference.

In some cultures the male (whether traveler or guide) opens the door and holds it open for the female as a courtesy. If so, the following modifications of the DOORWAYS WITH A GUIDE may be employed (LaGrow & Weessies, 1994):

To negotiate doors with a guide when the traveler is carrying something in her free hand, employ the following:

COMMON ERRORS AND CORRECTIONS

Error:
The traveler fails to place her free arm in the UPPER HAND & FOREARM position when the guide signals her to assume the NARROW SPACES WITH A GUIDE position.

Correction:
Placing her free arm in the UPPER HAND & FOREARM position places the traveler in the optimum position to contact the door and to then take its weight from the guide.

Error:
The guide fails to look back at the traveler as they pass through the doorway.

Correction:
Looking back at the traveler as they pass through the doorway enables him to verify that the traveler will clear the doorway without bumping into the doorframe.

Error:
The guide rotates his trunk when looking back at the traveler as they pass through the doorway.

Correction:
Keeping his trunk facing forward as he looks back prevents him from inadvertently moving the traveler out of position to pass through the doorway safely.

Error:
The guide fails to pause and gently place the door stile against the traveler's hand as he passes through the doorway.

Correction:
Pausing and gently placing the door stile against the traveler's hand enables her to take the weight of the door safely from the guide and ensures that the door will not swing back and hit the traveler unexpectedly.

Error:
The traveler reaches for a "pull" door.

Correction:
Maintaining a static UPPER HAND & FOREARM position and not reaching for a "pull" door prevents her hand from passing behind the door and exposing her face and body to injury.

Error:
The traveler fails to straighten her grasp arm fully when assuming the partial transfer position.

Correction:
Straightening her grasp arm fully places her a sufficient distance behind the guide to contact the door successfully. It also prevents her from stepping on the guide's heels.

Error:
The traveler reaches for a push door before the guide pauses and she has arrived at the threshold.

Correction:
Waiting until the guide pauses and she has arrived at the threshold before reaching for the door ensures that the traveler's hand will not reach too close to the door hinge, where it may be exposed to injury.

Error:
The traveler catches the door by wrapping her hand around the door edge rather than placing her hand flat against the stile of the door.

Correction:
Assuming the weight of the door with a flat hand against the stile helps to avoid getting splinters or cuts from grabbing a rough or sharp door edge.

Error:
The guide fails to place the traveler in the NARROW SPACES WITH A GUIDE position when necessary.

Correction:
Unless the doorway is wide enough to easily accommodate the width of both the guide and traveler, the guide should place the traveler in the NARROW SPACES WITH A GUIDE position to prevent her from bumping into the door frame. The NARROW SPACES WITH A GUIDE position also makes it easier for the traveler to contact the door from the partial-transfer position.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Doors With a Cane and Guide

STAIRS WITH A GUIDE

PURPOSE

To ascend and descend stairs when traveling with a guide. Specific skills within this technique enable the guide and traveler to negotiate stairways of varying sizes and shapes. This technique is also used when negotiating steps on buses and even when going up or down simple curbs.

PREREQUISITE TECHNIQUES

Human Guide
Narrow Spaces With a Guide**
Reversing Direction With a Guide*
Transferring Sides***

* Knowing the REVERSING DIRECTION WITH A GUIDE technique makes it easier for the guide and traveler to turn around to practice walking up and down the same staircase, especially when space on the landing is limited.

** Knowing the NARROW SPACES WITH A GUIDE technique will be helpful if it is ever necessary to negotiate stairs that are only wide enough for one person.

*** Knowing the TRANSFERRING SIDES technique makes it easier for the traveler to move to the other side of the guide in order to be next to the handrail if needed.

TEACHING ENVIRONMENTS

Begin in a quiet, familiar or semi-familiar area. The stairway should consist of

Progress next to negotiating a variety of stairs, including those with the following features:

Gradually lead up to negotiating congested stairways.

Practice this technique on stairs, with and without handrails, in a variety of environments that may require the use of this skill (e.g., public buildings, schools, theaters, shopping centers, bus and train stations, boarding and disembarking city buses).

SKILLS

Ascending Stairs

A common method of negotiating ascending stairs when traveling with a guide

  1. The guide and traveler approach the stairs perpendicularly. This ensures that the guide reaches the stairs before the traveler does. This also makes it easier for some travelers to maintain their orientation.
  2. The guide stops in front of the first step. He pulls his arm forward (referred to as "giving an arm pull") to bring the traveler alongside himself and up to the edge of the step.

Modifications

Below are several different ways in which the guide and traveler can position themselves and take the first step. Choosing which method to use is generally a matter of personal preference.

Ascending stairs: step up and pause.

This method eliminates the need for an "arm pull." It provides the traveler with a proprioceptive cue that she and the guide are about to walk up one or more steps.

The guide climbs the first step and pauses, automatically bringing the traveler directly up to the edge of the bottom step.

Ascending stairs: arm pull.

This method saves time by not requiring the guide and traveler to stop at the bottom of the stairs. For safety reasons, however, this modification is generally used only by more experienced travelers who have good balance, who respond quickly to signals from the guide, and who are not fearful of stairs.

The guide does not come to a complete stop at the beginning of ascending stairs, but merely pauses. When the traveler's foot is directly in front of the first step, the guide gives a gentle arm pull and begins to climb the stairs. The traveler takes a natural first step onto the stairs.

Ascending stairs: no pause.

This method saves time by not requiring the guide and traveler to stop at the bottom of the stairs. For safety reasons, however, this modification is generally used only by more experienced travelers who have good balance, who respond quickly to signals from the guide, and who are not fearful of stairs.

The guide does not pause, but tenses his arm and hikes his shoulder slightly as he begins to climb the first step (see Figure 6.01). This indicates to the traveler that her next step will be on the first stair.

Figure 6.01
The guide does not pause, but tenses his arm and hikes his shoulder slightly to signal the traveler as he begins climb the first step.

  1. The guide climbs the stairs and the traveler follows one step behind the guide. The traveler's posture should be erect with her head up and with her weight forward on the balls of her feet for optimum balance when walking up the stairs.
    • Following one step behind the guide ensures that the traveler will have sufficient reaction time to respond to signals from the guide that indicate their arrival at a landing (see step 4).
  2. Upon reaching the landing, the guide may pause while the traveler climbs the last step. Or, he can give the traveler a verbal or tactile signal to indicate that she has reached the landing. Tactile signals might include such things as giving a slight "arm pull" or gently pressing the traveler's hand against his side as the traveler places her first foot on the landing.
    • For the smoothest and most efficient movement, the guide should watch the traveler's feet carefully and give the "arm pull" or other tactile signal at the moment that the traveler places her first foot on the landing.

Descending Stairs

The standard method of negotiating descending stairs when traveling with a guide

  1. The guide and traveler approach the stairs perpendicularly. This ensures that the guide reaches the stairs before the traveler does. This also makes it easier for some travelers to maintain their orientation.
  2. The guide stops in front of the first step and pulls his arm forward (gives an "arm pull") to bring the traveler up to the edge of the top step. It is important that the guide always watch the traveler's feet in order to ensure that the traveler does not overstep the top step. If the traveler does begin to move too far forward, the guide tenses his arm as needed to prevent the traveler from overstepping the edge of the step.
    • For very inexperienced travelers, or for those who do not always respond reliably to the guide's signals, the guide can extend his guiding arm across the traveler's body as he tenses it to ensure that the traveler will not overstep the edge of the step (see Figure 6.02).

    Figure 6.02
    The guide can extend his guiding arm across the traveler's body, if necessary, to prevent her from overstepping the top step.

  3. The traveler follows one step behind the guide as they walk down the stairs. The traveler's posture should be erect with her head up and her weight slightly back on her heels for optimum balance when walking down the stairs.
    • Following one step behind the guide ensures that the traveler will have sufficient reaction time to respond to signals from the guide that indicate their arrival at a landing.

      Modification.

      Travelers who have poor balance or excessive fear may choose to slide their foot forward to locate the edge of each descending stair before stepping down. For added security they may also choose to slide the back of their heel down the riser of each stair as they step down. These modifications should be discouraged unless absolutely necessary, however, because they are inefficient, break the normal rhythm of walking down the stairs, and may unnecessarily instill uncertainty or fear in the traveler.

  4. Upon reaching the landing, the guide may pause while the traveler walks down the last step. Or, the guide can indicate to the traveler that they have arrived at the landing by giving a slight "arm pull" or gently pressing the traveler's hand against his side as the traveler places her first foot on the landing.
    • For the smoothest and most efficient movement, the guide should watch the traveler's feet carefully and time the "arm pull" or other tactile signal for the moment that the traveler places her first foot on the landing.

Using the Handrail

For use by travelers who need to use the handrail for support, or who simply wish to use it for any other reason.

  1. After walking up to the first step, the traveler locates the railing by reaching her free arm forward and to the side in an arc from thigh to mid-chest height with her arm fully extended (see Figure 6.03).

    Figure 6.03
    The traveler locates the railing by reaching her free arm forward and to the side in an arc from thigh to mid-chest height.

    Railings, however, are not present on all sets of stairs. Unless the traveler needs the railing for physical support or for another reason, it is important to encourage the traveler to have confidence in his or her ability to negotiate stairs without using the railing in order to avoid developing any unnecessary dependence on railings.

    • It is also important to keep in mind that railings are often irregular—sometimes stopping short of, or extending beyond, the stairs.

GENERAL MODIFICATIONS

On Stairs That Vary in Depth

The guide and traveler simply adjust their stride to variations in step depth; at deeper stairs, the guide and traveler will simply take longer strides or they can pause at each individual step.

On Stairs That Are Shaped Irregularly

On most circular staircases, the stair depth at the middle third of each step most closely resembles the depth of stairs on a standard staircase. The traveler should therefore be positioned in the center of the stairway where the steps are most consistent in depth. The guide should walk on the outside curve where the steps are deep enough to provide secure footing.

On Stairs That Are Narrow in Width

The guide and traveler can use the NARROW SPACES WITH A GUIDE technique. The traveler walks two steps behind the guide, instead of one. When walking up or down a curb, the guide steps up/down and pauses; he then moves forward allowing the traveler room to step up/down the curb behind him.

On Curbs

A curb is simply treated as a single step.

It is important that the guide and traveler approach all curbs (including rounded ones) perpendicularly. This will prevent the traveler from reaching the curb ahead of the guide and will ensure that they are both positioned correctly at the curb edge to step up or down safely. When negotiating rounded curbs, it may be necessary to alter one's direction of travel slightly in order to approach the curb perpendicularly and then realign after stepping up or down (see Figure 6.04).

Figure 6.04
The traveler and guide should approach rounded corners perpendicularly.

On Ramps

To indicate a change in the walking surface at each end of the ramp, the guide may simply slow his pace, he may pause momentarily, and/or give a verbal cue.

COMMON ERRORS AND CORRECTIONS

Error: The guide and traveler fail to approach the stairs perpendicularly.

Correction: Approaching the stairs perpendicularly ensures that both the traveler and guide are aligned to walk up the stairs without tripping. It also ensures that the traveler will not reach the stairs before the guide, either stubbing her toe against the first ascending riser or overstepping the edge of descending stairs.

Error: The traveler walks on the same step as the guide rather than one step behind.

Correction: Walking one step behind the guide on the stairs provides the traveler with sufficient time to react to signals from the guide or to changes in the guide's movement (e.g., arrival at a landing, encountering unexpected people or objects on the stairway).

Error: The traveler walks two steps behind the guide when walking up or down the stairs.

Correction: Walking one step behind the guide provides her with sufficient time to react to signals from the guide or to changes in the guide's movement. Walking further behind the guide is not necessary and can be awkward.

Error: The guide fails to stop at the top of descending stairs before walking down them.

Correction: Stopping at the top of descending stairs before walking down alerts the traveler to a possible change in elevation, and allows her time to react to the guide's movements.

Error: The guide fails to pull the traveler up to the edge of the first step before starting to walk up or down the stairs.

Correction: Pulling the traveler up to the edge of the first step before starting to walk up or down the stairs indicates to her the location of the first step and also positions her to walk up or down the stairs safely.

Note: When ascending stairs, the guide can bring the traveler up to the first step either by giving an "arm pull" or by stepping up onto the first step and then pausing.

Error: The guide fails to tense his arm when the traveler reaches the edge of the first descending step.

Correction: Tensing his arm when the traveler reaches the edge of the first descending step can prevent her from overstepping the edge.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Escalators With a Guide
Stairs With a Cane and Guide

WITH A CANE

CARRYING A CANE WHEN WALKING WITH A GUIDE

PURPOSE

To safely and efficiently carry or use a cane when walking with a guide

PREREQUISITE TECHNIQUES

Diagonal (for Diagonal method only)
Human Guide
Shortened Cane*
Touch (for Touch method only)

* When walking in a congested area, the traveler may choose to concurrently use the SHORTENED CANE technique to avoid tripping a passerby with her cane.

TEACHING ENVIRONMENTS

Begin in a quiet, open, familiar area that is free of obstacles. The ground should be level and smooth and not require the traveler and guide to ascend or descend any steps or negotiate doors.

Progress to quiet, controlled, unfamiliar indoor and outdoor areas in which there are obstacles to walk around. Walking around obstacles gives the traveler practice in following the guide's movement as he changes direction. Progress next to areas that have an uneven or irregular walking surface (e.g., rugs, carpet, ramp, curbs, grass). Lead up to areas that are more congested (e.g., busy hallways, cafeterias).

Practice this technique in a variety of environments (e.g., residential, small business, downtown) and situations (e.g., while the traveler and/or guide are carrying items such as a cafeteria tray, grocery bag, books).

SKILLS

Vertical Position

This skill is used when the traveler chooses to rely completely on her guide for safety and does not use the cane for detection of obstacles or elevation changes. This skill lessens the amount of effort the traveler needs to exert when walking with a guide, but it can only be used when walking with an experienced and competent guide.

The traveler can use either of two arm positions below according to her own preference and comfort.

Straight Arm Position

The traveler holds the cane vertically against the front of her shoulder; her arm is straight, grasping the cane at mid-shaft, with her forefinger pointing down the shaft and her palm facing backwards (see Figure 7.01). Facing her palm backward enables her to grasp the cane more securely than if she were to face her palm toward midline.

Figure 7.01
Straight Arm Position: The traveler holds the cane vertically against the front of her shoulder; her arm is straight, grasping the cane at mid-shaft, with her forefinger pointing down the shaft and her palm facing backwards.

Bent Arm Position

The traveler holds the cane about 6 inches in front of her body either at midline or just short of midline (see Figure 7.02). This position keeps the cane out of the way of pedestrians passing close by the traveler's side.

Figure 7.02
Bent Arm Position: The traveler holds the cane about 6 inches in front of her body either at midline or just short of midline. She grasps the cane with her thumb and fingers flexed around the shaft, or with the pencil grasp.

The traveler's elbow is bent to 90 degrees so that her forearm is parallel to the ground. She grasps the cane with her thumb and fingers flexed around the shaft or with the pencil grasp (see Glossary).

Diagonal Technique

This skill is used when the traveler chooses to rely primarily on her guide for safety, yet wishes to use the cane to obtain more environmental information than she might receive using the Vertical Position, and/or to provide some limited independent detection of obstacles or elevation changes in her path. This skill requires that the traveler already know the DIAGONAL technique.

  1. The traveler holds the cane in a modified DIAGONAL position in which the cane tip is placed in front of her foot that is nearest the guide. Placing the cane tip in front of her own foot keeps it out of the way of the guide's feet (see Figure 7.03).

    Figure 7.03
    The traveler holds the cane in a modified DIAGONAL position in which the cane tip is placed in front of her foot that is nearest the guide.

    Modifications.

    If the cane is long enough so as not to be in the guide's way, however, the traveler may hold the cane in a standard diagonal position with the tip 1-2 inches outside of her body width.

    When traveling in congested areas, the traveler should use the SHORTENED CANE technique to keep the cane tip from interfering with other pedestrians.

Touch Technique

This skill is used with inexperienced guides or any time that the traveler wishes more information about the environment than she might receive using the Vertical Position or Diagonal Technique. It is also used whenever the traveler chooses not to rely completely on the guide for her safety but prefers to have an independent means of detecting obstacles or elevation changes in her path. This skill requires that the traveler already know the TOUCH technique.

  1. The traveler performs a modified TOUCH technique in which the cane's arc is shortened on the guide's side in order to keep the tip out of the way of the guide's feet (see Figure 7.04).

    Figure 7.04
    The traveler performs a modified TOUCH technique in which the cane's arc is shortened on the guide's side.

    Modifications.

    If the cane is long enough so as not to be in the guide's way, the traveler may use the touch technique with a standard arc (1-2 inches outside of her body width).

    When traveling in congested areas, the traveler should use the SHORTENED CANE technique to keep the cane tip from interfering with other pedestrians.

COMMON ERRORS AND CORRECTIONS

Error:
When using the Diagonal Technique, the traveler allows the cane tip to drift in front of the guide.

Correction:
Keeping the cane tip in front of her own foot ensures that the cane will not trip the guide or get in the way of his feet.

Error:
When using the Diagonal Technique, the traveler allows the cane tip to rise more than 2-4 inches above the ground.

Correction:
Keeping the cane tip only 2-4 inches above the ground helps to prevent poking a nearby pedestrian with the cane tip.

Error:
When using the Touch Technique, the traveler fails to narrow her arc on the guide's side.

Correction:
Narrowing her arc on the guide's side ensures that the cane will not trip the guide or get in the way of his feet.

Error:
When holding the cane in the vertical position, the traveler fails to hold the cane truly vertical.

Correction:
Holding the cane in a vertical position keeps it out of the way of nearby pedestrians and avoids tripping them with the cane tip.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Accepting/Declining Assistance When Carrying a Cane
Doors with a Cane and Guide
Escalators with a Cane and Guide
Narrow Spaces with a Cane and Guide
Reversing Direction with a Cane and Guide
Seating*
Stairs With a Cane and Guide
Transferring Sides When Carrying a Cane

* When the traveler is using a cane, the CARRYING A CANE WHEN WALKING WITH A GUIDE technique is prerequisite to Auditorium Seating and Seating With a Guide.



NARROW SPACES WITH A CANE AND GUIDE

PURPOSE

To travel with a guide through narrow spaces when carrying a cane

PREREQUISITE TECHNIQUES

Narrow Spaces With a Guide
Carrying a Cane When Walking With a Guide

TEACHING ENVIRONMENTS

Begin in a quiet, open space in which there is room to practice this technique without contacting any obstacles.

Progress to a quiet, familiar area that has narrow spaces (e.g., open doorways) through which to pass. Choose an area in which the ground is level and smooth and does not require the traveler and guide to ascend or descend any steps or to negotiate closed doors.

Progress next to areas that have an uneven or irregular walking surface (e.g., rugs, carpet, ramp, curbs, grass). Lead up to areas that are more congested (e.g., busy hallways).

Practice this technique in a variety of environments (e.g., narrow aisles, cafeterias, congested hallways, stores, theaters, restaurants, narrow stairways).

SKILLS

Standard

The standard method of negotiating narrow spaces when using the CARRYING A CANE WHEN WALKING WITH A GUIDE technique

  1. Using the NARROW SPACES WITH A GUIDE technique, the guide signals the traveler that they are approaching a narrow space.
  2. The traveler positions her cane vertically or semi-vertically and close to the front of her body (see Figure 8.01) to prevent it from accidentally hitting or tripping the guide as they walk through the narrow space.

    Figure 8.01
    The traveler positions her cane vertically or semi-vertically and close to the front of her body.

    • In the semi-vertical position, the cane can be held either across the traveler's entire body width or with the tip positioned at midline.
    • If the traveler is using the Diagonal or Touch Technique positions (handshake grasp) of CARRYING A CANE WHEN WALKING WITH A GUIDE, she can most easily bring her cane into a vertical or semi-vertical position by either: (a) sliding her hand below the grip and rotating her arm inward (as though looking at a watch) to bring the cane close to her body, or (b) by changing to a pencil grasp before moving the cane closer to her body. If the traveler has been holding the cane with a pencil grasp, she simply moves the cane into a vertical or semi-vertical position without changing her grasp.
    • If the traveler is using the Vertical Position of CARRYING A CANE WHEN WALKING WITH A GUIDE, she will not need to modify the position of the cane, just pull it in closer to her body.
  3. The traveler and guide then perform NARROW SPACES WITH A GUIDE technique through the area.
  4. When the guide signals the end of the narrow space (using NARROW SPACES WITH A GUIDE technique), the traveler resumes CARRYING A CANE WHEN WALKING WITH A GUIDE position.

COMMON ERRORS AND CORRECTIONS

Error:
The traveler fails to hold the cane tip close to her feet when passing through a narrow space.

Correction:
Holding the cane in a vertical or semi-vertical position with the tip close to her feet as she passes through a narrow space prevents the cane from accidentally hitting or tripping the guide.

Error:
The traveler fails to fully straighten the elbow of her grasp arm when walking behind the guide through a narrow space.

Correction:
Straightening her grasp arm fully when walking behind the guide through a narrow space places the traveler at a sufficient distance behind the guide to avoid stepping on his heels or contacting him with her cane.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Doors With a Cane and Guide
Escalators With a Cane and Guide*
Stairs With a Cane and Guide*

* Knowing the NARROW SPACES WITH A CANE AND GUIDE technique will be helpful if it is ever necessary to negotiate a stairway or an escalator that is only wide enough for one person.



REVERSING DIRECTION WITH A CANE AND GUIDE

PURPOSE

To reverse direction when walking with a guide and carrying a cane

PREREQUISITE TECHNIQUES

Carrying a Cane When Walking With a Guide
Reversing Direction With a Guide
Trailing*

*Knowing the TRAILING technique may assist in learning how to locate the guide's other arm by trailing across his back when reversing direction using either the Hand-Over-Hand or Scoop methods.

TEACHING ENVIRONMENTS

Begin in a quiet, familiar area that has plenty of room in which to turn around.

Progress next to areas that have limited room in which to turn around (e.g., the end of a narrow hallway).

Practice this technique in a variety of environments that require the use of this skill (e.g., crowded rooms, cafeterias, restaurants, theaters, elevators, narrow hallways).

Note: Do not perform this technique on stairs because it can cause the guide or the traveler to lose balance.

SKILLS

Pivot

This skill is the easiest to perform, but it requires more room to do so; it is therefore only used in relatively spacious areas.

  1. Either the guide or traveler indicates a need or desire to reverse direction.
  2. The guide and traveler come to a complete stop.
  3. The traveler pulls her cane tip close to her feet.
  4. Without breaking contact, the guide and traveler make a U-turn; either guide or traveler serves as the pivoting point.
    • Some travelers prefer to serve as the pivot point as they find it disorienting to swing around the guide who is acting as the pivot point.

Breaking Contact

An easy and natural-looking method for reversing direction when the traveler is carrying a cane while traveling with a guide

  1. Either the guide or the traveler indicates a need or desire to reverse direction.
  2. The guide and traveler come to a complete stop.
  3. The guide rotates his arm to break contact with the traveler, or the traveler can break contact with the guide.
  4. The traveler positions her cane in front of her, either vertically or semi-vertically; the traveler and guide turn around, turning toward each other.
    • Turning toward each other looks more natural than turning away from each other.
  5. The traveler transfers the cane to her other hand and positions it for carrying.
  6. The guide reestablishes contact with the traveler by touching her hand or forearm with the back of his hand.
  7. The guide and traveler resume the CARRYING A CANE WHEN WALKING WITH A GUIDE position.

Maintaining Contact

This skill is useful for travelers who require physical support from the guide or who become fearful or disoriented when separated from the guide.

  1. Either the guide or traveler indicates a need or desire to reverse direction.
  2. The guide and traveler come to a complete stop.
  3. The traveler positions her cane vertically with the tip approximately1-4 inches above the ground and transfers it to her grasp hand. The traveler can
    • grasp the guide's arm with the thumb and forefinger of her cane hand, holding the cane shaft with her remaining three fingers curled around it (see Figure 9.01);

      Figure 9.01
      The traveler grasps the guide's arm with the thumb and forefinger of her cane hand, holding the cane shaft with her remaining three fingers curled around it.

    • grasp the guide's arm with a "U" shaped grasp, with the cane secured in the crook of her thumb and forefinger and held firmly against the guide's arm (see Figure 9.02).

      Figure 9.02
      The traveler grasps the guide's arm with a "U" shaped grasp and secures the cane between her thumb and the guide's arm.

    • Keeping the cane tip 1-4 inches above the ground enables the traveler to maintain control of it most easily during the transfer and lessens the likelihood that the cane will swing out of the vertical position.
  4. The guide and traveler turn 90 degrees toward each other. As they do so, the traveler reaches her free arm out slightly wider than body width, then brings it in slowly to locate and grasp the guide's opposite arm.
    • The guide can also reach out with his free hand to touch the traveler's free hand. She then trails up his forearm to grasp above his elbow.
  5. The traveler releases her original grasp on the guide's arm, keeping the cane in its vertical position.
  6. The guide and traveler turn another 90 degrees to complete the turn, then resume the CARRYING A CANE WHEN WALKING WITH A GUIDE position.

Hand-Over-Hand

A method for reversing direction when carrying a cane that may be especially useful for travelers who require physical support from the guide or who become fearful or disoriented when separated from the guide.

  1. Either the guide or traveler indicates a need or desire to reverse direction.
  2. The guide and traveler come to a complete stop.
  3. The traveler positions her cane vertically with the tip 1-4 inches above the ground.
  4. The traveler grasps the guide's arm with her cane hand, just above her original grasp. She then releases her original grasp.
    • The traveler can grasp the guide's arm with the thumb and forefinger of her cane hand, holding the cane shaft with her remaining three fingers curled around it (see Figure 9.03).

      Figure 9.03
      The traveler trails the guide's back with her free hand to locate his other arm. The traveler can grasp the guide's arm with the thumb and forefinger of her cane hand, holding the cane shaft with her remaining three fingers curled around it.

    • She can grasp the guide's arm in a "U" shaped grasp, with the cane secured in the crook of her thumb and forefinger and held firmly against the guide's arm (see Figure 9.04).

      Figure 9.04
      She can grasp the guide's arm in a "U" shaped grasp, with the cane secured in the crook of her thumb and forefinger and held firmly against the guide's arm.

  5. The guide and traveler turn 90 degrees, both turning in the same direction. As they turn, the traveler reaches out slightly wider than body width with her free hand, and then brings her hand in to locate and grasp the guide's opposite arm; or if she prefers, she can trail the guide's back with her free hand to locate his other arm (see Figure 9.05).

    Figure 9.05
    The guide and traveler turn 90 degrees, both turning in the same direction. As they turn, the traveler can trail the guide's back with her free hand to locate his other arm.

    • If the guide extends his bent elbow backward slightly, it will make it easier for the traveler to locate his elbow.
    • If the traveler trails the guide's back, she should cup her trailing hand slightly to avoid snagging the guide's clothing or hair.
  6. The traveler releases the grasp of her cane hand on the guide's original guiding arm and reaches across to grasp his opposite arm. She then releases the grasp of her non-cane hand on this arm and transfers the cane to that hand.
    • The traveler keeps the cane vertical at all times to ensure that it does not strike the guide.
  7. Guide and traveler complete the turn, then resume CARRYING A CANE WHEN WALKING WITH A GUIDE position.

COMMON ERRORS AND CORRECTIONS

Error:
The traveler fails to position her cane vertically before turning.

Correction:
Positioning her cane vertically before turning keeps the cane from striking the guide as they turn.

Error:
When performing the Hand-Over-Hand method, the traveler trails the guide's back with the hand in which she is holding the cane.

Correction:
Holding the cane in her non-trailing hand prevents the cane from poking the guide as she trails his back.

Error:
When performing either the Hand-Over-Hand or Maintaining Contact methods, the traveler holds her cane with the tip more than 4 inches off of the ground.

Correction:
Holding her cane with the tip no more than 1-4 inches off of the ground enables her to best control the cane's position and to keep it from hitting the guide.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Doors With a Cane and Guide*
Seating***
Stairs With a Cane and Guide**

* Knowing the REVERSING DIRECTION WITH A CANE AND GUIDE technique makes it easier for the guide and traveler to turn around to practice going in and out of a door, especially when space on either side of the door is limited.

** Knowing REVERSING DIRECTION WITH A CANE AND GUIDE technique makes it easier for the guide and traveler to turn around on a landing to practice walking up and down the same staircase, especially when space on the landing is limited.

***Knowing REVERSING DIRECTION WITH A CANE AND GUIDE technique can be helpful, especially in theater seating when the guide and traveler may need to turn around to return via the same aisle by which they approached their row of seats.



TRANSFERRING SIDES WHEN CARRYING A CANE

PURPOSE

To reposition oneself to stand or walk on the other side of a guide when carrying a cane. Common situations in which this technique is used include transferring to the guide's other side to reach the handrail on stairs and positioning oneself to follow the guide into a narrow row of seats in a theater or auditorium.

PREREQUISITE TECHNIQUES

Carrying a Cane When Walking With a Guide
Trailing*
Transferring Sides

* Knowing the TRAILING technique may assist in learning how to locate the guide's other arm by trailing across his back when transferring sides.

TEACHING ENVIRONMENTS

Begin in a quiet, familiar area that has plenty of room in which to practice transferring sides.

Practice this technique in a variety of environments that require the use of this skill (e.g., when the traveler needs to transfer sides for ease in negotiating a doorway or stairway).

SKILLS

Scoop

This skill is easier to perform than the Hand-Over-Hand skill. Some travelers, however, find it difficult to maintain contact with the guide when performing this skill while walking.

  1. Either the guide or traveler indicates a desire to change sides.
  2. The traveler places her cane in a vertical position and transfers it to her grasp hand, holding the shaft between her thumb and the guide's arm. The cane tip is held 1-4 inches above the ground to enable the traveler to maintain control of it most easily during the transfer and to lessen the likelihood that the cane will swing out of the vertical position or get in the guide's way (see Figure 10.01).

    Figure 10.01
    The traveler places her cane in a vertical position and transfers it to her grasp hand, holding the shaft between her thumb and the guide's arm. The cane tip is 1-4 inches above the ground.

  3. The traveler places the back of her now free hand on the back of the guide's guiding arm, above her grasp hand; her fingers are pointed toward the guide's opposite arm, held together and curled slightly (see Figure 10.02).
    • This position of the fingers facilitates trailing across the guide's back and positions the traveler's hand to grasp the guide's opposite arm. Curling the fingers slightly ensures that the traveler's hand will not accidentally pull the guide's hair or clothing.

      Figure 10.02
      The traveler places the back of her free hand on the back of the guide's arm; her fingers are pointed toward the guide's opposite arm, together and curled slightly.

  4. The traveler releases her original grasp on the guide's arm, continuing to hold the cane in that hand. Turning 90 degrees or straightening her non-cane arm fully (to avoid stepping on the guide's heels), she then trails the guide's back with the back of her hand to locate the guide's opposite arm (see Figure 10.03).

    Figure 10.03
    The traveler trails the guide's back to locate the guide's opposite arm.

    • The guide may extend his elbow backward to make it easier for the traveler to locate his other arm.
    • In order to maintain contact with the guide, the traveler must be certain not to release her grasp on the guide's arm before she has her other hand positioned to trail. Travelers with good kinesthetic awareness, however, may omit trailing.
    • This skill is more difficult to do when walking than when standing still. If done while walking, it may help the traveler to avoid losing contact with the guide if she moves quickly and even applies slight pressure against the guide's back as she trails. It may also help the traveler to perform the transfer more smoothly if the guide slows his pace slightly.
  5. The traveler grasps the guide's opposite arm just above the elbow and resumes the CARRYING A CANE WHEN WALKING WITH A GUIDE position.

Hand-Over-Hand

This skill is perhaps a bit more cumbersome than the Scoop skill presented above, especially due to the added challenge of manipulating and controlling the cane during the transfer. It can be more secure, however, because the traveler always has a firm grasp on an arm of the guide. For this reason, elderly travelers, those who have physical disabilities, or those with balance problems, may prefer this skill because it affords the most stability.

  1. Either the guide or traveler indicates a desire to transfer sides.
  2. The traveler places her cane into a vertical position and holds it with her lateral three fingers (see Figure 10.04). She then grasps the guide's arm with the thumb and forefinger of her cane hand. Some travelers may prefer to grasp the guide's arm in a "U" shaped grasp, holding the cane firmly against the guide's arm (see Figure 10.05).

    Figure 10.04
    The traveler places her cane into a vertical position and holds it with her lateral three fingers. She then grasps the guide's arm with the thumb and forefinger of her cane hand.


    Figure 10.05
    Some travelers may prefer to grasp the guide's arm in a "U" shaped grasp, holding the cane firmly against the guide's arm.

    • The cane is held with the tip approximately 1-4 inches above the ground.
      • Keeping cane tip only 1-4 inches above the ground enables the traveler to maintain control of it most easily during the transfer and lessens the likelihood that the cane will swing out of the vertical position or get in the guide's way.
  3. The traveler releases her original grasp on the guide's guiding arm and straightens her new grasp arm fully (to avoid stepping on his heels as she transfers sides).
  4. The traveler steps behind the guide, reaching her free arm out slightly wider than body width. She then brings her arm in to locate and grasp the back of the guide's opposite arm; or if she prefers, she can trail the guide's back with the back of her free hand to locate his opposite arm.
    • Her trailing hand should be cupped slightly to avoid snagging the guide's clothing or hair.
    • The guide may extend his elbow backward to make it easier for the traveler to locate his arm.
  5. The traveler grasps the guide's opposite arm.
  6. The traveler releases the grasp of her cane hand on the guide's original guiding arm and reaches across to grasp his opposite arm. She then releases the grasp of her non-cane hand on this arm and transfers the cane to that hand.
    • The traveler keeps the cane vertical at all times to ensure that it does not strike the guide.
  7. The traveler then resumes the CARRYING A CANE WHEN WALKING WITH A GUIDE position.

COMMON ERRORS AND CORRECTIONS

Error:
When performing the Hand-Over-Hand method, the traveler holds her cane with the tip more than 1-4 inches from the ground during the transfer.

Correction:
Holding her cane with the tip no more than 1-4 inches from the ground during the transfer enables the traveler to keep the cane from swinging and hitting the guide.

Error:
When performing the Scoop method, the traveler trails the guide's back with the same hand that is holding the cane.

Correction:
The traveler should hold the cane in her non-trailing hand. This keeps the cane from hitting the guide as she trails his back.

Error:
When performing the Hand-Over-Hand method, the traveler releases her grasp on the guide's arm before grasping his arm with her other hand.

Correction:
The traveler should not let go of her grasp on the guide's arm until she has grasped his other arm with her free hand in order to avoid losing contact with the guide. This can be especially important when performing this technique while walking.

Error:
The traveler fails to fully extend her trailing arm.

Correction:
Traveler must either turn 90 degrees (Scoop) or extend her trailing arm fully so that she does not step on the guide's heels when transferring sides.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Doors With a Cane and Guide*
Escalators With a Cane and Guide**
Seating***
Stairs With a Cane and Guide**

* Knowing the TRANSFERRING SIDES WHEN CARRYING A CANE technique makes it easier for the traveler to learn how to position herself behind the guide in order to negotiate a door when she is on the latch side of the door.

** The traveler can use the TRANSFERRING SIDES WHEN CARRYING A CANE technique to move to the other side of the guide in order to be next to the handrail of the stairway or escalator.

*** The traveler can use the TRANSFERRING SIDES WHEN CARRYING A CANE technique to move to the proper side of the guide in order to enter a row of theater seats.



DOORS WITH A CANE AND GUIDE

PURPOSE

To negotiate closed doors when carrying a cane while traveling with a guide

PREREQUISITE TECHNIQUES

Doors With a Guide
Narrow Spaces With a Cane and Guide
Reversing Direction With a Cane and Guide**
Transferring Sides When Carrying a Cane*

* Knowing the TRANSFERRING SIDES WHEN CARRYING A CANE technique makes it easier for the traveler to learn how to position herself behind the guide in order to negotiate a door when she is on the latch side of the door.

**Knowing the REVERSING DIRECTION WITH A CANE AND GUIDE technique makes it easier for the guide and traveler to turn around to practice going in and out of a door, especially when space on either side of the door is limited.

TEACHING ENVIRONMENTS

Begin in a familiar area that is quiet and free from a lot of pedestrian traffic. For initial instruction, use indoor, lightweight, self-closing doors where wind and other weather factors will not interfere with teaching, and where there are no steps to walk up or down immediately before or after going through the doorway.

Gradually progress to areas that have heavier, self-closing doors, including those that lead to the outside.

Give the traveler experience with many different doors. Introduce her to manual-closing doors as well as self-closing doors, to doors that open to the right and those that open to the left, to doors that present a variety of doorknobs and handles, and to doors that are placed closely in sequence (e.g., at entrances to some stores or hotels, especially in colder climates). Also introduce the traveler to doorways that have a step going either up or down immediately before or after the doorway.

Lastly, practice the technique in areas where there is heavier pedestrian traffic.

The following are some tips for making the initial teaching process easier:

SKILLS

Traveler on the Hinge Side

To negotiate a closed door when the traveler is on the hinge side

  1. When the guide opens the door, the traveler slides her hand to a point just below the cane grip and positions the cane vertically.
    • If the traveler has been holding the cane with a handshake grasp, she can rotate her arm inward to bring the cane to a vertical position before transferring it to her other hand (see Figure 11.01), or she can change to pencil grasp before bringing the cane to the vertical position (see Figure 11.02).

      Figure 11.01
      The traveler rotates her arm inward to bring the cane to a vertical position before transferring it to her other hand.


      Figure 11.02
      The traveler changes to pencil grasp before bringing the cane to the vertical position.

  2. The traveler transfers the cane to her grasp hand, keeping the tip 1-4 inches off of the ground.
    • The traveler can hold the cane vertically with her three lateral fingers while grasping the guide's arm with her thumb and forefinger (see Figure 11.03), or she may prefer to hold the guide's arm with a standard "U" shaped grasp and secure the cane between her thumb and the guide's arm (see Figure 11.04).

      Figure 11.03
      The traveler holds the cane vertically with her three lateral fingers while grasping the guide's arm with her thumb and forefinger.


      Figure 11.04
      The traveler holds the guide's arm with a standard "U" shaped grasp and secures the cane between her thumb and the guide's arm.

    • Keeping her cane tip only 1-4 inches above the ground enables the traveler to maintain control of it most easily and lessens the likelihood that the cane will swing out of the vertical position or get in the guide's way.
  3. The traveler and guide perform the DOORS WITH A GUIDE technique.
    • Depending on the width of the doorway, the traveler and guide may need to concurrently perform the NARROW SPACES WITH A CANE AND GUIDE technique.
  4. After passing through the doorway, the traveler resumes the CARRYING A CANE WHEN WALKING WITH A GUIDE position.

Traveler on the Latch Side

To negotiate a closed door when the traveler is on the latch side

  1. When the guide opens the door, the traveler slides her hand to a point just below the cane grip and positions the cane vertically, keeping the tip 1-4 inches off of the ground.
  2. Holding the cane just below the grip with her middle, ring, and little fingers curled around the shaft (see Figure 11.03), the traveler grasps the guide's arm with the thumb and index finger of her cane hand.
    • Holding the cane with the tip 1-4 inches above the ground enables the traveler to maintain control of the cane while performing the partial transfer and lessens the likelihood that the cane will swing out of the vertical position or get in the guide's way.
  3. The traveler and guide perform the DOORS WITH A GUIDE technique.
  4. After passing through the doorway, the traveler and guide resume the CARRYING A CANE WHEN WALKING WITH A GUIDE position.

GENERAL MODIFICATIONS

If the traveler wishes to catch the door with her cane hand, she can perform the following modification:

COMMON ERRORS AND CORRECTIONS

Error:
The traveler fails to hold her cane vertically when holding it in the hand that is grasping the guide's arm.

Correction:
Holding her cane vertically prevents it from either interfering with the guide's movement or contacting other pedestrians.

Error:
The traveler holds the cane with its tip more than 1-4 inches off of the ground.

Correction:
Holding the cane with its tip no more than 1-4 inches off of the ground enables the traveler to maintain maximum control of the cane's position while negotiating the doorway with the guide.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Doors With a Cane*

* Prior experience negotiating doors using the DOORS WITH A CANE & GUIDE technique may lessen the initial anxiety that some travelers feel when negotiating doors without a guide.



STAIRS WITH A CANE AND GUIDE

PURPOSE

To ascend and descend stairs when carrying a cane while traveling with a guide

PREREQUISITE TECHNIQUES

Carrying a Cane When Walking With a Guide
Contacting & Exploring Objects With a Cane*
Diagonal (for Diagonal method only)
Narrow Spaces With a Cane and Guide***
Reversing Direction With a Cane and Guide**
Stairs With a Guide
Transferring Sides When Carrying a Cane****

* The CONTACTING & EXPLORING OBJECTS WITH A CANE portion of this technique is used when the traveler's cane contacts the first step. It enables her to maintain safe and effective cane contact with the first step as she walks up to it.

** Knowing the REVERSING DIRECTION WITH A CANE AND GUIDE technique makes it easier for the guide and traveler to turn around to practice walking up and down the same staircase, especially when space on the landing is limited.

*** Knowing the NARROW SPACES WITH A CANE AND GUIDE technique will be helpful if it is ever necessary to negotiate stairs that are only wide enough for one person.

**** Knowing the TRANSFERRING SIDES WHEN CARRYING A CANE technique makes it easier for the traveler to move to the other side of the guide to be next to the handrail if needed.

TEACHING ENVIRONMENTS

Begin in a quiet, familiar or semi-familiar area. The stairway should consist of the following features:

Progress next to negotiating a variety of stairs, with and without handrails depending upon traveler needs and preferences, and including those with the following features:

SKILLS

Ascending Stairs

The standard method of negotiating ascending stairs when carrying a cane while traveling with a guide

  1. The guide and traveler approach the stairs perpendicularly.
  2. When the traveler's cane tip contacts the first riser, she slides her hand down the shaft of the cane and "anchors" the cane against the riser using the CONTACTING & EXPLORING OBJECTS technique. She walks with the guide up to the first step.
    • If the traveler's cane has not located the riser of the first step, the guide can give an "arm pull" to bring the traveler closer to the first step, and/or he can verbally indicate to the traveler that they are at the bottom of a set of ascending stairs.

      Modifications.

      When walking with an experienced traveler who responds quickly to signals from the guide and who is not fearful of stairs, the guide may choose to not come to a complete stop before beginning to walk up the stairs. This modification saves time, but for safety reasons, it should only be used with proficient travelers.

      • If the traveler carries her cane using the handshake grasp, the guide may need to pause at the bottom of the stairs just long enough for the traveler to place her cane in the proper position to climb the stairs; less time is needed for travelers who hold their cane using a pencil grasp.

      If the traveler has been carrying her cane in the vertical Position (see CARRYING A CANE WHEN WALKING WITH A GUIDE), she can either

      • position the cane as described above, or
      • keep the cane in the vertical position, with the cane tip next to the side of her foot, and maintain this position while walking up the stairs (see Figure 12.01).

        Figure 12.01
        The traveler maintains the cane in the vertical position, with the cane next to the side of her foot.

  3. The traveler positions the cane tip against the riser of the second or third step (depending on personal comfort), 1 inch below the nosing (the horizontal edge on the front of each stair where the tread and the top of the riser meet). The traveler holds the cane either vertically or semi-vertically with her arm parallel to the ground.
    • It is important that the traveler maintain the cane in a vertical or semi-vertical position (no wider than her body width) so that it is out of the way of the guide's feet.

      Modification.

      If the traveler is tall, has long arms, or just finds it more comfortable, she may decide to place the cane tip against the riser of the third step.

  4. The traveler follows one step behind the guide as they climb the stairs; the traveler's cane tip contacts each riser lightly. As she walks, the traveler
    • keeps her weight forward, and over the balls of her feet for balance;
    • keeps her cane arm extended, allowing the forward and upward movement of her body to move the cane tip forward to lightly contact the riser of each successive stair;
      • If the cane tip bounces excessively as it contacts each riser, the traveler can correct this by applying slight forward pressure of the cane tip against the riser (but not so much as to move the cane out of its vertical or semi-vertical position).
    • does not let her arm drop (allowing the cane shaft to contact each riser rather than just the cane tip). Were this to happen, she would need to "lift" the cane to the next step, thereby decreasing the fluidity and ease of movement with which she can climb the stairs;
    • keeps the cane in a constant position 1-2 steps ahead of her so that it does not get in the way of her feet as she climbs the stairs (see Figure 12.02)

      Figure 12.02
      The traveler keeps the cane in a constant position 1-2 steps ahead of her.

  5. To signal arrival at the landing, the guide may either give an "arm pull" as the traveler's first foot falls on the landing or may pause while the traveler climbs the last step. The traveler will also know that she has only 1-2 more steps to reach the landing when her cane tip no longer contacts a riser ahead of her.
    • As the traveler climbs the last step or two, she can "clear" the landing with the cane, if she desires, to detect any objects or other environmental features (e.g., additional stairs) in her path.
  6. At the landing, the traveler resumes the CARRYING A CANE WHEN WALKING WITH A GUIDE position.
    • Because the traveler has slid her hand down to the bottom of the grip when performing the CONTACTING & EXPLORING OBJECTS WITH A CANE technique, she will need to reestablish her grasp at the top of the grip. She can do so by quickly sliding the cane forward through her loose grasp and then grasping the grip firmly at the top of the grip as it slides through her hand (see Figures 12.03a, 12.03b and 12.03c)

      Figures 12.03a, 12.03b, 12.03c
      The traveler reestablishes her grasp at the top of the grip by quickly sliding the cane forward through her loose grasp and then grasping the grip firmly at the top of the grip as it slides through her hand.

      • Some travelers may need to finish ascending all stairs before they can manipulate the cane to return it to its original carrying (handshake) position. The guide may need to stop, pause, or slow his pace while the traveler does this.

Descending Stairs

The standard method of negotiating descending stairs when carrying a cane while traveling with a guide

  1. The guide and traveler approach the stairs perpendicularly, stopping at the edge of the top step.
    • The traveler locates the edge of the first step with the cane tip. She anchors her cane shaft in a midline position against the edge of the top step. This gives the traveler a reference point to know exactly where the edge of the step is located.
  2. The guide pulls his arm forward ("arm pull") to bring the traveler up to the edge of the top step and then tenses his arm to prevent her from overstepping the edge. The traveler "anchors" her cane shaft against the edge of the top step and walks up to it.
  3. The traveler places her cane into a DIAGONAL position in which the cane tip is held 1-2 inches above of the nosing of the first or second step below, depending on the length of the cane (see Figure 12.04).

    Figure 12.04
    The cane tip is held 1-2 inches above the nosing of the first or second step below, depending on the length of the cane.

    • If the traveler has been carrying her cane in the Vertical Position (see CARRYING A CANE WHEN WALKING WITH A GUIDE), she can either
      • position the cane diagonally, or
      • keep the cane in the vertical position, with the cane tip next to the side of her foot, and maintain this position while walking down the stairs.
    • If she wishes, the traveler can use the Tread Method or Edge Method of using her cane on the stairs instead of holding the cane with the tip above the nosing of a lower step (see Long Cane Module, Stairs With a Cane Technique).
  4. The traveler follows one step behind the guide as they walk down the stairs. As she walks, the traveler
    • maintains her trunk erect (not leaning backward), placing her weight over her heels for optimum balance. Leaning the trunk backward does not improve one's balance and doing so can elevate the arm, altering the proper position of the cane;
    • holds her cane firmly in position
      • allowing the cane tip to rise while walking down stairs can delay the tip's contact with the landing and can position the cane to interfere with other people on the stairs;
      • allowing the cane tip to drop while descending can cause it to contact a lower stair (which can be mistaken for the landing) and can interfere with the momentum of the guide and traveler as they descend the stairs.
  5. When the cane tip contacts the landing, the traveler can, if she chooses, "clear" the landing with the cane as she walks down the last step or two. At the landing, the traveler resumes the CARRYING A CANE WHEN WALKING WITH A GUIDE position.
    • "Clearing" the landing detects any objects or other environmental features (e.g., additional stairs) in her path.
    • The guide may also pause or give a slight "arm pull" at the moment that the traveler places her first foot on the landing to give additional confirmation that she is at the landing.

Using the Handrail

For use by travelers who need to use the handrail for support, or who wish to use it for any reason

  1. After walking up to the first step, the traveler transfers the cane to her hand that is grasping the guide's arm, placing the cane between her thumb and the guide's arm (see Figure 12.05).
    • When ascending the stairs, the cane tip should be positioned 8-10 inches above the ground so that it does not catch on the steps.
  2. The traveler locates the railing by reaching her free arm forward and to the side in an arc from thigh to mid-chest height with her arm fully extended (see Figure 12.05).

    Figure 12.05
    The traveler frees her cane hand to grasp the railing by transferring the cane to her other hand and placing it between her thumb and the guide's arm. The traveler then locates the railing by reaching her free arm forward and to the side in an arc from thigh to mid-chest height.

    Railings, however, are not present on all sets of stairs. Unless the traveler needs the railing or physical support or for another reason, it is important to encourage the traveler to have confidence in his or her ability to negotiate stairs without using the railing in order to avoid developing any unnecessary dependence on railings.

  3. After negotiating the stairs, the traveler removes the cane from her grasp hand and resumes CARRYING A CANE WHEN WALKING WITH A GUIDE position.

It is also important to keep in mind that railings are often irregular—sometimes stopping short of, or extending beyond, the stairs.

COMMON ERRORS AND CORRECTIONS

Error:
The guide and traveler fail to approach the stairs perpendicularly.

Correction:
Approaching the stairs perpendicularly ensures that the traveler will not reach the stairs before the guide, thus preventing her from stubbing her toe against the riser of the first ascending step or falling off the edge of the first descending step. Also, depending upon the angle of approach and how the traveler holds her cane (e.g., vertical position when approaching ascending stairs; tip off of the ground when approaching descending stairs), there is no guarantee that her cane will find either the riser or edge of the first step before her feet do.

Error:
The traveler fails to hold her cane consistently 1-2 steps ahead.

Correction:
Keeping her cane tip consistently 1-2 steps ahead at all times ensures that it will provide forward coverage while not interfering with her movement. It will also ensure that the traveler will have time to react when the cane detects the landing.

Error:
The traveler holds the cane so that the tip extends further than her body width.

Correction:
Holding the cane so that the tip extends no further than her body width provides forward protection without interfering with the guide's movement.

Error:
The traveler fails to lower her grasp on the cane to a point just below the grip before ascending the stairs.

Correction:
Holding the cane below the grip will enable her to reach her arm forward and to place the cane tip 1-2 inches below the lip of the first or second step ahead without having to hold her arm uncomfortably high.

Error:
The traveler fails to hold her cane so that only the tip touches the nosing of the first or second step ahead as she ascends the stairs.

Correction:
Holding her cane so that just the tip touches below the nosing of the first or second step ahead enables the upward movement of her body to move the cane to the step ahead without her needing to actively lift the cane to clear each step.

Error:
The guide fails to stop at the top of descending stairs before starting to walk down.

Correction:
Stopping at the top of descending stairs alerts the traveler to a change in elevation and also provides her with sufficient time to align at the edge of the top step and position her cane before walking down. Even though the traveler is holding a cane, this does not guarantee that she will find the edge of the first step independently (especially if she is holding the cane with the tip off of the ground).

Error:
The guide fails to pull the traveler up to the edge before starting to walk down.

Correction:
Pulling the traveler up to the edge before starting to walk down tells the traveler exactly where the edge of the first step is located and positions her to walk down the stairs safely.

Error:
The traveler lets her cane tip drift higher than 1-2 inches above the steps below while descending the stairs.

Correction:
Holding the cane tip no higher than 1-2 inches above the steps below helps to ensure that the cane will accurately detect the landing and that it will not poke people on the stairs.

NOTES FOR TEACHERS

RELATED TECHNIQUES

Escalators With a Cane and Guide
Stairs With a Cane*

* Prior experience negotiating stairs using the STAIRS WITH A CANE & GUIDE technique may lessen the initial anxiety that some travelers feel when negotiating stairs without a guide.

REFERENCES

Hill, E., & Ponder, P. (1976). Orientation and mobility techniques: A guide for the practitioner. New York: American Foundation for the Blind.

Jacobson, W. (1993). The art and science of teaching orientation and mobility to persons with visual impairments. New York: American Foundation for the Blind.

LaGrow, S., & Blasch, B. (1992). Orientation and mobility services for older persons. In A. Orr (Ed.), Vision and aging: Crossroads for service delivery. New York: American Foundation for the Blind.

LaGrow, S., & Weessies, M. (1994). Orientation and mobility: Techniques for independence. New Zealand: Dunmore Press Limited.



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