Orientation and Mobility for Teens with Recent Vision Loss
If your teenager has just been diagnosed with a visual impairment—whether from a condition such as retinitis pigmentosa (RP) or Stargardt’s disease or because of an accident or other trauma—or if her vision has deteriorated, she has a lot to cope with. Like you and the rest of the family, she may have a number of concerns and emotions.
Among the most immediate challenges are dealing with the sudden loss of physical independence and learning how to regain the ability to know where she is and how to get from one place to another by herself. To accomplish that, she’s going to need the help of an orientation and mobility (O&M) instructor.
The focus of O&M instruction will vary depending on your teenager’s usable vision, medical and physical condition, and motivation to travel independently. Because she probably traveled on her own until recently, using her vision and other senses to help her get where she wanted to go, she has the advantage of understanding concepts such as:
- What a block of buildings looks like
- The layout of various intersections
- How streets and avenues intersect
- The way stores are arranged in shopping malls
- Familiar “landmarks” that help her know where she is in her neighborhood
She probably visited friends in other neighborhoods, used the big regional library on the other side of town when she had a research assignment to complete, and went from one place to another confidently, without guidance from you or anyone else. Now, with instruction from an O&M specialist, she can learn skills to gain back her ability to travel on her own. The instructor will work with your daughter in some or all of the following ways:
Evaluate how she uses her vision (if any) and other senses when moving in familiar and unfamiliar environments.
Evaluate her knowledge of the community, such as different types of intersections and how to use public transportation.
Teach her techniques such as sighted guide or cane techniques to travel safely.
Determine whether using a long cane will give her the information and protection she needs to travel safely; and if so, teach her how to use this tool.
Determine whether optical devices, such as a monocular, might enable your child to use her vision more efficiently. If the O&M specialist feels that optical aids could be beneficial, a referral for a clinical low vision evaluation should be made so that appropriate aids may be prescribed.
Conduct a sun lens evaluation to determine if non-prescription sun lenses (eyeglasses with colored-filter lenses) will help her use her vision more efficiently during daytime travel.
Motivation Is Important
Your teenager may be hesitant or perhaps anxious about traveling by herself. She may feel self-conscious using a long cane or wearing sun lenses—reactions that aren’t unusual. She’ll need time and reassurance to adjust to all the major changes going on in her life, and the O&M specialist will need to be sensitive to her feelings. However, your teen may be more motivated to learn travel skills if the lessons will increase her access to places and activities that particularly interest her. For example, if music is one of her passions, and she plays the guitar, she may be eager to learn how to travel to a music store across town.
Back to School
To travel safely around school, your daughter will need lessons from her O&M instructor on how to get around both outside and inside the building, how to move from one classroom to another, how to navigate crowded hallways, and how to get up and down stairs. While some of her classmates may act as human guides, she’ll still need strong O&M skills to travel safely and independently on her own.
Depending on your child’s various interests and plans for the future, the O&M specialist will also design lessons specific to her needs. For example:
Taking your daughter to unfamiliar locations such as a larger town or a nearby city in order to teach her more advanced O&M skills;
Using public transportation, including how to get information about schedules; locate a bus stop, train platform, or subway; pay the fare; alert the driver or other passengers if she needs help to determine where to get off; appropriate behavior during the trip; how to exit the bus or train; and how to find her destination;
Using taxis, including how to call for a taxi, how to communicate any special needs to the driver and dispatcher, and how to manage paying and tipping;
Numbering systems both within blocks and within buildings;
Maintaining safety while traveling and what to do if her safety is threatened;
Using optical devices, such as a telescope, while traveling to increase access to visual information;
Using maps, the Internet, and the telephone to gather information and prepare for traveling—whether going a few blocks or across the country; or
Planning for how to manage in a new place if your daughter expects to go away to college or move to another town to work after she graduates from high school.