The Real Goals for Mobility Education
Presented to Mobility & Independence Specialists in Education(MISE) Conference at Exhall Grange School, Coventry, March 2000
by Kevin Carey
Editor, British Journal of Visual Impairment (BJVI)
After the Second World War the United States Veterans Administration gave its visually impaired soldiers, and the rest of us, two things, the Perkins Brailler and the Long Cane. These two pieces of equipment came to symbolise the post-War settlement in blindness. Buoyed up by the number of children entering special schools as the result of retinopathy of prematurity, braille and independent mobility boomed in the United States and though the use of the long cane took much longer to establish here, by 1970 there were successors in the line of the great Bob LaDuke and Stanley Suterko working at the newly founded National Mobility Centre (NMC).
The problem with braille and mobility is that they each require a formidable set of skills. It was clear by the mid 1970s that many VIPs either did not possess the skills for braille or they decided, quite rationally, that they would be better off with radio, television and perhaps 'talking books' and other tapes. In the field of orientation and mobility I don't think the penny dropped until the RNIB Needs Survey of 1992 showed how many VIPs hardly went out at all. The trouble with both of these facets of VI training were that they became professionally emblematic; you could identify yourself as a special teacher of blind children or as a specialist rehabilitation worker if you had a Braille Certificate. Equally, orientation and mobility became emblematic for independence, the good life, the right to roam; the macho Scandinavian view of what it's like to be blind.
I should not go on without making a personal confession. Although I received my long cane instruction under blindfold, on the verge of losing my sight, under the brilliant tuition of one of Le Duke's pupils, I never liked using it but never really had a choice, disliking dogs even more. As I have got older the concentration required has increased as I have become much less concerned with mobility as an emblem, as an excitement. Now I just want to get about and concentrating on not being killed is a great deal more boring than thinking about the wines of the lower Loire or what tactics I am going to use at a meeting. One night after a couple of celebratory glasses after clinching a contract I almost killed myself at Victoria Station because I was content and preoccupied; my cane went over the platform edge and I only just braked in time. What sort of a life and death is that?
What I want to argue in this speech is that the means, the role and the purpose of orientation and mobility all need to be fundamentally reconsidered; that we ought to look at these skills in the context of other vital needs; and that the way our society is now structured means that we are going to have to look at the way any service is delivered.
I want, then, to look at five aspects:
- 1 Negotiating skills
- 2 Description
- 3 Orientation versus mobility
- 4 Environmental design and robotics
- 5 Professional priorities
1 Negotiating Skills
Let me start with an obvious point. The whole purpose of training and rehabilitation is to ensure that the lives our clients lead is as near as possible to that of their peers. If a person goes blind in a family, which is accustomed, to take-away dinners there's no reason to press cookery classes on our client. So it is with mobility. Talking to some people you would think that we still live in the age when Mr. Clement Atlee would cheerfully queue at a bus stop. By whichever way you measure it, our situation has changed: there is much less public transport available, particularly for people who live in rural areas, so that integral part of an independent life has been taken away for many people; there are far more cars and other traffic now than there has ever been before and navigating in our towns and cities is more difficult, more hazardous and less often graced with offers of help; whether or not the statistics justify it, many of us, particularly in cities, are much more frightened than we used to be of walking alone at night. These are three very serious reasons for considering how much value we should put on independent mobility; but I offer you one more reason why we need a radical re-think and it goes back to my first point. As most of society has completely given up independent mobility, preferring private cars, why should we impose this difficult and anachronistic set of skills on our blind and visually impaired clients? Now many people get very upset when I say this which only leads me to wonder whether they're upset on behalf of their clients or themselves. I think back to Mr. John Crossland's observation on his work as a rehabilitation officer that he has been more often asked to teach blind people how to roll a joint than how to make a cake.
I therefore go on to wonder why there is not a great deal more talk about community transport schemes. There are only three kinds of people who voluntarily use public transport schemes; Londoners who find the balance of advantage over private cars; idealists who want to do their bit for ecology; and poor people. As it happens, the majority of our clients are in this third class. I can perfectly understand why we might want to provide comprehensive independent mobility skills to Londoners and to the idealists; but the poor want help, greater than the mobility component of the DLA can provide, with door-to-door services. In my village with its very adequate array of shops there is strong evidence that people don't use it because they don't want to walk from the car park into the high street. Were they to do a complete shop they would actually walk a shorter distance in the village than they would in a hypermarket but there's no point going on about that; people expect to go door-to-door as often as possible.
There is absolutely no point my grumbling that children are driven to school, clogging the morning roads and that in my day we always walked. True, it is the very mothers in their cars that make walking to school more dangerous so the trend strengthens itself; but if that is how most people live then shouldn't blind children live that way too; why should they trudge through the rain in their unstylish mackintoshes and sensible shoes while their peers ride to school in fashionable gear and trainers that have never seen a running track?
We seriously have to ask ourselves what we are doing and why. The answer I usually get to this last set of questions is that at some point there will be a crisis and a blind child will be left stranded; not with a mobile phone and an account with a taxi company she won't! We really have to think about how we put our money into special services. I think that the GDBA missed a golden opportunity when considering its long-term strategy. Surely the key point to consider was the finding of the RNIB Survey that so few blind and visually impaired people actually get out of their houses on a regular basis and that their greatest complaint is being isolated. There isn't very much point in behaving like Marie Antoinette on these occasions; let them have long canes isn't the right reply to a complaint that the bus service has been discontinued. Nor, for that matter, is let them have dogs.
The other response, at least at a subconscious level, is that it's good for them. It isn't in the least. It is chronically horrible not being able to see very well or being blind. It creates an endless succession of minor irritations and major drawbacks; it is neither heroic nor pathetic, it is simply tedious and painful. People treat you badly, they condescend or they exalt with alarming inconsistency; their behaviour oscillates like a perpetual re-telling of Palm Sunday and Good Friday; one day you're a hero and the next day you're useless. People think that it is their absolute right to interrogate you on your medical history: rarely a day goes by without a total stranger asking me how long I have been blind, what caused it and whether there is any chance of my having my sight restored. You know that at the beginning of every new encounter you have to get over the blindness obstacle; to get people to think past your blindness to your real self. I earn my living as an expert on information technology and social exclusion but everybody I meet for the first time assumes automatically that I specialise in IT access by blind people.
Now I raise these matters in this way because of the old fashioned idea that blind people, like other groups accustomed to receiving charity and condescension, ought to do certain things because it is good for them. What I am saying is that things are difficult enough without us having to fit into somebody else's pattern to which they've accorded some moral worth. When I lived in the Caribbean people used to bemoan the lack of the work ethic in some communities to which my reply was if there was fish and fruit all year round and people were happy to live on that and not create surplus income and wealth then there was no particular virtue in work. Equally, for blind people, there's no particular virtue in independent mobility unless it meets some greater end; it's not an end in itself.
Let me put this in another way. If you and I could cadge a lift off a friend to save us taking a walk a bus and a walk to some destination in the middle of town, who would miss the chance. One of the problems that disabled people have, in addition to their genuine functional limitations caused by their condition (known as the medical model) is problems arising for want of self confidence (which we might loosely associate with the social model). One of the reasons many blind people find it hard to negotiate good deals is that they think they have nothing to offer. For this you need strategies, you have to work out what to give as well as what to take. So, for instance, when I am accepting mobility help across a huge railway station concourse I invariably ask my guides about what concerns them. It occasionally goes wrong, as in the case where a lady told me she was coming to London because her husband had dropped dead yesterday; but that's a risk you are well justified in taking. The very least you can do for somebody who has taken enough interest in you to offer help is to show interest in him. I don't remember that being drummed into me during my mobility course. When I am in a restaurant I need somebody to read the menu to me, so you can be sure that I have boned up on the way menus are written and can help to explain obscure foreign terms for dishes; I have also tried very hard to learn about wine, a subject where people with poor vision can be very good, so that I can help people to drink what they like. Most people are frightened by wine lists and fancy menus; I'm not; so I have something to offer.
Let me tell you about a little piece of research I've been doing for a number of years. I have been to conferences on visual impairment all over the world for twenty years, on mobility, technology, ophthalmology, library services, braille coding, whatever. At each such conference on the first evening I toss a coin; heads I decide who to eat with; tails I go with the flow. On subsequent nights I then alternate deciding and being passive. Whether my first night is active or passive makes no difference in the long run. If I choose with whom I'm going to sit I end up with people who are making conference decisions or making the running; I think I contribute reasonably well to discussion and people seem to enjoy my company. But on passive nights following such rewarding evenings it is always the same, I end up at the bottom of the table with all the totally blind people and those who don't speak English. Now if this happens at specialist VI conferences, how do you suppose matters stand when blind people participate in the real world? Recently I went to a Demos Foundation seminar on IT and social exclusion and at lunchtime everybody drifted off and left me on my own; I was helped by a Kenyan lady who obviously felt excluded, too. I told this story at a subsequent seminar on the same topic and one man actually did offer help at lunchtime but he didn't know how to describe the food on offer and I had a horrible lunch!
Now that's all that I'm going to say in complaint. I make a rule in my presentations always to say more on the positive than the negative side; so here goes.
I want you to understand the importance of negotiating skills as a method of becoming a fully participating member of society. We all spend our lives in a state of permanent negotiation with our families, colleagues and friends. In those discussions we are sometimes dominant, sometimes dominated and sometimes roughly even. The problem for most VIPs is that they exist in a permanent state of being dominated because either they have nothing to offer in negotiation or think they don't. That is why there are a few people like me who have figured out that the only way to deal with this is to be very positive. Because most of our VI peers are not like this, the few that make a move are characterised as arrogant, inflexible, dogmatic, provocative, and outspoken; we have gone outside the stereotype established for us. So, when I sit down at the end of this speech there will be many who will think of what I have said as provocative, as if I were trying to engineer some sort of outraged reaction; I'm not, I'm speaking as I find my life and trying to be as honest as I can. If somebody with a degree and no visual impairment got up and said what I'm saying there would be no accusations of being provocative; but as I am permanently cast as a client, as a consumer of largely monopoly supplied services, people with far fewer brains or graces than me are allowed to treat me as a child, to castigate me for upsetting them.
In a very real sense to offer clients negotiating skills is to disempower professionals; all well and good if clients go and negotiate with the Citizens Advice Bureau or London Transport but problems arise if they start negotiating with monopoly or cartel suppliers of services. Personally speaking, I'm not a great lobbyist and advocate on behalf of VIPs and I think there's something a little suspicious about professional protesters - they tend to get things out of proportion and to lack humour - but we have got ourselves into knots in the visual impairment world; for a sector that is so small and tight we have found dialogue horribly difficult.
So, to return to my theme, what we need to emphasise above everything else is negotiation. We might have had other words for this in the past but the essence of the idea goes with the grain of contemporary culture. Inclusion and exclusion are quite decent words in their way but they don't actually describe the dynamic I am looking for. Exclusion is usually an odd mix of irrationalism and selfishness and inclusion is usually done to the people to be included; when they struggle for that inclusion themselves there is, as I've pointed out, a certain amount of resentment; so negotiation is what I'm looking for. I don't want us to be over optimistic about our clients; I don't want to send them into negotiations with a false view of the hand they've got. If you find your client has a poor hand or just about no hand at all, you have to fall back, quite rightly, on an emphasis on basic human values like respect and decency; we have to evolve a much better language to describe human relations than simply couching everything in terms of "rights"; having said that, one chronic feature of specialist services is that they almost invariably underestimate the skills of clients; so if you think a client has a poor hand at first sight, look again.
One of the reasons the client may have a poor hand may simply be because he has a poor appreciation of style. It's difficult to pin this down and very difficult to know where to put this topic into a speech like this but in it must be put somewhere. We are all influenced to an immense extent by style in such things as clothes, decor, posture and address. Yes, body language is part of this area but body language is usually a combination of spontaneity and style and it's the ability to assert style that counts in complex cultures. It isn't just that many VIPs can't see and interpret body language, they can't express themselves in a way that optimises their position in our culture. Put simply, it's terrible to be rude by accident but quite acceptable to be rude on purpose; it's important to know whether a certain garment is simply gauche or whether the very gaucheness is a heterodox statement; it may be important to tell the truth with your eyes and lie with your words, or vice versa; the exact degree to which you want to deviate from a norm is immensely important. This particular area of complexity shades over into other areas of expression like parody, irony, allusion, collage and deliberate ambiguity. For many people with poor vision statements delivered and received are fatally monochrome. It's a situation that seeing people couldn't possibly survive for a minute; how are VIPs supposed to survive any better. The answer is, of course, that they don't. We're gauche by accident instead of on purpose; we mistake irony for hostility; we turn up at interviews with the wrong neckline; we go up the housing market but we don't leave our garden gnomes behind! No wonder 80% of us of working age don't have a job. We're hopeless. Meanwhile, those put in professional charge of us go on about boiling eggs and climbing stairs!
The area of style impinges directly onto a key skill and that is description. It might stagger you to know that no cadre of providers of service to visually impaired children or adults that I know are taught how to describe things and then examined in this vital skill. Now it's obvious that mobility officers have a head start in this area; they might just know how to describe a land layout, to calculate the width of a road, the height of stairs or the degrees of an angle. Well, don't knock it; it's a good start. Most people don't even know how to describe the house they've lived in for years. So there is some foundation here but it needs to be built on. Let me give you an old example. There's a poster on the wall of a soldier in uniform. He's wearing an outrageously flamboyant uniform and he has a diamond stud in one ear; the lettering of the message is in one of Gill's typefaces and the background refers to Escher, or is it Lowry? Now how much does all this matter? Well, it matters whether or not the poster is a piece of army recruitment propaganda or a pacifist statement by a gay rights organisation. People under Stalin who couldn't deconstruct like this were often killed. I'm not saying it's quite that important here but you see my point. We really can't have robotic clods as our intermediaries. We need people with flair and creativity to interpret our environment; and if they don't have all the skills - and why should they? - we need teams; why not ask people who describe for a living, such as novelists, to help us; why not ask radio script writers who have to convey everything in words; why not talk to people in art and design colleges about style?
Without a better appreciation of the complexity of the environment, VIPs simply won't have the raw material which might enable them to interact more effectively in society. You also have to remember two other factors in description: first, most people nowadays live inside a small number of metres, they're not agricultural workers but live in front of screens or in small rooms, so description has to be at a micro level; secondly, information moves, it's not static, so we need to be much better at gesture and transformation; just being able to make sense of a geometry drawing or even an Escher print isn't good enough.
3 Orientation versus Mobility
After adultery, the most important cause of divorce is poor map reading. I've been interested lately in the ability of ordinary folk to travel south using a North-oriented street map. The findings, though still sketchy, indicate that huge numbers of people, including highly qualified professionals, just can't manage. So when you put a poor map reader into the passenger seat of a moving car and present them with a road atlas of France there's bound to be trouble.
It's my suspicion that orientation needs another boost in terms of its importance relative to mobility. It's a bit like the importance of information handling as opposed to the basic ownership of equipment. So, for instance, in using the Internet it is important to own a hardware device and all the software but if you can't find your way round, if you can't navigate in three-dimensional hypertext, your performance will be very poor. I have found orientation much more central to my life than high-grade independent mobility skills. That isn't to say that others won't have different experiences but I find that I'm using my orientation skills almost constantly not only in a purely physical sense but also in a more abstract sense. One of the key features of my overcrowded life is ergonomics; you simply don't want to have to do more physical tasks than is absolutely necessary; so I have to undertake a huge amount of mental ergonomic analysis, whether we're talking about journeys to the cellar or the dishwasher or whether I'm trying to work out the order in which to visit a number of shops in a medium sized town. This kind of orientation isn't simply a matter of understanding a directly applicable environment - the direction of current travel, the distance between traveller and object - it is also a matter of placing a human being in a three dimensional world, physical or mental, and teaching them how to navigate it optimally. This is going to be a vital skill, as I have implied, in the use by VIPs of the Internet; if they can't find something they can't benefit from it.
Now I am not saying for a moment that professionals can solve this problem as matters now stand. Navigating the Internet is like finding your way through a building site in search of a destination that could feature in a Holidays from Hell programme. The whole ramshackle edifice is a mess; so we are going to have to do some work on the way that information is designed and the way in which navigation systems are constructed. I am already involved in that but I think it would be timely for professionals to start looking at orientation in this micro reality, abstract fashion as well as in the atrium and the street.
4 Environmental Design and Robotics
With all these new tasks that I am urging on you it is perhaps as well that some of your traditional concerns will be mitigated by technological development. Recently Demos has published a key policy report on disability entitled "An Inclusive Future? Disability, social change and opportunities for greater inclusion by 2010". It shows that disability is not a condition suffered by a few people with the rest of society being 100% able-bodied. As the population lives longer there are more and more people who suffer from major disability and hosts of minor disabilities such as arthritis, poor vision and hearing, memory loss, clumsiness and more sluggish reflexes. Society, it points out, can no longer be designed for fully fit 20 somethings. Not only is this poor social policy it is bad marketing; design for almost all is not as tidy a slogan as Design for All but it conveys the truth of the report.
We are now altering our environment so rapidly and radically that good basic design for VIPs will become a feature of an increasing proportion of our physical facilities or, rather, it will if that is where we choose to put at least some of our resources. It is the age-old problem of trying to deal with clients now as well as trying to influence the future; the more we improve design the less problems our clients will face in the future. I am aware that there has been some campaigning about the physical environment but I think it needs beefing up. When you have all read this Report you should have a better idea of the way in which society is changing and then it will be the right time to work with other professionals to get some action. As this is a matter of commercial viability as well as good social policy you should have some of the right levers but you will still have to overcome some old fashioned attitudes. Just sticking braille labels on doors isn't going to be enough. We want micro environmental positioning capacity in public buildings so that when I walk into, say, Victoria Station, I switch on my mobile phone, press one digit and I'm automatically switched into the station's system; it tells me where I am and as I turn the phone, which has a censor like that on a remote controller, it tells me which way I'm facing. If you want to be even more sophisticated I might ask the system for Platform 15 but, in the meantime, I'm happy for it to respond to censors through a handset. This is technically perfectly possible and we need to see that this sort of capacity gets into all major new building projects.
Then there are robots. Sony claims that by 2050 eleven of its robots will beat any football team in the world; of course they will, all eleven will know exactly where the ball's going next and at what speed. I'm not sure how good they will be at defence but they're bound to score almost every time they attack; so at the worst they would draw over a given period. There are two kinds of technological development which are important here. The first is the ambient assistant, the robotic equivalent of a guide dog or a long cane plus satellite positioning system plus voice in voice out computing capacity. Such a device would help you to get from place to place, monitoring the environment and feeding information. I believe that this kind of robotics has now progressed far enough for us to say that it is no longer a Tomorrow's World speculative phenomenon. The second kind of device is the variant on the intelligent agent that can sort your e-mail. Intelligent agency relies on a piece of software analysing behaviour and drawing conclusions. So, if I always answer e-mails from Samantha before I do anything else but wait for days before replying to Joe then the agent can currently put my e-mails in the order I generally like to deal with them; and as my behaviour changes so does the prioritising process. So if I happen to learn that Samantha's been seen around with another bloke I am not so eager to answer her e-mails and she falls down the priority list. Well the area of intelligent agency in environmental design is even more fascinating. Imagine that every time you glare at a door it opens and that every time you smile at the same door it shuts. That will soon be possible because the door's intelligence will base its actions on analysing behaviour. Of course, there will be an awful problem in the short term if you smile for open and I smile for shut but over time the door, particularly in a house or an office, will learn to recognise each of us and respond to our behaviour. Now you see why the ability of VIPs to manage their own gestures might be important. At a simpler level, though, this kind of technology is vital because it is finding the doorway and finding the handle that are frustrating, not finding the building.
I could go on about this for much longer but I think I've said enough to alert you to the possibilities. What I am saying is that we need to begin to take these technologies seriously. Don't be put off by the currently complex navigating and positioning systems; these are primitive; they will soon be much more user friendly.
5 Professional Priorities
I have now sketched out an array of what I think are important priorities for the future which make long cane training sound rather banal and old fashioned. I am not saying that teaching these skills will be of no use but it must be put in perspective and I am glad that you as a body are already looking at broadening your remit and becoming more involved in a wider variety of daily living skills.
There is, of course, a danger that different specialities will be rolled into a host of rather ill focused generic workers and you must, I think, guard your speciality but not through being exclusive but by guarding the standard of the modules you teach; don't mind if other people teach the same modules and for goodness sake don't fight with rehabilitation specialists. What we need to do is to identify user requirements and build modules to meet them. The world of visual impairment has been bedevilled by professional rivalries and, paradoxically, by a lack of professional identity and security. Teachers and doctors have their traditions but rehabilitation workers and mobility officers don't have that same depth of tradition; so there is an up side and a down side to this. The up side is that, not having very much professional baggage you can be flexible; but the down side is that insecurity will lead to squabbling.
I think I have said enough to convince you that there are more interesting things to do than fight over turf; there's more turf and more clients than the whole visual impairment sector can even contemplate dealing with so whatever changes come along there's no danger of you losing business except, of course, the danger that the funding will run out. The voluntary sector in visual impairment spends huge amounts of money and so does local government and central government. The visual impairment professional community has been too busy squabbling to lobby effectively; it's very lucky to have kept what it's got; by rights it should have been siphoned away to other problems; but, given the favourable position in which we are regarded by the public, doubtless because they feel so sorry for people like me, it is time that we became more accustomed to being judged by our results.
This material is the intellectual property of Kevin Carey, Director HumanITy. It may be copied or quoted in part or in whole in any format as long as it is properly acknowledged and not exploited for commercial purposes.