Orientation and Mobility for Babies and Toddlers

What Is Orientation and Mobility?

Orientation and Mobility (O&M) includes the skills needed to orient to surroundings and to move independently and safely in the environment. To learn and master these skills, a blind or low-vision child commonly works with an O&M specialist from infancy through late adolescence. They may occasionally work with an O&M specialist again as an adult to learn routes around a college campus, unfamiliar town, or new job.

For babies and toddlers who are blind or low vision, O&M entails encouraging movement and developing foundational concepts and skills which we’ll call “the building blocks” of O&M.

How Do O&M Specialists Approach Instruction?

O&M specialists talk with the family about the typical sequence of O&M skills and the family’s vital role in a child who is blind or low vision skill development.

The family and O&M specialist then work with the child informally through play to 1) encourage purposeful movement, developing the child’s gross and fine motor skills; 2) recognize what they are seeing, hearing, smelling, and touching; 3) learn body parts and how they move; and 4) learn concepts about the child’s surroundings, beginning with the immediate environment.

If the child has low or high muscle tone or any additional disability that may hinder movement, the mobility team will include a physical and/or occupational therapist or another additional service provider. Encouraging movement, including the motivation to move, is a team effort.

As the young toddler begins moving independently, the O&M specialist will teach the child beginning techniques to move safely, including use of a sighted guide, use of an early mobility device such as a push toy or small cane, and to use protective techniques such as holding a hand in front of the face when walking independently.

When traveling outdoors, the team will ensure the child’s vision isn’t hindered by direct or indirect sunlight. The child will wear a brimmed hat and a good pair of sunglasses.

How Can You Support O&M Instruction at Home?

The following are “building blocks” needed for proficient orientation and mobility skills; you’ll find you are, naturally, the expert teacher of the following:

• Early movement begins with muscle development and coordination. As you hold your baby, they will learn to hold their head upright, improve balance, coordinate movement, and feel how your body naturally sways, shifts, and purposefully moves. Likewise, when you place your baby down for tummy time, you promote muscle development and coordination.
• Your child needs motivation to move! Invite your child to explore interesting activities and environments, place appealing (visually and/or auditory) objects just out of reach, and get down on the floor with your child as you ask him to move toward you.
• Your child will need to understand body concepts to safely and efficiently negotiate his environment. Teaching body concepts involves demonstrating how a body moves through space (this is accomplished by holding your baby or young child on your hip, inviting your toddler to stand on your feet while you walk, etc.), teaching body parts through play and song, and helping your child understand how his body moves. Help your child explore movements and teach the vocabulary involved in activities such as pushing a button, rotating the wrist, reaching over the head, ducking down low, crawling, lunging, pulling up, walking, etc.
• Your child will benefit from heightened sensory awareness because traveling with minimal sight involves listening for patterns of traffic and paying close attention to sights, textures, and smells. You can help your child develop sensory awareness by involving your child in countless opportunities to explore and describe what your child is seeing, hearing, smelling, and feeling. You can learn more by reading, Living Life While Helping Your Child Develop.

Developing Your Child’s Skills

• The better your child understands location and travel concepts, the better equipped your child will be to traverse his environment. Give him ample opportunities to explore his surroundings: hallways, walls, doors, doorknobs, pantries, closets, elevators, cars, homes, buses, etc. You can learn more by reading, Building Knowledge in Blind Infants and Toddlers.
• Your child will need to follow directions when traveling. Beginning with a familiar routine, ask your child to perform a task (such as, “hold the toothbrush”) and praise them when they follow the direction. Continue teaching direction following; ask your child to follow two, three, four, and more directions.
• Help your child obtain positive and safe mobility experiences to increase their confidence. Your home furnishings should be kept in predictable locations while your child is learning his environment; the floor should be kept free of loose items; and you can talk with the mobility specialist about providing your child with a device (hula hoop, grocery cart, walker toy, adaptive mobility device, or cane) to keep them from bumping into their surroundings.