Guiding Hands: Help or Hindrance
By Lilli Nielsen Ph.D Spring 1996
(Editor's note: This article was taken from Future Reflections, Vol 14 #3. National Federation of the Blind 1800 Johnson Street Baltimore, MD 21230 (410) 659-9314)
Lilli Nielsen is known all over the world for her success in working with blind multi-handicapped children.
Although Lilli is sighted, members of her family were blind, consequentially she has had a unique view on blindness. NATHHAN readers may remember the "Little Room" and other information we have published about her work.
This particular piece is actually a research article. Dr. Neilsen challenges the "helping hand" practice used by many professionals: that of physically picking up and guiding the blind child's hand when showing them something.
When a sighted person wants to show an object or an environment to a child or an adult who is visually impaired, the sighted person often uses the approach of guiding the child's or adult's hands over the surface of the object or from one specific spot of the environment to another one.
The person who is visually impaired seems to dislike being exposed to this approach. Even the blind infant reacts to this approach with disappointment or by withdrawing his hand. Is this reaction just an emotional protest or should it rather be seen as the child trying to protect his cognitive abilities?
In a review of the development of the haptic-perceptual (touch perception) modality Van der Poel (1988) states that:
Adequate stimulation of the haptic receptors leads to perception of touch, pressure, temperature, and pain. In this way the surface of the skin becomes prepared for the ability to assimilate specific information. This leads to haptic consciousness. When the child starts to become conscious about the specific meaning of different haptic experiences a cognitive coupling takes place and thus prepares the child for more sophisticated haptic perception.
Van der Poel also refers to Warren (1982) who has stated that the infant, in the beginning, is satisfied with the haptic experience itself. Together with the maturity of the cognitive processes a move from performing subjective to more objective and meaningful activities is taking place. The child can then acquire knowledge about his surroundings by the haptic-perceptual modality.
This means that the information coming from the haptic (touch) receptors are necessary for the visually impaired child if he is to perceive the qualities of the objects or the environments to which he is exposed. This perception can easily be disturbed if the child's hand is guided. This is because some of the child's haptic receptors will be activated by the touch and pressure of the adult's hand, thus bringing to the child information that has nothing to do with the object or the environment that the child is supposed to perceive.
According to Baddeley (1986) the child can only establish a memory if he has opportunity to repeat his experiences. This means that when the child starts to combine the information coming from his kinesthetic and tactile receptors as well as when he combines new haptic experiences with those already stored, he will have to repeat such cognitive activities.
Van der Poel (1988) mentions that the visually impaired child has at his disposal only weak strategies for solving cognitive problems regarding spatial orientation.
Edelman (1994) states that the child learns by selecting. With regard to acquiring strategies for tactile search, Edelman's statement means that the visually impaired child will discover different strategies by means of his own activities and so develop several strategies from which to select.
Observations of blind persons, both children and adults, while performing tactile search of an object or an environment show that the blind person develops different strategies for different purposes or tasks.
The first strategy used for exploring a novel object may be perfunctory. The second, third, or fourth time the child explores this object he may use a strategy which includes more differentiated exploration, and he may perform more repetitions of this way of exploring. Or maybe, in some situations, the strategy of differentiated search is used immediately followed by a more perfunctory strategy. After this exploration, the object may be so familiar that only a slight touch is necessary to call forth in the visually impaired person's mind the image or the map of the entire object.
While the child is building up strategies for tactile orientation he will also add to the haptic information the information he can achieve from other sensory modalities. The child during the first year of life will depend very much on the olfactory sensory modalities while building up his strategies for tactile orientation. Later, he will often prefer to gain support from the auditory sensory modality.
Building up sensory-based strategies for imagining and mapping objects and environments (and doing so on his own) is an important part of the visually impaired child's cognitive development.
The following figure shows the steps of the cognitive process of learning to imagine and to map objects and surroundings.
• Information from the sensory modalities of hearing, touch, smell, taste, and kinesthetic ability are by means of repetitions stored in the child's memory.
• According to the child's experiences a cognitive process establishes in the memory categories, associations, connections and the ability to recognize.
• From this storage the child makes plans and strategies for performances of tactile search and he acquires the ability of imagining and mapping objects and surroundings.
This process is disturbed or interrupted whenever anyone guides the child's hand without his permission. When a sighted person guides or leads the blind child's hand, it is the sighted person's strategy for tactile search that is used. The sighted person's strategy is influenced by her ability to see as well as by her degree of comprehension of how a blind person experiences his surroundings.
Does the person who is guiding the visually impaired child know which sensory elements are most important for this child to discover? Does she know how much time this child needs to be able to assimilate tactile sensory information? Does she know how many times this child needs to repeat every single action in order to be able to relate them to each other and thus finally achieve a reasonably good image of the object or environment in question?
During the period of time in which the child is building up a certain strategy for performing a certain activity or for mapping a certain object or a certain environment it will surely harm, disturb, and/or delay the child's opportunity to develop these strategies if adults (teachers, physiotherapists, occupational therapists, parents, or others) are interfering by guiding the child's hand. This is so for they use strategies different from those the child is trying to achieve.
The child whose hand is guided in one way by one person, say, at eight o'clock in the morning, in another way by another person two hours later, in a third way by a third person at 2 p.m., and in yet another way by a fourth person at 5 p.m., is presented with so many strategies that the child experiences total chaos, bewilderment, and frustration. This approach also results in the child having too little time and too few opportunities to build up his own strategies.
From this point of view it is not surprising that so many visually impaired children withdraw their hands, or become unwilling to touch anything at all.
Poor tactile and haptic development also affect the child's control over his own body. Guiding the child's hand is restricting his movements. Since his spatial skills are based on movements (Nielsen, 1989, 1992, 1994; Van der Poel, 1988) he loses control over his own body as well as the environment whenever his movements are restricted.
So, there is every reason for refraining from guiding the blind child's hands.
The negative effect of guiding the blind child's hands during the preschool years may only be obvious (such as in the development of tactile defensiveness) when the child is six, seven, or eight years old. By this time he is no longer with the preschool teacher who exposed him to the hand-over-hand approach. Thus, it is hard for the preschool teacher to discover the effect of her or his way of teaching.
The adult should refrain from taking the child's hand and trying to show him where he should touch an object or how he should search it. This is so even if the adult sees that the child's hand is moving in the wrong direction, moving in a direction that the adult finds more complicated than necessary for searching the object in question, or if the adult sees that the child omits exploring a certain part of the object or a certain small detail of it. It would be better for the adult to suggest to the child that he make a more differentiated search, or allow the child to use more time for his search.
It also disturbs the child's building up of strategies for searching if the adult moves the object, even if this is done with good intent. Interference or delay also takes place if the adult talks to the child while he is trying to build up a strategy that works for him.
If interference happens often or always, it will be very difficult for the child to succeed in building up strategies. His knowledge about himself and his surroundings will be so fragmentary that his cognitive development will be negatively affected.
The visually impaired child who gets the opportunity to explore objects without interference can develop a strategy for mapping which later he can correct and further develop according to his enhanced motor capability, capacity for memorization, his ability to exclude information which is less important, and his enhanced cognitive development.
The child must repeat both the "useful" and the "wrong" strategies while experimenting with different strategies for tactile search. Both kinds of strategies must be stored in his memory so that later he can consider them, exclude those that are less effective, and make his choice.
The conclusion of the above considerations regarding the process by which visually impaired children build up strategies for tactile orientation must be that when the child withdraws his hand or protests against having his hands guided he is either trying to defend himself from the bewilderment caused by the guiding, or he is trying to protect the strategies for tactile orientation which he has already achieved. The conclusion must also be that the visually impaired child benefits when his teachers exclude the approach of guiding his hands from their educational methods.
Finally, the only strategy for tactile search which is of value to the child who is visually impaired is his own.
(Editor's note: When I first read Lilli Neilsen material, I was fascinated. It is truly a different approach and one we have used with several of our children with success. Giving our children time to explore on their own without hanging over their shoulder so to speak gives them a freedom to find out about objects in their own way. The same principle applies to learning other skills. Older blind children should be given the general goal and an explanation of what is going on, but left to accomplish the task on their own. What a lesson in patience for parents! If it bothers you to watch, go in the other room and get busy with something else!
Try this experiment: Close your eyes and have your husband or child find an unfamiliar object for you to identify. Have him firmly grasp your hand and "show" you the details. Can you feel how another's "guiding hand" adds unwanted "data" to the exploratory process?