Before we address the developments of the more recent past which led to the development of orientation and mobility as a profession is helpful to examine the development of the treatment and education of individuals with blindness and visual impairment in the past. Lowenfeld (1975) divides the history of the status of the blind in western civilization into four phases: separation, ward status, self-emancipation and integration.

The separation phase of the development of the status of the blind is divided into two stages: prehistory and antiquity. The reports on conditions in prehistoric time are based on the generalized treatment of the aged, sick and infirm by primitive tribes in various parts of the world. "There is among primitive groups a great variety of attitudes and practices ranging from accepting and loving treatment to rejection expressed in killing, cannibalism and necrophagia. Though generally inclusive statements cannot be made, there appears to be no doubt that negative practices prevailed" (Lowenfeld, 1975, p. 13). Much of the negative treatment may be attributed to the harshness of living conditions and the difficulties in obtaining the necessities of life during this era. Exposure, abandonment and killing served the social purpose of security and survival for the group by sacrificing weak individuals, who were also saved from further suffering due to their weakness.

The roots of western civilization are generally traced to ancient Greece and Rome. The status of individuals with disabilities during this era remained that of separation, either by annihilation or veneration. Even Plato and Aristotle supported the notion of disposal of deformed newborns. During this era, generally, if blindness occurred after a person was accepted by the family, they were treated as members of the family and usually became beggars (Lowenfeld, 1975). It is possible that it was at this time that the image of blindness and the beggars staff became connected. Based on the frequency of blindness in Greek mythology, it is possible that blindness was common in that time, with a large population blinded by force as punishment for defeat in war. There are also many stories in Greek and Roman lore which support the theory of separation by veneration, as those who were blinded late in life became famous philosophers, poets, lawyers, politicians, and teachers (i.e., Homer, Tiresias, Appius Claudius Caecus). It is theorized that individuals were venerated while the majority of individuals who were blind were employed as mine workers or beggars (Lowenfeld). It is interesting to note that during this era in Greece we find the first connection between the war blinded and improved services for the blind in general. The Laws of Solon granted financial assistance to individuals crippled by war, which was later extended to include all citizens of Athens who were crippled (Lowenfeld). It is important to note that the societies of this time were elitist aristocracies which tolerated social injustice, economic inequity and indifference to all who were not within the ruling classes.

In the ward status era, following Christianity and until the 18th century, individuals who were handicapped, aged and orphaned were protected, pitied and given special concern. The western religions fostered the notion of ‘my brother’s keeper’. Care was given, but not education. The first hospital exclusively for the blind was reportedly established in the fifth century and "was located near Cyr in Syria where St. Lymnaeus assembled blind beggars and housed them in little abodes in the vicinity of his hermitage" (Lowenfeld, 1975, p. 36). The most important and well-known center for the blind, l’Hôpital des Quinze-Vingts (hospital of the twenty-five) was established in 1254 by Louis IX in Paris for blinded Crusaders. It is interesting to note that some of the contemporary criticism of the hospital addressed orientation and mobility skills, "They push each other and inflict on each other contusions because nobody is there to guide them" (Kretschmer, 1925, p. 58, translated in Lowenfeld, 1975, p. 36).

"The 17th and 18th centuries may, so far as the blind are concerned, be called the era of self-emancipation" (Lowenfeld, 1975, p. 44). It was during this era that the philosophy of individual independence for all men was spreading through the western world. Until mid-18th century there were only scattered attempts to educate blind children—none provided for the development of systematic programs (Roberts, 1986). The establishment of educational facilities was profoundly influenced by the examples of achievements of numerous individuals who were blind (i.e. Thomas Blacklock, Carolan, John Fielding, Francois Huber, John Metcalf, Nicholas Saunderson, Melanie de Salignac, Lenôtre). The philosophical groundwork for all education of individuals who are blind has been attributed to Diderot’s 1749 Letter on the Blind for the Use of Those Who See, which he based on his encounters with three blind individuals and set forth the philosophy that the blind can lead normal lives and are intellectually competent.

The three great founding fathers of the education of the blind can be considered to be Valentin Hä uy in France, Samuel Gridley Howe in the United States and Johann Wilhelm Klein in Austria. Häuy established the Institution des Jeunes Aveugles (Institution for the young blind) in 1784 that focused on the study of music, acquisition of vocational skills, reading, writing, and everyday activities. It was closed in 1799 by Napoleon, who sent the children to a home for blind adults, with no educational services. Häuy went on to other parts of Europe to help found other residential schools for the blind. Samuel Gridley Howe was instrumental in establishing the New England Asylum for the Blind (currently Perkins School for the Blind) in 1829 and was a well-known educator of children who were blind in the United States. Klein published Lehrbuch zum Unterrichte der Blinden (textbook on instruction of the blind) which was used by many as a guide for educating children who were blind. This text included a description of a rigid harness for a dog guide and methods for training the master and dog that are similar to those used today.

Although residential schools for blind children began to be established in Europe in the late 1700s, and residential schools began to flourish in the United States throughout the 1800s, systematic instruction in orientation and mobility was not included in the curriculum, nor in personnel preparation programs. It has been reported that in the early years children who were blind asked the children with partial sight to serve as guides, which caused overwork and fatigue for the children with partial sight (Roberts, 1986). As students graduated from schools for the blind, they had difficulty finding employment. This led the residential schools to build workshops for vocational training purposes, with the first being opened at Perkins School for the Blind in 1840.

Instruction for individuals who were blind was organized around the same time as America was becoming industrialized. One of the key changes to the American landscape due to industrialization was the proliferation of urban areas. The urban environment is characterized by heavy traffic, crowded sidewalks, construction, and other hazards. The result of the urbanization of the United States was that "problems of mobility could no longer be solved by personal initiative or intervention or friends, special training was now required" (Scott, 1976, p. 124).

The dog guide movement
After World War I Dr. Gerhard Stalling trained German Shepards for use as guide dogs for the war blinded in Oldenburg, Germany. In 1923 this mode of travel training was presented at an American Association of Workers for the Blind conference, but it was not until 1929 when Dorothy Harrison Eustis, with the help of Elliot S. (Jack) Humphrey as a trainer and Morris Frank as its first spokesperson, established the Seeing Eye in Nashville, TN that the dog guide movement began in the United States. The Seeing Eye was later moved to Morristown, NJ with the help of Willi H. Ebeling, who offered to use of his estate for the new school and later became the Executive Director. This was the first organized approach to mobility training. While it only applied to adults, it laid the groundwork for a change in philosophy regarding the potential for independent travel for individuals who are blind.

Use of the cane
The use of a cane by individuals with visual impairment dates back to antiquity, a short, stout cane was traditionally tapped to warn others out of the path and set up echoes as clues to the environment (Hoover, 1963). One of the first published analyses of the mobility needs of persons who are blind, Blindness and the Blind, in the chapter On the Blind Walking Alone, and of Guides, was published in 1872, in London by William Hanks Levy. It included such hints as to use a cane and an erect posture. During this time, the average person (sighted or visually impaired) usually did not travel very far and usually in less crowded conditions than are present today. Iron wheels and horses were usually loud enough to prevent highway accidents. Rubber tires and autos with higher speeds created more problems.

Before World War II and the development of a profession of orientation and mobility travel techniques were taught by home teachers, most of whom were blind themselves. They generally taught the way they got around, which my be satisfactory for indoor travel but is hardly adequate for safe unescorted movement on unfamiliar city streets (Koestler, 1976).

The war blinded of World War II were instrumental in the development of orientation and mobility as a profession. In July 1943 two Army hospitals were designated for medical treatment of the eye wounded, Valley Forge General Hospital in Phoenixville, PA and Letterman General Hospital in San Francisco, CA (later moved to Dibble General Hospital in Menlo Park). The long cane foot travel system was developed at Valley Forge by Sergeant (late Lieutenant) Richard Hoover. Before the war he had been a teacher and physical training coach at the Maryland School for the Blind. At Valley Forge, Hoover developed and trained a group of instructors in a systematic and orderly method by which they could train newly blinded men to travel. It involved using a longer, lighter cane in a systematic manner. C. Warren Bledsoe had worked with Hoover at the Maryland School for the Blind in the 1930’s and later at Valley Forge Hospital where he assisted Hoover in training medical corpsmen as instructors for the blind. In 1948 the rehabilitation of the war blinded was moved to the administration of the Veterans Administration at Hines Hospital in Illinois. Bledsoe helped choose and train the first six mobility instructors at Hines. In 1952 the film The Long Cane was produced at Hines. It was the first presentation of the training to the general public. Bledsoe (1980) proposed the idea of benign surreptitiousness in order to explain the early resistance to use of the cane. This theory proposes that in order to minimize the impact of blindness on others, do nothing that will make it clear to all that you are blind.

In 1959, the first formal step was taken to establish university programs for training orientation and mobility instructors. A national conference on mobility and orientation was held by leaders in the field of blindness and mobility. Topics discussed at this meeting included criteria for selection of O&M personnel, training curriculum, length and academic level of training courses, and appropriate sponsorship of training programs (New Outlook for the Blind, 1960). Based on the program developed by the Veterans Administration to assist in the rehabilitation of blinded WWII veterans, in 1960 the first university program was established at Boston College under the name of Peripatology Program. In 1961 a second O&M program was opened at Western Michigan University in Kalamazoo as the Orientation and Mobility Specialists Program. "It was first believed that 100 instructors would meet the training needs of the visually impaired population; however, the discovery that O&M could be broadly applied to children as well as adults created a need for many more O&M instructors" (Weiner & Uslan, 1990, p. 57). In 1966, San Francisco State University and Florida State University started O&M programs with special emphasis on personnel who were prepared to work with children. Since then, a number of programs have come and gone, with Boston College’s program closing in 1991.

Legislation related to blindness and orientation and mobility
In the 1840s financial aid or special welfare programs for the needy blind began in Indiana and eventually spread to the rest of the country. The American Printing House for the Blind was founded in Louisville, KY in 1858 as a state agency producing materials for the blind. In 1879, the Act ‘To promote the education of the blind’ was passed, which made the American Printing House the national resource for educational materials for individuals who are blind. This act provided and continues to provide funding for provision of materials for the education of individuals who are blind or visually impaired according to their needs.

The Social Security Act (1935) established a separate relief category for persons who are blind (Title X). It also established the legal definition of blindness.

The Pratt-Smooth Act (1931) The return of blinded veterans after World War I focused attention on the lack of reading material available to blind individuals. This law gave the Library of Congress the responsibility of providing books for the blind to regional libraries to be circulated free of mailing or other charges. This act was amended in 1939 to include talking books.

P.L. 732 Randolph-Sheppard Act (1936) This act established a program in which persons who are blind or legally blind are given preference in the assignment of vending stands on federal premises. Many states eventually followed the federal example and required that vending stands on state property must give preference to individuals who are visually impaired.

In the 1930s the Lions Club in Peoria, IL began to press for the first of the white cane laws, to give motorists part of the responsibility for pedestrian safety. The white cane became a symbol of identification of the blind. Eventually white cane laws passed in all states. They were later revised to guarantee access to public areas and transportation by individuals who are blind and for guide dogs. They were also revised to reflect the capability of individuals who are blind to travel independently.

P.L. 75-739 Wagner-O’Day Act (1938) created a committee on purchases of blind-made products and authorized the National Industries for the Blind as a clearinghouse for government orders. The committee established guidelines for workshops that included the regulation that "specified that at least 75 percent of the workers engaged in the production of federally purchased articles (under this act) be blind (Koestler, 1976, p. 216).

P.L. 78-113 Bardon-LaFollette Act (1943) also known as the Vocational Rehabilitation Act This act established the need and feasibility of a core of services available for individuals with disabilities and established the Office of Vocational Rehabilitation. It provided for the core of services including vocational counseling, supervised vocational training and job placement. The Federal Government provides for the cost of administering such programs and a 50/50 share with the states for the cost of the provision of such services as vocational training and occupational tools and equipment. This law established services to individuals who are blind as a separate unit of vocational rehabilitation to develop standards and techniques to improve and expand services to individuals who are blind, provide consultant services to blind persons or businesses, plan and provide technical guides and other materials, and to plan, organize and conduct workshops and training institutes for state personnel. It was amended by P.L. 83-565 Vocational Rehabilitation Act (1954) which authorized separate grant programs for personnel preparation and supported O&M demonstration training grants.

P.L. 93-112 The Vocational Rehabilitation Act (1973) This law provides a comprehensive plan for providing rehabilitation services to all individuals with requirements to be in effect by 1979. Section 504: provides for civil rights enforcement of this act. Section 502: ensured the requirements of the Architectural Barriers Act (1968), established Minimum Guidelines and Requirements for Accessible Design (MGRAD), Uniform Federal Accessibility Standards (UFAS) and the American National Standard Institute (ANSI) that establishes federal guidelines for accessibility to the environment by individuals with disabilities. It was amended by P.L. 98-221 (1983) and P.L. 99-506 (1986).

P.L. 101-336 ADA (Americans with Disabilities Act) (1990) expanded the guidelines for public access as a reauthorization of the Vocational Rehabilitation Act. It includes specific accessibility guidelines for individuals with visual impairments

P.L. 89-10 Elementary and Secondary Education Act (1965) provided a comprehensive plan for equal educational opportunity for economically underprivileged children. Early special education legislation used this law as a statutory base. It was amended by P.L. 89-313 (1965) which was the first federal grant program to state institutions and schools targeted for children and youth with disabilities. It was further amended by P.L. 89-750 (1966) which moved the federal grant support to the local school level and established the Bureau of Education of the Handicapped (BEH) and the National Advisory Council (now the National Council on Disability). It was amended again by P.L. 91-230 (1970) and P.L. 93-380 (1974).

P.L. 93-380 Education Amendments (1974) contained the Education of the Handicapped Act Amendments and the Family Education Rights and Privacy Act. This was the first law to mention the provisions of an appropriate education for all children with disabilities and gave parents and students the right to examine their records. These amendments were the beginnings of the provisions for P.L. 94-142.

P.L. 94-142 Education for All Handicapped Act (1975) mandated free appropriate public education for all children, individual education plans, and education in the least restrictive environment, ensured due process rights, and is the core of federal funding for special education. The provisions were to be in effect by 1978. This law established the federal requirement for educational access for all children. It also established and educational definition of a visual handicap. It was the impetus for special education as it stands today. Further amendments include P.L. 98-199 (1983) and P.L. 99-457 (1986).

P.L. 99-457 (1986) expanded the educational opportunities of children with disabilities or at-risk for disabilities to include those below school age, specifically from age 3. It included some provision for services to children from birth, particularly in those states where services from age 3 were already in existence. The provisions were to be in place by 1991.

P.L. 101-476 Individuals with Disabilities Act (IDEA) (1990) is the reauthorization of P.L. 94-142. It expanded discretionary programs, mandated transition services and assistive technology services. It also added autism and traumatic brain injury to the list of eligible categories. The reauthorization of this is P.L. 105-17 (1997).

P.L. 105-17 IDEA (1997). Of particular importance in O&M, this reauthorization was the first to mention orientation and mobility as a specifically identified related service. There has been much debate over whether or not this identified related service is now to be made available to all students with disabilities, not just those with visual impairments. For the actual text of this law from the Federal Register click here.

*For information about the latest Medicare Bill progress go to http://www.medicarenow.org/aboutus.htm

References

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DHEW (August 23, 1977). Implementation of Part B of the Education of the Handicapped Act. Federal Register, 42 (163), 42490.

Hallahan, D. P. & Kauffman, J. M. (1986). Exceptional children: Introduction to special education (3rd ed.). Englewood Cliffs, NJ: Prentice Hall.

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