I have experienced this conundrum in my own practice. When I was the O&M Specialist for Envision, I always ran the placement of a support cane with a client through the PT consultants they kept on contract. I do not remember a time when a PT disagreed with my recommendation. Ethically, however, I have a problem with always deferring to PTs before putting a white support cane in the hand of a client. If a person is navigating in the built environment while using a non-white support cane, but vision loss is causing them to ?need to identify as visually impaired in order to travel with utmost possible safety, then I will replace the support cane with a white support cane set to the exact same height and of the same weight. If a white support cane which is almost identical to their non-white support cane is not available, then, with their permission, I paint their support cane white with a red section at the bottom. White and red reflective paint, and masking tape, ?are included in my usual supplies. I have also used white and red reflective tape in the same manner. I have great respect for the work of the field of PT. I would never attempt to initially fit a support cane for someone who has not been using one, even though I believe I understand the basics of doing so. At the same time, now as a private practitioner, if a person is using a support cane, and they are also experiencing vision loss, I want to make them as safe as possible as quickly as possible. That may mean replacing a colored support cane with a white one. Referral to a PT to prescribe the white support cane can take a month or longer in my geographic areas of practice. I think our field needs to understand that, whether we like it or not, people can go into any Walgreens, CVS, or other pharmacy chain and purchase a support cane off of the rack. Recently I have also found that some manufacturers of long, white canes are marketing their products to retail entities that then re-sell them over the counter. I have encountered several clients who have purchased long, sort of white, and red canes manufactured by Drive Inc.? These canes have usually been much too long or, more often, too short for the individual, and their tips are of questionable quality, but they do indeed feature the characteristics of folding white canes that we might place. ?My point here is that, ideally adaptive equipment, both which we prescribe, and which OTs prescribe, should be fitted by qualified experts in the appropriate fields, but consumers can easily get around that requirement. Given these realities, I do not think we should make an experienced support cane user wait for a PT referral in order to get a white support cane, if that is the adaptive equipment they need to travel with utmost safety.

Michael Byington, Certified Orientation and Mobility Specialist

President of Kansas Association for the Blind and Visually Impaired

Membership Coordinator for Friends In Art of the American Council for the Blind

712 S Kansas Avene, Suite 414

Topeka, Kansas 66603

(785) 221-7111

ByingtonCOMS@...

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