Survey on Fast Forward: Early Intervention Orientation and Mobility Curriculum App with Pediatric Belt Canes

Survey of Fast Forward Early Intervention OM App with Pediatric Belt Canes

Safe Toddles, Inc

www.safetoddles.org
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Fast Forward Early Intervention Orientation and Mobility Curriculum will be paired with a smart belt connected to a pediatric belt cane (wearable white cane).

For more information about Fast Forward Early Intervention Orientation and Mobility curriculum with Pediatric Belt Canes go to: https://drive.google.com/drive/folders/1gFHlfLpaxMOBsksp_899FRswx6G8xIq7?usp=sharing

Please answer the questions below about your interest in obtaining the curriculum for assisting you to include the pediatric belt cane into the daily routines of a child who is blind or mobility visually impaired.

2.Are you a: (select one or more)

Family member of someone who is visually impaired

Teacher of learners with visual impairments

Teacher of orientation and mobility for learners with visual impairment

Teacher of daily living skills for learners with visual impairment

Person with a visual impairment

Other (please specify)

3.Years of experience with blindness and visual impairment?

4.Do you have experience working with toddlers (aged 11 months to 3 years) with severe visual impairment?

Yes

5.If yes, please indicate approximately how many years of experience you have working with toddlers (aged 11 months to 3 years) with severe visual impairment?

7.If Fast Forward EI OM Smart Belt App were available today, how likely would you be to buy The EI OM App Smart Belt pediatric belt cane?

8.How likely are you to replace your current mobility method for toddlers who are blind with The Fast Forward EI OM app with pediatric belt cane?

9.How would you like to receive additional information about the Fast Forward EI OM curriculum and smart belt pediatric belt cane?

Phone call

Text

Include phone number or email address

11.Please add any further comments here (optional):