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Developmentally Appropriate Orientation and Mobility

Objectives. After completing this session, participants willdescribe the legal basis for assessing infants and toddlers with visual impairments, including assessment of family resources, concerns, and priorities.describe the process of an orientation and mobility (O

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Developmentally Appropriate Orientation and Mobility

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    1. Developmentally Appropriate Orientation and Mobility

    2. Objectives After completing this session, participants will describe the legal basis for assessing infants and toddlers with visual impairments, including assessment of family resources, concerns, and priorities. describe the process of an orientation and mobility (O&M) assessment, including gathering background information, conducting a routines-based assessment, completing natural observations, and participating in a transdisciplinary play-based assessment.

    3. Objectives After completing this session, participants will explain how a routines-based assessment can be used to gather initial information for an O&M assessment. explain how naturalistic observations in multiple environments are necessary to adequately assess a young child’s O&M skills and concepts.

    4. Objectives After completing this session, participants will describe a transdisciplinary assessment and how it can be used as one component of an O&M assessment. describe the process of completing a sensory assessment of young children with visual impairments.

    5. Objectives After completing this session, participants will describe the process of assessing cognitive development as it relates to orientation and mobility concept acquisition. describe the relevant components of a motor assessment, including self-initiated movement.

    6. Objectives After completing this session, participants will describe the roles of orientation and mobility specialists (OMSs) and teachers of children with visual impairments (TVIs) in assessing children’s social-emotional development as related to self-initiated movement and O&M. describe the assessment of communication skills and how this assessment is related to early orientation and mobility.

    7. Objectives After completing this session, participants will describe the process of, and rationale for, completing an environmental assessment. describe formal and informal O&M assessment tools for young children, including assessment for adaptive mobility devices and tools. identify and describe the primary components of an O&M assessment report for young children with visual impairments.

    8. Legal Requirements Appropriate assessment practices are mandated for children with disabilities between the ages of birth to 3 years through Part C of the Individuals With Disabilities Education Act (IDEA, 1997).

    9. IFSP Children who are eligible for Part C must have an individualized family service plan (IFSP) that is based on assessment. An IFSP must include a statement describing the child’s current level of functioning in the following domains: physical, cognitive, communicative, social-emotional, and adaptive development.

    10. Assessment Considerations Part C requires assessment of family concerns and priorities. To accurately describe current levels of functioning, consider children’s developmental levels and functioning within daily routines. To meet the complex needs of infants and toddlers, professionals from at least two different disciplines must be involved in their assessment.

    11. Transdisciplinary Team Model A TVI and an OMS with training and experience with infants and toddlers should be integral members of the transdisciplinary team that serves infants and toddlers with visual impairments.

    12. The Assessment Process The O&M assessment process involves four components: gathering background information (Zimmerman & Roman, 1997) conducting the routines-based assessment (Hatton, McWilliam, & Winton, 2003) observing children in their natural environments (i.e., naturalistic observation) conducting a transdisciplinary play-based assessment (Linder, 1993)

    13. Background Information A thorough assessment includes information about visual and hearing status, medical status (detailing other possible diagnoses or conditions), use of medications, current early intervention supports and services (including childcare), and families’ strengths, priorities, and concerns for their children.

    14. Frequency of Assessment The frequency of assessment should be based on the needs of infants and toddlers. Assessment should not be limited to a mandatory review of the IFSP at 6-month intervals followed by a re-assessment at 12 months; the IFSP is a living document that should change with the needs of the child. The shortage of OMSs can make frequent, ongoing O&M assessment a challenge.

    15. Routines-Based Assessment Routines-based assessment (RBA) is recommended for securing information about families’ concerns and priorities as well as children’s current level of functioning. The RBA is also appropriate for securing information about children’s visual abilities, purposeful movement, motor skills, and other components of O&M within daily routines. Hatton et al., 2003

    16. What are routines? Routines are the everyday or frequently occurring events needed to maintain family life. Routines occur in the family’s natural environments. Routines reflect cultural and personal values, vary from day to day, may appear chaotic or rigid, may be organized or disorganized, and may reflect a family’s goals. Bernheimer & Keogh, 1995

    17. Benefits of the RBA The RBA emphasizes that intervention is family-centered, provides a structure for families to have a meaningful role in planning, generates a list of functional intervention outcomes, and aids in developing a positive relationship with families. Hatton et al., 2003

    18. Components of an RBA Routines-based interview An early interventionist interviews the family about daily routines and how the child and family interact during those routines. Identification of concerns From the interview, family members generate a list of concerns that they would like to address. Prioritization of concerns Family members prioritize the list of concerns so that their most immediate concerns become outcomes for intervention planning. Hatton et al., 2003

    19. Steps to Ensure an Effective Routines-Based Assessment Prepare: Think about routines and logistics; devote full attention to planning. Listen: Conduct the routines-based interview; learn about daily routines; highlight the family’s concerns. Summarize: Identify major concerns; ask family members what they would like to work on; assist the family in prioritizing these potential outcomes. Hatton et al., 2003

    20. Questions About Daily Routines

    21. Questions About Daily Routines

    22. Roles of TVIs and OMSs Organize the RBI and conduct the interview, if this hasn't already been done Participate, but not be the primary interviewer Receive the information after the fact Train other team members to do RBAs Integrate information from the RBA and the FVA Hatton et al., 2003

    23. Naturalistic Observations Naturalistic observations provide valuable information about children’s sensory, cognitive, motor, communication, and social skills in real-life contexts, and environmental factors that affect visual functioning and orientation and mobility.

    24. Naturalistic Observations Naturalistic observations result in more accurate assessment because children are in their natural environments (e.g., the home, Grandma’s house, childcare setting), and children can be observed several times during various routines.

    25. Transdisciplinary Assessment A transdisciplinary play-based assessment can provide information about all areas of a child’s development that affect O&M. This model allows the team to collaborate to gather information specific to each professional’s area of expertise. Linder, 1993

    26. The Process of Transdisciplinary Play-Based Assessment In transdisciplinary play-based assessment, one team member interacts with the child during play, while the caregivers and other interventionists observe. Initially, the caregiver should interact with the child to increase the child’s level of comfort. Each professional involved has a specific assessment assignment. Linder, 1993

    27. Sensory Assessment Provides information about the types of sensory information that alert, calm, inform, and overload children Identifies sensory preferences Identifies how sensory preferences and skills can be used for O&M within daily routines

    28. Components of a Sensory Assessment To complete a sensory assessment, interventionists should gather appropriate medical information, interview caregivers and interventionists, observe children in several environments and daily routines, and describe children’s sensory preferences.

    29. Sensory Assessment Tools The Individual Sensory Learning Profile Interview, or ISLPI, is used to gather information from caregivers and team members about how children appear to access sensory information. The Observational Assessment of Sensory Preferences, or OASP, can be used to identify the types and possible combinations of sensory stimuli that elicit attending and motor responses. Anthony, 2003a, 2003b

    30. Cognitive Assessment Cognitive assessment should address body image of self and others, object concepts, object permanence, cause-and-effect/ means-end, imitation, and spatial and positional concepts.

    31. Motor/Movement Assessment OMSs and TVIs should collaborate with other team members, such as physical and occupational therapists, to assess and plan motor interventions for gross motor skills, fine motor skills and upper extremity strength, and self-initiated and purposeful reaching and movement.

    32. Social-Emotional Assessment OMSs and TVIs are able to evaluate the impact of visual impairments on children’s awareness of themselves as separate persons, ability to distinguish familiar and unfamiliar persons, and security to move away from familiar people in a variety of settings.

    33. Communication Assessment OMSs and TVIs can collaborate with speech and language pathologists to address communication skills. In order to make appropriate recommendations, OMSs and TVIs must understand early communication development.

    34. Safety Awareness Team members, including caregivers, must keep children safe while promoting exploration. Before encouraging exploration and movement, check stairs, sharp edges, floor coverings, and fireplace edges, and adapt them as needed.

    35. Environmental Features Environmental features can either enhance or hinder the movement, exploration, and learning of children with visual impairments. Environmental cues include illumination/glare, space, time, and contrast.

    36. O&M Assessment Tools Assessing Infants Who Are Visually Impaired or Deaf-Blind for Functional Vision and Orientation and Mobility (Davies, 1989-90) Carolina Curriculum for Infants and Toddlers with Special Needs (Johnson-Martin, Jens, Attermeier, & Hacker, 1999) Growing Up: A Developmental Curriculum (Croft & Robinson, 1984)

    37. O&M Assessment Tools Hawaii Early Learning Profile Birth-3 Years (Parks, 1997) Individual Sensory Learning Profile Interview or ISLPI (Anthony, 2003a) Individualized Systematic Assessment of Visual Efficiency or ISAVE (Langley, 1998) Inventory of Purposeful Movement (Anthony, 2004a)

    38. O&M Assessment Tools Observational Assessment of Sensory Preferences (Anthony, 2003b) Oregon Project for Visually Impaired and Blind Preschool Children or OR Project (Anderson, Boigon, & Davis, 1991) O&M Assessment: Early Years of Birth Through Three Years (Anthony, 2004b)

    39. O&M Assessment Resources O&M Assessment for Infants and Developmentally Young Children: What to Look For (Lowry, 2004a) O&M Assessment for Toddlers and Developmentally Young Children: What to Look For (Lowry, 2004b) Peabody Mobility Kit for Infants and Toddlers (Harley, Long, Merbler, & Wood, 1980)

    40. O&M Assessment Tools Preschool Orientation and Mobility Screening (Dodson-Burk & Hill, 1989) Teaching Age-Appropriate Purposeful Skills—Mobility Curriculum for Students With Visual Impairment: Comprehensive Assessment and Ongoing Evaluation (Pogrund et al., 1993)

    41. Components of an O&M Assessment Report Relevant child and family background information Caregivers’ perspectives on children’s development and their priorities for early orientation and mobility as derived from the RBA Information about sensory preferences, cognitive development, motor development, goal-directed movement

    42. Components of an O&M Assessment Report Social-emotional development, communication development, and environmental factors influencing navigation as derived from naturalistic observations and transdisciplinary play-based interactions Summary Recommendations

    43. Report Writing The report may be written as a self-standing narrative or may be embedded within a team report. The background information portion of the report should begin with a favorable snapshot of the child that personalizes the report.

    44. Report Writing The report should be clearly written and free of acronyms and jargon. The report should focus on what children are currently doing, with descriptions of the environment, children’s body position, position of objects, and tool use (e.g., adaptive mobility devices) that assisted the child in demonstrating specific skills.

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