Multiple Disabilities

How to Conduct an Orientation and Mobility Assessment for a Student with Multiple Impairments

Background: Woman with blond hair working at a wooden table with notebooks around her.

We were walking down the hallway when my student turned to another staff member. He grabbed for the staff member’s arm. “Ayy-ee-oooh”, my student said to the staff member. “Oh, cheerios?” the staff member repeated back to my student.

He then turned to me “Ayy-ee-oooh”, he said as he grabbed my arm and pulled me closer to him. “Do you want some cheerios?”, I asked him. “Ya.Ayy-ee-ooh. Ayy-ee-ooh.”, my student repeated.

In that moment, my student, who did not speak in anything but vowels, had a severe learning disability, and light perception in one eye (no light perception in the other eye), had just completed a very complex task.

He was able to locate a person in the hallway who knew his word for Cheerios and then coordinate a complex system of communication in order to get his needs for Cheerios met.

If you pay attention to the tiny details of your students with multiple impairments, these intricate skills can be seen many times over.

Today, we are going to dive in to How to conduct an Orientation and Mobility assessment for students with multiple impairments, what assessments I love best, and some typical pitfalls that we need to be aware of during our assessments.

First, let’s clarify:

What defines a Student with Multiple Impairments?

The Individuals with Disabilities Education Act (IDEA) defines a student with multiple impairments as a student with more than impairment that affects their learning. The Special Education Guide website provides an exemplary definition and overview.

For us, we are going to classify that as a student with a visual impairment + another impairment.

This could fall in to at least one category:

  • Visual + Physical

  • Visual + Other Sensory

  • Visual + Cognitive

  • Visual + Social

Physical Impairments are: a limitation on a person's physical functioning, mobility, dexterity or stamina.

Some impairments that you might see include:

  • Cerebral Palsy

  • Neuropathy

  • Spinal Cord Injury

Sensory impairments are a disability of the senses (e.g. sight, hearing, smell, touch, taste).

  • Deaf Blindness

  • Sensory Integration Dysfunction

  • *Autism is sometimes included here

Cognitive Impairments cause significantly impaired cognitive functioning.

Some examples we often see are:

  • General Learning Disability

  • Traumatic Brain Injury

  • Neurodegenerative Diseases

  • ADHD

As Orientation and Mobility Specialists, we also often need to teach students with cluster syndromes as students with multiple disabilities.

Cluster Syndromes include conditions that affect multiple systems:

Conditions with more than one symptom.


  • Sickler’s

  • Norrie’s Disease

Parts Orientation and Mobility Assessment for a Student with Multiple Impairments:

  1. Folder Review

    1. Medical Information

    2. Visual Information

    3. Review past reports

  2. Parent Interview

  3. Student Interview*

4. Observations: Using the assessment, observe skills in:

a. Variety of environments

      • Familiar: Home, School, Community, familiar vehicles

      • Unfamiliar*: Different parts of school, new community environment, unfamiliar vehicles

      • Familiar environment, UNFAMILIAR routine.

      b. Variety of lighting conditions

      • Darkened area

      • Sunny environment

      • Just walked under a tree?

      • Is the building casting a shadow?

    c. Variety of situations

      • Familiar environment, UNFAMILIAR routine.

      • Seated vs standing/walking

5. Summary* (Some people include a subjective summary, other’s don’t. I haven’t seen a definitive right or wrong with this. I like reading subjective summaries, but I was also taught the our assessments need to be as objective as possible).

6. Recommendations

a. Travel guidelines (for parents, staff)

b. Goal area recommendations

How to Conduct an Orientation and Mobility Assessment for a Student With Multiple Impairments

  1. Determine the purpose of your assessment. Be as clear as possible with yourself. This will help you determine which assessment you choose, and which portions of the assessment you choose to conduct. For students with multiple impairments, you probably aren’t looking at assessing on the entire TAPS curriculum. Depending upon their age, TAPS may not even be the best option. But I am getting ahead of myself.

  2. Decide on an assessment tool. My favorite tools* are:

*Not affiliate links.

3. Gather as much information about the student as possible before you observe. Review their folder, call their parents, talk with their teachers and paraprofessionals. Then, Write out all of the things that you know about your student.

4. Write a list of the skills you need to assess during your observation
. Since you already have your report started, you can then walk in to your observation with a clear list of the skills you need to seek out.

5. Now it is time to assess your student! Use the template of your assessment as a guide. 

This is my biggest teaching tip: 

During your assessment, gather information from a macro to micro level. Macro: What is going on in the environment? What is the lighting like? What ambient sounds are around? Down to the micro: was the teacher on the left or the right side of the student? What happened when the teacher moved to the other side? What happened when their peer suddenly clapped their hands loudly? Could they still do the skill you were looking for?

The gems are in those tiny intricate details. When your students can't verbally tell you the information you need to assess, you have to be very observant. 

Seeing a skill done in a familiar, routine setting does NOT indicate that the student has the skill. It just means that they have memorized a routine. Try to see a skill in a an unfamiliar routine. Conversely, a skill performed while seated and instructed is NOT indicative of full comprehension. You will also want to see them perform the skill while in their routine and while traveling. 

Here is a quick, 2 minute video sharing how to conduct an Orientation and Mobility Assessment for a student with multiple impairments

Common Pitfalls of Assessing Students with Multiple Impairments

When you are only given a few hours to assess a student that you have never met before, it can be tricky to know exactly what to do and where to start in order to get the information you need.

Pitfall #1: Thinking that because the student does/does not perform a skill in one area, that they do/don’t do it across the board.

To do: remember, this assessment is only going to be a snap shot of what you see during that time. Do not generalize seeing a student trail the wall once to a sentence that reads “Student is able to trail the wall”. Try “Student was observed to trail the wall while walking from his classroom to the restroom.”

Pitfall #2: Not teasing out the difference between static and dynamic skills.

This can be an entire blog post in itself. Test BOTH static (seated) understanding of spatial concepts (such as left/right over/under) and dynamic (while traveling). You may get different results.

Pitfall #3: Not coming prepared with a list of skills that you need to assess.

Tip: Write down everything you know about the student before you assess them. Then call their primary caregiver and ask them what they have seen and what they want for their loved one. Call the teacher to find out what they see. I also suggest calling the physical therapist, occupational therapist and speech therapist as well. The speech therapist may have information as to how the student communicates that will help you formulate the questions you ask during your assessment.

In Summary, in order to conduct and Orientation and Mobility assessment for a student with multiple impairments, you will want to:

  • Plan your assessment and strategy

  • Perform the records review and interviews.

  • Write down everything you know about the student on your Assessment Template.

  • Then, make a plan to observe the skills you need to see in a variety of environments or routines.

What do you think? What did I miss? Tell me your thoughts below or come hang out with me on Facebook and share your ideas.

Woman with blond hair at table with notebooks. Text: How to Conduct an Orientation and Mobility Assessment for Students with Multiple Impairments.


3 Simple Techniques to Increase Your Students' Independence

There has been a 16% increase in children with disabilities over the past decade.

The good news is, Asthma is down. The bad news is, neurodevelopmental disabilities are on the rise. That's CVI, ONH, and Autism.


We, as educators, are charged with leading our students’ teams in the fight for their independence.

Tips for Helping Students with Spatial Awareness Issues

It was the second day of school. I was waiting outside of the restroom for a student that I had just met the day before.

I waited. 

And waited.

And waited.

Turns out, she was literally lost in the bathroom stall. 

Helping students with spatial awareness issues can seem daunting. Here is how I was able to modify this student's Orientation and Mobility curriculum in order to help her travel around the bathroom, her classroom, and her school building. 

If those tips helped you, or if you want more information about the Fall 2018 O&M Study Groups, you can find more information here. 


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