O&M

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.

  • CHARGE

  • 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.

 




Easy Activities to Celebrate Blindness Awareness Month

October is a great time to focus our attention on what really matters. It isn’t the paperwork. It isn’t managing the bureaucracy. Nor is it finding the coolest new invention for people with visual impairments.

October is our time to educate the people around us about visual impairments. It is our time to celebrate with our loved ones, our students, and our peers who have a visual impairment.

Here are a few easy ways that you can educate our students’ community and celebrate their uniqueness with them!

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.

How to Get the Most Out of Your Planning Sessions

All too often, I see O&M teachers who once had a zest for their job get caught up in the “Not enough” story that we can start to tell ourselves. Not enough time. Not enough money. Not enough resources.

 

Where we once felt an abundance of life-giving energy, we now see it all as a sea of hardened concrete.

 

I know some people who don’t even attend conferences any more because they tell themselves that there is nothing more to learn. They don’t have enough time to implement their new ideas, so they don’t even bother.

 

Check out this video where I explained where most O&Mers get stuck and how to get out of the O&M rut.

 

My challenge to you today is to flip that switch. What if what we have IS enough. What if we can make miracles happen with what we do have?

 

For years, my planning periods were split into two 15 minute sessions in any given day. Now, I’m not paid for any planning time. It is all on me.

 

This is how I make the most of my planning periods, and how you can too:

  1. Brain Dump. At the beginning of every week, do a brain dump. Write down everything you have to do for the foreseeable future. Make this one list. One life, one list. Write down all of your upcoming IEP meetings, your client needs, your child’s dentist appointment, your taxes.. Everything. Break them down in to 10 minute tasks if you can. For example, 1. Gather tactile map supplies. 2. Tactile map layout. 3. Glue tactile map. Do this part with pen and paper if you can. If not, just a note in your phone will be fine.

  2. If you want to take an extra step here, you can separate them in either:

    1. TODAY, UPCOMING, and LATER; or

    2. I. Important and Urgent, II. Urgent, but not Important, III. Important, but not Urgent, IV. Not Important and Not Urgent (from 7 Habits of Highly Effective People)

  3. Choose 3 things to get accomplished this week. ONLY 3. Choose the most urgent and important at first, then move on to the upcoming or important but not urgent items.

  4. Every day, start at least one item on your list. Aim to accomplish it.

 

By being prepared for your planning sessions, you will cut out a lot of wasted time trying to figure out what to do with your planning session.

 

Then, you can start to see your way out of the O&M Rut, and be able to fit in time for other things.

 

Like data.

 

Just kidding. Like study groups, obviously. If you are ready to leave that O&M Rut behind and use your newly acquired time to help your students become better travelers, you are more than welcome to join the O&M Study Groups this fall.

 

In the study groups, we will meet 4 times over the course of the semester in live, interactive webinars. Each webinar topic will give you specific strategies to use with your students.

 

There are two study groups to choose from. Head over to the website to see if you would prefer to join the MIVI study group or the technology study group!

 

Registration for the study groups opens next week! 

Collaborating with Your Students' Team Members

I had a student who was 13, multiple impairments, no verbal communication, and using an AMD. 

Every lesson, he would hit, bite, and scratch me all the way from his classroom to his dorm. 

None-the-less, he was ready to move away from the traditional Connecticut AMD to a less restrictive device. I wanted to move him to an L-bar, but his teacher adamantly disagreed. 

Here are a few ideas of how to handle this type of situation WHEN it happens. 

How to use Google Maps app with VoiceOver to Travel a Route

How to use Google Maps app with VoiceOver to Travel a Route

Technology is all the rage right now. We are obsessed with everything from our mobile devices, to wearable devices, to apps, to beacons... 

How can we keep up with it all? 

The truth is. You don't have to. Focus on the fundamentals. Cane Skills. Getting out of bathroom stalls. Traveling routes INDEPENDENTLY. Those skills are the foundation of all of your students' travel skills. 

From there, you can start to incorporate new technology and mobile apps in to your students' curriculum. 

Today, we are going to deep dive in to using Google maps and voiceover for students visual impairments.

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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O&M Study Group

Professional Development for dedicated O&M Specialists