Michigan's Orientation&Mobility Severity Rating Scale 1997

Michigan's Orientation & Mobility
Severity Rating Scale 1997

Following is a draft of the Severity Rating Scale developed earlier this year by Division 9 of Michigan AER. It was promised to be printed and distributed as a Department of Education, Special Education Services pamphlet along with SRSs developed by Teachers of VI and for VI students with multiple impairments. A massive exodus (due to early retirement incentives) of some of our most valuable allies in SES has prevented this project from being followed through on. I hope you're able to make use of this draft. If, for some reason, it isn't legible feel free to e-mail me and I'll send you a paper copy.

Susan Langendonk, COMS
Lansing School District
Hill AVC S. Mezzanine
5815 Wise Road
Lansing, MI 48911
517-325-6953
fbarton@pilot.msu.edu

edited by:

Susan Bradley, Orientation & Mobility Specialist, Livonia Public Schools
Jennifer Burch, Orientation & Mobility Specialist, Teacher Consultant for Visually Impaired, Calhoun Intermediate School District
Janet Damon, Orientation & Mobility Specialist, Calhoun Intermediate School District
Wayne Jansen, Orientation & Mobility Specialist, Michigan School for the Deaf and Blind
Susan Langendonk, Orientation & Mobility Specialist, Lansing Public Schools
Chuck Luken, Orientation & Mobility Specialist, Kalamazoo Valley Intermediate School District
Meri McGegor, Orientation & Mobility Specialist, Teacher Consultant for Visually Impaired, Macomb Intermediate School District
Thomas Van Hoven, Orientation & Mobility Specialist, Teacher Consultant for Visually Impaired, Jackson Intermediate School District

adapted from:
Pennsylvania's Montgomery County Intermediate Unit 23
Program for the Visually Handicapped Severity Rating Scales Handbook

March 1991

To fit the needs of visually impaired students within Michigan

INTRODUCTION

The Orientation & Mobility Severity Rating Scale (O&MSRS) has been developed to assist Orientation & Mobility Specialists in making recommendations for services to the blind and visually impaired population in the state of Michigan.

An O&MSRS should be completed before every Individualized Educational Planning Committee meeting (IEPC). In addition, it is recommended that the O&M Severity Rating Scale be up-dated at the end of each school year.

Each of the six categories is structured in terms of impact on independent travel skills as it relates to the student's age appropriate needs. When using the O&M Severity Rating Scale, criteria provided within each of the categories is not all inclusive and many criteria overlap from one severity level to the next. Additional factors may influence the selection of the severity level by the Orientation & Mobility Specialist.

RATIONALE

A committee consisting of Orientation & Mobility Specialists throughout the state of Michigan and from Michigan School for the Deaf and Blind was formed to address the standardization of service delivery to the visually impaired population. The need for consistency when determining the Orientation & Mobility needs of the blind and visually impaired was voiced repeatedly. Other concerns frequently mentioned were:

Current level of age appropriate independent travel
Visual functioning / visual efficiency
Visual status as reported by an eye care specialist
Use of mobility aids
Cognitive level of the student
Need for travel
Additional impairments

Each of the these concerns was discussed extensively. The O&MSRS is the result of these discussions.

PURPOSE AND DEVELOPMENT

The purpose of this manual is to define criteria and guidelines for using the Orientation & Mobility Severity Rating Scale (O&MSRS) with students identified as visually impaired. It is intended to assist the IEPC in the selection of an appropriate program of Orientation & Mobility training for blind and visually impaired students. The Scale may assist in documenting change from one service delivery model to another.

The O&MSRS consists of the following six categories:

Level of Vision (Medical)
Level of Vision (Functional)
Use of Travel Tools
Proficiency in Use of Travel Tools
Current Age-Appropriate Independence
Complexity or Introduction of New Environment

This scale is sequentially structured based upon a student's need for instruction in age appropriate travel skills by a certified Orientation & Mobility Instructor with input from the parents other staff and other interested individuals.

Each of the six categories is structured in terms of impact on independent travel skills as it relates to the student's age appropriate needs. The severity level descriptors within each category purposely overlap to some degree. To aid the Orientation & Mobility Specialist in the selection of the level that is most characteristic of the visually impaired student, additional evaluations may be necessary.

CATEGORY DEFINITIONS

Level of Vision (Medical) - refers to the student's level of vision as reported by an eye care specialist.
Level of Vision (Functional) - refers to the student's ability to use vision for all travel tasks (i.e. movement within the classroom, school building and community) as reported by the Orientation & Mobility Specialist.
Use of Travel Tools - refers to the student's need for use of a white cane or alternative mobility device (i.e.pre-cane, etc.).
Proficiency in Use of Travel Tools - refers to the student's skill level in use of a travel tool.
Current Age - Appropriate Independence - refers to the student's ability to travel safely and proficiently in a developmentally age-appropriate manner.
Complexity or Introduction of New Environment - refers to the type of environment in which instruction is required (i.e., business district, new school, neighborhood).

See Appendix A for samples of vision related travel tasks.

MODEL OF SERVICE DELIVERY

MONITORING / CONSULTATION -- The student is seen by a Certified Orientation & Mobility Specialist 1 to 5 times per school year. An annual evaluation may be conducted by the Certified Orientation & Mobility Specialist. Contact may be with the student or other pertinent individuals.

SUPPORTIVE-- The student is seen directly by the Certified Orientation & Mobility Specialist 1 to 2 times a month or during regularly scheduled times throughout the school year for 20 to 60 minutes each. In addition, the Certified Orientation & Mobility Specialist may provide direct support to pertinent individuals.

INTENSIVE -- This direct service model is designed for a severely visually impaired traveler who may need to carry a cane for identification purposes / limited use or for a traveler with emerging orientation and mobility skills. A non-visual traveler who is maintaining and applying orientation and mobility skills in various settings would also be included. The student in this model requires direct service from the Certified Orientation & Mobility Specialist 1 to 2 times a week for 30 to 90 minutes each. The Certified Orientation & Mobility Specialist provides regular communication to pertinent individuals regarding the student's needs.

COMPREHENSIVE-- The student is seen by the Certified Orientation & Mobility Specialist 3 or more times a week for 20 to 90 minutes each. This model is designed primarily for a non-visual traveler who requires an inclusive program in all areas of instruction related to becoming a safe and independent traveler.

PROFESSIONAL JUDGMENT FACTORS

On occasion the professional judgment of the Certified Orientation & Mobility Specialist can influence the selection of a service delivery model that has been determined by the Severity Rating. The selection of one or more of the Professional Judgment Factors on the O&M Severity Summary may be used to place a student at a higher or lower level Model of Service Delivery than indicated by the Severity Rating alone.

The use of the Professional Judgment Factors may be necessary when it appears that the Model of Service Delivery indicated by the Severity Rating does not reflect the true needs of the visually impaired student. Based upon the professional judgment of the Certified Orientation & Mobility Specialist, all factors which influence the modification of the Model of Service Delivery should be marked.

The following factors are to be considered:

Posture, gait and motor development
Cognitive ability of the student
Other physical or mental impairments
The nature of eye disease / condition
Transition to a new school, neighborhood, worksite, etc.
Recent vision loss
New, hazardous, complex or difficult environment
Potential for improvement
Age of on-set of blindness
Maturity and motivation
Parental concern / input
Parental commitment for follow-up
Travel time needed to transport student to area of instruction
Certified Orientation & Mobility Assistant
Instruction in low vision aids
Instruction in electronic travel aids
Other (explain)

Remember, each of these factors may be either positive or negative and should be marked if modifying a service delivery rating.

DIRECTIONS FOR COMPLETING THE ORIENTATION & MOBILITY SEVERITY CHARACTERISTICS AND VISION SEVERITY SUMMARY

This chart may be used three times.

Category names are listed vertically along the left hand side of the O&M Severity Characteristics Worksheet. Refer to definitions on the preceding page as necessary.
Descriptors are listed horizontally for each category. The descriptors are listed sequentially in terms of severity, from mild to profound.
The numbers attached to each severity are considered part of a continuum. The specific numbers under each severity name are the numerical rating to be given for that severity. For example, under MILD, a numerical rating of 0, 1, or 2 is possible, while under SEVERE, a numerical rating of 6, 7, or 8 is possible.
For each category, mark the descriptor that best describes the visually impaired student. Place the appropriate severity number in the right hand column (SEVERITY SCORE COLUMN). Three columns are provided for evaluation on three separate occasions.

The LEVEL OF VISION (MEDICAL) category may receive two scores under MODERATE or SEVERE if the student has both a field loss and an acuity loss.
Total the right hand column to get a TOTAL SEVERITY SCORE.
Using the TOTAL SEVERITY SCORE, refer to the O&M SEVERITY SUMMARY to determine:
- Severity rating
- Frequency of service
- Total minutes of service per week
- Model of service delivery
Record these findings in the RECOMMENDATIONS OF SERVICES section on the ORIENTATION & MOBILITY SEVERITY SUMMARY.

APPENDIX A

EXAMPLES OF VISION RELATED TRAVEL TASKS

Student is able to:

visually track a moving object
imitate gross motor movements based on visual observation
see facial expressions and gestures
visually discriminate basic colors and geometric shapes
visually scan area and avoid large obstacles in path
visually locate or identify familiar rooms in school
visually distinguish shorelines and/or intersecting sidewalks
visually detect steps and drop-offs
visually detect blended curbs see turn signals on cars while standing at a corner
see drivers inside cars motioning to pedestrians
see color change on walk/don't walk signal
see color change on traffic signal
read walk/don't walk signal without a distance aid
read name of approaching bus without a distance aid
visually determine desired bus stop without assistance from driver
visually locate doors to stores and other commercial buildings
read grocery store aisle signs without a distance aid
understand how lighting conditions affect travel skills
explain the status of own vision related to travel (day / night)