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From: Michigan Department of Education - Low Incidence Outreach

INTRODUCTION

The Orientation & Mobility Severity Rating Scale (O&MSRS) has been developed and revised to assist Orientation & Mobility Specialists in making recommendations for services for students who are blind or visually impaired in the state of Michigan. In addition to the Revised O&MSRS, an Orientation and Mobility Severity Rating Scale for Students with Additional Needs (O&MSRS+) has been developed.  It should be stressed that the Severity Rating Scales are not assessment / evaluation instruments, but rather tools for assisting in service delivery times. 

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

RATIONALE

A task force consisting of Orientation & Mobility Specialists throughout the state of Michigan and from the Michigan Department of Education–Low Incidence Outreach was formed to continue the process of revising the O&MSRS and to address the standardization of service delivery to students who are blind or visually impaired. Proposed revisions were presented and discussed during a working session at the 2008 Michigan AER conference.  The draft scales were also presented at the AER International Conference in July of 2008 in Chicago where they received much support and useful comments.  The need for consistency when determining the level of Orientation & Mobility services for students who are blind and visually impaired was voiced repeatedly. Other considerations 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 travel tools
  • Additional needs of the student such as level of communication and compliance with instruction
  • Opportunities for use of skills outside of school
  • Whether a discrepancy exists between present and projected levels of travel

Each of these considerations was discussed extensively. The Revised O&MSRS / O&MSRS+ are the result of these discussions.

PURPOSE AND DEVELOPMENT

The purpose of this manual is to define criteria and guidelines for using the Revised Orientation & Mobility Severity Rating Scale (O&MSRS) and the Orientation and Mobility Severity Rating Scale for Students with Additional Needs (O&MSRS+) with students identified as visually impaired. It is intended to assist the Individualized Education Program Team in the selection of an appropriate program of Orientation & Mobility training for students who are blind or visually impaired. The Scales may assist in documenting change from one service delivery model to another.

A Revised O&MSRS or O&MSRS+ should be completed before every Individualized Educational Planning Team meeting (IEPT). In addition, it is recommended that the SRS/SRS+ be up-dated at the end of each school year.   Listed below are the steps that are suggested to be followed when evaluating a student.

  1. Assess the student to determine O&M strengths and needs using a variety of assessment tools (see Appendix B).
  2. Complete the O&MSRS or O&MSRS+ to determine service delivery times.
  3. Include recommendations of O&M services in the O&M report and share at the IEPT meeting.

The Revised O&MSRS consists of the following eight categories:

  • Level of Vision (Clinical/Medical)
  • Level of Vision (Functional)
  • Use/Proficiency of travel tools
  • Discrepancy in travel skills between present and projected levels
  • Independence in travel in current/familiar environments
  • Spatial / environmental conceptual understanding
  • Complexity or introduction of new environment
  • Opportunities for use of skills  outside of school

The Orientation and Mobility Severity Rating Scale for Students with Additional Needs consists of the following eight categories:

  • Level of Vision (Clinical/Medical)
  • Level of Vision (Functional)
  • Use / proficiency of travel tools
  • Communication
  • Non-visual additional needs
  • Level of supervision needed for safe travel
  • Spatial / environmental conceptual understanding
  • Compliance with instruction

The Severity of Need in each of the scales 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 eight categories is structured in terms of impact on independent travel skills as it relates to the student's age appropriate needs. The Severity of Need descriptors within each category purposely overlap to some degree. To aid the Orientation & Mobility Specialist in the selection of the Severity of Need that is most characteristic of the student with a visual impairment, additional evaluations may be necessary.

CATEGORY DEFINITIONS for O&MSRS

  • Level of Vision Clinical (Medical) - refers to the student's distance vision and/or peripheral vision as reported by an eye care specialist.   Special considerations for student with Cortical Visual Impairment (CVI):  It is recommended that students with CVI whose vision fluctuates and who may, at times, have usable vision for travel be placed in Severity of Need category that best reflects their need for O&M services.  
  • 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.  Special considerations for student with Cortical Visual Impairment (CVI):  It is recommended that students with CVI whose vision fluctuates and who may, at times, have usable vision for travel be placed in Severity of Need category that best reflects their need for O&M services.     
  • Use / Proficiency of Travel Tools - refers to the student's need for use and skill level of a white cane or alternative mobility device
  • Discrepancy in Travel Skills Between Present and Projected Levels - refers to possible situations when a discrepancy exists between the student’s actual functioning in travel skills and the projected level of independence based on the O&M Specialist’s professional judgment.
  • Independence in Travel in Current/Familiar Environments - refers to the student’s ability to travel safely and proficiently in a familiar environment (i.e., school, neighborhood) based on current literature of age appropriate travel levels and expectations.
  • Spatial / Environmental Conceptual Understanding – refers to the student’s conceptual understanding and how O&M progress is affected.
  • Complexity or Introduction of New Environment - refers to the type of environment in which instruction is required (i.e., business district, new school, neighborhood).
  • Opportunities for Use of Skills Outside of School – refers to whether the student has the opportunity to use O&M skills in the community, at home, etc. outside of O&M instructional time.

CATEGORY DEFINITIONS for O&MSRS+

  • Level of Vision Clinical (Medical) - refers to the student's distance vision and/or peripheral vision as reported by an eye care specialist.  Special considerations for student with Cortical Visual Impairment (CVI):  It is recommended that students with CVI whose vision fluctuates and who may, at times, have usable vision for travel be placed in Severity of Need category that best reflects their need for O&M services.     
  • 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.  Special considerations for student with Cortical Visual Impairment (CVI):  It is recommended that students with CVI whose vision fluctuates and who may, at times, have usable vision for travel be placed in Severity of Need category that best reflects their need for O&M services.    
  • Use / Proficiency of Travel Tools - refers to the student's need for use and skill level of a white cane or alternative mobility device.
  • Communication – refers to the ability of the student to communicate with the O&M Specialist and benefit from instruction.  Students with little ability to communicate with the O&M Specialist may not benefit from a high level of direct O&M service.
  • Non-visual Additional Needs – refers to the impact of the additional needs on the instructional process.   Students whose additional needs prevent progress in travel skills may not benefit from a high level of direct O&M service.
  • Level of Supervision for Safe Travel – refers to the supervision needed to maintain the safety of the student during travel.  Students requiring a certain level of supervision many not benefit from a high level of direct O&M service. 
  • Spatial / Environmental Conceptual Understanding – refers to the impact that the student’s level of concept development has on progress in travel skills.  Students who are unable to improve in conceptual understanding may not benefit from a high level of direct O&M service.
  • Compliance with Instruction – refers to the amount of time needed to manage the student’s behavior so that learning can take place.  Students needing a certain level of behavioral management may not benefit from a high level of direct O&M service.

RECOMMENDATIONS OF SERVICES

SERVICE NOT INDICATED -- The student does not require Orientation & Mobility services provided by a Certified Orientation & Mobility Specialist.

ONE TO FIVE TIMES PER YEAR -- Contact by the Certified Orientation & Mobility Specialist may be with the student or other pertinent individuals, 1 to 5 times per school year.  An annual evaluation may be conducted by the Certified Orientation & Mobility Specialist.

THREE TO FOUR TIMES PER SEMESTER-- The student is seen directly by a Certified Orientation & Mobility Specialist 3 to 4 times per semester. Services may consist of direct instruction in short “units” of instruction clustered within several days or weeks.  Consultation is with the student and other pertinent individuals.

ONE TO TWO TIMES PER MONTH -- The student is seen directly by the Certified Orientation & Mobility Specialist 1 to 2 times a month for 20 to 60 minutes each. In addition, the Certified Orientation & Mobility Specialist may provide consultation with pertinent individuals.

ONE TO TWO TIMES PER WEEK -- This recommendation is designed for a student with a severe visual impairment who may need to carry a cane for identification purposes or for limited use for some travel safety tasks.  Also included may be a traveler with emerging orientation and mobility skills or a traveler who is non-visual and who is maintaining and applying orientation and mobility skills in various settings. The student requires direct service from the Certified Orientation & Mobility Specialist 1 to 2 times a week for 30 to 45 minutes each. The Certified Orientation & Mobility Specialist provides regular communication to pertinent individuals regarding the student's needs.

TWO OR MORE TIMES PER WEEK-- The student is seen by the Certified Orientation & Mobility Specialist 2 or more times a week for 30 to 60 minutes each. This recommendation is designed primarily for a traveler who is non-visual and who requires an inclusive program in all areas of instruction related to becoming a safe and independent traveler.

CONTRIBUTING FACTORS TO SERVICE DELIVERY

The professional judgment of the Certified Orientation & Mobility Specialist can influence the selection of a “Recommendation of Service” that has been determined by the Severity of Need Score. The selection of one or more of the Contributing Factors to Service Delivery may be used to place a student at a higher or lower level “Recommendation of Service” than indicated by the Severity of Need Score alone.

The use of the Contributing Factors to Service Delivery may be necessary when it appears that the Recommendations of Services indicated by the Severity Rating does not reflect the true needs of the student. Based upon the professional judgment of the Certified Orientation & Mobility Specialist, all factors which influence the modification of the Recommendation of Services should be marked with a plus (.5) or a minus (-.5).

The following factors are to be considered:

  • Posture, gait and motor development
  • Other physical or health impairments (O&MSRS only)
  • The nature of eye disease or condition
  • Transition support needed (O&MSRS+ only)
  • Transition to a new school, neighborhood, worksite, etc. (O&MSRS only)
  • Recent vision loss
  • New, hazardous, complex or difficult environment (O&MSRS only)
  • Complexity or introduction of new environment (O&MSRS+ only)
  • Potential for improvement of travel skills
  • Age of onset of visual impairment
  • Maturity and motivation (O&MSRS only)
  • Team availability for follow-up
  • Travel time needed to transport student to area of instruction affects frequency of instruction (O&MSRS only)
  • Instruction in low vision aids
  • Community Based Instruction opportunities (O&MSRS+ only)
  • Instruction in use of GPS (O&MSRS only)
  • Other (explain)

Remember, each of these factors may be either positive or negative and should be marked when modifying a “Recommendation of Services”.


DIRECTIONS FOR COMPLETING THE ORIENTATION & MOBILITY STUDENT PERFORMANCE PROFILE AND SUMMARY

  • Category names are listed vertically along the left hand side of the O&M Student Performance Profile 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 of need, from none to profound. ***
  • The numbers attached to each severity of need are considered part of a continuum. The specific number under each severity of need name is the numerical rating to be given for that level. For example, under MILD, a numerical rating of 1 is possible, while under SEVERE, a numerical rating of 3 is possible.
  • For each category, mark the descriptor that best describes the student. Place the appropriate severity of need number in the right hand column (SEVERITY SCORE COLUMN).   
  • Total the right hand column to get a SEVERITY OF NEED SCORE.   This can be done on paper after printing the SRS or on the computer using the Excel Worksheet.  If completing the SRS on the computer, the Severity of Need column will be added up automatically and copied onto the Student Performance Summary.
  • If appropriate, fill out the Contributing Factors to Service Delivery on the Student Performance Summary by adding or subtracting .5 points.   If completing the SRS on the computer, the column will automatically add up the factors.  This number will be combined with the Severity of Need Score on the Student Performance Profile and the result will be placed in the Final Severity of Need Score box on the Student Performance Summary.
  • Using the Student Performance Summary, refer to the table titled “Severity of Need Score and Frequency”. Locate the range which contains the Final Severity of Need Score to determine the frequency of service.

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 read signage to aid with locating unfamiliar rooms, streets, businesses, etc.
  • 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)

APPENDIX B
RESOURCES FOR INFORMATION ON ORIENTATION & MOBILITY

  • Beyond Arms Reach
  • Concept Development for Visually Handicapped Children
  • Early Focus
  • Move with Me
  • Reaching / Crawling / Walking / Let's Get Moving
  • Preschool O&M Screening
  • Standing on My Own Two Feet
  • TAPS Curriculum
  • Foundations of Orientation and Mobility
  • The Oregon Project for Preschool Children who are Blind or Visually Impaired
  • Where In the World Am I
  • BRIGANCE® Inventory of Early Development
  • Hill Performance Test of Selected Positional Concepts
  • Body Image of  Blind Children
  • Perkins Activity and Resource Guide: A Handbook for Teachers and Parents of Students with Visual and Multiple Disabilities
  • Teaching Orientation and Mobility in the Schools
  • Imagining the Possibilities: A Creative Approach to Orientation and Mobility Instruction for Persons Who Are Visually Impaired
  • The Art and Science of Teaching Orientation and Mobility to Persons with Visual Impairments
  • Orientation and Mobility:  Techniques for Independence
  • Orientation and Mobility Techniques: A Guide for the Practitioner
  • Independent Movement and Travel in Blind Children

This is the final product of many rewrites of the Orientation and Mobility Severity Rating Scale and the Orientation and Mobility Severity Rating Scale for Students with Additional Needs. The MDE-LIO Orientation and Mobility Task Force has spent hours upon hours sifting through the input gathered at O&M Task Force meetings, MAER conference presentations, and the presentation at the 2008 AER International Conference.

The O&M Task Force tried to address all needs and concerns and feel that the final products are tools which you will find to be extremely useful Susan Bradley, COMS, and Susan Langendonk, COMS

Co-chairs of the 2007-2008 MDE-LIO O&M Task Force

edited by:
Susan Bradley, COMS, MDE-LIO
Amanda English, COMS, Kalamazoo RESA
Judy Holmes, COMS, Macomb ISD
Erica Ihrke, COMS, Leader Dog for the Blind
Susan Langendonk, COMS, Ingham ISD
Lynn Pensari, COMS, Livonia Public Schools 
Amy Schreiner, COMS, Association for the Blind and Visually Impaired
Dawn Staley, COMS, Traverse Bay ISD
Dr. Annette Skellenger, COMS, Western Michigan University
Carol Walker, COMS, Detroit Public Schools
Crystal Yachak, COMS, Genesee ISD
Anne Zanger, COMS, Genesee ISD

Return to Michigan's Vision Severity Rating Scales List 1996 - 2008