Developmentally Appropriate Orientation and Mobility

1
Developmentally Appropriate Orientation and
Mobility
Assessment Session 5
The University of North Carolina at Chapel Hill
Early Intervention Training Center for Infants
and Toddlers With Visual Impairments
FPG Child Development
Institute, 2004
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 (OM) assessment,
  including gathering background information,
  conducting a routines-based assessment,
  completing natural observations, and
  participating in a transdisciplinary play-based
  assessment.

5A
3
Objectives

• After completing this session, participants will
• explain how a routines-based assessment can be
  used to gather initial information for an OM
  assessment.
• explain how naturalistic observations in
  multiple environments are necessary to adequately
  assess a young childs OM skills and concepts.

5B
4
Objectives

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

5C
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.

5D
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
  childrens social-emotional development as
  related to self-initiated movement and OM.
• describe the assessment of communication skills
  and how this assessment is related to early
  orientation and mobility.

5E
7
Objectives

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

5F
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).

5G
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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
  childs current level of functioning in the
  following domains physical, cognitive,
  communicative, social-emotional, and adaptive
  development.

5H
10
Assessment Considerations

• Part C requires assessment of family concerns and
  priorities.
• To accurately describe current levels
  of functioning, consider childrens 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.

5I
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.

5J
12
The Assessment Process

• The OM 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)

5K
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.

5L
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 OM assessment a challenge.

5M
15
Routines-Based Assessment

• Routines-based assessment (RBA) is
  recommended for securing information about
  families concerns and priorities as well as
  childrens current level of functioning.
• The RBA is also appropriate for securing
  information about childrens visual abilities,
  purposeful movement, motor skills, and other
  components of OM within daily routines.
• Hatton et al., 2003

5N
16
What are routines?

• Routines are the everyday or frequently occurring
  events needed to maintain
  family life.
• Routines occur in the familys 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 familys goals.
• 
  Bernheimer Keogh, 1995

5O
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

5P
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

5Q
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
  familys 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

5R
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Questions About Daily Routines

• What does everyone else do?
• Home other family members?
• Classroom other children?
• What does the child do?
• Engagement
• How much does
• the child participate
• in the routine?
• McWilliam, 2003

5S
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Questions About Daily Routines

• Independence What
• does the child do
• without assistance?
• Social relationships
• How does the child
• communicate and
• get along with others?
• How satisfied is the
• caregiver with the routine?

McWilliam, 2003
5T
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

5U
23
Naturalistic Observations

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

5V
24
Naturalistic Observations

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

5W
25
Transdisciplinary Assessment

• A transdisciplinary play-based
• assessment can provide information
• about all areas of a childs
• development that affect OM.
• This model allows the team to
• collaborate to gather information
• specific to each professionals area
• of expertise.
• Linder, 1993

5X
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 childs level of
  comfort.
• Each professional involved has a specific
• assessment assignment.
• Linder, 1993

5Y
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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 OM within daily routines

5Z
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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 childrens sensory preferences.

5AA
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

5BB
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.

5CC
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.

5DD
32
Social-Emotional Assessment

• OMSs and TVIs are able to evaluate the
• impact of visual impairments on childrens
• 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.

5EE
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.

5FF
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.

5GG
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.

5HH
36
OM 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)

5II
37
OM 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)
  

5JJ
38
OM 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)
• OM Assessment Early Years of Birth Through
  Three Years (Anthony, 2004b)

5KK
39
OM Assessment Resources

• OM Assessment for Infants and Developmentally
  Young Children What to Look For (Lowry,
  2004a)
• OM 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)

5LL
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OM Assessment Tools

• Preschool Orientation and Mobility Screening
  (Dodson-Burk Hill, 1989)
• Teaching Age-Appropriate Purposeful
  SkillsMobility Curriculum for Students With
  Visual Impairment Comprehensive Assessment and
  Ongoing Evaluation (Pogrund et al., 1993)

5MM
41
Components of anOM Assessment Report

• Relevant child and family background information
• Caregivers perspectives on childrens
  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

5NN
42
Components of anOM Assessment Report

• Social-emotional development, communication
  development, and environmental factors
  influencing navigation as derived from
  naturalistic observations and transdisciplinary
  play-based interactions
• Summary
• Recommendations

5OO
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.

5PP
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, childrens body position, position
  of objects, and tool use (e.g., adaptive
  mobility devices) that assisted the child
  in demonstrating specific skills.

5QQ