1. Loreta Martinez-Cargo, MA, COMS, TVI
Implementing the B-6 O&M Inventory O&M Assessment & Strategies in Early Intervention
Loreta Martinez-Cargo, MA, COMS, TVI
Julie Maner, MA, COMS, PT
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2. Family Infant and Toddler Program
Our team developed a definition of what the role of an O&M specialist is in the context of early intervention. It was adopted by the FIT program of NM under the department of health who is responsible for EI services in NM.
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3. Orientation & Mobility Definition
Services delineated in the IFSP that address purposeful and independent movement in children who are blind, visually impaired or are at risk for visual impairment.
Services involve the development of skills including concurrent motor skills, sensation, environmental concepts, body image, space/time relationships, and gross motor skills.
Orientation and mobility instruction is focused on travel and movement in current environments and next environments and the interweaving of skills into the overall latticework of development.
Services include evaluation and assessment of infants and toddlers identified as blind/visually impaired to determine necessary interventions, equipment, and strategies to promote movement and independence. (Skellenger &Sapp, 2010)
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4. Summary of Definition
IFSP (Individualized Family Service Plan) instead of an IEP
Services to address purposeful and independent movement for children who are B/VI or at risk
Mobility skills, orientation skills & concept development: body awareness, direction, location, along with spatial, environmental awareness and safety/risk awareness.
Safe and independent travel and movement in various environments
Ongoing evaluation and assessment
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5. Journal of Visual Impairment & Blindness, November-December 2015
Expanding the Frontiers of Orientation and Mobility for Infants and Toddlers in
New Mexico and Utah
Hong Phangia Dewald, Cindy Faris,
Karen S. Borg, Julie Maner,
Loreta Martinez-Cargo, and Mark Carter
Journal of Visual Impairment & Blindness, November-December 2015
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6. Points to remember Start young
Movement improves all areas of development
Children learn best through play & active learning
Learning should occur in home & community settings
Learning should be family centered
Using family guided routines
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7. arrows moving in a circle
O&M Process
Referral
Evaluation: B-6 O&M Inventory
Define areas of need
Goals: develop goals w family
O&M lesson plans
Re assess progress
Prepare for transition
arrows moving in a circle
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8. At NMSBVI Our long term goal is to refine the B-6 O&M Inventory
Develop lesson plans & strategies
for each of the skills on the Inventory
Photo: street sign says “Goals”
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10. B-6 O&M Inventory Six Domains
1. Orientation 2. Mobility 3. Concept Development 4. Sensory Specific Skills 5. Precane/Cane/Basic Travel Skills 6. Communication
Computer Screenshot:
B-6 O&M Inventory Domains
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11. Cover Page
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13. Overview Sheet
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17. Example of Written Report
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21. Sensory Everything else…. O&M Strategies in Early Intervention
Community outings
Communication
Concept
development
Cane skills
Family
guided
routines
Parent education
Active learning
Purposeful
movement
Social
skills
This, that & the other &
Everything else….
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22. Power to Parents & caregivers!!
If you empower/educate parents & caregivers you have done more for that child than any other intervention you could possible give.
A parent or caregiver who understands the needs of their child will be a life long advocate and teacher for their child and others.

23. Orientation Skills Early skills a. Uses hands to make contact
b. Uses feet to make contact
c. Reaches to find nearby object or person (within arms’ reach)
d. Searches and locates nearby object in sitting
e. Searches for items or persons in environment (beyond arms’ reach)
f. Searches for and locates dropped objects
2. Moving with a Purpose
a. Moves to person who is initiating engagement
b. Moves to person who is in the environment
c. Moves to an object of interest
d. Moves to find/follow to another room
e. Moves to another room
f. Knows/travels through home
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24. Orientation skills (con’t)
3. Use of Auditory Information for Orientation
a. Listens/responds to environmental sounds
b. Localizes a stationary sound
c. Moves toward a stationary sound
d. Tracks a moving sound
e. Demonstrates the ability to identify & label environmental sounds
f. Uses sound to orient to the environment
g. Travels in a straight line using sound
h. Recognizes presence of sound shadows and/or echoes
i. Detection of a wall
j. Detection of an opening in a wall
k. Auditory discrimination between environmental materials (windows, walls, drapes etc) when noise is generated from source
l. Auditory discrimination between environmental materials (windows, walls, drapes etc) from self generated sounds bouncing off of materials
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25. a. Uses simple one-way routes at home
4. Travel Routes
a. Uses simple one-way routes at home
b. Uses simple one-way routes at preschool
c. Uses route reversals at home
d. Uses route reversals at preschool
5. Outdoor Travel
a. Plays outdoors
b. Plays on community playground
c. Follows someone to a location
d. Finds a specified location
6. Advanced Orientation Skills/Environmental Awareness
a. Names current room
b. Differentiates indoors and outdoors
c. Names other people in the room
d. Names current building
e. Identifies familiar outdoor spaces
f. Detects and identifies obstacles
g. Detects drop offs
h. Detects traffic
i. Identifies known risks in familiar environment
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26. Orientation concepts These concepts include: Location Position Spatial
Temporal
Safety awareness
Environmental awareness
Photo:
Student with O&M instructor
Cane lesson down steps
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27. Guiding principle for early movement
Facilitate a tolerance to movement & positional changes early A child needs to experience normal movement from birth. These experiences include being carried, movement play & various positional changes (rolling, bouncing on laps, “flying” movements), and experiencing safe movement in space.
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28. Early movement experience develops
sensory integration
balance
strength
coordination
transitional movements
bonding
trust
Body confidence & awareness
fosters a joy of movement
and a willingness to explore
Photo of a baby held in flying position
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29. Mobility Skills Prone Skills a. Cuddles in caregivers arms
b. Lifts head from surface
c. Elbows under shoulders; lifting head
d. Pushes onto extended arms
e. Pivots on stomach
2. Crawling Skills
a. Rolls both ways
b. Combat crawls (on belly, army crawl)
c. Assumes hands and knees position
d. Crawls on hands and knees
3. Sitting Skills
a. Sits with support
b. Independent sitting for one minute
c. Dynamic play in independent sitting (rotating, reaching)
d. Moves in/out of sitting
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30. b. Stands for at least one minute to play at furniture
4. Pre-walking Skills
a. Pulls to stand
b. Stands for at least one minute to play at furniture
c. Lowers self into sitting position
d. Cruises furniture (at least two steps left and right)
5. Standing Skills
a. Stands with support (hands held or trunk support)
b. Stands up to 30 seconds after being placed in balanced standing
c. Stands independently
d. Transitions in and out of standing
6. Walking Skills
a. Takes steps with support (one or two hands held)
b. Takes 5 independent steps
c. Takes 10 independent steps indoors
d. Takes 10 independent steps outdoors
e. Walks independently on various surfaces indoors & outdoors
f. Able to walk with a cane or other object
7. Hurried Walk/Running Skills
a. Takes 10 hurried steps indoors
b. Takes 10 hurried steps outdoors
c. Runs 20 feet indoors
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31. 7. Hurried Walk/Running Skills continued d. Runs 20 feet outdoors
e. Runs with guide holding hands or prop/rope
f. Runs independently on various surfaces indoors and outdoors
8. Quality of Independent Walking
a. Stride (demonstrates appropriate stride length)
b. Arm Swing (demonstrates arm swing when walking)
c. Stance (demonstrates appropriate stance phase)
d. Walks with balanced heel to toe foot strike
e. Aligns head, shoulders, hips and feet when walking
f. Demonstrates walking speed appropriate for conditions
g. Balance (demonstrates balance when walking on typical more varied surfaces)
9. Climbing Skills
a. Climbs on-off furniture
b. Climbs up/down stairs with assistance
c. Climbs up/down stairs independently
d. Climbs/plays on playground equipment independently
e. Walks up and down stairs without alternating feet using wall or handrail
f. Walks up and down stairs alternating feet (may or may not use wall or rail)
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32. a. Moves forward on riding toy b. Jumps clearing both feet
Additional Skills
a. Moves forward on riding toy
b. Jumps clearing both feet
c. Kicks playground ball
d. Tosses ball with two hands
e. Chase ball
f. Marches
g. Skips
h. Hops on one foot
i. Pedals a tricycle or bicycle
j. Rides a bicycle
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33. Concept Development 1. Body Concepts a. Infant molds to caregiver
b. Plays with own hands and feet
c. Touches three body parts on request (e.g., nose, mouth, stomach
d. Uses body parts upon request to complete an action
e. Walks forwards, backwards, sideways
f. Turns left, right and around
g. Places objects in relation to body
2. Spatial Concepts
a. Demonstrates understanding of in/out
b. under/over
c. up/down
d. high/low
e. top/bottom
f. front/back
g. left/right
h. toward/away
i. Names the 4 compass directions (NESW)
j. Identifies front, back, left, right sides of a room in relation to the door
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34. a. Responds to name by attending
3. Risk Awareness
a. Responds to name by attending
b. Responds to “no” by stopping activity
c. Responds to redirection by changing activity
d. Stops when told “stop”
e. Holds caregiver hand outdoors or on stairs
4. Problem Solving Skills & Travel Behavior
a. Identifies that a problem exists
b. Formulates a plan
c. Executes plan
d. Reassesses whether the problem is solved
e. Cooperates with instructor
f. Exhibits age-appropriate behavior in public
g. Exhibits confidence during travel
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35. Sensory Specific Skills
Visual
a. Looks at visual target at 7 inches
b. Attends to a visual target across the room (10 feet)
c. Attends to a visual target outdoors (10 feet)
d. Attends to people or objects across the visual field
e. Shifts gaze to environmental features
f. Visually scan & identify or locate a desired person or object
g. Track a moving object in the environment
2. Auditory
a. Shows sensitivity to sound (startles, alerts, stops activity to listen)
b. Turns head to sound source (voice or noise)
c. Reaches towards a sound source
d. Localize source of sound
e. differentiates between two or more sounds
f. Localizes desired sound among competing sounds
g. Identifies source of sound
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36. a. Shows sensitivity to smells b. Localizes source of smell
3. Olfactory
a. Shows sensitivity to smells
b. Localizes source of smell
c. Differentiates between two or more smells
d. Localizes desired smell when other smells are present
4. Tactual/Mapping
a. Touches/explores variety of textures (smooth, rough, hard, soft) with hands
b. Touches/explores variety of textures with feet
c. Discriminates between different textures
d. Walks on different textures
e. Tactually explores natural environments
f. Tactually explores a 3-D model of the environment
g. Tactually explores a 2-D model of the environment (ex. Wheatley)
h. Tactually explores a raised line drawing
i. Tactually explores a tactual graphic/map and use Braille key
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37. Precane/Cane/Basic Travel Skills
Reaching/Holding Skills
a. Reaches/swipes at toys/objects
b. Reaches/grasps toys/objects
c. Reaches/holds objects with either hand
d. Transfers object from one hand to the other
2. Adapted Mobility Device Skills
a. Explores the device
b. Holds onto AMD for 30 seconds
c. Maintains balance and alignment while pushing toy or AMD
d. Stops when AMD or push toy detects an obstacle
e. Stops when AMD or push toy detects a surface change
f. Safely moves around people or obstacles using AMD or push toy
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38. b. Holds cane for 30 seconds c. Pushes cane in front when walking
3. Cane Skills
a. Explores the cane
b. Holds cane for 30 seconds
c. Pushes cane in front when walking
d. Maintains constant contact of the cane for one minute
e. Stops when cane detects an obstacle
f. Stops when cane detects a change in surface
g. Safely moves around people or obstacles
4. Basic Travel Skills
a. Uses human guide techniques
b. Uses hand for trailing
c. Uses upper forearm protective technique
d. Locates dropped objects in a systematic manner
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39. Adaptive Mobility Devices
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40. Communication Early Skills a. Attends/notices others
b. Demonstrates joint attention
c. Imitates sounds and gestures
d. Responds to name
e. Uses words and gestures to communicate needs
2. Following Directions
a. Follows one step directions
b. Follows two step directions
c. Follows two step unrelated directions
d. Demonstrates ability to make choices
e. Follows more complex directions to complete a task
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41. 3. Social Awareness & Interactions
a. Recognizes/participates in familiar routines and games
b. Follows more complex directions and requests
c. Responds with a “yes” or “no” to “Do you want to __?” questions
d. Answers who, what and where questions
e. Answers why and how questions
f. Answers ye/no questions that require judgement (ex.: Did you pass the cafeteria?)
g. Shares information about home and community
h. Plays and interacts with other children, sharing experiences and ideas
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42. Active Learning Children learn by doing
Create environments that build skills
Dr. Nielsen has developed materials and approaches for use with children with sensory impairments and additional disabilities to help them be more actively involved with the world around them.
Lilli Nielsen
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43. Summary
This is our attempt to have a more comprehensive picture of O&M in early intervention from Evaluation (B-6 Inventory) to defining needs, setting goals and implementing strategies.
This continues to be a work in progress
Please visit our website for the most recent version of the
B-6 O&M Inventory
Link to our website:
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44. B-6 O&M Inventory References
Screen shot
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45. References from JVIB Article
Adelson, E., & Fraiberg, S. (1974). Gross motor development in infants blind from birth. Child Development, 45,
Anthony, T. L., Bleier, H., Fazzi, D. L., Kish, D., & Pogrund, R. L. (2002). Mobility focus: Developing early skills for orientation and mobility. In Early focus: Working with young children who are blind or visually impaired and their families (2nd ed.) (pp ). New York, NY: AFB Press.
Ferrell, K. A. (1998). Project PRISM: A longitudinal study of developmental patterns of children who are visually impaired. Final report. (Grant H023C10188, US Department of Education, Field-initiated research, CFDA ). Greeley, CO: University of Northern Colorado.
Morgan, E. (Ed.). (1995). Project VIISA: Resources for family centered intervention for infants, toddlers, and preschoolers who are visually impaired (2nd ed, Vols. 1-2). Logan, UT: Utah State University, SKI-HI Institute.
Skellenger, A. C., & Sapp, W. K. (2010), Teaching orientation and mobility for the early childhood years. In W. R. Wiener, R. L. Welsh, & B. B. Blasch (Eds.), Foundations of orientation and mobility, Volume II: Instructional strategies and practical applications (3rd ed.) (pp ). New York: NY: AFB Press.
Troster, H., & Brambring, M. (1993). Early motor development in blind infants. Journal of Applied Developmental Psychology, 14,
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