Orientation and Mobility Assessment

Lyra had her first Orientation and Mobility assessment on October 16th. She was 17 months old. I had been and still am doing a lot of research on Orientation and Mobility, and the benefits of the services to infants, toddlers, and preschoolers. Orientation and mobility(O&M) is 3 things: knowing where you are, knowing where you want to go, and knowing how to get there.

Do kids with albinism need these services? Maybe…maybe not. It depends on a lot of things. It can’t be determined based on visual acuity alone. It depends on how they are using the vision they have, how they are moving in their environment, and if they are doing this safely and independently. It’s important to know that many children with low vision will figure out how to move around safely and independently in familiar places like home or daycare, without difficulty. However, behavior in unfamiliar environments can be surprisingly unpredictable. Regardless of your child’s visual acuity, it is very important that your child receive a thorough assessment by a certified orientation and mobility specialist. If a child is moving around in his/her environment, whether that’s rolling, scooting, crawling, pulling up, or walking, he or she could potentially benefit from O&M services.

There are a variety of concepts and skills taught through O&M, including body awareness, spatial concepts, sensory awareness, and searching skills. O&M training also includes techniques to facilitate safe independent movement. These may include sighted guide technique, protective techniques, and cane skills.
WHAT!!! ———– A CANE!?!
Don’t let the word scare you…like it did me. The thought of the possibility of my daughter needing a cane used to give me a big lump in my stomach. A cane is so…OBVIOUS! I just wanted her to look normal and a cane would totally mess that up. Slowly, after watching Lyra struggle with learning to walk and get around, I realized that her being safe and confident was more important than worrying about what other people think. Based on her initial O&M assessment, Lyra will not likely need a cane. When she’s older, that could change. The majority of people with albinism do not use a white cane, however the use of an ID cane is not uncommon. It lets other’s know to “watch out for you” and people are more forgiving when you bump into them if they know you can’t see.

O&M service delivery methods vary, depending on the needs of the child and also the availability of qualified providers. In many cases, services can be provided indirectly, through consultation. In other cases, direct services may be provided through weekly one-on-one sessions with the O&M specialist. Parent’s can request an evaluation, or a child’s TVI, OT or other service provider may make the request. Even if your Early Intervention service providing agency/organization does not currently have an O&M specialist on staff, they are still legally required to locate a qualified specialist to complete an assessment if you request one.

How do you know if your child should have an assessment? There are no required behaviors or problems that would tell you definitively that he/she might need O&M services. Some of the behaviors/issues parents might notice include, tripping over or not noticing surface changes, overstepping surface changes, running into objects/people, falling and not using protective techniques, dropping to the ground and crawling over surface changes. The important thing to remember is that every child is different. We can’t predict how our children are going to adapt on their own or how they’ll respond to interventions. Don’t be afraid to let the professionals help. Don’t let selfish pride prevent you from at least getting your child an O&M evaluation.

I’ve heard people say that kids with albinism generally do “Okay” developmentally. I think people with low vision did “Okay” before the development of monoculars, and biopics, or computer magnification software, but does that mean we should reject the technology? No. Just because something is new and unfamiliar, doesn’t mean its unnecessary. As a parent looking toward the future of my child, “Okay” just isn’t good enough. I’d rather my toddler not have to smack her head on the corner of the wall 10 times to learn that she needs to scan her environment as she’s walking.

View: Lyra’s Orientation & Mobility Assessment

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