Provision of High-Quality Orientation and Mobility Services to Older Persons with Visual Impairments

Abstract

This article discusses the problems associated with providing appropriate high-quality orientation and mobility (O&M) services to older persons with visual impairments, including problems in attitudes, characteristics, financial considerations, in-service training, and the availability of age-appropriate assessment instruments. It also reviews research on interventions related to O&M and considerations in developing O&M strategies for older persons.

Orientation and mobility service decisions: What is guiding them if it is not assessment?

“…Included within the seven research studies were 279 children ages birth to graduation or 21 years old, 36 adults receiving services from the Veteran Administration (VA), and 253 O&M specialists (Geruschat & De l'Aune, 1989;Harley & Merbler, 1980;Hill, Dodson-Burk, & Talor, 1992;Lord, 1969;Munro et al, 2018;Wall Emerson & Anderson, 2014;Wall Emerson & Corn, 2006). The remaining 10 articles included: three geared toward O&M services and assessment for individuals with deafblindness (Bourquin, Mascia, Rusenski, 2002;Geruschat, 1980;Smith & Herlich, 2014), one geared toward O&M for adult (Hill & Hill, 1991), five geared toward O&M in the K-12 education system (Barrella et al, 2011;Bryan, 1989;Daugherty, 2014;Hill & Hill, 1990;O'Mea, 2013), and one was geared toward birth to three O&M (Dewald et al, 2015). (Geruschat, 1980) Practitioner Report K-12 students with deafblindness…”

“…Intended for recording observations, however, participants assessment used it as assessment and service delivery qualifying tool. (Hill & Hill, 1991) Practitioner Report…”

“…As best practice, assessment guides goals and instructional services, not diagnosis or other factors (Pierangelo & Guiliani, 2017). It is crucial that the O&M specialist select the correct assessment because the entire education plan and ability of person with a visual impairment to move safely and independently rely on it (Bryan, 1989;Geruschat;Geruschat & De l'Aune, 1989;Harley & Merbler, 1980;Hill et al, 1992;Hill & Hill, 1991;Wall Emerson & Corn, 2006). The specialist must ensure the tool is age and developmentally appropriate, as well as account for their individual medical and support needs (Geruschat, 1980;Hill & Hill, 1991;O'Mea, 2013;Smith & Herlich, 2014).…”

“…Nine articles discussed O&M assessments or mentioned assessment in addition to the primary topic of the article. These articles discussed the creation of individual assessment tools, the assessment process, or other factors that may influence assessment results (Geruschat, 1980;Geruschat & De l'Aune, 1989;Harley & Merbler, 1980;Hill et al, 1992;Hill & Hill 1991;Lord, 1969;O'Mea, 2013;Smith & Herlich, 2014;Wall Emerson & Corn, 2006). Two studies worked specifically to establish the travel and compensatory skills that should be targeted for assessment and instruction (Lord,1969;Wall Emerson & Corn, 2006).…”

“…Geruschat added that when evaluating individuals with additional support needs, like those with deafblindness, that the collaborative assessment should include nursing for a medical evaluation, a teacher of the visually impaired, a behavior specialist, a movement specialist or physical therapist, and someone who specializes in the child's mode of communication (Geruschat, 1990). Hill and Hill (1991) provide guidance on the administering of O&M assessments to older clients; however, the information is beneficial to individuals with complex support needs as well.…”