Birth to Three Orientation and Mobility

New Mexico Style

Click icon to add pictureAER International O&MNew Orleans, LA

New Mexico School for the Blind and Visually Impaired

www.nmsbvi.k12.nm.us

Cindy Faris, TVI/Lcfaris@nmsbvi.k12.nm.us

Loreta Martinez-Cargo, COMSloretacargo@nmsbvi.k12.nm.us

Julie Maner, COMSjuliemaner@nmsbvi.k12.nm.us

Mark Carter, COMSmcarter@nmsbvi.k12.nm.us

NM is a BIG state

NM is the fifth largest state in square miles… as large as Wisconsin and Florida combined

125,000 square miles

In the NMSBVI B-3 program there are 18 providers (three O&Ms and 15 Developmental Vision Specialists)

NM has many rural areas and the urban centers of Albuquerque, Santa Fe and Las Cruces

DIVERSE POPULATION

OVER 50% HISPANIC

10.5% INDIAN CITIZENS

19 INDIAN PUEBLOS

2 INDIAN TRIBES

NAVAJO NATION

STATE COLLABORATION

NMSBVI B-3 JOINING WITH A SYSTEM OF STATE FAMILY INFANT TODDLER SERVICES: 2000

IDENTIFY MORE KIDS WHO NEED VISION SERVICES

NM DEPARTMENT OF HEALTH, FAMILY INFANT TODDLER AND NAVAJO NATION OFFERED SUPPORT AND COLLABORATION

ALLOWED TO BILL MEDICAID FOR SERVICES THROUGH FIT

INTEGRATION OF VISION SERVICES IN AN INDIVIDUALIZED FAMILY SERVICE PLAN

SERVICES

VISION SCREENING TOOLIDENTIFICATION OF KIDSSERVICES IN HOME & COMMUNITYTRAINING & TA FOR EI STAFFSERVE KIDS “AT RISK” FOR VISION

IMPAIRMENTNM IS ONE OF TWO STATES WHO

SERVE KIDS “AT RISK”: MEDICAL, ESTABLISHED CONDITION, ENVIRONMENTAL

VISION AND ORIENTATION AND MOBILITY SERVICES

VISION SCREENING TOOL

LOCATED AT:

www.nmsbvi.k12.nm.us

NEW MEXICO VISION SCREENING TOOL FAMILY INFANT TODDLER PROGRAM (Adapted with permission from Baby Watch, Utah Early Intervention Program) This screening does not equate with an assessment by a medical professional.

Child’s Name

DOB

Parent's Name

Phone

Chronological Age Adjusted Age

Signature (person doing screening)

Date

Eye care Specialist _________________________________

Date of last exam

PARENT INTERVIEW

Results of parent interview; describe any concerns: _____________________________________ ______________________________________________________________________________ ______________________________________________________________________________

I. HISTORY: (Check all that apply) No Concerns

A. Child’s History Low birth weight < 3.5 lbs. Hydrocephaly/microcephaly PVL (periventricular leukomalacia) Prematurity w/oxygen < 32 wks Syndrome . Shaken Baby Syndrome Small for gestational age Cerebral hemorrhage Significant illness: Meningitis/encephalitis Hypoxia, anoxia, low apgars Hearing loss Medications: Head trauma/tumor Neurological disorder Sepsis Seizures Retinopathy of prematurity (ROP) Intraventricular hemorrhage (IVH) Vacuum Extraction Cerebral Palsy

B. Exposures during pregnancy

Rubella Toxoplasmosis Cytomegalovirus (CMV) Significant Illnesses: Herpes Alcohol / drugs Medication(s):

C. Immediate family history of childhood vision loss

Strabismus/Amblyopia Retinal dystrophy / degeneration Systemic syndromes w/ ocular manifestations Congenital Cataracts Glasses in early childhood Retinoblastoma Congenital Glaucoma Sickle cell disease Other:

II. APPEARANCE OF THE EYE(S): (Check all that apply) No Concerns

Cloudy or milky appearance Abnormal constriction or dilation of pupil (s) Keyhole pupil Difference between eyes (size, shape, etc.) Sustained eye turn inward or outward? (after 4-6 months) Excessive tearing Droopy eyelids Jerky eye movements (nystagmus) Absence of eyes moving together

III. BEHAVIORS THAT ARE OFTEN ASSOCIATED WITH VISUAL IMPAIRMENT: No Concerns

Tilt or hold head in unusual position? Visually inattentive/uninterested? Hold objects close to eyes or bend close to look? Inconsistent visual behavior? Seem to look beside, under, or above an object or person? High sensitivity to room light or sunlight? Stare at lights, ceiling fans? (after 3 months of age) Difficulty sustaining eye contact?

CHILDREN WE SERVE

REFERRALS FROM:

EI STAFF

EYE DOCTORS

2000 served 40 kids statewide

July 2012 to May 2013 we have provided screenings and services for 1,542 kids

Of 1,542; 721 were screened and 821 were provided ongoing services

HOSPITALS, DOCTORSWE HELP CONNECT FAMILY FROM MEDICAL PROVIDER TO FOLLOWUP SERVICES AROUND THE STATE

PROVIDE VISION SUPPORT TO HOSPITALS FOR INPATIENT AND DISCHARGE

PICU, GPU, NICU

COLLABORATE WITH PRIMARY CARE PROVIDERS,PEDIATRIC OPHTHALMOLOGISTS, AND NEUROLOGISTS

S e r v i c e s d e l i n e a t e d i n t h e I F S P t h a t a d d r e s s p u r p o s e f u l a n d i n d e p e n d e n t m o v e m e n t i n c h i l d r e n w h o a r e b l i n d , v i s u a l l y i m p a i r e d o r a r e a t r i s k f o r v i s u a l i m p a i r m e n t .   S e r v i c e s p r o v i d e d i n v o l v e t h e d e v e l o p m e n t o f s k i l l s i n c l u d i n g c o n c u r r e n t m o t o r s k i l l s , s e n s a t i o n , e n v i r o n m e n t a l c o n c e p t s , b o d y i m a g e , s p a c e / t i m e r e l a t i o n s h i p s , a n d g r o s s m o t o r s k i l l s .

O r i e n t a t i o n a n d m o b i l i t y i n s t r u c t i o n i s f o c u s e d o n t r a v e l a n d m o v e m e n t i n c u r r e n t e n v i r o n m e n t s a n d n e x t e n v i r o n m e n t s a n d t h e i n t e r w e a v i n g o f s k i l l s i n t o t h e o v e r a l l l a t t i c e w o r k o f d e v e l o p m e n t .   S e r v i c e s i n c l u d e e v a l u a t i o n a n d a s s e s s m e n t o f i n f a n t s a n d t o d d l e r s i d e n t i f i e d a s b l i n d / v i s u a l l y i m p a i r e d t o d e t e r m i n e n e c e s s a r y i n t e r v e n t i o n s , e q u i p m e n t , a n d s t r a t e g i e s t o p r o m o t e m o v e m e n t a n d i n d e p e n d e n c e . ( S k e l l e n g e r & S a p p , 2 0 1 0 )

Orientation and Mobility DefinitionNM Family Infant Toddler Program

• O & M S E R V I C E S S H O U L D S TA R T W H E N A C H I L D I S Y O U N G• M O V E M E N T I M P R O V E S C O G N I T I V E F U N C T I O N I N G A N D I N C R E A S E S

S K I L L S I N A L L D E V E L O P M E N TA L A R E A S• C H I L D R E N S H O U L D H AV E A N O P P O R T U N I T Y T O L E A R N B Y E X P L O R I N G

A N D M O V I N G W I T H I N FA M I L I A R A N D N E W E N V I R O N M E N T S • M O V E M E N T S H O U L D B E D E V E L O P M E N TA L LY A P P R O P R I AT E• O & M S H O U L D B E F U N , B E C A U S E C H I L D R E N L E A R N B E S T T H R O U G H

P L AY• C H I L D , FA M I LY A N D T E A M C E N T E R E D O & M I S M O S T S U C C E S S F U L• A C T I V E PA R T I C I PAT I O N A L L O W S T H E C H I L D T O L E A R N I N A

M E A N I N G F U L C O N T E X T. • C H I L D R E N L E A R N B E S T W H E N T H E Y A R E E N G A G E D I N N AT U R A L

L E A R N I N G E N V I R O N M E N T S .

NMSBVI B-3 O&M Guiding Principles

James Gibson: eco log ica l approach: “percept ion i s in tune wi th the propert ies o f the env i ronment that are use fu l in da i l y l i fe . ”

“Percept ion and act ion are a cyc le : people act in order to l earn about the i r surroundings , and they use what they learn to guide the i r act ions .”

Foundations of Orientation and Mobility

“ I t i s important for O&M spec ia l i s ts to he lp ch i ldren wi th v i sua l impai rments deve lop many o f the sensor imotor sk i l l s that the i r peers who are s ighted learn so eas i l y. ”

“O&M spec ia l i s ts can do th i s by encouraging meaningfu l movement , demonstrat ing sk i l l s us ing k inesthet ic and v i sua l model ing , and prov id ing s tructured sensor imotor deve lopment sk i l l s whi le emphas iz ing the host o f audi tory, o l factory, tact i l e , ves t ibular, and o ther sensory inputs that are part o f such exper iences”

Sandra Rosen Volume I , page 171 :

Foundations of Orientation and Mobility

“Necess i ty o f fac i l i ta t ing the in formal , inc identa l nature o f l earn ing when prov id ing or ientat ion and mobi l i ty in tervent ion”

“The process o f or ientat ion and mobi l i ty wi th ear l y ch i ldhood learners may be thought o f as arranging for the fac i l i ta t ion o f t rave l both in current and in next env i ronments .”

“…learn ing dur ing the ear l y ch i ldhood years appears to be a cont inuous process o f g i ve and take between the ch i ld and the env i ronment…” ( t ransact ional l earn ing)

Volume I I , Teaching O&M in the Ear ly Years , Ske l lenger and Sapp

Foundations of Orientation and Mobility

 

Vo lume I I , page 203

Foundations of Orientation and Mobility

O&M Skill Infant Toddler Preschooler

Public Transportation

Plan periodic family “field trips.” Instead of driving… take a city bus, or take a cab to the grocery store occasionally.

Continue family “field trips.” Talk with student about what type of transportation you will take, read a story about the type of transportation…

Continue family “field trips.” Give the child responsibility for portions of the trip… have him hold the money and hand it to the bus driver as you get on…

NMSBVI Birth – 3 YearsOrientation and Mobility Assessment

Demographics Functional Vision ResultsParent ReportCommunication Sensory: Auditory/Tactual/Olfactory Gross MotorFine MotorQuality of Movement

OrientationMobilityConcepts Travel DevicesSafety and Environmental

AwarenessExploration and Learning B-3 O&M assessment in Word:

http://www.nmsbvi.k12.nm.us

NMSBVI Programs - Family-Infant-Toddler Program under Additional Resources