SEARCH WITHIN CONTENT
Citation Information : International Journal of Orientation & Mobility. Volume 8, Issue 1, Pages 62-83, DOI: https://doi.org/10.21307/ijom-2017-067
License : (CC-BY-NC-ND-4.0)
Published Online: 16-April-2018
A review of the 50 US state education websites revealed wide variation among state O&M credentials. Less than half of the states designated a qualified provider as a credentialed O&M specialist and many identified a role for the Teachers of Learners with Vision Impairment (TVI) in providing Individualised Education Program (IEP)-driven O&M-related services. A survey of US Personnel Preparation programs preparing TVIs asked respondents to select the O&M curricular items they taught to TVI students and their purpose(s) for teaching them. Respondents taught TVIs in all 10 general areas of O&M curriculum: Outdoor/Commercial, Outdoor/Residential, Cane Technique, Cane Skills with a Guide, Mobility Tools, O&M Knowledge and Skills Protective Techniques, Non-Cane Techniques, Orientation Strategies, and Guide Techniques. Respondents indicated the reason (Skills Practice, Teach, Referral, and Evaluation) for teaching these skills to TVIs. Results suggested that TVI programs prepared TVIs to teach non-cane skills and to provide skills practice on more complex travel skills. Federal Statute, IDEA Part C (2004) stated O&M begins in early intervention and named the O&M specialist as the provider. Only O&M specialists are professionally prepared to evaluate and teach O&M. Personnel preparation programs in TVI might need to evaluate the purpose of educating TVIs to teach such a narrow aspect of O&M content. Further, with only one TVI course offered in O&M, TVIs are not adequately trained to teach O&M and, therefore, should not be taught this role or be required by states to perform it.
A paradigm shift in the provision of orientation and mobility (O&M) services began in the United States when the term ‘O&M specialist’ was specifically named in Federal Statute (IDEA, 2004, Part C) as one of the qualified personnel designated to provide early intervention (EI) related services. Prior to the enactment of PL. 94-142, re-titled The Individuals with Disabilities Education Act, (IDEA) in subsequent reauthorisations, parents and teachers of learners with vision impairment (TVIs) were tasked with providing O&M to learners with vision impairment (COMSTAC, 1966).
The 1997 IDEA reauthorisation was a landmark change enabling access to O&M services in schools. However, the legislation did not go further and name the O&M specialist as the provider of those services. This situation changed, when in 2004 IDEA Part C included the O&M specialist in the list of qualified providers of EI services.
A review of the 50 state education websites was conducted to determine the ways states have implemented the shift in recognition of the O&M specialist as the qualified provider of O&M services under IDEA. In May 2015, state education agencies listed one or more of nine designations or requirements for the O&M service providers including:
no specific qualification (e.g., auxiliary or qualified personnel)
state issued non-teacher O&M certification/license
Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) O&M certified
Teacher of Learners with Visual Impairments (TVI) certified, special education/ general education teacher certified
National Orientation and Mobility Certification (NOMC) certified
Association for the Education and Rehabilitation of the Blind and Visually Impaired (AER) O&M certified
American Association of Workers for the Blind (AAWB) O&M certified, and/or
Rehabilitation Therapist (RT), Occupational Therapist (OT), or Physical Therapist (PT). Table 1 indicates the number of states that listed no qualification or one or more qualifications of O&M service providers.
Table 1 suggests that there is wide variation among state required O&M credentials. Less than half of states designated a qualified provider as a credentialed O&M specialist and many identified a role for the TVI in providing all or a portion of IEP-driven O&M related services (Table 2).
The majority of states have no specific O&M qualification. Eight states created a license/ certificate for O&M specialists that allowed states to hire O&M specialists to work in schools without a teaching credential. Seven states required the O&M specialist be teacher certified and six other states required the O&M be TVI certified. While there are individual city and school district policies that might have more specific hiring standards, this article examined only state-education websites.
According to Nevada’s website, the O&M specialist must “have a degree and completed the AER O&M certified program”, but stated that “such an endorsement is not required to teach pupils in a program of orientation and mobility”. Similarly in Hawaii, teacher certification was required, but not an O&M credential: “… Preparation in O&M for students who are visually impaired is sought, though the credentialing process does not require it” (Dr. J. Prickett, personal communication, January 30, 2002).
TVIs in the US have been called upon to provide instruction in some aspects of O&M since the 1960s. At that time, there were very few university prepared O&M specialists (Weiner, 1980; Weiner & Sifferman, 2010). At the same time, there was also a belief that young learners benefited from learning to negotiate their environment without a mobility tool, and consequently an O&M specialist was not seen as necessary until junior high or high school (Costello & Gockman, 1966; Lord & Blaha, 1968; Mecklenburg Association for the Blind, 1965; Metropolitan Society for the Blind, 1963).
Lord and Blaha (1968), in the only research study found on this topic, identified an instructional model for preparing TVIs where, after receiving one course/workshop in O&M, TVIs were asked to teach pre-cane skills to their students to ready them for O&M instruction by an O&M specialist. Lord and Blaha (1968) also reported that they found TVIs lacked “time for systematic instruction, as responsibilities in the resource room prevented them from an adequate opportunity to follow up on the campus” (p. iv).
In the 1960s, US university TVI programs began including a course in O&M. The number of university TVI programs offering the course O&M for TVIs grew from one, in 1962, to 10 in 1969 (AAIB, 1962, 1968; Hill, et al., 1984; Weiner, 1980). The description of the role of TVIs in provision of O&M services was also found in the Council for Exceptional Children Standards (CEC). CEC standard VI4K11: “Strategies to prepare individuals for structured pre-cane orientation and mobility assessment and instruction” (2003, p. 109).
A review of state education websites indicated that 26 states required TVIs to provide some O&M instruction, whereas 11 states only expected that TVIs have knowledge of O&M services, and the remaining states published no expectation of TVIs with respect to provision of O&M services. Table 2 lists the states grouped by the amount of O&M services included in their TVI regulations.
The TVI role in providing O&M services is defined in past and current textbooks for TVIs (Dote-Kwan, 2014; Fazzi, 2014; Griffin-Shirley, Trusty, & Rickard, 2000). Although Griffin-Shirley et al. (2000) clearly stated that “O&M is a unique area of the Expanded Core Curriculum (ECC) for which a professional, other than the TVI, is largely responsible for instruction” (p. 531) the authors at that time maintained that “to enable a child who is visually impaired to move safety (sic) through the environment, the teacher of students with visual impairments should teach the sighted guide, trailing, and protective arm techniques …” (p. 541).
More recent texts on O&M services in EI settings named both the TVI and O&M specialist as O&M service providers. Dote-Kwan (2014) stated that the classroom teacher could consult with the TVI or the O&M specialist “regarding specific O&M techniques that the child needs to be encouraged to use inside and outside of the classroom …” and either the O&M specialist or TVI “can also provide assistance in analysing the school campus for realistic travel routes” (p. 547).
Fazzi (2014) defined the TVI’s role more narrowly stating that the O&M specialist was an essential instructor of O&M techniques and the TVI role was “to become familiar with the concepts and skills of O&M in order to effectively support O&M specialists in their efforts to teach students to travel as independently as possible … such as expecting the student to use the long cane during travel on specified routes” (pp. 248-250).
Interactive play and ambulatory exploration of the environment are important developmental activities for young children. However, recent studies have documented that preschoolers with vision impairment remain stationary and engage in solitary play in preschool settings (Celeste & Grum, 2010). These results point to a concern about access to high quality O&M instruction in the early years of learners with congenital vision impairment.
Learners with vision impairment are at risk of developing global developmental delays even with current early intervention methods (Celeste, 2005, 2007; Hatton, Ivy, & Boyer, 2013). Celeste (2005) stated that “children who are visually impaired are at a particular risk for delays in the motor, social, and self-help domains of development” (p. 44).
In 2013, Hatton, Ivy, and Boyer analysed the data on young children who were referred to specialised agencies providing services to learners with vision impairment between 2005 and 2011 (n=5,931). Of those, 28.3% were identified as having developmental delays, despite the fact that they were born with no identified additional disabilities. These developmental delays were related to limited sensory-motor opportunities that resulted from vision impairment.
Although federal law has identified the O&M specialist as qualified personnel, there are many states where regulations have tasked TVIs with the evaluation, provision, and oversight of O&M services. This situation suggests that for decades TVIs have at a minimum been in the role of providing support for O&M services, and at a maximum evaluating, teaching and/or overseeing their students’ O&M needs for basic skill, or pre-cane skill acquisition, especially for younger learners in EI and preschool settings.
Now that federal law designates the O&M specialist as the qualified personnel for providing O&M services, an important question arises: what is taught in the TVI personnel preparation courses in O&M? The purpose of this study was to survey instructors who taught the O&M course for TVIs in the United States to learn what aspects of the O&M curriculum the course covered and for what purposes. The study was approved by The Hunter College Human Research Protection Program (HRPP) Office.
A list of TVI personnel preparation programs in the United States was generated through online websites that listed TVI programs. Forty programs were identified although only 35 programs were currently being offered. An email that included a brief description of the study together with informed consent was sent to program coordinators. The coordinators were asked to forward the link to the survey to any faculty or staff (i.e., instructors) who taught the O&M for TVIs course.
The 30 respondents included 24 women and six men; 19 were full-time instructors and 11 were hired to teach the course. Seven respondents were tenured and four were on tenure track. The age of the respondents and their length of time teaching O&M were unknown. The course instructor had to be dually certified in TVI and O&M (n=11), O&M certified (n=9), co-taught by a TVI and O&M specialist (n=2), not sure (n=6), not reported (n=2).
The 76-question survey was created using the survey software ‘Survey Monkey’. To establish the survey’s content and face validity, three O&M faculty members reviewed it and submitted critical feedback. The survey was then pilot tested on 10 subjects. In addition to demographic data and course instructional methods, the survey enquired which of 10 general areas of O&M techniques and strategies the course covered: Guide techniques, orientation strategies, non-cane techniques, protective techniques, O&M knowledge and skills, mobility tools, cane skills with a guide, cane techniques, outdoor residential, and outdoor/commercial. Within each general area was a list of skills. The content for the general areas and the list of skills were selected from O&M textbooks (Hill & Ponder, 1976; Jacobson, 2015).
When an instructor selected any of the skills within the 10 general areas, s/he was prompted to answer the question, “in addition to wanting the TVI scholar to learn O&M knowledge and skills, what are the top reasons for teaching TVI scholars the following O&M knowledge and skills:
Referral – sufficient knowledge to recognise whether or not a learner should be referred for O&M services
Skills practice – sufficient knowledge to aid students with vision impairment in O&M technique practice under O&M specialist supervision
Evaluation – sufficient knowledge to evaluate the O&M technique competency of the students with vision impairment; and/or
Teach – sufficient knowledge to teach students with vision impairment the O&M technique independent of O&M specialist supervision.”
Five of the 40 programs contacted were no longer offered (Table 3). Of the remaining 35 programs, 30 surveys (i.e., 30 respondents) from 29 programs were received providing a response rate of 82.8%. Two respondents did not complete the survey in full and two surveys were submitted by faculty of the same university. As this was a survey of the course ‘O&M for TVIs’, all responses were included in order to best reflect how the particular course was characterised by those who taught it.
Of the 28 TVI program instructors completing the survey in full, 24 indicated that they offered one course in O&M as part of the TVI curriculum. Three programs covered the material in multiple courses that also included instruction in daily living skills.
Twenty-six (92.9%) instructors provided the name of 19 assigned textbooks. Eight O&M textbooks were mentioned 35 times; the most frequently used O&M text was Teaching Age-Appropriate Purposeful Skills (TAPS) (n=9). Respondents indicated that only certain chapters of the O&M texts were assigned reading. Eleven education textbooks were mentioned 18 times, the most frequently mentioned was Foundations of Education (2nd Edition): Instructional Strategies for Teaching Children and Youths with Visual Impairments (n=5).
Twenty-nine respondents provided the course purpose and 30 respondents provided course objectives. Fifteen (51.7%) respondent purposes were similar to the example, “to teach basic skills in O&M and provide an introduction to the field of O&M and related concepts”. Ten respondents’ (34.5%) were deemed similar to the example, “development of spatial and environmental concepts and sensorimotor skills in young learners with visual impairments. Application of O&M-related concepts to travel in home, school, and community environments.” Four respondents (13.8%) stated the course provided an introduction and/or overview of O&M.
The 307 stated course objectives were grouped according to whether they described teaching supportive roles (provide support to students being taught by an O&M specialist) or instructional roles (teach the O&M content directly to students) to TVIs. There were 152 supportive role objectives (49.5%). Respondents stated that these course objectives were aligned with CEC TVI standards. They included knowledge of: the impact of vision impairment on development (n=25), O&M history and laws (n=24), basic O&M skills (n=21), daily living skills (n=20), mobility tools (n=15), O&M screening (n=10), roles of vision professionals (n=10), collaboration with O&M specialist (n=8), how to explain O&M to others (n=4), difference between TVI and O&M (n=4), access to O&M (n=3), low vision (n=2), teaching college partner (n=2), multicultural issues (n=1), task analysis (n=1), equipment (n=1), and transition (n=1).
There were 155 objectives (50.4%) that indicated direct O&M instruction, including teaching O&M skills and techniques (n=112), performing O&M assessment (n=19), developing IEP goals (n=8), analysing environments (n=6), teaching mapping (n=5), and adhering to O&M standards/laws (n=5).
Within teaching O&M objectives were: teach basic skills (n=32), development of concepts (n=21), teach individuals with multiple disabilities (n=12), teach orientation in familiar and unfamiliar environments (n=11), assess student progress (n=9), development of sensory awareness (n=7), use O&M instructional strategies (n=5), development of mapping and spatial updating (n=5), implement O&M; teach route planning, teach problem solving (n=3), development of mechanics of locomotion (n=3), development of motor functioning (n=2), and teach mobility skills (n=2). Eighty-eight O&M specific instructional objectives cited ACVREP O&M standards (78.6%).
Respondents were asked to indicate whether they covered any of the 10 general areas of O&M instruction (Figure 1). One respondent indicated the course taught none of the 10 O&M areas listed, and wrote, “I am unsure of what we are talking about here … we explain devices but we do not teach these beginning students how to use them.” Graph 1 shows which areas of O&M content were covered (yes) or not covered (no) in the course.
One respondent who indicated that specific skills in all 10 O&M general areas were covered by the course wrote, “… this is not a course that is designed to have TVIs teach O&M, but to be familiar with O&M so that TVIs can support the OMS with follow-up and make referrals to O&M …”
Twenty-eight respondents completed this section of the survey. When a general area was selected ‘yes’, respondents were asked to select from specific skills taught within the area. For each specific skill selected, respondents were asked to indicate the reason (Skills Practice, Teach, Referral, and Evaluation) for teaching that skill. A ‘reason percentage’ was calculated by dividing the number of times a reason was selected by the number of times that skill was selected.
Twenty-seven of 28 respondents (96.4%) taught guide techniques. All 27 selected basic guide, narrow passageway, and reversing directions. Twenty-six respondents selected transferring sides and doors and 25 respondents selected accepting/refusing aid, stairs, and seating. The reason percentage of guide techniques was: Skills Practice (89.4%), Teach (39.8%), Referral (25%), and Evaluation (16.2%).
Twenty-seven respondents (96.4%) selected orientation strategies. All selected landmarks, cues, and clues. Fewer selected non-visual (n=24) and low vision (n=23) orientation strategies, soliciting aid (n=21), the cognitive process (n=21), map skills (n=19), compass (n=18), numbering strategies (n=9), and smartphone apps (n=16). The reason percentage of orientation strategies were Skills Practice (96.8%), Referral (40.3%), Teach (25.5%), and Evaluation (7.8%).
Twenty-six respondents (92.9%) selected non-cane techniques. All selected trailing and traversing open doorways. Twenty-four selected direction taking, search patterns, and dropped objects. The reason percentage of non-cane techniques was Skills Practice (83%), Teach (42.1%), Referral (25.8%), and Evaluation (12.1%).
Twenty-six respondents (92.9%) selected both upper and lower hand forearm techniques. The reason percentage of protective techniques was Skills Practice (88.5%), Teach (38.5%), Referral (30.8%), and Evaluation (11.5%).
Twenty-four (85.7%) respondents selected O&M knowledge and skills. All selected teaching concepts (e.g., spatial, positional, environmental, and time), orientation concepts and O&M terminology. Fewer selected using sensory information (n=23), O&M screening (n=22), teaching learners with multiple impairments (n=21), travel practice at school (n=15), travel practice in the community (n=10), travel practice at home (n=9) and travel in adverse weather (n=5). The reason percentage of O&M knowledge and skills was Skills Practice (80.8%), Teach (26.2%), Referral (42.6%), and Evaluation (9.3%).
Twenty-two (78.6%) respondents selected mobility tools; all of those respondents selected Adaptive Mobility Devices (AMDs). Fewer selected teaching parts of long cane (n=21), vision as a mobility tool (n=20), dog guides (n=18) and electronic travel aids (n=16). The reason percentage of mobility tools was Skills Practice (62.0%), Referral (49.7%) Teach (3.9%), and Evaluation (2.9%).
Nineteen (67.8%) respondents selected cane skills with a guide. Of those, 17 respondents selected cane placement and walking with a guide. Fewer selected accepting/refusing aid (n=16), doorways and transfer sides (n=15). The reason percentage of cane skills with a guide was: Skills Practice (92.4%), Referral (27.5%), Evaluation (15.0%), and Teach (17.3%).
Thirteen (46.4%) respondents selected cane skills. All of those respondents selected touch technique and constant contact touch. Twelve selected diagonal, diagonal trailing, contacting objects, and ascending/descending stairs. Fewer selected doorways (n=11) and changing hands (n=10). The reason percentage of cane techniques was Skills Practice (89.2%), Referral (30.1%), and Evaluation (2.7%) purposes. No respondents indicated TVI students were to teach cane techniques.
Six (21.4%) respondents selected outdoor/residential. All selected the specific skill “introduction to outdoor travel”. Of those, five selected shorelining. Fewer selected touch and drag (n=4), residential street crossings (n=3), sidewalk recovery (n=3), street crossing recovery (n=3), touch and slide (n=3), 3-point touch (n=1), and car familiarisation (n=1). The reason percentage of outdoor residential skills was: Skills Practice (90.7%), and Referral (54.4%). No respondents indicated the reason was to Teach or Evaluate these skills.
Six (21.4%) respondents selected outdoor/commercial skills. Of those, five selected elevators. Fewer selected escalators (n=3), pedestrian traffic controls (n=2), revolving doors (n=1), sequencing for lessons on street crossing (n=1), and subways/EL trains (n=1). The reason percentage of outdoor/commercial skills was Skills Practice (18.5%), Referral (5.6%), and Evaluation (3.7%), with no respondents indicating the reason was to Teach these skills. Buses, Airport Terminals, and Primary Commercial Facilities were the only O&M techniques not selected by any respondent.
Respondents were asked the number of hours TVI students spent learning skills wearing blindfolds and low vision simulators. The highest number of hours with blindfolds was 40 and the lowest was two hours with an average of 12.3 hours across the 28 respondents. The highest number of hours spent using low vision simulators was 10 and the lowest was zero with an average of 2.8 hours.
Thirty respondents completed all or part of the survey. Human guide techniques, orientation strategies, protective techniques, and other non-cane skills were the most commonly covered O&M techniques and strategies in the O&M for TVIs course.
Skills practice was the most common reason selected for teaching any of the O&M skills. The second most commonly selected reason depended on which skill was being discussed. Teach was the second most common reason selected for teaching guide techniques, non-cane techniques, and protective techniques.
Referral was the second most common reason for covering the remaining skills. Evaluation was the least often chosen reason for teaching any of the O&M skills. This suggests that personnel preparation programs continue to define the role of TVIs with respect to O&M services as responsible for teaching non-cane skills. The TVIs are being taught to refer for O&M services for more complex travel.
In spite of the advances in O&M services, instructor preparation, and federal law, it would appear that the course O&M for TVIs continues to teach an instructional model created in the 1960s. The most frequently required textbook was TAPS, which was written 20 years ago, whose content was unchanged in the 2006 reissue, and was “designed to be used by O&M practitioners who work with children 3-21” (Hill, 2006, p. vii). Most of the texts used in these courses were O&M textbooks.
CEC has never created O&M standards for O&M services. However, about half of the O&M for TVIs course objectives were reported to be aligned with CEC TVI standards, standards intended for the TVI, but not specifically written to address the O&M needs of children. About half of the O&M for TVIs course objectives were directed at O&M assessment, evaluation, creation of Individualized Education Program (IEP) objectives, and teaching O&M by TVIs. The O&M standards used to support these course learning objectives were taken from the ACVREP O&M certification handbook, which was developed specifically for O&M specialists, not for TVIs.
While there has been a paradigm shift in federal law with respect to the education of learners with vision impairment receiving O&M services from O&M specialists, there appears to be status quo with respect to the instruction and expectations of TVIs in provision of O&M services. One contributing factor might be that most states provided no standards for the O&M specialists on the state education websites. In addition, some states that identified the O&M specialist qualification used out-of-date certifications such as AAWB and AER, or included qualifications such as certified teacher, RT, OT, and PT.
Some states charged TVIs with the provision of O&M services and some university personnel preparation programs of TVIs covered O&M instructional strategies. However, none of these single courses could be considered sufficient to enable TVIs to adequately teach O&M skills and techniques as reflected in ACVREP O&M certification requirements. Despite the professional literature that indicated the TVI was equally prepared to address EI O&M services, this survey suggested that TVI pre-service preparation in O&M makes this unlikely.
Given the findings of this study, the bigger question needing to be studied returns to the original premise of the O&M for TVIs course, which is: “Do learners with vision impairment need to attain prerequisite skills and pre-cane or basic skills prior to beginning ‘formal’ O&M instruction taught by an O&M specialist?” However, the fact that in Federal Statute, IDEA Part C (2004) O&M begins in early intervention and names the O&M specialist suggests that there are no prerequisite skills needed prior to the start of O&M instruction, and the O&M specialist is best equipped to provide O&M services.
The study findings and the current patchwork of O&M service delivery to learners with vision impairment demands an examination of options at the state level and in personnel preparation programs. One option might be to find a way to make it easier for states to hire O&M specialists. For example, create a new pedagogical designation to stand beside the TVI, i.e., a teacher of O&M. This could be assisted by CEC creating O&M standards and the O&M personnel preparation programs requiring their students to complete general or special education certification programs in addition to the O&M coursework. This might then enable states to include O&M teacher, separate and apart from the TVI teacher, as part of their state education regulations.
Another option might be for states to adopt O&M licensure. O&M licensure would place O&M specialists on par with other allied health professionals like PTs and OTs. While a third option might be for states to agree upon a mutually acceptable national certification process, the educational requirements for either of the two current O&M national certifications are not equivalent to teacher education standards required by most LEAs.
Without a universally recognised credential in O&M, the most important question is whether or not students with vision impairment are receiving vital services when they need them from adequately prepared personnel. Based on the data from this survey, there is little evidence that TVIs are equipped to provide the O&M services they have been, or may be asked to provide by state education departments.
Without a new approach to address the serious concern of identifying the credential of the O&M service provider, and appropriately defining the roles and responsibilities of the TVI and the O&M specialist in O&M instruction, learners with vision impairment will continue to be at risk of not obtaining O&M services from qualified O&M professionals.