Vocational Rehabilitation Services Manual C-600: Orientation and Mobility Services

Introduction

An orientation and mobility (O&M) instructor prepares Vocational Rehabilitation (VR) customers who are blind to travel independently with competence and confidence. O&M tools may include white canes, dog guides, and electronic travel aids.

"Orientation" refers to the process of applying the customer's working senses to establish his or her position and relationship to the environment.

"Mobility" refers to the act of moving in the environment with the use of an established tool to aid in travel.

"White cane," for the purpose of O&M services, specifically refers to a rigid, non-folding, long, fiberglass white cane with a metal tip.

Return to Top

C-601: Legal Authorization

Per 34 CFR §361.5(c)(7)(K), O&M services are available only to individuals who are blind.

Per Human Resources Code §91.002(2), "blind" means a person having not more than 20/200 visual acuity in the better eye with correcting lenses or visual acuity greater than 20/200 but with a limitation in the field of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees.

Return to Top

C-602: Contracted Orientation and Mobility Services

For detailed information regarding contracted O&M services, see VR Standards for Providers, Chapter 5: Orientation and Mobility Services, or contact a VR regional program support specialist.

Return to Top

C-603: Services Provided by Orientation and Mobility Instructors

C-603-1: Role of the Orientation and Mobility Instructor

Orientation and mobility (O&M) are core skills that help customers who are blind to achieve an effective employment outcome. Both the VR counselor and the O&M instructor should encourage customers who do not travel efficiently and effectively to learn O&M skills.

Independent travel skills are learned nonvisually with a white cane so that the customer develops the necessary skills and confidence to travel safely and independently, regardless of available visual information. In rare exceptions, an aluminum cane might be needed to fit nonmetal tips such as a roller tip. Exceptions must be clearly justified and documented in a case note.

In all cases, use of a customer's remaining vision may be transferred to training when the O&M instructor believes it would be helpful to the learning process, usually after nonvisual skills are mastered.

O&M instructors may teach customers travel skills, including (list is not inclusive):

  • white cane skills;
  • compass directions;
  • stairs;
  • indoor self-familiarization;
  • auditory skills;
  • grocery, mall, airport, and rural travel;
  • sidewalk travel;
  • in a residential neighborhood, skills such as:
    • recovery techniques;
    • turning at corners;
    • numbering systems;
    • soliciting directions;
    • drop-offs;
    • crossing at stop-sign-controlled intersections;
    • crossing light-controlled intersections with light traffic; and
    • bus travel;
  • in a small business area, the following additional skills:
    • analyzing and crossing at light-controlled intersections (four-way plus sign-shaped, three-way T-shaped, and offset) with heavier traffic;
    • advanced recovery skills; and
    • traveling in heavier pedestrian areas and unfamiliar areas;
  • problem solving;
  • independent travel;
  • transportation;
  • for downtown travel, in addition to the skills listed above, exposure to a variety of different environments to help build confidence in skills already learned (the sounds of downtown travel are very different from those in small business areas, and the customer must learn them to prepare for travel independence in all areas for employment options); and
  • travel at night.

In teaching these skills, O&M instructors may work with:

  • VR counselors and other VR staff;
  • families;
  • educators;
  • community providers; and
  • others who support the customer's work and independent-living goals.

C-603-2: Orientation and Mobility Employment Assistance Services

O&M instructor services support the customer's ability to achieve an employment outcome. O&M instructor services must be coordinated with the VR counselor through all phases of the rehabilitation process, including:

  • sharing information with the VR counselor regarding the customer's emotional adjustment to blindness and acquisition of motivational, problem-solving, organizational, and independent-living skills;
  • accompanying the VR counselor to employer contacts or work site tours and assisting with job-travel analysis;
  • providing nonvisual skills training based on the customer's known or anticipated job-travel responsibilities and researching travel methods for employment assistance; and
  • providing transferable skills so that the customer can apply skills to unfamiliar areas.

C-603-3: Orientation and Mobility Instructor and Vocational Rehabilitation Counselor Staffing Sessions

Staffing sessions must:

  • develop a team approach for services with each customer;
  • provide frequent and regular communication between the O&M instructor and VR counselor during the provision of O&M services; and
  • ensure that comprehensive O&M services are provided in a timely manner.

Staff sessions focus on:

  • cases selected by the O&M instructor and VR counselor;
  • customer's training progress;
  • any customer issues requiring immediate attention; and
  • any changes to the O&M instructor's plan or the customer's individualized plan for employment (IPE).

The O&M instructor must notify the VR counselor by case action when the assessment is completed.

C-603-4: Customer Referral Process

If adult customers require O&M services, the VR counselor refers the customers to the O&M instructor.

Customers who are blind must be referred to the O&M instructor for assessment, unless there is pending eye surgery or the customer recently completed training at the Criss Cole Rehabilitation Center (CCRC). Visually impaired customers with severe functional limitations may also be referred if O&M services are needed.

Customers demonstrating immediate critical needs before surgery may be referred to the O&M instructor, depending on availability.

Customers are referred to the O&M instructor through a service record in ReHabWorks (RHW) and completion of DARS2897, Orientation and Mobility Referral.  

C-603-5: Orientation and Mobility Assessment Report

The O&M assessment provides critical information to the VR counselor and customer in the development of the customer's IPE. This information can help determine training needs and the potential length of training. A white cane and blindfold may be used for evaluation purposes.

The O&M assessment focuses on the alternative skills needed to live independently and obtain or maintain employment.

Except for assessment-only requests, O&M services cannot begin before the case is moved into either the Extended Evaluation or the IPE is completed in RHW.

O&M instructors provide assessments that may include such areas as:

  • the customer's home and immediate surrounding area;
  • public areas, such as a bank, church, doctor's office, or college campus;
  • commercial areas, such as a store or mall;
  • transit systems, such as paratransit or taxis (if available);
  • public transportation, such as buses (if available);
  • rural areas (if applicable);
  • residential areas (described as light vehicular and pedestrian traffic with some stop signs);
  • small business areas (described as heavier traffic and simple traffic lights);
  • downtown areas (described as heavy vehicular and pedestrian traffic with complex traffic lights);
  • commercial transportation systems such as buses, trains, and airplanes (if applicable); and
  • travel using low-vision devices (if applicable).

When the assessment is completed, it is entered into a case note in RHW titled "O&M Assessment." The assessment must include at least the following information:

  • Customer's current level of travel
  • Specific travel skills needs and issues
  • Summary of independent travel abilities at the time of the assessment
  • Dates of assessments
  • Number of training hours recommended

After the O&M assessment is pasted into a case note, the O&M instructor determines with the VR counselor if and when training should begin.

C-603-6: Assessment Focus and Employment Outcome

Although the O&M instructor does not determine the customer's employment outcome, the O&M instructor's assessment is completed with independent functional travel as the ideal goal. Travel skills are critical to an employment outcome, but different employment outcomes require different skill levels.

If the assessment is developed before an employment outcome is known, the assessment focus is on independent functional travel and its general application to employment.

C-603-7: Orientation and Mobility Training Process

Based on customer needs and the O&M instructor's input, the range of training services must include:

  • training in the use of nonvisual skills;
  • employment assistance for independent functional travel needs;
  • adaptive supplies for travel, such as a white cane and blindfold; and
  • use of problem-solving skills for customers to build confidence in travel and realize an opportunity for independence.

An O&M trainer cannot have more than 25 customers in an active group training at any time. VR counselors and assigned regional program specialists working with an O&M trainer must be notified by email of the total number of customers in active training.

C-603-8: Orientation and Mobility Services Monthly Progress Report

During active training, a monthly progress report must be completed by the O&M instructor and entered into a case note in RHW titled "O&M Services Monthly Progress Report." The monthly report must include at least the following:

  • Customer's progress for the report month
  • Number of hours worked with the customer for the month
  • Training dates
  • Recommendations for next steps
  • Any issues or concerns with training, or changes in initial recommendations

Completion of O&M Services

When services are completed, the O&M instructor:

  • writes a "Summary Report" case note that describes how the services helped the customer reach his or her O&M goals, and, if they were not reached, why not; and
  • closes the service record when the instructor and VR counselor agree that no further services are needed.

C-603-9: Providing Additional Services after Service-Record Closure

If additional services are needed after the service record is closed, a new RHW service record is required, with the VR counselor specifying what skills are needed. When O&M services are purchased, the vendor submits the post-training report to the VR counselor. The VR counselor writes the "Summary Report" case note and closes the service record.

If services extend beyond 30 days, the O&M instructor must provide a monthly progress report, entering a case note titled "O&M Services Monthly Progress Report," until service needs are completed.

If services are purchased, the O&M instructor must provide a monthly progress report and the VR counselor must enter a case note titled "O&M Services Monthly Progress Report" until service needs are completed.

O&M Case Services Management and/or Case Notes

The O&M instructor must document all customer contacts and other pertinent information in RHW case notes. Select the appropriate case note "Topic" and then include "O&M" in the "Add to Topic" field, followed by clarification of the content of the case note. Examples of "Add to Topics" include:

  • "O&M Assessment"
  • "O&M Monthly Progress Report"
  • "O&M Summary Report"
  • "O&M Service Record Closure"

C-603-10: Action List

For more information on searching action lists, see the ReHabWorks User Guide, Chapter 6: Case Actions and Action Lists.

Ordering Rehabilitation O&M Instructor Supplies

For information on ordering O&M instructor supplies, see VRSM D-200: Purchasing Goods and Services.

C-603-11: Recommending Purchase of Equipment

The O&M instructor may recommend that the VR counselor purchase equipment that is not immediately available, or, if the O&M instructor works for TWC-VR and has access to ReHabWorks (RHW), they may recommend a purchase by:

  • creating a service record in RHW for the items; and
  • delegating the purchase to the VR counselor.

The O&M instructor must determine before the purchase how the VR counselor would prefer to complete the purchase.

Justification must be provided for all purchase recommendations.

C-603-12: Customer or Staff Purchases from Control Account 40

For information on ordering O&M instructor supplies, see VRSM D-200: Purchasing Goods and Services.

C-603-13: Guidelines for Electronic Travel Aids

Examples of electronic travel aids include the following:

  • Laser cane
  • Mowat sensor
  • Sonic guide
  • Global Positioning System
  • Talking compasses

C-603-14: Maintaining Inventory Levels in the Local Office

Staff must use the following procedures to maintain inventory in local offices:

  • Order in bulk to maintain one month's supply of high-use rehabilitation supplies for the office.
  • Order small quantities regularly to maintain stock levels, rather than allowing stock to be depleted and ordering large quantities.

C-603-15: Accountability

Accountability for adaptive supplies and equipment issued to customers is verified by:

  • documentation in the O&M instructor case notes;
  • review of the case file by the VR Supervisor or VR Manager; and
  • maintenance of an established inventory level in the field office.

Return to Top

C-604: Orientation and Mobility Interns

C-604-1: Types of Orientation and Mobility Interns

Currently, VR has the following types of O&M interns:

  • In-house providers supervised by an O&M instructor through CCRC or a field office
  • Contract providers supervised by a contracted VR-approved provider. Providers must submit DARS3455, Provider Staff Information, for all interns, indicating intern status under "Position Title."

Internships are typically initiated by O&M-accredited universities. The O&M Program Specialist (the blindness, training, and development specialist) in charge of coordinating internships contacts the appropriate full-time O&M instructor to determine if he or she is available to supervise an intern. The O&M Program Specialist approves supervision of interns.

C-604-2: Orientation and Mobility Instructor Requirements

O&M instructors approved to work with O&M interns must be certified by one of the following:

  • Academy for Certification of Vision Rehabilitation and Educational Professionals (ACVREP); or
  • National Blindness Professional Certification Board (NBPCP).

The O&M instructor must:

  • observe 12 lessons taught by the intern; and
  • supervise the intern for the entire internship.

Return to Top