Certified Orientation and Mobility Specialist (COMS) Handbook, Section 3, Orientation and Mobility Body of Knowledge

Orientation and mobility graduates must demonstrate knowledge and understanding of a multitude of competencies in O&M. These are listed below in the body of knowledge.

1. Know Professional Information
1. Identify and describe basic laws and regulations that affect O&M services, e.g., IDEA (Individuals with Disabilities Education Act), Rehabilitation laws, ADA (Americans with Disabilities Act), Medicare, etc.
2. Identify and describe resources for consumers to obtain services, support, and/or information related to visual impairment [e.g., dog guide schools, NAPVI (National Association for Parents of Children with Visual Impairments), NFB (National Federation of the Blind), ACB (American Council of the Blind), Department of Veterans Affairs, BVA (Blinded Veterans Association), etc.].
3. Identify and describe professional resources pertinent to the O&M profession, e.g., AFB (American Foundation for the Blind), JVIB (Journal of Visual Impairment & Blindness), AER (Association for Education and Rehabilitation of the Blind and Visually Impaired), ACVREP (Academy for Certification of Vision Rehabilitation & Education Professionals), etc.
4. Identify and describe the major historical events and persons responsible for the establishment of the O&M profession as it exists today.
2. Understanding Relevant Medical Information
1. Describe the anatomy and physiology of the visual system.
2. Describe common eye conditions/etiologies (macular degeneration, RP, ROP, glaucoma, diabetic retinopathy, CVI, optic nerve hypoplasia, refractive errors, etc.) of consumers and their implications on visual functioning, and be able to interpret eye reports.
3. Describe the basic anatomy and physiology of the auditory system and be familiar with the components of audiological reports.
4. Describe basic procedures necessary to react appropriately to medical situations (e.g., insulin reaction, seizures, etc.) during O&M lessons.
3. Understand and Apply Learning Theories to O&M
1. Describe basic principles of learning theories and their implications for O&M instruction.
4. Plan and Conduct O&M Assessment
1. Develop a plan for O&M assessment that includes obtaining and interpreting medical, education, and rehabilitation reports; interviewing the consumer and relevant others; and selecting appropriate assessment tools, materials, activities, and settings.
2. Assess the consumer's present level of functioning in each of the following areas as related to O&M: vision, senses, orientation and mobility skills, social/emotional issues, concepts/cognition, medical and physical limitations, and personal goals.
3. Based on the O&M assessment, determine the consumer's O&M needs and/or make recommendations for services, mobility devices and/or systems (e.g., long cane, etc.), and additional assessments.
4. Describe the roles of related professionals (OT, PT, low vision specialists, rehabilitation specialists, optometrists, teachers, ophthalmologists, etc.) who provide relevant O&M assessment information.
5. Conduct ongoing assessment to monitor progress, to determine the need for change in instructional strategy or O&M program, and to determine when the skill level is sufficient to graduate or move on.
5. Plan O&M Programs
1. Describe service delivery models for O&M programs such as itinerant, center-based, and residential.
2. Develop O&M goals and objectives/benchmarks for individualized programs.
3. Describe the components and process for the development of early intervention, education, and applicable rehabilitation plans [e.g., IFSP (Individualized Family Service Plan), IEP (Individualized Educational Program), IWRP (Individualized Written Rehabilitation Program), etc.].
6. Teach O&M Related Concepts
1. Describe the relationship of O&M-related concepts (body, environmental, and spatial) to purposeful movement.
2. Describe the impact of visual impairment on the development of concepts and how consumers develop concepts.
3. Provide instruction to facilitate the development of O&M-related concepts (e.g., body, environmental, and spatial, etc.).
4. Teach life skill concepts related to O&M, e.g., money organization, social skills, time management, etc.
7. Teach Orientation Strategies and Skills
1. Develop orientation skills through the use of environmental features (e.g., sun, sounds, slopes, etc.).
2. Facilitate optimal development of the consumer's spatial organization skills using strategies such as cognitive mapping and spatial updating.
3. Assist the consumer in route planning using various approaches such as route shapes, mapping skills, and compass directions.
4. Teach problem-solving strategies related to establishing and maintaining orientation while traveling, using instructional approaches such as drop offs, re-orientation, planning alternative routes, hypothesis testing, etc.
5. Familiarize consumer to novel environments using techniques appropriate for persons with various frames of reference (object-to-object, self-to-object).
6. Compare and contrast approaches for orienting dog guide handler to new environments versus long cane users.
8. Teach Mobility Skills
1. Know the mechanics of locomotion that affect efficient mobility, e.g., integration of reflexes, muscle tone, coordination, balance, gait patterns, posture, etc.
2. Identify and describe basic O&M skills, including protective and human guide techniques, and the rationale for teaching these skills.
3. Determine appropriate mobility device and/or system by considering advantages, disadvantages, and consumer's needs and preferences, including, but not limited to human guide, long cane, dog guide, ETA, functional vision, and AMD.
4. Identify and describe O&M cane skills, (e.g, cane use with a guide, diagonal technique, two-point touch, etc.) and the rationale for teaching these skills.
5. Apply appropriate sequence of street crossing instruction, i.e., simple to complex.
6. Teach consumers to analyze intersections in simple and complex environments.
7. Identify and describe traffic controls (e.g., uncontrolled, 2-way and 4-way stops, traffic signal systems, roundabouts, yields, etc.) and implications for consumer crossings.
8. Identify and describe street crossing techniques and when to apply them, such as determining when to begin crossing, alignment, use of pedestrian button, etc.
9. Teach consumers how to access, plan, and execute simple and complex transportation systems, including buses, rail, and Paratransit.
10. Teach travel in special environments, including adverse weather conditions, rural areas, airports, malls, stores, gas stations, etc.
9. Teach Use of Senses
1. Explain principles of vision development as they apply to visual efficiency training.
2. Teach use of optical and non-optical low vision devices for O&M tasks.
3. Teach visual skills that optimize O&M performance, e.g., eccentric viewing, scanning, tracking, tracing, etc.
4. Teach consumer to use tactile information for O&M-related tasks.
5. Teach consumer to interpret kinesthetic and proprioceptive information to maximize O&M skills during movement/travel, such as using time-distance estimates, making accurate turns, recognizing/using slopes, etc.
6. Teach auditory skills to maximize effective movement/travel, e.g., use sounds to align/position self, echolocation, Doppler effect, etc.
10. Teach Consumers who have Additional Disabilities
1. Describe the implications of additional disabilities upon O&M instruction, e.g., physical impairments, cognitive disabilities, multiple disabilities, hearing impairments, traumatic brain injury, etc.
2. Adapt instructional strategies for consumers with additional disabilities, e.g., physical impairments, cognitive disabilities, multiple disabilities, hearing impairments, traumatic brain injury, etc.
11. Teach Diverse Consumers
1. Describe the implications of diversity, including age and cultural differences, as they relate to potential adaptations in O&M instruction.
2. Apply principles of human development and the aging process to O&M instruction.
12. Analyze and Modify Environment
1. Analyze travel environments to identify and overcome potential barriers to consumer access in home, school, work, or community environments.
13. Know the Psychosocial Implications of Blindness and Visual Impairment
1. Identify and describe factors to be considered to minimize the psychosocial impact of vision loss upon consumers with congenital or adventitious visual impairments and their families.
2. Identify strategies to assist consumers during the process of adjustment to visual impairment, including providing resources, informational counseling, etc.

CLINICAL PRACTICE COMPETENCIES

1. Communication and professional relationships - Candidate is able to establish and maintain effective communication and professional relationships with students, families, colleagues, and supervisors, including individuals from culturally and linguistically diverse backgrounds.
2. O&M assessment - Candidate is able to plan and conduct individualized comprehensive O&M assessments, synthesize the findings in a professionally written report, and communicate results with students, families, and members of the individualized intervention/education/rehabilitation team, as appropriate.
3. Instructional planning - Candidate is able to plan for individualized O&M instruction through the:
   • review and interpretation of relevant records and reports;
   • selection and preview of potential training areas (e.g., home, school, work, or community);
   • design and/or procurement of instructional materials and appropriate devices (with appropriate medical consultation regarding optical devices);
   • provision of accurate information regarding options for mobility systems (e.g., long cane, dog guide, electronic travel devices) to student and family so that students can make informed choices regarding the most appropriate option for a given time;
   • collaboration with student, family, and colleagues to develop appropriate goals and behavioral objectives; and development and sequencing of individual lessons based on student abilities, needs, and goals.
4. Instruction - Candidate is able to effectively teach and reinforce the following elements of O&M instruction across a range of environments (such as indoor, residential, and light business):
   • Concepts related to independent movement and orientation (such as body, laterality, directionality, spatial, environmental, and time-distance).
   • Mobility techniques, including, but not limited to, basic skills, cane skills, adapted mobility devices, route travel, street crossings, and the use of public and other transportation systems.
   • Orientation skills, including, but not limited to, use of cognitive processes; landmarks; cardinal directions; room, store, and community familiarization; address system; independent information gathering; route planning; and maps.
   • Use of low vision in maintaining safe and independent movement and orientation (such as use of non-optical devices, use of optical devices in conjunction with eye care professionals, use of visual skills, and incorporating vision use with cane or other mobility systems).
   • Use of remaining senses (other than vision) in maintaining safe and independent movement and orientation (such as the use of auditory skills, reflected sound, tactile recognition, proprioceptive, and kinesthetic awareness).
5. Monitoring and safety - Candidate is able to effectively monitor orientation and mobility skills, recognize potentially dangerous situations, and intervene as appropriate to ensure student safety.
6. Facilitating independence - Candidate is able to facilitate student independence and problem solving ability across a variety of travel situations, in familiar and unfamiliar environments.
7. Professionalism - Candidate demonstrates professional conduct consistent with the Code of Ethics for Orientation & Mobility Specialists, finds and accesses appropriate resources, keeps on-time scheduling, and follows and maintains appropriate record keeping and reporting procedures.