The GFPD has you covered! Read below to learn all about these important services and even participate in a 1-minute activity that can help you better understand the process of understanding your body position and where you are in space.
Individuals with peroxisomal disorders often benefit from seeing several types of specialists throughout their life. One of those specialists is a Certified Orientation and Mobility Specialist (COMS). Orientation and Mobility (O&M) services are provided by a Certified Orientation & Mobility Specialist (COMS). A COMS is a highly trained expert who specializes in working with individuals who are blind, have low vision or who have functional visual limitations, and empowers them to achieve their life goals for education, employment, and independence.
Does this mean that you must be walking, using a cane, attending school, or have the goal of employment to benefit from O&M services? No.
In fact, I spoke with Ms. Ami Morrison and Ms. Sara Borlie, both certified Teachers for the Visually Impaired (TVI) and Certified Orientation & Mobility Specialist (COMS), to help us better understand Orientation and Mobility (O&M) services, how to request these services, how they work with other specialists to help GFPD Warriors, and more.
Ms. Sara Borlie and Ami Morrison shared that COMS begin to work with individuals who are blind or have low vision as soon as they can. There are specialized mobility devices for toddlers! “Orientation and mobility is a lifelong learning process,” according to TSBVI, and it “begins with understanding where your body ends and the environment begins.”
As a mom to a GFPD Warrior, I was introduced to this remarkable service when my own son with deafblindness began working with a COMS in elementary school. Our first COMS helped me and those working with him to learn how to better navigate with my son. I can still recall the brightly colored tape all around the school to help with navigating his educational environment. In the years since, I have learned that many families and even professionals, do not know about these valuable O&M services that COMS provides.
So, what is orientation? It is where you are in space, your relative position.
Ms. Ami Morrison shared with us how “Orientation begins with understanding the parts of your body, where your body is in space, and the different ways your body can move. We encourage this development in many ways, which may include putting bells on socks or wristbands, or using a little room for sensory exploration. These experiences help the child understand that the feet and hands are part of their body.”
Ms. Ami Morrison also shared how “Mobility begins with understanding how your body can move to interact with the environment. This development may be encouraged by using visual targets, sound sources, or smells to gain attention. Once they have a desire for the target, we move it just beyond reach. This encourages interacting with the environment to get what they want.”
Therefore, a very simplified explanation would be that O&M is the process of understanding your body position, where you are in space and how to get from one point to another using specialized techniques and concepts to guide you, as you problem solve along the way. It is safe, efficient travel and purposeful movement!
1-Minute Learning Activity for Readers:
As a mom to a deafblind child, a seemingly simple task I ask others to do when talking about my own sons struggles with where he is in space is to ask others to close their eyes and do two things. Let’s do that in a moment. Before doing so, here is what you will do once your eyes are closed, place your hand about a foot away from your face, then with your eyes still closed you will touch your nose with the tip of your index finger. Okay, let’s do this! Close your eyes and follow the instructions you just read above.
Finished? That was simple, right? But how did you know where to put your hand? How did you know it was in front of your face? And how did you find your nose with the tip of your finger? How did you do all of that with your eyes closed? Because you know where your body is in space.
GFPD Warriors have multi-sensory impairments and therefore can benefit from services provided by a COMS. Ms. Sara Borlie said it is beneficial “because helping a child with sensory impairment to understand and interpret themselves and their environment helps them to have confidence and independence.”
Orientation and Mobility Components Include:
- Body Concepts
- Environmental Concepts
- Mobility Concepts
- Orientation Skills
- Spatial Concepts
- Interpersonal Skills
- Perceptual/Sensory Skills
- Decision-making Skills
- Problem-solving Skills
Earlier this year when we sat down with Sara Borlie, she told us, “We need those services to teach us how to provide access to everything in the kids’ environment. Everything. If you want to dress, how do I adapt for that? If you want to eat, how do I adapt for that? If you want to walk from here to there, how do I adapt for that? If you don’t have that information, you don’t have the basis of performing all of those therapies.”
They also shared that when a child has a sensory impairment it requires specialized instruction for how to access things when that sense has been affected. Without instruction in those techniques it really impedes comprehensive knowledge, safety, and independence.
The goals will vary, as they should, but overall, COMS will teach a sequence of skills helping individuals be safe, independent, problem-solving travelers. This includes teaching routes in the home, to classes, jobs, and more. That’s right, COMS provides services across environments! Why? Travel can occur everywhere and according to Sara Borlie, “community travel is important for independence and success.”
All goals should be SMART goals, meaning they are specific, measurable, achievable, results-oriented, and time-bound. Never hesitate to ask your team to work together on creating and reaching goals!
Ami and Sara helped us navigate roadblocks that GFPD Warriors may face when access to these O&M services are needed and not available. Sara Borlie said, “without services provided by a COMS, an individual can become reliant on others to help them do things they really may be able to learn to do for themselves. When they rely on others to interpret and react to their environment rather than truly knowing it for themselves it makes them less safe and independent.” Ms. Borlie shared how it really inhibits their overall well-being when this happens.
Now that we have learned a little more about O&M services, let’s talk about what type of training a Certified Orientation and Mobility Specialist (COMS) must undergo to deliver these services. COMS must meet a rigorous standard by meeting the educational requirements, supervised fieldwork experiences in their internship and passing the certification exam. As COMS, Sara Borlie and Ami Morrison completed an extensive educational program and successfully completed a 350+ hour internship under the supervision of experienced COMS. Additionally, a COMS will recertify every five years to ensure that they maintain current knowledge. These requirements are for the US, but COMS is a profession seen in other countries, such as New Zealand, where a colleague of Sara Borlies accepted a job a not too long ago.
Are all COMS also Teachers for the Visually Impaired (TVI)? No. Ms. Morrison and Ms. Borlie are both certified COMS, but also TVI’s, which according to Ms. Borlie, “has become more common in order to meet student needs, especially due to shortages in the field and the distances that must be covered by some caseloads.” Ms. Sara Borlie also shared, “personally I feel it’s beneficial because it helps me to be a part of the whole process in educating my students. It helps me to provide more comprehensive instruction both inside the classroom and beyond the walls of the school. Lots of the skills overlap and can be used together.”
Overlap is something GFPD families are all too familiar with! GFPD Warriors have a multi-system disease that creates multi-sensory impairments, and multiple disabilities, so how would a COMS collaborate with other professionals to best serve the individual? In a school environment, COMS often collaborates with a lot of the Individualized Education Program Individualized Education Program (IEP) team members (e.g., TVI, PT, PE teacher, classroom teacher, paraprofessional, parent, etc.).
Ways COMS Collaborate with Team Members:
- Teacher for the Visually Impaired (TVI) – They collaborate with the TVI to understand the best functional use of vision, what equipment or aids are being used, what accommodations and supports are needed.
- Physical Therapist (PT) – They collaborate with the PT about gross motor movement, gait, and balance.
- Physical Education Teacher – They collaborate with PE teachers for adaptation of activities/games that involve movement.
- Classroom Teacher or Staff – They collaborate with the classroom teacher (and paraprofessional or Deafblind Intervener) about where the student needs to travel, how they are to get there, what routines or cues are best used to make them as independent as possible.
- Parent – They collaborate with the parent to learn routines in the home environment, determine goals and to gain medical information that is helpful to know to keep the student safe.
It really does take a village to do it correctly! Ms. Sara Borlie shared, “having everyone on the same page helps to be unified in approach and makes more progress” and I cannot agree more!
Considerations When Requesting O&M Services:
- If the individual is school-aged and the student has a documented visual impairment or receives services from a TVI, then an O&M assessment can be requested through the IEP process to determine if services are needed. Note: A COMS may complete an O&M screening to determine if there is a need for a full assessment.
- In some states within the US the assessments are mandatory.
- If attending public school in the US, then a great first step is requesting this at an IEP meeting to discuss as a team, and ensuring you receive the school’s response in a Prior Written Notice.
- An IEP team may conclude a student should receive these services, but the school district does not have a COMS on staff. If that happens, it is the public school system’s responsibility to provide one.
- Some districts hire outside contractors to deliver the services, which can sometime include services being given virtually (although this is not a best-case scenario and the ability for the student to access the information fully must be able to occur).
- If services are required, then the public school district must provide them with compensatory services for any time missed.
- This is an IEP team educational service delivered free as a part of the school expanded core curriculum.
- COMS are part of the IEP team, just like the parent and GFPD Warrior are team members too!
- For those not yet attending school, an Individualized Family Service Plan (IFSP) may be written and if so, parents may ask an IFSP team member, especially the TVI, to consult with a COMS.
- Vocational Rehabilitation is another resource that may be able to assist with these services.
- For adults with deafblindness, reaching out to Helen Keller National Center for resources, checking with your local Commission for the Blind, or your case worker may be helpful too.
- For all individuals with deafblindness, seeking guidance from your State Deaf-Blind Projects, the National Center on Deaf-Blindness (NCDB), or the National Family Association for DeafBlind (NFADB) can be helpful in finding information and support. Depending on the location, O&M services are not always covered by medical insurance.
- For GFPD Warriors (or anyone with combined hearing and vision loss), it can be beneficial to seek out a COMS that has experience or knowledge in dual sensory loss (also frequently referred to as deafblindness or multi-sensory impairment).
- An IEP team may conclude a student should receive these services, but the school district does not have a COMS on staff. If that happens, it is the public-school system’s responsibility to provide one.
- Some districts hire outside contractors to deliver the services, which can sometime include services being given virtually (although this is not a best-case scenario and the ability for the student to access the information fully must be able to occur).
- If services are required, then the public school district must provide them with compensatory services for any time missed.
- This is an IEP team educational service delivered free as a part of the school expanded core curriculum.
- COMS are part of the IEP team, just like the parent and GFPD Warrior are team members too!
- For those not yet attending school, an Individualized Family Service Plan (IFSP) may be written and if so, parents may ask an IFSP team member, especially the TVI, to consult with a COMS.
- Vocational Rehabilitation is another resource that may be able to assist with these services.
- For adults with deafblindness, reaching out to Helen Keller National Center for resources, checking with your local Commission for the Blind, or your case worker may be helpful too.
- For all individuals with deafblindness, seeking guidance from your State Deaf-Blind Projects, National Center on Deaf-Blindness (NCDB), or the National Family Association for DeafBlind (NFADB) can be helpful in finding information and support.
- Depending on the location, O&M services are not always covered by medical insurance.
- For GFPD Warriors (or anyone with combined hearing and vision loss), it can be beneficial to seek out a COMS that has experience or knowledge in dual sensory loss (also frequently referred to as deafblindness or multi-sensory impairment).
To hear directly from Ms. Sara Borlie, TVI and COMS, about her experience working with Patrick, The GFPD 2023 Patient Ambassador, watch here!
Written By Katie Sacra, GFPD Director of Family Programs and Parent to GFPD Warrior, TJ.
Interviewees: Sara Borlie, TVI, COMS and Ami Morrison, TVI, COMS
Sources: ECC Essentials and TSBVI Education OM Benefits