Orientation and mobility for children with visual impairments during COVID-19: Creative and collaborative curriculum and instruction

Abstract

This research explored the instructional practices and strategies used by orientation and mobility (O&M) specialists in March and April 2020 during the COVID-19 pandemic. The Access and Engagement survey from the American Foundation for the Blind included open-ended responses from 318 O&M specialists. The authors used thematic analysis to examine the main themes regarding instructional practices consistent throughout the responses. This article focused on the themes of collaboration between families and professionals and the creative instructional strategies used for adaptive O&M lessons. Parents took on a more active role and professionals found creative ways to make instruction useful in most cases. There were fundamental changes to the content and structure of O&M lessons when they were moved from in-person to online instruction. Creative and collaborative practices were used to adapt for the absence of the travel environment. Virtual instruction in O&M will continue to be used in certain circumstances when in-person services are not possible, but we need to better explore how to ensure it is safe and effective.

Keywords

Collaboration COVID expanded core curriculum O&M virtual instruction

Orientation and mobility (O&M) instruction was described by Jacobson (2013) as an “art and science” as it relied on the creativity and ingenuity of the professional in addition to following a set of skills and techniques. Creativity is integral to O&M lessons for selection of environments and individualized strategies for instruction (Fazzi & Petersmeyer, 2001). Virtual instruction for O&M removes the student and instructor from the real learning environment and requires instruction to adapt to other content. Virtual education lessons in any subject often involve a student participating through an online learning platform (e.g., Zoom) in a static environment, listening to their instructor or classmates, or receiving assignments to complete independently, or with assistance from a family member. However, virtual instruction for students with visual impairments is more challenging due to accessibility issues, and if the family does not have the appropriate technology or are unavailable to assist with virtual or independent practice. These factors can create an inequitable situation affecting the quality of O&M instruction for students with visual impairments. Professionals were challenged by the COVID-19 pandemic to create and develop alternative approaches to O&M instruction to meet the needs of students.

In the United States, the Individuals with Disabilities Education Act (IDEA; 2004) identified O&M as a service under federal law for children with visual impairments, including those with additional disabilities, to prepare them to travel in school, home, and community environments. The Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP) maintains the certification requirements for Certified O&M Specialists, which allows them to work with individuals with visual impairments of all ages and abilities. Thus, university preparation programs in the United States provide education and training for teaching individuals who have diverse characteristics and instructional needs including blindness and low vision, development from infancy through older adulthood, and disabilities in addition to visual impairments. According to the Scope of Practice paper (Kaiser et al., 2018) approved by the Association for Education and Rehabilitation of the Blind and Visually Impaired O&M Division, instructional domains in O&M included the following:

Concept development – environmental, body, spatial;

Sensory awareness and development – visual, tactile, auditory, proprioceptive;

Sensorimotor development and facilitation – controlled movement using sensory and motor systems;

Orientation – awareness of position in space;

Mobility – use of mobility devices, transportation systems in various environments;

Assistive technology – high and low-tech devices to enhance travel skills;

Environmental access – accessing environmental information;

Social – personal safety, soliciting assistance;

Psychosocial – adjustment to visual impairment.

An O&M lesson often involves a student and instructor moving in a dynamic, real environment and standing close enough for verbal feedback or physical prompting. Instructors control the difficulty of the lesson by the characteristics of the environment selected for the lesson and adjusting the amount of input or feedback they provide based on the student’s independence and skill level (see Figure 1). This equilibrium between the student’s skill level, environmental variables, and amount of instructor input must be maintained for the lesson to function appropriately. The student must be able to react to and learn from the environment for these lessons to be effective.

Figure 1.

Overview of the components of traditional O&M instruction.

To better understand education during the pandemic, a survey was conducted by the American Foundation for the Blind that asked O&M specialists, among other professionals, to describe the impact of the pandemic on services (Rosenblum et al., 2020), which collected quantitative data from participants about their experiences. As a result of the COVID-19 pandemic, professionals, students, and families were asked to undertake roles and responsibilities beyond their comfort and/or experience level. Even using remote instruction, O&M specialists were still working with more than 90% of the students who had individualized education program (IEP) goals focused on school campus travel, residential travel, and/or business/commercial environments (Rosenblum et al., 2020). Family members were clearly feeling the pressure involved in their role with their child’s education and were unsure of the expectations of their child’s education team.

Background

In traditional services, O&M professionals often try to involve parents and other IEP team members to direct and reinforce skills that were first taught by the instructor. O&M skill development was most effective when content was integrated into the academic core curriculum and the expanded core curriculum (ECC) with support and reinforcement by all education team members (Pogrund & Griffin-Shirley, 2018). The ECC includes concepts and skills designed to assist with functional and developmental areas impacted by the student’s visual impairment (Hatlen, 1996). The nine areas of the ECC are as follows:

O&M;

Sensory efficiency;

Compensatory skills;

Social skills;

Independent living;

Career education;

Self-determination;

Assistive technology;

Recreation and leisure.

Teachers of students with visual impairments have the primary role of assessing and addressing student’s needs regarding the areas of the ECC. The ECC was identified as a priority for students with visual impairments because these areas require deliberate and specially designed instruction. However, there is no clear guidance on how much ECC content should be taught by O&M specialists compared to teachers of students with visual impairments. While O&M is one of the nine areas of content, some O&M specialists typically only focus on the other subjects when it overlaps significantly with the traditional O&M curriculum, such as the independent living skills to understand basic money concepts or developing social skills for soliciting assistance. In contrast, some O&M instructors more consistently integrate the ECC into their curriculum due to its importance and how it can impact other areas of functioning. In addition, many professionals are dually certified as O&M professionals and teachers of students with visual impairments allowing them to include ECC content into their teaching whenever convenient or to integrate O&M concepts into their other lessons.

As part of an IEP team using transdisciplinary collaboration, the O&M specialist may use a type of role release to allow other IEP team members to provide direct instruction with the guidance from the O&M specialist (Cmar et al., 2015). Role release involves teaching basic skills and instructional strategies so that others can reinforce and support instruction. This can also be similar to a coaching model, where the O&M specialist directs the actions of the parent with verbal guidance. However, this does not release the professional from accountability for how they manage that process (Szabo & Panikkar, 2017). Paraprofessionals are typically involved in role-release processes, and not parents (Parker & Tellefson, 2018).

The primary role of the parents should be to reinforce the skills their child has already been taught. In a study in Pakistan, Malik and Manaf (2020) found that basic O&M skills could be integrated into the ECC activities used at home and reinforced by the parents. Parents can integrate concept development into daily routines, such as tasks involving maps, cardinal directions, or environmental concepts. For effective collaboration, the roles of the parent must be clearly defined with details provided for which O&M skills they should and should not focus on with their child. Effective consultation and collaboration between family and professionals were essential to the instructional process for students with visual impairments and additional disabilities (Szabo & Panikkar, 2017).

Virtual instruction and remote learning

For virtual instruction to be most effective, you should be able to incorporate the best aspects of face-to-face instruction into virtual lessons (Smith et al., 2016). Although O&M professionals must adapt to changing situations and student motivation regularly, it is much more challenging to incorporate the learning experience from the real environment into virtual instruction. There are O&M lessons that adapt more easily to a virtual environment, such as concept development for understanding an intersection or using digital maps to plan a route. However, much of O&M instruction requires individuals to react to a changing environment with consistent safety monitoring and instructor feedback. Virtual and augmented reality experiences can be used as part of O&M instruction to artificially simulate sensory stimuli, providing visual, auditory, or tactual feedback. In a virtual game, 60% of participants who were blind were able to use haptic and auditory feedback to enhance the effects of traditional O&M instruction and to help them construct a cognitive map (Lahav et al., 2013, 2018). In most cases, it appeared that virtual environments were not yet capable of providing adequate proprioceptive and tactual learning experiences.

This article explores the themes prevalent in the qualitative survey responses regarding O&M instructional practices and strategies. The following research questions were explored:

What instructional strategies and adaptations were used initially by O&M specialists in virtual instruction due to the COVID-19 pandemic?

What aspects of curriculum and instruction for O&M lessons changed from an in-person lesson to a virtual lesson?

Methods

Instrument

This current research study was based on the qualitative survey responses from open-ended questions from the American Foundation for the Blind survey that have not been previously analyzed or reported. The survey was created using Qualtrics, an online survey tool. There were three sections of questions that were provided for O&M professionals completing the survey including demographics and questions regarding their instruction during the pandemic. Before being sent out, the survey was reviewed by multiple experienced, certified O&M professionals. The survey was designed so that it would be understandable for professionals but was not tested for reliability and validity as to capture the immediate situation in the beginning of COVID in the United States and Canada. The survey was widely distributed on websites in the visual impairment field, social media groups, and electronic mailing lists.

Professionals were asked up to 14 open-ended questions depending on their experiences during the pandemic and their students’ ages and IEP goals (see Table 1). Professionals were asked to describe their experiences implementing O&M instruction under the restrictions identified by their district or state. These participants were also asked to identify their thoughts on the quality of services and what modifications were required to provide services to students. The survey specifically asked questions about how they were addressing lessons for students with O&M IEP goals involving the school campus, neighborhoods/residential settings, public transportation, rideshare services, and low vision driving. The survey was completely anonymous and no identifying information was collected or examined by the researchers.

Table 1.

Examples of survey questions.

Response type	Questions
Open-ended	What has been the most rewarding or greatest successes of providing O&M services to your students during the COVID-19 pandemic?
	What have been the most challenging aspects of providing O&M services to your students? Describe how the COVID-19 pandemic has impacted your work as a professional serving students with visual impairments.
	What materials can you not access at home? How are you handling the inaccessibility of materials so your academic blind student(s) can continue their education?
Closed-ended (Other write-in answers)	Since the decision was made for students to stop attending school, how are you providing O&M services and support to your students whose IEP goals focus on learning to travel using public transit, rideshare services, and/or exploring low vision driving?

O&M: orientation and mobility; IEP: individualized education program.

Procedures

The Access and Engagement survey was open in April and May 2020. This study was approved by the Institutional Review Board and informed consent was obtained from all participants. The study was open to O&M specialists in the United States and Canada who worked with children with visual impairments during the 2019–2020 school year. The survey was completed by 318 O&M specialists. Of these participants, 180 of these participants were also certified as teachers of students with visual impairments. Since the survey was only available online and advertised through websites and email, there were likely individuals who did not participate in the survey due to this issue of access and awareness.

Data analysis

The authors coded the qualitative responses and applied thematic analysis to identify the consistent concepts present throughout the data. The authors were all Certified Orientation and Mobility Specialists and they relied on their background and teaching experience in analyzing and coding the data. An inductive approach was used to create codes as they became more prevalent in the data. Two researchers separately coded each of the responses for each question and then reviewed and compared results of that question. Additional researchers also participated in this process for some of the questions to ensure consistency. Interrater reliability was established by having the two primary researchers independently code the data from each question and then compare and discuss their results until they reached 100% agreement. Detailed explanations of instructional practices were selected to emphasize the themes explored in this article.

Results

Professionals found creative and collaborative strategies to adapt the instructional process and content necessary for implementing O&M lessons virtually and to account for the absence of the real learning environment. Within this overall theme, three subthemes were identified that help to provide context and detail for the rest of the results: (1) professionals were left to determine creative methods for appropriately adapting curriculum and instruction to account for the lack of a travel environment; (2) the lesson focus often changed to concept development or ECC areas and; (3) much more collaborative instruction between parents and professionals was necessary. These themes were integral to examining how O&M instruction changed from in-person traditional lessons to virtual lessons (see Figure 2). The subthemes were identified numerous times throughout the responses: creative instruction and planning occurred 66 times; focus on the ECC and concept development occurred 33 times; and collaborative instruction with parents occurred 43 times.

Figure 2.

Comparison of traditional O&M lessons adapted to a virtual O&M lesson.

Main Theme: When online O&M lessons were most effective, O&M professionals and parents often found it necessary to collaborate with each other and incorporate creative instructional strategies and curriculum to make it more useful and appropriate for students with visual impairments.

I can’t be thorough. My lesson planning is nearly nonexistent between trying to connect with families and making mini-lessons for them to access on Google Classroom . . . I think that strong consult with parents during “regular” times is the key because in a situation like this it is important for parents to know that they actually are already doing O&M and ECC as part of their lives and they can be reassured that their child will progress, even without as much direct instruction . . . [I have my] low vision student walk in [their] neighborhood with parent and have the parent take pictures of landmarks and route turns. [It] will turn into a slide show for student to watch back.

Policies regarding instructional delivery were modified so quickly that little or no guidance was provided regarding implementation of virtual instruction. O&M professionals were primarily expected to figure out on their own how to make this accessible and appropriate for students with visual impairments. Initially when instruction moved online, professionals, families, and students with visual impairments were not prepared with the appropriate technology skills or equipment for making virtual instruction accessible using the available online education tools (e.g., Google Classroom, Canvas).

Subtheme 1: Professionals were often responsible for determining and implementing creative adaptations needed to account for the lack of the travel environment when providing virtual O&M lessons without adequate technology or training.

I love getting my students together via video. I appreciate the time to explore other venues of instruction. I feel like I can grow more on helping them explore new areas without taking them there. I don’t know if I would have given lessons to my students to explore another town if I hadn’t been forced to by this virus . . . I have many students transitioning to a new school next year. My biggest concern is that many of them have not had the opportunity to explore the school, eat lunch at the school, and get comfortable with the new school. I usually start exploring new schools in February or March [but] we didn’t get much time.

Adapting lessons was complicated for O&M as the entire focus and content of the online lesson needed to account for the lack of the real environment. Without the environment, the focus of the O&M lesson was often altered significantly due to required changes in content or lack of student engagement. These online lessons also had to account for how the information presented in-person with tactual prompts or materials can be virtual and accessible for a student with a visual impairment. Often O&M professionals simplified the focus of lessons entirely because that was the only realistic option to make it relevant for the student:

The student and I had already begun making a map of the next year’s campus. I left the map on the student’s porch and sen[t] the student questions to answer related to the campus that she can use the map to complete.

With the sudden shift to virtual instruction and closure of school buildings, many professionals were not able to get the materials that students needed for hands-on practice with concepts and models. The O&M specialists found useful and adaptive ways to circumvent these challenges. In some cases, O&M professionals created tactile learning materials and mailed or personally delivered them to the students. However, even these types of contact were restricted in many districts.

When effective communication and collaboration were possible, professionals worked with parents to determine what materials already in their house could be used to enhance learning experiences for their children. For students who were a little older or more experienced with tactile maps, the O&M instructor provided feedback and guidance, but ultimately expected the student to create the map on their own. While O&M professionals adapted to teaching virtually, they felt that these services were more superficial to fulfill basic requirements and lacked the substance of lessons in the real environment.

Subtheme 2: For students with goals focused on environments or experiences that were no longer available, professionals adapted the instructional content and used this opportunity to place much more focus on other ECC areas and concept development.

We are not working on that [community travel] goal and are doing other ECC related activities or completely changed the topic focus from travel skills to travel preparation, meaning weather and supplies . . . [The most rewarding aspects of services have been] seeing students using self-determination skills to make choices suggest new topics on what they want to work on talking to parents more and being able to teach them more about how their child sees and what accommodations they need in real life, not just in the classroom.

Many of the examples provided included ECC content for independent living, assistive technology, sensory efficiency, social skills, and self-determination. Professionals encouraged parents to give children a daily task or chore like getting the mail, cleaning up after dinner, feeding pets, or other activities that would contribute to a routine while also keeping them active. In some modified lessons, instructors focused on preparation for adverse weather and emergency situations:

The Expanded Core Curriculum means more to students/families when they get to see the results up close & personal. When I suggest the kid needs to cook & clean[,] ain’t nobody saying MATH is more important.

Parents were able to provide guidance and modeling for children to develop skills for cooking and cleaning in the same environment where they will practice the skills. For students that were able to access virtual lessons consistently, O&M specialists were able to help develop their independent living skills by researching and practicing with grocery delivery and rideshare services. Professionals also covered specific topics that were especially relevant during the pandemic, including etiquette for soliciting assistance and maintaining social distancing guidelines in public environments:

I think the most challenging aspects of providing O&M services to my students is simulating street crossings, especially for my higher-level students who are being asked to cross in small business/commercial areas. You can make up scenarios, draw the intersection well, etc., but it is almost impossible to simulate . . . The most rewarding part is seeing some of my high school student’s develop and plan non-transfer bus routes using Google Maps, Google Docs, and the [public transit] website.

Virtual instruction provided opportunities to facilitate more student-directed lessons while encouraging self-determination and problem-solving abilities. In some cases, students were more likely to express their travel needs to parents and actively made choices for virtual lesson topics. Professionals identified that some students were continuing to work on their IEP goals through exploring digital maps and planning transit routes. The most effective lessons were with older academic students who already had some independence.

Subtheme 3: When virtual O&M lessons were effective, parents had often taken on a more active role in online instruction and had increased communication with professionals.

[I have had the most success] connecting with parents – some are really stepping up and participating – so they are learning right alongside their kids. . . . I consult with the parent of my direct service students who is non-verbal. The only way the student can continue with mobility is with me working through the parent in a consult model. But these lines are blurry, as I see him via videos the parent sends and then direct the parents in what to do.

In the beginning of the pandemic, parents of students with visual impairments experienced a major shift in their role regarding their child’s O&M instruction. Depending on the curriculum and independence of the student, many parents were necessary participants in virtual lessons to help make things more interactive for their child with a visual impairment. The parents’ availability and level of communication with the O&M specialist were some of the most common factors related to positive and negative experiences for families and professionals. In many cases, O&M specialists were developing stronger bonds with parents than they had at any other time. These strengthened relationships resulted from the need for increased communication and greater understanding of how to support their child’s O&M skills:

My student has been moved to a new foster home during COVID. I do not have access to the AMD that I ordered for my student, as it was shipped to my office and I am not permitted to visit with students at this time. I spoke with the student’s new foster mother over the phone and recommended he use a push toy when traveling around the house. I discussed the purposes of a push toy and how to assist the student with orienting to the new house. I discussed how to use human guide technique and provided handout materials to the family.

As a result of improved collaboration throughout the pandemic, instructors increasingly recognized the crucial role that parents served in reinforcing O&M skills leading to student success. Modeling instruction for the parents occurred through live video with the intent that it generalizes into the real environment increasing student’s proficiency and cohesiveness of skills. Professionals further concluded that demonstration of skills by the student with the instructor present, even in a virtual setting, educated the parents and raised their confidence level to reinforce skills throughout natural environments. Families were able to reinforce skills when walking through their neighborhood using a cane or AMD and even began using terms such as “landmarks” and “clues.” In other circumstances, students with visual impairments were restricted from actively traveling independently indoors or outdoors preventing them from having opportunities to problem solve and learning from those experiences. It was important for parents to understand that problem-solving skills only develop with opportunities for practice and considerable patience. While parents may be willing to accept the responsibility of monitoring their child’s independent travel, professionals must also remember they are not trained instructors.

We created a daily schedule for the parent to include daily time outside in the backyard, using the playground across the street and walking around the block using the cane. I think they prefer to stay inside, but if I ask about outside activities, they are more likely to do it because they know I will be asking about it on a weekly basis.

Reciprocal and active communication was a key factor to the success of instruction. Professionals worked with families to identify how to encourage the child to explore the environment, to make the child aware of auditory stimuli in the environment, and how to use descriptive language in everyday routines. Collaboration was able to occur in real time with the use of smartphone videos or mobile phone calls. Professionals were able to provide detailed recommendations through live video. Professionals also observed from a distance as parents interacted with their child in an outdoor environment while the professional provided immediate feedback or prompting on positioning and student performance using a smartphone. Professionals were able to make recommendations on how the parents can modify their home environment to appropriately support infants and toddlers and encourage safe and active exploration. As a result of the pandemic, education teams have focused on collaborative work for enacting remote learning plans.

Discussion

Virtual instruction changed fundamental aspects of O&M lessons when adapting from traditional service models. An essential component for effective O&M lessons traditionally was for the student to be able to learn from the environment. Students learn O&M skills that prepare them to interpret and respond to changing environmental stimuli. The environment is a crucial variable to facilitate and enhance student learning. During the pandemic and in the future, O&M instructors and students need the opportunity to work in-person whenever possible to provide meaningful learning experiences. Many children require the authentic experience of being in the environment and perception of sensory stimuli to learn some O&M skills effectively. While there were immense challenges for virtual instruction in O&M, professionals and parents found unique and creative strategies to adapt the lessons and curriculum appropriately.

Collaborative instruction with family involvement

Communication and collaboration between professionals and the family can improve the overall skill development for the student. In some cases, children were able to demonstrate their skills and independence, helping parents to raise their expectations. Independent living and self-determination are areas of the ECC that are integral to effective O&M skill development. These areas are inextricably linked to the home environment and expectations from family and parents. Professionals and parents could collaborate on an integrated home O&M and independent living program to emphasize to students that their parents and teachers are each engaged in promoting their independence. This type of program could provide instruction for students and possibly parents through some in-person instruction focused on O&M skills and other skills for independent living in their home. Any in-person instruction could be supplemented with more frequent virtual instruction. This would allow instructors to provide guidance and prompting on the use of techniques and the use of descriptive language in the home environment. This would allow students to learn these skills in their natural home environment instead of learning independent living skills in a school setting and generalizing those skills to their home.

Numerous instructional resources for virtual O&M and ideas for parents were created and shared during the pandemic. Activity-a-day calendars tailored with O&M related ideas were an example of an easy and consistent way of how parents could get used to having time for a different daily experience. Sensory learning experiences could be provided by parents with activities including outdoor play and exploration of nature. There were O&M lessons with students traveling in outdoor environments and on sidewalks with a parent holding the camera. While a parent could likely serve in this role, they should not be asked to hold the recording device while also ensuring the child’s safety. The nature of O&M skills and techniques often present potential hazards and safety concerns that may not be seen through a video or not anticipated by the parents. For O&M instructors to promote student success and design appropriate lessons, they should be able to control the amount of feedback given and what information is included in the curriculum.

Implications for practitioners

Virtual instruction will continue to be used in some situations when in-person O&M lessons are not an option. Since virtual instruction in O&M requires novel approaches, O&M professionals have opportunities to develop and create new instructional strategies. Virtual instruction could be especially effective to reinforce the services of an O&M professional when lessons are infrequent or excessive travel for each lesson is required. Older students were likely more successful in online lessons because they were able to maintain their attention for longer periods of time and focus on the use of smartphone apps and online maps.

Professionals incorporated additional elements of the ECC into their teaching as part of virtual instruction. For O&M to be effectively implemented, parents and teachers need to reinforce and encourage the student to be independent, to use appropriate techniques, and to consistently use their mobility devices. Self-determination, physical activity, and independence are often directly related to an individual’s competence with O&M skills. While O&M is not measured as part of standardized tests, these skills are critical to every aspect of that student’s life aside from when they are sitting at a computer. They still need to be able to move independently through their house, outside of their house, and to engage in physical activity and exercise.

Footnotes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Justin T Kaiser

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