Birth to Three Orientation and Mobility New Mexico Style AER Bellevue, WA

1. New Mexico School for the Blind and Visually Impaired (505)859-0427 Julie Maner, COMS LoretaMartinez-Cargo, COMS Joanne Habelt, O&M Mark Carter, COMS mcarter@nmsbvi.k12.nm.us Birth to Three Orientation and Mobility New Mexico StyleAERBellevue, WA

2. NMSBVI INFANT TODDLER PROGRAM 2000 TO 2012 Cindy Faris Program Coordinator (505)859-0427 cfaris@nmsbvi.k12.nm.us

3. INFANTS & TODDLERS SERVED IN NMSBVI PRESCHOOL CENTER • LIMITED NUMBER SERVED IN NM BY OUTREACH • VISION DIAGNOSIS REQUIRED • 40 CHILDREN SERVED STATEWIDE IN 2000 HISTORY 40 KIDS IN 2000

4. LINDA LYLE PRIMARY INFANT TODDLER TEACHER • 2000 FIRST DEVELOPMENTAL VISION SPECIALISTS HIRED • OFFICIAL INFANT TODDLER PROGRAM STARTED • EARLY INTERVENTION PHILOSOPHY THERE MUST BE MORE KIDS 1997-98 Linda Lyle comes out to connect with EI staff

5. INCREASE COLLABORATION • IDENTIFY MORE KIDS WHO NEED VISION SERVICES • ANDY GOMM, (FIT) AND PAULA SAENEZ, (NAVAJO NATION) OFFERED SUPPORT AND COLLABORATION STATE COLLABORATION JOINING WITH A SYSTEM OF STATE SERVICES

6. VISION SCREENING • IDENTIFICATION OF KIDS • SERVICES IN HOME & COMMUNITY • TRAINING & TA FOR EI STAFF • AGREE TO SERVE KIDS “AT RISK” FOR VISION IMPAIRMENT NEGOTIATIONS WHAT CAN WE OFFER?

7. CONSISTENT WAY TO SCREEN VISION ACROSS STATE • RESEARCH BEGINS AND FIRST TOOL DEVELOPED • 2003 FIRST SCREENING TOOL • TRAINING FOR EI AGENCIES • VISION 101 IS BORN • ANDY SUGGESTS MEDICAID BILLING FOR VISION/O&M WHAT DOES ANDY WANT? TOOL TO SCREEN VISION

8. 2000 served 40 kids statewide • 2006-07 served 450 kids • 2007-08 served 750 kids • Month of May 2012: 442 kids served • July 2011 to May 2012 we have provided screenings and services for 1,471 kids • Of 1,471; 731 were screened and 741 were provided ongoing services WE FOUND THE KIDS EI STAFF REFER THE LARGEST NUMBER OF KIDS

9. 1 PROGRAM COORDINATOR • 1 ADMINISTRATIVE ASSISTANT • 17 DEVELOPMENTAL VISION SPECIALISTS • TRAINING AS TEACHERS OF THE VISUALLY IMPAIRED AND/OR ORIENTATION AND MOBILITY SPECIALISTS • 4 O & M SPECIALISTS • INFANT TODDLER/EARLY CHILDHOOD; 4 OT, 1 PT, 1 SLP CURRENT STATEWIDE STAFF WE ARE PAID TO DRIVE

10. DIRECT SERVICES FOR CHILD AND FAMILY • VISION SCREENING, FUNCTIONAL VISION EVALUATIONS, ONGOING ASSESSMENT • TRAINING FOR EI AGENCIES • RESOURCE AND INFORMATION • PARTICIPATE IN IFSP TEAM AND OTHER TEAM MEETINGS STATEWIDE SERVICES PARENTS OR AGENCIESARE NEVER CHARGED FOR SERVICES

11. PROVIDE VISION SUPPORT TO HOSPITALS FOR INPATIENT AND DISCHARGE • NICU, PICU, GPU • COLLABORATE WITH PRIMARY CARE PROVIDERS,PEDIATRIC OPHTHALMOLOGISTS, AND NEUROLOGISTS HOSPITALS, DOCTORS WE HELP CONNECT FAMILY FROM MEDICAL PROVIDER TO FOLLOWUP SERVICES

12. PRIMARY CARE DOCTORS FREQUENTLY MISS SIGNS OF VISUAL IMPAIRMENT • MAJORITY OF REFERRALS FROM EI STAFF • SERVING KIDS AT RISK ALLOWS OUR STAFF TO HELP WITH DIAGNOSIS • WE SERVE MORE CHILDREN, B-3, THAN OTHER STATES • CHILDREN RECEIVE TRANSITION SERVICES EARLY IDENTIFICATION AND VISION DIAGNOSIS EARLY ID/DIAGNOSIS LEADS TO FUTURE SERVICES

13. INCREASE OF OPTIC NERVE HYPOPLASIA • INCREASE OF SHAKEN BABY/NONACCIDENTAL TRAUMA • INCREASE OF PREMATURE BABIES • INCREASE OF MEDICALLY FRAGILE BABIES TRENDS AND CHALLENGES STAFF MUST BE WELL TRAINED

14. COMMITTED STAFF • STATE AND COMMUNITY COLLABORATION • NMSBVI BOARD SUPPORT FOR EARLY IDENTIFICATION • SUPERINTENDENT HAS EARLY CHILDHOOD BACKGROUND STRENGTHS STAFF ARE OUR GREATEST RESOURCE

15. OUR ROLE IN THE TRANSDISCIPLINARY TEAM PROVIDER MODEL AS VISION SPECIALISTS • ACTIVE PARTICIPATION AS TEAM MEMBERS WITH KIDS, FAMILIES, AND AGENCIES • CONTINUED STATE AND COMMUNITY COLLABORATION • MODEL FOR OTHER STATES LOOKING TO THE FUTURE DEFINING OUR ROLE

16. Orientation and Mobility DefinitionNM Family Infant Toddler Program Services delineated in the IFSP that address purposeful and independent movement in children who are blind, visually impaired or are at risk for visual impairment.  Services provided involve the development of skills including concurrent motor skills, sensation, environmental concepts, body image, space/time relationships, and gross motor skills. Orientation and mobility instruction is focused on travel and movement in current environments and next environments and the interweaving of skills into the overall latticework of development.  Services include evaluation and assessment of infants and toddlers identified as blind/visually impaired to determine necessary interventions, equipment, and strategies to promote movement and independence.

17. NMSBVI B-3 O&M Guiding Principles O & M services should start when a child is young Movement improves cognitive functioning and increases skills in all developmental areas Children should have an opportunity to learn by exploring and moving Movement should be developmentally appropriate O & M should be fun, because children learn best through play Child, family and team centered O & M is most successful Active participation allows the child to learn in a meaningful context. Children learn best when they are engaged in natural learning environments.

18. NMSBVI Birth – 5 YearsOrientation and Mobility Assessment • Parent Report   • Eye Exam •  Functional Vision • Communication •  Sensory: • Auditory/Tactual/Olfactory •  Gross Motor • Fine Motor • Quality of Movement • Orientation • Mobility • Concepts •  Travel Devices • Safety and Environmental Awareness • Supporting Purposeful Movement in Learning Situations

19. NMSBVI B-3 O&M Services in NM Work closely with NMSBVI developmental specialists and other team members Early development of tool use and purposeful reaching Try canes at early age… not sure how a child will respond to a cane unless you try

20. Sensory Motor Learning Sensory Zone Sensory Learning Zone • Awareness of sensory experiences • May not understand source of sensory information received • May not have opportunity to recreate sensory experience. • May not know how to create or repeat sensory experience • Experience may have limited sensory input • Child is directly experiencing activity that produced sensory input • Child should have opportunity to create her own sensory experiences • If appropriate, child should have as many senses as possible involved in the activity. • Shared activities offer opportunities for imitation and creativity and support learning