Room 3 - Delivery Room (Section 6 of 12)
Section 6 – Review
Description of the review process
Children who have a visual impairment are not a homogeneous group in terms of their needs for mobility and independence support. Some children may require ongoing input, for example if they are totally blind or long cane users, whilst other children with some useful vision, may only need mobility and independence intervention at important times of transition or for one-off programmes when mobility and independence issues crop up. These children may never need to follow an actual mobility and independence programme, but will still need monitoring as a safety net, on an assessment basis only, e.g. once per year.
There are essentially three areas to consider within ‘review’:
- Monitoring a child’s level of mobility and independence whilst not actually on a mobility and independence programme.
- Reviewing and recording of a child’s progress whilst on a ‘one-off’ or rolling programme.
- Reviewing the effectiveness of intervention, i.e. of a mobility and independence programme designed and implemented for the child.
Monitoring children’s M&I
Ongoing assessment of the mobility and independence needs of children with a visual impairment is important since their needs, unlike those of adults, can quickly change over time. Since many children do not need to receive continual mobility and independence support, monitoring is crucial to ensure any mobility and independence needs that may develop are identified and addressed as soon as possible. It is important to have a developmental approach with a long-term perspective, which plans for the future needs of the child. Ongoing assessments of the child are often planned to coincide with their annual reviews.
The type of professional that should be responsible for monitoring the child will vary according to which agencies are involved in providing mobility and independence support. Where the mobility and independence educator is employed by the education service, there are often monitoring systems in place that the mobility and independence educator oversees. However in authorities where either social services, a voluntary organisation or an outside consultant is employed to provide mobility and independence support, the education service often takes responsibility for monitoring children and referring cases to the provider when necessary. The following are examples of this identified in the research:
The education service monitors children, and sends through an annual list of children needing assessment to the voluntary organisation RO. BUCKINGHAMSHIRE
The education service monitors children and re-refers when necessary to the consultant MO. The system works because the education service staff have a good awareness of mobility and independence, and tend to be over-cautious. Therefore it is unlikely that children ‘slip through the net’. COVENTRY
Many respondents used similar methods for both initial and ongoing assessments. These might include checklists, mobility and independence curricula, observation and discussions with the child and significant others, and reading reports.
Given its importance to a child’s education, mobility and independence should be routinely included in Individual Education Plans (IEPs), and the statementing process as well as annual reviews. Each of these serve as opportunities to raise awareness of mobility and independence with those responsible for writing IEPs and statements, as well as to get parents and staff involved and develop working relationships with them. The following is an example:
An annual (or more frequently if needs change) mobility report is written for each child on the MO caseload. From this, recommendations can be used in the child’s IEP. HEREFORD
Although the MIE should always be invited to contribute, it may not always be necessary to attend annual reviews in person. If mobility and independence issues are of concern, a report should be written for the QTVI to take along on the MIE’s behalf, for discussion at the meeting. If another person is representing the mobility and independence educator, there needs to be close liaison between them to ensure their view is represented appropriately.
It is recommended that if mobility and independence is identified as an educational need, then the Mobility and Independence Educator responsible for leading this work should attend the annual review.
Reviewing and recording a child’s progress
Activity 18
Before reading on, you should first note down why it is important to keep written records of any M&I intervention. You may then wish to reflect upon when written records are kept in your service or a service known to you. You can then compare your notes with the findings from the M&I research project which are reported below.
It is essential to keep written records of any mobility and independence intervention. Records not only give details of the progress the child is making and identify areas which still require input, but also allow others to access the information, in order to be kept up to date about the child’s mobility and independence needs. Written reports are the most obvious method by which to capture this information, and are compiled:
- After assessments are carried out (see section 3 - Assessment).
- After each mobility and independence lesson.
- At the end of term or school year.
- For specific purposes, e.g. annual reviews.
The following are examples from the research project:
The RO from a voluntary organisation writes a sentence/paragraph/page after each lesson, and then at the end of term writes a report for the education service. A summary is kept in the child’s file by the voluntary organisation. The RO also writes a report for SSD if they are involved with the child. BUCKINGHAMSHIRE
The SSD RO keeps records of each lesson in client’s file held by the SSD, and writes a ‘closing summary’ which is copied to the education service, parents, the SSD Care Management Team and anyone else involved with the child. LONDON BOROUGH OF RICHMOND
Reports are mainly written by the mobility and independence educator, though occasionally teaching assistants or others who may be involved in reinforcing skills with the child or monitoring their progress will compile reports.
Reports should then be kept in a personal file for each child, and copies given to relevant agencies and others who are involved with the child, e.g. parents and school staff, including class teachers and teaching assistants where appropriate. This ensures that information is shared between agencies and professionals.
A number of interviewees described formal methods of accrediting students for mobility competence, a common practice in many special schools for visually impaired pupils. Accreditation is
- Often associated with other external schemes (RoSPA Award Scheme, West of England School)
- Sometimes specific to certain client groups (e.g. wheelchair users)
- Used to communicate abilities of the child and therefore their level of dependence and independence to all staff within the school (e.g. Royal Blind School), and
- Recorded in personal records of achievement for the child to keep.
Accreditation for children in mainstream education would be beneficial, since it gives them a record of their achievements which can inform other children, school staff and their families of exactly what they have been doing in mobility and independence lessons, and what they have achieved. As well as informing others of the child’s present abilities and areas where they may need assistance, it may also help to raise awareness of the importance of mobility and independence education.
In mainstream education accreditation for children seems much less common. However, the research identified some examples of accreditation:
Many children put together ‘mobility books’ which might include tactile maps or route instructions in Braille or print. These not only aid revision, but are a kind of record of achievement that the child can show to classmates, teachers and their families. CAMBRIDGESHIRE
Blind children receive ‘tactile certificates’ when they reach a target level which is individual to them since all children operate at different levels. The school then has a record of their achievement in mobility and independence. NORTH YORKSHIRE
A checklist of mobility and independence skills is completed for each child in the resource base, which is made into a ‘record of achievement’ booklet for them to keep when they leave school. Children also receive certificates for achieving different tasks, e.g. for going to the post box unaided. Children are not compared to each other, only to themselves. KIRKLEES
Review of effectiveness of intervention
Continual re-evaluation of teaching styles and methods is very important. Assessment of the effectiveness of any intervention has to be an ongoing process of constant re-evaluation, leading to adaptation of a programme if one approach is not working.
Examples of where this has happened is where services operate ‘trials’ or projects intended to assess and address mobility and independence needs in the authority, and have regular team meetings, often in conjunction with professionals from social services or voluntary organisations, in which they discuss how they can improve present provision.
Rcommendations based upon good practice
Activity 19
We present below a number of recommendations which have arisen from good practice identified in the M&I research project. You may wish to use these as the basis for an audit tool to evaluate the extent to which the provision offered by your own service, or a service known to you matches each of these recommendations.
Services must adopt a long-term perspective when organising mobility and independence provision which is reflected in long-term educational goals regarding mobility and independence, rather than a series of ad hoc interventions. To achieve this, the following is recommended:
- The mobility and independence policy document should detail the procedures adopted for monitoring children.
- Children must be monitored whether they receive one-off support or are on a rolling programme. Responsibility for this monitoring should be allocated to a person or persons who have a good awareness of mobility and independence issues (likely to be the QTVI).
- The Mobility and Independence Educator must be involved in educational planning and reviewing processes, including IEPs, statements and annual reviews for all children where mobility and independence is a concern.
- Formal record keeping mechanisms should be in place to record the child’s progress. This should be linked to other formal educational planning and reviewing processes.
Reports should detail what has been achieved with the child and any areas needing further input, with recommendations about when further assessment/intervention should take place, if appropriate.
- Copies of reports must be given to parents and agencies involved with the child so that everyone is kept informed and duplication of effort is avoided.
- Accreditation should be considered to reward children for their achievements, and raise the profile of mobility and independence with school staff, the child’s peers and with their family. It also builds up the child’s own self-esteem.
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