RO&Ming with Lil

Alana Bogart is an O&M specialist from Canada who now works for Blind Low Vision New Zealand. Alana takes us on a journey into the snow-bound villages and islands of British Columbia at minus 25 degrees, where she worked with First Nations people. She learned to call a cane a stick, fall down safely in the snow, and look out for bears. In Christchurch, she found some clients were more interested in learning long cane skills after the earthquakes – it seems that independent travel skills are handy in a crisis!

This episode, we’re talking with Darren Moyle, an O&M Specialist who works for Vision Australia in Melbourne. Darren has a passion for integrating sport and technology into O&M programs. He loves working with kids and he has just become a dad himself. Darren describes some of his Aha! moments in training as an O&M specialist 9 years ago, the things he finds life-giving about the job, and his own use of technology in navigating public transport and travel while working in Melbourne suburbia as an O&M specialist who has low vision. Darren is on the professional development committee for the OMAA, so we are spruiking the forthcoming OMAA Online Symposium on 22 September.

Today we meet Bronwen Scott and Heidi Zec. Bronwen is an independent Orientation and Mobility Specialist and Heidi is the mother of Luka, a delightful two year old with cortical visual impairment. They have worked together with Luka for the past 18 months to help develop his functional vision in the context of daily routines. This year Bronwen and Heidi have joined forces to create the CVI Community Australia. This online group connects and supports parents and professionals who are navigating the world of CVI. Heidi and Bronwen remind us that CVI is different to ordinary low vision. It is tricky to simulate, but in CVI we have that rare opportunity to be part of developing a child’s vision and preventing avoidable blindness. We have a lot to learn about CVI, and we need to start as soon as possible.

Four years ago, traveling independently in inner city Melbourne, Ross de Vent scored VROOM 14/50 for his functional vision (Fragments), and OMO 33/50 for his functional mobility (Capable). Ross now lives on the fringe of metropolitan Melbourne and has been in COVID isolation with his household and guide dog for the past 4 months. Today, we found that Ross’ vision and mobility scores have both dropped to VROOM 6/50 (Fifty shades of grey) and OMO 28/50 (Cautious), despite his clinical vision remaining stable. The drop in VROOM rating suggests that it not worth looking when there is nothing new to look at in the COVID cave, and the OMO score captured the gloom and limited life-space of COVID restrictions. During this time, Ross has valued frequent contact with his support worker, Josh Glover, in tackling technology challenges and making some big life decisions. Ross prompts us to rethink the relative importance of independent mobility when also wanting to stay COVID-safe, connect with people to dispel the gloom, and save some energy for professional commitments.

Lisa Petrie is an Habilitation Specialist with Guide Dogs UK, based in Scotland. Lisa enjoys working with children who have complex needs, and she also manages O&M services for adults, children and young people (CYP). Lisa and her teams have been piloting the VROOM and OMO functional assessment tools with all ages. In 2018, we tested out the VROOM and OMO tools assessing the functional vision and mobility skills of two year old boys, Theo and Luke. They both have CVI – cerebral visual impairment – and travel in a manual wheelchair. In this episode, we get an update on these wee bairns, and Lisa’s perspective on the VROOM and OMO tools for children with multiple disabilities.

Diana Grobler works in northern New South Wales, serving orientation and mobility clients across a large region. She has many older clients with macular degeneration who love to chat. Diana is a relative newbie in the O&M field, but she has done 12 or 13 VROOM and OMO assessments this year, both face to face and via tele-practice. Diana shares with us some of her Aha! moments, and questions that have arisen while using the VROOM and OMO tools during COVID restrictions.

In Episode 5 we did a did a VROOM and OMO assessment with Erica Tandori, who scored 29/50 for her functional vision and 39/50 for her functional mobility. Erica chooses not to use a mobility aid most of the time, relying on her peripheral vision and fabulous mental mapping skills to maintain her orientation and her safety on familiar routes like the public transport trip to work. But Erica likes to take an arm when walking in less familiar places. This frees up her vision to look around and enjoy what she sees. The co-rating conversation with Erica has raised questions about comparisons and precision in using the VROOM and OMO tools, and some varied opinions about the mobility aids we might recommend for someone with mid-range low vision.

Orientation and Mobility (O&M) textbooks talk about indoor and outdoor travel skills. Outdoor places are usually classified according to their purpose or zoning – residential, semi-business and business environments, petrol stations and shopping centres. However, environmental purpose doesn’t necessarily tell us about complexity. It can be easier to cross at the traffic lights in the city than an uncontrolled residential road. The O&M Environmental Complexity Scale provides a way to think about the aspects of complexity that matter to clients. We can use it to rough-sort any environment in the world into one of six levels without getting bogged down in the details. Podcast pals, Jo Anson-Smith, Amy McKibbins, Tayler McBrien and Zoe Gephart join me again to talk about choosing environments for VROOM and OMO assessments using the O&M Environmental Complexity Scale.

Mel Stephens is an independent 26 year old, horse-loving train tragic with no light perception and an addiction to cruises. Mel was a research participant in the Bionic Vision Australia project in 2013, so she was there at the inception and birth of the VROOM and OMO functional assessment tools. We have now done four VROOM and OMO ratings with Mel over a seven year period. The VROOM tool captured her decline from low vision to blindness from Leber’s Congenital Amaurosis. The OMO tool captured her dip in energy while living in the big smoke, then a return of energy as she moved to Mildura in country Victoria. In the process, she has become a valued research collaborator. This was helped by the fact that Mel lived independently in Lil’s back yard bungalow for a while, where we talked about research under the clothesline.

In this episode, Jo Anson-Smith, an orientation and mobility specialist from Newcastle, reports the VROOM and OMO scores for the client she assessed through tele-practice a few weeks ago. Let’s call him Ken. We also revisit Erica Tandori’s VROOM and OMO results from last episode. I explain how we can interpret these results in 10 point categories, with F words for VROOM categories and C words for OMO categories. Jo explains some of her decision-making challenges in using these assessment tools, and we explore the implications of mid-range low vision – the Formwork category – where Ken and Erica see linear structures and outlines, but no internal detail. To cane or not to cane? …that is the question!