Review of Developmental Orientation and Mobility Service Delivery
The purpose of the review was to provide the Ministry with ideas and options for how best to meet children’s DOM needs within existing resource constraints. The Ministry wanted the review to consider the funding, management, service models and provision of DOM services as well as future workforce needs and implications. The needs of Māori, Pasifika and children with complex needs were also considered.
Author(s): Dr Barbara Disley
Date Published: September 2011
Latest Updates November 2011All stakeholders involved in developing the report agree that DOM skills are an integral part of the expanded core curriculum which allows blind and low vision students to access the regular curriculum and is the base of BLENNZ teaching and learning programmes.
The report suggests that the preferred service management option is to use BLENNZ and its national network to provide DOM services to school-age children. Special Education’s national management team has supported that option.
The Ministry is suggesting a phased approach for BLENNZ to gradually build up a national service delivery model for DOM.
The BLENNZ Board of Trustees are open to discussions with the Ministry with a view to take over the provision of the services, depending on the outcome of these discussions.
RNZFB has proposed a plan that will review all active programmes at each child’s next IEP, continuing the programme where approved. It is envisaged that these plans will be complete within 18 months.
The RNZFB continues to focus on the enhancement of their early childhood, preschool, youth and adult services.
Introduction to the Review of Developmental Orientation and Mobility Service Report
All stakeholders involved in producing the report have also had the opportunity to provide written feedback on the report and engage in workshops to discuss implications and ways forward.
There is ongoing work on designing and implementing a new model of service delivery for developmental Orientation and Mobility.
The Ministry of Education commissioned Cognition Education Ltd to review developmental orientation and mobility (DOM) services. DOM services teach children skills to travel independently and to move safely, confidently and well within their environments. DOM also includes teaching of concepts that underlie spatial reasoning, navigation and movement.
DOM skills are seen as critical to enabling blind and low vision students to fully access the curriculum and to participate fully in all aspects of life. They are essential to enabling an inclusive educational and societal context for people who are blind or low vision.
MethodologyA sector advisory group supported the review by engaging closely with the process, providing information and ideas and reviewing options.
The review canvassed the international literature and explored the current service context within New Zealand.
Key informant interviews and an on-line survey were used to canvas views on current needs, existing service arrangements, funding arrangements, ideas to improve services, and models for future service provision. The information from the surveys was analysed and a separate report compiled that is appended in this review.
Current Contracting and Service ProvisionDOM services for school age children are funded by the Ministry through two main contracting arrangements. A national contract for children with moderate vision needs with a funding pool of $88850 per year and four regional contracts for ORS verified blind and low vision students at $173,000. ORS fund holding schools contract for DOM services for individual students.
The Ministry contract with BLENNZ for the moderate contract. BLENNZ then subcontract with RNZFB and Moving Forward to provide these services. RNZFB hold the ORS contracts.
RNZFB have had difficulty staffing and providing services in all parts of New Zealand. They have also raised concerns about the sustainability of these services. Where services are provided parents express satisfaction with the services received.
Perspectives on Current ServicesPerspectives on current services were gathered from key informants. The concerns identified in this review include:
- Lack of clarity in respect of funding mechanisms and how resources were determined and allocated
- Lack of information on DOM needs of children with vision impairments
- Little information on the DOM needs of children in special and fundholder schools
- Strong sector perceptions that children’s DOM needs were poorly met
- The importance of children’s DOM needs not well understood within the education sector
- Lack of integration between DOM services and the Expanded Core Curriculum
- Variable links between home and school in respect of DOM services
- Few opportunities for training of parents and other support people
- Historical and bureaucratic contracting practices as opposed to needs based service contracting
- Variable access to services depending on geographical location
- Inconsistent models of DOM practice
- Workforce issues including inability to attract and retain skilled DOM staff by providers.
Service Delivery Ideas and OptionsOptions for future service provision have been identified and ideas presented on funding, service management, best practice models, ways to strengthen the workforce, meet the needs of Māori and Pasifika, and ensure smooth transitions from early childhood to school and from school to post school environments.
Future service delivery models will need to be:
- Funded so they are sustainable
- Well managed to ensure maximum return for funding
- Based on international best practice adapted to our New Zealand context
- Staffed with well trained, efficient and effective professionals who are competent in developmental orientation and mobility training, understand child development and learning and have the ability to work with Māori, Pasifika and within diverse contexts
- Well integrated into educational contexts and wrap around the student/family
- Child and family/whānau needs and outcomes driven
- Focused on children’s early years and whole of life needs to establish strong learning foundations.
FundingFunding streams need to be fully identified and an efficient mechanism for distributing the funding determined. Clarifying the funding requires:
- Determining the ORS specialist resources that blind and low vision students attract and the proportion that should be directed toward DOM services
- Determining the needs and the level of funding available to support students with moderate needs.
- Once funding streams are clearly identified, the Ministry needs to determine service funding mechanisms that:
- Streamlining funding processes to maximise the amount going into service provision
- Allow service priorities and decisions to be made as close to the student as possible.
- Pooled funding -All DOM specialist service funding (ORS and moderate contract) is pooled by the Ministry who provide/contract directly to providers for DOM services.
- Individual Funding Packages - ORS specialist service funding for students who are blind or low vision is notionally allocated to each student and decisions on the use of the funded resource made by teachers, specialists and parents through an IEP process. In this option the moderate funding contract would remain as a separate contract.
- All Specialist Vision Resources Fundheld by one provider - All specialist service funding for all ORS funded vision impaired students and the moderate contract are contracted to one fundholder. This is the preferred funding option.
Service managementA range of service management options were identified. The preferred service management option was for BLENNZ to provide all DOM services through its Visual Resource Centres. This option would transfer all specialist resource allocated to DOM services to BLENNZ who would then provide/contract all services to school based children through its existing network of visual resource centres.
Other options canvassed included:
- RNZFB provides all DOM services – The Ministry contracts with RNZFB for DOM services for students who receive ORS or have moderate needs. This would remove the current subcontracting arrangement through BLENNZ for moderate students.
- Special Education provides DOM services - Special Education expands its specialist service base to include DOM services. Other fundholders contract to provide DOM services for the students for whom they fundhold.
- Independent DOM practitioners contract to BLENNZ, the Ministry and schools to provide services. This model would involve a network of private practitioners contracting out their services for a fee to SE, BLENNZ and fundholder schools
Strengthening DOM Practice ModelsThere are currently a range of different practice models for providing DOM services. Best practice approaches that build on international best practice and are appropriate within the New Zealand context need to be identified and developed. Practice models will need to reinforce the roles of family, paraprofessionals and teachers. Ways for DOMs to skill share with these key people could maximise students’ outcomes. DOM practitioners have a role to play in developing information and support materials for parents, teachers and paraprofessionals. Developing on-line resources and self-help tools for students and families could also enhance future DOM service provision.
Strengthening the WorkforceStrengthening the profession will require determination of:
- The professional training requirements and status of the DOM specialist and possible paraprofessional support roles. This will require clarification of the skills needed for both the specialist DOM role and supporting paraprofessional DOM roles. Possible tiered training options could then be developed. These could include: post graduate training through the Specialist Teachers Diploma; achieving NZQA credits through an apprenticeship model; undertaking training through Renwick Centre in Sydney.
- The ongoing professional development and support of DOM practitioners including consideration of DOM practitioner networks and national practice advisors.
- Employment conditions (salary, working context, access to professional development, teaming arrangements) including clarifying roles, qualifications and employment expectations.
Meeting the Needs of MāoriA well functioning DOM service would meet the needs of Māori students/whānau. Stakeholder feedback suggests that a well functioning DOM service would take a holistic, integrated approach working closely and appropriately with all families.
Options need to be explored to encourage Māori to consider undertaking DOM training. Other options include future service delivery that builds strong links with Ngāti Kāpo (Māori health and disability advocacy organisation). Other considerations are to provide scholarship options to Māori teachers to support them to undertake specialist education training of which DOM training could be a component. Establishing paraprofessional training avenues that lead to accreditation of skills in DOM implementation could also increase Māori staffing numbers.
Meeting the Needs of Pasifika FamiliesFinding out more about service engagement is required prior to decisions being made on what changes might need to be put in place. Given the relatively small number of students, it is likely that strategies that ensure all DOMs have the attitudes, values, knowledge and skills to work across diverse cultural context will be more feasible than attempting to develop ethnic specific service options.
Transitions from Early Childhood Education to SchoolCurrently, DOM service for young children prior to their going to school are funded by the Ministry of Health and provided by RNZFB.
Once children begin school it is perceived that there is less funding and flexibility in the use of the funds. Transitions are too important to be left to chance and work needs to be done to ensure that there are effective transition processes in place for all children.
The Ministry of Education will need to engage the Ministry of Health in communicating any changes to school based services so that policies across both agencies enhance transitions.
Transitions from School to Post School Environments
Currently RNZFB and a range of other providers are contracted to support transitions from school to work or other education. There is a lack of clarity as to where DOM services feature in these arrangements with a number of organisations working in this context. There is a view that some vision impaired students do not have adequate consideration given to the DOM needs at this crucial point with the consequence that this could impede their independence. The Ministry may need to liaise with other funders in this domain to work through transition issues and concerns.
Provision of Information and Support
Greater consideration needs to be given to training and supporting parents, paraprofessionals, teachers and other educational staff in DOM techniques so that children receive higher levels of ongoing support and encouragement in developing orientation and mobility skills. Increased use of online learning communities and activities could greatly influence the understanding of DOM competencies and their importance to children’s overall development.
The review has highlighted a number of areas that have policy implications. These include a range of policy decisions in respect of the way funding is determined and allocated. Pooling current ORS and moderate contracts will require Ministerial approval as will any changes to fundholding arrangements for children who are verified for ORS as a result of the vision criteria.
Policy work to determine consistent service models, frameworks and standards will also be required. The training qualifications required for an individual to provide services and mechanisms for future funding and provision of training will have policy implications.
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