1. Michigan Severity Rating Scales Vision Services Severity Rating Scales (VSSRS) VSSRS+ (for students with additional needs) Orientation & Mobility Severity Rating Scales (O&MSRS) O&MSRS+ (for students with additional needs) Available from the Michigan Department of Education Low Incidence Outreach https://mdelio.org/blind-visually-impaired/severity-rating-scales

2. Severity Rating Scales What they are… The severity rating scales support consistency in determining service delivery times for students who are blind or visually impaired. Use the scales to establish how often a particular service should be delivered to a student What they are not… Assessment/Evaluation instruments Caseload planners

3. VSSRS Vision Services Severity Rating Scale

4. VSSRS Vision Services Severity Rating Scales Target Students: Students in general education settings May be applicable for some students with additional mild impairments When to Complete: 1.Initial assessment 2.IEP team meeting 3.End of each school year 4.Visual status changes 5.Placement changes 6.Other

5. VSSRS Vision Services Severity Rating Scales Prior to completing: Assess the student to determine his or her strengths and needs using a variety of assessment After completing: Include recommendations in report and share with team at and prior to IEP

6. VSSRS Seven Categories Level of Vision (Medical) Functional Near Vision Reading Medium Low Vision Devices/Technology Material Preparation Compensatory Skills Communication with Student’s Team/Pertinent Individuals Each category is structured in terms of impact on the educational program as it relates to the student’s age-appropriate needs. The categories purposely overlap to some degree.

7. VSSRS Category Definitions Level of Vision (Medical): Refers to the student’s distance vision and/or peripheral vision as reported by an eye care specialist. *If both an acuity loss and field loss are present, add the two Severity of Need scores together and enter the sum in the Score column. Functional Near Vision: Refers to the student’s level of functional near vision as determined by the TVI

8. VSSRS Category Definitions Reading Medium: Refers to the student’s primary mode of learning (i.e. braille, print, print modifications, auditory, or combination) Low Vision/Technology: Refers to the student’s need for an use of low vision devices and technology to facilitate maximum participation in the general education curriculum.

9. VSSRS Category Definitions Material Preparation: Refers to the estimated time needed by the TVI to modify materials necessary for the student’s participation in his or her educational program. *Additional material preparation may be completed by a teaching assistant/paraprofessional/braillist but is not to be considered for this rating scale. Compensatory Skills: Instruction in skills such as auditory and tactile efficiency, awareness of body in space, social skills, activities of daily living, etc.

10. VSSRS Category Definitions Communication with Student’s Team/Pertinent Individuals: Refers to the amount of time needed for communication with school personnel, parents, medical personnel, technology support personnel, and agencies concerning the student’s educational program.

12. VSSRS Contributing Factors to Service Delivery Age of student Attendance Availability of materials/equipment Consultation and coordination of Expanded Core Curriculum activities Progressive condition Recent vision loss School staff need for support Student cooperation Training of Paraprofessional/Teaching Assistant/Braillist Transition to new school/building Travel time Numerous accommodations Direct Curriculum Instruction (additional 1 to 4 points) Other One or more of these factors may increase or decrease the frequency of service

15. VSSRS Recommendation of Services Amount of ServiceExplanation 1 to 5 times per yearWith student or consultation other pertinent individuals 3 to 4 times per semesterDirect service in clusters; consultation with student or pertinent individuals 1 to 3 times per monthDirect service with consultation 1 to 2 times per weekDirect service 1-2 times/week (30-40 minutes) 2 or more times per weekDirect service 2 or more times/week (45 or more minutes each)

16. VSSRS+ Vision Services Severity Rating Scale for Students with Additional Needs

17. VSSRS+ Seven Categories Distance Visual Acuity Level of Functional Vision Impact of Developmental/Communication Delays Response to Vision and/or Other Sensory Stimulation and/or Instruction Level of Skills in Activities of Daily Living Need for Material Preparation by the TVI Need for Communication with student’s team/pertinent individuals by the TVI

18. VSSRS+ Category Definitions Distance of Visual Acuity: Refers to the student’s level of distance vision as reported by an eye care/low vision specialist Level of Functional Vision: Refers to the student’s ability to apply visual skills to the educational setting.

19. VSSRS+ Category Definitions Impact of Developmental/Communication Delays: Refers to the impact of these delays on the student’s ability to benefit from services from the TVI Response to Vision and/or Other Sensory Stimulation and/or Instruction: Refers to the ability of the student to respond to stimulation and/or instruction.

20. VSSRS Category Definitions Level of Skill in Activities of Daily Living: Refers to the level of independence in skills of daily living. Need for Material Preparation by the TVI: Refers to the estimated time needed by the TVI to modify materials necessary for the student’s participation in his or her educational program.

21. VSSRS Category Definitions Need for Communication with Student’s Team/Pertinent Individuals: Refers to the amount of time needed for communication with school personnel, parents, medical personnel, technology support personnel, and agencies concerning the student’s educational program.

24. O&MSRS Orientation and Mobility Severity Rating Scale

25. O&MSRS Eight Categories Level of Vision (Medical) Level of Vision (Functional) Use/proficiency of travel tools Discrepancy in travel skills between present and projected levels Independence in travel in current/familiar environments Spatial/environmental conceptual understanding Complexity or introduction of new environment Opportunities for use of skills outside of school

26. O&MSRS Category Definitions Level of Vision (Medical): Refers to the student’s distance vision and/or peripheral vision as reported by an eye care specialist. *If both an acuity loss and field loss are present, add the two Severity of Need scores together and enter the sum in the Score column. Level of Vision (Functional): Refers to the student’s ability to use vision for all travel tasks (i.e., movement within the classroom, school building, and community) *Mastery of Cane Skills scores a zero regardless of vision

27. O&MSRS Category Definitions Use/Proficiency of Travel Tools: Refers to the student’s need for use and skill level of a white cane or alternative mobility device. Discrepancy in Travel Skills Between Present and Projected Levels: Refers to whether a discrepancy exists between the student’s actual functioning in travel skills and the projected level of independence based on the O&M specialists professional judgment.

28. O&MSRS Category Definitions Independence in Travel in Current/Familiar Environments: Refers to the student’s ability to travel safely and proficiently in a familiar environment (e.g. school, neighborhood) based on current literature of age-appropriate travel levels and expectations. Spatial/Environmental Conceptual Understanding: Refers to the student’s conceptual understanding and how O&M progress is affected.

29. O&MSRS Category Definitions Complexity or Introduction of New Environment: Refers to the type of environment in which instruction is required (e.g., business district, new school, neighborhood). Opportunities for Use of Skills Outside of School: Refers to whether the student has the opportunity to use O&M skills in the community, at home, etc. outside of O&M instructional time.

31. O&MSRS Contributing Factors to Service Delivery Posture, gait, and motor development Other physical or health impairments The nature of eye disease or condition Transition to a new school, neighborhood, worksite, etc. Recent vision loss New, hazardous, complex, or difficult environment Potential for improvement of travel skills Age of onset of visual impairment Maturity and motivation Team commitment for follow-up Travel time needed to transport student to area of instruction affecting frequency of instruction Instruction in low-vision aids Instruction in use of GPS Other (explain) One or more of these factors may increase or decrease the frequency of service

33. O&MSRS Recommendation of Services Amount of ServiceExplanation Service not indicatedStudent does not require service 1 to 5 times per yearWith student or consultation other pertinent individuals 3 to 4 times per semesterDirect service in clusters; consultation with student or pertinent individuals 1 to 2 times per monthDirect service 1-2 times/month (20-60 minutes) 1 to 2 times per weekDirect service 1-2 times/week (30-40 minutes) 2 or more times per weekDirect service 2 or more times/week (30-60 minutes)

34. O&MSRS+ Orientation and Mobility Severity Rating Scale for Students with Additional Needs

35. O&MSRS+ Eight Categories Level of Vision (Medical) Level of Vision (Functional) Use/proficiency of travel tools Communication Non-visual additional needs Level of supervision needed for safe travel Spatial/environmental conceptual understanding Compliance with instruction

36. O&MSRS+ Category Definitions Level of Vision (Medical): Refers to the student’s distance vision and/or peripheral vision as reported by an eye care specialist. Level of Vision (Functional): Refers to the student’s ability to use vision for all travel tasks (i.e., movement within the classroom, school building, and community) *Mastery of Cane Skills scores a zero regardless of vision

37. O&MSRS+ Category Definitions Use/Proficiency of Travel Tools: Refers to the student’s need for use and skill level of a white cane or alternative mobility device. Communication: Refers to the ability of the student to communicate with the O&M specialist and benefit from instruction. *Students with little ability to communicate with the O&M specialist may not benefit from a high level of direct O&M service.

38. O&MSRS+ Category Definitions Non-Visual Additional Needs: Refers to the impact of the additional needs on the instructional process. Students whose additional needs prevent progress in travel skills (i.e., cane travel, echolocation) may not benefit from a high level of direct O&M service Level of Supervison Needed for Safe Travel: Refers to the supervision needed to maintain the safety of the student during travel. Students requiring close supervision may not benefit from a high level of direct O&M service.

39. O&MSRS+ Category Definitions Spatial/Environmental Conceptual Understanding: Refers to the impact that the student’s level of concept development has on progress in travel skills (i.e., cane travel, echolocation). Students who are unable to improve conceptual understanding may not benefit from a high level of direct O&M service. Compliance with Instruction: Refers to the amount of time needed to manage the student’s behavior so that learning can take place. Students needing significant behavioral management may not benefit from a high level of direct O&M service.

41. O&MSRS+ Contributing Factors to Service Delivery Posture, gait, and motor development The nature of eye disease or condition Transition support needed Recent vision loss Complexity or introduction of new environment Potential for improvement of travel skills Age of onset of visual impairment Team availability for follow-up Instruction in low-vision aids Community-based instruction opportunities Other One or more of these factors may increase or decrease the frequency of service