Service delivery models

This is a discussion board entry that only has to be a paragraph or so, not too long. Use simple wording and cite. You also have to add comments two of my classmates’ responses with a sentence or two. The other responses will also help you see what others submitted for ideas but don’t copy. Also attached lecture notes. This needs to be done asap, please let me know if you have any questions.


The question:

  • Discuss your experience with, or understanding of, service delivery models discussed in Module 2 lecture and readings.  Please do not duplicate pros and cons presented in the lecture, rather share your perspective.


This should be based on my understanding because I never experienced 0&M training before, or anything related. -most of my work currently is centered based as I work in a clinic and we don’t do house visits.



Other students’ responses: You only have to respond to two:

Response 1

I’ve worked in hospitals and clinics that would fall in the center-based model of service delivery but we would occassionally go out onto home visits. To me, this is a way for a client to learn initial skills in a controlled environment, and then transition into a more realistic environment with more normal challenges the client would face everyday. This also allows for the client to practice the actual route or in their home where they’ll be living and traveling. I have also worked using the itinerant model as a home health occupational therapist for a couple years. This model is sometimes good because the client can practice in their actual living area but sometimes not all of the practice and trial equipment is available as might be in a center-based model.

From the aspect of being a new low-vision therapist or O&M specialist, I like the idea of having other professionals on-site that I could collaborate with as opposed the itinerant/traveling O&M specialist. The itinerant model of service delivery might be better suited to an O&M specialist with a lot of experience from a provider’s perspective who is already competent and confident in their professional skills and abilities because they will usually be working alone.



Response 2

What I personally like about both the itinerant and center-based model is that both are very focused on the student and allow them to be comfortable with the tools and skills that make up O&M. Both models’ main goal is for the student to learn techniques in a wide variety of settings to safely navigate from one point to another.

When I had O&M services in middle/high school, we used the itinerant approach when I was learning how to use MARTA (Metropolitan Atlanta Rapid Transit Authority). I liked this approach of learning O&M because I got really comfortable using my cane in places that were relevant to me, such as taking the train to the airport, riding the bus to the mall, or going to ATL. It also helped me to be more comfortable if people I personally knew saw me in town with my cane. It was challenging and embarrassing at first, but with more practice and exposure it got a little less scary. I liked this way of learning O&M because it allowed me real life experiences when first learning to use the cane. I also faced fears like walking across the street blindfolded.


If I were an O&M specialist using the itinerant method it would be challenging because I don’t drive. I have friends of mine who are O&M instructors who have so much stuff in their cars for lessons. I would not be able to have my office in my car (like the book describes). I wonder how O&M instructors (who are blind/visually impaired or don’t drive for other reasons) transport all the equipment without a vehicle. Additionally, the center-based model is a much better approach for rural areas, instructors who don’t drive, etc.  This approach would be great for refreshing or doing workshops, but it doesn’t give individuals enough experience in “the real world”. Additionally, I do like that more lessons can be accomplished using this model. I hope that places such as rural Georgia can implement the center-based model more into their communities. These areas are very isolating  and having a center in the community to be trained in O&M and other skills could be very beneficial. Right now, there is a lack of service in Georgia. It can take individuals hours living in rural areas to go to a vision rehabilitation center.


In both models, it is important that the educational team is always in communication with one another. No matter what the model is, the education team’s main goal is for the student’s O&M goals and objectives be reached utilizing tools, services, and strategies within the field. I like that while the models differ in approach, the fundamentals don’t. At the end of the day, both models are to help students with visual impairments to become independent individuals utilizing tools and services for safe and efficient travel.


Pogrund, R. L., & Griffin-Shirley, N. (2018). Partners in O&M:  Supporting orientation and mobility for students who are visually  impaired (pp. 1-11, 15-19). New York, NY: AFB Press,  American Foundation for the Blind.


Response 3

I currently work for a VA Eye Clinic in Kansas with a Low Vision team including O&M and LVT. We currently utilize both models of instruction – center based at our clinic and Itinerant, frequently traveling to our veterans to administer services. Our clinic serves the majority of the state and there is no set territory – essentially if a veteran wishes to have services through our clinic; we will also serve them in their home/area. We generally wish to see them in the clinic first, to establish care with our OD but also because we can offer other services through LVT, assitive devices, additional training and the like.  After that inital visit then the veteran may continue care through either model as they wish. When we do utilize the Itinerant model our reach is very broad, as we service such a large swath of the state and into Colorado, Oklahoma and Nebraska. Typical travel time could be anywhere from 30min to 3hr for a lesson/training session.


Throughout the last year we have had challenges on how we were able to administer services due to restrictions with Covid. We had significant limitations as we could no longer travel to homes and our clinic also saw a reduction in how many we could see in a particular day. We were advised by the powers-that-be to attempt to do telehealth and other video conferencing type applications as much as possible but it was often insufficient for the type of care we needed to provide. This most likely slowed the progress of many of our veterans, most of which are on an already somewhat slow schedule. The clinic is now back to its normal operation (for the most part) but due to Covid, there was a significant backlog of those needing and seeking services.


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