Michigan Severity Rating Scales: Solving the Puzzle of Service Delivery Time.

Michigan Severity Rating Scales:Michigan Severity Rating Scales:Solving the Puzzle of Service Delivery TimeSolving the Puzzle of Service Delivery Time

Michigan Severity Rating ScalesTools Supported by Data

Michigan Severity Rating ScalesTools Supported by Data

Orientation and Mobility Severity Rating Scale (O&MSRS)

Orientation and Mobility Severity Rating Scale for Students with Additional Needs (O&MSRS+)

Vision Services Severity Rating Scale (VSSRS)

Vision Services Severity Rating Scale for Students with Additional Needs (VSSRS+)

Orientation and Mobility Severity Rating Scale (O&MSRS)

Orientation and Mobility Severity Rating Scale for Students with Additional Needs (O&MSRS+)

Vision Services Severity Rating Scale (VSSRS)

Vision Services Severity Rating Scale for Students with Additional Needs (VSSRS+)

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Michigan Severity Rating ScalesHistory and Development


Adapted from the Montgomery County, Pennsylvania model beginning in 1995

Published and disseminated by the Michigan Department of Education – Special Education Services in 1996

Adapted from the Montgomery County, Pennsylvania model beginning in 1995

Published and disseminated by the Michigan Department of Education – Special Education Services in 1996

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First versions – 1996 and supported by the Michigan Department of Education – Special Education Services

Michigan Department of Education-Low Incidence Outreach (MDE-LIO) created and sponsored committees beginning in 2007 to revise the three existing scales and develop the O&MSRS+

First versions – 1996 and supported by the Michigan Department of Education – Special Education Services

Michigan Department of Education-Low Incidence Outreach (MDE-LIO) created and sponsored committees beginning in 2007 to revise the three existing scales and develop the O&MSRS+



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Web search indicated the Scales were being used and referenced in documents in several other states

Referred to in O&M university preparation programs

Internationally recognized

Web search indicated the Scales were being used and referenced in documents in several other states

Referred to in O&M university preparation programs

Internationally recognized



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Michigan Severity Rating ScalesMichigan Severity Rating Scales

What they are:

• Data collection tools

• A guide based on best practices

• Guideline for IEP team service discussion

What they are:

• Data collection tools

• A guide based on best practices

• Guideline for IEP team service discussion

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Michigan Severity Rating ScalesMichigan Severity Rating Scales

What they are not:

• Not an assessment

• Not a severity of disability but a severity of student’s need for services

• Not a pre-determiner of service

• Not the only data source

What they are not:

• Not an assessment

• Not a severity of disability but a severity of student’s need for services

• Not a pre-determiner of service

• Not the only data source

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Michigan Severity Rating ScalesThe Surveys


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2011 – MDE-LIO partnered with the Department of Blindness and Low Vision Studies – WMU

Dr. Robert Wall-Emerson & Dr. Dawn Anderson oversaw the development of the surveys

Surveys administered by MDE-LIO and sent to listserves in early 2012

2011 – MDE-LIO partnered with the Department of Blindness and Low Vision Studies – WMU

Dr. Robert Wall-Emerson & Dr. Dawn Anderson oversaw the development of the surveys

Surveys administered by MDE-LIO and sent to listserves in early 2012

Number of respondents in the national surveyNumber of respondents in the national survey

O&MSRS / O&MSRS+ O&MSRS / O&MSRS+

125 complete or partial125 complete or partial

VSSRS / VSSRS+VSSRS / VSSRS+

103 complete or partial 103 complete or partial

Number of respondents in the national surveyNumber of respondents in the national survey

O&MSRS / O&MSRS+ O&MSRS / O&MSRS+

125 complete or partial125 complete or partial

VSSRS / VSSRS+VSSRS / VSSRS+

103 complete or partial 103 complete or partial



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Survey questions included:

• O&M, TCVI or Dual service provider• Previous experience with the scales• When the Scale is completed & with whom• Are the Scales used for caseload analysis and

how important of a role do they play?

Survey questions included:

• O&M, TCVI or Dual service provider• Previous experience with the scales• When the Scale is completed & with whom• Are the Scales used for caseload analysis and

how important of a role do they play?



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Respondents read scenarios and Respondents read scenarios and answered questions based on student answered questions based on student profilesprofiles

•How well are areas of concern covered?How well are areas of concern covered?•How well do contributing factors address adding How well do contributing factors address adding or subtracting from service time?or subtracting from service time?•How well do service times match instructional How well do service times match instructional needs?needs?•What are the reasons if recommended service What are the reasons if recommended service time can’t happen?time can’t happen?

Respondents read scenarios and Respondents read scenarios and answered questions based on student answered questions based on student profilesprofiles

•How well are areas of concern covered?How well are areas of concern covered?•How well do contributing factors address adding How well do contributing factors address adding or subtracting from service time?or subtracting from service time?•How well do service times match instructional How well do service times match instructional needs?needs?•What are the reasons if recommended service What are the reasons if recommended service time can’t happen?time can’t happen?

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Reliability (precision)Reliability (precision)Respondents overwhelmingly identified the Respondents overwhelmingly identified the scales as measuring the significant factors to be scales as measuring the significant factors to be considered in determining service time for O&M considered in determining service time for O&M and Vision Servicesand Vision Services

Validity (accuracy)Validity (accuracy)O&MSRS above 90%O&MSRS above 90%

O&MSRS+ 84%O&MSRS+ 84%

VSSRS 87%VSSRS 87%

VSSRS+ 79%VSSRS+ 79%




VSSRS 87%VSSRS 87%


Orientation & Mobility Severity Rating Scale


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Fill out the student information on the Fill out the student information on the Severity of Need ProfileSeverity of Need Profile

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The numbers attached to each severity of The numbers attached to each severity of need are considered part of a continuum.need are considered part of a continuum.

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Each of the Severity of Each of the Severity of Need categories is Need categories is structured in terms of structured in terms of impact on independent impact on independent travel skills as it relates travel skills as it relates to the student's age to the student's age appropriate needsappropriate needs

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Severity of Need CategoriesSeverity of Need Categories

Refers to the student's distance vision Refers to the student's distance vision and/or peripheral vision as reported and/or peripheral vision as reported

by an eye care specialistby an eye care specialist

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Refers to the student's ability to use vision Refers to the student's ability to use vision for all travel tasksfor all travel tasks

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Refers to the student’s need for use Refers to the student’s need for use and skill level of a white cane or and skill level of a white cane or

alternative mobility devicealternative mobility device

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Refers to possible situations when a discrepancy Refers to possible situations when a discrepancy exists between the student’s actual functioning in exists between the student’s actual functioning in

travel skills and the projected level of independence travel skills and the projected level of independence based on the O&M Specialist’s professional judgmentbased on the O&M Specialist’s professional judgment

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Refers to the student’s ability to travel safely and Refers to the student’s ability to travel safely and proficiently in a familiar environment (i.e., school, proficiently in a familiar environment (i.e., school, neighborhood) based on current literature of age neighborhood) based on current literature of age

appropriate travel levels and expectationsappropriate travel levels and expectations

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Refers to the student’s conceptual understanding Refers to the student’s conceptual understanding and how O&M progress is affectedand how O&M progress is affected

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Refers to the type of environment Refers to the type of environment in which instruction is required in which instruction is required

(i.e., business district, new school, neighborhood)(i.e., business district, new school, neighborhood)

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Refers to whether the student has the opportunity to Refers to whether the student has the opportunity to use O&M skills in the community, at home, etc. use O&M skills in the community, at home, etc.

outside of O&M instructional timeoutside of O&M instructional time

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Total the right hand column to obtain a “Severity of Need Score” at the bottom

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Severity of Need SummarySeverity of Need Summary

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If appropriate, fill If appropriate, fill out the Contributing out the Contributing Factors to Service Factors to Service Delivery on the Delivery on the Student Student Performance Performance Summary by adding Summary by adding or subtracting .5 or subtracting .5 pointspoints


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Locate the range Locate the range which contains the which contains the Final Severity of Final Severity of Need Score to Need Score to determine the determine the frequency of servicefrequency of service

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Completion of the O&MSRSCompletion of the O&MSRS

Sam is an 8Sam is an 8thth grade student in general education classes. He grade student in general education classes. He has a diagnosis of ocular albinism and a recent low vision has a diagnosis of ocular albinism and a recent low vision examination indicated a visual acuity of 20/200 OU. He has examination indicated a visual acuity of 20/200 OU. He has excellent orientation to his community and can describe routes excellent orientation to his community and can describe routes from his house to many destinations including the names of from his house to many destinations including the names of streets in his description. He has experience using public streets in his description. He has experience using public transportation with family and friends. He rarely has access to a transportation with family and friends. He rarely has access to a computer except during directed class time and has little computer except during directed class time and has little experience using internet mapping sites for route planning or to experience using internet mapping sites for route planning or to preview unfamiliar destinations.preview unfamiliar destinations.

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DiscussionDiscussion

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Orientation & Mobility Severity Rating Scale +Orientation & Mobility Severity Rating Scale +


The Level of Vision (Medical)The Level of Vision (Medical)is identical to the O&MSRSis identical to the O&MSRS

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Refers to the student's ability to use vision for all travel tasks (i.e. movement within the classroom,

school building and community) as reported by the Orientation & Mobility Instructor

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Refers to the student's need for use and skill level of a white cane

or alternative mobility device



Refers to the ability of the student to communicate Refers to the ability of the student to communicate with the O&M Specialist and benefit from instruction. with the O&M Specialist and benefit from instruction.

Students with little ability to communicate with Students with little ability to communicate with the O&M Specialist may not benefit from a the O&M Specialist may not benefit from a

high level of direct O&M servicehigh level of direct O&M service

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Refers to the impact of the additional needs on the Refers to the impact of the additional needs on the instructional process. Students whose additional instructional process. Students whose additional

needs prevent progress in travel skills may not needs prevent progress in travel skills may not benefit from a high level of direct O&M servicebenefit from a high level of direct O&M service

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Refers to the supervision needed to maintain the Refers to the supervision needed to maintain the safety of the student during travelsafety of the student during travel

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Refers to the impact that the student’s level of Refers to the impact that the student’s level of concept development has on progress in travel skillsconcept development has on progress in travel skills

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Refers to the amount of time needed toRefers to the amount of time needed to manage the manage the student’s behavior so that learning can take placestudent’s behavior so that learning can take place

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Severity of Need ScoreSeverity of Need Score

As with the O&MSRS, As with the O&MSRS,

total the right hand column to obtain a total the right hand column to obtain a

““Severity of Need Score” at the bottomSeverity of Need Score” at the bottom


Fill out the student information Fill out the student information

on the second pageon the second page

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If appropriate, fill If appropriate, fill out the Contributing out the Contributing Factors to Service Factors to Service Delivery on the Delivery on the Student Student Performance Performance Summary by adding Summary by adding or subtracting .5 or subtracting .5 pointspoints

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Completion of the O&MSRS+Completion of the O&MSRS+

Rochelle is a severely multiply impaired student in a center Rochelle is a severely multiply impaired student in a center based program. Her visual acuity is estimated at 20/100 in both based program. Her visual acuity is estimated at 20/100 in both eyes. There is no suspected field loss. She is able to use a eyes. There is no suspected field loss. She is able to use a power chair for independent mobility, however, she frequently power chair for independent mobility, however, she frequently refuses to operate the joystick and waits for staff to drive her to refuses to operate the joystick and waits for staff to drive her to her destination. When motivated, she is able to negotiate her destination. When motivated, she is able to negotiate around furniture and through doors, but at a very slow speed. around furniture and through doors, but at a very slow speed. She has little expressive language other than some inconsistent She has little expressive language other than some inconsistent ability to point to symbols on a communication board to indicate ability to point to symbols on a communication board to indicate basic wants and needs. She is dependent on others for basic wants and needs. She is dependent on others for transfers and all activities of daily living.transfers and all activities of daily living.

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Vision ServicesSeverity Rating Scale


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Each of the eight categories ach of the eight categories listed on the VSSRS, listed on the VSSRS, Severity of Need Profile is Severity of Need Profile is structured in terms of the structured in terms of the impact on vision functioning impact on vision functioning as it relates to the student's as it relates to the student's educational programeducational program

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Level of Vision (Medical) is identical Level of Vision (Medical) is identical to the O&M Scalesto the O&M Scales

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Severity of Need Categories

Refers to the student’s level of functional near vision as determined by the TCVI or TVI (Appendix A)

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Refers to the student's primary mode of learning (i.e., Refers to the student's primary mode of learning (i.e., braille, print, print modifications, braille, print, print modifications,

auditory, or combination)auditory, or combination)

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Refers to the student's need for and use of low vision Refers to the student's need for and use of low vision devices and technology to facilitate maximum devices and technology to facilitate maximum

participation in the general education curriculumparticipation in the general education curriculum

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Refers to the estimated time needed by the TCVI or Refers to the estimated time needed by the TCVI or TVI to modify materials necessary for the student's TVI to modify materials necessary for the student's

participation in their educational programparticipation in their educational program

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Refers to instruction in skills such as auditory and Refers to instruction in skills such as auditory and tactile efficiency, awareness of body in space, social tactile efficiency, awareness of body in space, social

skills, activities of daily living, etc.skills, activities of daily living, etc.

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Refers to the amount of time needed for Refers to the amount of time needed for communication with school personnel, parents, communication with school personnel, parents,

medical personnel, technology support personnel medical personnel, technology support personnel and agencies concerning the student’s and agencies concerning the student’s

educational program. educational program.

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Severity of Need ScoreSeverity of Need Score

As with the O&M Scales, As with the O&M Scales,

total the right hand column to obtain a total the right hand column to obtain a

““Severity of Need Score” at the bottomSeverity of Need Score” at the bottom


Fill out the student information Fill out the student information

on the second pageon the second page




Contributing factors are Contributing factors are different so as to different so as to address the additional address the additional needs of students needs of students receiving Vision receiving Vision Services. Add or Services. Add or subtract .5 points. subtract .5 points. Direct Curriculum Direct Curriculum Instruction may receive Instruction may receive more pointsmore points

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Completion of the VSSRSCompletion of the VSSRS

Ashley is an 11 year girl with a history of retinopathy of Ashley is an 11 year girl with a history of retinopathy of prematurity according to an ophthalmology report. She has no prematurity according to an ophthalmology report. She has no light perception. light perception. Ashley has received TCVI services since enrolled in Early Intervention Ashley has received TCVI services since enrolled in Early Intervention Home Based Service. She is transitioning to Middle School and is Home Based Service. She is transitioning to Middle School and is enrolled in general education classes for much of her day. She will enrolled in general education classes for much of her day. She will have access to a generic special education resource room for pull out have access to a generic special education resource room for pull out services.services. Ashley is a fluent Braille reader and reads often for pleasure. She Ashley is a fluent Braille reader and reads often for pleasure. She struggles with math and has not mastered basic math concepts. The struggles with math and has not mastered basic math concepts. The TCVI will provide significant follow-up to Ashley’s general education TCVI will provide significant follow-up to Ashley’s general education math class. math class.



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Completion of the VSSRS cont.Completion of the VSSRS cont.

She is demonstrating an aptitude for using the braillenote and She is demonstrating an aptitude for using the braillenote and continues to improve in use of it. Use of the computer is continues to improve in use of it. Use of the computer is challenging for her and she knows approximately half of the challenging for her and she knows approximately half of the alphabet keys. She can type 8 words a minute with 60% alphabet keys. She can type 8 words a minute with 60% accuracy. She is being introduced to JAWS.accuracy. She is being introduced to JAWS.

A certified braillist is housed at the elementary school and A certified braillist is housed at the elementary school and materials for middle school which are given ahead of time can materials for middle school which are given ahead of time can be prepared by this person. It is anticipated that some regular be prepared by this person. It is anticipated that some regular material preparation / adaption will be required of the TCVI material preparation / adaption will be required of the TCVI during middle school. A paraprofessional will be available for during middle school. A paraprofessional will be available for Ashley in Middle School and will be assigned to provide Ashley in Middle School and will be assigned to provide assistance in classes such as Science and Physical Education assistance in classes such as Science and Physical Education and others to be determined. and others to be determined.



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Vision ServicesSeverity Rating Scale+


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Category 1 refers to the student's level of distance Category 1 refers to the student's level of distance vision as reported by an eye care / low vision vision as reported by an eye care / low vision

specialist and category 2 refers to the student's specialist and category 2 refers to the student's ability to apply visual skills to the educational settingability to apply visual skills to the educational setting

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Refers to the impact of these delays Refers to the impact of these delays on the student’s ability to benefit from on the student’s ability to benefit from

services from the TCVI / TVIservices from the TCVI / TVI

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Refers to the ability of the student to respond to Refers to the ability of the student to respond to stimulation and/or instructionstimulation and/or instruction

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Refers to the level of independence Refers to the level of independence in skills of daily livingin skills of daily living

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Refers to the estimated time needed by the Refers to the estimated time needed by the TCVI or TVI to modify materials TCVI or TVI to modify materials

necessary for the student's participation necessary for the student's participation in their educational programin their educational program

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Refers to the amount of time needed for Refers to the amount of time needed for communication with school personnel, parents, communication with school personnel, parents,

medical personnel, technology support personnel medical personnel, technology support personnel and agencies concerning the and agencies concerning the student’s educational programstudent’s educational program

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Contributing factors are Contributing factors are different so as to different so as to address the additional address the additional needs of these needs of these students. Add or students. Add or subtract .5 points. Age subtract .5 points. Age of student and of student and Direction Curriculum Direction Curriculum Instruction may receive Instruction may receive more points.more points.

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Completion of the VSSRS+Completion of the VSSRS+

Clark is a 3 year old with a history of trauma during delivery. He Clark is a 3 year old with a history of trauma during delivery. He has an undiagnosed visual impairment and began a school has an undiagnosed visual impairment and began a school program at the beginning of this school year in a program for program at the beginning of this school year in a program for students with severe multiple impairments. He does not have a students with severe multiple impairments. He does not have a blink reflex, but parents feel that he recognizes their faces and blink reflex, but parents feel that he recognizes their faces and he passed a vision screening to the one month developmental he passed a vision screening to the one month developmental level with an early intervention teacher who is not a vision level with an early intervention teacher who is not a vision services specialist. Clark did not receive services from a services specialist. Clark did not receive services from a Teacher of the Visually Impaired prior to enrolling in school. He Teacher of the Visually Impaired prior to enrolling in school. He has extremely low tone and is unable to participate in activities has extremely low tone and is unable to participate in activities of daily living. He fusses when he is not held and is difficult to of daily living. He fusses when he is not held and is difficult to quiet. Clark is in a classroom where several other children quiet. Clark is in a classroom where several other children receive consultation from the TCVI. receive consultation from the TCVI. 11-2-12 69




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Michigan Severity Rating ScalesSurvey Findings

Michigan Severity Rating ScalesSurvey Findings

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VSSRS 87%VSSRS 87%





VSSRS 87%VSSRS 87%


Michigan Severity Rating ScalesCaseload Analysis

Michigan Severity Rating ScalesCaseload Analysis

Service information from the Michigan Severity Service information from the Michigan Severity Rating ScalesRating Scales

Additional hours per week needed for support Additional hours per week needed for support

Hours per week for travelHours per week for travel

Tools for caseload analysisTools for caseload analysis

http://tinyurl.com/453fy8j http://tinyurl.com/453fy8j

http://tinyurl.com/43ebsrxhttp://tinyurl.com/43ebsrx

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Contact InformationContact Information

[email protected]@michigan.gov

[email protected]@michigan.gov

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Michigan State Board of Education

Michigan State Board of Education

John C. AustinPresident

Casandra E. Ulbrich Vice PresidentNancy Danhof

SecretaryMarianne Yared McGuire

Treasurer

John C. AustinPresident

Casandra E. Ulbrich Vice PresidentNancy Danhof

SecretaryMarianne Yared McGuire

Treasurer

Richard ZeileNASBE Delegate

Kathleen N. Straus

Daniel Varner

Eileen Lappin Weiser

Richard ZeileNASBE Delegate

Kathleen N. Straus

Daniel Varner

Eileen Lappin Weiser

Rick Snyder, GovernorRick Snyder, Governor

Michael P. FlanaganMichael P. FlanaganSuperintendent of Public InstructionSuperintendent of Public Instruction

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Michigan Severity Rating Scales: Solving the Puzzle of Service Delivery Time.

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