Free Orientation And Mobility Evaluation Template
Orientation And Mobility Evaluation
Date: January 20, 2055
Purpose: The purpose of this evaluation is to assess the orientation, mobility skills, and safety awareness of individuals with visual impairments. The data collected will help identify strengths and areas for improvement in navigating and orienting within various environments.
Overview of the Evaluation: This evaluation consists of several criteria to assess different aspects of orientation and mobility skills. Participants will be asked to perform tasks and demonstrate their abilities in various scenarios. The evaluation aims to provide a comprehensive understanding of an individual's navigation skills and safety awareness.
Instructions: Please carefully review each criterion and provide your feedback accordingly. You can rate each criterion on a scale from 1 to 5, with 1 being the lowest and 5 being the highest. Additionally, feel free to provide additional comments or suggestions in the designated section at the end of the form.
Rating Scale
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1 - Poor
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2 - Fair
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3 - Good
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4 - Very Good
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5 - Excellent
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Evaluation Metric |
Description |
Rating |
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Route Planning |
Ability to plan and select appropriate routes for navigation, considering obstacles, landmarks, and cues. |
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Orientation Skills |
Proficiency in determining location and direction within an environment, using orientation techniques. |
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Mobility Techniques |
Competence in using mobility aids (e.g., cane, guide dog) and techniques for safe and efficient navigation. |
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Safety Awareness |
Awareness of potential hazards and ability to navigate safely, including crossing streets and avoiding obstacles. |
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Problem-Solving |
Capacity to solve navigation-related problems encountered during travel, such as finding alternative routes. |
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Environmental Awareness |
Awareness of environmental features and changes, such as changes in terrain or landmarks. |
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Confidence |
Level of confidence in navigating independently and interacting with the environment. |
Additional Comments & Notes:
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Additional Comments & Notes |
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