Clinical pathway

Community mobility

The student is hesitant or unsafe navigating hallways, stairs, crowds, curbs, or unfamiliar community settings.

Step 1

Occupational performance problem

The student is hesitant or unsafe navigating hallways, stairs, crowds, curbs, or unfamiliar community settings.

Step 2

Clinical reasoning

  • Distinguish confidence from capability — both need intervention, but not the same one.
  • Depth, contrast, and lighting transitions are frequent culprits at stairs and doorways.
  • Coordinate with O&M and TVI colleagues when a documented visual impairment is involved.

Step 3

Likely limiting level

  • Level 1: Visual Access

    Contrast and field determine what can be detected in travel.

  • Level 5: Functional Integration

    Travel demands sustained visual work while moving.

Step 4

Intervention options

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Step 5

Movement-based options

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Step 6

Teacher strategies

  • High-contrast stair edges and doorway markings on the student's route.
  • Consistent, rehearsed routes before novel ones; early passing time when hallways are crowded.

Step 7

Parent carryover

  • Practice familiar community routes at low-traffic times, then increase complexity.

Step 8

Progress monitoring

  • Level of assistance on a defined route.
  • Student-reported confidence rating before and after.

Step 9

Reassessment

Re-screen the limiting level after 6–8 weeks of consistent intervention. If the occupational problem has not changed while the contributing level has, look upstream for a different limiting factor. If neither has changed, or symptoms are worsening, refer out rather than continuing to treat.