Mobility Match
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Connecting You with Choices of Community Mobility
Physical Disabilities
Intellectual Disabilities
Autism Spectrum Disorder
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Occupational Therapy Community Mobility Skills Checklist for Individuals with Intellectual Disabilities (CMSC-ID)
Objective: This tool examines an individual’s functional skills and abilities in relation to the environmental and task demands required by different transportation types (excluding driving) to assist in identifying transportation options that support and/or increase safe and effective community mobility for individuials with physical disabilities and whether training is needed, or a companion is necessary.
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Default all Answers to Yes/Able
Default all Answers to No/Unable
Section I: Completed by Individual and/or Parent. Please indicate which of these transportation options are available in the community and if used or tried.
Options
Public (City) Bus
Coach (Intercity Bus)
Train/Subway Trolley/Tram
Taxi
E-hailing (Uber, Lyft)
Ferry
Walk
Bicycle/Scooter
Other
Available
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Tried
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Use
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Select
Yes
No
Section II: Completed by Occupational Therapist or Service Provider. Please identify the level of independence or assistance needed for each of the functional skills and ability items.
Functional Skills and Abilities: Is the individual able to: Ex. = Example
Skill Level
Comments
Cognitive
1. Ambulate independently, including steps/stairs
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
2. Physically maneuver within a familiar or unfamiliar environment
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
3. Recognize and follow signage with no external cues (Ex: driver wave, vehicle signal lights)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
4. Scanning the environment for safety when exiting the vehicle or getting off the bus
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
5. Initiate use and secure own seatbelt, if appropriate.
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
6. Maintain attention to anticipate correct destination/stop
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
7. Plans a trip considering time to and from destination
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
8. Read and decipher a schedule
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
9. Navigate/wayfinding with a schematic, map, or GPS (Ex: start point, within transport center, destination)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
10. Manage money/money card/fare card to pay for and register travel
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
11. Problem-solve when a problem arises (e.g., cancellation, delay).
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
12. Use appropriate wear for weather (e.g., rain, snow boots)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
13. Plan ahead to carry water, food, charged cellphone, and /or medication as needed.
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
14. Cross a street with traffic signals and pedestrian controls while monitoring vehicle traffic
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
15. Cross a street without pedestrian controls (with/without traffic signals)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
16. Awareness of people who may take advantage of individual (e.g.scammers, con artists, grooming).
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
Communication
17. Able to hail a taxi or flag a bus for stopping
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
18. Communicate needs effectively with a driver; knowing when and if appropriate (Ex: when getting on a bus, not while driving)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
19. Communicate identification information and/or phone number to an appropriate individual
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
20. Use a cellphone/mobile phone for requesting and managing service (Ex: apps for ordering rideshare)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
21. Recognizes an emergency situation and contacts the correct person (Ex: caregiver vs 911)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
Behavioral
22. Tolerates motion of vehicles (including bus, train, ferry)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
23. Follow social etiquette for community mobility (Ex: no feet on seats, does not intrude on other passengers’ space)
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
24. Sit or stand without disruptive behavior during the trip
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
25. Recognize and respond appropriately to one's current level of energy or pain
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
26. Recover from feelings of being overwhelmed or anxious if a problem occurs in order to continue the travel
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
27. Aware and plan for potential discomfort, fatigue or pain with travel.
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands
28. Aware of unsafe situations or dangers in the environment and appropriately respond or adapt (e.g., broken sidewalk, construction, detour).
Select
Performs Independently
Potentially Able with Training
Unable to Meet Demands