Session 7: Wednesday October 21, 2015:CVI

Housekeeping Assessing CVI CVI Range CVI Case Study CVI Assignment: ONLY TIME FOR

QUESTIONS!!

Gathering information Interviews Observations Direct Evaluation Completing the range Writing goals or creating a program.

The type of information you gather for students with CVI will depend on the student.

There should always be an eye report documenting any other eye conditions or refractive errors.

Developmental records. Occupational Therapy/ Physical

Therapy/Speech Language Pathologist. Education or behavioural plans.

Interviews should be completed with anyone who is involved with the student and the students programming.

Parents or other caregivers Teachers, resource, guidance, daycare

workers and/or TA’s Conversations with any other specialists,

i.e., OT, PT or SLP.

What is the child’s medical background? What does the eye care specialist report? What, if anything, does the child prefer to look at? What are the concerns of the family and teachers? Does the child have a preferred colour? When is the child most visually alert or interactive? Does the child look directly into faces? Does the child notice things that move more than

things that are stable? Does the child seem to “look through” rather than

directly at objects?(Roman, 2010)

Observations should be conducted in as many environments as possible.

Indoor and outdoors at school. Home Daycare or after school programs.

Assessment should be conducted in any areas there still may be questions.

For example: Do they act differently in a controlled

environment? Can the environment be controlled to enable them to use their vision more efficiently?

Would they respond visually if the object were simple or bright? If the object produced sound?

Will they respond differently in different lighting? Do they recognize people without auditory or

movement clues?

“CVI can mask the symptoms of ocular impairment. This would make it impossible to assess the effects of an eye condition on the student’s use of existing vision until most of the effects of CVI were resolved.”

(Roman, 2010)

A study conducted on the reliability of the CVI range concluded that: “the results of the study indicate that this assessment has high interrater, test-retest, and internal consistency reliability” (The Reliability of the CVI Range: A Functional Vision Assessment for Children with Cortical Visual Impairment by Sandra Newcomb (JVIB, 2010).

The CVI range was created by Christine Roman Lansky, a teacher of students with Visual Impairments to be used by TVIs.

The range should be completed a minimum of three times a year.

The range plots the level of involvement of different characteristics and from here presents a level of CVI from 1-10.

Once a level is decided teachers can create plants to compensate for visual deficiencies and to support the student in gaining the next levels on the range.

Rating 1A checklist of characteristics or behaviours you

may see at the different stages.

Rating 2A range of numbers and you chose where the

student fits according to the scoring guide at the top.

How to combine them together:The lowest to highest score to represent the range

of functioning.

R the state represents a resolved visual behaviour

+ describes current functioning of student

=/- partially describes student- Does not apply to student

Peter was diagnosed with Septo Optic Dysplasia and Optic Nerve Hypoplasia at birth. At the age of two, he was diagnosed with CVI. He did not appear to have any vision when he was born.

Peter is now four, is learning to walk and is starting to use full sentences.

He is beginning to use his vision, but it is variable. He is in a busy daycare and at home has four siblings who are close in age.

Peter attends a small, but busy daycare. He has a full time assistant and many other professionals that see him throughout the day.

Peter does not appear to use his vision other than for navigating or light gazing unless he is in his “work corner.” This is a special area in the daycare, where Peter is able to go with his assistant or when his TVI comes to visit to work on his vision. They are working on the Lightbox level 1 materials and looking at images on the iPad.

When Peter started walking everyone was very excited. His family had been told, he may never walk. What was really amazing was how well Peter moved in his environment. He never bumped into other children, chairs or other obstacles. However, he would often trip over toys on the floor or a child lying on the floor colouring.

Although he misses most obstacles, Peter is completely unaware of where he is headed. For example he could not tell if the playground was up ahead or if that was the pond.

Peter has three toys that he takes with him everywhere. He will not look at or play with other toys.

He will play with kitchen utensils or ribbons on presents, but he has no interest in opening the present, seeing a toy inside or using the utensils to feed himself.

Peter’s playing consists mostly of mouthing or banging toys. With the utensils or ribbons he likes to wave them in front of his face.

If he drops any of these toys he is unable to find them again in the daycare and will instead stare at the lights on the ceiling.

When toys are given to Peter or presented to him on a table. He will respond only if there is nothing else on the table and it is a clear background. He will often take time to reach for the item and can be observed to look away when he finally decides to reach.

When new toys are introduced to Peter, he may take several introductions to the toy before he will attempt to reach for it. Distractions, such as the other kids or other objects on the table can delay the reach longer.

Peter does not notice people that come to see him or differentiate between kids in his class. His mother came to get him one day and didn’t say anything, but started to put his jacket on. He asked her if they were going out to the playground to wait for Mommy because he thought it was the daycare teacher.

Peter does not look directly at anyone and will look away or close his eyes when people are talking to him.

I have completed the CVI range, but now what?

Program planning using the range.

“Scaffolding” in education refers to building on what the student already knows and working from there. It is important with all students, but especially with students with CVI, to start where they are and build from there.

When planning for a child with CVI, look at where they are now, provide the accommodations they need and find little ways to move them to the next step. Such as: using colour preference to help transitioning to new objects, move from an isolated room to a safe place in the classroom, etc.

It often feels right to give help to people with visual impairments [and other disabilities], but this may not be in their best interest. Use this list to help yourself to step back. 1. You’re stepping back so your students can step forward and become independent. Keep this in mind. 2. Clock how long it actually takes for students to start zippers, pick up dropped papers, or find page numbers. What’s a few more seconds in the grander scheme? 3. Sit on your hands for a whole task while you practice giving verbal instead of touch cues. Hands off the hands! 4. If you need touch cues, try hand-under-hand instead of hand-over-hand. This gives students much more choice. 5. Let students make mistakes and get into trouble. It’s part of the human experience! 6. Acknowledge your own needs. There’s a reason you chose the helping profession. 7. Sit further away. If you’ve been within arms reach. Sit just within earshot. If you’ve been sitting within earshot, sit across the room. 8. Pat yourself on the back every time you help with seeing, not thinking. Your job is to give information. 9. Even though helping can feel right, be aware that too much assistance is short-sided. Sometimes less is more, less is better. 10. Catch yourself before you correct your student’s work. Don’t cover for them. This is about their skills…not yours. 11. Commit to no intervention for a whole activity. Take data instead. Things might not fall apart as much as you had expected. 12. “What page are you on?” “What’s for lunch?” Have students ask their classmates instead of you, both during school and on the telephone. 13. Assign student learning partners and sighted guides. 14. Teach students to decline assistance,” Thanks, but please let me try it by myself.” 15. Whenever you add prompts, include a plan to phase them out. 16. Let the boss know that you need to step back so that your students can be more independent. You’re not shrinking your responsibilities. 17. Collaborate with other adults to break your habits of helping too much. Agree to remind each other to step back. 18. Try helping only when classroom teachers give you a signal. They may prefer to respond directly, or to give students longer to work it out alone. 19. Post a sign, “Are there any other ways I could step back?” - Adapted from Classroom Collaborations by Laurel J. Hudson, Ph.D.