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Direct Service
CATEGORYLOW NEEDS - 1AVERAGE NEEDS - 3HIGH NEEDS - 5SCORE
VISION
  • No "severe vision loss" noted on eye report, but ability to attend to visual stimuli is questionable
  • Uses vision very well in a variety of settings
  • Very sure of functional vision
  • Visual diagnosis made over 1 year ago
  • Vision is not expected to change in the next 6 months
  • Able to attend to visual stimuli
  • New visual skills being developed
  • Visual diagnosis made 1 year ago
  • Unsure of functional vision
  • Difficulty attending to visual stimuli
  • Vision fluctuates
  • Severe vision loss or totally blind
  • Prognosis for improved visual functioning appears to be good (CVI, ROP)
  • Progressive loss of vision expected in next 6 months
  • Visual diagnosis made less than 1 year ago
DIRECT SCORE
HEALTH
  • Very Medically Fragile
  • No health concerns
  • Some health concerns (nutrition, etc.)
  • Chronic ear infections
  • Very premature/low birth weight
  • Significant time spent in hospital
DIRECT SCORE
OTHER IMPAIRMENTS
  • No additional impairment
  • Additional impairment
Two or more additional impairments DIRECT SCORE
DEVELOPMENTAL
  • No developmental delays
  • Very slight developmental delays
  • Vision loss may be contributing to developmental delays
  • Modifications needed
DIRECT SCORE
FAMILY MEMBERS/PRIMARY CAREGIVER
  • Does not want additional professionals making weekly home visits
  • Understands about their child's vision
  • Distressed about issues other than this child (Financial, Marital, etc.)
  • Does not readily participate in parent child trng.
  • Needs help learning about the educational systems
  • Want additional resource info
  • Need information about getting the most out of ophthalmological appointments and interpreting reports
  • Has lots of vision related concerns
  • Needs lots of info about their child's vision
  • Needs additional support
  • Grief issues about vision
  • Needs help bonding with child
  • Needs help reading child's communicative cues
DIRECT SCORE

 

Consulting Service
CATEGORYLOW NEEDS - 1AVERAGE NEEDS - 3HIGH NEEDS - 5SCORE
PROFESSIONALS ON TEAM
  • All have experience working with babies with similar vision
  • No questions about ECI or ISD procedures
  • Few questions about ECI or ISD procedures
  • Few questions about assessment, stategies, etc.
  • Have no experience working with child with visual impairment
  • Need training in implications, modifications, strategies, communicative cues, etc. for child with VI
CONSULT SCORE
VI TEACHER (Activities in Support of Instruction)
  • Has significant experience working with babies, babies with visual impairments, and babies with multiple impairments
  • Has moderate experience working with babies, babies with visual impairments, and babies with multiple impairments
  • Has little or no experience with babies
  • Needs time to learn from other professionals on team (Motor, Handling, Communication, Infant Development, Working with Families, etc.)
  • Suspected or diagnosed auditory impairment
ACTIVITIES IN SUPPORT OF INSTRUCTION SCORE
OTHER    
  • Child actively explores environment
  • Needs adaptations to learn basic concepts
  • Needs help to generalize skills
  • Needs more exposure to concrete experiences to develop language skills
  • Body imaging, spatial awareness
DIRECT OR CONSULT SCORE
*PROFESSIONAL JUDGEMENT FACTORS (POSITIVE OR NEGATIVE)       DIRECT OR CONSULT SCORE
TOTAL SCORES DIRECT SCORE CONSULTING SCORE ACTIVITIES IN SUPPORT OF INSTRUCTION SCORE  

*PROFESSIONAL JUDGEMENT FACTORS:

(THESE CAN BE POSITIVE OR NEGATIVE)

SCORE FACTORS BRIEF DESCRIPTION
  Age of Student  
  Transition Issues  
  Parent Concern/Issues  
  Attendance  
  Home Environment  
  VI Teacher Issues  
  Other Professional's Issues  
  Child Issues  
  Other  
  TOTAL  

 

DIRECT SCORE FREQUENCY AND AMOUNT: DIRECT SERVICES CONSULTING SCORE FREQUENCY AND AMOUNT: CONSULTING SERVICES ESTIMATED TIME FOR ACTIVITIES IN SUPPORT OF INSTUCTION
1-5 2 HOURS PER MONTH 1-2 2 HOURS PER MONTH PLANNING
6-20 1 HOUR PER WEEK OR 2 30 MIN. SESSIONS/WEEK 3-4 1 HOUR PER WEEK PREP
21-25 2 HOURS PER WEEK 5-9 2 HOURS PER WEEK LIAISON
26-30 3 HOURS PER WEEK 10+ 3 HOURS PER WEEK EVALUATIONS
30+ 3+ HOURS PER WEEK     IFSP
        MEETINGS
        OTHER

____ DIRECT SERVICE TIME

____ CONSULTING TIME

____ TRAVEL TIME

____ ACTIVITIES IN SUPPORT OF INSTRUCTION

____ TOTAL NUMBER OF HOURS

Teacher of the Visually Impaired

NOTE: To be used with: "GUIDELINES FOR AMOUNT OF SERVICE TO STUDENTS WITH VISUAL IMPAIRMENTS: SAMPLE" (Developed by the VI staff of Denton ISD, Revised by D. Leff and O.F. Morris), Found on pages B-57-58 of the Quality Programs For Students With Visual Impairments Manual

Adapted by Stacy Shafer from:

Michigan's Vision Severity Rating Scale
1996
Printed by the Office of Special Education Services, Michigan Department of Education