Main content

Alert message

Lynne:
So now we're going to look at the forms in the back of Christine Roman's book. 2 pages after page 185 starts the "Essential Forms" section. Look at the first form, which is called "The CVI Range: The Across-CVI Characteristics Assessment Method", or "Rating 1". We'll compare the notes we've taken from all of our information sources including the interview, the observation, and the direct assessment to the "CVI Range Scoring Guide" which is in the book on page 97, or appendix 5.A.

Sara:
The first statement in the first section, "CVI Range 1 to 2: Student functions with minimal visual response," is "May localize, but no appropriate fixations on objects or faces." We looked at our data sheets in the rows mentioned in the column on the Scoring Guide called "CVI Characteristic." Those were color, movement, latency, visual fields, complexity, and novelty. We found information from the interview and from the observation supporting that the description under the plus-minus column best describes Brandon. That is, He "gives brief, inconsistent attention toward an object or face."

Lynne:
The second statement is "Consistently attentive to lights or perhaps ceiling fans." We found information in the areas of movement, complexity, and light-gazing on our data sheets that best characterizes Brandon's behavior in the column plus-minus from all the data sheets: This says, "Occasionally able to attend to non-lighted targets, even in the presence of primary sources of light."

In the third statement, "Prolonged periods of latency in visual tasks," we found our data matched the plus column, which says "Demonstrates a delay in directing vision to a target every time or nearly every time a new object is presented or a new activity begins." We found that information from the observation and from the direct assessment data sheets in the latency row.

Sara:
The fourth statement, "Responds only in strictly controlled environments," we found to be more of a plus-minus, in that Brandon has "occasional attention to visual targets in the presence of certain or familiar visual, auditory, or tactile distractions." We found that kind of data in the complexity section of all of our data sheets.

The fifth statement, "Objects viewed are a single color," we found to also be a plus-minus because Brandon "Glances at or briefly fixates on objects of [his] favorite color and occasionally on objects of other colors," and because he "May also glance at or briefly fixate on objects that have more than a single color." We looked in the sections on color, complexity, and novelty, as suggested by the Scoring Guide and found support on all of our data sheets for this.

Lynne:
With the sixth statement, "Objects viewed have movement and/or shiny or reflective properties," the statement that seemed to fit Brandon the best was again the plus-minus, in that Brandon seems to "...need movement and/or shiny or reflective objects to initiate visual attention." He also "occasionally attends to objects without movement properties." Information from the interview and direct assessment data sheets confirmed this in the area of movement.

Statement seven, "Visually attends in near space only," was best defined by the plus-minus option when looking at Complexity and Distance viewing from all areas of the data, because Brandon "Occasionally glances at or fixates on objects beyond 18 inches."

Sara:
The eighth statement, "No blink in response to touch or visual threat," posed difficulty because we hadn't yet tested that, so we asked Brandon's classroom teacher, who is a teacher of the visually impaired, to test Brandon's blink response. He said that Brandon blinked consistently in response to being touched at the bridge of the nose, but not when an object was coming toward his face. We marked this in the column that was closest to that information: "Occasionally blinks in response to touch or threat." We counted that as part of the direct assessment.

The variation of the ninth statement, "No regard of the human face," that we found best described Brandon was the plus, or "No attention to human faces, may seem to 'look through' people." We found this from the interview section on complexity. We also noticed that Brandon did not look at people's faces throughout our interactions with him, but we did not mark it on any data collection sheet, we just made a mental note of it. This was a more global observation.

Lynne:
The second section, "CVI Range 3 to 4: Student functions with more consistent visual response," begins with "Visually Fixates when the environment is controlled." We found the plus statement in the CVI Range Scoring Guide, "Intermittent eye-to-object contact, but only when visual, auditory, and tactile distractors are reduced or eliminated," was true for Brandon from looking at the complexity section of the observation and direct assessment data sheets. The statement, "A small degree of additional sensory input may be tolerated while viewing," was true at times as well.

The second statement in this section, "Less attracted to lights; can be redirected," we found to be true in the plus column when looking at light gazing in the observation and direct assessment data. Brandon "may stare at lights, but is able to shift attention from lights when appropriate visual targets are presented in controlled environments."

Sara:
The third statement in this section, "Latency slightly decreases after periods of consistent viewing," seemed more true in the plus-minus column. We noticed, through the observation and direct assessment data in the area of latency, that the statement, "Delay in directing vision toward a target occurs frequently, but not every time a familiar target is presented," was the one that best matched the data we took.

The fourth statement, "May look at novel objects if they share characteristics of familiar objects," we found to be resolved. Many novel objects were presented in the direct assessment, and we had to take that into consideration. The ones Brandon was able to look at most quickly shared characteristics of familiar items, were one color as opposed to multi-colored, and were his favorite color. He was definitely able to look at unfamiliar items, sometimes only by glancing. Sometimes he looked for a bit longer. Not all seemed to resemble favorite or familiar items. We found that to be the case from the overall direct assessment, but not so much from single pieces of data.

Lynne:
The fifth statement is, "Blinks in response to touch and/or visual threat, but the responses may be latent or inconsistent." We found the variation in the plus-minus column to describe Brandon, "blinks to touch, but not to a target moving quickly toward the face," from what the teacher told us, which we counted as direct assessment.

The next statement, "Has a 'favorite' color," had a description in the plus column that seemed to match the data on color from all our collection sheets. Red seems to be Brandon's favorite color. The plus column states, "Continues to most consistently glance toward or have eye-to-object contact with targets made of a single, preferred color, over objects of all other colors."

Sara:
The sixth statement, "Shows strong field preferences," needs to be considered in that this is an ocular condition and cannot be resolved in the brain. The minus column best described Brandon's data from all sources, "Glances toward or has eye-to-object contact in one viewing field only."

The seventh statement is "May notice moving objects at 2 to 3 feet." We found this to be in the plus column from the interview and observation data on movement and complexity, and that Brandon "Glances toward or has eye-to-object contact with objects that move in space or are made of shiny or reflective materials and are at distances up to 3 feet."

Lynne:
The next statement, "Look and touch completed as separate events," seemed to ring true for Brandon in the plus-minus column from looking at visually guided reach in the observation and the direct assessment. Brandon "Occasionally uses visually guided reach."

We found all of the statements to fall in the minus category except the following in the next section, "CVI Range 5 to 6, Phase II: Student uses vision for functional tasks."

Sara:
The first statement, from information on color and complexity in the direct assessment, "Objects viewed may have two to three colors," seemed to fall more in the plus-minus column for Brandon: "Looks directly at targets that have two and occasionally three colors, preferred color is always one of the colors."

The second statement, "Light is no longer a distractor," applies to Brandon more in the plus-minus column again: we saw Brandon "Occasionally gazing at primary sources of light," during the observation and direct assessment and it was found in the section on light on the data sheets.

The third and fourth statements are minuses.

Lynne:
The fifth statement is "Student tolerates low levels of background noise." The plus-minus column described what we saw in Brandon, in that he "Occasionally is able to maintain visual attention in the presence of sound." We saw this from the observation and from the direct assessment in the area of complexity.

The sixth statement is "Blink response to touch is consistently present." We found that the plus-minus statement, "Emerging pattern of blink-to-touch response present," was the best description of Brandon's behavior, since his teacher said his blink to touch was consistent, but delayed.

The rest in this section were minuses.

Sara:
In the section on "CVI Range 7 to 8, Phase III: Student demonstrates visual curiosity," we marked three that were not minuses. The first one was the first statement, "Selection of toys or objects is less restricted; requires one or two sessions of 'warm up.'" The statement under the plus column, "Looks at new objects that have attributes of familiar objects: recognizes new object immediately after one to two presentations," seemed to best describe Brandon's visual behavior. We looked in the complexity and novelty rows of our data sheets and found information that supported this in the observation and direct assessment.

The second one was the second statement, "Competing auditory stimuli tolerated during periods of viewing; the student may now maintain visual attention on objects that produce music." In the column plus-minus, the statement "Occasionally is able to maintain visual attention while other sensory input competes," is true in the very occasional sense. We found this supporting data in the observation and direct assessments under complexity.

Lynne:
The third one, in the fourth statement "Latency rarely present," the plus-minus seemed to describe Brandon best: "Novel objects, complex environments, or fatigue may increase degree of delayed response." We saw Brandon's looking behaviors decrease after 10 to15 minutes of asking him to look at items. We found this in the direct and observation data in the area of latency.

All of the rest of Rating I were minuses.

On page 61 of "Cortical Visual Impairment" Roman writes "The individual statements that describe visual behaviors are matched to the child's visual responses and scored until a 'ceiling effect' has been reached. A ceiling effect occurs when the pluses that indicate the student's current level of functioning end, and a cluster of minuses occur for four or more consecutive items. The minuses indicate that the student has not yet reached the level of functioning described in that range. The student's score of the assessment is determined by the number of the CVI Range in which the last plus item occurs prior to the shift to scores of plus/minus and minus. Since each group of statements is identified by a range of two scores, the lower number of the range is assigned if the plus statements end in the middle of the cluster, the higher number is used if the plus-scored statements are marked to the end of the cluster."

Sara:
We had five plusses in Range 3 to 4 before scores turned to all plus/minus and minus, and they were dispersed throughout the cluster, so that would make Brandon's score for Rating I a four, which can be recorded on the front page.

The next section is called Rating II, the "Within-CVI Characteristics Method." The numbers stand for "not resolved" at 0, and in increments of .25, stand for various levels of resolution up to 1, which means "Resolved." These numbers correspond with numbers on the top row of the CVI Resolution Chart. The CVI Resolution Chart can be found at the end of the book within the forms in the same section as the CVI Range Ratings I and II. Rating II can be completed by matching the level of resolution described on the Resolution Chart of each characteristic that best depicts the child. Each characteristic is given a number, and after that, the numbers are added up to find a value for Rating II.

Lynne:
For number 1 Color preference, we noticed that Brandon is able to look at many different single colored items, not only red. He also showed interest in several items or patterns that had more than one color in limited situations. We scored him with a point two five, Range 3 to 4.

For number 2, Need for movement, we noticed that Brandon was able to look at some items that did not have movement properties, especially if they were lighted or light was shined upon them. We scored this characteristic with point two five, Range 3 to 4.

Sara:
For number 3, Visual latency, Brandon really was able to look fairly quickly at some items, even novel ones, but some items still had longer periods of latency. This was more prevalent when he was tired, but sometimes it happened at the beginning of a testing session as well. We scored this characteristic as .25, or Range 3 to 4.

For number 4, Visual field preferences, Brandon showed a distinct field dependency. This is not surprising since he has a detached retina on one side. This is not something that will be resolved. We scored this as a 0, or Range 1 to 2.

Lynne:
For number 5, Difficulty with visual complexity, Brandon was able to occasionally tolerate some level of noise while looking, especially if the visual target emitted light. He does not look at faces, not even familiar ones, at this point. We marked this characteristic at point two five, Range 3-4.

For number 6, Light-gazing and nonpurposeful gaze, we saw Brandon being able to look away from primary sources of light when engaged in activities, but he was definitely still distracted by light. We marked point two five in this characteristic, Range 3 to 4.

For number 7, Difficulty with distance viewing, the CVI Resolution chart's description of Range 3 to 4, or point two five, perfectly describes Brandon's visual behavior, so that is where we marked this characteristic.

Sara:
Number 8, Atypical visual reflexes, was tested by his classroom teacher, who is also a Teacher of the Visually Impaired. It was reported that Brandon did have a blink response to touch, but that he did not have a blink to threat response yet. This leaves .25, Range 3 to 4, as the most appropriate place to score this characteristic.

Number 9, Difficulty with visual novelty, was interesting because most items that Brandon looked at during our observation of his routines, and some that he didn't look at, were familiar and a single color. All items that were presented during direct assessment, except a few patterns, shared similar characteristic of familiar items in that they were a single color, and many were the same color as items Brandon had been observed looking at, or had been reported as favorite colors. Complexity seemed to be more of the interfering factor than novelty. We marked this characteristic as .75, or Range 7-8.

Lynne:
Number 10, Absence of visually guided reach, was scored at .5, Range 5 to 6 because Brandon was definitely able to use visually guided reach, difficult as it might be due to looking with his left eye and reaching with his right hand, within a familiar routine with a familiar, single color visual target. He also reached toward shiny and red items without looking away.

So all ten scores, .25, .25, .25, 0, .25, .25, .25, .25 .75, .5, added together equals 3. This can be recorded on the front page for Rating II. The CVI Range is between what was found for Rating I and Rating II. Brandon's CVI range, then, we found to be 3 to 4 with a difference of 1. If you refer to the very top of the CVI Resolution Chart, Brandon would be functioning at a high Phase I, Building Visual Behavior, and at a low Phase II, Integrating vision with Function.