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Sara:
Now we'll look at the forms in the back of Christine Roman's book, 2 pages after 185, or maybe page 187, called "Essential Forms." The part we'll fill out first is called "The CVI Range: The Across-CVI Characteristics Assessment Method", or "Rating I". We'll compare the notes we have taken from all of our information sources to the "CVI Range Scoring Guide" which is on page 97, or appendix 5.A. On the CVI Range Scoring Guide in the column marked "Characteristic," you will be directed toward the section of your data collection form where you might find supporting information.

We found all the scores in the first section, "CVI Range 1 to 2: Student functions with minimal visual response," to be marked in the "R" column. The characteristics at this level we found to be resolved.

Lynne:
In the second section, "CVI Range 3 to 4: Student functions with more consistent visual response," we still have some characteristics that were resolved, but not all. The first statement, "Visually fixates when the environment is controlled," we marked as Resolved, because the statement from the "CVI Range Scoring Guide" which seemed to best describe Cassie's visual functioning we found under the "R" column: "Establishes eye-to-object contact with familiar or novel objects or human faces, even in the presence of visual or other sensory stimuli." We found support for this in the complexity section of the observation data collection sheet.

Sara:
For the second statement, "Less attracted to lights; can be redirected," we found the stipulation to be true under the plus column, so we marked her with a plus: She "may stare at lights, but is able to shift attention from lights when appropriate visual targets are presented in controlled environments." This information was found in the "light" row of the observation and direct assessment data collection sheets

For the third statement, "Latency slightly decreases after periods of consistent viewing," we noticed that Cassie did not exhibit delays in looking at familiar items, but did sometimes with novel items, if she was tired. We found that out from the latency section on the direct assessment sheet. We marked that as resolved in the column described as, "A delay in directing vision toward a familiar object is rarely, if ever, present."

Lynne:
The fourth statement, "May look at novel objects if they share characteristics of familiar objects," we marked as resolved because Cassie regularly was "able to glance toward or have eye-to-object contact with objects never previously seen that may or may not resemble 'favorite' objects." We found that information from the observation and the direct assessment in the area of novelty.

The fifth statement, "Blinks in response to touch and/or visual threat, but the responses may be latent and/or inconsistent" seemed like a pretty good description of what Cassie did during the direct assessment, in that her response was just a little slow. We found the plus description to be consistent with that: "Blinks to touch at bridge of the nose and possibly to the quick movement of a target toward the face, but responses may be delayed or slightly inconsistent."

Sara:
The sixth statement, "Has a 'favorite' color" definitely seemed resolved. We marked it in the "R" column, which is described as, "Visual attention to objects is not dependent on a particular color." This was supported by information from all three data collection sheets in the area of color.

The seventh statement, "Shows strong visual field preferences," we found to be true as described in the plus column, "Glances toward or has eye-to-object contact with targets when presented in specific positions of peripheral and/or central viewing fields." We found support for that in the corresponding row on all data sheets.

Lynne:
The eighth statement, "May notice moving objects at 2 to 3 feet" we marked in the plus column because we saw that Cassie "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." We did not see that she could see things that did not have these qualities beyond three feet. We found support for this in the movement, distance, and complexity sections from all data sheets.

The ninth statement, "Look and touch completed as separate events," we marked in the plus-minus column because we saw that Cassie "Occasionally uses visually guided reach." We found support for this in the "visually guided reach" section of all data sheets.

Sara:
In the next section, "CVI Range 5-6: Student uses vision for functional tasks," we continued to find some that were resolved. For the first statement, "Objects viewed may have two to three colors," we found the resolved description to be the most true from all the data collection sheets in the areas of color and/or complexity, because Cassie "Pays visual attention to multi-color or multi-pattern objects, with or without preferred color."

For the second statement, "Light is no longer a distractor," we found the plus-minus description, "Occasional gazing at primary sources of light," to be the most true, with support from information in the row called "light" on all data collection sheets.

Lynne:
The third statement was, "Latency present only when the student is tired, stressed, or overstimulated." We found the plus-minus description to be the most true according to information from the rows on latency and complexity in the direct assessment data, in that Cassie exhibits an "Occasional delay in directing visual attention to a target."

The fourth statement, "Movement continues to be an important factor for visual attention," we found, in the plus-minus column, "A small element of movement may help establish or maintain visual attention," to be the most true for Cassie, which was supported by data from all collection sheets in the area of movement.

Sara:
The fifth statement, "Student tolerates low levels of background noise," seemed to best describe Cassie in the plus-minus column, "Occasionally is able to maintain visual attention in the presence of sound. One or two particular sounds are tolerated during viewing; many are not tolerated." This was supported by our notes from the observation and direct assessment information on complexity.

The sixth statement was "Blink response to touch is consistently present." We marked that one as resolved, which read, "Blink-to-touch response present; blink-to-visual-threat response (when target moves quickly toward face) inconsistently present." We found this in our notes on visual reflexes on the direct assessment information sheet.

Lynne:
The seventh statement, "Blink response to visual threat is intermittently present" we also marked in the resolved column, since Cassie's "blink to visual threat response" is "consistently present," even if it is sometimes slow. This information was in the visual reflexes row of the direct assessment information sheet.

In the eighth statement, "Visual attention now extends beyond near space, up to 4 to 6 feet," we marked a plus. Cassie "can visually locate or fixate on certain targets at distances as far as 6 feet away," and her "ability to detect objects or movement at 4 to 6 feet may depend on the degree of environmental complexity," as stated in that column. We found support for this in the area of distance in the observation and direct assessment information sheets.

Sara:
The ninth statement, "May regard familiar faces when voice does not compete" we found to be a plus. This is described as "Glances or looks directly into faces of familiar people, but only when the familiar person is not speaking." That description seems to be dead-on for Cassie, which we saw more than once during the observation.

In the next section, "CVI Range 7 to 8: Student demonstrates visual curiosity," we no longer found items that were resolved, but did still find a few plusses. The first was one of those: "Selection of toys or objects is less restricted; requires one or two sessions of 'warm up'." The plus statement in the CVI Range Scoring Guide was, "Looks at new objects that have attributes of familiar objects. Recognizes new object immediately after one or two presentations." We interpreted recognition as visual attention, since Cassie doesn't verbalize most of her thoughts. In our notes about the observations and direct assessment, we found supporting data in the areas of complexity and novelty.

Lynne:
The next statement was, "Competing auditory stimuli tolerated during periods of viewing; the student may now maintain visual attention on objects that produce music." We marked this as a plus-minus because the description, "Occasionally is able to maintain visual attention while other sensory input competes. Particular types of sensory inputs may continue to interfere with visual attention," was accurate for Cassie. We noticed Cassie using her vision in some familiar noisy environments, like the cafeteria and during her hygiene routine, during the observation. Other times during the observation, low-level noise, even if it was familiar, seemed to interfere. There were notes alluding to this in the observation information sheet in the area of complexity.

Sara:
The next item, "Blink response to visual threat consistently present," seemed to best describe Cassie with the plus statement from our direct assessment notes in the section on visual reflexes, which was, "Blinks simultaneous to the approach of an object or open hand moving quickly on midline toward the face." So we marked it as a plus.

For the statement, "Latency rarely present," we found the plus-minus to be a better description of Cassie's behavior, which was, "Seldom demonstrates a delay in detecting a target after it is presented." We mainly saw a quick visual response to all sorts of targets during the observation and direct assessment, even if the response was brief, except for when Cassie was tired. This data was gathered by considering visual behavior patterns across multiple observations; there was not a single clip that gave us this, it was more the summation of all the clips.

Lynne:
The statement, "Visual attention extends to 10 feet with targets that produce movement," we found to be a very good description of Cassie. We marked her in the plus column, which was, "Is able to visually locate and/or fixate on certain targets at distances as far as 10 feet away, especially with targets that produce movement. Attention at this distance may depend on the degree of complexity of the environment." We found that during the observation, in a familiar location -the classroom- Cassie could find things that move. She also moves a lot herself, which may be helping her find things. These notes were also on the observation information sheet in the area of distance.

Sara:
For "Movement not required for attention at near distance," we found Cassie to be best described by the plus-minus statement, "Occasionally is able to detect and attend to visual targets beyond two feet." This one was a hard call since Cassie moves herself so much, and when we did see her being still and detecting items that were beyond 2 feet, they often had movement qualities, but some familiar ones did not, such as her accordion. Cassie is also able to travel successfully indoors visually, and maneuver around items without tripping for the most part. We found support for our choice of the plus-minus statement in the direct assessment information in the areas of movement and distance.

Lynne:
For the statement, "Smiles at/regards familiar and new faces," we found the plus-minus again to be the best description, which was, "Occasionally glances toward and/or makes eye contact with familiar faces." We found this in the interview and observation data collection sheets in the area of complexity. Cassie did not look at her less familiar assessors at all during the direct assessment.

The statement, "May enjoy regarding self in mirror," was a tricky one. We weren't sure whether Cassie was looking at herself in the mirror, exactly, or if she just had a social script about mirrors, (such as, she has learned when you see this shiny flat thing you put your face on it and say your name). It seemed as if she was looking for a little bit, so we thought the plus-minus, "Inconsistently glances at own image in mirror," was the best description from the direct assessment information sheet in complexity.

Sara:
For the statement, "Most high-contrast colors and/or familiar patterns regarded," we thought the plus-minus column, "Is able to visually attend to some simple patterns, especially familiar ones or those that are highlighted with the preferred color," best described Cassie. Cassie doesn't seem to have a preferred color, but she seems to find items that are one or two colors, rather than three or more, easier to visually attend to, and she seems very interested in stripes. Stripes with many colors seem to be too complex to visually study at this point, though Cassie really tries. We found information on this in the color, complexity and novelty sections of the observation and direct assessment information sheets.

Lynne:
The next statement, "Simple books, picture cards, or symbols regarded," also seemed to be most applicable to Cassie in the plus-minus column, which is, "Visually attends to a small set of two dimensional materials; is not able to generalize the images to new contexts." Cassie did not seem to really attach much meaning to the 2-D items we saw her look at. She seems to be just beginning to look at non-complex 2-D items. We found information on this in the novelty and complexity sections of the observation.

Sara:
In the next section, "CVI Range 9 to 10: Student spontaneously uses vision for most functional activities," we marked the minus for all items except the following two, which were plus-minus. In the second row, "Only the most complex environments affect visual response," Cassie seemed best described by the plus/minus description, "Demonstrates visual curiosity in familiar environments that have low degrees of sensory complexity." We found support for this in the complexity and/or novelty sections of all areas of data collection.

Lynne:
In the eleventh row, "Look and reach completed as a single action," the choice that best described Cassie was again the plus-minus, "Uses visually guided reach only when the background complexity is reduced." Cassie used visually guided reach on a plain background when the complexity of the target was lower, or when the item had movement qualities. There was only one time when she was able to find a very familiar item on a complex background and reach directly toward it. We found data to support our choice in the visually guided reach section on the direct assessment information sheet.

Sara:
There is one minus you may have a question about if you continue to compare the information from our data collection sheets to the statements in the CVI Range Scoring Guide. For the description, "Visual attention extends to beyond 20 feet," we realized that we didn't have any data. We went back and asked Cassie's teacher if she had seen Cassie looking at anything 20 feet away or more. The teacher said that Cassie doesn't do that during any of their classroom activities inside or outside, so we went ahead and marked that one as a minus from interview information. The rest of the minuses should be evident from notes on the data collection sheets.

Lynne:
On page 61 of "Cortical Visual Impairment" Roman wrote, "The individual statements that describe visual behaviors are matched to the child's visual responses and scored until a 'ceiling ef-fect' 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."

This would put Cassie in Range 7 to 8, in which she had 4 plusses and 6 plus-minuses. We would pick the lower number, since plus statements end in the middle of the cluster, not the end. So we wrote Cassie's Rating I score as a 7.

Sara:
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.

For number 1, color preference, we found that Cassie was able to detect items with multiple colors or crazy patterns, but she didn't really attend to or examine them unless they were just a couple colors, or had a "striped" pattern. We scored this characteristic as .75 (Range 7 to 8).

Lynne:
For number 2, need for movement, we found that the description, "movement continues to be an important factor to initiate visual attention," was right on the money for Cassie, so we scored this one as .5 (Range 5 to 6).

For number 3, Visual latency, we found that Cassie only seemed to take longer to look when she was tired, such as when we asked her to look at lots of new things out or her routine for a sustained amount of time. We scored that one as .5, (Range 5 to 6).

Sara:
For number 4, Visual Field Preferences, we found that Cassie only seemed to notice her non-moving, striped, but extremely familiar and favored accordion in her best visual field, which was lower and central. She noticed moving or supercharged shiny things in her peripheral fields. We marked this one as .25, (Range 3 to 4).

For number 5, Difficulties with visual complexity, we found that Cassie was able to tolerate low levels of familiar background noise and that she would occasionally look briefly at familiar faces, but only if those people were not talking, so we marked this as a .5, (Range 5 to 6).

Lynne:
For number 6, Light-gazing and nonpurposeful gaze, we thought that Cassie wasn't that distracted by lights because she always self-directed her visual attention away from lights to other targets. We marked her as .5, (Range 5 to 6).

For number 7, Difficulty with distance viewing, we found that Cassie was definitely able to see things beyond 10 feet if they were moving or if she was moving, so we scored that one with a .75 (Range 7 to 8).

Sara:
Number 8, Atypical visual reflexes, was best described in Range 7 to 8, "Visual threat responses consistently present (both reflexes near 90 percent resolved)," which would make that one a .75.

For number 9, Difficulty with visual novelty, we found that the statement in range 9 to 10 best described Cassie, "Selection of objects not restricted," in that she could detect almost any novel object. For her to study or examine objects visually, there were more requirements in the areas of color, complexity, and movement. So we would definitely want to think about those characteristics when choosing items for functional routines. We marked her as a 1.

For the last one, number 10, Absence of visually guided reach, we noticed that Cassie uses visually guided reach best with familiar objects, so we marked her as a .5, (Range 5 to 6).

Lynne:
So adding up all ten numbers, .75, .5, .5, .25, .5, .5, .75, .75, 1, and .5, we got a total of 6. Cassie's score for Rating II was recorded on the first page as a 6, making her CVI Range from 6 to 7, with a difference of 1. If you look at the very top of the CVI Resolution Chart for reference, it appears that Cassie's visual abilities fall into the high Phase II CVI Range, "Integrating Vision with Function."