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Return to a Process for Identifying Students with Deafblindness (Birth-22)

As a Teacher of the Visually Impaired, you are aware of the importance of hearing for a child with a visual impairment. The Functional Vision Evaluation and the Learning Media Assessment both consider how the child uses his/her hearing for learning. Here are some things that you should try to determine through parent and staff interviews and/or the student's records. (Adapted from the Checklist for Deafblind Census of Texas)

  1. Does the student have a documented auditory impairment meeting Texas eligibility requirements as cited in the Commissioner's Rules?
  2. Does the student have a documented unilateral hearing impairment (conductive, sensorineural, or mixed) of at least 15 dB?
  3. Does the student have a documented bilateral hearing impairment (conductive, sensorineural, or mixed) of at least 15 dB?
  4. Does the student have a documented syndrome, disease or disorder associated with hearing loss?
    • Bacterial meningitis
    • Cytomegalovirus (CMV)
    • CHARGE
    • Usher Syndrome
    • Down Syndrome
    • Microcephaly
    • Rubella
  5. Does the student have a documented syndrome/disorder associated with a progressive hearing loss?
    • Cytomegalovirus (CMV)
    • Norrie Syndrome
    • Goldenhar Syndrome
    • Hurler Syndrome
  6. Does the student have a diagnosis of a central auditory processing disorder (CAPD) by a speech language pathologist or an audiologist? May also be called central auditory processing problem, central auditory processing dysfunction, auditory neuropathy. ORDoes the family or staff report the child having difficulty understanding what he is hearing?
  7. Is the student at risk for hearing loss? Factors to alert to include:
    • Documented chronic/persistent otitis media
    • Caregivers/professionals who know the child suspect impaired hearing based on:
      • significant and otherwise unanticipated delay in receptive and/or expressive speech-language skills or
      • Responses to full range of auditory stimuli in the environment is less than anticipated
      • Ototoxic medications such as those given for cancer, serious infections, etc.
      • Prematurity
      • Balance problems
      • Family history of hearing loss

Other risk factors include:

  • Drug or alcohol consumption during pregnancy
  • APGAR scores lower than 4 at one minute and below 6 at five minutes (APGAR scores measure newborn vital signs at birth)
  • Low birth weight (below 3.5 pounds)
  • Neonatal jaundice at birth requiring transfusion
  • Craniofacial anomalies
  • Visible malformations of the head, neck or ears including middle and/or inner ear structures
  • Family history of permanent or progressive hearing loss in childhood
  • Childhood injuries (especially skull fracture, sharp blow to the head or ears, loud noise exposure, and items accidentally inserted into ears resulting in damage)

Speech and language development are impacted greatly by hearing impairment. Even mild to moderate impairment can have dramatic consequences, especially if the child also has some type of vision loss. Below are typical milestones for a child with normal hearing according to the Alexander Graham Bell Association for the Deaf and Hearing Impaired. Be sure to visit their website at www.agbell.org for more detailed information.

Average Speech and Hearing Behavior by Age Level

Birth-3 Months

  • Startled by loud sounds
  • Soothed by caretakers' voices

3-6 Months

  • Reacts to the sound of your voice
  • Turns eyes and head in the direction of the source of sounds
  • Enjoys rattles and noisy toys

7-10 Months

  • Responds to his/her own name
  • Understands "mama," "dada," "no," "bye bye" and other common words
  • Turns head toward familiar sounds, even when he/she cannot see what is happening: e.g., dog barking or paper rustling, familiar footsteps, telephone, person's voice

11-15 Months

  • Imitates and matches sounds with own speech production (though frequently unintelligible), especially in response to human voices or loud noises
  • Locates or points to familiar objects when asked
  • Understands words by making appropriate responses or behavior: "Where's the dog?" "Find the truck."

15-18 Months

  • Identifies things in response to questions, such as parts of the body
  • Uses a few single words; while not complete or perfectly pronounced, the words should be clearly meaningful
  • Follows simple spoken directions

2 Years

  • Understands yes/no questions
  • Uses everyday words heard at home or at daycare/school
  • Enjoys being read to and shown pictures in books; points out pictures upon request
  • Interested in radio/television as shown by word or action
  • Puts words together to make simple sentences, although they are not complete or grammatically correct: "Juice all gone" "Go bye-bye car"
  • Follows simple commands without visual clues from the speaker: "Bring me that ball." "Get your book and give it to Daddy."

2 ½ Years

  • Says or sings short rhymes and songs; enjoys music
  • Vocabulary approximately 270 words
  • Investigates noises or tells others when interesting sounds are heard: Car door slamming, Telephone ringing

3 Years

  • Understands and uses simple verbs, pronouns and adjectives: Go, come, run, sing, me, you, him, her, big, green, sweet
  • Locates the source of a sound automatically
  • Often uses complete sentences
  • Vocabulary approximately 1000 words

4 Years

  • Gives connected account of some recent experiences
  • Can carry out a sequence of two simple directions: "Find your shoe and bring it here." "Get the ball and throw it to the dog."

5 Years

  • Speech should be intelligible, although some sounds may still be mispronouncedsuch as the /s/ sound, particularly in blends with other consonants (e.g., "street", "sleep", "ask").
  • Neighbors and people outside the family can understand most of what your child says and her grammatical patterns should match theirs most of the time.
  • Child carries on conversations, although vocabulary may be limited
  • Pronouns should be used correctly: "I" instead of "me" "He" instead of "him"

 

New concern arises from:

  1. Full Independent Evaluation process or
  2. Expressed concern by staff or parents about possible vision loss or
  3. New medical information or
  4. Teacher

Step 1

School nurse conducts vision screening. Was the concern about the vision loss validated? NOTE: If Vision Loss Quick Check indicates possible field loss, current screening may not address this type of loss – Continue to step 3.

If YES or Could Not Test, Staff requests ARD and collects information:

  1. Preparation for ARD When Vision Loss is Suspected (Appendix B-1)
  2. Team conducts Informal Vision Skills Inventory (Appendix C-1).
  3. Teacher of the Visually Impaired (TVI) is contacted (TEA Q & A – Appendix E)

If NO:

Vision loss is ruled out. No additional information is needed at this time.

Step 2

At ARD to consider new assessment:

  1. TVI is invited to ARD
    • Team requests VI eligibility information including but not limited to: eye doctor’s report, FVE and
  2. Team develops Vision Testing Plan before eye doctor’s visit with informal support from the Teacher of the Visually Impaired–Appendix D-1
    • Obtain parents’ permission for additional assessment
  3. Following receipt of eye doctor’s report, TVI and TD&HH collaborate to complete the FVE/LMA and to review the Communication Assessment for needed

(Note: In completing the FVE/LMA and reviewing the Communication Assessment it must be determined if vision loss impacts access to the child’s preferred communication form in any educational environments.) Reference the following articles:

  1. Issues Regarding the Assessment of Vision Loss in Regard to Sign Language, Fingerspelling, Speechreading, and CuedSpeech–AppendixF
  2. Making Sure the LMA, FVE and Communication Assessments Address Dual Sensory Loss – Appendix G

Step 3

All assessment is completed. ARD committee receives all results. Is vision loss confirmed?

If YES:

ARD committee:

  1. Considers educational need and deafblind (Deafblind Checklist Appendix Questions about identifying the student as deafblind should be directed to Regional Deafblind Specialist or to the Texas Deafblind Project
  2. Amends related services, accommodations, adaptations and modifications as needed (see Documenting Adaptations, Accommodations, Modifications, and Related Services in the IEP for the Student with Deaf-Blindness)
  3. Amends IEP goals and as (Reference the IEP Quality Indicators for Students with Deafblindness)
  4. Paperwork completed by designated school to add student to Texas Deafblind Child Count

If NO:

Vision loss is ruled out. If there is still concern, the ophthalmologist will make a referral for medical follow-up. Otherwise, no additional information is needed at this time, but results must be reported back to ARD committee.

New concern arises from:

  1. Full Independent Evaluation processor or
  2. Expressed concern by staff or
  3. Teacher

Step 1

The school nurse conducts hearing screening. Was the concern about the hearing loss validated by the hearing screening?

If YES or if COULD NOT TEST

Staff requests ARD and collects information:

  1. ARDPreparationListWhenHearingLossisSuspected(AppendixB-2)
  2. TeamconductsInformalAuditorySkillsInventory(AppendixC-2).
  3. TeacherofDeaf&HardofHearingiscontacted(TEAQ&A–AppendixE)

If NO:

Hearing loss is ruled out. No additional information is needed at this time.

Step 2

At ARD to consider new assessment:

  1. Team discusses the need for audiological and communication
  2. Team develops Audiological Testing Plan with support from the TD&HH
  3. Obtain parents’ permission for the additional assessment.
  4. TVI collaborates with the TD&HH to complete the communication assessment making sure to address the impact of the vision loss on the child’s access to their preferred communication form and amends the FVE/LMA as needed. Reference these articles:
  • Issues Regarding the Assessment of Vision Loss in Regards to Sign Language, Fingerspelling, Speechreading and Cued Speech
  • Making Sure the LMA, FVE and Communication Assessments Address Dual Sensory Loss

Step 3

All assessment is completed. ARD committee receives all results.

If YES:

The ARD Committee:

  1. Considers educational need and deafblind eligibility. (Deafblind Checklist). Questions about identifying the student as deafblind should be directed to Regional Deafblind Specialist or to the Texas Deafblind Project.
  2. Amends related services, accommodations, adaptations and modifications as needed (see Documenting Adaptations, Accommodations, Modifications, and Related Services in the IEP for the Student with Deaf-Blindness)
  3. Amends IEP goals and objectives as needed. (Reference the IEP Quality Indicators for Students with Deafblindness)
  4. Paperwork is completed by designated school to add student to Texas Deafblind Child Count and submitted to Regional Deafblind Specialist.

If NO:

Hearing loss is ruled out. If there is still concern, the audiologist will make a referral for medical follow-up and/or consider testing for CAPD.  Otherwise, no additional information is needed at this time, but results must be reported back to ARD committee.

Return to a Process for Identifying Students with Deafblindness (Birth-22)

As a teacher of the deaf and hard of hearing, you are aware of the importance of vision for the child with a hearing impairment or deafness. Here are some things that you should investigate through parent and staff interviews and/or the student's records. (Adapted from the Deafblind Census of Texas Checklist)

  1. Does the student have a documented visual impairment meeting Texas eligibility requirements as cited in the Commissioner's Rules?
  2. Does the student have a vision loss in one eye only?
  3. Does the student have a documented syndrome, disease or disorder associated with vision loss?
    • Congenital Rubella Syndrome
    • CHARGE
    • Down Syndrome
    • Cerebral Palsy
    • Prematurity
    • Meningitis
    • Congenital cataracts
    • Prematurity
    • Hydrocephaly
  4. Does the student have a documented syndrome/disorder associated with a progressive vision loss?
    • Usher Syndrome
    • Leber's Congenital Amaurosis
    • Hurler's Syndrome
    • Glaucoma
  5. Does the student have a diagnosis of cortical visual impairment, which results in difficulties in processing visual information, from an ophthalmologist and/or neurologist?
  6. Does the student have a documented visual impairment of 20/70 or greater after correction in better eye or a loss in visual field?
  7. Is the student at risk for vision loss? Factors to alert to include:
    • Diagnosis of nystagmus (an involuntary rapid movement of the eye)
    • Diagnosis of untreated amblyopia (uncorrectable blurred vision due to disuse of the eye) after the age of 6 years?
    • History of untreated eye condition, such as cataracts (a clouding of the lens of the eye), during the first three years of life
    • Impaired occulomotor functioning resulting from strabismus (a deviation of the eyes so they are not simultaneously directed to the same object) or cerebral palsy or other neurological impairments
    • Prematurity
    • Caregivers/professionals who know the child suspect visual impairments because visual attending and/or visual examining behaviors are less than anticipated
    • Family history of vision loss
    • Childhood injuries especially blows to the head
    • Craniofacial anomalies
    • Drug or alcohol abuse of parent during pregnancy
    • Low birth weight

ABC CHECKLIST FOR VISION OBSERVATION AND HISTORY

It's as simple as A, B, C!

There are three common areas to look for when determining whether a child has a vision problem. A simple A, B, C Checklist can help you along the way! Your job is to be a good observer of the child's eyes and activities. If you have any questions about the vision of a child, please talk to a teacher, a school nurse, or a doctor. Many vision problems can be corrected, if caught early. Be a vision detective and identify vision problems early!

A = APPEARANCE

Do eyes look normal?

  • Eyes turn in or out
  • Crusty or red eyelids
  • Different size pupils or eyes
  • Swelling of eyelids
  • Conjunctivitis (Pink eye)
  • Drooping lid(s)
  • Any other observation about "eyes that just don't "look right"?

B = BEHAVIOR

Teacher/Parent Observation

  • *Tilts head, covers or closes one eyes for critical seeing
  • Difficulty in keeping place while reading -a "finger" reader
  • Disinterested in activities involving critical seeing
  • *Excessive stumbling, awkwardness or daydreaming
  • *Holds printed material in unusual position
  • *Has (reported) difficulty seeing at night or in the dark.
  • Other behaviors the child does that seem to indicate vision problems.

C = COMPLAINTS

Child's Statements or Your Observations that the Child Might be Experiencing Discomfort During Visual Tasks

  • Eyes hurt or blur while reading
  • Headaches when reading
  • Words move or jump about when reading
  • Double vision
  • Eye problem following a blow to the head
  • Cannot see the chalkboard
  • *Cannot see well at night or in dark situations
  • *Eyes hurt or bother child when in bright lighting
  • Other complaints or observations that might mean a child is experiencing discomfort during visual tasks

*Underlined items may be an indication of problems with field loss.

Reprinted from Vibrations Newsletter of Colorado Services for Children who are Deafblind, Winter 2000 Edition with adaptations by Region 12 Deafblind Stakeholder Committee.

Chrissy Cowan, TVI
Texas School for the Blind and Visually Impaired

Designing Educational Environments to Optimize Vision

As you work with students with low vision, there are general adjustments that can be made to classroom environments that will enhance visual functioning. The following should be considered for each individual student, based on information from a functional vision evaluation.

Consider the Etiology

Familiarize yourself with the characteristics of the most predominant visual conditions resulting in low vision and their effects, such as retinitis pigmentosa, ocular albinism, retinopathy of prematurity, optic nerve hypoplasia, cortical visual impairment, cataracts, coloboma, nystagmus, central scotoma, glaucoma (this list is not complete). A current (October 2015) web resource for this is “Visual Impairment”. For each etiology, look for such things as:

Effects of Light

Examples: cataracts cause light to be scattered over the retina meaning that bright light and glare will usually cause problems for the student, whereas the student with retinitis pigmentosa (RP) will require high illumination. Glare for some would be disastrous. Overhead lighting might be too low/high, depending on the etiology. Illuminated screens (any type of lighted display) would be difficult for some, necessary for others.

Field Deficits

Examples: students with Stargardt’s Disease can have a central acuity loss, making staying on a line of print difficult without specific training. Students with retinitis pigmentosa tend to lose the peripheral field, thus making large print and/or enlarged maps/charts/graphs/photos difficult to scan.

Eye Motor

Examples: students with nystagmus tend to have problems shifting gaze from one target to another (typical of copying assignments).

Consider Posture

A work surface and/or computer work station that is poorly arranged in regards to lighting would reduce visual efficiency. Whereas marketed reading stands straighten the student’s posture and elevate the reading material, students typically need to write on the same (slanted) surface. Look on occupational therapy websites, such as www.therapro.com, for a writing stand that does not have the ridge at the bottom which makes writing uncomfortable. Or, use a 3 inch 3-ring binder turned sideways to slant work at an angle.

Consider Organization

It takes the student with low vision longer to find things. Students need to access their materials quickly, so storing for quick retrieval is necessary. Consider a small, stick-on battery operated closet light that you press for inside desks and other darker spaces. Backpacks will need folders and other organizational containers to keep papers organized, and smaller objects in desks should have dedicated containers. The TVI will need to check and reinforce that an established system is used consistently.

Consider Lighting

For Work Surfaces
With some eye conditions, a lamp might be necessary to put light precisely where it is needed. If an outlet is nearby, the APH lamp is wonderful. Another option is a battery powered OTT light that can be moved from room to room. When positioning the light, make sure the student’s head or hand does not occlude the light, or that the light is shining on the student’s face.

Students with albinism or cataracts might have difficulty with too much ambient light and/or glare, which can cause headaches and have a “wash-out” effect on certain materials. Tinted lenses might be beneficial for some, or a light blue filter placed over the reading surface could change the contrast (watch for glare off of shiny surfaces). Avoid seating that is directly under harsh overhead lighting or near a large window.

Overhead Projector Screens and Interactive White Boards
When the target surface is lighted or bright, students with lighting issues may have difficulties. The classroom lighting can be adjusted to accommodate, or in extreme cases, the student may need to have a desk (print) copy if significant copy work is required. There are apps available that connect the student’s tablet with the teacher’s computer or the interactive white board that would provide a clearer copy for the student.

Consider Writing Tools and Materials

Provide adapted paper and writing tools, and adjust lighting and positioning of materials (see writing slant board above) if needed. Examples of writing tools include drafting pencils (or #1 soft lead, available in art/craft stores) and fine point felt tip pens, such as a Flare® pen. Students may perform better with bold line paper, or commercially available wide ruled notebook paper with darker lines (compare these at the grocery store—some are darker than others). Gradually move toward fewer adaptations as the student becomes more proficient.

Consider Optical Devices

Assuming the student has been seen by a low vision specialist, start by making sure the prescribed optical devices are on hand and the student has learned how to use them correctly. Devices that tend to be handed to students by well-intentioned people should be avoided (e.g., full page magnifier, bar magnifier). Electronic near devices are best used for “spot” viewing, and will slow the student down when reading longer passages.

If a video magnifier (CCTV) is in the room, find out if it is being used consistently. If it is not (perhaps due to portability, placement, too much enlargement) consider retraining the student on a handheld or stand magnifier. There are now products available from APH and Education Service Center, Region 4 that are designed for teaching optical device use. Refer to Looking to Learn: Promoting Literacy for Students with Low Vision, D’Andrea and Farrenkopf, Eds., AFB Press.

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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 

 

Eye ConditionEffects On VisionEducational Considerations

Achromotopsia (color deficiency, colorblindness, achromacy, or rod achromacy)

Cone malformation, macular deficiency, and partial or total absence of cones.

  • Limited or no color vision
  • Colors may be seen as shades of gray
  • Loss of detail
  • Decreased acuity
  • Central field scotomas
  • Normal peripheral fields
  • Associated with  nystagmus  and Photophobia
  • Adapted color-dependent activities
  • Alternate methods for matching clothing
  • Support of eccentric viewing
  • High contrast materials
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Reduced or diffused lighting
  • Supplement vision with auditory and tactile information

Albinism

Total or partial absence of pigment, causing abnormal optic nerve development

Lenses and tinted lenses may be prescribed.

  • Decreased acuity
  • Photophobia
  • Increased sensitivity to glare
  • High refractive error
  • Astigmatism
  • Central scotomas
  • Nystagmus
  • Muscle imbalance
  • Eye fatigue with close or detailed work
  • Reduced depth perception
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Close viewing
  • High contrast materials
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Lighting from behind
  • Reduced glare
  • Line markers and templates - placeholders
  • Frequent breaks

Amblyopia (was Anopsia, called “lazy eye”) See strabismus

Reduced visual functioning in one eye, which causes the person to use one eye instead of both.

With young children, eye exercises, oclusion or patching of one eye or surgery may help.

  • Monocular vision
  • Reduced visual field
  • Reduced depth perception
  • May develop blindness in one eye
  • Reduced visual-motor abilities
  • Eye fatigue with close or detailed work
  • Frequent breaks
  • Seating should favor functional eye.
  • Familiarization with new environments
  • Time to adjust in new situations
  • May need adaptations for activities requiring visual-motor coordination

Aniridia

A rare genetic disorder that causes absence of all or part of the iris, usually affecting both eyes

It also causes the cornea to lose clarity over time by inhibiting the stem cells that “refresh” it with new, clear epithelial cells. Aniridia is often associated with amblyopia, cataracts, the development of closed angle glaucoma, and sometimes, displaced lens, under-developed retina, and nystagmus. Contact lenses with an artificial iris, tinted spectacles, or bioptic glasses may be prescribed. iris and stem cell implant surgeries are now possible.

Hereditary aniridia is associated with Gillespie syndrome. Sporatic Aniridia may cause nephroblastoma (Wilm’s tumor), and it is associated with WAGR syndrome

  • Decreased acuity
  • Photophobia
  • Large pupil that may be misshapen
  • Generally, respond very well to use of low vision devices
  • Corneal involvement: Scattered light, increased glare, blurred vision, and further reduction of  acuity
  • If cataracts develop: further reduction of visual acuity, blurred vision, and decreased color vision
  • Fovial involvement: loss of detailed (fine) vision
  • If glaucoma develops: fluctuating visual functioning, field loss, poor night vision, and decreased sensitivity to contrast

 

  • Vision stimulation for infants to maximally develop the visual cortex
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Allow time for adjustment to lighting changes
  • Provide seating in the front of the classroom with back to windows
  • Reduced glare
  • Provide lighting from behind
  • Reduced or diffused lighting
  • Lamps with rheostats and adjustable arms
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Use of a black chalkboard and bold chalk
  • If white board is used, bold black markers are recommended over other colors
  • Felt-tipped pens and tinted paper with bold lines
  • Place paper/worksheets on a dark/black background (e.g., blotter, construction or butcher paper, posterboard, etc.)
  • Provide copies of materials presented on the board.
  • Use black backgrounds and white san serif fonts in slide presentations

Anophthalmia

Absence of one or both eyeballs

Causes can be heredity, injury, or secondary to disease. Prosthetic eyes are prescribed to preserve the health of the eyelids and surrounding tissues.

  • Monocular vision:
  • Reduced fields
  • Reduced depth perception
  • Blindness
  • May need visual efficiency training to develop scanning skills
  • Seating and presentation of materials should favor functional eye
  • May need tactile and auditory learning media

Aphakia

Absence of the lens

Although it can be caused by injury, aphakia is usually a result of cataract surgery. Treatments include lens implants, contact lenses, and/or glasses.

  • Inability to accommodate to varying focal distance
  • Inability to accommodate to lighting changes
  • Reduced depth perception
  • May have peripheral field distortions
  • Support wearing of any prescribed lenses
  • High contrast materials
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Enlarged printed materials
  • Close viewing
  • Adequate lighting (e.g., lights with rheostats and adjustable arms)
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Allow time for adjustment to lighting changes

Astigmatism

Irregularity in the curvature of the cornea and/or lens, which prevents light rays from being properly focused on a single point on the retina

Astigmatism commonly occurs with myopia and hyperopia. It also can be associated with albinism and keratoconus. Corrective lenses may be prescribed.

  • Blurred vision at any distance (uncorrected)
  • Distorted vision
  • Tendency to squint to create a pinhole effect
  • Visual fatigue associated with close work
  • High contrast materials
  • Adequate lighting (e.g., lamps with rheostats and adjustable arms)
  • Frequent breaks from close/detailed work

Buphthalmos (Infantile glaucoma)

Enlarged eyeballs

Caused by congenital glaucoma; hereditary; onset from birth to three years; can cause enlargement and increased depth of the anterior chamber, damage to the optic disc, and/or increased diameter and thinning of the cornea; requires surgery, and blindness occurs if left untreated.

  • Photophobia
  • Reduced central acuity
  • Corneal opacity
  • Excessive tearing
  • Refractive error
  • Eye pain

 

  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Reduced or diffused lighting from behind
  • Sunglasses, visors or hats may be worn indoors
  • Allow time for adjustment to lighting changes
  • High contrast materials
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Enlarged printed materials
  • Close viewing

Cataracts

Opacity or cloudiness of the lens, which restricts passage of light to the retina; usually bilateral

Opacity increases over time until “mature” cataracts can obscure the fundus and the pupil may appear white. Mature cataracts are usually removed surgically, requiring lens implants or contact lenses.

  • Reduced visual acuity
  • Blurred vision
  • Reduced color discrimination
  • Photophobia
  • Associated with nystagmus
  • Visual ability fluctuates according to light
  • If cataracts are centrally located, near vision will be reduced
  • Increased sensitivity to glare

 

  • Support of the wearing of any prescribed lenses
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Enlarged printed materials
  • Close viewing
  • Support of eccentric viewing
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • May need reduced or diffused lighting
  • Lighting from behind
  • May need lamps with rheostats and adjustable arms
  • Reduced glare

Chorioretinitis

Posterior uveitis, or an inflamation of the choroid that spreads to the retina

This can be caused by tuberculosis, histoplasmosis, or toxoplasmosis.

  • Blurred vision
  • Photophobia
  • Distorted images
  • Central scotomas
  • Support of eccentric viewing
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Enlarged printed materials
  • Close viewing
  • Diffused, less intense light to enlarge the pupil
  • Telescope
  • May need to use tinted lenses, sunglasses, visors, or hats outdoors and indoors as well
  • High contrast line markers or templates for reading, finding math problems, or locating other information

Coats’ Disease  (Exudative Retinitis or retinitis telangiectasia)

A congenital, nonhereditary, and progressive disorder that is characterized by abnormal development of the blood vessels behind the retina

Coats’ occurs mostly in males. Symptoms typically appear in children around six to eight years old but they can appear in infancy. Coats' usually affects only one eye. Severity depends on the size and number of affected blood vessels. Leakage of blood and fluids cause retinal swelling and detachment. Cryotherapy and laser photo-coagulation sometimes are used to stop the progression of blood vessel growth and leakage. 

  • Decreased central acuity
  • Loss of detail
  • Progressive central field loss
  • Reduced night vision
  • Loss of color vision
  • May develop strabysmus
  • May have iritis
  • May have glaucoma
  • May develop cataracts
  • May be blind in one eye
  • Peripheral fields can be affected
  • Avoid contact sports and other high risk activities to prevent retinal detachment
  • Seating and presentation of work should favor more functional eye
  • Visual efficiency training to develop scanning skills

 

Coloboma

Hereditary birth defect that causes a notch or cleft in the pupil, iris, ciliary body, lens, retina, choroid, or optic nerve

A “Keyhole” pupil often occurs. It can be associated with refractive error, cataracts, nystagmus, strabismus, and glaucoma (later in life).

  • Decreased acuity
  • Photophobia
  • Muscle imbalance
  • Restricted fields (if retina is affected)
  • Reduced depth perception

 

  • High contrast materials
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Average to bright light
  • Reduced glare
  • May need to use sunglasses, visors, or hats outdoors and indoors as well (if iris is affected)
  • High contrast line markers and templates may be helpful for reading, finding math problems, or locating other information

Color deficiency (colorblindness) 

See Achromotopsia

 

 

Cone Monochromacy

See Achromotopsia

 

 

Corneal Ulcers, Corneal Opacities, Corneal Scarring, Keratitis, and Interstitial Keratitis

An open sore or scarring on any part of the cornea

It can be caused by bacteria, viruses (herpes), fungi, vitamin deficiency, injury, a hypersensitive reaction, diabetes, or severe dry eye. Superficial ulcers (called abrasions) usually heal quickly and completely, but deep ulcers cause growth of scar tissue or new blood vessels that impair vision. Corneal ulcers are usually quite painful, and other symptoms may include vision loss, squinting, and tearing (watering). Early diagnosis and treatment are crucial. With extensive scarring, a corneal transplant may be necessary. There are promising results with use of artificial corneas, which seem to be less likely to be rejected.

  • Photophobia
  • Fracturing of light (like looking through broken glass)
  • Increased glare
  • Blurred vision
  • Reduced acuity
  • Blindness

 

  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Reduced or diffused lighting
  • Sunglasses, visors or hats may be worn indoors
  • Seating in front of room with back toward windows
  • Reduced glare
  • High contrast materials
  • Diffused lighting from behind
  • Lights with rheostats and adjustable arms are helpful for close work.
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Enlarged printed materials
  • Frequent breaks from visual tasks
  • Support of eccentric viewing
  • May need auditory materials for longer reading assignments

Cortical Visual Impairment (CVI)

A neurological visual disorder resulting from damage to the optic nerve and/or parts of the brain that process and interpret visual information (i.e., visual cortex)

CVI is characterized by:

  • Specific color preference, especially for red and/or yellow
  • Attraction to movement
  • Visual field preference, especially for peripheral fields
  • Visual latency: delayed visual processing - in directing gaze, identification, recognition, and/or discrimination
  • Difficulties with discrimination and interpretation of complex visual information
  • Poor visual attention
  • Atypical visual responses (e.g., looking at something while appearing not to look)
  • May not look at an object and reach for it simultaneously (look first, then look away while reaching)
  • Better visual performance with familiar objects/settings
  • Unique visual features (i.e., light gazing and non-purposeful gaze)
  • Fluctuation in visual functioning
  • Reduced visual fields
  • Photophobia
  • Fatigue has a negative impact on visual performance
  • Use of movement to increase visual attention
  • Use of preferred color to increase visual attention
  • Present visual information in preferred visual field
  • Present visual information on a solid background (e.g., black or white cloth)
  • Use of bright, high contrast materials
  • Increase line spacing and white space on a page of text and/or images to reduce visual clutter and complexity
  • Use high contrast templates to reduce the amount of information seen at one time
  • Close viewing
  • Vision efficiency training
  • Frequent breaks from visual tasks
  • High illumination from behind
  • Sunglasses, visors or hats may be worn indoors
  • Support use of one sense at a time
  • Reduce visual, auditory, and tactile distractions
  • Extra time to respond
  • Extra time to adjust to new environments
  • Use of consistent language
  • Use of color coding as visual cues for recognition
  • Use of consistent visual cues across settings

Diabetic Retinopathy

Changes in the blood vessels of the retina, causing hemorrhaging in the retina and vitreous

It is caused by juvenile or type 2 diabetes. It may lead to retinal detachment and blindness.

  • Increased sensitivity to glare
  • Lack of accommodation
  • Floating obstructions in the vitreous
  • Fluctuating acuity
  • Diminished color vision
  • Reduced visual fields
  • Double vision
  • Blindness
  • Adequate high quality lighting (e.g., lamps with rheostats and adjustable arms)
  • High contrast materials
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Large button/key technology may be helpful
  • Training in use of auditory materials may be needed due to loss of vision and tactile sensitivity
  • Training in use of speech recognition input software may be helpful
  • Precautions related to decreased sensitivity in hands and feet (e.g., burns, cuts, falls)

Diplopia

Muscular defect that restricts the ability of the eyes to work together

It causes double vision, as the image from one eye is imposed on the image from the other eye. Left untreated, this condition can develop into amblyopia. Corrective lenses may be prescribed.

  • Visual confusion
  • Double vision
  • Dizziness
  • Suppression of the image from one eye, causing monocular vision
  • Eye fatigue
  • Blurring of print
  • Headache
  • Loss of place in visual tasks
  • High contrast materials
  • Reduced glare
  • Extended time to adjust to new situations
  • Frequent breaks from visual tasks
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Familiarization with new environments

Dislocated Lens

The lens is not in its natural position.

It is sometimes associated with coloboma, Marfan’s syndrome, or Marchesani’s syndrome. Also, it may be associated with diplopia or cataracts.

  • Blurred vision
  • Double Vision
  • Visual fatigue during close or detailed visual tasks

 

  • Frequent breaks from visual tasks
  • High contrast materials
  • Adequate lighting (e.g., lamps with rheostats and adjustable arms)
  • Reduced or diffused lighting
  • High contrast line markers or templates for reading, finding math problems, or locating other information

Enucleation

The anterior chamber or the entire eyeball is surgically removed from the orbit (eye socket).

Prosthetic eyes or scleral shells are usually recommended.

  • If one eye is removed, there is no depth perception.
  • Monocular vision
  • Reduced visual field
  • Effects of any eye condition(s) of the remaining eye
  • Blindness
  • Effects visual-motor skills, especially reach and negotiation of steps and drop-offs
  • Training in care of prostheses
  • Vision efficiency training (i.e., scanning)
  • Considerations related to the visual impairment of the remaining eye
  • Considerations related to possible changes in learning media

Esophoria, Esotropia, Exophoria, and Exotropia   See strabismus

 

 

Glaucoma

An eye disease which causes increased pressure in the eye because of blockage in the normal flow of the fluid in the aqueous humor

Causes include changes in the lens or uveal tract, trauma, reaction to a medication, surgical procedures, and heredity. Eye pain and headaches are associated with glaucoma. Prescription eye drops to reduce pressure must be used regularly, and surgery may be necessary. Untreated, glaucoma can lead to degeneration of the optic disk and blindness.

  • Fluctuating visual functioning
  • Field loss
  • Poor night vision
  • Photophobia
  • Difficulty reading
  • Difficulty seeing large objects presented at close range
  • Decreased sensitivity to contrast
  • Eye redness
  • Hazy cornea
  • Wide open pupil
  • Stress and fatigue have a negative affect on visual performance

 

  • Support use of sunglasses, visors, or hats in bright sunlight and bright lighting indoors
  • Allow time for adjustment to lighting changes
  • Reduced glare
  • Adequate lighting (e.g., lamps with rheostats and adjustable arms)
  • High contrast materials
  • May benefit from magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • May need visual efficiency training to develop scanning skills
  • Frequent breaks from visual tasks
  • May need instruction in tactile learning and braille
  • Teachers must be alert to signs of pain and increased ocular pressure.

Hemianopia (hemianopsia)

Blindness or impaired vision in one half of the visual field in one or both eyes

If both eyes are affected, vision loss may occur on the same side in both nasal fields, or in both temporal fields. Visual acuity in the unaffected field(s) remains unchanged. Hemianopia can be caused by stroke, other brain trauma, tumors, infection, or surgery.

  • Field loss
  • May be unaware of missing visual information
  • Visual efficiency training to develop scanning skills
  • Use markers at the beginning and/or ending of each line of text to facilitate reading the entire line

Histoplasmosis (Presumed Histoplasmosis Syndrome - POHS)

This is a syndrome affecting the choroid and retina, which is characterized by peripheral atrophic chorioretinal scars, maculopathy, and atrophy or scarring adjacent to the optic disc. Vision loss is secondary to macular and choroidal neovascularization (CNV).

POHS is most likely caused by a fungal infection acquired through exposure to spores in bird droppings and bat guano. Treatments include steroids to treat the initial infection, laser, anti-vascular endothelial growth factors, and photodynamic therapy. Prism lenses may be prescribed.

  • Distorted vision
  • Blind spots
  • Macular damage or central scotomas cause “patchy” fields, central vision loss, and reduced color vision.
  • Peripheral damage causes loss of night vision
  • Lamps with rheostats and adjustable arms
  • High contrast line markers or templates for reading, finding math problems, or locating other information.

Central damage:

  • Eccentric viewing
  • Magnification to enlarge an image beyond the scotoma
  • Enlarged printed materials
  • Close viewing
  • Adapted color-dependent activities
  • Alternate methods for matching clothing
  • Diffused, less intense light to enlarge the pupil so that more area can be viewed
  • CCTV with reversable foreground and background (white on black)

Peripheral damage:

  • High illumnation
  • NOIR lenses or overlay filters may be helpful
  • CCTV for maximum contrast
  •  Night vision devices (e.g., Streamlight flashlights, Third Generation® Night Vision Devices, etc)
  • Visual efficiency training in organized search (grid) patterns
  • May need to be seated farther away from the front to see more of the viewing area (e.g., board, screen, chart, etc)

Hyperopia (Farsightedness)

A refractive error in which the focal point for light rays is behind the retina

It is caused by the eyeball being too short from front to back. Corrective lenses are usually prescribed.

  • Distance acuity is better than near acuity
  • Uncorrected, close visual tasks may cause headache, nausea, dizziness, and eye rubbing

 

  • Support use of prescription lenses for close visual tasks
  • Magnification for near tasks (e.g., hand-held magnifier, electronic magnifier, screen enlargement software)
  • Frequent breaks from close visual tasks
  • Alternate near and distance visual tasks

Hyperphoria, Hypertropia, Hypophoria, Hypotropia    See strabismus

 

 

Hypoplasia  See Optic Atrophy

 

 

Keratitis See Corneal Ulcer

 

 

Keratoconus (KC)

Degenerative disorder in which the cornea thins and takes on a conical shape

Keratoconus is often bilateral but not symmetrical, so vision may be significantly better in one eye than the other. Vision deteriorates at varying rates (sometimes quite rapidly), and plateaus of stable vision can occur. Although it seems to be hereditary, keratoconus is typically diagnosed in adolescence. It is sometimes associated with retinitis pigmentosa, Down’s syndrome, Marfan’s syndrome, and aniridia.  Treatments include prescription lenses and various surgeries: intrastromal corneal ring segments, cross-linking, mini asymmetrical radial keratotomy, and corneal transplants. There are promising results in transplants with use of artificial corneas, which seem to be less likely to be rejected.

  • Slightly blurred vision in early stages, increasing as KC progresses
  • Distortion of entire visual field, which worsens in low light
  • Decreased visual acuity especially distance vision
  • Irregular astigmatism (parts of the field are in focus, and parts are out of focus)
  • Increased sensitivity to glare
  • Decreased night vision
  • Multiple images
  • Flaring of images
  • Streaking
  • Stationary objects/lights may appear to move
  • May develop photophobia
  • Cornea can rupture
  • Can lead to blindness
  • Avoid activities that could cause corneal damage, such as  contact sports and swimming in heavily chlorinated water
  • Reduced glare
  • Diffused lighting
  • Lamps with rheostats and adjustable arms
  • High contrast materials
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)

Leber’s Congenital Amaurosis (LCA, Leber’s Congenital Amaurosis)

A rare hereditary disorder that leads to degeneration of the macula

LCA becomes evident within the first few months of life. Progressive central field loss can occur, although vision is generally stable. LCA is a subset of retinitis pigmentosa with at least thirteen described types that are distinguished by genetic cause, patterns of vision loss, and associated eye conditions. Nystagmus, keratoconus, photophobia, extreme hyperopia, and sluggish (or absent) pupilary response to light are often present with LCA. Excessive rubbing of eyes (also poking or pressing) is a characteristic behavior. 

 

  • Decreased acuity
  • Reduced night vision
  • Progressive central field loss
  • Loss of color vision
  • Loss of detail
  • Peripheral fields can be affected
  • May need visual efficiency training to develop scanning skills
  • Support of eccentric viewing
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • High contrast materials
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Enlarged printed materials
  • Close viewing
  • Adapted color-dependent activities
  • Alternate methods for matching clothing
  • Lamps with rheostats and adjustable arms
  • Support use of sunglasses, visors, or hats in bright sunlight
  • Seat in the front of the room with windows behind back
  • May need frequent breaks from visual tasks
  • May need instruction in use of auditory materials
  • May need instruction in tactile learning and braille

Leber’s Hereditary Optic Neuropathy (LHON, Leber’s Optic Atrophy)

It is a rare hereditary disease caused by a mitochondrial mutation and passed on by the mother. It is characterized by rapidly progressive and severe optic nerve degeneration (atrophy).

It occurs in young men and, rarely, young women. Onset is usually in young adulthood. Most often, there is acute vision loss in one eye and then, a few weeks or months later, in the other eye, but vision loss sometimes occurs in both eyes simultaneously. It can include other types of central nervous system involvement.

  • Reduced central acuity
  • Vision may be blurred
  • Fluctuating visual performance
  • Color vision may be impaired
  • Visual perception may be impaired

 

  • High illumination
  • High contrast
  • Enlarged printed materials
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Avoid visual clutter:
  • Present visual information in isolation
  • Avoid busy backgrounds
  • Avoid wearing patterned clothing when presenting visual information

Macular Degeneration (Macular Disease, Congenital Macular Disease, and Age-Related Macular Degeneration)

Progressive (degenerating) damage to the central part of the retinal cones

The dry form involves yellow deposits (celluar debris) on the macula and eventually, thinning of cells in the macula, which leads to tissue death. In the wet form, there is abnormal growth of blood vessels in the choroid underneath the macula. These blood vessels leak blood and fluid into the retina, causing distortion, blind spots, loss of central vision, retinal scarring, and risk of retinal detachment. Macular degeneration is the leading cause of blindness in people over sixty, but it also can occur in children below age seven. Factors contributing to the development of the disease include heredity, diabetes, head injury, nutritional deficits, high cholesterol, smoking, and exposure to sunlight without eye protection. There is no cure, but treatment can slow progress of the disease. Treatments include nutritional supplements, laser therapy, and medication. 

  • Reduced central acuity
  • Peripheral vision is not affected
  • Central scotomas
  • Distorted vision
  • Blurred vision
  • Decreased color vision
  • Slow recovery from changes in light
  • Loss of contrast sensitivity
  • Visual fatigue
  • Support of eccentric viewing
  • Support use of sunglasses, hats, or visors in bright sunlight
  • Allow time for adjustment to lighting changes
  • Adequate lighting (e.g., lamps with rheostats and adjustable arms)
  • Diffused lighting may allow the pupil to enlarge so that more area can be viewed
  • Close viewing
  • Magnification (e.g., hand-held magnifier, electronic magnifier with light text on dark background, screen enlargement software, telescope for distance viewing etc.)
  • Reduced glare
  • High contrast materials
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Seating in front with back to window
  • Adapted color-dependent activities
  • Alternate methods for matching clothing
  • Frequent breaks from visual tasks
  • Avoid standing in front of a light source when speaking to the student

Microphthalmia (Microphthalmos, nanophthalmia, nanophthalmos)

A hereditary, developmental disorder that causes one or both eyes to be abnormally small

It may occur with other congenital abnormalities such as club foot, additional fingers or toes, webbed digits, polycystic kidneys, and cystic liver. This disorder can be associated with Patau Syndrome, Triploid Syndrome, or Wolf-Hirschhorn Syndrome. It may result in  cataracts, glaucoma, aniridia, and coloboma.

  • Decreased visual acuity
  • Photophobia
  • May have fluctuating visual abilities

 

  • High contrast
  • Reduced glare
  • Average to bright light
  • May need magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Expectations may need to be adjusted due to the frustration related to fluctuating visual abilities
  • Frequent breaks from visual tasks
  • Instruction in strategies for stress reduction and dealing with frustration related to fluctuating visual abilities

Muscle Imbalance See Strabismus and Amblyopia

 

 

Myopia (Simple and Degenerative Myopia, nearsightedness)

A refractive error in which the image of a distant object is formed in front of the retina and cannot be seen distinctly; eyeball is elongated from front to back

Degenerative myopia is progressive, causing increasingly severe nearsightedness, so that visual acuity often cannot be corrected to normal with lenses. It can lead to retinal detachment, choroidal hemorrhages, reduced central vision, opacities in the vitreous, macular swelling, and cataracts. Treatments include corrective lenses and LASIC surgery.

  • Reduced distance acuity
  • Near vision is better than distance vision
  • May squint and frown when trying to see at a distance

 

  • High illumination
  • Reduced glare
  • May need to be seated closer to the front in order to see written information, videos, and demonstrations
  • If myopia is progressive, take precautions to protect the retina

Nystagmus

Involuntary eye movements, which can be horizontal, vertical, circular, or mixed

Causes can be heredity, neurological disorders, toxicity, pharmaceutical drugs, alcohol, inner ear disturbance, or unknown. Nystagmus can be increased by stress, spinning, and rhythmic movements. 

  • Inability to maintain steady fixation
  • Reduced visual acuity
  • Visual fatigue
  • Vertigo (rare)
  • Stripes and other patterns may increase the rate of the nystagmus
  • Shifting gaze or tilting the head may help to find the null point at which the nystagmus slows.
  • Frequent breaks from close visual tasks
  • Vary visual tasks
  • Adequate lighting
  • Good contrast
  • Line markers, rulers, typoscopes, and other templates may be helpful for keeping the place on a page
  • Instruction in stress reduction strategies

Optic Atrophy (Optic Nerve Atrophy)

Hereditary or acquired damage to the optic nerve that limits or stops transmission of visual information from the eye to the brain

It is evidenced by a pale optic disc and reduced pupilary response. Acquired optic atrophy can be caused by disease, pressure on the optic nerve, trauma, glaucoma, or toxicity. Type 1 optic atrophy is progressive.

 

  • Fluctuating visual performance
  • Color vision may be reduced
  • Night vision may be reduced
  • Visual perception may be impaired
  • May have photophobia
  • Visual stimulation in infancy and early childhood.
  • Low vision training in early childhood to help the child interpret visual information
  • Supplement visual information with tactile and auditory information
  • High illumination
  • If photophobia is present:
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Provide adequate lighting through use of lamps with rheostats and adjustable arms)
  • High contrast
  • Enlarged print
  • May need magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Avoid visual clutter:
  • Present visual information in isolation
  • Avoid busy backgrounds
  • Avoid wearing patterned clothing when presenting visual information
  • May need adapted color dependent activities
  • May need alternate methods for matching clothing
  • May need instruction in tactile learning and braille

Optic Nerve Hypoplasia(ONH)

ONH and Septo-Optic Dysplasia (SOD) are related disorders of early brain development. ONH is a congenital, nonprogressive condition in which the optic nerve is under-developed and small.

It may affect one or both eyes, and when both are affected, side-to-side nystagmus is frequently present. During the first few years of life, vision may improve as the brain continues to develop. The incidence of strabismus is increased with ONH. It is one of the three defining characteristics of Septo-Optic Dysplasia, which is also called DeMorsier’s Syndrome. Learning disability, autism, cerebral palsy, and intellectual developmental delays can occur with ONH and SOD. Possible causes include young maternal age, genetic mutation, fetal alcohol syndrome, trauma, and viral infection.

  • May have decreased visual acuity
  • May have better acuity In one eye than in the other
  • May have nystagmus
  • May have strabismus
  • May have variable field restrictions
  • Visual perception may be impaired
  • High illumination
  • High contrast
  • Enlarged printed materials
  • May need magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Avoid visual clutter:
  • Present visual information in isolation
  • Avoid busy backgrounds
  • Avoid wearing patterned clothing when presenting visual information
  • Provide opportunities to confirm or clarify visual information through tactile exploration
  • May benefit from verbal descriptions to help make sense of visual information.
  • May need adapted color dependent activities
  • May need alternate methods for matching clothing
  • May need instruction in tactile learning and braille

Peter’s Anomaly

A congenital, genetic disorder that involves clouding (opacity) and thinning of the cornea

It is caused by abnormal development of the front third of the eye (anterior segment), and central opacities are most common. The iris may or may not be attached to the cornea (Type 1), and cataracts and other lens abnormalities may be present (Type 2). It is very common for amblyopia and glaucoma to develop. This condition can be associated with peters plus syndrome.

  • Blurred vision
  • Decreased central acuity
  • May have scotomas in peripheral fields
  • Photophobia
  • Increased sensitivity to glare
  • Reduced color discrimination
  • Visual ability fluctuates according to lighting
  • May have reduced near vision

 

  • Support of eccentric viewing
  • May need visual efficiency training to develop scanning skills
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Adequate lighting from behind using lamps with rheostats and adjustable arms
  • Reduced glare
  • Seat with back to windows
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Enlarged printed materials
  • High contrast materials
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Close viewing
  • May need adapted color-dependent activities
  • May need alternate methods for matching clothing
  • Frequent breaks from visual tasks

Photophobia

Abnormal sensitivity to light (any type)

It is usually associated with an eye disease or disorder (e.g., iritis, ocular albinism, aphakia, aniridia, dislocated lens, cataracts, glaucoma, etc.). However, many people experience mild photophobia that is unrelated to another eye condition. Other causes include corneal inflammation, some medications, and eye injuries. Severe photophobia can be quite painful, even in relatively dim light. 

  • Squinting
  • Closing the eyes
  • Eye pain
  • Headaches
  • Eye fatigue
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Reduced or diffused lighting
  • Provide lighting from behind
  • Use of shielded lamps with rheostats and adjustable arms)
  • Reduced glare
  • May benefit from use of NOIR sunglasses and/or filters (colored overlays) when reading
  • May need breaks from visual tasks or rest periods in a darkened area

Phthisis bulbi

Abnormally low intraocular pressure, which can cause shrinkage of the eye

It may occur as a complication of eye surgery, or it can be caused by eye diseases, serious and long-term inflammation, or injury. Low pressure damages the macula. The tissues inside the eye deteriorate, become disorganized, and scar tissue is formed. In some cases, the eye can become completely nonfunctional. Sometimes a scleral shell prosthesis is prescribed for proper lid function, eyelash direction, healthy tearing, protection of the cornea, and aesthetics. 

  • Reduced central acuity
  • Reduced color vision
  • Blindness
  • Average or bright light
  • Reduced glare
  • May need high contrast
  • May need magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • May benefit from use of high contrast line markers or templates for reading, finding math problems, or locating other information
  • May need some materials presented auditorily
  • May need instruction in tactile learning and braille

Presbyopia

The gradual loss of flexibility of the lens that occurs with age

It results in inability of the eye to focus at near distance. Presbyopia generally begins to noticeably affect visual functioning around age 40, and people often need prescription lenses by age 45. Options for prescription lenses include glasses for near-distance tasks, bifocals, transition lenses, and monovision contact lenses. Vision also can be corrected by reshaping the cornea using lasers (LASIK), radio waves (conductive keratoplasty - CK), or gas bubbles (IntraCor). Other surgical treatments include artificial lens implants, corneal inlays, and corneal overlays.

  • Blurred vision at normal reading distance
  • Headaches from doing close visual tasks
  • Further compromises the vision of aging adults who have existing visual impairments

 

  • Adequate lighting
  • High contrast
  • Frequent breaks from near-distance visual tasks

Ptosis

Drooping (sagging) of the eyelid

It may affect upper and/or lower lids and one or both eyes. Ptosis is usually due to weakness of the muscles that control the eyelids, damage to the nerves that control these muscles, or very loose skin of the upper eyelids.  Commonly associated with the aging process, ptosis also can be congenital and hereditary, or caused by injury or disease. A ptosis crutch may be prescribed to elevate the eyelid. Medications may be prescribed for those who have myasthenias gravis. Children with severe ptosis need eyelid lift surgery early in life to insure normal visual development and to prevent amblyopia.

  • Severe ptosis obscures the upper visual field
  • Long-term reduction of visual field can cause amblyopia

 

  • May need visual efficiency training to develop scanning skills
  • Ensure access to information that is elevated (bulletin boards, black/white boards, video screens, etc.)

Retinal Detachment

An emergency situation in which parts of the retina pull away from the underlying tissue that nourishes it and from the supporting structure of the eye

Detachments can be repaired if treated within 24-72 hours, but detached parts deteriorate rapidly. Any detachment endangers the entire retina. Detachments are caused by retinal tears, fluid under it, or shrinkage of the vitreous. These conditions may be due to injury, inflammatory eye disorders, advanced diabetes, degenerative myopia, and other retinal disorders.  

  • Field loss
  • Blind spots (scotomas)
  • Blurred vision
  • Possible loss of central vision
  • May develop myopia and/or strabismus
  • Avoid contact sports and other high risk physical activity to prevent retinal detachment
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • May need visual efficiency training to develop scanning skills
  • Support of eccentric viewing
  • High illumination
  • Reduced glare
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Seating in front with back to window
  • Adapted color-dependent activities
  • Alternate methods for matching clothing
  • Frequent breaks from visual tasks

Retinal Dysplasia

A rare, hereditary disorder resulting in abnormal development or growth of the retina and characterized by retinal folds, overgrowth of cells, and rosettes of retinal tissue

It can be associated with Meckel syndrome. 

  • Field loss
  • Blind spots (scotomas)
  • Blurred vision
  • Possible loss of central vision
  • Reduced visual functioning at night or in dimly lit places
  • Nighttime orientation and mobility evaluation
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Visual efficiency training to develop scanning skills
  • Support of eccentric viewing
  • Lamps with rheostats and adjustable arms
  • Reduced glare
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Adapted color-dependent activities
  • Alternate methods for matching clothing
  • Frequent breaks from visual tasks

Retinitis Pigmentosa (RP)

A group of hereditary disorders causing degeneration of the retina

It is characterized by progressive loss of vision and reduction of visual fields, usually from the periphery inward. However, in some cases, central vision is affected first. RP may be associated with Usher’s syndrome, Leber congenital amaurosis, Laurence-Moon Biedl, and Bassen-Kornzweig syndrome. 

 

  • Loss of peripheral vision
  • Night blindness
  • Tunnel vision
  • Decreased acuity
  • Decreased depth perception
  • Blind spots (scotomas due to retinal scarring
  • Photophobia
  • May develop cataracts
  • May become totally blind
  • May be associated with myopia, vitreous opacities, cataracts, and keratoconus
  • Avoid contact sports and other high risk physical activity to prevent retinal detachment
  • High illumination
  • Reduced glare
  • NOIR lenses or overlay filters may be helpful
  • Video magnifier for maximum contrast
  • Night vision devices (e.g., Streamlight flashlights, Third Generation® Night Vision Devices, etc.)
  • Visual efficiency training in organized search (grid) patterns
  • Orientation and mobility evaluation at night and in dimly lit places
  • For central vision loss: magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • For peripheral field loss: increase viewing distance to see more area.

Retinoblastoma

A rare type of cancer in which malignant cells grow in the retina

It usually develops in early childhood. The majority of children who develop this cancer have mutations only in eye cells (non-germinal). They will not pass on the mutation, and usually, retinoblastoma develops only in one eye. When the mutation occurs in all body cells (germinal retinoblastoma), the disease is hereditary. These children are more likely to develop retinoblastoma in both eyes, pineal brain tumors (trilateral retinoblastoma), and other forms of cancer anywhere in the body. Current treatments include surgery, radiation, and chemotherapy. Retinoblastoma can become life threatening if the tumor extends beyond the eye, so enucleation is frequently necessary.

  • Strabismus is one of the first signs of retinoblastoma.
  • Restricted fields due to removal of tumors
  • Blind spots (scotomas) due to removal of small tumors
  • With monocular vision, there is no depth perception and visual field is restricted.
  • Blindness
  • Medications can negatively affect residual vision.

 

  • Avoid contact sports and other high risk physical activity to prevent retinal detachment
  • Orientation and mobility evaluation at night and in dimly lit places recommended
  • May need visual efficiency training to develop scanning skills
  • Support of eccentric viewing
  • May need magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • May benefit from access to auditory materials
  • May require instruction in tactile learning and braille

Retinopathy of Prematurity (ROP, retrolental Fibroplasia)

Incomplete development of the blood vessels of the retina

It occurs in premature infants. The vessels also may grow abnormally from the retina into the back of the eye. They may bleed into the eye, scar tissue may develop, and retinal detachment may occur. The major risk factors are degree of prematurity and low birth weight. There are five stages of ROP, ranging from mildly abnormal blood vessel growth in stage one to retinal detachment in stage five. ROP may be associated with other issues caused by incomplete development. Lasers or freezing (photocoagulation and cryotherapy) may be used to stop the abnormal blood vessels from continuing to grow. Also, surgery may be done to re-attach the retina. 

  • Retinal scarring
  • Decreased visual acuity
  • Severe myopia
  • Field loss
  • Partial or complete retinal detachment
  • Blind spots (scotomas)
  • Strabismus
  • Total blindness
  • May develop glaucoma

 

  • Early intervention and sensory stimulation
  • Avoid contact sports and other high risk physical activity to prevent retinal detachment
  • Nighttime orientation and mobility evaluation
  •  May need visual efficiency training to develop scanning skills
  • Visual efficiency training in organized search (grid) patterns
  • Adequate to high illumination (e.g., lamps with rheostats and adjustable arms)
  • Reduced glare
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Frequent breaks from visual tasks
  • May benefit from access to auditory materials
  • May need instruction in tactile learning and braille
  • May benefit from magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Reduced glare
  • Night vision devices (e.g., Streamlight flashlights, Third Generation® Night Vision Devices, etc.)
  • Balance need for a larger viewing area with the need for magnification
  • Balance need for close viewing against the need for increased distance and a larger portion of the text/pictures
  • Adapted color-dependent activities
  • Alternate methods for matching clothing
  • Support of eccentric viewing

Retinoschisis

A degenerative disorder in which the retina splits into two separate layers, resulting in progressive loss of vision, beginning in the fields that correspond to the areas where the retina splits

The hereditary form (juvenile X-linked retinoschisis) affects mostly boys and young men. The more common form can affect both men and women, and it usually is acquired in middle age or older (senile retinoschisis). Both forms may be associated with cysts (sack-like blisters) that form a spoke-like pattern in the retina. Retinal detachments can occur, and if detected early, they sometimes can be repaired with surgery. Prismatic glasses may be prescribed to increase field of vision.

  • Strabismus
  • Nystagmus
  • Central field loss
  • Peripheral field loss
  • Reduced visual acuity
  • Reduced color discrimination
  • Blind spots (scotomas)
  • Blindness

 

  • Avoid contact sports and other high risk physical activity to prevent retinal detachment
  • May need visual efficiency training to develop scanning skills
  • May need visual efficiency training in organized search (grid) patterns
  • Adequate lighting (e.g., lamps with rheostats and adjustable arms)
  • Reduced glare
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • Frequent breaks from visual tasks
  • May benefit from access to auditory materials
  • May need instruction in tactile learning and braille

For central vision loss:

  • Nighttime orientation and mobility evaluation
  • Magnification (e.g., hand-held lighted magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • High illumination
  • Night vision devices (e.g., Streamlight flashlights, Third Generation® Night Vision Devices, etc.)
  • Adapted color-dependent activities
  • Alternate methods for matching clothing

For peripheral field loss:

  • Increase viewing distance to see more area
  • Support of eccentric viewing
  • Balance need for a larger viewing area with the need for magnification

Rod Achromacy     See Achromotopsia

 

 

Scotoma (pl. scotomata, scotomas)

A portion of the visual field that is blind or partially blind and surrounded by relatively normal vision, depending on the presence of other eye conditions

Scotomas can occur in any part of the visual field. They can be caused by retinal disorders, tumors, stroke, or traumatic brain injury. 

  • May affect central or peripheral fields
  • Reduced acuity
  • May cause loss of detail
  • May cause photophobia
  • May cause reduced color vision
  • Visual efficiency training to develop scanning skills
  • Support of eccentric viewing
  • Seating and presentation of work should favor more functional eye
  • May need to use sunglasses, visors, or hats outdoors and indoors as well
  • Reduced glare
  • May need lighting from behind using adjustable lamps with rheostats and adjustable arms
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • May benefit from enlarged printed materials
  • May benefit from close viewing
  • High contrast materials
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • May need adapted color-dependent activities
  • May need alternate methods for matching clothing

Septo-Optic Dysplasia See Optic Nerve Hypoplasia and "Syndromes"

 

 

Strabismus (muscle imbalance

Abnormal alignment of the eyes; an inability to look at the same point in space with both eyes at the same time

It can be caused by a defect in the extra-ocular muscles or in the part of the brain that controls eye movement. It can be hereditary, and it may be associated with brain tumors, cerebral palsy, Down syndrome, extreme farsightedness, cataracts, or having much better vision in one eye than in the other. Strabismus includes:

  • “phorias”– muscle imbalances that are controlled by the brain's efforts toward binocular vision. Not always present, they tend to manifest when the person is tired.
  • “tropias” - observable deviations that the brain cannot resolve. They are always present.
  • Eso – turned inward/nasal (esophoria and esotropia)
  • Exo – turned outward/temporal (exophoria and exotropia)
  • Hyper – turned upward (hyperphoria and hypertropia)
  • Hypo – turned downward (hypophoria and hypotropia)

Treatments can be effective for young children: eye exercises, occlusion of the better eye, medications, and surgery. Prismatic glasses may be prescribed to increase field of vision.

  • Impaired ability to achieve binocular vision
  • Decreased depth perception
  • Affects eye-hand coordination
  • Difficulty fixating
  • May have difficulty scanning, tracking, and tracing
  • Difficulty following fast-moving objects
  • Difficulty making eye contact

 

  • Orientation and mobility evaluation recommended, specifically for negotiation of drop-offs and stairs in unfamiliar places
  • Vision efficiency training in scanning, tracking, and tracing

 

Toxoplasmosis

Congenital or acquired inflammation of the retina and choroid (retinochoroiditis), which can cause retinal scarring

Toxoplasmosis is caused by infection with the toxoplasma parasite found in animal feces and unpasteurized milk. Unborn babies are most vulnerable to the infection, and it can cause damage to the brain, eyes, or other organs. Treatments include anti-inflammatory medications, photocoagulation (laser) therapy, and cryotherapy (freezing).

  • Scotomas
  • Peripheral field loss
  • Central field loss
  • Loss of visual acuity
  • Decreased color vision
  • Photophobia
  • Increased sensitivity to glare
  • Visual efficiency training to develop scanning and eccentric viewing skills
  • Reduced glare
  • May need lighting from behind using adjustable lamps with rheostats and adjustable arms
  • Magnification (e.g., microscopic lenses, electronic magnifier, screen enlargement software, telescope, etc.)
  • May benefit from enlarged printed materials
  • May benefit from close viewing
  • High contrast materials
  • High contrast line markers or templates for reading, finding math problems, or locating other information
  • May need adapted color-dependent activities
  • May need alternate methods for matching clothing

Trachoma

A contagious bacterial infection of the eyes and eyelids, causing scarring and buckling of the eyelids

This causes the eyelashes to turn under, which leads to corneal scarring. Repeated and prolonged infection causes permanent visual impairment and blindness. Trachoma is spread through direct contact with secretions from the eyes, eyelids, or nose of an infected person. It is the leading cause of preventable blindness worldwide.

  • Photophobia
  • Fracturing or scattering of light (as in looking through a broken windshield
  • Increased glare
  • Blurred vision
  • Reduced acuity
  •  
  • Sunglasses, visors or hats outdoors, and indoors as well
  • Reduced or diffused lighting from behind (e.g., lamps with rheostats and adjustable arms)
  • Front row seating with back toward windows
  • Reduced glare
  • High contrast materials
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Enlarged printed materials
  • Frequent breaks from visual tasks
  • Support of eccentric viewing
  • Auditory materials for long reading assignments
  • May need instruction in tactile learning and braille

Uveitis

Inflammation of the uveal tract (middle layer of the eye), which consists of the iris, choroid, and ciliary body

The most common form affects the iris, and it may be called anterior uveitis or iritis. The cause may be unknown. Known causes include autoimmune disorders, infection, toxoplasmosis, tuberculosis, and histoplasmosis. Complications can cause glaucoma and damage to the retina or cornea, leading to permanent vision loss.

  • Photophobia
  • Blurred vision
  • Floaters
  • Decreased acuity
  • Glaucoma
  • Retinal scarring
  • Corneal damage

 

  • High contrast materials
  • Reduced glare
  • Allow additional time for adjustment to new visual conditions
  • Use of lamps with rheostats and adjustable arms
  • May need visual efficiency training to develop scanning and eccentric viewing skills

Wilm’s Tumor (nephroblastoma)

Rare abnormalities of the eye, especially aniridia, related to a malignancy of the kidneys

Although the cause is sometimes unknown, this form of cancer can be caused by genetic changes, which also can be hereditary. Pinhole contact lenses and sunglasses may be prescribed.

See “Syndromes" for associated conditions.

  • Decreased acuity, further reduced by other conditions
  • Photophobia
  • Large pupil (misshapen)
  • With corneal involvement: Fractured light, increased glare, blurred vision
  • With cataracts: blurred vision, and decreased color vision
  • Fovial involvement: loss of detail vision
  • With glaucoma: fluctuating visual functioning, field loss, poor night vision, and decreased sensitivity to contrast
  • May have nystagmus
  • May have ptosis
  • Vision stimulation for infants to develop the visual cortex
  • Sunglasses, tinted contact lenses, visors or hats in bright light outdoors and indoors
  • Allow time for adjustment to lighting changes
  • Front row seating with back to windows
  • Reduced glare
  • Provide reduced or diffused lighting from behind
  • Lamps with rheostats and adjustable arms
  • Magnification (e.g., hand-held magnifier, electronic magnifier, screen enlargement software, telescope, etc.)
  • Use a blackboard and bold chalk
  • Use of bold, black markers on a white board
  • Felt-tipped pens and tinted paper with bold lines
  • Use of dark/black background
  • Provide copies of materials presented on the board.

January 2015

compiled by TSBVI Deafblind Outreach Staff

Testing the hearing and vision of some children may be very difficult if the child does not respond in traditional ways to clinical assessment. To assist the ophthalmologist, optometrist, otologist or audiologist obtain good testing results on these children it is often helpful to conduct informal assessment prior to or in conjunction with their formal assessments. This type of informal assessment may be carried out by the educational staff and parents. Texas Deafblind Outreach has compiled a variety of assessment tools which we hope will help parents and educational staff gather functional information that may then be shared with these doctors to aid them in making a definitive determination of hearing or vision loss. These materials include those which will: guide observations and organize that information to share with medical staff; expand the range of questions to explore with the professionals to get good testing results; and help prepare the student for more formal testing procedures. Additionally, we have included materials which will aid the educational staff in determining modifications to improve programming for the child in the classroom.

These materials are in no way meant to supplant formal testing done by ophthalmologists, optometrists, audiologists or otologists. Law and common sense dictates that formal testing must be done. Rather it is meant to aid in getting good testing results on hard to test children. If you need some help using these materials, the Texas Deafblind Outreach staff is also available to help. You may request their assistance by contacting Cyral Miller, Outreach Director, at (512) 206-9242.

Your region may know of other useful vision and/or auditory assessments. TSBVI Outreach would love to share your resources! 

 

STUDENT CATEGORY DEFINITIONS

FI = FULL INDEPENDENCE

These students are expected to achieve full Independence in adult living roles. They will probably be assessed using TAAS at their appropriate grade level. They may have additional impairments so long as they function within 2 grade levels of their chronological peers. Post high school education for these students is likely to be college, trade school, or vocational programs.

SEMI-I = SEMI-INDEPENDENCE

These students are expected to be able to live independently without direct or constant assistance. They are likely to be assessed using either the TAAS or release TAAS. These students have reading, math, and writing skills at least 2 grade levels below their chronological peers. They can complete tasks which require a moderate degree of abstraction, but they must first have a very concrete learning foundation. Post high school education for these students is likely to be a trade school or vocational program. It is expected that these students will be able to participate in competitive employment in the general job market with only minimal assistance or support.

FS = FUNCTIONAL SKILLS

These students are in 6th grade or above. If this student category is being considered for a K-5 student, assign the student to the Semi-Independent category. These students will be assessed using an alternative instrument (as opposed to TAAS). They are not expected to read, write, and/or perform mathematical computations beyond the second grade. The appropriate curricular focus for these students is on helping them to develop practical skills necessary for living as independently as possible. Their educational program is typically community based, concrete, and action oriented. These students learn best when they can practice what they are learning in age-appropriate settings which provide experience with the tasks of daily living (e.g. cooking, counting money, etc.). They are able to generalize concepts from one environment to another. The expected outcome for these students is that they will be able to participate in competitive employment with assistance, and that they will be able to live with consistent support (e.g. supported living facility, etc.).

SUP-I = SUPPORTED INDEPENDENCE

These students are expected to require continuous ongoing support as adults. They will be assessed using alternative assessment procedures. Educational programs for these students are typically community based and emphasize routines and calendar systems. These students have difficulty generalizing from one environment to another. Instructional domains typically include domestic, vocational, and recreation/leisure skills. Social competence, social interactions, emotional development, and organization skills are the emphasis of these students' instructional programming.

P = PARTICIPATION

These students have multiple impairments, which usually include severe cognitive delays, the inability to generalize from one environment to another, and the inability to use meaningful verbal communication. They are typically assessed with alternative assessment procedures which could include portfolio and biobehavioral state assessment. As adults, they are expected to require extensive ongoing support. The emphasis of their instructional program should be placed on environmental awareness and appropriate forms of communication

References used in developing these definitions include the Assessing Unique Needs (AUEN) , Texas School for the Blind and Visually Impaired's Continuum of Service document, and the Regional Student Performance Indicators (RSPI)


 

Assessment Resources for Vision and Hearing

Assessment Resources for Vision and Hearing

Compiled by Jenny Lace, Texas Deafblind Outreach in 2009

Assessment Area Editor / Order Type Student Categories

ABC Checklist for Vision Observation and History - It's as Simple as A, B, C

Vision

Modified by Tani Anthony: VIBRATIONS Newsletter of Colorado Services for Children who are Deafblind, Winter 2000 Edition

Checklist

FI, SEMI-I

A G Bell Speech & Hearing Checklist

Auditory

Alexander Graham Bell Association for the Deaf & Hard of Hearing

www.agbell.org

Checklist

Infant

Assessing Basic Auditory Skills

Auditory

J.C. Durkel, TSBVI, 1100 W. 45th St., Austin, TX 78756

 

All

Assessing Children's Vision: A Handbook

Vision

Colorado Services for Children who are Deafblind, Lending Library, Sheryl Ayresm, CDE, 201 E. Colfax Ave, Denver, CO 80203

Book

Unknown

Assessing Young Children with Dual Sensory & Multiple Impairments (Ages Birth-Five) Assessment Guidelines Volume 1

Vision

Auditory

By: Ellin Siegel-Causey, Ph.D. University of Nebraska-Lincoln, 1996 GLARCDB, 665 E. Dublin-Granville Rd., Columbus, OH, 43229

Instrument

Infant-Preschooler, SUP-I, P

Assessment and Instructional Resources

Vision

Auditory

Texas School for the Blind and Visually Impaired Website

Website

All

Assessment of Auditory Functioning

Auditory

By: D. Gleason, 1984; found in appendices from VIMI, M. Smith & N. Levack; order from: TSBVI, 1100 W. 45th Street, Austin, TX. 78756

Guide

SEMI-I, FS,SUP-I, Preschooler

Assessment of Auditory Functioning of Deaf-Blind / Multihandicapped Children

Auditory

By: Deborah Kukla & Theresa Thomas Connolly, 1978, South Central Regional Center for Services to Deaf-Blind Children, Dallas Texas

Guide

FS, SUP-I, P

Assessment of Biobehavioral States & Analysis of Related Influences

Vision

Auditory

By: M. Smith & S. Shafer, based on Crib, Simeonsson & Project Able, Guy. Found in Appendices from VIMI, M. Smith & N. Levack; order from TSBVI, 1100 W. 45th Street, Austin, Texas 78756

Guide

P

Assessment of the Visually Impaired

Vision

By: Nan Bulla, M.Ed., 1996; order from: TSBVI, 1100 W. 45th St., Austin, TX 78756

Guide

All

Audiological Assessment of Individuals w/ DeafBlindness Utilizing Behavioral Methods

Auditory

By: Moore, John Mick; Connix, Frans. 1996; Assessment Bibliography from DB Link 

http://nationaldb.org/ISLibrary.php

Paper

FS, SUP-I

Audiometric Procedures Commonly Used to Identify Potential Hearing Loss

Auditory

J.C. Durkel, TSBVI, 1100 W. 45th St., Austin, TX 78756

Chart

All

Auditory Assessment & Programming for Severely Handicapped Deaf-Blind Students

Auditory

By: L.Goetz & B.Utley; order from: The Association of the Severely Handicapped, 7010 Roosevelt Way, NE, Seattle, WA 98115; Words & Pictures Corporation, PO Box 1001, Parsona, KS 67357

Manual

FS, SUP-I, P

Auditory Assessment of the Difficult to Test

Auditory

By: Robert T. Fulton & Lyle Lloyd; Assessment Bibliography from DB Link

Book

FS, SUP-I, P

Auditory Brainstem Response & Otoacoustic Emissions

Auditory

ASHA Let's Talk, Apr. 1994

Article

All

Auditory Development - Objectives for Child

Auditory

Infant Hearing Resource, Good Samaritan Hospital and Medical Center, 1015 N.W. 22nd Ave., Portland, Oregon 97210

Checklist

Infant-Preschooler, ALL

BAR- Beyond Arms Reach

Vision

By: Audrey Smith, Ph.D. & Lizbeth O'Donnel, M.S., Pennsylvania College Of Optometry Press, 1200 Godfrey Ave., Philadelphia, Penn. 19141

Instrument

FI, SEMI-I, FS

Basic Vision Skills

Vision

TSBVI- Outreach 1100 W. 45thSt., Austin, TX 78756

Packet

All

Callier Azuza Scale, The

Vision

Auditory

By: Robert Stillman, 1978; order from: University of Texas at Dallas, Comm. Disorders, 1966 Inwood Rd., Dallas, Tx. 75235

Instrument

SEMI-I, FS, SUP-I,P

Central Auditory Processing Disorders (CAPD)

Auditory

By: Judith W. Paton

LDOnLine http://www.ldonline.org/ld_indepth/process_deficit/capd_paton.html

Article

FI, SEMI-I, FS

CAPD Handout for Parents & Teachers

Auditory

Web site- ABC's of LD/ADD; The Audiology & Speech Pathology Clinic at Wilford Hall Medical Center, The United States Air Force hospital at Lackland Air Force Base, San Antonio, TX

Handout

All

Central Auditory/ Vision Processing Disorders

Vision

Auditory

Search websites: ABC's of LD/ADD

http://www.ldonline.org/ld_indepth/process_deficit/pro_deficits.html

Article

All

Characteristics of Students with Auditory Processing Problems That May Be Observed in the Classroom

Auditory

By: Susan Bell, The Speech Bin, Catalogue No.1545 from "What is Auditory Processing?"

Article

All

Checklist for Deaf-Blind Census of Texas

Vision

Auditory

By: Roseanna Davidson, Ed.D., Texas Tech University, Deafblind Census of Texas, College of Education, PO Box 41071, Lubbock, TX. 79409

Checklist

All

Children with Dual Sensory Impairments Series Guidelines for Determining Functional Hearing in School-Based Settings

Auditory

by: Flexer, Baumgarner, Wilcox, 1990. Order from: M. Jeanne Wilcox, Ph.D., Family Child Learning Center, 90 West Overdale Dr., Tallmadge, OH 44278

Module

All

Children with Dual Sensory Impairments Series: Guidelines for Determining Functional Use of Vision in School-Based Settings

Vision

By: Cambell, Ph.D., Baumgarner, Wilcox 1989 Order from: M. Jeanne Wilcox, Ph.D., Family Child Learning Center, 90 West Overdale Dr., Tallmadge, Ohio, 44278

Module

All

Comparison of the Frequency & Intensity of Various Environmental & Speech Sounds

Auditory

TSBVI- Outreach 1100 W. 45th St., Austin, TX 78756

Graph

All

Conditions with Hearing Loss & Retinitis Pigmentosa Different from Usher Syndrome

Vision

Auditory

By: Davenport, Sandra, M.D., Sensory Genetics/Neurodevelopment, 5801 Southwood Dr., Bloomington, MN 55437-173

Table

All

Considerations for Detecting Hearing Loss in Infants

Auditory

TSBVI- Outreach 1100 W. 45th St., Austin, TX 78756

Article

Infant

Cortical Visual Impairment

Vision

By: Jan, Groenveld, Sykanda, Hoyt, 1987

 Article

 All

Cortical Visual Impairment - An Overview of Current Knowledge

Vision

contact Tanni at: Colorado Dept.of Education, State Office, Bldg. 201 E., Denver, CO 80203

Article

All

Cortical Visual Impairment Presentation. Assessment and Management. Monograph Series Number 3.

Vision

By: Heather Crossman, 1992, The Royal New South Wales Institute for Deaf and Blind Children. North Rocks Press, Australia: http://www.ridbc.org.au/index.asp

Monograph Series

All

CTEVH XXXII Annual Conference: Cortical Vision Impairment, Delayed Visual Maturation, Cortical Blindness

Vision

By: Takeshita, Bill, 1996 Center for the Partially Sighted, Director of Children's Services, 720 Wilshire Blvd., Suite 200, Santa Monica, CA 90401

Handout

All

DAP - Diagnostic Assessment Procedure

Vision

APH, PO Box 6085, Louisville, KY 40206-0085

Instrument

FI, SEMI-I, FS

DB-LINK Assessment Bibliographies

Vision

Auditory

Website: http://nationaldb.org/ISLibrary.php

Website

All

Deaf-Blind Infants and Children: A Developmental Guide

Vision

Auditory

By: McInnes & Trefrey, University of Toronto Press, 1982

Guide

Infant -KDG., FS, SUP-I, P

Deafness and Vision Disorders: Anatomy and Physiology, Assessment

Procedures, Ocular Anomalies, and Educational Implications

Vision

Auditory

By: Johnson, Donald D., Order from: Charles C. Thomas Publisher, LTD.,  www.ccthomas.com

email: 

Book

All

Diagnostic Patching Regimen for the Profoundly Multiply Handicapped,

Vision

By: Freeman, O.D. & Jose, O.D.; Journal of Behavioral Optometry, 1995

Article

SUP-I, P

Early Identification of Deaf-Blindness

Vision

Auditory

By: Davenport, Sandra L. H. 1993; Assessment Bibliography from DB Link http://nationaldb.org/ISLibrary.php

Outline

Infant-Preschooler

Early Identification of Hearing Loss in Infants & Young Children

Auditory

www.hsdc.org/hrgloss

Checklist

Infant

Educating Young Children A Developmental Approach

Vision

Auditory

S. G. Garwood, E. pg 235-281 Rockville, Md. Aspen Systems Corp 1983; "Working with Sensorily Impaired Children," Rebecca Fewell

Book

Infant-Preschooler, P

Educational Methods for Deaf-Blind and Severely Handicapped Students, 1980

Auditory

Texas Education Agency, 1701 North Congress, Austin, Texas 78701

Article

Birth-6YRS.

Effective Practices in Early Intervention - Infants Whose Disabilities Include Both Vision & Hearing Loss

Vision

Auditory

By: Deborah Chen, Ph.D., California State University, Northridge

Guide

Infant, P

Every Move Counts - Sensory Based Communication Techniques

Vision

 Auditory

Therapy Skill Builders, 3830 E. Bellevue, PO Box 42050, Tucson, AZ 85733

Manual, Video

Infant, SUP-I, P

Functional Auditory Assessment

Auditory

By: Gee, Kathy. San Jose State University, 1996; Assessment Bibliography from DB Link nationaldb.org

Packet

All

Functional Hearing Assessment

Auditory

By: Peggy Miller Tarver, Texas School for the Deaf, 1102 South Congress, Austin, TX 78704

Handout

Infant

Functional Skills Screening Inventory

Vision

 Auditory

Functional Resources, 3905 Huntington Drive, Amarillo, TX 79109-4047

Instrument

SEMI-I, FS, SUP-I

Functional Vision & Media Assessment (2nd Edition) for Students who are Pre-Academic or Academic & Visually Impaired in Grades K-12

Vision

By Vision Consultants, Larhea Sanford & Rebecca Burnett, 1996; PO Box 8594, Hermitage, TN 37076 ph: (615)885-0764

Instrument

K-12TH GRADE, FI, SEMI-I, FS

Functional Vision Assessment & Interventions

Vision

Topor, Irene L. 1996; Assessment Bibliography from DB Link 

Packet

All

Functional Vision Assessment Birth to Three Years & Multihandicapped Recording Form

Vision

By: Kathleen Appleby, 1996; Vision Associates, 7512 Dr Phillips Blvd., Orlando, FL.

Form

BIRTH-3YRS., SUP-I, P

Functional Vision Evaluation

Vision

Region VIII Education Service Center, PO Box 1894, Mt. Pleasant, TX 75456-1894

Instrument

All

Functional Vision Screening

Vision

By: Beth Langley & Rebecca Dubose

Instrument

All

Gathering Information for Programming for the Student with the Most Profound Disabilities: Information Packet, 1997

Vision

Auditory

Texas School for the Blind and Visually Impaired Outreach, 1100 West 45th Street, Austin, TX 78756-3494

Packet

P

Getting the Most out of Clinical Low Vision Evaluations & Ophthalmologic Evaluations for the Student w/ Deafblindness

Vision

Tarver, Peggy Miller; Blaha, Robbie 1996; Assessment Bibliography from DB Link

http://nationaldb.org/ISLibrary.php

Packet

All

Great Lakes Area Regional Center for Deafblind Education Assessment Guidelines

Vision

Auditory

University of Dayton/UDRI Project #93985, Assessment Guidelines, GLARCDBE, Poste Lake Building, Suite 100, 665 East Dublin-Granville Rd., Columbus, OH 43229

Guide

Infant-Preschooler; Ages 6-15; Young Adults- SEMI-I, FS, SUP-I

Guide for Observing Auditory Responses

Auditory

By: Karen Wright, Texas School for the Deaf, 1102 S. Congress, Austin, TX 78704

Guide

All

Hearing Observation Form

Auditory

By: TSBVI Outreach, 1995, 1100 West 45th Street, Austin, TX 78756

Chart

All

HELP (Hawaii Early Learning Profile)

Vision

Auditory

Vort Corporation, PO Box 60132, Palo Alto, CA 94306

Instrument

Infant-Preschooler, P

Here's Looking at You Kid - The Proceedings of the Eighth International Conference on Blind & Visually Impaired Children, 1993

Vision

Order from: Diane McConnell & Bill Mckeown, The Canadian National Institute for the Blind, 12010 Jasper Ave., Edmonton, Alberta, Canada T5K 0P3

Paper

All

How is All the Information From a Functional Vision Assessment Put Together?

Vision

Indiana Deaf-Blind Services Project Information Updates.5. Blumberg Center for Interdisciplinary Studies in Special Education, Indiana State University, Terre Haute, IN; 

Unknown

Unknown

How to Read an Audiogram

Auditory

By: Sandra Davenport, M.D., Sensory Genetics/Neuro Development, 5801 Southwood Dr., Bloomington, MN 55437

Article

All

Informal Assessment of Listening Skills

Auditory

TSBVI - Curriculum, 1100 W. 45th St., Austin, TX 78756, ph: (512) 454-8631

Assessment KIT Listening

Infant-Preschooler

Informal Auditory Observation Form

Auditory

By: Robbie Blaha & Stacy Shafer; TSBVI Outreach, 1100 W. 45th St., Austin,

TX 78756

Informal

All

INSITE

Vision

Auditory

Project INSITE, Utah School for the Deaf and the Blind, 846 20th St., Ogden, UT 84401 order: HOPE INC. 55 E. 100 North, Suite 203, Logan, Utah 84321

Manual, Video

Infant-Preschooler, P

Issues Regarding the Assessment of Vision Loss in Regard to Sign Language and Fingerspelling for the Student with Deaf-Blindness

Vision

Auditory

By: Robbie Blaha; Order from: TSBVI, 1100 W. 45th St., Austin, Tx. 78756

Article

F-, SEMI-I, FS, SUP-I

Learning Media Assessment of Students with Visual Impairments - A Resource Guide for Teachers

Vision

By: Alan Koenig & M. Cay Holbrook, 1993; Order from: TSBVI, 1100 W. 45th St., Austin, TX 78756

Guide

All

Low Vision - A Resource Guide with Adaptations for Students with Visual Impairments

Vision

By: Nancy Levack, 1991; Order from: TSBVI, 1100 W. 45th St., Austin, TX 78756

Guide

All

Low Vision: A Resource Guide w/ Adaptations for Students w/ Visual Impairments

Vision

By: Levack, Nancy; Stone, Gretchen; Bishop, Virginia 1996. Texas School for the Blind & Visually Impaired (TSBVI) 1100 West 45th St., Austin, Texas 78756-3494

Guide

All

Making Choices in Functional Vision Evaluations: "Noodles, Needles and Haystacks"

Vision

By: V. Bishop, Journal of Visual Impairment and Blindness. 82, 94-98;  http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=EJ368869&ERICExtSearch_SearchType_0=no&accno=EJ368869

Article

All

Making the Most of Early Communication

Vision

Auditory

VIDEO By: Deborah Chen and Pamela Schachter; Order from: AFB Press

Video

Infant-Preschooler

Michigan Severity Rating Scales for Students with Visual Impairments,

Vision

Michigan School for the Blind Outreach Department, 1996-1997

Packet

All

New Methods for Evaluating Vision

Vision

By: Cress, Pamela J. & Spellman, Charles R. 1991; Assessment Bibliography from DB Link  http://nationaldb.org/ISLibrary.php

Article

Infant-Preschooler P

Nonhearing World, The; Understanding hearing Loss

Auditory

Films for the Humanities, INC, Box 2053, Princeton, NJ 08543-2053

Video

All

Oregon Project

Vision

Auditory

Jackson County Education Service District, 101 N. Grape St., Medford, OR 97561

Instrument

Birth-6 Yrs.FI, SI, FS

Parent Checklist

Auditory

By: Peggy Miller Tarver, Texas School for the Deaf, 1102 S. Congress, Austin, TX 78704

Checklist

Infant-Preschooler

Peabody Model Vision Project: Functional Vision for the Multiply & Severely Handicapped

Vision

By Beth Langely, 1980; order from: Stoelting Co., 1350 S. Kostner Ave., Chicago, IL 60623

Manual

SEMI-I, FS, SUP-I

Possible Indicators of Persons Who May Not Be Deaf or Hard of Hearing

Auditory

By: Peggy Miller Tarver, Texas School for the Deaf, 1102 S. Congress, Austin, TX 78704

Checklist

All

Procedures Commonly Used for Determining Potential Hearing Loss

Auditory

By: Jim Durkel, TSBVI-Outreach 1100 W, 45th. St., Austin, TX 78756

Chart

 

Reactions Frequently Reported by Hard of Hearing People

Auditory

TSBVI-Outreach 1100 W, 45th. St., Austin, TX 78756

List

All

Screening for Hearing & Vision Loss

Vision

Auditory

Arizona School for the Deaf and Blind-ASDB Tucson, AZ. Assessment Bibliography from DB Link  http://nationaldb.org/ISLibrary.php

Article

Birth-6 Yrs.

Sensory Assessment Manual

Vision

Auditory

By: Cress, Pamela. Monmouth,1989 OR: Oregon State System of Higher Ed. Teaching Research Division, 345 N Monmouth Ave. 97361

Manual

FI, SEMI-I

Sounds of Texas: Can Your Baby Hear Them

Auditory

Texas Department of Health http://www.tdh.state.tx.us/audio/sotbroch.htm

Checklist

Infant

South Carolina Functional Vision Assessment

Vision

South Carolina Department of Education, 1429 Senate St., Columbia, SC 29201

Instrument

All

Steps in Preparing the Functional Vision Assessment for Students with Multiple Disabilities

Vision

From Foundations of Low Vision: Clinical & Functional Perspectives By:: Corn & Koenig; From Foundations of Low Vision: Clinical & Functional Perspectives.

Book

P

Suggestions for Parents in Preparing a Childe for Audiologicals

Auditory

By: Karen Wright & Peggy Miller Tarver Texas School for the Deaf, 1102 S. Congress, Austin, TX 78704 ph: (512) 462-5353

Article

All

Systematic Procedures for Eliciting and Recording Responses to Sound Stimuli in Deafblind Multihandicapped Children

Auditory

By: Susan M. Kershman & Deborah Napier

Article

Toddlers, SUP-I, P

Teachers Guide to the Special Educational Needs of Blind and Visually Handicapped Children - Functional Vision Checklists-pg..37-44

Vision

American Foundation for the Blind, 11 Penn Plaza, Suite 300, NY, NY 10001

Book

FI, SEMI-I, FS

Teaching Students with Visual & Multiple Impairments

Vision

Auditory

By: M. Smith & N. Levack; Order from: TSBVI, 1100 W. 45th St., Austin, TX 78756

Guide

All

Team Approach to Audiological Assessment

Auditory

VIDEO: Infant Hearing Resource/Hearing & Speech Institute, 3515 SW Veterans Hospital Rd., Portland, OR 97201

Video

Infant

Test of Auditory Perceptual Skills

Auditory

Morrison F. Gardner (for ages 4-13); order from: Stoelting Co., 620 Wheat Lane, Wood Dale, IL 60191; ph: 630-860-9700; fax: 630-860-9775; www.stoeltingco.com

Kit

FI, SEMI-I

Texas Early Childhood Intervention Vision & Auditory Forms

Vision

Auditory

Contact your local ECI program

FORM

Infant, SUP-I, P

The Nonhearing World; Understanding Hearing Loss

Auditory

VIDEO: Films for the Humanities, Inc., Box 2053, Princeton, NJ 08543-2053

Video

All

Things to Consider: Preparing for an Eye Exam of your Child

Vision

By: Tani Anthony CDE, 201E. Colfax Ave., Denver, CO.

Checklist

All

Things to Know Before You Go To the Audiologist

Auditory

By: Stacy Shafer, Robbie Blaha, 1997. order from: TSBVI, 1100 West 45th St., Austin, TX 78756 ph: (512) 454-8631

Packet

All

Things to Think About When Looking at CAPD

Auditory

By: Jim Durkel, TSBVI Outreach 1100 West 45th St., Austin, TX 78756

Handout

Infant

Understanding Central Auditory Processing Disorder

Auditory

By: Dorothy A. Kelly; Order from: Communication Skill Builders

Guide

FI, SEMI-I, FS

Understanding Low Vision

Vision

by: Randal T. Jose, Ed., 1989; American Foundation for the Blind

Book

All

Usher Syndrome Screening Checklist

Vision

Auditory

TSBVI- Outreach 1100 W. 45th St., Austin, TX 78756

Checklist

FI, SEMI-I

Usher's Syndrome Adolescent

Vision

Auditory

TSBVI- Outreach 1100 W. 45th St., Austin, TX 78756

SCREENING FORM

Adolescent, FI, SEMI-I

VIISA (Resources for Family Centered Intervention for Infants, Toddlers, and Preschoolers Who Are Visually Impaired)

Vision

SKI*HI Institute, Utah State University, Department of Communication Disorders, Logan, UT 84322-1900; order: HOPE INC., 55 East 100 North, Suite 203, Logan, Utah 84321

Manual

Infant-Preschooler

Vision Assessment and Program Manual for Severely Handicapped and/or Deaf-Blind Students

Vision

Eric [document Reproduction Service No. ED 250-840] Reston, VA: Council for Exceptional Children

Unknown

Unknown

Vision Associates

Vision

7512 Dr Phillips Blvd., #50-316, Orlando, FL 32819 

Checklist, Instrument, Kit, Video, Book

All

Vision Questionnaire - For Teaching Parents / Teachers Usher)

Vision

TSBVI- Outreach 1100 W. 45th St., Austin, TX 78756

Questionnaire

Usher, FI, SEMI-I

Vision Screening for Deaf & Hard-of-Hearing Students

Vision

Auditory

Minneapolis Children's Medical Center, 2525 Chicago Ave-South, Minneapolis, MN 55404; Sensory Genetics/Neuro-development, 5801 Southwood Dr., Bloomington, MN 55437

Questionnaire

All

Vision Test for Infants

Vision

By: Chen, Deborah California State University order: AFB Press, American Foundation for the Blind, Eleven Penn Plaza, New York, NY 1001

Video

Infant

Visual and Auditory Processing Disorders

Vision

Auditory

National Center for Learning Disabilities, 381 Park Avenue South, Suite 1420, New York, NY 10016

Variety

All

Visual Impairment and Learning Disabilities

Vision

By: Bulla, 1997 TSBVI 1100 W. 45th St., Austin, TX 78756

Article

FI, SEM-I, FS

What Can Baby Hear?

Auditory

VIDEO By: Deborah Chen, Ph.D., California State University, 1997; Order from: AFB Press

Video

Infant

What Can Baby See?

Vision

VIDEO By: Deborah Chen; Order from: AFB Press

Video

Infant

What is Usher Syndrome? How to Recognize the Combination of Hearing Loss and Retinitis Pigmentosa

Vision

Auditory

DRAFT - Indiana Deaf-Blind Services Project http://www.indstate.edu/blumberg/

Guide

FI, SEMI-I, FS

What's Functional About a Functional Vision Assessment?

Vision

By: I. Topor (with Penny Rosenblum) (1994), Indiana Deaf-Blind Services Project Information Updates. 5., Blumberg Center for Interdisciplinary Studies in Special Education, Indiana State University, Terre Haute, IN; 

http://www.indstate.edu/blumberg/

Article

Unknown

When Families & Staff Go to the Ophthalmologist or Audiologist

Vision

Auditory

By: Blaha, Robbie 1995 TSBVI Outreach 1100 West 45th St. Austin, TX 78756

Article

All

Why is it Important to Screen for Usher Syndrome?

Vision

Auditory

TSBVI- Outreach 1100 W. 45th St., Austin, TX 78756

Article

FI, SEMI-I, FS

American Association of the Deaf-Blind - The American Association of the Deaf-Blind (AADB) is a consumer membership organization of, by and for people with combined vision and hearing loss. Membership is available to any person with a vision and hearing loss, as well as supporters such as family members, professionals, and interpreters.. TXDBA's mission is to bring people who have hearing and vision loss, their families, friends, and professionals together to understand hearing and vision loss and to cope by supporting each other.

American Council of the Blind - The American Council of the Blind strives to increase the independence, security, equality of opportunity, and quality of life, for all blind and visually-impaired people.

American Council of the Blind of Texas - The American Council of the Blind of Texas, Inc. (ACBT) was organized in Waco in 1978 as an affiliate of The American Council of the Blind (ACB). The mission statement of ACB states that the American Council of the Blind “strives to increase the independence, security, equality of opportunity, and to improve quality of life for all blind and visually impaired people.” ACBT subscribes to this mission statement and works to be an advocacy organization and positive, proactive support system to Texans who are blind or visually impaired. Our state motto is TEAM – Together Everyone Achieves More. Although the majority of members are blind or visually impaired, sighted persons who share the common goals and interests of our organization are also welcome to join. ACBT currently has ten chapters and six special interest affiliates.

Association of Education and Rehabilitation of the Blind and Visually Impaired (AER) - The mission of AER is to support professionals who provide education and rehabilitation services to people with visual impairments, offering professional development opportunities, publications, and public advocacy.

Charge Syndrome Foundation - The mission of the CHARGE Syndrome Foundation is to provide support to individuals with CHARGE syndrome and their families; to gather, develop, maintain and distribute information about CHARGE syndrome; and to promote awareness and research regarding its identification, cause and management.

Deaf-Blind International (DbI) - The Deaf-Blind International is the world association promoting services for individuals with deafblindness.

Learning Ally - The world's largest provider of audio text for individuals who have disabilities impairing their access to print.  This organization now has a lot of information and training for parents on their website.

National Center on Health, Physical Activity and Disability - This organization promotes and advocates for improvement of physical health and participation in regular physical activities for people with disabilities.

National Federation of the Blind - Founded in 1940, the NFB advocates for the civil rights and equality of blind Americans, and develops innovative education, technology, and training programs to provide the blind and those who are losing vision with the tools they need to become independent and successful.

National Federation of the Blind of Texas - The Texas chapter of NFB.

National Organization for Albinism and Hypopigmentation (NOAH) - NOAH is an organization that offers information and support to people with albinism, their families and the professionals who work with them.

Optic Never Hypoplasia / Septo-Optic Dysplasia Focus Families - Provides information, support and networking for families of individuals with Optic-Nerve Hypoplasia and Septo-Optic Dysplasia.

Texas Association of Blind Students - TABS is a membership organization devoted to the advancement of blind students of all ages. Since its inception in 1990, TABS has worked on multiple levels to encourage the equal participation of blind individuals in all functions of society. Through instructional seminars, state and national conventions, legislative action, social events, and literature, we strive to promote independence and self-advocacy. The organization operates as a whole under the principle that inside and outside the classroom blind students are fully capable of leading normal productive lives. In order to reinforce this belief, it is necessary to view the change within blind students themselves. Thus, our ongoing objective is to work in conjunction with the National Association of Blind Students (NABS) and to a larger extent with the National Federation of the Blind (NFB) to build a sturdy foundation of useful skills, solid confidence, and raw determination so that we may in turn show the public that blindness is not the limitation it is thought to be. In essence, the primary goal of TABS is to follow its parent organizations in changing what it means to be blind.

Texas Deaf-Blind Association Texas Deaf-Blind Association (TXDBA) is an organization for people who live in Texas with combined hearing and vision loss. Our members are deaf-blind, deaf with low vision, hard of hearing with any kind of vision loss, family members, friends, interpreters, support service providers (SSPs), and professionals who work with people with combined hearing and vision loss

The Assessment of Deafblind Access to Manual Language Systems (ADAMLS) is a re­source for educational teams who are responsible for developing appropriate adaptations and strategies for children who are deafblind who are candidates for learning manual lan­guage systems. Our scope here is intentionally narrow; however we want the reader to remember how complex the approach to instructional strategies for children with deafblindness can be and we encourage you to refer to the resources listed.

A child who is deaf or hard of hearing depends heavily on the visual channel to access information and interaction. Sign language, fingerspelling and speechreading are visual by definition, and vision loss can greatly affect the ability of the child who is deafblind to access these modes of communication. Because little or no attention has been focused on this problem, it is typically not addressed in evaluations. As a result, many qualified students are considered incapable of learning these language systems, and educators may be so unfamiliar with adaptations and strategies to teach them that the child fails to show progress. Effective teaching practice requires that the influence of vision loss on the acquisition and use of manual communication forms be fully considered so that appropriate adaptations can be implemented.

The assessment tool should be used for all children with a dual vision and hearing sen­sory loss (deafblindness) in educational settings that use a form of manual communica­tion. Communication is the means by which a child gains access to the curriculum and to education generally. Therefore, if there is a breakdown in this critical exchange, the child is essentially denied the right to a free and appropriate education. We hope the ADAMLS provides unique and important information in a user­friendly manner to fulfill a need that exists in the field of deafblindness.

Download the assessment.