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Lynne:
The Ratings in the CVI Range have uses that may be important to teachers of the visually impaired or others who are considering CVI assessment results and how they affect educational programming. Rating I can be used to determine present levels of visual functioning and Rating II can be used to determine modifications or adaptations for the Individual Education Plan.

These two sets of information are important when writing a functional vision evaluation and learning media assessment, and can make up the bulk of the CVI narrative, if done separately.

Sara:
The plus statements in Rating I of the CVI Range can be used to determine present levels of visual functioning: we also used the more specific description provided in the CVI Range Scoring Guide under the plus column. For Ian, these are the plus statements:

"Latency (is) present only when (Ian) is tired, stressed, or overstimulated."

Ian has a "delay in directing (his) visual attention toward a target only when experiencing fatigue or inappropriate levels of multisensory input."

Ian is able to participate visually in routine events, though in non-routine events or when presented with many novel items, Ian may have a more and more difficult time looking, particularly at additional novel items.

Lynne:
Ian regards familiar faces when voices do not compete: Ian is able to glance at or look "directly into faces of familiar people, but only when the familiar person is not speaking."

"Simple books, picture cards, or symbols [are] regarded" by Ian: he "visually attends to two-dimensional materials that have little complexity and that include one- to two-color images."

"Selection of toys or objects [is] not restricted."-Ian "is able to visually examine and/or interact with objects of any color and of any surface pattern, even if they are novel."

Sara:
Ian has "no color or pattern preferences"

"Color highlighting or pattern adjustment or highlight is not required for visual attention." It's not required, but it does make things easier.

Ian's "visual attention extends beyond 20 feet."

Ian "is able to visually locate and/or fixate on certain targets at distances up to and possibly beyond 20 feet away."

Ian "uses vision to imitate actions."

He is able to repeat "actions in response to a direct model."

Lynne:
Ian "demonstrates memory of visual events"

He "demonstrates recognition of a person, place, or event that has occurred in the past." "Look and reach [are] completed as [a] single action" for Ian. Ian uses visually guided reach most of the time, even with complex backgrounds, but occasionally looks away just as he is reaching. This may happen more when he is tired or stressed.

Sara:
The numbers on Rating II, or the highlighted areas of the CVI Resolution Chart, can be used as a helpful guide to appropriate modifications for your student. Here is what that might look like for Ian:

Christine Roman states that instruction for a student, such as Ian, with a high resolution of CVI characteristics, has two main themes: teaching sorting skills with reference to the concepts of alike and different, and disembedding salient features from a background. Learning how to compare and contrast the visual properties of objects supports the ability to analyze novel information and complex situations. Learning to differentiate a feature or object from a background supports the development of the ability to differentiate details and make fine visual discriminations.

Lynne:
Ian does not require a certain color to be able to visually attend to items, but having a primary color does seem to help focus his visual attention. Use labeled color photographs of items, places, etc., that contain color as symbolic representations in Ian's daily schedule and activities. Drawn pictures may also be useful as an organizational tool within lessons, especially if Ian is involved in the drawing and labeling process. These labeled pictures may take the place of written notes. Perhaps experiment with bold print on a red or yellow background to see if this aids in his sight word recognition. The goal is to allow Ian access to a learning media that does not depend on another person to deliver it. Ian may not be able to recognize either the picture or the word at first, but through consistent exposure he may be able to more easily process the information to the point of the picture no longer being necessary. Use bright primary colors to create templates to help Ian's organizational skills so that he does not visually lose items he uses often, the way he would when items are in baskets or are in a pile. For example, on his dresser, create an outline, with adequate free space around it, in the shape of things like hygiene supplies, cd player, ipod, etc, so that he can put items back in their location and easily find them again.

Ian does not require movement for visual attention. In fact, when he is upright and walking he is also concentrating very hard on those motor skills, and his ability to see becomes more difficult. It will be easier for Ian to perform complex visual tasks when his body is stable and seated.

Sara:
Latency and novelty are not separate areas in Ian's case, so they will be addressed at the same time. Ian is able to look at and especially identify familiar items much more readily than those that are unfamiliar. When he is asked to look at many new items he may tire out easily. Periods of sustained viewing of novel items should be limited to ten minutes max. Reduce visual demands when Ian is participating in a novel setting or routine. Give him extra time to process and respond to visual targets. When setting up a visit to a novel setting, or participating in a new routine, it may be helpful to consider the reduction of background noise by selecting a time when the area is less busy, or by turning down distracting sounds like the radio. It might be helpful to take pictures of the visual targets in the novel setting, and then preview them with Ian, adapting them to help point out the visual target in the setting by occluding some of the background, such as with a black frame. He then may compare the picture to the setting when he arrives, with assistance. Allow Ian time to study a novel object or word before requiring a response. Perhaps he could be given the opportunity to examine materials for an upcoming lesson without adult intervention so that he has some degree of visual recognition of the task.

Ian is able to use all visual fields, though with items that are complex, particularly small items and two dimensional items, he may need to move closer to examine them. It may reduce fatigue to place items on a black slant board so that he does not have to lean over.

Lynne:
When Ian is looking at you, lengthen the amount of time he can look at you by waiting to talk for a little bit. Ask Ian to keep looking at you while you say one particular thing in social contexts, such as, "Thank you," so that he can practice maintaining his gaze upon a person's face with familiar auditory input. Encourage Ian to look at new people in social contexts, even if just briefly. Use photographs of familiar items, settings and people to represent the activities in Ian's day. To help Ian practice sorting by looking at salient features of photographs, use activities such as grouping photographs of people by different attributes (eye color, hair color, etc.). Use strategies to isolate salient features, such as one brightly colored item that is always present in that setting.

Start with a close up view and when those are easily understood, take photographs from different perspectives and continue to identify those salient features. Introduce Ian to line drawings, if they are frequently encountered in everyday life, so that he can become familiar with them. Use some sort of occluder to block out excess detail on a page of images or symbols. For example, block out all but the individual word that is being read.

Experiment with spaces between letters in words to see if it is easier for Ian to recognize the interior letters when they are farther apart. Also experiment with outlining high frequency sight words in red to assist Ian in recognizing the shape of the word. As he is able to identify words with increasing accuracy, those shapes can be faded, first with a black line, then with a dotted black line, then with no line. Make sure the line hugs the shape of the word very closely. For most people with typical vision, sight word reading is done by recognition of the shape of the word, not the individual letters.

Ian has typical responses to light. He may like to wear sunglasses outside when it's sunny, but don't we all?

Sara:
Ian is able to attend to familiar items and locations beyond 20 feet away. To reinforce this, during travel, it may be helpful to have photographs that can help Ian identify landmarks. Photographs may be taken from closer distances and then compared at that distance, and then from increasing distances can be compared at those distances. This can also help Ian with complexity issues.

Allow Ian tactual access to objects to assist in recognition. Also, encourage exploration of objects to increase Ian's knowledge of the tactual properties of objects as they relate to the visual aspects. Encourage Ian to look at and manipulate objects at the same time.