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Sara: During this observation, Ian goes with his Orientation and Mobility instructor to a grocery store that he has not previously been to. Competing stimuli include the music piped into the store, the person videoing him -there's a little red light on the camera- and the general novelty of the environment. It is a motivating trip because Ian will get to buy his favorite gum. We will mark our results for this in the section of the data sheet called "Observation Information."

During clip one, Ian maneuvers himself into the van. He reaches for the door handle twice. The first time, it's not clear exactly where his gaze falls while reaching, but the second time, it is quite clear. Let's watch.

[video clip 1]

>>Teacher: Now you see that curb down there, right?

>>Ian: Yeah.

>>Teacher. Ok. Thank you. Oh, alright! First time going off campus for O&M! Yeehaw!

So we made a note of that second reach in the tenth row, "Visually guided Reach," since Ian looked and reached simultaneously.

In clip 2, we see Ian and his O&M instructor enter the store. She asks him to identify some things on the shelf from about eight feet. He identifies the cooler, saying, "Drinks" and the items on the shelf, saying, "Fruit." Let's watch.

[video clip 2]

>>Teacher: Go all the way to the far wall. What do you see there without touching anything.

>>Ian: Drinks.

>>Teacher: Drinks and...

>>Ian: Fruit.

>>Teacher: Fruit? Cool! What kind of fruit?

>>Ian: Oranges...

We marked that observation down on the data sheet on the fifth row, "Complexity," since the environment was so complex, and in the seventh row, "Distance," since he identified items from a little ways away.

In the third clip, his instructor has asked him if he wants to feel some of the items on the shelf. He moves toward the red peppers and she asks him if he can pick it up and identify it. She then shows him an apple, which is not as deep a red as the pepper, and he identifies it as an orange visually, then after he touches it, he identifies it as an apple. Let's watch clip 3.

[video clip 3]

>>Teacher: You want to feel one? See what that red thing is: what's that? Ok you can pick that up. What is that? Is it a fruit or a vegetable?

>>Ian: Vegetable.

>>Teacher: It's a vegetable. Here, let's compare. So from a distance that might have looked like that. What's that?

>>Ian: An orange.

>>Teacher: It's an orange? Here, feel.

>>Ian: Apple.

>>Teacher: Apple, sure enough.

We marked the information from this clip in the first row, "Color," because he was drawn to the red peppers and in "Complexity," because of Ian's misidentifying the apple in a visually complex situation.

The fourth clip involves his instructor asking him about the number of shelves, then whether the fruit is a lemon or lime. Ian leans in very close to try to take in the specific visual information.

[video clip 4]

>>Teacher: How many shelves do you see? Yeah? Yeah. Wanna count? What are those?

>>Ian: Um...I don't know.

>>Teacher: Is it a lemon or a lime?

>>Ian: Lemon.

>>Teacher: Lemon? Which one's a lemon?

We marked the information from that clip in "Complexity," since Ian moved so close, perhaps to reduce the visual complexity, since moving close allows one to see fewer items.

The fifth clip is one of those that is very telling. Ian is asked to identify a fruit he is holding against a complex background and has a hard time telling what color it really is. It is suggested to him to move it so that the background is the plain, tile floor. After that, Ian readily identifies that the fruit is "kinda greenish." Let's watch clip five.

[video clip 5]

>>Teacher 1: What color do you see there?

>>Ian: It's hard to tell the color.

>>Teacher 2: Maybe where you're holding it.

>>Ian: It's kind of a, I guess a [inaudible].

>>Teacher 2: Hmm? Why don't you turn and not hold it over everything else?

>>Teacher 1: Here, come bring it over here so you have just like the floor underneath it, so not all that clutter. There you go. Can you stand over by me? Can you see what color it is there?

>>Ian: Kinda greenish.

>>Teacher 1: Kinda greenish! Cool! There you go.

We marked that information in "Complexity."

Clip six is a repeat of the same kind of example. Ian is asked to identify an orange over the non-complex tile of the floor, and is able to immediately identify it.

[video clip 6]

>>Ian: Orange.

>>Teacher: That's an orange. Cool.

We marked that in "Color," because he seemed to have trouble before with the red/orange spectrum in not knowing which was which, and "Complexity," because of how well the strategy worked.

In clip seven, Ian is asked to go find a vegetable from a different part of the shelf. Out of the green, orange, purple, and yellow array, Ian goes immediately for the yellow squash. Let's watch.

[video clip 7]

>>Teacher 1: Alright. Alright. Thank you!

>>Teacher 2: Cool. Alright.

We marked that one down in "Color" as yellow is a color that Ian is more drawn to.

In clip 8, Ian is being asked to identify what is on the top shelf. The grocery store soundtrack seems to have gotten louder, the area is cold, the array is cluttered, and Ian is tired. Ian seems to need extra time to identify the item that is there. Let's watch clip 8.

[video clip 8]

>>Teacher: Milk, uh huh. And how about the top shelf?

>>Ian: Fruit juice?

>>Teacher: Ok. Where's the top shelf?

>>Ian: Over here? Top shelf?

>>Teacher: Yeah, what's on the top shelf?

>>Ian: Here?

>>Teacher: No, right here. What's that? Yeah.

>>Ian: Eggs.

>>Teacher: Eggs, sure enough. So what department would these be?

We marked that one in the third row, "Visual Latency," because of Ian's fatigue and him taking longer to look, and in "Complexity" because all the competing sensory information made this a more difficult task.

Clip 9 is similar to clip 8, but Ian is less successful. He is even more fatigued, the item being searched for is small and probably more complex. Ian tries to look at the shelf with the candy and gum and he can barely do it.

[video clip 9]

>>Teacher: How many shelves do they have with gum on it?

>>Ian: Right there.

>>Teacher: And where else? Ok, yeah. Any other shelves with gum on it right here in front of us here?

>>Ian: There?

>>Teacher: Uh-huh, there you go. Now you were telling me what gum you liked. You said Trident. Do you see Trident on there?

We marked that one in "Visual Latency," because of the fatigue noticeably decreasing looking behaviors, as well as in "Complexity," because the visual target is extremely complex and Ian tries and tries to make sense of it, but doesn't seem to be able to.

In clip 10, we see Ian paying for his purchase. He does not look at the cashier at all.

[video clip 10]

>>Cashier: 2.15.

>>Ian: Is this good?

>>Cashier: Can I get 15 more cents?

We marked that information in "Visual Latency" as well as "Complexity." Ian does not look at the unfamiliar face of the cashier. It should be noted that during this observation, Ian glanced toward his instructor's familiar face infrequently. We see him do that briefly during this clip. It might also be noted that she was talking to him a great deal of the time during this observation.

In clip 11, Ian seems happy to be leaving that store, and begins heading toward the van as soon as they round the corner. He wants to go straight for it, but his instructor cautions him to stay near the wall.

[video clip 11]

Teacher: You're coming out the door on the left. Man! Hey Ian, you want to stay on the sidewalk until you get in front of the van, because you don't want to just cruise through the parking lot, ok? There you go. Staying close to the van. I don't think I locked it. There you go.

We marked that one in the seventh row, "Distance Viewing," since Ian is able to identify the van from 20 feet away, possibly a stingy estimate: It may be further than that.

We asked Ian's family and educators to answer questions about Ian's visual behaviors. Ian's classroom teacher, who is a teacher of the visually impaired, interviewed Ian's mother by phone and wrote down her answers. Sometimes she also added her own input when she saw something different from what mom saw, though this was infrequent. We will consider input from both parent and teacher when recording our information. We'll skip over questions that don't contain any information for us to record on our data sheet, unless they seem to bring up something to take note of. We recorded this information on the data sheet called "Interview Information." You can look at the parent interview guide on page 41 (Appendix 4.A) in Roman's book to help you interpret what the questions are getting at.

Question 1 asks what they do to get Ian interested in an object. The answer said that he used to require movement and the color red but "they are past that." We marked that in the first row, "Color" on our data sheet, and in the second row, "Need for Movement."

Question 2 asks about how they know that Ian sees something when it is shown to him. His mom said she asks him to describe it, especially with objects. She commented that with pictures they "wonder if he is guessing." We recorded that information in the fifth row, "Complexity."

Question 3 asks if Ian has a favorite side or head position. It's reported that he tilts his head to the right, and seems to see things better if they are up or at eye level, and that it seems like he may have a hard time with things that are down and in front of him. We marked that data in the fourth row, "Field Preferences."

Question 4 asks if Ian usually finds objects visually or tactually. His mother answered mostly by looking, except when things were on the table in that lower field; he may sometimes find those by feeling. We marked that part of the answer in "Field Preferences." The next statement, "They had a big keys keyboard and he could tell you all the letters that were yellow," we marked in the color and complexity rows.

The last statement, "Using his hands and using his eyes at the same time was difficult," we marked in complexity, because it could be a complexity of the sensory environment issue and we also marked this in visually guided reach, because it could be a visual motor issue.

Question 5 asks if there are concerns about they way Ian sees. There was a note that vision didn't seem dependable. Also there were concerns about reading. We didn't mark this down on our data sheet, but this concern seems very related to possible CVI characteristics.

Question 6 asks where someone would hold something for Ian to look at. His mom said at eye-level but that Ian can see "on any plane. It is the 2D that is trickier." We marked "eye level" and "on any plane" in "Field preferences," and 2D is tricky in "Complexity."

Question 9 asks about when Ian likes to look at things. The answer identifies that he sees best when he is awake and alert, and doesn't see as well when he is tired. We marked this answer on the data sheet in the third row, "Visual Latency."

Question 10 asks about Ian's favorite color of things to look at. HIs mother said, "If we are on the highway, he always points out yellow cars. Also things that are red. Bright colors. He is not dependent on color to see like he used to be." We marked that data in the row for "Color." We also marked it in "Distance" since he identifies cars on the highway from a distance.

Question 11 asks about what Ian does near shiny and mirrored objects. His mother said this is not applicable now but that they used to get his attention. We marked that data in the row "Need for Movement."

Question 12 asks about Ian's response to lights or ceiling fans. He behaves normally around them. We marked that one in the sixth row, "Light."

Number 13 asks if it is easy to identify what Ian is looking at, and mom answers that it's sometimes difficult. We marked that one in the sixth row, "Light" as well.

Question 14 asks about whether Ian notices things that move or things that don't move first. His mom said movement used to be needed to get him to look, and it continues to help in getting his visual attention, but it is no longer required. We marked that one in "Need for movement."

Number 15 asks about Ian's head positioning while he is looking at something. His teacher said he may hold his head down and toward the left. We marked that in the row called, "Field Preferences."

Number 16 asks again about favorite colors. Mom said that yellow & red seem to be what he responds to the most, though his favorite colors are the Laker's colors, Purple & Gold. We marked that in the first row, "Color."

Question 17 asks about whether Ian notices things in new places more, or in familiar places. Mom said he could point out landmarks or items of interest while traveling familiar routes on the highway. She thought unfamiliar situations might cause difficulty. We marked this data in the rows called "Complexity" and "Novelty."

Question 18 asks about how Ian holds his head when reaching toward something. His mom said that he "reaches with his left hand and his head is cocked to the right." His teacher said she thought she saw his head cocked to the left while reaching with the same hand. We marked this one in the row called "Visually Guided Reach."

Question 19 asks how Ian responds when given unfamiliar items to look at. His mom said that she's not sure whether language retrieval or vision would be the reason for the difficulty Ian has with new things. We marked that one in the row for "Visual Novelty."

Question 20 asks again about positioning of materials. The answer applies to fields, with "eye-level" being mentioned as more successful than "things on the table," as well as complexity, when she says, "there can not be a lot of stuff competing with what he is trying to do," and that "he can point to details on a picture card..." We marked that information in the corresponding rows.

Question 22 asks what Ian does when he has many items in front of him to look at. Mom said, "That is overload. He may try but then it is just too much." We recorded that response in "Complexity."

Question 23 asks about Ian looking at faces. His mom said that he likes to look at a calendar of pretty girls' faces. We marked that in "Complexity," and in "Novelty" since the calendar girls are not familiar people.

Question 25 asks about the visual characteristics of Ian's favorite objects. His mom said he'll look at anything that is three dimensional, but the two dimensional things seem to cause trouble in looking. We marked that in "Complexity."

Our phase III case study is a young man named Ian.  Ian has a diagnosis of CVI due to traumatic brain injury that happened 8 years prior to this CVI assessment.  According to his eye report, he has no interfering ocular conditions. 

Ian has pretty typical social and language skills, though he does at times have difficulties with word recall.  He’s had a hard time with reading since his accident, and currently uses a calendar with pictures supported by verbal reinforcement.  He’s a pretty easy going guy for the most part.  He does not think of himself as visually impaired.

Maneuvering through space is challenging for him due to motor impairment on one side.  Oral motor skills were also affected and this, paired with the fact that Ian is rather soft-spoken, can make understanding his speech challenging.

For the following case studies, you will need a copy of Christine Roman- Lantzy’s book, Cortical Visual Impairment, An Approach to Assessment and Intervention, copyright 2007, as we will be referring to it frequently.  We will be using some of the “Essential Forms” starting on page 187.  The first one is “The CVI Range”, which is seven pages long.  The second one is the three page “CVI Resolution Chart,” found further into the forms.   You may also use the data collection form we used if you find it helpful in assessing your students.  As you gain experience with the CVI Assessment or if you already have experience, you may find some other way of collecting data works better for you.  

You can make copies from your book and fill out Rating I and Rating II to find the CVI Range, as well as the CVI Resolution Chart, as we go.  You will need to have access to the book in order to do this, and it will be good to practice interacting with the Essential Forms.  

We found that the “CVI Resolution Chart” left us with some questions when it came to “Light Gazing and Nonpurposeful Gaze” at higher levels of resolution.  This is being revised and will be included in a new book by Christine Roman-Lantzy, which she hopes will be available within a year or two.

Broad overview:

We chose students that had a diagnosis of CVI and fit roughly into Phases one, two, and three. We had each parent fill out an interview, and did a observation and direct assessment for each of the students. We videotaped each of those and then analyzed them together. Some of the characteristics of CVI are so subtle that without video, we would have missed so much. We would, however, caution against scoring from video alone.  Many things could be noticed only by being present.  Also, we cannot overemphasize the benefit of having two brains to help translate what we saw to each of the items on Rating 1 and 2.

Getting comprehensive information may be time consuming. We needed multiple videos in different environments to draw from. Also, student visual fatigue happened very rapidly after periods of sustained viewing, which meant we needed multiple short sessions.

We mentioned Sandra Newcomb's study in the Introduction.  This study was summarized in the American Foundation for the Blind's publication, the Journal of Visual Impairment and Blindness, October 2010, vol. 104, found on page 642. This study found, among other things, that the difference between Rating I and II was no more than 1.5 when assessors were highly trained.  If the range is larger than that, it is a sign that the interpretation of the test items should be examined more closely. This would be a good time to enlist the opinion of another TVI who has more experience in performing the CVI Range, to seek out more training opportunities, or to schedule yourself some time to intensively study Roman’s book.

In our accommodations, we looked at nine areas, since the blink reflex cannot be addressed in programing, but resolves along with other characteristics naturally.  This should be addressed in the accommodations if a student fails to close his or her eyes when touched, because they could scratch their cornea on, for example, a blanket, if they do not close their eyes.  

Parent interview:  

All of our students were officially diagnosed with CVI, and some of the parents were generally knowledgeable about the characteristics that are associated with it. I think that this may be somewhat uncommon, as some of the interview questions seem to target parents of children who have not yet received a CVI diagnosis and have not learned about it.  Also, all of our students were school age, while some of the questions pertain more to small children or babies. We had to substitute words like “objects” for “toys”. Parents gave answers that sometimes pertained to CVI characteristics that weren’t targeted by the questions as defined on the Answer Guide to CVI Parent Interview Questions, appendix 4.A, in Roman’s book on page 41.  We recorded that information in our data sheets we created called “Interview Information.”

Indirect and direct assessment:

We found that it was much more difficult to interpret some of the CVI characteristics of Phases 1 and 3, as opposed to  Phase 2. Brandon in Phase 1 was very very subtle with his responses, and it was hard to tell if he was seeing and what he was seeing. Ian in Phase 3 was at such a high level of resolution that the challenge lay in figuring out what he wasn’t seeing. Ian also had good conversational and social skills, as well as many reference points and visual skills from when he was fully sighted, which sometimes led us into thinking he had more vision than he actually did.

We will go through many items, and it will be much faster than it took us to initially compile and synthesize our data.  The pause button on the video player will be helpful if you need more time to process this information for yourself!  I know I would use it frequently.

Data Collection

CVI characteristics are not always easy to isolate, in that they are occurring at the same time and are often closely related to each other.  Many things that apply to, for example, distance, also apply to complexity.  Color is often a common thread, as is movement.  Many of our data points were recorded in multiple areas on the data sheets, such as when we asked Ian’s mother, “Does your child usually find objects by look or by feeling for them?” She answered,  “Most of the time by looking.  Sometimes when things are on the table I catch him feeling for items.  They had a big keys keyboard and he could tell you all the letters that were yellow.  Using his hands and using his eyes at the same time was difficult.”  That answer was recorded in color, field preferences, complexity and visually guided reach.  The point is that the same information may pertain to several different characteristics.

Rating 1

Once our data sheet was complete, we began transferring the information to the CVI Range Rating 1. We used the chart on page 97, Appendix 5.A, called, the “CVI Range Scoring Guide,” to help guide us through interpreting the data. When we were really having trouble deciding between two scores, we generally chose the all the time behavioral definition over the maybe sometimes definition. We went through a process we will explain within each case study to come up with a score for Rating 1.

Rating 2

We then filled out the CVI Range Rating 2, using our data sheets paired with the CVI Resolution Chart as a guide for each of the 10 CVI characteristics. We added up the points and got a number, which was Rating 2. We then compared the two numbers (Rating 1 and 2). None of them had a greater difference than 1.5.  YEA!


Next we began creating what the TVI and classroom teacher would need to do to maximise their student’s use of vision, and those were the Present Levels of Visual Functioning and the Accommodations. Both of these can be used to create a CVI narrative, and this narrative is modeled several times in Christine Roman’s book.  Also, starting on page 118 of the book, there are examples of the types of environmental support that would be appropriate considering what kinds of visual skills the student is working on.  

When you find the Phase your student is in, that will direct you to what those skills are, for instance, Phase I kids are working on building visual behavior, or just  looking.  Phase II kids are integrating vision with function, or using vision, in conjunction with other senses, to act upon the world.  Phase III kids are really working on resolving their visual behaviors, and the environmental considerations will be very specific to specific tasks.

Right, for example, kids are not ready to use two dimensional items (like photographs or Boardmaker pictures) meaningfully until they are functioning at a higher resolution level, so if you have a phase I or low to mid phase II kid using pictures to communicate, please reconsider either your CVI assessment findings or the meaningful use of pictures from the child’s perspective.  Is this visual input really meaningful or is it just what the adults find is the easiest modification to make?  

End (of beginning)

So we hope you find this process understandable and helpful when you are going through the assessment yourself. We feel like we got very good information about the visual abilities of each of our students, and were a lot better equipped to program for them. If you notice anything we missed, please comment!  Ok, now on to the case studies!

Brandon Introduction Transcript


Our phase I case study is a young man named Brandon.  Brandon was born prematurely and developed retinopathy of prematurity, or ROP.  Sometime between the most recent functional vision evaluation and the last eye doctor visit, the retina in his right eye became completely detached.  A recent low vision evaluation reported Brandon had no light perception in his right eye, and he had form perception in the left and that his field was restricted to 40 degrees. Brandon's eye report also identified right esotropia and optic atrophy.  These ocular conditions may have a large impact on Brandon’s ability to take in visual information and get the experience needed to resolve some CVI characteristics.

Along with the ocular visual impairment caused by damage to his retina, Brandon also has a history of having a closed head injury, which is one of those red flags when thinking about visual behaviors a person might have due to neurological differences or changes.

Some other information about Brandon you might want to know is that he uses an object calendar to communicate receptively, has cerebral palsy which affects all of his limbs, uses a wheelchair to move from one place to another, and he has a seizure disorder which is well controlled.

Socially, Brandon is super active.  He really enjoys verbal and sound related interactions with other people, especially when they make funny noises or talk in silly voices.  He engages others in this sort of interaction regularly, and initiates it by greeting them or by laughing and turning his head toward them.  He makes specific requests by verbalizing stuff like "Hug," or “Eat.”

Brandon Introduction Transcript

  1. Definitely interested in any kind of basketball, balls of any size (size doesn’t matter).  Doesn’t take much to get him interested in something. Before it may have needed movement or be a red color but they are past that. 
  2. I ask him to tell me about it.  That is where we have gotten to pictures.  Describe it for me and he does.  Especially objects in space.  In pictures we question and wonder if he is guessing. 
  3. He tilts to the right.  When we have worked on visual things especially with picture cards/ etc.  We always do them up or eye level.  (Such as on a white erase board more on the right then on the left).   He has a harder time attending to things that are down in front of him. 
  4. Most of the time by looking.  Sometimes when things are on the table I catch him feeling for items.  They had a big keys keyboard and he could tell you all the letters that were yellow.  Using his hands and using his eyes at the same time was difficult.  
  5. Yes, it is not something that is constant and you can have days that are different.  We will start understanding what he is seeing more and more.  The other part is that I am concerned about his vision in the way of reading and him being completely independent.  Three or four years ago they worked on sensitivity in his fingers for Braille.
  6. At eye level (best).  Ian can see objects pretty much on any plane.  It is the 2D that is trickier.
  7. Basketball, mixer, monkey (named Dexter), anything with the Lakers, Air Hockey table and his Wii.  His CD’s- he learned through repetition. 
  8. That they are 20/20.  There is nothing wrong with his eyes- it is all in the brain. 
  9. When he is awake and alert.  When he gets really tired it is hard to see.  It takes a lot of conscious effort to see things- low contrast.
  10. If we are on the highway, he always points out yellow cars.  Also things that are red.  Bright colors.  He is not dependent on color to see like he used to be.  Contrast definitely helps him see better/ he misses a lot of detail.
  11. These is not as applicable now- but early on it would get his attention.
  12. Doesn’t stammer on them.  He is normal around them. 
  13. Sometimes it is difficult.  Mom has been told that his peripheral vision in his brain is strong than his straight on focus. 
  14. When he first started getting into objects it required movement.  He probably attends to things better if they move.  He does not require it anymore.
  15. I don’t know.  (Maybe down towards the left, teacher thinks.)
  16. Purple/Gold (Lakers).  As far as visually yellow or red.
  17. If it is objects or when driving to san Antonio he can point out where they are.  In some unfamiliar situations it may be harder. 
  18. He reaches with his left and guessing that his head is cocked to the right (guessing to the right/teacher sees to the Left).
  19. Both the language retrieval and vision are when he has a difficult time with new things.  He knows what they are.  If you give him multiple choice he can retrieve it. 
  20. When they would do cards they did it at eye level.  He was not as successful when things were on the table.  There cannot be a lot of stuff competing with what he is trying to see.  He can point to the details of an object on a picture card and then he would be able to put those cards together and label the object.
  21. No
  22. That is overload.  He may try but then it is just too much.
  23. Pretty girl faces.  Calendar of pretty girls he would rather look at that! That is one of the suggestions one center had made about retraining Ian’s brain that there should be pictures of pretty girls and have Ian describe what they are doing different in the pictures.
  24. Depends on what the other object is. 
  25. Pictures of girls, basketball, etc.  Can be anything and any size. Flat and does not have the dimension that is the problem- it is not going to help just making it bigger. 


Interview Information


1.  May have needed movement or to be a red color but he is past that. 
4. Could name large keys that were yellow. 
10. Yellow cars on highway, also red.  He likes bright colors.  (Is not dependent on color to see like he used to be.)
16. As far as visually: yellow or red.

Need for Movement

1.  May have needed movement or to be a red color but he is past that.
11. Shiny or mirrored objects not as applicable now, but early on it would get his attention. 
14. He probably attends to things better if they move.  He does not require it any more. 

Visual Latency

9. When he gets really tired it's hard to see: it takes a lot of conscious effort to see things.

Field Preferences

3. Tilts to the right.  Up or eye level on slant board easier.  Has trouble attending to things "down or in front" (lower field). 
4. Finds things on table by feeling instead of by looking. 
|6. Hold things at eye level.  15. Maybe down toward the left teacher thinks. 
18. Reaches with his left hand and guessing that his head is cocked to the right, teacher sees to the left. 
20.  Not as successful when things are lying on the table.


2. He can describe objects in space, in pictures we question and wonder if he is guessing. 
4. Big keys keyboard: he could tell you all the letters that were yellow.  Using hands and eyes together was difficult. 
6.  Ian can see objects pretty much on any plane, it's the 2-D that is tricky.
17. If it is objects or when driving a familiar route he can point out where they are.  In some unfamiliar situations it may be harder. 
20.  There cannot be a lot of stuff competing with what he is trying to see.  He can point to the details of an object on a picture card… 
22. Many objects to look at=overload.  He may try but then it is just too much. 
23. Likes looking at a calendar of pretty girl faces. 
25. Flat and does not have the dimension that is the problem--it is not going to help just making it bigger.


12. Is normal around lamps or ceiling fans. 
13.  Sometimes it is difficult to identify what he is looking at.

Distance Viewing

10. Looks at cars on highway.

Atypical Visual Reflexes


Visual Novelty

17. If it is objects or when driving a familiar route he can point out where they are.  In some unfamiliar situations it may be harder. 
19. Both the language retrieval and vision are when he has a difficult time with new things.  He knows what they are if you give him multiple choice he can retrieve. 
23. Likes looking at a calendar of pretty girl faces.

Visually Guided Reach

4. Sometimes when things are on the table I catch him feeling for them.  Using his hands and eyes at the same time is difficult. 
18. Reaches with his left hand and guessing that his head is cocked to the right, teacher sees to the left.


Interview Information


10. & 16. Maybe prefers red.

Need for Movement

1. Move object to gain interest. 
11. No response to shiny objects/mirrors. 
12. Looks at ceiling fans
14. Notices movement.

Visual Latency


Field Preferences

3. Uses peripheral fields (left).
6. center left. 
18. Positions head straight while reaching. 
20. Position items on left side.


23. Does not look at faces.


1. Put object on light board to gain interest. 
2. Orients head toward light box.
9 Likes to look at things in front of light board. 
12. Light gazes. 
20. Position items on light box to help him see it.

Distance Viewing

6. Within 1 foot.
13. Puts face ON object to see it.

Atypical Visual Reflexes


Visual Novelty

19 Reaches out and touches new things. 

Visually Guided Reach

4. Primarily finds objects tactually. 
19 Reaches out and touches new things. 
18. Positions head straight while reaching. 


Observation Information


Clip 2: Yellow not "favored." 
Clip 4: Blue is "favored." 

Need for Movement

Clip 3. Attends to large moving object at 3 feet.

Visual Latency

Cllip 2: Needed more time to look before he could process whoopee cushion visually. 
Clip 4: Several short glances before he could act.

Field Preferences

Clip 4 & 5: Definite preference of left central field.


Clip 1: Is unable to look and touch at the same time with light environmental noise. 
Clip 2: Tried to use vision with small amount of environmental noise, then completely stopped when became more noisy. 
Clip 3: Uses vision briefly when noise does not compete (physical factors are also competing here).
Clip 4 & 5: Fixated on blue button briefly with little competing visual/auditory information, and later when teacher is talking.


Clip 1: Light gazing during activity

Distance Viewing

Clip 3: Visually attended to large moving object at 3 feet (teacher walking in front of him) and identified as a person by saying, "Hello."

Atypical Visual Reflexes


Visual Novelty

Clip 4 & 5: Favorite object (blue button) elicited visual attention.

Visually Guided Reach

Clip 5: Looks and touches at the same time with familiar, motivating object. 

  1. Parent: If it plays music or lights up I push the button to make it do it.  If it is a toy without music or lights I hold it in front of her face to get her interested in it.  School: Make noise with it.  Mostly she finds things on her own.  Put it in her field.
  2. Parent: Cassie will grab it or reach for it.  School: She brings it to her face or moves it.  Looks out window of van when moving for the whole trip.
  3. Parent: Haven’t really seen a true preference but sometimes she’ll tilt her head up.  School: Holds head back, like when looking at faces.  Forward gait-eyelids partially closed.  Blocking field?
  4. Parent:  ½ by look and ½ by feel.  School:  Looking then touching.
  5. Parent:  Worry about lack of depth perception causing falls.  School: Nope, only curious.
  6. Parent:  I hold it about a foot to a foot and a half away from face directly in front of her eyes.  Sometimes I wiggle it.  School:  Right in front-central.
  7. Parent:  Her guitar, vacuum cleaner, closets.  School:  Accordion, rolling chair, pots and pans, keyboard, toy car (for crashing), swing, trampoline, slide.
  8. Parent: physically they are fine except for a little astigmatism in one eye.  School: No problem.
  9. Parent:  When they light up or glow if they vibrate or wiggle.  School:  Varies.
  10. Parent:  Haven’t really seen a preference.  School:  No major color preference.
  11. Parent:  If it’s very shiny she will squint her eyes.  She will be curious about them.  School:  No large attraction to shiny stuff unless it’s reflecting a lot of light.
  12. Parent:  Likes to see them turned on and off.  School:  Lights, especially to turn off/on.
  13. Parent: Majority of the time.  School:  Yes, because she’ll reach for it.
  14. Parent:  Notices things that move first.  School:  Both-she moves.  Can label when swinging.
  15. Parent:  Might slightly raise her head up.  School:  Varies.
  16. Parent:  Have not seen her make a preference for a specific color.  School:  No.
  17. Parent:  I would say more in new places.  School:  Doesn’t search things out in new places.  Runs through.  Moves all the time in new environment with no attention to detail.
  18. Parent:  Holds her head straight towards it for the most part but sometimes will turn head away.  School: Varies.
  19. Parent:  She will shake it and turn it over and around in her hands and then will look at it.  School:  Varies.
  20. Parent:  No.  School:  NA
  21. Have you ever been concerned about the way your child’s eyes move?  Parent:  No.  School:  NA
  22. Parent:  She’ll just take each one at a time and check them out.  School:  Looks less.
  23. Parent:  Her Mom’s Dad’s, and babysitter’s because they are faces of the people she knows, trusts, and loves.  School:  All.  She likes faces but doesn’t seem to differentiate.
  24. Parent:  For the most part she’ll check out the new object but sometimes she’ll choose the familiar object.  School:  Depends.
  25. Parent:  Likes toys or objects that are musical or light up or have soft texture. School:  Varies.


Interview Information


10. No color preference noted.
16. No color pref. 

Need for Movement

2. Moves items, looks out window of van for whole trip.
6. Wiggle objects for C. to look at.
9. Looks at items that wiggle. 
14. Notices things that move first. 
17. Moves all the time in new environments, maybe to get bearings?
19. Shakes & turns over/around new things.

Visual Latency

19. With unfamiliar items, shakes, turns around, then looks: takes a little while.

Field Preferences

1. Get interested in toy by putting it "in her field." 
3. Tilts head up/back, lowers lids while walking so not to trip indicates lower field preference.
6. Present object directly in front/central.
15. Might slightly raise head up indicating lower field pref.


2. Brings things close to view. 
22. When presented with large array, takes one thing at a time to look at or looks less.
23. Looks at familiar faces/ doesn't differentiate faces.


1. Interested in toys that light up.
9. Looks at object when they light up or glow.
11. Squint if things are very shiny, attracted to things that reflect a lot of light.
12. Likes to turn lights on and off.  25. Likes toys that light up.

Distance Viewing

6. Present objects 1-1 ½ feet from face. 
2. Brings things close to view.

Atypical Visual Reflexes


Visual Novelty

17. Moves all the time in new environments: maybe to get bearings? 
19. Shakes, turns around new things, then looks. 
23. Looks at familiar faces.

Visually Guided Reach

4. Looks then touches to find object.
18. Sometimes will turn head away when reaching. 
19. First acts on new object and then looks at it. 


Observation Information


Clip 3: Toothpaste tube has a striped pattern on the tube.
Clip 4: Reaches for stripes on wall (shadow). 
Clip 5: Picked up a single color yellow item from a complex array.
Clip 6: Out of an array, picks up a single color white item that has stripes.  
Clip 7: Looks at single-color item with stripes (comb).
Clip 10: Looking at Lynne's arm, which might be making a big stripe. Also looked at accordion, which has a striped pattern.
Clip 12: Looks at striped pattern (black on white). 

Need for Movement

Clip 3: Moves toothpaste while looking.  
Clip 10: Looking at Lynne's arm, which is moving. 
Clip 11: Saw moving teacher's hand from 15 feet. 
Clip 14: Movement draws attention in complex setting.

Visual Latency


Field Preferences

Clip 2: Holds picture close & in lower/central field. 
Clip 12: Places striped pattern on nose with eyes turned up for lower/central field viewing.


Clip 1: Listening to/touching keyboard and not looking.  
Clip 2: Picks up picture and holds it close, blocking background.  
Clip 5: Picked up a single color item from a complex array.  
Clip 6: Out of an array, picks up a single color item that has stripes.  
Clip 7: Examined comb (single color, striped) but when she began to tactually explore, stopped looking. 
Clip 8: With song playing loudly, looks to locate but then find object tactually and picks up.  
Clip 9: Once music is turned off, looks at teacher's face (for the first time during observation) but looks away as soon as teacher vocalizes.
Clip 12: Held picture up to her face, blocking out background, and when she begins counting, stops looking.  
Clip 13: Descends the stairs tactually: stairs are more visually complex and they change constantly when moving on them.  
Clip 14: Looks at favored visually complex item in visually and aurally complex environment. 
Clip 15: Looks at teacher's face in visually and aurally complex environment, but looks away as soon as extra sound is added. 


Clip 3: Abnormal response to light (Drawn to + squint).  
Clip 4: Stares at light and squints.  
Clip 7: Stares at reflection from metal can.

Distance Viewing

Clip 11: Saw moving teacher's hand from 15 feet.

Atypical Visual Reflexes


Visual Novelty

Clip 12: Places unfamiliar striped pattern on nose with eyes turned up for lower/central field viewing.

Visually Guided Reach

Clip 8: With song playing loudly, looks to locate but then find object tactually and picks up. 
Clip 13: Descends stairs tactually: is unable to look while reaching with foot, especially at end of stairs. 
Clip 14: Looks at favored item and reaches for it, but looks away just before touching it.