FVA COMPONENT



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|#6 - COMPONENTS OF THE FUNCTIONAL VISION ASSESSMENT: STUDY NOTES |

|QPVI Pre-Service Class - Nancy Toelle and Chrissy Cowan |

|The following is based on Looking to Learn, Chapter 2, Tanni Anthony. F.M. D’Andrea and C. Farrenkopf, eds. |

|Explanatory information has been added to assist teachers in training in understanding the details of conducting a FVA. |

|These materials should be used in conjunction with the text. |

|FVA COMPONENT |DESCRIPTION |WHY TESTED OR OBSERVED |HOW TO TEST OR OBSERVE |TEST/OBSERV. RESULTS |

|1. Appearance of eyes and presence of |Observed appearance of the eyes |Appearance of eyes can be your first |Observe students eyes and make notation of appearance. | |

|corrective lenses |indicating possible disorder or |indication that there is a visual | | |

| |disease. If prescribed, glasses MUST be|disability. | | |

| |worn for FVA | | | |

|2. Visual Reflexes |a) Pupillary response, |Indicators of gross light or object |a. Change lighting level in room and observe rate at | |

| |b) Defensive blink |perception (in developmentally delayed |which pupils respond | |

| | |students) |b. Move opened fingers of 1 hand rapidly toward student’s| |

| | | |eyes | |

|3. Reception and perception of visual |Student’s visual system receives the |To determine the student’s ability to |Darken room, wait 30 seconds, turn light on and note | |

|stimuli |stimuli and reacts to it. |detect and respond to: light, shadow, |student’s response/awareness (eyes opening, head turn, | |

| |Light perception |form, and motion. These are the first |etc) | |

| |Light projection |indicators of degree of visual loss. |Student looks toward source of light | |

| |Shadow and form perception | |Pass large object in front of student blocking light and | |

| |Detection of motion | |note if student attends to object | |

| | | |Dangle silent object (slinky) in front of student, note | |

| | | |eye orientation or head turn following movement. | |

|4. Muscle Balance |Both eyes move in the same way at the |Eye muscle movements can affect |Hirschberg Test: hold penlight 3 ft away from students | |

| |same time and in the same direction |student’s acuity, tracking, and |eyes, pointed at bridge of nose – reflection should be | |

| | |peripheral vision |symmetrical in both eyes. | |

| | | |Cover-Uncover Test: (with glasses, if prescribed) student| |

| | | |fixates on a visual target in central position. Cover one| |

| | | |eye and notice if there is movement in uncovered eye. | |

|4. Muscle Balance | | |Repeat with other eye | |

|(continued) | | | | |

|5. Eye Preference |When acuities are unequal, the student |Impacts positioning of materials, |Ask student to cover one eye to look at a distant target | |

| |frequently prefers to use the better |student’s mobility, preferential seating|and note which eye is covered or hand the student a | |

| |eye. |in classes |kaleidoscope or monocular and note which eye is used. | |

| | | |For young students a toilet paper roll works well. | |

|6. Oculomotor Behaviors |a. Fixation |Determine how the eyes move in relation |Fixation - Observe student, noting objects seen at near | |

| |b. Convergence and divergence |to visual targets. Difficulties can |and distance, note eccentric viewing (head turn), head | |

| |c. Tracing |impact fixating on objects, focusing, |and body positioning. Look for some indication that | |

| |d. Tracking |mobility, reading, copying, visually |student is actually fixing on the object, such | |

| |e. Shift of gaze |locating |maintaining gaze or reaching for it. | |

| |f. Scanning | |Convergence/divergence – ability to maintain binocular | |

| |g. Eye-hand coordination (see #16. | |vision as objects approach or retreat. Hold finger | |

| |Visual Motor Coordination) | |puppet 8” from bridge of the nose, wait for child to | |

| | | |fixate and slowly move toward bridge of the nose. Note if| |

| | | |eyes moves symmetrically inward as object approaches and | |

| | | |back as it retreats. | |

| | | |Tracing – visually following a stationary line. Ask | |

| | | |student to visually follow a line in the environment from| |

| | | |start to finish to locate an object.(follow line of | |

| | | |desktop to find trash can) | |

| | | |Tracking – Ability to track a moving object horizontally,| |

| | | |vertically, circularly, and diagonally. Standing close | |

| | | |enough for the student to see your hand or a larger | |

| | | |object, trace capital letters H, O, and / noting eye | |

| | | |movements in all directions. Are they smooth or jerky? | |

| | | |Shift of Gaze – Moving fixation between two objects. Note| |

| | | |if the student can look from one object to another or | |

| | | |copy from the board | |

| | | |Scanning – Ability to shift gaze from one stationary | |

| | | |object to another in a series, using both head and eye | |

|6. Oculomotor Behaviors (continued) | | |movements, and identifying each object. Examples are | |

| | | |identifying words in a row or columns without skipping | |

| | | |words or naming individuals standing in a row. | |

|7. Field of Vision |Normal field of vision is 160-180 |Field loss has implications for |Confrontation field test – this requires two people. A | |

| |degrees from side to side and 120 |student’s safe travel, placement of |person in front of the student provides a visual target | |

| |degrees from top to bottom, this |materials; detection of objects moving |(a clown nose for young children) and notes at what point| |

| |includes the central field of vision |and stationary in the environment (P.E.)|the student detects the target presented in each | |

| | |An O&M is the person to assess safe |quadrant. A person behind the student slowly moves a | |

| | |travel vision. |target into areas of the student’s visual fields: from | |

| | | |right, left, top and bottom. Performance should be | |

| | | |reported in functional terms, such as; the student’s | |

| | | |response indicates there may be a reduction of field to | |

| | | |the left, not in terms of degrees. | |

|8. Color Vision |Ability to detect the full spectrum of |Colors are often important in classroom |Match yarn samples or paint chips in primary colors. This| |

| |colors |instruction, mobility, daily living |is for young students or students who have never been | |

| | | |administered or passed a test of color vision. | |

|9. Depth Perception |Ability for eyes to team together to |Safety and efficiency in travel, |Note student accuracy while reaching for objects and the | |

| |detect depth and dimension |eye-hand/foot coordination. An O&M is |student’s ability to respond to changes in ground | |

| | |the person to assess safe travel vision.|surfaces and drop-offs. Note details of observations. | |

|10. Figure-Ground Perception |Ability to discern an object from its |To determine how objects & materials are|a. Ask the student to locate a specified object on a busy| |

| |background |presented or how a communication system |background, locate detail in a busy illustration, and/or | |

| | |is designed |locate an object in a jumble of other objects. | |

|11. Light Sensitivity and Light-Dark |Unusually sensitive to light, shielding|Affect mobility, stamina, comfort, and |Light sensitivity – observe the student’s visual | |

|Adaptation |the eyes from light sources. The amount|acuity. This is especially critical for|performance and facial expressions in a variety of | |

| |of time it takes for the eyes to adjust|students with albinism and retinal |lighting levels, always including outdoors and high/low | |

| |to an increase or decrease in lighting.|disorders, such as retinitis pigmentosa.|light and with light producing equipment. | |

| | |An O&M can assess travel at night. |Light-Dark adaptation – observe student’s mobility and | |

| | | |behavior moving from bright light to dark, noting the | |

| | | |amount of time needed for student to accommodate. | |

|12. Contrast Sensitivity |Ability to see differences in the |Affects the student’s ability to |Young students: Place several 1” or smaller objects on a | |

| |brightness of symbols or in objects |recognize faces, decode pictures, |same color background - ask student to point to each. | |

| |against their background |letters or words, to locate one item in |OR- Provide samples of print on a variety of colored | |

| | |a group, or travel safely |backgrounds and ask student which background color works | |

| | | |best from them. | |

| | | |OR - Administer commercial contrast sensitivity test. | |

|13. Visual. Acuity |The measurement of the sharpness of |Acuity measures (formal and informal |Formal – commercially available cards or charts for both | |

| |vision as it relates to the ability to |combined) provide information that is |distance and near acuities (Distance: Snellen Letter | |

| |discriminate detail at near, far, and |used to determine the choice methods, |Chart, Lea Symbol Chart and cards, Near: Lea Symbols, | |

| |intermediate distances. |modifications, materials across all |GAME Card, Continuous Text Read. Card) | |

| | |domains. |Informal – a functional estimate of acuity by observing | |

| | | |the student’s performance with a variety of visual | |

| | | |stimuli from a variety of distances (for example: 2” | |

| | | |letters on the chalkboard from 10’, 8’, 5’) Describe the | |

| | | |smallest object seen at near and distance. Assess | |

| | | |ability to perform with print on overhead, chalkboard, | |

| | | |computer screen. | |

|14. Current Print Functioning |Ability to read print in texts and in |To determine if modifications, |Document the size print used for near point (under 16”), | |

| |the environment. |adaptations or assistive technology are |intermediate (16” – 3’), distance (3’ and beyond as | |

| | |needed. |appropriate to developmental level), material used, task,| |

| | | |viewing distance, positioning of materials, head | |

| | | |movement, low vision device use. A printer’s rule, | |

| | | |available for under $5 at a printer’s supply store is | |

| | | |very useful in determining font sizes of print used. | |

|15. Reading Rate and Comprehension |A reading inventory will be covered in|It is critical to have literacy |Note the literacy media used (real objects, pictures of | |

| |the Learning Media Assessment |information on all VI students as |objects, shaded drawings, line drawings, symbols, print) | |

| | |literacy is a foundation skill. |& their success in using it. Note reading level, if | |

| | | |tested. Request a reading inventory if one hasn’t been | |

| | | |done. Note size of materials presented and his/her | |

| | | |ability to use them. | |

|16. Visual Motor Coordination |visual fine motor skills – coordination|Students use of fine (reaching, |This may be evaluated with O&M, O.T., Adaptive P.E. | |

| |of hands with eyes (reaching) |stacking, writing, copying), and gross |teacher | |

| |visual gross motor skills – moving body|motor skills (kicking a ball, traveling |Examples: Note if student has an accurate visually | |

| |in relation to visual target (kicking a|safely, using steps) in their school |directed reach for small objects (size of object, | |

| |ball) |careers contributes to successful school|distance from student, contrast to background), | |

| | |performance. |handwriting samples (darkness and spacing of lines | |

| | | |preferred), coloring within lines, cutting, tracing. | |

| | | |Examples: walking up or down steps, kicking a ball rolled| |

| | | |toward the student, calisthenics | |

|17. Visual-cognitive Skills |a. Visual imitation of movement |Measures student ability to acquire |Model different movements for the student at various | |

| |b. Identification, matching, sorting, |knowledge through vision – For example, |distances and observe the accuracy of their imitation | |

| |and classification of objects and |can they observe the gym teacher |(touch nose with finger or thumb, raise arm or leg) | |

| |pictures |demonstrate a movement. |Identification by naming objects or pictures, match | |

| |c. Visual sequencing | |objects or pictures, sorting silverware by separating | |

| | | |forks from knives, classifying objects or pictures by | |

| | | |function, such as things we eat with, modes of | |

| | | |transportation, toys. | |

| | | |Patterns produced by stringing beads to follow a pattern| |

| | | |or arranging pictures in sequence to tell a story. | |

|18. Visual perception skills |a. Visual closure |Tests of visual perception can help |Commercially produced tests of visual perception are | |

| |b. Part to whole relationships |determine if the student’s difficulties |available. Such testing would be indicated if a student | |

| |c. Pattern recognition |are related to perception not impaired |is experiencing difficulty processing print materials, | |

| |d. Figure-ground discrimination |vision. O.T.s & classroom teacher can be|but would not necessarily be completed on every student | |

| |e. Spatial orientation |involved in testing. |as part of a FVA. | |

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|ENVIRONMENTAL ANALYSIS AND CONSIDERATIONS |

|The TVI should note what environmental conditions enhance or reduce visual functioning and write recommendations in the FVA Report. |

|Consider the educational implications of the student’s visual impairment in each environment and activity |

|Lighting |Type, amount and position of lighting |These all contribute to the ease or |Note the student’s performance regarding lighting | |

| | |difficulty of a visual task |throughout the FVA. Is performance enhanced or reduced by| |

| | | |bright or low light, is lighting on a task helpful, does | |

| | | |the rate of travel increase or decrease with different | |

| | | |lighting. | |

|Glare |Discomfort glare is light that, because|Glare can interfere with a student’s |Observe and evaluate all environments to identify if | |

| |of its intensity or duration causes |ability to perform tasks visually that |glare is an issue. Address glare by such strategies as | |

| |discomfort, but does not interfere with|he or she would otherwise be able to |using filters, closing window coverings, or perhaps refer| |

| |visual performance |perform. Glare on the board, computer |the student for a clinical low vision evaluation to | |

| |Disability glare reduces visual |screen, or on any other shiny surface |determine if light absorptive lenses are appropriate. | |

| |performance due to blinding or dazzling|should be evaluated and minimized. | | |

| |effects. | | | |

|Color and Contrast |The difference in shade between an |If a teacher uses a yellow marker on the|The student’s performance with color and contrast can be | |

| |object and the background behind it. |white board, even if the letters are of |observed and tested. When observing the student in the | |

| |Are materials used in the room of |sufficient size, the poor contrast would|classroom, note if he or she is able to read or copy from| |

| |sufficiently contrasting color, |render the writing unreadable. Is there|the chalk or whiteboard and note the color and contrast | |

| |providing a level of contrast that is |enough contrast between room furnishings|involved. You may assess this by writing on the board in| |

| |adequate for the student’s visual |and floor covering to allow a low vision|a variety of colors yourself, noting which works best for| |

| |functioning. |student to navigate around furniture? |the student. Generally the darker colors work best, but | |

| | | |students with abnormal color vision must be evaluated to | |

| | | |note what colors the teacher can use. As a TVI, you may | |

| | | |want to provide the teacher with a supply of markers of | |

| | | |the best colors. For younger students, note the | |

| | | |student’s ability to identify objects of varying contrast| |

| | | |in the distance, such as a green tennis ball on a light | |

| | | |or dark floor, a white toy on a light or dark | |

| | | |background. | |

|Color and Contrast (continued) | | | | |

|Visual Clutter |The complexity of the visual learning |The more complex the environment, the |Note the amount of visual clutter in the instructional | |

| |environment. |lower the proficiency of functional |environment and evaluate the student’s response by trials| |

| | |vision. Visual clutter may dramatically|with cluttered and uncluttered settings. If the student | |

| | |influence some students’ ability to |performs markedly better without clutter, their workspace| |

| | |visually decipher classroom activities |should be arranged accordingly. Students with cortical | |

|Visual Clutter (Cont.) | |and/or materials |visual impairments may be especially sensitive to | |

| | | |clutter. | |

|Ambient Noise or Auditory Clutter |The noise level or complexity of the |A noisy environment may be disruptive or|Note student performance in a variety of environments | |

| |auditory learning environment |distracting to a student with a visual |with varying noise levels. Noisy environments: gym | |

| | |impairment, reducing performance. |class, cafeteria, halls between classes, auditorium. | |

| | | |Quiet environments: classrooms when students are working | |

| | | |quietly, library, hallways during class, outdoors. | |

NOTES:

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|WRITING THE FVA REPORT |

|A sample of a completed report of a functional vision assessment appears in Appendix 2.B, on page 78 |

| |

|An FVA should be concise, informative, and factual. Since it is to be read by parents, teachers and others, it should not be too lengthy. Neither should it be so short as to leave out important information. |

|The report should be written in simple and direct language, containing explanations of specialized terms whenever used. For example, instead of saying a student has poor figure-ground perception, relate an example, |

|such as the student has difficulty reading print that is written over a background photo, with the recommendation that work with confusing figure-ground should not be given to the student or should be reproduced on a |

|plain background. |

|The report should be factual, but also represent a personalized view of the student. |

|The purpose of the FVA should be stated, whether it is to help establish eligibility, needed adaptations due to a change in vision, or impact of the visual impairment in all environments. |

|Any person interviewed for the assessment should be mentioned in the report. |

|Provide the dates of assessment and date the report. The report should look presentable and be well formatted. Subheadings will help the reader organize information. Use of bullets or numbered lists may make it |

|easier to read. |

|It is helpful to link recommendations with student-specific needs: if the student is photophobic, recommend sunwear for outdoors and facing the student away from brightly lit windows. |

|Predictions of student’s future visual performance should not be made. |

|Observations of student performance should be reported, as well as details about lighting conditions, the size of objects, viewing distances and other pertinent information should be reported. |

|It is preferable to frame observations positively, stating what the student can do, rather than what he or she cannot do. |

|If a student used other senses to complete a task, this should be viewed as an important strategy for the child. |

|Avoid creating a hierarchy of sensory skills. Say a student was able to complete a task using tactile input, rather than the student had to use tactile input to complete the task. It is particularly important to phrase|

|references to Braille in positive terms to overcome negative stereotypes. |

|Report only medical information that is pertinent to the current situation of the student. Any medical terms used should be defined briefly. All acronyms should be spelled out: FVA written as Functional Vision |

|Assessment. Write the report for people without VI training |

|The FVA is a combination of art and science. The science refers to the technical aspects of the assessment process. Art is involved in the keen observation, interpretation and synthesis of the student’s visual skills |

|and the engineering of the appropriate environment, adaptations, and programming to meet the resulting needs. |

|Practice and experience with a variety of students increase the assessor’s skills over time. |

|NOTES: |

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