Transcript Case Study CVI - Teaching Students who are Blind or Visually

Session 7: Wednesday October 21, 2015:
CVI
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Housekeeping
Assessing CVI
CVI Range
CVI Case Study
CVI Assignment: ONLY TIME FOR QUESTIONS!!
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Gathering information
Interviews
Observations
Direct Evaluation
Completing the range
Writing goals or creating a program.
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The type of information you gather for
students with CVI will depend on the
student.
There should always be an eye report
documenting any other eye conditions or
refractive errors.
Developmental records.
Occupational Therapy/ Physical
Therapy/Speech Language Pathologist.
Education or behavioural plans.
Interviews should be completed with anyone
who is involved with the student and the
students programming.
 Parents or other caregivers
 Teachers, resource, guidance, daycare
workers and/or TA’s
 Conversations with any other specialists, i.e.,
OT, PT or SLP.
What is the child’s medical background?
 What does the eye care specialist report?
 What, if anything, does the child prefer to look at?
 What are the concerns of the family and teachers?
 Does the child have a preferred colour?
 When is the child most visually alert or interactive?
 Does the child look directly into faces?
 Does the child notice things that move more than
things that are stable?
 Does the child seem to “look through” rather than
directly at objects?
(Roman, 2010)
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Observations should be conducted in as many
environments as possible.
 Indoor and outdoors at school.
 Home
 Daycare or after school programs.
Assessment should be conducted in any areas there
still may be questions.
For example:
 Do they act differently in a controlled environment?
Can the environment be controlled to enable them
to use their vision more efficiently?
 Would they respond visually if the object were
simple or bright? If the object produced sound?
 Will they respond differently in different lighting?
 Do they recognize people without auditory or
movement clues?
“CVI can mask the symptoms of ocular
impairment. This would make it impossible
to assess the effects of an eye condition on
the student’s use of existing vision until most
of the effects of CVI were resolved.”
(Roman, 2010)
A study conducted on the reliability of the CVI
range concluded that: “the results of the
study indicate that this assessment has high
interrater, test-retest, and internal
consistency reliability” (The Reliability of the
CVI Range: A Functional Vision Assessment
for Children with Cortical Visual Impairment
by Sandra Newcomb (JVIB, 2010).
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The CVI range was created by Christine Roman Lansky, a teacher
of students with Visual Impairments to be used by TVIs.
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The range should be completed a minimum of three times a year.
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The range plots the level of involvement of different
characteristics and from here presents a level of CVI from 1-10.
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Once a level is decided teachers can create plants to compensate
for visual deficiencies and to support the student in gaining the
next levels on the range.
Rating 1
A checklist of characteristics or behaviours you may
see at the different stages.
Rating 2
A range of numbers and you chose where the
student fits according to the scoring guide at the
top.
How to combine them together:
The lowest to highest score to represent the range of
functioning.
R the state represents a resolved visual
behaviour
+ describes current functioning of
student
=/- partially describes student
- Does not apply to student
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Peter was diagnosed with Septo Optic
Dysplasia and Optic Nerve Hypoplasia at
birth. At the age of two, he was diagnosed
with CVI. He did not appear to have any
vision when he was born.
Peter is now four, is learning to walk and is
starting to use full sentences.
He is beginning to use his vision, but it is
variable. He is in a busy daycare and at
home has four siblings who are close in
age.
Peter attends a small, but busy daycare. He
has a full time assistant and many other
professionals that see him throughout the
day.
Peter does not appear to use his vision other
than for navigating or light gazing unless
he is in his “work corner.” This is a special
area in the daycare, where Peter is able to
go with his assistant or when his TVI comes
to visit to work on his vision. They are
working on the Lightbox level 1 materials
and looking at images on the iPad.
When Peter started walking everyone was
very excited. His family had been told, he
may never walk. What was really amazing
was how well Peter moved in his
environment. He never bumped into other
children, chairs or other obstacles.
However, he would often trip over toys on
the floor or a child lying on the floor
colouring.
Although he misses most obstacles, Peter is
completely unaware of where he is headed.
For example he could not tell if the
playground was up ahead or if that was the
pond.
Peter has three toys that he takes with him
everywhere. He will not look at or play with other
toys.
He will play with kitchen utensils or ribbons on
presents, but he has no interest in opening the
present, seeing a toy inside or using the utensils to
feed himself.
Peter’s playing consists mostly of mouthing or
banging toys. With the utensils or ribbons he likes
to wave them in front of his face.
If he drops any of these toys he is unable to find
them again in the daycare and will instead stare at
the lights on the ceiling.
When toys are given to Peter or presented to
him on a table. He will respond only if there
is nothing else on the table and it is a clear
background. He will often take time to
reach for the item and can be observed to
look away when he finally decides to reach.
When new toys are introduced to Peter, he
may take several introductions to the toy
before he will attempt to reach for it.
Distractions, such as the other kids or other
objects on the table can delay the reach
longer.
Peter does not notice people that come to
see him or differentiate between kids in his
class. His mother came to get him one day
and didn’t say anything, but started to put
his jacket on. He asked her if they were
going out to the playground to wait for
Mommy because he thought it was the
daycare teacher.
Peter does not look directly at anyone and
will look away or close his eyes when
people are talking to him.
I have completed the
CVI range, but now
what?
Program planning
using the range.
“Scaffolding” in education refers to building on
what the student already knows and working
from there. It is important with all students,
but especially with students with CVI, to start
where they are and build from there.
When planning for a child with CVI, look at
where they are now, provide the
accommodations they need and find little
ways to move them to the next step. Such as:
using colour preference to help transitioning
to new objects, move from an isolated room
to a safe place in the classroom, etc.
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It often feels right to give help to people with visual impairments [and other disabilities], but
this may not be in their best interest. Use this list to help yourself to step back.
1. You’re stepping back so your students can step forward and become independent. Keep
this in mind.
2. Clock how long it actually takes for students to start zippers, pick up dropped papers, or
find page numbers. What’s a few more seconds in the grander scheme?
3. Sit on your hands for a whole task while you practice giving verbal instead of touch cues.
Hands off the hands!
4. If you need touch cues, try hand-under-hand instead of hand-over-hand. This gives
students much more choice.
5. Let students make mistakes and get into trouble. It’s part of the human experience!
6. Acknowledge your own needs. There’s a reason you chose the helping profession.
7. Sit further away. If you’ve been within arms reach. Sit just within earshot. If you’ve been
sitting within earshot, sit across the room.
8. Pat yourself on the back every time you help with seeing, not thinking. Your job is to give
information.
9. Even though helping can feel right, be aware that too much assistance is short-sided.
Sometimes less is more, less is better.
10. Catch yourself before you correct your student’s work. Don’t cover for them. This is
about their skills…not yours.
11. Commit to no intervention for a whole activity. Take data instead. Things might not fall
apart as much as you had expected.
12. “What page are you on?” “What’s for lunch?” Have students ask their classmates instead
of you, both during school and on the telephone.
13. Assign student learning partners and sighted guides.
14. Teach students to decline assistance,” Thanks, but please let me try it by myself.”
15. Whenever you add prompts, include a plan to phase them out.
16. Let the boss know that you need to step back so that your students can be more
independent. You’re not shrinking your responsibilities.
17. Collaborate with other adults to break your habits of helping too much. Agree to remind
each other to step back.
18. Try helping only when classroom teachers give you a signal. They may prefer to respond
directly, or to give students longer to work it out alone.
19. Post a sign, “Are there any other ways I could step back?”
- Adapted from Classroom Collaborations by Laurel J. Hudson, Ph.D.