Functional Assessment of Vision

Presented 19-20 March 2008

Janis Sugden

Vision: The primary learning avenue for most individuals.

• Guides the developing child's motor milestones.
• Allows immediate access of incidental learning.
• Vision "brings us the world".
  Tanni L Anthony Colorado Department of Education.

Functional Vision Assessment (FVA)

• FVA is one of the hallmark features of vision services in the education of children who are visually impaired.
• By whom?

How does this differ from a clinical assessment/evaluation?

• It is not diagnostic.
• It is not treatment orientated.
• It assesses how vision is used in real-life situations.
• The evaluation combines information from many sources.

Why carry out FVA

Goals:

• To determine what and how a child sees.
• To determine what can be done to facilitate learning through the visual sense.

Children who have additional difficulties (MDVI)

It is vital that these pupils have an accurate assessment of functional vision; Ongoing Collaborative Assessment.

Visual Functions

1. Visual Acuity
2. Visual Field
3. Contrast sensitivity
4. Light sensitivity
5. Colour discrimination
6. Oculomotor control
7. Accommodation

Timescale

• The optimal FVA occurs over several sessions.
• If possible in more than one environment (essential for MDVI pupils).

Collaborative Assessment: A team approach:-

• The child or young person,
• Family members,
• Appropriate professionals medical and educational.

All will work from the same frame of reference, use the same language.

Preparing for FVA

• Collate details: Vision history, medical, educational records.
• Consultations: Meet the family, interview, observations.
• Consult with the classroom teacher.

Know the child

• Take time to observe
• How does the child interact?
• What interests does the child have?
• Be aware of the child's cognitive abilities.
• Where does the child sit in class? How do they use materials? etc
• Observe the child in different environments? (Indoors, outdoors in the gym hall dining room etc.)
• Try a variety of lighting situations. How does the child react?

Appropriate test materials

• Every child is different.
• Think of the child's preferred learning styles and abilities.

FVA Report: What needs to be included?

• Consider who the report is for.
• Avoid jargon. If a technical term is used explain what it means.
• Circulate findings to everyone in the team.

Report by Teacher of the Visually impaired on:-

• Name DOB
• Address & details
  
• School/Placement Stage
• Address & details of key person
• Name of referrer and reason for referral.
• Name of Eye condition: Brief summary visual diagnosis (if appropriate)
• Date of last visit to eye specialist and brief summary of report.
• Any advice eg; correction.
• Visual Acuity figures etc.
• Details and dates of assessments
• Visual Acuity: with/without correction
• Distance Vision, assessment used, Right eye, left eye and Both eyes.
• Near Vision.
• Print Size: Assessment; Print/symbol size that allows the student to sustain reading or viewing for a certain period of time from a specific distance.
• Contrast Sensitivity
• Colour Vision
• Field Loss; based on observations functional use of peripheral and central vision. Observation of head tilt, abnormal positioning etc.

Include if applicable:-

• use of vision in a variety of lighting situations, eg; indoors, outdoors, different times of day etc.
• Light sensitivity preferred lighting for reading, reaction to glare, reaction to changes of light eg; going indoors from playground.
• Use of printed materials: Identification of 'crowded symbols', tracking ability; reading print on a line.
• Figure/ground discrimination
• Fluctuation in vision.

Recommendations:

• Examples of print size, layout and adaptations of materials and resources (print, Braille, other tactile auditory or combination).
• Usefulness of nonoptical low vision aids (video magnifiers, computer modifications etc).

• Mobility
  NB: any concerns regarding the child's ability to move around safely and confidently should be referred to a mobility specialist for further assessment.

• Speech& language, OT, physio etc.

FVA Report

• Copies to whole team.
• Take time to discuss findings with the pupil/child.