University of Edinburgh

Functional Vision Assessment

Observation as part of FVA

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This is the part of functional vision assessment that I had greatest difficulty in explaining to class teachers when I was going around. I think they thought "what is she doing? She's just sitting there." I think that when you were in the class they sometimes thought "oh here's an extra pair of hands", when in actual fact I was really closely observing the child. As I became more confident, and I say this to all of my students, don't apologise for observing. That is a key role that you should have. Take time to observe. It allows you to see how the child is moving, it allows you do pre-assessment checks. It allows you to talk to the child, to look at the child, to see how the child is using their vision; asking the child to gain the child's understanding of vision. And how their understanding of vision interacts with any special needs they have. What modifications to their environment could you maybe introduce to support the maximum use of their vision? So always take time to do a really sound observation. In fact if I had time and I'd try to build it in, if a child was referred to me and I didn't know them from before, I would always ask just to be introduced to the class as a visitor, so that the child didn't know that I was observing them. Before I even spoke to the child, just sit and watch them or go into the nursery; spend time just following them. I'm actually quite good at watching children in the playground; watching them walking along the corridors. You should take time to do that. You should learn a lot from watching a child; how they're moving; how are they talking to their pals; are they talking to their pals at all? What do they do in the playground? Do they stand still and don't interact with the other children? So take time to do that. It's a critical part of a functional vision assessment observing the child taking part in everyday activities in a variety of settings. I've said before it's not possible for eyecare specialists to have the luxury and the time to do that in a medical setting. Although I'm not saying that they don't do that as soon as a child enters the room. My understanding is that they're observing how the child enters the room; how they reach out for objects; how they react to activities; how they maintain eye contact with you. But we would do that in much more depth in an observational assessment. I've put a note into your pack and I've taken it from this book Functional Vision: a Practitioner's Guide to Evaluation and Intervention. It's typed up and it's in your pack. It's a guilde to observational assessment of functional vision. It's very good. I actually had the pleasure of meeting Amanda when I was at a conference and it really is a very good guide. We don't have time: I could spend a day talking about each of the points on this sheet; but it's a guide for what we should be looking at. Reading ability and efficiency. How are they reading? Are they holding it up close to their face? Are they holding it away down? Are they wearing their glasses? Do they take their glasses off to read? Are they looking over their glasses? I was part of a multi-agency team, and we had the luxury of having an orthoptist come out to see the kids in a non-clinical setting. And they were saying that was something in the clinical setting; they wear their glasses well but when they were doing everyday tasks, no they weren't. And they actually found that very useful to see them working. We can do that; we can report to the orthoptist. The class teacher's seeing them every day. You can ask them to report back to you. There aren't very many Teachers of the Visually Impaired so we can't be with the child every day but what you can do; what I did when I was in early years, is there's usually a nursery nurse or someone who's a key person. I would ask them to record when the child was wearing their glasses for me, so that we had a record to go back to the orthoptist. It truly should be a team effort when you're carrying out a functional vision assessment. If you take the time to read that it really is quite a comprehensive list of where you might want to report back and areas which you can say "is there a difference?" Look back to the child's work 3 months previously. Is there a big difference in the size of their letters? Well why is that the case? Are they able to write on the lines here? No they can't but they did beforehand, so why? Why is that?

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