Functional Vision Assessment

Name: Student
Age: 13
Birthday: 2/6/2001
Placement/Grade: 8th grade in an exceptional center in self-contained classroom
Date of assessment: October 2014
Evaluator(s): Tiffany
Diagnosis/Acuity: Cortical Visual Impairment with fix and follow, as well as hyperopia

Teacher Interview: COMMUNICATION/ LEARNING STYLE

1) (a) How does the student communicate (e.g., verbal, sign language,
communication board)?
Student is verbal.
(b) How do others communicate with the student?
Verbally
2) How would you compare the students current functional level to students of the
same age (below, average or above)?
J. is functioning below level in academics in some Independent Living Skills
areas (i.e. tying shoes) but he does very well with cooking, washing dishes, and
task assignments once they are taught to him.
3) Does this student have any known disabilities other than the vision loss?
No
Please explain.

Yes

J. qualifies as a student with intellectual disabilities (IND)

4) Do you have any other concerns about the students learning that you believe
should be observed or evaluated further?
NO.
5) In which of the following settings does the student work best?
Independently, on his/her own
In small cooperative workgroups
In larger groups, e.g., with the entire class
With one-to-one assistance
6) How does the student use unstructured time in the classroom?
J. enjoys manipulating small objects and gadgets and likes to participate in jobs
such as paper shredding, recycling, laundry pick-up, and snack shack cashier. J.
likes to dance with a peer during music and movement activities or school wide
dances.
7) (a) What tasks/subjects are easiest for the student, and why do you think they are
easy?
Js interests are in hands on activities and jobs things he can do with his hands
and manipulate. He seems to prefer Science for academic areas.
(b) What tasks/subjects are most difficult for the student, and why do you think
they are difficult?
Reading and writing are the least interest to J. and it takes him a while to focus on his
task or assignments. He requires prompting and timers to encourage him to begin
working. I think, he lacks confidence but he is also stubborn.

8) What have you observed to be the most and least effective methods of
reinforcement for this student?
The most effective reinforcement is earning chips to spend at the school store or
classroom treasure box. Least effective is constant verbal encouragement because
I think he enjoys listening to people constantly prompt him.
VISUAL BEHAVIORS
1) (a) Check any of the following behaviors the student has demonstrated:
Rubbing eyes/eye poking

tilting head

squinting

holding

objects/books close to face.

Sensitivity to light

visual fatigue, headache

Please describe any other behaviors, related to a possible visual impairment, that
you have observed.
J. is aware of light and shadows and can move around quite well when he is
paying attention. J. remembers landmarks so unless something has been moved
or changed in his environment, he can move with confidence.
(b) Are there times in the day or situations during which these behaviors are more
evident? Please explain.
He only bumps into things if his environment has changed and he doesnt have his
cane.
2) Where does the student sit in the classroom in relation to the teacher, the
chalkboard, and the windows?
He sits to my left but for no special reason he is blind. We dont have windows
and I dont use a chalkboard.

3) Does the student wear eyeglasses or use any magnifiers or visual aids?
He wears glasses mostly for protection.
4) If the student is a reader, does she/he function at or near grade level in ageappropriate reading skills? Please explain
J. is below grade level in reading but he has an age level vocabulary.
5) Does the student have more difficulty looking at objects/people up close or far
away? Please give examples. His vision is fix and follow and he has the
difficulty with both near and far.
6) How do you think the students ability to take in information is limited by his/her
visual functioning, if at all?
He learns through auditory and tactual means he cannot visually take in
information required for learning.
7) How do you think the students information output is limited by his/her visual
functioning, if at all? He can show his understanding through other means;
He is able to Braille both read and write un-contracted but his fluency is low.
He can demonstrate understanding through verbal or tactile means (Braille).
SOCIAL/ EMOTIONAL BEHAVIORS
1) How does the student interact with peers?
J. gets along well his peers; he likes to joke with them.
2) How would you describe the students social strengths and/or weaknesses?
His social strength is being helpful to his peers and teacher.
His weakness is answering and greeting others. J. tends to remain quiet or talk
in a very low tone that can be difficult to hear.

3) Does the student function better on independent tasks or in groups?

J. does both well.
4) How would you describe the students confidence? Motivation?
J. is motivated by hands on activities, jobs, and task assignments. He is confident
with job related tasks after shown how to do it once. In academic areas, his
confidence is low.
5) Does the student make his/her needs known in socially appropriate ways?
Yes, he is polite when making requests or expressing a need but still he is very
quiet.
Parent Interview: Parent was not available for interview
Introduction
Student is a quiet, mischievous boy. He seems to enjoy taking items that he finds
and hiding them in the classroom. When it is time to use that item again and the teacher
begins to look for it, he will help look for it, if he does not remember where it is.

Review of Records
Student has cortical visual impairment as well as an intellectual disability. He was
also diagnosed with hyperopia and nystagmus.

General Observations
Student seemed to hold his eyelids closed with his hand when his vision is
working and he doesnt want to use it. I did observe him using his vision, but never for
academic tasks. I observed him looking for people and once looking at his food.

Ocular Observations
Student had normal appearing eyes, with occasional nystagmus. He did not
demonstrate a muscle imbalance. He attended to light easily, thus I did most of my
testing with light up toys. He was able to track a light, but it appeared to be jumpy. He
also did not shift his visual attention while I observed him. When I tested his peripheral
vision I asked him to hold his head still and tell me when he saw the light; he only was
appeared to see the light when it was in front of his face, so he appears to have reduced
peripheral vision.
Student was able to track a light left, right up and down and over midline, but I
was not able to assess his scanning ability or convergence.
When looking for an item he knew was on the table, he felt for it rather than
looking for it.
Student did not appear to have an eye preference.

Near and Distance Vision

As I was preparing to test Student on his near and distance vision, using LEA
Symbols tests, which contain the symbols apple, circle, square, and house, I handed him
the card with the square on it. He attempted to tactually feel the card. I asked him what he
saw on the card, with out giving him choices and after about 5 minutes he held his eyes
closed and told me it was a picture of a boy.
I have observed him looking for people in a room, to see if they are still there, and
occasionally at his food. When he does this, he usually tries to get within a few inches to

what he is looking at, unless it is a light. Student usually fixates on ceiling lights, but
when testing I allowed him to hold the light up toys I was using, he brought them all to
within a few inches of his face, although he was able to see them farther away.

Contrast Sensitivity and Depth Perception

Student would only look at lights so I could not test his contrast sensitivity or
depth perception.

Behavior Abnormalities
I did not observe Student poking his eye; although his teacher said he exhibited it.
I did observe him holding his eyes closed occasionally.

Color Vision
While preparing for another test I asked Student what his favorite color was and
he stated that he did not have one. He also never referred to a color name, but rather used
other descriptors, the bright one, the fan, etc.

Academic Tasks
Student is learning nemeth numbers and symbols, as well as addition and
subtraction using manipulatives. In his work, he is using literary numbers rather than
nemeth numbers and gets confused about spacing. He is also very slow at academic tasks.
His teacher does not know if this is because of his disability or it is a behavior issue.
Student is also using uncontracted braille in his class.

Daily Living Skills

Student goes to the restroom, washes his hands, and feeds himself with ease and
without mess. I have not had the opportunity to see him cook food, although I know he
does with his class.

Orientation and Mobility

Student travels with a white cane and walks with a normal pace when using his
cane in a familiar area. When he is without his cane, or in an unfamiliar area, he is very
slow moving.

Learning Media Assessment Strategies

I observed Students use of his senses in his classroom environment at varying
times. I also observed him in orientation and mobility, art, and family consumer science.

Assessment Results
Use of Sensory Channels
I observed Student during breakfast, math, and science and wrote down his
behaviors. For each behavior I noted if it was visual, tactual, and/or auditory.
Student tactually gathered most of his information and used auditory information
as his secondary source of information. Student mostly used his vision to look at lights,
but would occasionally look at people.
Reading Efficiency

Student read an uncontracted, brailled first grade passage at 8.9 words per minute.
I had him read a letter from a previous teacher before beginning the reading passage. In
the letter, when he reached a word he did not know, he stopped reading. He did not sound
the word out. He told me he did not know the word until at least 15 seconds after his
fingers stopped moving over the word. In the passage he knew all the words and read
each word without stopping. Student is a very quiet reader and the mistakes I heard may
not have been made, but they were saw read as see and legs read as leg.
Handwriting
Student uses a braillewriter to complete homework assignments in uncontracted
braille. Student has decent fine motor skills, as he is able to remove staples from paper he
is going to shred and take apart items he finds to discover more about the item.
Literacy Tools
Student currently uses braille for reading. He does not use any auditory forms for
reading. He is in a traditional reading program that has been slowed down for the other
students in the class and is significantly below his grade level.

Summary
Student is a quiet mischievous 12-year-old boy. He enjoys looking at lights and
will not look at much else. He seems to have a severe peripheral loss. Student will look
for people in a room, to see if they are still there. He is learning nemeth numbers and
symbols, as well as adding and subtracting. He uses uncontracted braille for reading and
writing tasks.

Student uses tactual information for his primary source of information and
auditory information as his secondary source of information.
Communication Summary
Student is a very quiet speaker when he speaks to adults. When speaking to his
classmates and the class pet rats, he speaks loudly and clearly. Student also does not turn
to face people when speaking to them.

Recommendations

Student should continue to learn nemeth symbols.

Students speed on academic tasks should be increased.

Student should work on speaking at an appropriate volume to adults.

Student should work on looking at the person speaking to him.

Submitted by: Tiffany Stevens