Procedure Cards adapted from The CVI Range p. 57-60, the CVI Resolution Chart p. 75-77 and the CVI Range Scoring Guide p. 97-109. Roman-Lantzy, C. (2007). Cortical visual impairment: An approach to assessment and intervention. New York, NY: AFB Press.
CVI Range 5-6 Student uses vision for functional tasks
- Procedure cards #19-27
- Photos of items appropriate to assess the characteristics
- APH product connections to increase use of vision for functional tasks
- Strategies to consider for children in this range
Item 19. Objects viewed may have two to three colors
Procedure
- Observe the student with the object identified as “favorite” or preferred.
- Note the number of colors on the surface of the objects only if the student is able to demonstrate eye-to-object contact with the objects named.
- Note whether the favorite objects have additional sensory aspects (noise, music, voice, etc.).
- Note whether the favorite objects have lighted or movement properties.
- Offer objects to the student that have two, three, and four colors or patterns.
- Note which objects result in eye-to-object contact.
Examples of Scores
| Resolved | Pays visual attention to multicolor or multipattern objects with or without preferred color |
| + | Looks directly at targets that have a pattern of two to three colors; preferred color is at least one element of the pattern |
| +/- | Looks directly at targets that have two, and occasionally three, colors; preferred color is always one of the colors |
| – | Pays visual attention only to objects of a single preferred color |
See Suggestions for assessment― color, complexity
Item 20. Light is no longer a distracter
Procedure
- Observe whether the student demonstrates visual attention to primary sources of light (ceiling lights, lamps, window light, etc.) at any time.
- Ask the parent/educator/caregiver whether the student has even occasional periods of staring at lights.
- Do not adjust lighting environments.
- Present objects to the student that have lighted components and those that do not.
- Does the student only look at the objects that have light?
- Does the student reportedly, or by observation (direct evaluation), continue to demonstrate visual attention primarily on objects that have backlighting (television, tablet devices, etc.)?
- Position the student facing windows or room lamps, and note whether the student is able to engage in familiar activities without light gazing behaviors.
- May close eyes when direct light from a color-filtered flashlight is passed in front of eyes.
Examples of Scores
| Resolved | Normal responses to high and low levels of light |
| + | No light gazing behavior, though light may support visual attention for certain near point tasks |
| +/- | Occasional gazing at primary sources of light |
| – | Light gazing occurs consistently |
See Suggestions for assessment― light
Item 21. Latency present only when the student is tired, stressed, or over stimulated
Procedure
- Observe the student during a period of time identified as most fatiguing.
- Note whether the student demonstrates visual latency.
- Ask parent/educator/caregiver about visual behaviors that may be interpreted as inattention.
- Offer visual targets to the student during the time identified as inattention; observe the student for delays in visual response or latency.
- Compare the latency responses to visual responses that occur during times when the student is not tired, stressed, or over stimulated.
- Visual latency is likely to increase in a period after a student experiences a seizure.
Examples of Scores
| Resolved | No delay in directing visual attention to a familiar or noncomplex target |
| + | Delay in directing visual attention toward a target only when experiencing fatigue or inappropriate levels of multisensory input |
| +/- | Occasional delay in directing visual attention to a target |
| – | Consistent delay in directing visual attention to a target |
Item 22. Movement continues to be an important factor for visual attention
Procedure
- Ask the parent/educator/caregiver about targets that most consistently result in visual attention.
- Note whether the named targets have movement or are shiny.
- Observe the student in a variety of settings, and note whether the targets that result in visual attention have movement properties.
- Offer objects to the student at near that are presented against a variety of patterned backgrounds.
- Note whether the student is better able to detect the object when the target is shiny or if it has the physical properties of movement.
- Offer simple two-dimensional images to a student with or without movement.
- Does a dynamic display with movement (as with tablet devices) result in greater visual attention?
Examples of Scores
| Resolved | Moving, shiny, or reflective materials not required for visual attention at near or up to 6 feet away |
| + | Visual attention is most consistent with materials that move or have shiny or reflective surfaces; some element of movement is necessary; the entire target does not have to be moving, shiny, or reflective for visual attention to occur |
| +/- | A small element of movement may help establish or maintain visual attention |
| – | Only materials with elements of movement establish or maintain visual attention |
See Suggestions for assessment― movement
Item 23. Student tolerates low levels of background noise
Procedure
- Observe the student in classroom, home, or social setting.
- Note whether the student is able to visually attend to an intended target even when there is a low volume or level of music or environmental auditory input.
- Note whether the student is able to visually attend to an intended target while low volume levels of voice are present.
- Present an object to the student that has sound as an option. Once the student is visually attending to the object, introduce the sound (music, voice).
- Note whether the student looks away or maintains visual attention on the object once the auditory input is initiated.
- Attempt sound plus object with a variety of objects or combinations of sound plus visual targets.
Examples of Scores
| Resolved | Visual attention established and maintained in typical multisensory environments |
| + | Visual attention is maintained even in the presence of low-volume sound, familiar voices, or familiar environmental sounds |
| +/- | Occasionally able to maintain visual attention in the presence of sound; one or two particular sounds are tolerated during viewing; many are not tolerated |
| – | Little or no visual attention in the presence of other sensory inputs |
Item 24. Blink response to touch is consistently present
Procedure
- Without verbal prompt or forewarning, gently and quickly touch the student on the bridge of the nose between the eyes.
- Observe whether the student blinks simultaneously with the touch, blinks with latency, or fails to blink to touch.
- Repeat this procedure several times throughout the assessment session.
- Tap at bridge of the nose two or three times each trial.
- It is important to repeat this intermittently to consider potential habituation to the touch and potential affects of latency.
Examples of Scores
| Resolved | Blink to touch response has been present for a least one previous CVI range assessment; blink to visual threat is inconsistently present |
| + | Consistently blinks simultaneously to touch at bridge of nose |
| +/- | Emerging pattern of blink to touch response |
| – | Occasional or absent blink to touch response |
Item 25. Blink response to visual threat is intermittently present
Procedure
- Without verbal prompt or forewarning, quickly move an open hand toward the student’s face on midline and at eye level.
- Observe whether the student blinks simultaneously with the threat, blinks with latency, or fails to blink to the visual threat.
- Repeat this procedure several times throughout the assessment session.
- Attempt the visual threat technique two or three times each trial.
- It is important to repeat this intermittently to consider potential habituation to the touch and potential affects of latency.
Examples of Scores
| Resolved | Blink to threat response is consistently present |
| + | Blink to threat response is present in 50% of attempts |
| +/- | Blink to threat response occurs, but in fewer than 50% of attempts |
| – | No blink to threat response |
Item 26. Visual attention now extends beyond near space, up to 4-6 feet
Procedure
- Ask the parent/educator/caregiver about greatest distance at which the student consistently visually locates a particular target.
- Observe the student in familiar and unfamiliar settings.
- Note objects, people, and environmental features that capture the student’s visual attention.
- Place familiar and novel objects in a familiar or unfamiliar setting and ask the student to locate named objects.
- Using an object that is highly familiar to the student, slowly move toward the student holding the familiar object in one hand (but extend both in a symmetric manner) and note when the student first visually locates the target object.
- Begin moving toward the student (without speaking) from a distance of 10 feet.
- When appropriate, position yourself in the student’s best field of view.
Examples of Scores
| Resolved | Visual attention or eye-to-object contact with targets occurs beyond a distance of 6 feet |
| + | Can visually locate or fixate on certain targets at distances as far away as 6 feet and always at 4 feet; the ability to detect objects or movement at 4-6 feet may depend on the degree of environmental complexity |
| +/- | Occasional ability to locate or fixate on targets as far as 6 feet away, even when the background is noncomplex |
| – | Visual attention or eye-to-object contact within 3 feet |
Item 27. May regard familiar faces when voice does not compete
Procedure
- Ask the parent/educator/caregiver whether the student notices or responds to her face if she unexpectedly approaches with and without voice.
- Observe the student’s behavior when face-to-face with a familiar person, a novel person, and the student’s own mirror image.
- Observe whether there is attention to faces, eye-to-eye contact, or disregard of face.
- Attempt with and without voice.
Examples of Scores
| Resolved | Makes eye-to-eye contact with familiar and novel individuals |
| + | Glances at or looks directly into faces of familiar people, but only when the familiar person is not speaking |
| +/- | Glances at or looks directly at faces, but the responses are inconsistent or fleeting |
| – | No regard of the human face |
See Suggestions for assessment― complexity