Procedure Cards adapted from The CVI Range pp. 57-60, the CVI Resolution Chart pp. 75-77 and the CVI Range Scoring Guide pp. 97-109. Roman-Lantzy, C. (2007). Cortical visual impairment: An approach to assessment and intervention. New York, NY: AFB Press.
CVI Range 7-8 Student demonstrates visual curiosity
- Procedure cards #28-37
- Photos of items appropriate to assess the characteristics
- APH product connections to increase visual curiosity
- Strategies to consider for children in this range
Item 28. Selection of toys or objects less restricted; requires one to two sessions of “warm-up”
Procedure
- Ask the parent/educator/caregiver whether the student continues to have preferred objects.
- Ask the parent/educator/caregiver how the student generally responds to new objects.
- If the objects are highly novel, the student may have difficulty visually attending to the new object.
- If the student shows increased visual attention to the novel object, it may be a sign that novelty is resolving.
- Observe whether the student demonstrates visual curiosity.
- Does the student visually alert to new objects, people, and materials?
- Does the student visually alert in new environments?
- Present the student with familiar objects, objects that share visual characteristics of the familiar objects, and highly novel objects one at a time.
- Note which objects result in visual attention and those which, if any, are visually disregarded.
- Note whether the novel objects become “known” objects within a session, a few days, or a longer period of time.
Examples of Scores
| Resolved | Novel objects that match complexity requirements are visually regarded |
| + | Looks at new objects that have the attributes of familiar objects; recognizes new object immediately after one to two experiences with the object |
| +/- | Looks at new objects that have attributes of familiar ones, but requires more than two presentations before the object is recognized immediately |
| – | Looks at familiar objects; novel objects must closely resemble the familiar ones |
See Suggestions for assessment― novelty and complexity
Item 29. Competing auditory stimuli tolerated during periods of viewing; may now maintain visual attention on objects that produce music
Procedure
- Observe the student in home and school settings.
- Note whether the student is able to establish and maintain eye-to-object contact on materials and people while there is additional sensory competition.
- Offer the student a variety of novel sensory inputs while the student is engaged with a primary visual input.
- Note the ability to look and listen while there are competing auditory inputs (multiple voices, music plus voice, television plus voice, and machinery plus voice).
- Note the student’s ability to attend to two-dimensional materials while also listening to verbal directions or other sensory inputs.
Examples of Scores
| Resolved | No amount of sensory competition or information interferes with visual attention |
| + | Is able to look at objects that simultaneously produce music or other sounds |
| +/- | Occasionally able to maintain visual attention while other sensory input competes; particular types of sensory input may continue to interfere with visual attention |
| – | Visual attention depends on low or no additional sensory input |
See Suggestions for assessment ― complexity
Item 30. Blink response to visual threat consistently 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 during 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 | Blinks to approach of unexpected input that come near the student’s face, even within a complex environment |
| + | Blinks simultaneously with the approach of an object or an open hand moving quickly on midline toward the face |
| +/- | Occasionally blinks to the approach of an object or hand moving quickly on midline toward the face |
| – | No blink to threat |
Item 31. Latency rarely present
Procedure
- Ask the parent/educator/caregiver whether he ever observes a delay in visual response between the time a visual target is presented and the time when the student first visually alerts or attends to the target.
- Throughout the CVI Range assessment, observe and note whether there is ever a delay in visual response between the time a visual target is presented and the time when the student first visually alerts or attends to the target.
- Be sure to look for the possibility of visual latency in the beginning, middle, and end of the evaluation sessions.
- Be sure to ask about or observe the possibility of visual latency when the student is fatigued, hungry, not feeling well, or post seizure.
Examples of Scores
| Resolved | Delayed response to visual input never occurs |
| + | Seldom demonstrates a delay in detecting a target after it is presented |
| +/- | Novel objects, complex environments, or fatigue may increase the degree of delayed response |
| – | Delayed response to new and familiar targets continue to exist |
Item 32. Visual attention extends to 10 feet with targets that produce movement
Procedure
- Ask the parent/educator/caregiver about the general distance and greatest distance at which the student visually detects or notices visual targets.
- Offer preferred objects and novel objects to the student at varying distances of up to 20 feet.
- The largest dimension for at least some of the targets should be 4 inches or less.
- Compare distances at which the student visually alerts to familiar targets.
- Note whether the student is able to even occasionally notice the movements of people or the movement that emanates from environments at distances that are greater than usual for the student.
Examples of Scores
| Resolved | Visual attention even beyond 10 feet and/or visual attention up to 10 feet with targets that are nonmoving or stable |
| + | Is able to visually locate and/or fixate on certain targets at distances as far away as 10 feet, especially with targets that produce movement or are shiny; attention at this distance may depend on the degree of complexity of the environment |
| +/- | Occasionally directs visual attention to targets at 10 feet, generally when the environment is controlled for other sensory inputs |
| – | No visual attention to any targets at distances as far as 10 feet |
See Suggestions for assessment ― complexity, environment
Item 33. Movement not required for attention at near
Procedure
- Present familiar objects to the student on backgrounds of various levels of complexity and patterns.
- Begin with a black background, progress to a two-color background, and then add degrees of complexity to the background.
- Place a number of small 1-3 inch objects or one to four food items in a random array on the black or patterned background.
- Note whether the student is able to locate an object; if the student cannot visually locate any objects, shift the background so that movement of the target objects occurs.
- Note whether the addition of movement now results in visual attention to or fixation on one or more target items.
- If the student is unable to locate the object or food item, repeat this activity using 1-3 inch Mylar® or sparkly balls; Mylar® objects are often perceived as movement even when the object does not physically move.
- Note whether the student can locate the sparkly ball (perceived as movement).
- Present simple images in two-dimensions on the APH Light Box as well as dynamic, moving displays on a tablet device.
- Note whether the student demonstrates a difference in visual attention using the moving versus nonmoving targets.
Examples of Scores
| Resolved | Is able to detect targets that do not have moving, shiny, or reflective properties beyond near distance |
| + | Is able to visually detect and attend to objects or visual targets that do not move or are not made of shiny or reflective materials within 18-24 inches |
| +/- | Occasionally, is able to detect and attend to nonmoving visual targets within 2 feet |
| – | Is not able to detect or attend to nonmoving targets within 2 feet |
See Suggestions for assessment ― complexity, movement
Item 34. Smiles at and regards new and familiar faces
Procedure
Ask the parent/educator/caregiver whether the student notices or responds to her face if she unexpectedly approaches with and without voice.
- Ask the parent/educator/caregiver whether the student notices or responds to the faces of unknown adults when they approach the student.
- Note behaviors that may indicate recognition of a familiar or unfamiliar person:
- Quieting, smiling, eye-to-eye contact, or apprehension
- 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 present.
- Note behaviors that may indicate recognition of a familiar or unfamiliar person:
Examples of Scores
| Resolved | Has eye-to-eye contact with most faces; discriminates new from known people |
| + | Glances at and/or has eye-to-eye contact with familiar and new faces |
| +/- | Occasionally glances toward and/or makes eye contact with familiar faces |
| – | Demonstrates no regard of faces |
See Suggestions for assessment ― complexity
Item 35. May enjoy regarding self in mirror
Procedure
- Ask the parent/educator/caregiver whether the student likes to look at his own image in a mirror.
- Place a mirror in front of the student within 18-24 inches from his face.
- Note whether the student looks directly at his facial image, reaches or touches his facial image, smiles, or imitates his own facial gestures.
- Note whether the student avoids his facial image in favor of light reflecting from a portion of the mirror surface.
Examples of Scores
| Resolved | Maintains consistent eye-to-eye contact with self in mirror |
| + | Consistently glances and/or looks directly at mirror image even though eye-to-eye contact may not occur |
| +/- | Inconsistently glances at own image in mirror |
| – | Mirror primarily serves as a light gazing object |
See Suggestions for assessment ― complexity
Item 36. Most high-contrast colors and/or familiar patterns regarded
Procedure
- Ask the parent/caregiver/educator whether the student has “favorite” objects.
- Note whether the objects are similar in color or pattern or whether the objects have a variety of patterns.
- Observe student interactions in the home or classroom.
- Note whether the student seeks out objects that have simple, single color surfaces, two-color or patterned surfaces, or multiple colors on the surface of the object.
- Offer the student objects that are single color, two-color, and multiple colors on the surface of the object.
- Note whether the student looks at, regards, or interacts with the objects equally or whether the highly complex, novel objects are disregarded.
Examples of Scores
| Resolved | Is able to visually attend to materials that have more than two to three colors that may not include preferred color |
| + | Is able to visually attend to objects of any bright color or objects that have simple to multicolor patterns |
| +/- | Is able to visually attend to some simple patterns, especially familiar ones or those that are highlighted with the preferred color |
| – | Preferred color continues to be necessary as an element of an object viewed |
See Suggestions for assessment ― color, complexity
Item 37. Simple books, picture cards, or symbols regarded
Procedure
- Ask the parent/educator/caregiver whether the student visually attends to books or other two-dimensional materials.
- Observe whether the student regards the images in books with single- to two-image picture pages.
- Note whether the student primarily watches the turning of the pages.
- Note whether the student visually investigates individual images (touches picture, moves closer to visually inspect it, looks at or touches image upon request).
- Offer the student single color symbols against black backgrounds and against color background.
- Note whether the student is able to identify the “same” image even when the background array differs slightly.
Examples of Scores
| Resolves | Is able to visually detect elements of age-appropriate books or other two-dimensional materials |
| + | Visually attends to two-dimensional materials that have little complexity and that include single to two-color images |
| +/- | Visually attends to a small set of two-dimensional materials; is not able to generalize the images to new contexts; may use APH Light Box and Light Box pictures to facilitate visual attention to two-dimensional details |
| – | Is visually inattentive to two-dimensional materials |
See Suggestions for assessment ― complexity
Proper Trademark Notice and Attribution
Mylar® is a registered trademark of Dupont Tejjin Films.