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 9-10 Student spontaneously uses vision for most functional activities
- Procedure cards #38-49
- Photos of items appropriate to assess the characteristics
- APH product connections to support vision use
- Strategies to consider for children in this range
Item 38. Selection of objects not restricted
Procedure
- Ask the parent/educator/caregiver how the student visually responds when new objects are presented.
- Note whether the student reportedly prefers new or novel objects or materials.
- Note whether the student visually detects the salient, key features of the new object or material.
- Observe whether the student demonstrates visual curiosity in new materials.
- Note whether the student visually examines the new object and/or attends to or probes the salient, defining features of the new object.
- Offer the student a variety of age-appropriate new objects.
- Note whether the student visually examines the new object and/or attends to or probes the salient, defining features of the new object.
Examples of Scores
| Resolved | Demonstrates visual curiosity and seeks out novel objects or materials |
| + | Is able to visually examine and/or interact with objects of any color and of any surface pattern, even if the object is novel |
| +/- | Recognizes and/or attends to visually novel objects with a single previous experience |
| – | Visually attends to objects that share elements of familiar objects |
See Suggestions for assessment ― complexity, novelty
Item 39. Only the most complex environments affect visual response
Procedure
- Ask the parent/educator/caregiver whether the student’s behavior changes when taken into a novel and visually complex setting.
- Does the student fail to become oriented to the surroundings?
- Does the student become “clingy” or more dependent upon the verbal and physical supports of adults or peers?
- Observe the student in a novel and/or visually complex setting.
- If ambulatory, does the student appear to move at an unnatural pace?
- Does the student fail to demonstrate visual curiosity?
- Does the student orient to targets that may be considered familiar?
- Color or light
- Moving or shiny targets
- Objects or environmental features that match ones that are well known by the student
- Take the student into a novel or highly complex setting.
- Place familiar and novel objects randomly in the setting.
- Ask the student to locate the objects, but do not name them ahead of time.
- Observe whether the student locates the objects, at what distance, and against varying degrees of complexity of array.
- Does the student locate only the familiar objects, or both the familiar and novel objects?
- Note the distance and fields of view in which the objects were located.
Examples of Scores
| Resolved | Demonstrates visual curiosity in complex environments; identifies or attends to novel elements within 20 feet |
| + | Demonstrates visual curiosity in familiar and novel environments, except those with an extreme degree of visual and other sensory complexities |
| +/- | Demonstrates visual curiosity in familiar environments that have low degrees of sensory complexity |
| – | Does not demonstrate visual curiosity |
Item 40. Latency resolved
Procedure
- Ask the parent/educator/caregiver whether she ever notices the student demonstrating a delayed response in visual attention between the time a target is first presented and the time in which the student first visually localizes or fixates on the object.
- Observe whether the student is demonstrating a delayed response in visual attention between the time a target is first presented and the time in which the student first visually localizes or fixates on the object.
- Observe in a variety of settings and times of the day.
- It is important to note any latent responses during times of hunger, fatigue, or multisensory inputs.
- While performing modified confrontation visual field evaluation, note whether there is latency in response to the introduction of the lighted, moving object as it moves through right and left peripheral/lateral fields.
Example of Scores
| Resolved | Readily directs visual attention to indicate wants or needs |
| + | Demonstrates no delay in visually detecting a target as it is presented |
| +/- | Rarely demonstrates a delayed visual response to a target |
| – | Demonstrates a delayed visual response to targets when tired or overstimulated |
Item 41. No color or pattern preferences
Procedure
- Ask the parent/educator/caregiver about the objects or materials that are most alerting or that appear to be “favorites.”
- Note any similarities in pattern, degree of complexity, and/or color shared by these preferred materials.
- Observe the student’s behavior with a variety of materials.
- Note any similarities in pattern, degree of complexity, and/or color shared by these preferred materials.
- Offer the student a variety of materials that are age and/or interest-appropriate.
- Note whether the student can identify “same” in three-dimensional objects and two-dimensional materials (“Show me one like this.”).
- Identify salient or defining features
- Locate the target object or image against backgrounds of increasing levels of complexity
- Note whether the student can recognize a target object or image when the object or image name is provided (“Show me the ____.”).
- Identify salient or defining features
- Locate the target object or image against backgrounds of increasing levels of complexity
- Note whether the student can identify a target object or image when asked (“What is this called?”).
- Identify salient or defining features
- Locate the target object or image against backgrounds of increasing levels of complexity
- Note whether the student can identify “same” in three-dimensional objects and two-dimensional materials (“Show me one like this.”).
Examples of Scores
| Resolved | Demonstrates typical abilities to attend to colors, patterns, and details |
| + | Color highlighting or pattern adjustment is not required for visual attention or interpretation |
| +/- | Some novel patterns or symbols require color highlighting or adjustment for visual attention or interpretation |
| – | Color highlighting of salient features or details is required for visual attention or interpretation |
See Suggestions for assessment ― complexity
Item 42. Visual attention extends beyond 20 feet
Procedure
- Ask the parent/educator/caregiver about the greatest distance at which the student can consistently locate any object.
- Observe the student in a variety of settings.
- Note the distances at which the student locates targets that result in visual attention or movement to the target.
- Place familiar objects (with no dimension greater than 4 inches) at distances between 10-30 feet from the student.
- Note the greatest distances at which the student locates the target objects.
- Note the condition in which the object is located.
- Located only in low-visual complexity environment
- Located only when near a light
- Located only when the target has movement properties
- The greatest distance is that at which the student can locate the target in any condition of complexity, degree of light, or without movement.
- This CVI Range item can also be conducted using environmental features.
- Exit signs, water fountains, signage, etc.
Examples of Scores
| Resolved | Is able to locate and/or fixate on targets at distances commensurate with peers |
| + | Is able to visually locate and/or fixate on certain targets at distances up to and possibly beyond 20 feet |
| +/- | Is able to locate and/or fixate on targets that produce movement, or are shiny or reflective, at distances of 20 feet; is able to visually locate and/or fixate on targets without movement 10-19 feet away; complexity of environment will continue to affect distance viewing |
| – | Is able to visually locate and/or fixate on targets up to 10 feet away |
See Suggestions for assessment ― complexity, distance viewing
Item 43. Views books or other two-dimensional materials, simple images
Procedure
- Ask the parent/educator/caregiver whether the student is able to isolate or identify a target image in familiar and novel books or other two-dimensional materials.
- Observe whether the student is visually locating and/or touching named images in an array of one, two, or more details.
- Present the student with books or two-dimensional materials that have up to 10 images per page.
- Note whether the student can identify “same” in two-dimensional materials (“Show me one like this.”).
- Identify salient or defining features
- Locate the target object or image against backgrounds of increasing levels of complexity
- Note whether the student can recognize a target image when the object/image name is provided (“Show me the ____.”).
- Identify salient or defining features
- Locate the target object or image against backgrounds of increasing levels of complexity
- Note whether the student can identify a target image when asked (“What is this called?”).
- Identify salient or defining features
- Locate the target object or image against backgrounds of increasing levels of complexity
- Note whether the student can identify “same” in two-dimensional materials (“Show me one like this.”).
Examples of Scores
| Resolved | Identifies salient features of two-dimensional materials with no adjustment or adaptation |
| + | Detects or identifies pictures or symbols in books or two-dimensional materials that have simple configurations |
| +/- | Detects or identifies familiar elements in familiar two-dimensional materials |
| – | Is visually inattentive to two-dimensional materials |
See Suggestions for assessment ― complexity
Item 44. Uses vision to imitate actions
Procedure
- Ask the parent/educator/caregiver whether the student is able to watch an action and then repeat it.
- Observe whether the student imitates actions.
- Waves good-bye in response to a good-bye wave from an adult or peer.
- Repeats actions associated with a song or poem when a model is provided.
- Spontaneously, and without verbal description, provide gestures and ask the student to repeat.
Examples of Scores
| Resolved | Repeats actions in response to an indirect, incidental model |
| + | Repeats actions in response to a direct model |
| +/- | Repeats actions in response to a visual and physical prompt or model |
| – | Does not imitate actions |
See Suggestions for assessment ― complexity
Item 45. Demonstrates memory of visual events
Procedure
- Ask the parent/educator/caregiver whether the student recognizes environmental locations, events, or activities as familiar.
- Note whether the student is reported to demonstrate signs of recognition through visual and/or social responses.
- Smiles as the car turns into the home driveway.
- Reported to verbalize words that confirm awareness of a familiar location, event, or activity.
- Shows distress as student enters an unpleasant setting (doctor office, dentist, etc.).
- Observe student’s behaviors when he approaches a familiar location, event, or activity.
- Note whether the student shows signs of recognition, pleasure, or distress as appropriate.
- Note whether the student is reported to demonstrate signs of recognition through visual and/or social responses.
Examples of Scores
| Resolved | Anticipates an action or event based on environmental visual cues |
| + | Demonstrates recognition of a person, place, or event that has occurred in the past |
| +/- | Demonstrates recognition of a person, place, or event that occurs in a rote or fixed routine |
| – | Demonstrates no recognition of actions or events that occur even as a rote or fixed routine |
Item 46. Displays typical visual-social responses
Procedure
- Ask parent/educator/caregiver how the student responds to the presence of familiar and new people.
- Note whether there are descriptions that include responses associated with socially typical responses.
- “She smiles when her favorite uncle enters the door.”
- “She pouts when her physical therapist enters the classroom.” “She has an especially difficult time with the stretching exercises the physical therapist does with her.”
- “When I come into her bedroom, before I say a word, she smiles when she sees it is me.”
- Observe the student’s behavior in a variety of situations and with a variety of adults or peers.
- Note whether there are differentiated responses based on the student’s visual recognition of an adult or peer.
- Offer the student photo images of smiling, frowning, or crying people.
- Note whether the student shows differentiated responses based on the content of the photo.
- Note whether there are descriptions that include responses associated with socially typical responses.
Examples of Scores
| Resolved | Initiates social contact or demonstrates withdrawal from unfamiliar individuals |
| + | Demonstrates appropriate, affective social responses to input from facial expressions or gestures of adults or peers |
| +/- | Demonstrates appropriate, affective social responses with familiar people |
| – | Demonstrates no reliable affective or social responses to peers or adults |
Item 47. Visual fields unrestricted
Procedure
- Ask the parent/educator/caregiver whether the student demonstrates difficulties anticipating curbs, steps, drop-offs, corners, or environmental obstacles.
- Note whether there is a pattern of difficulty with obstacles in any particular field of view.
- Observe the student at near and at distance.
- Note whether the student locates objects or obstacles in all peripheral fields.
- Perform a modified confrontation visual field technique.
- Note whether the student is able to appropriately detect the moving, lighted target as it moves from behind and through right, left, superior, and inferior fields.
- Take the student into novel environments that have steps, drop-offs, and obstacles.
- Note whether the student missteps, fails to locate the drop-off, or has unintended contact with the environment.
- Note whether there is a pattern of difficulty with obstacles in any particular field of view.
Examples of Scores
| Resolved | Has full use of both central and peripheral visual fields |
| + | Has fully functional use of peripheral visual fields; some central difficulties related to visual complexity remain |
| +/- | Demonstrates greater reliance on peripheral fields; may continue to use near viewing for two-dimensional materials |
| – | Demonstrates visual field preferences |
Item 48. Look and reach completed as a single action
Procedure
- Ask parent/educator/caregiver if the student is able to look at a target while also reaching toward it.
- Observe whether the student looks and reaches as a single action.
- Note the pattern of look and reach in a variety of settings.
- Objects of various sizes against simple and complex backgrounds
- Offer the student a variety of objects that are placed against simple backgrounds and complex backgrounds.
- Does the student look and reach as a single action?
- Does look-look away-reach occur in conditions of increased complexity or with smaller objects?
- Note the pattern of look and reach in a variety of settings.
Examples of Scores
| Resolved | Consistently uses visually guided reach regardless of the size of the target or the complexity of the background |
| + | Uses visually guided reach but may be affected by the size of the target or complexity of the background |
| +/- | Uses visually directed reach only when the background complexity is reduced |
| – | Rarely uses visually guided reach |
Item 49. Attends to two-dimensional images against complex backgrounds
Procedure
- Ask the parent/educator/caregiver whether the student encounters difficulty using materials of any level of detail, number of images or symbols, or degree of complexity of the background.
- Observe the student using a variety of materials that are known to be novel.
- Select symbols, photos, illustrations, or stylized images
- Words or numbers may be appropriate for some students.
- Offer the student:
- Groups of novel three-dimensional objects that have unique salient features
- “Find all the dogs” from a complex array of various animal figures
- “Find all the trucks” from a complex array of various vehicle figures
- Select symbols, photos, illustrations, or stylized images
- Ask the student to identify individual symbols, illustrations, or images from a complex array
- Words or numbers may be appropriate for some students
- Ask the student to identify individual words or numbers from a complex array
- Hidden picture puzzles (if age appropriate)
- Ask the student to locate individual target images in the complex background
- Images with detailed internal features
- Ask the student to locate or match a target image to “same”
- Groups of novel three-dimensional objects that have unique salient features
Examples of Scores
| Resolved | Is able to identify salient features and additional details in unadapted two-dimensional materials with backgrounds of high visual complexity |
| + | Is able to identify salient features and additional details in age-appropriate two-dimensional materials with minor or no adaptations |
| +/- | Is able to identify salient features in adapted two-dimensional materials with backgrounds of low complexity |
| – | Is not able to identify salient features in two-dimensional materials |
See Suggestions for assessment ― complexity