CVI Range 9-10

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

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

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

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.

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.

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?

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”

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