Using Assessment Results in Intervention Session 5

1. Using Assessment Results in Intervention Session 5

2. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Objectives After completing this session, participants will 1. recognize that intervention planning for young children with visual impairments should be based upon results from the functional vision assessment and/or developmentally appropriate learning media assessment; family concerns, resources, and priorities as identified in routines-based assessment; and assessment results from multiple disciplines.

3. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Objectives After completing this session, participants will identify developmentally appropriate and functional interventions within the child’s natural environment that facilitate the development of visual skills. describe the relationship between postural stability and optimal use of vision and the use of positioning to facilitate the use of vision.

4. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Objectives After completing this session, participants will identify environmental modifications that promote young children’s optimal use of vision within the context of daily routines and naturally occurring activity settings. describe the use of cues and prompts as an intervention strategy that may promote optimal vision use for children with visual impairments. describe the TVI’s role in supporting the use of corrective lenses with children with visual impairments.

5. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Objectives After completing this session, participants will describe the role of TVIs and OMSs in implementing the recommendations from low vision specialists and in helping children learn how to use optical devices recommended by low vision specialists. describe the relevance of a patching (penalization) program and strategies to support young children in adapting to penalization. identify strategies that support efficient use of vision in children with cortical visual impairments.

6. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Assessment guides intervention planning. The FVA and DALMA provide information about children’s use of functional vision and other senses in the context of daily routines. Assessment of families’ priorities, concerns, and resources as identified in a routines-based assessment provides useful information for identifying functional goals. Part C of IDEA (1997) requires that assessment be completed by professionals from at least two disciplines.

7. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Current Levels of Visual and Sensory Functioning Describe how children currently use sensory information, provide baseline information about sensory skills, and can change considerably over the course of a few weeks or months

8. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Assessment and Intervention Guidelines As addressed in Part C of IDEA (1997), assessments should be conducted by professionals from two or more disciplines, and interventions should be based upon assessment from multiple disciplines.

9. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Intervention Goals Intervention goals should be continually monitored and updated to meet the changing visual and developmental status of the child as well as the family’s concerns and priorities. Revised goals should be developed by all team members to ensure a consistent, holistic approach to promoting optimal development.

10. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Motivational Considerations Meaningful learning occurs within the context of activities in which children are engaged and motivated. Intervention goals and strategies that motivate children are more likely to be effective and enjoyable.

11. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Developmental Considerations Cognition is involved in visual processing. Basic visual behaviors that involve physical visual function are less difficult than those requiring higher cognitive ability. Children who are functioning at lower developmental levels may be expected to acquire basic visual tasks.

12. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Visual Skill Considerations Integrating the use of visual skills within motivating, naturally occurring contexts and routines will enable the young child to have more meaningful visual experiences. Localizing Shifting gaze Fixating Tracking Scanning Eye-hand coordination

13. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Localizing Localizing means locating a landmark and moving toward it.

14. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Fixating Fixating means focusing on an object, such as a caregiver’s face during communicative exchanges or food during meals.

15. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Scanning One example of scanning is looking for clothing items in a dresser drawer during the morning dressing routine.

16. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Shifting Gaze Shifting gaze can be used when choosing between two toys during playtime.

17. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Tracking An example of tracking is visually following the movement of a family pet.

18. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Visual Clusters Visual clusters are observable behaviors that occur in a sequence. For example, Hayden looks for the red toy, reaches for it, and grasps it.

19. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Critical Visual Moments A critical visual moment is the time during task performance when continuous eye contact or fixation on the task materials is necessary to complete the task. If TVIs can identify critical moments within daily routines and can help the child look at that moment, the routine will be completed more efficiently. Goetz & Gee, 1987b

20. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Sensory Integration Recommendations to enhance sensory integration include providing children with opportunities to use vision and hearing during their daily routines, such as preparing food, and giving children ample opportunities to tactually and visually explore objects, particularly those objects that are outside the child’s visual range. Erin et al., 2002

21. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Sensory Integration Encourage children to use their sense of smell to provide additional cues in identifying objects and events. For example, a child might differentiate an orange from a lemon by smell and color. Expose children to different movement experiences to support the integration of vision and movement. Erin et al., 2002

22. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Postural Stability Some children with visual impairments and dysfunctional postural and movement systems can improve visual efficiency through stable positioning. When working with children with physical impairments, it is important to consult with occupational and physical therapists to identify optimal positions for visual functioning. Erin, 1996; Langley, 1998b

23. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Environmental Modifications Implement modifications during daily routines and activities across settings to facilitate optimal visual functioning. Change illumination Adjust seating Reduce glare Reduce clutter Alter color or contrast Minimize noise

24. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Cues and Prompts Cues and prompts can promote optimal visual use for children with VI. Physical Auditory (tapping) Verbal (“look at”) Visual cues Time out Chen & Dote-Kwan, 1995 Utley, Goetz, Gee, & Sailor, 1981

25. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Corrective Lenses Eye care professionals will often prescribe corrective lenses and suggest that they be worn for specific amounts of time in the day.

26. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Adjustment to Corrective Lenses Adjustment to corrective lenses may be challenging because toddlers assert independence, glasses may feel unusual and be a source of distraction, glasses may actually be uncomfortable, and lens prescription may be incorrect. Wisely et al., 1990

27. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Promoting Acceptance of Corrective Lenses Encourage the child to wear glasses for short periods of time initially (e.g., during the beginning of mealtimes). Praise the child for wearing glasses. Gently replace the glasses without comment when the child removes them. Gradually increase the amount of time that the child wears the glasses. Wisely et al., 1990

28. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Optical Devices Use of optical devices such as magnifiers and monoculars may help children with low vision gain visual access to their world. Optical device training may improve self-image, facilitate independence, facilitate learning, and heighten motivation and curiosity to explore. Wilkinson, 2000

29. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Optical Devices Facilitating the development of visual skills is critical because children with low vision cannot be expected to look through prefocused monoculars if they are not able to maintain fixation. Watson, 1989

30. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Patching as an Intervention Eye care professionals may recommend that an eye with better vision be patched in order to allow the weaker eye to become stronger through forced use.

31. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 Patching Methods Encouraging young children to tolerate an eye patch can be difficult. TVIs should be aware of methods that facilitate this medical treatment. Firmness and consistency Engagement/distraction Positive reinforcement

32. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 CVI Strategies Levack, Stone, and Bishop (1994) suggest the following strategies for working with children with CVI: Use other sensory cues to stimulate or support visual information. Avoid visual overstimulation by introducing items one at a time in an uncluttered environment. Levack, Stone, & Bishop, 1994, pp. 16-17

33. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 CVI Strategies Work with only one sense at a time when using other sensory cues to stimulate visual performance. Watch for preferences in color, shape, size, movement, and field. Make changes gradually, recognizing that these children can have difficulties processing information. Levack, Stone, & Bishop, 1994, pp. 16-17

34. Early Intervention Training Center for Infants and Toddlers with Visual Impairments FPG Child Development Institute University of North Carolina at Chapel Hill June 4, 2004 CVI Strategies Try shaking or moving objects as they are brought into children’s line of vision. Determine the best position for individual children to use their vision. Make visual cues bold and simple, and use them consistently. Present visual stimuli in a simple figure-ground environment. Levack, Stone, & Bishop, 1994, pp. 16-17