FV/LMA – Ricky Alamo
FUNCTIONAL VISION EVALUATION
AND
LEARNING MEDIA ASSESSMENT
Student Name: Ricky Alamo
DOB: 4/3/28
TVI: Liz Parker
School: Hawthorne Elementary
Greene County School District
Current Eye Report Date: 11/1/13
Current Clinical Low Vision: N/A
Assessment Date: November 4, 2013
Hearing Screening: Passed 10/30/13
Assessments/Instruments used in this evaluation:
EVALS (Evaluating Visually Impaired Students), Oregon Project Inventory, Jerry Johns Basic
Reading Inventory, Written Language Observation, Koening and Holbrook Learning Media
Assessment, Parent Interview Guide.
Background: Ricky was referred for evaluation due to his visual diagnosis of aniridia
(incomplete formation of the iris, retina, and optic nerve), a coloboma (a small hole) in the
retina OD (right), anomalous optic nerve OS (left), microphthalmia (smaller than usual eyes)
esotropia (inward turning of the eyes), exotropia (outward turning of the eyes), pendular
nystagmus (involuntary side-to-side movement), and high myopia (nearsightedness). Corrective
lenses were prescribed previously but appear not to significantly improve visual acuity and are,
therefore, not recommended at this time.
Functional Vision Evaluation
Ricky was evaluated over three days at his school in various environments: general education
classroom, one-to-one instructional setting, and during movement through the school. A
parent interview was conducted with Mrs. Alamo on 11/4/13 to gather information regarding
how Ricky uses his vision functionally in his home. The parent interview is attached to this
report.
Ricky uses and relies upon his vision as his primary mode of retrieving information even with his
serious visual impairment. Observing Ricky in his classroom and in a one-to-one learning
environment, it became apparent that he must have direct and active exposure to instruction
and materials as much as possible through a multi-sensory approach. Ricky compensates well
for his vision impairment, but it can often appear to others that he is retrieving information in
its entirety when, in fact, he is missing details of which he is unaware.
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FV/LMA – Ricky Alamo
Eye Appearance: Ricky’s eyes appear slightly smaller than normal. The aniridia OU is evident.
His left eye appears to turn slightly inward with straight gaze. Right eye turns slightly outward
with straight gaze.
Acuity: Ricky’s most recent eye exam was performed on 11/1/2013. Ricky’s visual acuity at
distance is 20/400 or greater OD, OS and OU. His near vision is also 20/200 or greater OD, OS,
and OU. No field restriction was noted on the doctor’s report. The print size with which he
appears most comfortable is 48 point. This is a very large font.
This is 48 point font.
Convergence: Ricky is unable to use both eyes together to converge upon an object when it is
brought toward his face.
Tracking: Both eyes exhibit mild nystagmus with straight gaze and with nystagmus increasing
with movement to right upper and lower quadrants. Nystagmus appears to decrease
somewhat with movement to lower left quadrant. Nystagmus is present with both horizontal
and vertical tracking.
Visual Attention/Fixation: When objects are placed at midline, Ricky must move his head and
change viewing distance to fixate upon the objects. He tends to favor the lower left quadrant
for fixation and viewing. He inspects objects at a distance of 4 to 6 inches.
Shift of Gaze: Ricky was unable to shift his gaze between two objects when placed within one
foot of his eyes regardless of quadrant.
Light Level: Ricky shows sensitivity to bright light such as direct sunlight due to his aniridia.
Ricky has and wears prescription sunglasses when going outside. In the classroom, Ricky does
well with normal, indirect lighting levels, but should not be seated where there is glare from
sunlight or glare from any other direct lighting.
Handwriting/Copying: Ricky is able to copy one letter at a time at a close distance
(approximately 4 inches) using dark lined paper. He is able to write his first and last name. He
performs better with a 20/20 pen than with a standard pencil. The use of a slant board appears
to help him significantly during writing activities as he is not required to lean down as far to see
what he is writing. Ricky is using only manuscript letters and most letters are legible. The letters
are large at approximately one cm. He is able to write the entire alphabet in upper and lower
case.
Distance Viewing: Ricky is unable to view at distance with any accuracy. He can identify colors,
shapes for large objects, and movement. He will be unable to attend to information presented
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FV/LMA – Ricky Alamo
on a white board or bulletin board. He will be unable to participate in games that require
action be visually followed at a distance.
Near Viewing: As stated above, Ricky prefers 48 point font for near reading. He reads word by
word for shorter, high frequency words, and letter by letter for longer or unfamiliar words. He
uses a CCTV to look at pictures and enjoys looking at them. He can pick out larger or more
evident details, but has difficulty finding smaller details or objects without verbal cues. He can
locate top and bottom of pages. He still confuses right and left sides of an object or page. He
does better with high contrast materials and black on yellow contrast when available. He is
using a CCTV to access grade level materials in his classroom. Ricky is able to operate the CCTV
independently to view materials. He struggles to write using the CCTV, but this is improving.
Computer: Ricky uses a regular keyboard with enlarged letter labels. He has tried to use
Microsoft screen enlargement, but this does not help him. He is unable to follow the movement
of a mouse or to locate the cursor on a regular computer screen. He has begun to use screen
enlargement and reader software (Zoomtext) with success as long as the font is large enough.
He uses 7.5 magnification level and prefers black print on yellow background. Ricky is learning
to use Zoomtext, but is not yet independent in all functions.
Mobility: Ricky has quickly become accustomed to his daily routes at school: classroom to
bathroom, playground, lunchroom, media center. However, he has difficulty with unfamiliar
routes. His mother reports that he moves through his home easily, but has difficulty on family
outings and a family member must hold his hand when navigating an unfamiliar setting.
Clinical Low Vision Evaluation: Ricky is a five year old kindergartner and is not yet required to
have a clinical low vision evaluation. However, because Ricky presently uses his vision as a
primary modality and because he is cognitively, physically, and behaviorally capable of
participating in a clinical low vision evaluation, this evaluation is indicated for him at this time.
Summary: Ricky is a highly verbal and well-motivated student who has significant vision loss at
both near and distance that will interfere with his access to his educational environment and
will present a barrier to learning without specialized interventions. He is inefficient in the visual
modality when reading or writing because the print size he must use is not conducive to
fluency.
LEARNING MEDIA ASSESSMENT
Language Development: Ricky’s expressive and receptive language development appears to be
within the norm for his age though he does demonstrate some weakness is visually mediated
concepts and vocabulary. He knows many positional concepts, but also lacks some that would
be expected in a child his age (ex: below, above, upon, next to, through, apart, diagonal).
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FV/LMA – Ricky Alamo
Tactile/Perceptual Skills: Ricky recognized the following tactile characteristics of objects and
could name them: shape (circle, square, triangle, star, and heart), texture/feel (rough, smooth,
hard, soft, raised, flat, fuzzy, sticky, hot, cold, and wet), weight (heavy, light), size (long, short,
longer, shorter). He was able to put together a wooden puzzle fitting three dimensional shapes
into correct slots that included cylinders, cubes, rectangular solids, and star shapes. Ricky is
right handed and can cut with regular kindergarten scissors.
Proprioceptive: His gross motor proprioceptive skills appear to be near age level. He can jump,
hop on one foot, kneel and rise, do jumping jacks, touch fingers to nose and other body parts,
and run. He cannot yet skip. He was able to balance on a balance beam while holding the
instructor’s hand with just one of his hands. He could not balance well independently.
Pre-Braille Skills: : Ricky has had no exposure to braille and very little preparation for learning
braille as he has had no formal instruction in tactile readiness and discrimination. He has had
no exposure to writing in braille – using a braille writer or slate and stylus. He is not yet able to
identify any individual braille letters or identify same vs. different braille letters. Presently, his
vision is his primary mode of receiving information even though it is inefficient for reading and
writing. He shows strengths in interpreting tactile stimuli and in understanding what a book is
and how to use it. He shows weakness in fine motor skills such as cutting and sorting and in
more refined book skills such as tracking. He does not yet use two hands for tracking.
Listening: Though Ricky’s speech and language appear normal for his age, he exhibits a
weakness in his listening skills as exhibited by poor auditory recall of details. He has had no
formal training in listening for and recalling details, and, since he has difficulty seeing details, he
may be unaware of the need to know them.
Ricky could follow simple two and three step directions. He is able to quietly listen to a short
story for 5 minutes. He can retell a story in broad circumstance, but not finer details. He can
recall character names and the larger outcome of the story, but he does not recall finer details
that describe how characters or elements in the story look or feel. He was able to sequence the
greater action and story outcomes, but tended not to recall the finer physical description of the
action unless it was repeated as an integral part of the story.
Reading: Ricky is below grade level according to Fountas and Pinnell scoring of his
Developmental Reading Assessment. He is at Level B-3. Ricky reads at the single word level,
word by word as opposed to phrases. This negatively impacts his comprehension and fluency.
Even so, his word recognition skills are on level at 71 out of 100 high frequency words based on
the 40 out of 100 for his age/grade at this time.
The Jerry Johns Basic Reading Inventory was administered on 11/5/13. Graded word lists were
presented to Ricky in Times New Roman at 24 point font. He used a reading stand to bring
materials nearer and had nose pressed to paper during the entire assessment.
Graded Word Lists:
BB (Pre-Primer): 15/20 Instructional/Frustration; Time: 4:05
B (Primer): 15/20 Instructional/Frustration; Time: 3:50
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FV/LMA – Ricky Alamo
Reading Passages:
BBB (Pre-Primer): 5/5 Independent; Time: 1:28 (17.04wpm)
BB: (Primer): 5/5 Independent; Time: 3:59 (12.6 wpm)
B: (Primer): 3/10 Independent/Instructional; Time: 7:53 (12.7 wpm)
Note that Words Per Minute is not typically used for Kindergartners as they are usually still
learning word attack skills. WPM is not derived until the winter of the 1st grade year. Reading
times and WPM are noted only to give the IEP team an understanding of the length of time
Ricky requires to read words and passages. Additionally, visual fatigue and the need to take
frequent breaks became evident after 15 minutes of close work.
Learning Media Finding: Ricky’s Primary Learning Channel is braille, his Secondary Learning
Channel is Auditory, and his Tertiary Learning Channel is Visual.
The above is found due to:


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Extreme inefficiency in reading and writing visually due to his need for a font size too
large for fluency in phrase or sentence reading or writing
The negative impact of word-by-word reading upon his fluency and comprehension
His inability and inefficiency in gaze shift for copying
The onset of visual fatigue after 15 minutes of close visual work
Recommendations:
1. Ricky should receive instruction in braille/tactile readiness and grade one braille and use
of a manual braille writer
2. Ricky should receive instruction in listening and recalling auditory details
3. An orientation and mobility evaluation should be performed to determine need for
O&M services
4. Ricky should receive instruction in the use of his screen reader/enlarger program so that
he can increase his independent use.
5. Ricky should continue to use the other assistive devices that he is using currently and
should continue to receive instruction in their use in order to increase independence:
slant board, reading stand, 20/20 pen, dark-lined writing paper, and CCTV.
6. Schedule a clinical low vision evaluation for Ricky this school year.
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