Guidance for RTI for Vision Concerns
*REASONS student fails school vision screening
 teacher observations
 parent concerns
 sudden loss of vision/accident
 student moves in from another state without proper
documentation (IEP, eligibility form, etc.) of visual impairment
*WHAT STEPS DOES THE SCHOOL NEED TO DO-?
 Talk to parent to discuss history/concerns (school personnel)
 Detailed teacher checklist to gather information (school
personnel)
 KIMRC eye report sent home (school personnel)
*NEXT STEP- TVI steps in*
 Once the eye report is obtained, teacher checklist, and family
history, an informal meeting shall take place to discuss the
results. Accommodations/Modifications based on all the results
are recommended by the TVI or Outreach Consultant and put into
place in the regular education setting. *any academic issues need
to be addressed as well by other staff at this time.
MODIFICATION SUGGESTIONS:
 (preferential seating, line guide, typoscope, black expo marker,
service provider write in larger font (contrast) on active board or
white board, Use Arial or Verdana font, eliminate visual clutter,
Oral presentation of directions/classroom materials/explaining
instructions, close proximity to student, have the student repeat
instructions back to the service provider, NEVER ASSUME THE
STUDENT CAN SEE YOU
*It is noted that if the eye report states certain visual acuities or
conditions that qualifies the student based on the Eligibility
Determination Form, the referral for the FVLMA/ECC may take place.
At this time, an ARC shall be convened to get permission to evaluate,
complete the evaluation plan and proceed with the assessment. The
RTI (consisting of the modifications suggested by the TVI or
Outreach Consultant) may take place in conjunction with the
assessment process. RTI is completed when the assessment process is
finished.
*If eye report does not indicate 20/70 or worse,
accommodations/modifications take place for an agreed amount of time
by all parties. After that time period, another informal meeting will
take place to discuss the results monitored by the regular education
teacher including the accommodations/modifications and to decide if a
referral is warranted or if the accommodations/modifications have
been successful.
* At no time shall the RTI process inhibit or delay the referral
process.
Parent/Guardian Questionnaire
Questions to ask parent/ guardian when calling to get more information on eye difficulties
may include:
Has your child had an eye exam? If not, encourage them to obtain one using the KIMRC
form.
Who is your child’s eye care physician?
When was your child’s last eye exam?
What information did the doctor share with you?
Did the doctor give a specific diagnosis?
Does anyone else in your family have an eye condition?
Do you have any concerns about his/her vision at home?
Are there any other medical conditions that we need to know about?
What kind of medications does your child take at home?
Checklist for Students Experiencing Vision Difficulty
Student Name:
Date of Birth:
1.
2.
3.
4.
5.
Grade:
Teacher:
Does the student have glasses or contacts?
Does the student wear prescribed lenses?
Is there an eye report in the student’s cumulative file?
Date on eye report
Please list any medications that the student currently takes.
ACADEMICS
YES NO
NA
academic performance is commensurate with grade level peers. (If no, please explain)
copies information from board, overhead, or Smartboard/ Activeboard with ease and
accuracy
locates materials consistently in the same spot in the classroom
uses and reads math manipulatives (ruler, protractor, calculator, etc...) with accuracy.
attends to visually presented information (circle time, charts/maps, board work, etc.)
maintains on task behavior when reading or copying
completes and turns in assignments on time
keeps materials organized and neat
uses their finger or marker to keep place while reading
often loses place while reading
often rereads or skips lines unknowingly
maintains an upright posture when reading at desk
must feel things in order to interpret or understand
comprehension decreases as reading continues, loses interest to quickly
Other:
HANDWRITING
YES NO
NA
forms letters correctly (if 3rd grade or above)
consistently writes within and on the lines and within the margins of paper
consistently lines up math problems
orients drawings correctly on the page
consistently uses writing utensil AVOIDING undue pressure to make letters wider or
darker
consistently spaces words or letters properly on the page
Other:
PHYSICAL
YES NO NA
squints when reading material near or distant
rubs eyes after extended reading or focusing
pokes at eyes
blinks excessively at desk task or reading
eyes water after reading or focusing for more than 5 minutes
complains of headache
covers one eye when reading or writing
exhibits excessive touching of eyes
exhibits head tilting (eccentric viewing) when reading/writing
leans/sits closer than 12 inches from paper or book when reading or writing (proximity)
positions reading materials awkwardly HOW?
has shaking of the eyes
has one eye that turns in or out at any time
has large pupils that do not vary with lighting conditions
light sensitive around windows and lights
picks up or turns paper to adjust light or glare
complains of burning or itchy eyes after reading or desk work
complains of being unable to see material or print size either near or far
complains of seeing double
often complains of nausea or dizziness
has frequent styes or encrusted eyelids
responds to facial expressions from 10 feet or farther away
eyes or eyelids appear reddened
looks for/retrieves dropped objects
Other:
TRAVEL SKILLS
YES
NO NA
navigates classroom without stumbling over students or furniture
transitions from place to place or class to class without getting lost
avoids bumping/running into peers when transitioning class to class
maintains pace with other students during transition
participates in gym or recess
walks up and down stairs without stumbling/falling/ hesitating
follows peers without looking down at their feet in a crowded situation
alternates feet up or down stairs
locates doorknob without searching
walks up or down stairs without depending on hand railing
Other:
LUNCHROOM
YES NO NA
eats with utensils instead of hands
locates items on the tray without searching
finds peers in lunchroom
opens and pours liquids without spilling due to over or under reaching
Independently goes through breakfast/lunch line getting all needed food and supplies
and handling tray
Other:
ENVIRONMENT
YES
NO NA
visually locates person speaking
locates bus
has friends that he/she regularly talks to/ interacts with
locates or gets into locker without difficulty
tracks a ball during gym
reads signs or finds specific rooms in the building (e.g. bathroom, door numbers)
avoids hesitating or tripping when flooring changes in texture or color (e.g. white tile to
red tile, carpet to tile)
recognizes peers in classroom when peer has not spoken
finds peers in room without consistently scanning for them
Other:
COMPUTER
YES NO
NA
moves/tilts screen or positions self closer to screen
remains seated while accessing computer screen
locates cursor on the screen
follows the cursor
locates keys on keyboard without getting close to keyboard
enjoys using the computer
Other: