The Functional Vision Evaluation "How To" Chart
Test Item and
Why it is Important
Pupillary Response
Under normal conditions, the
pupil responds to changes in
lighting/illumination by
constricting with increased
lighting and dilating with
decreased lighting. Knowing
how the eye responds to light
is critical in designing
accommodations in the
student's environment. This
should be tested functionally.
If the results are not
conclusive, a penlight may be
used with care.
How To Test
Atypical Response(s)
 Observe pupil size under
normal conditions.
 Observe pupillary changes
when moving from high to
low illumination.
 Observe pupillary changes
when light is directed close
to eyes.





 Move hand or object toward
face and observe responses
(avoid air movement).
 Cover/uncover test: Have
the student fixate on a
target. Observe for
immediate repositioning of
the left eye when the right
eye is covered and then
again when the right eye is
uncovered. Repeat to test
the other eye.
Possible Educational
Implications
Recommendations
 Exhibits sensitivity to light
 Demonstrates difficulty in
dimly lit environments
 Needs extra time for the
pupil to adjust to lighting
changes
 If pupillary response is
slow, allow time to adjust to
lighting changes.
 If light sensitivity is present,
reduce lighting/glare or use
eyewear or visor.
 If difficulty functioning in
poor lighting is exhibited,
increase the lighting (e.g.,
task lighting).
 Provide assistance or
guidance when poorly lit
areas can't be avoided.
 No blink
 Delayed response
 May have difficulty detecting
moving objects at near
proximity
 May demonstrate difficulties
with awareness of or
attention to visual stimuli
 May indicate a neurological
problem
 If student has central field
loss, present object in the
peripheral field.
 Determine distance, size,
and color of object to use.
 Allow extra time to shift
focus.
 Pair objects with sound or
light.
 Muscle imbalance exists
when the light is reflected
unevenly
 One eye realigns when the
other eye is covered and
uncovered
 The eyes look misaligned
 The eyes drift from the
target to the left, right, up or
 Fatigues at near point
 May have difficulty with
copying
 May have difficulty shifting
focus
 May have difficulty crossing
midline
 May exhibit poor
concentration
 Provide a personal copy of
board work.
 Consider shortened
assignments.
 Allow frequent breaks in
case of fatigue.
 Allow extra time for work
completion.
 Offer place marker.
Sluggish
Absent
Looks away
Squints
Pausing when moving
between varied lighting
conditions (dark to bright
and vice-versa)
Defensive Blink Reflex
A blink reflex occurs when an
object moves toward the face,
and is usually developed by
five months of age. This reflex
may indicate light or object
perception. A delayed
response may indicate a
neurological problem such as
CVI or TBI, and difficulty
seeing light or objects.
Muscle Balance
If the eye muscles are
balanced both eyes should
move in the same way, at the
same time, and in the same
direction.
For examples of muscle
imbalances see the
illustrations on types of
strabismus.
 Penlight test (Hirshberg
test): shine a penlight from
approximately three feet
away and note if the light is
reflected in corresponding
places in both eyes. Do this
in all visual fields.
 Convergence test: Hold an
object 2 feet in front of the
student, slowly move the
object toward the nose.
Note how the eyes converge
on the object.
down (especially when
fatigued)
 May not be able to detect
drop-offs
 May exhibit poor hand-eye
coordination
 May have difficulty detecting
moving objects
 Consider O&M evaluation
and/or instruction.
 May exhibit difficulty with
orientation and mobility
 May not be able to use light
projection to orient
themselves within an
environment

Reaction to Light Source
Reaction to a light source is
the first sign of visual
awareness. Some
characteristic responses to a
light source are: blinking,
squinting, closing the eyes,
gazing toward the light,
turning the head toward the
light source, and verbalizing.
Light Perception – the ability
to perceive the presence or
absence of light.
Light Projection – the ability to
orient in the direction of a light
source.
If the student has
demonstrated visual
awareness of objects, it is not
necessary to test reaction to
light.
Perception:
 Observe to determine if the
student is reacting to light
sources in the environment
(e.g., window, sun, lamps,
overhead lighting, penlight)
by blinking, squinting,
closing the eyes or stating
that there is a light on.
 Test for reactions using a
penlight or other lights (with
or without colored filters)
presented in various fields
of view.
 Use an object to cover and
uncover a light source
checking for reactions.
 No reaction

Consider O&M evaluation
and/or instruction.
Consider tactile learning
approaches.
Projection:
 Observe to determine if
student is reacting to light
sources in the environment
(e.g., window, sun, lamps,
overhead lighting, penlight,
flashlight, lightbox, lighted
toy) by shifting gaze, turning
toward, pointing to, or
describing the location.
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Identification of light source
Being able to identify light
sources could be used to
further evaluate both cognition
and visual acuity.
 Ask the student to identify
light sources in the
environment (e.g., window,
sun, lamps, overhead
lighting, penlight, flashlight,
lightbox, lighted toy) by
verbally naming or pointing
to a picture or tactile
representation.
 Testing should Include light
sources in various fields and
at various distances.
 Inability to identify a light
source
 May exhibit photophobia
 May exhibit difficulty with
orientation and mobility

 Place an object in front of
the student and watch for a
reaction. Repeat with
objects of varying sizes and
attributes (static).
 Walk quietly or pass a toy
between the student and a
light source, watching for
student reaction, such as
gaze shift, head turn,
pointing, reaching, and/or
verbalizing (dynamic).
 Roll differently sized balls
across the student’s field of
vision (dynamic).
 No reaction
 May demonstrate difficulty
with basic travel skills
 May have difficulty locating
objects or places in the
environment
 May not be able to use
vision for functional
purposes
 Consider O&M evaluation
and/or instruction.
 May need visual efficiency
training.
 Consider use of tactile
materials.
 Student may benefit from a
multi-sensory approach to
instruction.
 Provide extended response
time if needed.
 If neurological difficulties
(e.g., CVI, TBI) are present,
use preferred color,
reflective materials and
movement.
 Place a familiar object in
front of the student and ask
him to identify it.
 Repeat with several objects
of varying sizes, shapes and
 Misidentification of objects
 Inability to identify a
specified object
 May demonstrate difficulty
performing functional tasks
visually
 May have difficulty locating
objects or places in the
 Consider O&M evaluation
and/or instruction.
 May need visual efficiency
training.


Familiarize students with
new environments.
Consider O&M evaluation
and/or instruction.
Consider tactile learning
approaches.
Reaction to Objects
These reactions can be
categorized as form
perception and detection of
motion. Some characteristic
responses to objects include:
moving fingers or object in
front of the eyes, gazing
toward the object, reaching or
pointing, and/or verbalizing.
The reaction to forms or
shadows may indicate the
presence of functional vision.
The reaction to motion may
indicate the use of peripheral
receptors in the eye. This is
particularly important when
testing students with CVI as
they may not react to static
objects.
Identification of objects
The ability to Identify objects
provides information about the
student’s visual discrimination,
depth perception, and
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cognitive functioning.
colors.
 Repeat in all fields of view.
environment (door vs.
window)
 May have trouble with facial
recognition
 Provide tactile skills
development.
 May need tactile materials.
 May benefit from a multisensory approach to
instruction.
 Provide extended response
time if needed.
 If neurological difficulties
(e.g., CVI, TBI) are present,
use preferred color,
reflective materials and
movement.
 Also see recommendations
for size, color, contrast, and
clutter.
Fixation
The ability to visually establish
and sustain focus on a target
in the area of clearest vision
so it can be recognized with
the greatest detail. The object
may be still (static fixation) or
moving (dynamic fixation).
The two types of dynamic
fixation are:
Convergence: the ability to
maintain fixation on an object
as it is moving toward the
eyes.
Divergence: the ability to
maintain fixation on an object
as it is moving away from the
eyes.
 Ask the student to look at an
object or penlight.
Determine if the gaze is
central steady and
maintained in both eyes.
Test eyes together first then
separately with both
stationary and moving
targets. Convergence and
divergence must be tested
with both eyes together.
 Eyes widening or squinting
 Unusual eye, head, or body
positioning
 Eccentric viewing
 Nystagmus is present
 Demonstrates an eye
preference
 May have trouble locating
visual targets
 May have difficulty
maintaining focus on visual
targets, both static and
dynamic
 Target may disappear from
view as it is moved
 May not be able to follow
the target in specific fields of
view
 May have difficulty viewing
media on a screen
 Allow student to control
positioning of self or
materials.
 Allow eccentric viewing.
 Consider giving the student
frequent breaks and/or
shortened assignments.
 Place two familiar objects in
front of the student and
observe whether the student
can shift gaze from one to
 Presence of head
movement instead of eye
movement
 May have difficulty shifting
gaze from one reading or
visual task to another (from
distance work to close work,
 Student may need to use
place or line marker when
shifting gaze.
 Student may need reduced
Shifting Gaze
Looking from one visual target
to another. Being able to shift
gaze serves as a foundation
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for many visual skills, such as
reading, traveling, etc.
the other.
from book to paper, etc.)
 May have difficulty with
visual clutter
 May have difficulty with
travel
visual clutter.
 Student may need objects to
be spaced closer together or
farther apart.
 Provide a personal copy of
board-work.
 Consider giving the student
frequent breaks and/or
shortened assignments.
 Consider O&M evaluation
and/or instruction.
 Student may need visual
efficiency training.
Tracing
Visually following a stationary
line, border or edge. This
helps establish and maintain a
line of direction.
 Ask the student to visually
trace existing lines in the
environment such as
windowsills, chair railings,
baseboards, or sidewalks in
a specific direction toward a
given target.
 Eyes deviate from stationary
line and cannot locate
designated target
 May have difficulty with
visual-spatial tasks such as
travel
 May have difficulty with
visual-spatial tasks such as
reading and writing print,
mathematics alignment, art
 May have difficulty with
visual-spatial tasks such as
participating in sports
 May exhibit fatigue during
reading
 Consider O&M evaluation
and instruction.
 Student may need visual
efficiency training.
 Offer place marker for
academic tasks.
 Consider giving the student
frequent breaks and/or
shortened assignments.
 Ask the student to visually
track an object or penlight
checking all directions:
horizontal, vertical, circular
and diagonal (consider
moving the object in an “H”
pattern).
 Check for the fluidity, range
of motion of eye
movements, and ability to
cross midline.
 Eye movement not fluid
 Unable to visually cross
midline when tracking
horizontally
 Exhibits significant head
movements when tracking
 Displays saccadic (back and
forth) eye movements
 May have difficulty with
visual-spatial tasks such as
travel due to inability to track
moving objects
 May have difficulty with
visual-spatial tasks such as
following a mouse cursor
 May have difficulty visually
following the
teacher/speaker
 May have difficulty with
visual-spatial tasks such as
participating in sports
 Consider O&M evaluation
and/or instruction.
 Student may need visual
efficiency training.
 May need to teach the
student to support visual
tracking with head
movements.
 Set software for enlarged,
bolded, slow-moving cursor
with “trails”.
Tracking
Visually following an object as
it moves through space. It
gives information about the
quality and range of eye
movements, the ability to
maintain fixation on a moving
target across fields, and the
ability of the eyes to work
together.
5
 May not be able to follow a
moving target in specific
fields of view
Scanning
Using a systematic search
pattern to visually inspect an
area and/or locate a target.
Scanning typically involves a
combination of fluid eye
movement and head
movement. Effective scanning
is a key skill for visually
mapping one’s environment.
Scanning difficulties may
reveal field losses.
 Place several objects on a
small table and ask the
student to locate a specified
item. Note eye movement,
head movement and
systematic search pattern.
 Ask the student to search
for and locate specified
items in their environment
within both cluttered and
uncluttered spaces.
 Exhibits disorganized
search pattern
 Cannot locate targeted
objects
 May appear to avoid
scanning and searching in
the presence of visual
clutter
 May consistently miss items
located in a specific area if
field loss is present
 If too much visual clutter is
present the student may not
be able to scan an area
 May have difficulty with
travel, detecting traffic
patterns
 May become easily
frustrated in a visually
complex environment
 May not be able to locate
objects needed for tasks
 May not be able to locate
items in the environment
 Encourage scanning to
detect objects in path while
traveling.
 Student may need visual
efficiency training.
 Teach systematic search
patterns for use in home
and school environments:
left to right, top to bottom,
etc.
 Consider O&M evaluation
and/or instruction
 Allow extra time for tasks
involved in scanning.
 Reduce visual clutter in the
environment.
 Observe for: student
avoiding obstacles, reacting
to forms or objects between
himself and a light source,
reaching for objects.
 Exhibits no response to
objects
 Exhibits inconsistent
response to objects
 Runs into obstacles or
people in path while
traveling
 May be unable to detect or
identify objects
 May exhibit safety issues
while traveling in the
classroom or the larger
environment
 Consider O&M evaluation
and/or instruction.
 Teach protective
techniques.
 Student may need visual
efficiency training.
 Teach systematic search
patterns to locate objects.
 Use visual and tactual
landmarks.
 Reduce visual clutter in the
environment.
 Increase contrast in the
environment.
 Consider tactile learning
approaches.
 Observe the student’s
functioning in various
 Squints eyes
 Covers eyes or turns away
 Performance (academic and
functional) may be effected
 Control lighting conditions
according to student need.
Form Perception
Form perception is the ability
to detect (visually perceive)
the shape of solid objects.
These shapes take on
meaning and give students
information about the location
and functionality of objects in
their environment.
Light Sensitivity,
Illumination and Glare
6
Light sensitivity encompasses
the various responses to
lighting conditions.
Depending on the individual,
visual efficiency may be
positively or negatively
impacted by the type and
amount of lighting/illumination
in the environment.
Glare refers to the light
reflected off of objects in the
environment that may cause
discomfort and a reduction in
acuity.
lighting conditions,
(classroom, cafeteria, sunny
vs. cloudy days, nighttime).
 Observe the student’s
functioning when
experiencing significant
changes in lighting
conditions (when moving
from indoors to outdoors
and/or outdoors to indoors).
 Observe changes in
performance (e.g., reading,
traveling) in different lighting
conditions.
from light
 Exhibits excessive tearing in
bright light
 Indicates pain or discomfort
when lights are too bright
 Avoids areas that are either
too bright or too dim
 Hesitates when moving
between drastically different
lighting conditions
 Displays inability to see at
night
by lighting levels
 Performance may be
effected by different types of
lighting (fluorescent,
incandescent, halogen,
natural lighting)
 May have difficulty
transitioning from indoors to
outdoors and/or outdoors to
indoors
 May have difficulty with
glare
 Might need illumination to
draw attention to an object
or figure
 May have difficulty in
copying from an overhead
projector or white board
 Student may need
additional time for eyes to
adjust to lighting conditions.
 Student may need to wear
sunglasses and/or visor –
indoors and outdoors.
 Student may need overlay
filters to reduce glare.
 Student may need to sit
with back toward window.
 Student may need
personal task lighting.
 Student may need indirect
lighting.
 Student may need lighted
magnifier.
 Student may need to carry
a flashlight for situations in
which there is low light.
 Use tinted windows.
 Do not use laminated
materials.
 Provide a personal copy of
overhead work.
 Use a reading stand.
 Use materials with
maximum contrast.
 Matte finish can be used to
reduce glare.
 Change the angle of view to
reduce glare.
 Encourage the use of NoIR
lenses. These lenses offer
ultraviolet, visible and
infrared protection.
 Observe and note if the
student shows a preference
for any particular color.
 Have the student match,
find and name colors using
candy, markers, blocks,
 Displays inability to match
colors
 Can match some colors but
not others
 Student may be able to
match bright or primary
 Brightness and intensity of
color may affect color
identification and matching
(bright vs. pale)
 Often students with CVI, or
other neurological
 Use the student’s preferred
colors.
 Adapt activities that totally
rely on color.
 Teach the student to read
the color names on crayons
Color
Color vision is the ability to
discriminate colors. It involves
stimulation of specialized
cone receptors in the retina.
7
Color deficiency is the partial
or complete inability to
discriminate colors.
balls, paint cards of varying
shades, etc.
colors but has difficulty with
muted variations of that
same color
differences, may display
strong preferences for or
against specific colors
or markers.
 Teach the colors of
common objects.
 Use visual shading patterns
to indicate colored areas on
graphics.
 Use high contrast colors as
opposed to colors that
would appear similar to the
student.
 Highlight instructional
materials in preferred
colors.
 Teach traffic light positions.
 Use color identification
technology.
 Teach a color matching
system for clothing.
Contrast Sensitivity
Contrast sensitivity is the
ability to detect shades of grey
and differences in the
brightness of symbols or
objects and the surrounding
area or background.
Low contrast sensitivity can
be a symptom of certain eye
conditions or diseases such
as cataracts, glaucoma or
diabetic retinopathy.
Contrast sensitivity is often
difficult to evaluate and can
lead to underestimation of
functional visual acuity.
 Use contrast sensitivity tests
such as Hiding Heidi Low
Contrast Test, Pelli-Robson
Contrast Sensitivity Test,
Bailey-Lovie High and Low
Contrast charts, and
Hamilton-Veale Contrast
Sensitivity Test.
 Misses visual information in
low contrast environments
 Misses visual information
when using low contrast
materials
 May have difficulty visually
distinguishing details
 May have trouble
recognizing faces and
decoding tactile symbols,
pictures, letters or words
 May have trouble with
mobility tasks such as edge
detection of stairs and curbs
 May have difficulty with
tasks at night or in darkened
environments
 Work in close collaboration
with a low vision specialist.
 Consider changes in
lighting/illumination.
 Increase contrast by using
high contrast background
colors.
 Use yellow filters to reduce
glare.
 Encourage the use of NoIR
lenses. These lenses offer
ultraviolet, visible and
infrared protection.
 Add contrasting elements to
help identify environmental
features (e.g., mark stairs or
paint door facings with a
high contrast color).
 Ensure that there is good
contrast between furniture
and flooring.
Clutter and/or Complexity
8
(figure-ground perception)
The ability to discern an object
from its background is called
figure-ground perception.
When typical environments,
work-spaces or materials
appear visually cluttered
and/or complex, it may
negatively impact visual
functioning.
This issue can result in a
visual overload that may lead
to an inability to discriminate
an object from its background.
Difficulty with clutter and
complexity is particularly
prevalent in students with eye
conditions related to the optic
nerve, visual cortex and brain
injury.
 Have the student find a
designated object on a busy
background.
 Have the student find a
specific object within an
array of objects of various
colors and sizes
 Have the student describe
details in an illustration.
 Has difficulty locating an
item when too many
features, patterns or colors
are present, either on the
background or in the object
itself
 Cannot perceive differences
within an object (faces, toys,
etc.)
 May shut down visually,
may be unable to continue
with the task or gives up
 May not be able to locate
items on a cluttered
background, including
worksheets
 May be easily frustrated in a
visually complex
environment
 May have difficulty with
scanning for both near and
distance tasks
 May switch to tactual
methods to gather
information
 Consider the background
when presenting
instructional materials.
 Limit visual complexity in
both instructional tasks and
tasks of daily living.
 Present objects and/or print
against a solid background
 Instructor should not stand
against cluttered
backgrounds.
 Unclutter the environment
by reducing visual clutter on
tabletops, desks, kitchen
cabinets.
 Teach organizational skills
to reduce the need for
environmental scanning.
 Teach the student personal
strategies to function within
a visually complex
environment such as: using
a tactual search system,
deliberately looking at one
object at a time, learning
when to ask for help, etc.
 Teach the student to use
personal coping strategies
to define large, complex
spaces (i.e., by visually
locating large, simple
features of rooms such as
doors, windows, furniture
and landmarks).
 Instructors should avoid
wearing highly patterned
clothing or consider wearing
a solid color vest over
clothing.
 Consider the use of a
telescope or binoculars to
help control for visual clutter.
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Visual Closure
Visual closure is the ability to
identify an object or
representation when part of it
is missing.
This skill helps us rapidly
process information from our
environment so we don’t have
to analyze every detail of what
we are seeing. It allows us to
make interpretations from
familiar but partial visual input.
Visual Closure is an essential
part of automaticity in reading
and spelling, because words
are perceived as a whole,
instead of individual letters.
 Have the student identify an
object that is partially
hidden.
 Have the student identify a
graphic representation (i.e.,
picture, symbol, text) that is
partially hidden.
 Use the Visual Closure
section of the Test of Visual
Perceptual Skills -3.
 Cannot identify an object
that is partially hidden
 Cannot identify a graphic
representation that is
partially hidden
 May not be able to identify
an object or graphic when
part of it is hidden or
missing
 May have difficulty quickly
recognizing sight words (as
a whole-not decoding) when
reading text
 Make sure instructional
materials are fully visible
and not partially hidden.
 Allow student to reposition
materials for optimal
viewing.
 Ensure that clear
photocopies are used for all
activities.
 Allow additional time for
reading instruction to
develop automaticity.
 Allow additional time for
completion of reading tasks.
 Teach visual closure skills:
o Start with real objects
that are familiar to the
student. Hide a small
portion of the object
and have the student
identify the object.
Increase the hidden
portion in subsequent
lessons.
o Show partial graphic
representations and
have student identify
the whole.
o Use simple puzzles to
work on picture
completion.
o Select a single puzzle
piece to match the
recess of a simple inset
puzzle.
o Put parts of pictures
together to make a
whole.
o Label incomplete
picture of a familiar
object.
o Use flash cards to
match partial pictures to
10
o
o
Visual-motor (reach, grasp,
transport, place, release,
imitation of movement)
Visual motor skills consist of
both fine motor and gross
motor skills.
Visual fine motor skills are
the coordination of small
muscle movements usually
involving the synchronization
of the hands and fingers with
the eyes.
Visual gross motor skills
are movements that involve
the larger muscular systems
of whole body.
Note: Visual-motor skills also
involve depth perception and
spatial orientation.
Fine Motor
 Observe student to see if he
accurately reaches for a
visual target.
 Have the student place and
remove items of various
sizes into a container.
 Observe activities that
require the student to reach,
grasp, transport and place
objects: putting beads on a
string, nesting objects,
putting toothpaste on a
toothbrush, inserting coins
in a vending machine,
swiping a credit card.
 Have the student color
within lines.
 Have the student draw
shapes and then cut them
out.
 Observe the student
manipulating a pen or pencil
for handwriting.
 Have the student imitate fine
motor movements of
another person.
Gross Motor
 Observe visual navigation
during travel.
 Have the student catch
and/or kick a ball.
 Observe the student
navigating steps.
 Have the student imitate
whole body movements of
 Unable to trace and cut
 Illegible writing
 Unable to perform daily
living tasks such as dressing
self, eating without making a
mess, personal hygiene
 Under or over reaching for
items
 Inability to nest items
 Inability to put materials
away in small spaces
 May have difficulty with fine
motor tasks, handwriting,
etc.
 May have difficulty with selfcare such as hygiene,
eating, and other daily living
tasks
 May have difficulty with
sports and other physical
activities
 May have difficulty with
travel especially in
unfamiliar environments
the whole.
Complete dot-to-dot
worksheets.
Work on sight word
development.
 Reduce pencil-paper tasks.
 Practice fine motor skills
such as cutting, writing.
 Practice daily living tasks
and determine needed
adaptations.
 Allow for more time to
complete tasks.
 Use adapted equipment as
appropriate.
 Provide physical support
when needed.
 OT referral may be needed.
 Consider O&M evaluation
and/or instruction
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another person.
Depth Perception
The ability to perceive the
environment in three
dimensions as well as the
ability to judge the relative
distance of objects in one’s
visual field.
Depth Perception may be
affected when only monocular
vision is present or the visual
abilities of both eyes is
significantly different.
 Observe student to see if he
accurately reaches for a
visual target.
 Observation in mobility
situations. Does the student
search with their cane or
feet to determine drop-offs,
steps or curbs? Does a
student run into objects
frequently?
 Runs into objects
 Misses curbs, drop-offs or
steps
 Over or under reaches
 May have difficulty with
 Play a game like Simon
Says using directional and
positional terms.
 Observe the student during
activities of daily living for
use of spatial orientation
skills.
 Give the student a task to
complete that involves
directional and positional
concepts and laterality.
 Have the student use spatial
concepts in academic tasks
(e.g., locating the top of
page, aligning numbers for a
math problem, interpreting
charts and graphs).
 Displays lack of purposeful
movement
 May not be able to
differentiate left and right or
top and bottom
 May have difficulty traveling
from one place to another
 May not be able to locate
items in environment
 May not be able to use
spatial orientation for
completion of independent
living skills (e.g., placing
clothes on hangers, locating
grooming supplies in
bathroom, setting the table)
 May have difficulty with
activities that involving
 May have difficulties judging
personal space when
interacting with others
 May have problems with
laterality, directionality and
positional concepts
 May not be able to locate
and use landmarks
 May have difficulty
interpreting instructions that
involve spatial relationships
 May have difficulty with
reading, writing and math
tasks involving directional
and positional concepts
(e.g., following mazes,
copying or producing
patterns, labeling diagrams,
sports and other physical
activities
 Lack of depth perception
may be a safety concern
 Mobility may be challenging
especially in unfamiliar
environments
 Give verbal cues about the
environment.
 Use physical prompting.
 Consider O&M evaluation
and/or instruction.
 Teach student how to use
cues to identify position and
location (e.g., relative
position and linear
perspective).
 Mark the environment using
visual and tactual landmarks
(both natural and teachercreated).
 Use environmental cues
such as sounds or tactual
cues (e.g., surface
changes).
 Teach protective
techniques.
Spatial Orientation
The ability to perceive where
people and objects are
located in the environment in
relationship to oneself.
Laterality, directionality and
positional concepts are crucial
components of spatial
orientation.
Laterality is the perception of
left and right, starting with
body awareness. Laterality is
the foundation of directionality
and other positional concepts.
Directionality is the perception
of left/right, up/down,
 Teach student to
consistently use left and/or
right sides within a
functional activity (e.g.,
using a utensil, opening a
door, washing the left arm).
 Practice social skills that
focus on judging appropriate
physical proximity to others.
 Use a multi-sensory
approach when teaching
spatial orientation concepts.
 Consider O&M evaluation
and instruction.
 Teach spatial orientation
skills:
o Create an obstacle
course and use
12
ahead/behind extending
outward from the body into the
environment.
moving self in space
aligning math problems)
Positional concepts include
over/under, near/far, high/low,
forward/backward, etc.
Note: Spatial Orientation also
involves the visual skills of
scanning and tracking in the
environment or on paper.
Directionality plays a vital role
in the decoding of letters.
directional and
positional language.
o Play Simon Says or
Hokey Pokey.
o Play games that involve
judging distances such
as throwing a beanbag
toward a target.
o Design a Scavenger
Hunt using directional
and positional concepts
in both familiar and
unfamiliar environments.
 Provide practice in
academic tasks that involve
directional and positional
concepts.
Latency
The amount of time between
the introduction of stimuli and
response; visual processing
time.
Latency is comprised of both
the delay in directing vision
towards the target and the
delay in correctly identifying
visual characteristics or
showing recognition of the
target.
 Observe how long it takes
for a student to look at and
identify a target. Note if
there is a delay. It may help
to watch the facial
expression of the student
when the target is present
and note when the
expression changes.
 May exhibit a delay in
response time to the target.
 Does not respond to the
target
 May take an extended time
to complete visual tasks
 May prefer tactual material
 Delays in visual processing
may be a safety concern
 May have difficulty with
sports and other physical
activities
 Allow for extended time to
process visual information.
 Use a multi-sensory
approach, allowing student
to use other senses as
preferred.
 Give extra time to adjust to
new environments.
 Consider O&M evaluation
and instruction.
 Show student novel items
and observe how he reacts.
 Use an object that is new,
unusual or exciting to see if
this will draw visual
attention.
 May turn or look away
 May use tactual exploration
to identify object
 May resist participating in
the task
 May exhibit reluctance to
travel in new environments
 May only respond to familiar
objects
 Will have difficulty
participating in novel tasks if
objects are not familiar
 May need more assistance
with traveling in new
environments
 Use preferred, familiar visual
targets to increase looking
behavior.
 Use preferred, familiar visual
target and attach something
new to it.
 Introduce new visual
information within the
context of visually familiar
surroundings.
Visual Novelty
The ability to process visual
information about novel
versus familiar objects. This is
often associated with Cortical
Visual Impairment (CVI).
The student does not respond
to a novel/new object. This
may lead to an
13
underestimation of visual
functioning.
Functional Acuity
Clinical visual acuity,
determined by a medical
professional, is the sharpness
of near and distance vision as
it relates to the ability to
discriminate detail. Functional
visual acuity is a measure of a
person’s use of vision in a
variety of daily tasks.
Functional visual acuity
consists of awareness and
identification acuity. Preferred
viewing distance is also a
critical part of functional visual
acuity.
Awareness acuity is the
greatest distance at which a
student first becomes visually
aware of an object.
Identification acuity is the
greatest distance at which a
student can recognize an
object.
Preferred viewing distance
is the distance at which the
student is comfortable and
accurate with performing
visual tasks during everyday
activities. It should be noted
that a student’s clinical visual
acuity may be different that
the preferred viewing
distance.
 Perform informal functional
acuity testing using tests
such as LEA symbols,
Lighthouse Pediatric Visual
Acuity Cards and Chart.
 Use Approximate Functional
Visual Acuity For Different
Sizes of Objects and
Distances Chart to test
awareness and identification
acuity. Remember to report
results in functional terms.
See page – in book
 Note the farthest objects
that a student can see
(awareness acuity) and
identify (identification
acuity).
 Squinting
 Head tilt may be present
 Moves materials closer or
further away
 Fails to see visual
information in the
environment
 Misidentification of peoples,
places and things in the
environment
 Inability to read standard
print, aided or unaided
 Complains of headaches
when performing visual
tasks
 Avoids visual tasks or
utilizes other sensory
channels
 Labored or inaccurate
reading
 Exhibits fatigue when
reading
 Need for increased font size
as signs of fatigue appear
 Use larger materials (e.g.,
playing cards, game boards,
books).
 Increase font size on
instructional materials.
 Allow student to reposition
self or materials for optimal
viewing.
 Provide enlargement,
screen reading, and/or
dictation software for
computers.
 Use optical and
magnification devices.
 Provide hands-on
demonstrations during
instruction as necessary.
 May need to provide
frequent breaks.
 Provide a personal copy of
board or overhead work.
 Read or verbally describe
board or overhead work.
 Provide auditory materials
as necessary – tape record
lectures, electronic or digital
books.
 Use bold-lined paper, bold
pens (e.g., 20/20 pens,
sharpies).
 Reduce pencil/paper tasks.
 Provide extended time for
academic tasks.
Visual Fields
14
The entire area that can be
seen when the gaze is
directed straight ahead
without shifting gaze or
moving the head; measured in
degrees. Visual fields can be
divided into central and
peripheral fields, including left,
right, upper and lower.
A normal field of vision is 160180 degrees from one side to
the other, and 120 degrees
from top to bottom.
 Observe for indicators of
field loss. (See atypical
behaviors.) Note if student
has a particular field
preference.
 Central Fields:
Bring a familiar, preferred
object approximately 12
inches from the student’s
face. Observe if the student
reacts.
 Peripheral Fields:
If possible this is best tested
with two people. Have one
person sit in front of student
to observe. Have second
person stand behind student
with penlight. Have student
cover one eye. Start
penlight behind head and
slowly move penlight into
the student’s visual field
from the left, then the right,
from above and then below.
Repeat with the other eye.
Repeat with an object.
 Consistently missing visual
information when it is
presented in a certain visual
field quadrant (left, right,
upper, lower).
 Backing away when
searching a specific area
 Consistently missing curbs
or drop-offs
 Frequently turning the head
in one direction when
looking at something
 Bumping head on objects
above
 Student may resist covering
one eye. This could reveal
an eye preference.
 May have difficulty reading
 May exhibit night blindness
 May fail to see information
in written texts
 May have difficulty detecting
moving targets
 May have difficulty traveling,
especially in unfamiliar
areas
 Present instructional or
independent living materials
in student’s preferred field.
 Increase illumination and
decrease glare.
 Teach systematic search
patterns.
 Provide seating to
accommodate visual field.
 Allow student to reposition
self or materials for optimal
viewing.
 Teach protective techniques
when traveling
 May need to provide
extended time for scanning
an environment to find
needed items or locations.
 Consider O&M evaluation
and/or instruction both
during the day and in the
evening.
 Use magnification for central
vision loss
 Increase viewing distance to
maximize viewing area for
students with peripheral field
loss.
 Consider use of bookstand.
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