Evaluation+Summary+for+Jason


 * Student:** Jason


 * Date of Birth:** May 12, 2003


 * Age:** 6 years, 4 months


 * Grade:** Kindergarten


 * Date of Evaluation:** January 15, 2010


 * Evaluator:**


 * Evaluator Title:** Teacher of Students with Visual Impairments


 * Eye Specialist Diagnosis:** Retinopathy of Prematurity


 * Visual Acuity:** 20/710 OU


 * Visual Fields:** Some peripheral vision


 * Other Medical Diagnosis:** N/A

Assessment of Residual Vision in Multiply Impaired Children, Motivation Assessment Scale
 * Test(s) Administered:**

Jason is a 6 year old boy who is currently a kindergarten student at LaPorte Elementary School. He has been diagnosed with Retinopathy of Prematurity (ROP) and previously received services at the state preschool for the blind and visually impaired. Jason required an initial IEP evaluation this year and because he has residual vision he was referred for an Educational Low Vision Evaluation. Jason’s medical evaluation confirms his ROP and states that he has additional developmental disabilities and is suspected of having autism. The staff at his preschool also suspected autism and recommended that he be tested. Jason exhibits repetitive behaviors such as hand writhing, eye poking and rocking. He often has emotional outbursts when there is a change in his routine or when he experiences sensory overload (he screams at the wind for example). Jason’s speech is echolalic, which means he repeats other’s speech instead of generating his own. Because of Jason’s echolalia and behavioral sensitivity, parts of his medical evaluation were difficult to complete. Jason was born prematurely and this affected the development of his eyes. Retinopathy of Prematurity is a condition that occurs when blood vessels of the retina do not form properly and can cause the retina to detach from the inner surface of the eye. Jason’s condition is permanent and will not improve with time. His behavior precluded the administration of visual acuity, visual field and other tests, but Dr. Smith estimates his acuity as less than 20/200 or legally blind. Legally blind does not mean Jason is completely blind and is not a measure of how he functions using the vision he has. It is a legal term designed to ensure that services are guaranteed for people whose vision acuity is 20/200 or less. The functional vision assessment results reveal more about how Jason uses the vision he has to function during his daily activities.
 * General Information **

** Results of Evaluation **
Jason's pupillary response was present as the pupils in both eyes responded to light being introduced in the dark by dilating. There was no muscle imbalance detected as both eyes were shown to work together. The blink reflex was absent when the evaluator's hand was brought to Jason's face quickly. Different visual behaviors were observed in that Jason could watch flashing lights when asked to do so for up to 30 seconds. However, he was unable to fixate steadily on an object. Jason demonstrated the ability to use light perception as he walked toward a window when it was sunny outside. The presence of light perception was also demonstrated when Jason stared at the colored lights on a Light Brite an inch away in a dimly lit room. He showed a preference for using his right eye over his left eye. Using a flashlight in the dark, it was shown that the central field of vision is present in both eyes, although he does not seem to use this field to notice detail from his surrounding environment. It was also shown that there is vision in his peripheal fields and that he uses his peripheal vision when traveling. Using his peripheal vision he can detect where the wall is while trailing. The evaluator could not tell if there was any preference in his peripheal fields. Jason was able to track using both eyes, however this tracking showed jerky movements of the eyes and Jason was unable to do this for longer than 1-2 seconds before he was unable to continue following the penlight. Jason was able to shift focus using both eyes looking for flashing red lights in the dark as well as scan using both eyes to look for a penlight in the dark. The evaluator did not observe any reaching behaviors during this time. Throughout this evaluation, it was observed that Jason did not use his residual vision to explore or get information about his surroundings.

One behavior that occurred frequently was Jason poking his eyes. In order to figure out the motivation behind this behavior, the Motivation Assessment Scale was administered. The results showed that this behavior is largely due to sensory stimulation. There is some attention getting as this behavior occurs when the adult stops paying attention to Jason. The behavior has occurred as well at times when a favorite toy was taken away from Jason or when he was told he couldn't do something he wanted to do. If Jason was given something he wanted or was able to do an activity he requested, he would momentarily stop the eye poking behavior. The eye poking was shown to occur a few times as an escape when Jason was asked to do something that was difficult for him. However, the results of this assessment showed that the majority of the behavior was due to sensory stimulation.

Jason is a student who is legally blind with an eye condition that will remain stable. He is not effectively using his residual vision but is able to use light perception when entering rooms with bright lights. Jason has limited capabilities with his current vision and should increase visual opportunities to make available vision more functional. This report reflects the findings of the optometrist and TVI in different settings with a number of tests administered. The IEP team needs to consider the information provided in this report when making educational decisions and program placements.
 * Summary and Recommendations **

**Recommendations for Jason's education:**

 * Teach Jason how to use his residual vision for gathering information about his environment
 * Work on braille skills with the Teacher for the Visually Impaired
 * Work on strategies to reduce the eye poking and come up with replacement behaviors
 * Expand on Jason's orientation and mobility skills to move off of the wall when traveling
 * Improve Jason's communication skills by giving him choices he can answer verbally or by choosing picture cards
 * Provide hands on instruction or activity to stimulate Jason's senses- work up to multi-sensory
 * Obtain Jason's attention prior to addressing him
 * Look into the possibility of getting Jason tested for autism
 * Organize a workshop that will educate the school staff and Jason's team on the working with a student with a visual impairment