1. Marnee Loftin, M.A; LSSP loftinmp@att.netloftinmp@att.net 512.423.8342

2. Visual Impairments may be:  Congenital or Acquired  Total Blindness or Low Vision  Neurological or Ocular in origin Marnee Loftin, 2016 2

3.  Neurological etiologies have increased risk for other conditions  Approximately 60-75% of students with VI will have another condition  These may be a variety of conditions including ID, LD, ED, or AU Marnee Loftin, 20163

4.  Retinopathy of Prematurity (ROP)  Optic Nerve Hypoplasia (ONH)  Cortical Visual Impairment (CVI)  Infections or Illnesses Marnee Loftin, 20164

5.  Glaucoma (high pressure of fluids inside the eye which may cause optic nerve damage)  Albinism (lack of pigmentation in retinas)  Retinitis Pigmentosa (progressive retinal disorder)  Diabetic Retinopathy (progressive complications including clouding of vision) Marnee Loftin, 20165

6.  Cortical Visual Impairment  Retinopathy of Prematurity  Optic Nerve Disorders Marnee Loftin, 20166

7.  Approximately 8,000 children (school age) in the state of Texas  40% of these children live in Greater Houston  25% of these children live in Greater DFW Marnee Loftin, 20167

8.  Increasing complexity of Retinopathy of Prematurity  Dramatic increase in Cortical Visual Impairment  Dramatic increase in Optic Nerve Hypoplasia Marnee Loftin, 20168

9.  Determine appropriate changes in the IEP  Determine presence of other eligibilities  Assist with transition process Marnee Loftin, 20169

10.  The rumors…..  The facts….  The difference in language…. Marnee Loftin, 201610

11.  Law does not preclude determining that other eligibilities exist.  VI must not be the PRIMARY cause for the difficulties  Appropriate intervention must have occurred  Evaluation must be a collaborative process Marnee Loftin, 201611

12.  Lack of progress  New difficulties emerge  Escalation of behavior problems  Parent request Marnee Loftin, 201612

13.  Follows best practice guidelines  Notes need for caution in interpretation  Supplements formal testing with observation and interviews  Interprets results cautiously Marnee Loftin, 201613

14. EVALUATORS WILL ALWAYS NEED TO MAKE AN INDIVIDUAL DECISION ABOUT TEST SELECTION.  Diversity of population  Constant development of instruments Marnee Loftin, 201614

15.  Establishing eligibility of VI  Differences in developmental process  Complexity of Low Vision Marnee Loftin, 201615

16. Functional Vision/LMA Braille or Large Print Marnee Loftin, 201616

17. Eligibility is determined by two factors:  Eye exam by optometrist or ophthalmologist documenting serious vision loss after correction OR a progressive condition  AND  Functional Vision/Learning Media Assessment by TVI documenting educational implications of vision loss. Marnee Loftin, 201617

18.  Legal blindness does not necessarily qualify a student for VI  FV/LMA provides critical information for instruction AND evaluation  TVI and COMS teach disability-specific skills  Expanded Core Curriculum is a significant factor in developing an IEP Marnee Loftin, 201618

19.  Etiology and prognosis  Near and distance acuities  Any field restrictions  Information about optimal lighting, impact of clutter, eye fatigue, positioning, egocentric viewing  Type and size of font  Appropriate adaptive devices  Reading media for different tasks Marnee Loftin, 201619

20.  Recommendation made in FV/LMA  Multiple media are often used  Process of learning braille  Psychological aspects of media Marnee Loftin, 201620

21. Motor Social Language Cognitive Marnee Loftin, 201621

22.  Developmental process is different from children with normal vision  Degree of difference is largely dependent upon degree of vision loss as well as experiences  Little research is actually available on topic Marnee Loftin, 201622

23.  Remember that we will be talking about an extremely diverse group of individuals.  Always rely upon your knowledge of individual rather than “rules for groups” Marnee Loftin, 201623

24.  Degree of vision loss  Age at which it occurred  Early intervention  Neurological involvement  Opportunities for experiential learning Marnee Loftin, 201624

25.  Generally delayed developmental milestones  Lack of purposeful movement  Self stimulatory behavior  Minimal physical and outdoor activities Marnee Loftin, 201625

26.  Early bonding and smiling behaviors  Hesitancy in exploration and initiation  Lack of imitative and pretend play  Egocentric approach  Overidentification with adults  Problems understanding peer culture  Difficulty in maintaining peer relationships Marnee Loftin, 201626

27.  Delayed babbling  Echolalic speech  Misuse of pronouns  Use of words without understanding  Tangential or egocentric conversations  Limited ability to maintain age-appropriate discussions Marnee Loftin, 201627

28.  Difficulty with generalizing to new situations  Tendency to rely on rote memory  Inability to focus upon multiple elements of a concept  Complications in estimating abilities because of large vocabularies and rote memory Marnee Loftin, 201628

29. In the classroom? In the home? Marnee Loftin, 201629

30.  Experiential learning  Specific teaching of general concepts  Opportunities for peer-based instruction  Minimal extraneous conversations  Well-organized materials and rooms  High expectations for independence  Clearly-defined transitions Marnee Loftin, 201630

31.  Opportunities for real-life experiences  High expectations for behavior  Opportunities for independence  Interactions with different individuals  Attention to medical and health issues Marnee Loftin, 201631

32. Marnee Loftin, 201632

33. Impact of Low Vision is often underestimated and misunderstood by evaluator. It impacts fatigue as well as efficiency in problem solving. It creates more difficulty in interpreting results than does blindness. Marnee Loftin, 201633

34.  Appearance of eyes  Variability of vision  Clutter and its impact on evaluations Marnee Loftin, 201634

35. Best Practice Guidelines Marnee Loftin, 201635

36.  Review the records  Collaborate with TVI  Use information in FV/LMA to prepare  Choose your testing site carefully  Allow additional time Marnee Loftin, 201636

37.  Level and frequency of VI instruction  Regular attendance in school  Adequate health to focus  Access to recommended materials as well as adaptive devices Marnee Loftin, 201637

38.  Review etiology and implications  Clarify specific issues of concern  Clarify intervention and results  Determine consistency of instruction  Discuss evaluation process Marnee Loftin, 201638

39.  Availability of any needed equipment  Information regarding font  Remember “bigger is not always better.”  Understand basic operation of equipment  Review testing materials with TVI Marnee Loftin, 201639

40.  Avoid sites with high levels of noise  Observe carefully to be sure that unobtrusive noises are not present  Avoid sites with visual clutter  Be certain that appropriate positioning of materials can occur Marnee Loftin, 201640

41.  No single best instrument exists at this time  Attempts to develop instruments specifically for students with VI have had mixed results  Evaluator will need to choose based upon knowledge of student and eye condition  Evaluator will need to consider aspects of the individual instruments Marnee Loftin, 201641

42.  Evaluation may require up to three times more time than usual evaluation  Collaboration with TVI will be an ongoing process from beginning to end  Observation will be a significant factor in the process Marnee Loftin, 201642

43. Results will always be an estimate without the validity and reliability of an instrument that is administered as specified. AND Reports should always state that it is an estimate but that it is consistent with other observations. Marnee Loftin, 201643

44. Cognitive, Adaptive Behavior, Educational and Emotional/Behavioral Marnee Loftin, 201644

45.  No single instrument for students with VI  Consider use of multiple instruments to measure following areas: ◦ 1. General intelligence ◦ 2. Working memory ◦ 3. Executive function  Always supplement with observations Marnee Loftin, 201645

46.  What is the question?  What do you already know?  What instruments are available for that purpose?  How do necessary accommodations impact the results? Marnee Loftin, 201646

47.  Emphasize language and vocabulary  Focus on rote memory and recitation  Provide no opportunities for demonstration  Emphasize speed of response  Use small manipulatives Marnee Loftin, 201647

48.  Multiple measures of working memory  Require least amount of accommodations  Allow guided practice with multiple demonstrations Marnee Loftin, 201648

49.  Discussions of appropriateness of IQ testing  APH effort to develop best practice guidelines  Understanding of what IQ tests do and do not provide Marnee Loftin, 201649

50. When appropriate practices are followed, cognitive or intelligence testing of individuals who are blind or VI provides useful and valuable information to test- takers, their families, instructors, and other decision makers. www.aph.org/tests/intelligencetesting.html Marnee Loftin, 201650

51. Point 1: Intelligence test results yield valuable information about an individual and increase the usefulness of the overall evaluation. Point 2: Administrators of tests need training in theory of assessment and test construction as well as child development and communication of individuals who are blind or VI Marnee Loftin, 201651

52. Point 3: The reason for the evaluation and specific clinical judgments and recommendations should be clearly documented. Point 4: The TVI, classroom teacher, family, and individual must be involved during planning, evaluation and report writing Marnee Loftin, 201652

53. Point 5: Evaluators should be aware of the individual’s medical and developmental history, as well as the implications of the eye condition on the tasks to be performed (and implementation of recommendations). Marnee Loftin, 201653

54. Point 6: Adaptations, which include accommodations that do not change the concept nor the difficulty level of the test materials should be planned in advance in collaboration with the visual impairment and/or rehabilitation professional and the test developer, and be well-documented in the final report. Marnee Loftin, 201654

55. Point 7: Symbols, tactile graphics, and miniature objects must be carefully considered and used with caution to represent pictorial or graphical information. Real objects must be used whenever possible. Point 8: Evaluation should include direct observation in multiple situations. Marnee Loftin, 201655

56. Point 9: When visual-spatial items or tests are administered, these results should be used only for clinical purposes and to identify appropriate modifications of educational or vocational materials and instructional methods. Results obtained from visual- spatial evaluations must never be reported as scores or used to determine other eligibilities. Marnee Loftin, 201656

57. Point 10: Reports of assessments of individuals with visual impairments need to be expanded to include an explanation of the procedures followed, changes in standardized administration, and the description of performance observed. Marnee Loftin, 201657

58. Revisions in the DSM V support looking at cognitive functioning as an amalgam of abilities rather than a single score Marnee Loftin, 201658

59.  Wechsler Intelligence Scale for Children (WISC) V (Selected Portions)  Woodcock-Johnson Test of Cognitive Abilities (Selected Portions)  California Verbal Learning Test  Behavior Rating Inventory of Executive Functioning Marnee Loftin, 201659

60. Students with VI often demonstrate:  High scores on Similarities and Vocabulary during elementary school years  High scores on Digit Span  Low scores on Information during early elementary years  Low scores consistently on Comprehension Marnee Loftin, 201660

61.  Any adaptations and/or accommodations made  Adaptive devices student has used (or refused)  Collaboration with TVI  Supplementary information  Appropriate cautionary statements Marnee Loftin, 201661

62.  Adaptive Behavior instruments provide helpful information about progress on Expanded Core Curriculum  Useful for all students with VI  Consider use for students who are NOT being evaluated for possible ID Marnee Loftin, 201662

63. Selection is considerably wider including:  Vineland Social Maturity  Adaptive Behavior Assessment System  WJ SIB-Short Form for Visually Impaired Marnee Loftin, 201663

64.  May need appropriate accommodations  Be certain that accommodations maintain original intent of item  Interpret results with clear understanding of behavior expected for a student with VI  Use results to review pattern of growth toward independence Marnee Loftin, 201664

65.  Multiple instruments are available for evaluation in this area  Both criterion and norm-referenced instruments are available with appropriate accommodations  Process should consist of multiple measures supplemented with observation Marnee Loftin, 201665

66.  Skills in basic academic areas  Reading speeds  Aural comprehension  Work samples  Observation of efficiency in classroom Marnee Loftin, 201666

67.  Using a collaborative evaluation model  Using an instrument that has a standardized approach for developing braille materials  Avoids simply enlarging materials Marnee Loftin, 201667

68. Woodcock-Johnson Test of Achievement is now available in both contracted and uncontracted Braille as well as Large Print. Process of development was supported by Riverside Publishing Replicated standardized procedures and content as much as possible Marnee Loftin, 201668

69. WJ Test of Achievement-IV Key Math Diagnostic Arithmetic Test Marnee Loftin, 201669

70. Multiple observation checklists are available in the MEM book. Specific factors of concern are:  Ability to initiate tasks  Ability to organize materials  Speed in comparison to classmates  Ability to complete tasks  Independence in making corrections  Problem solving skills Marnee Loftin, 201670

71.  Qualitative Reading Inventory  Ekwall Shanker Reading Inventory  Gray Oral Reading Test  Diagnostic Achievement Battery Marnee Loftin, 201671

72. A SUGGESTED PROCESS FOR DETERMINING ADDITIONAL ELIGIBILITIES Marnee Loftin, 201672

73.  TVI provides information about vision and intervention  Evaluator and TVI conduct collaborative evaluation  MDT reviews data and cautiously interprets for determination of eligibility Marnee Loftin, 201673

74.  Specific etiology and possible relationship  Specific concerns resulting in intervention  Interventions that have occurred  Current concerns/behaviors Marnee Loftin, 201674

75.  Evaluator reviews FV/LMA  Evaluator reviews educational and developmental history  Evaluator and TVI plan evaluation, including adaptive devices and accommodations  Evaluation is conducted using best practice guidelines Marnee Loftin, 201675

76.  Diversity of population  Complexity of low vision  Issues associated with CVI  Benefits of braille  Importance of age and functional level in determining need for evaluation  Canes and dog guides Marnee Loftin, 201676