1. Minimally Responsive Child
These students need to be assessed over time and in different environments, and w/ caregiver or other who knows child well!
Children who may have complex medical complications requiring ventilation, tube feedings & highly technical wheel chair design and/or postural supports due to severe physical limitations, asymmetries, contractures, and quality of postural tone.
Regulatory systems are often significantly impaired, second-are to brain injury, trauma, seizure disorder, and/or medication to manage medical needs & to support life functions.
These students manifest behavior states that range from constant agitation to deep, profound sleep states.
For these children, programming often focuses on massage & visual & auditory stimulation/bombardment rather than on integrating the CNS so the visual system can become organized and ready for taking in and using information.

2. Posture-Vision Relationship Apparent Light Perception
Strategies:
Posture-Vision Relationship –
Items may be elicited by therapists during sessions, interviews with caregivers & others, or elicit the postures yourself through play and social interaction.
Apparent Light Perception –
GIVE BLACK LIGHT WARNING!!
Ensure that student is in state of readiness to respond, and in a posture that offers sufficient stability for movement of head and eyes.
This part of the assessment may need to take place over time and in different environments and contexts.

3. Posture-Vision Relationship Rationale
Interrelationship between postural system and visual system is so powerful that deficit in one significantly influences the other.
Vision may be present but cannot be expressed until postural and motor system is prepared
So, what this is saying, is………………

4. We Must Prepare the Visual System for Function!!

5. Assessment Sequence Organize postural alignment and symmetry
Facilitate quiet alert state
Influence movement and postural components that support visual function

6. We Won’t Impact Vision Until We Get Postural System in Place Every Time We Make a Postural Adjustment We Must Allow For a Visual Adjustment
As we’ve stated before, the interrelationship between the postural system and the visual system is so powerful that a deficit in one significantly influences the other. Vision may be available but cannot be expressed until postural and motor system is prepared for expression of visual potential.
Another thing to remember when looking at posture: the less the student has to work against gravity, the easier it is to organize the visual system.
Remember, we want to:
Organize the student’s posture to provide proximal stability for eye mobility
Align the head and neck, when appropriate, to prepare the visual system for function
Facilitate optimal arousal and attending behaviors to enhance visual functioning

7. Intervention with the Child is Your Assessment
Intervention consists of positioning and aligning.
And, intervention strategies should include activities that are designed to address:
Organization of visual system
Integration of vision within a movement activity
Immediate application of the visual skill within a functional
Materials used should share attributes likely to elicit visual awareness and attention in neurologically impaired systems:
Faces (especially familiar ones), reflective surfaces, fluorescent materials, illuminated toys, etc

8. Minimally Responsive Child
Posture & Movement
Components of Visual Function
Postural tone
Head/neck Components
Shoulder Girdle Components
Upper Extremity Components
Trunk Components
Movement Skills
Indicate with a check-mark if each is WNL or deficit, based on child’s chronological age.

9. Apparent Light Perception Rationale
If light perception is apparent, it may represent minimal level of visual functioning
Any amount of light may be made more efficient for functional application
Student may be made aware of visual capacity and attend to motion, color, and distant lighting sources to better orient to and discriminate his surroundings and, subsequently, increase his independence

10. Minimally Responsive Child Apparent Light Perception
Eliciting Context /Nature & Quality of Visual Response
Facilitated Contact
Imposed Light
Motion Against Light
Form Against Light
Detail Against Light
What we’re trying to do is find out if child has LP; to elicit what’s there and then expand it! LP is important – using to orient, etc.
We will look at and report on:
Source of light
Quality of light
Contrasting light
Distance
Field
For each of the above eliciting contexts, there is a hierarchy of responses:
Does not respond
Alerts
Orients
Localizes
Reaches
Activates
Shifts
Moves toward
Pursues
Searches *
Scans *
Discriminates * * these are cognitively driven

11. Good Lookin’ Video
- Video #2