Structured Visual Assessment of Children with Severe Visual

Structured Visual Assessment of Children with Severe Visual Impairment and/or Multiple Disability G Coyle, M Campbell, U O’Colmain NHS Tayside History Children with severe visual impairment and/or multiple disability are more challenging to assess due to a ‘lack of interest’, inability to use conventional quantitative visual acuity tests or difficulty in recognising the child’s response when it is not a typical observable ‘fix and follow’. Less than 5% of children with visual impairment have no perception of light. Any sight the child has; no matter how little, can add to experiences, enjoyment and learning. Parents, carers, teachers and therapists therefore, need to know the visual abilities of the child. Each child has a Functional Vision Assessment: in Tayside, the joint assessment team comprises an orthoptist, paediatrician and qualified teacher for visual impairment. Clinical Findings Our team uses a structured hierarchical assessment protocol based on that designed by Sonksen & Dale (Figure 1). The child is presented with a series of ‘visual lures’, decreasing in size and the minimum size of visual lure to elicit a response is noted. As there is no standardised set of visual lures, the Visual Impairment Network for Children & Young People (VINCYP) Minimum Size Detection Set was produced (Figure 2). Response to visual stimulus- areas of visual skills to be considered: • visual awareness • visual attention • visual localisation • fixation • following • saccades • scanning • visually directed movement • visual recognition of people and objects • visual recognition of photographs and pictures These skills are developmentally hierarchical involving increasing visual processing, and are also dependent on cognitive ability. Figure 1 Figure 2 Results We were able to describe the visual abilities and responses to visual stimuli in each child. Conclusion Visual information is obtainable and utilised to plan strategies for stimulation and use of vision for communication, play & learning and movement & mobility. If vision is identified children with even the most profound developmental delay can make progress to reach their maximum potential. www. vincyp. scot. nhs. uk