TRANSCRIPT - Resources & Guidance for Using the CVI Range Ð 2/27/23
>>Sara: What we're really looking at today is CVI assessment. Specifically, we're looking at the CVI Range, Christine Roman-Lantzy assessment. There is a Perkins CVI assessment that's being developed, and Diane Sheline did a Coffee Hour previewing that on February 6. And I think maybe you can go and look at the recording of that perhaps, if it was recorded. But we're not that familiar with that one yet and since it's not really finished yet, we're still using the CVI Range, since that's the main assessment that we have. So, what we're going to look at today, depending on where you are there should be something for everybody, depending on where they are in their CVI assessment journey. There are resources that we'll share for increasing your CVI knowledge. And then there are resources for learning about the CVI Range. If you haven't ever really had a lot of exposure to it, there are some nice resources that you can be a passive observer so you're not put in the hot seat immediately. You know, so you want to be able to observe before you actually have to do the assessment. And so, there are some nice resources for that. There are a lot of tools that we're going to list, and it's all written down in your handout and in this PowerPoint so that you can refer to it later that we use in coaching and collaborating with people. And we also wanted to just share with you the whole process that we go through when we collaborate with people to do a CVI Range with a team. So, let's go on to the next slide. 

>>Lynne: Okay. So, we want to show you really quickly some of the resources here that we thought were some of the most valuable ones out there. The first one is the Pediatric Cortical Visual Impairment Society. Once you click on this, it will take you to this page. If you go up to the top where that little menu is, it pops this up. So, they have a lot of information here. If you open the educators -- I mean, just tons of information here for educators. There's information you can share with families. This is just kind of a treasure trove of knowledge. The next one is CVI resources. This is Dr. Roman's page. She has really a lot of information specific to her book and some suggested interventions there at the top of her picture, like the bubble words and things like that that she kind of invented. And then she also has a YouTube channel -- we're not going to show you. You can just search for her on YouTube -- with a lot of really nice, short videos that you can share with families, again. And she kind of talks about the different steps of the CVI Range. CVI Scotland has these little lessons and they're very, very, very accessible and they're very, very, very short. And so, if you just click on any one of them. Just pick one. You can either watch Dr. Dutton as he goes through the lesson. It's about three minutes. They're all about three minutes long. Or if you keep scrolling you can just read the material. So, these are very, very nice and accessible. The Perkins CVI Now page also has resources there at the top. And then Diane Sheline's Strategy to See website. Diane is kind of known for her do it yourself items that she thought of. This is really a strength of hers to kind of think outside the box and make materials for kids in different phases of CVI. She goes into a lot of detail on how to make this stuff. And she goes all the way from Phase I to making books for kids in Phase III. So, you should definitely check that out if you haven't seen it. You do have, in your handout, several more links. We're going to go through a few more on the next slide. So, of course, there's Dr. Roman's book that contains the assessment. There's also Sara and I along with Diane Sheline have collaborated to make three kind of case studies where we go through the CVI Range from the very, very beginning to the very end when we score it. And then we talk about interventions for a kid in Phase 1, Phase II, and Phase III. These are all free. You can get up to 12 CEUs for it. They're each about four hours or so, start to finish. Perkins also has a class on the CVI Range Approach, which walks you through scoring it. Now the difference between our scenarios and the Perkins' webinar is that our scenarios, you're not really required to do anything. So, really, you're just watching Sara, Diane, and I go through the process. In the Perkins class you are going to be required to score based on kid descriptions and video. Score and submit, so it's like a little test that you're doing. And it's $400. But you do get 50 CEUs. 

>>Sara: It's a great opportunity. Great time to have to have a conversation with the teacher, with the other people who are taking the course. Lynne and I took the course and it was a good one. 

>>Lynne: I would caution you though, if you are a beginner, I would not take the Perkins course at this point. Until you have a little bit of knowledge of CVI under your belt, because you are being evaluated on how you score the range and they decide if you know what you're doing or not. 

>>Sara: Right. The CVI scenarios are really nice as far as an introductory way to look at the CVI Range and to go through the whole entire process, because there's no pressure on you to have the right answer. You have plenty of time to think about it without, you know, anxiety. 

>>Lynne: Right. Terry says you have used the scenarios. I'm glad you found them useful. Yeah. Those took a long time to create. 

>>Sara: Many, many, many iterations of those. So, are we ready for the next slide? 

>>Lynne: Yes. 

>>Sara: Okay. We're going to go through a couple of different ways of looking at these things. The first thing we're going to go through is many, multiple tools related to each of these steps of performing the CVI Range. And these -- we generally -- when we do this, we're talking about a CVI Range collaboration, which is -- we think it's the best way to do it because it's kind of a conversation. You have multiple people looking at each of the steps that you take and it's a lot easier for me to feel confident about scores when I have other people looking at them too, because it is a subjective assessment. We're going to go and look at all the resources connected with each of these things but on the next slide the first thing we like to have, before we start diving in to the assessment, is a data collection form. It's great to have this in advance because then you have a place to put down all your data so that when you're actually scoring the CVI Range you can have all your information in one spot and just look at each characteristic and look at each place and just go, okay. Here are all of my examples. It's very specific. I can, you know, take this and put it on to the CVI Range. And so, you want to have a place to write down information about each characteristic and visual complexity is broken down into four parts, so you want to have a section for each of the sections of visual complexity. That would be complexity of the object. Complexity of the array. Complexity of the sensory environment and complexity of faces. And then under each of those parts, that would be about, what, 14 characteristics, sort of. Maybe 13. You would have a section for the parent interview -- because it's nice to know where you got your information. And the observation, these are the three steps of the CVI Range. And then the direct assessment. So, you can know exactly when you saw each of those bits of information. Was it from the parents' perspective? Was it from when they were in their regular environment? Or was it under a controlled environment and a direct assessment. And we have an example -- if you want to click on that link, you also have this as a handout. And you can choose any color you want for the parent interview, the observation, the direct assessment. We like to just choose really different colors. It looks like we didn't choose very different colors for the observation, the direct assessment on this particular one. But it's nice. And then you can just hone in on the parts that you want to hone in on. So, this is just an example. It's in your handouts. It was created by Sandra Newcomb, who we took that Perkins course from. Lynne and I took that together and we got this data collection sheet from Sandra Newcomb and she said share it with anybody you want to. That's what we're doing. You can make your own if you don't like this one, but this is a nice example. 

>>Lynne: The questions on the parent interview are numbered, but we also number the observation clips and the video assessment clips because you're putting a description into this data collection form. It's nice to just put the number of what you're referring to. So, you might say, you know, clip No. 3, the student had a delayed blink response. 

>>Sara: Yes. And that's part of our procedure is making -- is videoing everything. And that way you can go back and look at it again if you have any questions. Or if you want to run it by someone else who wasn't able to be there. The video is a great tool for scoring this assessment. And on the next slide this is a list of the kinds of things that will help you complete the parent interview out of Dr. Roman's book. Her 20172nd edition version. There are the questions to the parent interview that are asked. Those questions were really designed for very young children. So, you can definitely modify those for older children. And then there's the answer guide, which gets at -- it's kind of a key to what was the question getting at. What are you actually trying to ask the parent about. When you want to ask what are your child's favorite toys? You're asking what are the visual characteristics of your child's favorite toys. So, once you ask that question you find out the favorite toy is, oh, they like the vacuum cleaner. The vacuum cleaner is a noisy toy or just a noisy object around the house. What do they like about the vacuum cleaner? Does it have a light on it or is it just the sound? You try to find out about the visual characteristics. And then -- I think we went to the next slide a little too fast. And then there's a how to do the parent interview. One of the things that is really good is that they point out that -- that Roman points out is to have a conversation. So, once you're very familiar with all the characteristics, you can start teasing out the important information while you're having this conversation. And, you know, so you have to have a conversation. You wouldn't have it where you would give the parent this questionnaire and say just fill this out and send it back to me. You will not get nearly the wealth of information. And you may get some that just don't give you any information. They might say, yes. Or no. Then you don't know. You're not anywhere further along. So those are just some things that will really help guide you if you're new to doing the parent interview. Or if you've done it before and you did send it home and you'll do it this other way now, because you'll realize -- you realize probably if you did send it home that you didn't get that great of information. Let's go on to the next slide. 

>>Lynne: So, the next step in the assessment process is observation. So, Dr. Roman describes the observation pages 91 and 92 of her books. And so, I don't know if this maybe is the next slide, Collin. Nope, nope. Go back to observation. Sorry. My fault. Yeah. Nope. Wrong one. So, observation, we're going to talk a little bit more as we go down. We do this through a series of video clips and we'll explain more when we're going through the process that we go through. But we did want you to know that there's a resource in the book about what the observation should look like. Okay. Next slide. The next step is a direct assessment. So, you have the parent interview and you have the observation. So that's when you have that information, then you plan the direct assessment. You're like, okay, what are the things that I still don't know from each of these two? So, what do we need to directly assess? So, the resources in the book are the procedure guide. Christine Roman has ideas for how to do the direct assessment. Suggestions for the direct assessment and her suggestions for an assessment kit. Okay. You can go on. 

>>Sara: So generally, what we learned in our CVI Perkins course is you score Rating II first. We never knew that but it's kind of a great idea because it's more of a global perspective. Whereas Rating II is little picky parts. So, the description of Rating II is on page 103 to 105 in Dr. Roman's book. There's a special extra part on scoring complexity in Rating II because that has changed since the first iteration of the CVI Range. So, scoring the complexity has its own special directions. And then there's a Rating II scoring guide. That's another thing that helps you, if you have questions, whether I should go with the .5 or the .75 on that number line. Let's go on to the next one. And then we score Rating I. And in -- let's go ahead and look at that first link. At the bottom of the first page of the CVI Range Assessment, there is a -- keep on going down to the bottom of that first page. Right here. Stop. Okay. So, in the columns you will put a plus, a plus -- an R, a plus, or a plus minus. I really like this way of looking at it. So, an R represents a visual behavior that's resolving or approaching typical behavior. A plus describes the current functioning right now of the child. And the plus minus partially describes the child emerging. That's the first set of rules we look at for scoring the CVI Range. 

>>Lynne: There's also a minus. Is that on the next page or did we just not -- 

>>Sara: Sorry. You're right, Lynne. It does not apply to the child. It's on the next page. Generally, it's on the same page but I don't know why it's not on the same page as this one. Yes, minus does not have anything to do with this child at this time. Thanks for pointing that out. So, let's go back to the PowerPoint. But that's a nice guide that you can use on your first -- when you're looking at scoring Rating I. There is also a scoring guide on page 153. So, if you're looking at those -- that plus, plus/minus are resolved and you can't quite figure out what you want to put, then I would refer to the scoring guide and see if that can help you decide if you're on the fence about one of those. There is also, on page 101, directions for what they call the ceiling effect. And that describes when you stop scoring. When you've reached the top of their range where they're at. And you can read all about that on page 101. It's basically if you have a string of minuses or plus/minuses. Beyond a certain number, then it tells you how to score that. 

>>Lynne: Sara, there's a question. Give an example of does not apply to child. In what case would you put a minus? 

>>Sara: So, if the child -- if it says looks at or glances at faces and the child doesn't do that. Then, no. It doesn't apply. Does that help you? Let's go on to the next slide. I think we're ready. 

>>Lynne: So, after you score Rating II and then you score Rating I and each one of those documents will give you a number, just one single number. And so that number is the CVI Range. There's only two numbers and they are whole scores. Sometimes we have seen teachers score each characteristic of CVI that Dr. Roman has identified, and that's incorrect. You have one score from Rating I and one score from Rating II and that's it. Now, the second bullet is not in the book. If the difference between Rating 1 and Rating II is greater than 1.5 you need to reevaluate your scoring decisions. We learned this in the class and so their opinion is it's not valid if it's too big of a range. And so, in the case that we get scores that are larger than 1.5 difference, we would go back and relook at really specifically the stuff we had questions about, we were on the fence, and maybe we scored a little too high for that one. 

>>Sara: I think that's a more typical thing to do is to score too high. Often, we find that people do that. 

>>Lynne: Right. And so, you know, Dr. Roman stresses this, we stress this. When in doubt, score conservatively, score lower. If you're caught between a .5 and a .25, go to .25. Okay. 

>>Sara: And I think the reason for that is important to mention. And that is because it's better to err on the side that's easier to see rather than something that's impossible to see when you're doing your interventions. 

>>Lynne: Right. And you don't want to give a false impression of how this child uses their vision to where people will think, oh, they can see fine. All I have to do is one or two things and they'll be fine. But so much goes into it. It's so complex. You want the child to have as many supports as they can. So, for the direct assessment, in the book the resources are procedure guide, ideas for the direct assessment. Suggestions for direct assessment of CVI characteristics. And then suggestions for an assessment kit. I think we already talked about that. Is this me, Sara? 

>>Sara: I think somehow we ended up going backwards. So, go forward. This is where you just were. 

>>Lynne: This is where I was. So, the next slide. So, if you are going to use the CVI Range as a part of your Functional Vision Evaluation, which you should, because it's a plethora of information about how the child uses their vision. You also will need to think about the learning media. And so, Dr. Roman has a new book. Sensory balance: Planning for students with CVI. It's more of a booklet. It's cheap. It is really short. They have a web tutorial, Matt Tietjen and Dr. Roman on the website that's free. You want to pop to that, Collin? It takes about an hour but it's a nice way -- they walk through the book and they really explain in detail how to use the different forms that are in it. The forms -- you can go back to the PowerPoint. We're not going to show you the forms but you have the link in your handout. All the forms used in the book are provided free on the website, which is really, really nice. Next slide. 

>>Sara: Okay. This is our last slide about what are the tools and where do you find them. For intervention, there are sample recommendations and interventions for CVI based on the child's phase. But not only their face, but their smaller number, their range. So that is on page 231 of Dr. Roman's book. And then the whole entire Chapter 6 on page 175 is about program planning and intervention. And that can be -- you can find the parts that you need in that that pertain to where your student is functioning. It's just a really great chapter. It's the meat of the matter. If you're going to read just one of the chapters in Dr. Roman's book, read that one. 

>>Lynne: Right. I think she really got the feedback in the old book. It was all about the assessment and then she stopped. She didn't have anything in there about what to do after the assessment. This is really great information. 

>>Sara: Right. That gives you so many ideas, so many ideas. Of course, you're going to tweak everything according to what your student needs, that you will know by the time you get to this intervention piece. So, let's go on to the next slide. So now we're talking about -- right now this is where we start talking about what all the steps are we do. When we get together and meet with the team and do this whole entire process together in little tiny chunks. So, you find a student. You know the student needs to have the CVI assessment. Then you decide who will be the lead. There can be a lead -- that's the person who is going to gather all the information, do the parent interview, and make the video clips. You can also have another person -- depending on your team, you can have someone -- if one person is good at getting all this information but they're not good at interacting with the web and internet -- because that's a nice place to story, especially videos and such. You can have that person be the internet lead and they can make sure to upload all the files and there will be meetings scheduled and things like that that need to happen. People will need to take roles and sometimes a person takes all those roles. A lot of times when Lynne and I assist a team, we pair with the TVI, generally, to do this lead thing. The TVI is generally the lead because they're the ones gathering all the information. Can't do anything without the information. Then you find out from your team who wants to be in on the conversations. Who wants to hear all of these things that this group -- and contribute to all the things that this group is really talking about. 

>>Lynne: Really, have another set of eyes, at least one other set of eyes is nice. 

>>Sara: Right. You can involve the vision staff, the OT, people who are familiar. You have to have at least a couple of people who are familiar with CVI and who have done this process -- at least one person who has gone through the process before. And that can be your VI staff at the Education Service Center. Lynne and I can help. We're the people who generally do that. You know, we can work with you but you can also do this in district. The COMS and the TVI are a great example of two vision staff that both know this vision piece and can have these conversations and lead these conversations. So, let's go on to the next slide. 

>>Lynne: So, we really recommend video clips for the observation and the direct assessment, just because we found that some of these characteristics are displayed so subtly and so fast that if you're just in the moment trying to keep track of what you're looking for, all these different ways, it's really, really difficult. So, we recommend short video clips, maybe not over two minutes each. And then, you know, you're going to have to figure out where to put these video clips. So, we used Google Drive and then we share that folder with everyone that's participating. We create a data sheet that we just showed you. And then we -- the TVI, actually, we talk with them about how to do a parent interview -- like Sara was saying, have a conversation. Dr. Roman also I think has a YouTube video about how to do the parent interview. And then we would collect information from the parent. 

>>Kaycee: We had a really great question come in the chat also asking if there was a page or a website or a document that you guys know of for parents that explain the phases and ranges that you could use to accompany your report. 

>>Lynne: I think if you look on the resource page, I have a parent website. Is it start seeing CVI? That is parent-led that has resources. That Pediatric Society also has a whole page for parents. So, check out those resources and hopefully you'll find what you're looking for. So, the next step is to take these small, short video clips of the student in a typical environment. You don't want to really do anything with them but you do want more than one environment. It might be classroom. It might be home, if the parent can contribute to some of these video clips. Might be outside. Just different environments. Maybe like in the gym when it's super noisy or the cafeteria or one-on-one in a really quiet environment. And then you're going to meet as a team. We do this virtually. And we watch the video clips. Like we had said previously, we number them and then we watch each one. And so, from -- so clip number one we might say student reached and picked up red ball but not the yellow ball, you know, or something like that. Whatever we see in the video. Just kind of a running record of what we see in the video based around the CVI characteristics. 

>>Sara: What we end up doing a lot of times is we'll say the description of what we saw. The student, after three seconds the student reached directly for and touched and then looked away the red ball. So, you can actually just copy and paste that one into color -- because it was a red ball. Maybe latency, because it took them a little while to do it. Visually-guide reach. You'll have examples of various things and you can separate that out later. But that's one of the fast ways that we end up doing it is, okay, that has to do with this, this, this, and this. You'll often find it there. It's not going to be one characteristic that is happening at a time. 

>>Lynne: Right. Barbara shared that Chris Russell created a fact sheet and she put the link in the chat. 

>>Sara: That's a good one for parents? Awesome. 

>>Lynne: Yes. All right. I think we're ready for the next slide. 

>>Sara: After you looked at the parent interview and the observation videos and recorded some of your data, it is -- you're ready to start thinking about your direct assessment. One of the things that is important about the direct assessment is that especially when a student is in the earlier phases of CVI, you want to be efficient when you're directly assessing. So, it's nice to plan the direct assessment. And one of the ways we found that we could plan it is to look at the criteria in Rating I and see -- and compare it to what we have on our data sheet so far. And then, you know, don't worry so much about questions that we feel like we have a pretty good idea of their answer, whether it's a plus, minus, or plus/minus, R. The ones we aren't sure about, those are the ones we highlight and make sure we test those items. And another thing that is good to do when you're looking at this is you view the descriptions of each of the sections of the range. So, let's go ahead and click on that link and look at the descriptions of the sections. So, we have overall descriptions for Phase I, Phase II, and Phase III. You know building visual behavior. 

>>Lynne: Collin, do you mind opening that link for us? 

>>Sara: Sorry. I was coded in my speech. We know that Phase I and Phase II in the overall descriptions but let's go ahead and look at -- go down to the top of the second page. Right here. CVI Range 1 to 2. Student functions with minimal visual response. Think of which of these describes what you have seen so far, because that's probably the section you're going to hone in on. You're really going to look closely at. If that's not the case then you're going to look at CVI Range 3 to 4. Student functions with more consistent visual response. That might be where you're really focusing. You're looking at the section that best describes what you've seen and then maybe a little bit on both sides of those two. That way you really know to focus your attention on where the student is working as opposed to -- and that will make it so you're more efficient when you're with the student so you're not just going to tire them out completely in one assessment setting. And then you'll have to go back and try again because you won't get the results that you would if you could be more efficient about it. We found that is a really good guide for helping our thinking. Let's go back to the PowerPoint. If you are in doubt in any of those sections, just start with 1 to 2. Just start with the very beginning. So, you're going to use the information from the data sheet and the Rating 1 scoring guide and, you know, find the things that you have the most sufficient information on, highlight what you don't on Rating 1. And then there's that nifty procedure guide that we gave you all the page numbers for and such. For Rating 1 it's really great, if you need help with how to test that specific statement. So, if there are specific statements you do not know the answer to, go to the procedure guide, follow what it says to do, and that gives you a good solid way to test that specific statement. And that way you can be sure of knowing the answers to all of what the Rating 1 is asking about, all of the little details. Let's move on to the next slide. 

>>Lynne: I just want to mention -- we did not put this in your handout -- but if you have a student Phase III, there is this thing called the CVI Phase III Extension Chart, which is not part of the assessment but it does give you nice detailed checklist of things you might really want to test. Specifically, I think it looks at how many. There's three different verbs that she uses in that extension chart. So that information isn't scored but it will help you with a kid in Phase III who may be hard to test. Figure some stuff out. 

>>Sara: It will help you with the answers that are much higher up in the CVI Range to be able to know whether the child is sorting by color or by salient feature and things like that. And I can't believe we didn't put that in here. 

>>Lynne: The extension chart is in the book, yes. It's called the Phase III Extension Chart. And it's just a nice little road map for testing those kids that their CVI is super subtle. You might not even know how to test that. And so, the next step in the process is you have to decide what your kit is going to be. There are suggested items in the book but there's also things that can guide you from Rating 1. If you know you're going to test things like can they look at multicolored objects, you're going to bring a couple of those multicolored objects. Maybe even stuff of, like, two colors and then maybe more than five colors or things like that. 

>>Sara: Right. And sometimes you're going to want to create items that are pictures of their favorite items. Like what does Diane do? She makes a transparency of a picture if they have a favorite cartoon character or something. And to put that on the light box to see how the child responds to that image. And so, there are a number of different things you can do to prepare, some very specific to the child. 

>>Lynne: Yes. And so, you're going to want to find a location for the assessment. And so, this is a location where you can control the environment. So, you need to be able to dim the lights. It needs to be quiet. And it should not have a bunch of stuff in it. So, then you're going to determine who will video and who will perform the assessment. And then you video the direct assessment in short clips and upload the clips into a shared folder. Next slide. The next step is to meet as a team and watch the videos and record what you see on the data collection form. And then you fill out the CVI Range Rating 2 based on the overall knowledge that you have about the student. And you use the Rating 2 scoring guide. Next slide. 

>>Sara: Okay. The next thing that you're going to do is fill out the CVI Range Rating 1 based on the data and the scoring guide. And then you'll have both Rating 1 and Rating 2. That determines the CVI Range. The CVI Range is those two numbers, like Lynne was saying. It's not a number for each characteristic, it's two numbers and that's the overall rating for this child. CVI Range is between here and here. 

>>Lynne: And I do want to interrupt, Sara. For one student, just one, of all these years we've been doing this, the Rating 1 and Rating 2 is the same. It can be the same. I just wanted to let you know that. This kid had a 1 to 1. These very Phase I. 

>>Sara: It's more likely that Rating 2 will be a little lower than Rating 1. It's a guide that Rating 2 is a little lower than Rating 1. That's the overall big picture stuff and the Rating 1 can include some more splinter skill-like things. And let's move on to the next slide. So that range score, those two numbers will help you determine the phase the student is in. And then you look at the book -- we provided that page number again -- for intervention suggestions. You can do it by characteristic and by phase and then you can identify recommendations to increase the child's visual functioning across the day. There is also -- there are a couple of -- I think there's a program planning sheet that has to do with the activities throughout the day in the book. And I don't know whether we put the page number for that, but it helps you determine whether you can adapt that environment for the student to use their vision or whether that's not an environment where the student will be using their vision. 

>>Lynne: I think it's called the CVI Schedule in the book. 

>>Sara: Okay. Let's go on to the next slide. I think I have written down that this is you, Lynne. 

>>Lynne: You can use the data sheet with all your information to report on each characteristic if you're going to use it as part of your Functional Vision Evaluation. It's really good information and, you know, the other thing about using video clips is if you have a team member that disagrees with your conclusion, you can go back and look at the video clips. You have proof about where you came up with this information. And so, you can use the statements from Rating 1 to determine the present levels of visual performance. That you can take straight off the data collection sheet. And then the statements from Rating 2 determine accommodations for the student. Next slide. Okay. So that is the process for completing the CVI Range. If you have any questions about the CVI Range process, please feel free to put them in the chat and we can address them. The next thing the team is going to do is start thinking about learning media. And so, the two forms that we use the most from the book -- we showed you that link. They're free online. The learning media profiles -- let's take a look at that. And so, this is you fill out together with an always, sometimes, or never. Put a check mark here. Basically, what the book says is that you are, you know, sometimes students are going to use their vision as their primary learning media. So, the learning media for these guys is fluid. Sometimes it's going to be primary, in certain situations and activities, and sometimes tactile will be primary in certain situations. I know we have to identify what their learning media is on that VI supplement. In fact, you know, in real life it's going to fluctuate, as you guys know. Kids with CVI, their vision fluctuates. It's not accurate that the vision fluctuates. What fluctuates is the environment. You can go back to the PowerPoint, Collin. Thank you. This activity planning form. So basically, this is kind of like the CVI schedule that she has in her book after you do the assessment. So, you're going to figure out what activities do you think the child would be most successful in for them using their vision primary and what makes more sense to do auditory or tactile as primary. When you think about it, we use all of our senses all the time. Sometimes we use our tactile sense more than our visual sense and vice versa. Sometimes we're listening, as the main learning channel. And so, it shouldn't be thought of as static. If you identify an activity like, say, active learning, if you identify an activity that's going to be primarily tactile, you still can incorporate, you know, the strategies of CVI that help them see better. But you have to know -- you know your teaching goal. Your goal is tactile, right? So, you can -- if they like looking at red shiny things, you can have red shiny things mixed in there with all the other stuff in an active learning environment. But your primary goal is not that they're going to use their vision, per se. If they can use their vision, it's great, but it's not your primary goal. Thank you, Kaycee. 

>>Sara: Don't make a noisy box with three items because the point of that activity is tactile and auditory activity. If you want to highlight the things that are close to their face, make those shiny or their favorite color. That's different. That's not the same. But like Lynne said, know your goal. If you're doing a tactile-auditory activity. Those kids that are in Phase I are not going to be using their vision to access information. They're learning to use their vision. So as teachers of the visually impaired, we have to consider not only are they learning to use their vision -- so there are times they are learning to use their vision but when they're learning to access other information and they have to access that differently. It's kind of -- you are looking at dual media, kind of, when you're looking at kids. And there's a really great explanation of that that Matt Tietjen and Christine Roman describe in their Perkins webinar on the Learning Media Assessment book on the sensory balance. Really check that out because it's a great global understanding of how do these sensory channels work for kids at various phases of CVI. 

>>Lynne: Next slide. So, in conclusion, Sara and I want to say, you know, if you need help going through this process or you feel like you just need another set of eyes, your regional service center in Texas may be able to help you. If not, you can go to our TSBVI website. Collin, you want to go there? We want to walk you through this because our website has changed and it's kind of hard to find stuff. Go up to the top of professional resources or statewide resources, I believe. And go to "outreach." Go ahead and go there, Collin. 

>>Sara: I think he's trying. There it is. 

>>Lynne: Okay. And then you scroll to the bottom. And there's a picture of me. And then there's a little button that says "contact outreach." And so, this is where it will take you to a Google form and it will ask you what, you know, why are you contacting Outreach? Do you want a student consultation? Would you like training? You would indicate that you wanted a training and it would be the CVI Range coaching is what we call it, or collaboration. And then we can help you go through each one of these steps virtually -- we have done it 100% virtually. If you're close enough, sometimes we'll go out and help with a direct assessment, but it is very doable virtually. So, go back to the PowerPoint, Collin. And then you can always contact us if you have questions about how that works. We are free of charge unless we are in person. CVI Range form is a fillable -- go ahead. 

>>Sara: There is a version of it but we aren't -- we haven't been okay'd to give it out. But if you go to one of the trainings that Chris Russell does on CVI, he will -- he has been given permission to give that out. Or you can -- if you know Chris Russell, you can just contact him and if he knows you have had enough training and such. People didn't want it going out if people didn't know how to use it, I think. So that was a little guard on that one. 

>>Lynne: And Elsa, I had a student, the nerve raises the eyelid had been severed. This young man had CVI as well but he could not open his eyes. You can't assess because his mother was like I can open his eyelid and you can do the assessment. But that's not functional. You know, he can not. Basically, if he can't open his eyelids, he would be blind. You would indicate that he was functionally blind because without that outside assistance he can't open his eyes. 

>>Sara: But if he doesn't move his hands or feet, I would definitely use something that will help him develop those motor skills. And active learning is a great way to help develop -- I don't know if this is since birth or something new but active learning is a really great way to encourage children to move, beginning with their gross motor skills and then moving into the fine motor skills. And definitely check out activelearningspace.org. It's got a ton of information on how to use all of these things. And all of the principles of active learning, all of what's behind it. 

>>Lynne: Elsa, you wouldn't be responsible for including CVI information. You can't get CVI information if he can't open his eyes. You can't artificially -- that's the whole point of saying it's a Functional Vision Assessment is because it's real life. It's not in the clinic. If it's real life, how does this child use his vision? And he can't because he can't open his eyes 

>>Sara: Unless there's some sort of new technology that will hold his eyes open and let him blink when he wants to, that's where he's at, unfortunately. 

>>Lynne: All right, everyone. Well, thank you very much. One more question. Do students with CVI 3 have issues with memory? Student knows A to Z and different times the student cannot recall the letters or sounds. Does that fall under CVI Range? That is not visual. His memory is something else and so that would not fall under the CVI Range, but it's very important for you to note that. 

>>Sara: And it is more difficult for kids with CVI to build visual memories. But if he knows it sometimes and doesn't know it other times, I was wondering what else was happening in the environment when he can recall or when he can't recall. I would be curious to see if he's too distracted and it's not easy for him to recall that information. It could be outside influences. It could be something else. 

>>Lynne: Right. Can you show the slide again that said rating 1 can be present levels and rating 2 -- do we have time, Kaycee? 

>>Sara: Every bit of information in that is in your handout. Your handout is like exactly like the PowerPoint. So that's why we put all that detail on it so you could take it with you. You don't have to remember any of this stuff. You can look at it, because it is really detailed. And we did want to go through it in a very specific way, just to make sure you had all the steps and you wanted to follow exactly the way we did it.