[ Music ] >> Lois Harrell: Our next focus is, what do I do with the information from the functional vision assessment? And the first question we have, what is this child's diagnosis of visual acuity? And a question that' always asked is, "My child is nonverbal, how can the ophthalmologist assess his acuity?" With some ophthalmoscopes and magnifiers and they measure the distance of the eye and they can get some visual acuity. And if the visual acuity is not, is really out of normal then that child may be prescribed glasses. The appearance of the eyes, are they normal? Some eyes can be smaller than others, some eyes can have what's called ptosis where the eyelids are down, and they have a limit on the visual field. Some eyes can have what's referred to as colobomis or little dips in their irises, their irises are different, and when a child is light-sensitive they may shut their eyes when the light's too bright, that means they're getting fragmented input because they're only looking when the light is not bright, and that, they have to fill in the gaps, and that takes a developmental aspect too. [ Music ]  In the functional vision assessment checklist we went to the section on observations of functional vision. We saw two beautiful babies, I used the pen light for light perception. This baby was able to grab onto the light perception, not an even flow, but she was aware of the vision in her field. She was motivated by the light perception, especially when she was pulled in a blanket and pulled around past the window, [Background Music] you could see her open up her eyes and look at the light. [ Music ] The second child has very severe underdeveloped optic nerves, and he did not reflect awareness of the light except just very minimally. He does have enough light perception to make it functionally useful for moving about, and sometimes even for reaching for objects. With the little girl we used the light to follow. She was intermittent in following, but she was aware of it. We touched the object to her hand, letting her know that it was in her space, and therefore she was more motivated to follow it. And then when I brought it across to touch the other hand, and then back, and had a pattern, invited her to recognize that she could sometimes lock in, at least peripherally, on the object that was in her space. Able to fix and follow on an object. Fix and follow is often detail vision. The light is something you can fix on briefly and kind of follow it. Fix and follow gets a little bit more sophisticated sometimes when we're going for an object of interest rather than a light and they're kind of curious, "Ooh, what are the details of that object?" With the little boy that had very poor vision he did see some of the light, and then he had his cup of water, and it was not in contact with him and he reached directly for it. And then a second time, I had a card with a pattern with a broken corrugated line that he could feel, and he traced it once. And then I took it away. But then I put it in front of his other hand and he reached for it -- no noise, and then he reached for it again. So that child is cranking up his vision when he's aware of an object [Background Music] or he's internalized it in some way -- he went for it. He starts to crank up his vision to anticipate when the object is coming in his space. And now what we do is take that information and help the child to develop his functional vision, if we can, and if he doesn't have functional vision, help him to make adaptations that will help him to interact with others in his environment and his world.