REFERRAL PROCESS FOR VISION SERVICES
By Carmen Willings
Revised May 5, 2017
Having taught students with visual impairments in North Carolina, Ohio, and Georgia, I am aware that it is important to keep in mind that each state and/or agency may have different eligibility guidelines or criteria. The following is the typical sequence to follow when a student is going through the initial referral process.
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Parents/Caregivers, School Nurse, Teachers or Therapists have concerns about a child’s use of vision. Sometimes, the student may identify that they are having a difficult time seeing. Either way, identifying concerns is the starting point of the referral process.
In order to determine if the student meets the criteria for eligibility, the school or agency must receive a current (within one year) eye report from the child's optometrist or ophthalmologist. A school vision screening is not adequate information to determine eligibility as it must be obtained from an eye doctor. If the parents/caregivers have not already done so, they must schedule an appointment with an Optometrist or ophthalmologist to evaluate the child’s vision. It is critical to have current information as the student's vision can change as well as their cooperation with the evaluation.
(For students with Cortical Visual Impairment, a report from a neurologist diagnosing the student with CVI is also permissible.)
Once the eye report is obtained, the Teacher of Students with Visual Impairments (TVI) will review the Eye Report. The TVI will note the acuity, visual field loss if any, the diagnosis and also the prognosis. If the student does not meet the eligibility criteria set forth by the state in which they are served for school based vision services, the referral will stop. However, if the team has concerns about the student's use of vision, the TVI may still provide a consultation to explain the eye report and identify accommodations that would minimize the negative impact of reduced visual functioning. If the student meets or is suspected to meet the eligibility criteria, the referral process will continue.
If the student meets the eligibility criteria, the Parents/Caregivers must sign permission for a Teacher of Students with Visual Impairments to conduct a Functional Vision Evaluation and Learning Media Assessment.
The Teacher of Students with Visual Impairments conducts the Functional Vision Evaluation and Learning Media Assessment. The FVE/LMA will identify how the student's vision loss is negatively impacting their education and identify what strategies or accommodations could reduce the negative impact. This evaluation will also determine the need for vision services and identify the need for any additional vision specific evaluations.
For infants, toddlers and preschoolers, the team will assess the developmental strengths and needs of the child (required) and the priorities, resources and needed supports for the family (optional). Services necessary to meet identified child and family needs are specified. Outcomes (goals) to be reached through participation in EI supports and services are also formulated.
For school age children, a Clinical Low Vision Evaluation is scheduled for students with low vision for the purpose of determining the need of prescribed low vision devices for near and distance viewing. (It is unlawful for a Teacher of Students with Visual Impairments to prescribe low vision devices. These MUST be prescribed by a certified low vision specialist.)
Note: It typically takes weeks to months to receive a Low Vision Evaluation. For this reason, the evaluation process may continue and the IEP will be amended as needed based on the results of this evaluation.
For children who are birth through age 2, an IFSP meeting will be scheduled to discuss the outcome of the evaluation. An Individualized Family Service Plan (IFSP) is a written plan that states child and family outcomes, as identified through the assessment process. It also spells out the services and supports necessary to reach intended outcomes. The initial IFSP is written by a team, including the child’s parents.
If the student is 3-21, and in need of school based services, these will be identified on an Individualized Educational Program (IEP).