VISION CONCERNS IN CHILDREN

By Carmen Willings
teachingvisuallyimpaired.com
Updated October 4, 2017

The process of referring a student with a suspected visual impairment for school based vision services begins when there are concerns about a child's vision or the lack thereof. If you have a concern about a child's vision, the first step is to take the student to an optometrist or ophthalmologist.

For younger children in particular, it is important to find a doctor who specializes in working with children. If the child has additional disabilities, it is particularly important to locate a doctor who specializes or is experienced in working with students with multiple disabilities. The ophthalmologist or optometrist will need to determine the cause, receive a visual diagnosis, approximated visual acuity, and determine if the student needs to be referred for school based vision services (or early intervention for children birth through age 2). The following is a list of the ABC'S of vision problems. Some of these concerns may be related to other medical conditions or medications. It is always best to address any concerns with the student's pediatrician as well.

Appearance

• One or both eyes turn inward or outward, or one is slightly higher or lower than the other eye.
• Crusty or red eyelids or red eyes.
• Eyes that are in constant, rapid motion.
• Drooping eyelids(s)
• Pupils of different sizes, or different reactions to light and accommodations.

• Glands that are enlarged, inflamed, or otherwise infected.
• Excessive tearing, light sensitivity, lid spasms.

Behavior

• Lack of or reduced eye contact.
• Shows poor eye muscle coordination.
• Covers or closes one eye for critical seeing.
• Thrusts head forward to see distant objects.
• Tilts head to one side for critical seeing.
• Tries to "brush away" a blur.

• Rubs eyes often or blinks often while reading or looking at books.
• Frowns or squints when looking at or trying to see distant objects.
• Stumbles often over objects, is awkward
• Holds book, toy, or picture too close or too far away.

Complaints

• Sensitivity to light.
• Burning or itching of eyes or eyelids.
• Seeing double, or blurred vision.
• Headaches, usually after a critical visual task.
• Nausea or dizziness.
• Eyestrain, fatigue.

School Related

• Difficulty copying from the board.
• Difficulty with handwriting.
• Confuses similar words.
• Needs more light to read than expected.
• Reading comprehension deteriorates with time.
• Doesn't read to the end of a sentence before going to the next.
• Head moves instead of eyes when reading or looking at pictures.
• Loses place when reading and skips lines.
• Needs to use finger as a line marker.
• Difficulty solving maze puzzles and word searches.
• Math errors due to misalignment of numbers.

Vision Concerns Checklist

This checklist, available free for download on the Printables page, can be used to help those outside the vision field identify vision concerns and know when to make a referral for vision services.

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TVI’s Guide to Teaching the ECC: An Activities Based Curriculum for Teaching Students who are Blind or Visually Impaired
The TVI’s Guide to Teaching the ECC is a digital pdf available for download. It is designed specifically for fellow itinerant Teachers of Students with Visual Impairments (TVI’s), and consists of over 400 activities and topic areas of discussion for instructing students in the Expanded Core Curriculum. The activities are age-neutral and multi-sensory and therefore can meet the needs of the broad range of students served on an itinerant caseload serving. The activities can be individualized to the students various learning modalities and scaffold in order to challenge students but ensure success. Select those activities that align with the student’s learning objects based on the student’s unique visual needs and academic and developmental level. In addition to the core activity areas, each of the 32 Thematic Units incorporates additional unique ECC concepts and skills providing you with a years’ worth of activities. These units are cyclical and can be used repeatedly to help students build on prior knowledge and develop a deeper understanding of concepts. Each unit includes suggestions for activity adaptation associated with the unit. These include lists of objects, possible community-based experiences, environmental print, poems, children & young reader books, children's songs, pop culture songs, movies, and websites.


In addition to the book, the following two supplements are included:
·      TVI’s Guide to the ECC Concept Checklist
·      TVI’s Guide to the ECC Activities Checklist


For complete product details and additional images, visit the TVI's Guide product page.


TVI's Guide to the ECC Product details
·      Digital pdf download: 346 pages (11 pt font)
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Visual Efficiency & Near Magnifier Fluency Worksheets: TVI's Guide to the ECC Grab and Go Supplements
The Near Magnifier Fluency Worksheets is a Grab and Go supplement to the TVI's Guide to Teaching the ECC. This workbook is a pdf download that can be printed on demand for use with students. It contains five different types of worksheets for developing visual motor skills and near magnifier fluency skills particularly with the use of a video magnifier. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to each of the 32 ECC Thematic units. The worksheets, along with a list of environmental print for each thematic unit, are designed to help students refine their visual motor skills while reinforcing ECC concepts presented in the thematic units.  


For complete product details and additional images, visit the Visual Efficiency & Near Magnifier Product Page.


Visual Efficiency & Near Magnifier Fluency Worksheet Details:
·      Digital pdf download: 210 pages
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Thematic Keyboarding & Braille Fluency and Maintenance Worksheets: A TVI’s Guide to Teaching the ECC Grab & go Supplement
The Thematic Keyboarding & Braille Fluency and Maintenance Grab and Go ECC worksheet packet is a print on demand workbook that contains worksheets in print and simulated braille to use for data collection. Present the student with a hard braille copy and use the worksheets to document accuracy and fluency in reading braille. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to the ECC Thematic activities presented in the curriculum guide. These word lists and sentences will help the student refine their keyboarding or braille reading skills while bridging ECC concepts presented in the thematic units. Although the lists and passages can be produced using a manual braillewriter, you may also copy and paste the passages into any braille translation software for quick production on an embosser. They may also be entered into a typing program such as APH’s Talking Typer to build keyboarding fluency.


For complete product details and additional images, visit the Thematic Keyboarding & Braille Fluency & Maintenance Product Page


Thematic Keyboarding & Braille Fluency Worksheet Details:
·      Digital pdf download: 338-page print and simulated braille worksheets
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Thematic Vocabulary Cards and Checklists: Grab & Go ECC Supplement
The Thematic Vocabulary Cards and Checklists Grab and Go ECC supplement is a 446 page pdf downloadable print on demand workbook that includes 2940 vocabulary card on 3 1/2" x 2" templates divided by each of the 32 Thematic Units along with a checklist of each unit words in print and simulated braille. As a companion to the TVI's Guide to the ECC, the vocabulary cards correspond to the ECC Thematic activities presented in the curriculum guide. 


Additional Use:
Teachers of Students with Visual Impairments can have a extremely varied caseloads. It is possible to go several years without having a student on your caseload who requires braille instruction. Like other skills, if you do not practice your braille regularly, it is easy to lose those skills. Use these checklists and cards to maintain your braille skills. Fold the checklist along the line dividing the print from the braille. Choose to either read the print and produce the word in braille using a braillewriter or read the simulated braille and decode it. Finally, these vocabulary cards and checklists may be used with family members or peers who are interested in learning and practicing the braille code.


For complete product details and additional images, visit the Thematic Vocabulary Cards & Checklists Product Page


Thematic Vocabulary Cards and Checklists Details:
·      Digital pdf download: 446-page print on demand resource
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


BONUS!
Lotto Cards
The LOTTO Cards Grab and Go Supplement includes 37 theme related unit cards along with activity suggestions that support activities within the TVI's Guide to Teaching the ECC.


On My Way File Folder Cards
Print and use these cards to represent locations the student may visit that are related to the current thematic unit. Use these with the On My Way File Folder Game outlined in the TVI's Guide to Teaching the ECC p. 27.

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