VIP Evaluation Flashcards
Steps to a VIP evaluation
Comprehensive exam
BV evaluation
VIP evaluation
Three component model of vision
Visual pathway integrity
Visual efficiency
Visual information processing
VIP history
- Parents should be allowed to speak freely and express concerns
- Parents often feel inhibited by the presence of their child
- May be necessary to interview the parent and child separately
- Important to be sensitive to the child’s feelings
Taking a good VIP history
- who referred you?
- visual difficulties?
- any behavioral issues (attention or impulsivity?)
- schoo lperformance?
- best and worst subjects
- letter or number reversal
- any repeated grades
- performing to the child’s potential
- receive any special services from school?
- completed any evaluations? Psychoeducational eval?
- receiving any other outside therapies?
- do they have an IEP or 504?
- specialized seating in the classroom?
- private tutoring?
- any other parental concerns?
Birth history and VIP testing
Want to know about the pregnancy and labor and delivery
Two parts of psycho eval
Psychologist: conginitive and emotional testing
Learning specialist: academic achievement testing
Purpose of psychoed eval
Evaluate a discrepancy in the kids aptitude and level of achievement
Where do ODs come into play with psyched eval
Visual perceptieual, auditory perceptual skills, ad memory
Cognitive testing and psychoed eval
- assessment of various abilities including language, memory, auditory, and visual perceptual skills,
- performance levels in math, reading, and writing
- include information regarding the kids learning style, type of instruction, that would be successful and history of previous instruction
IQ testing
100 is the mean
- between 85-115 is where 2/3 of the population sits
- if outside, going to be concerning
Wechsler intelligence scale for children IV
IQ testing
Achievement testing
Determine achievement levels in all academic areas
Example:
- decoding: abiltiy to recognize words and apply word analysis strategies
- reading comprehension-reading in context of representative text material
Emotional or personality testing
- direct measure: clinical interview
- projective (indirect) measure: sentence completion tests and drawing interpretation
VIP testing
Establish a standard battery of tests to elicit information about each important function
Each diagnostic entity has identifiable characteristics, signs, and symptoms-look for them
These disorders may not exist in isolation (patients may present with multiple deficits)
Administration of VIP tests
- Core battery: admintered to all patients
- auxiliary tests: administered when necessary (refine the diagnosis)
4 areas looking to evaluation with VIP
Visual spatial dysfunction
Visual analysis dysfunction
Visual motor disinfection
Auditory visual dysfunction
Visual stationary dysfunction
Bialteral integration
Laterality
Directionality
Visual analysis dysfunction
Visual discrimination + spatial relations
- visual closure
- figure ground
- form constancy
- visual memory
Visual motor dysfunction
Visual motor integration
-fine motor skills
Auditory visual dysfunction
Audturoy visual integration
Observation of performance for VIP
- vital to observe the way in which the child achieves a particular result
- helps one to better understand the child’s abiltiy
- aids in planning a treatment program
- provides info into the degree of difficulty
- evaluates any compensatory strategies used to complete a task
- attention and cognitive style must be considered in the deign of a visio therapy program
Reflective style
Work slowly and produce few errors
Impulsive style
Work quickly and make more errors
Z scores
Distance form the mean
0=equalvelnt of the mean
Higher=greater deviation from the mean
Positive=above average, negative=below average
Scarred score
10 indicated that the child’s performance is probably average for his age
Standard scores
A derived score with assigned a mean of 100 with a standard deviation of 15
Percentiles
- raw scores must be converted into percentile scores
- 50th percentile is equal to a scale score of 10 and standard score of 100
Age equivalent
- represents the Rae score that us normal for that age
- not used that often
Analysts of VIP test results
- significant deviation from the expected findgins indicate problems in that particular area
- scores between the 15th and 50th percentile are considered suspicious findgins and may be clinically significant when compared to the child’s overall level of functioning
- general rule: a score is significantly low if the patient scores below the 15th percentile on any given test (greater than 1 standard deviation)
Diagnosis in VIP testing
- analysis of case history
- actual test results
- observation of the child’s performance
- review of all previous reports and testing
Goals of optometric intervetion in VIP
- primary role: diagnosis and treatment of underlying vision problems
- foals of optometric intervention should be specific or problem oriented
- optometrists do NOT directly treat a reading or learning problem
- recognize that patients may need a variety of services
ODs may provide..
- Comprehensive diagnostic services-primary care, visual efficiency, visual information processing
- Managemtn of treatment services-refractive correction and therapy for visual efficiency and VIP disorders
- Information to assist the educator in devising a more suitable educational program for the individual student relative to his/her visual problems
Other services for kids with VIP problems
- educational remediation
- psychological counseling
- occupational therapy
- speech/language intervention
ODs role in VIP
- should not make suggestions of rentetion or special class placement unilaterally
- imperative that an OD act as a member of the multidisciplinary team
Don’t make a diagnosis
Communication with educators and VIP
Call them
Provide into needed for parent
Send a letter to the school for accommodations
Communication as with other professionals in VIP
- often referred by another professional to rule ou vision problems that interferes with learning
- important to provide written report to summarize the evaluation results and recommendations
- coordinate the treatment with any other treatmetns that the patient is receiving
Limitation of abduction, adduction, or both
Duanes retraction syndrome
Things about Duane’s retraction syndrome
- congential condition with no clear etiology
- remember to count the number of Ds
- associated with globe retraction (enophthalmos) and narrowing of the palpebral fissure with aDDuction
Browns syndrome
- superior oblique tendon sheath syndrome
- can be congenital or acquired
- can be present with a small hypotropia in primary position
- limited elevation during aDDuction
NRC
Fovea of each eye has the same visual function
- if the fovea of one eye is deviated compared to the other due to strab, diplopia and confusion will occur
- if the fovea misalignment develops before age 5, the visual cortex will respond by developing ARC to elimate diplopia a d confusion
ARC
A non fovea point of the deviated eye is linked to the fovea of the other eye
- this ensures that the object will be perceived in the same direction by each eye, eliminating diplopia and confusion
- only occurs under binocular conditions (monocular conditions=eccentric fixation)
Angle of anomaly
Difference between the objective and subjective angle of deviation
