Hi! We have the same situation here where I am at. For those students that are referred with Convergence Insufficiency and receiving vision therapy, I like to observe them while they are completing their vision therapy with the Dr. I have found many of the students that have gone through that therapy receive my services at the end. I evaluate, then meet with the team and usually the student is put on a BLV IEP at that time.
I really like that perspective and approach. Its been my goal for years to incorporate push-in time, but I’ve not done it successfully. You’ve inspired me to try doing at least 1 day next year if I can make it work in my schedule.
Its nice to see other teachers who use the same approach I do. that’s one of my best strategies for increasing fluency. I also find that my students are really proud of themselves when they really increase their reading speed.
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Eligibility Determinations for Children Suspected of Having a Visual Impairment Including Blindness Under the Individuals with Disabilities Education Act (OSERS, 2017)
- How did The Eye’s Role in Learning to Read shape or alter your opinion of serving students with Convergence Insufficiency?
It is not altering my opinion of serving students with Convergence Insufficiency, but do we make a team decision about services for that student depending on your role within the district. Should it be vision therapy or OT that does the servicing.
I have a new student that is coming in this fall that was just diagnosed with a Convergence Insufficiency. Her left eye crosses and causes her to lose her place or makes in hard for her to read. As well as making her tired. I will only be consult and it saddens me because I serve a dual role in my district and won’t be able to devote the time I would like. She will have para support and may be moving from an IEP to a 504. But that discussion leads to the next question.
- How does the OSERS 2017 memorandum contribute to your understanding of eligibility for students with visual impairments, including blindness? Evaluate the implications of removing modifiers from state level definitions of visual impairment, including blindness.
Any student with a visual impairment that can not be corrected with glasses could qualify.
I know this is a discussion my Sped director and Process coordinator are pondering due to the fact of a student coming in under an IEP that is getting services for Educational goals. And I struggle with this because we are going to need to large print and use a magnifier to bring text and presentations up closer. So, IEP or 504?
Our district also has a student with a degenerative eye disease, but at this moment is under a 504 and is functioning in class with accommodations and modifications. She has corrective lenses her parents took her to Canada to get. The parents are taking her to a low vision clinic in the fall to help me as well as the district to have a better understanding of possible equipment needs.
It is a lot and I am not sure I answered, but I gave a lot of information. I feel this class came alont when I needed it most as a TVI.
I totally agree. I know I discuss a lot with the OT that I share a room with about this very issue. There is still a lot I need to learn, but I know that since I there is limit TVI’s or resources close in our area, I will be the support. Support is what we seem to be in many cases.
Reading Instruction for Students with Visual Impairments: Whose Job is it?** (JVIB, 2008, p. 197-209)**
- What has your involvement with literacy instruction looked like in your role? What factors have limited your involvement in literacy instruction? Are those factors things that can and should be changed? Why or why not?
I have been a BLV Teacher for over 27 years. I have found myself changing strategies and implementing new ideas quite often. I always make sure I teach Braille instruction and students with low vision as individual as I can. What works with one student may not work with the other. I incorporate the Gen Ed. reading teacher’s curriculum along with the Braille instruction. Spelling lists, grammar worksheets etc. are always implemented with the Braille. When I have students learning the Braille language, I do use a separate curriculum to jumpstart the learning process but I still try to incorporate the Gen. Ed. Teacher’s lesson plans. This has always required intense communication and teamwork which I find myself very deeply involved. I make sure the Gen. Ed teacher, Para, and myself collaborate on a weekly basis to ensure the BLV Student has the next week’s assignments all ready to go! This process has seemed to always benefit my student and results are fantastic. I also find the Gen. Ed. teachers are very responsive to this format because they want to learn more about the BLV world and how they can help.
- Which author’s (Blankenship, Swenson, Farrenkopf, or Holbrook) response is most influential to you? Why?
I really enjoyed Swenson and her thoughts on this topic. I also believe the BLV Teacher should be the main person responsible for the instruction of reading to our students since we are the ones who specialize in the field. Collaborating and promoting a teamwork effort is important to advocate for our students. Through my career I have seen more people “wanting” to learn about BLV and wanting to assist where they can. Especially the elementary teachers where our students learn the basic fundamentals. I also like the quote from this author: “There is no right way of teaching Braille reading.” I take this quote literally to the whole idea of individualized instruction… isn’t that what Special Education is all about? As I teach each of my students, I use different strategies and curriculums that work best for that student.
I know that even though I am not itinerate, my district also utilizes me as a resource special education teacher, so at times I have to rely on the para. This is where a one on one could be trained not to teach, but facilitate in the area of literacy. Or make sure what is going on in the room can be relayed to the TVI. I know this is not always the best choice.
I don’t think districts always get the idea that there is more to a TVI than just teaching braille, modifications to the the environment, or making accommodations to the the students curriculum.
But agreed many times there is an increased probability of a breakdown when executing the lesson.
Eligibility Determinations for Children Suspected of Having a Visual Impairment Including Blindness Under the Individuals with Disabilities Education Act** (OSERS, 2017)
- How did The Eye’s Role in Learning to Read shape or alter your opinion of serving students with Convergence Insufficiency?
I struggle with this definition. In my role as a BLV Teacher, I try to explain to the teams I work with to understand that I am not a vision therapist. As we see educational performance is reduced in the classroom with these students, it’s difficult to agree with this rule due to the fact most insurances don’t cover this for students and many families can’t afford it. Therefore, these are the students we serve because of the ruling. I look at the vision therapy requests reports and try to dissect them as much as I can to “fit” the student with the proper accommodations. I have also noticed most of the the time, the vision therapy doesn’t work as suggested and the student ends up being on a BLV Iep. But, during the therapy session times I consult with teachers to make sure the accommodations from the report are being followed through.
- How does the OSERS 2017 memorandum contribute to your understanding of eligibility for students with visual impairments, including blindness? Evaluate the implications of removing modifiers from state level definitions of visual impairment, including blindness.
I feel this is definitely making our jobs harder. So many referrals for students needing visual therapy and I am not a therapist in this field. It takes a majority of my time. The expectations of administration, teachers, and families thinking we can “fix” ALL vision disorders with caseloads that are beyond able to control.
Hi! Yes, I believe in Swenson’s theory also. I like how she says that there is no right way to teach braille reading. I to individualize each one of my students lessons accordingly. I also like how you incorporate teamwork into your philosophy. I also agree with one of the other replies to your statement. I arrive at different times each day for Braille instruction to avoid the student being taken out of the same class every time I arrive. If the teacher prefers me to …
Thanks for your responses. When it comes to the question as to whether a student should have an IEP or 504, I guess it would depend on if the student will require direct instruction on how to use the accommodations. I think after a little instruction up front, a student and the classroom teacher could figure out how to use a magnifier, a reading guide, large print, etc. without continual instruction, hence the 504 plan.
I agree with your approach to serving students with Convergence Insufficiency. I have also had to explain many times that I am not the vision therapist and cannot provide the prescribed treatment. I don’t have a lot of experience in seeing the efficacy of vision therapy, but from what you’re saying and what others are saying in this discussion, sounds like it’s pretty mixed. I like your approach to help provide needed accommodations and be available to consult and check in to make sure the accommodations are working for the student.
Hi Theresa,
I am a huge fan of Anna Swenson, too! I attended several sessions that she presented at when the AER International Conference was in Jacksonville. I even got a photo with her! 
During my university training, I was fortunate enough to take several braille courses from a TVI who trained under Sally Mangold. I think Mangold’s work goes hand-in-hand with our discussion of braille and literacy instruction. Braille reading fluency is achieved with a solid foundation in tactual discrimination and tracking. It also strongly correlates to reading comprehension! I firmly believe this cohort is necessary though with the shift to more effectively using the science of reading research. I agree that we definitely need to prioritize our instructional time. ~Lacey
Hi Rose,
I appreciated reading about your involvement with literacy instruction. Your successful team is a great example of ‘when the stars align’ to most effectively serve students who are blind or have low vision in an itinerant capacity. Unfortunately, with the nationwide teaching shortages, it seems consistency is rarely the case anymore and collaboration is difficult to schedule and the barriers are significant.
My role as an itinerant was spread over two counties in a multi-district special education unit. As you mentioned, it is almost impossible to keep up with new literacy curriculums when you work in several school districts. Thankfully, I do have a background in elementary education and teaching English learners and students with specific learning disabilities. ~Lacey
Thank you for your suggestions, it is incredible frustrating I will continue to encourage home involvement and support - I know every family is unique but when you see what a difference it make it is hard to be an observer and not be able to make an impact on this front.
Reading Instruction for Students with Visual Impairments: Whose Job is it? (JVIB, 2008, p. 197-209)
- Which author’s (Blankenship, Swenson, Farrenkopf, or Holbrook) response is most influential to you? Why?
I resonated with Cay Holbrook’s explanations on the fact that we cannot separate learning to read from Braille, just like we cannot separate learning to read from print with our sighted students.
I never thought about how students born without vision would need to learn braille, understand the meaning of words and the many nuisances of sentence structure, all while grasping ideas and concepts which leads to reading comprehension. As an individual with sight, it’s extremely confusing to wrap my brain around how to begin. I typically work with students with low vision whereas various accessibility tools are needed, so they basically have word recognition (decoding - D) and language comprehension (LC) which is explained in the video “The Simple View of Reading”
Holbrook explained that Braille and reading should be taught together because it goes hand and hand which I fully understand, but I wrestle with the idea of how it’s supposed to be accomplished universally so students are actively reading at their grade level. Holbrook goes on to explain that as a kid with vision, you were not taught learning to read in one class and print in another class, it was all taught together. That concept blew my mind because she’s absolutely right! I never really thought how I was taught to read, but everything seemed to come together effortlessly, the little that I do remember.
The video, “The Five Strands of Reading” which includes: phonemic awareness, systematic phonics, fluency, vocabulary development and reading comprehension all needs to be incorporated in reading and braille instruction. And as Holbrook stated, as sighted adults, we learn braille in a particular way because we already knew how to read and write. In our minds, we match the dots to the particular letter, and we interpret based on us already understanding the rules of reading and writing. But we learn in a way that we can’t teach braille. As an educator, how am I supposed to teach students reading and braille if I don’t understand how they’re receiving my instruction? As a sighted individual, I cannot fully understand or perceive how they are learning because my brain is hard wired differently.
I thought about Holbrooks’ discussion on combining reading and braille, I rolled it over and over in my brain. It makes perfect sense but do schools have enough qualified educators to work on reading/braille congruently or is it just easier to separate the two? I found Holbrooks’ response most influential because she raises questions on how are we teaching students? How should we teach students in order for them to understand “The Five Strands of Reading”? She tossed out concepts that I’ve never thought about, concepts that I didn’t even know to think about. I will definitely need to learn more about this subject so I can best educate my students.
I am on the same page as you. I’m glad that kids on the cusp of vision impairment can now get the services they need, such as the loss of one eye when the other is functioning well.
While it is good that they can get the support they need, it does enlarge our caseloads. Likewise convergence insufficiency is another area that causes our caseloads to explode. Just 2 years prior to the paper, I had a family that was fighting tooth and nail to get services for their child with convergence insufficiency. We had a vision therapy agency that moved into my area and was diagnosing a lot of this. We dealt with it by making sure appropriate modifications and accommodations were in place for the child.
Thanks for your response! I have found Marnee Loftin’s book and webinars very helpful when (trying to) work with school psychologists to determine if a “VI only” student who struggles to read has a co-morbid learning disability. (Marnee was the school psychologist at Texas School for the Blind and now is a consultant). The reluctance to identify dyslexia (or even use the word!) is strange to me because it seems that Child Find tasks school systems with the responsibility to actively search for and identify children who may require special education services due to disabilities. (Not that I am into putting “labels” on students! But I typically explain to IEP Teams that students who are “VI only” and are not identified as having an SLD could face obstacles in getting the support they need, especially if the student moves to a new school.
Your comment that you “have several low vision young boy students who really need more interventions, but because they are below 3rd grade, it seems they need to fail before their issues are taken seriously” is reflective of many students, not just those with VI! The early years (K-3) are crucial for students to develop fluency and comprehension reading skills, making intervention essential and timely!! With struggling readers in elementary school, the challenges with reading have a domino effect over time!
Here’s some info from Marnee Loftin that has been helpful to me:
Video: Can Students with VI Have Dyslexia?
[Can students with visual impairments have dyslexia? | National Center on Improving Literacy]
Video: What are some signs a student with visual impairment may need an evaluation for dyslexia?
[What are some signs a student with visual impairment may need an evaluation for dyslexia? | National Center on Improving Literacy]
Her book: Making Evaluation Meaningful
Making Evaluation Meaningful | Texas School for the Blind and Visually Impaired
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I also appreciated Anna Swenson’s article. I believe there are many “right” ways to teach braille. I’ve approached each student individually and have used most of the curriculums out there including my own that I’ve created.
I also liked the article that stated that it takes a community and the one that believes that TVIs should also be certified in reg. ed and/or reading. I’m thankful to have my BS in Elementary Education and my Masters in Specialized reading. It has helped me become a better braille reading teacher.
I agree in that the TVI should develop and teach the lesson. Having worksheets or other activities that support staff (paraeducator, braillist, OT) can use to help reinforce concepts or maintain skills is ideal. I think when the student realizes that there are others providing the same information in different presentations may help the individual to process the importance of what is being taught. We all learn in different ways and sometimes the presentation can make the difference in making the information click. I know working with older veterans and teaching them about their vision and using the strategy to “Teach Back” (asking the person what they heard from the information presented) I often get a totally different story of the information imparted. Makes me stop and figure out how to present the material in a different manner the person might better understand. But overall, I think there are many team members that can help support the TVI in helping the student learn to read.
I appreciate your statement above and have felt similarly with my own students! For example, two of my students, twin boys with
achromatopsia who will be starting high school in August, struggle to read mightily despite interventions from the SLP (Wilson Reading Program). Each year, I find myself explaining to the parents and teachers that the boys’ reading deficits are language-based (phonological awareness) and have nothing to do with their vision!
Regarding your statement excerpted above, I’ve frequently joked that vision gets blamed for EVERYTHING—even why Johnny doesn’t like cabbage!
Somehow I came across this wonderful handy-dandy publication “Vision Therapy and Educational Visual Impairment Services: What’s the Difference?” from the Pennsylvania Training & Technical Assistance Network. It thoroughly explains the difference between special education VI support/services and vision therapy. Here’s the link: https://www.tsbvi.edu/tx-senseabilities/issues/tx-senseabilities-spring-2023-issue/vision-therapy-and-educational-vi-services
Regarding supporting students with a diagnosis of convergence insufficiency… while I do take into account the optometrist’s diagnosis, IDEA requires us as TVIs to thoroughly evaluate the student for eligibility, not just go on a medical report. Do you agree that the results of the FVELMA are what should drive SPED eligibility as well as the accommodations that will provide the student access to his or her educational materials?
Finally, what also concerns me about vision therapy is the premise that it can help students with learning disabilities like dyslexia! The American Academy of Ophthalmology (AAO) points out that while vision therapy might be used for certain eye problems like convergence insufficiency, it’s not clear how well it works for bigger learning issues like dyslexia.
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