Hi, Angela! I agree with you in that I, too, have felt that even with all the FVAs, LMAs and CVI assessment tools (including The CVI Range and the more recently released Perkins CVI Protocol), there are still “unique” situations which come about while assessing our students and their current visual functioning. I like using prescribed protocol assessments, as I feel I am bound to forget to assess something when I do not use protocols. However, as you stated in your response, there is no good single, standard way to assess our students and their vision. Which makes our job more difficult to rely on our experience of attempting to see all, assess all, and determine what may benefit our student(s), by means of accommodations, modifications, etc. While I agree with your last sentence of needing to continue to assess the student across many different environments at different times of the day, as an itinerant TSVI, I am rarely afforded the luxury to assess a student over multiple days/times, due to my schedule. In that sense, I really do feel I am more prone to missed opportunities to observe/interpret potential CVI behaviors.
“1. In what ways do results of the 2D image assessment intersect with data collected for the Functional Vision and Learning Media Assessments?”
This is a timely question, as I am currently developing a professional development session focused on the Learning Media Assessment (LMA). In our program, we recommend the use of the 2-D Image Assessment as a supplemental tool when evaluating a student with CVI—specifically regarding their visual access across the educational environment.
The 2-D Image Assessment offers valuable insights into how a student perceives and processes two-dimensional images, which are foundational to early learning and literacy. In lower elementary grades, for example, worksheets frequently rely on black-and-white 2-D images to support skills such as letter recognition, phonemic awareness, and vocabulary development. Without understanding how a student with CVI interprets these images, we cannot accurately determine whether they have meaningful access to instruction.
If a student demonstrates difficulty recognizing common 2-D representations, this may suggest that traditional visual materials are not appropriate as the primary learning channel. In such cases, modifications—such as high-contrast color photographs, simplified visuals, or even 3-D or tactile representations—may be necessary.
The results from the 2-D Image Assessment directly support the LMA process by helping the educational team determine which sensory channels and media formats best support the student’s learning. For students with CVI, this tool plays a critical role in bridging the gap between what their eyes see and what their brain understands—ultimately informing how they access the curriculum, and which instructional strategies will be most effective.
2. Analyze how individualization of the 2D image assessment might lead to more accurate conclusions about a student’s needs. What variables (e.g., cultural relevance, personal familiarity, sensory preferences) should be considered?
I really found the article on Assessing 2D image recognition for students with CVI helpful, as I often work with students with CVI and complex needs who are nonverbal and collaborating with SLPs on communication devices are an important part of programming for my students. The images that are often used on Go Talks or other communication devices are abstract PECS and have no relevance to the students. I often have to explain how real pictures of the actual items that the student is using is more effective for them to try to recognize. Also, that pairing the real objects with the actual coloured pictures are a starting point before relying on the image alone. This also helps with object calendars as opposed to a visual calendar.
This is why having the 2D image assessment more individualized to what the student interacts with and is familiar with is more meaningful.
Also, having parent input for the 2D image assessment would be greatly helpful, bringing items and actual pictures of items from home to assess whether the student recognizes and can discriminate the item amongst similar items. The data from this type of assessment would be more meaningful as when I looked at the list of pictures in the attached article, the items were out of context and could have little meaning to my students. Also, throw in there if they are feeling unwell, or in new surroundings at the beginning of a school year (new classroom), then it would be very difficult to gauge how much visual discrimination the student has based on a standard 2D image test, as opposed to pictures from familiar toys and items (sippy cups, lunch bag) from home.
The cultural relevance is also important to consider, as not every family/culture interacts with the same types of items at home. Some pictures of daily activities may seem to be second nature for us as the assessor but could have zero meaning to the student. Take for example the picture of an elephant or horse — if the student has not been to the zoo or seen a horse up close due to various reasons, those pictures would be meaningless and quite abstract for them. There is so much to consider and so many layers for assessing 2D image recognition and understanding that I feel we need to continue to assess our students throughout the school year, as they build up their visual library of images, items and the contexts within which these images hold meaning to them. **
When reading your discussion on CVI assessments and the related article, it really occurred to me how much information we are missing about our current and potential CVI students when it comes to current and ongoing assessments. I am familiar with the CVI Range by Dr. Roman Lantzy, where parent interviews, observations and direct assessment are used to place the student in one of the 3 phases of the CVI Range. I have found, based on this current course and understanding the 16 Manifestations of CVI and how to incorporate them into an FVA and LMA, how much more information we can gather to help us with programming and supporting our students. What I am also struggling with is what do we turn to as a standard for CVI assessments across the board? Similar to the questions you have raised and the importance of having a standardized and validated set of assessments for CVI that we can all refer to in our practice.
Great posts and I fully relate to the immensity of our roles and how many more students we need to service and assess — many of whom who have not yet been diagnosed! I find when I visit schools I notice students that are not on my caseload and I ask the Resource Teacher if there is an eye report for those specific students and the reply is no. But then I can see the students exhibiting CVI tendencies and I know we can do more for them to assess and program for them as multi needs and exceptional students. There is so much more to learn as a TVI and I am finding that the assessments are lengthy and the caseloads are large! Time is limited and as we are seeing a growing number of students being diagnosed with CVI, I am wondering if the need for more TVIs and more interdisciplinary collaboration is needed to balance and meet the growing needs.
From an itinerant TSVI perspective regarding using only a single-time assessment like the 2D image assessment to capture a student’s true visual ability is that while obtained information may be beneficial, it would also most likely be extremely limiting. The 2D image assessment only determines if a student best recognizes photos, drawings, colored forms, iconic pictures, or symbolic pictures. However, in order to gain a true overall understanding of a student’s current visual functioning, one must also gather information from additional comprehensive assessments, such as the Learning Media Assessment (LMA) and Functional Vision Assessment (FVA) – both of which help determine the most accessible way to present learning materials/activities to students. In addition to being limited as a single-use assessment, 2D images do not necessarily provide information in real-time, natural environments, as the student most likely may be assessed outside of their typical educational environment. In as such, additional factors, such as lighting, contrast, glare, background clutter/noise may play a huge role in how a student with CVI may react to assessment-like manipulatives (i.e. 2D images) in a typical classroom environment vs. a clinical/assessment-type environment.
As far as additional/complementary methods which may be used (in addition to the ones already mentioned above – FVA and LMA), classroom observations (in multiple settings and/or at different times during a school day) may show what time of day and/or what kind of classroom set-up may best benefit the student in their active learning environments. One student may be more of a morning person and works well with having their heavy academics at the beginning of their day. Another student may work best within their core academic classes after lunch/recess. Being able to observe students over multiple sessions and/or at varying times throughout the day may provide invaluable information to help determine best options for the student.
[Barbara_Hollick]
Preteaching the images is a great strategy and we do this as well. We also remove images that are not needed for understanding as they add to the clutter making the materials less accessible. With administrative and even state permission, I have done the same with any standardized assessments for these students as well. It’s critical to their ability to complete assignments.
HI Vicki!
I couldn’t agree more with you comments on fatigue, changes and overload. These can create huge barriers for our students and are often overlooked. Some students will shut down under any of all of these circumstances and better understanding the impact is so important. Our students, at times, are viewed as defiant when the issue lies in the 3 areas you mentioned. I have one student who was working hard on a typing program for 10 minutes using her iPad and an external keyboard. She stopped suddenly after 10 minutes and just sat. When she was asked what was wrong she said, “It’s hard.” Further questioning revealed, “I can’t see it!” The font was enlarged more than it was and she beamed stating, “That word is believe! Can you make it that big for the rest of it?” Once she completed the sentence she said, “I think I need a break now!” She was in second grade at the time and it was her first time being able to share such information.
I agree with your statements. I do a lot of task based observations in my assessments and probably do use this as my primary means of obtaining information. I think it’s because it’s the real world for a student and setting up specific assessment components is more staged and may not provide me with as much information. I can also observe a situation and try to validate the observations with specific tasks.
I have had similar experiences and have screened and/or assessed several students over the last few years who demonstrated CVI indicators but don’t show some of the classic pieces. I have not quite figured out how to address these concerns but do explore accommodations for the areas of need to see if they work. I am cautious as I cannot diagnose CVI and we have no eye doctors in our area who can so many families never get that medical diagnosis. I do appreciate how most tools have “CVI suspected” as a choice when we do assessments.
I share the same sentiment as you regarding the “yes/no” system for determining CVI in a student. The more I research CVI and thanks to this course, I am more aware of the spectrum of CVI. Not every student with CVI is going to exhibit all of the CVI characteristics. As TVIs we need to be fluid in our approach of assessing students with CVI, including those that present with other disabilities. Thanks for your post!
Megan, I appreciated your post and how you are working with other service providers to best assist your student in accessing materials. I think it is imperative that we continue to assess students on their access using the 2D image assessment throughout the school year as the child grows and experiences new concepts. It’s great that you can use some of what you learned in this course to help guide your teaching for the next school year!
Thanks for your reply - and yes it is a tricky thing! We also are very limited in the eye doctors in the area who will even consider a diagnosis of CVI, and my experience with that office is she looks to me/my colleagues to let her know if we are finding CVI characteristics. While I truly appreciate that trust and acknowledgement of our connection to these kiddos, it to some extent puts more pressure on us. BUT if we can identify these students and even just address the aspects that are providing challenge to them then it is a win of sorts!
Thanks for replying!
Hello. I LOVE that term fluid … that really captures so much of what we do. Sometimes when I’m working with a school/district that is already overwhelmed and over budget (which is virtually all of them) I am feeling like I’m just applying more pressure to them. However every child deserves access to their education and social life to the best of their abilities. It is our responsibility to educate them on why this is so important.
Thanks for your reply!!
Hi Angela. This is the area that “keeps me awake at night” so to speak - I do worry about missing things or not capturing enough of the whole child. I was working with one tricky student this year and he was so confusing I kept bringing it back to my colleagues to get their input and feedback. And this class is definitely redoubling my thoughts and intentions to chase the CVI thread for him because in my heart I feel it is there (he has neurological complexities and seizures). It really is about the whole child, and not what is easy for the district.
Thanks for your post!
I also wish that there could be a prescribed protocol that we could use, because like you said, I seem to always forget to assess something or run out of time in my session to gather all of the information and need to go back. I am also itinerant and feel that limit on the ability to see children at different times and in different environments, though I know that is very important information to gather!
Hi Lynn,
I have also witnessed the same thing with my students. It’s also a reason why I stress the importance of self advocacy skills with my students who are verbal and can communicate their fatigue. With my students that are non-verbal it’s more difficult to determine when visual fatigue is affecting them. Loads of documenting their behaviors and trying to figure out the puzzle.
1. In what ways do results of the 2D image assessment intersect with data collected for the Functional Vision and Learning Media Assessments?
The data received through the 2D Image Assessment can be integrated into a FVA/LMA. The results would show how the student is functionally interacting with visual images. Specifically, the student’s ability to recognize different levels of contrast, determine color and respond to thin vs bold lines. The results would then help identify what type of visual accommodations the student may need in the classroom. The results would also be able to determine whether visual information is effective for the student or if they would benefit from tactile or auditory support as a learning medium.
I definitely agree that it is important to consider cultural relevance when conducting the 2D assessment. Like you said, if the image is of an object unfamiliar to the student, asking them about it will not be super helpful. I like the idea of customizing the assessment for the individual student. I think the results would be much more applicable to what the student can functionally see and help guide how we can support them.
I agree with your point about how it’s essential to continually research and explore resources to ensure our students don’t “fly under the radar.” Staying current with best practices is crucial, especially as our field continues to evolve. I believe cohorts like this one are so helpful, not only for gaining new knowledge, but also for the opportunity to collaborate with fellow professionals. This will help us bring improved strategies that we are currently learning about to our practice as we work with students in the upcoming school year.