Comprehensive Evaluation Student: Lily Aaron DOB: 11/28/1995 Age: 18 years 3 months Evaluator: Ms. Martinez Parents: Mr.

And Mrs. Aaron: (615-555-1234) Tennessee School for the Blind Assessment Dates: February 2014 This assessment (FVA, LMA, & ECC) was conducted as part of a re-evaluation process to demonstrate a continued impact of the disability on the general education programming, and as an initial evaluation of the student, Lily, at Tennessee School for the Blind. A quality assessment incorporates a review of all records (educational, medical), interviews of all team members (Including student as appropriate) for visual functioning, primary, secondary, or tertiary sensory channels for learning/ literacy, and expanded core curriculum (ECC) areas of strength and need, observations in multiple environments (school/ home/ or community) over multiple days for visual functioning, primary, secondary, or tertiary sensory channels for learning/literacy, and ECC areas of strength and need, and formal and informal tests. The assessment consisted primarily of observations of Lily in several environments, conversations and interviews with Lily and her educators and of formal and informal testing conducted at her school. Lily was entirely cooperative throughout the assessment, although at times she demonstrated slight frustration over lengthy assessments. It is the opinion of this assessor that the findings described below are accurate. All assessments were conducted in English, Lilys native and only language. Grade: 12th

Formal assessment tools: Learning Media Assessment of Students with Visual Impairments, ECC assessment as provided by Tennessee School for the Blind, and Foundations of Low Vision by Corn and Erin, Basic Reading Inventory 11th edition by Jerry Johns and Ishiharas color blindness test. Background Lily Aaron lives with her natural parents and a younger brother in East Tennessee on the weekends. During the week she resides at Tennessee School for the Blind (TSB). Lily started at TSB at the start of the 2014 calendar year. She indicated that attending the school was her idea, and she intends to graduate June 2015. Lily has an understanding of her eye condition, including the potential future deterioration of her vision. She is a happy and well-adjusted student who claims transitioning to TSB was a major factor contributing to her happiness. Lilys visual impairment is a result of cone-dystrophy secondary to Bardet-Biedl Syndrome Eye Health Report

Date of last eye Exam: 02/25/2013

Completed by: Dr. Eye Ball

Visual Condition, Etiology: Lily has a diagnosis of cone dystrophy secondary to Bardet-Biedl Syndrome. History and Description: Bardet-Biedl Syndrome is characterized by rod-cone dystrophy, truncal obesity, postaxial polydactyly, cognitive impairment, and renal abnormalities. It can often impair speech and some degrees of cognitive functioning as well as motor skills such as walking and standing. This syndrome can also affect the heart, liver, and digestive system. (GHR.GOV) Cone dystrophy is a term used to describe a group of disorders that affect cone cells in the retina. The cones are what allow for eyes to see color, and also aid in spatial acuity. Cone dystrophy often leads to decreased central vision, reduced color vision, and sensitivity to bright lights. (ssc.education.ed.ac.uk) Distance Visual Acuity:
With correction: OD (right) OS (left) OU (both) 20/100 20/200 20/100 Without correction: NA NA NA

Near Visual Acuity.

With correction: OD (right) OS (left) OU (both) 20/70 NA 20/70 Without correction: NA NA NA

Glasses prescribed: Yes Refractive error: Myopia Field Restriction: N/A Prognosis: N/A Re-examination date: 02/28/15 Optical devices prescribed: Near: Dome magnifier

Distance: Monocular

Cumulative folder review Other disabilities (explain): None Other pertinent Medical Information: None Schools Attended: Tennessee School for the Blind (Jan 2014- Present) Daniel Boone High (2010-2013) Excessive Absences: None

Functional Vision Evaluation The functional vision evaluation has three purposes: a) to determine whether a visual impairment interferes with the learning process, b) to determine the quantity and quality of functional vision for planning intervention strategies to maximize the childs potential to use ones vision purposefully, and c) to determine certification or recertification eligibility for vision services. Assessment environments: Information for this evaluation was collected through: Observation and Interaction with student Direct contact and testing which took place in a familiar classroom setting Observation that occurred directly outside of the classroom on in direct sunlight Lighting: The lighting of the room in which the indoor portion of the assessment occurred was fluorescent lighting that came from overhead. The brief outdoor portioned of the assessment involved natural sunlight with no cloud obstruction. Appearance of the eyes: Upon observation, Lilys eyes appeared to be free of redness, irritation, cloudiness, or infection. Lilys pupil reactions were typical. Lilys eyes did not indicate nystagmus. Lilys eyes appeared to be properly aligned Lily exhibited an appropriate blink reflex Convergence and Divergence were both observed and typical Lily was observed to track and systematically scan. Eye dominance was determined to be right. Field of vision Upon testing, Lilys field of vision appeared to be normal and balanced on all sides. Color Discrimination: In a functional setting, Lily demonstrated difficulty with color discrimination, especially among colors with similar shades and hues. Ishiharas color blindness test was used to determine the degree of color impairment and it indicated red/green color blindness. Lily was aware of her poor color discrimination and managed to compensate in functional situations appropriately. Light sensitivity: None Near Acuity/ Discrimination:: 20/60 Distance Acuity/ Discrimination: 20/120 Contrast Sensitivity: Yes Current Print Functioning: Lily correctly read the directions on a box of cake mix holding the container 5 inches from her eyes. Lily was unable to clearly read the size listed on a teaspoon when the font was about 8 point font .

Lily was mostly successful in reading a recipe with 12 point font when holding the sheet 10 inches from her face. Lily was most comfortable reading print about 18 point font with a distance of about 10 inches.

Learning Media Assessment: The learning media assessment is an objective process of systematically selecting learning and literacy media for students with visual impairments. This assessment process guides the educational team in making decisions on the total range of instructional media needed to facilitate learning for students with visual impairments. The learning media assessment, when used in a meaningful and holistic manner, will provide essential information needed to develop appropriate programs for all students, regardless of the level of vision or severity of additional disabilities. The assessment materials used included the completion of the continuing assessment forms in the Learning Media Assessment of Students with Visual Impairments (Koenig & Holbrook) and Basic Reading Inventory 11th edition by Jerry Johns Handwriting Lily can produce neat and legible print with a pencil and regular line paper. She is able to read her own handwriting with ease and thus is able to use handwriting as an efficient means of communication. Lily writes at a distance of about 6 inches.

Primary Learning Media: Vision Sensory Channels: Primary: Vision Secondary: Tactual Tertiary: Auditory

Primary Literacy Media: Large print

From Johns Basic Reading Inventory:

Oral Reading Words Per Minute Comprehension Level 100 Frustration level- 11 Instructional reading level- 10th Independent/instructional reading level 9th. Silent Reading 132 Frustration reading level- 11 Instruction reading level- 10th Independent/instructional reading level- 9th

Word List Grade Level:

Grade 12 at an instructional level

Expanded Core Curriculum Screening AT/Technology: Strengths: Lily is able to navigate a computer with the use of screen magnification software. She is also able to use and operate a CCTV when needed, though seldom does. Needs: Lily would benefit from use of assistive technology in her daily, life she admits she uses assistive technology at home but not at school. Lily would also benefit from instruction in keyboard shortcuts in order to increase her speed on the computer. Career Education Strengths: Lily has a grasp on her post-secondary interest and has been researching her options related to furthering her education after high school. Lily is able to explain her eye condition and her needed accommodations effectively to superiors. Needs: Lily would benefit from further exploring the level of education that she wishes to obtain- if she would like a degree or a certification. Lily often fails to bring materials to class expecting that she will not need certain supplies. Compensatory Skills: Strengths: Lily demonstrates basic compensatory skills through using tactile means to gain information when needed. Lily is also proficient at expressive and receptive communication. She has an instructional reading level at 10th grade. Needs: Lily may be benefit from, considering the degenerative nature of her visual impairment, to begin rudimentary instruction in braille related skills. Independent living skills Strengths: Lily has shown tremendous strength in skills related to cooking, organization, and household chores. Needs: Lily would benefit from additional household management lessons including budgeting and money management. She may also benefit from learning to cook healthy meals for one, and grocery shopping related skills in order to maintain develop independence upon graduation. Orientation and mobility skills Strengths: Lily has strong orientation and mobility skills and can always locate objects needed as well as navigate independently around the school and her classrooms. Needs: Lily may benefit from more instruction on navigating independently throughout the community. Recreation and Leisure Skills Strengths: Lily has vocalized interest in bowling and in a member of a childrens bowling league in her hometown. Needs: Lily may benefit from exploring available clubs and activities available for students at TSB as she does not currently participate in any. Self-Determination Skills Strengths: Lily demonstrates effective communication when faced with a problem or issue and is able to self-advocate in many situations Needs: Due to her impending graduation, Lily may benefit from lessons in setting and achieve short and long term goals.

Sensory Efficiency Strengths: Lily is very effective at using her vision to solve problems in functional situations. When her vision is not effective- such as in contrast situations, Lily is able to use her sense of touch to provide her with needed information. Needs: Due to Lilys color vision impairment, additional consideration and emphasis on devices and materials with appropriate contrast should be given. Lily admitted to not using optical devices at school. In order to be as independent as possible, Lily should be bringing the devices with her to school and using them as needed. Instruction on the best use may be needed. Social Interaction Skills Strengths: Lily has demonstrated adequate social skills through her quick acquisition of friends upon transferring to the school 2 months ago. Needs: No social skills related needs were identified at this time. Summary of Assessments Lily uses her vision as the primary means to access information. Lily is able to read regular print if needed, though she reads at a much slower pace. Large print is her preferred method of media. Lily has a red/green color impairment Lily has difficulty seeing objects when there is not enough contrast Lily is well adjusted and motivated towards independence. Lilys reading rate and comprehension levels were of those of students 2-3 grades below her. Lilys vision efficiency appears to fluctuate slightly, and may less reliable when she is tired or experiencing eye strain. Lily is able to read word list at a 12th grade instructional level. ELIGIBILITY CRITERIA:. Visual Impairment Including Blindness means impairment in vision that, even with correction, adversely affects a childs educational performance. The term includes both partial sight and blindness. Definition (State Board of Education Rule 0520-1-9-01) According to Tennessee rules and regulations, Lily Aaron meets the criteria for visual impairment based on the following definitions or eligibility standards: (1) Visual acuity in the better eye or both eyes with best possible correction: _____ (a) Legal Blindness-20/200 or less at distance and/or near; __X__ (b) Low Vision- 20/50 or less at distance and/or near; (2) Visual field restriction with both eyes; _____ (a) Legal Blindness-remaining visual field of 20 degrees or less; _____ (b) Low Vision-remaining visual field of 60 degrees or less; __X__ (c) medical and educational documentation of progressive loss of vision, which may in the future, affect the students ability to learn visually, or (3) ______ Other visual impairment, not perceptual in nature, resulting from a

medically documented condition. (b) The characteristics as defined above are present and cause an adverse effect on educational performance in the classroom or learning environment.

RECOMMENDATIONS 1) Continued instruction by a teacher of the visually impaired. Lily needs the services of a teacher of students with visual impairments to provide information to his/her teachers concerning his/her visual needs and identify modifications or adaptations needed in materials and/or teaching strategies. 2) Low vision evaluation through Project PAVE. This service is free of charge and glasses, sunshields, magnifiers, and telescopes, if prescribed, are provided free. Follow-up instruction by the PAVE teachers is also made for using the low vision devices prescribed. If interested, contact Brandi McRedmond at (615) 936-3718 or at [email protected]. 3) Encourage usage of low vision devices in and out of the classroom. Lily shows knowledge on how to use her devices and verbalized that they are helpful to her academically. Lilys teachers should remind her to use her devices in the classroom when she would benefit from them 4) Provide Instruction in braille related skills. Due to the progressive nature of her visual impairment, it may be beneficial to Lily in the event that she loses additional functional vision. 5) Provide instruction on keyboard shortcuts and related skills. This will allow for Lily to increase her computer speed and provide for a swifter transition into using a screen reader should it become necessary.

EDUCATIONAL CONSIDERATIONS 1) Access to Large print books. Due to Lilys visual impairment, large print books should be ordered from the Resource Center at the Tennessee School for the Blind. In the information packet sent to the Special Education director in January of each year, there is a form for large print books. This must be done early (April) to receive books at the beginning of the next school year. 2) Preferential seating in a classroom 3) Access to Assistive Technology. Devices such as computer magnification software, such as Zoomtext, and a CCTV device in the classroom will help Lily to access educational material more effectively 4) Verbalization of any color coding. Due to Lilys loss of color vision, any color coding should be verbally relayed to Lily, and environment should allow for increased contrast. 5) Access to high contrast materials and mats. This will help Lily to work with objects and distinguish colors when possible.

The information outlined in this report is intended as an aid in the development of an appropriate education for Lily Aaron. The report reflects Lilys behavior and performance during the period that she was assessed. The purposes of the recommendations are to enhance Lilys learning and contribute to her educational growth. These findings also provide a basis for future reference.

Please feel free to contact me at [email protected] if you have any further questions regarding these findings or recommendations. Ms. Maddie Martinez, TVI/COMS Teacher of students with Visual Impairments