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					Review of DETA criteria
 for Vision Impairment
education adjustment program       Department of Education, Training and the Arts




                   Key Issues

• Ensuring understanding of links between the vision
  impairment and the educational impact.
• Ensuring the criteria are based on sound evidence for
  the given purpose.
• Reflective of national and international trends.
• Decision making is consistent.
• Driven by consultative and collaborative involvement of
  specialists in the area of paediatric vision impairment.
education adjustment program   Department of Education, Training and the Arts




              Focus of the Review

• Investigated models used for identifying vision
  impairment.
• What is an activity limitation/participation
  restriction for Vision Impairment.
• Effectiveness of 2006 verification form.
Models for Identifying
 Vision Impairment
education adjustment program                Department of Education, Training and the Arts




  International Classification of Functioning,
             Disability and Health
“Seeing Function” – identifies vision as “sensing the presence of light
   and sensing the form, size, shape and colour of the visual stimuli”.
   (WHO, 2001, p62) It includes:

    – visual acuity functions (sensing form and contour, both
      binocular and monocular, for both distance and near);
    – visual field functions (relating to the entire area that can be
      seen with fixation of gaze);
    – quality of vision (involving light sensitivity, colour vision,
      contrast sensitivity and the overall quality of the picture);
    – the functions and structures adjoining the eye that facilitate
      seeing functions.


      It does not include Perceptual Functions
education adjustment program             Department of Education, Training and the Arts




        National and International Criteria

   • National and International criteria were inconsistent in
     definitions used. (This seemed to be determined by funding)
   • National criteria were consistent with their usage of:
      – Visual acuity
      – Field loss
      – A report (e.g. functional vision report, educational impact
         statement or assessment of need)
   • Visual Acuity and Field loss varied based on state
     department funding models.
   • No state/territory consider quality of vision or the functions
     and structures around the eye
education adjustment program                Department of Education, Training and the Arts




         Criteria (until 12 November 2007)
•   DETA recognises a Vision Impairment when:
    – visual acuity is 6/18 or less corrected in the better eye; or
    – a field loss impairs visual functioning; or
    – damage to visual centres of the brain impacts on visual
      functioning. A diagnosis of cerebral (cortical) Vision Impairment
      is necessary for this to apply.

•   A diagnosis of a condition that results in a Vision Impairment is
    provided by an ophthalmologist, or in some cases of Cerebral
    (Cortical) Vision Impairment by a paediatrician or neurologist.
education adjustment program      Department of Education, Training and the Arts




• Under this criteria a number of students who were
  diagnosed with a vision impairment and had associated
  educational impact were excluded.

• DETA has a duty of care to ensure that information is
  provided to schools regarding the unique characteristics
  of these conditions which may be at risk if appropriate
  adjustment aren’t made.
education adjustment program               Department of Education, Training and the Arts




                    Current Research

   • visual acuity below a critical level of 6/12 is associated with
     disability and affects participation (Taylor, 2003)
   • a moderate level of vision impairment –that is less than 6/12
     has a significant impact in…daily living, social functioning
     (Taylor 2003)
   • with increasing human development the visual acuity
     requirements are also increasing. This would indicate that
     even a mild visual loss has a greater impact in today’s society
     (Dandona & Dandona, 2006).
   • Students with visual acuity <6/12 are limited in career
     options, transport arrangements and lifestyle choices.
   • In Australia a visual acuity of <6/12 inhibits the capacity to get
     a drivers license.
education adjustment program      Department of Education, Training and the Arts




• Even though studies indicate that a visual acuity of
  less then 6/12 has a significant impact there are no
  indicators regarding the prevalence. It is
  recommended that further studies be undertaken to
  investigate the educational impact of acuity between
  6/12 and 6/18 and the consequent prevalence.

• Due to the unknown prevalence the usage of <6/12
  was not accepted.
education adjustment program         Department of Education, Training and the Arts




                   Current Practice

• The most common testing tool is the Snellen chart. The
  limits of this chart is it cannot measure acuities which
  may fall between 6/12 and 6/18.
• Some students may be tested using more refined tools
  which are able to identify an acuity of 6/15. Under the old
  criteria these students would have effectively been
  excluded.
• By identifying the testing tool as the Snellen (6/18) it will
  ensure that students identified using more refined tools
  are included if their acuity falls between 6/12 and 6/18.
education adjustment program       Department of Education, Training and the Arts




   New Criteria (from November 12 2007)

Criterion 1
• Student must be diagnosed with a vision Impairment
  involving:
   – Ocular components; or
   – The Visual Cortex; or
   – the Functions and Structures Adjoining the eye.
• With either:
       • a visual acuity of  6/18, according the Snellen
         Chart, best corrected; or
       • a visual field loss; or
       • significant fluctuating visual access
education adjustment program   Department of Education, Training and the Arts




New Criteria (from November 12 2007)

Criterion 2
• Have documented evidence of activity
  limitations or participation restrictions
  resulting from the Vision Impairment in one
  or more of the following focus areas:
   – Curriculum,
   – Disability Specific curriculum, and
   – Learning environment
Vision Impairment - Activity
  Limitation / Participation
  Restriction in the school
           context
education adjustment program    Department of Education, Training and the Arts




            ICF’s nine domains of life

•   learning and applying knowledge
•   general tasks and demands
•   communication
•   mobility
•   self-care
•   domestic life
•   interpersonal interactions and relationships
•   major life areas
•   community, social and civic life
education adjustment program             Department of Education, Training and the Arts




          Impact in an educational setting
   • Delays in concept development which severely impact on the
     student's social, emotional, academic, and vocational
     development;
   • Compromised capacity to be independent, both in immediate
     learning environment and the wider school community.
   • Reduced reading rates to that of sighted peers, requiring
     additional time for all reading tasks and regular monitoring of
     low vision aids.
   • Required development of alternate mediums, i.e. tactile and
     auditory sense, for learning;
   • Reduced access to standard learning materials, requiring the
     development of specialised skills as well as modified
     specialised books, materials and equipment for learning
     through alternate modes,
   • Compromised capacity to gather information through
     observation and therefore reduced incidental learning.
     (Lewis and Allman, 2000)
education adjustment program       Department of Education, Training and the Arts




            Educational Focus Areas


  These areas are:
   – Curriculum;
   – Disability specific Curriculum; and
   – Learning Environment.

  Students must have a significant impact in one or more
  of the three focus areas for verification in the DETA
  criteria for the category of vision impairment.

      Appendix 4
education adjustment program                 Department of Education, Training and the Arts




    New Criteria (from 12 November 2007)
   Criterion 1
   • Student must be diagnosed with a vision Impairment involving:
        – Ocular components; or
        – The Visual Cortex; or
        – the Functions and Structures Adjoining the eye.
   • With either:
        – a visual acuity of  6/18, according the Snellen Chart, best
           corrected; or
        – a visual field loss; or
        – significant fluctuating visual access
   Criterion 2
   • And have documented evidence of activity limitations or participation
       restrictions resulting from the Vision Impairment in one or more of
       the following focus areas:
        – Curriculum,
        – Disability Specific curriculum, and
        – Learning environment
Verification Form
education adjustment program                Department of Education, Training and the Arts




   2006 Verification Data Indicated:
   • The need to clarify the link between impairment and
     educational impact.
   • The need for consistency in information provided by medical
     specialists.

   It is expected that the Specialists information be current. This
   does not mean that the report needs to be recent but rather that
   the information within the report is reflective of the student at the
   time of the verification request.



   2007 EAP Verification – VI Form
education adjustment program     Department of Education, Training and the Arts




                     Curriculum

•   Reduced volume of work;
•   Uses concrete materials
•   Modified assessment delivery e.g.auditory
•   Alternative format presentation e.g. Braille, large
    print, auditory
•   Planning
•   Alternative subject/content/activities
•   Additional support e.g. 1:1, small group
•   Extra time to comprehend and process work
education adjustment program        Department of Education, Training and the Arts




           Disability Specific Curriculum

•   Functional Academic skills
•   Communication Skills
•   Concept development
•   Orientation & Mobility
•   Social Interaction Skills
•   Sensory Motor Skills
•   Independent Living Skills
•   Career or Voc Ed skills
•   Recreation and leisure skills
•   Technology
•   Visual efficiency skills
education adjustment program   Department of Education, Training and the Arts




              Learning Environment

•   Specialised equipment
•   Modified access
•   Glare reduction.
•   Lighting
•   Seating
•   Adaptive Technology
•   Visual Aids
•   Modified room set up
•   Excursions/camps/night activities
Verification Reviews and
Removal from Category
education adjustment program        Department of Education, Training and the Arts




             Review of VI Verification

• No mandatory review for most diagnoses
   – Eg conditions that are lifelong and stable
• Reviews required for some diagnoses
   – Eg conditions that fluctuate or after intervention such
     as patching
• Date of review determined by Verifier


             Removals from Category
education adjustment program           Department of Education, Training and the Arts




                 Contact Details

• chris.gilbert@deta.qld.gov.au
• For VI specific Verification questions
   – Ph: 3240 9348 (Alt Fridays – pay weeks)
   – Ph: 4616 9175 (Alt Fridays – non pay weeks)
• For general Verification questions
   – Ph: 3240 9348 (Jeannie Grace)
   – Fax: 3240 9300
• EAP Verification Team
  141 Merton Rd
  WOOLOONGABBA Q 4102

				
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