Title: Assessment of Vision, Hearing, Health, Sensory and Motor
1Assessment of Vision, Hearing, Health, Sensory
and Motor
2Vision Screening and Assessment
- Schools must state pass/fail criteria for vision
screening in the district compliance plan. - Criteria for diagnosis of partially sighted
states a central visual acuity range of 20/70 to
20/200 in the better eye with best correction.
3Vision Must Be Evaluated
- Some individuals with ASD may not respond to the
typical screening instruments
4Vision Screeningcont.
- Criteria for blind states 20/200 or less in the
better eye after best correction. 20/20 indicates
a person can see a standard sized object for a
standard number of feet away. A person can, for
example, distinguish a letter or number at 20
feet that an average person can distinguish at
20 feet. - 20/200 indicates a person can distinguish at 20
feet what the average person can distinguish at
200 feet.
5Visual Impairment
- May have normal central vision (acuity) with
deficits in peripheral field (tunnel vision). - Color Blind Usually not all or nothing may
perceive different hues. Inherited trait.
6What Tests are Most Common?
- VISION Snellen Chart, Titmus, Keystone
- HEARING Beltone Audiometer
- MOTOR
- Bender Visual Motor Gestalt Test
- Developmental Test of Visual Motor
- Integration 4 (VMI), DTLA-4
- Bruiniks-Oseretsky Test of Motor Proficiency
- Motor Free Visual Perceptual Test
7Snellen Chart
- A Snellen chart is an eye chart used by eye care
professionals and others to measure visual
acuity. Snellen charts are named after the Dutch
ophthalmologist Herman Snellen who developed the
chart in 1862. ? -
8Titmus Vision Screener
- The Titmus 2s Vision Screener is an instrument
that can test for binocularity, visual acuity,
color and depth perception and vertical and
lateral phorias. the T2s model with perimeter can
also test for peripheral vision in the horizontal
field. - Tests for acuity near, far, color,
- binocular functioning, and depth.
9Keystone
- The Keystone Ophthalmic Telebinocular is the
accepted pioneer instrument of modern binocular
vision testing and training.
10Visioncont.
- Functional vision assessment Response to
environmental stimuli, colors, photographs, line
drawings, details in the environment.
11Visual Behaviors
- Close scrutiny of visual details
- Prolonged staring
- Over/under response to visual cues
- Lacks visual attention
- Poor eye/face regard
12What Tests are Most Common?
- VISION Snellen Chart, Titmus, Keystone
- HEARING Beltone Audiometer
- MOTOR
- Bender Visual Motor Gestalt Test
- Developmental Test of Visual Motor
- Integration 4 (VMI), DTLA-4
- Bruiniks-Oseretsky Test of Motor Proficiency
- Motor Free Visual Perceptual Test
13Hearing Must Be Evaluated
- Hearing
- Tests such as audiograms and tympanograms can
indicate if a child has a hearing impairment.
Audiologists, school nurses and educators can
evaluate the functional hearing of individuals by
measuring responses such as blinking or staring
or turning the head when a light is presented and
response to environmental stimuli.
14Hearing Screening and Assessment
- Schools must state pass/fail criteria for hearing
screening in the district compliance plan. - ASHA (1985) recommends failure of pure tone
hearing screening when individual fails to
respond to screening levels presented in either
ear.
15Hearing Screeningcont.
- ASHA has recommended for screening using
frequencies of 500, 1000, 2000 and 4000 HZ at a
HL of 20 DB. - Hearing speech sounds in range of 500 to 4000
crucial to understanding conversational speech. - ASHA regards 20 DB as upper range of normal
hearing for children.
16Hearingcont.
- Screen for failure in either ear after 20 DB
- Rescreen if failure, more complete functional
hearing assessment audiogram or Tympanometery
(screening of middle ear or eardrum) conducted by
an audiologist.
17Beltone Audiometer
18Auditory Behaviors
- Non/over response to varying sounds response to
same sound may change over time - Seems not to hear
19Medical Assessment
- Assessment based on screening information, in
depth social and developmental history. - Medical tests are not required for an educational
diagnosis of autism however, screening may
warrant medical referral due to concomitant
conditions and a detailed medical history and
current health status is required.
20Medical Assessment
- Metabolic Screening Blood and urine lab tests
measure how a child metabolizes food and its
impact on growth and development. - Magnetic resonance imaging (MRI) Magnetic
sensing equipment creates, in extremely fine
detail, an image of the brain. - (Sicile-Kira, 2004)
21Medical Assessment
- Computer-assisted axial tomography (CAT scan)
- CAT scans are useful in diagnosing structural
problems in the brain by taking thousands of
exposures which are then reconstructed in great
detail. - (Sicile-Kira, 2004)
22Medical Assessment
- Genetic testing
- Blood tests can show abnormalities in the genes
that could cause a developmental disability. - Electroencephalogram (EEG)
- An EEG can detect tumors or other brain
abnormalities. It also measures brain waves that
can show seizure disorders. - (Sicile-Kira,
2004)
23Sensory
- Sensory input vision and hearing
- Sensory integration (OT assessment)
- Fine and Gross Motor
24Sensory and Motor
- Sensory differences are often an indicator of
autism. Absence of differences does not
necessarily mean that it is not autism.
25Sensory and Motor
- Consider and handle Motor skill assessment as you
would any other student with suspected deficits
in that area.
26Sensory and Motor
- Before the Review of Existing Data (RED)
- Contact your OT
- Complete the paperwork for a screening
27Who Should Assess Sensory and Motor?
- Trained Professionals
- Occupational therapist, physical therapist,
adaptive PE and regular PE, nurse, medical
professionals. - Certain Procedures and instruments
- Speech and language clinicians, trained
educational professionals.
28Sensory Assessments
- Sensory Profile School Companion
- --Important for students when Autism is
- suspected
- --Filled out by one or two school team
- members
- --Scored and interpreted by an OT
29Sensory Systems Involved
- Tactile Behaviors
- 1. Hypo/hyper response to touch and
- temperature
- 2. Unusual response to pain stimuli
- 3. Self-injurious behavior
30Sensory Systems Involved
- Olfactory Behaviors
- 1. Smells objects/repetitive sniffing
- 2. Licks inedibles
31Sensory Systems Involved
- Vestibular Behaviors
- Over/under response to gravity stimuli
- Whirling without dizziness
32Sensory Systems Involved
- Use of Objects
- May use objects inappropriately
- May become fascinated with parts of objects
- May engage in ritual behaviors (spinning,
arrangements of objects, etc.) - May form attachments to unusual objects such as
sticks or string
33Sensory Systems Involved
- Stereotypic Behaviors
- May engage in unusual body posturing, finger
flicking and toe walking - 2. May use repetitive, stereotypic words and
phases
34- These examples are only a partial listing of
possible referral characteristics and are not
intended to provide an exhaustive list.
35Motor Assessments
- Typical assessments for any student with fine
motor concerns - --Bruininks-Oseretsky Test of Motor Proficiency
- --Follow the advice of the OT
- --Fine motor observation done by the OT would be
good for initial evaluation for Autism - --OT will help support educational impact of
sensory/motor differences (if there are some) in
her observational report.
36Connections to Other Disciplines
- Sensory differences should be documented
throughout the evaluation report. Possible
places include - - Classroom observations
- -Observational notes during formal
- assessments
- - Student history
- -GADS, GARS, ASDS, etc.
37What are Current Dilemmas in Sensory, Motor, and
Sensorimotor Assessment?
- Assessment does not always generate effective
information for programming and therapy.
Particular difficulty is noted with assessment of
perceptual skills and the relationship of
perceptual assessment to educational programming.
38What are Current Dilemmas in Sensory, Motor, and
Sensorimotor Assessment?
- Serious concerns are noted with technical
adequacy of standardized tests, particularly with
validity of perceptual tests.
39What are Current Dilemmas in Sensory, Motor, and
Sensorimotor Assessment?
- Trained professionals are not always available in
school districts. - Lack of training, understanding in regard to
relationship of sensory and motor problems to
academic difficulties.
40What are Current Dilemmas in Sensory, Motor, and
Sensorimotor Assessment?
- Sensory and motor deficits may adversely affect
performance in assessment. - Score and results may not be conducted outside of
the educational setting and results may not be
shared with educational professionals.
41What are Solutions to the Dilemmas in the Areas
of Sensory and Motor Assessment?
- Supplement results with standardized testing with
informal/authentic and functional analysis. - Relate programming and therapy decisions to
behavior manifestations and environmental
analysis of perceptual motor and sensory
deficits. Conduct systematic observation across
natural environments.
42What are Solutions to the Dilemmas in the Areas
of Sensory and Motor Assessment?
- Be sensitive to sensory and motor problems in
assessment planning, select instruments and
procedures that will as much as possible reflect
ability. - Provide appropriate assistive technology in the
assessment process and include in your assessment
an analysis of assistive technology needs.
43What are Solutions to the Dilemmas in the Areas
of Sensory and Motor Assessment?
- Coordinate assessment and instructional planning
efforts. Obtain outside medical evaluations.
Communicate with medical professionals outside
the educational system.
44What are Solutions to the Dilemmas in the Areas
of Sensory and Motor Assessment?
- Have OT, PT, nurse and speech and language
clinicians conduct assessment in natural
classroom, school, home and community
environments including systematic observation of
the individual in those environments.