Functional Assessment and Individualized Service Planning
Assessment is functional, ecological, and continuous
The CVRT's assessment answers 'what does this person need and want to do, and what supports or blocks that?' rather than 'what is the diagnosis?' Gather the eye report for background - acuity, fields, contrast sensitivity, prognosis - but never let a number predict performance. Observe the person performing real tasks in real environments: lighting, glare, clutter, contrast, floor surfaces, furniture layout, and the rhythms of the household. Use interviews, task analysis, trial teaching, and baseline data. Consider health, cognition, hearing, dexterity, medications, culture, language, transportation, and the consumer's own priorities.
Building the service plan
Write goals with the consumer, not for the consumer. A well-formed goal names the condition, the behavior, and the criterion, and is measurable, functional, and time-bound. Sequence objectives from what matters most to the consumer, and from low-risk to high-risk. Build in plans for generalization across rooms, times, and people; a method for data collection; criteria for mastery; and a date for reassessment. Document objectively: what was observed, what was taught, the response to instruction, and next steps. Coordinate with O&M, low vision, occupational and physical therapy, social work, and vocational rehabilitation to avoid duplication.
Traps
Confusing the medical eye report with functional ability; writing provider-centered goals ('client will understand contrast') instead of observable ones; skipping baseline data so progress cannot be shown; assessing only indoors and never in the community; treating the plan as fixed after the first visit.
Worked example
Weak goal: 'Improve kitchen safety.' Strong goal: 'Within six weeks, Ms. R. will independently prepare a hot breakfast using a talking timer and tactile markings on the stove, on four of five consecutive trials, with no safety prompts.' One behavior, one setting, a measurable criterion.
Rule of thumb: if you cannot count it or observe it, rewrite it.