FTCE Visually Impaired cheat sheet

Legal blindness (US): central visual acuity of 20/200 or less in the better eye with best correction, or a visual field of 20 degrees or less in the better eye.

IDEA category is 'visual impairment including blindness'; it covers impairment in vision that, even with correction, adversely affects educational performance, including both partial sight and blindness.

Functional definitions used in schools: blindness = no functional vision or learns primarily through nonvisual channels; low vision = usable vision for some tasks, often with optical or nonoptical aids.

Visual acuity notation: 20/200 means the student sees at 20 feet what a standard eye sees at 200 feet; larger denominator = poorer acuity.

Visual field norms: a normal monocular field extends about 60 degrees nasally, 90-100 degrees temporally, 50-60 degrees upward, and 60-70 degrees downward.

Cortical visual impairment (CVI) is now a leading cause of pediatric visual impairment in developed countries; it is a brain-based visual dysfunction, not an eye disorder.

The field's professional bodies include AER (Association for Education and Rehabilitation of the Blind and Visually Impaired) and CEC's Division on Visual Impairments and Deafblindness (DVIDB).

Person-first language ('student with a visual impairment') is standard; avoid 'the blind kid' and avoid framing disability as tragedy.

Teachers of students with visual impairments (TVIs) provide specialized instruction, braille, and consultation; they do not replace the general education teacher of record.

Light path: cornea → aqueous humor → pupil/iris → lens → vitreous → retina → optic nerve → optic chiasm → optic tract → LGN → optic radiations → occipital cortex.

Refractive errors: myopia (image focuses in front of retina, distance blur), hyperopia (behind retina), astigmatism (uneven corneal curvature), presbyopia (loss of accommodation with age).

Accommodation is lens shape change via ciliary muscle; the pupil constricts (miosis) for near viewing and dilates (mydriasis) in dim light.

Retina: rods handle dim light and peripheral motion; cones handle color and detail and cluster at the fovea. Macula is the central area for sharp vision.

Optic chiasm: nasal fibers cross, temporal fibers stay ipsilateral; damage after the chiasm produces homonymous (same-side) field loss.

Common pediatric etiologies: retinopathy of prematurity (ROP), optic nerve hypoplasia, albinism, congenital cataracts, congenital glaucoma, and CVI.

ROP staging runs 1-5 with plus disease; stage 5 is total retinal detachment. Oxygen therapy in premature infants is a major risk factor.

Albinism reduces melanin, causing foveal hypoplasia, nystagmus, photophobia, and often 20/100-20/200 acuity; refractive correction and tints help.

Progressive conditions (e.g., retinitis pigmentosa, Stargardt disease, Leber congenital amaurosis) require periodic functional reassessment and planning for future needs.

Grief stages families often move through (Kübler-Ross): denial, anger, bargaining, depression, acceptance; these are not linear and recur across developmental transitions.

Family-centered practice: the family is the constant; professionals build on family priorities, routines, and culture rather than imposing a single model of adjustment.

Infants with visual impairment are at risk for 'learned helplessness' and passivity; responsive contingent feedback and self-initiated movement counteract it.

Social isolation risk rises in adolescence; peer groups, role models who are blind or have low vision, and extracurricular inclusion are protective factors.

'Spread' (overgeneralization of disability) leads peers and adults to underestimate competence; accurate, specific information about the student's functional vision counters it.

Sighted-guide etiquette and 'ask before assisting' norms build autonomy; unsolicited grabbing or guiding is a psychosocial barrier, not just a mobility issue.

Sibling needs, parental respite, and extended-family reactions are legitimate targets of family support and referral to parent organizations and counseling.

Cultural and linguistic diversity affects interpretation of disability; interpreters, translated materials, and cultural brokers are required for equitable engagement.

Transition points (preschool entry, middle school, graduation) trigger renewed grief or anxiety and warrant proactive family conferencing.

Eligibility requires a documented visual impairment that adversely affects educational performance; acuity alone does not determine services.

Functional Vision Assessment (FVA) evaluates how the student uses vision across environments, lighting, materials, distance, and fatigue; it is not a clinical eye exam.

Learning Media Assessment (LMA) determines primary and secondary literacy media (braille, print, auditory, tactile) and the efficiency of each sensory channel.

Clinical reports (ophthalmology, optometry) supply acuity, field, diagnosis, prognosis, and medical recommendations; the TVI interprets them for educational planning.

Orientation and Mobility evaluation assesses concept development, spatial awareness, cane skills, route travel, and safety in school and community settings.

The Expanded Core Curriculum (ECC) screening covers nine areas; results feed the IEP as goals or as accommodations, not as a separate eligibility category.

Assessment accommodations: extended time, separate setting, large print or braille, reader/scribe, tactile graphics, and preferential seating with controlled lighting.

Ecological assessment observes the student in natural routines (cafeteria, hallway, playground) because clinic-based measures predict performance imperfectly.

Reevaluation timelines follow IDEA (at least every three years); functional vision should be rechecked sooner when vision changes or new settings demand it.

The nine ECC areas: compensatory/access skills, orientation and mobility, social interaction, independent living, recreation and leisure, career education, assistive technology, sensory efficiency, and self-determination.

ECC instruction is delivered through direct teaching, consultation, and embedded routines; it is individualized, not a fixed sequence for all students.

Compensatory access skills include concept development, organizational strategies, listening skills, and use of accessible technology to access the general curriculum.

Sensory efficiency training teaches systematic use of residual vision (eccentric viewing, scanning, lighting) and of touch and hearing.

Self-determination instruction builds choice-making, goal setting, self-advocacy, and knowledge of one's own visual condition and accommodations.

Career education begins in elementary school through awareness, exploration, and work-based learning, not only at transition age.

Universal Design for Learning (multiple means of representation, engagement, and expression) reduces the need for retrofit accommodations.

Instructional planning aligns IEP goals with grade-level standards while embedding ECC goals; avoid watering down content because of the visual impairment.

Recreation and leisure instruction includes adapted physical activity, community recreation access, and hobbies that build lifelong peer connections.

Standard English braille uses a 6-dot cell (dots 1-2-3 left; 4-5-6 right); the literary code in the US is Unified English Braille (UEB), adopted in 2016.

UEB contractions: 189 contractions including alphabetic word signs, strong contractions, lower signs, shortforms, and groupsigns; shortforms like 'ab' (about) are used as whole words.

Braille is read tactually with the index finger pads; reading rates are typically slower than print, so efficiency and fluency instruction matter.

Nemeth Code is the braille code for mathematics and science; UEB handles literary text, and code switches require indicators.

Nemeth indicators: the numeric indicator (dots 3-4-5-6) precedes digits; the letter indicator distinguishes letters from numerals in some contexts.

Braille literacy requires the same five components as print reading: phonemic awareness, phonics, fluency, vocabulary, and comprehension, taught with tactile materials.

Slate and stylus, Perkins brailler, and refreshable braille displays are the core writing and reading tools; electronic braille files use BRF or formatted braille.

Tactile graphics need simplification, clear key, distinct textures, and consistent orientation; too much detail reduces comprehension.

Braille instruction is a presumptive right for students with blindness or severe low vision; the IEP team must justify any decision not to teach it.

Low-tech AT: bold-line paper, slant boards, typoscopes, magnifiers, tactile markers, and high-contrast tape. High-tech AT: screen readers, refreshable braille displays, OCR, and video magnifiers (CCTV).

Screen readers (JAWS, NVDA, VoiceOver) need accessible digital content: headings, alt text, table headers, and logical reading order.

Refreshable braille displays connect to computers and mobile devices; they provide braille access to digital text and support editing.

Accessible materials production: NIMAS files can be converted to braille, large print, audio, or digital text; the NIMAC is the national repository.

IDEA requires accessible instructional materials in a timely manner; states operate AIM systems, and the IEP documents the format the student needs.

Large print is not simply enlarged text: font size (often 18-point), sans-serif type, high contrast, and spacing affect readability.

Optical aids (telescopes, magnifiers) and nonoptical aids (tints, lighting, glare control) are prescribed by low vision specialists and trained by the TVI.

Digital accessibility standards (WCAG) and document structure (tagged PDFs, accessible slide decks) are prerequisites for AT to work.

AT assessment considers the task, the environment, the student's abilities, and training needs; devices without training do not improve outcomes.

Orientation is knowing one's position in space and relationships to objects; mobility is moving safely, efficiently, and independently.

Cane techniques: diagonal cane for general travel, touch technique for detecting obstacles, and constant-contact technique for detecting drop-offs and changes in surface.

Human guide technique: the guide offers an arm; the traveler grips above the elbow, stays half a step behind, and the guide signals stops and turns.

Landmarks are fixed objects used for orientation; clues are sensory information (sound, texture, temperature) that confirm location.

Route travel includes indoor routes, residential travel, crossing at controlled intersections, and use of public transit; instruction is sequenced by risk and complexity.

Sighted guide, protective techniques (upper and lower hand), and trailing are foundational skills taught before independent cane travel.

Independent living skills include meal preparation, money management, clothing care, cleaning, and personal care, taught with tactile labeling and systematic routines.

Accessible pedestrian signals, tactile maps, GPS apps, and audible/talking devices support community travel and daily living.

O&M instruction is provided by a certified orientation and mobility specialist (COMS) and is distinct from TVI instruction.

The TVI consults with general education teachers, paraprofessionals, related service providers, and families; consultation is a service, not a favor.

Paraprofessionals should support access and independence, not become the student's primary instructor or 'shadow'; over-support reduces self-advocacy.

Transition planning under IDEA begins by age 16 (younger in many states) and includes measurable postsecondary goals in education, employment, and independent living.

Transition assessments include interest inventories, work-based learning, and functional skill probes; results feed the IEP's transition plan.

Pre-employment transition services (Pre-ETS) include job exploration, work-based learning, counseling on postsecondary programs, workplace readiness, and self-advocacy training.

Interagency collaboration involves vocational rehabilitation (VR), developmental disabilities services, colleges' disability offices, and community agencies.

Effective consultation uses clear roles, written communication, modeling, and follow-up coaching rather than one-time trainings.

Self-advocacy instruction teaches students to request accommodations, explain their visual condition, and disclose appropriately in school and work settings.

Transition to adult services requires early referral to VR, benefits counseling, and planning for assistive technology continuity beyond school.