(a) Definition.

1. (1)

   1. (A) "Visual impairment, including blindness” means an impairment in vision that, even with correction, adversely affects a child's developmental/educational performance.
   2. (B) This term includes both partial sight and blindness.
   3. (C) This impairment refers to abnormality of the eyes, the optic nerves, or the visual center for the brain resulting in decreased visual acuity.
2. (2) Students with visual impairments are identified as those with a corrected visual acuity of 20/70 or less in the better eye or field restriction of less than twenty degrees (20°) at its widest point or identified as cortically visually impaired and functioning at the definition of legal blindness.

(b) Screening information.

1. (1) Required:

   1. (A) Hearing;
   2. (B)

(i) Vision.

1. (ii) For some children, vision screening may consist of observations of possible deficits in visual functioning.

   1. (iii) Such observations should be confirmed, when possible, by an eye care specialist (optometrist or ophthalmologist) to include near point and distance vision acuities when such measures can be obtained.

      1. (iv) Screening of this nature may be obtained through a low vision clinic; and

   2. (C)

      1. (i) Formal measures of development.
      2. (ii) May include the areas of:

(b) (b) Communication;

1. (c) (c) Motor;

   1. (d) (d) Social/behavioral; and

(e) (e) Self-help.

1. (iii)

(b) (b) Otherwise, it is required.

1. (2) Recommended. Informal measures, such as:

   1. (A) Checklists;
   2. (B) Inventories;
   3. (C) Rating scales;
   4. (D) Interviews;
   5. (E) Observation in home and/or other preschool environments; and/or

   6. (F) Access to and review of existing records and available information.

      1. (c) Required evaluation data.
2. (1) Social history. Emphasis on developmental, family and health/medical.

3. (2) Assessment.

   1. (A) Medical, including an evaluation by either an ophthalmologist or optometrist conducted within the past year, comprising:

      1. (i) Visual acuity;
      2. (ii) Refractive errors;
      3. (iii) Prescription correction where indicated;
      4. (iv) Etiology;
      5. (v) Prognosis; and
      6. (vi) Low vision evaluation.

   2. (B)

      1. (i) Cognitive/intellectual abilities.
      2. (ii) May be assessed through a formal evaluation or in the program assessment.
   3. (C) Social/behavioral (one (1) adaptive behavior assessment required).

   4. (D)

      1. (i) Self-help.
      2. (ii) May be included in the adaptive behavior, cognitive/intellectual, and/or the programming assessments.

   5. (E) Communicative abilities:

      1. (i)

(b) (b) Both receptive and expressive areas must be assessed.

1. (c) (c) Assessment must be comprehensive and must not be limited to one-word vocabulary tests;

   1. (ii) Articulation (when indicated); and

      1. (iii) Augmentative/alternative communication (when indicated).

   2. (F) Orientation and mobility (one (1) required):

      1. (i) Basic concepts;
      2. (ii) Body awareness; or
      3. (iii) Range of motion.
   3. (G) Motor (when indicated).

   4. (H)

      1. (i) Programming.
      2. (ii) One (1) required criterion or curriculum-based measure, which may also serve to assess cognitive abilities, appropriate for visually impaired children.
      3. (d) Evaluation data analysis.

2. (1)

   1. (A) Children ages three (3) to five (5) are considered to have visual impairment when they demonstrate a documented limitation in visual functioning that interferes with the acquisition of new knowledge or skills in defined developmental areas.
   2. (B) The qualified provider's evaluation report must document how the limitation of vision adversely affects the child's developmental/educational performance.

3. (2) The following characteristics should be considered in analyzing the evaluation data:

   1. (A) Behavior.

      1. (i) Rubs eyes excessively.
      2. (ii) Shuts or covers one (1) eye, tilts head, or thrusts head forward.
      3. (iii) Has difficulty with work requiring close use of the eyes.
      4. (iv) Blinks more than usual or is irritable when doing classwork.
      5. (v) Holds books close to eyes.
      6. (vi) Is unable to see distant things clearly.
      7. (vii) Appears clumsy, especially in a new situation.
      8. (viii) Squints eyelids together or frowns.
      9. (ix) Holds head in an awkward position to look at something.
      10. (x) Holds a book or other objects in a peculiar position to look at them.
      11. (xi) Constantly ask others for environmental information.
      12. (xii) Shows unusual signs of fatigue or inattentiveness.
      13. (xiii) Exhibits repetitive self-stimulation behavior;

   2. (B) Appearance.

      1. (i) Crossed eyes.
      2. (ii) Red-rimmed, encrusted, or swollen eyelids.
      3. (iii) Inflamed or watery eyes.
      4. (iv) Recurring styes;

   3. (C) Complaints.

      1. (i) Eyes itch, burn, or feel scratchy.
      2. (ii) Cannot see well.
      3. (iii) Dizziness, headaches, or nausea following close eye work; and

   4. (D) Communicative abilities.

      1. (i) Less effective use of nonverbal communications.
      2. (ii) Uses less lip movement in the articulation of sounds.
      3. (iii) Excessive echolalia.
      4. (iv) Constantly asks others for environmental information.
4. (3) Children with visual impairments are those who, because of the type and degree of visual impairment, are unable to perform satisfactorily without modifications in curriculum and instructional materials, equipment, and methods.

5. (4) Effects of visual impairment vary depending on:

   1. (A) The severity of the impairment;
   2. (B) Age of onset of impairment;
   3. (C) Developmental opportunities; and
   4. (D) The type and degree of any other disability.