Children with useful but impaired vision are a large group in the schools for the blind and scattered in thousands of schools in integrated education. Before school age visually impaired children are either at home or in groups of normally sighted children in family day care or day care centres. In larger cities there may be special groups for visually impaired children. With integration, the number of people, who should understand a visually impaired child's needs, is growing. This means understanding the information given by the hospitals and private ophthalmologists but also observing the child and participating in the assessment of visual functioning.
In developing countries the limited number of ophthalmologists and optometrists precludes their carrying out functional assessment which therefore needs to be carried out by the educators.
In developed countries there is plenty of clinical information but this depicts the impairment and is not of great value in the assessment of functional ability/disability. Even in developed countries, functional assessment depends on therapists and special educators except in those places where low vision therapists have been trained to assess infants and children, and medical experts have the time and interest in developmental and educational issues.
Evaluation of vision can be divided into two categories:
As a part of the assessment, INTERVIEWs with the child, his/her teacher(s) and parents provide important information to the IEP.
Structured OBSERVATION of each child is needed to determine which skills need to be taught in communication, orientation and mobility (O&M), activities of daily life (ADL) and during sustained near vision tasks (SNVT). Simulation of the child's impairment with appropriately modified spectacles can prove helpful by allowing non-specialist teachers, parents and carers to understand and appreciate the vision available for learning. The child's motor abilities cannot be similarly demonstrated and therefore require careful observation and explanations.
Assessment of vision of children with other impairments has specialized requirements, which are discussed in the Part II of this manual. The requirements of infants and children at an early developmental level are described in Part III.