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PRESCHOOL FUNCTIONAL VISION/HEARING SCREENING Case Study Committee Referral Child s Name Referring Person Date of Birth This screening is for children ages 2 to 5 years. It does not evaluate vision or hearing acuity but it does address whether functional vision an/or hearing seems adequate to continue with the assessment process. VISION check all that apply Does the child. Have eyes that look forward not inward or outward Make eye contact with the objects Follow moving objects with eyes Look...

How to fill out functional vision screening form

How to fill out functional vision and hearing:

1. Start by assessing the individual's visual and auditory abilities.
2. Use standardized assessment tools and tests to gather objective data about their vision and hearing.
3. Document the individual's visual acuity, visual field, contrast sensitivity, color vision, and depth perception.
4. Assess their hearing ability, including their ability to hear different frequencies and their speech recognition.
5. Take note of any visual or auditory impairments or conditions that may affect their functional vision and hearing.
6. Consider the impact of these impairments on the individual's daily activities and quality of life.
7. Make recommendations for assistive devices or interventions that can help improve their functional vision and hearing.

Who needs functional vision and hearing:

1. Individuals with visual impairments, such as those with low vision, blind individuals, or individuals with conditions that affect their vision, like macular degeneration or glaucoma.
2. Individuals with hearing impairments, such as those with hearing loss, deaf individuals, or individuals with conditions that affect their hearing, like sensorineural hearing loss or conductive hearing loss.
3. People of all ages, from children to older adults, who rely on their vision and hearing for everyday tasks, communication, and engaging with their environment.

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What is functional vision screening?

Functional vision screening is an assessment process that evaluates how well an individual's vision functions in everyday situations, rather than just measuring visual acuity or eye health.

Who is required to file functional vision screening?

Typically, functional vision screenings are required to be filed by educational institutions, healthcare professionals, or agencies responsible for assessing the vision of individuals, especially children in school settings.

How to fill out functional vision screening?

To fill out a functional vision screening, one should document the results of the assessment, including observations regarding the individual's visual capabilities in various tasks, relevant history, and any specific tools or methods used during the screening.

What is the purpose of functional vision screening?

The purpose of functional vision screening is to identify individuals who may need further vision evaluation or intervention, and to ensure that they receive appropriate support for their visual needs in everyday activities.

What information must be reported on functional vision screening?

Information that must be reported typically includes the individual's name, age, date of the screening, observations made during the assessment, any identified vision problems, and recommendations for further evaluation or services if needed.