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Wells, Randi
Jordan, Christian "Christy" Sent: Tuesday, June 22, 2010 6:50 PM To: Wells, Randi Cc: Henry, Darcy Jane Subject: Gorman eye visit
From:

Well, Just wanted to let you both know how today's visit went with Dr. Flemming. It was interesting to say the least. I was not sure if we were paying or parents were, so did not offer and secretary said she would let me know. Dr. Flemming did an excellent job with assessing Jacob. She took her time and actually got some pretty accurate acuities. But, that being said, with his CVI, they will probably fluctuate from day to day based on if he is having a good day. Not sure if parents know this or not. She used some acuities cards which grossly estimated his acuties by having him touch stripes on a big card that progressively got smaller and closer together and moved around on the cards. This gave her an acuity of 20/300 Left eye and 20/500 right. She did not do both eyes together for some reason, but patched each one individually. She said his left eye was much better than the right. I was impressed with how he was able to pretty acurately touch the square as it moved from card to card.

She said he had lots of CVI characteristics, which the parents agreed with. She asked about what he was working on at school and they said basically nothing. It sounded to me as if they did not agree with his IEP's and wanted more academic stuff. Dad said that he had something like standing for X amount of time in stander, or moving X amount, and something about picking out his picture of himself, but that was it. They mentioned that Aram said Jacb could not answer yes/no questions several times. Dad said something to the effect that Jacob had attended Carrollton til May and then did not elaborate on where he went or why after that time. He also mentioned that he will not be in the developmental center next year, but in regular ed. 1st grade???? Dr. Flemming looked at the communication board and asked who had set that up. Dad said he did it, and that Jacob had started out with 8 squares, went thru that ver quickly, moved to 15, and now is at 45 tiles. It was very cluttered and Dr. Flemming commented on that as well. She asked if he saw the pics or if he had them memorized as to what they said and Mom said he probably did not see them and had placement memorized. Dad thinks he tells jokes with it randomely and they truely believe he communicates effectively with the device and not just accidentally. Talk of the power chair was a hot topic too. Dr. Flemming asked how he moved, got around, etc. Mom and Dad both agreed that he can roll, and is beginning to get up on elbows for army crawl. They said a power chair was ordered and that he would be using it when it came in. Dr. Flemming went over this issue with them in great depth, the pros and cons of putting a child with no experience in a power chair and how dangerous it will be if not practiced in a controlled area with close superivision. She said that he could run over others and other kids parents will get mad, and that he can also damage his eye further if not carefully trained very slowly on how to scan and look for drop-offs, things in his visual field before moving to them. They debated back and forth over how it can make him more independent, but Dr. Flemming was totally not on board with him just being slapped into a chair and turned loose for safety reasons. Dad asked about a Flipper (a camera device that will bring things up close to Jacob so he can see teacher or board). Dr. Flemming again said that with his motor and vision, that at this time, that might be too difficult for him since the parents were wanting to focus on academic skills and he would be trying to take in new information and trying to work the equipment at the same time. She just kept on saying how difficult it was for a regular student to listen, work the flipper, and take in all the information, and how difficult it would be for Jacob to do all of this in a new classroom. She suggested more real modifications such as desk copies from the overhead and pictures so he can take his time and look at them as best he can. This was a hot debate and not sure if Dad ever

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got it. She stated that she was not sure about his visual fields right now because he is not mobile and that is something that will have to further be tested as he gets older and more mobile. Again, she was very cautious about him and the motorized wheelchair with lack of knowledge of his visual fields. She gave a new prescription for glasses and explained how he needed to wear them, especially for protection, if he was going to be using power chair. I think parents bought into that. Dad asked what size he could see and she said about 1 in. letters. That is about 20/400 or maybe a size bigger on our near acuity cards. Pictures must be much larger especially if he is to see all the details. She said most preschool computer games will be big enough for him to see and interact with and said that would be good exercises for his vision. That was about it. I am sorry so long, but I took notes and said very little. I played dumb!! She will be sending her report soon. Thanks!!!

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