Vision Support Team

Vision Support Team

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The Vision Support team are a team of specialist staff, comprising of Qualified Teachers for Vision Impairment (QTVIs) and Specialist Sensory Teaching Assistants (SITAs) and a Habilitation Specialist. We work to promote the educational inclusion and achievement of children and young people who have a diagnosed vision impairment.

What do we do?

We support children who have a diagnosed vision impairment from the time of diagnosis until they leave full time education.

The team works closely with the child, their family and any educational professionals to help them to understand the diagnosis and offer advice and support as the child develops. We visit children in their home, early years' setting, opportunity group, school or college. Working closely with families, teachers, and medical professionals means we can offer tailored and targeted support aimed at helping children and young people achieve their potential. In conjunction with the setting, specialist equipment and training can also be provided by our service.

The level of support offered to each child and family is based on the child's needs, their stage of development and the knowledge and support that they have around them.

It can include:

Support for and liaison with parents
Training and advice for school staff
Signposting parents, carers and staff to other appropriate agencies
Contributing to the assessment, monitoring and reporting of needs both formally and informally
Providing advice on access to the curriculum, target setting and record keeping
Providing programmes of support including help to promote the use of functional vision and social and emotional interventions.
Attending annual reviews and other multi agency meetings as appropriate
Representing the needs of children and young people to officers in the LA and help the child/young person express his/her views
Providing direct teaching to children working on specific skills (e.g. Braille) as appropriate
In conjunction with the school, providing equipment/ICT to support pupils' needs within the setting if their visual impairment hinders/prevents curriculum access and recording
Providing training on the use and maintenance of equipment
Advising on access arrangements for national examinations and internal assessments
Providing advice on adaptations to the environment
Programmes of habilitation skills when necessary, including early movement skills, spatial and body awareness, cane training and route planning.
Programmes of independent living skills when required.
Observing children/young people within their settings and provide feedback for staff

Who is the service for?

We work with babies, children and young people with a diagnosed vision impairment. This includes children with additional special educational needs and disabilities. For a more detailed description of our referral criteria visit the teams Right Choice (opens new window) page.

We are not able to support children and young people with a visual perception difficulty which is not accompanied by other concerns identified by the eye clinic. We are also unable to offer support to children/young people with Dyslexia or Irlens Syndrome. Please refer to the SEND Cognition and Learning Team via DART (opens new window)for support with these conditions.

How can I start using the service?

We require a referral from an ophthalmic service or eye clinic, ideally at the time of diagnosis. If you have concerns regarding your child's vision your first port of call should be your GP or your local optician. If necessary, they can refer your child to the specialist ophthalmic services within your area. The ophthalmic service can provide a diagnosis of your child's eye condition or vision impairment and if appropriate, will refer your child to our service and you will be asked to complete a Parental Permission form with your contact details. The Referral form and Parental Permission form are sent to the Lead Professionals for Sensory Impairment Physical and Medical Services and your child will be allocated to a Qualified Teacher of the Vision Impaired (QTVI). The QTVI from the Vision Support Service will make contact as soon as possible with you, your child and any educational setting they attend. An initial visit will be arranged within a half term (excluding school holidays).

The QTVI will provide information about what the diagnosis means and offer advice on how best to support your child. We work closely with the ophthalmology department and parents in providing ongoing support to settings. The frequency of our visits will be agreed dependent upon the degree of visual need and the level of support needed by your child, yourselves and/or their educational setting.

All referrals to the Sensory Impairment Service are from hospital based medical professionals. Ophthalmologists, ENT specialists and Paediatricians diagnose the causes of the sensory loss and make referrals accordingly. Audiologists and Orthoptists make clinical assessments of the hearing or sight loss in the clinics and also make referrals based on these results. There are service referral forms available for the medical professionals to refer a child or young person with a Hearing and/or Visual Impairment. The forms include signed parental permission to share the medical information with the Advisory Teachers. The Advisory Teachers have strong links with the Audiology and Ophthalmology departments of our local hospitals and ensure that the medical professionals are aware of our referral criteria so that inappropriate referrals are not made. Referrals are also made to the service from specialist hospitals such as Moorfields or Great Ormond Street, as appropriate.

All referrals are received centrally to the service and checked for eligibility. If the criteria are met the referral is allocated to an Advisory Teacher. The referrer will be notified by letter of the outcome.

The Advisory Teacher will make contact with the school, or early years setting, to make an appointment and parents are informed. If the referral is for a baby or child not yet at pre-school the Advisory Teacher will visit the home.

Once a child has been referred and accepted as an appropriate referral, an initial assessment will be carried out and a written report produced. Support is determined by the NatSIP (National Sensory Impairment Partnership) eligibility criteria which gives a score and a support pattern.

A child or young person with a suspected vision loss should be taken to an Optician in the first instance. The Optician will refer to the GP or eye clinic if there is an underlying vision problem that cannot be corrected with lenses.

Referral Criteria for Visual Impairment

We will work with children and young people from point of diagnosis (if necessary, from birth). Children and young people will receive support if they meet one or more of the following criteria:

A corrected distance vision of 6/18 or less, in the better eye.
A corrected distance vision of 6/18 or less with both eyes together.
A near vision of 6/18 (difficulty reading print size N14 or smaller at 30-33cm)
Restricted Visual Fields which might be central affecting near vision i.e. Cone Dystrophy associated with Bull's Eye Maculopathy, or peripheral loss. Peripheral defects must be extensive enough to meet criteria for registration.
A degenerative eye condition (early referral vital) e.g. Retinitis Pigmentosa, Usher's Syndrome, Juvenile Batten's Disease.
Any diagnosed ocular condition (not including refractive errors).
Registration as sight impaired or severely sight impaired. This is on the recommendation of an ophthalmologist. The orthoptist/ophthalmologist will complete the registration form and the VI service will carry out the functional vision assessment.
Cortical Visual Impairment (diagnosed by a consultant ophthalmologist)
Acquired VI e.g. traumatic head injury leading to loss of vision.
Refractive error not fully corrected by glasses or other visual impairment which prevents effective use of vision.

The following are nationally agreed definitions of degrees of vision loss. They refer to the corrected vision (with glasses if worn) in the better eye.

Distance vision
Mild vision loss	Within the range 6/12-6/18 Snellen/Kay, Logmar 0.3-0.48
Moderate vision loss	Less than 6/18-6/36 Snellen/Kay, Logmar 0.5-0.78
Severe vision loss	Less than 6/36-6/60 Snellen/Kay, Logmar 0.8-1.00
Profound vision loss	Less than 6/60 Snellen/Kay, Logmar 1.02

Near vision
Mild vision loss	N14-18
Moderate vision loss	N18-24
Severe vision loss	N24-36
Profound vision loss	Educationally blind/Braille user/can access small quantities of print larger than N36

We offer support to all children and young people (0 to 18 years or 25 years with EHCP) with a diagnosed visual impairment who meet the criteria described above. We support pre-school children and like to be involved as soon as a visual impairment has been diagnosed and confirmed. There is no lower age limit

If vision is better than 6/18 in any of the above conditions the Vision Impairment team will provide guidance, but the child may not be placed on the regular caseload and may receive 'one off' or 'on request' visits.

The following do not meet the criteria for referral if there is no associated diagnosed eye condition.

Mild vision loss as described above
Monocular vision where sight is within normal limits in the good eye, and stable
Squints (dealt with by Orthoptists at the Eye Clinic)
Refractive error fully corrected by glasses
Mild colour deficiency
Visual perceptual difficulties
Lack of binocular (or 3D) vision (usually associated with squints or monocular vision)

In all cases referrals must be accompanied by form giving signed parental permission.

Assessment of vision

The eye clinic will gather a more detailed picture of your child's vision during follow up appointments and should share with you a clinical report. Glasses, if prescribed, will be specifically made for your child.

The QTVI will carry out functional visual assessments to inform you and your child's educational setting about how your child is managing to access activities and the environment around them.

Our team can:

Liaise closely with the ophthalmologists
Help you and your child's setting to understand reports from the eye clinic
Provide functional vision assessment results and observations to the eye clinic staff as required

School Support

As a parent or carer you will need to decide on which school you would like your child to attend. This is most likely to be a local mainstream school in Wiltshire. The placement will involve planning with yourselves, the school and the Vision Support Service in plenty of time to ensure your child's needs can be met. Additional support will be put in place depending on the degree and implications of your child's visual needs. If your child has complex needs, then you may decide that a Wiltshire special school may be more appropriate to meet their needs. You will need an Education and Health Care Needs Assessment for your child, if you would like to apply for a special school place.

Please visit EHC assessments for further information:

In a mainstream school, our service can:

Provide training to the staff in your child's setting if required.
Provide support throughout full-time education. The level of support will depend on the degree and implications of your child's visual needs and will be assessed at least once a year, using the National Sensory Impairment Partnership (NATSIP) Eligibility Criteria.
Monitor your child's progress and give advice on areas where he/she may need additional support to access learning opportunities
Ensure that any low vision aid equipment is in good order and being used appropriately.
Work with the class teacher/SENCo to ensure full access to the curriculum.
Discuss any social issues which you or your child may be concerned about. We can provide vision awareness training to your child's peer group, if appropriate.
Provide Guided Walking training, via our Habilitation Specialist, if appropriate.
Encourage your child to become competent in caring for his/her glasses and equipment and to be an independent learner.
Provide and maintain any other specialist equipment required.
Contribute to the preparation of My Support Plans and where appropriate provide advice for the preparation of Education and Health Care Plans.

For further information visit the teams Right Choice page.

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