Conference Vision 99, 12-16 July 1999, New York

"When children have disabilities in addition to low vision that affect their ability to communicate and understand the world, the assessment of their vision is a particular challenge".
Dr.Lea Hyvarinen, the great Finnish ophthalmologist, designed tests especially for children with multihandicaps. She visited Poland and our Center several times and trained us to use the following tests:
For observation of fixation, following moving objects, visual attention and convergence we use plastic paddles of three different diameters. On one side are high contrast faces, on reverse side there are stripes of various width. We also use them for visual stimulation and training as they allow for frequent changes of activity. Using the paddles we can determine at which distance and how small the object should be during therapy and at home while playing. It is very concrete and useful information for parents and therapists.
Using high contrast paddles helps us in the rough assessment of child's visual field.
Paddles are of three calibrated sizes and enable repetition of the test in various places by different person.
Assessment of problems in low contrast is performed with low contrast faces "Heiding Heidi". Those pictures are of decreasing levels. We notice the lowest contrast level at which the infant or child respondse and the needed distance. The results of the test are presented to parents to demonstrate them at what distance the child can communicate. This is of great importance because the babies learn facial expressions during their first year of life. Suggestion on how to organize the space around the child are offered to the parents.
Grating acuity tests are used for evaluating the ability to detect black and white stripes.