Teaching Students with Visual Impairments
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      • Adjust Lighting
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      • Sensory Areas & Rooms
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      • Morning Meeting
      • Weather Check
      • Dramatic Play
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Vision Therapy Controversy for Students who are Visually Impaired

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Vision Therapy Controversy

By: Carmen Willings
teachingvisuallyimpaired.com
​Revised October 4, 2017

A subset of optometrists called developmental or behavioral optometrists, have been practicing vision therapy for decades. Vision therapy, also known as vision training, is an individualized, supervised, treatment program that is used for children (and sometimes adults) who have binocular vision problems, such as convergence insufficiency, focusing problems, tracking difficulties, eye teaming difficulties and for visual perceptual difficulties.
The goal of the therapy is to train the brain to process visual information more efficiently. For most people, vision therapy means once a week visits to their optometrist's office for a period of time, where they work with the optometrist or a trained vision therapist working under the supervision of an optometrist. They will guide the patient through activities designed with the goal to correct visual processing problems and/or build visual skills. Programs typically involve eye exercises and the use of lenses, prisms, filters, occluders, specialized instruments, and computer programs. The therapist or optometrist might provide a few activities to work on at home. The vision activities (or exercises) usually take about 15 minutes a day. The therapy, that takes weeks to months, is closely monitored by vision therapists in the clinical setting.

What is the Controversy?

​This treatment is not usually prescribed by medical doctors (ophthalmologists) but is prescribed by optometrists (ODs) who specialize in this area. Many ophthalmologists feel that there is no benefit to vision therapy as there are few randomized, controlled trials that show the benefit of vision therapy. Although there have been cases where vision therapy has proven to be helpful, there have been only few valid scientific studies addressing the effectiveness of vision therapy. This is why there is a lack of acceptance of this as a treatment option within the vision field as a whole. Furthermore, the therapy is very costly (thousands of dollars) and is not covered by many insurance companies. There is a possibility that major medical may cover visual training (this may vary from state to state). Some optometrists have been able to successfully file it under the category of physical therapy, but that depends on the insurance company.

Is Vision Therapy Provided by Schools?

If a family chooses to participate in vision therapy, they must understand that it is performed by Vision Therapists, not Teachers of Students with Visual Impairments, in a clinical setting and homework is provided for home use. As stated earlier, Vision Therapists are not employees of schools but rather in medical settings. It is at the discretion of school districts whether or not they will pay for these outside therapies. For those students who are prescribed vision therapy, a doctor should provide intervention. IDEA and the No Child Left Behind, Elementary and Secondary Education Act require educators to consider evidence-based educational practices. Due to the lack of scientific evidence of the efficacy of eye exercises, vision therapy as an educational intervention is not practiced by educators, specifically a Teacher of Students with Visual Impairments (TVI).

​Additionally, vision therapy is considered a medical service and therefore in most states, it is excluded as a related service under IDEA and should not be listed on the IEP (Some states, such as California, do provide Vision Therapy Services and Vision Therapists are employed by the school - separate from Teachers of Students with Visual Impairments). If a family decides to participate in vision therapy it should be obtained privately through an optometrist or vision therapist under the guidance of an Optometrist. Teachers of Student with Visual Impairments do, however, teach visual efficiency skills which should not be confused with vision therapy. Instruction in visual efficiency skills may be included in the IEP for students who are eligible and in need of instruction by a TVI as it is a part of the Expanded Core Curriculum.
 
Although vision therapy is typically not provided by the schools, the students may still receive adaptations or other services that may help them. The optometrist may recommend school accommodations that may assist the student throughout the day. These recommendations are generally simple to provide and may include using a line guide or a bookmark to keep their place while reading, positioning books on a slant board or incline, receiving a copy of notes or information presented on the board and being seated closer to the board. 

Keep in mind that although the student may need support or accommodations in these areas related to vision, they will typically not meet the eligibility criteria to be identified as a student with a visual impairment as the criteria for that label is reserved for students who are severely impacted by their vision (see eligibility criteria). Although the student may not meet the eligibility criteria for vision services provided by the school, the student may meet the eligibility criteria for school based occupational therapy.  The occupational therapist may be able to work with the student in the area of sensory processing problems. Similarly, they may be able to receive support from a reading specialist.
The information presented here  was taken from the Boston Children's Hospital FAQ's on vision therapy; wikipedia on vision therapy; and the Optometrist Network. 

Position Papers

​The College of Optometrists have created a position paper on the topic of vision therapy. The Association of Education and Rehabilitation of Blind and Visually Impaired (AER) has also created a position paper. Both can be downloaded and printed for your reference:
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College of Optometrists Position Paper on Vision Therapy
Picture
AER Position Paper

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      • Biblical Passages Concerning Blindness
      • Notable People
      • Helen Keller
      • APH Museum
      • Leaders & Legends
      • History of Braillewriters
      • Legislation
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      • Books about Dog Guides
      • Teen & Young Adult Books
      • Non-Fiction Books
      • Helen Keller Books
      • Parent Resource Books
      • Grief & Suffering Books
    • Impact on Development & Learning
    • Psychological Impact
    • Social Etiquette
    • Financial Assistance
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      • The Expanded Core Curriculum
      • IDEA and Vision
      • Federal Quota Funds
      • Deaf-Blind Child Count
      • State SpEd Agencies
      • Schools for the Blind
    • Referrals >
      • Vision Concerns
      • Referral Process
      • Eligibility Guidelines
      • Vision Therapy Controversy
      • When Student Doesn't Qualify
    • Medical Vision Exams >
      • Medical Professionals
      • Vision Tests & Tools
      • Visual Acuity
      • Lenses
      • Visual Fields
    • FVLMA >
      • What is the FVE
      • Interpret the Eye Report
      • Environmental Observations
      • FVLMA Observations
      • Interviews
      • Assessment Kit Materials
      • Oculomotor Skills
      • Near Visual Acuities
      • Print Comparisons
      • Distance Acuity
      • Test Visual Fields
      • Vision Skills
      • Learning Media Assessment
      • Reading Rates
      • Writing the FVE Report
    • Service Planning >
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      • Least Restrictive Environment
      • Early Intervention Services
      • Students with Multiple Disabilities
      • Student Led IEPs
      • 504 Plans
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    • Writing Goals >
      • Writing SMART Goals
      • Blooms Taxonomy
      • Independent Living Goals
      • Compensatory Goals
      • Sensory Efficiency Goals
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    • Home Adaptations >
      • General Home Safety
      • Kitchen Adaptations
      • Bathroom Adaptations
      • Medication Adaptations
      • Clothing Management Adaptations
    • Curriculum Adaptations >
      • Numbers & Counting
      • Algebra
      • Geometry & Spatial Sense
      • Measurement & Data
      • Early Literacy Experiences
      • Create Tactile Books
      • Reading Instruction
      • Reading Efficiency
      • Science Adaptations
      • Social Studies Adaptations
    • Material Adaptations >
      • Accessible Educational Materials
      • Large Print
      • Braille Code
      • Photocopying
      • Font Legibility
      • Increase Contrast
      • Pictures and Worksheets
      • Tactile Graphics Guidelines
      • Creating Tactile Graphics
      • Teacher Made Materials for Students with MD
    • Instructional Adaptations >
      • Individual Schedules & Communication Cards
      • Movies & Assemblies
      • Lectures & Instruction
      • Board Work (Chalk, Interactive, White)
    • Environmental Adaptations >
      • School Campus Adaptations
      • Classroom Design Tips
      • Labeling System
      • Adjust Lighting
      • Playground Adaptations
      • Sensory Areas & Rooms
    • Early Childhood Adaptations >
      • Daily Schedule
      • Morning Meeting
      • Weather Check
      • Dramatic Play
      • Blocks
    • Adaptations to the Arts >
      • Art Adaptations
      • Art Materials
      • Music
      • Music & Movement
      • Dance
    • Recreation & Leisure Adaptations >
      • Recreation Adaptations
      • VI Sports Associations
      • Recreation Resources
      • Camps for VI
      • Card and Board Game Adaptations
      • Transcribe Playing Cards
  • VI AT
    • Overview of Assistive Technology
    • VI Assistive Technology >
      • Non-Optical Low Vision Devices
      • Low/Medium Tech Devices for Tactual Learners
      • Optical Devices for Near
      • Optical Devices for Distance
      • Video Magnifiers
      • Screen Magnification & Readers
      • Braille Technology
      • Tactile Graphics Technology
      • Auditory Access Devices
      • Braillewriter Repair
    • Apps for VI >
      • Note Taking Apps
      • Apps for Accessing Books
      • Identification Apps
      • Navigation & Location Apps
      • Braille Apps
      • Magnifier Apps
      • Sound Making Apps
      • Cause & Effect Apps
      • Vision Skills Apps
      • Apps for Early Learning
      • Read to Me Story Apps
      • Apps for Communication
      • Android Apps for VI
    • AT Instruction >
      • Video Magnifier Instruction
      • Notetaker Instruction
      • Accessing Audio Books
      • Navigate Computer without a Mouse
      • Word Processing and Shortcuts
      • Keyboarding Instruction
    • iOS for VI >
      • iPads as Instructional Tools
      • Making the iOS Device Accessible
      • iOS Accessibility Resources
      • VoiceOver
    • Assistive Technology Assessment
    • VI AT Resources
    • Vendors
  • Instruction
    • Virtual Instruction
    • Instructional Strategies >
      • Development of ECC Resources
      • Teaching in Thematic Units
      • Teaching the ECC
      • Summer Reading (braille)
      • Summer Outdoor Activities
      • Rainy Day Activities
    • Compensatory >
      • Guiding Principles of Concept Development
      • Functional Skills
      • Community Based Experiences
      • Concepts to Teach
      • Organization & Study Skills
      • Cranmer Abacus Instruction
      • Time Management
    • Communication Modes >
      • Language Development
      • Braille Instruction
      • Braille Instruction Materials
      • Writing Braille
      • Signature & Handwriting Instruction
      • Nemeth Braille Code
      • Tactile Graphics Instruction
    • Sensory Efficiency >
      • Sensory Input
      • Encourage Use of Vision in Students with MD
      • Lightbox Use
      • Sensory Activities for Students with MD
      • Sensory Table
      • Visual Efficiency Skills
      • Visual Attend and Scan Activities
      • Visual Tracking Activities
      • Visual Discrimination Activities
      • Visual Motor Activities
      • Optical Device Use
      • Tactual Readiness
      • Developing Skillful Hands
      • Auditory Readiness
      • Listening Skills Instruction
    • Independent Living >
      • Responsibility & Independence
      • Mealtime Independence
      • Eating Adaptations
      • Food Preparation
      • Recipe Activities
      • Hygiene & Grooming
      • Dressing & Clothing Management
      • Money
      • Housekeeping Instruction
    • Orientation & Mobility >
      • Transition Between Activities
      • Proper Guide Techniques
      • Orienting Student to Environment
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