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Should My Child See an Occupational Therapist or a Developmental Optometrist that provides Vision Therapy?

vision therapy 640When a child struggles in school, parents naturally want to help.  At times it is difficult to know what kind of help a child needs and who is best to provide that service.   

Occupational Therapists (OT) are employed by schools and that may be a good place to start.  School systems, and their OT's, are often stretched thin and can offer only a limited therapy program.  It also draws the child out of the classroom, and may take them away from learning.  Many private OT's offer pediatric care and provide OT care outside the school system.

When a vision problem interferes with learning, the best place to turn is a Developmental or Behavioral Developmental Optometrists.  This is a subspecialty within Optometry.  Optometrists obviously understand the vision system, provide eye examinations, eye medications, and eye glasses.  Developmental Optometry is the subspecialty that understands how vision impacts learning and helps individuals to solve vision problems that affect learning.  These doctors provide Vision Therapy (VT).

How are OT and VT similar?  How are they different?  Perhaps we can offer some guidance for parents and educators. 

Most people are aware that there is an overlap between OT and PT, physical therapy.  There is also an overlap with SLP; speech and language pathologists.  Some OT's and some PT's say they provide Vision Therapy.  Vision Therapy is an entity onto itself, much as Occupational Therapy is not Physical Therapy.  It is specific to visual problems that affect learning and for other visual problems that eyeglasses and contact lenses can't treat.

Developmental Optometrist offer Vision Therapy.  Problems with the visual system are often best treated by someone who understand the visual system.  There are parts within a Vision Therapy program that are similar to OT and PT, but in Vision Therapy, as the name implies, the main 'focus" is vision.  Vision is the sense that supplies our brain with the most information.

What is the Difference Between OT and VT? 

diagramThere is some overlap between OT and VT, but there are considerable differences as well. 

Occupational Therapists help people gain or regain the ability to perform various daily tasks through the use of sensory-motor exercises and interventions. OT aims to improve gross and fine motor coordination, balance, tactile awareness, bilateral awareness, and hand-eye coordination. 

Eye Doctors that provide Vision Therapy, and the Vision Therapists in those practices help children and adults who have not yet developed the visual skills needed to succeed in school.  Behavioral and Developmental Optometrists help patients improve how the vision system works and strengthens the eye-brain connection.  This then helps solve vision problems that affect learning and schoolwork.  It is often these vision problems that causes a child to struggle with poor reading and then produces anxiety.  Children then procrastinate completing assignments and become frustrated.  The reasons for these problems are not always apparent to a parent.  A child assumes that the way they see is normal, and is the same as how their classmates see.  They may not realize that they see blurry or double.  They may not realize that they have eye strain or headaches that are due to a vision problem.

Some of the important visual skills for reading and school success are eye teaming, tracking, focusing, depth perception, visual processing, and visual-motor skills.  These are eye movement and higher visual function skills.  

How does a visual deficit look in a real world situation? 

A child may have 20/20 eyesight, but that only means how someone can see at a distance of 20 feet.  Yes, that's where the "20" of 20/20 comes from.  It does not tell us how someone functions at near, for example reading or computer use, that is so critical now, when so much of learning is computer-based.   It doesn't tell us how the two eyes work together, as a team.  A child may need to read a sentence several times in order to understand its meaning, or tilt their head to read the whiteboard.  They may ultimately avoid doing activities that are visually demanding.  Poor performance in school and on the playing field can often be attributed to visual skill deficits. 

Which Therapy Is Right For Your Child? 

If the child’s visual system is the underlying cause of behavioral or learning problems, then a personalized Vision Therapy program is usually the best answer to help the child gain the visual skills needed to succeed. 

So, when is best to consider Vision Therapy for your child?  The answer is simple and straightforward.  If your child is struggling in school it is important to first be evaluated by a doctor who specializes in vision problems that affect learning.  If a child has trouble with visually demanding tasks, like homework, reading, spelling, or complain of headaches, then a doctor skilled in this area is able to evaluate and determine if Vision Therapy is indicated.   This also applies to children who avoid sports.  There may be an issue in judging space and how fast a ball is coming toward them.  Developmental optometrists also work on sports vision.

The point is that a Doctor of Optometry, and specifically a Developmental Optometrist, is the doctor that provides the expertise needed to address the visual system, and how someone is able to read and learn. 

This is not to lessen the benefits that Occupational Therapists provide.  OT's and PT's often refer patients to our office.  OT’s sometimes perform visual exercises with children, but only an eye doctor experienced in Vision Therapy can prescribe therapeutic lenses, prisms, and filters that enable the child to develop visual skills needed for school success.   

Not all optometrist are trained in Vision Therapy.  Dr. Roth is a Fellow of the College of Optometrist in Vision Development.  This means taht he is certified in this subspecialty.  Dr. Tiomno, Dr. Roth's associate, completed her residency with Dr. Roth.  Our doctors are experienced  in diagnosing and treating people of all ages with all types of visual dysfunction. 

Often children who have passed a school’s vision screening, or "passed the eye test" at the pediatrician's office, may still have a significant problem with visual processing and other skills.  A screening "test" usually measures how each eye sees individually and does not test how the two eyes work together as a team.  A school vision-screening tests only for visual acuity (eyesight) and do not test for the other visual skills that are so important for a child to be able to succeed.  

The visual system is highly integrated with other systems, and therefore, an interdisciplinary approach is often the most effective approach.  OT and VT overlap, but don’t always have to be undertaken simultaneously.  Some children may benefit from both of these therapies 

If your child is struggling with learning or behavioral problems, their vision could be an underlying cause or contributing factor. To schedule your child’s functional visual evaluation, contact Family Eye Care in Old Bridge today. 


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