New Year....New Experiences. What is she up to now?!

A new year brings new experiences, new activities, and you guessed it, NEW OCCUPATIONS.  That goes for me as well.  I truly believe that education and program development are the cornerstones of giving good care to those we serve.   Everyday is a new opportunity to rethink out of the box and resolve ourselves to improving our skill set.  This year I am fortunate enough to be able to offer that education to our state professional organization (POTA) members regarding vision dysfunction's impact on occupational performance.  I hope this forum will provide an arena for discussion and education for others, as well as myself, in order to move our profession forward and continue my own growth and understanding. 

I am posting this blog here as well because it is important to know who is treating you, what's the backstory, and....what is she up to now?
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...We wanted to start the group off by introducing ourselves and giving you a brief history of why we asked for this network to be initiated within the Commission on Practice sector of POTA.

I have been an occupational therapist for 18 years and, in that time, have worked primarily with adults and geriatrics in various settings.  My love revolves around neuro rehab, including strokes, MS, Parkinson’s and most recently concussions.  As concussion rehab has come to the forefront over the last several years, my interest became locked in on visual dysfunctions and symptoms that were common place for those who sustained a concussion. 

In 2013, I took my first vision continuing ed course, “From Eyesight to Insight”, co-taught by Mary Kawar, OTR, of astronaut training fame, and Carl Hillier, OD, FCOVD, creator of the multimatrix game.  It was geared towards pediatric therapists but I thought that it could definitely apply to adult neurological rehab as well, so I took a chance and took the course.  Little did I know at the time how influential these two would be on my understanding of visual screening going forward. 

I took their information and started to apply it to my practice.  So now I had this awesome toolkit on how to screen for visual dysfunction, but no one to refer to.  Within our network there was no one who acknowledged the need for vision remediation and the closest optometrist who did was 50 minutes away in another state.  I tried to work with an ophthalmologist 2 blocks away who said to me upon meeting, “You don’t believe in that vision therapy stuff do you?”, and handed me the American Academy of Ophthalmology’s position statement from 1999 that stated there was no research and it didn’t work.  This was 2014.  I was so frustrated having identified a huge area of dysfunction that no one was addressing, and I, as an OT, couldn’t address, as prisms and lenses were out of my scope of practice to assist with blurred and double vision.

Fast forward to 2016.  My supervisor, knowing I had an interest in vision, sent me a link to another pediatric course, taught by Mitch Scheiman, OD, PhD, FCOVD.  It was here that I learned of the new clinical OTD that was being offered at Salus University.  My mother, Maxine, had just passed away 6 weeks prior to this course, my dad was most likely going to be moving in with us from CT…how on earth could I even entertain getting my doctorate just because I liked vision and identified its impact on occupational performance?  At the end of the day, Dr. Scheiman mentioned a story about his wife, who was an OT…. her name?  Maxine.  I took it as a sign to follow my instinct and sign up.  After 16 years of practice, I was back in school and learning from the best.  I was honored to have the support of Dr. Scheiman as my mentor, who has over 200 published articles regarding vision dysfunction and remediation.

After explaining my frustrations to him both from an OT standpoint with every therapist having a different understanding of skills and role, and frustrated with the eye-care profession after hearing for the millionth time, “Their eye health is fine”, I developed my capstone.  It was a survey that I created, sent to therapists in the most densely populated OT licensed states, regarding “Concussion-related vision disorder practice patterns in occupational therapy”.  Questions revolved around screening technique knowledge, treatment practice patterns, referral patterns, certifications and continuing ed, scope of practice beliefs, frames of references and what, in fact, is OT's role, if any.  And the results that I got were proof positive that something needed to be done! 
Data from this study suggested the need for the following changes in occupational therapy practice:

• More education is required for entry level therapists on proper vision screening techniques to establish standards of care for concussion-related vision disorders and ensure competency
• There is a need to develop entry-level education about the various eye-care professionals, models of vision, and which professionals are most likely to help therapists manage concussion-related vision disorders
• There is a need for additional advanced training for occupational therapists to prepare them to participate in remedial vision rehabilitation similar to the Low Vision Therapist Certification offered through AOTA
• There is a need for research within the occupational therapy literature regarding the effectiveness of remedial vision rehabilitation on changing occupational performance

While presenting this information to the POTA District V meeting in the Fall, I met Joe.  We immediately identified we had the same passion for creating a standard of practice within the field we love in order to improve patient care.  We wanted to educate PA practitioners so that we were screening properly and consistently with objective measures, treating what fell within the scope of OT and referring out to the correct preferred provider who would actually help our patients.  And with that, this forum was born. 

Having presented my poster this past Fall at the American Academy of Optometry in San Antonio, and being accepted to present this April at AOTA in New Orleans, I know that my research is important not only to me, but at least two other professions.  I look forward to providing you with evidence-based practice and information that will help you help your patients when they demonstrate dysfunction with visual acuity, visual efficiency and visual perceptual skills.  Let’s move the profession forward.  Cheers!

#OTCanHelp