During CVI Awareness Month so far, I’ve shared resources to help define and identify risk for cortical visual impairment (CVI), and offered a few tools to fill your AAC tool box. But, as you can see in my credentials (or lack thereof), I’m not a vision “expert”. I’m not a TVI, or an eye doctor, or a vision therapist, or any other highly skilled vision professional-so my ability to identify and support the vision needs of my students has clear limitations. Luckily for me (and you!), I don’t have to solve the vision mystery alone! My vision colleagues are on my team, eager to collaborate for the benefit of students who struggle to see, or struggle to make sense of what they see.
If you are serving students with CVI and other vision needs, you’ll definitely want these vision pros on your AAC dream team:
1 - Eye Doctor
An ophthalmologist is a medical doctor (MD) who specializes in the medical and surgical care of the eyes and the ocular aspects of the vision system, such as the optic nerve. These professionals may support AAC users by prescribing glasses when needed, treating eye diseases, and correcting eye conditions like strabismus via patching, medication, or surgery. Some ophthalmologists may have additional training and experience diagnosing and supporting children with cortical visual impairment (CVI), but not all understand this unique condition.
An optometrist is not a medical doctor, but rather a doctor of optometry (OD). These professionals are licensed eye specialists who may work with an ophthalmologist, or practice autonomously, to provide services like eye exams, diagnosis and treatment of eye disorders and diseases, and provision of prescription eyeglasses. The key difference between an ophthalmologist and an optometrist, is that an optometrist doesn't perform surgery on the eye. An optometrist may support AAC users by conducting eye exams and providing eye glasses. They may also serve in specialty roles related to low vision support and vision therapy.
2 - Teacher of the Visually Impaired
A teacher of the visually impaired (TVI) is not a medical professional, but rather an educational professional with specialty training in the education of children with blindness and visual impairment. A TVI may support AAC users by conducting a functional vision assessment, a learning media assessment, and an environmental assessment, all of which support the development of appropriate learning plans. You can learn more about the TVI’s roles and responsibilities in this great blog post on Perkins School for the Blind. TVI’s may also support AAC users by working with others on the team to adapt learning, life, and communication materials to best suit each individual’s vision needs. Additionally, many TVI’s, but not all, have special training in CVI and can assist in the diagnosis and treatment endeavors related to CVI.
3 - Orientation & Mobility Professional
As the name suggests, O & M professionals are trained to assist people with blindness and vision impairment in navigating their environment. These experts may teach AAC users how to use the vision they have to navigate safely in their world, either by walking or using a wheelchair. O & M experts may teach visually impaired people to use canes and guide dogs as well. Although not directly involved in AAC decision-making, an O & M specialist is a great resource with whom to consult as you are working to support the whole student- after all, communication and mobility are integrated.
4 - Low Vision Specialist
A low vision specialist is an eye doctor (ophthalmologist or optometrist) with additional skills and experience in low vision. Low vision means having impaired vision that cannot be corrected by glasses, surgery, or medication. Low vision is different from CVI in many ways, although sometimes, these conditions can co-occur. A low vision specialist may support an AAC user by providing a low vision exam, and assisting with the identification of tools and strategies to maximize the use of the vision present. Tools offered by low vision specialists may include assistive technologies like screen readers, screen magnifiers, and magnifying devices. Low vision specialists can also assist families and teams in modifying the living, learning, and communication environments to best support the student’s vision needs.
5 - Vision Therapist
For specific vision problems that involve the function of the whole visual system (not just the ocular aspects, or what is within the eye), an AAC user may be referred to an optometrist that provides vision therapy. Developmental optometrists, also known as behavioral optometrists, focus on the connection between the brain and visual system, which can be improved by a process known as vision therapy. Additionally, some optometrists are trained and experienced with diagnosis and support for children with CVI. Vision therapists may also be professionals of other licensure and training, such as occupational therapists (OT).