1. Emerging Trends: Field of Vision Rehabilitation Mary Frances McAndrews, CVRT Jayne Meekings, CVRT, CLVT Julia Halpern-Gold, COMS, CVRT

2. How has the field changed? University Trained Instructors Home Training Instructors

3. Agency Trained Instructors 1950’s Veterans Administration was training individuals at Hines VA to provide O&M instruction These individuals were then returning to home agency and training other instructors

4. University Training Programs 1960-Boston College started 1 st graduate O&M training program 1961-Western Michigan started graduate O&M training program 1963-Western Michigan started 1 st graduate Rehab Teaching training program

5. Who are all these people??? Orientation and Mobility Specialist Rehabilitation Teacher Low Vision Therapist Vision Rehabilitation Therapist Living Skills Instructor Manual Skills Instructor Travel Trainer ADL Instructor Mobility Instructor Peripatologist

6. Dual Certification Programs 1983-Boston College pilots dual certification program-O&M and RT 1997-Low Vision Therapist certification is offered through AER January, 2000-ACVREP becomes certifying body for blind rehabilitation professionals

7. Vision Rehab vs Blind Rehab vs Multisensory Vision Rehabilitation- focus on LOW VISION individuals short-term targeted training /training offered in home or outpatient program Comprehensive Rehabilitation- focus on PROGRESSIVE VISION LOSS long -term training/training offered in residential setting Multi-sensory Rehabilitation- focus on individuals with vision loss and other disabilities (deafness, TBI, stroke) training offered long-term with interdisciplinary team inpatient and outpatient

8. Demographics: Vision Impaired Population Summary of Virginia Statistics -2009 LB = 34,627 25,521 > 44 years of age VI = 232,651204,731 > 44 years of age Totals: 267,278230,252 > 45yr. Virginia OBG Statistics from 2008 & 2009 (DBVI) 20 case workers 2009 - 1,434 people served 2008 – 1,317 people served

9. Demographics: Professionals Serving Them Low Vision Demonstration Project Final Report November, 2010 VRTs – Less than 550 O&M Specialists – 2,000 OTs – 100,000 (this number does not indicate the numbers trained in vision rehabilitation) 50% of DBVI VRTs are over the age of 55

10. Where are VRTs & LVTs going? Medical Community is recognizing Occupational Therapists as Vision Therapists & Vision Rehab Therapists American Academy of Ophthalmology SMARTSIGHT-MAKING THE MOST OF REMAINING VISION 2007-Academy Initiative in Vision Rehabilitation Order for Rehabilitation Training “The physician’s order for Medicare –reimbursed occupational therapy rehabilitation training should include :…… Glaucoma Research Foundation January 2011 Gleams Newsletter Article “Getting Help if You Have Low Vision” “An occupational therapist can also help you learn new ways to do daily tasks”….. “Occupational therapists help patients decide what type of lighting is most comfortable… Janet R. Meyers, MS, OTR/L, CLVT and Denise Thomas Wilcox, PT, OD, PhD of the Philadelphia VAMC Advanced Low Vision Clinic Program have coauthored a chapter on low vision evaluation in a book just published by the American Occupational Therapy Association Press. Occupational Therapy Interventions for Adults with Low Vision is a textbook that will be used in occupational therapy curricula across the country.

11. Functional Independence No Matter Who Provides the Service Smartsight OT Rehabilitation Training Activities List Scotoma awareness and uses for central and peripheral field loss Visual Motor-scanning, tracing, tracking and target localization Visual Perceptual skill: visual closure, visual perspective Reading & writing ADL Application of optical and non-optical devices Environmental adaptations: lighting, contrast, labeling, organization, hazards Workplace assessments and adaptations Adaptive computers: enlargement, speech output Safe mobility in home and community Recreational Resources-local & national Caregiver support and training Driver evaluation and training (not reimbursable)

12. Medical Model=Effectiveness, Accountability, and Professionalism Contrast Sensitivity Testing Visual Field Testing for Central Scotomas Near Vision Testing Distance Vision Testing

13. Contrast Sensitivity Tests MARS ($150) LEA Flip Card-More reasonable & portable ($90)

14. Visual Field Testing Macular Mapping online Testing My Vision Test A free modern Amsler Grid test for Macular Degeneration

15. Near Vision Reading Assessments Smith Kettlewell Reading Test Kit-Available from Mattingly International

16. Medical Model=Effective Service Provider Consultation on multi-disciplinary team Established licensure & clinical practice standards More opportunities for professional growth and career advancement

17. Licensure-History & Debate 5-year Medicare Low Vision Rehabilitation Demonstration Project NY Licensure Bills to “Provide for the licensing of orientation and mobility specialists and vision rehabilitation therapists” Benefits of licensure to profession, agency and customers

18. Future of Vision Rehab AER Blindness Professionals Recruitment Taskforce Strategic Work Plan 2011 Mission Statement: Goal 1: Partnerships: The AER Blindness Professionals Recruitment Committee will establish and maintain partnerships of professionals, parents, blind students and other committed organizations and individuals to ensure that recruitment efforts effectively meet appropriately documented service needs. Goal 2: Products: The Committee will develop recruitment products and venues as well as strategies to attract potential professionals to the field, and will provide these materials and strategies as well as training in their use to recruiters and employers. Goal 3: Promotions: The Committee will actively mobilize professionals, parents, students, and others to help promote the field, recruit potential professionals to join, and mentor new professionals on an ongoing basis.

19. ACVREP news for CVRT Certification eligibility guidelines are up for review Stakeholder input scheduled March 26 th @ 1:00 PM EST. For more information contact gholm@acvrep.org gholm@acvrep.org Focus strategic goal planning and formalizing standards-Subject Matter Expert Committee

20. Resources for Review AER- American Association for Education & Rehab Personnel Prep Committee www.aerbvi.orgwww.aerbvi.org ACVREP- Academy for Certification of Vision Rehabilitation and Education Professionals- www.acvrep.org www.acvrep.org Conference -www.envisionconference.orgwww.envisionconference.org Research and info- www.lowvisionproject.orgwww.lowvisionproject.org Veterans’ Services for Persons –Blind & Low Vision www.veteranseyecare.com/veterans/news/low- vision.cfm