Is Vision within the Scope of practice for School Occupational Therapists?
Occupational therapists are not vision therapists or eye doctors, but we routinely address physical development, range of motion, reflexes, and many other weaknesses that children may have. That includes SOME vision deficits.
The MYTH About Occupational Therapy
There is a myth about Occupational Therapy – that we treat the upper half of the body or just the hands. Realistically, we treat the whole child.
The purpose of Occupational Therapy in the school-based setting is “to help children fulfill their role as students by supporting their academic achievement and promoting positive behaviors necessary for learning” (AOTA, 2014).
One of Occupational Therapy’s distinguishing characteristics is that we focus on the whole child. The OT looks at the child’s skills and weaknesses, “in addition to his or her visual, sensory, and physical capabilities” (AOTA, 2014).
In school, children spend a great deal of time on tasks that require an adequate vision system.
Children rely on vision to function
- looking at the board
- reading up close and far
- writing up close
- copying from notebook
- keeping place when reading and copying
- discrimination of objects in space
- matching, sorting, and categorizing
In recess and physical education:
- tracking a ball
- coordinating vision with motor skills to kick, use a bat, or use a racket
- running/looking toward a base or home plate
- negotiating the classroom furniture, the cafeteria and the bus
- finding their way to other rooms, bathrooms, the nurse, etc.
Outside of school: children also rely on their vision systems to engage in social activities, group games, sports, and independent play. Older children often rely on functional vision skills to participate in socializing via texting or emails.
Occupational Therapy in School – All About Function
Occupational therapists utilize developmentally appropriate activities and may emphasize physical skills to increase movement, strength, and/or coordination; and adaptive skills or equipment to address deficits in cognitive and executive function, sensory processing, visual motor and perception, and the ability to socialize and maintain friendships.
In terms of vision, the occupational therapist may use treatment activities to increase the range of motion of the eyes to improve a child’s ability to smoothly track a line of text. They may design activities to improve the coordination of the two eyes (binocular vision skills) for children who struggle with reading, difficulty copying from the board, or inability to follow a moving object.
The goal of the therapist’s work is always to improve the child’s functional performance, independence, and quality of life. According to Mitchell Scheiman (2020), a vision therapy optometrist who routinely presents to occupational therapists about vision, “occupational therapists can comfortably participate in providing therapy in the context of eye movement and visual information processing disorders”.
BEST PRACTICE IN SCHOOLS INCLUDES VISION
Best Practice for Occupational Therapy in Schools (2nd edition) states that visual impairment, (according to IDEA 2004) is “any impairment in vision that even with correction adversely affects a child’s educational performance” (p 321). According to the Office of Special Education and Rehabilitation service, 2017, this includes conditions caused by any etiology, including…ocular-motor issues (as cited in Lampert, 2019).
As School OTs, it’s important that we educate parents, teachers & administrators about our complete scope of practice. Here’s a free printable to spread the word!
Occupational Therapy treats the Whole Child!
Hofmann, A. O.. (2014, November) What parents need to know about school-based occupational therapy. Retrieved from: HTTP://www.aota.org/About-Occupationatl-Therapy/Professionals/CY/Articles/School-consumer.aspx
Lampert, J. (2019). Best Practices in Supporting Students With Visual Impairment. In G. F. Clark, J. E. Fioux, & B. E. Chandler (Authors), Best practices for occupational therapy in schools (2nd ed., pp. 321-327). Bethesda, MD, MD: AOTA Press/The American Occupational Therapy Association.
Scheiman, M. (2020). Vision Impairment. In J. C. O’Brien, H. Kuhaneck, & B. A. Ball (Authors), Case-Smith’s occupational therapy for children and adolescents (pp. 844-869). St. Louis, MO: Elsevier.