British Columbia Vision Teachers Association Q&A on Visual Impairment and Vision Therapy

Introduction

In British Columbia (BC), teachers of students with visual impairments (TSVI) often receive referrals for students who do not qualify for their services. For example, in the case that parents/caregivers have informed the school that their child has been diagnosed with a binocular vision disorder and the school has made a referral to the teacher of students with visual impairments.

Here is where confusion may arise. Who do TSVIs serve and what is their role? How is their role different from the professionals who provide vision therapy?

What is the role of a Teacher of Students with Visual Impairments (TSVI)?

TSVIs are specialist teachers who provide school-based educational services to a wide range of students who have low vision or are blind. These students have a medically diagnosed condition that has an impact on, or could become a barrier to, their learning. The visual loss/condition could have an impact on a student’s learning across a range of subject and developmental areas, including the core curriculum and disability-specific areas of functioning (e.g., assistive technology; Koenig & Holbrook, 2000). TSVIs conduct formal and informal assessments to determine the extent of the services they will provide in specific curricular and developmental areas.

Who do the BC TSVIs serve?

In BC, TSVIs support students from Kindergarten to grade 12 who meet the BC Ministry of Education eligibility criteria for Visual Impairment as outlined in Special Education Services: A Manual of Policies, Procedures, and Guidelines:

A report from an ophthalmologist, optometrist, or from the Visual Impairment Program at BC Children’s Hospital must clearly state that the student’s vision meets one or more of the following criteria:

- Visual acuity of 6/21 meters or 20/70 feet or less in the better eye after correction (glasses or contact lenses); visual acuity is a measurement of vision clarity

- A visual field of 20 degrees or less (peripheral vision)- Any progressive eye disease with a prognosis of becoming one of the above in

the next few years; or

- An uncorrectable visual problem or reduced visual stamina such that the student functions as if his/her acuity is limited to 20/70 or less [italics added]. This functional deficit must be documented by an ophthalmologist, optometrist, or by the Visual Impairment Program at BC Children’s Hospital.

The eligibility criteria, as outlined in the BC Special Education Policy Manual, indicates that these criteria are “not intended to include students described as having visual perceptual difficulties unless they also have a vision loss as described [above]” (p. 74)

Who are vision therapists?

Vision therapists are optometrists who are specifically trained in vision therapy, sometimes known as developmental or behavioural optometrists, provide this service. Qualified TSVIs do not receive training in vision therapy and are not qualified to provide vision therapy.

What is vision therapy?Vision therapy is an individualized treatment program that is used with children who have binocular vision problems, such as convergence insufficiency, focusing problems, tracking difficulties, eye teaming difficulties, and for visual perceptual difficulties.

What are the steps in response to referrals?

Student is referred using Provincial Resource Centre for the Visually Impaired/School District Form

Provincial Resource Centre for the Visually Impaired / District determines if student is eligible

YES NO

A Qualified Teacher of Students with Visual Impairments determines level of support

needed based on assessed need

Referral to Learning Support Teacher

What should a school-based team or a parent/caregiver do if the student doesn’t qualify for specialized instruction/support from a TSVI?

It is important that school teams and parents/caregivers understand which students are placed on the TSVI caseload and how the school district handles this process

- TSVIs will review the eye report and explain the role of the TSVI (if necessary) - TSVIs will define eligibility criteria (see above)- Further assessment and a referral to the Learning Support Teacher may be

deemed appropriate by the school-based team

When communicating with parents/caregivers, the school-based team in consultation with the TSVI, can then explain the distinction between these two roles.

Given the critical role that vision plays in the learning process, it is imperative that all students with visual dysfunction receive appropriate service that is best matched to their educational needs. For students with a qualifying visual impairment, this will include service from a TSVI. For students with vision issues that do not meet BC Ministry of Education criteria for visual impairment, this may include other members of the student’s educational team with specialized training in addressing visual-perceptual challenges.

References

BC Ministry of Education (2016). Special Education Services: A Manual of Policies, Procedures, and Guidelines. Victoria, BC. Accessed at http://www.bced.gov.bc.ca/specialed/special_ed_policy_manual.pdf

Holbrook, M.C., & Koenig, A. J. (Eds.). (2000). Foundations of Education, Volume 1: History and Theory of Teaching Children and Youths with Visual Impairments (2nd

ed.). New York, NY: AFB Press.