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Letter to the editor.

I must compliment Duane Geruschat, my colleague at Johns Hopkins, for his editorial comments in the April 2007 issue of the Journal of Visual Impairment & Blindness (JVIB) in regard to occupational therapy and low vision rehabilitation. There is no denying that there is an increased interest and involvement in the area of low vision rehabilitation by the field of occupational therapy. There are many reasons for this heightened awakening and provision of low vision rehabilitation services by occupational therapists, with a greater demand for low vision service providers topping the list. Like Dr. Geruschat, I have, at times, found the reaction of traditional low vision and blindness service providers less than embracing of the idea of occupational therapists providing low vision rehabilitation care.

It has been my experience that occupational therapists who serve people with low vision have been very enthusiastic and professionally concerned with the improvement of their skills in the area of low vision. This enthusiasm has been demonstrated in the large numbers of occupational therapists who have pursued continuing education opportunities in the area of low vision rehabilitation. I have had direct experience with occupational therapists seeking continuing education in the area of low vision through my work at Johns Hopkins Vision Research and Rehabilitation Center, and in the low vision division, Divison 7, of the Association for Education and Rehabilitation of the Blind and Visually Impaired. The largest number of new applicants for certified low vision therapist status through the Academy for Certification of Vision Rehabilitation and Education Professionals are in the occupational therapy discipline.

Are there some occupational therapists who would provide services beyond what the scope of practice covers? The answer, as with any professional group, would be yes. My comments are directed to the majority of occupational therapists who are complementing the existing services traditionally provided by low vision and blindness rehabilitation staff members. How do we bridge the gap of limited resources and provide the most comprehensive low vision rehabilitation services to consumers with low vision so they may maintain their independence? The recognition of occupational therapy as a needed and viable resource is a vital first step.

The April 2007 issue of JVIB also contained a Speaker's Comer, written by Bryan Gerritsen, that summarized the progress of the Centers for Medicare and Medicaid Services (CMS) Low Vision Demonstration Project, which presents the perfect opportunity for partnerships among certified low vision therapists, certified orientation and mobility (O&M) specialists, certified vision rehabilitation therapists, and occupational therapists. The use of occupational therapists in this project would allow for the specialized services of a certified low vision therapist, certified O&M specialist, and/or certified vision rehabilitation therapist to be covered by CMS if the delivery model of service is properly coordinated and administered by a supervising physician. A consumer with low vision would have the opportunity to receive up to nine hours of specialized low vision rehabilitation instruction by certified low vision professionals, in addition to the services of an occupational therapist. These services could occur in the patient's home environment, if needed. In order for this model of service to happen, traditional low vision and blindness rehabilitation service providers need to become proactive and collaborate with, rather than just talk about, occupational therapists. The caseloads of occupational therapists today will generate many referrals to certified low vision therapists, certified O&M specialists and certified vision rehabilitation therapists if the occupational therapists are aware of what these professions can provide to individuals with low vision. Many of these individuals are low vision patients in a health care model who often would not receive low vision rehabilitation services as part of their standard care.

The meeting that Duane Geruschat referred to in his editorial, the Josephine L. Taylor Leadership Institute, is an annual event that has included occupational therapists in its program for the past two years, evidence that occupational therapists are attending the forums and educational opportunities at which information about low vision rehabilitation is being disseminated. Should this type of professionalism and motivation be talked about? I would strongly say yes. It is time for the members of the field of visual impairment and blindness to take a lesson from the discipline of occupational therapy and learn about other service providers who operate outside the traditional "blindness sector." Members of the field need to make an attempt to learn about the benefits and role of occupational therapy for clients or patients with low vision. I encourage members of the field to attend occupational therapy conferences or make presentations for local occupational therapy groups to share their expertise; seek continuing education opportunities from the occupational therapy community; and provide continuing education training to the community of occupational therapists in return. In short, members of the field need to make themselves known outside of the blindness community and be encouraged to contact low vision service providers to explore how such services might be expanded to increase the depth and quality of low vision rehabilitation through use of certified low vision therapists, certified O&M specialists, certified vision rehabilitation therapists, and occupational therapists to address the needs of patients with low vision.

It is my hope that a future editorial in JVIB might highlight the increased number of consumers receiving low vision rehabilitation services, especially as part of the CMS Low Vision Demonstration Project through a working collaboration of the various disciplines mentioned earlier. This type of working relationship, if successful, will increase the demand for specialized services for consumers with low vision. The challenge presented to the field of visual impairment and blindness is to have the specialized resources and appropriately trained staff members that the increased involvement of occupational therapists will require to meet the growing numbers and demands of consumers with low vision. I look forward to reading about such developments in future issues of JVIB.

Jim Deremeik, M.A., CL VT, education and rehabilitation program manager, Low Vision and Visual Rehabilitation Service, Lions Vision Research and Rehabilitation Center, Johns Hopkins Wilmer Eye Institute, 550 North Broadway, 6th Floor, Baltimore, MD 21205; e-mail: <jderemeik@jhmi. edu>.
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Author:Deremeik, Jim
Publication:Journal of Visual Impairment & Blindness
Article Type:Letter to the editor
Date:Jun 1, 2007
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