handout 2 - Association for Education and Rehabilitation of the Blind
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Transcript handout 2 - Association for Education and Rehabilitation of the Blind
Kendra Farrow, CVRT
VRTs
address the physical, emotional,
and social implications of vision loss
Provides counseling and training in NEW
skills and adaptive techniques
Success is based on level of
independence and emotional adjustment
Work to enhance vocational
opportunities, independent living, and
educational development
OTs
address physical, cognitive, psychosocial
and sensory performance
Provides activities with an aim towards
improving health, well-being, and quality of life
Success is based on increasing participation
and performance
Engagement in daily life activities
(occupations) that support health and
participation in home, school, the workplace,
and community life (AOTA, 2008)
OT
Work with all impairments
as well as states of wellness
If billing insurance,
Treatment is defined in the
Plan of Care (POC) written by
the OT & authorized by the
physician
• OT must perform an
evaluation to identify medical
necessity of services
•
Anyone can refer.
•
If utilizing medical insurance
requires physician
involvement
VRT
Focuses on blindness and
vision impairment
Has community B/VI
connections
Free services, generally
Flexibility in service hours
Anyone can refer
1. OTs with training to
work with Low Vision and
may also work in the
Blindness Stream.
• Services are directed at
LV patients
2. OTs who work in other
settings and may
occasionally have a
patient who is also
experiencing vision loss.
• OTs in hospitals and
nursing homes without LV
training frequently provide
vision services to clients
with field limitations and
loss secondary to brain
injury
If
we don’t use the same words with the
same meanings, it leads to;
misunderstandings, confusion, and
frustration.
If we can’t communicate, we can’t work
together.
Disability and Health (ICF)
Developed by the World Health
Organization to help communication
Offers specific terminology and
definitions to describe disability and
functioning
OTs use this language
OT
Patient
SNF (skilled nursing
facility)
MCB
Physician Prescription or
Orders
Plan of Care (POC)
Training, Participation
Eccentric Viewing
Training (EVT) Using
Preferred retinal locus
(PRL)
VRT
Client
Nursing Home
Medicare part B
Referral
Individualized service
plan
Teaching
Eccentric viewing
Vision – OT uses
this phrase to
describe vision
rehabilitation,
including legal
blindness.
Low
Vision – VRT
uses this phrase to
describe specific
training
Low
Terms
Blindism
Acuity
Photophobic
Charles Bonnet
Syndrome
Lumens
Diopter
Concepts
Perceived brightness
Color perception
Contrast sensitivity
Focal distance
Color temperature
Principles of task
lighting
Reading
an eye report
Measuring low vision using near and
distance charts
Knowledge of low vision aids and
appliances
Braille
instruction
Transition services
Advocacy skills
Concept development
Training under blindfold
Adjustment to vision loss counseling
Link to vocational services
Sighted guide and protective technique
OT
referrals must have:
• Visual acuity of 20/70 or worse
• Must have doctors’ orders and use medical
codes, CPT and ICD9
VRT
referrals are for clients who:
• Want to learn Braille
• Are not eligible for OT services
• Need only one appointment
http://www.mdsupport.org/deliverymodel/deliverymodel.html
Model
developed 2007 by a group of
professionals representing:
• Ophthalmology
• Low Vision, optometry
• Vision Rehabilitation
• Occupational Therapy
• The Consumer
In 2002, Medicare issued transmittal AB-02-78: Medicare
Coverage of Rehabilitation Services for Beneficiaries
With Vision Impairment
All licensed rehabilitative therapists eligible to provide
and bill services provided to those with vision impairment
• “Medicare beneficiaries who are blind or visually impaired are
eligible for physician-prescribed rehabilitation services from
approved health care professionals on the same basis as
beneficiaries with other medical conditions that result in reduced
physical functioning.” (Centers for Medicare & Medicaid
Services, 2002)
Diagnosing
Physician
Low Vision
Evaluation
Older Blind or
Vocational
Occupational
Therapy
VRT O&M
Community
Services
Keep
a positive attitude
Respect the OT
Offer training
Offer shadowing opportunities
Give resources
Keep the door open for further
communication
Using
a hand squeeze to detect
tremors and strength
Exercises for hand-eye coordination
improvement
Awareness of tripping hazards like
throw rugs
Occupational Therapists
Over 100,000 OTs
Vision Rehabilitation Therapists
Approximately 600 CVRTs
Up to 2,500 working in the field
Overview
of types of vision loss
• Causes
• Different patterns of vision loss
• LV devices are not one size fits all
What
is a Low Vision Exam?
• The importance of LV exam
• LV doctors in your area
• Stress the importance of using the correct
device for each task
Blindness
Services
• Your services and how to make a referral
• Funding for LV devices
• Courtesy rules for blindness
• Other specialized services
• NLS, Newsline
• O&M services
• Support groups
Introduction
to Functional vision
impairment assessments & screens
Consideration of co-morbidities
Centralized OT domain articulating
occupational roles, participation &
performance
Treatment, progress & discharge notes
Introduction
to functional and acuity
assessment tools
Implications of other disabling
conditions
Scope of work of the OT
Documentation
AFB
eLearning
The Carroll Center
Lighthouse
University of Alabama at Birmingham
Hadley School
The NRTC on Blindness and Low
Vision
Low
Vision Rehabilitation: A Practical
Guide for Occupational Therapists,
Second Edition
Occupational Therapy Interventions for
Adults with Low Vision
Be
proud of what you do
Keep up your certification
Educate yourself about medical
terminology
Take opportunities to talk with OTs
Provide education when appropriate
Your
role is valuable and needed
VRTs can be a great resource
Referring your patient to the VRT does
not mean your services are
unnecessary
Keep learning, you can never learn
everything about vision loss
Communicate
with your staff
Have specific expectations and goals
Support the VRT staff
Require LV qualifications from OT staff
Debrief and assess service delivery
Communicate with staff
Carmen Garcia-Hommel, OTL
Occupational Therapist
VisionCorps
244 N. Queen Street
Lancaster, PA 17603
717.205.4145
717.291.9183 fax
www.visioncorps.net
Number of OTs
http://www.bls.gov/ooh/healthcare/occupational-therapists.htm
AOTA overview of LV Certification
https://www.aota.org//media/Corporate/Files/EducationCareers/CE/SCLV%20Overv
iew.pdf
VRT Scope of Practice
www.acvrep.org
OT Scope of Practice
www.aota.org
International Classification of Functioning
http://www.who.int/classifications/icf/en/
[email protected]
662-325-8694
The National Research and Training
Center on Blindness and Low Vision
at Mississippi State University
www.blind.msstate.edu