A Sit Down – with Jenni Roeber COVT
This post appears as part of a series called Sit Down – candid conversations with real people detailing their journeys and experiences with Vision Therapy.
A Sit Down – with Jenni Roeber COVT
For the benefit of our readers, can you explain how you are involved in Developmental Optometry?
I am a Vision Therapist in the office of Amy Cecil O.D., FCOVD, a practice which offers Primary Care and Vision Therapy. Located in Basalt, CO, our therapy patients come from as far as 2 ½ hours away by car, and as close as the nearby schools. We see many children and students, and given our mountain resort location also patients with head injuries from ski, bike, and auto accidents. Stroke patients and sports vision patients are also seen in our practice.
My understanding is you have a background in Education. Can you tell us more about that, and explain how you discovered Developmental Optometry?
Developmental Optometry actually found me! I wanted to be a teacher throughout my school years, and my original training “back in the day” was in Elementary Education with a Science minor. I’ve worked with diverse ages including 8th graders, 1st graders, and in an inclusive preschool meaning that some students had identified special needs, and others did not. At that time, I wasn’t even aware that Vision Therapy existed. However, working with children of all personalities (and their parents), in a Multilanguage situation, and with a wide range of needs was terrific preparation for a Vision Therapy room which would appear later in my life. Our goal in this school district preschool was to offer multi-sensory experiences daily, adapting as needed for individual children. That experience of flexibility and adaptation was probably the most valuable life skill I’ve ever acquired, as it serves me in both my work and private life. Little did I know that I was about to enter a profession that would require using all of those skills every day. Developmental optometry came to me when a mutual friend asked if I’d be interested in working with an Optometrist and training as a vision therapist. I met with my now-employer, and the rest is history. That was about 15 years ago. I discovered as I was explaining to my parents about my new job that my mom had “done some eye exercises that really helped” her eyes when she was young….that would have been in the early 1950’s.
For parents who may be researching possible avenues to help their struggling child, what are some good questions to ask the teacher at conference time, or anytime there might be a concern?
1) Tell me about my child in your classroom. What are some strengths that you’ve noticed? Any areas or behaviors that my child struggles with?
2) Tell me about how my child approaches their _________. (Insert terms such as desk work, reading, penmanship, relationships with other children).
3) Have you noticed anything that makes you think there might vision issues? Hearing issues? Motor or sensory issues? When does this occur, or where? Would you be willing to complete a brief checklist of behaviors to quantify it for all of us?
4) Does my child comment upon anything in particular that might be especially enjoyable – or problematic?
Vision Therapy can, at times, seem to not be as widely visible to the public as say, Occupational or Physical Therapy. Coming from Education, perhaps there was a time when you, yourself, were unaware of VT’s existence. If we were to adjust our collective marketing efforts to better reach those who are in the same position perhaps you were in when teaching, how would that look?
I’ve always found the teachers I know and have contact with to be very interested in what we do. There are so many of them who have very good, pertinent observations about their students’ visual behavior in the classroom, and often they know that something’s wrong. Until they are aware of what vision therapy can offer, they just don’t know what to do about what they are observing, or where to look for help. If the parent gives permission, I think it’s often helpful to personally contact a patient’s teacher to let them know what we are working on with a patient, how that may help the child in their classroom, and if they ask or the parent has requested, I’ll share several things that might help in the classroom as the child proceeds in vision therapy. That’s the personal side of it.
I think we need to offer to present to parent groups, teacher in-services, and like occasions. This can be tough…to simply offer information that helps kids succeed, rather than seem like a business promotion activity to our audience. My office has volunteered in local schools several days to do vision screenings, which include things like tracking, and focusing rather than just the distance eye chart. Teachers have never had a lot of extra time to attend functions outside of school so the more we can let people know about vision therapy in the context of the school setting and their students; the better off we will be. How about volunteering to speak at Career Day (both ODs and VTs) at local schools? School nurses, special education staff and counselors are school personnel that are likely to be aware of struggling students, so they are also people who need to hear about vision therapy.
As a former teacher, perhaps there was a point where you were asked to recommend medication for children who misbehaved or had attention challenges. Did you have a perspective on medication as a teacher, and was it different from your perspective now as a Vision Therapist?
Fortunately, I’ve never been asked to recommend medication specifically, and I don’t think that most teachers are necessarily pro-medication. I do think that teachers often feel desperate when they have a child in class who is missing a lot of important information and learning experiences because they are unable to attend, or a child who is so active/verbal/disruptive that other students are having trouble learning. It’s harmful to the child also when fellow students develop negative attitudes about his/her classroom and playground behavior. These attitudes can really impact the child’s friendships and other relationships. I often tell parents who ask about their child’s short attention span that symptoms of ADHD, visual issues, sensory integration issues, motor issues, and auditory problems can look the same, and that professionals other than teachers are needed to diagnose what the cause(s) of those symptoms (is) are.
There were some times as a teacher that a child’s behavior was so disruptive to him/her, or the class as a whole that I would have been supportive of a parent’s wish to try medication with a proper diagnosis from a professional. But even when medication might be appropriate, it should never be used without supportive therapies including counseling, teaching children organization/calming techniques, and any classroom adaptations that might help such as private study areas, earphones, and all other adaptive ideas that teachers typically are good at. Medication isn’t a cure-all by itself, and there are some potentially nasty side effects. Had I known about vision therapy when I was a teacher, I certainly would have preferred a visual evaluation and therapy over medication anytime, or at least as the first option. I sometimes think of students I had and knowing what I know now, I’m certain that visual issues were involved.
I’d rather see such children evaluated by developmental optometrists, occupational and physical therapists trained in sensory integration therapies, specialists able to diagnosis auditory filtering problems, gifted/talented professionals, and those trained in autism spectrum disorders. I’ve had many patients who really improved with vision therapy in their ability to attend, and many who attended other therapies concurrently that really augmented the Vision Therapy.
In 2012, you completed your Certification as a Vision Therapist, and immediately chose to become a mentor for other therapists enrolling in the process. What has that experience been like?
It’s been a learning experience for me, as far as how people think about things differently, and how to best recommend resources so that the therapist gets the benefit of the many great minds and colleagues working in the field of developmental optometry. I found while on the COVT journey myself, that sometimes I really needed several ways of having the same thing explained to me in order to understand it well. I feel very responsible for pointing this person toward lots of sources of information, guiding him/her toward learning what’s expected for the candidates for COVT. It’s challenging to get a sense of the person you are mentoring when you have never met, and of what their needs are both in terms of content and the way in which they express themselves in writing. It’s a position of trust on both sides for sure! I think it’s a lot like guiding our patients on their vision therapy quest…the most effective learning comes through self-discovery.
Parents will often ask how quickly they will see results once a Vision Therapy program is started. Clearly, many factors come into play when answering this question and no definitive or universal answer applies to every patient. If asked, how do you address this question?
We are often asked this question, and usually reply that if attendance and practice are consistent, MOST patients/parents notice some difference between 8-12 weeks of weekly visits. We see patients for an evaluation at 8 weeks; some are already noting two or three areas that are looking/feeling better to the parent or child. Others need several more weeks before change is noticed.
In your experience, what can parents do to ensure Vision Therapy is a positive and successful experience for their child, and for themselves?
In our office, we ask that at least one parent be on hand for the first session, where we discuss the “whys and hows” of Vision Therapy. So please plan on attending, without siblings or other children. This is a time for just the child who will be doing the Vision Therapy. Please be on time, with your child fed, reasonably rested, and not in a rush to be anywhere else (either one of you). Listen as carefully as you can, and ask questions if you don’t understand or are unsure. Encourage your child to ask questions also if they wish. Take notes if you feel a bit overwhelmed…and the first visit CAN feel that way. Vision is learned, and so is the ability to be the most helpful parent to your child in vision therapy. I say this because the first visit can really set the tone for the rest of the visits.
Be as positive as possible always about the work being done…and be honest about the fact that learning how to do something better is often hard work, but that it can be fun. Parents should think about what motivates their particular child, because at some point it is likely that the child may need a “boost”. We all hit plateaus, and we all need extra encouragement at times. Vision Therapy is no different. Consistent practice and attendance are necessary to get where the child – and the parent – want to go. As therapists, we try to consistently point out why the activities we do with our patients will help them meet their goals. Parents can do the same at home. The investment in time and money for Vision Therapy is considerable….but so is the payoff.
Lastly, if your child has special needs, takes a fall, has new symptoms, a tendency toward sudden vomiting, issues with stealing – please let us know. We want the best for your child just like you do. Withholding information doesn’t help anyone involved, and in some cases, can be harmful for your child.
As Vision Therapists, at times we find our greatest challenges in our youngest patients. Do you find this to be true? Is there an age range that you enjoy working with most?
Young patients – say 2 to 5 years – require a lot of energy, and a lot of things to do so that you can keep their attention. Because our therapy room is right next to our exam area, and young patients are frequently loud, cry, yell, etc., I find this age difficult in our particular setting. Another difficult age can be the boys who are around the age of 8 or 9, who just don’t want to be there. My favorite is the patient of any age who is curious…..Yes, sometimes their hands are on everything at once, but I love that they are asking questions, and open to “experiments”, and I always wonder if they will be vision therapists someday. I have one such patient currently who happens to be five years of age, one who is 10, and a former adult neuro-rehabilitation patient who still emails ME articles on head injuries, diet, and vision exercises.
You work in a small office where you are the only therapist. It would seem difficult at times to not feel isolated from the rest of Developmental Optometry. Do find this to be true?
Sometimes that’s true. At one time, I had another therapist who I trained, but she retired several years ago. I miss the opportunity we had to discuss each patient from our two sometimes differing viewpoints; it provided lots of support for both of us. Fortunately, I have several colleagues in the Denver area that I know I can contact if I have a question, or for suggestions. Recently, Dr. Simonson in Boulder, CO and Dr. Schneebeck in Centennial, CO have sponsored several study group meetings which have been wonderful times of learning and collegiality. When you practice/live in a rural area, it’s important to make the effort to join with other colleagues when the opportunity arises. This blog (VT Works), the VisionHelp Blog, the Vision Therapist Forum, and the Online Journal publications all give me a chance almost daily to connect, so it’s really not too bad. And, I have to add that Dr. Cecil is always interested in discussing the latest news in developmental vision, or learning a new therapy technique herself, so I have that opportunity in-house as well.
If you could waive your magic wand and change one thing about Vision Therapy or Developmental Optometry, what would it be?
I’d probably wish that health insurance would cover Vision Therapy like most policies have benefits for Physical Therapy. If one has feet or knees that don’t work well together because of injury or conformation inherent to that person, insurance will cover therapy for that. But if your eyes don’t work well together because one is out of line, one doesn’t focus like the other one does, or you’ve had a head injury, health insurance doesn’t cover that. In the field of Developmental Optometry, we are skilled professionals who work one on one with patients, and it is fair that we are compensated akin to other medical professionals. However, I wish all children who needed VT could afford to access it, and more insurance coverage might help with that.
Come October, COVD’s Annual Meeting is being held in Orlando and you’ve shared that you’ll be in attendance. What do you enjoy most about the meeting?
Being with all my colleagues, and absorbing all the new ideas, conversations, arguments (yes, arguments) and research. It’s incredibly stimulating. I’m always left feeling really grateful to be part of what we do, part of this larger community that I only get to be with every so often. Of course, I hope to be among the very first to shake the hand of my mentee as a new COVT!
Some closing thoughts – A special thanks to Jenni for taking the time to share her thoughts. Please join me in wishing her and Dr. Amy Cecil great success. Vision Therapy is very lucky to have Jenni as our representative in Basalt, Colorado. She has been doing great work as a Vision Therapist for 14 years!! Kudos Jenni!