A Sit Down – with Dr. Charles Boulet
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 Dr. Charles Boulet
For the benefit of our readers, can you explain how you are involved in Developmental Optometry?
I run a clinic in a small town, serving a regional population of 8000 directly. Because it’s a small town, we provide comprehensive medical care for eyes and vision. My professional interests and practice focus bring in clients from a much wider geographic area, in particular regarding child behaviour and learning concerns. Public and professional education, writing, research and advocacy are all integral parts of what I do day-to-day. For your interest, you can find some of my work here.
How did you first hear of Developmental Optometry?
A friend and fellow graduate of Pacific University College of Optometry was very persuasive at the right time. One day while we were discussion graduate program options, he insisted Pacific’s behavioural and developmental focus would be a great fit with my background in education and neural science. He himself had graduated from Pacific not long before.
After graduating with a degree in Computer Science, what was it that led you back to school years later, and why Optometry School?
My academic background includes undergraduate degrees in neural science and education, and this was followed by 8 years teaching high school sciences. Out of necessity and interest, I was also involved in curriculum and instructional design, including early integration of computer tech in the classroom. I had a longstanding interest in IT and had taken various courses in programming and web development. Opportunities arose in the computer tech sector in Canada’s North, and I was invited to join the team that was installing and integrating the security systems at the first diamond mine there. It was a nice diversion for a while (you can’t complain about buying diamonds at cost and flying all over the continent) and public education was not providing the same benefits. Before long, the romance and perks of the diamond industry were wearing thin and I wanted to return to education and child development through graduate studies. Optometry wasn’t even on the radar until my friend mentioned it. Ironically, he was not terribly excited about VT, and I was fully oblivious to the details of child vision development.
After achieving so highly with your Canadian education, why did you choose to attend an American college for your doctorate?
Pacific University came highly recommended and I liked its history and program offering. I only ever submitted one college application.
When we spoke initially, you mentioned you are heavy into research. Can you elaborate?
Writing and education are vital to the profession, my children are grown and I have time to pursue things that interest me. These include child vision development, public health policy, and visual profile multiplicity and bias in the classroom. By multiplicity I mean that for example, Caucasian children tend to be more frequently hyperopic than other ethnicities, and some Canadian First Nations communities show very high astigmatism. These things matter in the classroom and at the doctor’s and psychologist’s office. Not sure if I’d say I’m ‘heavy’ into research, but I try to have a few things going on at any one time. I’m awed by the wisdom and experience of my colleagues who have been doing this work for many decades and am only too happy to contribute what I can.
What is LearningManagement?
LearningManagement.ca is a resource site for vision development and a soap box for commentary on vision, vision health and function, and public policy in particular regarding education. Behind the public content, there is a library of content for developmental professionals and parents who are working with children with behaviour and learning problems.
You’ve also shared your interests in Yoga, and mentioned some of your family members are also involved. Can you elaborate?
My daughter (pictured above) is a nursing student who has spent her summer working towards instructor certification. There are several yoga studios around our area and a general awareness of good eating and health in the region, which is rich in agriculture and organic farms and markets. Mount Royal College in Calgary has been offering a Yoga Therapy certificate for about 5 years and I happen to meet one of the program graduates about a year before she graduated. You can read about Carlie here. Carlie impressed me with how the program was teaching her how tailor a yoga program to the individual, focused through the lens of a more western clinical model. It seemed a perfect fit as a vehicle to achieve developmental goals of many of my clients.
Assuming Yoga is introduced at a young age, how might its benefits alter the course for children who may have a propensity to struggle in early education?
Yoga has been practiced by literally billions of people over the ages. It’s ancient roots attest to the physical and mental benefits of its many forms. It offers simple and progressively more difficult challenges to develop strength, balance, bilateral integration and coordination. These are at the core of strong visual skills, and we know that this also reinforces perceptual awareness. As part of her course requirements, Carlie and I undertook some collaborative efforts to integrate visual training needs with children’s yoga. Many of the poses and movements approximate what is often recommended for supplanting primitive reflexes. We also integrate visual spatial training elements when we can – this can be as simple as ensuring a mirror is available to allow the child to view his own body as it moves. We were encouraged early on with some very positive results and comments from parents and continue to develop these concepts today. Yoga provides a fun, relaxing, and engaging vehicle for integrating vestibular, visual, and motor skills. Yoga training for children also helps them to focus their minds and become more aware of themselves and their impulses. There is no doubt this sort of training can have a very positive impact on behaviour and visual performance as part of a comprehensive program.
Patients with strabismus often are suspected of having a “strabismic body”, meaning their subconscious awareness and use of the hemispheres of their body is unequal. In the context of assisting body knowledge during VT, how might Yoga’s effect differ from Occupational Therapy?
In fact, Yoga is very much complementary to what Occupational Therapy provides. It is in no way a substitute for OT, but they are both efficacious because they draw on similar principles of neurophysiology, though not in the same terms. Yoga by its nature is a much slower process that involves the entire body in more or less gross motor and vestibular activities, while OT covers a much broader field and has its roots in a much more Western medical perspective. As for the comments regarding a ‘strabismic body’, this is purely speculative. But if the goal is the return balance to neural functioning, then thoughtful Yoga programming should provide an effective means of achieving this for a great many people: This is precisely what Yoga is for, after all.
In the last few years, much more awareness has been called to the diagnosis and treatment of head injuries. As a Developmental Optometrist prescribing Vision Therapy, do you find there to be benefits in the simultaneous use of VT and Yoga during a patient’s recovery?
The fundamental approach to developmental cases is going to be very different from a TBI case, and care must be adapted to the needs and abilities of the client. Yoga provides both therapeutic and symptomatic benefits, but like with developmental cases it provides only one aspect of a comprehensive care solution that can include much more medical care, medications, orthoptics, and so on. In developmental cases, we’re trying to encourage development, while in TBI cases, we’re trying to return function to its original state or better. In a more direct answer to your question, Yoga provides one means to challenge vision, balance and vestibular function, and motor control in a safe environment, so yes, it’s going to help. Not all Yoga programs will be suitable, and care must be taken to not endanger the TBI patient. Yoga practice serves to bring balance to the person physically and emotionally. As part of a comprehensive approach to re-stabilizing the patient, it can be valuable on many fronts.
There seems to be an ongoing debate surrounding the efficacy of medicating children with attention challenges rather than offer therapeutic treatment. As a doctor who has experienced the medical models of two different countries, where do you stand?
I’m not an MD, but I have maintained my interest in neural science since my undergraduate work. What I can say is that too few children are ever checked for vision concerns prior to medication. I refer to ‘pseudo-psychiatric vision concerns’, that is, problems like Convergence Insufficiency, hyperopia, astigmatism, and a variety of muscle control difficulties that can cause a child to appear to have ADHD, dyslexia, and even give the impression of moderate developmental delays and autism. Medications for controlling a child’s behaviour should be one option presented to parents, and only after vision concerns have been addressed. Parents should also be provided with other options. Schools for their part would serve these families well by moving away from a sedentary text-based approach to instruction and engage children in a multi-sensory investigative approach to learning instead. It’s no small wonder Montessori schools report a much lower incidence of learning and behaviour concerns.
Many American practioners perpetually battle the conundrum of insurance coverage. Some have chosen to separate themselves entirely and operate strictly on private pay policies, while other practitioners offer different strategies for maximizing the return on insurance billing. Does practicing in Canada carry similar challenges?
Optometric care is provided by the Province for children and seniors, and this covers medical needs and annual exams as required. Adults are also covered for medical through the Province. Rules vary from Province to Province, and the three northern Territories have spotty coverage at best. Healthcare does not cover hardware or other services, such as visual rehab for TBI. Insurance, like Blue Cross and a few others are around and these will cover adult’s exams and generally some amount for hardware. It’s very difficult to get any public or private coverage for the rehabilitation side of things, and this is a shortcoming I’ve recently been asked to help address through creation of a visual rehab centre, but this is many months away from a reality.
Finally, the one project that clearly has combined your love of computers and Optometry is http://www.vtdocs.net Can you tell me more about it?
I’m a computer geek from when I was in Jr. High School. It was very cool that you could program in Logo and BASIC on a Commodore 8-bit processor, and save the instructions to a cassette-based read/write device. These days, it takes literally hours to build what used to take months, and you can do so much more. vtdocs.net is an example of a number of web-based projects I’ve developed for professional use in the promotion of vision awareness and clinical practice.
The vtdocs.net site is a favorite project, like my mountainpostcards.com site, partly for what it does, partly for how it works. vtdocs.net is a collaboration site mixed with a wiki: All members are ‘Authors’ and can post whatever they wish, including opinions, research notes, papers, relevant videos and audio, whatever. I do strongly encourage members to create their own member posts so we can all learn who they are. Members can also create public pages that the general public can see. So, for example, you could create public service announcements, or an advertisement for your own clinic. You can return to your posts at any time to modify them and/or re-post. Users can have ‘friend’ relationships, and create Groups for discussions or research. All that is posted to the site is searchable by members and should be in support of vision therapy, public awareness, and collaboration. It’s a useful site in what it provides, and has grown quickly in it’s short life. Members from different domains including family optometrists, VT optometrists, MD’s, psychologists, and we also certainly invite vision therapists to join as well. All you need to do is go to the site and read the ‘Welcome’ post to learn more. (When you enter your information, you get a blank screen… sorry about that, I’ll have to fix it… one day… but it does work.)
Thanks for the opportunity to share this with other developmental professionals. We need to make a lot more noise and work hard to network and spread the news about the importance of vision in child development in particular. Keep up the good work!
Some closing thoughts – Special thanks to Dr. Charles Boulet for sharing his thoughts. Please join me in wishing him, his beautiful daughter, and the rest of his family the absolute best! This interview was a lot of fun for both of us! 🙂