Today’s guest blogger is Jessica Stevenson. Jessi graduated from Capital University with Presidential Honors in Biology and Chemistry in 1998. She is the Clinical Director of Vision Therapy at Professional VisionCare, where she has been integral in the developmental of treatment programs for autism, traumatic brain injuries, and athletes for the past 14 years. In 2001, she became a Certified Optometric Vision Therapist (COVT). Jessi lives in Westerville with her husband Preston and her children, Lincoln and Lola. This originally appeared in Visions, the newsletter of COVD.
I am so grateful for the opportunity to work with the special needs community. Here is what they have taught me:
Lesson #1—Listen and look at everything. Keep your ears, eyes, heart and mind open at all times. Watch how the parent interacts with the child for cues on your own interaction. For example, if mom uses short, specific directions, then your poetic (yet long-winded and abstract) ways to describe activities can be distracting.
Lesson #2—Always use person first language. The word “autistic” focuses on the disorder and not the child. “Child with autism” is a verbal reminder you are caring for a child, not a disorder. Parents will notice and appreciate this shift in your language.
Lesson #3—Make modification your new mantra. During a standard vision therapy session, I plan 3 activities. With a child with special needs, I plan dozens. Be willing to try lots of things, if something works, stick with it. If it doesn’t work, don’t take it personally, just move on and try something different. Be flexible even with your equipment. A child with Down Syndrome once refused to wear red and green glasses. Her mom transferred the lenses to a pair of Dora sunglasses and the child loved them. When working with a child with tactile issues, try holding red and green acetate in front of his/her face instead of fighting to get the child to wear the red/green glasses. This idea turned a “challenging case” to an “underwater explorer” as the colored acetates transformed his world. Imagine the creatures we discovered!
Lesson #4—Parents aren’t allowed to apologize for their child’s behavior and don’t apologize to other patients (within reason). So often, these parents are burdened by explaining their child’s behaviors and justifying them. Taking away this obstacle allows therapy to flow more smoothly and goals to be reached faster.
Lesson #5—Play. Be silly. Play some more.
Lesson #6—Be humble. No matter how smart you are, none of us can claim to be an expert about the patient in front of us. The parent can. Let them. Ask for input, listen to their ideas. When a parent tells you about a procedure, disease, side effect or characteristic that you don’t know about, don’t claim to know if you don’t. Early in her practice, my mentor Dr. Carole Burns, FCOVD, had a mom ask, “What do you know about autism?” Dr. Burns truthfully responded “not much.” This excited the mom because she knew Dr. Burns wouldn’t have preconceived notions or prejudices about her child. Dr. Burns is now sought out in the autism community, but still looks at every child as a unique individual and a chance to learn.
Lesson #7—Be aware of triggers that could cause a behavior or be distracting. When a new patient with special needs schedules an examination in our office, we invite the parents for a walk through before the appointment. We ask them to evaluate smells, sights, noises and overall atmosphere of the office. We invite the child into the exam rooms to touch the equipment with the emphasis that nothing is made to hurt them.
Lesson #8—When communicating with a child with special needs, realize your inability to understand them is not because they are unable to communicate. I learned this lesson with Brandon who was age 4 and non-verbal. While working on parquetry blocks in which two triangles were connecting at the points, Brandon “signed” what I believed to be butterfly. I assured him it was a butterfly, but he needed to build the blocks. Brandon continued signing. I continued prompting him to build the figure. This continued for several minutes, with Brandon’s signs getting more animated. Finally a fellow therapist informed me he was trying to say bird. With that, Brandon jumped up to hug her and then quickly built the blocks. I have learned that whether it is a speech impediment, a toddler’s rambling, or a non-verbal communication, it is my responsibility to figure out the puzzle.
Lesson #9—Count your blessings. Whether I am struggling to get my two children into bed, to eat their peas, or to not use each other as punching bags, I am often struck by how much stronger I would have to be to have a child with special needs. It is then that I am most grateful, not only for my children’s health, but for parents who trust me to work with their children and learn these amazing lessons. I have truly been given a gift and I will never forget that, no matter how many years I am in this profession.
Mindsight 
Nice weblog. It is so practical Thank you
Very helpful. Thank you for the insights. I’m relatively new to vision therapy and find your lessons on point with some of the patients I’m learning to work with.
Dr. Stevenson, thank you so much for your insightful and heartwarming blog post. The lessons you’ve outlined are one that are learned through experience, compassion and the love of your patients. I appreciate your candid sharing of your learning experience and the suggestions for us to use.