Understanding DT/Vision Services
What is the difference between a DT and a DTV?
The biggest difference is their background and specialty training. A DTV has been trained as a Teacher for the Blind and Visually Impaired and holds a Bachelor's in Special Education with a type 10 Blind and Partially Sighted certificate. A DTV has a background that allows her to offer the family some special services. These could include:
Understanding of the Visual System A DTV has studied the visual system. She understands how it works and where there can be problems. She can help a family understand their child's visual diagnosis. She can also help a family interpret ophthalmologic reports.
Understanding of Visual Loss A DTV can perform a functional vision evaluation. This evaluation is used to determine how the child is able to use his vision in the everyday environment. This helps those involved with the child to understand how he sees and what conditions optimize his visual abilities. In addition, children occasionally have a visual diagnosis that is progressive. A DTV has experience with visual loss and can help families anticipate what to expect as their child's vision decreases.
Understanding the Impact of Vision Loss on Development A visual loss can effect development in all areas. Some of the most obvious areas of development that are often effected include gross motor development, eating skills, toilet training, and speech development. A DTV can help a family understand the reason for these delays. When this impact is understood it can be addressed. If the reason for the delay is based on a visual loss the intervention approach needs to be focused with that in mind.
Resources A DTV has experience with technology and adaptive devices that might be helpful to a family. The DTV also has a special resource available called the Illinois Instructional Materials Center or IIMC. The IIMC loans materials free of charge through the Teacher for the Visually Impaired or DTV for use in working with children with a visual impairment. The DTV is connected to a variety of local, state, and national resources that are helpful for families.
Literacy A DTV has been trained to assess the appropriate reading medium for a child with a visual loss including regular print, large print, Braille, or auditory reading. She has also been trained to teach pre-literacy and literacy skills accordingly. She has the appropriate resources available to obtain necessary materials for children. These materials could include Braille or large print books, a Braillewriter, or books on tape. She can help the family to learn the Braille code. She understands the urgent need to make books accessible to very young children so that they can develop an understanding that the written word has meaning.
Adaptive Methods When a child cannot see he must learn about the world using his other senses. A DTV has a broad background in introducing a child to their world using his other senses. The DTV will help the family learn to think in a less visual manner so that they can teach their children.
Maximize Visual Function Children with some residual vision need to learn to use that vision to the best of their ability. A DTV will help families understand what their baby can and cannot see. They will help families develop realistic expectations. They will also teach the family to adapt the environment to maximize the child's visual ability.
Should I use a DTV or a DT for a given child?
If a child has a diagnosed visual impairment a DTV should always be a service that is offered to a family. The question, then, is whether to use the DTV in conjunction with a DT or not. I will offer general scenarios for using the services together and separately.
DTV with no DT
Vision is the only or primary disability and the DTV has availability to serve a family as needed.
Parent choice. Just as parents sometimes choose to have a speech therapist with no DT support, they might choose to have a DTV with no DT support.
DT with no DTV
The child has multiple impairments including a visual impairment and the parents choose to decline DTV services.
Parent choice. Just as parents sometimes choose to have a DT while not accepting any of the other offered therapists, they might choose to have a DT with no DTV support even though the child has a visual impairment.
Situations when services from both a DTV and DT might be appropriate.
When a DTV has limited availability in your area. In this case a DTV might work together with a family and a DT on a monthly basis. The DT can carry out the suggestions from the DTV on a more regular basis.
If a child has multiple disabilities and the DT in your area has a better background for this. In this case, the team might decide to have the DT come half the time and the DTV come the other half. The IFSP team might decide the family needs weekly support from the DT while the DTV could come in less often to offer the vision component that is needed.
If a child is diagnosed with Cortical Visual Impairment (CVI), use of a DTV and DT is important. This is a special case in which the DT and DTV will serve completely different roles. The DT should be used to meet the general developmental goals. The DTV will need to focus heavily on the child's visual needs. Depending on the severity of the case, a DT and a DTV may both be needed on a frequent basis.
A parent may simply choose to use a DTV in conjunction with a DT. Perhaps the team has recommended once a week for both services and the parents do not want that much intervention. In this case, encourage a family to keep at least some contact with a DTV because of the specialized services and resource that are available.