Occupational Therapy Referral Resources for Patients with Blindness

Occupational therapists may work with people who have low vision, such as people who have had diabetes or a stroke, or on occasion, those who are completely blind. Low vision is taught in occupational therapy educational programs, but students may have limited exposure to this topic leading to feelings of imposture syndrome in practice when working with people who have low vision or blindness. This was the case for me, even though I did my very own capstone which was published on patients who have had low vision and use guide dogs to live their lives.((Li, K., Kou, J., Lam, Y., Lyons, P., & Nguyen, S. (2019). First-time experience in owning a dog guide by older adults with vision loss. Journal of Visual Impairment & Blindness, 113(5), 452-463.)) But new grads or even occupational therapists with years of experience should not feel bad about this because low vision is considered a specialty of OT compared to general knowledge of low vision and blindness as a generalist occupational therapist.

An occupational therapist who specializes in low vision works with individuals who have visual impairments to help them perform daily tasks and activities, such as dressing, grooming, cooking, and using assistive technology. The therapist will assess the individual’s abilities and needs, and then develop a treatment plan that may include exercises, adaptive techniques, and the use of special equipment to help the person maintain or improve their level of independence. The goal of low vision occupational therapy is to help the individual maximize their remaining vision and improve their quality of life. What about cases in patients who have complete blindness?

One aspect of being a good OT is the recognition of one’s own limitations and the need to make a referral to an allied professional who can continue rehabilitation for people with blindness. And there are actually a lot of professionals in this space that share similar roles, but also have unique differences and strengths. This post is a guide of which professional resources are available to patients who are blind and a brief description of their role and how they can help.

A search of O*NET online, a database of occupational information for job seekers returned these associated job titles:

  • Certified Low Vision Therapist (CLVT)
  • Certified Orientation and Mobility Specialist (COMS)
  • Mobility Specialist
  • Orientation and Mobility Instructor (O and M Instructor)
  • Orientation and Mobility Specialist (O and M Specialist)
  • Rehabilitation Teacher
  • Rehabilitation Therapist
  • Students with Visual Impairments Teacher (TVI)
  • Vision Rehabilitation Therapist (VRT)
  • Visually Impaired Teacher (TVI)1

Description of each job title is beyond the scope of this article. But as someone who has researched this topic for my group of participants who used a guide dog, the most familiar to me is the Orientation and Mobility Instructor and Specialist (O&M). The second is a Vision Rehabilitation Therapist (VRT). This post will describe the similarities and differences between O&Ms and VRTs.

An orientation and mobility (O&M) instructor is a professional who teaches individuals who are blind or visually impaired how to move safely and independently within their environment.((Miller, J. (2002). The role of orientation and mobility instructors and rehabilitation teachers in enhancing employment opportunities for persons who are visually impaired. Journal of Visual Impairment & Blindness, 96(12), 852-855.)) This may include teaching techniques for using a white cane or guide dog, navigating public transportation, and crossing streets. The focus of O&M instruction is on helping individuals develop the skills they need to travel independently. An O&M instructor may work in a variety of settings such as schools, rehabilitation centers, or in the community.

A certified O&M specialist (COMS) is also a professional who works with people who are blind or visually impaired, but their focus may be more specialized. For example, they may work specifically with children or older adults, or they may have expertise in a specific area such as using technology for travel or working with individuals who have additional disabilities.

A vision rehabilitation therapist (VRT) is a professional who works with individuals who have visual impairments to help them regain or maintain their independence in daily activities. This may include teaching adaptive techniques, such as using magnifiers or other assistive technology, and providing training in areas such as cooking, dressing, and grooming. The focus of VRT is on helping individuals perform daily activities and improve their quality of life.((Connors, E., & Lee, H. (2020). Roles of vision rehabilitation therapists in the 21st century. Journal of Visual Impairment & Blindness, 114(3), 173-184.)) A VRT may work in rehabilitation centers, hospitals, or in the community.

Both O&M instructor and VRT have different focus and skill sets but both of them work to improve the independence and quality of life of individuals with visual impairments. An O&M instructor focuses on helping individuals travel independently, while a VRT focuses on helping individuals perform daily activities. Both professions work closely to ensure that the individual is able to move safely and independently within their environment, and to maximize their remaining vision.

O&M instruction and VRT may also involve working with other professionals such as occupational therapists, teachers of the visually impaired, and rehabilitation counselors to provide comprehensive services to individuals with visual impairments. The goal is to ensure that individuals receive the support they need to live independently and achieve their goals.

An O&M instructor and a VRT are both professionals who work with individuals who have visual impairments, but they have different focus and skills. Although O&M instruction and VRT are two separate professions, they may overlap in some cases.

Both O&M instructor and VRT require specific training and certification. An O&M instructor helps individuals travel independently, while a VRT helps individuals perform daily activities, and both work together with other professionals to provide comprehensive services and support for individuals with visual impairments.

Some individuals may need both O&M instruction and VRT services to achieve their goals. For example, an individual who is blind may need to learn how to travel independently with a white cane or guide dog, but they may also need to learn how to use adaptive techniques to cook or dress themselves. In these cases, the O&M instructor and VRT may work together as a team to provide coordinated services to the individual.

In a way, COMS and CVRTs can be considered counterparts to each other. Click on these links to read more about the certified COMS and CVRT‘s scope of practice. I couldn’t find certification information for the O&M Instructor at the time of this writing.

  1. https://www.onetonline.org/link/summary/29-1122.01 []