Vision rehabilitation therapists help persons with vision impairment live productive and interdependent lives through the teaching of compensatory skills and effective use of access technology (Academy for Certification of Vision Rehabilitation & Education Professionals [ACVREP], 2023a). Currently there are 646 vision rehabilitation therapists (VRT) certified through ACVREP (February 23, 2024). It is difficult to estimate the number of uncertified VRTs. The field’s small numbers are not adequate to serve the number of individuals who currently need services, nor are new professionals entering the field at a pace expected to meet the rapidly expanding need (National Academies of Sciences, Engineering, and Medicine [NASEM], 2016; National Technical Assistance Center on Blindness & Low Vision, 2023; World Health Organization, 2019).

In 2021, a survey asking VRT practitioners about their perceptions on possible strengths, weaknesses, opportunities, and threats to the VRT profession was carried out to better understand how current VRTs in the United States and Canada perceive the state of the VRT field (Connors et al., 2023). The goal of the survey project was to determine a baseline of shared perceptions to serve as a foundation for a grassroots movement aimed at strengthening the VRT profession. The results of the survey were shared with professionals in the field so that they could begin brainstorming and organizing potential action steps to strengthen the VRT field.

The results of the survey project were shared at two national conferences to provide opportunity for grassroots organization and discussion. Participants in the two discussions were predominantly VRTs, but any conference attendee was able to participate. It is possible that some participants were at both conference sessions. The first discussion took place at the 2022 international conference of the Association for Education and Rehabilitation of the Blind and Visually Impaired (AERBVI) in St. Louis, Missouri. After the survey results were presented, the approximately 78 audience members were grouped into 7 small groups based on location in the room and led through a guided discussion of three questions developed by the authors and based on the survey results. The three questions included: 1) We all agree that we are the most highly trained to provide VRT services; however, this is not necessarily what others believe. How can we promote this strength? 2) We have identified that VRTs are the bridges between medical and educational professionals. How do we magnify this connection to better support potential clients and inform fellow professionals about our skills, services, expertise, etc.? 3) We have the opportunity to work more collaboratively with other vision rehabilitation professionals (i.e., orientation and mobility specialists (O&Ms), low vision therapists (LVTs), teachers of the visually impaired (TVIs)). How can we, as VRTs, work with all vision rehabilitation specialists to present a united front to increase public awareness of blindness professionals and our services?

After the small group discussions, each small group orally reported back to the whole group. Two authors served as scribes to collect all audience feedback. The action items offered during the first discussion were categorized into four themes, or areas of influence, as agreed upon by a consensus of the authors: ambassador, recruitment and outreach, professionalism, and policy.

The second planned discussion occurred in November 2022 at the Association of Vision Rehabilitation Therapist (AVRT) conference in Raleigh, North Carolina. After sharing the survey results and the action items raised at AERBVI, the audience members were asked to validate and add their suggestions to each of the four areas of influence. Approximately 60 audience members were invited to join the group that most interested them. All groups orally reported back to the whole audience. Authors collected each group’s recorded notes and added them to the list of potential action items, which are presented in Table.

Table

Responses from VRT professionals and stakeholders on action items to strengthen the field of VRT, organized by area of influence.

Responses from VRT professionals and stakeholders on action items to strengthen the field of VRT, organized by area of influence.
Responses from VRT professionals and stakeholders on action items to strengthen the field of VRT, organized by area of influence.

The Ambassador area of action for strengthening the field of VRT includes activities within the profession. Individual VRTs who focus solely on direct service would best serve the profession by growing their skill sets in terms of both knowledge and instruction. Taking advantage of continuing education offerings is crucial for staying current, especially in technology. Beyond knowledge, the ambassador VRT aquires teaching skills by employing creative and adaptive instructional strategies to communicate information. By sharing their expertise and experiential knowledge, the ambassador VRT strengthens other service providers. By staying abreast of changing client needs, the ambassador VRT is best able to serve clients and work effectively on multidisciplinary teams.

In the area of Recruitment and Mentoring, there are many potential avenues of engagement. While the field of blind and low vision rehabilitation has historically grown through word of mouth, our outreach needs to be more intentional, strategic, and broad. Professionally made and intentionally targeted videos, public service announcements, social media, and print materials will better communicate the exciting career possibilities of CVRTs (Certified VRTs). Targeting audiences across many walks of life, such as university students, children and senior organizations, and social workers, will also broaden exposure.

Raising awareness of services for persons with vision loss will be impactful not only in getting others interested in VRT as a profession but also in having potential clients specifically ask for certified VRTs as service providers. Therefore, consumers of services and consumer advocacy groups should be a targeted audience to increase awareness of the existence of specialized professionals in the vision field. When potential clients and family members are educated about the professionals who are the most highly trained in vision rehabilitation, demand for the field will grow (American Council of the Blind, 2020).

Recruiting new professionals goes hand-in-hand with the greater visibility of the field of vision rehabilitation as a whole. Recruitment efforts would benefit from collaboration across all specialties within blind and low vision rehabilitation, as there is a general lack of awareness and understanding of vision rehabilitation professionals across society. This general lack of awareness and knowledge of the vision rehabilitation system in the United States was identified in an investigation by NASEM as a primary barrier to developing a national high quality and accessible vision rehabilitation system to meet the growing need of persons with vision loss (NASEM, 2016).

Utilizing digital media, VRTs will reach a much broader audience. Current social media endeavors for the field of VRT include Facebook pages and an Instagram account. Videos such as “Time to be Bold” (National Research and Training Center on Blindness and Low Vision, 2021) and “Vision Rehabilitation Therapist (VRT)” (Older Individuals who are Blind – Technical Assistance Center, 2022) are being used to raise public awareness. Other current social media outreach endeavors include #RecruitCVRT and multiple events surrounding VRT Appreciation Week, which celebrates the profession on and around April 14th in honor of Anne Sullivan Macy.

In the area of professionalism, action items surround educating other professionals and working collaboratively on multidisciplinary teams. In the process of educating other professionals, VRTs help to codify and protect their scope of practice. This process of educating other professionals includes educating other vision rehabilitation professionals and employers. VRTs should not assume that fellow vision professionals understand the full scope of VRT practice (Connors et al., 2023).

VRTs should collaborate with other blind and low vision rehabilitation professionals so as to not work outside their scope of practice, even when encouraged to do so by their employers. An employer may not be aware that ACVREP certification may be suspended if it is reported that an employee is working outside their scope of practice, in violation of their code of ethics (ACVREP, 2023b). If the employer requires ACVREP certified staff, this will support the hiring of a CVRT in addition to other ACVREP certified staff. Similarly, because of the inability of vision professionals to engage in third party billing, some agencies are choosing OTs over VRTs, though most general OTs are less highly trained in providing instruction in the specialized compensatory skills required by people with vision impairment and blindness.

Some of the most powerful ways to strengthen the profession are through policy involvement. In understanding how to be involved, it is important to understand how policy decisions are made and who the stakeholders are. VRTs who actively participate on committees in the field will more easily stay abreast of potential legislation and ensure that the VRT perspective is being voiced.

An example of a policy change to strengthen the field at the agency or state services level might be a requirement to hire only CVRTs or VRTs who are willing to be certified. Additionally, when writing job descriptions, using the job title of VRT for clarity and consistency will help with the recognition of the field. VRTs should help their employers understand the VRT scope of practice and their many critical areas of expertise. It is essential that employers be aware of the liability issues within the VRT scope of practice. The dangers of taking medications incorrectly due to a lack of an effective identification strategy or accidents or fires in a kitchen are no less critical than the dangers of faulty street crossings.

On a national level, working towards having CVRTs provide related services in the schools through incorporation in IDEA legislation, as well as third-party reimbursement for services, will help build reliable funding streams. Understanding how services are provided and funded is essential for developing effective policies that work for all stakeholders, including the individuals who are receiving the services.

Current initiatives at the policy level include the work of the Aging and Vision Loss National Coalition (AVLNC) (Vision Serve Alliance, 2022). The AVLNC is a collaboration of national, state, and local agencies to advance equal access and quality of life for older Americans with vision loss (AVLNC, 2023). Their focus is to build awareness of the challenges of older adults adjusting to vision loss and the impact of professional vision rehabilitation services for sustaining independence. VRTs should seek to ensure that their voices are heard in this arena.

Recent job task inventories have demonstrated the large role that VRTs play in the rehabilitation of clients due to their comprehensive scope of practice (Connors & Lee, 2020; Connors et al., 2020). The goal of this project is to collect and magnify the voices of current VRTs regarding how to strengthen the profession so that clients will be better served. Through the action items brainstormed by participants, VRTs indicate a great need for both education and advocacy. Impactful and meaningful strategic organization to strengthen the field will require coordination among professional organizations. AERBVI and AVRT are two professional organizations that provide continuing education and should take a leading role to help educate the VRT field and advocate with employers and governmental entities. It is imperative that our professional organizations help to promote the message of the unique skill set that VRTs possess and to act as a catalyst and partner to elevate and expand the services of VRTs. Likewise, these organizations should assist in connecting other key stakeholders, such as Vision Serve Alliance, ACVREP and other related stakeholders, to help magnify the efforts and message. AERBVI and AVRT are encouraged to work together on developing a five-year strategic plan to further these efforts.

Every VRT should be involved in promoting and strengthening the profession through their personal channels of communication and spheres of influence. There is work to be done within the field of vision rehabilitation, both in collaboration with other professionals and with society at large. Similarly, there is work to be done at the agency, state, national, and international levels. The guiding principles for VRTs will be to educate and recruit to build awareness of the field. It is imperative that all efforts seek better services, access, and inclusion for people with vision impairment.

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