Certified Low Vision Therapist (CLVT) Handbook, Section 3, Low Vision Therapist Body of Knowledge and Competencies

KNOWLEDGE OF THE VISUAL SYSTEM

1. Know the visual system (oculomotor system, eye, optic pathway, and brain).
2. Know eye conditions and their implications.

KNOWLEDGE OF THE IMPACT OF DISEASE, TRAUMA & AGING ON VISUAL SYSTEM

1. Know normal changes in vision with aging, such as changes in the lens, pupil size, light/dark adaptation, and glare sensitivity.
2. Know visual and non-visual effects of other medical conditions such as diabetes, head injury, multiple sclerosis, cerebral palsy, or Parkinson's on vision rehabilitation.
3. Know psychosocial consequences of vision impairment.

KNOWLEDGE OF OPTICAL AND NON-OPTICAL EQUIPMENT AND INTERVENTION STRATEGIES

1. Know and use principles of optics including implications of refractive errors, effects of lenses on magnification, effects of prisms, and the different definitions of magnification.
2. Know clinical rationales for prescription of optical devices.
3. Know optical devices used for near tasks including magnification and optical specifications, advantages and limitations, positioning requirements, appropriate visual skills, and care and maintenance.
4. Know optical devices used for intermediate tasks, magnification specifications, including advantages and limitations, appropriate visual skills, and care and maintenance.
5. Know optical devices for distance tasks including magnification specification, advantages and limitations, appropriate visual skills, and care and maintenance.
6. Know field expansion devices.
7. Know non-optical and electronic, computer based devices for magnification.
8. Know optical and non-optical devices for lighting and glare control.
9. Know non-optical devices for activities of daily living, leisure skills, educational and vocational activities.
10. Know other options including text-to-speech systems for reading.

KNOWLEDGE OF THE REFERRED CONSUMER

1. Know normal human development across the life span (visual development from birth, major physiological, motor, cognitive, and sensory changes, and their implications).

KNOWLEDGE OF COMPONENTS OF LOW VISION EVALUATION

1. Review and interpret vision reports including abbreviations and notations that describe pathology, visual functioning, and refractive error.
2. Know tools and techniques for evaluating the visual function of consumers who have differing cognitive and linguistic abilities.
3. Know tools, techniques, and notations for evaluating functional visual acuities, interpreting results, and integrating results into treatment.
4. Know tools and techniques for evaluating functional visual fields, interpreting results, and integrating results into treatment.
5. Know tools and techniques for evaluating contrast sensitivity, interpreting results, and integrating results into treatment.
6. Know techniques for observing, evaluating, & interpreting performance of ocular motor skills, use of Preferred Retinal Locus, and light/dark adaptation.
7. Evaluate environment (school, work, and home) including lighting, glare, visual clutter and impact on visual function, and ergonomics.
8. Evaluate visual demands of a task considering size and distance of target, lighting, contrast, duration and speed.
9. Know how to calculate and apply acuity reserve, contrast reserve and field of view requirements for reading.
10. Know basis for and how to complete a reading media assessment.
11. Evaluate the appropriateness of devices for the performance of daily living, vocational and educational activities.
12. Know the basis for referral for Braille instruction.

KNOWLEDGE OF HOW TO PLAN AN INDIVIDUALIZED VISION REHABILITATION PLAN WITH CONSUMER & FAMILY

1. Know techniques and strategies for eliciting vision rehabilitation goals during the interview with the consumer and family.
2. Know how to write observable and measurable goals.
3. Know how to present and write recommendations, accommodations, and use of appropriate materials across environments.
4. Know the basis for referral to other vision rehabilitation and rehabilitation professionals including, but not limited to, vision rehabilitation therapist, vocational counselor, educator, orientation & mobility specialists, occupational therapists, physical therapists, speech therapists, social workers, physicians, psychologists, and psychiatrists.

KNOWLEDGE OF HOW TO IMPLEMENT AN INDIVIDUALIZED VISION REHABILITATION PLAN WITH CONSUMER & FAMILY

1. Know techniques for integrating the performance of ocular motor skills, and eccentric viewing into daily activities.
2. Know how to meet visual requirements of a task by considering size, distance, lighting, contrast, duration, and speed of a target.
3. Know methods and materials for teaching visual skills including localizing, focusing, fixation, tracing, scanning, tracking, and distance and depth judgment.
4. Know methods and materials for teaching awareness and implications of central and peripheral visual field loss and use of remaining vision.
5. Know and apply principles of optics, size and relative distance magnification and implications of refractive errors to compensate for impaired visual acuity to enable performance of a variety of activities.
6. Know how to select alternative optical devices that have equivalent magnification properties.
7. Know how to teach use of optical devices to perform a variety of self-care, leisure, academic, household and vocational activities.
8. Know how to design and teach use of non-optical strategies to achieve magnification, ergonomic solutions, contrast enhancement, optimal lighting, glare control, performance of activities of daily living.
9. Know how computer assistive devices and software enable achievement of home management, vocational and educational goals.
10. Know appropriate referral resources including vision rehabilitation services, medical and other healthcare, social/recreational, educational support services, vocational rehabilitation, and community services.

KNOWLEDGE OF HOW TO MANAGE PRACTICE AND RESOURCES

1. Know aspects of maintaining confidentiality of consumer information.
2. Know application of professional code of ethics and standards of practice.
3. Know the laws and legal issues that apply to education and rehabilitation practice.
4. Describe policies and requirements for insurance and governmental funding for services and devices.

CLINICAL PRACTICE COMPETENCIES

1. Demonstrate appropriate interpersonal relationships and the ability to work closely with colleagues and community professionals as a member of the interdisciplinary low vision team.
2. Demonstrate a professional attitude and ethical behavior.
3. Demonstrate a working knowledge of teaching and learning principles.
4. Demonstrate the ability to assess the visual environment, provide appropriate environmental adaptations, and teach the use of environmental cues for using vision.
5. Demonstrate an ability to interpret assessment data provided by professionals from a variety of disciplines.
6. Demonstrate the ability to understand and utilize information from the clinical low vision examination.
7. Demonstrate the ability to administer vision assessments and interpret results appropriately.
8. Demonstrate the ability to assess and evaluate learners' needs and abilities in a variety of environments.
9. Demonstrate the ability to assess the learners' effective use of low vision devices.
10. Demonstrate the ability to plan appropriate goals for enhancing visual functioning with and without optical devices.
11. Demonstrate the ability to select, design, and implement a sequential instructional plan.
12. Demonstrate a working knowledge of the effects of disabling co-morbidities.
13. Demonstrate knowledge of community, state, and national resources for vision education/rehabilitation.
14. Demonstrate the ability to teach visual skills including fixation, localization, scanning, tracing and tracking to numerous learners with low vision for a variety of everyday tasks.
15. Demonstrate the ability to record data, keep timely and accurate records, and participate in staff meetings.
16. Demonstrate the ability to make appropriate referrals to other professionals and acquire/provide resources to address a variety of needs of learners who have visual impairments.
17. Demonstrate the ability to design and implement low vision intervention programs for everyday tasks that are appropriate to the age, developmental level, and goals of the learners.
18. Demonstrate the ability to instruct learners in the appropriate use of optical, electronic, and non-optical low
19. Demonstrate the ability to teach or refer for the use of alternative media or senses for tasks that are not efficiently or safely accomplished using vision.
20. Demonstrate the ability to write appropriate reports of the learners' progress in reaching the goals and objectives of their vision education/rehabilitation programs.
21. Demonstrate the ability to evaluate outcomes of intervention and provide appropriate follow-up.