06 Special Education and Vision - Part 01 - a podcast by The InBound Podcasting Network

An advocate for children diagnosed with dyslexia, specific learning disability, ADHD, autism, conduct disorder, oppositional defiance disorder, and any other students in special education, Douglas W. Stephey, O.D., M.S provides valuable information regarding Child Find regulations and why students with IEP's and 504 plans are not being comprehensively assessed. Strategies will be provided on how to get what your child needs to move, look, and listen through their life with ease.

Douglas W. Stephey, O.D., M.S.

208 West Badillo St Covina, CA 91723

Phone: 626-332-4510

Website: http://bit.ly/DouglasWStephey

Website Videos: http://bit.ly/DrStepheyOptometryVideos

The Move Look & Listen Podcast is brought to you in part, by Audible - get a FREE audiobook download and 30-day free trial at www.audibletrial.com/InBound

If interested in producing a podcast of your own, like the Move Look & Listen Podcast, contact Tim Edwards at tim@InBoundPodcasting.com or visit www.InBoundPodcasting.com

 Transcription Below:

Tim Edwards: The Move Look and Listen Podcast with Dr. Doug Stephey is brought to you by audible. Get a free audio book download and a 30 day free trial audible membership www.audibletrial.com/inbound. You'll find over 180,000 titles to choose from, including several books mentioned here in the podcast. Support the Move Look & Listen Podcast by visiting www.audibletrial.com/inbound. 

Dr. Stephey: If our two eyes are not working together well as a fast synchronized team. Our internal mapquest continues to be off. It's consistently inconsistent with our ability to judge time and space. Those that don't feel well-grounded, those that have some measure of anxiety, oftentimes it starts in the visual system. If you can't move, look and listen in a fast, accurate, effortless, sustainable, age-appropriate, meaningful way, you're in a world of hurt. There's a whole world in vision and how it affects brain function that no one's ever shared with you. 20/20 is perceived as a holy grail of going to the eye doctor. Well, I'm here to change that paradigm. 

Tim Edwards: Hi and thanks for joining us for episode number six of the Move Look & Listen podcast with Dr. Doug Stephey. Hopefully you have found our previous episodes to be educational and insightful and eye opening. No pun intended, but today we're going to talk a little bit more about how vision plays a part in your child's special education needs. 

Dr. Stephey: Well, Tim, I'm glad to have this episode being recorded because it's important information and I think the listeners, not only will it resonate with them, but I'm hopeful that it will act as a springboard and they can use this information and share with others. Because even if the listeners of this podcast don't have a child of their own, who would benefit from this information, I'm confident that everyone is going to know someone who does have a child who would benefit from this information. And the reason I know that to be true is because I've been in practice now for 30 years and from the first week that I was in practice, I decided that we were going to have to provide vision therapy services because the need is too great. 

Dr. Stephey: For example, it's estimated that 10 to 20 percent of the population at large have some sort of vision related problem. Meaning their two eyes don't work together very well. As an integrated team. That's probably the most common problem, so when you think about that from the population at large, 10 to 20 percent, that's one out of every five people or one out of every 10 people that you're going to meet on the street who has a problem with the way their eyes work together. And it has nothing to do with seeing 20/20. That's tremendous. Now, if we preselect the populations, those that have a migraine history of a brain injury, history of dyslexia, learning disorder, reading problem, specific learning disability, carry a diagnosis of autism or ADHD or inattentive ADD or executive dysfunction. The prevalence of those populations, having an associated or causative vision problem associated with those diagnoses, I can confidently tell you it's at least 80 to 90 to 95 percent. 

Tim Edwards: So this is a no brainer for you to incorporate this into your practice. 

Dr. Stephey: This not only is it not a no brainer, I don't know how you can't practice this way. And I've said for years, I don't mind if you don't practice this way. But you can't pretend like these patients don't exist in your practice. More than 20 years ago, probably almost 30 years ago, I was pretty involved with our state association. So I would travel the state, meet different doctors at different venues and invariably we'd have a discussion. I would have a discussion and say, hey, remember when we were in school, like how common are these vision related problems? And invariably the doctors would say, oh, 10 to 20 percent. Isn't that right? I'm like, yeah, that's about right. So if you're doing 10 exams a day and you work five days a week, you're doing 50 exams a week and if 10 to 20 percent of the population have these problems, so what you're telling me then is that you're talking to patients five or 10 of them every week about vision therapy, and then their eyes get big as saucers. 

Tim Edwards: Do their eyes get big as saucers because they looked at the potential revenue stream from something like that by offering vision therapy or the amount of money they're leaving on the table? 

Dr. Stephey: No, no. That should only be too easy and I'd be happy if that was the reason because it would mean that more people are getting their needs met. No, their eyes get big as saucers because they are playing a movie in their head thinking, when's the last time I ever talked about vision therapy? And they know it's been forever and so they typically. then after they contemplate that in their minds, then they tell me, oh, Doug, I don't see patients like that in my practice, because they can't even remember the last time they discussed it. 

Tim Edwards: Well, like I mentioned to you before in previous episodes, Dr. Stephey is, I've had the opportunity to interview dozens and dozens of optometrists throughout southern California and in those interviews you are the only one that has ever mentioned vision therapy to me to talk about your practice. 

Tim Edwards: None of them have ever mentioned vision therapy. And so that just goes along with what you're saying. They don't think they have the patients who need it because they don't ask about it. Or they don't know how to present the material, right? 

Dr. Stephey: Yes, exactly, and the truth be told, they don't want to know those patients exist and the reason they don't want to know those patients exist is because if they find them, they have to act upon the information. 

Tim Edwards: Are they just not educated enough regarding vision therapy or have the means to acquire the unnecessary and appropriate equipment and software and skillset to execute vision therapy? 

Dr. Stephey: I'd like to tell you that was the case, but it's not. Every optometrist in this country has had that vision therapy training 

Tim Edwards: Then what could possibly be the reason why they don't venture into that area of their practice? 

Dr. Stephey: I think the reason most doctors don't venture into vision therapy is because it requires a fair amount of work. 

Dr. Stephey: You have to think about what you're doing and the way you're going to treat these patients. And that requires a commitment of time. It requires a commitment to ongoing education to read outside your own discipline. To try to incorporate what you do into the practice and how you're going to change the trajectory of the lives that you treat every day. And then it does become somewhat of a money game because minute for minute, if we broke practice down into revenue, dollars per minute of time spent in patient care. The truth is you can make a lot more money prescribing glasses and contacts and medical management and pre and post op refractive surgery kinds of outcomes relative to the time that you allocate towards vision therapy. 

Tim Edwards: So it's the path of least resistance? 

Dr. Stephey: Yeah, I think it is a path of least resistance. I think more importantly, my experience over the years is if you don't do vision therapy in your practice, you don't want to find patients that need it because you either are going to ignore the problem and then have to go home everyday and feel guilty about what you didn't do or you've got to bring up the vision therapy discussion and refer to someone like me who will take care of the patients needs. 

Dr. Stephey: And I think at that point you're more worried about the patient leaving your practice and not coming back. 

Tim Edwards: All right, so instead of looking at the total care of the patient, there is a need that's not being met. And it sounds like an epidemic. 

Dr. Stephey: I would argue that it is. And with the help that you provided me over the last couple of years, I have more of a presence on the web. Hopefully an increasing presence on the web and from week to week I have patients that call my practice even though it's out of the area who say, I think I need to come and see you or my kid needs to come and see you. Because the things that I found that you do in your practice sounds like my child. And that transitions us into the topic of the day, which is school districts and kids that have special education needs. 

Dr. Stephey: There is something called the child find regulations. This is close to verbatim, but the language might be a little different, but child find regulations stipulate that school districts will have written policies and procedures in place, to systematically seek out and find the children that have special education needs and that those students will be comprehensively assessed in all areas of suspected disability by qualified personnel. Including the following areas, vision, auditory, speech, language, motor and cognition. Which goes along with the whole theme of my practice, which is move, look and listen. So these regulations are supposed to be in place. The problem is a systemic one. I've been involved with school districts for over 20 years now and it's still a battle every single day. 

Tim Edwards: Even though it is spelled out in black and white, that this is a right for the students? 

Dr. Stephey: Yes. You stated at wonderfully. This is an educational right. This is a civil right to have equal access to the educational curriculum to meet your individual placement needs. A typical scenario for me that I might see a student for the first time, maybe third or fourth grade, and let's say that they have a diagnosis of autism. And I say, how long have you been involved with your public school district and trying to meet your kids special education needs? Well, if a parent is savvy enough, they got an individual education program or an IEP when their child turned three years old. So you don't have to be in public school to get an IEP. You can get one when you're three years old. 

Tim Edwards: And before kindergarten. 

Dr. Stephey: Yes. Two years before kindergarten. Right. So let's say this is the fourth grader. They've had an IEP since they were three years old. I say to the parents, what kind of services have you received and how many hours would you speculate that you've received them? 

Dr. Stephey: And invariably the two most common services, are speech therapy and occupational therapy. Twoo therapies fairly entrenched within the public school system. It's not unusual that I'll see kids in that age group who've had six to seven to 800 hours of those therapies and then when I measure their abilities to move, look and listen in the model that I've adopted over the last 20 years or so, they still have major deficits in those areas. Even six, seven, 800 hours into doing these other therapies. 

Tim Edwards: So none of the therapies have anything to do with vision, but it sounds like that should be the first step, but that's foundational. 

Dr. Stephey: It is one of the first steps because we go back to the child find regulations. It says kids will be comprehensively assessed in all areas of suspected disability. 

Tim Edwards: All areas? 

Dr. Stephey: All areas and it listed very clearly including vision. But when I see a battery of tests that have been conducted at the school, usually referred to as a psychoeducational battery or psych ed battery of tests. Typically on the first page, two thirds of the way down, there's a line item that says vision. And then next to it, it says past or right eye left eye 20/20 and that's usually it. And let me tell you, as a neurodevelopmental optometrist, that's not a comprehensive vision assessment. It's not even a fraction of what these kids need and are entitled to. So when I see someone who's got an IEP, one of the first things that I will coach a parent on, is you need to write to the district and ask for an independent educational evaluation in vision, and I would prefer you name me to be your provider of choice so you don't get misdirected, in my opinion, to someone who's still not going to do a comprehensive assessment. 

Dr. Stephey: So there's. There's very specific language how a parent requests that. So for our listeners who have a child with an IEP or 504 plan or no one who does, here's the letter that you write to the district. In reviewing my child's psychoeducational testing battery, I disagree with the vision conclusions drawn and I am now asking for an independent educational evaluation in vision and I'm naming Dr. Stephey to be my provider of choice. If he doesn't have a contract with the district already, please contact him at the following address, et cetera, et cetera. And that's what you submit to the district. 

Tim Edwards: Well, what we're going to do for our audience too Dr. Stephey is we'll include a pdf in the show notes for them to download that particular letter where they can just kind of use it as a template, fill in the blank and then send it off. 

Dr. Stephey: That's wonderful. And what's really interesting about writing such a letter is the response that you're likely to get back from a district. Because the shot across the bow that you've just sent them is that you are now a parent who's increasingly knowledgeable about what your kids' educational rights are. And my gosh, you're going to ask them to step up and provide the assessments these kids have been entitled to all this time. 

Tim Edwards: Dr. Stephey, is there a particular age range where this might not apply? I know we talked about it'd be great for these parents to get these for their children when they're around the age of three, prior to going into kindergarten, but say a parent has a child that is struggling and they might be in high school. Is it too late? 

Dr. Stephey: It's never too late. And it's interesting that you would pose me that question because that's exactly what I was going to just bring up. I've got a handful of kids right now who are 11th and 12th graders who've had IEP since they were three, four, five years of age, who as seniors in high school still read like second graders and can't comprehend what they're reading because no one has ever assessed their abilities to move, look and listen in this manner, and my heart bleeds for those kids because we changed the trajectory of their lives by failing to provide them their educational rights and having equal access to the curriculum we have precluded them from having further educational opportunities. We've reduced their opportunities for gainful employment and in some cases we've almost completely knock them off the idea of independent living, which is the purpose of special education. Special Education regulations are not specifically about academic achievement, although that's where the singular focus tends to be. It is about further opportunities for education, gainful employment, independent living, and it also includes aspects of social and emotional development. It is not simply about academic achievement. 

Tim Edwards: Or just moving them through the system. 

Dr. Stephey: Even sadder still, and I say this with some measure of cautiousness, but there's truth in what I'm saying when we know the educational regulations and what these kids are entitled to and we know neurodevelopment related to motor and auditory and vision and how those tie into speech and language and vocabulary and logic and reasoning skills and the ability to make an argument and think your way through an argument to come to a reasonable conclusion. When we have withheld those abilities from these kids, I think that is a form of child abuse. Honestly, I do and people should be held accountable for the way they apply these special education laws. If I practice optometry, the way I see educational laws practiced, I would lose my license for malpractice. But there seems to be no personal accountability within the system. 

Tim Edwards: Well you have been an advocate for this for many, many years. What type of progress have you seen Dr. Stephey in moving the needle towards the direction it should be pointed? 

Dr. Stephey: Probably the first 15 years that I was involved with this, it was arguably a significant struggle in great part because I didn't fully understand educational laws. I know them better now because I'm more battle scarred, but I learn stuff every day and parents can learn it too and I'm happy to be a resource to point them in the direction of how to become more knowledgeable because there's nothing worse than feel like you're an old tin can, getting kicked down the road and that you're just worn out from arguing with your school district about what your kids' needs are. There truly is power in knowledge. And knowledge is power and there are resources available. There are folks like me who serve both a clinical and an advocacy role. 

Dr. Stephey: There are advocates and educational attorneys who are designed and whose mission in life because that's what I really feel this to be. This is a mission in my life. It is a cross that I am happy to bear and I can't imagine not practicing this way and not advocating for kids and their needs. For me to have this knowledge and not share it just seems wrong, 

Tim Edwards: Well I've seen it firsthand with you, Dr. Stephey, because when you and I had an appointment a couple of weeks back for me to get a new pair of glasses, I know immediately following our appointment together that you had a very important phone call where you had to go to bat for one of your patients children. 

Dr. Stephey: That's true. And so here's how the scenario usually plays itself out. So there's two ways that you're likely to come and see me. You find me on the web, you contact my office and say, Hey, I think my child's got an IEP at school or a 504 plan, or they have a diagnosis of ADHD or ADD or autism or dyslexia or reading disorder, and it seems like you really know what you're doing both with your optometry degree and your education degree. So how does this play itself out? And I said, well look, you can come and see me and simply pay out of pocket for the kind of testing that I do and we can take it from there and I can give you a therapy plan and you can simply adopt the plan. We work it out and you never involve your school district. That's an option that you have. Option two is I coach you on what your educational rights are. You realize that you have access to a lot more things than you thought you did. 

Dr. Stephey: You're ever led to believe that you have rights in areas that you didn't know about. So one option is I send you the IEE letter and you ask for the educational evaluation independently of the district at the public's expense and you get to come and see me that way. I do my testing, I write a report I submit it to the district. You schedule an IEP or a 504 plan meeting. You tell me what it is. I teleconference into that meeting. I have a chance to review my results for consideration by the special education team. And it's supposed to be a team decision that then says, yes, we adopt the plan and we will fund the services, or no, we reject the plan. Which is not uncommon for the plan to be rejected. Is that the end of it then? No, because then you can go to alternative dispute resolution or you can go to mediation or you can file a due process complaint. 

Dr. Stephey: So there are systems in place to not take the first no as an answer. And again, listeners need to know that those are options. It's hard to do this on your own. It's really hard to do this on your own as a parent. And I think many districts understand that and their job is to wear the parent down until they give up. So I know a handful of advocates and a handful of education attorneys who are wonderfully effective at what they do. And we can go from a parent hearing, no, we're not going to pay for the assessment and no, we're never going to pay for vision therapy to, oh well we're just kidding. We will pay for the assessment and we will pay for vision therapy. Now that you have an attorney who knows how to call us out on how we're violating your kids' educational rights, and so yes, we will provide them services that we've been refusing for a long time. 

Dr. Stephey: So in closing today, I want you to know that you've got lots of rights that you didn't know about both in terms of assessment and treatment. So if you have a child with an IEP or a 504 plan, regardless of their qualifying diagnosis, so it could be autism, inattentive ADD, ADHD, specific learning disability, dyslexia, reading disorder, language disorder, working memory or executive function disorder, or other health impairment, including anxiety, bipolar disorder, schizophrenia, it doesn't make a difference what the diagnosis of the label is. Your child is still entitled to a comprehensive assessment in all areas of suspected disability. We're going to include access to my website and access under the resources section of my website. There'll be a number of resources that you can access to learn how to become a better advocate for you and your child. So please contact me. There's no reason not to. 

Tim Edwards: Thank you for listening to the Move Look & Listen Podcast with Dr. Doug Stephey brought to you by audible. Get a free audio book download and a 30 day free trial of audible membership at audibletrial.com/inbound. You'll find over 180,000 titles to choose from, including books mentioned here in the Move Look & Listen podcasts. You can listen to these books through your iphone, your android, your kindle, your computer, or even an MP3 player. And if for any reason and at any time you choose to cancel your membership, you keep all of your audio book, downloads. Give it a shot for 30 days. You got nothing to lose. Support the Move Look & Listen podcast by visiting audibletrial.com/inbound. We will include a link for your convenience, in the show notes of this and every episode of the podcast. And of course if you like some more information regarding Dr. Stephey's practice or to make an appointment, we will include links in the show notes to Dr. Stephey's website and his youtube channel. 

Tim Edwards: Dr. Stephey's website is stepheyoptometry.com. That's s t e p h e y optometry.com. You can also call the office at 626-332-4510. Again, all of Dr. Stephey's contact information will be included in the show notes of each and every episode. One last request before we let you go on to the next episode. Please subscribe to the podcast from whichever platform you might be listening in. Of course, it is free to subscribe and it ensures that every time we post a new episode, you'll find it right there waiting for you to listen in your podcast app of choice. We really do appreciate your listening and until next time for Dr. Stephey of the Move Look & Listen podcast. I'm Tim Edwards with the Inbound Podcasting Network.  

 

 

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