Unlocking a child’s potential through vision therapy – An Interview with Dr. Joel Warshowsky

Joel H. Warshowsky is a Behavioral and Developmental Optometrist. He is Associate Clinical Professor and founding chief of pediatrics at SUNY State College of Optometry where he has taught for 35 years. He has served as Optometric Consultant to numerous schools for child development throughout the U.S. states of New York and New Jersey, and has lectured internationally and published widely in the field of Optometry.

Here, he answers questions about his new book, How Behavioral Optometry Can Unlock Your Child’s Potential.


Can you please tell us about your background and the path that led you to specialize in Behavioral and Developmental Optometry?

I always knew that my life career was going to involve caring for people.

My 35-year path began at the SUNY State College of Optometry in New York. Before I got into this profession, I chose dentistry. I actually took the dental school entrance exam twice. All was fine except for the spatial relationship component of the test. I failed miserably. The handwriting was clearly written on the wall: Joel, you won’t make it in dentistry! What my choices then were seemed to evolve into two somewhat related fields, podiatry or optometry. In as much as contact lenses had an appeal that toenail clippers lacked, optometry it was! Soon I found myself immersed in the specialized area of contact lenses. Any thoughts of visual therapy were far from my mind.

One day I found myself in need of information on accommodative esotropia (a crossed eye), a condition one of my patients had. As a result I met with Nathan Flax, my supervisor and chief of the vision therapy service. I clearly didn’t know how to evaluate and/or treat this condition and Dr. Flax let me know with no uncertainty that I didn’t have a clue. Through Dr. Flax’s efforts, I began to see the effect vision therapy could have on my patients. The changes were as direct and efficacious as the modifications I was making with hard contact lenses. Further, I soon became fascinated with the idea that not only could I affect a patients’ skills in such a consistent, reliable, and valid way, but I could also actually affect the way they felt about themselves. I approached my fourth year with my sights set on the vision training residency. I was accepted as the first SUNY professional in just the third SUNY vision therapy residency. This put me on my way to reach my path, my destiny in behavioral optometry.

What is behavioral optometry, and how can it help a child who appears to be underachieving?

Behavioral optometry is the art and science of treating visual dysfunction as a result of a lag or insult to visual development. Its basic tenet is based on the idea that visual dysfunction is treatable. Behavioral optometry considers vision in a way that lets children know they can develop effective, efficient, and effortless visual function with a resultant positive change in behavior and perception. This, in a very natural way, leads them to be able to resolve their own visual and associated behavioral dysfunctions. They become able to do this by being capable of going to the core of their visual dysfunction and remedying it.

Through behavioral optometry children reach a level of self-discovery within the visual process that introduces them to a new-found freedom heretofore unknown. It is a freedom to know and to cherish their very own true essence of self and their unique and special connectedness to the world. Underachieving children typically don’t feel connected. The process of training children to reframe their visual connectedness with the world is not only about vision. It is about utilizing vision to reframe the relationship between children’s inner reality and their external reality. Vision is merely the vehicle, the classroom, the training ground. The true benefits accrue when a child, perhaps your son or daughter, takes what he or she has achieved in the safe and nurturing environment of therapy and applies it to the outside world. It is then that a child’s entire sense of who they are and what they are capable of, has been modified for the better. And that modification has the potential to last a lifetime.

What is your new book about and what experience(s) motivated you to write it?

This book is about how visual dysfunction can not only create difficulty in sight, but it can also create a false sense of identity. When one has difficulty coordinating and focusing their eyes, there is difficulty locating where objects are in space and identifying what they see. One option is to make up what we think we see, creating a sense of illusion. This book shows how behavioral optometry can redevelop visual function into what I believe is our true inner sense of vision, leading us to our true self. Children who are aware of their true selves emerge into the powerful beings they truly are and thus reach their full potential. What greater gift can we give children than to help them in this process if and when that help is needed?

What motivated me to write this book was the idea that the visual, motor, and/or auditory dysfunctions children face are but one obstacle to their success. The greater the obstacle, however is misunderstanding what they encounter as a result of their dysfunction. They are told that they are wrong. They are told that they are bad. They are even told that they are stupid. Not always in so many words, but the message is nevertheless clear: they are the problem. And as a result of that message, spoken or implied, the harm is done: self-image is severely damaged. Their sense of failure becomes all-pervasive. They simply do not feel safe and they do not have the inner resources to become safe on their own. On top of the perceptual challenges they face, they must also face the challenges of rejection, of pain, and of loneliness. I wrote this book because no child should have to face all of these challenges at the same time. We as parents and as professionals have a responsibility to them, to meet them where they are, to see the world through their eyes, and to guide them to a new and healthier understanding of their full potential and value in this world. They need our help.

What are some misconceptions about vision problems? How can the book help bring clarity?

The most significant misperception about vision problems is the concept of 20/20, perfect vision. There are simply too many times that a youngster is examined by an eye doctor who states that a child’s eyes are fine because he or she sees at 20/20. This frequently leads a school’s child study team and parents alike, to falsely conclude that the child’s vision is not a cause of their reading and/or learning problem. The takeaway message here is that a vision problem is not necessarily because of eyesight, but rather it often results from a focusing and/or eye coordination problem. I cannot stress this enough: bright children will often see 20/20, but they may still not be able to comprehend what they have seen. Vision, one of the primary elements in the learning process, if not the primary one, is so much more than 20/20 vision. Just about any eighth grader can tell you what 20/20 vision means, but parents and educators alike often don’t know how little it means in the process of learning.

If 20/20 is considered the be all and end all of vision, very often the cause of the problem is missed and that child’s problem will continue to be misaddressed. When that happens, when their symptoms are continuously treated while the cause itself is unwittingly ignored, there can be no hope of remediation. The vexing problem will continue to exist with little hope of resolution. Children should be made aware of the joys and rewards of reading and learning. They deserve to know the benefits of knowing what their problems are and what solutions are available to remediate them.

Through this book you will gain a better understanding of the importance of the totality of vision in the learning process. You will recognize that your sole dependence on 20/20 representing vision is a waste of time and money when it comes to finding the root cause of a visually related reading or learning problem.

Copyright © Jessica Kingsley Publishers 2012.

Books related to this blog post

How Behavioral Optometry Can Unlock Your Child's Potential

How Behavioral Optometry Can Unlock Your Child's Potential

Identifying and Overcoming Blocks to Concentration, Self-Esteem and School Success with Vision Therapy

Joel H. Warshowsky


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