Move Look & Listen Podcast with Dr. Douglas Stephey

Have questions about an eye condition or vision problem?  Douglas W. Stephey, O.D., M.S. explains the differences between hyperopia, myopia, astigmatism and presbyopia. You will also learn how many of these conditions can be treated with lenses, prisms and vision therapy. Douglas W. Stephey, O.D., M.S. 208 West Badillo St. Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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: Welcome to episode two of the Move Look & Listen podcast with Dr. Doug Stephey. I'm Tim Edwards with the Inbound Podcasting Network and a client of Dr. Stephey's over the past couple of years. In our last episode, we got a chance to meet Dr. Stephey and get to know him personally and professionally and to learn a little bit more about some of Dr. Stephey's unconventional methods that he practices at his optometry practice. And when we say unconventional methods, we mean when you visit Dr. Stephey, you're going to experience a session unlike you've had with any other optometrists. I can almost guarantee that. Can you back that guarantee up with me Dr. Stephey? I think that's pretty true.  Dr. Stephey: Tim, I think that is true. I do practice all the kinds of regular optometry that most people can eventually know. But I do things that go back in optometry to the 1930s and 1940s. So what's interesting about a lot of this stuff is it's not really new. It's just that the profession in expanding its scope has moved away from some of the tenants that has made this kind of optometry so unique and yet at times in the field of neuro rehabilitation, especially with traumatic brain injury and concussions, the rehab community understands the value of this kind of optometry better than regular optometry itself in some cases, and certainly that's true that the neuro rehab community understands this better than the educational community or the medical community as it relates to how this kind of optometry practice can affect the quality of somebody's life. Whether they get migraines or motion sickness or headaches or have a history of dyslexia or a learning disability or ADHD or autism. This kind of optometry cuts across a lot of different disciplines and a lot of different diagnoses.  Tim Edwards: And as you mentioned in our last episode, we are going to dive deep into each of those elements that you just described and how through vision therapy and through some of the modalities that you use at your practice can be relieved, hopefully, maybe and sometimes eliminated.  Dr. Stephey: I think that's true.  Tim Edwards: And today what we're going to do, we're going to bring it down to the elementary school level. For people like me, if you don't mind Dr. Stephey, and we're going to talk about common eye problems. So I think it would be important for those that are binge listening to this podcast, much like people do on Netflix, right? You find a show you like and you'll watch every episode, the same type of consumer habits occur with podcast listening, so let's give some basic common eye issues that you would deal with that we are all dealing with.  Dr. Stephey: So the most common things that people know are nearsightedness, farsightedness, astigmatism and reading glasses.  Tim Edwards: That's pretty much the scope, no pun intended, of my knowledge or something like this.  Dr. Stephey: And the idea that seeing 20/20 is the holy grail of going to the eye doctor. I'm here to suggest that seeing 20/20 is a small, albeit an important piece of the puzzle, but it's just a tiny piece of the puzzle. So for example, the expression 20/20 conventionally means that you can read a letter just slightly smaller than nine millimeters at 20 feet. That's it.  Tim Edwards: That's where the 20 comes in.  Dr. Stephey: That's where 20/20 comes in. That's all it means. It doesn't say anything about the way you use your two eyes together, whether you see fast, how you integrate vision and auditory or vision and motor or visual and processing speed or vision and attention or vision and movement skills. It just means you can read a tiny letter at 20 feet.  Tim Edwards: And why did they choose that? Whomever created this chart, right? And the distance. Why at 20 feet.  Dr. Stephey: Honestly I have no idea.  Tim Edwards: Because that's the size of the room when they put this whole thing together and they say well..  Dr. Stephey: There's probably some logic behind why they chose the 20 feet, but I honestly do..If I ever learned that in the past, I don't remember it.  Tim Edwards: So that it's not that relevant anyway. It's just a, a baseline form of measurement.  Dr. Stephey: So and as an extension of that thinking, people are nearsighted. Maybe they read the big E on the eye chart and that big E is referred to as a 2,400 letter. And what that means is that the "normally sighted person who could read that size letter at 400 feet, a nearsighted, a person has to walk up closer and closer and closer until they're 20 feet away from the letter. And then they can finally read the big E."  Tim Edwards: I got it.  Dr. Stephey: That's where that fraction comes from. Common misunderstanding is when people refer to themselves as being legally blind. Well the definition of legal blindness has to do with the best corrected vision in your better seeing eye.  Dr. Stephey: So when we go back to that standard eye chart, it's called a Snellen chart. And if somebody has best corrected vision in their better seeing eye,no better than 20/80, that would meet one of the standards of, of truly meeting the definition of being legally blind. Because your best corrected vision is worse than 20/70 in your better seeing eye. Well if you don't have glasses on and you can't see the 2400 letter, that is not the standard of being legally blind. You could, you couldn't see two inches in front of your face without glasses on. But if you put glasses on and you can see 20/20, you're not legally blind. So that's a really common misunderstanding that patients have about their uncorrected vision versus their best corrected vision. And just for completeness sake, someone who's nearsighted, you think about what that word is saying, you have sight at near.  Dr. Stephey: So the implication is that you're blurry far away. And so that is true. If you're nearsighted and you don't have correction on you have distance blur. And the more nearsighted, the more blur you have at distance. Interestingly enough though, you can continue to see well up close if you're nearsighted and don't have glasses on. And that particularly is advantageous when you get to be 40 to 45, that's the most common window when you develop a condition called Presbyopia, which I looked up a few months ago and essentially it means old man eyes.  Tim Edwards: And I had been suffering from that for quite some time.  Dr. Stephey: But presbyopia is a gentler way of saying the same thing or at least it's a more confounding way. And patients don't really know that. I'm telling them that they're getting old, they just think that they're getting presbyopic.  Tim Edwards: Sounds a little nicer. a little bit, but if you.  Dr. Stephey: But if you're near sighted and presbyopic, you might be able to avoid reading glasses or a bifocal. You just take your glasses off and then you can see for for quite a long time, depending on the level of your nearsightedness. Farsightedness or hyperopia. That's more confounding because again, farsightedness means you have site at far, so there are limits though about what we can tolerate with faraway vision when we're farsighted and not wearing the glasses correction. So many people that are farsighted, their primary complaint is they have trouble seeing up close. That's not age related and so we might prescribe farsighted glasses that are primarily used for near vision or we might give you farsighted glasses that you wear full time. There is a term called accommodative esotropia. Accommodation, meaning eye focusing and esotropia meaning your one or both eyes turns in towards your nose.  Dr. Stephey: So the term accommodative esotropia means that without glasses on, you have one or both eyes. That turned way inward whether you're looking at far away objects or even up close objects.  Tim Edwards: Is that just a muscle issue in the eye?  Dr. Stephey: Well, it's a muscle issue in the sense that it's related to, and I'm having a lot of farsightedness, but nobody's figured that out yet. So someone who's an accommodative esotrope, you see that they have crossed eyes. What you don't know is that without crossing their eyes, the retina registers a fair amount of blur and the brain is experiencing that blur and his thinking to itself, this is not good. I don't want to see blurry. And the only way to make it clearer is that the brain has got to make the eye focusing inside. The brain has got to make the eye focusing system in the eye work harder and the eye focusing and the eye taming systems are neurologically tied to each other.  Dr. Stephey: So if you focus harder, your eye's going to turn in. So somebody who's an accommodative esotrope, they're really farsighted but nobody's figured that out. And when you finally do figure it out and you put glasses on them and the brain says, oh, I got the glasses to do all this extra work for me and I don't have to do that. Great. I'll turn the eyes back out to a straight ahead posture and get them to work together as a team. So that's what it means to be an accommodative esotrope.  Tim Edwards: So is that different than a lazy eye?  Dr. Stephey: Yes, yes. The simple answer to that is yes. So Lazy. I the common term that people know. Amblyopia is the fancier term. And most of the things that we talk about, there's always exceptions to the rule. So typically somebody who has a lazy eye, "can see 20/20 in one eye and less than 20/20 in the other eye." Dr. Stephey: Maybe it's 20/25, maybe it's 20/30, maybe it's 2100, maybe it's 2,400. But you don't really know why they have that poor vision until you do a comprehensive exam and begin to figure out why these things are true. So in an accommodative esotrope, if there's an asymmetry in prescription between the two eyes, one eye has got little to no prescription and the other one's got quite a bit of farsightedness. The far sighted eye that has not been wearing a correction is going to see blurry because the brain will take the path of least resistance. It will do whatever work it has to, but not anymore than it has to. So if you can see 20/20 with one eye and it takes very little effort, the brain says, well I'm not going to work that other eye because I'm seeing 20/20. That was my ultimate goal.  Dr. Stephey: I don't have to work the other eye harder so I'm just going to let it be blurry. Well, the longer that other eye stays blurry, the cells in the visual cortex or the occipital lobe or the back of the brain where visual input is sent to, those cells never get stimulated with clear vision. They constantly see blurry. So those brain cells that receive visual input don't know how to see clear. And so when you go to measure clarity of vision, like on the standard eye chart, they can't get to 20/20 because they've never seen 20/20. So in that context, oftentimes in every case is different. But oftentimes when you put glasses on, someone who's like that, and maybe give them four or five or six weeks just to put glasses on, wear them full time. Let clear images be on both retinas. Let both retinas send that information back to the brain to be stimulated.  Dr. Stephey: And perhaps we do a follow up exam in four to six or seven weeks and recheck the snellen chart again in the lazier eye and see how much better it's getting. If it's getting better on its own, maybe just more time is all that's necessary to get the eye back to 20/20 or close to it. And facilitate the brain's ability to begin to learn how to use the two eyes together. And if time alone and the prescription alone is not sufficient, then we come up with a vision therapy plan about how are we going to intervene to teach the brain how to keep both eyes on and see clearly at the same time. Because and historically, if you get diagnosed with a lazy eye, and this is still true to some degree in some circles, the classic example is that you patch the good eye, right?  Dr. Stephey: You cover up the good idea, have forced the brain to see through the blurry eye and sometimes even in 2018, that is still the conventional approach with a lot of eye doctors. And I'm going to tell you that is woefully inadequate because it is true that when you patch the good eye, the brain will look through the other eye because it has no choice. Once you take the patch back off, the brain goes back to look through the "good eye" and turns the lazy eye back off.  Tim Edwards: So this has never worked then.  Dr. Stephey: I wouldn't say it's never worked, but it has limited value because the ultimate goal and what's really necessary is the brain has to learn how to use the two eyes together as a team and you can't do that if you patch one of them. So the extension beyond patching, if patching is even necessary at all, is that you have to develop a vision therapy program where the brain is aware of what both eyes are doing, but that the brain is also aware that the two eyes are seeing different colors or different colored objects or that the objects at the right eye and the left are seeing are polarized.  Dr. Stephey: So the right eye sees one polarized target. The left eye sees a different polarized target so that if the brain doesn't keep both eyes on, one of the one of the targets is going to disappear. Well, when you can see that happen and your brain says, Hey, what the heck happened to that other object? Well, the brain's now got immediate real time feedback to turn that eye back on, and that's the coup de gras in this whole thing. The brain's got to be aware that it has two channels and that it is supposed to learn how to use the two eyes together as an integrated team. That's why patching has limited value. And I got an email several days ago from a colleague of mine that this is crazy when I tell you this. It is a practice that has been done within the discipline of ophthalmology who's big on patching.. Dr. Stephey: Not so much the binocular vision piece, but big on patching. And if you're a kid who sees good in one eye and really poorly out of the other and someone puts a patch on your good seeing eye, are you going to want to wear that patch? No. The answer is no. So you're going to take it off. Well, believe it or not, I've seen cases where an eye surgeon has actually sutured a patch onto somebody's face.  Tim Edwards: Sutured? Sutured, so they cannot take it off no matter what.  Dr. Stephey: They have stitched it into their skin. That seems really egregious. And the second one that's close to that is that they put elbows splints on the kids so they can't bend their arms.  Tim Edwards: Oh my goodness. Wow. That's like the cone that you put over a dog's head so it doesn't lick its wounds. Right.  Dr. Stephey: When when I read that email, I thought the exact same thing.  Tim Edwards: That's terrible. That's archaic.  Dr. Stephey: Yeah, well it seems pretty extreme. I don't know. I'd have to go back and read more about it and make my peace with whether or not it's ever necessary and maybe it is. But those are two pretty extreme examples of what it means to patch.  Tim Edwards: So we're going to take a short break Dr. Stephey and when we come back on the other side, give us a little insight as to what we can expect.  Dr. Stephey: When we come back on the other side of this, I'm going to talk a little bit about astigmatism. I'll talk a little bit more about presbyopia and I'll talk a little bit about myopia control. Because myopia is an out of control epidemic worldwide and there's lots of research and lots of discussion being done about how do we control this.  Tim Edwards: And why don't we also give some solutions as well too, that they can find at your optometry practice.  Dr. Stephey: Sounds great.  Tim Edwards: Welcome back to the Move Look & Listen podcast with Dr. Stephey. I'm Tim Edwards with the Inbound Podcasting Network. And today we're talking about common eye problems. Getting a nice education on when you hear that somebody has astigmatism, which we're about to talk about. Or presbyopia. Did I say it right?  Dr. Stephey: Presbyopia. Yeah.  Tim Edwards: And what's the other one?  Dr. Stephey: There's hyperopia, myopia, astigmatism and presbyopia.  Tim Edwards: I'll never be able to do that without it written down in front of me, unfortunately. After I listen to this number two, I will. So why don't we pick up where we left off?  Dr. Stephey: Well, let's talk about astigmatism because that's a common component of a lot of people's prescriptions. And I think there's some confusion about what it really means. So if you think about the shape of the basketball, it's got one radius of curvature and that's typical of whether you're nearsighted or farsighted. Meaning that when light focuses in front of or behind your retina to induce that blur, it's only got one focal point of blur, and that's to be implied by the shape of the basketball, only having one curve. In contrast, to a football which has one radius of curvature from the long end to the other long end, and it's got a steeper radius of curvature around the center.  Dr. Stephey: Those two major curvatures are 90 degrees apart from each other and each one has a different focal point. So with astigmatism, you've got two different blur points around your retina instead of the single blur point. So with myopia, you're primarily blurry at distance and have sight up close. With hyperopia, you're primarily blurry at close and have good vision far away unless you're really farsighted then you have blur everywhere. And astigmatism because you've got to blur points. You're blurry everywhere as well. So that's what astigmatism is. There's two different blur points and we have to correct both of those blur points to give you clear vision.  Tim Edwards: I've heard astigmatism my entire life. Never knew that. You're talking about different blur points within each eyeball.  Dr. Stephey: Yes, that's right. And furthermore there is something called the astigmatism axis. So if you think back to high school math class and you ever had to pull out a protractor, it's got degrees on it, right from zero to 180 degrees. And those degrees on that protractor make up part of your astigmatism prescription.  Dr. Stephey: And it's interesting to look at symmetry in the human body because most prescriptions that contain astigmatism are along the 180 degree line plus or minus 10 degrees. So like 170 to maybe 10 degrees somewhere in that range or they're 90 degrees away from that. So now you're at an axis 90 and maybe a common range from 80 to 100. That's pretty common with astigmatism prescriptions. And every once in a while you get an oddball prescription where it's at an oblique axis like 45 degrees or 135 degrees. Not along the 180 or the 90 degree line. And what's also interesting is how sensitive somebody can be to changes in that cylinder axis. So degrees on a protractor change in one degree increments. And if you don't have a lot of astigmatism, maybe you have a tiny amount of astigmatism prescription and your axis could change five to seven degrees and it wouldn't bother you very much.  Dr. Stephey: But if you have a lot of astigmatism, sometimes you can't even tolerate a one degree change in the axis in your prescription because if you're that sensitive or you have that high of astigmatism power, that one degree change, it doesn't feel right. Like it almost gives you eyestrain or a headache or blur or it throws off your visual perception or it's just not tolerable. I used to have about $4.50 worth of astigmatism. And if you think about prescription changes, we do it in quarter diopter units. Well $4.50 is 18 quarters worth of astigmatism. That's a lot. Before I had Lasik, I couldn't tolerate a one degree change in my astigmatism axis. If I got a pair of glasses made and literally they were one degree off, I have to send them back, I couldn't wear. And some people are really, really sensitive to that.  Dr. Stephey: If there's one thing I've learned over the years is that every single patient that comes into my practice is unique unto themselves and it doesn't make a difference. Yes, we have had a lot of training. Yes, I've had a lot of experience and yes, most people kind of fall in the bell curve of statistical population outcomes, but that's not you. Everybody's different. And I wouldn't have been sensitive to this probably the first 10 or 12 years that I was in practice. But now I really listened to every single patient that comes to me and what their complaints are and what I think their complaints could be. And nobody's maybe even asking those questions to find out if they have any of the symptoms that I might think you have. For example, there was a gal came into my office recently. She's 48 years old.  Dr. Stephey: Her two eyes don't work together very well and that's caused her a host of problems. Motion sickness, being clumsy, being ridiculously anxious, and really most of her life feeling like she's got two left feet. And when I started to ask her some of the questions that we're going to talk about in later episodes, she broke down in tears in my exam chair because she said, I've been trying to tell other doctors this most of my adult life. And no one has ever understood what I've been trying to tell them. Well, and they all just think I'm crazy.  Tim Edwards: Which type of doctors has, she asked?  Dr. Stephey: She's asked her family doctors this. She's asked neurologist this. She's ultimately been referred to psychology and psychiatry because no one has understood what she's trying to convey.  Tim Edwards: And you're the first optometrist she's asked?  Dr. Stephey: No, no, she's 40-years-old. She's been going to see eye doctors since she was a kid. So it's that no one took the time to listen to her and no one took the time to do the kind of testing that would reveal this to know what questions to ask, and so she broke down in tears because she finally felt like she had somebody who understood what she was trying to convey. All this time. It was unbelievable.  Tim Edwards: That must have been just one of those days like you talked about in the last episode where you just go home smiling because you just found a way to not only listen to this patient of yours, but to fix this patient of yours.  Dr. Stephey: Well, it's true. Most people probably have heard of the movie, the Matrix with Keanu Reeves. And there's a scene in there that's a red pill, blue pill moment. I love that scene and it's perfect for this kind of optometry because my contention is that when you learn this information, I dare you to go back and not practice this way. I can't do it. I can't unlearn what I know and when I have a chance to talk to parent groups or occupational or physical therapist or I go to maybe a special education conference. I'm going to a conference tomorrow. I'm one of the speakers on the visual aspects of dyslexia. I'm going to talk about that red pill, blue pill moment because once you learn this, you can't go back.  Tim Edwards: So you're offering them a red pill, blue pill moment as well.  Dr. Stephey: Yes, that's exactly what I'm going to do tomorrow.  Tim Edwards: And that is our intent on the Move Look & Listen podcast as well. Dr. Stephey we come to the close of this episode. Can we go over some of the solutions to these ailments that we've talked about for the last 25 minutes or so?  Dr. Stephey: I would love to do that. The one thing I'm really going to focus on right now is myopia or nearsightedness because it is a worldwide epidemic that is being studied in many countries and people throw in lots and lots of money research wise at myopia control and in part why that's a big deal is that myopia compared to the other kinds of prescription changes that you might need, myopia is associated with higher incidence of glaucoma and higher incidences of retinal tears and retinal detachments. So it's not just that, oh, I need a thicker and thicker pair of glasses to see better. It's that there really are some longterm consequences healthwise and vision wise and blindness wise. So trying to get this figured out is a big deal. Conventionally, the most common way that we handle blur is by prescribing glasses. While prescribing glasses this isn't solving your problem, it's compensating for your problem. And allowing you to see clearly. So what we want to do in myopia control is to see if there's other alternatives that might be better choices for you. And some of the common choices that have been tried and have some modest success and some that have really pretty significant success. A really simple fix would be put somebody in a bifocal, even if you're eight years old, you may benefit from being in a bifocal pair of glasses to slow down your runaway myopia.  Dr. Stephey: Or alternatively we might put you in a standard hard or gas permeable contact lens to slow down that progression. Or we might put you in a hard contact lens that you wear overnight. Much like you wear a retainer after you've had braces and the hard lens w overnight attempts to flatten your cornea overnight. So it does two things during the daytime. One, the ideal goal is that you don't need glasses or contacts then to see all day and that it's also designed to slow down the progression of the myopia so that over some period of time, even if you stop wearing the overnight lens at night, you will not progress to the same level of myopia you would have, had you never worn that lens to start with.  Tim Edwards: So it just reshaping the eye a little bit?  Dr. Stephey: It's reshaping the eye little bit. That's exactly what it's doing. And then there's atropine eyedrops and standard atropine eyedrops dilate the pupil really big and they pharmacologically knock out your eye focusing system so you can't see up close because your eye focusing system doesn't work because it's been pharmacologically paralyzed. Well, I'm here to tell you that in the US there is no one that's going to tolerate full strength atropine eyedrops for those two reasons. They may get by with that in some other countries, but people in the US just aren't going to tolerate that. And they don't really have to because there are diluted atropine eyedrops where they're diluted to a 0.01 percent. So you don't get the pupil dilation, you don't get the eye focusing problems, but you do get a significant myopia reduction control over time. So that's pretty cool.  Tim Edwards: And this is just drops that you put in your eye?  Dr. Stephey: Yup. Maybe once a day and off you go.  Tim Edwards: So it's like a pill. Except a drop for your eye.  Dr. Stephey: It's sorta like a pill but in drop form.  Tim Edwards: That's amazing. I've never heard of that before. It's great.  Dr. Stephey: Yup. And I would say that the diluted atropine drops are relatively new. I don't think they're particularly well known even in the eye care community and that has not been particularly well conveyed into the patient population at large. So I have a handful of patients who are doing the myopia control with the atropine eye drops, but it's not a huge part of our practice at this juncture. But it's an option that's available and you should know about it. Here's a final thought about presbyopia or old man eyes. Rememberit happens between 40 and 45.  Tim Edwards: Middle-aged man eyes.  Dr. Stephey: Yes. Yes, that's right. If you've been fortunate enough to have 20/20 vision at distance your whole life, I'm here to tell you, you feel cheated when you turn presbyopic.  Tim Edwards: Absolutely.  Dr. Stephey: And it's like, what do you mean I need reading glasses? I've never needed glasses my whole life.  Tim Edwards: And it grows subtle. I mean, it's not like overnight. You can't see. It just seems to happen over some time and you realize I am not functioning like I used to. It's, it's terrible. It's exhausting, actually.  Dr. Stephey: It, you know, that's a good point. It is exhausting. Even when you can see some degree of clarity, your brain has to work so hard to achieve that, that oftentimes those people can read without reading glasses initially, but they have trouble remembering what they're reading because their brain's working so hard to see. And that group is challenging because they typically don't want to wear glasses full time and I certainly understand that. But then they're confronted with these choices. It's like, well doc, how am I going to fix this? Well I can give you a reading glasses? Sounds great, but you're not going to be able to walk around in them. What do you mean? Well they're just for reading, if you try to walk around, you're going to get dizzy and fall over.  Dr. Stephey: Well yeah, but so what? Wait a minute. What are you, what are you telling me? Are you telling me you're going to use the B word? Yeah, that's the other choice.  Tim Edwards: That no young man wants to hear. No 45-year-old man wants to hear that.  Dr. Stephey: Like you're saying, I need a bifocal? And I'm like, well I didn't say that exactly. I implied it but I didn't say it.  Tim Edwards: Right, but then you know, a lot of men or a lot of people basically they don't want to see that line, you know, but there's a solution to that. That line in their glasses that tells the world I can't see up close without the aid. And so it looks like, I'm guessing there's a stigma attached to that. Sorry.  Dr. Stephey: And I think that it's, it is an acknowledgement that in fact you are getting older.  Tim Edwards: It is indeed. Yeah.  Dr. Stephey: And it's nothing to do with really the wearing of it. It's that it's acknowledgement of your aging. And people are really resistant to that.  Tim Edwards: Listen, I get it. I was that guy. I was like, I'm 51 now and I just gave up. I just gave up, you know, I need to be able to see and if you don't like the line on my glasses and think I'm an old man then too bad. I have to function. But then again, there are some solutions to that you don't have to have that definitive line.  Dr. Stephey: That's right. There are bifocals with lines that are obvious. There's bifocals with lines that aren't as obvious. There are round bifocals that technically have a line that are almost invisible and then there's progressive lenses that don't have any lines.  Dr. Stephey: And of course that has great appeal if you're bothered by the idea of a line and announcing to the world that yes, I'm wearing a bifocal. And I've been wearing a progressive lens for almost 16 years now. I don't think I would go back to wearing a bifocal with a line. But they do have some limits.  Tim Edwards: Some of the limits I learned this. First of all, it takes some getting used to. It does. There's some, there's some adjustment to that transition.  Dr. Stephey: Well, there's an adjustment of getting used to anybody bifocal.  Tim Edwards: Oh that is true. That is true.  Dr. Stephey: But it is also interesting because when I see patients that have trouble with the way their two eyes work together, if they have tried progressive lenses in the past and failed, it's usually not because they can't wear a progressive lens.  Dr. Stephey: It's because they can't adapt to the progressive lens because of the binocular vision problem that no one has told them about. So when you get a lot of motion and swim through the no line portion of a progressive, you can't tolerate that. Well then nobody told you why you're getting so much swim because your two eyes aren't working together in a coordinated manner. You just think that progressives aren't for you and you don't know that they're really a viable option. If we address this binocular vision piece.  Tim Edwards: So there are options. There are options there. And you know what, the only way to know is to get in there and try. And that's what exactly what I did and of course I settled for a great mix of contacts so I could see far away really well and reading glasses. And reading glasses that work while I'm wearing my contacts that you did for me.  Tim Edwards: It is a perfect combination. Now they're not bifocal glasses. I just put them on when I need to see up close. But this combination works for me.  Dr. Stephey: Well, Tim, and you make a good point, which is listen to your patients, come up with viable solutions, talk about the viable solutions and put them on the table so that you and the patient then can have a good discussion about their quality of life, what they do vocationally and avocationally and how these lenses are gonna work and how they're not going to work. Because it reminds me that there's also bifocal contact lenses that many people don't know even exist. And there's also instances where we'll fit one eye with the distance contact lens and the other eye with a reading contact lens. And roughly 85 percent of people that try that do really well with it. But again, you have to know it's an option and you have to know it doesn't work for everybody. But that's the point of listening to your patients and working with them and that you really are a collaborative team, which is exactly the kind of practice that I want to have.            

In this episode you will learn why seeing 20/20 is simply not enough. Douglas W. Stephey, O.D., M.S. will explain how the three circle Venn diagram of vision will most likely show that your last eye exam may have come up short to enable you to move, look, and listen through your 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/DouglasWStepheyWebsite 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 & 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 at 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 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: This is episode three of the Move Look & Listen podcast with Dr. Stephey. I'm Tim Edwards with the Inbound Podcasting Network. Happy to have Dr. Stephey with us here in our roster of shows as we move forward in the Move Look & Listen podcast. Dr. Stephey, we've talked about common eye problems in our last episode and now you alluded to this topic in our last episode and this is I think something that's quite interesting and I think might raise an eyebrow or two of somebody listening on the other side of the speakers. 20/20 is not enough. You've said that from the first day that I've met you and I've known you a couple of years now. 20/20 is not enough. `We've been told our whole lives. Oh you've got perfect vision. You could see 20/20. Not the case apparently.  Dr. Stephey: That is not the case. That's right. 20/20 is presented as a holy grail of going to the optometrist and it is. I'm here to tell you it is a tiny piece of the puzzle. It's an important piece because clarity of vision is a big deal, right? But it's only a piece. So for example, picture three circle venn diagram.  Tim Edwards: Okay.  Dr. Stephey: And one circle is can you see 20/20. One circle is related to eye health. Make sure you don't have dry eye or glaucoma or macular degeneration or bleeding in the eye if you're diabetic or any untold number of eye health issues. That's circle two. Circle one and circle two is where most eye doctors practice. They do have a place for sure and they do have value, but there's the third circle that oftentimes is missing. And within that third circle there's pieces like, eye taming, eye focusing, eye tracking. There's components related to visual-auditory integration, visual-cognitive skills, visual-spatial skills, visual attention, visual processing speed, magnocellular vision or motion processing, visual vestibular or vision and inner ear integration issues.  Dr. Stephey: There's a lot of stuff going on in that third circle. And my experience over the years is that if you don't do vision therapy in your practice, you tend to ignore that third circle. I went to a lunch meeting a number of years ago at a local credit union. They did lunch meetings for their employees. They invited me to come as a speaker and I talked about this specific topic. And I was talking about eye taming, eye focusing and eye tracking. And that if you didn't have those skills, you might get sleepy or tired when you read, you might get headaches when you read, you might get motion sickness when you're riding in the car. You might have to be the driver because if you don't, you get dizzy or motion sick that you're ridiculously clumsy. Can't play sports that include catching a ball or throwing a ball accurately, and one of one of the attendees, they were sitting in the back. They raise their hand and they said, hey, so what kind of questions do I need to tell my eye doctor the next time I have an eye exam? And I said, if you have to tell your doctor what kind of questions he should be asking you, you're going to the wrong eye doctor.  Tim Edwards: Absolutely. Well, what you just said that you really mentioned a good portion of the population there, Dr. Stephey with all of those things that people might be suffering from.  Dr. Stephey: Tim, the list is ridiculous. Right, so just a quick review. Headaches, migraines, motion sickness, ADHD, autism, dyslexia, learning disorder, clumsiness, can't play sports, uncoordinated. It goes on and on.  Tim Edwards: And all of those sit inside that third circle.  Dr. Stephey: They really sit inside that third circle.  Tim Edwards: And you said a minute ago that most optometrists disregard that circle or don't even acknowledge that it exists. So what do you do in your practice that's different so that you can help people that are suffering from this?  Dr. Stephey: Well, there's another story to tell you. I was at a meeting long, long time ago, probably more than 20 years ago. I used to be involved in with our state association politically before my first daughter was born. And when I would meet people around the state, I might ask the question, hey, remember when we were in optometry school?  Dr. Stephey: What was the percentage of patients that were thought to have vision therapy related problems? And all most to a doctor, they'd always come up with 10 to 20 percent.  Tim Edwards: Seems rather small.  Dr. Stephey: Well, if we look at the population at that's probably not unreasonable. The prevalence of those problems go way up almost to everybody. If you have any of those diagnoses I mentioned a minute ago. But population at large, I say, okay, I'll give you the 10 to 20 percent. So let's say that you do 10 exams a day and you work five days a week, so you're seeing 50 patients a week. So you're telling me that you're talking to five to 10 patients a week about vision therapy. And then that's when things get quiet. And the eyes get big as saucers because they're running a movie in their head about when's the last time I talked about vision therapy to anybody?  Tim Edwards: Now do they not because they don't know enough about it? Or did they not because they don't have time to take on the case load? Or and or should they because there's actually more revenue to be generated?  Dr. Stephey: Well, this has been my impression. It's not because they don't have the training because we all get this training when we go to optometry school. So it's not that. Their go to answer historically was, well, Doug, I don't really see patients like that in my practice. And my typical answer was I believe that you don't see them. It doesn't mean they're not there.  Tim Edwards: Well put.  Dr. Stephey: So I think there was truth in their statement. They don't see them and the reason they don't see them is because they don't ask the same kind of questions that I ask and they don't do the kind of testing that's going to reveal those kinds of problems.  Tim Edwards: It's true. And what's fun to watch is because I've had a front row seat, not only to be the one that you were asking those questions too, but I, I recently brought my wife and to meet with you to fix an ailment she's been suffering from.  Tim Edwards: And the look on her face as you were asking some of these questions was hilarious to me. Because these are not questions that one normally gets asked when they're sitting in the chair at the optometrist office.  Dr. Stephey: No, you never get asked these questions. You dig deep.  Tim Edwards: And you find solutions by digging deep.  Dr. Stephey: You know, one of the things that I thought for a long time about what sets my practice apart from most is that whenever I have an encounter, I'm going to presume you have one of these problems until I asked you enough questions or do enough testing to prove to me that you don't.  Tim Edwards: To omit it. Gotcha.  Dr. Stephey: That is a completely different mindset. Because I've had patients come where they have complained about a lot of the questions I'm going to ultimately ask of them and discuss. They've brought up these issues with many of their past exams and then get shined on so that's even more egregious.  Dr. Stephey: If he never asked the questions and the doctor doesn't find your problem, that's one thing. But if you're actually complaining about stuff and your needs still go unaddressed, that's just wrong. And I can't practice that way. I'll give you a good example. I got a phone call from a medical group yesterday who was calling me to work out a contract to provide vision therapy to a mutual patient of ours. This gal has an HMO that I'm not contracted with. I wrote her a treatment letter. It's been a long fought battle. It's been, I kid you not probably nine months since she started this trial with her medical group and her parent insurance company. Around and around they go. Well, somebody from the medical group calls me yesterday and she said, I've never heard of medical insurance paying for vision therapy. Okay, well, I don't know what to tell you.  Dr. Stephey: And then she said, well, one of my kids did vision therapy years ago and I paid for it out of pocket. Well, maybe your eye doctor should have had this conversation with you and been a better advocate for you. And then I said, by any chance, did that child have an IEP or a 504 plan at school? And she said, well they had a 504 plan and I said, well your optometrist should have told you that vision therapy is should have been funded by your school district as well. And they didn't tell you that either. And that's going to be one of the upcoming episodes that we do where we really dig deep into special education regulations and what these kids are not getting and how to be a better advocate for your child and really go out and fight for their educational rights because there's a lot of them.  Dr. Stephey: And we're going to spend at least one episode really drilling that down so that you'll be much more knowledgeable about how to go fight for your kids' rights. So then when this gal's on the phone with me, and I know now that she's got a child who's got a history of needing vision therapy, well I started to ask her some of my standard questions. Do you get sleepy and tired when you read? Does overhead fluorescent lights bother you when one of the bulbs starts to flicker? Does are you bothered by bright sign, light and glare. And of course she starts answering yes to all my questions and so we really kind of finished the conversation and she said, you know what I need to, I've been putting off making an appointment.  Tim Edwards: And that's not the reason she was talking to you in the first place? Dr. Stephey: No, heavens no. So she made an appointment to come and see me before we got off the phone.  Tim Edwards: I love it.  Dr. Stephey: So and I did the same thing. I went back to Illinois to visit family back in November and went up to the local small town bank that I grew up in and the person who's working with us at the bank, I start to ask him some of the same questions and sure enough he's got problems with the way his two eyes work together. So it doesn't make a difference who I'm meeting, where I'm meeting them. If it lends itself to have this conversation, we'll start to have it and I'm never surprised anymore about really how commonplace these problems are and nobody's finding out. Hopefully you begin to understand that 20/20 in fact is not enough and there's that third circle in the venn diagram that holds a whole bunch of magic in that third circle and those are about diagnosis. So you can't have a treatment option or you can't have a treatment plan if you don't have a good diagnosis. So we've got to dig deep into the third circle and do the kind of testing that's required to determine what's really happening and then once we know that information, we can come up with a treatment plan and how we're going to manage these things.   Dr. Stephey: And there's short term goals and there's long term goals. Short term goal for me is I want to improve your quality of life. If you get migraine headaches, I want you to have them less or to get rid of them altogether. If you're motion sick and you limit your travel because how sick you get driving in the car, well then I want to make a short term goal. What you do to be able to drive in the car, go to the local mountains, whatever, go to the amusement park, ride in the tea cups at Disneyland, whatever. Whatever it takes.  Tim Edwards: Those days are done. I can check that box or I need to go see you. We just got back from a Disney world vacation and just looking at the tea cups made me a little queasy, so..  Dr. Stephey: That's a magnocellular vision problem, Tim.  Tim Edwards: Let's fix it then. So I'm going to tea cups again with my kids.  Dr. Stephey: So short term goals are about improving your quality of life. How do we go about doing that? Well, I go about doing that primarily by being sensitive to your prescription needs, not just the conventional farsighted nearsighted astigmatism. One thing I've learned over the years is that there are many patients who are super sensitive to the tiniest amount of change. And because there's a tremendous amount of our brain space, if you will, that's allocated towards vision and vision processing. I might make the tiniest change in your prescription and you think I can walk on water because of how much better it feels. So we normally prescribe lenses in quarter diopter units, right? We go from a minus a quarter to a minus a half to minus three quarters to minus one, so on. But if you're really sensitive to what I'm alluding to, I might refract you down to an eighth of a diopter.  Dr. Stephey: So it's a point one, two power change. And I've had a number of patients over the years where I make an eighth of a diopter change, in one or both lenses, and it immediately changes their quality of life. Their entire perception changes.  Tim Edwards: Can you do that with contacts as well? Or are they all just made in quarter increments?  Dr. Stephey: You cannot get an eighth of adopter in a contact lens as far as I know. In a soft lens you can get an eighth of a diopter, I believe in a hard lens. Yep. So the first is be sensitive to the patient's prescription. Sometimes it's being sensitive to the frame that they were wearing. So one of the things that I do in my exam room, I've got two black clips that are,  like a black plastic ring that is about maybe an inch and three quarters in diameter and I can clip them over your glasses and what I will oftentimes do is have patients look at my standard eye chart, I sneak these two little black clips out of my drawer and put them over your glasses and ask you to tell me how my art shot looks and how it feels.  And namely is it clearer and is it calmer?  Tim Edwards: And that's the difference. How it feels.  Dr. Stephey: Yes. Because oftentimes people will pull back away from my black rings and they'll say what? I'm like, I want to know if it's clearer, but I'm also interested in whether it feels calmer. And so now they've got a new context of what to pay attention to because nobody's ever asked them how it feels to see just how clear is it to see.  Tim Edwards: Now explain that. There might be our friends on the other side of the speakers that are saying or thinking, what do you mean? How it feels to see?  Dr. Stephey: Well, if you have a problem with motion processing or binocular vision or visual vestibular or visual inner ear integration issues, you don't feel calm when you see.  Tim Edwards: You mentioned going on like some anxiety associated with it.  Dr. Stephey: Yes, and that's going to be in one of the next episodes where we talk about the polyvagal theory of affect, emotion, self regulation and communication. And that's going to be a really fun episode to do because it's one of my favorite topics to talk about.  Tim Edwards: Absolutely.  Dr. Stephey: So when we look around every day and every waking second of every day, it ties into us subconsciously asking ourselves the question, do I feel safe? Well, if you look around and can't answer that question, then you're not going to feel safe and you're more likely to be highly distractable, highly anxious, highly fearful, and that does not feel calm. If you're in a perpetual state of fight or flight, that does not feel calm. But because nobody's ever asked you that question before, if you have those kinds of experiences, you don't even know that there could be a vision component to those experiences.  Tim Edwards: So let's simplify that a little bit because you said, does one feel safe when they look around. Now that goes back to our primitive days, right? It's primal in terms of feeling safe and you're not talking about if you're in a good or bad neighborhood. You're talking about and how you're processing the information that you can see.  Dr. Stephey: I'm talking about you roll out of bed in the morning in your own home and your brain is looking around and asking itself the question, do I feel safe? And an example of that would be if you have a TV in your bedroom and if you've ever noticed if the room lights are dark and you stand off to the side, the TV images that are generated, it really has a strobe like effect. There's a great deal of flicker involved with the changing of that imagery. Well, if you're the kind of patient I'm talking about, you don't like flicker. You don't like flicker, you don't like bright sunlight and glare. You don't like movement in your periphery and you don't like regular repeating patterns. Certain stripes, checkerboards, plaids, polka dots, certain patterns really, really bother you.  Tim Edwards: And that's where one might not feel safe because they bother them. Those things that you're talking about, they're troublesome.  Dr. Stephey: It is troublesome, so it's like a neon sign flashing in your brain that says, look here, look here, look here, look here, look here, and like a tractor beam. You can't help but look, but you're more miserable when you do so. It's like the proverbial moth to the flame. One of the other questions that I love asking and when I get this as a yes answer, it really makes my day. Because one of the questions I'll ask people is, hey, when you drive in the carpool lane and the concrete dividers whiz past your peripheral vision, does that bother you? Well, I can't tell you how many people. When I say when you drive in the carpool lane, I don't do that.  Tim Edwards: Yeah, because that's right. They can stop you right there. It bothers me. Right.  Dr. Stephey: Yes. Here's my favorite part of that question and that's what I followed up and I say, okay, so has it ever felt like your car was and going to drive itself into the wall and that's when I look at me like how could you possibly know that will. That is a perfect example of whether one feels safe or not with the information they're eyes are bringing into their brain. Yes. And, and, and for those people that say that's exactly how I feel. Yes. It feels like the car's going to drive itself into the wall. Like how could you possibly. I know that and then I, then we have a chuckle about it because I say I'm pretty sure nobody else has ever asked you that question and I'm pretty convinced you've never offered it up as a symptom because people would think you were crazy. Yeah.  Dr. Stephey: But when you, when you don't see fast and you've got that movement in your periphery, zinging along in the periphery, it again, it's like a tractor beam to your attention. Your attention goes that way. Your eyes go that way. Your head wants to turn that way and when your hands are on the steering wheel, when you physically want to turn your head and look to the left, sometimes your arms want to move in the direction of your head turns and there goes the steering wheel and the car is going to want to drive itself right into the wall and those are the folks that are, even if they don't avoid the carpool lane, they white knuckle it the whole time they're in there, they break out in a cold sweat. They tell everybody in the car, don't talk to me right now. I'm concentrating. They turn off the radio and they break out in a cold sweat because they're exhausted when they get to where they're going.  Tim Edwards: Now that's just one example. There are many things, like you said, that people go throughout their day. That's just an obvious example, but little things throughout the day that trouble people, they might not even know that it's troubling them until you put that clip back to your exam again.  Dr. Stephey: Yeah, so we put the black clips on and oftentimes they will tell me. Well, yes, it's clear and calmer. I really liked these lenses. And then I take my black clips back that have no lenses in them and I stick my finger through the empty black hole and then they look at me like, what? What just happened? Like how, no, wait a minute, how did that work? And I say like, are you tricking me? I'm like, I didn't. No, I'm not tricking you. I didn't try to talk you into telling you who was going to be better. I just asked the question, you tell me is it clearer, calmer when I do this? And then of course when you have that experience, you immediately want to look again to see if you get the same effect. So I tell you that example because one, it's a great opportunity to discuss that 20/20 is not enough and that there's a whole lot more going on that people didn't know about. It may also tie in to when we go out front and talk to one of my staff about the kind of frame I'm going to tell that patient to pick out because I might tell that patient, you know you need to get a frame that's got a full wire, a full plastic rim to it.  Dr. Stephey: Don't get a rimless frame, don't get a thin wire frame. I want you to get a thicker frame with thicker temples and thicker eye wire because we want to use that frame like the black rings that you just told me are clearer and calmer. And sometimes the black rings don't really make a difference and that's okay. Because then we'll continue on with some other testing strategies to then compare their outcomes with their standard prescription or if I add color or prism over the top of their glasses prescription. I have a variety of ways that we're going to determine that outcome. And one of the outcomes that I love when it works, it is powerful. I will have those patients sit in my exam chair, look up at one of my overhead fluorescent lights and ask them to simply breathe, take two or three deep breaths, and they do and I watched their chest and abdomen when they do that and get an idea if that's easier, effortful, then I'll give them prism or color or some combination of things and have them do it again. And I can't tell you how many people take the glasses back down and look at me and say, how does this possibly work? Because that is remarkably easier for me to breathe.  Tim Edwards: Now let's tell our friends on the other side of the speaker again, that these are lenses that have, could have a little bit of color tint to them.  Dr. Stephey: These are lenses that could have a little color tint and I've got a whole briefcase of colors in my office. I've got about 50 pair of lenses, a variety of different colors, different shading of each of the colors. Most people that I do this with and most of the research that I've read over the last 15 or more years, blue itself is a very calming color. So if you have a nervous system, if you're prone to anxiety, if you're prone to motion sickness, if you're prone to headaches, if you're prone to high distractability, you've got a nervous system that is functionally hypersensitive, and if you're one of those patients you don't like bright colors.  Dr. Stephey: You don't like looking through bright colors. You don't like looking at bright colors. You don't want bright colors in your house at home. You're not going to typically wear bright colored clothing because yellows and reds and oranges take a hypersensitive nervous system and make it even more hypersensitive.  Tim Edwards: Which gives somebody a sense of anxiety. Dr. Stephey: It does, so that person is going to, their breathing is going to be worse if I have them to look up at my lights, let's say through a yellow, orange or red lens. But the more calming colors, blues, lavenders, sages, those are more calming and it really changes the reading outcomes. And I love talking about that stuff because it's powerful and people get an appreciation that they aren't having an exam like they've had elsewhere.  Tim Edwards: Well, you say it's powerful and I can just tell you from my own family's experience, when my wife was in there, I mentioned earlier that she's come to see you. And fluorescent light bothers her and so she is a substitute teacher and everyday she's in a different school and the lighting is different at each school and a lot of it is fluorescent if not all of it.  Tim Edwards: And sometimes they flicker and there are some schools that she will not substitute there anymore because the light bothers her. Well, I haven't told you this yet. So she wears her glasses with a slight blue tint in them everywhere to watch our son play volleyball in the big gyms with a lighting, watching TV at night. But then she tried one school where she stopped going because the light bothered her and it doesn't bother her anymore. So now she doesn't have to limit where she spends her time because it doesn't bother her anymore. All because of that little shift with a slight prescription, I believe in her, glasses as well, but mostly it's that blue tint. She loves them. She looks great. And, it's helped her quite a bit.  Dr. Stephey: You know, Tim, of course, I always love to hear stories like that and it's exactly why I practiced this way. I can't imagine not practicing this way and I can't imagine how anyone could not practice this way. Because that, those are life changing experiences and they are, they're powerful. And what seems like a little thing, it has given her options to substitute back at any probably variety of schools that where he was limited in their choices before now she doesn't have to. That's powerful stuff.  Tim Edwards: It is power stuff. And you know, and I said before, Dr. Stephey then, you know, I can say with great authority that the way you practice is very different. Extremely different because, and I'll say it again for those that might not have had the opportunity to listen to episodes one or two. But you know, I have a video production marketing company and I've filmed dozens and dozens of optometrists here in the southern California area where we're recording and none of them, and I mean that none of them compares to what you do Dr. Stephey, which is why you are the one and only optometrist we have here on the Inbound Podcasting Network because you've saying for a long time.  Tim Edwards: Listen, the world needs to hear this stuff. This is very different. The questions you ask, the way you practice and the enthusiasm of which you speak of how you do this. And I could see the joy in your face when I was telling the story about my wife. It really is astounding.  Dr. Stephey: Well, and for the people listening to this, you have to understand that when I first met Tim a couple of years ago and we did some videos for my website and we did talk about this stuff and he did say to me, well, you really need to get the word out better. And I said, well, okay, I hear you. I hear you. And then we didn't do anything for awhile, then we did some other videos together and he's like, hey, you really need to do some podcasts. And I said, yeah, okay, I'll, you know, I'll think about it.  Dr. Stephey: I'll put it on, put it on the calendar of things to do. And, I do remember probably a year or so ago having a conversation with Tim and saying  Tim. So what you're really saying is that I should just listen to you and get out of my own way and have you help me spread this message and that's why we're doing this.  Tim Edwards: It is a joy to be able to bring this to people and hopefully open their eyes, pun intended, as to how they can manage what they're doing with their eyes. You know, like we said, this is the title of this topic is 20/20 is not enough. And you alluded to the topic that we're going to have next time seeing fast polyvagal therapy.  Dr. Stephey: Well I, and I'm excited about it. So make sure you come back and listen to the next episode because motion processing or seeing fast and the polyvagal theory of affect and emotion, it's huge in our lives in ways that you just, you don't know and it's so not connected to 20/20, but it has everything to do with how we read body language and gestural language and facial expressions and how we develop those skills in ourselves and it's a powerful talk and I'm looking forward to the next episode.  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.      

What the heck is a magnocellular neuron you say? Douglas W. Stephey, O.D., M.S. will tell us why is it important to attention, movement, reading, and understanding where we are in space. Furthermore, the magnocellular visual pathway also plays a role in staying out of being in a perpetual state of fight or flight. This visual pathway will be explained in easy to understand detail and will be differentiated from the parvocellular or what visual pathway. Douglas W. Stephey, O.D., M.S. 208 West Badillo St.  Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 & 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 at 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 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: This is the Move Look & Listen podcast with Dr. Doug Stephey. I'm Tim Edwards, the founder of the Inbound Podcasting Network, and a patient of Dr. Doug Stephey. He located in Covina, California. Episode four today, Dr. Stephey. We're talking about seeing fast. Never heard that phrase ever. And I've said that a lot in the last few episodes. I've never heard that before. Going to visit various optometrists throughout the last 25 years or so when I first started wearing glasses. It seems like everything that you bring up, every time we get together, there's something new and enlightening regarding our vision and our brain and how our eyes work together. Seeing fast. Tell us what that means.  Dr. Stephey: Yeah. What the heck? Seeing fast. What's that all about? Well, certainly come into the optometrist. 20/20 is perceived as the holy grail of going to the eye doctor, right? If you could walk out seeing 20/20, it's all good.  Dr. Stephey: Well, I'm here to change that paradigm. Fundamentally, the world generally is made up of prey, animals and predators. And prey animals have eyes on either side of their head, like horses and rabbits and predators have eyes closely spaced on their face.  Tim Edwards: Like us.  Dr. Stephey: Like us. And the reason that's true when you really stop and think about it. Is prey animals have to have almost a 360 degree field of view because they want to know when a predator is coming to eat them and they need to be able to see fast themselves in order to give them enough time.. Dr. Stephey: To flee the scene. Right? Because prey animals generally don't have great fighting skills. Their abilities to survive another day is that they have camouflage and they're fast, short term sprinters, and then there's lack of movement. Like the proverbial deer in headlights.  Tim Edwards: So they can either hide or escape quickly.  Dr. Stephey: That's it.  Tim Edwards: To survive.  Dr. Stephey: So predators have eyes closely spaced on our face because we need to be able to see in 3D. Now inherently to that we have to use our two eyes together as a well integrated team. And we also have to be able to see fast. And we have to see a large volume of space. Because if you and I were out walking down a wooded trail and we're looking at something straight ahead of us at 12:00 and the deer that hurt us, or saw us coming was off at 10:00 and it's now holding still because it doesn't want to enter our visual radar. So you and I are looking at 12:00.. Dr. Stephey: There's a movement in our periphery. If we're able to see fast, one, we should be able to perceive the movement and two, we should be able to localize a general area space of where that movement is coming from. So that when we turn and look and use eye focusing, eye tracking, eye taming skills to localize where we think we perceive that movement well then we should kick in our pattern detecting abilities so we can break their camouflage. I'm pretty convinced that's why we like playing where's Waldo and word search puzzles and hidden picture things in the highlights magazines at the dentist office. Because it feeds into our skills. We're good pattern detectors. It's innate, it's innate. It's inherent in how we see that we should be able to see fast and use our two eyes together as a well integrated team to localize a target of interest in space. And that in its essence is predator versus prey.  Dr. Stephey: So when you think about the anatomy of our sensory systems, vision, auditory, taste, touch and smell, there's about 3 million sensory neurons in those five systems. And of that 3 million neurons, there's about 30,000 auditory neurons per ear. There's roughly estimated to be 1.2 million optic neurons per eye.  Tim Edwards: A big difference.  Dr. Stephey: It's huge. So almost two and a half of the 3 million sensory inputs are tied up in vision. And of those senses, vision, auditory, taste, touch and smell, the two senses that are our primary threat detectors, are vision and auditory. Because both of those sensory systems allow you to perceive a threat at distance in preparation for fight or flight. So that's the reality of how our sensory systems are put together. If you have to wait to feel something before you consider it to be a threat, it is way too late.  Tim Edwards: Too late. That's right. You're dinner.  Dr. Stephey: You're dinner, dinner, and your gene pool didn't make it. So you were weeded out generations ago. If we inherently had poor binocular vision and we couldn't catch an animal source of protein, we probably would have all ended up vegetarians because we never would've been able to catch an animal source of food. Because to be able to do that, you've got to be able to see in 3D because you've got to localize where that prey animal is in space and you have to be able to predict the future. You didn't know you had a visual system that look into the future. Did you?  Tim Edwards: No, I didn't. I can't wait to hear about this. Fight of the lottery numbers are for tomorrow.  Dr. Stephey: So typically does a prey animal runaway in a straight line?  Tim Edwards: No.  Dr. Stephey: No. They zigzag, because it's hardwired into their system that if they zig and zag, it is harder for us to predict where they're going to be in the future. If I'm going to throw a spear at escaping animal or shootable it. Or an arrow or a slingshot, whatever my mode is. If I can't predict where they're going to be in the next instant in time, if I shoot to where they were, I'm going to always end up shooting behind them. So we've got to be able to predict the future by being able to analyze where we think that animal is going to be at the next instant in time. And all of that is dictated by how fast we see and how accurate we use our two eyes together as a well integrated team. Because at that juncture the escaping prey animal is the apex of the triangle and our two eyes roughly 60 to 70 millimeters apart in our face is essentially the base of that triangle and we've got to be able to localize where that pretty animal is in space, but we can't do that if the base of our triangle isn't stable.  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. So in that context, a lot of patients that I see and certainly a lot of folks walking around every day, those that don't feel well-grounded, those that have some measure of anxiety, oftentimes it starts in the visual system. Because they truly don't feel well-ground because their internal mapquest is off and there's a significant visual component contributing to their sense of where they are in space.  Tim Edwards: So there is the need to see fast in today's society and not just back to the caveman days, right? You talk about anxiety issues because I would think that if somebody is not seeing fast based upon your examples, that they are in a constant state of fight or flight.  Dr. Stephey: I think that's a reasonable statement. And related to that is something called the polyvagal theory of affect, emotion, self regulation and communication.  Tim Edwards: That's a mouthful.  Dr. Stephey: It is. And it's been written about for the past 30 or 40 years primarily by a fellow by the name of Stephen Porges. He wrote a book called a pocket guide to the polyvagal theory. That's the more readable of his books. So if you're going to read a book that's the one to read. It's really user friendly and it's interesting too because fundamentally we want to feel safe. There's not much more that we can do in life if you can't feel safe. So when we roll out of bed in the morning and we look around our environment and throughout every waking, second of the day, our subconscious mind is asking yourself the question, do I feel safe? And we're primarily answering that question through auditory and primarily vision. Just because of the anatomy of two and a half, almost two and a half to 3 million neurons feeding information to the brain is tied up in vision.  Dr. Stephey: So when we look around and ask that question, do I feel safe? Well, a great part of that is your ability to see fast. So if you're able to see fast enough to just glance around your environment, subconsciously answered that question, why yes, I do feel safe. Then you go about your day and that question never bubbles up to your conscious awareness. It doesn't need to because your subconscious mind has already answered the question for you. But the problem is, in part, if you can't see fast or use your two wires together as a well integrated team and your subconscious mind asks itself that question again, do I feel safe and it can't answer that question below the level of conscious awareness, your brain goes into defcon one and the subconscious mind asks your conscious mind, well, do we feel safe? And the conscious mind says, you know what, I'm not really sure I appreciate you asking me for a second opinion so you know what I'm going to start to pay attention to whether or not I actually feel safe.  Tim Edwards: And there's a level of anxiety boosted a little bit right there.  Dr. Stephey: Absolutely, because now your conscious mind has to be on high alert status, which means now that you're more sensitive to movement in your periphery, right? Because that's where predators are going to come from out of your peripheral vision.  Tim Edwards: But a predator could also be a dresser in your bedroom. When you're getting up in the morning, you can't really see, a little dark and you nip your toe on it or something. Right? I mean, I'm being serious. Is that, that's not necessarily a predator, but like that's part of being able to see quickly or in the dark perhaps?  Dr. Stephey: Well, it is because I suppose at that juncture, any object in your peripheral vision, whatever that object is, can be perceived as a threat which goes along with that whole expression about perception is reality.  Tim Edwards: Yeah.  Dr. Stephey: Well, if your perception is off and in most cases when we talk about perception is reality, we are talking about visual perception. But it doesn't usually get elaborated on to that degree. But it's not just objects in your periphery anymore.  Dr. Stephey: Now your auditory hypersensitivity is elevated. Your touch sensitivity is elevated. Your tastes and smell sensitivities are elevated because now your brain is perceiving the environment as potentially one giant eminent threat and it better be on high alert status in preparation for anything that it needs to flee or fight from. Is that why individuals who are completely blind always seem to at least we're told, have this hypersensitive sense of, of, of smell and taste and sound. I think. I think arguably the answer to that is yes. If you. If you're losing out on that much visual input, but your brain still has to perceive your environment, it has to be tuned into other senses. The other interesting thing about blind folks is that when they use a white cane, for example, to maneuver around a room, their visual cortex lights up so they see the room in their visual cortex, but they're doing it through, feel, not through their eyeballs.  Tim Edwards: It's amazing. Dr. Stephey: From what I remember reading, when they read Braille, again, their visual cortex lights up at the same areas that relate to the written word in a sighted person. The same areas of the brain light up, but you're just doing that on your fingertips. You're looking through your fingertips. And I find that common in the patients that I see in my practice, typically more pediatric related. But when I see a kid in my practice who has a difficult time sitting in my exam chair when I'm talking with the parents, they want a slide out of my chair and they want to walk around my exam room because I got a lot of cool stuff to look at.  Tim Edwards: You do.   Dr. Stephey: So they feel compelled to go pick up everything and feel it. And most of the time I'm really tolerant to that because I understand the reason why. But I also understand what that kid is really telling me through their behavior, through their motor overflow, if you will, or what typically gets described as their ADHD behavior.  Dr. Stephey: I know in most cases that's just a vision problem and they're looking around, but they have to do it through their fingertips.  Tim Edwards: But the general public would say they're not paying attention. They're misbehaving and therefore they should be in trouble or suffer some type of consequences.  Dr. Stephey: Yes, absolutely.  Tim Edwards: Wow.  Dr. Stephey: And related to that, are the kids that do have a difficult time sitting still and it is true that if we looked at an ADHD or an ADD checklist of behaviors, a lot of the kids' behaviors will fit those checklists, but they're just checklists of behaviors. There hasn't been any actual testing that has gone on. There's not a blood test to determine if you're ADHD and my experience over the years that I've been in practice and everything that I've read inside my field of optometry and all the stuff that I read outside my discipline really says ADHD ought to be a diagnosis of exclusion. And what I mean by that is that you should have ruled out everything else.  Dr. Stephey: Things that ought to be measured and can be measured and can be trained, should be measured and assessed and treated. For example, there's something called retained primitive reflexes. There's nutritional aspects to behavior. There's seeing fast or magnocellular vision. There's eye tamng, eye focusing, eye tracking and working memory and executive function skills. All these things are tangibly measurable skills and they all could be trainable. We should do that rather than look at a checklist of behaviors and reach a conclusion that that kid's got ADHD and that we should put them on meds. That to me is malpractice. I'll give you a practical example. Picture yourself at the movie theater and they start the film and the video and the audio tracks are slightly out of sync. Maybe 20, 30 milliseconds. How's that gonna make you feel?  Tim Edwards: I hate it.  Tim Edwards: I've been to a few movie theaters where they're out of sync and I'm the guy that gets up and goes and complains in the back they fix it. No, it's aggravating.  Dr. Stephey: It is. And I think those frustrating, aggravating, discombobulating, annoying. Those are the kinds of adjectives that describe what it's like to do that.  Tim Edwards: Wow. So these people are living with their "films" out of sync all the time?  Dr. Stephey: Well, I think so because fundamentally I think what that represents, it means that vision and auditory aren't in sync together and that's very disturbing. Now, if I sat in the back of that theater with a clipboard and a checklist of ADHD behaviors, about five minutes after starting a film like that, pretty much the entire audience, is going to start manifesting ADDness and ADHDness.  Tim Edwards: Absolutely.  Dr. Stephey: So if all I did was look at the behavior and not the underlying skills related to moving, looking, and listening. I'm going to think everybody's got ADHD. Or they're inattentive and I would have missed the whole representation of what was really happening. Well and the reason I want to talk about those kinds of things because I'm going to circle back to a more fundamental component of how we see fast and what it represents in terms of us asking and ultimately answering that question about whether or not we feel safe and tied to that is the idea of autonomic state.  Dr. Stephey: Autonomic state relates to the idea that are we in a perpetual state of fight or flight? Or can we be calm and mindful and in the moment. And it's really intriguing because the brain has 12 cranial nerves. Or 12 branches that are nerves directly off of the brain itself. And roughly two-thirds to three quarters of those are directly tied up in the visual system and a few others tie vision and the inner ear and the auditory systems together. And the 10th cranial nerve. It's called the vagus nerve. Vagus means to wander. So the vagal nerve or the vagus nerve wanders throughout our organ systems. And and it ties into our ability to self regulate and the really fascinating thing to me is the patients that I might see and they could be an adult patient, what I'm going to describe as a neuro typical patient could be a kid who's been diagnosed with ADD or ADHD, could be a student, has been diagnosed with dyslexia or reading disorder, could be a kid on the spectrum, could be any child who has some sort of a medical syndrome that has challenged their abilities to move, look and listen.  Dr. Stephey: So there they do not find it easy to self regulate their behavior. And this is what's so fascinating about the work that I get to do every day. As an example, one of the assessments that I might do is to stand 10 feet across the room from somebody and I say, we're going to make eye contact with each other. I'm going to slowly walk towards you and you tell me when it feels like I've invaded your personal space bubble. I don't care how you measure it. Your heart skips a beat, you catch your breath, your palms get sweaty, you feel like you've got to step away. Or you feel like you want to run away from me coming across the room, you use your own benchmark. But I'm describing what we're going to do.  Tim Edwards: Basically when they don't like it.  Dr. Stephey: When they don't like it.  Tim Edwards: It hits a point when they're uncomfortable in any way, shape or form.  Tim Edwards: Interesting.  Dr. Stephey: Yes. Doug, you're too close. So I start 10, 11 feet away. We make eye contact with each other. I slowly started to walk across the room and I can't tell you how common it is that I might be six, seven, eight feet away. And people telling me you're too close.  Tim Edwards: Wow. Really?  Dr. Stephey: It's phenomenal. And one of the things that I do straight away in that measure is I'll usually give them colored lenses to look through or some kind of prism lenses to look through and then we'll do the same thing again. It's astonishing in many cases how close I can get. I did that with. I did that with one adult gal and I was so close to her with the glasses on. I couldn't. I couldn't have asked for her to do a better response because she said I was so close. She said, oh, I feel like we're going to kiss and I'm okay with that.  Dr. Stephey: Now mind you, this is the same. This is the same woman. That one I did at the first time without the glasses and I may be seven feet away and I describe this sympathetic overflow or this elevation of fight or flight, and she says, I felt like my arm pits are sweaty, and then she had this aha moment and she said, "do you think this is why I'm armpits get sweaty when I get in the crowd of people?" I'm like, yes, of course it is. Because the crowd milling around your periphery is triggering off this, this vagal response, your 10th cranial nerve is disregulating your behavior and it's wanting to push you into fight or flight.  Tim Edwards: Think about the children in classrooms that don't even know why they're uncomfortable because there's one child right in front of them in one to their left and one to the right and one behind them in a teacher, maybe six to 10 to 15 feet away and all of that. I mean, if you can alleviate that anxiety that a child is feeling in classroom alone, think about how much better they're going to do in school.  Dr. Stephey: Well, Tim, that's really well said. Because whenever I interact with school districts and the perception is, well the kids just not paying attention. When I say, well, it sounds to me like you've just rendered an opinion and that you act like they're willfully not paying attention. I'm here to humbly suggest that they are paying attention, but at survival based behavior. And survival based behaviors are going trump learning about reading and math every single time. So they are paying attention just not to the things that you want them to and that's not willful, that is reflexive behavior that's based in survival. It sounds a lot like what we're going to be talking about in our next episode. Actually that's true. We're gonna. We are gonna. Continue. The next episode was talking about the educational system and special education rights and how kids are being assessed and how they're not being assessed.  Dr. Stephey: But let's continue on with this idea about the vagal nerve because fight or flight is something that people commonly relate to and that's true. But there's other components to the vagal nerve as well. And in the wild, there are some animals that survive based on their ability to play dead. And classically, what does it mean to play possum? Right? And, and there's something about predators that don't like prey animals when they're dead. And you can see that with domesticated cats, right? If you have a domesticated cat and they happen to find a mouse in the house.  Tim Edwards: They're not interested. If it's dead.  Dr. Stephey: Well they're interested in it while they're slapping it around, but when the mouse is so overwhelmed by fear and their vagal response pushes them to basically pass out, the cats like, oh, oh, you're not going to try to run away from me anymore? Tim Edwards: I'm bored.  Dr. Stephey: I'm bored, I'm off to do something else. And then the animals got to wake itself back up because in that moment they've depressed their heart rate. They've depressed their respiratory rate. They literally are on the verge of death and you see that happen in humans. Oftentimes with trauma survivors or even if you've got a really dysregulated vagal nerve, some people just easily pass out on something that seems innocuous to, I don't know, 95 percent of the population. Those that have a really highly dysregulated vagal nerve will pass out at the craziest things. I don't think I've ever had anybody do this personally in my office, but I know of optometrist that have where they go to put a contact lens on somebody's eye and they pass out in the exam chair. That is a vagal response.  Tim Edwards: Sure.  Dr. Stephey: And it's beyond voluntary control. So the interesting thing about the vagal nerve is that it, it sets people up for fight or flight and Dr. Porges refers to that as mobilization with fear. So it is, I'm getting the heck out of town, I'm going to run away because I've had the pants scared off of me. Mobilization with fear. There's two branches to the vagal nerve, a relatively newer one from an evolutionary perspective and a much older ancient one. And the much older ancient one is where people pass out or some trauma survivors disassociate from reality in the middle of the trauma as a means of surviving. So one part of the vagus nerve that induces fight or flight, Dr. porges refers to that as mobilization or movement with fear. Another response of the vagal nerve, if fear is so overwhelming that you're frozen in time, you are that deer in headlights, that is immobilization. You are paralyzed. You cannot move a muscle because you're so scared. That's immobilization with fear. And then there's a third response which is really interesting. He refers to the third response as immobilization without fear and this is where it gets really interesting. Because the vagal tone of the 10th cranial nerve also ties in their idea of having a gut feeling right when we talk about having a gut feeling that's a vagal nerve response. Really interesting stuff. And play..  Tim Edwards: And let me hold on. So when we have that gut feeling, I think the gut feeling we have usually leans towards something negative or fearful. I don't know that I have too many gut feelings except for when I'm at a ball game and I think this guy might hit a home run and he does in my life to claim it that it was mom the reason for that. But no. Is that true? I mean, is that or is that just my perception? Do you think that gut feeling might normally be like something's a little off, something's wrong or can it go both ways? Well you're talking about fear here.  Dr. Stephey: Well, but that's where the third part comes into play. Because the third part, when I talked about immobilization without fear, that actually facilitates our social adjustment skills. And our social adaptive skills and our abilities to engage with other humans in a playful, productive, emotionally connected way. So it's still a vagal response, but in a good vagal response. So you're probably right. Maybe most gut feelings tend to associate with fear, but I don't think that's true all the time. And you know, when you meet somebody new, it's really interesting because in many cases you can have an immediate connection to that person. Absolutely. And, and you can't even explain why. And others, you're like, no way, I don't want to be in this room with you. That's a vagal response that is happening. That is a perceptive response below the level of conscious awareness happening through vision and auditory and then activating that 10th cranial nerve through that response and making it so that you feel really comfortable with that person.  Dr. Stephey: And if somebody you can welcome into your personal bubble and there's a lot of emotion and connectedness to being able to do that. The idea of being touched and a lot of cases, it's a pullback response like I don't like being touched or is it a touch that's really we would perceive as a caress and something that's inviting and something that we want more of. Ultimately that's a vagal response. Either that we invite more of the same response or you want to pull away from it. But it's a vagal response nonetheless and I find his body of work so fascinating because it ties in to the vision stuff that I do and he's looked at, Dr. Porges has looked at regulating vagal tone more through the auditory system and I'm looking at regulating vagal tone through the visual and the auditory system to the degree that I can.  Dr. Stephey: There was some research recently out of Duke University that's so new that people don't even know what to do with it yet. And it reveals the connectedness of the visual system and the auditory and the vestibular or inner ear system so that when we look in right gaze, both eardrums, move to the left and when we look in the left gaze, both eardrums move to the right. But I find it fascinating to know to look at the connectedness even further between vision and auditory. And I also want to make a comment about vagal nerve tone because regulation of the vagal nerve also ties into the seventh cranial nerve or the facial nerve. And this is what is so interesting about Dr. Porges' work to the how it connects to what I do. Because the facial nerve ties into our own ability to regulate our own facial expression.  Dr. Stephey: And I was just reading this morning about how exuberance and happiness is manifested by the facial nerve regulation of the orbicularis oculi muscles. Or the muscles that really circle around our face and eyes. So when you refer to somebody as having a twinkle in their eye, it's probably the facial nerve response in that orbicularis oculi muscle. And the flip side of that, if you've got poor vagal tone, it affects really more the lower jaw. And when we talk about somebody gritting their teeth or they set their jaw in a certain way. So if you have to fight your way out of survival or you have to bite your way out of survival, that's lower jaw. That's a different connection with the facial nerve. So how we express emotion ourselves happens to the facial nerve which is connected to vagal tone. The facial nerve connects to vocal cords, so how we intonate and the rhythm and the melody of our own voice is tied up in the facial nerve and those things are really interesting because they're also connected to our ability to perceive emotion in others and our ability to read their body language, which that's all vision, right?  Dr. Stephey: When we talk about when social psychologist talk about how 80 percent of our communicative language is through body language, reading body language is a visual language. And so the vagal nerve and how it sets that tone throughout the body, particularly in the facial nerve. If you're vagal nerve is poorly regulated, you likely are going to default to being more fearful. So you're going to misread somebody's facial expressions. You're going to misread the intent and their voice because now if you've got poor vagal tone, you're predisposed to be fearful. Because it's better to be safe than sorry, and it's also really interesting because the facial nerve also connects to tiny muscles in the auditory system that connect the middle ear to the inner ear and to the auditory system. Those three tiny little bones that regulate tension on the eardrum also connected to the facial nerve also connected the vagal tone. And it's really interesting because if you're in a perpetual state of fear or your vagal nerve is dysregulated, the tension that's placed on your eardrums predisposes you to hear low frequency sound.  Dr. Stephey: That tends to be more predatory based. So if we dial the clock back a number of generations, whether it was eat or be eaten, if you're in a fearful environment, predators are more likely going to make low frequency noise. So when your vagal nerve is disrupted, you're more attuned now. Your auditory frequencies are predisposed to low frequency sound and the human voice is more in mid frequency ranges. So if you lose the ability to hear human voice when your vagal nerve is disrupted, it's the whole thing is fascinating. One of the questions that typically arises in this discussion is, well, Doug it's really fascinating, really interesting that this is happening, but what the heck do we do about it?  Tim Edwards: We fix it.  Dr. Stephey: Because I don't want you to just tell me I got a problem that I can't make better. Yeah, and I don't like that either.  Tim Edwards: Well, that's the point of this podcast actually.  Dr. Stephey: Well, that's right. People need information so that they can then act upon the things that they learn and then know where to seek answers for because most eye doctors are not going to talk about this stuff.  Tim Edwards: Well, I think one of the reasons this particular topic, Dr. Stephey when I was in your chair was so fascinating to me because you really broke it down to a very simple example of why one might feel a sense of anxiety. Or why and how it relates to our vision. So therefore, it seems like it could be a simple little tweak or a simple fix to alleviate all of these problems and I'm focusing mostly on maybe children in school. So that they can be more at ease and learn or if they don't see fast, how they can see fast so therefore they can move forward through life without that anxiety or at least having it minimized. Dr. Stephey: Well so let's break it down into several different categories. The treatments ultimately are the same, but I do think it's important that the listening audience appreciate the breadth and the depth of how this applies across the spectrum. So if we talked about school age, kids that have an IEP for dyslexia or a reading disorder, well, lenses and prisms or vision therapy or sound therapy is designed to help regulate that vagal tone and ultimately shift them out of survival attention into learning attention. But it's fascinating stuff because I can really change somebody's quality of life frequently by color in prism in a prescribed pair of glasses. Sometimes they need vision therapy, sometimes color in prism is good enough. Sometimes they need sound therapy to access vagal tone in a different way and there are a number of optometrists that I believe I'm one of them and I think there are a number of others that incorporate sound therapy into the model of how they practice. And for me it's such an easy transition because the visual system and the vestibular or the inner ear are so intimately intertwined and because so much of our brain function, two thirds or three quarters of it is tied up in visual processing.  Dr. Stephey: That if I can affect one of the other systems, motor or auditory, I know there's going to have a salient or an improvement in the visual side of things. I think we're just remiss if we don't pay attention to global aspects of things. There were several optometrists and a pediatrician at Yale back in the 40s and 50s who studied vision development. From infants, I think up until 10 or 12 years of age and they wrote a book about that and a number of articles. One of the things that stuck with me from that perspective and that study that was done was an expression that went like this. If you want to understand the whole child, you have to understand their visual system. And if you want to understand their visual system, you have to understand the whole child. So we can't parse out vision from everything else and that's why when I talk about move, look and listen, I really mean that in its totality.  Dr. Stephey: So other than school age kids, who else? Well, some of the most highly dysregulated of the population are kids on the autistic spectrum disorder. They spend a tremendous amount of their time in fight or flight as a survival mechanism to not be overwhelmed by being in fight or flight all the time. They tend to be inattentive or they tend to disassociate, I think from their environment because it's an adaptive survival response. They have to learn how not to pay attention just to get through the day. So that's the pediatric sort of student population side of things. But does that mean that this doesn't carry over into the adult population? No, not at all because there are a number of trauma survivors who have made their way into adult hood who still have significant behavioral or emotional outcomes. And again, this is typically based in behavioral outcomes. But we're talking about autonomic state and vagal tone and how vagal tone is affected by the auditory and the visual system.  Dr. Stephey: And it's interesting because there are a number of psychotherapies that are designed to try to help trauma survivors let go of the emotional conflict that they experienced for years later. For example, there's something called EMDR. Eye movement desensitization and retraining. Well, think about that name, eye movement desensitization and retraining. So somebody who's doing EMDR, psychotherapist, who's doing EMDR, is typically using left or right, rhythmic eye movement in order for that trauma survivor to re-experience some component of that trauma, but do it in a more emotionally disconnected way so they can come to truly at the core of their being believe that what happened to them was not their fault and that they did the best they could in the circumstances that they found themselves in. And from the reading that I've done, if a trauma survivor can come to believe those two questions, it wasn't my fault and I did the best I could. They can let go of a lot of emotional problems that persist with that preexisting traumatic event.  Tim Edwards: Wow. Dr. Stephey: Eye movement, desensitization and retraining.  Tim Edwards: I'm familiar with that. I did some, a series of videos for a psychotherapist who actually had that modality in their office and it looks like it's a relatively simple form of therapy. It looks like watching pong, number pong.  Dr. Stephey: Yes, of course.  Tim Edwards: For this, for those of you who are now playing fortnite and are young and have no clue what pong is it's one of the very first video games. And there's that movement of following this dot.  Dr. Stephey: Well, you've heard of EMDR? Have you heard of brainspotting?  Tim Edwards: No.  Dr. Stephey: So brainspotting is a variation of EMDR. But rather than using the rhythmic movement from left to right, the psychologist who developed the brain spotting technique realize that he can have better outcomes and faster outcomes if he has patients look in certain positions of gaze.  Tim Edwards: You mean just shifting your eyes to a different place?  Dr. Stephey: Yes, so maybe up and right or maybe up and left or down and left. So still using eye movements to have this therapeutic outcome and I know I've had a number of patients over the years when we do some of the vision therapies that we do. They started remembering their dreams as an adult. There's one gal that was 67 I think when I did therapy with her and she hadn't been to the office for maybe six or seven visits. She came in one day and she said, hey, last time I left here on my way to the car, I started remembering stuff that I haven't thought about in 50 years. She's like, have you had people tell you that they're starting to have memories from long time ago? Well, it was her history that made me ask a handful of other patients back at that time. One adult who was for 47 years old when she did the therapy. She's the one that said, I haven't remembered a dream in 20 years, but I started remembering my dreams. The husband of my vision therapist at the time started the therapy and quit because he said, Doug, I've started having nightmares from when I was a kid growing up in World War II, Germany, and I've spent my whole life running away from that and now I'm having, I'm dreaming about that.  Tim Edwards: Alright. So we're talking to some potential negative effects from EMDR.  Dr. Stephey: Well, potentially negative effects for vision therapy and I won't, and I won't say negative effects from vision therapy, but the point I'm really making is that vision therapy is more than about learning how to see fast and using your two eyes together in a coordinated way. It is a, is a powerful tool of healing.  Tim Edwards: Wow. I've never thought of it that way. And you know, and you and I have known each other for a couple of years and you've mentioned vision therapy and I always perceived that as just a way to maybe strengthen your eyes, you know, like lifting weights for your eyes or something. And, maybe you've said that, forgive me if I didn't absorb the information correctly, but, but what you just said is pretty poignant. Please repeat that for our audience.  Dr. Stephey: Vision therapy is a powerful tool for healing.  Tim Edwards: For healing. Dr. Stephey: Emotional, mental, cognitive, physical. We keep a lot of memories stored in our body. One of the books that I have is called the body keeps the score. Well, people don't really realize that the visual system has a tremendous effect on balance and gait and posture. And for those of you listening audience out, quick way to demonstrate how much vision affects balance would be to have you stand with your arms crossed, eyes open, and then balance on one leg and then focus on how stable you are and then immediately see what happens when you close your eyes. You'll find your ankle wobbling and you probably won't be able to stand on one leg with your eyes closed for any length of time. People don't really realize how much vision affects everything. There's something called the Mcgurk effect.  Dr. Stephey: And the McGurk effect is when we use the visual perception of lip movements to prime the auditory cortex. So watching lip movements can actually change what you hear. That's fascinating.  Tim Edwards: You mean, you mean lip reading?  Dr. Stephey: No, not just lip reading. Because lip reading would be perceiving speech without the vocalization of speech. Well, let's go back to the movie analogy. When the audio track is slightly out of sync with the video track and it makes your brain hurt trying to put the two things together. That's that asynchrony between vision and auditory. So what I'm saying is that even when somebody's speaking, you hear better when you watch their lips move. Because vision happens so much faster than auditory, right?  Tim Edwards: The speed of sound as opposed to the speed of light, right?  Dr. Stephey: The speed of sound is about 1100 feet per second. The speed of light is 186,000 miles per second. And think about if you've got disrupted vagal tone and you don't see, lip movements fast. You don't read facial expressions fast and your default setting is to be pushed. And the fear to be rather safe than sorry. You can't socially engaged with others in a way that you should be able to. And if no one figures this out about you, you go through your whole lives and really become more and more isolated because you can't put yourself out in that social environment because your vagal nerve disrupts your ability to self regulate your behavior. And the whole thing just starts to snowball.  Tim Edwards: And you're labeled as socially inept and maybe a lot of this can be fixed, diminished and completely eliminated through various forms of healing therapies.  Dr. Stephey: You've got to be able to move, look and listen. You got to be able to see fast. You've got to have nutritional foundations. That's going to be one of our upcoming episodes. We're going to talk about the nutritional side of not only the visions discussion, but how it ties into memory and attention and reading and learning and cognition in general, so hopefully you'll tune in and the near future when we talk about the nutritional episode because I think you'll appreciate what I'm going to say about that topic as well.  Tim Edwards: Well, Dr. Stephie, I think there may be a lot of people and I'm sure parents that are listening to this that are elated at this information because you're offering some solutions that they've never heard of before that seemed quite simple, that don't involve medication. Well, that's true. You know, medication has a place. I'm not, I'm not anti medication. It does have a place, but again, I think generally it should be a diagnosis of exclusion and we've got to measure the things that we can measure. We've gotto  address all of these pieces. They're all trainable. I don't care if you're an infant. I don't care if you're 90-years-old. All these things can be measured and all of it can be trained.  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.        

"If you want to understand the whole child you must understand their visual system and if you want to understand their visual system you must understand the whole child.” - Famed Yale pediatrician, Dr. Arnold Lucius Gesell Vision therapy is a brain-based program of "eye exercises" designed to change the way one’s neural networks control any variety of visual skills which are assessed and remediated. Douglas W. Stephey, O.D., M.S provides information regarding the various vision therapy methods utilized in his practice. 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: This is the Move Look & Listen podcast with Dr. Doug Stephey. I'm Tim Edwards with the Inbound Podcasting Network and a patient of Dr. Stephey's and we appreciate you tuning into the podcast today. We know when you hear the, the term or the word or the profession, optometrist, you think I'm going to go get some glasses, get some contacts and be on my way. And that's traditionally what happens when you go see an optometrist. Well, if you listen to some of our previous episodes, you know that I have a video production marketing company and I have interviewed dozens of optometrists here in the southern California area, but there was this one day that I produced a video for Dr. Doug Stephey in Covina, California. That changed the way I thought of optometrists, or at least this one in particular. Because Dr. Stephey was the first optometrist that told me about vision therapy, not just how I could see 20/20.  Tim Edwards: Dr. Stephey we have touched on vision therapy in previous episodes, and you talked a little bit about what it entails. But let's just dedicate an entire episode to vision therapy. Because future podcasts will depend upon the information we present today.  Dr. Stephey: Tim, I think it's a wonderful idea and there is a lot of information and misinformation about vision therapy and what it is and what it does. So one of the first myths that I want to talk about is when somebody says, well, I heard vision therapy doesn't work. And I say it doesn't work to do what? And then they say, what do you mean? And I say, what do you mean? Dr. Stephey: You're the one that said vision therapy doesn't work. I'm asking you it doesn't work to do what? And then they pause again and then I say jokingly, well, does vision therapy cure world hunger? No. Vision therapy doesn't work to do that? And then we have a chuckle about that because that seems so preposterous, right?  Tim Edwards: Right.  Dr. Stephey: But it opens the discussion to talk about what vision therapy does and doesn't do. For example, there are components within medicine and education that put out the argument. There is no proof that vision therapy cures dyslexia. Therefore vision therapy doesn't work. Well that's a heck of a statement and conclusion. I don't really know of any optometrist doing vision therapy that would make the claim that vision therapy cures dyslexia.  Tim Edwards: That vision therapy or even glasses cures anything.  Dr. Stephey: Well, that's my point. So when the false premise is written by others that want to denigrate vision therapy, that vision therapy, there's no evidence that vision therapy cures dyslexia.  Dr. Stephey: Therefore vision therapy doesn't work and make a global blanket statement, right? That's the classic. You set up a strong man's argument and then argue the false premise. It's just wrong and it's disingenuous at best. So does vision therapy cure dyslexia? I would make the argument that no, vision therapy doesn't cure dyslexia. But we're back to the issue of what is vision therapy and what is it designed to do? Well, that's a really wonderfully complex and loaded question.  Tim Edwards: But for those like me who've never heard of vision therapy before, what is it?  Dr. Stephey: Right. What is it? So when I have that exact same conversation in the practice and I've got a limited amount of time to do it, kind of like doing this podcast. It goes something like this. I said, imagine a three circle venn diagram, one circle is can you see 20/20. The second circle is are your eyes healthy and that's where most eye doctors practice optometry and ophthalmology alike.  Dr. Stephey: In those two circles. You can have an exam like that and be told everything is fine and you could still have a profound vision therapy problem because that exists in the third circle. It's like the third rail at the subway, right? The third rail. Well in this case, that third circle, in it has items like this retained primitive reflexes, magnocellular vision deficits, visual aliasing and visual stress, convergence and facility, accommodative infacility, accommodative dysfunction, motor planning and sequencing deficits, working memory and executive function issues, rapid naming skills deficits, even phonological processing deficits, and even some auditory processing outcomes are affected by visual skills.  Tim Edwards: Okay, but I got to interrupt you because these are really cool sounding terms.  Dr. Stephey: I know.  Tim Edwards: But someone like me is like, I don't know what that is.  Dr. Stephey: And ultimately that's really my point to start with. My point is that when I list those terms off and it sounds like I'm talking to foreign language, that's really my point because I say anything that I just said, does it sound like it's related to seeing 20/20 letters out an eye chart at 20 feet. And then patients are like, well, no, I've never heard of those things before.  Dr. Stephey: Like that's my point. There's a whole world in vision and how it affects brain function that no one's ever shared with you. So in that context and in a simpler version of things, vision and auditory are our primary threat detectors. It's the primary sensory modality of how we interact with the world around us, both in us asking ourselves the question subconsciously, do we feel safe and do we have the visual skills to know where we are in space to be well grounded? And that goes to our sense of ego and our sense of self and how we fit in this world. We also use vision to read gestural language and facial expressions and I would argue that most social psychologist would make the argument that 80 percent of how we communicate is done through body language, not through the words that come out of our mouth.  Dr. Stephey: There was a show called Lie to Me that was about reading body language. Remember reading body language isn't through touch or auditory. It's happening through vision. So there's a number of skills like the terminology I rattled off a few minutes ago that people don't know about. So my job as a neurodevelopmental optometrist is to figure out do you have such a problem and what areas might it lie in and how does it show up in your day to day life. Whether you have issues with driving at dusk or night time. Or I have some patients that avoid driving the freeway. I can't do it. It's too anxiety producing.  Tim Edwards: I know several people that won't drive on the freeway, period.  Dr. Stephey: That's a vision problem because driving at freeway speeds is about using your visual skills to judge the movement of time and space. And the faster the speed, the less time and space that you have in order to make that judgment, so people avoid it.  Dr. Stephey: I have other people that don't drive in the carpool lane. The concrete dividers whizzing past their peripheral vision, acts like a magnet on their visual attention, and in some patients their car feels like it's demonized and wants to drive itself into the wall. So these vision therapy related skills and the deficits within those skills affect every aspect of our lives. I don't care if you're a baby learning speech or you're 90-years-old wanting to keep your drivers license, or not trip and fall and break something and then never recover from the broken bone. All of this ties into these visual skills. So in my estimation, the biggest challenge is doing the right assessment to start with. So you know all the pieces within that third circle of the venn diagram so that you can then create a developmental hierarchy to what should we treat first and second and third. Much like the expression you gotta walk before you run, or you got to crawl before you walk and you've got a rollover before you get up on all fours and before you can roll over, you've got to be able to lift your head off the floor.  Dr. Stephey: You got to be able to push yourself up with your arms, got to know that your arms and legs even belong to you and that you have some voluntary control over them. That's all a developmental hierarchy and it ties in to the whole theme of my practice and this podcast, which move, look and listen.  Tim Edwards: Dr. Stephey not looking for an exact number here, but maybe more of a ballpark figure. If someone hears the term like myself, vision therapy, my first thought would be, well that's probably a very small percentage of the population that needs something like that because of the word therapy. Right? But in your estimation, over your 30 years of being in practice, I'm sure that number's pretty high. What percentage of your patients you think could benefit from vision therapy?  Dr. Stephey: I think the more general question is what about the population at large? Not just about my population?  Tim Edwards: Yeah, absolutely. Sure.  Dr. Stephey: So 10 to 20 percent of the population at large likely has a vision related deficit that they know nothing about because it falls in the third circle that's never been assessed. But again, just generally speaking, If we look at different subcategories in the population, autism, ADD, ADHD, working memory, executive dysfunction, reading disability, dyslexia, learning disorder, bipolar, schizophrenia, motion sickness and migraine, chronic headache, fatigue, pick one.  Tim Edwards: Yeah, that's a lot of people.  Tim Edwards: That's a lot of people.  Dr. Stephey: That's a lot of people. It is estimated today that one out of, I think every 68 kids born today is getting a diagnosis of autism.  Tim Edwards: Wow.  Dr. Stephey: By 2030. It's speculated one out of every three kids and a retired psychiatrist that I know who's been to some continuing education says that where she's gone to the speculation is that by 2050 there'll be no neuro typical kids left.  Tim Edwards: Well, that's a whole other podcast because I in the Inbound Podcasting Network, we have other clients that talk about what they believe are the reasons for that increase. We don't need to get into that right now, but there are hard numbers, true data to support what you just said.  Dr. Stephey: Yep. So let's circle back to what is vision therapy then. The simplest explanation is that vision therapy is like physical therapy on the eyes and brain. Some people mistakenly think that vision therapy is something that we're doing that makes your eye muscles stronger. That is not the case. It's never a question or it's rarely ever a question that your eye muscles are quote unquote weak. What's more significant is how your brain tells those muscles what to do. So there's certain neural networks that control these skills. Visual attention, visual processing, speed. In lay terms, eye focusing, eye taming, eye tracking, visual-spatial skills, visual-auditory integration, visual-motor skills, visual-cognitive abilities. Again, each of those different categories has therapy tied to each of those singular items. But globally it's changing the way your brain tells your eyes what to do and it changes the way your brain processes visual data, so there's a sensory component.. Dr. Stephey: of how you take in visual information. There's an integrative component that's happening in your mind about how you process and assimilate that data in preparation for acting upon that data, usually through some sort of motor output, either with speech and language or that I've got to move from point a to point B or I've got to throw a ball from third base to first base or that I've got a parallel park her car and not hit the car in front of me or behind me. So you get the idea that vision's pretty pervasive in every waking second of everyday. So vision therapy is not making your eye muscles stronger. It's changing the way your brain processes visual input. That's the most simplest of explanations. And then there's a couple different models of the delivery of that care. There are models that would propose to really never, and you know the absolutes of never and always you're always going to want us to, you'rer always going to stay from absolutes. Tim Edwards: I think we understand it. You're right and I'm guilty.  Dr. Stephey: So one camp would say you need to do free space activities that do not involve a computer screen and that involved whole body component in the eye movement activities. So it's a whole body, eye movement experience and there's value in that. There was a pediatrician from Yale, I believe, named Arnold Gazelle back in the 50s, I believe it was. Worked with a handful of optometrists to study vision development from infancy up to the ages of 10 or 12. And one of the that that group wrote about way back then, think about that back in the 50s? They wrote, if you want to understand the child's vision, you have to understand the whole child and if you want to understand the whole child, you have to understand their vision development. So there seems to be a lot of misconception about that vision therapy is just an eyeball based activity.  Dr. Stephey: It is not. It is a brain based activity. For example, there are 12 cranial nerves that are direct branches off the brain itself, major cranial nerve, 12 of them, roughly two thirds to three quarters of them are directly tied up in vision. That's a lot of brain space allocated towards vision and vision development. Vision development really is kind of a lifelong process. Something I just re-read a few weeks ago said that the beginnings of the optic nerve and the beginnings of the eyeball begins to take shape roughly two weeks after conception. That two weeks. And on the same vein, there's something called frontal lobe activity or executive function skills and I think in some behavioral optometry circles we might describe frontal lobe activity as visual imagery. Can you visually image the consequences of your actions? Frontal lobe activity or these visualization skills seemed to not really fully develop until our early to mid twenties.  Dr. Stephey: So we're talking about..  Tim Edwards: Those are extremes right there. From two weeks after conception to our mid to late twenties or early what'd you say? Early to mid twenties?  Dr. Stephey: Yes early to mid twenties.  Tim Edwards: Oh my goodness.  Dr. Stephey: Vision development takes place over quite a long time. And beyond that we maintain neuroplasticity in the brain over our lifetime. So we can always make changes to brain based behavior. I don't care how old you are. I think the oldest patient, this is such a funny story because I sometimes will tell the story in the office where somebody is contemplating do they want to do vision therapy? And I say, you know, I had a mother and her daughter come and do vision therapy in my practice maybe year and a half ago. And people listening to the story, they're like, oh, that's interesting. And I say the daughter was 62. Dr. Stephey: They're like what?  Tim Edwards: Changes the whole perspective. That's right. Wow.  Dr. Stephey: Perception is everything.  Tim Edwards: It is indeed. That's right.  Dr. Stephey: Her mom was in the early nineties.  Tim Edwards: How about that.  Dr. Stephey: So it's never too late to do this in therapy.  Tim Edwards: So again, when you say that I'm chomping at the bit to go. What do we do? What is vision therapy like? You're talking about, you know, getting away from a screen but aren't there software packages that you have or where you need to be in front of a screen, and then there's getting out into the world and doing things.  Dr. Stephey: There is. So everybody is different. Everbody's their unique individual. Research studies are nice for global kind of statistics relative to the general population, but at the end of the day when you're sitting in my chair, your unique needs are your unique needs. So my job is to do a proper assessment to start with and then come up with a developmentally appropriate plan. What I go back to the comment about the name of this podcast, Move Look & Listen. My model, generally speaking from bottom up, we look at nutritional components of how you're functioning. We look at something called the retained primitive reflexes. We look at something called millisecond timing clock deficits, and whether they exist in your brain. You know the expression you are, he is walking to the beat of his own drum. That's this millisecond timing clock deficit and it is measurable and it is trainable. And the interesting thing about this millisecond timing clock and the company that has done something about it to measure it and train it, it's called interactive metronome and that was created by a music producer who was also a conductor. And I think he got tired of talking to musicians about their timing and how they were a little bit ahead or behind the beat and he created this instrument to measure it and then train them and it has taken on a whole life of its own.  Tim Edwards: That's awesome. That's awesome.  Dr. Stephey: It is phenomenal. So that's a millisecond timing clock and that's usually the first stage of my therapies, nutritional considerations, primitive reflexes and this millisecond timing clock. So that's stage one for me personally. Then we might move into stage two. Stage two is something called magnocellular vision or emotion processing. Your ability to see fast and do it under low contrast conditions because magnocellular visual skills, if it's not the gateway to attention, it's pretty close. So it is about seeing fast and my experience and the literature that I've read over the last 10, 15, 20 years from a variety of different disciplines, cognitive psychology, neuro psychology, social psychology, neuro optometry. When I tell you these things, they're in assimilation of me reading in a lot of different fields and then trying to weave that all together into the model of where I practice currently because it's very different then when I practiced 20 years ago. And I still learn stuff every day.  Dr. Stephey: I added a new therapy to my practice six weeks ago called the safe and sound therapy. People can google that, safe and sound therapy.  Tim Edwards: We'll put a link in the show notes for that.  Dr. Stephey: Yup and it fits into my model of what I do now. And there's the magnocellular theory of dyslexia that most of the people listening to this program are going to go, what? I thought dyslexia was just a reading disorder. Well, that's the outcome. It doesn't tell me why you're having difficulty with reading. It doesn't tell me why you're not benefiting from reading instruction that your peers are benefiting from. It's just given me a label and an outcome. Which is not the way to determine a course of therapy. I would say in most cases, if you have a child with a reading disorder or specific learning disability, which typically means a reading disorder or they even have the label dyslexia.. Dr. Stephey: Invariably what you're told is you just need to do more reading. I'm not going to be so bold as to tell you that there's not gains to be made if you're doing more reading because it's kind of like saying, well, if standard instruction is like trickling water into a bucket, over time, you'll fill your bucket up. That's true, but if you've got a bucket full of holes like primitive reflexes, millisecond timing clock problem, magnocellular vision dysfunction, focusing, tracking and taming problems, et cetera. It's like you've got a bunch of holes in the bottom of your bucket until you even know those holes exist, let alone to have the holes and what they represent assessed, and then put in some sort of developmental hierarchy in terms of treatment strategies, you're completely shooting in the dark. Right? So now if I take that same holey bucket analogy and I stick a fire hose in the bucket, like just doing more reading, I will temporarily fill your bucket up, but not because I plugged up your holes, it's because I poured it in so much.  Tim Edwards: Gotcha.  Dr. Stephey: But as soon as I stopped pouring that fire hose in, what I thought you knew it leaks right back out.  Tim Edwards: So vision therapy will help plug the holes.  Dr. Stephey: Big vision therapy is designed to help assess how many of those holes you have, what deficits and how big are the deficits, and then let's come up with a developmental plan that makes sense to plug your holes. Because remember there's primitive reflexes, millisecond timing clock, nutrition. Then there's magnocellular vision. Then eye focusing, eye taming, eye tracking. In my model, that's stage two. Stage three is really working memory, executive function, rapid naming, speed and phonological processing skills, and then ultimately if we still need to address it, then there's true reading outcomes and going back and retraining your knowledge of our alphabetic writing system. So that you now can benefit from reading instruction in a way that you couldn't benefit from before because we didn't know you had all these problems.  Dr. Stephey: I have some kids that it truly is painful to look at print. It's painful. So if I take a kid who's pained by looking at print and simply tell them and I don't recognize that that's the problem, and I say, oh, well, your eyes hurt after looking at print for five minutes while I need you to look at it for four hours a day because I need to do this reading to a dream to intervene to up your decoding outcomes. But your eyes hurt after five minutes of looking at print. Can you imagine looking at it for four hours?  Tim Edwards: Now there might be some listening saying, wait, what do you mean that there are people whose eyes hurt after looking at print? Because that sounds like a a ludicrous notion to most people. What do you mean, your eyes hurt? You have to read every day. How can you even function when your eyes hurt?  Tim Edwards: The way I understand it, Dr. Stephey is it's more than just it's, it's, it's almost repellent to some people because of how their brain is processing the way the words look on the paper. So it's not just that my eyes physically hurt, like someone stuck a needle in their eye, but it's also there's some anxiety associated with it.  Dr. Stephey: Tim, you are starting to catch on.  Tim Edwards: It's only taken me two years, but I'm getting there. Thankfully we have this podcast.  Dr. Stephey: There's a term called visual eylea scene and there's a term called visual stress. And visual stress and visual eylea sane really are representative of the same outcome, but their origins are slightly different. And there's a cognitive psychologist in the UK named Arnold Wilkins. W I L K I N S. Arnold Wilkins who wrote a book called Visual Stress, and he wrote a book called Reading Through Color.  Dr. Stephey: Both are powerful, powerful books. What he talks about is the black and white striped nature of print, specifically and how truly visually repellent it is, for some people you've probably heard the term photo epilepsy or how some people have seizure activity with certain rates of flicker. Well fluorescent lighting flickers and black and white stripes electrically have the potential to do the same thing to the brain that flicker does. And Wilkins, created a pattern of black and white stripes that is specifically designed to solicit this kind of a response from you if you are prone to visual eyelea scene or visual stress response. So you look at this center fixation dot of this pattern of black and white stripes, and my simple question to you initially is, is this comfortable or uncomfortable to look at?  Dr. Stephey: That's the first question. So if you're not prone to a visual eyelea scene or visual stress response, you look at the black and white stripes and you're like, it feels fine. If you are prone to this response, we have some people who can't even look at it for more than about two seconds and they say it's so disturbing to them in their eyes.. Dr. Stephey: In their brain, in their ears, jaw, throat, chest and/or gut that they can't even look at the stripes.  Tim Edwards: Yeah, again, that is part of what really attracted me to your practice was you asking me that question during my first visit with you. Because I was one of those who does not like looking at the printed paper and I do not like to physically read. I love to absorb my content through my ears, which is why I started a podcasting network and was in broadcasting for many years. And audible is a big sponsor of all of the shows on my network. But can you imagine though being a student who doesn't have the luxury of absorbing all of their content through their ears? Of course they, the teacher speaks, but you have to read your homework or read a book or do something that requires the visual component and that is why what you're saying is so paramount to the success of children in particular that are going through school.  Dr. Stephey: Well, I'll give you a couple of examples that are relevant to this discussion. One example is a guy who was in his early 50s, he's got a master's degree in social work and I was telling him this story about the way his two eyes work together and a light bulb went off. And he said, oh, you wanna know how it got to graduate school. He said, I couldn't read and comprehend at the same time. So I read my assignments, tape them, and then listen to myself on tape.  Tim Edwards: Now, that takes a lot of time to do that.  Dr. Stephey: Think about that.  Tim Edwards: That takes a lot of time. So think about had he perhaps had the opportunity to experience vision therapy at a younger age. How much time and how much easier would it have been for him to obtain his master's degree without having to go through that extra time arduous step.  Dr. Stephey: I had an optometrist come visit me in 2008. She was finishing the vision therapy residency. She came to see me about 11 months into a 12 month residency and during the course of my assessment with her, because she didn't like this grid that I'm alluding to. And when she saw me pull out this grid, she said, you know, I'm probably not going to do very good at this either. But I said, what do you mean? And in the span of about 30 seconds, she said, well, I don't really like to read. And then she said, that's not really true. I hate reading. And then she said I'd rather cut my fingers off than read. That's how painful reading is to her.  Tim Edwards: It's a real thing folks. I know there are a lot of people that just don't get it because they love to read. Like my wife loves to actually hold a physical book with paper and I'm not talking like on the kindle or something like she just loves the process and I can't think of anything more repellent.  Dr. Stephey: And that's the truth and so I get it.  Tim Edwards: It's a real thing and Dr. Stephey, we're running out of time on this episode right here, but it really is a perfect prelude episode to what we have coming up in our next episode.  Dr. Stephey: One final comment I want to make.  Tim Edwards: Please.  Dr. Stephey: Vision therapy is a pretty broad umbrella and there's lots of pieces that can come underneath it. And you could have had vision therapy elsewhere and still have a vision therapy problem. Because if we haven't comprehensively looked at all the pieces of this puzzle, it means that maybe all of your vision therapy diagnoses didn't get treated. Maybe some of them never even got assessed to be treated and maybe the things that got treated worked when you did the therapy. But maybe six to nine to 12 months passed and you come and find me by the web or word of mouth or a school district referral and I measure skills that purportedly we're fine six or nine or 12 months ago and now it seems like you've lost those skills altogether.  Dr. Stephey: I think those might be examples of why in some circles the perception is that vision therapy doesn't work. My experience would say that you didn't get fully assessed and you didn't get fully treated. And you didn't get treated in the right developmental sequence because for example, I won't do eye taming and eye focusing therapy in my office. If you've got a millisecond timing clock deficit or you've got retained primitive reflexes or you got a magnocellular vision problem. Because my experience has been over the years that if I try to do eye taming, eye focusing therapy without knowing those other lower level developmental skills, it's going to take me longer to treat those deficits to start with and they're likely not going to stick as well. My model is like a house of cards. If you got a shaky foundation to start with, which is primitive reflexes, nutrition, millisecond timing clock deficits.  Dr. Stephey: If you've got a shaky foundation, the second and the third foundation up is built on shaky ground. So I want to start from the ground floor up. You may not necessarily like all the things that I'm going to tell you, but you'll appreciate the depth of what you'll learn and you'll know the sequence of what should happen. You'll know the depth of what's happening with you or your child and you'll have a much fuller understanding of the work that lies ahead of you and that you know that there's a path that this can work and that's the most significant thing for me. At the end of the day. At the end of the day, you were the judge and jury of whether or not you accept my findings and the knowledge that I have to share. No one's ever accused me of not sharing enough information.  Dr. Stephey: You want literature on primitive reflexes? I will send it to you. You want magnocellular vision and the theory of dyslexia? Got it covered. You want things about convergence insufficiency and eye taming and eye focusing? I'll send you a couple links. I'll send you some articles. You want, millisecond timing cock deficits, and how it affects our abilities across the board? Got you covered. So be careful what you ask for when you come and save me because it is a red pill, blue pill moment from the matrix. If you will take the time to listen to me, there's no going back. It is going to change the course of how you think about life and what your needs might be and what your kids' needs might be.  Tim Edwards: I was intrigued from the moment I met you. It's the truth and it was right two years ago and I'm so thrilled to help get this information out because so many lives can be changed with what you're doing. I really believe that with all my heart and soul and like I said a few moments ago, and I'd love for you to kind of tease what our next episode is because all of this is so incredibly relevant to what we're about to talk about.  Dr. Stephey: And our next episode, I'm going to try to dive a little deeper into how to connect the vision therapy with your kids special education needs and what their educational rights are and how we can advocate with you and for you so that you have more power in your corner so that you can have more power in your corner and be a more effective advocate for your child and their needs.  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.     

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.      

>80-90% of kids on the spectrum can't move, look, and listen in a fast, accurate, effortless, sustainable-appropriate, and meaningful way. This results in high fear, high anxiety, high distractibility, and will leave your child in a perpetual state of fight or flight or your child will simply adapt and learn how to not pay attention. In this episode, Douglas W. Stephey, O.D., M.S provides information regarding children on the Autistic spectrum and how to effectively assess the visual system and provide solutions for them to move, look, and listen through their life with greater 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: Hello and welcome to episode number seven of the Move Look & Listen pocast with Dr. Doug Stephey. I'm Tim Edwards with the Inbound Podcasting Network and a patient of Dr. Doug Stephey, who is an optometrist practicing in the southern California area. Now Dr. Stephey. Today's topic, I believe is going to be a gold nugget found by parents of children who happened to land somewhere on the autistic spectrum. Never have I heard how autism and vision are connected, but we're going to discuss that here today.  Dr. Stephey: We're talking about autism and vision because about 80 percent of our brain's neurons are wrapped up in the processing of visual information. Remember, there's about 3 million sensory neurons that feed information to the brain, vision, auditory, taste, touch and smell. And of that 3 million fibers, there's about 30,000 auditory fibers per ear and roughly 1.2 million per eye. A staggering difference, and there's instances clinically.  Dr. Stephey: What I've seen this happen in the office where vision has the capacity to change how you hear, vision has the capacity to change balance and gait and posture. Vision has the capacity to change the way your body feels, your feet on the floor. It changes a term called proprioception or the awareness of your body in space. I've had patients, kids and adults alike where I'll tell them, I'm going to take my index finger and lightly rub it along your forearm. And I want you to tell me how it feels. And if you're a touch sensitive in this manner, it just about freaks you out. It's like walking into a spiderweb when it gives you the heebie jeebies. Who hasn't done that?  Tim Edwards: No. But it is fun to watch people do it.  Dr. Stephey: It sends a shiver through your whole body.  Tim Edwards: It's creepy. Yes.  Dr. Stephey: So people in this manner don't like light touch. And so I'll lightly rub their forearm and I can, sometimes I can see them visually get the shutters. And or they'll get a screwed up look on their face where it's like, oh man, I really don't like that. And then I stop and I say, how does it feel? And they're like, well, I didn't like it, number one. And if they don't spontaneously tell me, I always then ask, is it still itchy? And they're like, yeah, well then itch then and make it go away. So then they'll itch their forearm and I'll say, okay, well you know what, let's put on this pair of glasses with color in prism in them or color or prism or whatever. Whatever the combination is. And I'll say, let's try it again. And more times than not I'll do that when they put the glasses on and they're like, oh, just feels like you're touching me now.  Dr. Stephey: And how about when I stopped? They're like, well, you just stopped. It's not itchy anymore. No, it didn't feel like anything. Tim, it's the craziest stuff.  Tim Edwards: That is something you see at a circus that just seems like hocus pocus. I mean that's like something you'd see at a magic show or something.  Dr. Stephey: Well, it seems like hocus pocus to me as well, but I've learned over the years that this is repeatable outcomes. There's two adult stories to tell you. One is I did this with a wife who was in the exam room with me and her child. And she laughed about how annoyed she was by touch. And essentially she said it's a wonder we have any kids. Because I like it so little.  Tim Edwards: Never heard it put that way before. I like it, so little to be touched. Wow.  Dr. Stephey: So yeah, so I put the glasses on her and she's like, this is crazy. And then I had a different mom do the same thing and she remarked about how she didn't like it and hugs from her husband. And we put the glasses in prism on her and it again, remarkably changed her sense of touch. And then I said, well, you know what I want you to go out of my exam room. I want you to go out to the reception area with my glasses on and I want you to give your husband a hug and come back again and tell me how it was. And so she did. And she's like, oh, it was awesome. And he let go of me before I was ready for him to let go.  Tim Edwards: Dr. Stephey, it sounds like you could add marriage counselor to your repertoire there. Dr. Stephey: I am the love doctor.  Tim Edwards: And she had this and it's immediate. This is something that's immediate. Because they're putting the lenses on right there and boom, there's change instantaneously.  Dr. Stephey: It is the craziest stuff. Now, has anybody written an article about this? No. I don't know if any of my colleagues are even trying stuff like this. You know, I've, I've.  Tim Edwards: How did you discover this? Like how did you, how did you know? Maybe you didn't discover this. Maybe this is just something that that's been happening for years in your industry, but no one's talking about. Or is this something that you just happen to discover while experimenting with lenses with your patients?  Dr. Stephey: You know that's a good question, Tim. And I don't really know how to answer that because I don't think I've had this discussion with my colleagues, so I don't know if they're doing similar stuff. I haven't had anybody spontaneously tell me that they do. So I don't really know. I do know that there's a modest amount of time that I feel like I'm the only person on the planet thinking about these things and putting these things together. And there's very few people that I can really talk to about this because they just don't know.  Dr. Stephey: So if we circle back to the kids with autism, let's recognize a couple of things first of all. It is a behavioral disorder by its very definition. There's no test for autism per se, but you look at a checklist behaviors and the timelines of which they manifest and the consensus is you then fall on the spectrum based upon the checklist that's completed. Arguably and most commonly speech delays. Right? Kids have delayed speech or their nonverbal. It's one of the most easily recognized markers. There's some research that I don't particularly know all that well. That indicates that we might be able to use eye movement and eye contact and gaze of infants as a predictor of autism even before they're were even close to having speech.  Tim Edwards: Yeah, I've heard that many times.  Dr. Stephey: So I think speech becomes one of the most common indicators because if the kid's not talking when they should be or they're talking very little, well, it's obvious that that's the case. But if you have a child who doesn't know how to point and focus their eyes and space easily or effortlessly or accurately or sustainably, that's not obvious.  Dr. Stephey: They might be clumsy. They might not like wearing certain clothes or the tags in their shirts or the seams in their socks. So remember there's normal quote unquote, is a pretty broad spectrum and that's a pretty continuous continuum. And because again, autism and ADD and ADHD are behavioral disorders. They're really driven by a checklist of behaviors. And my whole contention is 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. So that's what I think in great part is happening with kids on the spectrum. Because so much of our sensory input is tied up in vision and the vision input we're talking about has nothing to do with the ability to see 20/20, which is where most eye exams default to, right? If you can see 20/20, everything's fine and vision has no role to play in your kid's autism.  Dr. Stephey: I could not disagree more. 20/20 is the tiniest little bit of what we're talking about.  Tim Edwards: And that's where most parents, this parent included just stops. Oh, you're 20/20. We're good. Don't need to investigate any further, as far as your vision is concerned.  Dr. Stephey: No absolutely.  Tim Edwards: You know 20/20 is what we're taught. That's what we were told. You get your glasses to fix it or contacts. Let's move on to something else and that's where it should not stop.  Dr. Stephey: This is universally as what is happening and that's why so many kids have trouble recovering function because in most cases I'm going to be so bold as to tell you conservatively 80 to 90 percent, 100 percent seems too boldt. But I can tell you 80 to 90 percent of kids on the spectrum have vision problems that have remained undiagnosed and untreated. And unless your finding somebody who really is taking the time to look at components of nutrition, retained primitive reflexes, something called a millisecond timing clock deficit, motion processing or magnocellular vision.  Dr. Stephey: Eye focusing, eye tracking, eye taming and working memory in executive function and visual-auditory integration, visual-cognitive skills, visual-spatial skills, visual processing speed, your kid's been under assessed, underdiagnosed and undertreated.  Tim Edwards: Now, are you talking about every child or just a child that might have been diagnosed as being somewhere on that spectrum?  Dr. Stephey: Well, the thing that I would just rattle off, they're all skills that we have to possess to function in a relatively normal way. What might be referred as neuro typical behavior. So I would suggest to you that any child who's been diagnosed with dyslexia or a learning disorder or a specific learning disability or reading disorder or have been diagnosed or suspected of having ADD or ADHD or is on the spectrum or has a diagnosis called clumsy childhood disorder, they likely have a vision component that again, has been underassessed, underdiagnosed, and undertreated. And the problem that I see is this is so commonly true that oftentimes these kids get lots of other therapies, speech therapy, occupational therapy, maybe adaptive P.E. through the school district. ABA therapy as a behavioral therapy. But the missing factor in all of that is nobody's looking at the vision piece. And it's tremendously huge.  Tim Edwards: Sounds foundational, again.  Dr. Stephey: It is foundational. And as an extension of that, I go back to something I believe we talked about before. It has to do with our subconscious mind continuously asking ourselves the question, do I feel safe? Do I really feel safe? I'm not sure if I feel safe. If you can't subconsciously answer that question, then you're gonna default to, well, I don't feel safe, which now means that all of your sensory systems are going to be at defcon one. You are on high alert status because your brain is perceiving your environment as one giant eminent, unrelenting threat.  Tim Edwards: Can't even imagine the anxiety going through one's being living like that and how it affects their behavior.  Dr. Stephey: Oh, absolutely. Because at that juncture, and especially when you're a kid, these outcomes now are reflexive in their outcome. Meaning you have no ability to control how you're behaving. So if you're that child and you have a meltdown that is beyond your voluntary control, because what.. Dr. Stephey: Whatever the episodic event was, it triggered you to have a fight or flight response, which is high anxiety, high fear, high distractability and survival at all costs. Which means that if you feel that you're being cornered, there's an expression that a wild animal is the most dangerous when you corner them. If you don't leave them an escape route, they have no choice but to go crazy.  Tim Edwards: For self-defense. Right. Dr. Stephey: Yes, their very survival is based upon them escaping the perceived or real threat. So much of these kids' aggressive behavior is beyond their voluntary control. You can talk to your blue in the face. But until they can regulate their autonomic nervous system and facilitate a more calmer response, you can't talk them off the ledge. It's very challenging because it's beyond their voluntary control. And remember, vision and auditory are our two primary threat detectors.  Dr. Stephey: They are the two sensory systems that we use to gauge a threat at distance in preparation for fight or flight. And you know, the idea of personal space and that your arm's distance is like a personal space bubble.  Tim Edwards: Yeah, no doubt.  Dr. Stephey: I don't know if somebody's written about it, I wouldn't be surprised. But my clinical take on this is if your visual system is operationally functional, you don't need a bigger bubble than arm's distance. Because your ability to perceive a threat at arm's distance gives you the opportunity to punch it away or push it away and then turn and run. Right? Does that make sense?  Tim Edwards: It does. Perfect sense. Yes.  Dr. Stephey: But here's the problem. If you can't see a large volume of space and you can't see it fast, arm's distance isn't good enough for you. You've got a bubble around you that's maybe 20 feet in diameter and any sound within 20 feet or any motion within 20 feet or any target or object visually within 20 feet is going to freak you out.  Dr. Stephey: So now the question becomes, remember separate from 20/20 because all that means you can see a tiny letter at 20 feet on a chart. The volume of space that you can see and the speed with which you see it is paramount to you being able to ask that question, do I feel safe? And is arm's distance as a personal space bubble around me an adequate amount of space? Well it's not, for these kids. One of the things that patients never accused me of is never giving them enough information.  Tim Edwards: That is true. I have a folder over here of information that you've given me, which I love. Thank you.  Dr. Stephey: And so because I read not only within my own discipline but because I read in so many other disciplines, I've got a book list that I put together that I share with parents. I have a computer full of articles that touch on every topic that I'm likely to discuss and assess. In the kind of evaluation that I do.  Dr. Stephey: The primary thing that I want parents to know is that almost without exception, the child has been under assessed and underdiagnosed and undertreated. So whatever they thought their child's life trajectory was going to be, I'm here to point them in a different direction and give them a different trajectory. Because of how the kids have been underassessed and underdiagnosed and undertreated. Typically when someone comes to see me for a first visit, I am going to talk about eye focusing, eye tracking, and eye taming. I'm going to talk about a concept called visual elea scene, which is the inability to look at black and white stripes either comfortably or without having eyestrain or the patterns move or blur or wiggle or you see colors or it's just overwhelming. And that you can't get yourself to look at these stripes. I might initially look at aspects of balance and gait and posture and how those things change with a low plus lenses or colored lenses or prism lenses.  Dr. Stephey: Because if I can notice a behavioral change in visual output or sensory input on the first visit, we have an opportunity right then to change that kid's life. Just by prescribing a pair of glasses, even if they can't see 20/20. So I will oftentimes prescribed glasses in this manner that have nothing to do with seeing 20/20 because I'm interested in how these glasses change the kids' physicality or their motor abilities or their ability to hold the pencil and improve their handwriting skills or make it so that they can tolerate a hug for mom or dad. Or they can play with a sibling and not freak out. Or they can join in other kids on the playground at school and not be overwhelmed by the motion and the sound of their environment. That's the initial part of what we do. When I do have patients come back and we do further testing, we do discuss components of nutrition. We look at a term called retained primitive reflexes. We look at this millisecond timing clock in our brain and how it facilitates our attentional control networks and how it facilitates our brain's ability to integrate different lobes in the brain, so that it improves our cognitive efficiency. We will look at eye focusing, eye tracking, eye taming. We look at working memory. What I want to do is do a comprehensive assessment so that when I come up with a treatment plan, we've got enough data to be able to do it in a logically, developmental hierarchy.  Tim Edwards: So you mentioned treatment plan. What are some examples of a treatment plan beyond lenses now? Something that I want to make sure that our listeners are not confused by. You said if a child comes in or a person comes in with 20/20 vision, you will still prescribe lenses. So we're talking color?  Dr. Stephey: Yes, we're talking color. We could be talking prism or we could be talking low plus lenses are any combination there of.  Tim Edwards: All right, so it doesn't just stop at seeing clearly.  Dr. Stephey: That's right. It doesn't stop at seeing 20/20.  Tim Edwards: So what other type of treatments are there?  Dr. Stephey: Well, typically there's nutritional interventions. Could be inulin fiber to change the gut bacteria. Could be omega-3 fatty acids to change and reduce inflammation in the body and in the brain. It could be zinc and magnesium discussion or calcium or sodium. I think the two most common things though are dealing with the microbiome. Microbiome being in the gut bacteria, and the omega-3 fatty acids. Those two things are monstrously huge.  Tim Edwards: And we'll be discussing omega-3s in our next episode.  Dr. Stephey: The next thing I look at is retained primitive reflexes. Retained primitive reflexes can be simply thought of as software that we're born, within our brain stem. And they're pre-programs, if you will, that facilitate our survival behavior.  Dr. Stephey: It helps us as a baby roll over on her stomach, lift our head, push up our upper body off the floor, get up on all fours, start to crawl, get up on two feet, free our hands to manipulate space around us and begin walking. And all of that motor planning and sequencing, serves a role into a springboard for developing speech and language and eye movement control and working memory and cognitive abilities. So primitive reflexes is something that's been commonly overlooked for a long time. And it can no longer be. It's too critical. I alluded earlier about this millisecond timing clock, the instrument that I use and the company that's been around for 25, 30 years now is called Interactive Metronome and there's no other device like it on the planet that I'm aware of. It is a powerful tool, not only for measuring whether you're timing clock is off, but more importantly to facilitate your brain's ability to retrain it and get it back to a normal timing function.  Tim Edwards: To retrain it. So that seems like a monumental task? Or is it?  Dr. Stephey: No, it's simple. It couldn't be simpler. The interactive metronome instrument was originally created by a music producer and a conductor. And it was designed to look at other musicians timing so that he wanted to produce better sounding music. So if your timing was a little faster, a little slow, he wanted you to be able to change that and feel where you were in that timing output. And he created this instrument to measure that. And it has just turned into this a wonderfully creative tool to change brain function. It is a powerful tool.  Tim Edwards: My goodness. Great Story.  Dr. Stephey: So, so the initial stage of therapy for me typically is nutrition intervention, retained primitive reflexes and this millisecond timing clock. Now I have some kids on the spectrum where the timing clock therapy, it's beyond their current abilities.  Dr. Stephey: So when that's true, I will either incorporate something called the safe and sound program put together by a researcher, neurophysiologist by the name of Stephen Porges, who has written about the Polyvagal Theory of affect, emotions, self-regulation and communication. It's a big deal. So if I, if I find somebody who is highly dysregulated, they don't feel safe and sound in their environment, we will do this program as a, as prep work for the other therapies.  Tim Edwards: To build them up too.  Dr. Stephey: Yeah, the safe and sound program is specifically filtered music where you, you do the listening one hour a day for five consecutive days.  Tim Edwards: That doesn't sound too arduous or painful, that's for sure. No sounds almost kind of fun. ] Dr. Stephey: It is. And it can really change your body's ability to regulate your autonomic nervous system or the part of your body that pushes you to be in fight or flight, or that you're so overwhelmed that you go into shutdown.  Dr. Stephey: So if we do the safe and sound program as a five hour introduction and interactive metronome is still beyond the child's ability. We'll then on incorporate different sound therapy into our treatment model. And this sound therapy is best done with bone conducting headphones and bone conducting headphones are over the ear headphones that have a, a button or a vibrating transducer, if you will, that sits on the top of your cranium. And it vibrates imperceptibly.  Tim Edwards: Wow.  Dr. Stephey: So if I turned the headphones off, but turn the music on, you'd still hear the music. But only by the way the bones in your cranium were vibrating.  Tim Edwards: Now is that how those who are deaf are able to enjoy music?  Dr. Stephey: Yes, it's called, it's called a cochlear implant. And they're getting sound into their head through that cochlear implant, which is vibrating the bones in the cranium.  Tim Edwards: Gotcha. Wow.  Dr. Stephey: And the bone conduction is different than air conduction. It's getting sound in the brain in a different way and in a more powerful tool and it seems to stimulate the stipular system or the inner ear in a way that air conduction can't do. And the reason that's a big deal for me as an optometrist is because the vestibular system and the visual system are intimately linked with each other. So we might see better eye movement control when we do sound therapy. And just like when we developed the visual skills and somebody is able to see faster, that person can use lip movements in order to prime the auditory cortex to change auditory processing outcomes. So the two systems are very interconnected with each other. So just to review, stage one, nutritional discussion, retained primitive reflexes, safe and sound program, if needed. Sound therapy. If they can't handle interactive metronome and if they can handle interactive metronome, I will usually start with that intervention rather than more conventional sound therapy.  Dr. Stephey: And the reason I do that is because interactive metronome involves physical movement in conjunction with this metronome beat and there's something magical about this temporal sequencing or you generating physical output in conjunction with this beat and being given feedback about changing your internal timing clock. So for me, that's stage one. Stage two, we're going to move on to magnocellular vision or motion processing and eye taming, eye focusing and eye tracking. And stage three therapy in my office is then working memory and executive function skills, the ability to multitask, how large of a chunk of information you can hold in your mind, components of processing speed, divided attention, selective attention, sustained attention. And that's stage three. And stage four might move us on into phonological processing and something called rapid naming speed. And then in stage four, I might even weave in some reading therapy at that juncture, either provided through my office and the training that I've had. Or then at that point suggest that the kids get other reading therapy even if it's not through my office.  Dr. Stephey: And that model, Tim, for me, it makes perfect sense. It's based on a developmental model. It's done in a order that we develop in as humans and it is not the model that is happening in practice today.  Tim Edwards: And you're talking about these four phases of therapy.  Dr. Stephey: I'm talking about these four phases of therapy and what I'm really more getting at is I think that the kids on the spectrum should see a developmental optometrist first, not last. And too often, what I see, is I get kids that come to my practice and let's say they've had an IEP through their school district since they were three years of age and maybe I see them at eight or nine or 10, so they've had an IEP for five, six, seven, eight, nine, 10 years, and never had this kind of a developmental vision exam. So they might've done speech therapy or occupational therapy six, seven, 800 hours, but they never had an exam like this.  Dr. Stephey: I think that parents need to know that this exists and need to seek out and find optometrist like myself that will do this body of work and do it in a comprehensive way. And too often I'll see kids again on the spectrum. Eight, nine, 10, up to 15, 16, 17 years of age who've had hundreds of hours of reading interventions and are still struggling to make any substantial gains in their ability to read and comprehend. And then I find them and they've got a whopping array of all the stuff that we're talking about today and parents have never heard it before.  Tim Edwards: Oh, my. That's a tragedy and that's why we're doing what we're doing.  Dr. Stephey: That's exactly why we're doing what we're doing. We want to. We want to get this word out so people know one, that this exists. Two, what's the depth of what exists and three, that they know if they're getting a comprehensive assessment or not.  Dr. Stephey: It's not enough to go and be told that you've had a vision therapy assessment. If it doesn't include all of these pieces. And that's one of the other reasons that I'm doing this podcasting because I would tell you that vision therapy either seems like it's the best thing since sliced bread. Or it doesn't work at all. And don't waste your time and money. And that really bothers me as an optometrist. Because I know the power of vision therapy when it's done correctly. I know the power of vision therapy when it's done comprehensively. I know the limitations of vision therapy. So if kids need assistive technology or they need an audiological assessment or they need further speech or occupational therapy or they need assistive technology to facilitate their ability to access the curriculum at school, I'm the first one to make those recommendations. And the supportive parent in and looking at other things. But there is just a vacuum of information that parents don't know because medicine hasn't told them that. Nor has the educational community. I'm hoping to fill that void.  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.     

Did you know that both good and bad fats play a huge role in the development of your visual system and brain? Douglas W. Stephey, O.D., M.S discusses the power fish oil supplements have in changing the course of inflammation in our body and brain. The arachidonic (pro-inflammatory) and eicosapentaenoic (anti-inflammatory) acid levels will be discussed: how to measure them and how to reverse this ratio when elevated. 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: This is episode eight of the Move Look and Listen, Podcast with Dr Doug. Stephey. You know, we've talked about a lot of things in this podcast, Dr. Stephey and today we're going to tie in vision and nutrition. So for those that maybe have just stumbled across Apple Podcasts or whatever platform they're listening to their podcast, they're probably wondering, what in the heck do these two have in common? And you've alluded to them several times. You've more than alluded, you've discussed them in detail in several previous episodes. But today we're going into fish oil, right? How fish oil, in particular, or omega-3's can help  your vision and other aspects of your being.  Dr. Stephey: Yeah, that's right Tim. So let's launch off into this. omega-3's, they are a big deal. There's one theory about human development that goes back, what, 20, 30, 40,000 or so years.   There's one theory that says that when humans started eating the seafood diet, the size of our brain exploded in size. Arguably that's the theory of human development. There's two theories that I've heard about why we have the brains that we do today. One is the amount of mega three fatty acids that we used to eat and the other was man's ability to use tools. Because using tools requires a concept called motor planning and motor sequencing, which ties to that millisecond timing clock that we were talking about last episode. But motor planning and sequencing, it is a platform for speech and language and eye movement control and auditory processing and cognitive abilities. All starting through motor planning and motor sequencing. So omega-3's, as people may or may not know, is the long chain fatty acid associated with fish oil and there's a ratio called the AA to EPA ratio, arachidonic acid to eicosapentaenoic acid levels. And the phenomenal thing about this ratio is that very few physicians actually seem to know or talk about it. And I tell you that because I was in to see my family physician a few weeks ago who didn't seem to know a lot about the AA/EPA ratio .  Dr. Stephey: I have a couple of brain injury recovery patients in my practice who have gone back and asked their neuro rehab doctors about this ratio. They didn't seem to know anything about it. Another patient of mine had a stroke last summer. She's in her late forties. She went back and talked to her cardiologist about this ratio. He didn't know anything about it but at least was interested to read and I talked to a friend of mine who's an ER physician back in Michigan who didn't seem to know a lot about it. And I'm stunned.  Tim Edwards: Flabbergasted. I think maybe because like you said, it's a big deal. You talk about brain development and overall health and yet these physicians know nothing about it.  Dr. Stephey: I remember about probably going back 15, 20 years when I first started to read about omega-3 fatty acid. There was a handful of pregnant women at the time in my practice and I said, hey, has your baby doctor talked to you about omega-3 fatty acids in your diet?  Dr. Stephey: Like, no, what are you talking about? I'm like, you should be taking  omega-3 fatty acids. You should've been taken them six months before you consider getting pregnant.  Tim Edwards: The baby doctor was probably talking about folic acid.  Dr. Stephey: Not omega-3s, and unlike if you don't believe me, just go do a google search for prenatal development and omega-3s. Or infant development and omega-3s. But at the time, this was not being discussed. I'm pretty sure today, most infant formulas have some measurable form of EPA or DHA in them.  Tim Edwards: Because we're talking about the development of the brain and their unborn child from the get go.  Dr. Stephey: Yes, I'm telling you if and when my daughters ever decide they're going to have kids. We're having a long talk about lungs. Six months before you need to be up in your omega-3 game in preparation for being a feeding tube for a newborn.   Tim Edwards: Right. Dr. Stephey: So omega-6 fatty acids versus omega-3 fatty acids. That's the ratio that we're really talking about today relative to what's happening in our blood and in our body dictated by the food we put in it. And the reality is that between vegetable oils and trans fats and processed foods, we're getting way more omega-6 fatty acids than omega-3s. And omega-6 fatty acids are pro-inflammatory and omega-3 fatty acids are anti-inflammatory. And there's a long biochemical pathway that goes from omega-6 fatty acids in our diet to arachidonic acid, that's the pathway. Or omega-3s to eicosapentaenoic acid, which is the anti inflammatory pathway. But now we're talking about what is that ratio in our diet? Well, I suppose the idealistic ratio would be one to one. But three to one or two to one is acceptable and considered still really good.  Dr. Stephey: So you might have three times as many omega-6s in your diet as omega-3s, but that's still considered good. No, that's better than good. So the Standard American Diet.. Tim Edwards: The SAD diet. Dr. Stephey: The SAD diet because in so many ways. The sad and pitiful, I'm going to be sick way before my time diet.  Tim Edwards: And if you don't mind me throwing a plug in for another podcast on the Inbound Podcasting Network, it's the Vibrant Living Wellness Center podcast and we go into the s-a-d or sad diet in great detail.  Dr. Stephey: I can't tell people to learn enough about it because there is a dearth of information people just don't know. And the more that they learn, the more that they're likely to change their behavior. And if you don't know, some years ago, the church I was going to, the pastor said one day said, "you know what," he said, "I've learned over the years that people aren't likely to change their behavior unless they have enough knowledge that stares them to do so, or they hurt enough that they need to change their behavior.  Tim Edwards: Great nugget of wisdom for sure. Unfortunately we all wait till we hurt enough. At least I do.  Dr. Stephey: Well and sadly further is that there are a lot of people today, both in emotional and physical pain that don't have to be, because they don't know this information and they have just come to accept that hurting this much is the way their balance of their life is going to be. And it does not have to be that way.  Tim Edwards: And so circling back Dr. Stephey, I think I derailed you a little bit and I apologize with my comment about the SAD diet, but you were going into omega-3s and omega-6 and the ratios.  Dr. Stephey: Yes. So, the Standard American Diet, I read this a couple of different ways now. The typical American has an omega-6 to omega-3 ratio of somewhere between 15 and 20:1.  Tim Edwards: Wow.  Dr. Stephey: And it's supposed to be 3:1 or better.  Tim Edwards: Have you ever had yours checked?  Dr. Stephey: I did.  Tim Edwards: Your markers?  Dr. Stephey: So my story is that I had my, AA to EPA ratio checked in September of 2016 and it was 9.8. Higher than four and less than 10 was considered goods.  Tim Edwards: So you were borderline good, barely.  Dr. Stephey: I had convinced myself that, oh look at me, I'm under 10.  Tim Edwards: A 9.8.  Dr. Stephey: So I don't really have to do that much about this.  Tim Edwards: You know what, that's a common tale for most of us. I'm sure. I'm in the range! I'm good! But that was in 2016, right?  Dr. Stephey: That was in 2016 and I don't know who's the worst patient. The patient who doesn't know what they should be doing and doesn't do it because they don't know. Or me because I know what I'm supposed to be doing and I don't always do it.  Tim Edwards: That's the worst patient.  Dr. Stephey: I was hoping you'd get me some slack on it.  Tim Edwards: I know, but you know what? Because I'm like you. I mean we're all that way. I mean, you know, we like our comforts unfortunately. But they can become deadly.  Dr. Stephey: Well, you know, here's what I talk about with patients all the time in my practice and then we'll get back really to the topic at hand but this is related to that. Indeed we will definitely get to how this ties into vision, but this is good foundational information. So when you say we like the foods, we like. Well let's be clearer about that. It's not even us that like the foods we eat, it's the bad bacteria in our GI tract. There is a continuous battle in our gut, in the microbiome or the bacterial population that lives there. So that is a good versus evil discussion.  Dr. Stephey: Bad bacteria loves sugar and simple carbohydrates. There's some research that has made the argument that sugar is more addictive than cocaine.  Tim Edwards: Yes, I've heard that, read that, discussed that many times before.  Dr. Stephey: And that proteins in wheat and proteins in dairy act in the brain on the same receptors that opiates do. So when this bad bacteria drives these cravings, it's not even us that really wants that. It's the bad bacteria. And the bad bacteria says to you as it's living host, you know what, I don't care if you get diabetes and lose a limb. I don't care if you get MS or Lupus. I don't care if you have asthma or respiratory disease and need an oxygen tank to carry around. I don't care if you get arthritis as long as you're feeding me sugar and carbohydrates, I'm okay with you being really sick for 40 years.  Dr. Stephey: That is not right.  Tim Edwards: No, but we listen to it so we need to stop. Right? But how do we do that? Is it, is the answer in the omega-3s?  Dr. Stephey: omega-3s I think do play a role in that. And I'll give you an example. So if we talk about that 15:21 ratio, 15 to 20:1 ratio, that means that we're producing way more arachidonic acid in our body than eicosapentaenoic acid, which means that our immune system is highly inflamed. Virtually every cell in our body now is on fire. That is not the way to go about your business. It physically hurt. Your brain hurts. You are more at risk for developing a mood regulating disorder. You're more likely going to have a learning disability. You're more likely going to get diagnosed with ADHD or ADD. This unchecked, runaway, unchecked inflammation is wreaking havoc on us every day and we don't have to have it be that way.  Dr. Stephey: So to go back to my own story, 9.8, I convinced myself it was pretty good. I wasn't taking enough omega-3s as I should have been. And then I had a physical earlier in the year and I've had some issues with my blood sugar being too high. And I'm like, oh, homies not doing that, no. Tim Edwards: Yeah, we're not going there.  Dr. Stephey: So, I decided.  Tim Edwards: You're talking about potential prediabetic?  Dr. Stephey: I was beyond prediabetes. My physician said, Doug, you're now type 2 diabetic, and I'm like, no I don't. I'm not doing that. So the first thing I decided was if my omega-3 to omega-6 fatty acid ratio should be less than four to one then I'm on it. And Tim, I started taking six to 9,000 milligrams a day of EPA and DHA.  Tim Edwards: Now tell me, what is the daily recommended dose?  Dr. Stephey: Well, that's an interesting question and it's why we're doing this podcast because pretty much you got to have a Ph.D. in fish oil to make any sense out of what the heck is going on and what should I be doing?  Dr. Stephey: So when you typically go to the store and pick up a bottle of fish oil and and especially if it's a capsule, it's likely going to say serving size is one capsule and one capsule is usually a thousand milligram capsule. So the first discussion that I have with patients is, are you taking an omega-3? Invariably, the answer is no, but on the rare case that somebody is taking an omega-3, I say, how many milligrams of EPA and DHA are you taking? And they say, I don't know. Okay, how many capsules do you take a day? Well, I take one because that's what the bottle says. All right, well I need you to go home and look at your bottle and report back to me in the thousand milligram capsule. How many actual milligrams of EPA and DHA are in that thousand milligrams because you're not taking a thousand milligrams of EPA and DHA.  Dr. Stephey: I'll tell you that right now because every brand is different. And then I play a numbers game and I say, well, we don't know what you'r AA/EPA ratio is at this point. We could talk about you ordering a test to get it done, but we don't know. But let's say conservatively that you should be taking 3000 milligrams a day. Well, if you were getting a full thousand milligrams of EPA and DHA in that capsule, then you should be taking three capsules a day. But if you go home and your capsule says, oh, this only has 500 milligrams of EPA and Dha, well to get to 3000, you should be taking six of those a day. And if you're a capsule says it's got a 100 milligrams of EPA and DHA in it, then you ought to be taking the 30 of those a day.  Tim Edwards: So not all fish oil is created equal by any means.  Dr. Stephey: Oh, good gracious. No, Tim, there are some commercial official products that when you look at the EPA and DHA content, there are no numbers. They just have little tiny asterisk. Tim Edwards: Oh, boy. So then you're just wasting your money.  Dr. Stephey: So, my AA/EPA ratio, September 2016 was 9.8 and I mentioned that I got diagnosed recently with type 2 diabetes. That I'm going to reverse and mostly have at this juncture. And it's, we're barely three and a half, four months into the diagnosis.  Tim Edwards: Right, you were a 9.8 and 10 was the back end of normal.  Dr. Stephey: 10 was the back end of good.  Tim Edwards: Back end of good.  Dr. Stephey: But 3 to 1 or less was ideal. This is where we all should be. So, I up my fish oil intake and within 60 days and I had my retesting done, it came down to 3 to 1.  Tim Edwards: Oh wow. Amazing! Tim Edwards: Based upon the appropriate amount of omega-3s that you should be taking. Dr. Stephey: Yes. Tim, and I'm glad you said it in that manner because it prompted a memory for me and that is what is an appropriate amount? Because people will often, we talk about this in the office and people say, well what should I be taking? I say, what's your AA/EPA ratio? They're like, what the heck is that? And I'm like, well it's this and this is how you measure it.  Tim Edwards: Yeah. Because the doses cannot be consistent for everybody in any type of medication or any type of supplement.  Dr. Stephey: Right.  Tim Edwards: The doses are different. So, the, the first step for someone to find out their levels, their markers is what?  Dr. Stephey: The first thing to do is get the AA/EPA ratio measured and we'll include a link on a test about how to do that so that you can go read about this test availability and that it's not that hard to get measured.  Doug Stephey: And the kit that I'm talking about is something that can be sent home to you. You take a fingerstick, collect a few drops of blood and you send it off to this lab and then usually within about 10 days, maybe two weeks, we've got these results back. We've got something tangible to discuss.  Tim Edwards: Yeah you've got a benchmark to work with and it's, can I say the name of it?  Dr. Stephey: Yeah, yeah, absolutely.  Tim Edwards: The reason being, because I did it the other day and I'm awaiting my results and I can't wait and this is a service provided through Dr. Stephey. So we'll include a link and then they could just go through you. It's called BrainSpan Laboratories. BrainSpan, cell health assessment. The health of your cells dictate the health of your entire body and we're talking about attention, memory, anxiety and stress, chronic nerve pain and inflammation, weight management and metabolism, soft tissue and musculoskeletal injuries.  Tim Edwards: I mean this test covers a wide range of markers for us to start from and then once we get the test back, then we can make some adjustments.  Dr. Stephey: And that's because cellular inflammation affects every cell in our body. And let's go back to the appropriate dosage because as an example, one of the books that I read some years ago called The Omega-3 Connection written by a physician named Andrew Stole. He's a neuropsychiatrist who specialize bipolar disorder. And in his book he said, look, I've done this research. We have patients with bipolar disorder who are on maximum medical therapy who still have wild mood swings until we put them on high dose pharmaceutical grade fish oil at the range of 10, 12, 14,000 milligrams a day. So if you've got a mood behavior disorder, odds are that you need high dose fish oil because of the cellular inflammation.  Dr. Stephey: Most likely driven by the way that you're eating and that you're getting way too many omega-6s in your diet and your body and brain is on fire. I've got other research that I've read where they took a group of kids, broke them into two. The experimental group and a control group, so they kept them in the same curriculum. The only thing they did, Tim, was to give the kids in the experimental group, 16,000 milligrams of fish oil a day for I think it was 20 weeks and over the 20 weeks I'm not and I'm not telling people to go out and do that much. I'm just telling you this research, but over the 20 weeks periodically, I don't know, at the six and eight week mark, maybe the 14th week mark, 16th and 20th, something like that. They will go back and measure these kids reading skills and the kids on the fish oil their reading outcomes.  Dr. Stephey: Just start climbing and going through the roof and the only thing they've done is up their fish oil intake. Now the the brain has the second highest concentration of fats in our body. Only behind the retina which has the highest concentration of fats in our body, and that's how this nutrition, omega-3 fatty acid vision piece ties together pretty much every cell membrane in our body is made up of a phospholipid layer, water and fat. And to get nutrients into a cell and waste products out of the cell, it has to go through these cell membranes. And your body's going to make these cell membranes out of whatever fat you consume the most of. So if you're consuming too much of bad fats, the cell membranes in your wall are made of like solid brick instead of the semi-porous membrane that nutrients and waste products can go back and forth between.  Dr. Stephey: It honestly it isn't any more difficult than what I've just said.  Tim Edwards: It's very simple for us to understand that the only challenge will be to make the shift, but it doesn't seem like it's that hard of a shift to take the appropriate amount of fish oil. I mean really. It seems like every episode we have this, this crazy astronomical problem and you're like, and we can fix it with this. It's been in front of our face the whole time. Yet we didn't even know it was there.  Dr. Stephey: And you know, sometimes it's about that simple. Even though the podcast and a lot of what I talk about is Move Look & Listen, what I didn't speak clearly about in that triad is the nutrition piece. But it is a discussion with every patient that I have.  Tim Edwards: Well it sounds like nutrition is a major component in all three of those triads in that, in that triad.  Dr. Stephey: Well, it has to be right because if your brain is going to train itself to develop a new skill or a better skill or a skill you didn't have, it can only do that if it's got the nutritional building blocks to be able to benefit from the training or the therapy that you're going to be doing. So yes, there are limits to what my vision therapy protocols can do. If you're eating a really bad diet and you're not willing to change it. Now, I'm not saying you won't make gains, but you won't make the gains that you should have and you won't lead the life that you should have and you won't feel like you should if you continue to eat a crappy diet and don't change those outcomes. And tied to that again, we got to reduce the inflammation in your body and brain.  Dr. Stephey: We've got to get the good bacteria to out populate the bad bacteria in your GI track and this has wide ranging implications. I don't care if you're 90-years-old and have dementia or Alzheimer's. Or if you're an infant who's just now developing their nervous system, including brain and body and auditory processing and motor controls skills. Yet truly we are what we eat. Dot, dot, dot. We are what we're able to digest. So even if you eat really well, but your GI tract is a train wreck, you're not absorbing what you're eating and your body can't use it and it does not have to be that way. And I am happy to be an agent of change to help you get back on track and know the value of these omega-3 fatty acids and how they affect your brain and vision. 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.         

Dr. Stephey welcomes Celeste Palmer to the Move Look & Listen Podcast. Celeste is a brain injury survivor and the founder of Bridging the Gap, a traumatic brain injury support group & resource network. With roughly 1.2 million optic nerve neurons per eye, there's almost no who escaping the negative visual consequences when suffering from a brain injury. Dr. Stephey and Celeste discuss how memory, gait, balance, risk-of-fall injury, motion sickness, headache, dizziness, speech perception, visual motor integration, etc. are affected in traumatic brain injuries.  Bridging the Gap - Connecting Tramatic Brain Injury Survivors: http://tbibridge.org 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 & 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 at 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 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: This is episode number nine of the Move Look & Listen podcast with Dr Doug Stephey. I'm Tim Edwards with the Inbound Podcasting Network. And today Dr. Stephy, this is exciting. We have our very first guest ever in this podcast and I have to say you've chosen a really great one to join us today.  Dr. Stephey: That's fantastic. I'm glad Celeste is here.  Tim Edwards: We're welcoming Celeste Palmer, the founder of Bridging the Gap and a traumatic brain injury survivor. And we're going to talk about what you do at your practice, Dr. Stephey in helping people that have suffered a traumatic brain injury. One of which of course is our very own guest, Celeste Palmer. Celeste, thank you for joining us today.  Celeste Palmer: Oh, well thank you guys. I'm really happy to be here.  Tim Edwards: Now, Celeste, if you wouldn't mind before we get started, I want to introduce our audience to you and let them know your story. You and I had a wonderful conversation a couple of weeks ago and you explained what happened to you and how you have bounced back with flying colors certainly so and to influence the lives of many of those who are benefiting from Bridging the Gap. So please start with your story. Celeste, if you wouldn't mind.  Celeste Palmer: Well, as I've been told my story is that I was in a near fatal car accident on May 1st 2000. And from that it was a retrograde and an antegrade amnesia. So the first 50 years of my life, I don't know, I've been told about them kind of scheduling. And the main thing is that I decided to start over. And to make a new Celeste and in the process of creating that, I've had the wonderful opportunity to meet and know a whole community of people and experiences that have turned out to be just amazing. From Peter Drucker at the Drucker School at Claremont Graduate University to numerous hospitals, rehab hospitals, organizations like the university and, and other schools. And so, that brings us forward to last summer. I believe it was when I met Dr. Stephey and through another one of our participants in a support group and said, "oh my gosh, this is timely." Because I had had vision therapy years ago after the accident because yes, it isn't about being 20/20. It's about being able to see and get your balance back and be able to walk without walking into things. And so it was absolutely amazing to have Kim introduce us and be able to then have someone to talk to and not only talk to, but to have him listen.  Tim Edwards: Have him listen, yeah. That's one of the things that certainly separates Dr. Stephey from, from the rest, for sure. Celeste, you said something that really struck me when you said, from what I've been told, I've suffered a traumatic brain injury. So you're telling us you have absolutely zero memory of the first 50 years of your life.  Celeste Palmer: Right.  Tim Edwards: And if that is not the epitome of reinventing oneself, I don't know what is. I can't even imagine having to relearn everything. And is that the truth? Literally relearning how to move your body, how to speak? Tell me how that worked.  Celeste Palmer: Well, when you're asked if you're in pain, you have nothing to compare it to. So the initial experience was I couldn't answer the questions. The first neurological evaluation you get is, you know, who's the president? Do you know where you are? Questions like that. And I didn't answer them according to the initial first responders, doctors at emergency and things like that. So it was pretty clear from their reports that I really didn't know what it was to be human and I didn't recognize my son when he was brought to the hospital. There were bits and pieces of information, but nothing that really stayed for any length of time or really was the glue of history. But the body and the brain hold muscle memory, I'll call it. So there was 50 years of learning that was in the muscle, bones, tissues that make up the human body. And I think that is what continued on. And so as people told me things, as I started, you know, walking. The fact that I couldn't get through a normal doorway made me think that I was huge. That I couldn't fit through the doorway then to come to find out that that had to do with how the eyes, we're not working with the brain the way they used to and things like that. So, fascinating. Tim Edwards: It is fascinating and an amazing journey of which you've been on. And you've discussed briefly about that journey on how you and Dr. Stephey intersected. So Dr. Stephey, if you wouldn't mind joining the conversation now. Letting us know what your thoughts were when you first met Celeste and what you did for her.  Dr. Stephey: One of the most striking things for me is, here we are in 2018 and yet the brain injury community through absolutely no fault of their own, don't know that optometrist like me exist. And part of the reason it seems is that we seem to have an identity problem in getting our message out there. And it's not from lack of trying. I don't know exactly what the obstacles are. I have a feeling I have some idea and some idea is that I almost get the impression that parts of the rehab community doesn't want to know that we exist or doesn't believe that what we do is as powerful as it is. I know, when I first met the member that introduced Celeste and I, and I told you this story a couple of weeks ago. She's been riding horses most of her life and suffered a brain injury herself 12 or 13 years ago, had done lots of rehabilitative therapies but not vision therapy. Came and started to do some work with us and it changed the relationship that she had with her horse. That really had been disrupted and I think was a significant social bond that had been severed. And so it was a powerful testimony to the work that we do and the way it can change people's lives in ways that it's easy to lose track of and not understand. So when I had the opportunity to meet Celeste, not only was I grateful for that opportunity just because of her own history, but it allowed this forum where she's got this support group and they were gracious enough to, for the first time, invite me in September of 2017 to come out and do a talk to the group. And Celeste had got the word out and I can't remember for sure. Maybe there was 12 or 15 people that were there. I think the message that I was conveying resonated with the group and then they invited me to come back again. I think it was in October and then the word spread further and there might've been 25 people that showed up at the second meeting and then they've been kind enough to invite me out a third time and hopefully in the next month or two I'm going out on for a fourth time.  Tim Edwards: Wonderful.  Dr. Stephey: Because the, so the forum that Celeste has created, it's a powerful tool. Because it's an opportunity to spread a message through the people that need it the most. And yet it's a message that has not been heard very frequently or very loudly or not often enough.  Tim Edwards: Well certainly a little bit later on the episode, Celeste, we're going to talk about Bridging the Gap. This wonderful support group that you've created that connects traumatic brain injury survivors. And let's go back to your story now. Celeste, if we could and tell us about your meeting with Dr. Stephey and what he did to help you on your road to recovery.  Celeste Palmer: The main thing I want to say about Dr. Stephey is that when you have someone who is making a change that rapidly, whether it's putting on tinted lenses or putting on the prism lenses and there's a change in how you can walk down a hallway without bumping into walls or just the fact that standing in place is not so riotous and, and you can actually think about looking at a picture and, and observing your surroundings rather than am I going to fall down? It was pretty significant. Tim Edwards: After how many visits with Dr. Stephey did you notice that difference?  Celeste Palmer: Oh, immediate. Tim Edwards: Immediate.  Dr. Stephey: Well, I think there was some change on the very first visit.  Celeste Palmer: Yes. Yes.   Dr. Stephey: The power of lenses should not be underestimated. You know, most people who know anything about the eye care community has the idea of you get lenses to see 20/20. What most people have no sensitivity to is the role that vision plays in our balance, in our gait, in our posture. One of the things that struck me with Celeste, and this wasn't initially. We had done some work together. I had prescribed her lenses with color in prism and they did provide her some level of relief. And then several weeks might have gone by. I don't remember the exact timeline, but I do remember she said, Doug, you know, I think things have changed again. Okay. Tell me more about that story and let me contemplate what we're going to try differently, and one of the memories I have. This is from several months ago, we were in the hallway and Celeste had made a comment to me about how I believe the left side of her body felt numb, including her fingertips. And I took the smallest lens change that I can make. It wasn't color, it wasn't prism. When you think about farsightedness and nearsightedness, farsightedness has to do with plus lenses. Nearsightedness with minus lenses, and then there's the word astigmatism, which is a whole different thing. But I took a plus, 1/8 of a diopter Lens. The smallest change that I could make and put it over her left eye and she could feel their fingertips when she wrote, when she rubbed them together.  Tim Edwards: That's amazing. That's amazing. Wow. I mean having. Really, it seems like such a simple solution, not to demean or devalue what you do, but it seems like it's such a simple solution that how many thousands of people are not coming to see someone like you to fix that problem. Going to neurologists or some other type of medical professional and the thousands of dollars and time and wasted time and money is spent.  Celeste Palmer: Sorry to interrupt, but the thing is that I've gone through 18 years now of seeing different levels of the medical community trying to help people in my situation and personally to go through nerve conduction studies and all these other things, you know, with people from their expertise trying to help and finding that they had to say we've done everything we can. So you're stable at the level you're at. Not meaning I was getting better or worse, but I was stable at the level I was at. Until well in back, what was it 12, 15 years ago I went through vision therapy with somebody in Texas who did similar to what Dr. Stephey does. It's been a long time since then and obviously technology is, has done amazing things as well and he stays current with what's available and so it is amazing the things that he has done that well I watched him do with others at support group where I have him bring his bag of magic tricks to support groups. So that he tries different things on different individuals and you see somebody coming in and doing the duck walk and he puts blue lenses on them and they walk across the room for the first time in front of a friend in a normal walk with his hands at his sides and his friend says, I haven't seen that in three years.  Tim Edwards: Wow. Yeah. You know, Dr. Stephey, we've mentioned several times in this podcast that I've produced several videos for you and some of the videos that we have not yet released that you have showed me through the permission of your patients, were something you see like if you were back in the old days,when you watch TV and they'd hold their hand over their head and they'd say you are healed and they get up and walk. You know, these videos you showed me where people walking on beams and they couldn't. And then you'd show me a video a moment later with a pair of lenses on and they're walking the beam without falling off.  Tim Edwards: It's, oh, I can't wait to show those videos. Absolute proof of what you do and how you adjust their lives by a simple adjustment in their lenses.  Dr. Stephey: And on a similar note, one of the reasons that I think this community of brain injury survivors is getting short changed is because medicine looks at them and says, well, there's nothing wrong with you because you look normal. And yet, when patients got a pounding migraine most days or they sit in the reception area in my office and the cars drive by on the street outside my office and they double over in pain because they are so sound sensitive, those kinds of outcomes don't show up on medical imaging.  Dr. Stephey: Right, it's not going to show up on a cat scan or an MRI. And I'm telling you, these patients' lives are being discounted because of that, and of course invariably when you still complain about the panning headache that you have or that you can't fit through the door because your body feels too big. Or you've got numbness in one side of your body. Or you're so sound sensitive that a whisper sounds like a Jackhammer in your brain when medicine doesn't understand that and ultimately just discounts that, the end game at that point is when medicine says, you know what, you need to go see the psychiatrist because you're just making this up now. I mean, that happens when somebody goes to qualify for a permanent disability and those kinds of behaviors are getting discounted. It's extraordinarily frustrating for me to hear these stories and I'm not living it every day. I kind of live vicariously through the patient's lives that I have the opportunity to see. And I think it's in great part why I do what I do. Why I listen to patients when they come and why we experiment with different lenses and different colors and different kinds of therapies. Because at the end of the day, if I don't share this information, I've had the opportunity to learn. I don't feel like I'm doing my job every day like I'm supposed to. And that's clear in the reception that I've had when I come to the support meetings and feel the gratefulness of me coming and practicing this way and simply spend time listening to what patients are telling me and then trying to come up with a solution. And you know, I think sometimes a great part of the benefit is just that we've got somebody in healthcare who's taking the time to listen.  And that's, I think, very validating for patients who have been trying for years and years and years to get someone to listen and try and help and they get pushed to the side and discounted. It's so wrong.  Tim Edwards: Well, I can also can't even imagine though, until I met you that somebody with a traumatic brain injury would even consider or think about or the thought entered their mind that they need to go see an optometrist to help them function better when really it's a weird connect, right? I mean it's kind of strange. But then, you know, you showed me the videos and we've interviewed people. And Celeste, you're joining us now of course. And the connection is quite clear. And Celeste, are you seeing that from some of the members of Bridging the Gap too? That have used some of Dr. Stephey's methods to help them function and live a happier, healthier life?  Celeste Palmer: Oh definitely. Definitely. We have, we have several that are already seeing him. We have several more that have just haven't met him yet. That's why we keep having him come back because we have people come through that are just hearing about the voodoo doctor. The magician and want to see. So even if he's coming to talk about a different subject, I have him bring his bag of tricks because there are those that haven't met. It would do them well to see the kinds of things he's offered to many of us. And the thing is he does extend, you know, have them come on over for 15 minutes off their insurance or whatever else. Or to deal with the other issues that we're dealing with. The frustration of trying to deal with the denials at insurance level. And to go the extra mile for us to get that coverage that is included back on, on, on deck. So it is a matter of understanding the, not just the vision frustration we're having because you can be told by an optometrist, well here's your 20/20 vision, but, and go home and get used to wearing these 20/20 vision glasses and still not be able to see even after months. So obviously the issue isn't entirely with the eyes being able to see with 20/20 vision. But it is the fact that the eyes aren't tracking together. The other issues that come with it, the as you mentioned before, we have sound and light sensitivity that's involved so, you know, although the eyes are so predominantly affected, hearing can be as well. And so it's, it's amazing the different aspects and watching. Well I think he was, I think he was being humble because I think we had one meeting where word had gotten out about the vision doctor. We had 45 people in the room. So yeah, he was, he was well, well received and, and folks wondering, well how do you do this and how is it that you do it, other people don't. So the questions that evening were really significant.  Tim Edwards: Well, a question I probably should have asked at the beginning of the episode is, you were talking about traumatic brain injury survivor. And that seems like a pretty broad stroke. So for our friends on other side of the speakers listening, tell us about the type of brain injuries that you can help Dr. Stephey. I mean, is this across the board? Anybody that's, I mean we're talking a concussion, yes? I would assume. But from a concussion up to what point? Is there a scale, a spectrum?  Dr. Stephey: I would say that there really is no upper end to that limit. So I'm going to say that we have the potential to help all brain injured patients. Doesn't make a difference if he had a brain injury from a car accident, a motorcycle accident, a fall, and a stroke, a concussion, repeated concussions, it doesn't make a difference. And what I would have the listeners know if they know somebody who's had any sort of a brain injury, whether it's mild or significant, almost all patients who've had a brain injury have some sort of visual consequence to it.  Tim Edwards: Dr. Stephey, you shared a story with me, I don't know, six months ago or so that really resonated. And if you wouldn't mind sharing that with us here today, and the story is about a gentleman who had suffered several concussions and as a result of those concussions, had some behavioral shifts. And those behavioral shifts lean towards a form of violence or agitation, strong agitation.    Tim Edwards: And through either vision therapy or lenses, he was able to squelch that to some degree. That's my remembrance of your story. Please tell me, I'm not sure how accurate I am.   Dr. Stephey: No, I think that's a reasonable description of what has happened. So, this is a patient who's had multiple concussions over his lifetime and repeated concussions. Right. There's an increase in risk of longterm consequences to it. And one of those consequences is to feel like you spend most days walking around on your last nerve. And so the slightest of things can just completely pushed you over the cliff. And the more I contemplate about this, the more I believe that's likely connected into this Polyvagal Theory of affect, emotion and self-regulation. And the Polyvagal Theory tied into the 10th cranial nerve or the vagus nerve. And vagal nerve tone, and how it contributes to your ability to correctly read and interpret gestural language, including facial expressions and the vagal nerve tone also facilitates your ability to read intent correctly in somebody's voice. So if you have a vagal nerve dysfunction, we'll just, we'll use that term right now.  If you've got vagal nerve dysfunction, you might glance at me across a room and think that I'm like staring you down. And all I did was make eye contact for a half a millisecond, right? Or, I might say something like, you know, hi, how you doing today? And you're like, what? How am I doing today? Like, what are you talking about?  Tim Edwards: You talking to me?  Dr. Stephey: Yeah, you're talking to me. So it's, striking the power of lenses in vision therapy to help reset that vagal nerve tone. That's what I think is happening. I don't know if I, I don't know if anybody right now is clear on the exact neurology, but that's the model and the theory of what I've learned to date that makes the most sense to me. I had a similar situation recently where somebody was complaining about the tinnitus or the ringing in the ears that was so severe for them. And I think that there may have been a recommendation to do surgery to try to reduce this ringing in her ears. And I said, let me pull up my bag of magic tricks and let's put some lenses on you and you tell me if that makes a difference. And she's like, it's dropped by 80 percent.  Tim Edwards: Wow.  Dr. Stephey: Like hitting the light switch. Now again, do I know the exact neurology of that? I have a couple of theories about it, but I don't know. And at the end of the day, would I like to know the neurology? I would love to know that. But does it diminish in any way the clinical effect of, I put the lenses on her and her tinnitus has dropped by 80 or 90 percent and I take it back off and it comes rushing back? No, I mean I don't need an experiment of 100 people at that point. If it changes your quality of life, do you care if there's some experiment or some article that's been published?  Tim Edwards: Especially one would not care because no medication is being consumed either. You know. There's no side effects.   Dr. Stephey: There's no medication, there's no surgery.   Tim Edwards: Right. It's just a pair of glasses.   Dr. Stephey: You're going to tell me I got to wear these purple glasses around. No, I'm not telling you anything. I'm telling you if you want to walk around and see and feel better then you probably should do that.   Tim Edwards: Not to mention look like a rockstar too with the cool purple lenses too, right?  Yes. Celeste Palmer: And I'm not walking around with the purple shoulder because I'm running into the door. Tim Edwards: Well put. That's right.  Dr. Stephey: That's a good one.  Tim Edwards: That's the line of the day, Celeste.  Celeste Palmer: It's all about, you know knowing where you are in your environment. And what that difference is to us. So the frustration, the anger that you're talking about with one person, yeah, it's very prevalent in our community. And we recognize it in each other. We recognize it in ourselves and not being able to do something about it without being told, oh, well you're anxious, so we'll give you a pill. You're either depressed we'll give you a pill. But to recognize that you put on these wonderful colored lenses and find out that all of a sudden the world is at peace around you when it wasn't and whether that's through the tinnitus, the sounds of things that they glare at lights. Just that there is a calm place to live without having to go through pills and the balance of, of going through what dosage works and everything.  It's just that moment. And so harking back to what we said earlier that you know, how fast after going into his office. Well, it was as quick as he said, okay, let's try these lenses. And yes, it is extremely, well it's why I had to invite him to the support group because we had caregivers as well as family members as well as survivors in there and family members and caregivers were thrilled to see their loved ones that were survivors of stroke or a concussion or experiencing PTSD, all of a sudden find a place for a few seconds even that was a much calmer place to be in that meeting. And, and already in a support group, you're in a safe place to discuss the things that are, you're having difficulty with. So on top of that, to find that with Dr. Stephey they're talking about, he was talking about explaining what we were going to be experiencing and then to all of a sudden have the magic glasses on and have that improvement of just your sense of well-being was pretty amazing.  Celeste Palmer: So you know, something else that Dr. Stephey has done for many in our group is the frustration with insurance companies denying their claims. And the fact that he is, has been willing to go the extra mile for those folks that, once you have that frustration and you try as a person already dealing with a situation like a TBI from concussion or stroke or whatever, and trying to make sense out of going after, getting your denial handled so that you can go to a doctor and get the help you need. He's gone ahead and gone to the insurance companies. He's gone ahead and stood up for us in order to get that waived  and make sure that they understand. I love the fact that when I first had my opportunity to talk to the membership services at my insurance, that what they said was well, his letter that went to them said, okay, here's what my patient needs.  Celeste Palmer: Here's what I can do for therapy for them. Here's the treatment and the bottom half of the letter was, you're going to deny this. So by the way, here's the next step. And they immediately said, okay, so that part's done. So we're going to go ahead and let you go ahead and be treated by Dr. Stephey. And that was so proactive compared to what other doctors are doing and so I can already say what goes in group that are saying, gosh, he's saying that he can help me and I can see that he can help me. So he could go ahead and with that first letter have two steps in to getting into his office and getting the treatment they need. And that was number one, the best thing. The second part was that we were finding that there are some insurance companies out there that weren't going ahead with the basic things that say Medicare approves, and he was taking that extra step and getting the federal administrative judge to approve and, and make them do what they should do by law. So to actually go that far, to stay on the phone with a frustrating process that his patients can't do because of their situation. I mean, if you have a brain injury and you're trying to make sense out of what they're saying to you, it doesn't make sense even more. Plus, it can be a trigger for those things that you're already dealing with, with a brain injury.  Celeste Palmer: So I don't have all the words, I guess right now. But to say it the most simple way, but that's part of what's wrong is that it's just the wrong thing is to ask a brain injured person to follow through with insurance companies who are there to make sure that they don't have to do what they should be doing. And here was Dr. Stephey stepping in to say, oh, I'll just go ahead and make this call to an insurance company. And then to another insurance company and at a different level take it that extra step. And he did that. So that's pretty amazing for a provider to go ahead and say, let's make this happen and since I can't make it happen overnight, I'm going to go ahead and see some patients that obviously are going to benefit right now by seeing coming to the office and getting some help.  Dr. Stephey: So in a nutshell, here's, the insurance issues and there's kind of a flow chart of things. So the first question to be asked is, is this insurance code for vision therapy, a covered benefit? And that's a yes or no question. If you have a medical plan where this code typically nine, two, zero, six, five, it's one of the insurance codes. If you're a medical plan says, well no, that's a specific exclusion in your plan. You're probably not going to win on appeal. It doesn't mean that we shouldn't try, but it's harder to do. But I'll take Medicare as an example. Medicare covers the nine, two, zero, six, five code. But if you have a Medicare HMO, you don't have the same freedom to see who you want to see. So you're confined to your medical group network. If you've got a Medicare HMO, I will write a treatment authorization request letter on your behalf.  Dr. Stephey: Here's the patient, here's the findings, here's how it's showing up in their real life. Here's the treatment plan. If you don't have an in network doctor that does this work, I'm happy to provide the care on this patient's behalf. Send me a contract and let's move on. Now I know that medical groups don't have anybody like me in their network. But they don't know that yet or they don't want to know that because the doctors that owned that medical group, if they don't have a contract, a doctor already in network, the doctors that's on the medical group have to pull out their wallet and pay me to do this work. With a premium dollars that the patient has put in their wallet. So it's really the patients money to start with, right? It's not the doctors' money, it's the patients' money, but I'm telling you this is a monster problem and it's true.  Dr. Stephey: Most doctors would just go, oh your medical group said no. If you want this help, I'm happy to provide them for you and it's going to cost you x number of dollars over the next number of months. And of course if you're a brain injury sufferer, you don't have a lot of money. So I've decided that I need to step up my advocacy game and try to push this through and get this changed and let me tell you it's not easy. And there's one patient specifically that I met in September, the first time it came and spoke to the group, I wrote to her medical group. She has a Medicare HMO. They denied her care. They sent her to somebody in network that doesn't do this therapy. I followed up with a letter to the medical group and said, where you sent her was inappropriate.  Dr. Stephey: So I want you to reverse that denial and allow her to come and see me. The medical group said no again, but this time they said, well, it's not because you're out of network that they've denied care. It's because her blue shield insurance said that this is not a covered benefit. So I wrote to Blue Shield and said, what the heck? This is a covered benefit by Medicare. You have to step up your game and provide the same things that Medicare does. Blue Shield said,no, we're not going to. I said, fine. Then I will appeal it to an independent third party who I've dealt with before and they're useless. I'm telling you this third party, I don't even know why they exist, so I knew the third party was going to be a continued denial, but that's the game and I said I'm going to see this out, so appeal to the third party, the third party without really any investigation of their own, sided with Blue Shield and said we uphold their denial and I said, okay, what's the next level of appeal?  Dr. Stephey: And they said, well, you can appeal it to a federal judge with the Office of administrative hearings for Medicare. Great. Sign me up. That's what we're going to do next then. Now mind you, this started in September and I had the phone call with the federal judge and Blue Shield in late March and so the judge and the Blue Shield representative and I are on the telephone and I explained my situation. Judge this is a covered code as an in network regular medicare provider. I build this code all the time. Medicare covers it. I've had other Medicare HMOs cover the code. I don't understand what blue shield is saying. And the judge says to the Blue Shield Rep, so what do you have to say? And the Blue Shield rep says, well, you know, judge, we've looked it, we just can't find anything in Medicare laws that says this is a covered benefit.  Dr. Stephey: And that's what I did to him. I shut my head. I'm like, what are you talking about? I, I said, judge, you want me to get you paperwork from Medicare? I'll do it. She said, I'm going to leave the case open for three weeks because I'm going to go on vacation. I said, I will have you information for Medicare before the day is out. And she said, great. I got all my Medicare stuff together. I faxed it to her and the Blue Shield people about an hour after we had the phone call, it took another six weeks for the judge to finally find in favor of the patient and said, Blue Shield you're misinterpreting Medicare law. You're going to approve this therapy. So this can be done. And my mission, it's a slow process, but my mission is to make these Medicare HMOs and the medical groups raise their game. Because these are people that are suffering every day, get no help when actually help is here and it's available and it's benefits that are covered by Medicare and they're still getting denied care and that's just wrong.  Celeste Palmer: We don't want this to be on the 6:00 news as a news flash. We want this to be common knowledge that doctors like Dr. Stephey are out there and it's not news. It is something that is when you need it, you go to that person and, there's the help. You know, this isn't, this needs to become common knowledge and, that's why I'm doing this. That's why we put it on the website, our website. That's why we have this support group to get the word out there any way that we can.  Tim Edwards: Well that of course is a beautiful, wonderful segue too, if you wouldn't mind, Celeste. Tell us a little bit more about Bridging the Gap, connecting traumatic brain injury survivors. You just kind of did a little bit with the type of people that have suffered various forms of brain injuries, but tell us what to say. Say Somebody is listening and they have themselves suffered or someone in their family or a friend that they know. How could they benefit by joining your support group other than what you've already told us here in this episode?  Celeste Palmer: Well, when I was going through this, I had several people, including the folks at the university, Peter F. drucker and his wife Doris were calling me the wonder woman. And I thought, well, I don't know any other way to be other than I could hide under the quilts, but instead I was researching trying to find my own help because I was told by some of the greatest neurosurgeons in the area that they were learning more from me than they could really help with diagnoses and how to recover from what had happened to me in a near fatal car accident. So, all of the research I was doing though, my friends were finding out that some could help me. But 98 percent was for somebody else, some other recovery, and they said, well don't lose that research, put it on a website, become a nonprofit.  Celeste Palmer: And I said, I'll find a nonprofit that I can help. It sounds like too much work. Nope, nobody else was doing it to the degree they are today. So the growth of this thing after starting Bridging the Gap, which is tbibridge.org, is to have a bunch of resources for folks that have been tried and proved that they work and to have the interviews and talks that we have and the books and the movies and videos that we've seen a place to go and find those things to help others. Because it's difficult to find obviously Dr. Stephey and others who are a benefit to, to all of us and all the different areas of recovery. What works for one won't work for another because every brain injury is different. So every recovery has to be unique.  Tim Edwards: Well, you're unique. And this is a wonderful resource for those that have suffered a brain injury. And we invite everybody to go visit a tbibridge.org. If you know somebody who has suffered a brain injury, we will of course have the links on the show notes. And Celeste, you have been a delight to join us today. Thank you so much for your time and being with us here in the Move Look & Listen podcast.  Celeste Palmer: Well thank you so much and thank you Dr. Stephey every time.  Dr. Stephey: Thank you.  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.          

Dr. Doug Stephey explains how to effectively advocate for your child and their IEP or a 504 plan needs regardless of their qualifying diagnosis- autism, ADHD, dyslexia, conduct disorder, specific learning disability, reading disorder, central auditory processing disorder, sensory integration dysfunction, dyspraxia, or clumsy child syndrome.  You will learn about Child Find regulations and the value what it means to have your child comprehensively assessed. Independent educational evaluations will be discussed including how to ask for and receive outside assessments at the school district's expense. When you have the knowledge you can move mountains. Dr. Stephey is here to help you. 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  

Dr Stephey discusses the aging visual system and several common eye disorders associated with aging: glaucoma, cataracts, macular degeneration, and dry eyes.  You will also learn how the visual system affects memory, gait, balance, attention, the risk of injury due to a fall, and memory. 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  

If you have migraines, are bothered by fluorescent lighting, bright sunlight and glare, movement in your periphery, and regular repeating patterns such as stripes, i.e.- print, there might be more to what’s causing your headache. Dr Stephey will discuss how binocular vision problems may be the cause of your headaches, dizziness, and vertigo. Moreover, if you get tired and sleepy when reading, lose your place, have poor reading comprehension, skip over words and lines, have to read out loud to yourself, or move your lips when you read you likely have an undiagnosed and untreated vision problem, having nothing to do with seeing 20/20. 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  

Tim Edwards of The InBound Podcasting Network joins Douglas W. Stephey, O.D., M.S., for Episode One of the Move Look & Listen Podcast.   Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. Douglas W. Stephey, O.D., M.S. 208 West Badillo St. Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 & Listen Podcast with Dr. Doug Stephey is brought to you by Audible. Get a free audiobook download and a 30-day free trial Audible membership at 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: Hello and welcome to the very first episode of the Move Look & Listen podcast with optometrist, Dr. Doug Stephey. My name is Tim Edwards and I'm the founder of the Inbound Podcasting Network. Amongst our roster of shows, we cover topics such as nutrition, high intensity strength training, celebrity interviews, wellness, family law, and many others. But the topic of this show is more than what meets the eye, so to speak. You might be thinking, why in the world is an optometrist doing a podcast? Well, that is because Dr. Stephey is much more than your everyday eye doctor. As you heard in the opening of the podcast, Dr. Stephey mentions that vision directly relates to one's ability to function in life and that one is very obvious. But vision also affects the development of your sense of self, your place in the world, how you socially engage with others, your ability over your lifetime to receive further education, to live independently and have gainful employment.  Tim Edwards: Now, most of what I just mentioned may seem easy for most, but in reality it's definitely not for some. Dr. Stephey not only has a thriving optometry practice in southern California, but he is also here on the Move Look & Listen podcast to educate how vision therapy combined with specific lenses or prisms can greatly benefit those who might be diagnosed with ADHD. Or for parents who have children that land somewhere on the autistic spectrum. Or maybe even has a student in special education. In this podcast, Dr. Stephey will also educate us regarding common eye problems. How nutrition plays a key role in your vision health, and what exactly is 20/20 vision and why seeing 20/20 is not enough to move, look and listen through your life with ease. Our sister company to the Inbound Podcasting Network is Inbound Films and as you are about to hear, we produced a series of videos for Dr. Stephey's practice a couple of years ago. I was so impressed with Dr. Stephey and his amazing staff that he became our family optometrist and has also become a good friend. So it gives me great pleasure to kick off the maiden voyage of the Move Look & Listen podcast with Dr. Doug Stephey.  Dr. Stephey: Well, thank you and I'm excited to be here. Since we met and you talked about the things that I should be doing, like the videos that are on my website and the podcasting, and at one point in time I said, so let me get this right. I should just listen to you and get out of my own way. Tim Edwards: Yes, you did. And I think it's taken us a couple of years and we're here. And your passion and the message that you have to share is one that our audience needs because you're a nonconventional optometrist. And I hope that you take pride in that and not offended by that. Because you're very different and I believe that the world needs you, not just so that they can have some really cool looking glasses sitting on their nose.  Dr. Stephey: Well, you know, what's interesting about that is no, I did not take offense to it and because many times when I do the weird stuff in my office, people will tell me that I'm a voodoo doctor, or that I'm a witch doctor. And you know what?  Dr. Stephey: I can live with that. I'm okay with that.  Tim Edwards: You know why there's results, right? You're seeing results. I've seen the results myself and with what you've shown me on video.  Dr. Stephey: What's really interesting about that is if I take somebody who has postural issues, right? And most people would not associate posture problems with vision problems. And certainly not in their understanding of that the holy grail of going to the optometrist is to see 20/20. And that's important, but it's not the most important piece. I don't think. So, if I'm going to assess somebody's posture and their response to changes in posture through their visual system, I will often preface our conversation with, I don't know if this is going to work with you or not, but I'm willing to take the chance because if it doesn't work, you're just gonna think I'm crazy. And if it does work, you're going to think I can walk on water. Because how could I change the way your knee hurts or the way your hip hurt or the way your back hurts or the way your neck hurts by putting on a pair of glasses with prism or color. You don't believe it until you've experienced it.  Tim Edwards: That's true and I've experienced it for myself than just a personal story. My wife is experiencing it as we speak. She had the opportunity to see you a couple of weeks ago. She's now wearing her lenses that you prescribed for her, her colored lenses and we'll get into more of that a little bit later. But she is around fluorescent light all the time. That used to bother her and now it doesn't, as a result of these lenses. And that's the first time I've told you that is right here in the recording. So, you know, like I said in the lead into the episode, I told the story of how this podcast came to be Dr. Stephey. We don't want to scare people away when you say the word witch doctor because that might make people freak out a little bit, but give us a rundown of your optometry practice because it's not your run of the mill optometry practice where you're in and out in an hour with a pair of glasses.  Dr. Stephey: Early on in my career when I first bought this practice in 1988 and I was reading practice management tools, one of the fundamental questions that has to be asked and answered is, do you want to be a quantity practice or do you want to be a quality practice? Quantity practice is just that. It's about. It's about crunching the numbers, how many people you can get through your exam in an hour, and I chose not to do that. I wanted to be a quality practice and I see less patients per hour, but I think I spend much more quality time. I actually listen to patients. I've gotten much better over the years about watching patients. It's not uncommon that I'll notice that somebody taps their leg or wiggles a foot or drums their fingers or chews their lip or other quirky behaviors that they oftentimes know they have, but nobody's explained why they have and that's not ADHD.  Dr. Stephey: Most of the time that's an undiagnosed and untreated vision problem and that they need that kind of movement in order to shower up thier otherwise poor vision skills. So I decided to be a quality practice and when somebody comes to see me for an exam, I want them to learn how the eyes and brain have to work together as an integrated team and that in order to function appropriately in life, you've got to have eyes that see fast, that see accurately, that see effortlessly and sustainably over the course of the entire day. And if you can't do those things, there's going to be behavioral consequences to it. Either you're going to be pushed to be in fight or flight or you're going to learn how not to pay attention, right? That's the group that describes themselves or others describe them as daydreamers or spacey or staring out the window or absent-minded professor.  Dr. Stephey: That's an adaptation to typically not being in fight or flight. High fear, high anxiety, high distractibility. And then the third way some people adapt is they're chronically fatigued and they feel like over the course of the whole day they end up walking around on their last nerve. And oftentimes that's one of these undiagnosed underassessed, and undertreated vision problems. So that's really why I have practiced the way I do.  Tim Edwards: And it's evident from the moment that you walk into your practice, again, referring back to the intro to this podcast, I was able to meet you on a video project. And I won't go into too much into it right now because I talked it about earlier. But when I met with you to prepare and plan the video, the very first thing you did was stick me in your chair and go, all right, here's what I do.  Tim Edwards: I mean, I've been wearing glasses and contacts for over 25 years. Even had LASIK surgery back in the early 2000s. And I mentioned earlier that I've filmed dozens of marketing videos for optometrists throughout southern California. So I can say with great confidence that your methods that a patient experiences in your initial exam are slightly unconventional, which is a word that you embrace with your practice. They go way beyond the typical, you know, which lens looks better, one or two. And it's truly Dr. Stephey not hyperbole when I say that you blew my mind when I produced that first video, which of course, again, we'll have links to in the show notes. So you can see Dr. Stephey for yourself, for those that are listening while you're driving to work or walking the dog or on the treadmill or something. But please share, if you don't mind with our audience, some of the things that a new patient can expect when they see you for the first time, for that consultation, that same consultation that blew my mind.  Tim Edwards: How you're able to assess what you just spoke about. How we can, how you can determine whether or not someone is in constant fatigue or feeling anxiety or lack of concentration.  Dr. Stephey: You Bet. So first thing I want to say is there is great value in the part of the exam about which one is better, choice one or choice two. But what's interesting is that oftentimes patients will stress out about picking an answer. And if I ever get the feeling or somebody voices that concern to me, I remind them or tell them maybe for the first time after years of being stressed out with other exams, I remind them that I'm trying to get them to a point where the differences between the choices are so small that they can't pick a right answer because they're both right. So the little secret is we should get you to the point where you can't tell the difference between one or two. So stop stressing out about the choices.  Tim Edwards: There's always anxiety associated with that because you know that you're going to be committing to some lenses and so you want it to be right and perfect. So that anxiety that I've always felt, you know, like I said, wearing glasses for a quarter of a century and going and seeing different optometrists throughout the country, that the anxiety of picking one or two, you alleviate that. Just by how you worded it. And that is the very first thing that I noticed was, oh, that, that was easier than I thought. And that's just step one. That's foundation. Dr. Stephey: That's foundation. And the other thing to consider is a two circle venn diagram. So if we take two circles and partially overlap them those two circles are where most eye doctors practice. And one circle is can you see 20/20 and the other circle is related to eye health and/or eye disease. And again, those two circles have great value but they're insufficient. So there's a third circle that we're going to add into the venn diagram. And that third circle is really in my estimation, where all the magic happens. In that third circle, there is eye taming, eye focusing, eye tracking, visual attention, visual-auditory skills, visual-spatial skills, visual auditory, visual motor. And on and on it goes. Most eye doctors pretend like that third circle doesn't exist. So even if you've got major problems in the third circle.. Dr. Stephey: It's probably gone undiagnosed and untreated. Whether you had an exam the day before you came to see me or whether you've been going to the eye doctor like you have for 25 years. If you don't measure components in the third circle, if you don't ask questions in your history about the symptoms typically experienced by somebody having third circle problems, then you're never going to find those problems.  Tim Edwards: That's pretty clear.  Dr. Stephey: It's pretty simple. So I think one of the fundamental differences in my practice is when you walk in my exam room, well you know what, that's not even really true because it could be outside of my exam room. If I go to a bank and strike up a conversation with the teller about what I do, it's not unusual for me to ask them if they have a history of migraines or headaches.  Dr. Stephey: That's a simple question and a lot of people have those problems. So if I get a yes answer to that, it's already opened the door for us to have a conversation about me asking some other questions and then the patient looks at me like, what? What is going on? Because I'm answering yes to everything that you're asking me. And it's just that easy. So when you walk in my exam room, I am assuming that you have a third circle problem until you prove to me that you don't. And what I mean by prove to me it's either going to be the questions I asked you during the course of the exam or the questions that I hand to you at the end of the exam and have you go home and think about for a few days or during the course of my exam itself where I measure some things.  Dr. Stephey: For example, how easily or how difficult it is for you to cross your two eyes. Because that allows us to strike up a conversation about the way your two eyes work together as a team. How, if we think about the two eyes is being global positioning satellites that have to be in synchronous orbit and if your two global positioning satellites are not in synchronous orbit, then your internal map quest is off. A couple of the other quick assessments that I do in my office, I've got a couple of devices that allow you to see, let's say a vertical line through your rigght eye and a horizontal line through your left eye. And if your brain is using your two eyes together as an integrated team, you should see a plus sign. Well some people look at these targets and only see one line.  Dr. Stephey: So that gives me an opportunity to demonstrate to them that that they weren't looking through one of their two eyes and that is a concept, I think you used the phrase earlier that blows their mind.  Tim Edwards: That was the first thing that blew my mind was, oh my gosh, how did that happen? How was it that I had been seeing this one line and not the other?  Dr. Stephey: Right. And what exactly do you mean that my brain isn't looking through my left eye? I thought our eyes just looked out in space, picked up information and filter it back to the brain that we then processed. Well, that is how most people think about vision, but remember the retina, which everybody's heard of, right? The retina is specialized brain tissue that's pushed out into the eyeball. And the optic nerve is one of the 12 cranial nerves that is a direct branch off of the brain.  Dr. Stephey: So to be very clear, the brain does the scene, not the eyes. And in this context, the brain has to pick up data from the right eye, has to correlate it with the data in the left eye and then combine the two in order to use the two eyes together as a well integrated team. But if there's too much conflict. And now that happens, oftentimes in fact I would argue that the smartest of brains, will figure it out how to turn one eye off because if you can't use your two eyes together as a well-integrated team, your brain's either going to use your two eyes together as a poorly integrated team and lend itself to you being physically clumsy or to have a lot of fatigue or get tired or sleepy when you're read or be prone to headaches or migraines. So the brain's thinking, well, I can use the two eyes together that way, but be miserable doing it.  Dr. Stephey: Or I can shut one eye off and test drive what's life like if I do that. And then what's really the most, I think one of the most fun things about that whole discussion is when I point out to the patient about their wiggley left foot or they're chewing on their lip and we'll do that same assessment again and I'll have them do whatever they're quirky behavior was and probably 95, 97, 99 times out of 100, when they do that kind of movement, their brain will turn that eye on and tend to keep it on. So then we have another blow my mind moment because you know, I convey to them it's like, are you beginning to understand that all that motor overflow that  you've been doing is actually trying to solve the vision problem you didn't know you had. I'm like, how smart is your brain that it has figured that out and you don't even know it.  Dr. Stephey: So I think in part that's how my practice is different. I'm assuming that you have this problem until you prove to me that you don't.  Tim Edwards: And I would venture to guess that the majority, if not every single person who's listening to this has never experienced that at their optometrist, unless of course they're already listening and they're clients of yours. Is this done elsewhere? The way you set up your practice.  Dr. Stephey: Interesting thing about that, Tim, is that optometrists, at least part of us have been doing this kind of work since the 1930s and it was likely more common in the 50s and 60s maybe up even until the mid to late 70s. And then optometry as a profession started to increase it's scope of practice and started to do more medical things, which is fine. I think we should be able to practice within our scope so we should embrace the things that we're trained to know how to do, but not abandon the things that have made optometry so unique in its history.  Dr. Stephey: And as more optometrists adopted the medical model, they moved away from this behavioral or this neuro-developmental model. So I would venture to say that there's maybe 10 or 15 percent of optometrists in practice today that practice in this way. But I wouldn't change it for the world. I've said this in other venues, being able to practice this way and change people's lives in the manner in which we can do this. It's chicken soup for my soul, so I get to feel great everyday about what I do because it is life changing. You bet, Tim. So as an example, you're going to learn in the future why 20/20 is not enough. It's important. But remember that third circle part of the venn diagram, 20/20 is not enough. There's a whole lot more going on. You're going to learn about a concept you've never heard before.  Dr. Stephey: Called the magnocellular visual system, which is about seeing fast.  Tim Edwards: Seeing fast.  Dr. Stephey: Seeing fast. People know that when they go to the eye doctor, it's about seeing 20/ 20, right?  Tim Edwards: That's what we're told.  Dr. Stephey: Well that's not enough. We also have to account for how fast or how slow we see. Because there are a number of patients, kids and adults alike who have been defined as having slow processing speed. What typically isn't getting discussed is what exactly are we referring to when kids have slow processing speeds. While invariably it's tied in to vision. Even though most psychologists and cognitive psychologists don't describe processing speed in vision terms in most cases, there is a tie into these visual skills. So we're going to talk about seeing fast or slow. We're going to talk about the volume of space that you can see. That's something else that doesn't get talked about a whole lot.  Dr. Stephey: Some people who exhibit inattentive tendencies essentially have tunnel vision. So imagine the cardboard tubes at the end of the paper towel roll, and if we took the two of those and glued them to the front of your eyes, and that's the volume of space you could see. Well your head's going to be on a swivel top because you only see that big volume of space. So in order to capture your environment, you have to look and take a snapshot of each picture. That's that tiny, and you effectively have to build a collage and your mind of all the snapshots that you've just taken in order to try to image then the volume of space that you're supposed to see. And similarly, in terms of the tunnel vision, oftentimes people do the same thing with auditory and touch. These are the kids as an example where you might say, Jimmy, Jimmy, Jimmy, because they have learned how to be auditory and attentive.  Dr. Stephey: They have hyperfocused to a task and tuned everything else out in order to be able to try and do the task at hand.  Tim Edwards: There is the listen part of Move Look Listen.  Dr. Stephey: Yup. And similarly, if you're somebody in their 60s and 70s, this becomes an issue when you drive. Because if you imagine again the paper towel tubes and you're looking straight ahead and that's the volume of space that you see and some kids playing in the yard and his ball rolls out in the street and you don't see them until he's right in front of you, that's not good. And when you can only function with a small volume of space, it also contributes to your clumsiness. These are the patients that have bruises from hip to ankle, from running into the corners of tables or chairs, they run into the edge of a door frame, they don't like driving in the car pool lane because the whizzing pass to their peripheral vision of the concrete dividers is too upsetting. So we're going to be talking about those things.  Tim Edwards: Boy, these are every day run of the mill tasks that we all have and without thinking of that volume. It's almost like tunnel vision and it just inhibits how we function.  Dr. Stephey: Yes, because your brain has to make a decision about the volume of space that you're going to attend to or can attend to, and the speed with which you do it. So you can either see big and slow, smaller and faster. And one patient said, well, what if I want to see big and fast anyway, even if I don't have the skills to do it?   Dr. Stephey: I said, well, you can force yourself to do that but then you will be tired and cranky at the end of the day.  Tim Edwards: It's exhausting, right.  Dr. Stephey: It is exhausting. You can do it, but there's going to be a price to pay and it's going to be exhausting. And when you're that exhausted, it's going to wear out your adrenal glands. It's going to have some role to play in chronic gut dysfunction and it's likely to play a role in headaches and that you're just fatigued all the time.  Tim Edwards: My gosh, it's foundational. It's just foundational and everything is connected. If you think about all of the different ailments and problems or struggles or anxiety or stress that can be a result of not seeing fast or having great volume with your vision.  Dr. Stephey: Well, what's interesting about that, Tim, because that ties right into the next topics which has to do with nutrition and fish oil. And I was just at a nutrition conference yesterday all day and during one of the breaks, one of the other attendees, we introduced ourselves and she's a chiropractor. And most people in this group, there were a number of chiropractors, some acupuncturists, there was one M.D., there was one pharmacist and me. And when I told her I was an optometrist, reflexively, she said, what are you doing here?  Tim Edwards: Yeah, why are you here?  Dr. Stephey: And we didn't have much time to talk about it, but clearly she had fallen into the trap of, well all someone would come to see you for is to be able to see 20/20. And then I just said, you know..  Tim Edwards: Send her a link to the podcast and then let her subscribe and then she'll understand.  Dr. Stephey: Yes. That's excellent. Well, you know, she did want my contact information. So I texted her.  Tim Edwards: Wonderful.  Dr. Stephey: I may follow up with her and say, hey, what's your email because I need to send you some stuff. And where are you located? Because you're an 818 area code. So you're, within striking distance to my office, you need to know what I know.  Tim Edwards: That's right.  Dr. Stephey: So further episodes we are going to talk about nutrition and vision because we cannot parse out our brain functioning abilities and the way our GI tract functions from these visual skills that are all happening in that third circle.  Dr. Stephey: So nutrition is a critical part of the way I practice this kind of optometry. It has to be.  Tim Edwards: And again, have never heard an optometrist say that, and it's foundational. I mean, it comes down to what we put in our body, how it affects everything, not just our weight.  Dr. Stephey: No. Every cell membrane in your body has a component of fatty acids to it as an example. And your body and brain is going to make those cell membranes out of good fats or bad fats. And the problem is that we're exposed to way too many bad fats. People have heard something about omega-3 fatty acids and omega-6 as well. We're going to talk about in more detail the differences between those two and the consequences to your brain and your visual skills and you're learning and attention. So those will be coming in future episodes.  Dr. Stephey: I'm going to be talking about something called retained primitive reflexes. Retained primitive reflexes have a foundational role to play in our abilities to develop our move, looking and listening abilities. So I've seen kids as an example who've done six, seven, 800 hours of occupational therapy and speech therapy and adaptive physical education services. They've been to reading tutors six to 800 hours.  Tim Edwards: My goodness. And I didn't hear vision therapy in there at all.  Dr. Stephey: No. And and they still have tremendously poor outcomes because I think most cases the visual skills are never assessed. So they're being jumped over and if you don't have these visual skills, you can't do those other outcomes in a way that you should be able to.  Tim Edwards: It's that key missing component.  Dr. Stephey: It's a key missing component. You know, at the bottom of my learning ladder, there's genetics and epigenetics, there's nutrition, then there's primitive reflexes. So it is really low down on the ladder and if you tried to jump over that and do things that are three or four rungs up the ladder, you're not going to have great outcomes.  Tim Edwards: Perfect example.  Dr. Stephey: And the sad thing about that discussion, which happens all too often, it's pretty much universal, is that you contribute to these kids misery because now there are six to seven out of eight hours in and not really getting better and it snuffs the spark of their really being interested in getting better because they increasingly don't believe they can. Because their life experiences would tell them, hey look, you're 700 hours into doing therapy, you're really not better than when we started. That is really sad.  Tim Edwards: It is very sad and expensive. I mean, of course it's more important that it's sad. But it's also quite expensive too.  Dr. Stephey: It is very expensive and it could be that the school district is paying for it. And in one of the upcoming episodes, we're going to talk about educational rights as it relates to your move, look and listening abilities.  Dr. Stephey: And you're going to learn a lot about what your rights really are as a parent. And how likely those rights have been violated even as we speak. So I think that's going to be one of the most exciting episodes for parents to hear. Parents, grandparents, and even some educators because if you're a classroom teacher who's, in the front lines, teaching these kids, those kids and their behaviors are disrupting the flow of your classroom. So you really want to know this information because it's going to make your life easier in the classroom. And ultimately it's going to affect that child's life who's in your classroom. If not during the year that you have them, certainly for the future.  Tim Edwards: And perhaps these educators with that knowledge can look upon those children with a lot more grace than they would before, knowing what they're going through.  Dr. Stephey: Well, I think they will. And another example of that, this past week I've had an opportunity to assess a 16-year-old. She's had an IEP for a number of years, has never had this vision assessment as is pretty much universally true. Let's be real. It's universally true. And she's currently kicked out of school because she's gotten in one too many fights at school. She's fairly disconnected when she's in class and I believe that it's primarily related to the problems that we're going to be talking about in these future episodes. It is a combination of nutrition and this vision piece. So she is perpetually in a constant state of fear that is beyond her control. I mean it's not surprising or would not be surprising to me that somebody brushes up against her in the hallway and she's ready to punch him in the face because she perceives that as a threat.  Dr. Stephey: And when, when you're pushed to be in survival based behavior, it's survival at all cost. So if somebody invades your personal space and touches you and you perceive it as a threat, you're going to fight back. So I think she's oftentimes swinging the first punch and doesn't even know it until after it's happened.  Tim Edwards: And others might look upon that as an offensive, aggressive behavior and it is. But the root of it is it's really defensive because of what's going on in her mind being in fear all the time.  Dr. Stephey: Absolutely. That's what's happening and I think that is in great part why she throws her hood up. When she's in class because she's trying to withdraw into her shell and not feel that miserable and not feel that anxious, not feel like I want to run out of the room screaming. I'm forced to be here, but the only way I can really survive this is to learn how not to pay attention.   Dr. Stephey: It is really sad and I was talking to her mom about this and you never know when you're going to strike the right chord because I was having a discussion with her mom about about this. Her being pushed to be in constant fear and I made the comment about how if you're in this state, if your autonomic nervous system is so dysregulated that you are in a constant state of fear that you could make eye contact with somebody across the room and be ready to go over and punch him because you perceive them looking at you as a glare. Right. It's like, why are you looking at me that way? Really? I'm just looking at you and then that turns into a confrontation and so her mom had mentioned to me that, that is exactly what happens to her. She misinterprets facial cues and that's going to tie into one of the future episodes as well. We're going to talk about something called the polyvagal theory of affect, emotion and self-regulation. And that if your autonomic nervous system is dysregulated that you are precluded or prevented from engaging in social behavior or at least positive social behavior. You may be engaged in negative social behavior and that's what's gotten her kicked out of school right now. So we're also going to be talking about learning disabilities and dyslexia because as an example, in my estimation, those are just labels.  Dr. Stephey: They don't really tell us anything. And when, when I meet somebody in my office and if it's a parent and they say, oh, my child has a learning disability or my child's dyslexic. I usually say, what do you mean by that?  Dr. Stephey: And then they look at me like, what do you mean, what do I mean? And I said, well, you're the one that threw out the term, I want to know what your understanding of that term actually means. And that's when they pause and they're like, I guess I don't really know what it means. I said, okay, well amuse me for a second. I'm going to rattle off some terms you tell me which of these terms you know could define and specifically how they apply to your child. Phonological processing, rapid naming speed, working memory, convergence insufficiency, vergence facility, accommodative facility, ocular motor skills, retained primitive reflexes, millisecond timing clock deficits, and your child's AA-EPA ratio as measured in their blood. And then I get that blank stare.  Dr. Stephey: They typically don't know any of these answers because nobody's sharing the information with them.  Tim Edwards: They were just labeled.  Dr. Stephey: They were just labeled. So you know, that's really the purpose of this first series of podcasts is that I want to broaden people's knowledge about what is out there. The labels don't mean anything, not really. Learning disability, dyslexia, reading disorder, dysgraphia, dyscalculia, ADHD, inattentive ADD. Those are just labels. They recognize the behaviors, but I want to go back to my holy bucket analogy, and assess why are you ending up with those behaviors. And how again, that ties into your abilities to move, look and listen. And shouldn't we be assessing for those skills and treating those skills because I don't care what your chronological age is. If there's a big gap between your developmental age and your chronological age related to your abilities to move, look and listen you're going to struggle.  Dr. Stephey: And that ties also into kids on the spectrum because you know when we go from however we define normal and we slide down the scale of behaviors while there is normal and then there's ADDness and ADHDness and then there's high functioning autism and asperger's, and nonverbal learning disabilities, and then there's more traditional spectrum kids that are not as high functioning and then there's kids who are nonverbal. All of this is on a continuum. So when I assess even a nonverbal child, I'm looking at their abilities to move, look and listen, and how those skills allow them to regulate their autonomic nervous system and engage their social behaviors to facilitate their ability to read gestural language and body language and facial expressions and think about that for a minute. Gestural language, body language and facial expressions all read through the visual system.  Tim Edwards: That's true. It's all absorbed through their eyes.  Dr. Stephey: It is, and most social psychologists would tell you that 80 percent of what somebody is telling you is through their body language, not the words coming out of their mouth. Because there's more messaging in the nonverbal cues. We're going to wrap up the first series with two different episodes. One is going to talk about brain injuries and alzheimer's and one is going to talk about headaches and migraines because both of those things have a tremendous visual overlay. For example, there's estimated to be 3 million sensory neurons that feed information to the brain through vision, auditory, taste, touch and smell. And of that 3 million nerve fibers, there's roughly 30,000 auditory nerve fibers per ear and roughly 1.2 million per eye. Almost two and a half of the 3 million sensory inputs to our brain and our brain's ability to experience our environment, are tied up in the visual system. And that goes directly in to the third circle of the venn diagram.  Tim Edwards: Wow, that's it. Move Look Listen with Dr. Stephey. You know you mentioned, you alluded to it earlier when we were going through some of the topics we're gonna cover in season one of the podcast, but I'd like for you to dive down just a little bit more to Dr. Stephey if you don't mind, into what it is in one statement, what it is you want to accomplish by producing and distributing this content through your Move Look Listen podcast.  Dr. Stephey: The purpose of my doing this podcast and how it relates to one's ability to move, look and listen, relates to your ability to function in life, your development of your sense of self, your place in this world, how you socially engage with others, your ability over your lifetime to receive further education, live independently, and have gainful employment. That's the purpose of Move Look & Listen.  Tim Edwards: Well, I can't wait to delve into season one with you, Dr. Stephey. This has been a long time coming and I do believe much needed information for anybody struggling with any of those issues that we've talked about here in our inaugural maiden voyage of the podcast. Thank you for your time and looking forward to season one with you Dr. Stephey.  Dr. Stephey: Thank you.  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 podcast. 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.    

Dr Stephey's guest today is Kelly Dorfman, author of Cure Your Child With Food. We'll be discussing: strategies for the picky eater, the role of zinc in taste and smell acuity, fish oil and omega 3 faty acids in attention and dyslexia, and the role of phosphatidylcholine in dyspraxia (childhood clumsiness disorder) and dysgraphia (handwriting challenges). 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 Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStephey YouTube Channel: http://bit.ly/DrStepheyOptometryVideos If interested in producing a podcast of your own, like the Move Look & Listen Podcast, contact Tim Edwards at tim@InBoundPodcasting.com or visit https://www.inbounddigitalmediaagency.com/inbound-podcasting  

What is Dyslexia? This episode with Dr Garth Christenson, an optometrist from Hudson, Wisconsin and co-author of the Decoding Encoding Dyslexia Screener discusses how dyslexia is diagnosed, the sub types of dyslexia (dysphonesia vs dyseidesia, or the combine type), multisensory teaching strategies, the role of optometry, and vision therapy and dyslexia (dispelling the myths from the realities). This episode is for parents of kids with dyslexia, specific learning disabilities, and reading disorders, as well as school psychologists, special education directors, school principals, educational therapists, reading therapists, speech language specialists, audiologists, occupational therapists, school counselors, clinical psychologists, neuropsychologists, and psychiatrists. Dr. Garth Christenson: http://www.christensonvisioncare.com 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 Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStephey YouTube Channel: http://bit.ly/DrStepheyOptometryVideos If interested in producing a podcast of your own, like the Move Look & Listen Podcast, contact Tim Edwards at tim@InBoundPodcasting.com or visit https://www.inbounddigitalmediaagency.com/inbound-podcasting

The Pervasive Role of Vision in Sensory Integration and Other Brain Based Disorders. Dr. Ingryd Lorenzana from Schaumburg, Illinois discusses the model she and Dr. Stephey have developed over the years in getting to the root cause of why your child may have been diagnosed with a sensory processing disorder, dysgraphia, dyspraxia, dyscalculia, dyslexia, ADHD, or other learning challenges. This episode is for parents of such kids, as well as school psychologists, special education directors, school principals, educational therapists, reading therapists, speech language specialists, audiologists, occupational therapists, school counselors, clinical psychologists, neuropsychologists, and psychiatrists. 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 Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStephey YouTube Channel: http://bit.ly/DrStepheyOptometryVideos If interested in producing a podcast of your own, like the Move Look & Listen Podcast, contact Tim Edwards at tim@InBoundPodcasting.com or visit https://www.inbounddigitalmediaagency.com/inbound-podcasting

Join Dr. Stephey and retired Army surgeon & co-founder of Brainspan Labratories, Dr. Dan Johnston for a discussion of the Brainspan test which is available from the office of Dr. Stephey. Taking the Brainspan test can be the first line of defense against aging, inflammation, vascular disease and poor brain function at any age. Silent inflammation is a killer and affects every cell in the body.  Listen in if you have a learning disability, autism, ADHD, migraine, motion sickness, dementia, Alzheimers, autoimmune disease, a thyroid disorder, want to lose weight, read better, move better, breath better, and have a better brain. For more information about Brainspan visit: https://www.mybrainspan.com To order your Brainspan test kit contact Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStephey Dr. Stephey's YouTube Channel: 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

Dr. Stephey discusses the brain-vision connection with Dr. Jay Faber, an integrative psychiatrist from The Amen Clinic. Specifically, they will  discuss the role vision plays in brain imaging in the diagnosis and treatment of attention and other mood regulating disorders for patients who have been diagnosed with ADHD, autism, and various mental health issues.  Contact Dr. Faber: www.AmenClinics.com 818-479-4400  or docfaber@amenclinic.com Contact Dr. Stephey: Website: http://bit.ly/DouglasWStephey Dr. Stephey's YouTube Channel: 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 https://www.inbounddigitalmediaagency.com/inbound-podcasting

Emily Stouffer joins Dr Stephey to discuss how we teach reading to both beginning and struggling readers with one of the most effective and fastest ways to do so: The Phono-Graphix method and the book Reading Reflex. This episode is a great resource for teachers or parents with students and children struggling with dyslexia, learning disability, reading disorder, ADHD, ADD, convergence insufficiency, oculomotor skills, eye strain, headache, and migraines. Visit www.readamerica.net and www.ontrackreading.com Contact Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStephey Dr. Stephey's YouTube Channel: 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  

Emily Stouffer joins Dr. Stephey again to discuss her own visual outcomes from when she was a kid until she came to California more than 10 years ago to see Dr Stephey. Emily shares her experiences of being clumsy, having challenges with attention, suffering from chronic postural issues, and having a brilliant mind but often struggling with fatigue. In this episode you will learn about postural prisms and how lenses can have positive body, brain, and postural outcomes. Visit www.posturmed.com Contact Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStephey Dr. Stephey's YouTube Channel: 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  

Dr. Doug Stephey welcomes Dr. Marla Omar DC, CAK of Tri-City Chiropractic Clinic in Walnut, California discuss what it means to be a neurologic chiropractor and the role the visual system plays in movement, posture, gait, balance, and gut function. Please visit this link to see the video Dr. Stephey references in this episode regarding the miracle of blue lenses: https://vimeo.com/324751244 Dr. Marla Omar, D.C., C.A.K. Tri-City Chiropractic Clinic 100 Pierre Road Suite A Walnut, CA 91789 Office: (909) 594-6181 https://drmarlaomar.com Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. Douglas W. Stephey, O.D., M.S. 208 West Badillo St. Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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

Dr. Doug Stephey welcomes back Dr. Marla Omar DC, CAK of Tri-City Chiropractic Clinic in Walnut, California discuss the role retained primitive reflexes play in overall development. Although these reflexes have been reported in the literature for decades they continue to be overlooked by education, medicine, and many therapy practices. Dr. Marla Omar, D.C., C.A.K. Tri-City Chiropractic Clinic 100 Pierre Road Suite A Walnut, CA 91789 Office: (909) 594-6181 Website: https://drmarlaomar.com Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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  

Alex Doman, founder and CEO of Advanced Brain Technologies joins Dr. Stephey to discuss the healing power of sound.  Learn how different sound frequency zones affect the body and brain whether it be to calm the nervous system, enhance social engagement skills, improve abilities to hear the human voice, act as a stimulus to arouse the brain, or to enrich creative abilities. If you have a heartbeat you can benefit from music listening therapy. Follow Advanced Brain Technologies https://advancedbrain.com http://bit.ly/AdvancedBrainPodcast_ApplePodcasts https://www.instagram.com/advancedbraintechnologies https://www.facebook.com/AdvancedBrainTechnologies https://twitter.com/advancedbrain https://www.youtube.com/advancedbrain Healing at the Speed of Sound by Don Campbell & Alex Doman https://www.audible.com/pd/Healing-at-the-Speed-of-Sound-Audiobook/B005NC848K?qid=1556313139&sr=1-1&ref=a_search_c3_lProduct_1_1&pf_rd_p=e81b7c27-6880-467a-b5a7-13cef5d729fe&pf_rd_r=YJ6W4PYB3W99PPPJNDZY Get a FREE download of Alex's audiobook by joining Audible! www.audibletrial.com/InBound 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 Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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 If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films Instagram: https://www.instagram.com/inbounddigitalmedia

Dr. Stephey invites special guest, Marina who suffered a brain injury nine years ago and has been on a long road to recovery. Dr. Stephey met Marina recently while giving a talk at Bridging the Gap, a brain injury support group. During the course of the evening's talk Marina graciously volunteered for a mini assessment to determine her response to a pair of blue colored lenses. You'll be surprised by her story. It's a story of survival and hope. Video of Dr. Stephey and Marina at Bridging the Gap: https://vimeo.com/324751244 Bridging the Gap - Connecting Tramatic Brain Injury Survivors: http://tbibridge.org 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 Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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 If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films Instagram: https://www.instagram.com/inbounddigitalmedia  

Dr. Stephey welcomes Dr. Joanna Haase and Sharon Duncan to discuss their body of work with the pediatric population who has been identified as cognitively gifted yet oftentimes are still struggling academically, socially, and/or emotionally. Gifted Research and Outreach: http://www.gro-gifted.org Joanna Haase Ph.D., MFT MFT License 22234 572 East Green St., Suite 208, Pasadena, CA 91101 626.799.7907 / drjhaase@mac.com  http://drjoannahaase.com http://cagiftednetwork.com http://www.gro-gifted.org Sharon Duncan with Gifted Identity http://www.giftedidentity.com/sharon-duncan (909) 802-0199 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 Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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 If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films Instagram: https://www.instagram.com/inbounddigitalmedia  

Dr. Bea Braun, an audiologist, is Dr. Stephey's guest today. She is hear (here) to discuss the differences between hearing acuity, auditory processing as it's conventionally thought of, and central auditory processing disorders. Dr Braun will discuss the diagnosis of these disorders, the treatment of these disorders, and accommodations for these disorders. For additional information on this topic: - PDF's available for download here in the episode notes - https://www.asha.org/Practice-Portal/Clinical-Topics/Central-Auditory-Processing-Disorder/ - www.auditoryprocessingctr.com Books available in Amazon: Like Sound Through Water When the Brain Can't Hear Hearing Equals Behavior Contact Dr. Braun: Bea Braun, Au.D., Doctor of Audiology, Educational Audiologist Auditory Processing Center of Woodland Hills, Santa Barbara and Pasadena www.auditoryprocessingctr.com 626-793-8711 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 Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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 If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films Instagram: https://www.instagram.com/inbounddigitalmedia

Dr. Orlando joins Dr Stephey to discuss Postural Deficiency Syndrome (Proprioception Dysfunction Syndrome). In this episode we will learn how the visual system affects our body and brain awareness in space.   This work has been done in Portugal for over 40 years and is essentially unknown in the USA. We'll be discussing how prescribing active prisms in your glasses will affect the proprioceptive system and our bodies/brain in space.   If you suffer clumsiness, headache, migraine, dyslexia, risk of fall injury, vertigo, balance disorders, problems with driving, can't go up and down stairs, being afraid of heights, have anxiety/depression, motion sickness, reading disorders, ADHD, autism, anger, conduct disorder, etc you need to listen to this episode.   See www.posturmed.com and www.drorlandoavlesdasilva.com Dr Stephey is looking into getting the book describing the affects of acitive prisms co-authored by Dr Orlando and Rucenita Queiroz translated into English Maddox Wing Test: https://en.wikipedia.org/wiki/Maddox_wing 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 Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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 If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films Instagram: https://www.instagram.com/inbounddigitalmedia

Dr. Stephey is joined by Dr. Teri Lawton, an experimental psychologist, who has been studying the magnocellular visual pathway for over 35 years and holds a patent on both measuring and treating this part of the visual pathway. The magnocellular pathway is a primary gateway to attention. There is a theory of dyslexia/reading disorders related the magnocellular system. There is a high prevalance of magnocellular deficits in the Alzheimer's population. Come listen to the power of the magnocellular / motion processing visual pathway that you have never heard anything about. www.pathtoreading.com www.pathtoinsight.com Additional Resources https://www.sciencedirect.com/science/article/pii/S0028393212005088   https://www.ncbi.nlm.nih.gov/pubmed/12072823   https://pubs.rsna.org/doi/full/10.1148/radiol.2541090558   https://www.researchgate.net/publication/40682705_Alzheimer%27s_disease_Visual_system_review   https://www.karger.com/Article/Pdf/80005 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 Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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 If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films Instagram: https://www.instagram.com/inbounddigitalmedia

Dr. Stephey welcomes Amy Vega, the clinical consultant for Interactive Metronome and a speech pathologist.  Interactive Metronome® (IM) is an evidence-based assessment and training tool that measures & improves Neurotiming, or the synchronization of neural impulses within key brain networks for cognitive, communicative, sensory & motor performance For more information regarding interactive metronome please visit https://www.interactivemetronome.com 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 Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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 If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films Instagram: https://www.instagram.com/inbounddigitalmedia

Former classroom teacher turned special education attorney, Tania Whiteleather joins Dr. Doug Stephey to discuss all that is Psycho-Educational Testing. What is it. How to ask for it. How to actually get it. What to do and more. Topics covered in this episode include: IQ testing, psychological education testing, IQ vs achievement discrepancy criteria, response to intervention, special education, specific learning disabilities, dyslexia, dysgraphia, dyspraxia, dyscalculia, speech and language, motor planning, occupational therapy, speech therapy, central auditory processing, vision therapy, visual processing, auditory processing, IEP, and 504 plans. 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 Douglas W. Stephey, O.D., M.S. is a full-service eye and vision care provider in Southern California and is a sought-after conference speaker, educator, and passionate advocate for patients diagnosed with dyslexia, specific learning disability, ADHD, autism, and any other qualifying diagnosis for an IEP or 504 plan. 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 If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films Instagram: https://www.instagram.com/inbounddigitalmedia

Special education attorney Tania Whiteleather returns for part two. Dr. Doug Stephey and Tania reveal the secrets to getting outside testing completed at the school district's expense. In this episode you will learn what IEE"s are, when you need them, how to ask for them, and how to get them completed by the providers of your choice. Moreover, you'll learn what the district's obligations are in responding to your requests. Douglas W. Stephey, O.D., M.S. is a full service eye and vision care provider in Southern California and is a sought after conference speaker, educator, and passionate advocate for patients diagnosed with ADHD, parents with a child that lands on the Autistic spectrum, and students in special education.  Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films   https://www.inbounddigitalmediaagency.com/

Dr. Doug Stephey is joined by Educational Technology Speaker, Leslie Fisher, for the first of a two part series on vision related learning disorders.  Leslie describes her own 50-year journey of learning new things about her visual system that have plagued her for a lifetime and how, through the use of technology, she has become a nationally sought after educational technology speaker. https://lesliefisher.com/ Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films   https://www.inbounddigitalmediaagency.com/

Dr. Doug Stephey is joined once again by Educational Technology Speaker, Leslie Fisher, for the first of a two part series on vision related learning disorders.  Leslie describes her own 50-year journey of learning new things about her visual system that have plagued her for a lifetime and how, through the use of technology, she has become a nationally sought after educational technology speaker. https://lesliefisher.com/ Below are links to the very valuable tools mentioned in this episode: Immersive Reader & OneNote Kurzweil 3000 Free Microsoft Office for Students and Educators Livescribe Smartpen https://learningally.org/ Bookshare Dragon Speaking Naturally Douglas W. Stephey, O.D., M.S. 208 West Badillo St, Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films   https://www.inbounddigitalmediaagency.com/

Dr. Doug Stephey welcomes Alan Heath who is a psychologist in the UK who created The Movement Program (TMP).  TMP is a web based physical movement program designed to be performed 20 minutes per day, five days per week, for 60 sessions. TMP has been shown to improve attention, balance, coordination, reading, and overall learning skills and is directly tied to the neuroscience of movement and learning. http://movementprogram.com Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim with InBound Digital Media www.instagram.com/inbounddigitalmedia/ InBound Digital Media - Marketing Videos & Social Media Ad Campaigns bit.ly/InBoundDigitalMedia tim@inboundfilms.com  

Dr. Doug Stephey welcomes Psychologist, Alan Heath back for an additional episode to discuss the TAVS instrument, the Test of Visual and Auditory Skills. TAVS is a unique tool for screening many subtle areas of auditory and visual processing. These areas are vital for listening, reading, attention and memory skills. Screening with TAVS can guide you to ensure that the correct remediation tools are used and help to understand why children are having difficulties within the classroom or at home.  Developed by Advanced Brain Technologies (https://advancedbrain.com) with an international team of specialists, TAVS offers a unique opportunity to assess low level auditory and visual skills without using words. This makes it a wonderful tool to understand more about the processing of frequency, amplitude, timing and spatial aspects – the fundamentals of listening and seeing. https://advancedbrain.com/tavs/ Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim with InBound Digital Media https://www.instagram.com/inbounddigitalmedia/ InBound Digital Media - Marketing Videos/Social Media Ad Campaigns http://bit.ly/InBoundDigitalMedia InBound Films Marketing Videos http://bit.ly/InBoundFilmsYouTube

Dr. Stephey welcomes Mitch Scheiman OD PhD, Dean of Academic Research at Salus University with optometric education for 45 years and optometric research for nearly as long.  Dr. Scheiman discusses the groundbreaking research he's been doing for over 30 years. More specifically, he's here to discuss the CITT ART study ( Convergence Insufficiency Treatment Trial Attention and Reading Trial). https://journals.lww.com/optvissci/Fulltext/2019/11000/Treatment_of_Symptomatic_Convergence_Insufficiency.4.aspx Douglas W. Stephey, O.D., M.S. 208 West Badillo St, Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com Follow Tim Edwards: InBound Podcasting & InBound Films   https://www.inbounddigitalmediaagency.com/

Dr. Stephey invites Dr Dillahey to discuss a different pandemic other than COVID 19. It's the pandemic of myopia or nearsightedness.Come and listen to what factors are connected to myopia development and what you can do to prevent, stop, or at least minimize the progression of myopia in you or  your loved ones.  www.mymyopia.com https://www.allaboutvision.com/parents/myopia.htm https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/myopia Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Edwards  https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

Dr. Stephey welcomes Dr. Arnold Wilkins, the worldwide pre-eminent author and creator of the Intuitive Colorimeter to discuss visual stress / visual aliasing and their relation to epilepsy, migraine, chronic headaches, and reading discomfort.  Dr. Wilkins has written two books and several articles on the subject (see links below). Visual Stress, Dr. Arnold Wilkins Reading Through Colour, Dr. Arnold Wilkins https://www.essex.ac.uk/people/wilki51608/arnold-wilkins Disturbing Vision Ted Talk  https://www.youtube.com/watch?v=GBOzv9HgoWM Color Vision Promoters Take on Critics https://www.youtube.com/watch?v=NZb5F5y8wuM Douglas W. Stephey, O.D., M.S. 208 West Badillo St, Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Edwards  https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

Professor John Stein, a neurologist, from Oxford University joins Developmental Optometrist Dr. Doug Stephey for a comprehensive discussion regarding the role of the magnocellular visual system as it relates to, not only dyslexia but,  a number of other diagnoses as well.  Additional topics include how the magnocellular system is not limited to the visual system but a number of other systems as well such as  auditory, motor, cerebellar, kinesthetic, and proprioceptive. It can be argued that Dr. John Stein is the world's leading authority on magnocellular neuron deficits.  He is the co-author of the book Visual Aspects of Dyslexia and is a prolific researcher and publisher.   http://www.ox.ac.uk/news-and-events/find-an-expert/professor-john-stein www.brainspan.com Douglas W. Stephey, O.D., M.S., 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Edwards Cicciarelli & InBound Digital Media https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

Professor John Stein, a neurologist, from Oxford University re-joins Developmental Optometrist Dr. Doug Stephey for part 2 of a comprehensive discussion regarding the role of the magnocellular visual system as it relates to, not only dyslexia but,  a number of other diagnoses as well.  Additional topics include how the magnocellular system is not limited to the visual system but a number of other systems as well such as  auditory, motor, cerebellar, kinesthetic, and proprioceptive. It can be argued that Dr. John Stein is the world's leading authority on magnocellular neuron deficits.  He is the co-author of the book Visual Aspects of Dyslexia and is a prolific researcher and publisher.   http://www.ox.ac.uk/news-and-events/find-an-expert/professor-john-stein www.brainspan.com www.pathtoreading.com Book titles- Visual Aspects of Dyslexia, Learning To See = Seeing To Learn, Eyes For Learning, The Dyslexic Advantage, Dyslexia A Visual Approach Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Cicciarelli & InBound Digital Media https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

Professor John Stein, a neurologist, from Oxford University re-joins Developmental Optometrist Dr. Doug Stephey for a third time to continue a comprehensive discussion regarding the role of the magnocellular visual system as it relates to, not only dyslexia but, a number of other diagnoses as well.  Additional topics include the genetics of the magnocellular system and dyslexia and the advantages of being dyslexic. It can be argued that Dr. John Stein is the world's leading authority on magnocellular neuron deficits.  He is the co-author of the book Visual Aspects of Dyslexia and is a prolific researcher and publisher.   http://www.ox.ac.uk/news-and-events/find-an-expert/professor-john-stein www.brainspan.com www.pathtoreading.com Book titles- Visual Aspects of Dyslexia, Learning To See = Seeing To Learn, Eyes For Learning, The Dyslexic Advantage, Dyslexia A Visual Approach Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Edwards Cicciarelli & InBound Digital Media https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

Developmental Optometrist Dr. Doug Stephey welcomes Dr. Michael Lewis, the author of the book titled When Brains Collide, for a discussion regarding how a Traumatic Brain Injury (TBI) is defined.  In this episode you will learn how common TBI’s  are, how men and women have different outcomes, the relationship of omega 6 and omega 3 fatty acids to inflammation and recovery, and the power of omega 3 fatty acids in healing. http://www.brainhealtheducation.org www.brainspan.com https://noravisionrehab.org https://conquerconcussion.com Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Cicciarelli & InBound Digital Media https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

Enid Whittaker of the Bonnie Prudden Myotherapy Institute joins Developmental Optometrist Dr. Doug Stephey to discuss the Kraus Weber tests of minimum fitness, trigger points and myotherapy techniques. Bonnie Prudden was a tireless advocate for physical fitness, strength, and flexibility, among other things. Bonnie’s mission was for us to be physically fit so that we could enjoy life and develop our minds and bodies over our lifetimes. Enid Whittaker had the great fortune to work with Bonnie for 40 years.   Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Edwards Cicciarelli & InBound Digital Media https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

Christopher F. Chabris, PhD is an American research psychologist and currently a Senior Investigator at Geisinger Health System. Dr. Chabris and Dr Simons are co-authors of the book titled Invisible Gorillas.  Dr. Stephey and Dr Chabris will be discussing the topic of in-attentional blindness and how our intuitions deceive us. http://theinvisiblegorilla.com http://www.brainspan.com/ Get a FREE audio book download of The Invisible Gorilla at  www.audibletrial.com/InBound 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 Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite Videos: http://bit.ly/DrStepheyOptometryVideos If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Edwards Cicciarelli & InBound Digital Media https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

Dr. Doug Stephey welcomes back John Stein, MD, neurologist from Oxford to discuss dyscalculia.  There is great confusion as to what exactly this term means. We will discuss definitively what this diagnosis is and how it relates to our ancient estimating counting system known as subitizing. Other confounding and co-morbid clinical diagnoses will be also be discussed. Resources: http://www.thenumberrace.com/nr/home.php https://cdn.ymaws.com/www.covd.org/resource/resmgr/ovd39-1/24-29subitizingvisualcountin.pdf https://cdn.ymaws.com/www.covd.org/resource/resmgr/ovd39-1/30-34effectsofdailypractice.pdf http://visiontherapysolutions.net/wp-content/uploads/2018/05/Sub_Broch-1.pdf Douglas W. Stephey, O.D., M.S. 208 West Badillo St, Covina, CA 91723   Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite 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 The Move Look & Listen Podcast, contact Tim@InBoundPodcasting.com Follow InBound Podcasting & InBound Films   https://www.inbounddigitalmediaagency.com/