Gamifying Vision Therapy and Learning with Jules Petteruto

Jules Petteruto is a Certified Optometric Vision Therapist (COVT) with twenty years of experience and numerous awards for excellence. She has lectured and presented workshops around the world and moderates the Tuesday Think Tank, a weekly zoom meeting for vision therapists. Her techniques for using games in vision therapy is truly awe inspiring.

NOTES: Regulation requires good posture, breathing, a good mood and your periphery.

GAMES & ACTIVITIES mentioned:

Spot It!, Tap-It, mini trampoline, balloons, Dr. Microbe, and Dr. Eureka from Blue Orange Games, Operation, jacks, Pindaloo, OuiSi, Zingo!, Hidden Pictures, Bananagrams, Hues and Cues, Minute To Win It, Tap-It.

BOOKS: Mindset: The New Psychology of Success, How we can learn to fulfill our potential by Carol Dweck. 

Generation Sleepless: Why Tweens and Teens Aren’t Sleeping Enough and How We Can Help Them, by Heather Turgeon, MFT and Julie Wright, MFT.   

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Transcript

Denise: This is the Healing Our Sight podcast where we discuss vision issues and healing strategies from the patient perspective.

The goal of this podcast is to create an awareness of the diverse types of vision issues people experience, to highlight the types of help available, and to open a dialogue between patients to show we're not alone in our vision struggles.

As a patient who gained 3D vision at age 54 through vision therapy combined with strabismus surgery, I feel uniquely qualified to offer a hopeful, balanced perspective on the possibilities.

Please use the link in the show notes to send me a message and thanks for joining me today.

Welcome to the Healing Our Sight podcast. I'm your host, Denise Allen. Very excited about my guest today, Jules Petteruto. Jules was born and raised in Southern California. She developed her passion for vision after she benefited from vision therapy when she was nine years old.

Jules has been a vision therapist at the center for Vision Development Optometry, Inc. In Pasadena, California since 2005. In 2009, she received her certification as an optometric vision therapist. In 2014, she received the Laura McGraw Award for Excellence in Vision Therapy. In 2017, Jules was honored as the COVT of the Year at COVD.

Jules completed her Bachelor of Arts in Childhood, Moral and Social Development Social Services from the United States Institute of Language and Clerical Studies. Jewel serves as a mentor for the Certified Optometric Vision Therapist COVT process. She has lectured and presented workshops for optometric meetings in the United States and other countries and loves teaching others of the art of vision therapy. She has served as the moderator of the Tuesday Think Tank, a weekly vision therapy Zoom meeting, since 2020.

She also enjoys cooking, traveling, learning from nature and spending time with friends and family.

And I am so excited because I saw you present at COVD last year.

Jules: Thanks for having me on. I. I had a really fun time doing that one. And when you messaged me and you were like, hey, we need to talk, I was like, yes, I'm down for that.

Denise: I am so excited.

Denise: Yeah, I was so excited that you were excited. It was. It was the best. I have to tell our listeners that when we went into that presentation, one of my friends said, I don't know how she's going to fill that time with only the Spot it game because that's just a simple game. You know, how is she going to fill it? And then immediately when you started, you said, I think I have eight hours worth of material for this. And we all looked at each other and went, wow, this is going to be amazing. And it was. 

Jules: I had to cut like nearly 60 slides out of that presentation. And then I don't know if you remember, I was speed talking by the end of it, just trying to get it all covered. And at the end, I don't think I had any time for questions at all. I literally, my timer was like, 3, 2, 1. And I was like, thank you. Bye.

Denise: It was great. Yeah, it was. It was great. In fact, I was on my phone going, okay, I need to order a Spot it game on Amazon to play it with my grandchildren so that it's at home when I get home.

Jules: I love it. I now have 26 decks of spot it at the office, which I feel is just a little bit of an inexcusable amount to have, but I use them all, so. So I guess it's really not that bad, Right? But, you know, I have be gotten the reputation of the Spot It  girl, and I'm okay with that.  It's totally fine with me.

Denise: I think it's amazing. Yeah. So we're going to talk today about how we can use games in vision therapy and hopefully how parents can use them at home as well. Because I think a lot of my listeners are probably in that boat. Right.

Start telling us how you decided to become a vision therapist and then transition into how you, what made you go more into games.

Jules: Okay, so it's kind of a twofold story. I had vision therapy when I was nine. I had basically every diagnosis that could be given to you that, you know, is possible in the vision therapy world, which was fun. I had vision therapy for two and a half years, and I went from reversing every letter and seeing double and having blurry vision and being the clumsy kid that was diagnosed with ADHD in the 80s when it wasn't popular to do so, to confidently playing ball sports. Cause I was only interested in ever doing solo sports. And my parents were like, this is so weird. Like, why does she only want to swim and only want to play golf? And like, what is the deal with that? And it turned out that I was not seeing in 3D.

Denise: Right.

Jules: So my parents sought out whatever they could and by the weirdest domino of events ended up at this vision therapy doctor.
And on that first visit, he told them, like, oh, yeah, your kid only sees out of one eye at a time. And this is why she hates reading. But she loves being read to. She's incredibly verbal, but she has no desire to be in a school setting. And I was a very interesting child because I'd work myself up into a tizzy going to school every single day to the point where I would vomit on the way to school because I didn't want to go.

Denise: Wow.

Jules: It was in that transition of learning to read versus reading to learn. Like right around third grade where things got really, really rough for me. So I started going to vision therapy. And I went twice a week. And on the Monday, I had a kind of hardcore woman who was like, all business. And then when I went on a Thursday, that lady was like, chill. And all about the games and all about experience. And she really spoke in a way that it was. She spoke in my currency because I was an experiential kid.

I'm still an experiential adult. But so that plays into my becoming a vision therapist, because that those two women had such an impact on my life. I remember a very specific day in third grade where I was looking at the word was. And I knew in my head, because I'm an in loud talker, I say everything in my head before it comes out of my mouth. I knew I was reading in my head saw,
but I knew that it wasn't saw, because saw doesn't start with a W. And I turned to my desk partner and I was like, how do you say this word? And she laughed at me and fully bullied me, and it was a horrible experience. So I went into vision therapy and I was like, hey, I don't know how to read. And the Thursday lady was like, what do you want to do about that? And I was like, well, I want to learn how to read. And she goes, well, I'm not going to teach you how to read, but I'm going to teach your eyes how to work together so that when you do learn how to read, it's going to work for you.

Denise: Mm.

Jules: And then I went on the Monday and I was like, the lady on Thursday told me that she's not gonna teach me how to read. And the lady on Monday was like, no, we don't do that here. We teach you how to control your eyes so that your eyes can send the right information to your brain, so that your brain can then do something about it and understand it, and then your body can have a response. And I remember just sitting with that.

And then I graduated from vision therapy, started doing a ton of sports, started doing really cool experiential things. For the first time, I was able to ride a bike without falling off of it. So my. My story is very deeply entrenched in my own experience, and it's very deeply Entrenched in the fact that I had these two diabolically different women who worked with me.

And I really wanted to be the fun lady. Like, it was very important to me that no matter what I did in life, I was the fun person and people enjoyed their experience hanging out with me.

Denise: Yeah.

Jules: When I became older, I really wanted to know, why did I have so much more return on my investment with the Thursday lady than I did with the Monday lady?

So that led me to getting into learning about psychology and learning about child development and learning about why we choose to do the things we do.

And I ended up going straight into optician school because there's no formal education place for vision therapists. You have to kind of grandfather in and learn under the tutelage and guidance of an optometrist.

That's currently where it is. And I'm very passionate about hopefully one day opening up a program where people can learn about vision therapy. That is something I'm. It's on the horizon, and I'm trying to work on it.

Yeah. And so I went to optician school, became an optician, started working for a large hospital group and just was finding no joy in life and ended up seeing in one of those throwaway papers that you got back in the early 2000s, vision therapist wanted. And I was like, hey, I know what that is. Called him up on a Wednesday. We met for an interview on a Thursday. On Friday, he offered me me the job. I quit my other job on the Friday, started working for him on the Monday.

Denise: Wow.

Jules: So. And that was February 8, 2005.

And so I've been working at that office center for vision development since then. And when I talked with that doctor, I was like, hey, I don't want this to be a job. I want this to be a career. It's really important to me that it's a career, because vision therapy changes lives. Like I am. The proof of the pudding is sitting right here.

I was not a reader. Now I'm a reader. I was not a coordinated person. Now I'm a coordinated person. Like, there. There's differences that can be made in doing this thing. And he's like, if you want this to be a career, I will facilitate it to be a career. And here I. Here I am 20 years later, and I've got this incredible career, and I've helped thousands of people in the process of vision therapy, and I. I'm not going to look back. So that's how I ended up working in vision therapy and kind of Having this passion. It really, really, really started early.

Denise: Yeah, it's amazing. And you're not just doing that stuff in the office either. You're doing all of this other outreach and presentations and teaching that is so impactful.

Jules: I think that's one of the things that I also really love about this field is people are willing to learn from other people. So when you have a cool idea and you bounce it off of somebody else in the vision therapy space, they'll sit there and go, oh, I want to try that. And then they'll maybe email me a couple weeks later and be like, hey, Jules, I did X, Y and Zed. What do you think? And this is what ended up happening. And then I'm like, okay, I'm going to try that out. And I find a patient that it might work really well with. Try that modification. See how it works. And then we bounce ideas back and back and forth off of each other.

And we've ended up making some really beautiful protocols that have helped tons and tons and tons of people to be able to get their eyes, their brain, their mind, their body to work together really coherently. And then they ended up. They end up having a really beautiful relationship with the space around them.

And that, to me, is my ultimate goal, is to improve people's vision, which ends up changing their lives. And that's kind of our motto in our office. So we're all about it.

Denise: Yeah, It's amazing. And you kind of alluded to this a little bit, but how did you go from the regular vision therapy protocol to using mostly games is what I'm getting from you in your office.

Jules: When I was doing my education and I was learning a lot about childhood development, I was specifically learning about Jean Piaget. And Jean Piaget, he did this whole developmental stages, and he talks about, like, object permanence and, you know, all of that stuff where he, from a psychology perspective, looked at how people learn and how people develop.

And a huge part of me learning about that was learning about safety.

And when the mind feels safe, the body is willing to play. And when you're willing to play, the brain, from a chemical position,
is ready to learn and is ready to have this dendrogenesis of new brain pathways.

And it's just ready to onboard. So when you're in a kill and drill situation where you're just hitting the same procedure over and over and over again, you know, it's reminiscent of. Of what was said, you know, the definition of insanity is trying the same thing over and over again and expecting a different result. 

When I learned about this element of safety, I learned tons of stuff about the chemical cascades that happen in the brain when the body feels threatened. And It's a minimum 20 minutes after the body feels threatened that the brain is in a space to learn.

Denise: Wow.

Jules: So when you think about it, let's say you're rushing out the door in the morning and by no fault of your own, you raise your voice and your kid gets into a heightened state of fight or flight or freeze or fallen or fib or whatever, Whatever autonomic nervous system trigger puts them in a state of dysregulation.

From that moment, it's minimum 20 minutes before they can get to a place where they can learn.

Well, now you're running late. You get to school and you're like, get out of the car, get out of the car, get out of the car. Whoop. New hormones, New stress hormones. The 20 minute timer restarts. The kids in a brain fog walking into class and the teacher goes, what's wrong with you? New spike of hormones. 20 minute timer resets. They sit there and then their friend across the room makes fun of them because they're in a fog.

New reset of that timer. Then all day long they, they battle this hormone spike of chemicals all day. And then they. The teacher sends a note home saying, johnny didn't pay attention in class all day. And the dad comes home and goes hard on the kid and is like, how come you didn't pay attention in class? New spike of hormones. So this poor kid is sitting in a. In a dysregulated state. From a chemical perspective, all day long their body has not been in safety, so nothing that they were exposed to that day allowed them to learn. 

Then they come into vision therapy and I notice that they're dysregulated. I have all this information. Knowing about these chemicals and knowing about the state of safety, what am I going to do? Sit there and go, hey, you need to pay attention to me. Hey, I need you to put this patch over your eye. That's going to further dysregulate your system. And you're not going to be happy, but you're going to do it anyway because I told you no, that's not how we operate.

My philosophy is whatever is best for the person sitting across from me in vision therapy is what I need to choose to do. And I'm not going to be tied to a program or plan that has been set out for me. I'm going to Work to make sure that my patient can leave there in a better state than when they came in. So when I learned all of this stuff about safety, I started implementing it. I would do all kinds of movement procedures, I do all kinds of breathing procedures, I would do everything in my power and that first 20 minutes of my session.

And I'm very lucky, in my office, sessions are 45 to 50 minutes. Some people have much shorter sessions than that. So I would spend those first 20 minutes getting my patient into a regulated state. When they became regulated and I started playing with them because the key to safety is are they willing to play with you?

So I'd find a way. They were willing to play with me and then I knew I had them. We're ready to go. We can get the eye movements in. We can do everything. We can get, we can build with this person. Their brain is in a chemical regulated state to be able to onboard new neural pathways. So when I would see that switch, which usually happened around 22 to 25 minutes into my session, that's when I'm like, okay, so I'd, I'd give them all that movement and then we would transition to using targets that were fun, targets that were engaging, and targets that were low pressure.

Because I don't know what happened to you through your day that led you to getting to me. I can only control what's happening in that 45, 50 minutes that I get to, to have an interchange with you. So that's. That knowledge about safety completely was a huge paradigm shift for me. And that happened in about 2009 is when I learned that, that little psychological piece and it's completely shifted everything that I do. And it is my personal goal for every single person who leaves my therapy room to have learned to, to have learned at least one thing in the day, either about themselves, their visual system or the world.

And to, for them to leave regulated. And I'm going to see that in the, their skin tone, I'm going to see that in their breathing rate, I'm going to see that in their, their facial tone. I'm going to just watch how their body changes because they're here and, and I'm facilitating the appropriate circumstances for them to be regulated. And I've noticed that when my patients leave regulated, their vision therapy program is shorter because we're actually getting the work done, even If I'm spending 20 minutes working to get them regulated.

Denise: Wow.

Jules: And I have a little charcuterie board of all the things that I do to help people get regulated. It's not an actual one. It's a mental charcuterie board.

Denise: Yes. I love that visual, though.

Jules: Yeah. Like, because, you know, you, sometimes you might need a little this, sometimes you might need a little of that.
But a huge part of that is understanding the autonomic nervous system and understanding the tools that we have in order to make it balanced.

Denise: Yes.

Jules: Because a balanced autonomic nervous system is the, is truly the key to regulation.

Denise: Is that something that you have them do in their therapy at home, too?

Jules: I try to.

Denise: Okay.

Jules: I don't always get the buy in or compliance at home that I would love to have because I can't control those circumstances.
So I usually will type out for all my patients and I will say, this is. I'm going to use Johnny. Johnny's just going to be the name of the day Johnny therapy Toolkit. And then I will do things like my main four big things are posture, breathing, a good mood, and your periphery. Those are the four things that I feel that if everybody did, they would automatically have a better visual system.

Your posture. The reason why I care about posture is because when everything is aligned in the spine, everything flows better. And when you have better flowing electricity, you have better outcomes. So I tell people, when you think posture, you think sitting up straight or standing up straight. But I'm thinking your posture needs to extend into your neck and up out through the top of your head.

So I ask people, imagine you're sitting on a string, and the string goes up your butt, up your butt, up your spine and out the top of your head. And I go, imagine that that string pulls up and what ends up happening to your body? Everything aligns. And when everything aligns, guess what happens? Your lungs now have room to open to breathe, to send oxygen to your vital organs. What do you think is the most vital organ in your body?

Your brain, Your heart. What do you think? And we'll talk about it and I'll say, okay, after your lungs send oxygen to or fill with oxygen and get renewed. Where does it send the oxygen? Up to your brain. And what's brain tissue? The back of your eyes.
So your eyes are benefiting very, very, very quickly after you take a breath. So let's try it. And I'll tell them, like, I want you to look at the room and see how much space you have to look at.

Now let's take some really big deep breaths and I'll remind them, like, if you look at a glass and you're going to pour water into a glass, where does the water go when you pour it into the glass? Does it hover up at the top, or does it fall straight down to the bottom of the glass? And they're like, oh, well, it goes to the bottom. Yeah. Well, let's think of our lungs like a glass.

Let's fill our lungs from the bottom, not from the top. Because we live in such a stressful state of the universe right now that a lot of people just breathe very shallowly up from the top of their shoulders. And you say to a person like, hey, take a big deep breath. And they, I know your listeners won't be able to see this, but imagine it. And they just inflate their.

Or they, like, make a gesture with their. The top half of their trunk. They're not explaining filling their lungs. So I'll talk to them about how good breathing begets beautiful vision because you're giving energy and food to that part of your body. The food for your eyes is oxygen. So let's fill it. Let's make it happen. 

Then my third thing is good mood. And I'll say, have you ever tried to do something when you're cranky? How does it go if you try to do something and you're cranky? Like, what's the be all end, all of that?

And they're like, it doesn't work out very good. And I'm like, okay. So if we can get our mind in a place where we're thinking about positive things, our outcomes can be more positive. So if somebody comes into me and they have a strabismus, or they have amblyopia, or they have something where they think there's something wrong with them, that's the first thing I'm going to want to try and change.

There's nothing wrong with you. We're just going to help your system work better. We're going to help it work different.
And different doesn't have to be difficult. It's just different. So let's learn what your cool superpower is with your eyeballs, and let's learn how to redirect it and make it to where you can see in 3D and make it to where you can see this, that, and the other thing.

And it starts with, there's nothing wrong with me. My eyes are just going to learn how to do something different because I don't ever want my patient to get this idea that there is something less than about them because they're coming to vision therapy.
Because when I find somebody who's stuck in this self talk spiral of my eyes don't work. My eyes don't work. My eyes don't work. They end up looking for evidence that their eyes don't work.

Denise: Yeah.

Jules: Whereas I want them to change that narrative. And I want them to say, I'm a human whose eyes can work and I'm gonna do exercises so that they can work even better than they work right now. And so we try and change that self narrative. And so my, my reminder for that is good mood. And then my fourth thing is I usually say, look easy and see the whole picture, which is my kind of layperson's term for periphery.

And our peripheral vision is the anchor for our visual system and what I've understood about our peripheral vision. So we have our central vision, which is responsible for detail, and then we have our peripheral vision, which is responsible for movement cues, contrast cues, and it's hugely responsible for helping us know where to go. And it also anchors our entire system. System.

So I will tell them, like, let's, let's break down reading. When you look at a word, your central vision is responsible for that. But your peripheral vision, your side vision, that look easy part is responsible for telling your central vision where to go next.
And if these two parts of your vision are not friends, then we end up having a problem. So we'll have this whole entire thing. 

And I'll make them this little Johnny's vision therapy toolkit. And I'll make these notes and I'll say, time you start doing your home practice, I want you to review and think about, how's my posture, how's my breathing, how's my mental state, how's my periphery? Do I have all of these things locked in and under my control? Because they are all things that are under my control.

They're not your mom's responsibility, they're not your spouse's responsibility, they're not anybody else's, they're yours. And so you can choose to do these things. So when I get people to start thinking about those things, I do find that the compliance and the return on the time investment of doing the home practice does change dramatically.

And I can tell when people don't apply these things. So just know if you're coming to vision therapy with me, I will know. So in, in seeing that shift, especially in regards to safety and kind of getting people having their own personal toolkit. 

If somebody has dry eyes, I'll talk with them about blink rates. A lot of times when you are working really, really hard and you're trying to read or you're trying to do something on the computer, you blink less. Blinking less means less moisture. Less moisture means itchy eyes. Itchy eyes means one more thing your brain has to think about. So I'll talk to people. And it also means dysregulated nervous system because blink rate similar to breathe rate. Breathing rate are all regulated by the autonomic nervous system. So if something's out of balance, we're going to see a knock on effect over time.

Denise: Yes.

Jules: So that's why I do all of that.

Denise: It's amazing that I loved the description of how you get everyone regulated. And I think that's maybe a missing piece for people when they're doing their therapy at home, particularly. Probably in the office as well. But when they're at home and they're frustrated,they need tools to be more regulated.

Jules: I agree. And I think a huge part of like why I choose to use game or I gamify everything is because buy in is different.
When you gamify something, than if something is a chore or if something is mentally bookmarked as work.

That's why I'm very passionate about never calling any home procedure homework. Yeah, I always call it your home activities or your home reinforcement or the games you're going to play later. I try and really make it fit the person, but it's like a less than 1% of the time do I actually call it homework Because I don't want people to view it. I don't want anybody thinking of something that's going to better their life as something that could be in the same connotation as something that's unpleasant.

If something in vision therapy is unpleasant, let's find a new way to do it. I mean, I would say that there's, and this is an exaggeration,50,000 ways to do vision therapy activities. You just have to frame it just the right way so that you're setting up the circumstances. If I understand the baseline activity of something that I'm giving someone and if it's not their vibe and they're just not doing it, I would get better compliance. Changing one thing and speaking to the currency of the person that I'm working with and that would allow me to then get results for this person.

I'll give you an example. I had a patient who was like anti letters and just even in the exam, the doctor was having such a hard time getting this person to respond. And he came in and he's like, he's like, I'm not reading anything and he was just like cranky. And I would, I could tell that this kid had been force fed reading.

And I'm like, well, I'm not here to teach you how to read. And he's like, yes, you are. And I'm like, no, I'm not.

I just went back and forth and I'm like, why am I fighting with a 9 year old? What am I doing? We were just having this little *** for tat and I found out that he loves Pokemon,as many of my patients do. And I just said, okay, well you tell me about your top 10 favorite Pokemon, because. And imagine that you're talking to somebody who's never, ever, ever heard of Pokemon before. And I'm going to pretend that I've never heard anything about Pokemon. You have to tell me about it.

And so he's like, well, my favorite one is this one called Rayquaza. And he's telling me about Rayquaza. And I'm like, oh, hold on, how do you spell that? He's like, I don't know. And I'm like, well, how am I supposed to look it up if you don't know how to spell it? So we went back and forth and then he's like, you're trying to get me to read. And I'm like, no, I'm trying to look up your favorite Pokemon on the Internet.

And so we went back and forth. And so I had him come over, we sat next to my computer and I'm like, okay, help me find the letters that make the sounds for the word Rayquaza. My guess is it starts with an R. What do you think? And we went back and forth and back and forth and we googled Rayquaza and it's spelled very phonetically, which is. I'm so thankful. Pokemon is. Is a phonetic situation. Yeah, but we went through and we sat there and he read with me for 25 minutes.

And I used what I used his currency. Yeah, I didn't use a chart on a wall. Is a chart on the wall a classic vision therapy procedure? Yes, it is. What is the underlying procedure that is with a chart? The underlying procedure is a single fixation point met with an additional saccade. So an I jump to the next single fixation point in succession with a larger jump and then more in succession.

And I'm like, okay, I can get this kid to do it. And so we sat there on my computer and I would point to things. I'd be like, okay, so now tell me about this character. And we would go down And I'm like, okay, now, what does this stuff over here mean about the height and the weight and the like? Why do I care about that? Why should I care? And we went on this whole entire Pokemon diatribe for 25 minutes. And the mom came in afterwards, and she was in tears, and she's like, I've never, ever, ever overheard my kid be so interested in something.

Denise: Wow.

Jules: And I was like, we found his currency.

And what did I do the next week? I spent all this time building charts that had different Pokemon characters and different Pokemon characteristics on them. And we did all kinds of reading. And I put reading in quotes because we weren't actually reading, but we were doing the function of reading so that when he got to school, he would have the skills available to be able to do that.

So that shift in my vision therapy administration, it makes the kids love coming to see me. It makes the kids enjoy the process of learning, because if they can learn more about their favorite Pokemon characters or more about Frozen or more about.
I have a patient right now who loves long words.And so, like, I know how to spell supercalifragious, listicate, spalidocious, and, you know,

pneumo Ultra, like, all those huge volcanic words and everything, because that's what their interest is in. And why should I make them fit my mold? It's their therapy. So I'm getting everything done. I'm getting the results that they need because we're setting up the appropriate circumstances. So if I need to use a game to do it, I mean, I take the game, I throw out the instructions,
because I'm going to make the game fit the procedure that I need for this person to be able to build the skill that they need to build.

So when I did that Spot it lecture, I think I shared 38 or 39 different ways to use Spot it to target different visual needs.
And I think that that's where the art of vision therapy comes in, is finding the way to modify and make it special for that specific person.

Denise: Right?

Jules: And yeah, 

Denise: You probably have a set that addresses the interest of each of the people that you're working with, too, because you have so many sets of Spot It!, right?

Jules: Oh, yes. So because. And because I have all of these different varieties, and because every time I make something new for someone, I save it. And so now I have a whole host of Pokemon things that if the next person comes around and loves Pokemon, we can make that work.

I have a whole set of stuff involved involving dragons, because some kids love dragons, but I have Some adult patients who are incredibly interested in butterflies, so I have a whole thing on butterflies.

I have one guy who's, like, so into instruction manuals for motors. And so I have this whole thing where I created this host of stuff about reading manuals and looking at diagrams of motors, because that's what is his career currency.

I have an older man who had a stroke, and his big thing is he can't tell the difference between different sizes of bolts.
So I went to the hardware store and I bought all these different sizes of nuts and bolts. And I have a distance chart that tells you, oh, you need a 5/8 inch coarse thread. And I don't know anything about this stuff, but I had to. But I learned for that guy.

Denise: Wow.

Jules: And I have this bag of nuts and bolts. And the doctor's like, what is this here for? I'm like, don't worry about it. It's gonna work. And so what I had this guy do was, like, find the nut and bolt that corresponded to the instruction that was on the board that was eight feet away, which was his viewing distance. That was very difficult for him. And then I'd have him screw the nut to the bolt that matched, and it worked.

Denise: That's awesome.

Jules: And so the people leave happy their visual systems are getting the work. And sometimes on a typical vision therapy chart, there's either 60, 25, 64, or 100 letters. Those are your typical a 5 by 5, an 8 by 8, or a 10 by 10.

Denise: Yeah.

Jules: A lot of times the stuff that I end up making, because it's their interest and it doesn't fit into that mold,
they usually end up doing more work. So that's my tricky little thing. But they end up doing more work, more repetitions of that same work. But because it's presented in a way that matters to the person, it flies by like nobody's business, which I'm here for.

Denise: Yeah.

Jules: So I would say you had asked me earlier, like, are there any games or toys that I would say that I use a lot in vision therapy that parents might really love? Spot It! is my favorite. I love that. I love a game called Tap It. It's a battery operated thing, and it flashes different colors of light, and you have to tap it to make the lights turn off. And it's like a competition game. And what I will do is I will set them up around the room and have the kids run to them to find their color. And this is part of that getting their body into a reg. Some people really need movement to become regulated. And when they've sat all day at school, they've used up all their quiet that their body has to offer.

Denise: Yeah.

Jules: And so if I sit there and I give them opportunity to move, they're going to get regulated for me. So tap it. I love a trampoline. A mini trampoline. Love those again. That Z, that Y axis movement, the up and down movement is so good for body reorganization, especially from a proprioceptive perspective. Both feet are hitting the trampoline and sending information up to the brain going, hey, you got two sides. Hey, how about this? And then it also embeds a bunch of rhythm into the body. So I love. I love a trampoline. 

I'm a big, huge fan of balloons. Then playing keepy-uppy and keep the balloon up off the floor. I also love, like, hit the balloon up in the air and say as many. As many colors as you can before it hits the ground. And so we're getting that executive function piece going on and getting them that visual tracking with. With the cognitive component, with the verbal expression, so getting that integrative piece moving as much as humanly possible. And then I'll say to the kids, like, if you look away from the balloon, I take points away. And what is the point system? We don't know what the point system is, but it's gamifying it, right?

It's gamifying it. Can you hit the balloon two times with your right hand and then kick it once with your left hand, Working that bilateral integration in and just kind of being really creative with how you use something like that. There's the company Blue Orange Games has a ton of really, really phenomenal games that are available. My favorite being Dr. Microbe and Dr. Eureka. And those two games are. They're basically exactly the same game just presented in a different way. In Dr. Microbe, you have this little card, and it gives you pictures of microbes. Then you use tweezers to move the microbes from the main dish into your little petri dish for examination. And the first person to build all of their little petri dishes full of these microbes is the winner.

I love it because it has the visual motor integration component, because you're using tweezers, which is embedding the pincer grasp, which is what you need for handwriting. And so I love that piece of it. I love that. We can then take the card that has the microbes that you're supposed to get. We can put it near to near. We can put it near to intermediate.

We can put it near to far. We can overlay it with a colored overlay. In vision therapy we do this quite often. And then we combine it with colored filtered GL classes that can help us to make sure that one eye is getting more information than the other if we need to. So I will combine that with those circumstances. I will say to them, I love doing, changing up the rules of games. And I'll say, like, I need you to build this exact petri dish, this, this exact card. But only the colors can match. None of the shapes can match.

Oh. And so we're working on exclusion principles and go, no-go principles, which are all executive functions. And so we want that visual discrimination component to be there and be very strong so that we're building working memory while we're doing this. I never want any one procedure to be one thing. A good procedure to me is going to hit like six to ten different visual areas.

Denise: Wow.

Jules: That to me is when I've really crafted something that's going to be valuable for a person. So I love Dr. Microbe. I love Dr. Eureka. Dr. Eureka has a very similar premise where you have the little card and then you have to build it, but it has beakers, it has little test tubes and you pour the little molecules from test tube to test tube.And pouring is one of these like absolutely up their skills, whereby the pouring component, you're having to judge depth, you're having to judge timing, you're  having to regulate how much strength and movement you're doing. There's so much value in pouring.

If I had a two year old, they would pour all day long. They would pour rice from this cup to that cup, they would pour and they would help me put leftovers away constantly. And I would just be like, how much spaghetti fits in here? Play. Because volume and concepts of movement happen when you have something that has a direct cause and effect, repercussion. So pouring, if it spills, you know.

Denise: Yeah.

Jules: So if you're, if you're in a place in a wet room, that's where you're gonna play with these things. And that's why I love Dr. Eureka because you have to be precise in your movement of those things. Love those. You know the old game operation?

Denise: Yes.

Jules: Love that. For the same principles, it's a near point of convergence with a visual motor integration component and it has a direct consequence for your actions. It will buzz at you. Now my caution with operation. If you know that you or your child have a retained moral reflex or retained fear paralysis Reflex. This is not the game for you because it's bend that cascade of chemicals up into your brain. It's going to push you into dysregulation. So that's my little caveat for the game operation.

And then I love, like, do you remember playing with jacks?

Denise: Yeah.

Jules: Like when you were a kid, like, I pulled. I ordered a ton of those off of Amazon and kids have never seen this game before. And so I'm teaching them. I know, right? Like, some of these throwback games were so phenomenal for our visual development and for our body development that it was just awesome. So I love that one. There's a game called Pindaloo P I N D A L O O I think.

And it's more for your teenage kids, but it's this curved tube that has like tennis ball bottle caps on either side. You remove the caps and it has a ball inside. And what you have to do is you have to keep the ball going in this constant circle. And it's so good for eye hand coordination. It's so brilliant for body. For body midline regulation and body midline maintenance.

And I just love it. But it's very difficult. So this is for your kid who is really involved in sports or anything like that.
Love that one.And man, I just. I love having games at my disposal.

Denise: Yeah.

Jules: Love, love, love. There's a game that I actually play with a lot of adults called We See O U I S I. I love that game because you're looking at different photographs and trying to find a cognitive way that they can match. So if you have somebody who's dealing with aphasia, which is the, the whole concept of you can't grasp a word or you're having trouble. Like, you can think about the things that you want to think about, but you can't think of the name of it.

This game is phenomenal for that. It's also great. I find it really good with teenagers, too. I'm like, okay, so you're a lawyer and you have to convince me that these two things should be grouped together. Can you explain to me why?

And I might give them like a picture of a fire hydrant and a picture of a baby foot or something. What commonalities do you see here? And I'm really trying to get them to think outside the box because one of the things that happens with our visual skills is we have to have critical analysis.

What is involved in driving. There's tons of critical thinking that's involved in driving. So if I have a teenager and I can get them thinking about why things match or why things don't match, they're going to be better drivers because they're going to be quicker decision makers because they're going to be able to analyze patterns of traffic faster than any other driver on the road.
So if I can do these procedures with them and help their the time between visual acquisition, visual processing and output be faster, then I'm going to enjoy driving on the road with them. I know it's selfish.

Denise: It sounds great to me that we see game.

Jules: Love it. And let's see, what are my other go-tos? There's a little a game for younger kids called Zingo. It's like a little bingo game whereby they give you a three by three grid and then these little tiles and you have to match them well. I just love using the tiles and the play boards for matching or for reading or for memory tools. And I'll show them the board at the beginning of the session and I'll be like, okay, let's make pictures of these in your head. Because I hid them in the room.

And so I'll hide like nine tiles in the room. And throughout the session I'm like, okay, you have 30 seconds to go find your next one. And they search through the room. So we're doing this like whole hidden picture thing in real life. So where's the application of real life? My kid can't find their shoes. Well, now they can.

Denise: Yeah.

Jules: Because we've played this game. My kid is always losing their homework. Well, now they don't because they know how to keep track of things and they're. We're working on this working memory component. A huge part of my and my doctor's building of the program for a person is looking what are the current complaints? Yeah, that the parent has. What, what things are not working at home. And we have a little bit of a weirder.

I mean I use weirder a little loosely but we have a very intense patient history form. It's long. It is long. But we're asking questions about like your child's personal organization. We're talking, we're asking questions about their eye contact, we're asking questions about the foods that they eat. We're asking questions about do they use a fork and knife or do they just use a fork or do you cut their food for them or do they do it themselves?

We ask about, would you describe your child as a clumsy child? Does your child get a lot of bruises? Does your child need to touch a wall as they walk through an area? All of those little teeny, tiny things help us piece together from a vision development perspective, where are the deficits? Because any testing is a snapshot in time. It doesn't give you the whole picture. So we take the snapshot in time, we take the feedback from the parents, and then we take observation.

We actually do it backwards. We do the observation first because we don't want to be biased by the other information.

Denise: Okay.

Jules: Because when we've learned over time that that bias that comes from things that the parents say, it's. It's not always the case. It's just their experience. And it might be that the parent is actually disorganized and the child is actually not disorganized. Like, there. There are times when there are mismatches, and then we have to help the family work together. But, it's really interesting. That's kind of how I like to approach things, is just really make it valuable for the person.

Denise: Yeah.

Jules: And I feel like Sherlock Holmes all the time.

Denise: Yeah. Which is awesome. It's amazing. It keeps everything interesting all the time for you, though.

Jules: It does. And I think that's why we. We have so much success with our patients, is because we're. We're finding these little teeny, tiny gems where we're helping the patient polish them. And at the end of the day, every single kid should leave feeling way better about themselves. Because I'm just sitting there telling them everything good that they did about their day.

Because I. I find this, when a lot of people read, is that I'll say them. They'll read a hundred letters, a chart that has 100 letters on it, and they'll say to me, Ms. Jules, that wasn't good. And I'm sitting there going, okay, whose barometer are you using as to whether or not this is good or not? And I'll say, okay, well, what makes you think that this is not good? And they'll say, well, I missed some.And by my accounts, they missed three out of a hundred. That's 97% correct. But they're only. They're judging themselves based on the three that they missed.

And so I need to find out, like, is this how you view everything? And we'll sit there, and I'll say to them, hey, if I was walking with a hundred. A hundred bubblegum balls in my hands and I dropped three, would you be mad? And they're like, no, you still got 97 pieces of bubble gum. Okay. Awesome. Well, you just read 97 letters and I'm happy about that. Are you happy about that? We talked about that. I really want them to build that sense of what did I do right, not what did I do wrong.

Because the school system, especially my area, is very error focused and not success focused. I read this really brilliant book by Carol Dweck, and I don't know. Do you know Carol Dweck?

Denise: I think I know the book you're talking about. Exactly.

Jules: Yes. It's all about like, mindset and having a growth mindset and everything.

Denise: Yep.

Jules: We try really hard to have that as a motto in our office because there's tons of research done by Carol Dweck. I think she's at Stanford or she was at Stanford at one point, but her whole entire approach to this book was, you know, if, if you have a closed mindset, you limit what you can do, but if you have this growth mindset, this idea of anything's possible, then the way you look at the world changes and your own limitations change because you don't have them anymore. And I think that, that that book was another turning point in my therapeutic journey because I don't have the benefit of an optometric education.

I'm not an optometrist, so I don't think that there's any limitations. You have a six adapter exotropia. Let's try it. Let's do it. Let's build these skills. You have had three strabismus surgeries. Let's try it. Let's do it. We can build this.

You've had 16 concussions. Okay, let's try it. We can only get you better from where you are. Where your starting off point was.

Denise: Right.

Jules: So. And that's very much my viewpoint. Any, any step forward is a step forward, so why wouldn't we take it?

Denise: Yes.

Jules: And you know, any road to recovery is not a straight line. And so as long as you're looking at the end goal and not your. And end goal and individual steps. You gotta be global and, and central, just like you do with your vision. You have to be here for it. So that's kind of my philosophy.

Denise: It's amazing. I think that there are a lot of ideas that people can take from what you've already said and probably not even know what to do with all the ideas that you gave. Honestly.

Jules: Well, hopefully it's not too much of a flood, but I think, I think the main takeaways would be get your body in a regulated state, which is going to mean movement, it's going to mean breathing, it's going to mean good nutrition, it's going to mean good sleep. I read a book called Generation Sleepless, I think it's called.

And that really changed my viewpoint as to how much sleep we should be getting and our kids are not getting. And I'm not getting enough sleep. Our kids are not getting enough sleep. And how are we going to ask them to operate at an optimal level when we're not giving their body the rest that they need? So I think regulation comes from a good routine for sleep.

So nutrition, sleep, posture, breathing, good mood. That mindset piece is phenomenal. And use your periphery as an anchor. See the shape of the world that you are looking at. See the air between you and other things. Interact with the things that you are around.

Play patty cake with your kids. You know, go outside and do jump rope. Take your shoes off and walk in the grass, unless you're in an area where there's lime, then be in a safer place. Lyme disease, it's hard, but that's a whole nother conversation.

But spend time outside, spend time moving. And you know, you and I had this conversation just before we started recording about how important movement is. And you know, and just think about just movement experience. Get away from screens if you can. If I had my way, no one would look at a screen until they were like 7 or 8 years old. But I'm biased because I'm an I lady.

But I think it's definitely there's actionable things that you can do for your family and for yourself. The 20, 20, 20 rule. I don't know if you've talked about it on here before. For every 20 minutes of work that you do, spend at least 20 seconds looking 20ft away.

Denise: Yeah.

Jules: And that is enough for the muscles that live on the inside of your eye to relax. And just like if you did a bicep curl for an hour, your muscle would fatigue. When the muscles on the inside of our eye, they're called the ciliary body, when it gets overworked or it's in a constant state of tension in the same plane for a long time. Just like your bicep would exhaust, it exhausts. And that's when you end up with eye strain, fatigue, pain.

But you can mitigate that every 20 minutes. Pop, pop a timer on every 20 minutes. Look past your computer screen every 20 minutes. Get up, go someplace else. I told my, all my patients, if you work from home, have a tiny glass of water, a tiny glass of whatever you're drinking. Because that's going to force you to get up and leave your workstation.

Denise: Yes.

Jules: And continue to fill it all throughout the day. Because that little tiny glass is going to allow you to have a visual break, it's going to allow you to have a movement break, it's going to allow you to have a mental break. And those things just absolutely push off fatigue. Those little teeny tiny breaks. You think about it, when we work in an office, we get up, we walk to the printer, we get up, we go get a drink, we get up, we go to the bathroom, down the hallway, we get up, we go. Do that. When you're working from home, do that too.

Denise: Right.

Jules: Involve all of those things and think about that for your kids. If your kid's school does not have frequent breaks, bring it up with the teacher. What kind of movement then? That's a question to ask the teacher. What kind of movement breaks do you build into your lesson plan and then just see, what are they doing? Are they getting up and doing jumping jacks?

Are they getting up and playing tag? Are they getting up and doing conga line through the, through the classroom? Like movement breaks, especially for young children from a developmental perspective, need to happen every 15, 20 minutes. It's not reasonable to ask your kid under 12 years old, it's not reasonable to ask your kid to sit and attend for an hour.

It's not in their wiring yet. They're still learning those, those skills. So I would say ask those questions and yeah, try and have meals together as a family. And don't involve screens and meals, you know, because that family time, that bonding time is as good for their visual system as it is for their body, as it is for their mental state. Because when your children watch you eat and they watch you be involved with them, they're going to mirror you.

And there are little things that happen in their brain chemistry. They're literally called mirror neurons. When they watch you do something that's the whole apple doesn't fall very far from the tree is because they're mimicking what you do. So you have a two year old, you have a three year old, you have a four year old sit across from them and eat with them. Don't feed them first and then sit with them and eat. Yeah, it's exhausting. Yes. You have kids, you know, they throw stuff that, it's all over the place.

But that throwing of stuff on the floor is literally them learning the cause and effect of. Oh, I looked there. Oh, I heard it fall. Oh, check it out. I just learned about space.

Denise: Yes.

Jules: And as they're doing it, it's like so, I mean, I could, I could talk for five hours about early childhood development and fun stuff like that and how vision impacts because it's, it's writing the code for the rest of your life.

Denise: Yeah.

Jules: Like, it's so stinking cool. So those would be my takeaways, my friend.

Denise: Awesome. I wanted to share one little thing that came up in the middle of that.

Jules: Please.

Denise: I just thought about it as you were talking in my classes. As I'm teaching college English In China, they're 90 minute classes and they're set up so that in the middle of the 90 minutes, after 45 minutes we have a 10 minute break and my students stop doing their, whatever we're doing in class and they get out their phones and they start playing video games or they're texting someone or some.

It's usually on their phone. They don't stand up. And so my practice in my class is I say, okay, if you're not going to take a break, we're going to keep going because it's pointless for you to just sit there still. So everyone has to stand up and I say, if you need to go to the toilet, go now. And you have to be standing up and doing something besides looking at your phone, put your phone down. Because they've been using their phone in class to look up words or translate even though they're not supposed to.

You know, all the stuff that they do to try and make it through the speaking class and I have to force them to do that because that's not their normal way of being.

Jules: Yeah, I love that you do that.

Denise: Pervasive in all, all society. It's not like we see it only in China or you only see it in the United States. You know, it's, it's just everywhere and we have to get away from the screens.

Jules: Yeah. When you think about it like 30 years ago, and I mean, I'm not trying to be an old fuddy-duddy or anything, but 30 years ago that was not an option because phones weren't a thing. But you had kids moving, people moved more. Right. And I see it a huge difference in my area we have a school system that is very anti screen and very pro movement and they hold off learning letters and things. They learn shapes first and they learn colors and they learn all kinds of, they learn very differently and all of the Kids who come to my practice who go to that school are just so different.

The rates of ADHD are different. The rates of. The rates of oppositional defiance disorder is different. The rates of autism are different. They're all just so different because those kids move. And I'm not saying that there's like a correlation or causation type thing. I don't know the research on that. I would love to look up the research on that, but there's a huge observational difference in kids who move versus kids who don't move.

Denise: Yeah.

Jules: And I would also caution, I would throw this out into the. Throw this log on the fire. We schedule our kids a lot. Yeah. At some point, sometimes it's over scheduling. There needs to be built in time in your skin. Your kids schedule to rest. And that might just be creative play. That might just be quiet time. That might just be like going out and digging in the dirt. But they need to not have every ounce of their days scheduled, and they need to have time to sleep and time to do their homework and time to do their chores and time to do those things. And we know that that structure is good, but over structure is bad.

So it's finding that balance. Just like everything in life is balance and everything in vision therapy is a balance. And that's why I will tell them every week when I assign a home reinforcement technique. I'll say, like, okay, what are your plans for the week? Talk to me about what you can devote to vision therapy this week. Because there are times when grandma comes into town and there are times when there's a family wedding, and there are times when there's a fishing trip or whatever may be, and I make the adjustments.

Okay, so you can't do 20 minutes of home practice this week. Can you do three? Okay, here. Here's your three minute assignment, and we're going to give you something new next week. And I make that adjustment because I'd rather have my patient come in the next week and go, I did my home practice every day than them come in and go, I wasn't able to do anything.

And they're all dejected looking or, you know, feeling like they suck because they didn't do it, or the parent feeling like, oh, man, we're wasting all this money because we weren't able to do it. No, be transparent with me. Talk to me about what you can and cannot do. And we will make the. We'll make the. The changes accordingly. And when I take away that stress of 20 minutes a day, because I would say that, that's the gold standard is 20 minutes a day. And for the majority of Everybody's program, it's 20 minutes a day.

But when you have a big week coming up, tell me so we can talk about it. And I will work with you if you work with me. Because at the end of the day, you have to feel good about what you're doing and do it in a regulated state. Because if you're not, we're not building anything. We're knocking on empty houses. Okay. It's not happening.

Denise: So do you find that if they do the three minutes that it turns into 20 minutes because they just sat down to do something?

Jules: Yeah, it's because you take the pressure off. And that's, that's one of the things that, that I've learned over the years is like 3 minutes of quality vision therapy will overrule 20 minutes of half hearted trash attempt. Yes, I know that that's a harsh word, but, but we've all been there. And, and here's the deal. I had vision therapy when I was 9. Stickers only motivate you so far.

Denise: That's true.

Jules: I, I remember fighting on some of the home practices and I remember loving some of the home practices. So I've been there and I know that certain things are not comfortable. And so, so just because something is difficult doesn't mean that it has to be uncomfortable. We can do difficult things and we can modify a difficult thing to where it's not uncomfortable and we can still do the difficult thing and we can still break through the difficult wall.

And I think that that's a huge thing that I really try and emphasize with my patients. If something is uncomfortable, we're doing something wrong. We should be able to find a nice little teeter totter balance to where it's difficult but not painful.

Denise: Yeah.

Jules: Because if you're pushing into pain, what happens? Chemical cascade. We go into sympathetic processing. We shut down. We're not in a learning state anymore.

Denise: Yeah.

Jules: So everything goes back to that. And I'm constantly trying to keep you on the edge. That learning edge of where are you still learning, but you're pushing the boundary. Because if we go over that boundary, we end up in territory where we have to, we have to backpedal. I'm not a fan of backpedaling. I like forward movement.

Denise: Right, Nice. So if parents were wanting to make things a little more fun at home, they could take any of the games that you suggested, I'm assuming, and, and just play with their children.

Jules: Yeah.

Denise: Or adults could do that too, I suppose.

Jules: Yeah. And I say like try and pick games that are everybody wins. Monopoly is a family killer.

Denise: Yeah.

Jules: Don't pick that. Sorry. Sorry can be a very difficult game. I love Bananagrams. I love the game hues and Q's. Love that game because it's like a group effort to play it. I love Minute to win it games. You can look those up on Pinterest. But there's like Minute to win it games where you stack up marshmallows and there's minute to win it games where you do like table bowling, win with, you know, Dixie cups or something like that. All of those fun family games that you can get everybody involved in.

It becomes vision therapy relevant when you look at what is my kid having to do and is their visual attention guided? Are they doing something with intention or is it trial and error? Like I do this with my nieces and nephews all the time. Their job when they're at my house is finding the right Tupperware to put the leftovers in. And I want it to fill perfectly. And I will happily dirty three or four things so that they have that evidence based learning as they are going through and trying different Tupperwares. And I don't mind cleaning extra Tupperware because it means my family learned something new and their system is going to onboard it. And next time they look at that volume of spaghetti or whatever it is, they're going to say, oh, that's not going to fit in that one.

That's going to fit in that one nice. And I just teach them parallel parking skills in 10 years. Like that's what it is when we do things like filling Tupperware. Think of everything like you're the apex of a triangle. When you do something correctly at near, when you open out and go into big space, you are more likely to do it correctly, add big space because you're the apex of the triangle and the triangle extends out from you.

So that's parking your car. That's playing sports, that's playing tennis and soccer and baseball and doing all of those things. That's, that's walking through a crowded mall and not running into people. That's walking past grandma and not knocking her over. That's being in the china shop and not being the bull. Right. And that's being able to look at something and see, oh, I think that might be heavy just by looking at it instead of having to go over and you know when the kids always say like, oh, can I see that? And they really just want to pick it up and touch it.

That is their visual system failing them. Because you should be able to look at something and go, hmm, I think that'll be heavy. I think it's going to be cold. I think that when it, when I pick it up, it's going to take a lot of energy. I think that when I look at that, it's going to. And you can make all of these inferences based on just looking at something.

And so I play in vision therapy and I play this with my nieces and nephews as well. And I'll say, okay, which one of these do you think is going to be heavier?

Which one do you think is going to feel soft? Which one do you think is going to feel hot? Which one do you think is going to feel cold? Which one do you think is going to be rough?

Which one do you think is. And then we go through and then we come back and then we give evidence to the system. Your hypothesis was, your guess was this was going to be heavy. Come on over here. Talk to me about it. Tell me about this. Is it true? Is what you guessed true? And no, it wasn't. Okay, well what can we learn from that? How does what you see have a mismatch with what you're experiencing right now?

And then we, we talk about it and I don't do this with, with every. I, I will do this with patients who are non verbal and have like severe autism and I'll just be like, touch bumpy and then I'll make them look. No look first touch bumpy. Look first touch soft. And, and then it's, it's building that look first component. Because eyes drive the body. And this is why this is my little bugaboo. When people say hand, eye coordination. Hands don't lead eyes. It's eye, hand coordination. Eyes lead hands.

Denise: Yeah.

Jules: And so think about it. How can you make circumstances in your life where eyes are going to make a judgment first? Where eyes are going to, are going to, to create a movement instead of it being trial and error. Because then pouring will be easier, cutting will be easier, feeding will be easier, writing will be on the line and spaced correctly.

So all of these things have a knock on effect and they all think of yourself. You're the apex of the triangle and everything extends out from you. So vision therapy's cool. And you know I love it.

Denise: I know. And I think we could just go on talking for many more hours.

Jules: It's getting a little come back and talk to you about something. Else if you'd like. It's lovely chatting with you. You're a lot of fun. Although I talked way more than you today.

Denise: Well, that's not unusual. And my goal is always to let my guest share their expertise. And that is exactly what we've had you do today. And I appreciate it so much.

Jules: I love it. Well, thank you so much for having me. It was a lot, A lot of fun and I really appreciate it. And hopefully I can come back and chat with you again.

Denise: Yes, we will definitely need to do that. And I. I can think of so many topics already. We probably could make a list and say, okay, when's the next time you want to come back?

Jules: We'll organize it. Sounds good.

Denise: Thank you.

Jules: Beautiful. Take care.

Denise: Thank you for listening to the Healing Our Sight podcast. I'd love to hear from you. Please share and also join our Facebook community at Healing Our Sight to leave suggestions or comments.

Have a great day.