Janice Cook: From piano teacher to optometry advocate

June 15, 2021
After more than 50 years as a piano teacher, Janice Cook’s eyes were opened to the connection between some of her most challenging students’ musical abilities and their underlying—and often undiagnosed—vision issues.
Janice Cook

It’s not often a person has a career-altering epiphany 50 years into their vocation.
But that’s exactly what happened to piano teacher Janice Cook at a music teachers’ conference in 2013 when she happened to catch a presentation on children's vision, vision development, binocular vision problems and eye movement disorders by Shane Foster, O.D. Dr. Foster discussed how these vision problems can influence learning—including the ability to read music. And something in Janice just clicked.

As she describes it, “Dr. Foster kind of rocked my world. His presentation completely changed the way I think about the whole eye vs. ear “controversy” among musicians: some musicians play mainly by ear and may never learn to read music, so therefore they must be auditory learners; some musicians become great readers and never learn to play by ear, so they therefore must be visual learners. But it is not that simple.”

Child frustrating trying to play pianoAfter seeing examples of how a piece of sheet music appears to students suffering from a variety of eye disorders, Janice came to believe that many students were mistakenly being labeled as auditory learners when, in fact, they simply couldn’t see very well—a belief that turned out to be well-founded when a number of her students were formally diagnosed with eye disorders after she persuaded their parents to get them examined by a doctor of optometry.

“Throughout my career, I have struggled mightily to figure out why some students cannot distinguish the difference between a step and a skip after three years of lessons. I used to think, well, there’s a learning disorder here, or an attention deficit, or a behavior problem. Or maybe they're auditory learners. Or maybe they’re just unintuitive or unmotivated. I have even wondered about my own ability to teach kids how to read music. I didn’t have a clue about different types of vision or vision processing problems,” says Janice.

"Kids with an undiagnosed vision disorder often are mislabeled with something else: ADHD, dyslexia, some kind of behavioral issue or learning disability. And they carry that label for the rest of their lives, which can be very influential in the learning process and in their eventual success.” -Dr. Foster

For many young children, one-on-one music lessons are their first exposure to uninterrupted and focused brain work with someone other than a parent. Janice believes this gives music teachers the unique ability to identify when something is standing in the way of a child learning to his or her fullest potential. The trick is knowing what to look for—and what to do about it.

She’s identified a number of red flags that, in her experience, often point toward a vision issue, including:

  • A child not wanting to read out loud.
  • A child who regularly acts out, changes the subject, acts silly or simply puts their head down as a way of deflecting when asked to sight read.
  • A child who relies heavily on memorization because actually looking at a piece of music is just too hard.

As an optometrist who has given presentations on the subject, Dr. Foster agrees with Janice’s list of red flags. He adds, “Kids with an undiagnosed vision disorder often are mislabeled with something else: ADHD, dyslexia, some kind of behavioral issue or learning disability. And they carry that label for the rest of their lives, which can be very influential in the learning process and in their eventual success. But I don't feel that you can diagnose any of these conditions without first having a comprehensive eye exam to rule out a vision problem.”

Janice believes these mischaracterized vision issues can go on to have serious repercussions not just in the way children see the world, but in the way they see themselves—ultimately affecting their self-esteem. That’s why she believes it’s so important that her fellow music teachers—and all teachers for that matter—learn to look at their students’ behaviors through a health lens and push for more rigorous vision testing.

Child playing piano“We want to make sure that parents understand that just because your child can see the board doesn't mean that there's not some kind of health issue with their eyes […] everyone needs a comprehensive eye exam every year—regardless of how you see—to check the health of your eyes.” -Dr. Foster

“The idea of children's personalities being affected by problems that may or may not ever get diagnosed is really profound to me,” explains Janice about her advocacy for comprehensive eye exams for children in that critical five-to seven-year-old age range who are just learning to read. “One of my dreams is that every kindergarten, 1st grade and 2nd grade teacher in the country knows about these things.”

But it’s not all on the teachers’ shoulders. Janice believes that parents need to be more proactive when it comes to their children’s eye health. Again, Dr. Foster concurs, “We want to make sure that parents understand that just because your child can see the board doesn't mean that there's not some kind of health issue with their eyes. And when teachers send home a report that says your kid passed the [school] vision screening, it creates a false sense of security for parents. It doesn't mean they shouldn't still get a comprehensive eye exam. In fact, everyone needs a comprehensive eye exam every year—regardless of how you see—to check the health of your eyes.”

For her part, Janice is doing all she can to encourage proactive eye care among her students, parents, teaching peers and within the larger music community. She states, “This subject has become a passion with me—I am somewhat obsessed and talk about it all the time with other music teachers. But I want to get this topic on the national stage for piano teachers since we are THE ONES who see these issues first, often more so than the parents, because of the focused and uninterrupted work we do with a child. Bottom line: we teach music, and we often change lives in the process.”

Shane Foster, O.D.

Shane Foster, O.D.

Shane Foster, O.D., owns a private practice in Athens, Ohio, where he practices primary care optometry with an interest in specialty contact lenses and children’s vision. He is currently the president-elect of the Ohio Optometric Association and volunteers on the AOA New Technology Committee. Dr. Foster also serves as president of the Ohio Optometric Foundation, which increases access to comprehensive eye care to children through its charitable in-school eye exam program (iSee). Find an AOA doctor of optometry near you.

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