Just wanted to report the effect OT had on vision therapy types of issues

[Laurie4b]

About 4 years ago, I took ds for first, a vision therapy eval, and then an OT eval. Resource-wise, we couldn't do both, and from advice on this board, we opted for OT. (Ds had severe visual efficiency issues as well as sensory and motor issues). Today, I took him back to the same VT provider, because I wanted to clear up any residual vision efficiency issues and also work on visual processing.

 

The good news is that the visual efficiency issues are nearly remediated. I feel strongly that that is due to OT.

 

We'll work on what is remaining plus the visual processing stuff with the VT.

 

I thought that was worth sharing because these issues do tend to overlap. I thought it might be useful to folks to know that OT, which insurance typically DOES cover, can accomplish a good deal of what VT covers.

[Claire]

I thought that was worth sharing because these issues do tend to overlap. I thought it might be useful to folks to know that OT, which insurance typically DOES cover, can accomplish a good deal of what VT covers.

 

This is very true when visual integration is an underlying cause of the visual efficiency problems. However, it's also possible to have severe visual efficiency problems without any sensory integration issues. This was the case with my dd, who did not qualify for any occupational therapy but who benefited greatly from vision therapy.

[Kathy in MD]

(I feel like I should be hunched over in a rocking chair with a crackly voice and a shawl. :D ) it was OT's who started training the eye muscles. DO's then took the OT's start and developed the field, while the OT's focused more on the other aspects of SID.

 

If someone chooses to go this route, I'd look for an older OT who was trained in the early VT techniques. They need to remember though that insurance often limits the amount of OT coverage. Do you want to delay SID OT for VT? Because unfortunately OT doesn't always concurrently fix SID and dev. vision problems.

[Laurie4b]

LOL on the crackly voice stuff! Actually, the dev. optometrist told me it's not about the eye muscles, it's about the brain telling the eye muscles what to do. They will be doing work on rewiring the brain, just as OT does. (I said the same thing about the eye muscles yesterday, thinking that was a distinction between the tracking stuff and the visual perception stuff.) There is quite an overlap now between what they do in VT and what is done in OT. Not that each area doesn't have their own thing that they are best at, but on a Venn diagram, there would be a big chunk in the middle.

[Laurie4b]

I think you're right that if the only issue appeared to be visual efficiency, that a child wouldn't qualify for OT. On the other hand, visual efficiency often shows up in fine motor skills, such as handwriting issues, which do qualify for OT. It's been my observation over the years I've worked with special needs kids that if a child has one thing wrong, the probablity is that there are other issues as well. So I think that there is a good probability that someone could qualify to see an OT whose kiddo also had tracking issues, etc. and who couldn't afford the out of pocket vision therapy.

 

Our experience was that the OT who first worked with our son worked directly on the tracking issues as well as sensory integration issues. We did this primarily with exercises at home that she prescribed. Our regular optometrist was astounded with the difference when he saw ds after about a year of OT. This was confirmed yesterday by the same VT who tested him in the first place. (In between was a VT on the COVD list who said that he had a whole slew of other problems not indicated by the first VT, who is considered the best in our state.) I don't know if it's accurate to say that sensory integration issues were underlying to our son's visual effeciency issues. There may be multiple things going on.

 

Our other son is just doing VT on a home computer program prescribed by the regular optometrist. He's one of the kids who wouldn't qualify for OT.

[Kathy in MD]

.....Actually, the dev. optometrist told me it's not about the eye muscles, it's about the brain telling the eye muscles what to do. They will be doing work on rewiring the brain, just as OT does. (I said the same thing about the eye muscles yesterday, thinking that was a distinction between the tracking stuff and the visual perception stuff.) There is quite an overlap now between what they do in VT and what is done in OT. Not that each area doesn't have their own thing that they are best at, but on a Venn diagram, there would be a big chunk in the middle.

 

So when an individual is tired and the eyes tend to mess up, it's more of a mental tiredness than a muscular tiredness.

 

BTW, It does make sense that OT and VT can overlap a lot, but in my ds's case, the OT knew he was recieving VT and didn't work on vision problems. My ds finished OT long before he finished VT. Now part of that problem was because ds loved OT and hated VT and fought VT excercises. :(

[Laurie4b]

I really dunno enough yet about the eye muscle thing. Maybe it's both when you're tired? Anyway, she corrected me when I asked about eye muscle testing versus visual perceptual and said it wasn't a problem with the eye muscles but with the brain not telling the muscles to do the right thing.

 

Oh, I hope, hope, hope that ds doesn't hate the VT exercises. We have JUST gotten to a point where his complaining was tapering off significantly...

[NCW]

Thanks for this thread. I'm going to check into this, as it was our OTs who suggested the vision eval.

 

NCW

[Kathy in MD]

Oh, I hope, hope, hope that ds doesn't hate the VT exercises. We have JUST gotten to a point where his complaining was tapering off significantly...

 

had many of his problems remediated. Also my ds had a poor match with his therapist. His first therapist was task oriented (this was assigned and we're going to do it!) and had no sense of humor. I think she was a lot like me :eek:

 

Just try to match personalities, not time slots. I didn't realize that not all therapists are trained to work with reluctant children and went for the convienient time slot.

[Claire]

I really dunno enough yet about the eye muscle thing. Maybe it's both when you're tired? Anyway, she corrected me when I asked about eye muscle testing versus visual perceptual and said it wasn't a problem with the eye muscles but with the brain not telling the muscles to do the right thing. QUOTE]

 

I think it can be both. It's true that VT is all about training the brain. However, I also know that during testing my dd's eye muscles got tired quickly from changing focus (near/far) repeatedly, to the point where they stopped changing at all and gave her consistently blurred vision. I likened it to picking up a brick and setting it down over and over again. If your muscles are weak, eventually they will quit working for you. It may be just accommodation (focusing) that involves weak muscles, though.... I know that convergence is mostly a brain issue.

[Rod Everson]

Here's my two cents worth on this.

 

First penny: VT trains the brain to make proper motor responses and that's the important part, but logically, if muscles are then being used for the first time, or in new ways for the first time, they'll become fatigued just like any other muscle being used in a new way for some time (remember those first situps of the season?)

 

Second penny: I think OT improves vision skills (and therefore reading ability over time) for the same reason that crawling programs, Dore center therapy, Balgau balance board therapy, etc., all seem to be able to claim some success in advancing reading skills. That's because they all work on essential developmental skills. Doing any of them improves the odds that the visual system will also be improved, especially if exercises overlap across therapies. In my opinion, however, by age 8 or 9 the main reading issue will be a poorly developed visual system and rather than leave it to chance that one of the other programs will contribute to a better-functioning visual system, it makes more sense to me to attack the problem directly via vision therapy (assuming, of course, that the need is indicated.) That said, if I had a child who was on a dyslexic track at an early age (3-5 years old, say) I would be putting my money and efforts toward the other therapies, proper exercise, proper diet, and very little or no television/computer game time, especially from birth to age three or so when key vision skills are developing.

 

Rod Everson

OnTrack Reading (The Exercise Piece)