Is this: normal? immaturity? or vision tracking issues? (reading advice)

[Amy M]

My 7.5 yo when reading often skips words or guesses at words. He doesn't seem to enjoy reading. I've thought for a long time that maybe he was simply lazy, or that he'd grow out of this, or that he was ready for silent reading, like perhaps he was skipping words because he wanted to read faster in his head. I tried to have him do silent reading, but then he doesn't comprehend the story very well, so I'm pretty sure that he's doing the same skipping or guessing habit that he seems to fall into when reading aloud to me--actually I suspect it's worse in silent reading. He will often skip little words or guess at big words, even when the little words are easy for him or there may be only one big word in a sentence. When I have him go back to the word skipped or mangled, he usually reads it easily and quickly. He can decode just about anything, if I can get him to focus on the word(s) he missed. I try to remind him to follow the words with his finger, and that seems to help, but he doesn't like to do it. 

 

It's sad to me, because I want him to enjoy reading, and his fluency has greatly improved. I am impressed with his phonics skills. But I really think the reason he doesn't enjoy reading, is that he makes so many mistakes through skipping or not careful reading, and so therefore doesn't comprehend the story, and therefore can't really get into a good story. 

 

I was talking to an older homeschooling mom who said that one of her children was just like that, and it turned out that she had tracking issues. One eye was much stronger than the other. She suggested I have an evaluation done. I know there are moms on here who have been down this road. What would you suggest? Does this sound familiar for some sort of vision tracking issue? Or is this something that is normal and will stop on its own if I'm more patient or work differently in some way (what, exactly?) with him?

 

TIA for any thoughts or advice.

[Mergath]

I know that with my six-year-old dd, she tends to skip words when reading books with tiny print and a ton of words on the page.  She can read pretty much anything fluently, so it's not a decoding issue. I think her brain just gets overwhelmed at how much information there is on a page when a book has smaller type and less white space.  I gave her my old Kindle when I got a new one, and if she wants to read a longer, denser book, I just download it onto the Kindle and set the font larger so there are fewer words on a page.

 

 

[bluedarling]

It does sound like a visit to a developmental optometrist is in order.  These can be symptoms of visual tracking issues.  My eldest's symptoms were very similar (mild tracking issues...but the developmental optometrist showed me how being just slightly off is worse than being severely off when it comes to trying to read.)  He also used to flip upside down and refuse to look at the book at times.  While waiting for an appointment, I would suggest just doing reading on flashcards (large print) or reading large sentences on a whiteboard.  Take the stress off, and don't force it.

[OneStepAtATime]

Agree, look for a COVD in your area.  You might be able to locate one through this site.  Get a vision screening that includes a preliminary developmental vision screening (insurance might cover this but many don't cover a full developmental vision evaluation).  At least it would check off a box for possible answers to his issues.

 

http://www.covd.org/

 

 In the meantime, do lots of read alouds with discussion.  Also, why not let him listen to audio books while he builds puzzles or works with legos or something?  I know my kids don't do well just sitting and listening but DS10 especially loves listening to audio books while he works on something else.  It gives him exposure to more advanced vocabulary/concepts/grammar than he could decode easily on his own.  In fact, he listens to books on his Kindle or reads the book while listening to the book and carts that thing all over the house.  He uses headsets (not ear buds) when he doesn't want to disturb someone.

 

But if your child continues to struggle, be aware that the issue may not be vision related.  There are several causes for reading difficulties that have nothing to do with vision whatsoever.  And even if there IS a vision issue, there may still be something else tripping him up.  You might read The Mislabeled Child by Brock and Fernette Eide and Homeschooling Your Struggling Learner by Kathy Kuhl for more ideas.  Also, the Learning Abled Kids website might help.  Good for you for seeking some answers instead of just hoping he will "grow out of it".

 

Good luck and best wishes!

[PeterPan]

Yup, like the others, it sounds like you should get his eyes checked.  A developmental optometrist can do just a regular annual check, the $60 appt, and you can tell him what's going on and ask him to screen.  They *do* have a longer, multi-hour developmental vision exam, and ask part of that they can use the Visagraph (infrared googles) and actually show the tracking of the eyes as he reads and determine if the pattern is normal or needs therapy.  My dd did vision therapy for convergence and tracking issues and got HUGE changes.  It's such an obvious thing to get checked.  Now that we've been that route, I use the developmental optometrist for all three of us (dd, ds, me).  Dh can stay at his old optometrist, but we all use the developmental optometrist.  They want to see the kids every year, just like you go to the dentist, because it allows them to screen and make sure everything is fine.  I started my ds when he was 3 and barely compliant, not talking much, and they could still check him.  He's dyslexic btw, so they're watching to make sure there aren't vision issues that sometimes go along with the dyslexia.  

 

COVD is where you find a developmental optometrist.  Make sure you take your time and find a good one, because of course they vary.  A Fellow is generally a good bet.  We drive about 40 minutes for ours, but it's definitely worth it.

[PeterPan]

Btw, font size was part of what drove us to the developmental optometrist.  Yes you make the font bigger with a small child to make the processing easier.  But she was 10-11 and I was with a group of ladies asking how long kids normally need larger print books...  One of the ladies was an optometrist and she looks at me REALLY FUNNY... and I say Yeah, you know, getting the larger size so the books are more comfortable to read, how long do they need that?  So we got her eyes checked by a regular optometrist who just said her focusing was slow and gave her reading glasses.  THAT was a huge mistake and SHOULD have been our big flag to go to a developmental optometrist.  The reading glasses eased the strain, yes, but the straining was what helped her eyes convergence.  Once that straining was removed, she started having HORRIBLE headaches.  Took VT to improve the convergence, and now she just wears bifocal contacts.

 

Anyways, that's just our little story/saga.

[Amy M]

I am in South Africa, but I think I can find a children's optometrist or opthamologist (sp?) about 75 minutes away. How do I know if they're just putting a "patch" on a worse problem, such as recommending glasses when he needs therapy? Should I go to an optometrist or opthamologist? Thanks so much for your thoughts.

[PeterPan]

Locate a Doctor  Try this link.  The doctor locator on COVD.org pops up 6 developmental optometrists in South Africa.  An optham. is a surgeon, and frankly they're often going to poo-poo it.  You're better off going to the developmental optometrist.  

 

Vision therapy doesn't replace the need for glasses.  Both my dc have astigmatism and still need glasses.  The red flag is if the doc suggests *reading glasses* to see if it solves the symptoms.  That's when you should ask why and whether it's something that would be better treated with VT.  

 

A developmental optometrist will sometimes do a blend, using prism lenses or different things in addition to therapy or trying certain things first.  So the main thing is to find a doc who seems to have a good reputation.  

[bluedarling]

I am in South Africa, but I think I can find a children's optometrist or opthamologist (sp?) about 75 minutes away. How do I know if they're just putting a "patch" on a worse problem, such as recommending glasses when he needs therapy? Should I go to an optometrist or opthamologist? Thanks so much for your thoughts.

 

A developmental optometrist is someone who has special training in vision therapy and visual processing disorders.  Not every optometrist has this training....only a few.  I have been to regular optometrists who were able to screen for this and send us to a developmental optometrist, but most don't from my experience.   If they say "vision therapy" on their website/advertisement, there's a good chance they can do at least a preliminary screen, but you really want one of the covd doctors.    Also, we saw a total of three different people for vision therapy.  The first one was extremely expensive, and only did 6 week or 12 week programs.  It was not enough to create permanent change.  The second was a specialized chiropractor who did Interactive Metronome and few eye exercises....that was not enough, either (though our final doctor said it was a really good start.)   Our final doctor did a 6-18 month program!  and he didn't do the therapy himself (but trained someone to do it) so that the cost stayed affordable....he did periodic checks for improvement.  His exams were extremely thorough, and I loved the way he did things.   When there are so few doctors to do this, finding a good one may be tough!  Keep looking, though. 

[Rod Everson]

I am in South Africa, but I think I can find a children's optometrist or opthamologist (sp?) about 75 minutes away. How do I know if they're just putting a "patch" on a worse problem, such as recommending glasses when he needs therapy? Should I go to an optometrist or opthamologist? Thanks so much for your thoughts.

 

Elizabeth is giving you good advice, particularly the links to the COVD optometrists. Don't go to an ophthalmologist as they usually have a real distrust of vision therapy. The children's optometrist also won't necessarily be much better unless he or she assesses children for vision therapy. In fact, if the optometrist doesn't refer regularly, you're probably going to be advised that vision therapy is a waste of money, or some such explanation. 

 

Assuming you do locate a developmental optometrist here's a page on my website that you should find useful: Find a Vision Therapy Provider. By the way, if none of the COVD optometrists are located near enough to you, try calling a couple of them to see if they can refer you to someone closer who does vision therapy. Also, in South Africa they could be called orthoptists and their specialty could be referred to as orthoptics. (Checking a search engine, it appears that's the case. For example, the Pretoria Eye Institute lists a Kate Housley as an orthoptist who treats eye movement disorders, which is what you're looking for.)

 

Rod Everson

OnTrack Reading

[Amy M]

Elizabeth is giving you good advice, particularly the links to the COVD optometrists. Don't go to an ophthalmologist as they usually have a real distrust of vision therapy. The children's optometrist also won't necessarily be much better unless he or she assesses children for vision therapy. In fact, if the optometrist doesn't refer regularly, you're probably going to be advised that vision therapy is a waste of money, or some such explanation. 

 

Assuming you do locate a developmental optometrist here's a page on my website that you should find useful: Find a Vision Therapy Provider. By the way, if none of the COVD optometrists are located near enough to you, try calling a couple of them to see if they can refer you to someone closer who does vision therapy. Also, in South Africa they could be called orthoptists and their specialty could be referred to as orthoptics. (Checking a search engine, it appears that's the case. For example, the Pretoria Eye Institute list a Kate Housley as an orthoptist who treats eye movement disorders, which is what you're looking for.)

 

Rod Everson

OnTrack Reading

This is incredibly helpful. Thank you ever so much!

[runninl8]

Amy, I was going through this with my 7.5 year old too, and I picked up Phonic Pathways. I wanted to really work on the tracking with him and decided if he didn't do better by December, I would get his eyes checked. After 4 weeks with PP, my son is now reading at a third grade level...I kid you not. Everything you described about your son, sounds like mine. We are still working on following the word from beginig to end here and there, but he is LIGHT years from where he was just a month ago. It is a very inexpensive book. I would recommend it even if it is alongside vision therapy.

[Rod Everson]

Amy, I was going through this with my 7.5 year old too, and I picked up Phonic Pathways. I wanted to really work on the tracking with him and decided if he didn't do better by December, I would get his eyes checked. After 4 weeks with PP, my son is now reading at a third grade level...I kid you not.

 

People tend to hold two misconceptions about vision skills issues:

 

1) It's not necessarily true that vision skills problems will keep a child from learning to read. In fact, many kids with vision issues can learn to read. However, they tend to either avoid reading, or are uncomfortable when they do read. Nevertheless, a good phonics program can often work with a vision-challenged child.

 

2) It's not true that vision therapy teaches a child to read. Instead, vision therapy prepares a child to read. The child still has to learn the process. With vision issues addressed, often almost any curriculum will get the job done. After all, as weak as many public school reading curricula are, most kids still learn to read.

 

The reason I bring these up is that you might consider the first one. If your son was struggling, he might still have a vision issue that you'd be better off addressing while he's young. Maybe he doesn't, especially if you see no obvious symptoms (although struggling with early reading is one such symptom), but at a minimum I would get him at least one regular eye exam by a developmental optometrist to see if something surfaces in the exam. 

 

In fact, I recommend that to any parent who has a child who is struggling to learn to read. First, have a developmental optometrist rule out vision issues before spending a lot of time and money on other avenues of investigation. Besides, reading instruction will usually go much easier once any vision issues have been addressed, especially if they're addressed before a child has become frustrated by a lack of progress.

 

In case you find it useful, here's a checklist that I put together for parents to use when trying to decide if their child might have vision skills problems: Vision Assessment Checklist

 

And I'm glad you found a program that works for you, by the way.

[ElizabethB]

I would get the vision checked out.

 

But, another possibility is that the sentences and stories are encouraging guessing, work on just word lists and syllables for a few months and see if that helps. Also, I like to use all uppercase and large letters on a whiteboard or paper, especially for my younger students. You can use the things on my how to tutor page, but not the sentences or stories, just the word lists and spelling and syllables.

 

http://www.thephonicspage.org/On%20Reading/howtotutor.html

[Amy M]

We're on holiday right now in Durban, so we've made several calls and have an appointment for my 7 and 5 yo Monday morning with an optometrist who supposedly also does vision therapy. We'll see what comes of it. I'm a little nervous, as I have no idea how good he is or what to expect. He was described to us by another office referred to us by a COVD doctor (this is the third link in a chain of referrals now...) as an "academic," because he teaches and writes on the subjects as well. Anyway, it's $40 for each child for a 45 minute evaluation. Does that sound right? (not the price--I know that's great! At that price I could always get a second opinion!) Anyway, we've talked to probably 6 offices right now, and they're all booked through the time we will leave for our home 14 hours away, so we're gonna take this chance. Would appreciate your prayers for wisdom and clarity on the matter!

 

As far as another phonics program goes, I'm pretty happy with Abeka, which is what I've used for K-2nd grade. We're almost done with 2nd grade now, and he is reading very well...except for the skipping/guessing habits, which I wanted help with. I don't think another phonics program will help too much actually (we also use AAS for spelling). If I continue with phonics, I plan to use Elizabeth's site if I can figure it out. ;)

[Rod Everson]

 

Your child's eyes can be checked by any optometrist or ophthalmologist- of course vision can be an issue for kids. 

 

That is not the case when it comes to having a child's visual skills evaluated, mainly because ophthalmologists, and most optometrists as well, simply don't treat vision skills deficits, and they certainly don't treat them with vision therapy.

 

In the case of optometrists there's also the consideration that vision issues tend to run in families, so a referral to another office that does do vision therapy risks losing an entire family of patients if they then switch optometrists, as they often will be inclined to do. Rather than take that risk, most optometrists (not all, but most) just don't do the sort of extensive and sustained testing required to sort out vision skills issues. Sure, they see the most obvious problems, and might even refer in those cases, but they aren't inclined to diagnose what they don't treat, so the majority of vision skills problems end up going undiagnosed, and therefore untreated.

 

For a longer explanation see: Why Such a Secret?

[Amy M]

That is not the case when it comes to having a child's visual skills evaluated, mainly because ophthalmologists, and most optometrists as well, simply don't treat vision skills deficits, and they certainly don't treat them with vision therapy.

 

In the case of optometrists there's also the consideration that vision issues tend to run in families, so a referral to another office that does do vision therapy risks losing an entire family of patients if they then switch optometrists, as they often will be inclined to do. Rather than take that risk, most optometrists (not all, but most) just don't do the sort of extensive and sustained testing required to sort out vision skills issues. Sure, they see the most obvious problems, and might even refer in those cases, but they aren't inclined to diagnose what they don't treat, so the majority of vision skills problems end up going undiagnosed, and therefore untreated.

 

For a longer explanation see: Why Such a Secret?

 

Helpful article, thank you. From your assessment, does it sound like a 30-45 minute exam could sufficiently find the vision problems described as needing therapy?

[Rod Everson]

Helpful article, thank you. From your assessment, does it sound like a 30-45 minute exam could sufficiently find the vision problems described as needing therapy?

 

If it's done by a developmental optometrist, or possibly an orthoptist in your country, I would say yes. If the OD finds problems, however, the followup testing is likely to be considerably longer (an hour or two.) The purpose of the additional testing would be to indicate areas that need therapy and to establish baselines in various vision skills including visual perceptual skills. They might do things differently there, however.

[PeterPan]

Helpful article, thank you. From your assessment, does it sound like a 30-45 minute exam could sufficiently find the vision problems described as needing therapy?

I'm sure every doc has their own way of doing things.  At the place we use, there's a regular vision exam (you know, like to check for glasses), and they *screen* for the developmental vision problems.  That tends to be a 30-40 min. appt, as you're saying, and they do it in their children's office where they can really slow down and focus on the kids and get them comfortable.  (The main office is MUCH faster-paced!)  When they do a developmental vision exam, they spend 2 1/2 hours, again at that slower-paced children's office.  They listen to you, do multiple kinds of visual perception testing, test all the ocular motor stuff (convergence, tracking, focusing, depth perception, etc.), and run a test on the Visagraph with infrared goggles to check tracking.  

 

In reality, if they were being really clippy about it, yes they could get in, run the basics, and get out in a shorter amount of time.  You just have to see what this doc is planning on doing.  I'm not sure what you mean about going home.  Where is home and how long will you be there?  No point getting an eval with a doc who won't be the doc you stick with for therapy. 

 

Maybe this doc is less expensive because he's a professor or something?  Those kind of appts tend to be less because a student is doing part of the work.

[bluedarling]

Our experience was similar to O Eliz.  Our therapy doc did a free 30 minute screening.  The full eval was 2-3 hours, and expensive!  I had my girls screened after my boys had issues, and they still recommended a full eval, even if the screening didn't pick up issues, since the full eval can pick up issues not found during a screening.  (We didn't do it, though.)  The screening will tell you if there are obvious issues....both boys had obvious issues with tracking, but additional issues were picked up for one son during the full eval.  Anyway, a 30-45 min appt is a start...if they find obvious issues you will know you are on the right path.  If there are no obvious issues, then you have to decide if its worth pursuing a full eval.  

[Amy M]

 

In reality, if they were being really clippy about it, yes they could get in, run the basics, and get out in a shorter amount of time.  You just have to see what this doc is planning on doing.  I'm not sure what you mean about going home.  Where is home and how long will you be there?  No point getting an eval with a doc who won't be the doc you stick with for therapy. 

 

Maybe this doc is less expensive because he's a professor or something?  Those kind of appts tend to be less because a student is doing part of the work.

 

The point in having the evaluation done here is that I am not sure if there will be anyone able to do it up where we live (in the poorest province of S. Africa).  If it is the case that we might have to drive 5 hours to Johannesburg to have it done or for therapy, we'll have to cross that bridge when we come to it. At least the evaluation could be done while we're in a big city, IYKWIM, but maybe this isn't something Americans can relate to... (I'm American, and there's just a big difference between all of the services available in other countries as compared with the US.) That also answers the second question perhaps. All medical work is much cheaper over here. I just had oral surgery this year with a specialist for $80. :) Positives and negatives to having medical issues here! 

[Caribbean Queen]

Sounds normal to me. 

[PeterPan]

Let us know how it goes!  :)

[Amy M]

Let us know how it goes!   :)

 

Thanks for asking! The optometrist wrote a prescription for reading glasses for my oldest. He said I should see an instant change in his reading using glasses. We have a more intensive evaluation scheduled for tomorrow that includes an eye movement assessment or something like that. If they say the same thing, I'm done spending money (except for glasses). :)