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Vision therapy frequency averages?


displace
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We had the developmental optometrist appt this week at a place that was recommended and was the least inconvenient.

 

The recommendations seemed dramatic. 7 phases x 6 weeks each. First phase 4! Times per week, rest of the time only! 2 times per week. This would be with a toddler in tow (or maybe we'd have to get a babysitter?) for each way one hour drive. It seems to be the standard at this practice as I was given a photo copied sheet with generic schedules on it.

 

Well, after seeing the price tag and doing some research I found one person about a little over an hour away who says they use our insurance for vision therapy. Everyone else said they don't have luck with our insurance and reimbursement. This one person stated on the phone their usual schedule is weekly. Other places stated weekly too. Is the first person's schedule they gave us because we have a severe case? Or are the others not likely to have as good results? Or are tgey just aesome? The first person was board certified and the others were not but they were on the covd website. I know this is dependent on personal diagnoses but 2-4 times per week vs weekly seems super different. Any insights or thoughts?

 

I'm still a little overwhelmed as I'm still on the fence about my beliefs in all of this but definitely if insurance will pay we'll do it. And I already called the insurance and discussed codes and diagnoses with them. And if they don't pay we will still consider doing it. But the commute and time commitment is an issue.

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The homework, done every single day here, was key to our success.

 

I mis-remembered. I think our office was a once a week visit, though they dropped down on even that for my son as time went on. You could ask if they could do less often and let you work at home with assignments.

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Sometimes the eye doc is wrangling with issues we don't anticipate, like parents not following through with homework. That's about the only reason I can fathom for a practitioner wanting so many sessions (4 X/week???).  I mean, can you IMAGINE the cost?!?!  I'd be shocked if insurance would be pay for that.  That's way more than ANY other practice I've seen ANYONE mention on the boards in the years we've been talking about this.  That doesn't mean the doc is a scoundrel, because he may have a reason.  Maybe your ds has some dreadful and unusual issue we don't realize? Maybe the cost per session is low?  (our place was $70 a session and the sessions were 1/2 hour long and that was several years ago) I'm *guessing* it's parental compliance driving this.

 

You can email them and be upfront.  What are the costs for that frequency, how long are the sessions, why so frequent, what happens if you prefer spaced sessions and homework?  We made fine progress going once a week for double sessions (1 hour total) and diligent work with homework.  I'd have to have some seriously compelling reason to do more than that.  We've had people get by with even less.  A good therapist will be faster, more precise, more instructive in correct technique, and help you get through problems.  However once they show you what to do, in reality you CAN do the homework.  

 

Btw, what did they diagnose him with?  Did they find something concrete, physical, and demonstrable like convergence insufficiency?  If there was NOTHING wrong with his tracking, convergence, etc. and they're suggesting massive amounts of therapy, it would be good to ask what in the world the therapy is supposed to be for.  For visual processing issues and dyslexia?  Seriously, make sure you know why they're supposedly treating.  My ds has some visual memory issues, etc., but that doesn't mean spending $$$ on VT right now is the most timely.  It's more important that he make tracks in Barton.  Anything else is a distraction.  As much as I'm a huge fan and advocate of VT, you want to make sure it's really necessary and that it's being done at the right time.

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This sounds like one of the practices that uses machines in the office instead of old fashioned therapy once weekly with a highly trained therapist followed by challenging homework assignments to be done between visits.

 

I got treatment estimates from two different practices - one a machine type place and the other an old fashioned therapy place.  The machine place was more than 2x the cost.   We went with the classic therapy practice, with an outstanding doctor and a fantastic team of therapists. The homework was very challenging but we got through it.  And we did get insurance reimbursement for the convergence insufficiency part of the therapy.  The doctor went to bat for us through two levels of appeals and an external peer review.  The coverage was BCBS IL medical coverage.   In the final analysis, they considered convergence insufficiency to be a medical problem of the eyes.  There are research case studies to defend this position with and the fact that VT is effective treatment for it. 

 

ITA with everything OhE says above.  They should be showing you the test scores for each area tested, and their plan of therapy for each specific issue.  It should take a long time to go through it all, and they should give you a thorough understanding of each problem they are diagnosing.  VT when done properly is very scientific and clinical, but a lay person can understand it if a good doctor or therapist is explaining it.  In fact in the old fashioned type of therapy, the parent has to understand it to take the child through the home assignments and report back on their progress.  If it seems like expensive mystery voodoo, I would not go there.  Especially if they want you to sign any contract of commitment  for a course of treatment, run away. 

 

BTW our son had a huge list of problems - severe amblyopia, many visual motor issues, severe convergence problems, and while only a few specific issues, his visual processing problems were really bad.  His therapy took over two years, which I understand is extremely unusual for it to take that long.  He still never went more than once per week, and it definitely worked.  He started out blind in one eye, with no depth perception, no sense of where he was in space, and completely unable to learn to read.  Now he reads a novel a week, is a very consistent hitter in baseball, and has recently taken up competitive archery.  The old fashioned VT was very effective. 

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Thanks for all the feedback. I didn't ask how the therapy is done as I didn't know there can be differences. Sounds like once a week should be fine. The first person did find convergence insuff (ETA - and multiple other things) which is why I'll be able to seek insurance reimbursement/coverage

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Definitely call them back and ask more questions.  This is very expensive stuff, so it's important to get all the information ahead of time!  You're totally normal, asking questions and then realizing you have more questions.  It's fine.  You want to be an informed consumer.  :)

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You could do a vision test on the developmental optometrist ?

Simply ask them to recall and describe your face?

 

Where you should be concerned, if they say that all that they recall and see ?

Is a  large dollar sign?

Oh man, we are all getting PUNCHY with Friday!!!   :lol:   :lol:  :lol:  

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