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Where should I start? neuronet, VT, neuropsych eval?


Guest Atlmom
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Guest Atlmom

My 7 year old son clearly has issues with writing- he keeps his head down and has no since of spacing or size. He also is having a very difficult time remembering his math facts. He seems to have difficulty with focus and getting him to do spelling words and math worksheets is very difficult! He is reading at a grade level above. We've been told he needs VT (convergence insufficiency, oculomotor dysfunction in pursuits and saccades, and accomodation dysfunction) but we've held off because of pricing. He also has issues with his gross motor and fine motor skills per an OT we worked with. We aren't quite sure what we should pursue next- neuronet, VT or complete a neuropsych eval. Are there things we should do first before moving on to the next? What can we do at home?

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I am not familiar with neuronet but from a website it looks like motor neuro therapy. From other experiences and optometrists views, it may be better to pursue OT prior to VT. They do a lot of bilateral things and crossing midline and may be constructive or similar to the neuronet and VT as well.

 

As for Neuropsych eval, I think that's a more difficult question. Usually with problems my first rec is to do a neuropsych eval. And while waiting for it to get done, go ahead and get ot or optometry Evals. Some health insurances will cover VT for converg insuff so look into it.

 

The OT should be covered at least somewhat by your insurance I would hope.

 

I would start looking into neuropsych testing while getting OT, only because of the struggles with attention and memorization as a lot of things go together (dyslexia with dysgraphia, dyscalculia, maybe giftedness). Others may have different recs like start VT and hold off Neuropsych testing.

 

in the meantime, since you know there is a gross and fine motor problem please limit writing to to 15 min handwriting practice with what you are using for handwriting (like HWT) and scribe for him, unless he wants to write more.

 

Btw, another reason to see Neuropsych is that diagnosis of dysgraphia or whatever is going on. This may not seem 100% necessary now, but is needed for accommodations in school or college later, in testing situations, etc.

 

I know others will give some great advice here!

 

ETA - welcome! :)

 

As far as what to do at home, it would help you to get a copy of the OT report. There's lots of exercises you can do to help at home with gross and fine motor development, but it may be better to focus on his needs. Is his core weak, upper body, global, etc? are there coordination concerns? So then if you use Pinterest or Google "exercises for fine motor", you'll get a lot, like cutting, using playdoh, beading, etc. for coordination concerns, usually sports recommended are swim, karate, and gymnastics. Gym and swim being especially good for upper body workouts too. There are even VT activities you can do at home but obviously there won't be any testing feedback. There are professional VT books on Amazon for optometrists to reference for exercises but anyone can read and buy them.

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My 7 year old son clearly has issues with writing- he keeps his head down and has no since of spacing or size. He also is having a very difficult time remembering his math facts. He seems to have difficulty with focus and getting him to do spelling words and math worksheets is very difficult! He is reading at a grade level above. We've been told he needs VT (convergence insufficiency, oculomotor dysfunction in pursuits and saccades, and accomodation dysfunction) but we've held off because of pricing. He also has issues with his gross motor and fine motor skills per an OT we worked with. We aren't quite sure what we should pursue next- neuronet, VT or complete a neuropsych eval. Are there things we should do first before moving on to the next? What can we do at home?

Given that you clearly have a vision problem and that EVERYTHING builds on vision (the neuropsych eval, his school work, etc.), you should get the VT.  You should continue OT if that is being suggested.  Did the OT find any retained primitive reflexes?  It would be very important to know that and to get them integrated, as they affect the vision.  

 

We saw some improvements with 1 month of VT and RADICAL improvements in 3.  VT literally changed my dd's life.  I would sell things, ask in-laws and relatives for money, take a job, petition your state child medicaid program, whatever it takes to get it done.

 

As far as neuronet and psych, those would be after VT.  *Some* kids find their issues pretty much turn around with VT.  My dd had her neuropsych eval after VT because she still had things remaining.  It takes 3-6 months typically to get into a neuropsych, so you can get the VT completed before you'd even be in to the psych.  My dd seemed to be relearning and surging after VT for about 6 months.  As helpful as a neuropsych eval is, I think it's just common sense to treat obvious vision problems first.  No need to pay almost $2K for a neuropsych to tell you there are vision problems in the mix.

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Bonus tip on the math.  Try using multi-sensory methods.  After you've built the facts and can visualize them (Ronit Bird, c-rods, MUS, whatever), then drill with an app *while reading aloud*.  My dd struggled for years and years where, ironically, my ds with a diagnosed math SLD actually does not.  Now granted he couldn't tell you what comes before 4, but he can say his math facts!  Anyways, a lot of drill is only visual, and my dd (before VT) and your ds don't process properly visually.  My dd actually is VSL because of her ADHD.  However because of her developmental vision problems, she was using her *auditory* to process rather than her vision.  So it's like she was using her weaker processing because what should have been strong was glitchy.  

 

The app I'm using with ds is Fast Facts math.  You can see in my sig we use Ronit Bird for lessons.  So we're spending a lot of time visualizing and understanding and then we read them aloud to get the auditory input during the app.  That's what I should have had my dd doing when she did Flashmaster, Math Shark, the Abeka drills, etc. all those years ago.  That way she would have had the auditory *and* the visual.  

 

Hopefully your VT place will work on visual processing as they improve the convergence, etc.  That can definitely help the visual processing kick in and get that visual memory going.  But still, go multi-sensory.  Have him say them aloud as he reads them on the app.  I like the Fast Facts math app because I can pick which facts show in the set and because I can slow it down enough that he has time to read the equation aloud.

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Guest Atlmom

We didn't really like our OT so we are back at square 1 with OT. Can anyone suggest how I find a good OT that understands all these things? I will definitely move forward with VT.

 

OhElizabeth- we are following montessori curriculum so most of his work is multi-sensory but I haven't explored any computer programs or apps. If you were to recommend one, would it be the fast facts math?

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Directory of Sensory Integration Certified Therapists   This is the SIPT certified link.  It's at least a place to start.  They don't have to be certified, but it will give you leads.  Also look for listings for IM (interactive metronome), BalavisX, or neurofeedback.  Some neurofeedback is done by psychs (very $$) and some is done by OTs.  The one we're doing is Zengar and it's with an OT.  

 

The Fast Facts math is the only one I've used with him, but to me the reason it's working for him is because he's reading them aloud as well as punching the answers.  I think anything you do that combo with would get a similar effect.  Really though, with his visual processing that challenged right now, the stuff using the vision is being affected.  

 

If you can move forward with the VT, that will be great.  Lots of people here have done VT, so we can commiserate with you, cheer you on, whatever.  :)

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   As helpful as a neuropsych eval is, I think it's just common sense to treat obvious vision problems first.  No need to pay almost $2K for a neuropsych to tell you there are vision problems in the mix.

 

I agree with this. You'll be more likely to get accurate NP test results if you try to address the identified issues first as much as possible. You don't want to pay $$$ for a NP to do an eval and then not know whether any low scores are due to visual processing or an underlying LD or both.

 

I just paid $$$ for a NP eval in June and while we got a lot of useful info out of it, it is still TBD whether my DD has any underlying phonological processing issues. Her receptive language impairment is too great at this point for a CTOPP or other phonological processing test to be valid. We have to work on improving her language and then test when she's older if she's still struggling with reading.

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I'm glad you are pursuing VT. I would start that before starting OT, and I would ask the VT people if they want you to do it separately or overlap. We followed VT with OT, but VT gave my son a DRASTIC improvement in coordination because it worked on those brain pathways so much. OT ended up being mostly for sensory. 

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If you can only afford to do one thing at at time, I'd go ahead and do VT. VT will impact and improve all sorts of things. You know he has issues that need to be worked on through VT so it is bound to help.

 

A neuropsych exam will answer a lot of questions and may point you in new directions, but it won't "fix" anything like vision therapy might do.

 

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