Vision Therapy diagnosis...now what?

[sixpence1978]

I got the results from my DD's vision screening today. She has some tracking, convergence, and visual memory problems and they recommended VT.

 

So...now what? Should I seek out another opinion by going through an our physician to find an opthalmologist?

 

We are a bit nervous about putting so much money toward something that may or may not work. If she doesn't get VT, she will get prescribed reading glasses to use for close-up work.

[Polly]

You might look at Dianne Craft's website. I haven't used it yet, but we probably will.

 

Polly

[peacefully]

.

[OrganicAnn]

There are many eye 'exercises' you can do at home. You may want to find out how much VT costs. Find out what you can do at home. Then make a decision. I think how severe the problem is would be the most important factor in my decision. Lots of kids have some of these issues that improve with age and a little work, but for some kids with severe problems VT will be the most beneficial. Also some kids respond better to a therapist (take the exercises more seriously and do them more conscientiously).

 

Vision is so important. Good luck with your situation.

[sbaloue]

When my younger son was 5, we were told he needed VT. We had him evaluated at The Illinois Eye Institute. This place WAS the 2nd opinion. The 2nd opinoin results were exactly the same as the 1st doctor's. We found out he had an "eye turn" and the brain was ignoring one eye. We were told the "ignored eye" would continue to get weaker and weaker. So, we made the decision to go ahead with the VT and are glad we did.

 

He had VT for 5 years. It involved patching for 2-8 hours a day,

excerises at home, theraphy and exercises at the office about 1x a week for about 1 year. His vision has improved to where it is nearly equal in both eyes. The theraphy was expensive, I think the office visits were $40/week.

 

Before his first eye exam I knew my son need glasses, but I was shocked at how bad his eyes were. The first thing my almost 5 year old said when he put on his glasses for the first time was, "Thanks for my glasses Mommy, now I can see." :confused:

 

I will be praying for the Lord's leading in this situation. Looking back, we can see how it all worked about, but it was scary facing this.

[wapiti]

I got the results from my DD's vision screening today. She has some tracking, convergence, and visual memory problems and they recommended VT.

 

So...now what? Should I seek out another opinion by going through an our physician to find an opthalmologist?

 

We are a bit nervous about putting so much money toward something that may or may not work. If she doesn't get VT, she will get prescribed reading glasses to use for close-up work.

 

Just fyi, most opthamologists do not do VT. Who did the screening? I'd look for a provider at www.covd.org. You could get a second opinion from such a provider as well.

[sbgrace]

We did vision therapy for my son at age 5. He was very severe in both convergence and tracking. We did get a second opinion. One optometrist told us he was the worst case he'd ever dealt with. At any rate, vision therapy was one of the hardest things I've worked with him on but we were diligent and disciplined to do the assigned exercises every single day. Torture but entirely worth it. His results were fantastic and he has normal tracking and convergence now. I wish I had thought to video the before and after. It still amazes me.

[Giraffe]

I had VT as a young teen, and my brother did too as a pre-teen. My eyes are only slightly near-sighted after years as an accountant (lots of computers and spreadsheets of small numbers). My brother never did need glasses, partially because he did VT at a younger age.

 

My mother is horribly near-sighted, my grandfather needed tri-focals at a comparatively young age, so we believe in VT. You need to find a reputable therapist, but it works.

[CalicoKat]

I got the results from my DD's vision screening today. She has some tracking, convergence, and visual memory problems and they recommended VT.

 

So...now what? Should I seek out another opinion by going through an our physician to find an opthalmologist?

 

We are a bit nervous about putting so much money toward something that may or may not work. If she doesn't get VT, she will get prescribed reading glasses to use for close-up work.

 

We had to go to a developmental optometrist for vision therapy for dd 9. They recommended 12 weeks of therapy (daily homework + 1/wk visit with the therapist). She' just finished her 5th visit and I can already see a difference in her ability to add columns of math during our homeschool time. It's working. It's a ton of work.

[sixpence1978]

Thanks for the responses everybody!

 

We did go to a developmental optometrist who is listed at COVD. They recommended a minimum of 24 therapy sessions with at least 4 days of homework a week. Because we homeschool and can come in during they day we get a little discount ($90 per session).

 

My DD has handwriting and spelling issues. Her reading is slightly behind grade level, but not by much (about a half a year behind). I can't tell a thing about her visual memory, because her memory in general is shaky. AWANAS were almost like torture to her. She did like the games though. :)

 

She was supposed to be repeating 1st this year, but we brought her home to do a 1st/2nd hybrid. I think I'm mostly nervous "put all my eggs in one basket" so to speak. How do I really know that this is what her issue is, and not something else all together? I'm mostly just wanting to help her this year because we really weren't looking forward to ANOTHER year of struggling and frustration.

[RootAnn]

If you know your child is really struggling with school work and your vision assessment showed strongly that your child has issues, I would spend the money on VT, if only for the "minimum" they will let you do. At that point, you will be able to assess how much benefit you have received and most likely, IMO, you will be very glad you did it.

 

And this is coming from someone who had her oldest assessed two years ago and decided NOT to do VT. (I do not regret not doing it then in the slightest. We may re-visit the issue in later years but not with the VT-therapist we originally saw. If you want to read about my daughter's VT assessment and our decision not to do VT, choose the Category "Vision Therapy" on my blog, listed below.)

 

Most people that I know who have done VT do NOT regret it. They were almost all amazed at the difference it made for their dc. Good luck!

[Twinmom]

If you cross-post this on the special needs board and/or just search that board, you will find a wealth of information and opinions on VT. There are many people here who have dealt with this issue...and chosen to address it in different ways.

 

To add a bit to what others have already said, I'll tell you about my DD. She was evaluated for a visual processing disorder at the same age as your DD and found to have significant issues. We chose a doc from covd.org who treated sports vision as well as children's cases and I'm SO glad we did! DD (now 11) did a summer's worth of condensed sessions (3x a week, 2 sessions a day, no homework due to intensity) and came out reading 2-3 grade levels higher than she went in! Many other behavioral/educational improvements were also immediately noticeable...tracking in math and other subjects, reduced anxiety overall, improved ability to do things like clean her room, less car sickness, etc. It was nearly miraculous in her case, magnified by the fact that it happened so fast due to the condensed therapy.

 

You mentioned wondering about other issues...many kids with visual processing problems have an underlying sensory processing (or integration) disorder (SPD). Read or Google either "The Out of Sync Child" or "Sensational Kids" (my personal fav.) for more information...also, there are lots of posts on the special needs board about this issue. This turned out to be the case for my DD, and we later discovered that my twin sons have similar issues. A thorough evaluation by an occupational therapist (OT) who specializes in SPD will give you the answers you need, as well as give you an idea of whether VT is putting the cart before the horse, so to speak. For my DD, VT before OT worked out beautifully, esp. because we used sports VT. For other kids whose parents post on the SN board, it was best addressed in reverse order.

 

Either way, both VT and OT are great options, esp. if both vision and SPD are an issue. VT is pricey, so if you believe your DD has both issues, I'd suggest you get both evals done before you jump into therapy. A good OT can suggest the best order of treatment for your particular child. Generally, doing both OT and VT at the same time is not ideal since the changes it brings can be overwhelming to the child.

 

Good luck, and great job figuring out what is going on with your DD!

[PeterPan]

Sixpence, were you there in the evaluation? The results are pretty obvious and concrete, at least the way my dd's doc analyzed things, so it's not like you need a 2nd opinion. With my dd they ran a computerized test with infrared reading googles to track eye movements. They quantified her issues with converge. It was all very concrete, measured.

 

But what I WOULD make sure of before you start VT is that you have the BEST therapist you can find. You need to talk with other people who have used them, and they should give you referrals. Would you buy a car without researching and asking other owners? The quality of the therapist and the program structure will make a HUGE difference. Your place sounds pretty good honestly, but I'd still ask for referrals.

 

They told you 24 weeks? We did 3 full months, with double sessions once a week and homework EVERY SINGLE DAY, as much as we humanly could. That brought our focusing and convergenece into normal. Her 3D/depth perception still is not right. Now we've started working on the visual processing. At our place they use separate notebooks of materials and supplies, so the processing is a new stage. Mercifully we had a break before this, or we would have been VERY burnt out. It is VERY hard going and very hard work. My dd has low tone (pretty much everywhere), so the eye muscles are trying to tone up as well as learning to work right. They get conflicts between the brain's old methods of processing and new. VT gives my dd headaches. At the beginning they were severe, and now they're short and just unpleasant. It has NOT been pretty or easy. Let's just say the shock of realizing we need another 3-6 months (after the 3 we've already one) has put me into a tailspin. I find myself not even wanting to homeschool, just sit back and do read alouds. Since your dd is so young, I suggest you find the simplest, gentlest, kindest way of getting your schoolwork done to the bare minimum and put your energy into your VT work (and rewards and fun stuff), not guilt-tripping yourself. It's much harder when you have a 6th/7th grader and the looming loads of work you need to prep for. With a 2nd grader, nuts I'd do read alouds, some math, and something like Science Excursion (very hands-on).

 

Ok, now for a few tips. The visual memory deficits mean they don't remember shapes, how words are spelled, how to form letters they're trying to write, etc. Let's just say it still blows my mind the things my dd can't nail, even though I know what's going on. Today she drew a diagramming line for a modifier going to the LEFT. She still can't remember how to form certain letters (especially that uppercase I). Spelling, we won't even go there. So in other words there are things that are going to be DRAMATICALLY when you get through the focusing/convergence stage, and there are things that you have to get through the processing stage of therapy before they improve. That's why I'm saying I would NOT feel the need to remediate her right now. Start AAS with tiles and take it slowly. I would even do a different twist and take this time to do some things she CAN do well that won't be affected by her weaknesses. She's at a great age to learn to type. She might like to take a sport like gymnastics. And yes, my dd also needs OT. We've had her evaluated and are going into the findings stage right now. Your VT will likely tell you if you ought to do that. My dd had all sorts of quirks (hand sore when writing, banging into things a lot, sick on hills, etc.) and it just made for a bunch of dots I couldn't connect. The OT connects all those for you. Turns out not only are there things I understood (vestibular), but there's something called apraxia. Turns out my dd needs a lot more structure and other things I didn't understand. So OT can be very enlightening. We've been doing horseriding this summer to build her core strength and wrist strength. That would be another thing you could do this year. Our instructor has her help groom the horse, which is good for their arm/wrist strength too. My dd finds it makes her feel very good, peaceful, centered. It's something about what it does for the sensory system.

 

Well you're at the start of the journey. Don't be afraid. Just make sure you have the best practitioner you can find and plunge ahead! The differences in my dd after 3 months are STUNNING.

[PeterPan]

BTW, about your reading glasses thing. We did that and I TOTALLY don't recommend it, oh mercy. It was great for the first week. Then we realized that in lessening the strain of focusing (which they do), they relieve the eyes' efforts to bring the eyes into convergence. If your eyes don't converge properly, you see double. Let's just say it was the MOST EXPENSIVE, WORST mistake I have made in a while. (I wanted to say ever, but I could think of some others, lol.) So PLEASE don't do this. Please just get the VT. You don't want reading glasses or what could happen as a result. They let you make that mistake so you can learn for yourself. Don't bother. Go right to therapy.

 

And just for a brief moment I'll diatribe and say that if you see any simplistic answers you're tempted to reach out for, well I don't believe them anymore. I've seen things online ranging from advice to do computer exercises (free) to coloring Dover books to wearing patches to taking special oils to... All those things are actually GOOD! But NONE of them will actually FIX the problems in your dd's eyes. I mean think with me, how is coloring going to change that my dd had no true depth perception??? She couldn't even sound out words because she didn't look at each and every letter in the word. It was torture to do a word search and have to scan a page for things. Now she's AWESOME at word searches, can sound out words, even knows the alphabet (which I didn't realize had not sunk in properly). She can CATCH BALLS!!! It's just unbelievable how things start changing when you get the eyes working right. There are no shortcuts.

[CalicoKat]

Thanks for the responses everybody!

 

We did go to a developmental optometrist who is listed at COVD. They recommended a minimum of 24 therapy sessions with at least 4 days of homework a week. Because we homeschool and can come in during they day we get a little discount ($90 per session).

 

My DD has handwriting and spelling issues. Her reading is slightly behind grade level, but not by much (about a half a year behind). I can't tell a thing about her visual memory, because her memory in general is shaky. AWANAS were almost like torture to her. She did like the games though. :)

 

She was supposed to be repeating 1st this year, but we brought her home to do a 1st/2nd hybrid. I think I'm mostly nervous "put all my eggs in one basket" so to speak. How do I really know that this is what her issue is, and not something else all together? I'm mostly just wanting to help her this year because we really weren't looking forward to ANOTHER year of struggling and frustration.

Ask them after how many weeks should you start to see improvements. If at that time you don't see any changes then a discussion or further research into "what's next."

 

For us the process of helping our daughter has been like peeling an onion. Diet changes. ADHD diagnosis with medication and the myriad of adjustments. Finally VT, no medication, Feingold Diet changes still in place with an occasional cup of coffee.

 

Maturity sometimes is the best thing too in getting to the bottom of things. Nothing like looking for something that you don't want to describe to her but you can't see or feel like she does but you know it's something. Our dd is just starting to be able to tell us what she's feeling, thinking, etc about her ADHD and it's made this more of a partnership to discover how to help her blossom.

 

Although some days it's still a fight, sigh. Good and the bad always together.

[sixpence1978]

Twinmom:

I looked at some information about SPD, and I don't think she has that at all. The only marker she exhibited are not liking the sound of toilets flushing. Nothing else really seemed to fit.

 

OhElizabeth:

This Dr. was the one recommended to me by friends, so that is why we went there.

 

I was there during her exam, so I saw what they did and her responses. First, she did the reading portion with the glasses on. The results showed that her fixations were right about grade level, but could be better. Her regressions were better than grade level, right about the target goal range. Her duration of fixation was low though and her reading rate was low. The evaluated her at a 1.7 grade level. She just started 2nd grade and is a young 7 (July birthday).

 

Then she did the convergence test. One side was close to converging, but the other side was off. After that she had to do some writing. She is very slow with this and the therapist noted that for longer words she had to look at the word several times before finishing it. Then she had to look at some shape pictures and draw them after they were covered up. This she scored low on...at about a 5.9 year old level.

 

After that she did the visual perception test, which she did very well on. She scored above age level.

 

So, she didn't score terribly, but there were some issues.

 

She's reading pretty well, but sometimes guesses or skips words. She also will sometimes say the words out of order. Phonics-wise, she understands a ton, but struggles with vowel sounds.

 

She is currently doing level 1 in AAS and really loving it! She also took horse-riding lessons over the summer, and we were hoping to start up again. Her confidence and maturity soared when she was working with the horses.

 

 

Thanks for giving me much to think about!

[PeterPan]

Sixp, not to scare you, but those stats are where my dd plateaued at. So even though they don't look bad, I wouldn't rest on them or take anything for granted. When my dd was in K5 and 1st, she did very well on perceptual books I got. I would consider her 2E (twice exceptional) and so her strengths were covering her weaknesses. When you're 11 and your visual perception is still at a 5 yo level on the tests, THEN you have a problem. But when she was young, I would have said the same things you did.

 

No, I would not have suspected SPD on my dd, but it's there. You need an OT to sort it out definitively. Our experience with ours has been so enlightening, I highly recommend it. Interestingly, dd says working with the OT makes her feel good, especially the next day. So if the horses made her feel good (by working her sensory system), the OT probably will too, just my guess. That's how it has been with my dd.

[MerryAtHope]

I can relate to how doing VT is a scary step. The only thing I can say is to be glad you discovered this at an early age--it's really not fun for a 13 yo boy to have to go through the exercises! We're seeing progress with them, but it is work, and as you know, expensive. I have looked at some of the other things available out there, but really so much is just a stab in the dark. The exercises are some of the same things my son's VT has him do, but you would just be guessing at which exercises would help & how long to do them and what some things are really supposed to look like when you do them--the info I get from my son's VT is worth the money for the expertise and direction we get.

 

Just our experience! Merry :-)

[Virg]

We have been doing VT although our eye dr gives us eye exercises to do at home as it is much cheaper. After a year of daily eye exercises, my son, who to begin with, had NO depth perception now has perfect stereo vision. According to the experts, that isn't supposed to happen at this age!

 

He still has a small tracking issue (although that has GREATLY improved) and is very far-sighted but we are going to continue our exercises. I would really recommend eye exercises to anyone! We found you can repeat what they do at VT at home daily and not do VT as often.

[sixpence1978]

Thanks guys for all the words of wisdom!

 

In discussing this with my DH, we probably won't be able to start (cost-wise) until January. I'm not terribly happy about having to wait so long, but my DH is the $$ earner and has the last sat,

 

In your opinion, should I be doing anything different in the meantime? Should I go through my DD's pediatrician to find an OT to evaluate her? I still am not convinced that she has SPD, but I guess it wouldn't hurt to get it checked out. Other than just being slower to read and write, she is a very happy girl who really has no issues. She's mostly just frustrated that it takes her longer to "get it" than her friends.

[Julie in AZ]

In your opinion, should I be doing anything different in the meantime?

 

My ds needed vision therapy and we didn't have the $4000 the developmental optometrist was charging. We decided to start with Dianne Craft's vision therapy and have ds re-evaluated. Our plan was to save and pay for vision therapy at that point. After doing the therapy at home, all the problems were corrected! :)

 

I highly recommended Dianne Craft's Brain Integration Therapy Manual while you're waiting. You may find you don't need the extra therapy.

[tenoraddict]

She was evaluated for a visual processing disorder at the same age as your DD and found to have significant issues. We chose a doc from covd.org who treated sports vision as well as children's cases and I'm SO glad we did! DD (now 11) did a summer's worth of condensed sessions (3x a week, 2 sessions a day, no homework due to intensity) and came out reading 2-3 grade levels higher than she went in! Many other behavioral/educational improvements were also immediately noticeable...tracking in math and other subjects, reduced anxiety overall, improved ability to do things like clean her room, less car sickness, etc. It was nearly miraculous in her case, magnified by the fact that it happened so fast due to the condensed therapy.

 

You mentioned wondering about other issues...many kids with visual processing problems have an underlying sensory processing (or integration) disorder (SPD). Read or Google either "The Out of Sync Child" or "Sensational Kids" (my personal fav.) for more information...also, there are lots of posts on the special needs board about this issue. This turned out to be the case for my DD, and we later discovered that my twin sons have similar issues. A thorough evaluation by an occupational therapist (OT) who specializes in SPD will give you the answers you need, as well as give you an idea of whether VT is putting the cart before the horse, so to speak. For my DD, VT before OT worked out beautifully, esp. because we used sports VT. For other kids whose parents post on the SN board, it was best addressed in reverse order.

 

Either way, both VT and OT are great options, esp. if both vision and SPD are an issue. VT is pricey, so if you believe your DD has both issues, I'd suggest you get both evals done before you jump into therapy. A good OT can suggest the best order of treatment for your particular child. Generally, doing both OT and VT at the same time is not ideal since the changes it brings can be overwhelming to the child.

 

I say, "Amen, and amen," to what Twinmom is saying. DS11 did a year of VT 4 years ago, with amazing results. He went from below grade level in reading comprehension to a few grade levels above. Because of his dyslexia, he still struggles with oral fluency, but not nearly to the same extent. He had many issues, focusing among them. After VT, he was focused more in life as well, and much of his hyperactivity disappeared. We were blessed in that our insurance at the time covered most of the cost. Just like physical therapy, VT can be exhausting for the kids. The homework was not fun. But it was soooooo worth it!

 

He and DS7 are about to embark on a year of OT for their underlying Sensory Integration issues. Reading The Out of Sync Child showed me that SID was probably a more accurate diagnosis for my boys than ADHD. DS7 wasn't a VT candidate, even though I had him tested 3 times, hoping for another VT miracle. Unfortunately, we have different insurance now, so we are pulling money out of any place where we might have it squirreled away and will live on rice and beans for a year to pay for it (OK, that's a bit of an exaggeration).

 

I highly recommend VT, but I also highly recommend Dianne Craft. I haven't looked at her vision program, but her Biology of Behavior CD changed our lives (and that's no exaggeration). If you can't afford the VT right now, I'm sure you won't regret looking into anything Dianne has to offer. We're also on a modified Feingold diet, which has helped, too.

 

Be warned that the average cost for an OT assessment is $450, and I've been fighting with my insurance company (a tradition BC/BS plan) for 6 weeks to reimburse it. It's not likely that they will. OT's are often equipped to handle VT issues, so you might be able to do some one-stop shopping if your DD has SID issues as the underlying cause for the VT issues (very common). We don't regret doing the VT and are so very grateful to the OD who treated him, but if we had had the option to treat all of his issues at the same time and place, we would've taken it.

 

By the way, kudos to you 6p, for doing the hard thing ~ drilling down to figure out what's making your DD tick. We just want our boys to be the best possible versions of themselves, and it sounds like that's what you want for your girl, too. Hang in there, Mom. :grouphug: