Visual and Auditory therapy....expensive? Does it work?

[ChristusG]

My DD is having trouble reading and she's always had really bad speech issues (she was a late talker and her articulation is not good at all....she's difficult to understand). Aside from that, she also has selective mutism and I believe a mild form of Tourette's.

 

That said, we had her evaluated by someone. Her diagnosis was that she has an auditory and visual processing disorder. The therapy is EXPENSIVE. And we have to drive an hour each way for the therapy....each week. The visual therapy lasts approximately 8 weeks. After that, she will be tested in order to start the auditory therapy. If she scores higher, she will go through the regular program which is once a week for 8 weeks. If she scores low, she will need to go through a remedial type program that is 3x a week for about 5 weeks. :001_huh: And that's an hour drive each way....three times a week. For 5 weeks. :001_huh: And then she'll also have to go through the regular program once a week for 8 weeks afterwards.

 

We have to pay for each and every therapy session, whether it be once a week or three times a week...and it is not cheap. Not to mention the fact that for the auditory part of the program, we will need to pay $900 to lease a computer program (this money does not go to the therapist, but we will be leasing it from the software company who sends weekly updates to the therapist). We will also need to purchase headphones. And if we want to have her tested at the end of the visual part and the end of the auditory part, it is several hundred dollars each. And insurance will not help with it.

 

Does this sound about right? It is so expensive. I want to do whatever it takes to help our daughter and will pay if this sounds right....but I just hope that it helps. I know someone who put two of their daughters through this program and they have nothing but good things to say.

 

I just hope that it helps our daughter's speech and her reading. She's gone to speech therapy for years and years.....and it doesn't seem to have helped at all. I feel like I'm out of options, except for this one.

 

I guess this therapist is supposed to be good....if anyone wants to look at the place it is here: http://www.merrittspeech.com .

 

Does our daughter need to have her vision checked? She's had her hearing checked and it is just fine. Does an opthamologist diagnose visual processing disorders? I thought they just did eye problems and prescriptions.

 

Any advice? Anyone been in this position?

[wapiti]

For listening therapy, I'd probably see an OT or other specialist in the Tomatis method. For vision therapy (not sure what "visual" therapy is?) I'd see an optometrist (and possibly an OT). I would not see a SLP for these particular services or even to screen for them as her website indicates. (Why pay for her to screen for such a thing when you would need to get an evaluation from the optometrist anyway? And some optometrists even do inexpensive screenings themselves?) My gut feeling, without knowing more, is that she's expanding her practice too far outside her original area of expertise.

 

I would, however, see a SLP for FastForward, apparently one of her primary offerings, if that was what I wanted to do. My understanding is that, just like listening therapy and IM, research shows gains to be temporary as a result of FastForward. That doesn't mean it isn't worth doing, but I'd factor that possibility into the cost. I haven't looked into that program in a very long time. You should spend awhile googling on it.

 

FWIW, we were happy with both the results of OT in combination with listening therapy, and vision therapy. But I'd be very careful about what this person is selling. I find it odd that she'd be doing vision therapy without being currently connected with an optometrist's office.

 

To answer your question, vision therapy is very controversial amongst most opthamologists. I would see an optometrist from www.covd.org , preferrably one with the "FCOVD" next to their name.

 

Another thing that sticks out is vision therapy for only 8 weeks. Most programs are months, not weeks - beginning with a 6 month course, with several progress checks with the optometrist himself, seems relatively standard. Some people need longer than 6 months. And the daily vision exercises at home are critical to success.

 

If she has a good listening therapy program, you could ask for the price for that portion separately. But I'd want specifics (more googling).

 

that's my two cents. I know that feeling, grasping for something that might be out there that might fix the problem. But I'd be a little wary based on a quick look at her website (I admit I don't get the point of all the Scripture references - seems irrelevant to me). Plus, little sentences like this one would cause me concern: "The good news for these children is that an auditory discrimination deficit is completely remediable." am I the only one who feels suspicious? But wait, there's more: "She is experienced in the diagnosis and treatment of auditory, visual and motor processing disorders." But she's not an audiologist, she's not an OT, she's not an optometrist, she's a speech therapist who has also done vision therapy, i.e. presumably at some point she implemented a VT program designed by an optometrist.

 

I guess my bottom line would be that if I'm going to pay the big bucks (and I sure have :glare:), it's going to be to someone I am quite certain has the correct tools for the job(s).

 

ETA: a few years ago we went to the Star Center for OT (http://www.starcenter.us/ ) and their thinking was that listening therapy would help facilitate changes in the brain faster if the listening therapy was added to another particular therapy. I believe there were even clients there who brought their speech therapist in to do speech during listening therapy sessions. Maybe is this sort of combination work, various therapies plus the listening, that she's trying to do?

Edited November 10, 2010 by wapiti

[PeterPan]

You might also look at PROMPT.

[VinNY]

My dtr is 9 yrs old, severe CAPD, dyspraxia etc, low memory. We will be pursuing vision therapy after Thanksgiving. She will be going twice a week for 35 sessions ($125 per session). They will evaluate mid session around 8 weeks of therapy. At that time I will start FastForWord with her but through a satellite program which should run around $1400 or so. I have done speech therapy for years also as well as OT, earobics, Brainware Safari. I did Brain Gym religiously last year which helped alot with her tracking. I did the exercises in Dr. Rosner's book for auditory and visual perception skills. She is improving, but unfortunately is not getting up to grade level. She was tested recently and she is performing at a 1st grade level. So in retrospect, I wish I did VT and FF last year and bit the bullet, borrowed money or put it on a charge card.

 

My dtr was evaluated by a COVD dr., but it will be a vision therapist doing the sessions with her. Your dtr is young still, I would work with this woman and get the help now and do the running around while she is young. Maybe they can do the FastForWord program for you offsite to save on gas?

 

Just my 2 cents

[PeterPan]

That brings up a really good point that people don't ask, which is that the therapies stick and work better if you go in an order. I suppose everyone has their own opinion of what that order should be, but just as a base example, they told us you have to work on the vestibular system before you jump to executive function. Basically you're going back to whatever order they develop in childhood. Or for VT, they work on focusing and convergence before they start on processing. If you jump to processing and haven't laid that foundation (getting the eyes to work together correctly), then how will it work? That's why you'll hear stories of things not sticking or kids who memorize the exact skill in the therapy session but couldn't apply it to new scenarios. I've been glad to find therapists who do quite a few things, so they could say which things they would do first and why.

 

And yes, VT has been SO life-changing for us, I probably would have gone to great lengths to get it, even taking a job if necessary. Mercifully, I prayed and the money came in.

[Guest]

 

Does our daughter need to have her vision checked? She's had her hearing checked and it is just fine. Does an opthamologist diagnose visual processing disorders? I thought they just did eye problems and prescriptions.

 

 

 

Having perfect physical hearing is very different from having an auditory processing disorder, which has to do with the brain, not the ears -- it's a problem with processing, understanding, retaining auditory information, not a problem with "hearing" as such.

 

Same thing with vision. A regular optometrist will check eye health and visual acuity (20/20 vision or whatever it actually is), but NOT evaluate problems with focus, convergence, depth perception, peripheral vision, etc.

 

Dd had many problems with vision that completely escaped regular optometry exams, for years. I wouldn't have believed it until I saw with my own eyes how during one test by the vision therapist/optometrist guy she was able to see only one side of a screen he showed her and was unable to see two colors -- she was actually physically closing off vision in one eye because of convergence problems and was seeing in 2-D and only a partial vision frame.

 

I agree with the poster who said that the usual course of visual therapy STARTS with six months, after which there is a follow-up re-examination.

 

All vision therapists are not created equal. You were referred to the COVD site; there's also PAVE, a site for parents about vision education. Do a little bit of reading before you meet and talk with anybody. It will be time well spent.

 

As OhElizabeth says, you certainly won't be alone with the long drives and big expenses. It is truly difficult on both parents and children. We were lucky in our VT and it has all been very worthwhile. Dd learned, at age twelve, to throw and catch and dodge a ball (in about the first three weeks), developed peripheral vision and depth perception for the first time, stopped running into everything and hurting herself all the time, and gained enormously in reading stamina within weeks of completing her therapy.

 

What I would personally be wary of: therapy that is exclusively paper-based or computer-based, unless the therapist has explained clearly and in detail why this is the necessary approach for your child and why other activities for integrating larger motor planning activities and hand coordination with the eye and brain work are not needed in this case. Dd had an earlier round of paper-based VT, for six months and at great expense, which did precisely nothing. Dd herself did not have a reading disability, but many if not most of the kids at our second, wonderful therapists' office did, and none of them were sitting in front of paper, doing pencil work or computer work the entire time. Kids themselves posted stories of what changed for them, and parents were encouraged to mingle and exchange stories, to view through a one-way window, and got to talk with the therapist at every weekly meeting before the therapy began. I think these are all very good signs.

[emonline]

I would like to address the auditory processing issues and speech issues, as I do have experience with both of those issues. First, I would like to inquire whether they are planning on utilizing Fast ForWord for auditory processing? That seems what the website is proposing, but we have done those programs, and they are typically 4-5 days per week for at least 45 minutes per session. I think the intensity of the program is one of the things that is critical to making it work. The FF program originally was 1 1/2 hours per day for 5 days per week. I believe clinical studies then found that similar good results could be accomplished in 45 minutes spread out over additional weeks. (Some have suggested that a much cheaper program -- Earobics -- if used with the same intensity can achieve similar results -- but I do not believe there are actual clinical results to back this up.) We did FF at home, with an initial SLP (speech therapist) consult and computer set-up. It was about the only way we could have possibly fit anything that intense in our schedule. I know a lot of SLPs will allow you to do it at your home, and that reduces their fee, but you will still have the costs associated with the FF program. Regarding speech, there are a lot of reasons a child will have poor articulation. While I am not willing to say FF will absolutely not help articulation, I would suspect that additional, different therapy will most likely be necessary. PROMPT is a good option for many of those with apraxia, or other severe articulation issues (though the therapist does frequently touch your child's mouth with this therapy -- if your child would hate that -- then a different form of speech therapy might be for you).

[HeidiD]

Anyone been in this position?

 

Yes, and by the time ds was diagnosed at 10 yo with CAPD and impaired hearing in one ear, he was already reading at grade level, so expensive therapy wasn't even recommended by the evaluator at that point. Visual processing problems improved over time, as well (for example, he went from not being able to make the letter "p" without the parts of the letter being on different areas of the page to fairly legible printing). His speech improved immensely over time as well.

 

We used a variety of programs at home: LiPS (which I think really helped his speech), Seeing Stars, Visualizing and Verbalizing, Earobics, Lexia reading software, and Handwriting Without Tears.

 

I'm not sure he would benefit from VT at this point, since the only letters he mixes up from time to time are "e" and "i", and since they don't look alike, the confusion appears to indicate more of a mix-up in the "linking letters to sounds department of the brain" :) rather than a visual processing problem.

 

In retrospect, I'm glad we didn't feel pressured to pursue expensive therapies since he's had good results without them (leaving us with more $$ to pay for expensive orthodontic work which has definitely improved his speech clarity).:)

 

My 5 yo may be having difficulty with the sound/letter connection - I'm still watching and waiting, but with the family history, it wouldn't surprise me. In the meantime, I have her working on the Lexia reading program and it seems to be helping a lot. I wouldn't be inclined to put a 5 yo through intensive, expensive therapies, because at that age, they're practically still babies, and I think it would be difficult to achieve the best possible results for your money with a child that young. I would tend to take a more gentle approach and see how she developed in the next year or two and then consider more intensive intervention if still needed. There are so many excellent programs you can use at home, and things can change dramatically from year to year. Just our experience! :)

[Guest]

I wouldn't be inclined to put a 5 yo through intensive, expensive therapies, because at that age, they're practically still babies, and I think it would be difficult to achieve the best possible results for your money with a child that young. I would tend to take a more gentle approach and see how she developed in the next year or two and then consider more intensive intervention if still needed. There are so many excellent programs you can use at home, and things can change dramatically from year to year. Just our experience! :)

 

I'd forgotten the child under discussion was that young! You have a great point, Heidi, especially if much of the concern with visual processing is about reading, and the child is still that young.

 

But also, I remember when I took dd in to the OT and VT at age eight, and they said, "I wish I had gotten her years ago!" So there are some things that it might have been really helpful for us to have pursued earlier if we had known -- at least a really good evaluation so we would have known about the problems of depth perception and peripheral vision. So much of dd's behaviors would have been understandable, particularly her fears; she was also electively mute, and part or even all of it was due to problems tracking fast-moving objects like other kids running around screaming. She just couldn't predict where they were in relation to her own body and was terrified of being run over. (I don't mean to imply the same is the case for other kids; it sounds as though the muteness in this case could have something to do with auditory processing, speech issues, and Tourette's.)

[ChristusG]

Thanks for all of the replies!!

 

See, DD doesn't exhibit some of the signs of a visual processing disorder that I thought would be apparent. She does not run into things, she doesn't seem clumsy, she can catch and throw balls/frisbees pretty well. She DOES, however, have a difficult time with writing a lot of letters and numbers backwards. One time she'll write it facing the left, the next time she'll write it facing the right. There's really no pattern to it.

 

And the reading is especailly difficult since she cannot pronounce consonant blends due to her speech disorder.

 

Someone asked about FastForward, and yes, the therapist will be using that program. She will begin with vision therapy, then move into auditory therapy where she will use FastForward. During this part of the therapy we will do the FastFoward portion at home for 5 days a week (I think) for about 45 - 50 minutes a day (I think). But we will still see the therapist once a week....though I'm not sure why.

 

I'm going to look into some of the other programs that some listed on here.

 

I know DD is young, but that's why I feel like I need to get started on this. I dont want to wait until it is too late. She's been in speech therapy since 20 months old and it hasn't helped one bit. I don't want to just sit back and do nothing and then wait too long.....know what I mean?

[peacefully]

.

[PeterPan]

Couple things. One, they can check for convergence and other issues very easily, even on the very young. You can't eliminate it as an issue just based on comparing yourself to someone else's set of symptoms.

 

Two, an experienced PROMPT therapist may be able to get it to work even for sensory-avoiders and kids who do not generally want to be touched.

[HeidiD]

So there are some things that it might have been really helpful for us to have pursued earlier if we had known -- at least a really good evaluation so we would have known about the problems of depth perception and peripheral vision.

Same here. Two of our kids had the same problems - they were fearful about descending even short stairways - would clutch the wall and proceed very slowly. Were reluctant to ride bikes for fear of tipping over. Had trouble with reading, writing and fine motor tasks. We had their eyes checked and were told that while they needed glasses, their prescriptions were very low. Clearly, there was a lot more going on. :D

[HeidiD]

See, DD doesn't exhibit some of the signs of a visual processing disorder that I thought would be apparent. She does not run into things, she doesn't seem clumsy, she can catch and throw balls/frisbees pretty well. She DOES, however, have a difficult time with writing a lot of letters and numbers backwards. One time she'll write it facing the left, the next time she'll write it facing the right. There's really no pattern to it.

Several years ago, my then five-year-old was writing everything backwards (complete mirror writing). Then his writing morphed into a combination of letters written in the proper direction mixed with reversals. And his numbers were full of reversals. I was really freaked out, particularly by the mirror writing, and was bracing myself for another dyslexic student in our homeschool. But a year later, he was writing everything correctly, and now, three years later, he's reading at a high school level. A certain amount of reversals are not necessarily cause for alarm at that age.

 

 

I'm going to look into some of the other programs that some listed on here.

 

 

Another helpful program is Lexia Cross-Trainer for visual processing. My 5 yo is able to operate this program on her own, as well as the Lexia Primary Reading program. Lexia uses research-based instruction techniques and we've found this software to be really effective.

 

 

She's been in speech therapy since 20 months old and it hasn't helped one bit. I don't want to just sit back and do nothing and then wait too long.....know what I mean?

 

 

Yes, absolutely. Are you seeing a therapist who specializes in APD's? That can really make a difference.

 

Good luck. :001_smile:

[VinNY]

Several years ago, my then five-year-old was writing everything backwards (complete mirror writing). Then his writing morphed into a combination of letters written in the proper direction mixed with reversals. And his numbers were full of reversals. I was really freaked out, particularly by the mirror writing, and was bracing myself for another dyslexic student in our homeschool. But a year later, he was writing everything correctly, and now, three years later, he's reading at a high school level. A certain amount of reversals are not necessarily cause for alarm at that age.

 

This was my dtr but unfortunately she is still reversing and not progressing with her reading and math.

 

 

Another helpful program is Lexia Cross-Trainer for visual processing. My 5 yo is able to operate this program on her own, as well as the Lexia Primary Reading program. Lexia uses research-based instruction techniques and we've found this software to be really effective.

 

Lexia doesn't sell this product anymore. Where did you buy it?

 

 

Yes, absolutely. Are you seeing a therapist who specializes in APD's? That can really make a difference.

 

Good luck. :001_smile:

I agree. My dtr has apraxia and APD and we work with a wonderful PS SLP who addresses these issues. She received training in PROMPT over the summer.

 

Whether to pursue more outside help or not is up to your Mommy gut. I think you wouldn't have driven for the evaluation if you didn't think your dtr needed help that you couldn't provide. I know that I tried alot of in-home therapies to the best of my abilities. My 11yr old boy has language processing,CAPD issues also and was a late talker. He had articulation issues,too. I used Straight Talk for his articulation and was able to remediate those and get him reading by 4th grade. But in retrospect I wish I had him evaluated and received some professional help with him. My 9 yr old dtr is too severe, I need help, now:001_smile:. It is a shame how much therapies cost. I will let you know how things go with VT for us. We start after Thanksgiving.

[PeterPan]

Just as an aside, if the op is interested in PROMPT, it's really unique among therapies in that they recommend only doing it ONCE, maybe twice a week. Traditional speech therapy is done much more frequently and is thus more expensive. With PROMPT they go so intensively, the theory is to do it less days a week and let the brain assimilate it. I'm talking pure PROMPT. So of all the things to try, it's one of the less expensive. And they make a huge emphasis on educating you on how to continue it at home, since of course you're with them more than the therapist.

 

I've been keeping a journal, and really ds' progress is quite fascinating. It literally seems like the concepts mull in his mind and perk out little surprises and bits of progress as the week progresses, even though it was just that one hour of intensive work. I'm doing the parent workshop now, which they developed specifically to help parents better understand the process and implement it in the home.

[HeidiD]

It is a shame how much therapies cost.

 

Isn't it? Exhorbitant costs and not enough long-term studies to ascertain effectiveness (a real sticking point if the costs entail significant financial sacrifice for the family).

 

Regarding Lexia Cross Trainer, I didn't realize they weren't selling it any more (bought it a few years ago). There are other visual and cognitive training software programs on the market, though, and even games designed purely for entertainment apparently have a positive impact on visual processing and hand-eye coordination. I used to think that my kids were wasting their time when they played games like Halo, Medal of Honor, etc., but studies indicate these games help improve processing as well as entertain. :)