Q about Vision Therapy

[Once Again]

What is it and what sort of problems does it help? My 7yodd has PDD-NOS and is struggling to learn how to read, but her eyes check out as 20/20. No headaches. Should I look into it? How expensive is it? We would have to pay out of pocket for it.

[laundrycrisis]

20/20 has nothing to do with whether or not one needs vision therapy. VT is for other problems, such as convergence, tracking and general eye teaming. It seems many optometrists are completely ignorant of these issues - I know our first one was. VT can also address visual processing problems.

 

Check out the COVD page:

http://www.covd.org/

 

VT is not a cure-all. It is very specific treatment for very specific problems. I would run away from any doctor who sells it as anything other than that.

 

The results of our son's VT have been amazing. I can't imagine where he would be today without it. Well, I can imagine, but I don't want to. It has been very expensive and a long hard process. We had to pay out of pocket for all of it. We have spent about $6k over almost two years. But most cases do not take as long as our son's to be done. One course of 18-20 sessions is very often all that is needed. At both doctors he has been under, one of these courses runs about $2k. Some kids only need 10 sessions and are done. Our son is on his third (and final) course of treatment. The first time through, he was coming out of the patching phase for severe amblyopia and his eyes did not team at all. The second time through was for some really bad visual processing problems. Now we are just fine-tuning his convergence/divergence skills. Before VT, his eyes did not work together at all and his brain did not correctly process visual information.

Edited December 28, 2011 by laundrycrisis

[PeterPan]

Well Laundry already gave you a great explanation. I'll just 2nd that you can be 20/20 and still have developmental vision issues. You are probably already clued into this because your ds has a developmental disorder label. You're just checking one more aspect of his development, the vision. It won't turn up problems and they won't recommend therapy if he doesn't need it. If he has issues, they'll be able to quantify them and demonstrate what's going on to your satisfaction. For instance they have this thing called a visa graph that is infrared goggles hooked to a computer. The dc reads and the goggles track their eye movements, allowing them to see and quantify regressions, skipping lines, etc. etc. They have tools to examine eye function (convergence, focusing, etc.) with each eye.

 

Our exam was 2 1/2 hours and $250. I'm guessing that's sort of average. You just have to call around to various COVD docs till you find one you can afford and who you trust. You don't know if he'll need VT till you do the full eval. Although VT is expensive (whew!), it's generally in terms of weeks or months. So for instance our initial run of VT to work on convergence, focusing, tracking, etc. was 3 months. Then we did another two months to work on visual perception (which kicks in naturally for some kids). Your doc may (hopefully will!) give you a written estimate upfront. We paid as we went, so we were always in control and could pause if we weren't happy. So just find a setup you're confident in. IF your dc needs it, it can be life changing.

 

BTW, since your dc has pddnos, have they also been checked for retained primitive reflexes and had an OT/SPD eval? Just asking. Hopefully the COVD doc will check for retained primitive reflexes. Some kids have them, some don't. Sensory integration problems and retained primitive reflexes can create serious roadblocks for the vision therapy. It's one of those things to ask about and deal with. If there's severe sensory integration problems, you can need a more experienced VT.

[Misty]

My 8yr old Aspie daughter began reading fluently within 6 weeks of vision therapy, after struggling for so long. You can usually get a free abbreviated evaluation from a vision therapist.. Just call them and ask.. We are paying out of pocket too, but it's very much worth it. My daughter also has 20/20..

[Walking-Iris]

Would this help something like esotropia? My ds has a right eye that turns inward. He has good eye sight and we've patched and right now he is wearing bifocals for it. But still he has a very "slow" look about his eyes. Hard to explain. Our dr said to start researching surgery...but yikes. He's very sensitive to light---tears up and grimaces and really has a hard time even on a very overcast day. A lot of his stims are visual as well---grimacing/staring at the screens or a picture in a book etc.

 

Just wondering what situations drove those of you to look into VT? Curious? And what sort of things do they do in VT?

[laundrycrisis]

Would this help something like esotropia? My ds has a right eye that turns inward. He has good eye sight and we've patched and right now he is wearing bifocals for it. But still he has a very "slow" look about his eyes. Hard to explain. Our dr said to start researching surgery...but yikes. He's very sensitive to light---tears up and grimaces and really has a hard time even on a very overcast day. A lot of his stims are visual as well---grimacing/staring at the screens or a picture in a book etc.

 

Just wondering what situations drove those of you to look into VT? Curious? And what sort of things do they do in VT?

 

I highly recommend having him examined by a COVD developmental optometrist before you look into surgery. Yes eye turns can be helped with VT sometimes. It depends on why the eye turns.

[Walking-Iris]

I highly recommend having him examined by a COVD developmental optometrist before you look into surgery. Yes eye turns can be helped with VT sometimes. It depends on why the eye turns.

 

I found a VT in a town pretty close to us---going to call this week and get more info. Thanks.

[mamakelly]

My dd did 16 weeks of VT. It was the best money we ever spent. She went from a reluctant frustrated reader, to the sneaky read with a flashlight in her bed kind of reader in a few short months. Our therapy was 100 per session, expensive but worth it!

[Laurie4b]

It's expensive, but you'll need to find out specifically from the practioner in your area. Be aware that there is not good research for it. There is lots of anecdotal evidence in the form of testimonies from people. You'll have to go into it knowing that you may spend thousands without results, or perhaps it will work for you or perhaps something else will change in your child or the environment that will help. For our son, we went into it knowing that it might well be snake oil, but we did the exercises diligently that we were supposed to do at home. It did not help him with his reading at all. His main problem with reading was that he skipped words, phrases, partial lines, etc. That did not change and is still a problem. He did improve his visual motor skills though. We went to the COVD therapist with the best reputation in our state.

 

If your child is having trouble reading, make sure you have a good sense of what the issue is and try research-based interventions first. For instance, you might find that you could invest a portion of the the money in a tutor who uses research-based methods and that his reading improves with that. VT is definitely a 'buyer beware" kind of thing.

[Walking-Iris]

My son isn't having any problems reading etc---I would just love mor einput about his visual stims kwim?

[mamato3 all-boy boys]

Be aware that there is not good research for it. .....His main problem with reading was that he skipped words, phrases, partial lines, etc. That did not change and is still a problem. He did improve his visual motor skills though.

 

Laurie4b, I'm so glad you posted. Most of the posts on VT are all glowing. We are using a computer convergence program that the ophthalmologist recommended for my son. She found he actually had worse problems with convergence than I thought! I decided that for $75 for a computer program, it was worth trying before anything more costly.

 

Although my son has recently become much more interested in reading (I'm not ready to say it is because we've done 3 -4 weeks of this program; I think he just discovered a great book that got him going!), he makes mistakes similar to your son's. So, I'm curious to know what your next step is/was. Have you found some tools or strategies to help him?

 

Blessings,

[Guest oneplaceforspecialneeds]

Both my son and I have gone through it so I can give you a first hand account. I had monocular vision in which each eye is used separately. I went two to three times a week for an hour and a half appt. This last a year and half. Your eyes definitely get a work out, like they have been lifting weights! They will have a lot of fun activities and home exercises like bouncing a ball with one hand and wearing an eye patch, using prism lenses and working your eyes to bring together a picture, near/far vision exercises, etc. I used to have double vision and eye fatigue which was gone after therapy.

 

My son was cross-eyed as an infant and had weak eye muscles. In 3rd grade he started complaining about being tired when reading and losing his place. Since I was familiar with the program, I found a vision place that would let me do the program as homework only with consultation. By 9 months his muscle strength was normal and we were able to discontinue. He is now 13 and has had no lapse in muscle weakness.

 

If you can afford the full intensive treatment, I would highly suggest it. When your vision is not working correctly, your eyes are working twice as hard. Here are some links about vision therapy along with a video showing an example session http://bit.ly/AfN8dC

[PeterPan]

Laurie4b, I'm so glad you posted. Most of the posts on VT are all glowing. We are using a computer convergence program that the ophthalmologist recommended for my son. She found he actually had worse problems with convergence than I thought! I decided that for $75 for a computer program, it was worth trying before anything more costly.

 

Although my son has recently become much more interested in reading (I'm not ready to say it is because we've done 3 -4 weeks of this program; I think he just discovered a great book that got him going!), he makes mistakes similar to your son's. So, I'm curious to know what your next step is/was. Have you found some tools or strategies to help him?

 

Blessings,

 

Alane, nobody replied to this, so I thought I'd jump in. Doing a computer-based program for convergence with an opthamalogist is not the same as doing the therapist-driven, hands-on vision therapy we've been talking about with a developmental optometrist. I know there's an opthmalogist in our area who does VT, and while people *like* her, I've also heard quite a few stories of people whose kids DIDN'T get completely better with her therapy. If you want VT, get a COVD doc. It's their specialty.

 

I also don't understand this whole thing of feeling like you (someone) got sucked in to pay thousands of dollars and then didn't like the outcome. I know we've had some people post about docs who required exorbitant sums upfront, and I HATE THAT. It SHOULD NOT be that way. We were able to pay by the session or by the month (with a discount), as we chose. And we were totally in control to stop at any point if we weren't satisfied. I don't think ANYONE should continue if they aren't happy with the results. We literally saw changes in function from one week to the next, so there's no sitting in the dark wondering. Either you're seeing changes that please you or you're not. If you don't like the doc, the therapist, or the progress, DROP THEM.

 

There's also a huge variance in practitioners. We've had people come on the boards mentioning screwy experiences with therapists who were supposedly certified. We've had people use docs who would do the accommodation, convergence, etc. but never bothered to go on and work on visual perception (where the vision skills get APPLIED and actually change how the child functions in school work). So you want to look at your particular doc, talk with people who've used him, look at the room and see what he has (hands-on, manipulatives, etc.).

 

VT isn't a cure-all and can't cure EVERYTHING. The first thing our VT doc asked was if we were using an OG-based program. If you aren't, time to change. So where Laurie said that she had to pursue good tutoring, I WHOLE-HEARTEDLY agree! In fact, our VT place had to go on to explore more techniques with their clients (PACE, etc.), because some kids *do* need more. The story I was told is that the lead doc's dc at our VT place weren't reading, despite VT, OG, etc. That was why they ended up getting into PACE. So it's not like *one thing* cures everyone. We have to take steps to getting there.

[laundrycrisis]

To add to what OhElizabeth posted - our DS was working with a specialist reading tutor at the same time he was going through VT. It was not one or the other. I would discuss his visual challenges and current VT exercises with his tutor and she would come up with lessons to go along with that. I would take her reports of the problems he was having in his tutoring sessions and tell his VT. Before we started VT it was established that he was having severe difficulties learning to read - over a year of working at it, at an appropriate age, with no progress at all. It was not just a little bit hard for him - it was impossible. The testing that was done was very clinical, and I had full explanations of each specific problem and how it would be addressed. There was never anything going on that I didn't understand or that he wasn't making progress in. And when the progress in VT stops - we pause the therapy for a while. The sessions should be producing measurable improvements.

 

VT is not a substitute for phonemic awareness. If a child needs intensive phonics instruction, VT does not take the place of that. It can only help with the visual parts of it. It also cannot replace therapy for auditory processing problems if those are present.

Edited January 4, 2012 by laundrycrisis