Convince me to try VT (or not)

[PhotoGal]

Ds has some convergence issues (as identified by his eye doctor). They don't seem to be extreme. He used to say that he saw double, but now he doesn't. He does say that he sometimes has trouble knowing what line he is reading in a chapter book. He much prefers comic books and doesn't often read chapter books for fun, though his reading level is high.

 

His eye doctor suggested prism glasses and "pencil pushups," which we have been doing, but from what research I could find online it seems that these aren't really effective.

 

VT testing will cost around $400 around here, with each visit being around $100. I am hesitant to do it for that reason, but I also think if we have the funds we should at least do the testing. On the other hand, his issues don't seem to affect him greatly. I am hoping that VT would help him enjoy chapter books and maybe improve his handwriting? I've seen many people post here that it helped their children, so I am really tempted.

 

So what do you think? Is it worth it for a mild case like this? Any opinion on prism glasses/pencil pushups? Other thoughts?

[Dobela]

It can only help in my opinion. VT made a dramatic difference in my child's life. Did you know that some pro football teams have their quarterbacks and receivers have vision therapy to improve their accuracy?

[amo_mea_filiis.]

We did 6 months since that was the span my insurance covered. I don't know if reducing his overall eye strain (home vs ps), occupational therapy, or maturity played a part, but in that time, ds made a lot of improvement. His reading jumped from CVC words to Dr Suess books, Fly Guy, and A to Z mysteries.

 

When the 6 months were up, ds did not want to go back. His OT started doing some vision activities.

[LittleIzumi]

It made a huge different in my dd with convergence issues (and tracking issues). HUGE.

[SKL]

My kid was age 3-4 when she went for therapy, but it made a huge difference for her as well. She was making extremely slow progress before, and afterwards shot to almost the head of her class in reading. Even though I paid 100% out of pocket, it was worth it and then some.

[PeterPan]

The quality of VT totally depends on who's doing it. This gets discussed on the SN board, and we've had people with astounding stories (like ours, like Dobela's, etc.), and then we've had stories that make you sick to your stomach with the money the doc was willing to take without actually doing any good.

 

Let me make sure I'm understanding. You're saying you found a developmental optometrist through COVD or another doc? And this COVD doc wants to put him in the prism glasses and do pencil push-ups? And he's going to do this for 4 sessions for a total of $400 plus presumably the cost of glasses?

 

I'm just asking, because that's NOTHING like the VT we did. We had a COVD-certified vision therapist. We did two sessions a week for months. We had lots and lots and lots of exercises. Prism glasses are only for specific cases, not run of the mill. I wouldn't even have expected them in your case. And our practice has a Fellow with COVD who writes for textbooks.

 

I'm just saying it's not all equal. I'm all for good VT. Pencil push-ups are not the extent of VT. I'd do some extreme checking before I plunked out money in your case. Make sure of what you're getting. Look on COVD's list and do some calling around. I'd drive farther but get someone really good that you only see once a month, rather than using someone not on the list or who is questionable that you see more often. Yes a good doc can usually give a written estimate upfront. What it sounds like you might have is an opthamologist, not a developmental optometrist. There are some opthm. who will try to do VT. Feedback I've heard around here is questionable. I recommend the developmental optometrist.

 

But maybe I'm not understanding your situation. Yes I'm all for VT, but make sure of what you're getting. ;)

[jujsky]

I would caution you to find a GOOD VT place if you're going to do it. Pay as you go. Don't sign a contract or commit to X amount of visits. Do not go to a place that primarily does their therapy on the computer and gives you no homework to do with your child.

 

I think it CAN work, but we had a bad experience with it. $2,000 and 6 months later, I saw only minimal improvements in DS that could have been due to naturally maturing in that time period. There are good and bad places. I felt pressured into using a bad place because it was the only place even close to my area. We would have been better off not bothering.

 

Edited to add: It is entirely possible that his handwriting is a coordination issue and your child could benefit from OT. See if your insurance will cover an OT evaluation to see if that is in fact the issue. OT is often covered by insurance whereas VT is not.

Edited July 15, 2012 by jujsky

[Parrothead]

From my understanding VT can help a great deal. But it may not help your ds be a reader. He is young yet for that. Also boys notoriously have bad handwriting.

 

If he needs VT to help his sight issues then go for it. But to help him become a reader you should read to him, co-read and make reading fun.

[PeterPan]

VT can radically affect reading and handwriting when convergence was part of the problem. Like jujsky says, doesn't eliminate the need for OT. A good VT doc will refer you off for that too; ours did.

 

As far as insurance, we have a high deductible and HSA (which we like), but when the VT place filed it the insurance *covered* it in the sense that it was an expense they would have covered under our policy if we hit our deductible. It brought the price down for those covered segments (not all but some) even though we were still paying for it with our HSA (health savings account). Other people have gotten the state child health system to pay for VT. It's increasingly recognized as medically necessary, especially when you had medical symptoms going in (headaches, etc.) vs. just school symptoms. Your particular practice will tell you upfront what they're successful getting insurance to cover.

[PhotoGal]

Thank you all for your advice so far!

 

I'm sorry it is a little confusing because I think our situation is a little unusual. So the kids' regular eye doctor noticed the convergence problem. She is not with COVD and doesn't even do VT. Her bio says she "has experience with binocular vision, perceptual skills and pediatric optometry." She gave us the prism glasses and recommend the pencil pushups. She did not say anything about VT, but after doing some research I wondered if it would be best to find out more about it. It seems like prism glasses and pencil pushups aren't really effective (?).

 

The Dr. who does VT was recommended by a few other homeschool parents. She is a fellow with COVD. I think we would be in good hands with her (at least as far as I can tell!). But since ds doesn't have many symptoms (no headaches, no longer has double vision, doesn't rub his eyes), I don't know if we will see any difference after therapy. On the other hand, he definitely does have a problem with his eyes working together. When we do the pencil push ups, his eyes sometimes move out again at slightly different times or seem to wiggle a little first. Something is definitely going on there!

[Dobela]

Lots of great advice so far! My son saw a COVD and VT with tracking issues, convergence issues, and more. What surprised me was learning that he was not consistently seeing in 3D. It was very difficult work and honestly the results were far more than we ever dreamed. Looking back we didn't realize just how much his vision was effecting other issues. He wasn't complaining of headaches, or double vision, or anything else before we began so I don't know just how he was seeing. He did however have all the other signs and symptoms on the list at covd.org. He was receiving OT prior to VT and it had not been successful for us. One, she was not that great and didn't supervise the assstant as she should have, and two, she refused to acknowledge the vision issues we were describing.

 

My dd5 just received glasses with prisms and in on the waiting list for VT with the same COVD. The difference with the prisms has been huge but I know she still has some other issues. With one eye wanting to drift, we are also patching her eye daily and doing some simple VT exercises sent home with us. Interestingly, it was the COVD that performed additional evals with her and discovered what I had been saying for years - that one eye drifted on occassion. No other eye specialist could make it happen in clinics. My dd qualified for OT a couple of years ago for other reasons, but now that we have identified vision issues, this OT (and her PT) are working hard with her on visual motor skills as well.

 

I would at least schedule an eval with the COVD. If nothing wrong is found, then you have not lost anything. If there are other issues, then you can start working on them. It can be very expensive if insurance doesn't pay, but reputable VTs will work with you. I know some that create home programs with regular follow-ups, or will work with you to make payments manageable.

[PeterPan]

Yes, get the eval with the COVD doc. You're seeing stuff and you don't even know all the parameters to look for. They'll definitely be able to sort it out and tell you what is and is not going along. What you're also finding is that sometimes the mild stuff can improve very quickly. How awesome that you have access to a Fellow. Definitely do this! :)

[PhotoGal]

Thanks again so much for your help! You have given me the courage to go for it. :D I think that is what my gut has been telling me, but I didn't know if I was just being a worrywart (which I tend to be). In any case, it will be better to know for sure what is going on. Hoping it is something that can be fixed rather quickly!

 

Thank you again for all of your help. I can't tell you how much it helped to be able to get feedback from people who have been there. :)

[PhotoGal]

Just had our VT appointment today and now I'm more confused than ever! :001_huh:

 

She seems to think ds has major issues. She said his depth perception is terrible (that he basically doesn't have any). This doesn't make sense to me because he plays tennis and hardly ever even misses a shot! How could he have no depth perception? We play catch all the time and he catches every ball.

 

She also said he should wear prism glasses all of the time. When I researched prism glasses online, I found that prism glasses have not been shown to be more effective than placebo glasses.

 

She wants him to do vision therapy once a week. They will evaluate at every 8 weeks. Then she laughed and said he will not be done anywhere near 8 weeks. I asked her how long does she think he needs to be in therapy (not looking for an exact amount, but an estimate). She said that after 30 sessions, they will see if the child has hit a plateau. If so, they discontinue. If the child is progressing, they continue. So I guess she is expecting it to take at least that long.

 

She really seemed to think he has major issues. I'm really confused! He has no symptoms on a day-to-day basis. The only thing I have seen has been during eye exercises themselves. He doesn't like reading long chapter books, but he also doesn't like me reading chapter books to him (rather than picture books), so I'm not sure that is an eye thing. So even if we have him wear glasses all the time and do therapy for 7 to 8 months or more, I still won't know if it was "worth it" because there is no symptom that I can see be resolved, kwim? I don't want to do it just so some numbers on some papers in a folder somewhere are better. If it doesn't affect his life in any way, why do it?

 

If he had double vision or trouble reading or something concrete, it would be a lot easier to commit to VT.

 

Ugh! I am just so confused. I don't want to put ds through all that for no reason, but I want to do whatever is truly needed. The more I research vision therapy the more I see how little real research has been done.

 

Somebody do a large scientific clinical trial, please! By next week! :lol:

[Trilliums]

Have you checked your library for resources ? We used a VHS tape for at home exercises in vision therapy when my son was younger. The hardest part was staying on schedule.

 

I do understand your frustration .

 

We ended up not pursuing VT mainly because the Dr. gave me such a hard sale. He sounded more like a car salesman than a doc. This just didn't sit right with me.

[chiguirre]

We didn't do VT because I thought that it would be too difficult for Geezle to comply with because of his asd. We overcame the tracking and the overwhelming amount of text on a normal page issues by using a Kindle set to big print and large spacing. Geezle went from struggling to read a chapter of MTH to reading Goosebumps (not great literature, but what he really wanted to read) almost immediately.

 

It can't hurt to give it a try, especially if your library has a good ebook collection. Even if you have to buy books, it would still be a lot cheaper than VT and might solve the problem.

[Tress]

Complete newbie with this whole vision thing here.

 

So probably dumb question: would a child grow out of these problems?

 

My dd6 keeps complaining about losing her place on the page and I'm not really sure what to do. She started reading at 4.5yo and and now at just 6yo she still complains. Her reading level is high, but she can't read more than 1/3-1/2 a page with normal adult print or maybe 1 page in a children's book.

 

There are almost no VT specialists here (the Netherlands), it is regarded as very very alternative. And I'm a bit hesitant to go for an assessment with the same people who are going to make money with the therapy, if you know what I mean. Normal eye specialists are not going to look at tracking issues, and besides......complaining that my just-turned-6yo is 'only' reading at a 9yo-level, while children in the Netherlands *start* reading at 6yo...is not going to convince anyone that there might be a problem :glare:.

[PeterPan]

Complete newbie with this whole vision thing here.

 

So probably dumb question: would a child grow out of these problems?

 

My dd6 keeps complaining about losing her place on the page and I'm not really sure what to do. She started reading at 4.5yo and and now at just 6yo she still complains. Her reading level is high, but she can't read more than 1/3-1/2 a page with normal adult print or maybe 1 page in a children's book.

 

There are almost no VT specialists here (the Netherlands), it is regarded as very very alternative. And I'm a bit hesitant to go for an assessment with the same people who are going to make money with the therapy, if you know what I mean. Normal eye specialists are not going to look at tracking issues, and besides......complaining that my just-turned-6yo is 'only' reading at a 9yo-level, while children in the Netherlands *start* reading at 6yo...is not going to convince anyone that there might be a problem :glare:.

 

Tress, if your dc is losing her place on the page, yes it would be good to get her evaluated. It's something they can fix pretty quickly, usually within a couple months. It really shouldn't be a "crap shoot" or shooting in the dark and hoping for the best the way Hip Girl is describing, and I'm going to respond to her thing specifically. The doctor should show you EXACTLY what's going on and why and tell you EXACTLY what he's going to do about it. In the US a developmental optometrist will have infrared goggles called a Visagraph. Google it. Basically they hook the kid up to a computer and the goggles track eye movements, so they can tell you exactly why she's losing her place, how much it's happening, etc. There's no guessing or hoping for the best. If you don't leave convinced, don't do it, kwim? A good doctor should be able to show you exactly what's going on. These doctors are NOT all equal, just like all ob/gyn docs are not equal or anything else.

[In The Great White North]

She said his depth perception is terrible (that he basically doesn't have any). This doesn't make sense to me because he plays tennis and hardly ever even misses a shot! How could he have no depth perception? We play catch all the time and he catches every ball.

 

Sue Barry explains how she dealt with no depth perception, and her reactions on acquiring it with vision therapy. She's a neurobiologist who didn't realize she saw depth differently until her first neuro course in college! And blew it off for another 30 years. Her descriptions on first seeing "the steering wheel popping" out from the dashboard and watching the snow fall are great. Needless to say, she's an advocate.

 

She also has a lot of descriptions of the actual vision therapy process.

 

http://www.fixingmygaze.com/

 

I found it in ILL.

[PeterPan]

Just had our VT appointment today and now I'm more confused than ever! :001_huh:

 

She seems to think ds has major issues. She said his depth perception is terrible (that he basically doesn't have any). This doesn't make sense to me because he plays tennis and hardly ever even misses a shot! How could he have no depth perception? We play catch all the time and he catches every ball.

 

She also said he should wear prism glasses all of the time. When I researched prism glasses online, I found that prism glasses have not been shown to be more effective than placebo glasses.

 

She wants him to do vision therapy once a week. They will evaluate at every 8 weeks. Then she laughed and said he will not be done anywhere near 8 weeks. I asked her how long does she think he needs to be in therapy (not looking for an exact amount, but an estimate). She said that after 30 sessions, they will see if the child has hit a plateau. If so, they discontinue. If the child is progressing, they continue. So I guess she is expecting it to take at least that long.

 

She really seemed to think he has major issues. I'm really confused! He has no symptoms on a day-to-day basis. The only thing I have seen has been during eye exercises themselves. He doesn't like reading long chapter books, but he also doesn't like me reading chapter books to him (rather than picture books), so I'm not sure that is an eye thing. So even if we have him wear glasses all the time and do therapy for 7 to 8 months or more, I still won't know if it was "worth it" because there is no symptom that I can see be resolved, kwim? I don't want to do it just so some numbers on some papers in a folder somewhere are better. If it doesn't affect his life in any way, why do it?

 

If he had double vision or trouble reading or something concrete, it would be a lot easier to commit to VT.

 

Ugh! I am just so confused. I don't want to put ds through all that for no reason, but I want to do whatever is truly needed. The more I research vision therapy the more I see how little real research has been done.

 

Somebody do a large scientific clinical trial, please! By next week! :lol:

 

Hip Girl, my dd has gone through VT and I just started myself. My ds will probably need it in a few years (they're watching him). So I'm a huge proponent of VT. HOWEVER I don't like anything you're saying. No you don't just slap prism glasses on every kid. There's a use for the glasses, but it's certainly not every kid that walks in the door. I don't like that the doc LAUGHED at you. Sorry, but that would totally irk me. It's a lot of money and a serious issue. Your questions are totally relevant. And I don't like that you left unconvinced of what is actually going on.

 

Remind me how you found this doc? They are NOT all equal. It's the huge disclaimer I've started putting on my replies, because it seems like for every couple good docs there's some screwball out there who took a course and knows just enough to piddle but not enough to do a good job. And there are even some unethical ones.

 

So back up and go through the basics. What tests did they run? Was this your only doctor or can you go to another, hopefully better, one for a 2nd opinion? Was this a Fellow or a regular doc? And with COVD or an opthamologist?

 

Now, the thing on the true depth perception is not screwy. That actually happens. My dd didn't have true depth perception before VT either. The brain is really amazing and just calculates it all out. So yes they can do tests and catch that and no it would not show up in tennis. In tennis you're seeing convergence. Did she do tests for convergence?

 

Just the fact that she didn't explain things clearly enough as she went is a bad sign. You should have left the exam understanding exactly what she was seeing and how that translated into the symptoms you're concerned about. Did you have references on this doc before you started with her? I would approach this very cautiously. I'd probably be looking for a 2nd opinion. Just one more grand reason I always tell people now to start with the REGULAR exam with the developmental optometrist. That way you have less into it and get screened. They can tell right in the screening what's going on with their convergence, tracking, etc. Mine screened me and said I didn't even need the full developmental eval.

 

So yeah, you're seeing a lot of red flags and aren't really getting enough concrete answers from this doc. I'd be concerned too. I don't know your best option. It could be your own anxieties about the process made you miss a lot of what she was saying and that if you call her back and talk it through it will all sound more sane. Ask what happens if you don't do the prism glasses. Ask how often she rechecks progress. Ask how his convergence was. Ask if they checked tracking. Don't latch onto the depth perception thing and get stuck there, because you don't understand it yet. Those other things though like convergence and tracking are very specific things that affect reading. You didn't even mention how those were. So call the doc and talk it through. That would be a conservative approach. Back up and have her re-explain how what she was seeing directly affects reading.

 

If she can't get concrete and explain it all to your satisfaction, walk and go elsewhere. But really, this could go either way. It could be the doctor did the right stuff and you were just so anxious and finding it all so new that you latched onto less important details. Or it could be the doctor is floozy and throwing every single thing at kids because they don't know how to get there otherwise. Could be either situation. Take some time and sort it out.

[stripe]

I had high hopes for VT for my child, who has completely different issues, by the hospital surgeon ophthalmologist ended up being more optimistic than the developmental optometrist, who seemed to think I would want to keep bringing my child in for weekly sessions until the end of time. I stopped going when the vision therapist lady seemed to be struggling to come up with activities. I was mad when I was paying to be told stuff that was already on the list of suggested activities or using some website that I had already found. I was already working with the child at home, so it wasn't worth it to me. I stopped going and the child's eyes have actually improved with the regimen suggested by the ophthalmologist, more than anyone hoped, because I was absolutely strict in enforcing daily compliance.

 

So I would proceed cautiously. I found the VT helpful at the beginning, but later on, not at all.

[PeterPan]

I had high hopes for VT for my child, who has completely different issues, by the hospital surgeon ophthalmologist ended up being more optimistic than the developmental optometrist, who seemed to think I would want to keep bringing my child in for weekly sessions until the end of time. I stopped going when the vision therapist lady seemed to be struggling to come up with activities. I was mad when I was paying to be told stuff that was already on the list of suggested activities or using some website that I had already found. I was already working with the child at home, so it wasn't worth it to me. I stopped going and the child's eyes have actually improved with the regimen suggested by the ophthalmologist, more than anyone hoped, because I was absolutely strict in enforcing daily compliance.

 

So I would proceed cautiously. I found the VT helpful at the beginning, but later on, not at all.

 

Yeah, for every 3 good ones there's some idiot out there who puts up their shingle. I'll take that back. In our state there were, when we started our therapy a couple years ago, *2* certified therapists in the state of Ohio. Now I think there's one more, and she's also in the office we use. So what does that mean about all the OTHER people out there doing therapy in the state??? I mean seriously, chew on that one. :glare: They took a course, think they know what they're doing, and out goes the shingle. Some of these people on the COVD list rarely do it. So yes, we used one of the two therapists certified in the state of Ohio. No never-ending lists and contracts. We go in and she knows exactly what she's doing, assigns a ton of homework, has measurable changes week to week, and are done in a concrete amount of time. That's GOOD vision therapy.

 

It can be good. If you have a good therapist and a good doctor. It's totally buyer beware. It's perfectly reasonable to walk. It's perfectly reasonable to ask why they are willing to do VT but aren't willing to get the therapist certified. Qualifications and experience matter. If it looks like they pulled it off a website, they aren't qualified. ;)

[Catwoman]

Oops.

 

I wish I had an answer for you, but I don't have a clue.

 

When I opened this thread, I thought you were thinking of moving to Vermont. I figured I could participate in that thread, because I wouldn't mind knowing more about VT myself.

 

I am so clueless.

[Jaz]

Could you try something at home first?

 

My ds saw a developmental optometrist who recommended VT. We used the vision section of Dianne Craft's Brain Integration Therapy Manual for 6-8 months then had my ds re-evaluated. It corrected his problems! :thumbup:

[GoVanGogh]

I might have missed it, but do you have a formal dx from an ophthalmologist instead of an optometrist? In our son's case, he needed surgery. All the VT in the world would not have corrected his vision issues and the optometrist was leading us down the wrong path. :glare:

[OrganicAnn]

While there are few scientific studies on VT, convergence is one of the areas that there are studies that show VT has proven results.

 

I had convergence and tracking issues as a child and had VT about 35 years ago (yep I'm that old). For most of my life I've been terrified of reading out loud because when I was in first grade my eyes skipped around so badly. With VT I improved.

 

My DD is now in VT. Despite my history, we did try other things when she was having difficulty with reading. Finally we went for testing. My DH was skeptical too. But the VT person sat with my DH across the table from my DD and asked her to look at a pencil erase. Within seconds her eyes drifted away. She couldn't keep them focused on one place and didn't know she was doing it.

 

I wish the whole eye, optometrist, ophthalmologists, psychologist etc community would do some systematic scientific studies of VT so that parents could be better informed. Even if they debunk much of it, I would rather know.

 

To answer the question about 'growing out of it'. I've asked that question before and was told that up until about 8 years old kids can grow out of some of these issues.

[PhotoGal]

Thanks for your insight, everyone. Obviously I'm thinking (and Googling!) a lot about this.

 

The VT we went to yesterday is a fellow with COVD. She was recommended on a local homeschooling email list.

 

When we went in, I was expecting her to say that he had convergence insufficiency (based on what his regular eye doctor said - going to the VT person yesterday was our second opinion). From the research I have done, it looks like VT *is* effective for convergence insufficiency - more effective than prism glasses and "pencil pushups (which is what his regular eye doctor had him doing).

 

She did say a lot of things were going on. The depth perception thing just threw me I guess because we never saw that as a problem. She also asked me a lot of questions that she seemed to expect me to say were a problem when they weren't. (So, she would ask how his reading was, how he was doing at sports, etc. - all things that are great). It felt like she was fishing for something to say would be fixed with VT, kwim?

 

I emailed her yesterday to ask how many months she wants ds to wear glasses (during his treatment time? forever?). Also, she wanted to put bifocals in his glasses and I wanted to know how necessary that would be. I also asked what she thinks about 2 to 4 months of VT instead of 7 to 8 or more (would it be worthwhile?). I just don't think we can sign up for that long of a treatment plan.

 

When she emails me back, I plan to ask her for a list of specific issues she saw so I can do some more research about them.

 

This was the "regular" eye exam - not the longer perceptual exam. I guess she saw enough issues to want to jump right to VT without the longer exam. (?)

 

Poor ds is getting braces as well right now, so I think we might wait on the glasses/VT at least a few months. This gives me more time to research and decide as well.

[PhotoGal]

Sue Barry explains how she dealt with no depth perception, and her reactions on acquiring it with vision therapy.

 

She also has a lot of descriptions of the actual vision therapy process.

 

http://www.fixingmygaze.com/

 

I found it in ILL.

 

 

Thanks! I just put her book on hold at the library.

[jujsky]

Just had our VT appointment today and now I'm more confused than ever! :001_huh:

 

She seems to think ds has major issues. She said his depth perception is terrible (that he basically doesn't have any). This doesn't make sense to me because he plays tennis and hardly ever even misses a shot! How could he have no depth perception? We play catch all the time and he catches every ball.

 

She also said he should wear prism glasses all of the time. When I researched prism glasses online, I found that prism glasses have not been shown to be more effective than placebo glasses.

 

She wants him to do vision therapy once a week. They will evaluate at every 8 weeks. Then she laughed and said he will not be done anywhere near 8 weeks. I asked her how long does she think he needs to be in therapy (not looking for an exact amount, but an estimate). She said that after 30 sessions, they will see if the child has hit a plateau. If so, they discontinue. If the child is progressing, they continue. So I guess she is expecting it to take at least that long.

 

She really seemed to think he has major issues. I'm really confused! He has no symptoms on a day-to-day basis. The only thing I have seen has been during eye exercises themselves. He doesn't like reading long chapter books, but he also doesn't like me reading chapter books to him (rather than picture books), so I'm not sure that is an eye thing. So even if we have him wear glasses all the time and do therapy for 7 to 8 months or more, I still won't know if it was "worth it" because there is no symptom that I can see be resolved, kwim? I don't want to do it just so some numbers on some papers in a folder somewhere are better. If it doesn't affect his life in any way, why do it?

 

If he had double vision or trouble reading or something concrete, it would be a lot easier to commit to VT.

 

Ugh! I am just so confused. I don't want to put ds through all that for no reason, but I want to do whatever is truly needed. The more I research vision therapy the more I see how little real research has been done.

 

Somebody do a large scientific clinical trial, please! By next week! :lol:

 

FWIW, the neurologist we saw at Children's Hospital of Boston, which is tied for #1 children's hospital in the country, told us that the most recent studies on VT show that it is not an effective practice. Our pediatrician told us the same thing. We saw the neurologist this past spring, and she said the study she read was a recent study.

 

If you have doubts about this place, that is your gut telling you to RUN!!!!! I should have listened to my gut. VT did nothing for my son. Several people here have had good luck with it, but it sounds like they went to places that had a different approach than the scam-artist loser practice I got suckered into. It sounds like they're telling you a lot of conflicting information and information you know as a parent doesn't make sense -- like the tennis thing. Some people have had luck doing it on their own at home. I don't know what program they've used, but if I had to do it over again, that's where I'd start first.

[PeterPan]

Thanks for your insight, everyone. Obviously I'm thinking (and Googling!) a lot about this.

 

The VT we went to yesterday is a fellow with COVD. She was recommended on a local homeschooling email list.

 

When we went in, I was expecting her to say that he had convergence insufficiency (based on what his regular eye doctor said - going to the VT person yesterday was our second opinion). From the research I have done, it looks like VT *is* effective for convergence insufficiency - more effective than prism glasses and "pencil pushups (which is what his regular eye doctor had him doing).

 

She did say a lot of things were going on. The depth perception thing just threw me I guess because we never saw that as a problem. She also asked me a lot of questions that she seemed to expect me to say were a problem when they weren't. (So, she would ask how his reading was, how he was doing at sports, etc. - all things that are great). It felt like she was fishing for something to say would be fixed with VT, kwim?

 

I emailed her yesterday to ask how many months she wants ds to wear glasses (during his treatment time? forever?). Also, she wanted to put bifocals in his glasses and I wanted to know how necessary that would be. I also asked what she thinks about 2 to 4 months of VT instead of 7 to 8 or more (would it be worthwhile?). I just don't think we can sign up for that long of a treatment plan.

 

When she emails me back, I plan to ask her for a list of specific issues she saw so I can do some more research about them.

 

This was the "regular" eye exam - not the longer perceptual exam. I guess she saw enough issues to want to jump right to VT without the longer exam. (?)

 

Poor ds is getting braces as well right now, so I think we might wait on the glasses/VT at least a few months. This gives me more time to research and decide as well.

 

Sorry, but this REEKS badly. You've got a skunk. Don't do it, run like the wind. Not another dime. Don't do the crazy glasses or bifocals or anything else this woman is saying. None of it. There are good developmental optometrists, and this is NOT one of them.

 

Sorry you got a skunk. At least you know before you invested money. Fwiw, her eval was NOTHING like at our place. But our place has a Fellow as the lead doc and multiple certified therapists. They do tons of VT and actually built a separate building just for it. They DO get changes. But throwing stuff randomly at problems they aren't. What you've got is preposterous and slipshod and so filled with warning signs and problems it's not even funny. Nothing like our experience, nothing.

[FairProspects]

If you have doubts about this place, that is your gut telling you to RUN!!!!! I should have listened to my gut. VT did nothing for my son. Several people here have had good luck with it, but it sounds like they went to places that had a different approach than the scam-artist loser practice I got suckered into.

 

:iagree:We had this experience too.

 

Our first VT doc was terrible, and actually gave ds glasses that CAUSED convergence insufficiency. He would never be clear with me about what the problem was, how the exercises would help, or how long it would take for therapy. We went for 18 months with no end in sight. He actually told me ds was not dyslexic (and he is) which is not even within his field of study.

 

We saw a 2nd COVD last week and she was fabulous. She could give me exact measurements on ds's eye muscles and immediately identified the problem. She told me right away that he didn't need VT and it was the glasses that were causing his problems.

 

Both docs were COVD fellows. Even among that designation the quality really varies. Find a 2nd opinion before spending a dime.

Edited July 26, 2012 by FairProspects

[PhotoGal]

I hear you. My instincts are telling me something is up as well.

 

I think I'm going to just let it rest for awhile, give ds a break and then go looking for a different COVD fellow in 6 months or so. I'm going to keep an eye on him as well - see if we are seeing any symptoms that might be connected.

 

It is such a tough road sometimes - being a parent and trying to do the right thing for your child!

[PhotoGal]

I also want to thank everyone again for your help. I can't tell you how much I appreciate hearing from people who have experience with this! I really really appreciate it. So thank you!

[OrganicAnn]

On the bi-focals. I had bi-focals as a kid. I think the reason was that they wanted my eyes to work harder at distance. So it was an attempt to improve my acuity and not associated with convergence or other issues.

 

I have bi-focals now (because I'm that old). I didn't have any adjustment because I had become used to them as a child.

[OrganicAnn]

FWIW, the neurologist we saw at Children's Hospital of Boston, which is tied for #1 children's hospital in the country, told us that the most recent studies on VT show that it is not an effective practice. Our pediatrician told us the same thing. We saw the neurologist this past spring, and she said the study she read was a recent study.

 

 

I would like to see these studies. I have seen what the pediatric neurologist gave to us, which is what is AMA article on VT and not a specific study but a review. It does say that for convergence it is effective, but it was not found to effective in some things like dyslexia.

 

Here is a abstract on a study on convergence:

http://archopht.jamanetwork.com/article.aspx?articleid=416768

Edited July 26, 2012 by OrganicAnn

[PeterPan]

I hear you. My instincts are telling me something is up as well.

 

I think I'm going to just let it rest for awhile, give ds a break and then go looking for a different COVD fellow in 6 months or so. I'm going to keep an eye on him as well - see if we are seeing any symptoms that might be connected.

 

It is such a tough road sometimes - being a parent and trying to do the right thing for your child!

 

Ok, the one bummer about this is that you're waiting 6 months if he actually *needs* some work. I know you got burnt, but I'd start looking and just see if you find somebody great. Might take you a couple months to filter through the list, etc. Definitely look for Fellows as your starting point, but then go visit their offices, see the rooms where they do therapy. Our place does monthly informational workshops. You might find a place like that or a place where the doc is doing speaking engagements you could go hear to meet him.

 

I'm just saying this because you don't actually know what you're looking for just to watch him. If you know vision (like if you're a therapist or you've been through therapy yourself and learned about eye function), you'd know what you're seeing. My dd is very good now at noticing oddities with eye function. She knows what they're supposed to look like as they converge, track, etc. But you aren't going to know, kwim? So just watching him isn't going to tell you much.

 

See to me, when I read your post (and don't know anything more about your situation), what I'm trying to figure out is whether it's eyes or whether it's actually an attention thing. Sure it could be his eyes, but it would be a real shame to spend another 6 months frustrated, find a better doc, get an eval, and find out it WASN'T his eyes, that it was actually a symptom of some attention issues or something totally different that you're not expecting. Or it could be a combo of things. I would want to know. But then I don't find it pleasant to teach against problems. Notice the goat wrestling thing in my sig. I'm all over that. No wrestling goats. If something is going on, you want to know.

 

BTW, on the seeing double thing, that may not have gone away in the way you're thinking. The brain is really amazing. For instance when they started working on depth perception with my dd, she started having these insane headaches and falling MORE and running into things MORE. They said her brain was trying to decide whether it was going to follow the *new* methods it was being taught or keep using the *old* methods it had used prior. These kids' brains create these calculations and ways of solving the problems. So just because a symptom seemed to go away doesn't mean the problem is actually gone or normalized, kwim? Means the brain just figured out a workaround.

 

Well whatever. I'm sorry you got burnt. I had word on the street from people before I started at the place we used. I corresponded with one of the docs and therapists via email (which is AWESOME, many of the COVD docs have their email up, USE it), met them at the workshop, and pretty much told them I had the biggest mouth this side of Texas and that they'd better do right by us. The lead therapist replied that *they* valued their reputation as much as *we* wanted results and that they would get the results. They did, we were happy, all's well. So don't be afraid to get all that info and be pushy a bit. I don't know why there are skunks, but the good docs aren't afraid to let you in and let you see what a good job they're doing.

[nrg]

Sue Barry's book is a gem! She mixes a personal tale with the information needed to really understand binocularity.

 

The website below shows the American Optometric Association's description of appropriate handling of vision related learning problems and visual inefficiency:

 

http://guidelines.gov/content.aspx?id=33584

 

An OD who is a COVD fellow would be familiar with this and base the VT practice around it.

 

As for whether any studies show the effectiveness of vision therapy:

 

http://www.convergenceinsufficiency.org/pdf/CITT_children_Scheiman.pdf

 

The study compares no therapy, simplified home therapy, and complete VT in remediation of convergence insufficiency.

 

covd.org provides COVD member lists and will answer your questions.

 

I am learning to do vision therapy and have visited several practices. They vary widely!

[PhotoGal]

Oh man. So I went to the COVD.org website to look at what other doctors are in the area. I looked at three other practices nearby. They all seem to emphasize the use of VT to address dyslexia - something the AAP specifically warned against. There is a lot of writing on their websites about dyslexia, ADHD, and other issues. I wonder if that is how they attract clients - people who know their kids are having issues at school and will try whatever they can that might help.

 

I don't know. This is going to be harder than I thought!

 

The VT did email me back and said she didn't know how long he would wear the glasses. She said that if we didn't want bifocals, we could get two pairs of glasses and switch them as needed. She said some results would happen by 4 months but from her experience, we wouldn't be anywhere near "done" at that point. She wrote repeatedly that they will assess every 8 weeks (but no word on the total timeframe we could be talking about).

 

The reason I want to take a break is because I don't want ds to get the idea there is something "wrong" with him or with his eyes. If we keep going to different doctors, it is going to seem like a huge problem. I feel like he may have a minor problem that we would be willing to do VT for a short time to solve. I don't know if we can navigate this VT world to find someone to handle that appropriately!

[PeterPan]

I wouldn't read too much into whether the word dyslexia appears on their website. Those websites are mostly canned and from COVD, meaning they all look the same. Dyslexia isn't even in the DSM if you remember. It's currently "reading disorder" which tells you just about squat. (You can tell there's no love lost between me and the DSM. ;) )

 

Not to be dumb, but do you really think you're hiding things from him?? I mean he's the one telling you he's having problems. The problem is not his eyes. The problem is the doctor. You tell him upfront the doctor was a nut and that you're going to see if you can find a better one who will take his concerns seriously.

 

And yeah, if that doctor wrote you back and said you'd hardly see results in 4 months, that she didn't know how long he'd need the glasses, etc., etc., then you've got someone who's way too inexperienced. In 4 months we were basically DONE with therapy. We had had massive changes by that point, and we went in with pretty distinct problems.

 

All this should be way more concrete.

 

BTW, are you currently wondering if it's dyslexia causing him to skip lines and that's why you're trying to sort it out? I don't think you're going to get a reading disorder label from a neuropsych with a high reading level. We didn't.

 

In our case, dd was just glad someone was finally taking her SERIOUSLY and explaining what she had been feeling all that time. You get a good doc, someone who understands what's going on and why they're having the symptoms, and the kid is going to come out feeling validated, not defective. At our place it's not really a negative thing or some sickness or a problem. They focus on the dc's goals and helping him achieve them. It's all very positive, kwim? I walked in the door and was worried I was going to be uncomfortable because I'm, ahem, a little bit older than their typical clientele. First thing out of her mouth was CONGRATULATIONS on taking care of myself! That's when you know you have the right place. :)

 

This first doc was just an idiot. I just can't even believe she wrote you back such stupidity. There are much better docs out there.

[PhotoGal]

I hear what you are saying. I don't think ds has dyslexia at all. I just wonder about VTs who claim that they can fix dyslexia. To me, that would be an indication that they are overstating what VT can do.

 

Ds did have the symptom of double vision, but that was a couple years ago. I went through the symptom list with him in April and the only one he said he had was having trouble staying on the same line when reading chapter books with small fonts. (No headaches, blurriness, double vision, head turning, eye strain, etc.).

 

The only time that his issues (whatever they may be?) seem to be during eye exams and eye exercises themselves. BUT I don't know what would be different if we did VT - maybe he would be more interested in reading chapter books with long blocks of text. Maybe not. It is so hard to act not knowing the consequences, kwim? I don't see enough of an issue on a day-to-day basis to really be fired up to fix anything. On the other hand, I don't want to ignore something that could be addressed. It is tough.

[Verity]

I'm reading this thread with interest because I've been considering VT for at least one of my children for a while but waited until dh got a job with insurance to pursue it any further. Well, he got the job so now I need to do something.

 

I found a local (45 min drive or so) COVD fellow and their office assistant told me it was $390 for the eval, then roughly 24 weeks of therapy at $150 a week. :eek: Reading the threads about VT I'm not sure it's even worth getting the eval. I can't imagine spending that kind of money on something not life threatening but I want to do what I can to help my children...still that is more than my car is worth!

 

My son's primary problem (that I'm aware of) is that at age 10 he still reverses letters and numbers. He has ADHD, SPD issues and fine motor issues. Maybe I should pursue OT first and see where to go from there? Hopefully OT would be covered by insurance whereas it appears that VT isn't.

[PeterPan]

I'm reading this thread with interest because I've been considering VT for at least one of my children for a while but waited until dh got a job with insurance to pursue it any further. Well, he got the job so now I need to do something.

 

I found a local (45 min drive or so) COVD fellow and their office assistant told me it was $390 for the eval, then roughly 24 weeks of therapy at $150 a week. :eek: Reading the threads about VT I'm not sure it's even worth getting the eval. I can't imagine spending that kind of money on something not life threatening but I want to do what I can to help my children...still that is more than my car is worth!

 

My son's primary problem (that I'm aware of) is that at age 10 he still reverses letters and numbers. He has ADHD, SPD issues and fine motor issues. Maybe I should pursue OT first and see where to go from there? Hopefully OT would be covered by insurance whereas it appears that VT isn't.

 

Call and shop around a bit before you draw any conclusions. Our place doesn't have a pat 6 months set-up like that. Many people complete in less than that. Some take longer. It really depends on where he's starting and how severe his issues are, frankly. There's no way a secretary can give you an answer like that over the phone and have it be accurate, not unless they put everyone through the same routine, regardless of problems.

 

As far as the OT, absolutely it's a great thing, but you've never seen such a big money sucker for amount of results. I was paying for it, and we finally dropped. A good dev. optometrist will screen for sensory integration and retained primitive reflexes and whatnot and send you off for OT. Sometimes the dev. optom. will have things to do for those through him. Anyways, OT and VT shake two ends of the vision stick but don't replace each other. But until you get some evals you don't know which thing is the bigger issue. You can do OT and VT at the same time; we did. You can also do OT first. Or you can do VT first. It really just depends on what symptoms are most pressing, who's paying, and what the mix is. If you have severe sensory integration problems or retained primitive reflexes, the VT won't be effective without OT first. We did 5 months and our VT doc told us to take a break, do more OT, and come back.

 

The prices your place is quoting seem pretty typical, especially if that eval includes a regular vision exam and dilation as well. Talk with people who've used them. Visit them and see where they do therapy. See if they do it a lot or if it's this back-room, side thing for them. Find out who does the therapy and if that person is COVD-certified. Talk with people who've used them and talk with more people who've used them. You want to know how progress is measured, how much homework they typically do, how it's structured, etc. You want to hear people saying they saw results in 1-3 months. Like at 3 months my dd's headaches with reading were GONE. At 2 months she stopped bumping into things. You should hear specific stories like that. Just check 'em out.

 

It can be really good with the right doctor, but they vary, as with anything. Ask that practice what OT's they refer kids to, then CALL those OTs and do the reverse, asking about their experiences with kids going to that dev. optom. ;)

 

And no, if there's little going on, you're talking a few months, not 6 months to a year. Just depends on what is going on. There may be more going on than you realize though. Not like you're trained to see this stuff, kwim? At our place, it typically takes a certain number of months to restore just basic visual function (tracking, convergence, focusing, depth perception, etc.). Then they retest to see if visual processing (visual memory, etc. etc.) has kicked in. On some kids it does at that point, and on some kids it doesn't. If it doesn't, then they go back and do therapy for those skills, building the skills that should/would have developed if the dc had had full function all those years. So that might be where the secretary chick is getting 6 months. But that just really varies with the kid.

 

Also, we've had people on limited incomes or who were driving a long way (much farther than 45 min). They did once a MONTH sessions and tons and tons of homework. Might take a little longer, but that can work just fine. So don't get your mind locked into one way. There are definitely options there. The more you're willing to do at home, the less they have to do in therapy with the therapist. Ask them about that option and how willing they are to pile on the homework.

 

It's definitely worth pursuing IF you get the right doc and OT doesn't replace it. The dev. optom. should be able to tell you if insurance will cover part of the therapy. Sometimes it does, especially if there's a physical/medical-related complaint going in. Our place knows exactly which portions they can get insurance to cover and which they can't. So just ask.