Vision therapy Q's

[mhaddon]

We suspected dyslexia with my 7 year old and took him for a consultation today for vision therapy. We were told he is having trouble with his tracking.

His eye movement deficiencies, saccadic and smooth pursuit

 

So we were given the cost and are in the process of moving and without insurance help (ours is horrible) we are not sure we can do it :( Also the drive is pretty far on top of the cost. We are rural so nothing is closer.

 

What can I do at home to help him? Do you know of any "homeschool" visual therapy programs that work?

TIA!

[PeterPan]

Well I've put my dd through VT and am now doing it myself. You can definitely get dramatic results, and those sound like very concrete things the doc has identified. Just out of curiousity, why did you go to this doc if you're moving? Are you moving so far that you wouldn't want to continue with this doc?

 

As far as the expense, you need to be upfront and talk with them. Some places have a sliding scale or other arrangements. It's also possible to do fewer visits and a LOT MORE homework. This is not rocket science and they can give you homework you can do at home perfectly well. I *don't* advise trying to do it on your own. The results won't be the same. I'd rather have one session every month, one every other month, whatever you can swing. That way you're focusing your efforts, doing things optimally, and getting questions answered. You need things (flippers, etc.) to do VT. There's just no point going to all that hassle and not knowing you're doing it optimally (in a way that's going to get results).

 

We've had multiple people on here do spaced visits. I'm certainly not doing visits every week, mercy. She gave me a pile of homework, and I'll work till that's done, then I'll go back. There are things they can only do in-office, but that's minimal. When you get a really good therapist, you're getting the feedback about why it's not working and the details you *don't* notice. For instance, I never realized when I did a certain thing I was actually straining. She could see the muscles moving in my face, so she could tell me what to change. You want that feedback. Don't just shoot in the dark and do it all yourself. But you don't have to do twice weekly visits either. Yes they'll speed it up, but you CAN do more at home and make it pan out in the wash.

 

So take your time and work it out. Talk with them and find a workable plan. Vision therapy is not going to remove phonemic awareness problems. It's for VISION and visual processing. Anything he's struggling with now that's a result of his vision problems is what will improve. Just having btdt a little bit, I'll also toss out to you that ignoring it doesn't make the problems go away. Then you have kids in 5th, 6th, high school getting VT. Happens on the boards here a lot. You have the blessing of finding it EARLY and being able to fix some of these problems before they snowball. If I could turn back the clock, I'd love to be in your position. So I know it seems overwhelming now, but it's a GOOD thing to have found it now, not later. :)

[mhaddon]

We are only moving 2 miles down the road, but it's the cost. Plus being a single family income and I'm taking college classes this fall. I've thought heavily about putting him in school so he'd have more help, I know that can go either way.

 

I'm thinking he may not have dyslexia after the screening. I at least know he has tracking problems and it isn't getting better. Her also has an eye shake when focusing and tracking.

 

I talked with my husband and I am thinking of calling some college universities and seeing if they have more affordable student classes. Anyone know if this is a possibility?

[PeterPan]

Totally none of my business, but college classes on top of 4 kids and having a kid who needs VT? You have more energy than me. :D

 

Sigh, the student thing. They have that near us, and I called. Price was almost the same as the place we use, and at the place we use we get one of only *2* certified therapists in the state, someone with tons of experience, someone who goes to the conventions, knows lots of techniques, has tons of experience, who has lots of tools to pull out of her bag when she sees something happening. It's not just some rote formula they put kids through. This is totally driven by the relationship with the therapist and their ability to get the dc to comply (some SN kids are infamously challenging to work with, having anxiety or other issues). That experience means they know exactly what they're seeing. They're not wasting your time or your kid's, and they're not missing something. So no, *I* chose not to go to the university setting, sorry. I would cut something else. If you have a really good, really experienced therapist option, that's where I would put the money, doing less sessions and more homework to make it pan out.

 

Now I'll be blunt. VT can make a difference beyond what you dream. VT also has homework, usually 15-20 minutes a day. If the dc doesn't comply or whines a lot, it can take an hour a day. (my kid did, ugh, like pulling TEETH) But the difference VT made was SO big in our house, I would sell things to get it. Like I would sell the car and give up paint and shrink Christmas and give up the dog and sell all my curriculum, and... And I'm totally serious about that. No, school and a professional teacher won't change the need for VT. Yes, you could be thinking it's dyslexia and it's totally his eyes. Or it could be something you're not expecting like eyes plus ADHD. They overlap quite a bit.

 

You just have to take it one step at a time. You've found out he has a legitimate physical problem, and it's something that does affect school and something they can fix. I want to say upfront I agree with the caveats others are going to post like that you don't pay a lot upfront, make sure you have feedback from other people who've used him to know he's reputable and effective, etc. etc. Scoundrels exist in this, just like in any other profession. I think last week we had 2 big threads on VT, one here on the SN board and one on the general board. And on the SN board the person just needed to plow forward, and on the general board we told the lady to run the OTHER WAY, that there were all sorts of warning flags.

 

But you don't sound like you have that kind of situation. They've told you very concrete things and it sounds like they have a concrete, reasonable place. So make sure the ducks are in a row and they have a good reputation and plow forward.

[mhaddon]

Yes I'm sure it is vision, I knew in the back of my head something was going on watching him read last year when his eyes would shake super fast at the end of a sentence. I talked to him and this is exactly what's going on. But, I also suspect ADHD, she also pointed it out during his evaluation and asked me if I had tried eliminating things in his diet. DH and I are already in the starts of a 30 day detox diet where we slowly add things back in. Starting after we move and settle in. We'd already removed food dyes, HFCS, sugars besides fruit, and next we are doing the whole 30 (I highly recommend the book It starts with food). As a family. My youngest is starting speech therapy too so I feel like going crazy. I'm sure it's because everyone has talked for her.

 

I love my son, but he is driving me crazy I just want to push through this and make everything better. Even if it means drastically changing our diets. I no longer want him to the be the show off dare devil getting other kids hurt :( including mine!! And of course I say no food dyes and my husband tells me great grandma had given him a class of koolaide earlier in the day :glare: So even great grandma is going to have to follow orders or I will have to go with them to see her from now on. Thankfully my mom and MIL are on board.

[eoffg]

Melissa, I would ask what his sense of balance is like, as for smooth pursuit and tracking. The eyes use the Vestibular system in each ear, for their guidance. Where this Vestibular system is a semi-circular canal in each ear, partially filled with fluid. Where our sense of balance is maintained, by tracking the movement of this fluid. Where just as when you tilt a glass from side to side. The fluid will remain facing directly up. This fluid remains facing up.

So that the eyes and our body use this to keep us constantly informed where up precisely is.

But when the eyes aren't getting this constant guidance? Then they have to keep looking around for where to go to next?

Where this looking around presents as hyper-saccadic movements.

So that is why I would ask what his sense of balance is like?

[PeterPan]

Melissa, I would ask what his sense of balance is like, as for smooth pursuit and tracking. The eyes use the Vestibular system in each ear, for their guidance. Where this Vestibular system is a semi-circular canal in each ear, partially filled with fluid. Where our sense of balance is maintained, by tracking the movement of this fluid. Where just as when you tilt a glass from side to side. The fluid will remain facing directly up. This fluid remains facing up.

So that the eyes and our body use this to keep us constantly informed where up precisely is.

But when the eyes aren't getting this constant guidance? Then they have to keep looking around for where to go to next?

Where this looking around presents as hyper-saccadic movements.

So that is why I would ask what his sense of balance is like?

 

A good developmental optometrist will refer off for OT if that is needed as well. In some kids it is. And yes, if the kid has ADHD and vision problems, he would probably benefit from an OT eval as well. But one step at a time. If it's a GOOD vt doc, they'll check for OT things that would keep the dc from getting full benefit from the VT. Sometimes kids have severe sensory integration problems, retained primitive reflexes, etc. and need to do the OT first. But as long as they checked that, she's probably good to go.

[Dobela]

I was told my son had dyslexia by professionals. I took him to vision therapy because I was noticing some serious tracking issues. 18 months of hard work later, he went up several grade levels in reading and I was told he never had dyslexia. We are one of the unusual families though. For children who have dyslexia, VT will only correct any other vision issues that are compounding the dyslexia.

 

For us an interesting, and totally unexpected 'side effect' was the huge reduction in sensory issues. His sensitivity to textures ended, his sensitivity to sounds ended, his odd food and drink cravings ended... We stopped having meltdowns from sensory overload. Apparently his vision was sending his brain such mixed signals that he was staying hypersensitized all the time. The change was gradual as his vision improved.

 

If you are having difficulty paying, you may see if you can purchase supplementary insurance thru your state. We did that, paid a small monthly fee, and it helped cover what our primary insurance didn't on therapies.

[PeterPan]

Yes I'm sure it is vision, I knew in the back of my head something was going on watching him read last year when his eyes would shake super fast at the end of a sentence. I talked to him and this is exactly what's going on. But, I also suspect ADHD, she also pointed it out during his evaluation and asked me if I had tried eliminating things in his diet. DH and I are already in the starts of a 30 day detox diet where we slowly add things back in. Starting after we move and settle in. We'd already removed food dyes, HFCS, sugars besides fruit, and next we are doing the whole 30 (I highly recommend the book It starts with food). As a family. My youngest is starting speech therapy too so I feel like going crazy. I'm sure it's because everyone has talked for her.

 

I love my son, but he is driving me crazy I just want to push through this and make everything better. Even if it means drastically changing our diets. I no longer want him to the be the show off dare devil getting other kids hurt :( including mine!! And of course I say no food dyes and my husband tells me great grandma had given him a class of koolaide earlier in the day :glare: So even great grandma is going to have to follow orders or I will have to go with them to see her from now on. Thankfully my mom and MIL are on board.

 

Not to burst your bubble, but we eat about as clean as you can get (all organic, lots of fruits and veges, all combined according to the rules of food combining, 3 cups of salad every night, etc., etc.), have for years (12?), and my kid still has problems. Omega3 can help. Diet helps. Take my kid off the omega 3, off the diet, yeah it's worse. But it's still diagnosable, still there.

 

I remember when we started VT and I had read so much about OT and this and that that I was worried the VT wouldn't work. There *are* OT issues that require OT to be done first (or dealt with by the optometrist, which some can for retained primitive reflexes). But a good VT doc knows if he's seeing OT issues that will get in the way of making the VT stick. You can only do so much at once. Just talk with them about it. For us (and this is just us) where the OT really started holding back the VT was when we hit sensory and working memory. But for some kids it's going to hit earlier. You just have to talk it through with the VT doc. You can only do so much at once.

 

Ok, now on the speech thing, sigh. The "my kids are talking for her and that's why my kid doesn't talk" thing is just a big excuse. I've heard it used twice, once about my kid who turned out to have moderate verbal apraxia (we weren't talking over him, he couldn't talk) and once about another kid who also probably had verbal apraxia. That kid did finally begin to talk (a year late), but he's still extremely reticent to speak, ie. he would have benefited from good speech therapy.

 

So don't lull yourself with the idea that they're keeping your kid from talking, because it's probably not true. My ds had symptoms of the apraxia for many months and was fully diagnosed when he was newly two. If apraxia is what you're thinking, PLEASE don't screw around with a regular speech therapist. PROMPT is the ultimate for it. Watch the video by Deborah Hayden on youtube. Look at the videos on youtube of kids who have done regular speech therapy for apraxia, not had it work, and then done PROMPT. If apraxia is what you think it is, PROMPT is what you want.

 

And btw, therapists will dance around the apraxia issue and sometimes not diagnose, either because they're not trained to recognize or because they just plain don't have an effective way to treat it. That was what happened to us at the first place. The lady patted me on the head (not really, but verbally), gave me the worried mother routine, and said we'd "work on communication." I walked out, said I didn't need communication; I needed him to TALK. Went to the PROMPT therapist and she had him TALKING the very first session. That was moderate apraxia. We literally had to move his jaw up and down, but he could TALK. It was all inside, just couldn't come out because of motor control. Makes me so angry I could SPIT to think about someone wasting my money and time showing my kid flashcards when it was really going to take something physical, doing the hard work and getting in there.

 

Wow I'm on a tangent. There is NO SUBSTITUTE for an involved mother once you start doing therapy. Take each thing seriously and make sure each therapist is pulling their weight and doing the best methods. Follow up with each one and see how much you can do at home. There's just no substitute for that, and it makes a HUGE difference in the outcome.

 

Make it your mission.

 

Sorry, that's your sermon for the day. :D

Edited August 2, 2012 by OhElizabeth

[mhaddon]

I know it is frustrating when they treat you like you don't know your own child :hugs: She has sounds, but not words. Does that make sense? She doesn't have all sounds and I can not understand her. It took a while to even get her to "talk", but she is now. So I don't think it's apraxia.

 

He has never had trouble with gross motor skills and his balance is fine. He has a great memory when it comes to anything other than reading and math. We could go out now and name at least 10 weeds and he identifies trees better than most adults. So I know he's smart and able to retain information.

[eoffg]

As his balance is fine, it rather rules out a vestibulo-ocular problem.

But something that can cause hyper-saccadic movement, is a hyper-sensitivity to glare from certain colours within the colour spectrum. Which is called 'scotopic sensitivity'.

But white paper presents a major problem with scotopic sensitivity, as white light is made up of from the full colour spectrum. Which will include the problem colour.

But a simple way to find out if this is to have him read some text, on some coloured tinted paper.

Trying a few different colours.

Though it can also be done on computer, by simply changing the background colour for a page of text.

Where if this is his problem, it will be immediately identified.

[PeterPan]

You can't rule out vestibular issues just by asking a mom if she thinks her kid's balance is off. The mom isn't trained to notice all the ways it would show up. From what our OT said, vestibular is the first system to develop neurologically and is almost ALWAYS off if a kid has other later-developing problems. So we don't want this mom to get some false assurance.

 

You want a thorough, hands-on, proper eval by an OT who does a lot of sensory to eliminate an issue like that. Our OT put dd on a very large platform swing and would move her various ways, watching her eyes. The way the OT approaches eyes is different from VT. Both are necessary. Doing the one doesn't eliminate the need for the other. Dd also had issues with weight-shifting that the OT said went back to vestibular. It's not something I understood or noticed, and it's not something I would have responded affirmatively about if someone had asked.

 

It's entirely possible the op is going to end up getting an OT eval at some point. The OT eval for us was this great epiphany where they finally explained all kinds of bizarre things we hadn't realized were connected. But take it one step at a time. You don't eat an elephant all at once.