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How can you know if problems with schoolwork are due to dyslexia or visual processing problems?

My son, who is now 17, has had all sorts of problems throughout his school career. He had not been formally tested for dyslexia, yet met most of the "things to look for" on dyslexia checklists. I have read several books on dyslexia, including The Secret Life of the Dyslexic, and have always thought that it fits him. He has undergone lots of different types of therapies over the years and I am finally getting around to looking into the vision component (be kind, there is only so much I can handle at once).

So, I have had him tested by a COVD registered lady who found him to be functioning in the first percentile on a lot of the tests. (heavy sigh)

He is reading and can read a lot better than he ever has, handwriting is better than some boys his age, but does not like to do either and his comprehension is not where it should be. He gets very tired when having to sit and do any sort of desk work.

At any rate, I guess I am rambling, but do you all think there is a good way to determine how much vision therapy will help (to the tune of $6200)? Or please feel free to give me any advice you can.

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Well sure vision could be causing his problems. If they've done tests of his convergence, focusing, tracking, etc., and have found weaknesses there, then yes you've found a problem. It sounds like on top of that he has visual processing problems. Those usually result from the developmental vision problems. You could have all that AND dyslexia or just the developmental vision problems.


To me the question is why you're getting quoted $6200 upfront. They're saying it will take 10 months? They want payment upfront or pay as you go? What if you do therapy sessions more widely spaced and do more homework? VT is not cheap, that's for sure, but it can make a huge difference. You should see changes pretty quickly, and you want to make sure you're confident in the therapist you're using. Don't pay a ton of money upfront.

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Well, $6200 is a lot. Granted it was about 5 years ago, but we spent somewhere around $2600 for 24 weekly visits (6 months). Our new place I think is around $125/visit, so a little bit more. Are they estimating a lengthy therapy time period? They can't know for certain how long it will take and some things are easier to fix than others. Older kids tend to take longer, though I recall one poster here recently had an older child and the particular problem was fixed relatively quickly (a few months?).


With that kind of price, I'd want to see what a different COVD optometrist would offer. You might take your report elsewhere to see what others would do for treatment and what they charge. Also, choose wisely - it's usually better to have a more experienced COVD and/or someone who comes highly recommended from others.


Differentiating between vision issues and dyslexia may be very difficult to do without professional help. It sounds like you covered the dyslexia bases earlier, and it's quite possible what's leftover are vision issues.

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When we underwent VT, the only research I could find about the effectiveness of VT was this (from the National Institute on Health):



In our case, ds did have convergence insufficiency. After treatment, ds could sustain reading much longer and not get lost on the page. So I feel it was successful. However, in the end ds is dyslexic.


What I really resent now is the VT implied that all ds's reading issues were vision related (they were not), and he even went so far to imply that there was no such thing as dyslexia.


Now, I feel frustrated by that because it really is horrible mis-information, and I was so ever hopeful that all ds reading problems would disappear once he completed VT, which they did not because he is dyslexic.


Indeed there may be a vision component to dyslexia, but there are also brain imaging to show that dyslexic brain's are neurologically different.


My advice, which you seem to be doing, is to do your research. Likely you are aware that the American Academy of Pediatrics did not find research to support VT (but again mentions the results for convergence insufficiency...improving reading stamina but not dyslexia). Of course there is a rebuttal to this in many Optometric/ Opthamology publications, along with others' personal experiences.

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Thanks for all the replies.

Here is some more info about where I had him tested--tell me if any of it sounds fishy. I have done other testing in the past and have heard a lot of different diagnosis, so hearing from yet another discipline that he would benefit from their therapy is not new.

The doctor in question has OD, MS, FCOVD behind her name.

The tests performed were:

Visual Acuity


Oculomotor Evaluation

Developmental Eye Movement Test

Evaluation of Accommodative Ability

Evaluation of Binocular Sensory-Motor Fusion

Randot Stereopsis Evaluation (Depth Perception)

Wold Sentence Copy Test

Jordan Left-Right Reversal Test

Test of Visual-Perceptual Skills (TVPS)

Beery Developmental Test of Visual-Motor Integration

Monroe III Visual Memory Test


He scored in the 1% in several. She based the 45 sessions, 11 month period on that and his age. He would be having a therapist work with him--not her directly. The therapist is working on her masters in special education.

The cost is based on $142 per session (45 sessions, once a week, over the course of 11 months). They are 1 hour long. We are to do home exercises for 10-20 minutes every day. If we require equipment, they will loan it to us free.

The doctor herself will evaluate him 6 times with an additional charge of $80 per evaluation. This occurs after eight in-office visits.

She accepts different payment options: pay $6390 in full, pay half now and half at session 16, or monthly with an additional fee attached.

If the doctor believes the patient has reached the goals sooner, payments will be refunded. If we cancel before the end, we lose whatever we paid.



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Actually, it all sounds relatively standard, with the high price being the result of the lengthy treatment time and the slightly higher per-visit price. The two places we've been frame the pricing a little differently, with there being a "discount" for paying upfront rather than an "additional charge" for not paying upfront, though I suppose the basic idea is the same.


FCOVD means she's a fellow, so she should be more experienced. I wouldn't pay upfront, personally. (On a shorter duration, I have paid up front but this is a much larger amount.) With such a high price overall, I might still be interested in a timeframe and pricing estimate by another doc.

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Would you mind telling me what sort of problems you are still seeing with your son's reading or schoolwork in general?


Well, my ds has now been remediated for dyslexia (diagnosed dyslexia/ dysgraphia by neuropsych team 2 years ago; completed 1 year of Orton-Gilligham type tutoring). But I would say that he would likely be diagnosed as dysgraphic now....spelling, sloppy handwriting. As far as reading, he is not a super accurate reader (although he is considered reading at grade level). His reading outloud can sound a bit glitchy (but that may be due to decreased processing speed). Also because of processing speed it takes him usually twice as long to do schoolwork.

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Have you talked with someone else who used this particular doc? It would be nice to have some feedback from others before you launch in. The price per hour sounds pretty comparable to what we paid. Our doctor checks were every month, not every 2 months. The masters in special ed doesn't mean much for this purpose. I'd ask if she's COVD-certified. (COVD certifies therapists as well as docs.)


It's a bummer that they're raising your price when you pay by the month. Our place let you pay by the session or buy a block of sessions (essentially a month) and NEVER asked us to pay more than that upfront. Some of these doctors seem to have their reasoning for why they ask for large amounts upfront, but personally I think it's appalling and controlling. Their work should speak for itself and people should see enough progress that they want to continue. They shouldn't have to be bamboozled into sticking with it or lose large amounts if they don't.


Like Wapiti said, I'd just do some checking and see about your options. It would be good to get some feedback on the doc and this therapist. Might be fine or might not be. And no, I'd only pay by the month, and I'd try to talk them out of the price increase. Has your dc met the therapist? That can be a very good indication of how it's going to go.

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Our story has been put here before, but I will share again. :) I had a dyslexia diagnosis for my son, by a qualified reading specialist, when we began VT for tracking issues I was also noticing. 18 months later, after multiple issues found with his vision and lots of hard work in VT, I was told he never had dyslexia. It was apparently his vision all along. I know he is a rare case though. And he still has other difficulties with reading that make me think we are still looking at an LD of some sort. The VT currently is charging about $125 for an hour (or 45 minutes) and usually expects the child to come once a week with homework daily in between. She also did minor re-evals about every 6 weeks. Payment was due at time of therapy, no advance pay unless we wanted a discount.

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