Vision Therapy/Testing Q

[Joker]

We received dd's test results today. She scored above average or very strong on every test except the Jordan Left-Right Reversal Test. On that she scored weak. Letter and number reversals were the main reason I took her to the optometrist. She did have an overall low score on the DEM part because of the time it took her to read horizontally. She does have one eye that wanders sometimes, but not often (mostly just when sick or tired), and she has poor vision in one of her eyes so she now wears glasses.

 

They've recommended vision therapy and I'm trying to decide. We were told it would cost $3200 for 24 sessions. The optometrist is a Fellow and listed on the COVD website, if that matters. It just seems so expensive and she only scored low on one part of the test. I don't really know much about any of this and am trying to understand it all. The dr. feels she needs therapy for focusing and eye teaming (she said both were inadequate).

 

Does the cost sound right? Are there things we could do at home for these issues, or is therapy the only way? Does it truly sound like a vision problem if she scored high on everything except reversals?

 

Thanks to anyone who read though all of this and can help!

[besroma]

I do not have answers to your questions, but wanted to post a link to this thread:

 

http://forums.welltrainedmind.com/showthread.php?t=433165

 

I found it very informative.

 

Also gives you a bump to get your questions answered.

[PeterPan]

Were you in the room when they did the testing? They have paper testing they do, but they also have a lot of tests they do with the eyes and tools. It sounds like you're understanding the paper-driven tests but didn't get to see the part where they looked at convergence and focusing and whatnot. When my dd was tested, I was in the room, so the doc would actually stop and show me what was *supposed* to be happening and how many times she could cycle through the task vs. what was normal, etc. So when your doc says your dc has issues with focusing and eye teaming, she's referring to the results on those other tests they did with the tools. It's not like there was only *1* thing that showed up as a problem.

 

Yes, VT is expensive. How are they asking you to pay? Occasionally you'll get some floozy doc who thinks people ought to lay out $3K-5K upfront to show how dedicated (or foolish) they are. Don't do that, mercy. As long as the cost is typical of the going rate for VT in your area and being paid by the month or by the visit, you're fine. Getting a Fellow is a good sign, yes. Did you talk with the therapist? What is their homework policy? At our place, when money is tight, you do more homework and less sessions. I always felt like they covered in therapy more in 1 hour than we could do with a week of effort at home. So, to me, the therapist really EARNED that high $$. They came in prepared, worked really hard, got compliance, and got a lot done. But they should be able to give you lots of homework and help you stretch visits if necessary to make it affordable. Just talk with them.

 

Yes, VT is worth it. If you're not understanding what happened in the testing and why they're saying she needs it, just talk with them again.

[Joker]

I was in the room for the first visit with the exam and tools, but she wasn't really saying much. I wasn't in the room for the paper test. They've offered several different ways to pay. The payment options are helpful but we've had a tough year and I don't know that we can swing any of them right now. I'll ask them about doing more at home right now vs the office. Thanks for the input.

 

ETA: I guess I also just expected more problems to show up on the paper test since they're recommending the therapy and it's so expensive. I can see though that the dr. saw other problems in the first visit as well. I guess it all takes some getting used to and it's hard since I don't know anyone who's done vision therapy and the research online seems to differ.

Edited November 9, 2012 by Horton

[Joker]

I do not have answers to your questions, but wanted to post a link to this thread:

 

http://forums.welltrainedmind.com/showthread.php?t=433165

 

I found it very informative.

 

Also gives you a bump to get your questions answered.

 

Thanks for the link! I think one of the problems I have with going forward is that dd tests extremely well and seems to have no trouble reading. Many in that thread talked of reading problems and I don't see that here. It's all writing and spelling.

[kalanamak]

 

Does the cost sound right? Are there things we could do at home for these issues, or is therapy the only way? Does it truly sound like a vision problem if she scored high on everything except reversals?

 

Thanks to anyone who read though all of this and can help!

 

For 133 dollars a session, I personally would look online. I took my boy for an eval when he started covering one eye, age 6. He did well except on two tests, and needed simple magnifiers for about a year. The lady, an older woman who'd been working in the field for decades and worked with children with significant neurological issues, gave me a couple of home exercised and we worked at it. I think it helped. I am rather certain if I'd gone to a plusher "business" model place, I'd have been offered the chance to pony up 3200 smackers.

 

On a board for homeschoolers ("do it yourselfers), I've been surprised at how many people pony up for this. Did it help because the mother feels it must for that much money, because the child grew up a little, or because some simple training you or I could have done did the trick. None of us have enough children to answer that question scientifically, and the studies I found have been put online by people who stand to profit from it.

 

I do admit to not having looked very hard for other studies not online for free. YMMV.

[nukeswife]

I was able to be in the room for all the tests and had the same interaction with our Dr as the pper mentioned.

 

Yes therapy is expensive, but in my eyes it was worth every penny. My dd is making progress in leaps and bounds. She did 40 weeks and that cost us about $4500. We were able to pay either all up front with a discount (and a written contract that said we could stop and get a refund for any unused sessions at any time) or we could pay per session each time we went in. Our sessions were weekly and 1hr long. Then we were given homework that they wanted us to do 4-5 days a week.

 

We loved our therapist and my dd looks forward to going back for her progress evals every few months now that she's graduated from therapy.

[SKL]

The wandering eye would concern me. However, 24 weeks sounds like a lot if she is not having a lot of problems. Can you seek a second opinion or sign up for a shorter stint of therapy and then re-evaluate?

 

I will say that VT was very helpful for my dd, but she scored horribly on about half of the tests during the eval. And also, we only did 18 weeks. (I paid roughly $2,000 for the 18 sessions.)

[PeterPan]

I was in the room for the first visit with the exam and tools, but she wasn't really saying much. I wasn't in the room for the paper test. They've offered several different ways to pay. The payment options are helpful but we've had a tough year and I don't know that we can swing any of them right now. I'll ask them about doing more at home right now vs the office. Thanks for the input.

 

ETA: I guess I also just expected more problems to show up on the paper test since they're recommending the therapy and it's so expensive. I can see though that the dr. saw other problems in the first visit as well. I guess it all takes some getting used to and it's hard since I don't know anyone who's done vision therapy and the research online seems to differ.

 

Thanks for the link! I think one of the problems I have with going forward is that dd tests extremely well and seems to have no trouble reading. Many in that thread talked of reading problems and I don't see that here. It's all writing and spelling.

 

We talk about VT on the SN board all the time. You're welcome to come over! :)

 

And no, it's sneaky with bright kids. The brain actually devises work arounds. So you can have a kid who for instance doesn't have actual depth perception. The brain will calculate out a pseudo depth perception. Then as they start working on it in therapy the kids are banging into things MORE rather than less, and the parent is wondering why! LOL The method the brain had figured out conflicted with the better method the therapy was teaching them. So yes, bright kids can read and test exceptionally well (my dd always has) and still need VT.

 

Just talk with them again. They should be able to explain the test results to you and what each thing means. It's not voodoo or something. There are actual physical parameters they test that you're expecting to see change.

 

I've heard higher numbers in expensive states like NY, so it really can vary geographically. I think ours was around $70 a session (1/2 hour), and they gave you a discount (buy 7, get 1 free) if you bought a block of 8. What I'm suggesting is that pay as you go allows you to make sure you're satisfied. We've had people post on the SN board saying they had to drive a long way and made do with *1* session a month and tons of homework. I don't know if those sessions at your place are 1/2 hour or 1 hour. If that's 1 hour for $130, that's not terrible and is similar to what we paid (2 sessions at half that apiece). Also, some places have sliding scales based on income.

 

VT is the kind of thing that benefits from some guidance but where a LOT of it can be done at home. So instead of thinking in terms of their paradigm (lots of sessions, lots of cost), think about what you *could* afford and how much help that will give you, with you making up the rest with hard work at home. It will work out fine.

[SKL]

 

On a board for homeschoolers ("do it yourselfers), I've been surprised at how many people pony up for this. Did it help because the mother feels it must for that much money, because the child grew up a little, or because some simple training you or I could have done did the trick. None of us have enough children to answer that question scientifically, and the studies I found have been put online by people who stand to profit from it.

 

 

Nothing wrong with delegating stuff to someone with specific experience in a given area, in my opinion.

 

I think that if there weren't value in doing so, you'd be seeing more commenters saying that they regret spending the money on something they could have done themselves.

 

Of course it doesn't work out for everyone, but neither do other types of therapy, or financial planning, or legal advice, or psychological counseling, etc.

 

I find it interesting that there are many people who clearly benefit from VT and yet some folks insist that it's snake oil. I mean, if I thought my dd's VT was a waste of money, I'd be the first to say so. I don't own stock in any optometrists.

[PeterPan]

For 133 dollars a session, I personally would look online....

On a board for homeschoolers ("do it yourselfers), I've been surprised at how many people pony up for this. Did it help because the mother feels it must for that much money, because the child grew up a little, or because some simple training you or I could have done did the trick. None of us have enough children to answer that question scientifically, and the studies I found have been put online by people who stand to profit from it.

 

I do admit to not having looked very hard for other studies not online for free. YMMV.

 

Depends on if the sessions are 1/2 hour or 1 hour. And some places like NY are just plain more expensive than other parts of the country. It varies.

 

And as for ponying up for VT, lol, well I did it because my dd was having headaches. The headaches got better, and then as we did the VT a lot of OTHER things started improving that we never REALIZED were vision-related. So VT is not snake oil. There are bad docs for it, just like there are bad docs in everything. That's definitely the case, and we shoo people away from bad docs regularly here and on the SN board. But there are also some really good ones.

 

Yes, there are also things you can do yourself at home that help. But that's shooting in the dark. At some point the parent needs to know what the issues are, what they're treating, and have a way to see if what the parent is doing at home is getting the job done. We've had some moms on the SN board do that as well.

[Embassy]

My two older children both have difficulties. One has convergence insufficiency and the other has tracking issues. The one with convergence insufficiency has no problems academically, but gets headaches. The one with tracking issues skips around when reading and gets distracted with everything.

 

When they tried to show me exercises to do with my son I discovered that I also had the same issue (convergence insufficiency) :tongue_smile Hmm...maybe I can get less headaches if I practice too.

 

We were given home exercises to do and are supposed to check back in 6 months. He said VT was very expensive and that we could split the sessions between the kids. I don't think we could do VT unless our insurance covers most of it. I've seen progress with our home exercises so I'm hopeful that we won't need the expensive sessions.

[Joker]

The sessions would be 50 minutes at $120/session. There is a supply fee as well (the paperwork says they loan stuff to us to use at home) so it comes to just over $500/month with a discount for auto pay. She did say we could get an extra discount if we took early morning hours on a certain day since the afterschool hours are so full. That's not a problem since this dd is still homeschooled.

 

The dr. did say based on the paper test results she knows dd is very bright and she thinks that's why she's been able to compensate so well this long. I think I will ask tomorrow about just paying as we go and being able to stop at anytime.

 

Also, does anyone know if you can use FSA or HSA funds to pay for vision therapy? Since it's not covered by our insurance, I'm wondering if we would still be able to use the card for it.

[PeterPan]

Yes, you can use your HSA to pay for it.

 

BTW, even though we have a high deductible with HSA, when they ran it through our insurance the rates for some of the months went down. Apparently it's how they code it. So it wasn't for the whole thing and didn't change that we were paying up to our deductible. It's just our insurance considered what they coded it for in those months covered, therefore the price went down. So let them run it through. You just never know.

 

And yes, turns out I have issues myself, which is part of why I get headaches. I started VT this summer while we were off, got to work a while, and got sidetracked when we got back in with school stuff. You don't know how odd you are till you start digging, lol. Now we know why I kept asking dh to explain where the blind spot is on the car and him wondering why I kept turning my head so far, lol. (peripheral vision issues, among other things)

 

If their program is structured enough that they have you buying a therapy notebook or packet, that's a good sign that you're going to be able to space those appointments and do more homework to keep the cost down.

[nukeswife]

Our therapy came to $95 for each 1hr session and most supplies were loaned to us, we only had to pay for them if we broke them or lost them. The only one we had to pay for no matter what was a computer program but we get to keep that and my dd still uses it even though she's not in therapy anymore. Some of the activities were fun for her so she likes to "play" those.

 

I agree with others that say some kids are very bright and have brains that came up with some interesting coping mechanisms that you just don't realize until you get into therapy.

 

I don't buy the "It could just be that they got older" suggestion as to why VT sometimes works. My dd didn't start therapy until she was 9.5 and due to tracking issues could barely read anything beyond a bob book. Now she's still not up to grade level but she doesn't freak out if she has to read things and will read for pleasure, things she would never do before VT gave her the tools she needed to actually read without huge obstacles.

[Joker]

Well, they gave me quite a break if I would take an early morning time that no one else wanted. It wasn't a problem for us since this dd is still homeschooled. It was going to be just over $500/mo but they lowered it to $365/mo. (and waived the supply fee). We can swing that but it will be a tough six months. Dd is excited and hopeful that they can fix her wandering eye and help her quit writing several reversals. She says it's embarrassing. :sad: I really hope it works.

[PeterPan]

Well that's awesome! Glad that could work out something with you!!! Yes, it's going to help her, and it actually doesn't take long to see results. In one month we thought we were, in 2 months we knew we were, and in 3 months we were into the totally wow.

 

So congratulations on getting started! Just so you know, it totally varies with the kid. My kid was utterly worn out with VT, both on therapy days and with headaches from the homework. You may need to modify your school work (or drop most of it) for a while. After the VT my dd had a huge surge, so I'd just go with it. It's worth doing whatever it takes.

 

Keep us posted on how it goes! :)