Vision Development Screening

[CraftyHomeschool]

Hi, I’m fairly new here. I have a 9 yr old (10 in May) who has struggled with reading since he started reading (or lack of in K/1st, PS). I have read a few different individuals recommending vision testing by a vision development optometrist rather than testing for dyslexia first. We live in a remote location (over three hours from any “cityâ€) so we haven't had too much reading related testing done. The local PS thought he had a language processing disorder but in Idaho they aren’t required to do testing besides finding out there is a difficulty and getting an IEP (not much help because we homeschool and they don’t want to work with us). We haven’t been able to locate someone to do any dyslexia specific testing (LONG story). In one of the posts there was a link to find a referral for a certified vision development optometrist. We AMAZINGLY have one only 3 1/2 hours from us! I set up an appointment for next week. I just don't know what I need to bring. I don’t want to overwhelm her with too much irrelevant information but I also want to give her enough information so she can hopefully help us. I'm just not sure what to expect. Will she go over his reading struggles or just vision related information? If anyone could tell me what to expect and what I need to bring/do to be prepared I would be forever be grateful!!!

 

Thanks,

Len

[wapiti]

Is this a screening or a full developmental vision evaluation? That's a long drive for just a screening. If it's a full evaluation, your concerns about reading should show themselves during the testing if they are vision-related. If it's just a screening, then by all means discuss the struggles while the doc is doing the screening. Either way, don't stay silent on the reading issues. I can't think of anything to bring unless you'd like to show a sample of a handwriting issue, for example.

 

FWIW, one of my kids had both vision issues and language processing issues (but not dyslexia). A speech and language pathologist (SLP) should be able to evaluate for language processing issues, which may include some tests relevant to testing for dyslexia. If you're looking for dyslexia testing, at some point you'd want to see an ed psych or neuropsych.

[CraftyHomeschool]

It's a screening for now. Our insurance will not pay for a full evaluation without a screening and pre-approval (several months of paper work). I have taken him to our regular dr twice, the first time he said it was because we homeschooled and my son needed to be in PS, the second time (I took ALL our curriculum and portfolio to show him EXACTLY what was going on) he referred us to a local psychiatrist. She kept talking to my son about how he felt about reading (for two months), she never listened to him read, even for a second. I finally had enough and we haven't been back since. I have figured out that if we get any help it will not be locally, meaning we have to travel minimum of 3 hrs. I'm just not sure what else to do. We are currently using a program designed for dyslexics (Reading Horizons Discovery). He has made progress but part of me thinks there should be something else I should be doing to help him. He is a very smart kid, he does fine in math (except his #s get mixed up), loves science, can verbalize a story (but can't write it down), and love listening to books (but can't read proficiently). It seems to take WAY more effort for him to read/write than it should, he seems exhausted after only a few sentences.

[3monkeys]

www.diannecraft.org might be useful for you since you're so far away from therapy.

[3monkeys]

www.diannecraft.org might be useful for you since you're so far away from therapy.

[PeterPan]

The gas to drive 7 hours will be more than the cost of doing the full eval, and you don't want to wait months before you begin therapy anyway. If you start therapy now, you'll be largely done by fall or at least have enough under your belt to have radical changes. If you wait several months for insurance approval for the $200-300 eval (which for us would be the cost of gas to drive that far) then you're starting therapy in the fall. So go, get the full eval, then you'll know. If you actually have demonstrable issues of vision problems that are prompting people to tell you to get the vision eval, then you know he's going to need it.

[CraftyHomeschool]

Thankfully it won’t cost us that much to travel out of town and is something that is fairly normal in our location. The insurance will cover the initial visit, just not the follow ups without paperwork. If we had the $200-$300 for a full evaluation out of pocket I would consider doing that. Unfortunately, we just don’t have the money right now, plus that would mean would have to pay for all/any follow up appointments and therapies out of pocket. What is the difference between the screening and the evaluation? If we just do the screening this appointment, will we find out if his vision is a problem (or THE problem)? I made a list of some of the more challenging problems we have been fighting. I plan to discuss that list with the doctor. If she determines that vision is not the problem then I find a neuropsychologist? There is one in the same city we will be visiting next week. Should I try to get in touch with them, or just wait and see what the VDO says? We have been treating his reading deficits as if he was dyslexic (or similar language based problem) but I would like to have an exact diagnosis so I know how I can help him more/better. Truthfully we sort of hoped/prayed he would “outgrow†some of the difficulties, or somehow the “light†would just turn on, but at 9 that doesn’t seem to be the case. We don’t seem to be able to do on-line programs (we already tried on-line tutoring and it flopped) so Diane Croft is out.

[3monkeys]

Just FYI....Dianne Craft is not an online tutor. She has a book you can buy to do exercises at home to help with learning difficulties. Her website if full of information and just thought it might be helpful to you.

[PeterPan]

Crafty, I guess talk with the eye doc and see what they're scheduling you for. Around here the docs have the regular annual eye exam (check vision, eye health, glaucoma, new scrip for glasses, all that) during which a developmental optometrist can also throw in a screening of developmental vision issues. So you mention it to them and he can quickly check convergence, focusing, a few other parameters. At that point he says yes, come in for the full developmental vision eval, I see stuff going on, or no that's not the issue. A full developmental vision eval is typically 2-3 hours and they go into all the dev. vision issues. They'll hook him up to a computer and use special goggles to record his tracking. They'll check depth perception and visual perception skills. They'll screen for OT issues like retained primitive reflexes and bilaterality issues that interact with vision.

 

So the main thing is to make sure, before you drive all that way, that you know exactly what they're doing. Hate for you to drive all that way and be dissatisfied (or worse yet, upset with us for suggesting it!).

 

Have you tried any OG methods? (SWR, AAS, WRTR, PR, LOE, Barton, Wilson, lots of options) It was the first thing our VT doc asked when we walked in the door.

 

Psychs take longer to get into. You're probably going to need that psych eval, so you might as well start looking. Around here it takes 1-3 months to get in for the initial appt. The VT doc might have a good recommendation for you. Given that the school is saying language processing disorder (not attention, the easy answer), I would get the ball rolling on that. It will give you a lot better information to teach with.

[CraftyHomeschool]

I'm sorry 3monkeys, it was a great recommendation for the books. I have looked at some of the material, especially the brain integration book. I also noticed that she offered on-line consultations, sorry I thought that's what you were recommending. Has anyone used her books? There is so much out there to "fix" or help a child who is struggling I have a hard time figuring out what's a hoax and what really is worth the money. OhElizabeth we are currently using Reading Horizons Discovery, which is OG based. He has made great strides (slow but steady) using the program. We tried SPIRE for almost a year, he did ok, I HATED it. I pulled him out of PS toward the end of 1st grade. They kept telling me that he just needed time and it would all work it's self out but they would send home photocopied readers with a few simple words on each page (similar to the first set of BOB books) and it took him over an hour to read them (and LOTS of tears). They put him in an hour long "special" class each day while the other kids got to go to recess and then they got upset with him because he got fidgety. VERY frustrating! When we brought him home we took a VERY relaxed approach to reading, he didn't have to read, but I read to him ALL the time. I needed him to enjoy at least looking at books again. Thankfully it worked and he now LOVES books, just struggles with the actual reading. We used Click N'Read for about 6 months (2nd grade) with VERY little progress. We used the Explode the Code books for about a 1 ½ yrs, (2^nd/3^rd) we worked through books 1-3 but he gets stuck on vowel digraphs. We used the SPIRE program most of this year (summer and 4^th) but I saw very little progress (he seemed to be at a plateau) so when the opportunity to try Reading Horizons Discovery came, I jumped on it. He has made more progress in the last few months on the program than almost a year using SPIRE. We requested an evaluation this year from the PS and my son met with a teacher via Skype 2X each week (for an hour each time) for several months to do reading “workâ€. It was at that point they diagnosed a language based learning disability. I'm hoping to get a more helpful evaluation, something that says why/what he is struggling with. Specific areas that need work and how I can best teach him. We are currently using (and have been for almost 3 years) All About Spelling and LOVE the program and we see steady (although slow) progress. There readers are much easier for him to read than most readers at that level, I’m not sure if it’s the font or the spacing but his is currently in Level 2 Vol 1 and does ok with that level. I’m not going to be upset if nothing comes out of this, we’ll just be in the same place we are right now but at least then I know it’s not a vision problem. I do truly appreciate every suggestion!

[PeterPan]

When you say his progress with AAS is slow, it's slow because he can't attend (sit still, pay attention) for more? Or is it not sticking? Have you tried doing two AAS sessions a day broken up or adding in some drill? AAS comes with nicely arranged flashcards for all his words. I would bundle them and have him drill them through several times a day. (Quick, go read your group 1 words and I'll time you, awesome!, later rinse and repeat with group 2, and a 3rd time in the day quickly drill group 3) It can take a long time to build automaticity.

 

Anyways, maybe that will give you some thoughts to pursue while you're waiting for that vision eval. Maybe that will turn up something. Definitely start checking into a psych. If your state has a dyslexia association, see who's on the board or who speaks at their meetings. Might give you a way to find someone. Then when you ask your VT doc for names, you'll get that overlap to give you confidence you're on the right path.

[CraftyHomeschool]

I guess part of our "slow" problem may just be me, I don't always know when he needs to move forward. He is REALLY inconsistent with his LA. One day it seems that our lesson is too easy and the next day he seems confused about writing/spelling/reading. That is a great idea to do it multiple times each day, we may bump it up to twice a day (just with the spelling card review?). He can read the spelling cards much better than he can spell them, reading out of context words is not really a problem, he can read his sight words on 3X5 cards and about 50% of the time in text but then the other 50% of the time he either skips it, substitutes a different word or sounds it out. My favorite part of AAS is the cards, it's really "mom" friendly :laugh: . We started doing his sight words similarly, in a box for daily review and that has been a huge help (exactly like this, just with sight words instead of scriptures). Part of the problem is attention span and part is just language issues. He was diagnosed ADHD but it doesn't seem "that" bad (and has gotten better with age). He can focus really well for about 15 minutes at a time before he gets fidgety. We just have to change what he is doing regularly, for example he does seat work for 15 min, then board work for 15 min, then I have him sit on the floor with me to do another 15 min activity (this is basically JUST for his LA). He can sit for extended periods if he has "fidgets" to play with. We don't feel that his struggles are attention related (but we could be wrong). We do a total of an hour and a half for LA, broken into sections (dictation/spelling/read out loud/handwriting). He can work through an entire double sided page of math and can sit to listen to history and science for about 30 min before he needs to get up and walk around. His listening comprehension is amazing, even though it seems like he is not paying attention. He says words move on the page and just doesn't have much stamina for reading (even silently). He starts rubbing his eyes and reads through the bottom of his glasses and under his glasses. It seems like he is looking at the very top of the wall where the wall and ceiling meet. His memory is not great (depending on the subject and interest) and is slow to think of an answer (even if he has it memorized). I hate to compare kids BUT I have two other kids (7 and 4) and they can blurt out a letter names and sounds very quickly. My son takes several seconds to say a letter name/sound, I know he knows them it just seems to take a while for his brain to find the correct answer. Writing is a joke, I either dictate or write it and have him copy in his own handwriting. When he is writing he can't spell worth anything, even simple words like "the" become more like "teh" and words that he spelled correctly while working in AAS are not spelled even close while writing. He likes to write me letters and bring them into me first thing in the morning so he can read them to me but he can't and he'll say "I can't even read it!" (because of spelling errors) and then we have a good laugh. I will talk to the VDO about recommendations when we're there. I'm going to call the VDO back and see if maybe we get a referral from our reg doc then hopefully we can get the full evaluation. I'm glad that was brought up because I don't want to have "just" a regular eye exam and I think I made that clear BUT just in case I'm going to check. We have a reg optometrist here that he sees (he has glasses already) so there is no need for a reg eye exam.

[PeterPan]

Yes, if you could go ahead and get the full eval, that would be good. That rubbing his eyes is a VT issue, easily correctable.

 

Yup, low processing speed is hard to work with. Bite your tongue and don't compare, as you say. Yes, the today not tomorrow thing is probably partly his vision. ADHD kids tend to be VSL (if you believe Freed, R-Brained Children in a L-Brained World), but when they have vision problems their VSL abilities are locked up. You do the VT and it may unlock it.

 

Don't put just his sight words on the flashcards. EVERY SINGLE WORD should be on the flashcards. This is where I don't like AAS (just truthfully speaking). It's way too slow. I taught my dd with SWR. You know a cheap option for you would be to get WRTR from the library and just start working through the words in their using your AAS techniques. Then put the WRTR words onto flashcards. That will bump up his reading level more quickly than AAS.

 

Well tell us how his vision eval goes. Definitely sounds like he needs it!