Spoke with a Neuropsychologist today about VT before testing

[Mandylubug]

So, I have been calling around today trying to find a neuropsychologist on our insurance plan (hello, pain in the butt!). Anyway, the NP gets on the phone after the receptionist went to ask a few questions on my behalf and wanted to warn me against VT. He was very polite, asked many questions about our testing and really listened to me. I didn't find him rude.

 

He encouraged me to follow through with treatment if I wanted to. However, he felt it just a waste of money. He considers eye tracking issues, blurring, tiredness, and others just symptoms of learning issues once sight health has been verified. He also stated he had known some kids come out with issues they didn't begin with.

 

His recommendation was to move ahead with a np evaluation and testing. If I wanted to continue with VT, he didn't care but he also admitted he was biased on the subject. He said in the end, I have to research it all and make my own informed decision. His opinion was that if I will need to go through with VT to realize that the dyslexia is a learning disability and not vision related then he thinks I should. The thing is, I told him the VT Dr. NEVER claimed that dyslexia was caused by Vision issues and actually referred us out to continue the process of testing for dyslexia and I don't think the vision issues can cause dyslexia.

 

So, I am at a crossroads. Do I use a NP for testing that is against VT? How does a NP explain tracking issues and how is it recommended to correct it if not through VT?

 

I admit to being completely mentally confused at the moment.

[GoVanGogh]

 

So, I am at a crossroads. Do I use a NP for testing that is against VT? How does a NP explain tracking issues and how is it recommended to correct it if not through VT?

 

My DS had tracking issues with strabismus.

 

He couldn't track to read prior to the surgery. (Could read, but everything but one word had to be covered up.) He was able to read without problems within hours of waking up from surgery.

 

HIs tracking issues for writing persisted, though. I tried to get VT, but doctors all warned me against it. First OT I contacted refused to do an eval without DS going through VT first, due to the eye surgery. Later OT and PT evals showed retained ATNR and STNR reflexes. Working on those has helped tracking for writing.

 

I have a friend whose child is going through VT right now. HIs therapy is so very similar to some of the OT and PT my son is doing.

 

I don't know about using the NP. If you got a good feel for him, aside from the VT, I would probably go with. I know some specialists look down on some therapy and I accept that. My DS goes to a chiropractor and has had a wonderful experience. But I don't share that with all of my son's doctors, you know?

[OneStepAtATime]

I fully sympathize.  There seems to be this weird dynamic between the different disciplines where one feels like they know it all and the other guy is just full of hooey and vice versa.  The different groups don't seem to want to admit that maybe there are MANY issues that need DIFFERENT types of remediation to make a better whole.  I am so tired of one doctor in one discipline acting like the other guys are fruitcakes.

 

My DS has a vision issue.  He needs help to correct that vision issue.  That vision issue is causing additional problems with reading.  He may also be dyslexic.  That is a separate issue, but manifests as being the same issue (Reading and spelling errors and difficulty).

 

 I was told by the OP that dyslexia is a vision issue and he can fix it.  No, he can't.  But he may be able to fix or at least improve the vision issue.

 

 I was told by the assessor we went to that dyslexia is not a vision issue and if we are told that, the doctor doesn't know what they are talking about.  Dyslexia is strictly a difference in neurological processing and never has been or ever will be a vision issue.  Well, dyslexia isn't a vision issue, but vision issues can mimic dyslexia issues or exacerbate dyslexia issues.  

 

I was told by an Opthalmologist that Optometrists are basically quacks and there is no such thing as vision issues with tracking, etc.  He also said that there was no such thing as dyslexia or dysgraphia.  

 

I take EVERYTHING told to me by professionals with a grain of salt now.  They only know what is in their own backyard and they have no interest in playing with others (at least the ones in my area.)

 

You might go ahead and use this NP since you are having difficulty finding someone on your insurance plan.  Just don't believe everything he tells you about VT.  See how VT is working, and just listen to the NP for everything else (with a grain of salt thrown in :) ).

[Lecka]

I like that he is honest. 

 

Can you call back and see what his answer is about the eye tracking?  Say -- what after 6 months of reading instruction, a child still exhibits the tracking issue, then what would he say?  Would he say wait another 6 months?  Would he say "then try this?"   

 

I have been told before -- sometimes it can be, that b/c of learning issues, there is a lack of practice, and the lack of practice, is causing the issue.  So -- they think it will resolve itself once there is some quality reading instruction, and reading practice. 

 

I have been told before -- some children develop the skills a little later, you can just wait, and it will resolve itself. 

 

So ----- those are two things he might say. 

 

My son's tracking has been addressed with OT.  He has a certain kind  (related to crossing the midline).  He sees an OT at school (well he just exited), and privately.  Separately -- the one at school, recommended he have an eval from a vision therapist.  The one privately, gave me contact information for a vision therapist she had heard good things about.  I ended up doing it.  It had looked like he was not making progress with her, when she gave me the contact information, and then he had a small breakthrough and started to have some things click with him, from the things she was doing. 

 

But I had taken him to a COVD eval after talking to the school OT, before talking to the private OT.  He told me -- he thought OT might work, he told me what he did might work, he thought that either one would work for a lot of kids, and then for some kids, they might really need one or the other.  But he could not tell me which would be the case for my son -- he was saying, he has to do 6 sessions and see what happens.  That is about what the private OT told me also (she said -- let's see where he is after 2 months). 

 

Sorry -- so long and incoherent.  But that is what I have got.

 

See what he says, though. 

 

I can tell you -- my son had good reading instruction (from me) and still had this tracking issue.  I think an issue with convergence insufficiency did resolve itself with more practice.  He showed it in K and 1st, but not in 2nd.  He is able to hold a book a normal distance away and read comfortably now. 

 

 

[Mandylubug]

I did ask him his opinion on tracking issues. He says he would get a second opinion from a dr that does not specialize in VT, Like an ophthalmologist to rule out any medically caused tracking issues. If nothing medically is causing the tracking issues, he believes it is developmentally a part of the learning disability that will improve with practice.

 

He didn't have too much of an opinion on it, his opinion was if she was cleared by a non VT Dr. has glasses that are recommended and using them, he is ok with moving forward with testing. He just didn't want to evaluate if she was unable to read due to needing glasses. Personally, I trust our VT Dr and don't think I require a second opinion. I have already seen an ophthalmologist with one child in December and I am more comfortable with our COVD Dr. She was way more thorough.

[FairProspects]

What is the VT for? Tracking or convergence? The research is pretty clear that VT helps for convergence; it is less clear on tracking which may resolve on its own or be related to SPD and other issues. I'd tend to go with the NP if the only issue is tracking, if it is convergence, I'd probably do the VT, but JMHO.

[Mandylubug]

What is the VT for? Tracking or convergence? The research is pretty clear that VT helps for convergence; it is less clear on tracking which may resolve on its own or be related to SPD and other issues. I'd tend to go with the NP if the only issue is tracking, if it is convergence, I'd probably do the VT, but JMHO.

Blurring, tracking and visual processing is what she summarized its purpose of treatment. She referred us to do further testing for dyslexia. No convergence issues.

[Julie of KY]

I think vision issues (like tracking, convergence, binocular vision, etc) need to be addressed by Vision Therapy. I think many reading disorders can be simply vsion problems, but many kids have overlapping problems of both vision and dyslexic difficulties. The label of dyslexia is sometimes used for anyone that has trouble reading reguardless of the underlying problem. Many people reserve the definition of dyslexia for problems with phonemic awareness resulting in difficulty reading.

 

When I told our psych that we were doing vision therapy, she said we could save a lot of money because there's an app for that. I think many people are misinformed about visual problems and their treatment.

 

If the neuropsych is a good evaluator for learning disabilities, I wouldn't worry too much about what they though of vision therapy unless they treat you differently because of it.

[EKS]

Here is something the Eides wrote about vision issues and dyslexia.  If you google "dyslexia vision eide", you'll get some other things as well.

 

I tend to trust the Eides over others in matters like this. 

[PeterPan]

Happily, if you do VT first, you're going to have a few months here to keep looking for more psychs while you do the VT.  Our np is on the state dyslexia advisory board, and he didn't poo-poo VT.  The psych could be out of the loop on more than just that, and if he's willing to be so condescending on one thing, he may find more to dump on you.  (his opinions on how your kids should be educated, etc.)  I'd keep looking, since there's no reason not to.  First and foremost in the psych you need a reasonable working relationship, someone you feel comfortable talking to.  

 

Did you ask your eye doc for recs?

[EKS]

One of the NPs we used also had a dim view of VT.  She told me it never did anything and was a waste of money.  This was after I had gone though a year of VT with each of my kids and saw obvious, substantial improvement from it.  For example, my younger son could barely catch a basketball with two hands (backed up by his body, if that makes sense) before VT.  After two months I could throw him a bean bag and he would reach out with one hand and snatch it out of the air! 

[Mandylubug]

Happily, if you do VT first, you're going to have a few months here to keep looking for more psychs while you do the VT. Our np is on the state dyslexia advisory board, and he didn't poo-poo VT. The psych could be out of the loop on more than just that, and if he's willing to be so condescending on one thing, he may find more to dump on you. (his opinions on how your kids should be educated, etc.) I'd keep looking, since there's no reason not to. First and foremost in the psych you need a reasonable working relationship, someone you feel comfortable talking to.

 

Did you ask your eye doc for recs?

I haven't yet. I will be now as well. I think I will throw out a mass email with my homeschool association asking for recommendations from other homeschool families.

[SKL]

There are a lot of different vision issues.  They can co-exist with dyslexia or not co-exist.  Just like anything else.  If your child was near-sighted or deaf, but also dyslexic, you wouldn't deny her glasses or a hearing aid just because the dyslexia is present.

 

I am an advocate for VT since it had great results for my kid and my niece.  I have also seen the skepticism among professionals in other fields, and my ex-ophthalmologist tried to talk me out of VT too.  I don't entirely understand the skepticism.  I know that VT doesn't help everyone, but the people I work with don't try to sell services that are not needed.  I think your NP is overstepping his bounds, just as much as if your vision professional tried to talk you out of going to a NP.

[geodob]

An NP evaluation and testing that didn't take into account the tracking and blurring issues, and how it could effect performance on some of sub-tests?

Can't provide an accurate diagnosis, as it would skew the results.

It would probably be better to complete the VT first and hopefully resolve the tracking and blurring to some degree.

Before having the NP evaluation and testing, so that it provides more valid results.

 

 

[Mandylubug]

Well, we requested local, homeschool friendly recommendations from about 300 families and received an outpouring of recommendations for using the same NP I spoke with. I actually called all the others near us and covered by our insurance. I called back spoke with them some more and due to how far out they are booked just for initial exams, not even including testing, we are scheduled for an intake interview in March. If we feel they are a good fit, we will then ask for them to preauthorize the testing and wait for those answers from insurance. Their estimated testing time frame is May.

 

We will have plenty of time to work on VT between now and then as well.

[OneStepAtATime]

Good luck, Mandylubug!  Hope the VT helps.

[srs]

We have had a similar experience, with our wonderful developmental pediatrician basically saying that she thought VT might be a waste of money, and to pay as we go and not upfront, if we chose to do it. We decided to wait because the primary issue seemed to improve on its own, and now we are going to start some tracking exercises through OT instead, at her therapist's suggestion. I am hoping it will provide at least some of the benefit at a lower cost, as OT is covered by our health insurance but VT is not.