Convergence...vision therapy, Lexercise, or????

[mcaskey826]

My 7yo son was diagnosed with convergence about 2 years ago and wears glasses for it.  After a lot of struggles with reading, I'm now discovering that this is causing more problems than we realized.  He saw an optomitrist today that specializes in convergence and she has set him up to do a full 1-2 hour evaluation in the next few weeks, and begin a plan to do vision therapy.  I was excited and feeling we were on the right track and now after a little research, I'm seeing that there are varying opionions on whether vision therapy is a vaild treatment, or to go with a program that implements Orton-Gillingham approach.  Either way I go it seems that it's an expensive prospect, but I'm willing to do what we need to in order to see him succeed and improve his confidence.  I figured many of you might have some insight on the best approach.  Thank you!

[Tiramisu]

There seems to be more agreement about the effectiveness of VT for convergence insufficiency than for anything else. And if insurance companies are going to cover VT, it's usually for convergence insufficiency, because of the research that's been done. I had one dd treated for convergence insufficiency and tracking and another is currently in VT for convergence excess, tracking, and accommodative insufficiency. The results have been especially dramatic for the one who is in VT now, though it certainly helped the other one, too. 

 

I recently ran into someone whose child had VT and we both agreed that the most impressive changes we've seen have nothing to do with academics. The learning issues are most definitely improved but it's the changes in everyday life stuff that have amazed me. And it makes sense; our eyes are probably what we use most in interacting with the world around us. The time we spend reading and writing, even if a lot, is limited compared with that. 

 

In terms of recommending the best approach, I'd say use a covd optometrist who is recommended in your area. Our covd optometrist is a leader in VT research. He usually has students do once a week in office therapy for about forty-five minutes and five days a week of homework. He offers twice a week therapy sessions but it depends on what the VT is for whether that's an option. It's about $200 for an eval and $100 per session for therapy.

[kbutton]

VT and O-G will not do the same things at all. VT can be amazing for convergence issues, and in our case, it was like getting a lot of occupational therapy to boot (he still needed some later, but the VT was an enormous boost). VT might be necessary for him to benefit from O-G or any other program since we rely on our eyes to read, but if your child has phonetic issues and such, he'll still need specialized instruction for that via O-G. It's more of a both than an either/or.

 

Make sure you do the VT homework as often as possible (like at least 5 days per week). It's what makes it stick and makes you get through it quicker.

[ashamama]

We've been in OT and VT for a year and it has made such a difference. My boy went from not reading at all to reading way above grade level in a matter of weeks after we began addressing his convergence insufficiency....the one thing we noticed was that once his convergence was "better" (not fixed, but better) we noticed an increase in his car sickness and anxiety about going fast (taking the highway or going over a tall bridge in the car will induce panic and a meltdown.) And this past month, we've been caught up being ill, having issues with the house (plumbing break, ac break), car issues, (Seriously been non-stop issues since the middle of summer) and I have noticed an increased ammount of pirate-eyeing from him where he closes the weaker eye to use his other eye more. So if you don't work vigorously it seems to go away again. Pri I r to this his eye was getting stronger. :( But it is worth the hours to get better at it.

[mcaskey826]

VT and O-G will not do the same things at all. VT can be amazing for convergence issues, and in our case, it was like getting a lot of occupational therapy to boot (he still needed some later, but the VT was an enormous boost). VT might be necessary for him to benefit from O-G or any other program since we rely on our eyes to read, but if your child has phonetic issues and such, he'll still need specialized instruction for that via O-G. It's more of a both than an either/or.

 

Make sure you do the VT homework as often as possible (like at least 5 days per week). It's what makes it stick and makes you get through it quicker.

 

This is exactly what I thought, about needing the VT in order to benefit from the O-G.  I have a sales guy that's been contacting me from Lexercise, and while I understand it's his job to sell his product, he was condescending in saying that VT has no scientific evidence and that to never use an optomitrist, only an opthamologist, and on and on with his laughing condenscending tone. I explained that we have only done the dyslexia screening tool on the Lexercise website and that convergence may be the problem (since we have gotten 2 docs to examine and give this dx) rather than dyslexia, and I need to get a thorough professional evalutation.  I've just got to quit accepting his calls ;-)  

 

I think my son has a great grasp at phonics, I really think he's just struggling seeing them on the page.  We have soared through Levels 1 and 2 of AAR and AAS, and he GETS it, then it's a new day again when he tries to apply it. Some days are great and I think we are making progress, then others he asks me every word on the page, or he wants to get a snack, he has to use the bathroom, stand on his head, he's too tired....ANYTHING but reading and LA.  We both end up in tears.  I think we will do the VT, see how he improves and move on to an O-G program if needed at that point.  I really appreciate the feedback.  

[PeterPan]

I'm a huge fan of VT, did it for my older dc and take both of my kids (and myself!) to a developmental optometrist.  That said, you're only wasting time failing to get proper evals for the dyslexia if you suspect it.  With what you're describing, you'd be wise to pursue both paths.  You can have BOTH problems going on.  

 

It often takes multiple months to find a good psychologist and then to get in.  It would be better to go ahead and start looking now, find the psych, get on the wait list, and then cancel if you realize every single issue was only due to vision and has resolved.  More likely, you're going to need both.  So you'll start the VT now for the convergence issues, and in 3 months, with more VT under your belt, you'll finally be in to the psych to get the *rest* of what's going on explained.  It's NOT one or the other.

 

Btw, my dd did VT for convergence issues and we got amazing changes.  

[mckive6]

My dd also did VT for convergance insuffiency, and she made great improvements.  She also has an eye turn, and even though that won't change, she has many fewer issues now.  Her VT was computerized.  We would go to the office every few weeks.

 

Pauline

[laundrycrisis]

VT is not a cure-all but if it is exactly what you need, then it is exactly what you need.  It is physical and occupational therapy specifically for the visual system.  I still don't get people who say it somehow isn't real.

 

It's real.  It works when it is done properly and was what was needed in the first place.  If it isn't what is needed, or it isn't done right or completely, then it won't help.  

[Tess in the Burbs]

My Dd had great success with VT. She still has turning and we know more VT will be needed in her lifetime, but she stopped having headaches and can read for hours! She is thrilled. We went weekly for almost a year. Insurance did not cover it. However, I asked for and received a cash discount.

[kbutton]

Our VT has a pay up front option that gives a discount. It's in six-week increments with a checkup in between sessions, so if you make really fast progress (my son did), you aren't stuck with lots of extra sessions. My son's issues were mild, so being able to reassess and tailor the VT at those checkpoints (and in therapy sessions) was really helpful. He had 1:1 therapy with a trained person. He had one or two sessions with the COVD doc as well, but the trained person was very competent and perfect for the job. She always made sure we understood the homework, what to watch for to be sure we were doing it correctly, etc. 

[displace]

ITA with others that convergence insufficiency is helped by VT. Even AAP (American academy of pediatrics) recommends it in that instance.

[Guest2]

We started an O-G program...(Barton Reading and Spelling-I'm a huge fan) long before we knew our youngest had major VT issues. I knew he was having a hard time reading and I had the Bartons program as his sister needed it. No reason that your son can't do both! Personally, I wouldn't wait for evals if he can pass the screening test. If not, then it is a great idea to get an eval scheduled. You may have to do shorter lessons for eye fatigue. I'm not sure how it works in other O-G methods, but for Bartons ,the only reading he would be doing is with you during the lesson. It is a good fit here(YMMV).

[kbutton]

We started an O-G program...(Barton Reading and Spelling-I'm a huge fan) long before we knew our youngest had major VT issues. I knew he was having a hard time reading and I had the Bartons program as his sister needed it. No reason that your son can't do both! Personally, I wouldn't wait for evals if he can pass the screening test. If not, then it is a great idea to get an eval scheduled. You may have to do shorter lessons for eye fatigue. I'm not sure how it works in other O-G methods, but for Bartons ,the only reading he would be doing is with you during the lesson. It is a good fit here(YMMV).

 

I agree with this, but OP, if you are going to be paying big bucks for a tutor or specialized O-G program outside of the house, I would be concerned about being locked in and then finding out that the VT needs to be taken care of first. (It sounds like you are considering an outside service.)

[PeterPan]

My dd was too fatigued during VT to do much else.  Some kids are, some kids aren't.  She had some OT issues that I think, in hindsight, were making the VT harder.  We were getting OT, but the OT was kind of hairbrained and didn't catch everything, didn't assign homework or follow through on things.

 

You really have to look at everything as a whole: how long to get in for a psych eval, whether an OT eval is indicated, how many months of VT is being suggested, then make a game plan that makes sense.  *I* would get the screening test for the Barton done, because he might not even be ready for Barton.  If that's the case, he might need LIPS first, and that won't really be affected by the vision issues as it's largely auditory and sliding tiles.  And it would be good to get that psych eval and get the dyslexia diagnosed to open doors on resources.  Some states have disability funding, even for homeschoolers.  You'll get access to Learning Ally, Bookshare, BARD, etc.  

[zyllah]

What is a good age to do VT? I ask because our OT was surprised they evaluated my six year old.

[PeterPan]

They can even do VT on toddlers and babies.  The new standard among dev. optom. is to do a free vision exam on infants (under age 1).  Early is better than late on this, because when your vision isn't developing properly the visual *processing* isn't developing either.

[zyllah]

I had her evaluated but we are trying a different place for a few reasons so we will see what they say. I'm just running into therapy overload here. If VT is 2x we are up to eight a week. Thanks for everything.

[mcaskey826]

update...

I just found out after visiting with my sister (who is a former school teacher) that there is a local (10 minutes from my house!!!) Scottish Rite clinic that offers FREE consult/eval and tutoring using OG for dyslexic children.  I visited on the phone with the clinic director and she is sending me a packet to fill out.  She said there is a several month waitlist, but considering we homeschool and are flexible with our schedule, we should be able to get in very soon.  She was very encouraging and pro-HS, so I'm very excited to see what we can accomplish.  We are starting this Tuesday with the eval for VT and then will move on to the tutoring. Best part is, DS is excited about going! (I think he is as frustrated with our working dynamic as I am  :crying: )

[PeterPan]

Oh that's fabulous!!!  I think it's definitely the right thing to do, and they're a great place to help you do it!  :)

[mcaskey826]

So the vision eval showed convergence insufficiency which is causing double vision, inability to track, unable to focus up close, and visual processing disorder.  It showed he was in <5th %ile with his up close vision abilites. No wonder he won't sit still for more than 5 minutes to do any schoolwork! They said he'd need therapy 2xweek for 4-5 months. However, they do not bill insurance, and want $4,500 up front to do the therapy on top of the $200 I paid for the testing.  I've found another clinic in town that takes our insurance and will bill them, my part will be about $10 per therapy session, rather than me selling a kidney ;)  He goes next Monday for them to do their own evaluation.  We are going this morning for the testing and consult with Scottish Rite clinic to get the tutoring started.  Poor kid is going through the ringer with all of these appointments, but being the youngest child, I think he's enjoying all of the attention and 1:1 with mommy :) 

[PeterPan]

I'm glad for you that you're getting answers!  Yeah, I would NOT pay $4,500 upfront, and I'm a huge fan of VT.  When you pay upfront like that, you have no recourse if you're not happy with the therapy.  

 

Sounds like you're working on a lot of good things!  The VT will give the Scottish Rite people more tools to work with as your ds gets his convergence, visual memory, etc.  Just recognize, he *may* be very tired during his VT.  My dd had horrible headaches with VT.  Now it turns out she also had at least one retained primitive reflex, which we didn't realize at the time.  But still, she got very little school work done during those months of VT.  If the SR can eval, maybe just sorta get started slowly, and give him a month or two of VT under his belt before they're doing much on paper, that would be good.  

 

Are you going to go get an actual psych eval and diagnosis?  Honestly, you should.  With this many issues, you want paper trail.  That way, when you need accommodations for high school testing, etc., you have the documentation.  It will also get you access to Learning Ally, etc.  Now would be the time.  You might get more than a dyslexia label, from what you're describing.  It would give you more complete information.  If SR is *only* looking at dyslexia and not doing a full psych eval, then you might want to look into getting that done.

[mcaskey826]

Good to know about the psych eval.  I really wanted to avoid going through all of that, but it sounds as if it may be necessary. I'll start my research on that and find someone to get that started. SR cannot do an official diagnosis,  but said she definitely believes he has dyslexia and wants us to start with book 1 of explode the code at home while on the wait list.  It could be 3-4 months before they get to him and I'm ok with that, it will give him time to get his eyes where they need to be.  We will do ETC, math, and I will read to him, but take a more relaxed approach while working on VT. I appreciate everyone's feedback, it's refreshing to hear from moms who have been through this and can lead me in the right direction :)