Vision therapy: worth the money?

[Ravin]

We had a consult today for vision therapy. If we go for it, it will be out of pocket we will likely run up a credit card to make the payments.

 

Is it worth it? Did it deliver results for your child?

[SKL]

It was very helpful for my daughter.  All out of pocket, but if it makes the difference between success and failure in school, it's definitely worth it to me.

[EKS]

Both of my kids did VT, the older one for maybe 9 months and the younger one for over a year.

 

The older one had convergence and accommodation issues on top of dyslexia (which, at the time, we didn't know he had).  I can't point to anything specific that the VT helped with, but I do know that his reading and handwriting improved immensely during that period.  But he was getting a lot of input during that time in other ways too, so I don't know how much the VT contributed.

 

The younger one had a moderate astigmatism in one eye that wasn't caught until he was 4.  At that time it was apparent that he was having some visual problems.  For example, he didn't catch a ball properly for his age and, though he had been reading for about two years, his improvement there had stalled because he couldn't deal with smaller letters and (ever so slightly) more crowded text.  In an OT evaluation, it was also found that he couldn't maintain his gaze for more than a second or two, which meant for reading that he was constantly looking away from the book.

 

I know for a fact that VT helped the younger one.  Within just a few months, his reading improved dramatically, and he went from not being able to catch a bean bag that was tossed to him to being able to snatch it out of the air with either hand.  There were also other indications that I can't remember right now.

 

As for whether it was worth the money (and time and effort), I would say yes.

[PeterPan]

Hmm, you want the comforting answer or the more involved, complete answer? On the comforting end, sure, it could make a huge HUGE difference. 

 

On the realistic end, you've got to balance that with whether the eye doc is good, whether they screened for retained reflexes, whether they're working on visual processing as well, whether their business model is efficient or treating you like a cash cow, whether they're presenting you all the options to save money, whether you're doing VT for one of the things it's most effective for, whether you could get insurance to offset *part* of the therapy or hit part of the issues with something they would cover like OT, etc. etc.

 

So in general, it's worth a lot to make happen. But once you say rack up credit card debt, honestly I would pause, slow down the emotions, and ask a lot of questions. We've had people do therapy just once a month with tons of homework. We've had people find after OT they didn't even need VT. We've had people do OT (which again, your insurance might cover) and then need *less* VT. We've had eye docs who were worthless at retained reflexes and left people spinning their wheels. 

 

There's even a low cost, at home option using a book by the man who used to be head of COVD. I'm not saying it's a great option, but it exists. And I'm saying I'd be looking at ALL those questions before I went into debt.

 

How old is the dc and how disastrous is the problem? In the scheme of things, slowing down and waiting a week or two or three to sort things out probably won't ruin the world. We waited, when my dd was 10, for a couple months because we didn't have the money for the VT just then. It wasn't ideal, and she was having headaches with reading because her convergence was so bad. Now that she's 18, that wait time is forgotten, kwim? 

 

So if you waited a month or two and saved up, would it allow you to go to once a month sessions with lots of homework and not go into debt? I'm not radically opposed to stretching for really worthwhile things, but still. And even the credit card thing is rough. A lot of practitioners now have something called Care Credit, which has the billing fees subsidized, making them much lower. You might even want to call around and talk prices with other dev. optometrists.

[PeterPan]

Also, it's not like you're talking labels of brokenness. There are extremely successful people with ADHD, dyslexia...

 

The psychs we've been to all wanted to talk strengths. You might be surprised how POSITIVE the effect with be. The psychs who've eval'd my dd spent a LOT of time talking strengths. By 16, they're going to be willing to talk career counseling, etc. They're going to have some really helpful advice for him, based on what they're seeing.

[Ravin]

There is one other dev. Optometry practice in the metro area that I know of.

 

They are straightforward and up front about the fee, and offer two payment plans. It wouldn't ALL go on the cc, but a chunk of it would have to. My credit card rate is better than the care credit I could get.

 

She's in 8th grade. Reading is very hard work for her. We would like to improve that significantly before she starts high school, as the plan is for her to transition back into public school.

 

She has had some OT in the past, mostly for fine motor skills.

[PeterPan]

Is the optom finding convergence issues? Did he demonstrate specifically what he's finding?

 

What is causing the reading to be hard? Besides vision, there can also be low RAN/RAS, attention, etc. 

 

Some optometrists will say things like dyslexia is actually a vision problem, blah blah, which obviously isn't correct. So it's just more you can tease apart. Now someone can have multiple issues, sure. Ironically, my dyslexic does not have developmental vision problems (so far as I know) and my straight ADHD kid did. But once you say reading is very hard work, I'd want to make sure you're targeting the exact problem (s).

 

Has she had a CTOPP and reading achievement testing with no ceiling like the DAR, WIAT, or WISC?

 

I'm not trying to give you a hard time here, because I'm actually really, really in favor of VT! We refer people ALL THE TIME for VT around here, my dd did VT, I have my ds checked regularly by a developmental optometrist. I'm just saying it's good for what it's good for and asking whether it will solve your problem depends on accurately identifying what the problem IS. Or what the problems ARE. :)

 

Did the OT screen for retained primitive reflexes? Did the eye doc? You can find tests for them and lists of the names by googling. VT without working on retained reflexes first can be ineffective. 

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Edited August 11, 2017 by OhElizabeth

[Ravin]

I have no idea about retained primitive reflexes. She hasn't had testing in a couple of years. We are also going to pursue testing and hope to have an IEP in place before she starts high school, through the school where she attends an enrichment program for homeschoolers.

 

She also has other stuff going on. She has never been diagnosed with dyslexia. They don't use that label here in the psychoeducational testing afaik. 5th grade while homeschooled (from K) she tested at grade level across the board in private testing. 2 years ago after a year of brick and mortar school and several disastrous months with an online charter before we went back to homeschooling she had testing that put her at a 4th grade level in math and an IEP for what we felt were inadequate interventions for math and writing, but no reading deficits. In the past she has tested to show poor working memory and slow processing speed (in 3rd grade). She also has anxiety and ADHD, for which she is on meds.

 

She really hit a wall in both attention and reading, as well as math. Put too much on a page in front of her and she gets overwhelmed.

 

She did show some convergence issues in the developmental optometrist's exam. The doc did exams on both my kids and I, and DD was the only one he suggested vision therapy for. I don't recall specific details but he was very clear on his diagnoses and he improved my glasses prescription, so the optometry appointments were money well spent whether we go forward with therapy or not.

Edited August 11, 2017 by Ravin

[prairiewindmomma]

Vision therapy got my ds to the point of having enough visual skill TO read, but it didn't magically resolve everything.  We actually did two rounds of vision therapy (search through the forums, as I've posted extensively on this topic).  The second round, which involved a lot more whole body work, finally put my son to above-average visual-motor function.  He still has the working memory and processing speed issues, but no reading issues.

Three thoughts: 

 

1. I'd want the Beery test done on my kid, and I'd want to understand the results. http://nspt4kids.com/parenting/understanding-beery-vmi/

 

2. If you bump up the font size to 48, put in double spacing between lines, and have 2-3 lines of complex material, how does she do?  What does your gut say about processing speed, attention, and actual visual issues (head tilt, double images, shutting one eye, etc.)? 

 

3. Find the book: Beating dyspraxia with a hop, skip, and a jump, and look into some of the other body work that has been discussed here (primitive reflexes, etc.).  Some of the other body work activities seem ridiculously stupid to a teen (tossing beanbags, hitting a swinging ball with a stick, walking on a balance beam) but IME, the stuff done in the gym (bouncing a ball with your right hand, then with your left, then alternating) did a heck of a lot to get both hemispheres of the brain talking to each other and it was a heck of a lot cheaper than $200/vision therapy session.

 

Interestingly, we found that processing speed bumped up quite a bit after motor work.  I don't claim to understand it, but it's something that ds's psych pointed out after working with him.

 

 

 

 

[Jennifer-72]

3. Find the book: Beating dyspraxia with a hop, skip, and a jump, and look into some of the other body work that has been discussed here (primitive reflexes, etc.). Some of the other body work activities seem ridiculously stupid to a teen (tossing beanbags, hitting a swinging ball with a stick, walking on a balance beam) but IME, the stuff done in the gym (bouncing a ball with your right hand, then with your left, then alternating) did a heck of a lot to get both hemispheres of the brain talking to each other and it was a heck of a lot cheaper than $200/vision therapy session.

 

That book was so helpful for ds! I have always said when recommending it to people, that it is a very underwhelming read and the program he outlines is very basic and seems like it wouldn't do much, but I was so happy we stuck with the program. Ds went from testing with a mild/moderate gross motor delay to just a mild delay within about three months of us starting.

 

Vision therapy made a difference here not only for my son, but for myself! I had vision therapy back when I was 9, and since I am ancient, lol, I think that it even predates covd. I was falling behind in school, had bad headaches and had a terrible time with most sports as I really couldn't track a ball, etc. Lucky for me my optometrist is still practicing and was able to do vision therapy with my son when he was about 6.

[PeterPan]

It would definitely be worth your time to google/youtube for the tests for retained primitive reflexes. She almost assuredly has them, and the VT will be difficult going, or worse yet ineffective, till you treat them. The odds of her having them, given her current list of diagnoses, are HIGH. And they'll be free. When you do the exercises, they'll integrate in 1-2 months typically. That would give you time to save for the VT. I get that the convergence is an issue, but I would work on the reflexes and do some free midline and metronome work FIRST. 

 

504 is more likely than an IEP. Either way, will they offer you services now? If they do, I would go ahead and take them to get her access to more OT, calming strategies, strategies for the anxiety. The school should have services for the anxiety, and that way you'll have something in place and rolling before she enrolls. If they wait, it can take the whole first year to get services going.

 

I have that book Beating Dyspraxia. We didn't actually end up using it, because ds pretty much got the same thing with his gymnastics. That midline stuff Prairie is explaining is HUGE, huge, huge.

 

In any of her testing, did they run a CTOPP? They still should be calling it SLD Reading, even if they don't call it dyslexia, and they still could run a CTOPP. What I'd be wanting there is the RAN/RAS score. Does any other test give a RAN/RAS? You can just flat work on it, nuts. There's also a book for word retrieval that might be STELLAR for her. Amazon.com: think talk laugh  It's only $16 and this book is SO thorough it's stunning. Like it will blow your mind the amount of therapy you're getting for $16. if she has any issues with word retrieval and getting her thoughts out, it would be money well spent.

 

Also look for Heathermomster's metronome work. You can add to that digit spans, midline work, the RAN/RAS, etc.

 

That's all stuff you could do before VT. Some of it the VT doc might bring in, but when you're paying $60 why pay him to do what you can do yourself for free? A lot of times the bump with VT is not only because of vision but because they're also working on EF. So this stuff we're giving you will bump EF. You might see astonishing changes.

 

You should also do the convergence work, but I would do the other stuff too. I wouldn't even begin the VT until you've checked for and made a game plan for the retained reflexes. Some eye docs test them and will give you exercises. Some eye docs dno't give a rip. That means they don't give a rip about whether their therapy sticks or is effective. Nice people but kinda thwacked in the head, wiling to take our money. Oh no, we would never get bitter about this...

Edited August 12, 2017 by OhElizabeth

[Julie of KY]

VT was expensive and very worth it in my home.

 

I would do your research and ask lots of questions if you are not sure.

[Ravin]

This morning I tested DD's reflexes. She shows a little bit of retained palmar reflex and some retained galant reflex (both sides), but that could be ticklishness. None of the others. Between OT, gymnastics, and dance, she has developed good mind/body connections overall.

[Pen]

My ds had amblyopia which was fixed by exercises recommended by a COVD type optemetrist.  I had vision therapy and while I was able to go from not being able to do certain exercises related to convergence to being able to do them, I did not find that it correlated to irl actual help with real issues I was having that it was supposed to help with.

[PeterPan]

My ds had spinal galant. It's not just ticklishness, not if you were doing it right. You might see some significant changes when you get that to integrate. I would want that palmer done too before VT, since often VT will have them write a bit.  Happily you should be able to get both to integrate in a couple months of daily, diligent effort, and it will be really obvious when they do! You can even work them 3-4 times a day, if you really want to kick it up.

 

Yes, gymnastics does a lot for midline, tone, etc. :)

[MistyMountain]

We are not even quite half way through yet but I can tell it is making a difference. His eye is no longer drifting out when he needs to focus on something close and he is learning how not to see double. He still has a ways to go but there is a difference. They are also working on extinguishing retained reflexes. The biggest issue is my ds hates doing it.

[laundrycrisis]

VT was hard work, expensive.  Also worth every penny twice over - literally life changing for our son.  Truly - life changing.

 

I would only go to a doctor who can test for and treat visual *processing* issues - these are different than visual motor.  Become an educated consumer and find out before committing.  Not all VT doctors go beyond visual motor.  They won't know if they need to do more after the visual motor issues are treated. 

 

IMO when someone completes VT and it "didn't work" as there are still visual system difficulties - it's probably because the doctor only treated the visual motor part, and there are untreated visual processing issues.  Doing only half the job will not get the results you do VT for.  

 

Go to a practice that uses weekly time with a live therapist, with homework to be done in between weekly appointments.  Avoid the practices that want you in there three days a week using machines.  

 

 

 

 

Edited August 14, 2017 by laundrycrisis

[Crimson Wife]

There's a lot you can do at home. Academic Therapy Resources has a bunch of books with VT exercises if you know what the weaknesses are.

[PeterPan]

Having been through it once, I like that idea of doing stuff at home. However, when I was going through it with my dd, her convergence issues were so unpleasant, it was really helpful to actually work with an experienced therapist. And that therapist could bang out in one hour more than we could get done in a WEEK. Seriously. 

 

There was just a learning curve of what should this be like, is this ok, what does it mean to do therapy, how do you do therapy with someone... 

Edited August 15, 2017 by OhElizabeth