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Was the doc a COVD doc? If he's COVD, he should have made a recommendation on whether to pursue the full eval or not. A full eval usually quantifies all the issues (convergence, depth perception, tracking, etc.) and also should include visual perception. So if he was a COVD doc and did *not* recommend the full evals for either kids, that tells you something. If he's *not* a COVD doc and found convergence issues, that's even more concerning. That means the problem could be more than what was being expressed. 

 

So depending on who was making the screening and how significantly you take it, then you think through the money and how to handle it. No, I personally would not just go run two kids through full evals, to the tune of $300-500 each (depends on the area, what's the cost in yours?), and end up with no money for therapy. You would triage, pick the more affected dc, do the evals on that one, but try to find a COVD doc who has a no child leaves untreated policy or a scholarship system or Care Credits or some such thing. They can usually find a way to help you. Sometimes they'll give you a lower price for coming at less popular hours. You might find a cheaper COVD doc who is a bit farther away and then only go once a month and get TONS of homework. That's another way to get the cost down.

 

If they won't tell you their costs upfront, that's concerning. Until you know the costs, you can't do the math and figure out what you can make happen. Then it's just a math thing. Like if you have $1k in your pot for the next 4 months, you work the combinations to see how you can get one or both kids eval'd and treated. Whatever you learn for the one could apply to the other, or they might be very different. So it depends on the set-up of the therapy (notebook of stuff driven vs. totally custom), whether they've already had work on their retained reflexes, whether they're compliant and easy to work with or would need support, etc. etc. If the place uses notebooks for therapy and the dc's situation is non-complex, you could probably just have dd younger work along while dd older does homework and nail them both. But if their problems are very different or compliance is an issue, suddenly all that goes out the window.

 

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Ok, I have the KL book, but there's a big gap between that and therapy. Therapy gets over the compliance hurdle, makes sure you're actually working on the right things, and makes sure you're doing them CORRECTLY. My dd had tons of things where the therapist would have ways to do it that were not obvious. She would see that dd was doing something incorrectly or just be able to explain why it was hard and how it would get better.

 

That midline jumping *can* be an OT issue. What you might do is see if your insurance will cover an OT eval (since they're more likely to cover that than most of VT), do the OT evals with somebody who's really, really kick butt stellar with retained reflexes, do the retained reflex work with the OT using insurance coverage, THEN go back and get your COVD evals. 

 

My ds had the jumping at the midline but actually tests as within range for VT stuff. We did OT for the midline and he has tested as fine with the COVD doc so far. Your midline issues and reflex issues, when fixed, would let you then work on the vision reflexes, etc. There's a progression of treatment. So if you can get coverage through the OT but not through the VT, it makes more sense for the OT to do the work. 

 

The price is really good on that eval. What are they saying is the cost of therapy? How long a wait would you have to bring therapy into range? And do they do it once a week or more often? And could they flex and go to monthly with homework or something? Our VT place did a monthly informational meeting. If the practice has something like that or has a contact person you could email, you could sort things out and make your game plan. 

 

I think it would be frustrating to do the evals and then have *no* money for therapy. I don't think you're going to find KL's book a satisfactory substitute. That would be your living in the bush, no other alternatives thing. You're going to be way, way happier getting therapy. But if you can do part of the work with OT first and have insurance coverage, that would be a way. Or triage and use what you learn with one to work with the other. Keep looking for options. Ask lots of questions. Some practices have a very quiet but very real "no child leaves untreated" policy and they'll help you figure out something. Ask questions and see what happens.

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Vision Therapy gives me heartburn to talk about because the cost of therapy is $4000-$6000 and usually no insurance covers it. My son had mixed dominance and convergence insufficency. I was able to get my insurance so cover all but 1000. They would not let me go in with him and they would  not give homework. I have since found a very good youtube channel where they talk about vision therapy. The thing is you have to be very patient and a cheerleader to do it. Keep it short and reinforce the positive. I did go to parent updates and found that they had my son do a lot of 3D recognition with the 3D vision cards. They also had the brock string and did many of the exercises in the book that was linked above. There is a computer program but no vision therapists in my area deal with it and would recommend it so I could get the code. If you could find someone to drive to once a month who would train you and let you help at home it would be a huge advantage. It takes between 3-9 months and is crazy expensive. I also had retained reflexes that I worked through with my son that made a huge difference but I admit that Vision Therapy was life changing for him

 

 

 

Here is the youtube area that got me started

Vision Therapy Training Videos
Brock String, Bilateral Circles, Distance/Near Hart Chart, Barrel Card, Lifesaver Card BI, Lifesaver Card BO, Flipper Accomodation, Eccentric Circles, Infinity Walk, Lazy 8s, Central to Peripheral Chart, Spin Game, Randolf Shuffle
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What EG describes is not necessarily the *norm*. It was the way it was at that practice, but lots of practices won't be that way. We had see-through windows, tons of homework. And I've had friends who live other places get told the total opposite, like 3-4 days a week, only in-office. It's just how that doctor sets it up.

 

Not all doctors will alter mixed dominance. It's kind of controversial.

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What EG describes is not necessarily the *norm*. It was the way it was at that practice, but lots of practices won't be that way. We had see-through windows, tons of homework. And I've had friends who live other places get told the total opposite, like 3-4 days a week, only in-office. It's just how that doctor sets it up.

 

Not all doctors will alter mixed dominance. It's kind of controversial.

Oh absolutely just sharing my experience here. I live in a rural small city and there are only two offices that offer vision therapy. I feel my son made great improvements and benefited from the therapy. We had evaluations at both offices and i would not recommend either place. Mostly because of the lack of homework and the secret nature of his therapy. We would never have been able to afford the therapy but my insurance had a special carve out that gave us coverage. It was only 30 sessions but we got all we could out of it.

 

 

 

Sent from my SM-N910V using Tapatalk

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Yeah, that would be so unsafe. I can see why you felt like secretive described it! And I think there are legit reasons to practice that way, but still it's unsafe. And you get harder kids, like my ds, and you'd have compliance issues. I never just drop my ds off somewhere behind closed doors when I don't know that person and don't know how it's gonna go. And frankly, I'd shocked ANY therapist or provider right now would be so idiot as to put themselves in that position. That's CRAZY. One wall of one-way glass and they could solve a lot there and make it safer for everyone.

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