Wednesday, December 28, 2011

Vision Update

Capt. N's eye doctor says he is about half way through his vision exercises - which is exciting. His dr is working on improving his eye tracking skills (reading left to right with ease), focusing ability & flexibility (changing focus quickly and accurately) and eye teaming strength & sustainability (getting his eyes to both work well together).

Daily, we work on exercises at home for about an hour. This is hard for me. I'm sure even harder for him. But, it's hard for me watching him struggle. And, in a selfish way, it's getting boring. I'm tired of timing him, listening for mistakes, & recording the results multiple times for every little test he does... every single day. I know this makes me sound like a terrible, ungrateful, disgrace of a human being. I know things could be a lot worse. In a way, I'm also irritated that the hour we work on vision is an hour we aren't doing other school stuff. I want him to learn everything and anything possible & this is holding us back. I feel heavy pressure of making sure his academics are at or above where they should be. If I'm going to pull him out of school, I better damn well make sure his education doesn't suffer. But, I know if he's going to excel in life he needs to master this vision stuff. As much as I'm complaining about doing it, I'm actually so glad I get to help him. I'm grateful that if one of my children is going to have an issue, I'm glad it's this. It's fixable & we live in a great place in proximity to his doctor & much knowledge on the subject.

In the beginning Capt. N had such a good attitude every time we sat down to work on his vision exercises. Even now he doesn't do much moping about having to do the work, but I can tell he's just not excited about working on it anymore. Don't tell his eye dr, but we've been slacking a bit this Christmas break. I've been giving him a bit of a break. We've been working on it, but not every day. I'm guessing this holds him back another week, but I need the break from it as much as he does. At one of our first visits the lady in charge told me, "When they start to get frustrated with doing the exercises is when you know it's working." So, hopefully that means its working.

About a month ago Capt. N took a progress exam with his eye dr. The results are promising. He is not yet where we hope he will end up, but he's definitely improving. He made fewer mistakes. One test he took he did at one of his first appointments was a computerized test where he wears goggles that track his eye movements. He reads a story that's printed on paper and the results & the goggles are connected to the computer. Some type of software records the results. The first time he took the test he did as bad as you can do. The ratings are based on grade levels. He should be testing in at 3rd grade. His scores showed him at the very beginning of 1st grade in everything - & that was the lowest possible score - who knows how low he really was. I don't know all the things it was testing, but one thing I remember is the way his eyes track - the eye movement while reading. It should be smooth & gradual, left to right. His eyes were back & forth, a lot. No wonder he has difficulty reading. When he took the test again he improved. Not into the 3rd grade level, but most things had at least moved further up into 1st grade & a time or two even into the 2nd grade level.

Here's a few of the exercises he's been working on the last 12 weeks:

My accessories - a kitchen timer & a stopwatch. I have to time many of his exercises & record it with the hopes that his time will improve. We use the stopwatch for this. The kitchen timer is used when he needs to do a task for x amount of time - usually 1, 5 or 10 minutes.

This was one of the first exercises he brought home. One of the things he did with it was say the first & last letter in each line, then starting back at the top say the second & second to last letters, then do it again with the third & third to last. Another exercise he did with this was I would call out a coordinate, say A2, & he would call out the letter that was there. The goal was to get as many letters as possible in 1 minute.

For this one he would patch one eye. Then he holds a lens up to the other eye & when his eye can see the letters clearly, he says the group of letters. He puts down that lens and holds up the other lens, when the letters are clear, he says them aloud. Repeat. After a set amount of time he moves the eye patch to the other eye & repeats the process with the lenses on the opposite eye. He did this one for a few weeks, each time the thick lens got thicker, making it harder for his eyes to focus when using it.

This is by far the hardest one for him. There's a lot going on & it's a real strain on his eyes. The red & green glasses and the clear sheet with red & green strips are to make sure his eyes are working together. This has been identified as a problem for him. His left eye is doing much of the work when he reads. (Just an observation, but he's also left handed.) If one eye isn't working well, the letters behind the strip will be blacked out. The whole strip of green is black if the eye behind the green lens isn't working like it should. This frustrates him to no end. Obviously he can't read the word if he can't see it. Then on top of this he also uses the flippers. When he gets to the end of a paragraph he flips them and he does this for a long 20 minutes.

And... he has to read aloud for those 20 minutes. I've come to realize he's just not good at reading out loud. I'm hoping, hoping, hoping that by the time he's done with vision therapy this will improve. I'm not totally convinced it will, though. He's at the half way point in his therapy & I don't feel as though he's reading aloud half way to where he should be. But, I do think his quiet reading is improving - which makes me extremely happy.

This is a slightly different way he has used these 3 items. The idea is the same, but instead of reading a book he is reading single letters. Each time he reads a letter, he flips the flipper, making his eyes refocus. He does this for 1 minute. We write down how many letters he read correctly in that minute. He does this for 10 minutes.

The Brock string. The best way I can explain this one is linking to this YouTube video.

This one makes his eyes work together to get the 2 images/paragraphs to become one so he can read what it says. The various cards told stories. He didn't seem to really enjoy this one either.

The paper on the left is the one Capt. N read from. He just read one number at a time in the direction you would read a book. The paper on the right is my answer sheet. The numbers are there for me to see if he's reading it correctly. Then I recorded his time & how many errors he made. Overall he did fine on this. But, occasionally he would repeat a line or skip a line. I also noticed him repeating the last number in a line many times. It's as if he would say it then scan down to the next line, but then go back up to make sure he was in the right spot. Sometimes he would say a number wrong - even though I know he was in the right spot.

These are paragraphs of nonsense words. In each paragraph he is to circle, in order, the letters a through z. As with everything else, this is timed. About half the time he would get these the first time through. But, the other half he would get to the end and realize he must have missed a letter somewhere because he wouldn't get to z.

I can't quite remember what this is supposed to work on - I'm guessing focusing or getting his eyes to work together. He would hold this clear sheet up with one hand. In his other hand he would hold a pen behind the sheet. He would focus his eyes on the pen and in doing so get the pair of red & green circles to form a third circle between them. Ideally, this circle should be brownish & have some depth to it. The bottom circles were easiest since they are closer together. He seemed to be able to get the top ones to come together too, though.

Every time he came to a pair of underlined letters he was to say them out loud & do this for the entire group. Timed, of course.

Read the first & last letter in every line. Timed.

He places his nose right at the end of the stick & looks through the hole at the pages behind it. He needs to get the image to become one. There's two different books & another thing to look through that has a hole for each eye to look through. This is a bit difficult for him.


Here's a few You Tube videos that I have found informative:
Vision Therapy & ADD ~ Describes how many kids are misdiagnosed with ADD, when they may actually have a vision problem. This is something I'm very curious about. Vision therapy doesn't seem to be widely well known. It was up to me to figure out the real reason Capt. N was having a hard time reading. No teacher or doctor led me on this path and I'm very curious how many kids are out there with the same problem & don't even know it.
Ocular Motility Testing ~ Her presentation isn't the best, but this video was actually quite informative. A lot of the words she describes are words Capt. N's eye doctor uses - and honestly I didn't fully understand.
Vision therapy for Reading problems ~  This guy mentions a few signs to look for: letter or word reversals, short attention span, inability to concentrate visually, loses their place while reading or skips lines, rereads words & headaches - Capt. N has every single one of these warning signs & I didn't even know to look for them.
Intro to Vision Therapy ~ This man mentions the symptoms as: trouble reading aloud, short attention span, difficulty doing close work, reversing words, losing their place, trouble with eye-hand coordination, avoidance of school work ~ again this absolutely describes Capt. N.

In this last video the man mentions that vision therapy is often covered under medical insurance. I'm not sure that's entirely true. Our insurance covers it - kind of, & the billing ladies at the office are surprised, telling me most insurance companies don't cover it. Btw, if they do cover it, it is your medical insurance that will cover it since this is a medical problem not a sight problem. Each visit, for us, is $50 - which I think is a cheap price compared to other vision therapy offices. With a lot of haggling & phone calls, our insurance pays $20, so we pay $30.

I'm sure I've said this in previous posts, but I've just got to mention it again - I am so proud of him. He doesn't take the easy way out or give me any trouble. Almost everything he does school related is difficult in some way for him & he always tries his best. These vision exercises take a lot of concentration & are mentally straining. He doesn't get through school half-assed, like some kids can. He works hard for every answer he writes down or passage he reads & I think being a hard worker is a great character trait. I know its a faux pas to compare children, but honestly how can you not & how else do you know when there's something wrong or great if you don't compare. It's just something I notice in my two boys now that Mr. T is in kindergarten & brings home homework. I never realized how slow Capt. N was at doing school work because I had nothing to compare to. But, Mr. T flies through his school work - which I'm glad about. But, I will say I'm a little disappointed in his lack of trying. I know he can try harder, but guess what, he doesn't need to. He does what's required of him quickly & moves on to other things. Which shows me just how different every child is & how every child has their strengths & weaknesses. This is going to make things a bit challenging next year when I homeschool them both. Mr. T really is a whiz & things come easy to him. He very well may be a kid that can learn well by doing worksheets - which does not work for Capt. N. Oh well, that's a topic for another day.

All in all, I'd say the vision therapy is a success!

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