Sunday, February 12, 2012

Vision Victory!

Capt. N has hit a Vision Therapy milestone! For the past few months he's been going to vision therapy once a week & spending nearly an hour on daily vision exercises. He's improved enough that now he only needs to go to therapy once a month & work on the exercises 3x per week. Yippey!

His dr. emailed me a progress evaluation report. For the most part things have improved quite a bit. Here's some of the test results:

Oh, and let me point out that when I'm listing a % I don't mean that he scored a 93% on the test. It means he scored in the 93rd percentile for his age.

DEM (Developmental Eye Movement) Test: This tests a few different things. His scores on the 4 areas she listed from the initial eval were 16%, 8%, 4% & less than 1%. Everything improved to now 93%, 81%, 27% & 48%.

Gardener's Reversals Frequency Test: The first time he was tested he scored less than 1% on reversal recognition. Yikes! This time his score was 7%. Not sure how to work on this or what exactly this means. But, it definitely could use improving.

TVAS (Test of Visual Analysis Skills): Initially he scored into 2nd grade equivalency. Now he scored 3rd grade equivalency - right where he should be!

TAAS (Test of Auditory Analysis Skills): Initially he scored 1st-2nd grade equivalency. Now it's 2nd-3rd grade.

Visagraph: This is an amazing piece of technology that tracks his eye movements while he reads. I'm going to list 3 scores here: initial eval / last week's eval / grade norms.
Fixations (the fewer the better): 253 / 160 / 155
Regressions (the fewer the better): 54 / 37 / 35
Average Span of Recognition (the larger the better): 0.4 / 0.62 / 0.65
Average Duration of Fixation (the larger the better): 0.31 / 0.31 / 0.28
Reading Rate (the more the better) (words per minute): 75 / 119 / 138

Accommodation (unaided): Focusing amplitude & focusing flexibility. Initially his score was "poor" with these scores: right eye -2.25/-1.00, left eye -2.25/-0.25, both together -2.50/-2.25. Now he's listed as "improved." His scores were: right eye -7.00/-6.75, left eye -7.50/-6.75, both together -3.25/-0.50

She also mentioned a few other topics:

Visual Motor/Fine Motor Skills: If these skills are lacking the student can have poor handwriting, excessive erasing, poor spacing, trouble finishing written assignments and a list of other issues. This definitely describes Capt. N. The dr's report says that she thinks the problem is with his fine motor skills as opposed to his visual motor skills. I would agree. He scored greater than 99% on the spatial relations portion of the TVAS, as opposed to the 2% he scored on the fine motor speed & 25% for fine motor coordination on the Developmental Test of Perceptual Skills - revised. Fine motor skills is not something they work on in the office. She gave me a list of things we can do to improve these skills such as dot to dots and mazes. It's weird, but except for his handwriting, I've never noticed his fine motor skills to be off a bit.

Visual Perceptual Skills
: Visual analysis skills are critical for recognizing & remembering orientation, shape & position to what we see. Here are his scores on the Test of Visual Perceptual Skills:
Visual Memory: 91%
Spatial Relationships: greater than 99%
Figure Ground: 84%
Form Constancy: 95%
Visual Closure: 77%
Visual Discrimination: 50%
Sequential Memory: 25%   (He has been working on a computer program at home on this. A random sequence of numbers flash on the screen & he needs to type those numbers in the correct order. He does ok when it's just 3 numbers. But, with a group of 4 numbers he does terrible. He gets less than half of them correct.)

All in all I'm impressed with his improvement. When it comes right down to it the reason we started vision therapy was to help his reading. The fact that his average reading score was 119 words per minute is outstanding. It's an improvement of 44wpm since he first took the test 4-5 months ago. When he reads quietly to himself I can just tell it's not such a strain on him, which for me, is a victory in itself. It was hard on me watching him struggle to read. He never wanted to read. Now he can finish a Magic Tree House book in 2 or 3 sittings and probably even quicker if he wanted to. His comprehension is staying good, too.

The interesting thing about Capt. N reading 119 wpm is that this was quiet reading. While taking this Visagraph test he's not reading aloud. He looks up when he's done reading & the goggles track that movement, which is how the dr. knows when he's finished. His aloud reading skills are not that good - although they are improving. He's reading about 82 wpm now, as opposed to the approx. 65 wpm he was reading over the summer. 119 wpm is getting pretty close to 3rd grade norms, but the dibels test is an aloud reading test. 82 wpm would still put him way below grade level. Why do I care so much about the words per minute? I know. It's because that's the test that started this whole sha-bang. Before learning that he was only reading 32 wpm at the beginning of 2nd grade, I never knew he had any sort of reading problem or any other learning problem. I know it really doesn't matter what it says on paper. What matters is that he can actually read & read at a decent speed with very little struggle. That's where he's at now and I'm so proud of him. For now, I'm going to have him finish up this vision stuff and then decide which direction we should go next. In the meantime, I'm sure I will be searching the web & other sources to work on figuring out if he really does have a glitch somewhere with getting information he takes in, processing it & getting it back out. He can obviously read quicker when he's reading quietly. But, I bet that's true for most of us. For him though, his fluency is just not good. He's slow & doesn't pay attention to punctuation. How much should I worry about that? I don't know. He also does have sloppy handwriting with reversals and odd spacing. How much should I worry about that? Reminder: One step at a time, Jennifer. One step at a time.

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