Vision Therapy

Vision therapy, mainly due to eye tracking problems, was a huge part of our first year homeschooling. In fact, it is connected to the reason we started homeschooling in the first place. In kindergarten & first grade, Capt. N didn't show any signs of being a struggling reader. So much so that in kindergarten he was in the highest reading group. By the beginning of second grade, though, it was apparent he wasn't where he should be and was placed in a special reading program. He enjoyed the program, but it didn't seem to be helping him. I decided I needed to help him in a way the school couldn't do & decided to try homeschooling him for 3rd grade.



WHY DID WE TRY VISION THERAPY?
The short, honest answer is that the initial testing was far cheaper than testing him for dyslexia. Capt. N's reading habits just weren't making sense. If you pointed to a word, he could read it. But, put a group of words together, such as in a paragraph, and he could still read the word(s), but extremely slowly. Everybody just told me to have him read more. Well, he was already reading more than most kids I knew. He was in a special reading program at school. He took a reading class over the summer. I had him read at home. Deep down, I knew it was something else. I just didn't know what. I spent month after month trying to pinpoint his exact problem. Unfortunately, nothing was hitting home. I talked to everyone I knew about it including teachers and his doctor, I went to the library, I spent hours online & I racked my brain trying to figure it out. The closest thing I could relate it to was dyslexia, but even that didn't sound exactly like his problem. I looked into various testing options & was shocked at the cost. So I dragged my feet a bit since I wasn't even sure that was his problem. In the mean time, I was talking about it with anybody willing to listen. Thank goodness I did because it was two random moms that led me down the vision path. Both these moms told me they had sons who had troubles with reading and, among other things, go to vision therapy. The common denominator was vision therapy & was something I hadn't looked into yet. After the second mom mentioned it, I right away started googling this new subject. I came across this blog post and it was an absolute ah-ha moment. Finally, something that sounded exactly like Capt. N. I found a behavioral optometrist and scheduled an appointment.


WHAT? THIS ISN'T AN EYE PROBLEM?
The problems Capt. N had with his eyes, actually have nothing to do with his eyes. He has 20/20 vision. This is a neurological issue. So, a couple things to keep in mind are:
• If your insurance will cover the therapy, it will be your medical insurance, not vision.
• Most likely the eye tracking problem will not be found in a typical eye exam. You need to go to a behavioral optometrist. I didn't even know such a doctor existed. I thought an optometrist was an optometrist.


WHY DID HE NEED VISION THERAPY?
After the initial evaluation it was concluded that Capt. N certainly could benefit from vision therapy. There were a few areas that needed improvement. The biggest area of concern was the way his eyes tracked. The initial test rated his ocular motility (eye movement) at 5th percentile for his age range. Instead of smoothly reading from left to right, his eyes bounced back and forth.

There were a few other areas that needed improving, as well. But, the next largest obstacle was the ability to refocus his eyes. He had difficulty focusing when first looking at a book close to him, then reading something on the whiteboard, then looking back at his book. He spent many of his vision therapy hours using different lenses while reading to help this.

One last problem I'll mention is that his right eye wasn't working as well as it should have been. His left eye was doing most of the work. So, a lot of time was also spent on improving his right eye.


WHAT WERE HIS "WARNING SIGNS?"
Typical signs to look for are:
• letter or word reversals
• short attention span
• inability to concentrate visually
• loses their place while reading or skips lines
• rereads words or lines
• headaches
• trouble reading aloud
• difficulty doing close work
• avoidance of school work

Capt. N had all these signs & I didn't even realize to look for them or what they all meant. The other thing I noticed was that no matter how little he read, it always seemed like a struggle. I don't mean just that it was a struggle to get him to read, it seemed physically difficult for him to read. He seemed strained and drained everytime he read.


DID IT WORK FOR MY 8/9 YEAR OLD SON?
Absolutely. He began vision therapy at 2 grade levels below normal and 10 months later he is 1 grade below. This is an improvement that probably wouldn't have happened had we not caught this. Instead, he would now be 3 grade levels below normal. I am so very thankful for the vision therapy.

His scores have improved dramatically. The DEM (Developmental Eye Movement) Test tests a few different areas. His initial scores were 16%, 8%, 4% & less than 1% on 4 of the areas tested. Everything improved in 5-6 months to 93%, 81%, 27% & 48%.

On the Gardener's Reversals Frequency Test he scored less than 1% on reversal recognition. You almost can't do worse than that. I actually watched him take this test & I was shocked. I knew that he sometimes wrote a few numbers and letters backwards, but I had no idea that it was this bad. This test had different groups of letters or numbers written the right way & a few different wrong ways. He was supposed to circle the correct one. He did horrible, he got nearly every answer wrong.  5-6 months later when he retook the test his score was 7% - still not great, but at least it was an improvement. Ten months later he took the test for a final time & it came back average for his age. Yippey! I had noticed throughout the year, too, an improvement. At the beginning of the year, he wouldn't even notice when he wrote a letter/number backwards. During the course of the year, he would continue to write them backwards, but he would notice it & rewrite it. Those mistakes got fewer and fewer through the year.

Outside of anything written on paper, the biggest, best example that he has improved is that it is no longer such a struggle to read. In June of 2011, Capt. N could barely read through one Magic Treehouse chapter in one sitting. He loves the stories, but reading a whole chapter (which isn't many pages) was too much for him. Now a year later, June 2012, he can & will read multiple chapters and it doesn't seem to be difficult at all. This reason alone is proof to me that the vision therapy has worked.


WHAT DID WE DO FOR VISION THERAPY?
Capt. N took his initial tests in August 2011. In September, he began vision therapy. Once a week we would go in to the office & work with the doctor. She would assign him homework for the following week. Every day we were supposed to work on the various exercises for an hour. I admit, it was painful - and I didn't even have to do the exercises. I was his helper. I reminded him what to do, timed many exercises, held equipment, etc. Honestly, we didn't do it every single day. I needed a break from it occasionally, as much as he did. In February 2012, he was retested and had improved enough to cut back a bit. Now he only needed to practice about 3 times per week and we came into the office every 6 weeks or so. At the beginning of June, 10 months after starting the program, his doctor said he was officially done. I was so proud of Capt. N & thankful to be done that I shed a few tears.


NOW WHAT?
The truth is, although the vision therapy helped tremendously, he is still not up to grade level reading. I believe he has other problems, as well.
• I don't think dyslexia is one of them. Or, if it is, it is a small part. A test the doctor did at vision therapy came back saying he most likely was not dyslexic. Also, I talked to a reading specialist who works with many dyslexic people of all ages & she didn't think he was dyslexic. So for now, I'm not taking any steps to pursue dyslexia - but it is still in the back of my mind.
• Although, the reading specialist did say she didn't think Capt. N is dyslexic she does think he has dysgraphia. Which is something else I have never heard about. I do think he has this. He has nearly all the symptoms. You can read more about dysgraphia here.
• I hate to fall on the ADHD bandwagon. But, I had a number of people mention that they thought Capt. N may have it. I'm really not terribly concerned about it, but I thought I should at least look in to it. I had him tested. On paper, the results came back showing that he does not have it. However, his doctor said just by knowing him his entire life, she would say he definitely has ADHD. Neither she nor I thought medication was needed, but she did give me a referal to a place that could help him harness his energy differently. Her example was that he has to learn how to sit still because eventually he will need to sit through hour long lectures in college or half hour meetings at work. The place she suggested would help him by showing him techniques such as squeezing a stress ball instead of moving his whole body. Honestly, I haven't followed up with that yet. It's only been a month since he completed vision therapy, I'm not ready to work on a whole new problem - especially when I don't think it's too much of a problem.
• I don't have a technical term for this, but a real issue with Capt. N is that he does not read well out loud. I believe his quiet reading has improved tremendously over this past year. But, his aloud reading is still quite bad. I feel like his brain has a difficult time taking in the information, processing it, then spitting it back out. I'm not sure of the best way to go about fixing this. So far, the only thing I have come up with is to have him read for fluency more often than is typical for his age. I'm not sure how much to worry about it. Most likely, as an adult he won't do much reading aloud.
• I'm a little afraid adding this last bit makes it sound like I'm either trying to find problems for my son that don't exist or that he's worse off than he is. He really is a typical boy, but has problems reading. That's it. The reading problems aren't even as bad as can be. If he were in public school he'd be in a regular reading group, but the lowest group of the "normal" readers. That being said, I'm not going to just sit back and let that be ok. I don't expect him to be a prize-winning reader, but I am going to do my hardest to make reading easier for him.

Whether vision therapy actually helps someone is a controversial subject. There have not been many studies done, so there is not much evidence supporting the fact that it really is beneficial. Most people, teachers included, have never even heard about it. This is not something the school would have ever found & even if a great teacher would have figured it out, the school is not equipped to help his reading in the way he needed. Initially, our insurance covered part of the cost. Later though, we received a letter stating they weren't going to cover it anymore because there wasn't enough evidence that it worked. In our experience, vision therapy absolutely works. And, it makes me wonder how many more kids are struggling with the same issue and nobody knows this vision stuff is even a possible solution.




To read more about our vision therapy process check out my VISION posts.

3 comments:

  1. See if you can find a Auditory processing specialist. Whether he has auditory dyslexia or not, I believe he is having auditory processing issues, and someone very familiar with auditory dyslexia might have answers that will help him.

    I have Auditory Dyslexia, something that was not considered possible to have until 1996, if I remember correctly. My auditory dyslexia was severe, but my dad refused to allow me to be officially tested for any learning disability (and he was a teacher!) My speech therapist told me that she thought I had Auditory dyslexia in 1970. Auditory Dyslexia wasn't allowed as an official diagnosis for children or adults until 1996 (I believe), when it was discovered by a doctor, whose name I forget, and finally recognized as a real diagnosis.

    The signs of auditory processing issues (in me):
    1. Auditory Memory is very poor.
    2. Taking notes is hard because point 2 is missed while the student tries to write down point 1.
    3. Auditory Dyslexia:
    A word here and there is heard scrambled. In severe cases, more words, or entire sentences sound like random sounds.

    What helped me:
    Reading word families outloud. Take Rhyming words, and say them outloud. Also, have someone read these words to student while student reads them, and then repeat with student not being able to see the words.

    I had the above done with me for many years. I would practice reading books out loud. I'd read the sentence to myself, and then reread it out loud. I'd repeat the same sentence until I felt I understood it auditorially. I would do this for an entire page. Over the next 2 months, I would repeat this process until the entire chapter was read through, 3 times (using a children's chapter book). I used to read Ramona and Beatrice series this way.

    ReplyDelete
  2. I am going to be starting a series of special needs posts on my blog and I was wondering if you would be willing to write a guest post for me about Vision Therapy since I don't know much about it myself?

    ReplyDelete
  3. Ok my goodness I just love your blog. I am trying to finish up some posts on my daughter's journey through vision therapy and came upon your blog. I am always so pleased to find others who have been touched my VT also. Thank you for sharing your story. Every story out there is one more resource for a mom looking for ANSWERS!!! Alli's story is HERE

    http://raisingcatandbug.blogspot.com/p/blog-page_1.html

    Thank you!!!

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