Vision Therapy for occular motor problems - sound familiar l

Hi Karen,
Does your son realize he has these vision difficulties?

I don’t think so . Its too subtle. He doesn’t realize he has motor planning issues either because despite his clumsiness he is able to play sports and run around well enough.

He does, however, complain that his eyes are tired and he does squint, sometimes close one eye and move his head when reading. So I told him the exercises will help make those uncomfortable feelings go away. He gets that connection now that we have begun.

My son has similar problems. I guess we could have guessed that. Even though he doesn’t reverse the letters when he writes anymore he tested as a child with alot of reversals. I am guessing he just compensates really well.
They are remediting my son’s reversals by addressing his bilateral motor issues.

I think that there is a correlation between the motor issues we see everywhere else and the eye motor functioning. It just makes sense.

I have to say I have seen improvements in my son’s abilities in many areas since starting vision therapy. The most profound changes are in reading and spelling. I mentioned his spelling problem to his teacher and she said, “He doesn’t have a spelling problem.” It kind of hit me how far he has come. I still see a bit of a problem when he is trying to write a story he sometimes just forgets how to spell even easy words.

He is much less averse to reading but still does not read as much as I would like. He is reading “Holes,” and really enjoying it. He read 6 chapters the first day he got it. He has trailed off a bit since but I will see if he picks it up over the weekend. It still isn’t that, “I have to read this and find out what happens next,” that I was hoping for.

I know he will be someone who will enjoy reading. He just loves stories.

Congratulations on finding something you know he needs. It sounds like his optometrist really addresses alot of different issues.

Karen,
Good luck with VT and please let us know how it goes!

It’s interesting to me that your son has adequate visual perceptual/spatial/motor skills since my son fits in that category as well. His weaknesses appeared to be more in occular motor, teaming and focusing.

We were going to start VT awhile back, but I was not thrilled with the doctor so we decided not to do it. Since then I’ve found a couple of other VT’s who seem to be more knowledgable and incorportate VT with other programs… so I’ve given my son a choise. We start VT now and work daily on it right away and through summer, or he goes to summer school.

Easy decision! ;-)

Linda F: When you say ‘addressing his bilateral motor issues’, can you share what they are doing (in layman’s language, I mean!) specifically? And, when you say ‘issues’, what are they, if you can elaborate…

My son’s reversals began in spring of Grade 1…got WAY worse in Grade 2, then resolved by spring of Gr. 2. Again, reversals were a problem at beginning of Gr. 3, but not huge, and they disappeared by Jan/Feb.

We had no formal summer remediation after grade 3 and our math slipped badly. Printing was better at beginning of Gr. 4, but reversals of numbers (mirror-writing) until just recently have been DREADFUL…now, he rarely reverses the numbers themselves, although he still has trouble with 2-digit numbers where he writes each number properly but reverses the two digits…

This year, I KNOW we are not ‘safe’ in this area, so I want to target it…any info or comments on reversals greatly appreciated! Thanks…

My son does not reverse but did when he was younger. One of his vision therapy exercises involves crossing out letters on a page that spell a specific word he crossed out the d instead of the b. He still has some reversals.

My son has problems with bilateral integration. This means he has difficulty with using both sides of your body in an integrated way. Swimming is very awkward despite tons of lessons. It doesn’t show up in every area. He seems to be able to integrate his arms (he is very good on the monkey bars)but when the feet and the arms are involved he can’t do it. I think it might manifest differently in different people or maybe he is just partially remediated.These kids also have trouble with jumping jacks.

This also is sometimes demonstrated by difficulty with activities that involving crossing the midline (middle of your body.) My son used to start in the middle of the page rather than crossing his right arm over to the left side of the page. You see some of these kids draw with their left hand when working on the left side of the page and switching to the right hand to work on the right side of the page.

This is more common in the mixed handed population. My son still tries to use his left hand for certain things despite the fact that he is mostly right handed. Some suggest you get these kids using just one hand for dominance.

Right left confusion seems to play a role. You might try getting him to really automate right and left. Audiblox has a good exercise using a large page of arrows set in a varying sequence of right, left, up and down that the child has to mimic by pointing up, down, right, left.

Bilateral integration is also tied to sequencing. My son saw a big jump in sequencing after IM. There were alot of exercises that addressed bilateral integration (using both sides of the body doing exercises to the beat of a metronome.) I do think helping his bilateral integration helped his sequencing.
His reversals aren’t terrible from what I can see so maybe that too is the IM.

The vision therapist does exercises like having him walk with his feet out (like a duck) hands turned out, then feet out hands in, then feet in (pigeon toed) hands in and the feet in with hands out. He walks forward and back. He couldn’t do this at all when we started but is now much better at it.
I also think that balancing exercises help these kids because it is tied to the vestibular system.

We will be doing interactive metronome again (he didn’t master the feet) this summer so it might clear up the rest of the problem.I have asked his therapist to concentrate on his feet and the exercises that involve using hands with feet.

If you have any other question let me know. I have a textbook used by OTs for sensory integration issues and the information in my post checks out with what the book states.

My son scored in the 1% tile for reversals during his VT evaluation. Even though he rarely does it when he’s writing anymore. Or reading either. When he does jumping jacks I’ve noticed they are a little lopsided, one side moves out more than the other. Like most of his deficits the impact is mild, its not like he can’t do it, but its definitely there.

He also is a master at the monkey bars, and rock climbing - things you’d think would be impossible given his motor planning issues.

We’ll be doing VT from now thru the summer. Then after we move I may add some OT back into his schedule, or more psychotherapy. I figure we’ll see how the new school is working out and which ever issue seems more pressing at the time will get the attention. I’m hoping the VT will hit at some of his core motor issues. I truly believe each therapy and its incremental improvements positively impact even on other areas.

Hi Elizabeth,
My son has a problem with reversals, but it’s not as bad as used to be. I bought a book called “Recognition of Reversals; Perceptual Training Workbook” by Dr. Kenneth Lane. I believe I paid $9.95 for the book.

Basically, this book contains sentences of letters and numbers with a one or more reversed. The child is to indicate which ones are reversed. There’s 4 levels of difficulty. Beginning with indicating the reversals to looking at a sentence containing upper case/lower case pairs and recognizing which ones are reversed. This level is not easy!!!

In addition to exercises similar to this, you’d want to do lots of games and activities that focus on right and left so your child can gain automaticity in it. I’ve been told this will help eliminate reversals.

Vision and/or Occupational Therapy would probably help, but these are ideas you can use in the meantime or in addition to any type of therapy.

Also, eye teaming problems can sometimes manifest in reversals. That is a vision therapy issue.

THANKS…this is beginning to look like some of our issues are similar. I remember one story he wrote in Gr. 2 (but not at school) where he began writing in exactly the middle of the page, and continued with an almost perfect margin.

I KNOW there is some kind of visual or visual/motor thing happening…my opt. has just begun a program of intensive testing which we can ‘almost’ afford — I think I’m going to start here…I really appreciate your clear descriptions.

THANKS…I’ll look for that book. There doesn’t seem to be any formal ‘vision therapy’ within any travelling distance here. After testing (we have been in a cash crunch so had to wait, tho we learned of this in Feb.) my Opt. offers ‘suggestions’ of things you can do at home…given the success of some on this board, where therapy is mostly done at home under supervision, this seems like a worthwhile summer activity…so thanks for adding to my collection!

Yes, that does sound visual/motor and possibly visual.

Dr. Lane’s book is excellent. His material is pretty similar to what my son’s VT does.

Let me know if I can help.

Another site for you is www.balametrics.com

They have alot of balancing exercises you can do.

Honestly the exercises that I think were the most effective were some of the most simple ones. Just have him follow your finger or a pen. Try to get him to do this for 2 minutes with each eye and then both. You need an eye patch.
I outlined some of the exercises we did in some old posts you could look for them by doing a search.

I will, thanks! He is not particularly clumsy, but did not ride w/out training wheels until 9th b-day…still won’t tie shoes (has learned twice but forgets and REFUSES to let me buy tie-ups so he could automate this skill)…although we are reading reasonably well, he still has trouble with certain sizes of print, etc. etc. I have a feeling that some work in this area will help us continue to improve. Thanks again…