Vision therapy? Why so controversial

Chris.

The reason why it is controversial is exactly what you have noted: there simply is no research yet that shows VT to be an effective treatment for most people with LD or ADHD. That doesn’t mean that it doesn’t work, or that it wouldn’t work for your child. It just means that when you are weighing the costs and benefits of doing it, you have to take into account that thus far it has not been demonstrated to be effective for most. All therapies start out unproven, so the absence of research alone does not necessarily mean that a therapy has no value, only that its value has not yet been established.

Parent experiences are one source of information, but they really aren’t the most reliable source. There are so many factors that can influence our perceptions of the success of a particular treatment that you really need a study where the participants and evaluators are “blind” as to which treatment is being received. Also, many times there are a number of factors going on at the same time that may influence how a child responds, including other therapies pursued, maturity, family situation, other physical conditions, educational setting, responsiveness to one-on-one interactions and increased levels of adult attention, degree of belief in and committment to the treatment, the particular constellation of diagnoses and symptoms in a child and their particular causes, etc. A good study will try to screen out confounding factors so that you can get a better picture of the true, clinical, measurable response to a particular treatment in a particular population.

The main risk of pursuing therapies that have not yet been thoroughly researched and shown to have a measurable positive result is that therapies that have been shown to be reliable will not be pursued. In addition, parents may have limited resources that can be exhausted seeking unproven therapies and leaving them without the money to provide proven therapies.

Some people are in a position to take that risk and some are not, but everyone benefits from knowing that the risk exists. It is one of those difficult, intensely personal decisions on which reasonable minds may differ but whichis more easily made when full information is available.

Andrea

One aspect of vision therapy that makes it controversial is that the effects of the therapy can vary depending on the depth of knowledge of the provider and the parent’s and child’s willingness to do the work. It takes a tremendos effort to go after these issues through therapy but you can see a tremendous change if you are willing to put forth the effort.

There has been some incredible research on vision therapy and I truely believe that those who say that visual skills are unimportant are uninformed and that is all.

This is from a book called, “Why Our Children Can’t Read and What We Can Do About It.” The author developed a program called phonographix which is based on her evaluation on all of the reading research of the last 50 years.

” Research support for this clinical observation has been provided by J.Stein and M. Fowler at Oxford University. Older children with severe reading problems were compared to younger good readers, mathced for reading ability. The older poor readers had poorer binocular control, and visual training alone improved reading test scores for these children.

Children with serious problems in binocular control tend to telegraph this in noticeable behaviors. They frequently rub their eyes, squint at the page cover one eye, or turn sideways to read, or move their head from left to right instead of their eyes. Any one of these behaviors, if persistant, is an indication that parents should have their child tested by an optometrist specializing in diagnosing and treating visuomotor problems. Binocular fusion and controlled scanning are highly trainable. ”

This is a discussion of reading and binocular control. Honestly, in our case my son’s vision issues caused much more pervasive problems than reading difficulties. The research is on reading because that it is the most studied area of school performance.

I personally have read much of the recent brain plasticity research. While such research does not directly support vision therapy it does support stimulation of specific areas of the brain through movement to induce change. Vision therapy is all about stimulating deficient areas of the brain through movement. It takes tremendous work to change the brain. I think that is really the key.
My experience has been that vision therapy like all such therapies PT, OT, ST is more about changing the brain than changing vision.

You might want to look on this site in What’s New, “In the News”-click on the latest analysis of sensory integration therapy that shows once again that it is not an effective treatment for LD. Use this type of analysis to decide about vision therapy, and decide if that’s where you want to spend your dollars…many on these boards can tell you the cost of this therapy.

I think posts like that are as bad as posts that state the ADHD doesn’t exist either, at least to those of us who have dealt with sensory integration issues. I could find a website that says that about ADHD not that I would.
I coulld find a website that stated dyslexia doesn’t exist too.

Visual issues don’t exist either and we just have to circumvent them rather than remediating them.

If I had taken that advice there is no telling where my son would be. I know where his self esteem would be.

Yes, I should have just accepted the PIQ of 89 as his lot in life.

My advice is to be informed, be very informed. Take all input with a major grain of salt and make your own decisions. Read the real research from real scientists. I suggest you look at the September issue of Scientific American. There is so much information out there about the brain that needs to be digested before one can come to anything close to an answer.

It isn’t the September issue but rather a special edition that came out in September.

Here is a link. http://www.sciam.com/special/toc.cfm?issueid=3&sc=rt_nav_list

Linda,
I didn’t make up the post about SI; it’s on this(LD OnLine) web-site and is an example of research analysis of many studies looking at SI, and other therapies like vision therapy. If it works for you and you can afford it that’s great; you mention Performance IQ…is vision therapy supposed to improve this? The classic LD kid has a much higher P IQ than V IQ, although readig therapy often improves the V score over time.

I dont think its any more controversial than any other therapy

They are all incredibly expensive and every parent has to choose what they guess is the best bang for their buck.

I do think providers vary in this field more than in other fields. Or maybe we are all familiar with general optometrists and that makes us feel we can somehow judge their performance more accurately than, say, an occupational therapist offering IM.

If it feels like it fits your kid, go for it!!!

What is the “classic LD kid”? (To SAR) My son has a much higher Verbal IQ than Performance IQ, and he was diagnosed with an LD in visual processing and written expression. I really don’t know what is typical, but am guessing that vision therapy would help a kid with a profile like my son’s more than with the reverse type of profile. (In our case, the optometrist didn’t recommend VT, but recommended reading glasses instead. It’s a very mild correction, but seems to make a huge difference to my son’s reading and writing ability.) A friend of my son with severe dyslexia was helped tremendously by the colored lenses (Irlen??). There is a lack of clinical trials proving usefulness of the therapies, but also lots of anecdotal evidence that these therapies help at least some kids. Hopefully LD researchers in the near future will do research that helps sort out who these therapies will help the most, and who won’t be helped at all.

Kay

I am just say you can find information that refutes the existance of many things without making anything up. There are thousands of opinions on the net.
I still don’t know why you brought up sensory integration when the topic was vision. They are not the same thing.

Yes, vision therapy can improve PIQ if a visual or visual motor deficit is hindering performance.

My son’s performance in many areas has improved dramatically including doing visual perception puzzles, drawing difficult shapes from memory, visual processing speed etc….

I guess the most important point is that this kid would never have survived a regular class without accomodations without therapy. He is doing well.
I spoke to his teacher yesterday and she told me that he is an incredible writer. This was his biggest deficit last year. He did write one beautiful story that brought a tear to my eye. His creativity is opening up as his deficits diminish. He is becoming all that he was already inside but could not express because of his deficits.

[quote=”Linda F.”]I think posts like that are as bad as posts that state the ADHD doesn’t exist either, at least to those of us who have dealt with sensory integration issues. I could find a website that says that about ADHD not that I would.
I coulld find a website that stated dyslexia doesn’t exist too.

[/quote]

Well, Linda, I’ve got to disagree with you on that point. I don’t think the article says that sensory integration disorder does not exist. Instead, it says the sensory integration *therapy* has not been shown, despite numerous studies, to be an effective treatment for the condition. That, unfortunately, is quite true, although it may be because no one has yet done the kind of research that would demonstrate its effectiveness. It may be because the concept (ie brain plasticity) is right, but the method is wrong.

Virtually everything we do affects the brain and its neural pathways. Those activities (mental and physical) in which we engage repeatedly definitely do cause changes in the brain. The question is, how do we know whether or how the particular patterned activity that is used during therapy is changing the brain? How do we know that these changes will be beneficial or that they will happen for most people with ADHD or some other diagnosis? The answer has to come from research because that is our best shot at an objective analysis. It is not enough merely to say that because a therapy is premised on the notion of brain plasticity it must therefore be an effective treatment. Unless there is an objective evaluation done, all we’ve got is a theoretical possibility.

Vision therapy may well be very effective for ADHD, but the research has not reached the point where that can be said with any degree of certainty or exactly what might be the ordinary profile of a person who would benefit from the treatment. The same is true of sensory integration therapy. Some people may wish to give these things a try anyway. Some people may be able to afford multiple approaches. Some, however, cannot, and no matter who you are, there is a benefit in knowing the pros and cons of pursuing a particular treatment. How can it hurt to make that information available?

Andrea

LINDA F SAID: “He is becoming all that he was already inside but could not express because of his deficits.” Kudos to you, Mama, for believing against ALL advice from the ‘experts’ what he truly was — THAT is parenting!

We need to remember that we have two distinct groups on this forum providing advice and experience: Parents and Teachers.

A teacher (as I believe you are, SAR) cannot make use of ‘unproven’ therapies. Teachers must teach to ‘the group’, though they often can help individuals using their experience and skill to do ‘what works’ for an individual child. They must answer to large groups, school boards, governments, etc, etc., and must provide results. What happens to a teacher who tries something unproven when it DOESN’T work for that particular child????? Obviously, teachers must view ‘unproven’ therapies with much more caution than parents do, and that is quite appropriate.

I do wish, though, that teachers would remember that they have huge ‘weight’ when they share an opinion, and try to remember that the ‘unproven’ therapies are NOT necessarily worthless.

That said, the teachers on this BB are MUCH valued and very welcome, even if we parents must sometimes ignore portions of their advice that are not valid for our unique children. The job of a parent, even a ‘tutor parent’ as many of us are, is very different from that of a teacher.

A parent CANNOT afford to overlook ANY avenue to help their child. Not everything is proven in empirical studies — each child is truly an individual, and though they might have similarities or patterns in common with others, they, and we, are all truly unique.

Of course we must research, research, research, and be careful before spending our money — but, as Linda F. makes clear, the factors that affect each child’s deficits AND each child’s remediation, are unique to each situation. I think it is clear from this BB alone that vision therapy has VALUE for at least some children — it should not be written off due to lack of ‘proof’ via empirical research.

Once again — this is not fair, Andrea! You have huge influence on this board, and I think it is quite wrong to tell people to ignore any therapy not proven by double blind empirical studies. LIFE cannot be replicated in the laboratory! But I don’t mean to say ‘don’t post’ — just, PLEASE remember that we parents must view this differently! It is not appropriate to apply criteria necessary for adopting a therapy or curriculum in a large setting with decisions being made by a parent to remediate ONE child…

to SAR,
the PIQ greater than VIQ is a profile for a child with a language based disability; as such the disability affects almost all academic areas since majority of what is learned in elementary school is taught through language.

Ewa

[quote=”Elizabeth TO”]Once again — this is not fair, Andrea! You have huge influence on this board, and I think it is quite wrong to tell people to ignore any therapy not proven by double blind empirical studies. LIFE cannot be replicated in the laboratory! But I don’t mean to say ‘don’t post’ — just, PLEASE remember that we parents must view this differently! It is not appropriate to apply criteria necessary for adopting a therapy or curriculum in a large setting with decisions being made by a parent to remediate ONE child…[/quote]

Sorry, Elizabeth but I disagree. I did not say anyone should ignore treatments that have not been fully researched and shown to be effective. I just said parents should know the facts about the treatment they are considering so that they can make informed decisions about where and how to allocate resources. I’m a parent and I make ALL of my decisions about treatments for my child based on a consideration of the evidence for and against effectiveness. As I see it, in the end, it is the parents who must make choices about what treatments to pursue so they, more than anyone, need to be informed about their options and to understand the difference between treatments that are known to be effective across a broad spectrum and those which may well be effective but which have not yet been thoroughly tested. Perhaps you see it differently, but that is a matter of opinion rather than of fairness.

I’m NOT saying that parents who chose therapies that have not been fully researched are doing something bad for their children. To the contrary, a parent might well choose (certainly I have) to employ an approach that is not empirically proven but which shows promise. As I’ve said, all treatments start out as unproven theories and there have always been those who were first in line for treatments that have ended up as mainstays.

However, I don’t agree that parents ought to make their decisions about treatments without reference to the scientific evidence for their effectiveness or that the decision-making process is any different for one child vs. a group. How the balance weighs out in particular cases may differ, but the procedure seems the same to me. As I see it, whether you are a parent deciding about your child or a school administrator making decisions about programs to offer many children with the same diagnosis, knowing that there may be a question about effectiveness is important. It allows parents to understand what they are choosing between and to discontinue that which does not seem to be working for their child, adminstrators and doctors to recommend that which is reasonable and well-supported for particular children and children on the whole and everyone to choose intelligently between different options.

I see posts all the time that say something to the effect of “I just heard about this new treatment that sounds great. Have any of you tried it?”. That is a fine question to ask, but, because our perceptions of the effectiveness of a particular treatment are so highly subjective, and because there may be many factors that influence a child’s progress, that question is best followed by research into the hard evidence for or against the treatment and the exact population for which it is intended. A parent might reasonably decide to go with a promising but not definitively proven treatment but IMHO it is much better to make that decision with full knowledge. In my view, the best decision on how to remediate a particular child is the one made by a parent who has educated him or herself about ALL of the options rather than rejecting (or accepting) particular choices without really understanding what those choices entail.

Andrea

I think you are stating that there is not empiricle evidence to support VT. I think the truth is that you have not researched this. I really don’t think it is your call to make if you haven’t had direct experience with this or at least read both the vision therapy journals and the latest research that provides significant evidence of brain plasticity.

Vision therapy has been around for decades, there are research journals dedicated to this field of study.
My point is that everyone should read the research and not just buy into the opinion and yes it is an opinion of some that vision therapy has not been proven to be effective.

I am certainly one to know, I started with the head in the sand approach. I think I extracted my head just in time to save my child.

The article I read in the news section (that was mentioned in a previous post) of this board was on SI therapy not being effective. I didn’t see any mention of vision therapy, which I think is a whole other topic. If you’re interested in learning about vision therapy, here is web link to start.

http://www.visiontherapy.org/vision-therapy/vision-therapy-studies.html

There is a link included there to the University of Indiana College of Optometry that gives references in the refereed literature. It’s not just LD kids who may need vision therapy, but there are other visual medical problems. All of these problems may not lead to learning disabilities, but if a kid is already wired to have learning problems, working on vision problems can help. Just being diagnosed as needing very weak reading glasses (by a pediatric optometrist) helped my son tremendously. A normal eye doctor not tuned to the particular learning problems my son was having would not have prescribed glasses, because it’s a very weak correction. It took an optometrist with experience with kids and learning problems to know what to do.

There are quacks in every medical field, so one has to be careful that the individual you pick knows what he/she is talking about. But for kids with learning disabilities that are not verbal language based, vision problems that are not simply corrected by glasses can be a contributing factor. In those cases, properly administered vision therapy can help, and there is controlled research that has examined it.

I still disagree…scientific research is NOT necessarily the end-all, be-all. Or even the starting point, for my money. Lack of empirical evidence is NOT a valid reason to ignore certain techniques. I think it is evident that there is NO one program that does it all, that children are highly individual and that different programs work for different children in different situations.

Whether vision therapy OR sensory integration therapy, there may be some value in ANY program for certain children. Scientific research via double blind studies is NOT appropriate for reading instruction; visual difficulties, hypersensitive ‘touchy types’ anyway — will you volunteer YOUR child to be the one who gets useless therapy or does nothing, to prove the effectiveness of another therapy? Or are you going to TRY anything that, given careful consideration, seems to work for children similar to yours? And be ready to change fast/modify if it doesn’t seem to achieve the desired results…

The normal caveats take care of us, provided we KNOW our kids and become informed about what IS effective…anecdotal evidence is plenty useful, for me. My son reads well in 5th grade because A) I ignored his first grade teacher and sent him for 6 weeks of Spalding instruction(direct, explicit phonics program) after 9 months of total reading failure in a whole-language classroom and B) because I learned as a community literacy volunteer that assisted reading WORKS to build fluency.

All my decisions were based on anecdotal, experiential evidence — no studies that I know of, just Ms. Spalding’s opinions, those of the teacher who taught her program, and my personal (successful) experience working with an adult dyslexic, ‘one of those people whose teachers told him he’d never learn to read well’. Of course, my opinion of the Gr. 1 teacher’s skills for TEACHING reading also informed my analysis of HER opinion…! Like Linda F, after surveying the options, I put my faith in my gut instinct and my kid, and so far I am pretty happy with that.

AN informed parent who KNOWS their child is better than all the double blind studies in the world! For the CHILD, that is!

Posted with all respect for those whose opinions differ, and with much thanks to those who are willing to enjoy heated debate in the interests of ALL our children… :)

One of the problems of having an unclassic child (mine had a 30 pt VIQ>PIQ but I’m telling you - he’s dyslexic) is that there are no easy answers. So the parent has to research and try to figure out what is real and what isn’t. And then even within the world of real therapies there is controversy. My son’s DO told him he wasn’t dyslexic because to the Dr. all reading problems are visual processing problems. I guarantee that just doing VT alone won’t help my son read. I also guarantee that just doing orton-Gillingham alone won’t get him the whole way. He needs both.

I have seen sudden, significant changes in my son as a result of vision therapy and Lindamood bell. I also believe the OT and speech and IM he has done has helped, but they were delivered more slowly over a longer period of time so the effects are more difficult to pin point.

I’ve chosen the therapies with alot of advise from trusted professionals (tutors who have seen VT work for their pupils, a psychiatrist who believes yoga can help a child with anxiety) and from all of you on this board.

As a parent of another unclassic child (I like that phrase!), I have been in the same boat. There are no easy answers. I think it is useful to know what research is out there and the quality of it. But if you have a atypical LD child, those generalities aren’t always accurate for your kid anyway. Remember the old 9 out of 10 people surveyed–well, my kid is the 10th one!!!

I have done therapy backed by randomized controlled trials and therapy developed just in a clinical setting. Both successfully, by the way. We also have done vision therapy with limited success but have been told by a second OD that more vision therapy is not the answer for what appear to be vision related issues. It appears to be an integration issue.

I think that it is important to remember that vision therapy, OT, and the like do not teach a child to read. They hopefully/might make the process easier. The child still needs to be taught to read.

Beth

I read a study once about preschool education. Kids were randomly assigned to three groups. One was a standard Head Start, with a little of this and a little of that and a lot of unstructured play. One was a highly structured verbal intervention program. The third was a computer-instruction individual program for an hour a day, and a standard preschool for the rest of the time.
At he end of the year, not only were students tested, but parents’ and students’ attitudes were surveyed. The active intervention programs gave students higher scores than the basic Head Start, not too surprising. But the interesting and unexpected finding was that nearly *all* the parents, whichever program they had, were firmly convinced that they had absolutely the best program. It seems that the teachers were doing a fair job of teaching preschool kids, but an absolutely fantastic job of selling themselves and their programs.

This is always a problem in evaluating any program — are you evaluating facts or self-promotion?
There are certain subtle signs that lead one to suspect more hard sell than content, but it is hard to be absolutely sure. It’s even harder on the internet where fake posts abound.
I tend to believe Linda F’s reports about IM and vision therapy for her son; there is a ring of reality and truth about them.

One problem with many programs discussd here is that they are needed and effective for such a small part of the population. It is hard to do a properly random study on a large group when to begin with only one kid in a thousand is a candidate for the therapy. And it’s really hard to get enough data to make a convincing statistical argument when you are targeting a tiny minoroty. This is just a fact of life when your kid doesn’t fit the pigeonholes.

I disagree with one post above — in a proper double-blind study, you don’t know whether you’re in the treatment group or not, and neither does your doctor; that’s *why* it’s called double-blind.
However, if a large difference shows up between the treatment group and no-treatment control group during the study, it is normal protocol to stop the study and put everyone into the treatment as soon as it has demonstrated its value. So if a study is being done, you really don’t need to worry hugely about wasting your child’s time.

One note — there is a huge, huge gap between “not proven” and “disproven”. Not proven means that either enough studies have not yet been done, or that it is so difficult to focus on the tiny number of people needing the treatment that the successes are badly outnumbered by the wrong targets. An unproven treatment *may* help — or it may not. You have to decide how much money and time you have. A *dis*proven program, on the other hand, has been run through the large studies, has been focused on the target group that it claims to help, and has shown no more improvement than either the standard treatment or no treatment at all. You are most likely wasting your time and money on it.

[quote=”Linda F.”]I think you are stating that there is not empiricle evidence to support VT. I think the truth is that you have not researched this. I really don’t think it is your call to make if you haven’t had direct experience with this or at least read both the vision therapy journals and the latest research that provides significant evidence of brain plasticity.

Vision therapy has been around for decades, there are research journals dedicated to this field of study.
My point is that everyone should read the research and not just buy into the opinion and yes it is an opinion of some that vision therapy has not been proven to be effective.

I am certainly one to know, I started with the head in the sand approach. I think I extracted my head just in time to save my child.[/quote]

I think posts that are personal attacks on other posters should be removed from this board. This kind of meaness would not be tolerated on other boards. That it persists here is the reason why so many are abandoning this site. It is my intention to do the same. Good luck to you all.

Andrea

I’ll leave and save you the trouble.

I think it is offensive to consistantly attack therapies that others have found so valuable. I did not mean to make it an attack on you but rather an attack on your approach which is to offer you opinion as factual research.
I have seen many up in arms over similar statements over possible long term effects of medication.
Why is what you do Ok?
You are entitled to your opinion but you should state that is is just an opinion.

I was just pointing out that you don’t tend to do this, it is misleading and personally offensive to me.

I don’t really need this site too much anymore because therapies like this have brought my child so very far. I was sticking around in hopes of helping others.
I can’t deal with the, “we can’t help the kids except through meds,” crowd anymore.
There is hope and I genuinely would like to see more kids get the help that my son has.

I’ll let those of you who feel the need get back to you hope squashing agenda.

It’s me Chris…the original poster.
I should have been clearer in my original request. I was looking for parental feedback. Between my husband and I we have 5 degrees up to post graduate…of course none are in education or learning. So I am confident that we are using our reseach skills and reading all the applicable scientific data.
For me personaly my preferred course of action is to research and then get feedback from people who have been through the situation. In this case parents of kids who have been through VT w/ good or bad results. I do appreciate the “academic” opinions I got but could tell they weren’t parental right away. I guess some parents who find their way to this great site may not pick up on the difference and could be heavily influenced by either school of thought. I appreciated all the feedback.

We’ve known about the ADHD for about a year and the executive/visual/motor is new but the missing piece of the puzzle for me…everything makes more sense now. We met to review his action plan at school yesterday, I am probably going to start the vision therapy shortly. I think IM will be our next step but maybe not until next summer…we have to keep DS from getting overwhelmed w/it all. He is 8 and in 2nd grade. If anyone sees any potential problems in doing VT then IM let me know. Again Thanks to all who replied. This is rushed apologies for any spelling errors.

Andrea and Linda,

It pains me to read your exchange. I have personally found both your posts interesting and informative. Andrea, I personally have found your knowledge of what studies are out there as an important piece of information. It is a piece of information that complements the personal experiences that Linda, you bring to this board. As a both a parent and an academic trained in research methods, I find both perspectives valuable. As a parent, I don’t feel like I can always wait for the research evaluation but knowledge of what support there is or is not helps me understand what risks I am taking.

Beth

Y’all need to go read Dad’s post on Parenting a child W/ADHD about alternative treatments. You might learn something.

Linda and Andrea,
I’m a new participant to this board, although I had read posts with great interest for quite a while before having the courage to “bare all” and write about the issues our family has been experiencing. The wonderful members of this board have not only offered experiences and suggestions to one another, but offer a therapuetic (sp?) service, kind of, to many of us who need that so badly just so we can see the forest through the trees and get a bit of a clearer picture on what we need to do for our kids (and know that we’re not alone!).

I ditto what Beth said. I hope you will both accept your differences of opinion and continue to participate on this board for all the parents and children out there whom you have helped and can benefit from what you have to say.

Lori

one more vote for you to stay and participate.

Ewa

One interesting thing I’ve noticed about vision therapy is that recommended treatment can differ quite a bit between practicioners. And also, it seems like practicioner expertise and ability can differ greatly. So perhaps the controversy could have something to do with a lack of standardization (?) That’s just a wild guess.

My son has been to three different offices (changes were made due to location difficulites). I did notice quite a bit of difference between each place. I think some doctors are probably going to be more effective than others depending on the patient’s difficulties.

One thing about Linda’s doctor is he seems to do a lot of integration and cognitive exercises in addition to basic VT. This seems to me like it would be much more effective (the more areas visually, perceptually and cognitively stimulated, the more likely there’s going to be some type of progress — this is another guess of mine! ;-).

I haven’t had time to read all of the posts in this thread. Just wanted to post the following website, which lists many research studies done on vision therapy.

http://www.childrensvision.com/studies_and_research.htm

Even if you eliminate all of the studies conducted by optometrists and look at only those studies conducted by opthalmologists and other medical doctors, there is a lot of evidence that vision therapy can be helpful. In fact, the professional association of opthalmologists believes the research on certain problems to be overwhelmingly conclusive and therefore sanctions vision therapy for specific problems. There is a sub-specialty of opthalmology (orthoptics) devoted to this kind of vision therapy. Unfortunately, most opthalmologists are not trained in this area and don’t know enough about orthoptics to even refer patients to opthalmologists who do.

Much of the controversy over vision therapy has arisen from the fact that optometrists have pioneered this area, not opthalmologists.

Another problem is that vision therapy has often been misunderstood by parents (and professionals) as to what it will and will not correct. In fact, vision therapy is designed to correct visual inefficiency problems (convergence, focusing, tracking, gross pursuits, gross saccades, etc.). Correcting visual inefficiency problems does not automatically ensure development of visual processing skills (visual sequencing, visual short-term memory) or the decoding skills necessary for reading. Often vision therapy needs to be followed up with cognitive training (Audiblox or PACE) to fully develop visual processing skills, and then by a good reading program (such as Phono-Graphix) to explicitly teach decoding skills.

Parents on this board are an invaluable resource about what actually works and what does not, and for which children. It seems obvious to me, but may not be to others, that a child whose problem with reading is *NOT* related to developmental vision problems will not be helped by vision therapy. Conversely, a child who has developmental vision problems may *ALSO* have other problems that *ALSO* need to be addressed before fluent reading is possible.

Nancy

I love this one because it touches so many things that effect his reading. Tracking of course, but this exercise also requires him to use fine motor and retrieval from memory.

The exercise:
He must circle the first and last letter in a newspaper column. As he circles he must say the letter being circled. We time him and record how many lines (2 circles) he can do in 30 seconds. He does this 6 times for each eye (patching the other) and then with both eyes.

Hi Folks,

I am an unclassic adult<G>. What I mean by that is I have NLD/ADHD and possible CAPD symptoms usually not seen with NLD.

I wanted to add my voice to the other posts who have expressed dismay at the exhanges between Linda and Andrea. Linda, you have been awesome and I have always enjoyed our back and forth exchanges on various issues. Your quest to help your son has been so inspiring.

Andrea, I don’t know you as well but have always found your posts to be the voice of reason. Anyway, reasonable people can disagree and even get extremely argumentative about their positions but don’t intentionally set out to attack another person. I hope Linda comes back and this can be settled.

A few years ago, being the daughter of a scientist, I wouldn’t have been caught dead trying therapies that didn’t have a strong track record of research. But I had gone of antidepressants because the side effects were starting to be worse than the depression. Unfortunately, the depression roared its ugly head and out of sheer desperation, I tried St. Johns Wort. Well, I am still on it in spite of the studies that allegedly say it doesn’t work for moderate to severe depression.

Also, we assume that medical science is never wrong and nothing could be further from the truth. Perfect example is hormone replacement therapy. Additionally, what about all those people with ulcers who for many years were told their condition was due to stress when it turned out to be due to a bacteria?

As far as vision therapy, I have considered it but am not sure I will go through with it. There are several reasons but I do realize that if I go through with it, it won’t cure my LD. By the way, the good and reputable practioners do not make the claim that it cures LD. While no one did this in any of the posts, I find it insulting when professionals lay that mantra on me as I am intelligent enough to know what VT can do and what it can’t do.

Regarding educators having to go with proven therapies, I understand why they can’t recommend VT. However, I find that position a little disingenous because they continue to use reading methods that have been proven not to work. Elizabeth, this is not a criticism of you or any teacher but is a shot at the administrators who put you in those unenviable positions.

Finally, to the person who wondered about the VIQ being higher than the PIQ (sorry I forgot your name), that can be a sign of NLD with the word “can” being the key. As I try to diplomatically remind folks, Dyslexia and other language LDS are not the only ones that exist.

I enjoy the discussions on these boards and learn so much from various posts. Let’s keep the friendly atmosphere going even when there is disagreement.

PT

Karen,

I was interested in your exercise, because my son has the same profile, but wasn’t clear on how to do it. Do you mean he looks at a newspaper column from the paper and then circles the first and last letter in each line?
If so, how do you insure that he doesn’t just jump to the end of the line?

We once did a variation of this—circle e—in which he had to circle all the e’s in a line of text.

Beth

Beth, I’ll try to explain better, because I think you’ll like this one. DS likes it because its short/sweet and he can try to beat his score.

He takes a pencil and circles the first letter in line of text in a newspaper. He has to say the letter when he circles. Then he immediately jumps to the last letter in the same line , circles it and says the letter. Then jumps to the first letter of the next line down. And so on. So his eyes and his pencil have to move in a left to right , top to bottom motion, much like reading. He also has to recall the name of the letter. I time him and at the end of 30 seconds we write down how many complete lines he’s finished. (If he circles the first letter, but not the last it counts as a half)

PT- I think it was me, speaking of my unclassic dyslexic child with a large VIQ>PIQ spread. Believe me, we’ve investigaged whether NLD would be an appropriate diagnosis. (along with ADD and just about everything else you can think of) He has some traits of many disorders, but they don’t seem to rise to the level of a diagnosis. And interestingly enough as we address the anxiety that accompanied the reading disability, the NLDish traits he has are diminishing. But yes, we are aware it can be an indicator. Thanks!

http://pediatrics.about.com/gi/dynamic/offsite.htm?site=http://www.aap.org/policy/re9825.html

Dear Guest,
I read the link you posted, and although I suspect it was intended to support the anti vision therapy point of view it didn’t persuade me. First, the article was written in 1998, and alot of information and research about dyslexia has been completed since then. I take no exception to the idea that most parents need to warned off of experimental therapies, particuarly therapies that purport to cure dyslexia and LD. A desperate parent will be vulnerable to peddlers of snake oil. But I’ve personally met too many parents that have found VT to be effective for their children to disregard it. And I’ve seen my son’s eye contact and motion sickness improve for no other identifiable reason besides VT. Has it cured his dyslexia? No, he still needs proper remediation.
Karen

[quote=”KarenN”]Dear Guest,
I read the link you posted, and although I suspect it was intended to support the anti vision therapy point of view it didn’t persuade me. First, the article was written in 1998, and alot of information and research about dyslexia has been completed since then. I take no exception to the idea that most parents need to warned off of experimental therapies, particuarly therapies that purport to cure dyslexia and LD. A desperate parent will be vulnerable to peddlers of snake oil. But I’ve personally met too many parents that have found VT to be effective for their children to disregard it. And I’ve seen my son’s eye contact and motion sickness improve for no other identifiable reason besides VT. Has it cured his dyslexia? No, he still needs proper remediation.
Karen[/quote]

This is the current position of the American Academy of Pediatrics on vision therapy.

Thanks Karen. I think having to say the letter is a nice touch—works on those retrieval skills too and forces integration between different systems.
The efficiency appeals to me too!!

Beth

Of interest when considering why treatments that do not enjoy scientific support may helpful.

http://pespmc1.vub.ac.be/ASC/HAWTHO_EFFEC.html
http://www.accel-team.com/motivation/hawthorne_02.html
http://www.nwlink.com/~donclark/hrd/history/hawthorne.html

The problem with using the Hawthorne effect to explain an effect is that it is based on the assumption that attention alone caused the affect. The problem with that explanation for many of our children is that we were already working intensely with our children. That work just did not address vision related issues. The other difficulty scientifically is that most of us do not stop reading therapy when we do vision therapy. So you have more than one “treatment” going on at the same time. However, in my son’s case, I saw a big difference in his ability negotiate worksheets and copy math problems after vision therapy—areas that are hard to explain by reading therapy.

Beth

Karen,
Great vision exercise!!!! I’ll have to try that one with my son. Thanks for sharing it! :-)