Vision therapy/behavioral optometry

Srikal,
If your student with a language based learning disability has visual processing problems then it completely appropriate. My dyslexic son has done VT and we’ve seen improvemetns in tracking and non-reading related areas. On the parent board you will find lots of information and testimony about VT.

Try http://www.childrensvision.com for lots of information. There is a link there to research on vision therapy.

You won’t find much (if any) reading research that deals with vision therapy to reading because they are two very different things. Vision problems will interfere with reading, but that doesn’t mean that all reading problems have a vision component. Also, correcting a vision problem in a child does not mean that a child will automatically be able to read.

Nancy

It does not seem an appropriate therapy to suggest for a student
with a classic language-based reading disability. Am I right?

Hi,

If you mean, by “classic language-based reading disability” that a child can’t seem to connect sounds to letters, as most of the reading research indicates, then no, you are likely wrong.

I have found that most of the kids who fit the profile of poor readers defined in the standard reading research are also suffering from vision issues. In most cases, I think the vision issue came first, and caused the deficits in phonemic awareness.

Basically, if you can’t attend to print visually, then there isn’t much reason (or opportunity) to attend to the sounds in words. The only reason to learn to segment out the sounds in words is to apply that knowledge to learning a sound-based writing system. If you can’t comfortably deal with the visual images, you may never get around to attending to the individual sounds in words.

The traditional sources of reading research are very poor sources to go to for this information. Most of them are biased to the extreme against this point of view. They take it so far as to claim research support for the opposite conclusion, i.e., that vision problems are NOT a root cause of reading problems. When examined closely, most of these conclusions are very poorly supported.

Frankly, I would recommend that the parents of any poor reader have their child checked by a developmental optometrist. You may save yourselves years of agony, and your child decades….Rod

While there are people who don’t have visual issues, it really would be a mistake to assume that difficulty between the sound-symbol connection means you should attend to the sound processing and not the symbol processing.

There is no evidence that vision therapy has any role in either reading disabilities or for that matter anything else. About ten years ago the method and claims were heavily criticized if not outright rejected in joint statement by Am Acad of Pediatrics, Ophthalmology, and Neurology. Even optometrists admit that Developmental Optometry is not a legitimate field. Personal testimonies notwithstanding, vision therapy persists only because it is still a lucrative business for some. Living in California, especially in S.F. East Bay area, in proximity to Berkeley Optometric I witnessed many wasteful referrals to developmental optometrists. For more information check these sites
http://www.quackwatch.org/01QuackeryRelatedTopics/eyequack.html
http://www.ntskeptics.org/1992/1992october/october1992.htm

FWIW,
ML, MD

Michael,

I teach reading to kids who have failed to learn to read in Wisconsin schools. Wisconsin schools are excellent, and kids who are failing to learn to read get a significant amount of extra attention. Yet, some kids fail to learn to read. In my opinion, most of these kids have undiagnosed vision problems, generally involving their ability to get both eyes working together consistently. The tests to determine this ability are reasonably straight-forward, objective measurements can be made, and improvements can be seen in those measurements during therapy.

In the last four years, I have found that to be successful at what I do, I often need the services of a competent vision therapist. I have worked with kids before VT and with the same kids after VT. I have also referred kids to VT who were poor readers, but did not require my services…they simply had vision problems.

In the case of the kids who come back to me after VT, I often (more times than not) notice that they are much easier to teach…they finally “get it.” In the case of those who already know the phonics, but are still poor readers, VT is often enough to turn them around in school.

Does this constitute scientific “proof?” Of course not. But MD’s have been laughing at things that turned out to be true for a long time. Even the doctor who claimed benefits from washing one’s hands before surgery was ridiculed in his day. We usually get the studies “proving” something long after intelligent beings have already seen distinctive patterns that can’t be ignored. The day the conclusive studies are done to cause you to change your opinion are probably not far off because, with the advent of the internet, more and more parents are finding competent vision therapists. “Why is vision therapy such a secret?” is the question most of them have after they see what it does for their children.

In the meantime, I would ask you to pay a visit to a vision therapy department and speak to the parents of the kids they are helping. You may have your eyes opened.

Rod

Rod and Michael both have a point. I actually went and read the article in question about scientific research on vision therapy, referred to in “Quackwatch”, referenced in a post above. Good thing to go and read those articles, highly recommended before throwing opinions into the argument.

The scientific community DOES support “orthoptics” which may roughly be described as eye-muscle training for problems with eye convergence and tracking — exactly the sort of thing that Rod is talking about. So yes, Rod, it can help in many cases, and the medical community backs you up.

Vision therapy does NOT teach reading — as Rod has pointed out, you get the orthoptic therapy to get the eyes focusing where they need to and the letter forms perceived properly and quickly; then you must also have a reading teacher, like Rod or others, to teach how to use those symbols. You need both. It’s not a one-or-the-other question at all!!

There is NO support for coloured lenses, although a light blue to reduce glare may do a little (very little) good. Coloured lenses certainly do not teach reading, and they don’t cure many other diseases as has been claimed.

Other forms of vision therapy are at best unproved, in some cases disproved. And they do not diagnose or cure other diseases or disorders.

So you have here the problem that some good and very valuable training is mixed up with a bunch of things that don’t work and others that are at best experimental, and all viewed and packaged under the same name. This is definitely a field where caution, skepticism, and research are called for; buyer beware.

So glad that Rod and Victoria responded as they know so much more than I do.

My perspective is one as a parent. I am an educated consumer and not likely to be scammed so I read web sites like those references by michael carefully.

If a VT provider told me that VT would cure my son’s dyslexia I would run the other way. It can’t, and he needs to be taught to read explicitly.

But I have a child with a history of mild motor problems: fine motor, gross motor, motor planning, and oral motor. So why should occular motor problems be a surprise? His inability to follow a pencil with his eyes without moving his head was obvious to me„ and was an obvious problem for him while reading. And VT has remediated this tracking issue.

But I do believe that therapy can be beneficial to the visual processing system, which does include how the brain processes visual input.

I have an adult friend whose eyes move somewhat independently from each other and she was told that it could be correctly surgically but that she would need VT to teach her brain how to use the visual input differently. I also read a story in people magazine about an adult man who lost his sight at age 3, and then had it restored as an adult. He reported that despite the fact that his eyeballs worked now, his brain couldn’t always process what he was seeing after a life time of not working that way.

My son had vision therapy, which helped him with work sheets and such—he couldn’t line up math problems before doing it. But we never got much transferance to reading. Interestingly enough, we got two jumps in tracking (he skips lines and words) this fall. One was when the second developmental optomtetrist prescribed developmental (more like a weak magnifying glass) lenses for him. The second was after he went to a PG intensive for reading therapy.

As his decoding improved, his tracking improved, which did not surprise the developmental optometrist. He had told me that his remaining issues were integration and did not recommend more vision therapy.

Beth

A good book to read is “Does Your Child Really Need Glasses?” by Robert A. Clark. It has eye charts in it and helps you to determine if your child needs glasses, and explains alot of different eye problems. It also explains what vision therapy does help and explains when you need it ( it also gives a couple exercises) and recommends going to vision therapy only if you can’t get your child to perform them at home. He also talks briefly about dyslexia and what helps (phonics training and rhyming exercises). It is a very good book that explains different eye problems.

Michael,

If vision therapy is quackery, could you please explain to me why opthalmologists now have a recognized specialty called orthoptics?

Funny how it’s quackery if done by developmental optometrists, but perfectly legitimate if it’s done by orthopticians.

If you are truly interested in the research, check out the link to research articles at http://www.childrensvision.com .

Nancy

I was very skeptical about VT, after all my daughter had 20/20 vision. Unfortunately she could not maintain her focus and could not, would not sustain reading for more than 10 minutes.

Pretty hard to learn to be a competant reader under those circumstances.

No, VT didn’t cure her LD or her ADHD - Still has organization and memory issues. But now she can read.

Interesting new developments: Sue directed us to a site called sciencedaily.com

What fun! I had to tear myself away — thanks Sue. Anyhow there were several interesting abstracts by researchers who did brain scans of dyslexic boys — boys only so be careful about overgeneralizing the left-right issue to girls, since it is already known that women have different left-right patterns than men.

Anyway, one of these abstracts noted that the dyslexics used much more brain area and energy in *both* visual *and* language processing areas, showing that the problem involves both functions and/or the interaction between them.

Also to be noted is the fact that training — in this case, FastForward for boys with language processing deficits — actually changed the brain functioning, as could be seen clearly from the scans.

Recommended to go check out this site for yourslef.

My son did VT and did not improve in reading fluency. He also has tested poorly in PA and RAN, two significant markers of reading disability. He is a nonreader.

During pre-testing in VT, he had many backtracks in his visual scanning for reading, noted as an eye processing problem. In the car, he told me he backtracked because he misguessed the words and had to reread the context to self-correct. In post-testing, he was told to attend to the backtracking, reminded to try not to do that. His reading rate was slow, perhaps slower, as the optometrist appeared at a loss for words that one who quickly zipped through the visual practices of letter recognition and scanning with ease was unable to demonstrate a similar apparent ease in reading fluency.

I believe visual processing of symbols could be an area of interference, but I wouldn’t bank on that as the answer. Maybe there are several processing problems that are wreaking havoc. A good psycho-educational evaluation that can test both the visual and the auditory processing of a child might be helpful and money better spent.

Do you verbalize when you read and process language? If you have trouble processing the visual symbols accurately, surely that could contribute an interference with the verbalizing what your visual system perceives. As well, if there is impaired sound/symbol processing, perhaps that is not a visual recognition problem, but a sound/symbol correspondence difficulty—a problem accurately processing , or coding, the visual images to the sound code of language. Is there a breakdown in grasping the chunks in the sound of language/words?

I have observed my son and this phenomenon, working through a process of elimination. He can visually recognize many words, having an appreciable sight word bank. He can attempt recognizing chunks and blurt a good guess at the parts using context as a guide. He often misguesses words. He skims to recognized words (confession) and often misses little words or replaces words and sometimes changes entire ends of sentences once he gets the direction of the context. Accuracy and details are quite at risk. What I do not see is an ability to sound out words, to deal in sound bites, the words that are not recognizable from the memory bank. Reading is a slow and unrewarding activity. As a younger early reader, he could not grasp word families. Unfortunately, I did not learn the reading process until he was quite far along in his schooling so to get appropriate intervention when the challenge to break the code was more obvious.

Hope this information helps to guide your exploration.