Gifted Issues Discussion homepage Forums Twice Exceptional UPDATE Vision Therapy Testing

Well we saw the COVD Optometrist. They first did a regular vision exam including dilation (which he had not done before and found a little traumatic in how it was done). All is normal 20/20 sight.

After discussing all the symptoms that may be related to vision issues, the Dr. said she wants to do a 2hr sensory motor exam and a 2hr visual processing exam scheduling a separate visit for each. So 3 visits in all to diagnose. Is that typical?

She did work with my son well which was important. She seemed to get him quickly and gave him jobs he enjoyed like assembling a model of an eye or challenging him to figure out how to operate some of her equipment.

He is having more and more complaints of nausea, dizziness, and stomach aches every day. He's having problems eating and brushing his teeth and is often refusing to participate in sports classes that he enjoys.

She noted how he was grabbing and touching all the equipment despite my correction. We struggle with this type of impulsivity/hyperactivity with him and have been connecting it to his ADHD diagnosis from a few months ago. She attributed it to a learning delay saying that he didn't progress from the sensory motor development stage as he should have since tactile discovery was easier for him than visual. He always touches everything regardless of consequences often getting in trouble at home or school. He's not malicious just overly touchy. I've never thought of it as being a development delay before and am mulling over that idea. I think she is the first person to ever say the words "development delay" to me about my son. So it is taking awhile to process and think through if this matches what we see with him.

So now we are waiting till next week and another visit.... then they schedule a 3rd visit..... then we finally have some more information about what is going on. It's a bit of a drive and I'm anxious for answers.

I'd love to hear how this mirrors or differs from the experience others have had. I always worry that I've picked the best person who will give us conclusive answers rather than just bringing up more unanswered questions. She is a Board Certified Fellow COVD but with no local recommendations my confidence is solely placed in the credential.

When we went to a COVD vision therapist, we already had been to our own optometrist who recommended this therapist. So for us, no additional eye exam. Our optometrist has a machine that takes pictures of the retina with no dilation though it is a little tricky for the kids to get their eye open far enough.

The vision therapist did an initial evaluation that was a mix of vision processing with some sensory that took about 3 hours. I may just be remembering more of the vision processing stuff because that is what we were more concerned. HTH

We had a shorter assessment visit, perhaps 2 hours total.

It sounds like the optometrist is picking up on an issue with touching that you, too, have noticed. However, I would wonder whether the optometrist is the best professional to do a sensory motor exam or explore overall development delay with you. Why would this be in the realm of the expertise of the optometrist? Hmmm. I would learn more about whether the this is something typically in the realm of a COVD.

Thank you so so much for typing all of the testing your did Portia!! It helps tremendously to compare and consider and understand what this looked like for others. I took your advice and changed the title.

Laurel, we have had a few clues to issues along the way. I'm expecting we will have more follow up with others once we figure out what pieces are related to vision. I think the optometrist was saying she thought this was related to his vision development and asked if I were aware that this was a developmental delay. We will see.

Knute thanks for chiming in too. I am still trying to figure out what is normal and expected with a developmental optometrist. It's all pretty new to me.

Thanks! Just got home from dinner after the two hour testing. It was pretty awful. Getting my highly hyperactive son to do testing for that long wore us both out. His hyperactivity was much worse under the stress.

I was often physically holding him to do the testing. He couldn't hold still and would impulsively push the buttons over and over when he wasn't trying to figure out how to work whatever equipment he was near or pulling my hair or leaning from side to side so hard I thought I would fall over. He also kept leaning forward, twisting, and standing on his head (literally!) in the chair. They were patient and kind and told him they were doing Ninja training but I thought we'd never get out of there.

What I noticed in the testing was that he found seeing with one eye only to be detestable and nearly impossible to tolerate. I asked him about it later and he said, "It was like losing half my vision!!" I told him that was useful information about his eyes because most people don't feel that same way. I said that his eyes were depending on each other more than usual. I told him we needed to help them get stronger so they could each do their own jobs by themselves. He is really enthusiastic about getting treatment and he really wants it to help his handwriting issues. We've been making a list of things we hope Vision Therapy might help with. (For motivation when things get trying later.)

It was really exhausting but he really wants some things in his life to be better so we are hopeful this will be a help. Clearly from the graphs I saw and how he responded, this is one of our major issues affecting life and making many situations unmanageable.

One more (even harder they say) round of 2hr testing to go to examine visual processing. We have a few weeks till then to rest up.

Oh my goodness, do we have twin sons? LOL What you described in the original post sounds much like my son and our visit to the development optometrist. He did about 2 hours worth of vision tests, a reading test, and a couple of motor tests. My son is slightly near-sided so wears glasses. He already had surgery for strabismus but his eyes still do not work together. The DO wrote that he has visual functional and visual perceptual difficulties in eye teaming ability, fixation ability, eye movement control, and significant lags in visual directional concepts. He also recommended an OT eval for motor-sensory integration issues. That eval happened on Monday and waiting on report from that. My son is also really touchy like you described and he also mentioned developmental delay, which was a first for me!

The DO said that he would also need to do a Visual Information Processing eval (which is another hour) before we start vision therapy. That will give them enough info to come up with a plan of action. It sounds like some of the other posters may have had all of the above done at one time or broken up. Sounds like this is normal to do all that testing.

I'm really encouraged by the results people have had from VT. I really hope my son just transforms into a new, improved version of himself. He lacks motivation (in school), can be very negative, doesn't complete his work, etc. etc.

Best wishes on your VT adventure!

Sounds like we will be spending out summers doing VT bronalex. I sure hope we get great results!

After my other post about standing on his head, swinging, etc. I've been reading up on SPD. I like the Optometrist that we have been seeing but don't feel confident about her staff who seem to do quite a bit with the patients. We have a pediatric rehab place nearby with whom we did handwriting classes previously.

On their website they list working with Sensory Integration Disorder, ADHD, and the following:

Vision and Visual Rehab
Our therapists work with a
neuro-optometrist to help the child
with vision, perception, and ocular
motor control difficulties. This therapy
improves handwriting, copying skills,
and other visual activities.

They have an NeuroPsych on staff as well. However, this would not be a "gifted" specialist.

We have an ADHD diagnosis and suspected Dysgraphia. Am I missing something or could we do our vision therapy at the Rehab Center?

Thanks for the lengthy response. It really helps. I think concern about therapist fit is why I am looking around... He hasn't clicked with any staff except the doc.

So what is the difference between a Neuro Optometrist and the COVD?? Is there specific training or certification for the vision therapist?

I don't think there is a difference because COVD is a nonprofit that some developmental optometrists belong to: https://covd.site-ym.com/?About_Us

Just another quick thought - the DO told me that the motor-sensory stuff and vision stuff is related but that success with vision therapy might not be as good if we don't address the motor-sensory first, which is why we got the OT eval.

He said that my son missed some developmental milestones and you have to go back and pick up the missing building blocks. Sensory integration needs to come first because that is developed (or should be) earlier. So our plan is to start OT and do that for a couple of months then start VT and do both simultaneously. Since we haven't started either yet I don't know how it's going to go but I am hopeful this will be the combination my son needs.

First, thank you to all who have been teaching me with your experiences on this thread! I am so much further ahead from reading the things you all are sharing.

We have our "visual processing" testing on Friday. Not looking forward to that. I have been on the phone examining our options. As I'm concerned about "fit" with the staff and distance. We travel a good 45min to get there.

The place I mentioned previously in this post that is a rehab hospital which offers vision therapy DOES work directly under the supervision of a Neuro-optometrist who is an associate of the COVD. Ironically her office is within walking distance of my home (!!) and I am rather impressed with her from speaking to her and reading her website. She has forms online for allowing her to speak with school about vision issues and allowing her to advocate as needed (!).

She also has good articles and links on her site including one to a neuro-psychiatrist who does some of the specialized things we were seeking when we flew out of state to get my son assessed earlier this year. Very holistic approach to all of it. She even recommended a book and a local psychologist who does neuro-feedback to check out.

She tells me that many insurers honor her as "in network" because the gap in mileage between her clients and the nearest in network providers. The Optometrist we've been seeing is 0.59 miles past the range most require to allow that exception.

I didn't find her at the COVD website because her location had not been updated to include the office near my house and the other location is extremely far. I never would have known she was there if I hadn't spoken with the Rehab people and asked for the name of the Doc they worked with. WOW!

I think the new plan is to finish testing on Friday as previously arranged and bring the results to discuss with her filling any testing gaps she may find and then setting up therapy at the newly discovered local place. I feel rather excited after talking with her. She was very accessible and helpful as well as very connected to the approach to medicine and therapy that I espouse. I am cautiously optimistic that we have found a great fit.

Has anyone else had their optometrist work directly with school? How was that or would that have been helpful?