Gifted Issues Discussion homepage Forums Twice Exceptional 504 and vision therapy guidance please

Thank you to all who have shared their vision therapy experiences. I am finding great comfort in reading previous posts.

My fourth grade daughter has started vision therapy. Her biggest issues are double vision for dynamic vision, eye teaming, and poor hand eye coordination.
As the visual tasks increased for fourth grade, it seems these deficiencies went from unnoticeable to daily occurrences.
School was never an issue for her in the past, but her math class has become a huge stress. The class is accelerated and students must have a B+ average to stay in the class. She understands the concepts but is making too many little mistakes - writing the problem down wrong, transposing numbers, misreading her handwriting, not reading the instructions, etc. When we review her work, she sees the mistakes and gets upset. Her confidence is low, and she is stressed, which is adding to her mistakes, I think.
Her eye doctor says that her eyes and brain are under stress right now from these deficits and the therapy, and her symptoms will improve in 4-6 weeks.
So here's my dilemma. I have been told that the 504 process in our district is slow moving (6+ weeks). We are also at a new school, so I don't know any of the teachers or administrators. Her main teacher wants to wait and see how she responds to therapy first. However, the math teacher is not taking her vision issues into consideration and is holding her to the scoring requirements.

If they move her to the non-accelerated class the pressure to ace every test and quiz will be gone, but she will be bored and not be able to attempt accelerated math again until middle school.
Should I push for some leeway in this math class until she has had two months of therapy? My thinking is that the other class is moving so slowly that she won't have any gaps by pushing forward and then dropping back if needed. My hesitations are that she has no history of academic struggles and vision therapy isn't always well received, so the teachers may not be willing to make accommodations. I was disappointed to barely receive a response from her teachers regarding the diagnosis and accommodations.
This is all new territory for me. I would appreciate in input based on your experiences. thank you

First of all I wanted to say that i find it horrifying how schools are putting pressure on kids to get A's and B's with the threat of removing them from the class the second they drop below that, even if the problems are due just to silly calculation errors. Great way to feed perfectionism and anxiety!

DS had double vision pretty constantly for several months in kindergarten, due to a brain injury (one eye was completely stuck and pointing inward), and he coped in school by wearing an eye patch on one of his eyes. Is this an option, at least maybe for math class? He said that without the patch there were two images and he learned to look at one and ignore the other one, but I imagine that would get cumbersome. When he read without a patch, he sometimes closed one eye. I'm just trying to think of a simple solution to get through the next couple months. I would definitely push them to wait and see if she improves after therapy (but if she doesn't, are you going to be able to demonstrate that the problems with accuracy are related to vision, and if they are will the school alter their grading policies for her?).

Don't wait.

I would request a meeting to discuss the disability right away, in writing, addressed to principal, person in charge of special education, and the relevant teachers. You need a 504 plan that includes accommodations for the vision disability. (Does she do better if she works on graph paper? or in Mod Math or Panther Paper apps?)

The school will need help in figuring out what works, and especially in seeing where her disability is affecting her work. The 504 should include accommodations for everyone to follow that will help her be successful ASAP.

It sounds like she may potentially be done with vision therapy by the time that the school actually writes a 504, but I agree with DeeDee that it makes sense to put in a request for a 504 immediately. If it becomes unnecessary later, you can always drop it. Strangely, I thought all of DD's teachers last year were trying to attribute her issues (which are similar to dysgraphia) to a vision issue, and putting pressure on me to take her to a developmental optometrist (when I didn't think that was the issue at all), so you never know what people are going to think.

Including grading accommodations.

1. If she copies the problem wrong...grade/check the problem she wrote and not the book problem.

2. Eliminate the copying... Provide her with a sheet with the problems already on it (using an enlarged font if she needs is) with plenty of room to work.

3. Reduce the number of problems (reduce fatigue and allows her Ike to check her work for mistakes).

And heck the patch sounds like a great idea temporarily for one class as long as the vision therapist okays it. I'd ask which eye or if she should alternate eyes each day.

Good advice from Deedee, as always. Additional thought: if there is any argument about whether she truly does understand the math material or not, could you push for oral confirmation of your DDs understanding during the next two months? If the math teacher wishes to argue that she can't keep up with the difficulty, oral checking could help demonstrate that her understanding is fine, it really is just her eyes causing translation issues when she writes.

I would actually *not* consider using the patch - I say that as the parent of a child who had severe double vision and went through vision therapy. The reason I wouldn't ask - it isn't going to correct the problem, your dd needs the VT to do that. Chances are her eyes may already be shutting one eye down when she is experiencing double vision (that happened with my dd). If you introduce the patch as an accommodation at school, they school staff may not be as willing to give you other accommodations that are truly needed, and, more importantly, I doubt that wearing the patch will significantly help with fatigue due to schoolwork. The patch will definitely help with visual confusion but think about doing close up work like writing numbers or reading - it's not easy to maintain focus when only one eye is working.

Re the 504, I agree with DeeDee - submit your request in writing right away. It will help if you have specific recommendations from your dd's DO - our dd had recommendations for things such as preferential seating near blackboard etc - your accommodation requests should be specific to your dd's needs.

I wish I had some great suggestions for you re accommodations on the issues such as copying mistakes, missing signs, etc in math problems - that's an issue that still haunts my vision-challenged dd to this day. My dd needs extra time to double-check her work.

I also would try to not look at this as a 5-6 weeks until a "cure" (I'm not sure you are, but one of the folks who replied above sensed that it was a 5-6 weeks and all is good type of situation, hence I would want to be sure you didn't give that impression to school staff). If it *is* a 5-6 week program and your dd is done and all is good - that's great! My dd's experience and the other children I've known who've been through VT usually have programs that last much longer - and not to be discouraging in the slightest (VT was truly close to a miracle for our dd)... the results didn't last forever. Her double vision returned a few years out from VT and she had to do another round. Even now, when her vision is 10000 times better than it once was, seeing clearly is still hard work for her and her eyes fatigue much faster than her peers' eyes do. She still makes silly mistakes in math, and she has difficulty memorizing non-fiction material such as science and history, because the writing isn't as contextual as reading from fiction/stories, which results in a higher level of eye fatigue.

Re the things you've heard about how long it takes to get a 504 - I'm wondering if someone who's given you information about that isn't confusing it with the IEP process? A 504 is a much easier document to put together than an IEP, and typically (here) only requires one team meeting. It's important that you do your legwork and go into that meeting prepared, but there really isn't any reason it has to wait for 5-6 weeks or be a significant "process". If you haven't already, I'd look and see if you have any parent advocate groups in your area that you can call for advice (in this case it will probably only take a phone call). Ask what the process is in your school district for requesting a 504, who to address the 504 request to (in most districts there is a 504 coordinator at each school, and it wouldn't hurt to cc the school district 504 supervisor). Your request can be in the form of an email.

One other thing that might happen (I don't know that it will, but it might happen here) - is that the school may tell you they can give the accommodations your dd needs without a 504 plan. I would push for the 504 in your case because of the threat of having your dd removed from the math class due to grades. I would also not let the school move her back into the regular math class if the issue she's having are related to copying, writing, timed assignments etc - those are all most likely related to vision issues and have nothing to do with her true math ability. If the school balks at this and tries to push her to move back, remind them that this is denying her FAPE (free appropriate public education) due to her disability (vision issues). Keep your advocacy simple and direct, but *do* speak up and be firm.

Good luck! and keep us posted -

polarbear

A note on the 504/IEP process and what happens to students in the meantime: schools must provide students with legal disabilities protections as soon as there is reason to suspect a disability. This means that, legally, the school should not be able to drop her from the program for criteria that are disability-related, if you can document that the school was already aware that there was a suspected disability (i.e., the 504 eligibility process had already started). Even if they have not yet reached the point of making an eligibility determination one way or the other.

In your situation, documentation that there is a suspected disability, with suspected educational impacts of the sort that would affect her math performance in the way it currently is, would support keeping her in her current placement without punitive consequences (keep the grades open, IOW) until the team makes a decision about the need for accommodations.

Since the school already knows there is a suspected disability, the school cannot punish her (academically or behaviorally) for behavior/performance that is suspected to be a result of her disability.

The school may not know that, though.

I wouldn't propose the patch as a long-term solution, but just while going through therapy, it sounds like there is some temporary extra stress relating directly to the therapy. I probably wouldn't always put the patch on the same eye, I'd switch back and forth (with DS we always put it on his NORMAL eye because he was developing amblyopia--but that is only an issue with very small kids). It is something I'd ask the eye doctor about and get a professional opinion. You could also try it at home and see what your DD thinks about it helping or not (you can get an eye patch at a pharmacy). When we were going through this I was on a forum with mainly adults who were suffering the same issue (a nerve palsy) and almost all of them were coping with double vision by using a patch, until the nerve healed (or in some cases, didn't heal, in which case the patients had to try other options like surgery, prism glasses, etc).

I asked for DD's 504 to be updated at the very beginning of the school year and we are still waiting...so yes, it can be a time consuming process. Legally, they shouldn't take 6 weeks though.

Very useful information. thank you