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

I went through vision eye therapy (counting on my fingers....) 25+ years ago. Caught the vision problem (farsighted + eye tracking issues) in 4th grade and started therapy the end of 5th. Back then, I went 3 times a week for 6 months. It was a big time commitment!

4th and 5th grade, my grades were poor, I was stressed and confidence low. 6th grade I switched from private to public school, got a fresh start and I think the eye therapy really began to help. I actually think it also helped with my focus/ attention issues. Long story short- without much intervention I made up all the lost ground in math and writing by 7th grade and was placed in 8th grade algebra (I didn't want to because I still had some confidence issues but I ended up doing fine).

My point is that ground can always be made up down the road- especially with a bright child. I would ask her what she feels most comfortable doing? If easing the workload means that she has more time to focus on the therapy (less stress, pressure and homework) that could actually boost confidence down the road if the message she gets from school and parents is "We understand you are struggling through a challenge but we also have confidence in your future because you are a bright, hard working student."

Sports analogy: If your younger high potential athlete had a sports injury (like tendinitis) that needed time to heal, would you continue to make them train at high volume/ overload principle with risk of further injury because they have an elite competition at a Jr. level coming up? Or would you reduce their training volume so they could heal properly and protect their future success at a Senior level?

Either way- there are multiple ways to handle the problem and listening to how she feels might give you the best direction in what is best for her at this moment.

Hils, thank you for sharing your experiences.
I agree that this math class doesn't impact her academic future, and she sees that too. As far as workload, the regular paced math classes have more work because they are not skipping problems or pages. That is one of the reasons for wanting to stay in adv. math. She also finds it more engaging and her friends are in the class. Tough decisions, plus I am considering homeschooling for math since she has it the last hour of the day.

I am coming up with solid ideas for accommodations based on your post. I would love any more accommodation suggestions.

The doctor is not supporting patching. She may prescribe glasses based on her progress. Dd's vision is +.75. I found out yesterday that one eye is handling most of the dynamic vision and the other does the up close focus work.

I found out more about the 504 process in our district. Once I submit a 504 request, the school has 30 days to schedule a meeting and then 60 days from the meeting date to put accommodations in place. So...it could be a short process or a long one depending on the school's response. I have heard from friends at other schools in my district who had a quick response, and others had it drag out for the full three months.
Our former school had a horrible reputation for pushing back on ieps and 504s, which is one of the reason we switched schools.

Is there a thread with accommodation ideas or tips for the 504 process? thanks!

This whole thing seems bizarre. What if a kid was in a car accident and lost the use of their hands or they were stuck in a wheelchair. The kid goes back to school in the wheelchair. The school says "Well, sucks to be you. We don't need to do anything for you for three months. You'll have to find another student willing to open your locker for you. And oh yeah, if you can't write to do your math, too bad. You don't get any accommodations for 3 months because our policy states we have the right to stall and stonewall."

DS was in an accident in kindergarten and went back to school with his eye patch on the normal eye, and the other eye turned in so much that you could barely even see his pupil. He also had a big plastic neck brace so he couldn't turn his head at all. The school acted like he had stubbed his toe. Teacher sent me a few emails implying that he was having problems finding his carpet square in the classroom, and that when he tried to write, he was shaky and the letters overlapped. He was also crying a lot, according to her. One time I pulled up in my car to drop something off and DS was stumbling across glaze ice on his way out for a field trip. The "normal" kid in front of him in line slipped and fell flat on his back, almost striking his head on the sidewalk. That could have been DS who already had a crushed skull. No teacher or adult anywhere. No one even saw the kid that fell. Other than the few random emails from the teacher, the school didn't seem to be the slightest bit concerned about DS. I told the classroom teacher in an email that there was a possibility of him having a seizure, because of the air in his brain, and she didn't respond at all. And when I told them he was supposed to go outside for recess wearing a helmet (doctor's written orders), once the neck brace was off, I got eye rolls. There were times I came to pick him up and saw him running around without the helmet. No phone call from principal or school nurse or anyone else asking what accommodations DS might need. I did insist that he stay out of gym, so he sat in the nurse's office for weeks. Otherwise they probably would have sent him to gym with an eye patch and fractured skull. I told the school that the prognosis for his vision was completely unknown, and still, no one had any suggestions. The bizarre thing was, he already had an IEP, for speech. How hard would it have been for his case manager to call a meeting? I don't think they were being deliberately callous, it just stemmed from profound ignorance and basically a systemic failure regarding special ed in the district. Later on I found out that the school basically never writes 504 plans.

Anyway sorry for that rambling vent. I wouldn't juust take that as the answer, but double check to see if that policy is really legal. I think there is a much shorter time limit and they are probably not in compliance.

Wow blackcat that is a disturbing situation. I hope you were able to find more support at that school or at another.
Last year I was so overwhelmed by the lack of individual support for the children at our former school that I started homeschooling my daughter. I know many other families with similar experiences at that school. I would like to blame it all on the principal, but it was just the overall culture of the school. Great district-school looked great on paper, but horrible at meeting students' needs. I'm happy to say that other schools in our district do a much better job.

We did ultimately get them to update his IEP (but then they didn't bother to follow it, another long saga). We switched to another school in the district which was fine, but I knew it was his individual teacher and IEP manager, and it wasn't necessarily indicative of the school as a whole, which was still headed by an ignorant administration (i.e. district curriculum directors, special ed directors, etc). Even the best principal can only do so much if you have crazy district policies/procedures and staff who move between schools. Luckily we now have the kids out of that district (for the time being, at least).