Gifted Issues Discussion homepage Forums Twice Exceptional Vision therapy for dyslexia

My dd11 is formally dx with inattentive type ADD but dyslexia really fits in many ways as well. She went to bed crying last night about how stupid she is. What prompted this was the fact that, like usual, she had a few questions on her Algebra homework where she didn't understand what they were asking b/c she just doesn't "word" things in her mind the way the typical person does. She really understands the concepts well, but not the way things are being asked.

None the less, she is doing quite well in school and tested as "advanced" on all of the state tests last year in 6th grade and very highly on the math MAPS. I still feel that something more needs to be done to help her.

She has issues with strongly disliking reading for pleasure despite reading comprehension being above grade level, losing her place on the page, fatigue while reading, headaches, and substitution of words. She is also HG (possibly +).

What she does not have is the traditional phonics issues or writing issues. Her phonemic awareness is very good and always has been. Her writing is not messy and does not run above or below the lines. She, technically, spells well in that any spelling tests such as the spelling subtest on the WIAT are in the 80s (percentiles), but she isn't really a great speller. It isn't causing her major angst, though. Spelling tests significantly below her other reading skills on these types of tests, though. The other thing that has tested well below other reading skills in the past is speed. She reads very slowly.

So, I am reading some stuff claiming that vision therapy would help with these issues. I am also reading stuff like this statement from Children's Eye Foundation that essentially say that we'd be wasting our money. Vision therapy is not covered by insurance and is very expensive and we can't afford to waste money if it won't help.

The worry I have is that, while we have a nationally well known behavioral optometrist in town as well as a number of other behavioral optometrists, I don't know anyone who has gone for an evaluation with any of these individuals and been told that there is not a problem that can be treated with vision therapy. I fear that we're going to be told that she needs vision therapy regardless of whether it will fix the issues she is having or not. Any thoughts?

Hmm. Yes, the behavioral optometrists would definitely be biased in favor of promoting their livelihood. What does your family doctor say? Also, do you have any way of finding & speaking directly with others who have actually had vision therapy to see what they think?

It may come down to a leap of faith on your part, like a friend of mine took with her daughter and cognitive training. Of course all the trainers themselves advocate the service and it's not covered by medical. She finally took the chance and spent (literally) thousands of dollars to put her daughter through it - classroom sessions, a trainer, homework... and it worked. It really, really worked. Her daughter is a different kid now: focused, organized, can self-manage, excels in school, etc etc.

Anyway, best of luck. I hope you find the answers you seek and if not and you take a leap of faith that you get the results my friend did with the CT

I honestly haven't asked. Are you asking what the ped thinks about vision therapy as a whole or whether she thinks that it would be beneficial for dd? We don't go to the dr very often and haven't discussed any of these issues with her, so I don't expect that the ped thinks that dd has any issues right now. She presents as quite "normal" on the surface and does well in school so the times we are at the dr and answering their typical developmental questions have never raised any concerns for the dr.

Maybe. I can always ask the OD's office, but I suspect that they'd only give me the #s of happy people. I can also ask around at work b/c I work at the local hospital or post something to a parenting listserv that I belong to. The listserv tends to draw more "crunchy" types and parents of younger children, though.

Both. I approached our GP to ask about chiropractic therapy for DS8's ADHD (it was an interesting idea to me because there are spine issues in our family), and my doc basically said "well if you have extra money to throw away trying that I suppose you could." I've never pursued it, and it's not because of her disdain for the idea (I tend to do what I want regardless of what people think). What occurred to me later was that I myself had doubts (safety?) and was really just bringing the idea to the doctor as a "should we rule this out?" question (does that make sense?). Anyway, you could ask your ped both questions: what does she think of VT in general and what impact she thinks it will have on your DD. More opinions are always good, and it might resonate something within you as to whether or not you should proceed (as in "show you how you really feel").


It would be good to do both, I think, if you've got the time. One of these people will say/write something that will ring true for you in either direction. The bottom line is no one can make a better decision for your DD than you - you just need a way of accessing your decision. I would definitely talk to people who have been involved though.

Hmmm. My son receives vision therapy so I am getting a lot of experience in this area these days! I'll give you some of my thoughts and experiences so far. Hope they help you.

First, my insurance (Aetna) covered all of my sons vision evals and tests with the behavioral optometrist (and he had hours of it) and covers the vision therapy; although, I have a somewhat high specialist co-pay. So, don't automatically assume it is not covered. I automatically assumed that last year and wasn't as persisitant as a result and lost of year because I kept hearing "insurance doesn't cover that."

Secondly, just as an overall comment on it, so far - I have definitely seen a big improvement in my son as has my son's OT. His OT (completely different place than his VT and not related in any at all) has been doing periodic assessments on his tracking and visual perception, etc. - there are significant improvements documented. It brought tears to my eyes last week when his OT showed me how far he has come. I should add though that he gets visual stuff incorporated into his OT as well. Also, most heart warming my son has noticed a difference. One basic physical improvement I have noticed is less complaining of eyes hurting and his eye rubbing while reading has dropped significantly.

Thirdly, I have known people to go to a practice near me (they are complete eye doctors - treat all ages, sell glasses, do the behavioral optometry things, too) and be told there is no big issue (no diagnosis or whatever) but they get told vision therapy can always help this that or the other thing and that it would be beneficial), etc., etc... My son, on the other hand, was actually diagnosed and the options are VT or surgery or both. Like, there is difference between - "yeah this could help anyone. Your child can certainly benefit" and "your child's eyes are crossing (or one is wandering or whatever) and VT is option and/or surgery" YKIM? I think you could tease that out with a good, above-board doc.

Fourth, I was able to observe the evals and tests. I could see my son's vision fall apart. It was really obvious in certain tests. So, I have so far never felt like I was being 'tricked' or being sold on something he didn't need.

Another thought I have is to take her to an OT *AND* one of the respected behavioral optometrist for two sperate opinons. With my son, not only could I see a problem with his vision, his OT could as well (actually two of them - different ones from different practices who did not know each other). My understanding is that there are evals OTs can give that can indicate problems with visual motor integration, tracking, visual perception, etc.

Just as a warning re pediatricians, I have heard that pediatricians completely discount Vision therapy. With my own pediatricain, my son did have problems with the exam - he had 20/20 but he complained his eyes hurt during the exam, he became temper-tantrumy, his eyes began to water, etc... the Ped simply put it down to behavior. I didn't discuss/question it or anything but I did file the experience away in my head as odd and added to it as I noticed various problems my son seemed to be having with vision. I have no idea what my pediatrician would have said but honestly I just don't ask their opinion about this sort-of stuff. My ped knows very little about hypotonia (he admits that himself). I have heard peds say the most grossly erroneous stuff about breastfeeding, etc... I just don't trust them for most issues other than like illness issues (like kid has a major sickness). YKIM? Another woman I was talking with in the VT office whose som has same diagnosis as mine said her pediatrician just pushed surgery to fix her son's eyes but she wanted surgery to be a last resort particularly b/c surgery really doesn't have a high success rate despite the fact that surgery doesn't have a high success rate he pushed that and discounted VT. So just my experience and some food for thought.

All in all I don't know yet if my son has dyslexia and the VT doctros told me VT will not "fix"/treat dyslexia. It will treat his crossing eyes though. So dylexia/dysgraphia is still currently on the table to be looked at for my son. However, I soooo wish I would have considered and tried vision therapy earlier. I truly, truly do... It is one of the biggest regrets so far I have with my son - seriously.

Hope all this helps you somewhat!

Oh and my son doesn't have the phonics issue either, which is why I suspect dyslexia but that it never quite sits right with me with my son. He sounds words out just great - as long as his eyes get the sequence right. I can see that when he reads - example: sometimes when he reads and a word ends in LS, he'll start sounding the word out with an "sl" sound meanwhile the word actually begins with say a "B" When I stop him and I say "what sound does B make?" he says, "Uh bbb of course mom" and I'll say "then why are starting that word with the sound of "sl"" and he'll seem confused and be like "Ohhhh I don't know." Then he'll sound it outright. It's like his eyes keep tricking him, yk? He constantly sees lower case "a" as "e" but he knows e sounds like "ehhh" and a sounds like "ahhh" no problem.

Basically, what I see is he can sound out words phonetically really, really well - he is a good decoder (he also spells well as a result). BUT one of his big problems is he is often not "seeing" the letter in the right order/sequence (or seeing the letter right or word if they look too much like each other).

And that is where I have noticed so much improvement since he started VT. He is now getting the sequence right more often!

These are my son's exact symptoms. Exactly. This sounds just like him. But he does have the writing issues; however, he does have hypotonia, which has been what his writing issues have been attributed to.

When my son did his tests, I could actually see his eyes crossing and him pulling them back. His left eye wantdered more than his right.

Also, my son loves to be "read to" - he loves "reading" and always has as long as he isn't physically doing the reading. It's so sad because he couldn't wait to be able to read himself, he loves books so much but it is soooo physically hard for him and just never seemed (prior to VT) to get easier, he never seemed to get more fluent... He began to run and hide and do all kinds of opppositional behavior to get out of readong. and now we know why.

Oh one more thing! (sorry) I read on the Children's Eye Foundation site that you linked this statement:

"Orthoptic eye exercises as prescribed by pediatric ophthalmologists, orthoptists, and optometrists can be beneficial in the treatment of symptomatic convergence insufficiency"

And that is my son's diagnosis symptomatic convergence insufficiency - specifically intermittent symptomatic convergence insufficiency. So actually it looks even the Children's Eye Foundation does endorse it for that diagnosis, which would be why it's been such a good experience for us so far.

I guess what you really need to find out is does your DD actually have dyslexia or does she have a symptomatic convergence insufficiency?

As an aside, once dyslesxia is diagnosed does insurance cover any of the costs in general of treating that? special tutors or whatever? Just wondering in case my son ends up witht hat diagnosis eventually.

My son has dyslexia, has an ADHD diagnosis, and is likely HG underneath it all (though he tests at slightly under HG).

He did vision therapy before he had a dyslexia diagnosis, and to her credit, the optometrist said after she evaluated him that she had "an answer, but not the answer."

I believe that VT helped him quite a bit, though it did not treat the underlying dyslexia. I think it particularly helped with allowing him to develop his strengths (M strengths, if you're read The Dyslexic Advantage). A bit of concrete evidence I have for this is that his block design score on the WISC IV went up by 6 points after VT (his IQ was tested about a year prior to starting VT and again about 4 months after finishing). Obviously the change could have been due to a number of factors (and probably was) but apparently depressed block design scores are a red flag for vision issues.