Gifted Issues Discussion homepage Forums Twice Exceptional Vision therapy for dyslexia

I work in healthcare and our insurance is through my employer. I am very familiar with our insurance and have already checked on all of these things. We have "basic vision" which will cover the cost of a regular eye exam, but not a developmental exam. They will not cover any treatment (OT, PT, vision therapy) for anything they view as a "chronic" condition not an acute condition. So, for example, my dd13 was dx with dyspraxia and SPD at 7. They won't cover a retest now that she is 13 b/c, even if they are no longer diagnosable and even though they are treatable, the types of things that the OT would be testing for are considered potentially chronic.

Convergence insufficiency and dyslexia are also considered chronic in their estimation even though they are/may be treatable so no testing or treatment for either is covered. For vision therapy, we'd be looking at $600-800/month. This could, obviously, add up quite quickly.

YUP - That was huge for me ... watching my son do the block design subtest on the WISC IV...

That's interesting. My dd has taken the WISC-IV twice, but not in a few years. Her block design scores (like all of the other scores) were erratic, but not technically "low." She got a 15 the first time and a 12 the second. Her two WISC GAIs were 99.9 and around the 98th, if I recall correctly. The second, much lower, GAI was due to the PRI index (which includes the block design) going down in the one year btwn the first testing and the second. Either way, she's gifted, but the varying scores were odd. Both times her VCI was in the 99th+(+), so HG+. I would expect a HG+ verbal kid to read more/better/like it more than she does, though.

I was told that, due to the controlled nature of the test, that there was no way a parent or anyone could watch the testing, so I have no idea what she looked like while testing, unfortunately, but I will definitely inquire as to whether I could watch a behavioral optometry exam.

This is interesting to me only because I have heard and read that before but the evaluators gave me no trouble about observing (My son was tested at AI Dupont so it's not like it was some rinky dink place or something)... A friend of mine in another state observed her son as well but it had to be such that her son could not see her. I feel so lucky I could observe... I really learned a lot about my child that I couls not have gotten from a psych report...

Oh bummer. So sorry to hear that... yes, $600-800 per month is so much money One thing I explored when I thought my insurance wouldn't cover the therapy was a teaching eye institute (http://www.teivision.com/services_pediatric.htm) where they do things a free or reduced costs... It would have been a hike into a very congested part of Philly (would have been a nightmare to do twice a week) but had i been somethign like that in your area you could look into that.

Just so sad that only the very wealthy can get help and therapies for their children... just doesn't seem right. My child would have suffered so much as he progressed in school as well as in other areas of his life if we couldn't afford the co-pays and get most of his therapy covered. Breaks my heart for those out there that can't get access b/c of money . This stuff is soooo expensive

For now, I changed the font on her Nook to Trebuchet, which is listed online as a good font for reading by dyslexics and we adjusted the line spacing so there is a lot of space btwn lines. She says that is easier to read.

If I can talk dh into it, I think that I am going to see if we can at least spring for a developmental eye exam with someone who is fairly local and who seems to be well known in the behavioral optometry field as I've seen a lot of national publications with his name on them. I don't know what we do if he says that there is a definitive problem and we can't afford to treat it, but I guess that we'll cross that bridge if we get there.

Cricket, my dd10 had VT when she was 8 and it made a *world* of difference in her life. She struggled with reading but did not have dyslexia - see my comments below:


This was true for both my dd who went through VT (before VT) and for my younger dd, who was found to have a weakness in associative memory. FWIW - it was recommended to us by her evaluator that if her reading didn't improve after other accommodations we should have her go through a VT eval also, which we will be doing later this fall.


There are other types of reading challenges that aren't necessarily dyslexia, including vision challenges. My dd10's phonemic awareness was actually among her highest scores on neuropsych testing. In her case, however, there were very very obvious dips in block design and symbol search on the WISC and another non-WISC test that relied on vision.


It will really help - if the reason reading is fatiguing, slow, etc is due to a muscle weakness.


This article isn't saying *you'd* be wasting your money, it says that Vision Therapy is successful for certain types of conditions and not for others. There are, from what I understand, behavioral optometrists that will try to sell it as a cure for anything, and it's not. It is, however, a very effective treatment for some types of vision disorders, some of which have symptoms similar to what you've posted re your dd.

When we were first referred for vision therapy, I was very skeptical - but I'd also known another mom whose dd had been through VT so I asked her about her experience, and it was very *very* positive. It still sounded like hocus pocus to me, so I asked our regular eye dr (our dd had just been through an exam with the regular eye dr and was found to have 20/20 eyesight). I was *floored* when our regular eye dr told us vision therapy (and the eye dr who'd been recommended by the neuropsych) is a very real and often beneficial treatment and that it would catch things that she never looked at in her exams. A regular eye dr looks at the vision in each eye, but a behavioral optometrist looks at how the eyes work *together*. According to our eye dr, if the eyes aren't working together and it's due to muscle weakness, VT can help in many cases. If it's due to a neurological challenge (as in the case of an LD), VT isn't going to help.


I'm really sorry your insurance won't cover it. Our insurance did cover it... and yes, the expense did add up. A few things you might consider: the initial evaluation was not hugely expensive and we learned so much from just knowing what our dd's vision issues were - if you can swing an evaluation it might give you good info. Another thought - our dd's VT office treated clients who lived far away and couldn't come in for weekly (or even monthly) therapy, so they would come in and the parents would learn how to do the exercises and then do everything at home - only visiting the office a few times per year. This kept costs way down. Kids who do VT usually have daily exercises to do at home anyway - it's not the kind of therapy you go in once a week for and forget about until the next visit.


How many people do you know who've been in for evals? Do you have a gut feeling that there wasn't really an issue or do you think they were scammed? I tend to wonder about the "nationally known" part - a good behavioral optometrist wouldn't necessarily have to be nationally known - so why are they nationally known? Is it due to their work or due to self-promotion?[/quote]

I would ask my regular eye dr who he/she would recommend for a vision processing evaluation. I would also check to see if they are a member of the organization our dr belongs to (which I can't remember the name of right now lol! - I'll look it up).

FWIW, we were curious if our ds also had minor vision challenges after the success our dd had with VT, because when he learned to read he also read very slowly, seemed to not recognize easy words, and held his head and eyes at really weird angles as he read, plus complained about his eyes being tired and not being able to read the board. He went through an initial evaluation by the same VT drs office and.... was found to have no visual challenges at all. Our dd otoh - we watched while she was going through her eval and that's when all my skepticism faded. About halfway through the exam she was asked a question and her answer totally floored me... and it was as obvious from that as daylight is obvious that she had double vision... yet we'd *never* had a clue at home, other than her fatigue and dislike of reading. Once we knew about it, we could see other signs that weren't as obvious.

I hope some of that helps -

polarbear

My DS8 does exactly the same thing! He has strabismus as well as a language processing disorder, and sometimes it's hard to pinpoint which issue is causing which problem. His version of strabismus is more of an "over" convergence - if he looks up or to the side sometimes one of his eyes will roll too far into the corner.

His reading is interesting. Sometimes he'll do exactly as you describe your son doing, and other times he'll fly effortlessly through reading (2-3 grade levels above).

Not sure yet if it's an eye fatigue issue, his ADHD kicking in, or the language processing, but he's either hot or cold. He'll sometimes start off great and then burn out. Other times he'll start off struggling through a "warm up" period then becomes fluent (as in, reading problems? What reading problems?) ...but then burns out and doesn't want to read anymore. I don't push him. I just have him do what he can, and he is getting better.

I've found that smaller reading sessions more often are the trick with him so he still gets the language exposure but he's able to take the frequent breaks that he needs.

The "nationally known" guy I mentioned is well known b/c he is listed as an expert on many articles regarding convergence insufficiency/vision therapy & b/c he's the author of a lot of publications about the same.

I, personally, know five people who've done vision therapy. I only know two well. One of them went through this years and years ago with her son (he's my age, so things may have changed a lot). She said that it was helpful, but that the results faded over time. The second has a child similar in age to mine. At the time, she thought that it was helpful as well but a few years later felt that it had made no difference for her child. I, honestly, can't recall who the woman with the child closer in age to mine saw for diagnosis and treatment of her child.