DS9 started weekly vision therapy 4 weeks ago for his convergence and focusing issue. We have been doing daily home practice diligently as well. So far I have not seen any noticable changes at all. He reads and still read for short period of time and needs streching for being tired. his handwriting is still very sloppy. His attention span is still very short just like before. I am getting a little impatient as we are skeptical of the vision therapy to begin with, although his case was confirmed by a second opinion. Appreciate if you could share yout VT experiences, how long will you see the impacts, in which way do you see the impacts?

It definitely took longer for us... But we didn't do the homework honestly. We started with the Vt twice a week tho . Also my son had over convergence and I found that his using his iPhone was not helping at all ( was making the problem worse).., so I insisted he use a computer or full sized iPad instead ... I wasn't sure that it was helping but I did notice his eyes stopped watering and bothering him when he read. Also, he insists it helped - he said it felt like one day reading stopped being so tiring and hard. He did jump several reading levels after that. He did the therapy for about two years with breaks.... This partially because I forced the school to provide some as well (they paid for 6 months worth). Hth!

Hi
We started VT with my DS7 back in June. I was also skeptical. We did our best with the homework, although DS hated it. We went for appointments for around 4 weeks before the summer started. During the summer we went as often as we could, but with vacations and activities it ended up being quite sporadic. We started up again regularly in September.

I have to say that after the 4 weeks in June, I did not see a big difference. DS7 was able to do better at the eye control exercises, but I didn't notice any changes in reading or writing. However, at about the end of September, DS started picking up books on his own and reading them. I believe that he had had about 10 sessions total at that point. Before VT, he would read a bit then give up and ask me to read to him.

And last week I noticed while helping with his homework, that he was writing more quickly and fluently, and didn't tire as quickly.

Of course, these changes _could_ be developmental (and I'll never know for sure), but my feeling is that the VT is playing a part in the improvements.

DS had a re-check with the Optometrist and she said he's improved a lot. So, we're going for 8 more weeks and checking again.

Following. Recently got a VT eval for my DS9 in same boat, convergence issues and sloppy handwriting (except he has no trouble reading, just gets headaches sometimes), awaiting report and then will see what's recommended.

It's been quite awhile, but I think that we saw the biggest change in our dd after about 2-3 months of VT, and then the changes became less obviously apparent after that. I will add though, that our dd had issues beyond simply convergence - she had severe double vision and extremely limited peripheral vision.

Do you sit in and watch the VT appointments? And does the vision therapist keep a record of improvements in the different exercises, or repeat certain exercises after a few weeks to see if there's been improvement? Our dd's VT program was very structured, with goals to meet on each exercise and once she'd met a goal she moved on, so even when it might not be obvious that she was making leaps and bounds improvements in reading, we could see she was making progress, and we had a good idea what specific areas of vision each of the exercises targeted.

Do you think it's possible there's more going on with your ds' reading than vision? Vision therapy addresses weak muscle tone and how muscles work together, but it doesn't remedy Learning Disabilities/etc. It's possible that a child who's diagnosed with a vision issue might have yet another layer of issues underneath, that you can't see until you have remediated the vision challenge.

Best wishes,

polarbear

ps - also curious - you mentioned having two different sources recommend vt for your child - who were the people who recommended it?

purpleviolin, I took a quick look back at your previous posts about your ds' WISC testing. He had a relatively large dip in processing speed subtests (both coding and symbol search), which *can* be due to vision issues, but can also be due to other things, including fine motor challenges. You mentioned that he was a daydreamer who didn't get started on writing assignments in that post, and also mentioned messy handwriting either here or there (please forgive me if I'm remembering incorrectly). If your ds had been seen by a private neuropsych, they would have included testing beyond the WISC to determine what the cause of the dips in processing speed subtests is (vision vs fine motor). If I understand your previous post correctly, you took your ds to a vision specialist for testing and received a diagnosis. Since it's been 4 weeks and you aren't seeing any improvement, I'd consider trying to ask either through the school or by finding a local private neuropscyh for testing that gives you more of an understanding of what's behind the low scores in processing speed. You may hear that it's common with children with ADHD (and I think it is), but it's also common with other LDs and challenges, and when a child is having to cope in school with an undiagnosed LD they often have behaviors that look a lot like ADHD, but really aren't ADHD. That doesn't mean your ds' diagnosis of ADHD is incorrect, just that there is a small bit of unexplored testing that might yield a great deal of information for you.

Best wishes,

polarbear

I am just not too sure about how much of his "problems" are associated by vision issues and how much are just what he is.
For $120 per 45 miniutes, I can't help second questionning the value of these simple activities.

It seems to me that the developmental optometrist will most likely find some problems if a child is brought to her office and make recommendations of lenthy and expensive therapy sesssions.

Without any real results, I find it hard to be convinced. Hopefully I am being totally biased and judgmental.

Polarbear, he was seen by a private neuropscyh 2 year ago and you can find on my older posts, it took extreamly long as he wasn't paying attention for some sections. For the large discrepancy (2 STD) across different subtests, the only further testing she suggested was vision testing. Are you suggesting we should get him tested one more time to uncover potentially other LD issues?

This summer we started vision therapy for DS8. He went once a week for 12 weeks, and he did daily homework at home. While he didn't like the homework in most cases, he did do it. After 12 weeks we decided to stop for four reasons 1) we weren't seeing any differences in his day to day life; 2) most days he wouldn't do the homework without a lot of fighting; 3) he said he didn't see a difference; 4) it was really expensive. While he did score higher on their eval tests, I wonder how much of that is because they were designed to test the specific things he was practicing with therapy.

We were skeptical to start the therapy, but I had talked to friends where it had done wonders for their child. We felt trying it for 12 weeks was long enough to see a difference if there was going to be any. We were only going to continue with it past 12 weeks if we could see a difference at home.

The psychologist who did DS's testing recommended the VT. She is actually pretty reputable in our area. However, there were inconsistency in the way she described DS's issue and her final report. We got very confused after two evaluation sessions in the ambiguous and noncommital way she explained thigns. We went to a second VT, did a quick screening and she confirmed DS has both convergence and focusing issues. We finally decided to start the therapy mainly because handwriting is such a daily struggle and it still is today.

Could it be a disorder like dysgraphia? DS has messy handwriting as well and has developmental coordination disorder.

DS's neuropsych (with a large university) did NOT recommend VT, said the research does not back it up. I thought that was kind of overboard harsh considering that his eyes were quite obviously crossed for several months due to brain damage (but maybe VT has little chance of helping in that circumstance anyway). The only person that "pushed" VT, was his OT. Neither opthamologist did (one was a neuro-opthamologist) nor the neuropsych. I think there are probably some legitimate cases where it might help, but I also think that convergence issues are probably way over-diagnosed by people specializing in VT.

I spoke to my DS's doctor about VT, he said he has seen it work a couple of times, but far more often it doesn't work. He wasn't sure why it did work in the situations that it did. When I read further it appears to be good for a couple of conditions, but often people think VT is a silver bullet and it will fix things that it won't fix.

I called one VT in my area, and I asked the person who answered how often they find problems when they do the initial evaluation, and she implied they always found problems….so that put me off. Statistically it doesn't make sense that they would always find problems...

Black cat has a good point ... My DS still had dysgraphia ... But never expected VT to help much was that.

DD8 started VT in July, and we are about halfway through. There is no doubt the whole process is a bit more of a leap of faith than I am comfortable with. However, there is some decent evidence plus solid expert opinion backing VT, under the right, very specific conditions. In other words, the right diagnosis (primary problem is convergence insufficiency) addressed by an experienced therapist, using appropriate approaches. That last bit is especially tricky, as there no doubt VT is still art not science (and teeters into voodoo some days). There is lots of snake oil out there, and probably even more well-meaning but inadequately experienced people claiming to solve the world's problems with VT. I have made the decision to trust the optometrist, based on his education, experience, references, and the consistency of his reccomendations with best practices.

Has your optometrist been able to define for you exactly what the problem is, and where you should and shouldn't expect to see differences when you are done? Or at least, after 10-12 weeks, which if I remember correctly is the point at which most evidence suggests some effect should be found? I wouldn't expect much at four weeks, even under the best of circumstances.

So now we live with our decision to trust the optometrist, but it's not easy, because in our case we may never have a clue if it works. DD herself swears it's making no difference - but the exercises hurt and she hates doing them, and she is unfortunately a well-recognized unreliable witness for this kind of thing. I can say that she is becoming better at doing all sorts of things through her daily exercises - and that it is often surprising, and sometimes disturbing, to see what she can't do. However, I truly cannot say how/ if any of these changes will result in meaningful functional improvements in real life. (I have to think it must be helpful in some way, though, that her eyes can now both follow the same object at the same time without one having a mind of it's own, not to mention they both now track something coming at her face instead of flying out sideways. Good for shooing away bugs, at the least! )

The main reason we may never have a clue if it works is that DD's biggest issue is reading, but she's also dyslexic and we've been remediating the heck out of her reading, with extra intensity over the summer. Her reading has gone through the roof (aside: YEAH!!!!!!! it's so awesome!!!!!!!!!!!). Is the VT helping? No idea. I don't have a clue how we could ever know. I think - I hope? - it's probably helping, by reducing fatigue and making fluency easier to attain/ maintain, but there's no way to untangle the two. I do notice she seems to find it much easier to keep track when she reads, not lose her place or skip lines. Maybe that's the VT contribution. Maybe it isn't though.

And if we hadn't also been remediating the dyslexia, we probably still wouldn't have seen any improvements, since her reading would still have been abysmal, even if she could follow the lines and see better.

So, my point, in all this rambling: it's critical to know, comprehensively, what are all the issues you are dealing with, because VT can only help in one specific area (visual processing, particularly convergence insufficiency). If your DS is affected by additional issues (fine motor, dysgraphia or anything else), it may be really hard to see change, even if the VT is highly effective. For us, our best hope is that the VT is making the other remediation easier and less painful than it would otherwise be - but it doesn't reduce any of the need for other remediation. I remain comfortable with our decision to trust this optometrist and stick with it. I won't deny, through, that it's unbelievably frustrating to spend this kind of money and never really know if it's helping. I am evidence-girl, and it hurts me to my soul to take this on faith. But I do, honestly believe it's helping DD, and is money well spent. But dang, I wish I could measure it!

I guess we were lucky - DD was prescribed reading glasses at the first eval. The first day with these glasses her reading teacher (daily Wilson intervention for dyslexia) measured that she went from 59 wpm to 81 wpm. This told me the optometrist had correctly identified her issues. I was told that the goal was to make these glasses unnecessary.

We did VT twice a week in the vision gym plus did the homework every day she didn't go in. She didn't like the excercises but did them without compliant because she wanted this to work. Within a few weeks we started to notice that the excercises were getting easier the more she did them. An excercises that was very difficult for her on Monday was much easier by the weekend. The excercises were changed each week and I was told what they were supposed to be addressing but I was a bit skeptical. We buckled in and ready to ride but not sure where we were going to end up.

They explained that over the course of her life DD had developed a whole host of compensatory strategies and the first weeks/months of VT would be spent undoing these. The older a kid is the more compensation has to be undone. About 8 weeks in DD noticed a change. She was doing an excercise with a white balloon wearing glasses with one red lens and one green lens. She could tell which eye was "on" by what color the balloon looked. All of a sudden she realized the balloon was brown - she was seeing it through both colors at the same time. After this I think the excercises became more complex. She made a ton of progress and they called her their "top student".

After 3 months the optometrist said DD gone from 20/32 in one eye and 20/40 in the other to 20/20 in both (this result was confirmed on a recent pediatrician visit). Optometrist rattled off a whole list of improvements and said prior visual perception testing was not valid because DD "couldn't see the page." She had her staff do a visual perception eval which did not seem to reflect the same level of improvement but since DD had scored in the 1st percentile 7 months earlier even things measuring in the 8th or 10th percentile were indeed improvements.

As I posted here we stopped VT suddenly after 17 weeks when I became uncomfortable with some billing practices. That same nagging concern over snake oil and taking advantage of desperate parents mentioned by others up thread was buzzing in my head. DD has continued to do VT excercises in the month and a half since we stopped going to the vision gym but the excercises have become so easy for her it hardly seems worth the time to do them. Interestingly she has decided she no longer needs the reading glasses at all. And for the first time in her life she is voluntarily reading. Quite frequently in fact. Going back to the reading teacher's measurement the first day with her glasses we know that she has improved at least 40% or so. And yes DD is dyslexic. For the first time ever she no longer confuses her lower case "b" and "d".

Not sure if this answers your questions but hopefully it helps to map out a success story.

Something that has me tripped up, as a person lacking binocular vision, is knowing just what IS normal, what should be expected. My skepticism kicks in when I think, well, is he not doing well on that evaluation because it's within the parameters of normal, or is he actually having trouble, as it appears? I personally cannot do those convergence things. So I'm watching the eval and thinking with a questioning mindset, does he understand the directions? Is the evaluation accurate? How experienced is the assistant performing the tests for the doctor, if one of the tests was totally confusing and I could tell DS was really irritated by the instructions? And how about those bifocals, how do they impact the tests vs single vision lenses? Questions I need to ask the doctor.

DS clearly has convergence issues, and alternates his eyes near, and his visual processing is visibly slower than his auditory processing. But he compensates well. How do you determine if it's just a natural weakness, visual processing, that you cannot change and need to accept and move on? Is the only way to know to try the VT?

DS was never evaluated for Dysgraphia,I feel there is not enough symptoms pointing to dysgraphia, or would like to wait until we see some progress with the VT. His handwriting is messy but the main problem is the neatness and spacing. His spelling is excellent and there is no letter omitting and reversing issues. In terms of vision processign issues, he has problems with convergence, tracking and focusing (accomodative). The 1.5 hour vision processing test did not find further problems.

During the parent meeting with the first VT, she suggested therapy would help but he might be able to grow out of it. She was very ambiguous and noncommital. However, in her written report that sent home a few days later, she clearly said he has deficiencyies in 3 of the 4 areas tested and recommended twice a week therapy. We were utterly confused about the inconsistency and went for the second VT. Equally reputable in our area, the second VT offered a quick screening and confirmed his convergence and focusing issues, plus tracking. The first VT never said DS had tracking issue. The entire process did not help us to gain more confidence in Vision Therapy. Increasingly we felt like they jsut wanted to make money from the expensive evaluation and screening sessions.

We still decided to give VT a try for at least 3 months, as we hear so many sucess stories and do not want to regret later.

DS is cooportive with daily practices but told me there have been no differences at all. It is really a leap of faith to keep spending money and time on something no evidence indicates is working.
like most of you have suggested, we will give it a few more weeks, until the entire first phase of 12 weeks.

Glad to hear sucess story like yours. I do see sutle chanegs in the daily exercise with block string. He is now able to see the "x" for each of the beads, whereas in the beginning he can only do that for the nearest three beads.

[quote=longcut] My skepticism kicks in when I think, well, is he not doing well on that evaluation because it's within the parameters of normal, or is he actually having trouble, as it appears? I personally cannot do those convergence things. So I'm watching the eval and thinking with a questioning mindset, does he understand the directions? Is the evaluation accurate? How experienced is the assistant performing the tests for the doctor, if one of the tests was totally confusing and I could tell DS was really irritated by the instructions? And how about those bifocals, how do they impact the tests vs single vision lenses? Questions I need to ask the doctor.

quote]

I had similar doubts during the screening. She explained to me after the exam that the easist way to tell if a child has convergence issue is to use pencil pushup. I did it right when we got home and DS was able to converge. I called the VT to ask if his issue is "real", she said" oh, good for him, when I tested him, he wasn't able to do that and there are other methods we use for the evaluation as well. But your son is really smart and he learns what your expectation is quickly and he does that for you"

We were going to quit after this conversation then DH insisted we had a second opinion. His reasoning is that the focusing issue (near-far focusing)was found out by our regular vision doctor in the summer, although for whatever reason, it was never noticed in the previosu 4/5 years of annual check up. He thought the regular vision doctor would have no bias.

We are on our fifth week of VT for double vision, focusing, and eye teaming. DD is 9, so our situations sound similar. We were only initially assigned 12 weeks of therapy, so her case isn't as complicated as some, but she does have double vision, words moving on the page, headaches, fatigue, etc. I keep asking her if she has noticed these issues lately, and she says no, but I don't know if she is just saying that so I will leave her alone
Just this week, I noticed better posture when writing and less mental fatigue. She is having an easier time with the VT homework. She bounced a small ball off the wall and caught it nine times in row. For her that is a huge accomplishment, and it took some of the sting out of the money being spent. We have been diligent about the homework, but seeing some progress and her confidence rise sure helps us stay motivated.
I am still concerned that she has other undiagnosed issues, so I need to figure out if further testing is needed. The VT practice did say they would conduct additional testing or refer us if they feel it is needed after her 10 week check up.

FWIW, DD13 went through VT when she was in second grade. The school psychologist recommended having DD's vision evaluated. We went to our optometrist who said that DD's eyes did not work well together close up. She prescribed reading glasses and referred us to a vision therapist. She said that this particular therapist seemed to have more consistent positive outcomes.

We did not see significant results with VT until DD had been going for almost eight months. Then something just clicked and her reading improved significantly. The therapist closed us out that month. DD had convergence and tracking issues. After things clicked, DD said that the words no longer "ran off the page" and almost seemed concerned that she only saw one image. Once her eyes started working together, her headaches that she had from reading disappeared. Once again, she seemed surprised that reading no longer made her head hurt. Six years later the results have stuck. Was it VT or something else developmental? No way to know for sure but I believe that the VT helped.

ETA: DD is still dyslexic. Anyone who tells you that VT will cure dyslexia is definitely in the snake oil category. For DD, it was much easier for us to work on helping her learn how to compensate for her dyslexia once the vision issues improved.

Thanks all for sharing your experiences. you helped me to adjust my expectations and be calm and patient.

DD's working the block string this week. I tried it myself and found it tough! She is better at it than me, but I know I have eye issues....
I am still trying to grasp the VT concepts myself, but for my daughter, she rarely noticed the vision issues, which is part of the reason it went undetected so long. It was brief double vision/blurring a couple of times of week.
I've been told that one eye was doing most of the reading/tracking, and the other was handling dynamic vision. I can see the difference in the eyes when she is patched for exercises.
I had a friend whose son completed 40 wks of VT. She saw improvements in reading speed/fluency and hand eye coordination, plus much less mental/eye fatigue, but she did say his handwriting did not improve as much as she hoped.

Maybe ask the VT what improvements you should see first and which assigned exercises will help with his handwriting? I just expressed a continued concern about letter/number reversals, and they incorporated specific exercises to address this issue.

How many weeks of therapy was recommended?
So glad we have each other to compare notes. I only have one RL friend who has been through VT.

This forum and DITD list are only places I ask these kind of questions. It seems that my RL friends don't really deal with similar problems. I do realize that I have children with very special needs.

DS is pretty good with block string, not so smooth with wall charts and near -far exercises. The VT said his left eye will suddenly move away as he does the "bug on a string" exercise. I have seen it once, but not really that bad. So I am not sure how much he is improving. I've asked the question but was told it's only the fifth week and every child is different in how quickly they responds to the therapy.

Our first "phase" is going to be 12 weeks, with progress check at the 8th week. We will see what differences at 8th week.

I feel much less irritated after reading responses from this forum.

Lets keep comparing notes as we move forward.

Just when we were about to lose patience in the process, DS for the first time since he started reading, read half of " BFG" yesterday. It was also the first time in the morning, I saw him reading along side his older brother quietly. In the evening after dinner, he told me that he was going to keep reading his book (instead of decorating his room for Halloween) and he read quietly for almost an hour. In the past, he would put his book down after about 10-20 minutes, depending on the material.
Since it is just the start of some good signs, maybe it's too early to say it's working, maybe it's just a favorite book.. he has always liked Roald Dahl's books... but I just want to share it with you guys. Hopefully this signals a good start.

Yeah!!!!!!!!!!