Gifted Issues Discussion homepage Forums Twice Exceptional Vindicated and not happy (vision issues)

Every time I saw threads here about vision therapy I thought, "That's not us. Yet." I was hoping "yet" wouldn't ever happen.

We were at a physical therapist for a completely different issue, and somehow the issue eye-hand-foot dominance came up, and the therapist said, "I don't think she's mixed dominance," and then she started testing her for convergence, and confirmed that DD can converge, but fatigues quickly on staying converged and tracking.

I've been saying for YEARS that DD7 has wacky visuo-spatial skills. She started reading short words at age 4, but is still not a fluent reader at age 7. She often starts out well with reading, but wears out really quickly. She is terrible at jigsaw puzzles. She is years behind on representational drawing, and much prefers abstract doodling. She doesn't appear to have any large-scale vision or spatial problems -- excels at gymnastics and archery and rock climbing.

I've always been a little worried that vision therapy was snake-oil, so I was a bit relieved when my search of the literature turned up much the same as what's been said here recently: there's a lot of nonsense in the field, but the stuff for convergence, accomodation, and related eye-muscle issues seems to be legit.

Anyway . . . big sigh. I've joined the ranks of people here whose kids need vision therapy. (The possible silver lining is that I would love it if her reading suddenly took off as a result.)

Um - welcome to the club?

It's a weird mixture of feelings, isn't it, when you pin down some issues? Frustration and oh god, really, do we have to make her do this too? All tossed together with relief and I knew there was something and now we can finally do something about it. Plus a nice unhealthy dose of guilt for not seeing it sooner when it seems so obvious in retrospect.

But maybe I'm projecting

We just finally started our VT this week. It ain't fun, but I am crossing fingers it helps. Something. Good luck, MegMeg

That sounds exactly like DS, with ages different. I'm going to have his ped make a referral for him. Good luck!

MegMeg could you post links to the stuff that convinced you it was legit? I am prepping for a meeting on Tuesday and could use some ammunition.

DD has been doing VT for 2 months and it hasn't been too bad at all. The drive to the vision gym has been very time consuming but she has been super cooperative with doing the excercises at home. She even did them while we were on vacation. She wants this fixed. (She has so many issues she want *something* to be fixed...) Some are difficult, or at least they were in the beginning. Now if she is assigned the same sort of thing it is much, much easier. I think this means it's improving. We go for a recheck in 2 weeks and will know more then.

In terms of reading improvement the first day with her reading glasses DD went from 59 wpm to 81 wpm. That told me the DO had accurately identified an issue or 2. The plan is to make the glasses unnecessary but we'll see what happens.

Aquinas I hope your pediatrician is cooperative. This is one of the first things I asked about when we started this journey 4 years ago and our pediatrician almost had a heart attack. Now that our insurance no longer needs a referral so I was able to do it. The only thing worse than the guilt of not seeing it sooner is having seen it and feeling like you failed to get your kid the help they needed when you DID see it and no one would believe you. Yeah that one's a whole lot of fun...

Aquinas - Let us know how it goes at the pediatrician. VT is not as well known in Canada I think as it is in the US. Our ped. discouraged us from pursuing it.

However, DS has DCD. The pediatrician told me this means he will need more practice to learn motor skills. To me, the eye control is a motor skill and the VT is his practice.

Unfortunately, there are not a lot of places where we are that do office-based VT. The place we are going - some of the stuff feels flakey, but I still think he benefits from most of the exercises. We've only done 6 sessions so far - we'll re-evaluate after 12.

Also - it's expensive and not covered by insurance. I'm not even sure I can use it as a deduction at tax time. :-(

Good luck Meg-meg! Your DD's reading issues sound very similar to my DS7. He _can_ read well but gives up quickly - especially with small, dense print.

He doesn't do well with puzzles and has a hard time picking out objects in a cluttered background (didn't find anything during my very easy Easter hunt this year).

We've only done 6 weeks so far of VT, so hard to say if it's helping. We're going to re-evaluate after around 12 weeks.

Pemberley, the main evidence all comes from one group, who have now done several trials of increasing size, all looking just at convergence insufficiency. Hardly overwhelming endorsement for the research junkies amongst us, but OK.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821445/
http://www.ncbi.nlm.nih.gov/pubmed/18300086
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782898/

Here's a Cochrane Review:
http://www.ncbi.nlm.nih.gov/pubmed/21412896

Treatment recommendations are more based on expert consensus than solid research. All the major optometry associations, the NIH eye institute, etc, all recommend office-based VT as the first choice of treatment for convergence insufficiency.

Here's the American Optometric Association Clinical Practice Guidelines. Treatment options for vergence issues start on p. 36.
http://www.aoa.org/documents/optometrists/CPG-18.pdf

Just noticing this one on LD-related vision issues - looks interesting too:
http://www.aoa.org/documents/optometrists/CPG-20.pdf

Also:
http://www.aapos.org/terms/conditions/38

FYI, I get better info searching "convergence insufficiency" than "vision therapy" - but each time I do this, I still seem to find material I hadn't come across before, like those clinical practice guidelines I am now reading...

Thanks for the links Platypus - there are some there I hadn't seen yet.

Here's what I've found (I think one of these was linked in a different thread):

Shin et al., 2011

Lavrich, 2010

Barrett, 2008

Do you know which specific issues your dd is dealing with re vision? For our dd, VT was tremendously helpful. The one gotcha is that - in her case, the issue was muscle weakness, and muscles need to be exercised. She made tremendous progress with learning to read (and enjoying it) with her first round of VT, as well as in many other areas relating to vision. Two years after finishing up that first round, she needed a refresher round because her muscle strength had regressed. She went through round 2, did well for around two years, and is now again experiencing eye fatigue and occasional symptoms that her eyes aren't working together well. I don't think she needs another round of VT, but I do think that it's going to be important for her to keep up with a few of her key strengthening exercises throughout her life. DD is 13 now, and not overly thrilled about that idea! OTOH, she is very aware of what a difference it's made in her life

Best wishes,

polarbear