What is this vision therapy?

[spotangel, DNP, RN, NP]

I could feel my anger and irritation growing as I did homework with my then 11-year-old son, Sam.

How hard was it to grasp the concept that the English explorer Henry Hudson sailed on the Half Moon and discovered the Hudson River in the year 1609? We were going at this for more than 40 minutes and Sam kept staring at his textbook in mounting frustration. I told him to take a 10 minute break and went out on my deck to get some air and cool myself down. Staring at the Hudson River that I could actually see from my deck and the hills of New Jersey on the other side, I had an idea.

I went back and grabbed a blank sheet of paper, drew a few hills and a river with a boat and a stick figure and a sail on the boat. I named the boat Half Moon, wrote 1609 on the sail and labelled the river Hudson River.

Calling Sam, I pointed out my drawing.

"What do you see Sammy?"

"A man on a boat?"

That's Henry Hudson an English Explorer. That's his boat "The Half Moon" and look at the sail. What year is on the sail?

"1609", was the excited reply.

"I got it mommy! Henry Hudson discovered the Hudson River in 1609. He sailed on the Half Moon. He was an Englishman."

"Aren't you smart?" I praised Sammy as I mentally realized that he was a visual learner.

I dreaded homework which took over 4 hrs. Now I had an idea that words strung together made no sense to my child even though he was very intelligent. Sammy had a diagnosis of Autism, even though he was at the higher end of the spectrum. He was socially awkward and did not make friends or sustain conversations beyond his areas of interest, which was basketball news.

I called his teacher the next day and asked for an appointment. When we met, I told her my discovery. She was quiet and listened intently.

She then told me,"Mrs.Radcliff, I am going to suggest that you look into Vision Therapy."

"What is this vision therapy?"

"Some kids eyes don't work together and you cannot find that out in a regular vision examination. You need a special test and if they find out that they are not working well together, they will reteach the eyes to relearn how to read as a team."

I was amazed that as a nurse I had never heard about this.

"How did you know about this?"

"One of my students struggled with reading and got vision therapy. His grades went up and I asked his mother what she had done differently." his teacher explained.

I thanked her and started my research. I was determined to find anything that would help my son. Through my research, I found out that the problem was that the decoding of what the eye was seeing was not happening in the brain. In very simplistic terms, vision therapy was like giving physical therapy to the eyes to strengthen them and rewire the way the brain interpreted the signals from the eyes

I could not believe that my ophthalmologist who had prescribed glasses for Sammy's Myopia did not know anything about this. When I called him, he pooh-poohed what I said and told me that the doctors who did this therapy (optometrists) were quacks and not to waste money on them. I decided to ignore his advice. I looked at places that offered it and finally settled on one place that had the best reputation and had government funding. I found out much to my dismay that insurance did not cover the three major tests he needed. We decided that this money was worth spending and put in the money so Sammy could get tested. They called us back and told us that he did need vision therapy and that we should bring him once a week to the center to do the therapy. We figured out a day a week we could take him from school to vision therapy which was an hour away for an entire year.

They made it fun for him by making him use a computer and animated games that made him unknowingly strengthen his eye muscles. They had an intern help him with his homework especially English and he did the rest on the train as we traveled back home. He had special eye homework at home which I had to help him with. After a year he "graduated "and I was amazed at the progress he made in his Subjects especially English Language arts, social sciences and other subjects that used a lot of words. For the first time in his life, his hard work was paying off. I felt my heart would burst when he came home one day with shining eyes holding a report card with a High Honor roll. Not only did his grades improve, his confidence improved too! My eyes were shiny too with tears! Today, he is in college working hard and rewarding himself for his good grades by playing his favorite game basketball!

My youngest daughter Sandra was tested for vision therapy and needed it too. The four-hour homework that dragged on and on just like Sammy's did, the frustration, the tears! She was started on Vision Therapy and also graduated but has to continue with homework for the next 6 months. It is too soon to see a difference but one thing I have noticed is that she does not take that long to finish her homework and has become more independent.

So how do you know if a child or an adult needs vision therapy?

Some of the most common reading issues are

• Struggling with "near work" such as reading or looking at a computer screen
• Frequently losing your place while reading
• Omitting or re-reading letters or words
• Confusing similar looking words
• Poor reading comprehension
• Reversing letters or words after age seven
• Seeing double

If so, what can be done?

Time is spent with each patient to get a complete picture of their overall health and how it impacts the health of their eyes. An experienced practitioner takes time to thoroughly assess the health and function of the patient's eyes, including:

• Eye and general health history
• Refraction
• Binocular assessment
• Eye health evaluation
• Glaucoma and cataract evaluation
• Evaluation of systemic disease, including diabetes and hypertension
• Routine and specialty contact lens services

A Visual Skills Evaluation - examines the visual system's ability to track and change fixation, maintain and accurately change focus and maintain the efficient use of two eyes functioning together. Problems in these areas may contribute to inefficient reading and poor attention span.

A Perceptual Evaluation - examines the patient's ability to process visual information and integrate this information with auditory and motor skills. Visual recognition, copying skills, visual memory, and directional organizational concepts are tested.

Pre- or Post-Surgical Evaluations - examines the need for surgical intervention for strabismus (an eye turn) or the need for Vision Therapy before or after surgery.

How can vision therapy help?

Vision Therapy is a treatment regimen that is designed to correct or improve specific dysfunctions of the visual system, including such disorders such as amblyopia (lazy eye), strabismus (turned eye), poor eye-hand coordination, focusing problems, perceptual difficulties and eye movement disorders.

What exactly do they do?

Treatment plans are tailored to specific diagnosed dysfunctions and encompass the use of lenses, prisms and patching (among other things). Because the therapy is individualized, the procedures used and the duration of therapy are dependent upon the nature and severity of the problem being treated and the specific needs of the patient.

I have used my experience with my children to help others that I know or hear that are struggling especially with reading comprehension within my professional and personal life. Since I presently work in Primary care, I have had ample opportunity to educate my coworkers, the health team and patients about vision therapy. Usually, the PMD puts in a referral for evaluation for visual perception. The family is advised to check vision therapy center locations that are close to them and also with their insurance company in terms of coverage for the comprehensive eye exam and vision therapy. Once they qualify for therapy they schedule dates when the patient can be seen weekly. Once they graduate they may or may not require continuing homework to strengthen their eyes and improve coordination.

Recently I redeemed a gift spa certificate that was going to expire and met a total stranger in the steam room. While being steamed like lobsters (!), we talked about our children and she told me about her triplets and their challenges in school. I told her about vision therapy. She was very grateful and promised to check it out as soon as she got out of the spa. I went home thankful that yet another parent had been given a ray of hope to help her children and their future!

---

References

1- Eyecare for Children - SUNY College of Optometry)

2- An Eye Doctor answers questions (FAQs) about vision therapy, visual training, eye exercises, pediatric optometrists, developmental optometrists, ophthalmologists, opthalmologists, opthamologists

3- Parenting Info: Learning Disabilities and Vision, Learning Disabled, Vision Therapy, Visual Learning, Visual Skills

4- Vision Therapy for Children | When Glasses Aren't Enough

5- How to Identify and Refer Patients for Vision Therapy - Vision Help

[3ringnursing, BSN]

That is so cool. I wish I had known about this when my son was in grade school, I bet this may have really helped him back when he used to struggle.

[kdkout, BSN, RN]

I have similarities with my child, and am also an RN.

We went to a "Vision therapy" appt years ago. We live in an affluent area. (I am not.)

So I took both kids for a "free" evaluation, not giving much detail about my kids' histories...and lo and behold, both kids desperately "needed" this therapy for $100/per appt, despite one of my children having no issues. The Dr loaded on the promises and the pseudo-guilt implying how much my kids needed this, how bad it would be if we didnt do it, etc etc I was quiet, but inwardly flabbergasted by this level of pushiness under the guise of "good parenting."

Not to mention it's not covered by insurance, so quite expensive with no end in sight of how many weeks/months this therapy would take.

When you have a special needs child, whatever that technically means....and you live in a coastal city where people have a lot of money and there are a lot of "keeping up with the Joneses" types, you really have to watch out for these types of "Drs" who will prey on parents who can be desperate to help their child.

Do I think it may work? Maybe, but after 4 years of advocating for my kid I could

see through the b.s. more than many. I'm not saying this new "therapy" is wrong, or that many kids wouldnt benefit from it - I'm just saying that as a parent you'd better follow your gut instinct and not believe everything people promise. The guy we saw was appalling. Very, very nice office - nice work hours, etc. Too good to be true, IMO.

I know one person who said it saved her son - but she also worked for this Dr, so I'm not sure if she was even slightly objective.

For some parents, figuring out your child's learning style can be effective. That's pretty easy to do these days.

[spotangel, DNP, RN, NP]

I have similarities with my child, and am also an RN.

We went to a "Vision therapy" appt years ago. We live in an affluent area. (I am not.)

So I took both kids for a "free" evaluation, not giving much detail about my kids' histories...and lo and behold, both kids desperately "needed" this therapy for $100/per appt, despite one of my children having no issues. The Dr loaded on the promises and the pseudo-guilt implying how much my kids needed this, how bad it would be if we didnt do it, etc etc I was quiet, but inwardly flabbergasted by this level of pushiness under the guise of "good parenting."

Not to mention it's not covered by insurance, so quite expensive with no end in sight of how many weeks/months this therapy would take.

When you have a special needs child, whatever that technically means....and you live in a coastal city where people have a lot of money and there are a lot of "keeping up with the Joneses" types, you really have to watch out for these types of "Drs" who will prey on parents who can be desperate to help their child.

Do I think it may work? Maybe, but after 4 years of advocating for my kid I could

see through the b.s. more than many. I'm not saying this new "therapy" is wrong, or that many kids wouldnt benefit from it - I'm just saying that as a parent you'd better follow your gut instinct and not believe everything people promise. The guy we saw was appalling. Very, very nice office - nice work hours, etc. Too good to be true, IMO.

I know one person who said it saved her son - but she also worked for this Dr, so I'm not sure if she was even slightly objective.

For some parents, figuring out your child's learning style can be effective. That's pretty easy to do these days.

Wow! I am sorry to hear that Kdkout.Although I had to pay for the evaluation, the insurance covered the actual visit and I paid $10 copay. While researching I did meet a few too good to be true types which is why I went to a state sponsored clinic.

Even though my son is a visual learner, he definitely benefited from vision therapy as his eyes were not teaming together and they basically helped him relearn how to read using prisms, eye exercises and computer games that made the eyes to work together. That is why when my youngest child started having similar issues, I asked for a referral and she ended up getting vision therapy at the same place.

[cerickson24]

I am wanting to know if there is a program or certification that I can do online. I am a school nurse, and I feel this would be very beneficial for me to do to help my students. I live in rural Wyoming, so there is no one in our community that provides this service.