NY Times Article on Vision Therapy

[Anonymous]

Has any read this article and have experience with vision therapy? It looks promising but controversial...

http://www.nytimes.com/2010/03/14/magazine/14vision-t.html?em

[Anonymous]

I read that article, too. To me, it seemed to confirm what the pediatric opthomologist told me: that VT is only proven to help one specific condition. She also told me that it won't hurt your child for other conditions, but is not likely to help. Incidentally, she did test my child for tracking problems and convergence issues, which the article seemed to indicate that an opthomologist would not.

I am not sold on vision therapy. I'd be curious to hear any success stories.

[Anonymous]

Our developmental ped said it could hurt if a child has a medical disorder and it keeps them from getting a medical evaluation. I agree with PP, our ophthalmologist tested for everything. I don't see how working with eyes does anything for a child's brain and I hate the way therapists who have something to offer some children make claims way beyond what they can do (I see OTs as often doing the same thing).

[Anonymous]

21:38 here. I agree with you, PP. As a parent, you feel that you have to do everything you possibly can for your SN child. I feel like some of thee folks are just snake oil salesmen and they prey on your vulnerability.

I guess that's why I am interested in hearing about success stories. I'm so curious as to whether VT is the real deal or just a way to soak parents for lots of $$.

[Anonymous]

I don't have a success story but I have made an appointment and am taking my son next week. When we lived in a different state a couple of years ago, he got evaluated by a developmental optometrist there at the insistence of our private ST and OT (he does have a lot of visual motor issues). Of course, the doctor found tons of issues and wanted us to start vision therapy immediately. At the time we were doing a lot of ST and OT and we really couldn't fit it in. I asked when this would really become an issue for my son and dr said when he starts reading chapter books. So I said that we'd be back then (if it was really a problem). Well, my son has always had focusing issues but they became a huge problem this year (second grade -- the year of chapter books) and the school diagnosed him with ADHD (also executive functioning issues). He is on medication but although it has helped, he is still very distracted in class. Reading this article in the NYT the other day reminded me of my conversation with the old developmental optometrist and makes me wonder whether my son really has ADHD or whether it is a vision issue. It is a long shot but worth a consultation with the optometrist. So I will let you know how our appointment goes next week. He meets with my son for two hours and then has a separate appointment alone with the parents to discuss the results. I am positive that he will recommend therapy for my son based on our prior appointment.

[Anonymous]

Good luck, PP! Keep us posted.

[Anonymous]

PP here with upcoming appointment. Thanks - I will! I also wanted to say that our pediatric opthamologist in old state tested my son as well and said that he was fine. This was one week before the appointment with developmental optometrist who found all of the issues. There is definitely tension in the vision community between the opthamologists and developmental optometrists as to whether this type of treatment is valid...

[Anonymous]

My DD did VT for a little less than a year with Dr Nancy Lewis in Silver Spring. Dr Lewis worked great with my DC and was always professional and pleasure to work with. We quit because of money. It was a weekly out of pocket expense that we couldn't afford. I'm sure it helped my DD some but she was improving a lot on her own due to corrective eye surgery that was successful. We went to VT after surgery because my DD's eye muscles were still weak and adjusting (tilted head, some double vision, a lot of images fading in and out). If she went to a traditional school where she had to look at blackboard and then quickly down at her own paper for note-taking, she wouldn't last more than a minute. Movement like that hurt her eyes. When first evaluated by the VT my DD demonstrated poor tracking and convergence. One example was my the VT had my DD put on a pair of glasses with a something like a rectangular piece of paper in the middle. This forced the eyes to work separately. She then put a pencil in each of my DD's hands and told her to draw a line with each pencil from a spot on the paper (one spot on left side of the paper and one spot on the right side) to a spot in the middle of the paper. With her stronger eye she was able to draw the line almost to the middle spot, with the weaker eye her line went off to nowhere, missing the middle spot.

I know another local family that speaks very highly of their DC's VT experience with Dr Henry Friedman. Their DC experienced significant improvements in eye-hand coordination and avoided surgery.

[Anonymous]

Has anyone noticed an improvement in reading? My DC gets similiar looking letters and numbers confused (either backwards, or says the simaliar letter/number).

[Anonymous]

We had DC evaluated at 7 because of concerns about reading (good basic skills but no interest and iffy comprehension). We were told he had significant issues with convergence, tracking, accomodation, teaming, and just about everything else. However, we did not proceed with therapy.

Why not? First, we had recent testing that showed sky-high IQ but a lot of unevenness between subtests. When we brought this up, thinking that the vision results should possibly be considered in conjunction with the other testing, the dr. was totally dismissive - said that this was not of interest at all. Second, when we repeatedly asked about research supporting either the tests used for diagnosis or the efficacy of treatment, the dr. just said vaguely, "Oh, I'll get to that", but never did. Third, when we pressed further for research, he finally gave us one article, which he said proved that VT is effective and was endorsed by the head of the Harvard Medical School. The article was a study of 12 kids and showed that all got better, whether they did reading remediation, VT, or nothing at all, and it was endorsed by the head of the Student Health Service at Harvard. We were...underwhelmed.

A year later something clicked for DC, and reading was no longer a problem.

[Anonymous]

DC did vision therapy for six months with no effect. So like some of the PP's I don't believe it is helpful. He did improve in other areas though and his coordination and balance improved. I attribute that to lots of OT, not vision therapy though.

[Anonymous]

I am the PP who was taking my son last week for the appointment. We went to Dr. Applebaum in Bethesda and I have to say that I was very impressed with the entire practice. I had been very wary of vision therapy in the past and had previously rejected it but we are moving forward with it now. Dr. Applebaum's tests were quite different than the ones the previous developmental optometrist had done on my son. He used a lot more equipment to measure his eyes whereas the original doctor we went to several years ago (in another state) had my son do puzzles or play with blocks. Basically, Dr. Applebaum diagnosed my son with "convergence insufficiency" which means that his eyes don't come together at the same time when he is reading (or looking at anything) so he isn't processing properly. We also discovered that when my son is reading, words get blurry once he is looking at the page (he never admitted this to us before -- of course, we felt terrible once we found this out). Dr. Applebaum is putting him in what he calls his "stress-reducing" glasses which are basically the lowest type of bifocals with the top part having no prescription (and my son can't wait to get them) and we are going ahead with vision therapy. My son is very motivated and is actually doing the exercises at home. Even though I am kicking myself for not having done it sooner, the only positive is that he wasn't reading back then and would have had no idea why he was doing the therapy. At least now, he will be able to gauge the improvement. It certainly isn't a "cure-all" and Dr. A. acknowledged that my son likely has ADHD and the vision issues and that the ADHD will remain after the vision issues are cured. But he did say that with some kids the ADHD is more manageable and some kids are able to go off of medicine...We will see...

[Anonymous]

Good luck, PP. Please keep us posted.

[Anonymous]

Thanks for the update, it was very informative. Also, please don't be too hard on yourself. All we can do is make the best decisions we can at the time. You're doing a great job!

[Anonymous]

For more information see:
http://www.2020mag.com/ViewContent/tabid/136/content_id/14152/Default.aspx20/20

http://newsfromaoa.org/2009/07/29/researchers-paper-on-vision-therapy-outdated-flawed/

http://aoa.org/x4813.xml
(Care of the Patient with Learning Related Vision Problems [CPG20] Revised 2008)