Aug 022013

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Q: Is vision therapy valid or does my child need vision therapy? Any advice/experience is appreciated.. My child is six and struggling with reading. Would you get an exam?


Vision therapy may or may not be the issue when a child is struggling with reading. MANY, MANY kids who have difficulty with reading have processing problems, not visual problems.

There are also a significant number of children who have what is called an “Ocular Motor” deficit, which means their eyes don’t sweep smoothly from side-to-side while reading. The child’s eyes may not have a full range of scanning to the left and/or right. In these cases, vision therapy will help.

The most common visual motor deficit is in the area of convergence insufficiency.  Convergence insufficiency occurs when a child cannot sweep his eyes towards his nose well when trying to read.  It’s an alternating sweep of the eyes, alternating right and left inward sweeping. It’s different than moving both eyes towards the nose simultaneously (as in cross-eyed) .

Symptoms your child may need vision therapy:

Ocular motor deficiencies can cause a lot of problems with reading. If a child has these types of eye-movement problems, it typically causes physical discomfort for the child when he reads.  Ocular motor deficits can cause the words to “jump around” on the page.  Children may get teary-eyed, get headaches, or frequently lose their place if they have ocular motor difficulties.

I’ve found that often ocular motor problems co-exist with phonemic awareness or processing difficulties, as they did with my child.  If a child has true dyslexia and needs vision therapy, the therapy alone will not bring about a significant change in the child’s overall reading ability, bit it will alleviate the eyestrain a child experiences while reading.

Research supporting vision therapy:

vision therapy

If you have concerns or questions about the efficacy of vision therapy, check out the research info at the College of Optometrists in Vision Development (COVD):

In particular, check out this PDF providing summaries of dozens of studies that have been done..
Summary of Research on Vision Therapy (pdf)

Finding a Developmental Optometrist for Vision Therapy:

You can find a Developmental Optometrist (D.O.) through the listings at the College of Optometrists in Vision Development (COVD). These doctors can perform a typical eye exam too. However, you need to know that having 20/20 vision is NOT the same thing as having ocular motor issues.

Vision that is not 20/20 is corrected with glasses. When a child can’t move his eyes smoothly in a coordinated fashion, vision therapy is needed to strengthen the eye muscles.

If the Optometrist (D.O.) finds ocular motor difficulties and therapy needed, it is a good idea to go ahead and have the vision therapy. Having the therapy will help your child read print more easily. Be aware though, visual motor issues alone may not solve all of your child’s reading problems.

Difficulties with phonemic awareness make decoding “painfully” slow. A child with phonemic awareness problems have difficulty remembering words from one reading to the next.

Phonemic awareness or other learning disabilities can be diagnosed by a psychologist who specializes in psycho-educational evaluations or a neuro-psychologist. Many Educational Consultants are also trained in administering tests that can point to potential problems. However, consultants won’t have the comprehensive training in identifying learning problems that a neuropsychologist has.

While your child is young.. it seldom “pays” to wait to pursue answers. A LOT of people think “he’ll probably grow out of it.” The International Dyslexia Association points out that 85% of children do NOT “grow out” of their reading difficulties. There is a much greater likelihood your child won’t grow out of it.

Waiting generally doesn’t pay off. The earlier a child is diagnosed, and can receive treatment, the smoother the road ahead.  If you address problems early, your child devise a lot of bad coping skills that he’ll have to “unlearn” later.

It would probably be beneficial to see about getting some testing for reading difficulties, dyslexia, and processing problems while you are pursuing vision therapy. If your child has visual tracking problems, that is a physical barrier to the act of reading. Therefore, it is usually best to address ocular motor issues first or early on in your efforts to help your child.

If you’re homeschooling, there are also home vision programs that some D.O.’s provide, which can allow you to do the vision therapy during your typical homeschool day. We did vision therapy as part of our regular educational program, which made it easy to do the daily exercises. Compliance with the program of exercises is of utmost importance for the therapy to be successful. Homeschooling while undertaking daily vision therapy can bring about good results if you do the exercises daily.

Vision therapy worked wonderfully for my son. He had convergence insufficiency, so he went through about a year of home-based therapy. Beforehand, my son’s eyes burned and watered when he tried reading. One of his teachers thought he was crying about reading. After the vision therapy, my son’s eyes no longer hurt him when reading.

Hope that helps!

Best Wishes,

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