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tntreefarm
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Posted: Aug 07 2007 at 6:14am | IP Logged Quote tntreefarm

Anyone want to share any vision therapy experiences. My daughter, Jian, (almost 10 Asperger's) has some serious visual perceptual and graphomotor problems-she also has a math LD. I'm really hoping that the VT will help her but I don't know if my experience with the optomitrist is common or just due to her personality and lack of experience.

This is the first therapy in nearly 17 years of being a special needs parent that I've been told I can't observe. Well, I have finally insisted. After observing I can see why I'm having trouble with doing the homework. Dr and assistant tell me that she can do the exercises when they explain the homework to me. I go home and try and do them and we have rages from small to dangerous. When I observe, I see how stressed she is over the work. So the next day when I ask her to do the same thing she knows that this is very hard and that she is "safe" with mom and can explode. I tried to tell them that if they see any aggitation at all, I won't be able to do the excercise at home. They don't get it......

I thing most of you would "get it" if I talked about the difference between teaching and testing. Handing out a worksheet and saying "complete it" is really "testing"- while reading and finding the answers with the child and even giving them the correct answers is "teaching".   

One activity that Jian is supposed to complete involves a paper on the wall with random letters. She holds in her hands a miniture copy of what is on the wall.   She is supposed to read the first 4 letters from the wall and then look down and read the next 4 letters from her copy then the next four from the chart, etc. After working with her on this and similiar activities I feel that one reason she gets so aggitated is that she's really not sure of what to do combined with the fear of making a mistake.

The whole thing is a dilemma for me. God is pushing me here. I'm not good at working things out and negotiating. With my personality I just like to quit and say several unkind things in the process. But, I do feel that Jian needs vision therapy, this is the only "game in town". We are lucky to even have a vision therapist in our slightly rural area.

gotta go

Cathy


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ALmom
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Posted: Aug 08 2007 at 1:39am | IP Logged Quote ALmom

Cathy:

We've done vision therapy at our house many times (different children) and all with good results. Now, I have never been told by anyone that I cannot observe therapy and would go nuts if I was. Being able to see it helped me know how to do it at home. The only time they cannot let me in the room is when there are other children in group sessions, but they don't mind me sitting in the hall and glancing in.

We did have minor glitches at home at times, and it was very exhausting. One child complained most of the way through it and it was hard. However, our therapist was quite empathetic and would try to make sure I understood how hard it was. One time I had real trouble at home because dd was getting sick - called therapist on the phone and she had me get a ruler and measure the distance between the ball and dd eyes. It had fallen down and was not at the right distance and since I don't have great depth perception, I just would never have seen this. This solved the problem.

We were also given an activity by the optometrist to do and the therapist figured out that she was suppressing and not ready for this yet and got back with the optometrist to change plans.

One thing I did was try to communicate with my child and therapist and I took very thourough notes of every home therapy session. Those notes then became clues to the therapist as to how to adjust. I was not working with any other challenge beyond the vision though. If my dd said that her eyes were getting worse or that she saw 2 of something or whatever, I wrote it down, it was noted as to which exercise and time of day. If she got stubborn and seemed to refuse, I'd note that too even if I insisted that we continue. (It did take me the better part of an entire day to just accomplish therapy with this one child - and though she spun in circles at the therapists, she did not give them near as much trouble as me. I know, I was in there watching every session.

The exercise you are describing is one we did not do till almost the end of therapy. Is it possible that someone has missed an underlying problem and are not going to the root yet? I think I would try and find out as much as I can from your dd as to what makes this difficult. (I find it very hard to see going near to far like that and also lose my place and get frustrated very easily - but I have fusion problems and this activity would be something that I would not be quite ready for). I'm not sure why someone wouldn't "get it" if you were having dramatic temper meltdowns over something.

I do know that we attempted an occupational therapist in town who gave us some exercises to do before we found the vision therapist and my dd absolutely was in tears. Well, they were well beyond her ability as this group had not figured out that she could not converge adequately - just thought she had tracking problems (which she had, too, just other things had to be corrected before anything would even have a chance of helping tracking).

Did the therapists ever sit down with you and go over all the diagnostic tests and what they meant? I know our optometrist and vision therapist did some initial testing, then another 2 hours of testing and then spent some time explaining what they found, what it meant and when therapies were assigned, they explained their purpose to me so that dd and I could both understand - and that helps you put up with the difficult knowing what the goal is at the end. We asked tons of questions to make sure we understood and that the conclusions made sense to us. The therapist spent all the time we needed to answer our multitude of questions.

The exercise that you describe is designed to help a child adjust from near to far focus and back and is called accomodative rock. Now it is great if convergence and divergence are as they should be, if you have binocularity, and focus ability. You are supposed to stand at a certain distance from the wall chart and read from the wall (far) and then in the hand (at the normal arm hand distance - near). We did a bunch of exercises before getting to this - like working with red/green glasses, marsden ball, brock string, and some computer exercises that got to the point where our dd could use both eyes together, converge to the 1" and was successful at computer testing of near to far and recovering focus quickly each way. Then we went to the wall chart exercises.

Also, sometimes lighting conditions, reflections (maybe something is shining on your chart and creating a shadow at home that isn't there in the office)or something else. Is it possible that either your dd or the doc or both are miscommunicating?

I would be firm but polite in terms of making sure I understand what they want you to do, that you really do need to see them working with your dd, and record all attempts you make at therapy and what happens including specific complaints from your child. (If she says something is bouncing around, believe her and be insistent about further testing if you think there may be something that hasn't been caught yet). Is there anywhere else nearby that you could go for therapy? We drove 3 hours for our optometrist and either work at home ourselves for therapy or have a therapist locally willing to work with our optometrist. If you are polite, calm and kind but firmly insistent, you should be able to get what you need. Anyone unwilling to answer your questions, I'd be worried about and start looking for alternatives even if I had to drive considerable distance.

Sometimes I have found that if I have all my written observations and then bring in dh for communicating to the doc, this sometimes gets quicker results in general with medical professionals. Try not to be emotional at all or they may tend to come to erroneous conclusions that cause them to overlook what you are observing.

Hope this helps some. If you have more questions, I don't mind if you PM me for more details.

Janet
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Anne
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Posted: Aug 08 2007 at 5:50am | IP Logged Quote Anne

Cathy,
I am wondering if you are from TN? We live in the Chattanooga area. Are we close?

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JenniferS
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Posted: Aug 08 2007 at 9:37am | IP Logged Quote JenniferS

I won't be much help since we just started vision therapy, but I will say our therapist is very good about haveing us observe, explaining why and what he is doing, and demonstrating what we need to be doing at home. My boys really seem to like what we are doing so far, but it's not very time intensive yet. I have noticed an improvement in our five year old already, ad we've only been doing this a month. I think it has been incredibly helpful that we can observe the therapy and that our doctor is very open to discussion.

Jen
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ALmom
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Posted: Aug 12 2007 at 1:35am | IP Logged Quote ALmom

Jennifer S:

My younger children had fun with therapy from start to finish so you probably won't experience the same kind of agony with your 5 yo as we do with our older children. The younger ones considered it all a game. It was my 9 and 10 yo and olders who HATED it and balked the whole way. Still, in the end, they all admit that it was the best thing we ever did. Well, everyone except the one we started at 16 - she still says all it did was make it possible for me to load her up with more work - BUT she no longer gets sick to her stomach after 20 minutes of close work so deep down we all know it was good. Actually this 16 yo was fine with therapy until we tried someone we who was closer who treated her more like a baby. Our local therapist was retiring too and we no longer had anyone local so it would have been 3 hour drive to therapy 2X per week or me trying to work with a highschooler in therapy and the way this dd and I rubbed at the time, it just didn't seem like a good idea. The end result was that both she and I had a real hard time with the new optometrist, don't think he was a great communicator, he didn't like me observing (which since this was a highly communicative high schooler, I didn't mind too much but thought odd. I'd forgotten about our brief venture with this optometrist who did his own therapy) and I agreed with my dd that he was not explaining the purpose of things or even believing her if she said she worked hard at home but he didn't see progress in the office. Well, we ended up quitting therapy for her before she was completely done. I regret switching from the optometrist that was so good and have always gone back to the one 3 hours away since then - but we were really trying to encourage her along a bit longer and thought if she wasn't losing so much time in the car, she wouldn't mind as much. We would have been much better off with driving the 3 hours even if I simply had to put her in total charge of her own therapy at home which is really how the local therapist was working it anyways - she adjusted how she worked with each child based on temperment and age of child and even their interests. I remember her using legos for some of the therapy with my lego fans - just had to be red and green bricks only with the red/green glasses.

Anyways, Jen, didn't want you to start worrying unneccesarily. When you catch these things at a younger age, it is easier, but the good news is that it is never really too late - just harder.

Janet
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tntreefarm
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Posted: Aug 16 2007 at 3:11pm | IP Logged Quote tntreefarm

Hi Anne, Jennifer, and Janet,

Thanks for writing and sharing your thoughts, experiences. I've been away from my e-mail for over a week and just getting back to it. It's wonderful that you have taken the time to write. I know how hard it is to have any time to finish anything.

Anne, yes we live in TN. Johnson City area so it's probably close to 5 hours between us.

Jennifer, thanks for sharing that you are observing and not getting an attitude about it. It makes a big difference when I can see what's happening.

Janet, Wow- you are the vision therapy resource lady..
sounds like what you are doing- have done is rather different than what I've got going. They did a Sensorimotor/Perceputal test that took about an hour then I went back a week later for a 30 min "conference" to have it all explained to me. Jian has 20/20 vision. On almost everything she scored extremelly low, on Visual Form and Visual Figure-Ground she scored 1-2 years above her age.    

the eye doc and "helper" work together in therapy and we only go once a week. I'm not sure I could go more often if it was an option. (they only do therapy on Wed and Thurs)

I wonder what type of stuff I'd get if I tried someone else. Problem is that the only other one that might be around is a 2 hour drive (one way) and I don't know her name- just that our doc mentioned someone she knew in
Ashville that she spoke to about Jian. I'd rather not go to someone that already has info from someone else about us.

Thanks for sharing

Cathy
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Cathmomof8
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Posted: Sept 07 2007 at 6:41am | IP Logged Quote Cathmomof8

I've started working as an OT in the school system and most of my kids have visual perceptual problems and have seen an optometrist and vision therapist who then referred for OT in the schools. I'm just learning myself about it all after working for 20 years in geriatrics. When I settle in a bit I'll try to share some resources/info
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