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Real Moms, Real Kids: Vision Problems

Did you know that your child can have 20/20 vision yet still have trouble reading text?

Undiagnosed vision problems are quite common. In fact, experts1 estimate that 1 in 10 children has a vision issue that affects learning. Here at All About Learning Press, parents regularly share stories with us that prompt us to suggest vision testing.

Elizabeth Bird is an All About Spelling user who discovered that her child had vision problems, in addition to several other significant developmental differences. Her hope is that their story will help other families find the help they need, so they won’t have to go through what she and her son have gone through!

Here’s Elizabeth…

My childhood was a treasure trove of tales. I was resolved to raise readers, so I continued down the path my parents had paved by reading aloud to my son even before he was born.

As a toddler, my son had a vast vocabulary. He loved long words, like micropachycephalosaurus, yet he didn’t speak in intelligible sentences. Over time, he was diagnosed with auditory processing disorder, sensory integration disorders, dyspraxia, and autism. But that wasn’t all. When he began to read and spell simple CVC words, I noticed that it was a monumental effort for him to focus on the page. During fleeting moments of focus, he’d read long words but skip short words, and sometimes skip entire rows of text.

I also noticed that my son would avoid eye contact, glance out of the corner of his eye, and hold his head while running. His vision screenings showed that he had 20/20 vison, so these behaviors were all dismissed as symptoms of his other diagnoses. My son couldn’t describe the vision difficulties he was experiencing because he didn’t realize they weren’t normal. But one day, in despair, he admitted that the “wobbling words” hurt his brain. That was a breakthrough for us!

We went to a board certified developmental optometrist, whose comprehensive assessment revealed a visual processing disorder. My son thinks in pictures, yet everything he saw for the first decade of his life was distorted and confined to a 10% functional visual field. That he had learned to read at all was a testament to his courage and perseverance. On one hand, it was frustrating to receive yet another diagnosis. But as it turned out, this was the most encouraging diagnosis we received because vision therapy fully remediated his vision and transformed his life!

Real Moms Real Kids: Vision Issues - a post from All About Learning Press

Vision therapy was intensive, but just understanding the problem brought relief. For nine months, a vision therapist worked with my son for 45 minutes once a week, after which I received 15 minutes of instruction and obtained tools necessary for homework. Each week there were new exercises, and we worked on those exercises at home five days a week. We rested on Sundays.

I will never forget the thrilling moment when, closely observing my son’s eyes during a challenging exercise, I witnessed neuroplasticity in action— his brain and eyes were working harmoniously! His joy made mine complete, and it made our arduous effort worthwhile.

Real Moms Real Kids: Vision Issues - a post from All About Learning Press

Vision therapy transformed every aspect of his life. Social situations are less confusing. Grocery shopping is not as overwhelming. Mathematics and reading and writing have all improved as text remains in focus and in place. Integrated reflexes, good peripheral vision, and clear targets contribute to greater proficiency and enjoyment of physical activities. Today, our son is an avid reader who reads to his brother daily and helps him with his reading.

During the demanding process, All About Spelling integrated well with vision therapy, enabling us to progress academically without placing undue stress on his brain or nervous system. This would not have been the case with traditional teaching methods.

Real Moms Real Kids: Vision Issues - a post from All About Learning Press

If you are using All About Reading or All About Spelling, yet your child is still having trouble, please don’t give up. There is hope, even for older students, since neuroplasticity continues even after ten years of age.

I wish all children could have a comprehensive vision assessment prior to schooling, and I strongly urge you to investigate this frequently hidden problem.

“Good reading becomes possible when you need not consciously think about eyes, or light, or print, or spelling.” –C.S. Lewis

Vision-related websites that were helpful to Elizabeth

Products Elizabeth used with her son during vision therapy

An All About Reading user with vision issues

Did you enjoy Elizabeth’s story? Read more stories from Real Moms and Real Kids.

Do you suspect vision problems with your child? What are the symptoms?

1College of Optometrists in Vision Development. (n.d.) ADD/ADHD & Vision. Retrieved from http://www.covd.org/page/ADD_vision

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Leave a Comment

Amanda

says:

Interesting!

Jennifer

says:

This was very helpful! Thank you for sharing it.

Christine Wielinga

says:

Thank you for this article and especially the resource references! I think we’re onto something here to help my son with his reading difficulties. Thank you so much for sharing your story.

Valerie

says:

Vision therapy was a game changer for us when my daughter was in 2nd grade. Now, in 4th, she’s an avid reader.

Robin E.

says: Customer Service

Valerie,
Thank you for sharing your daughter’s experience with vision therapy!

Lisa

says:

I’m wondering if anyone has had older teens who have been tested. My child read well and liked reading until about the 7th grade. They now hate reading. They suffered from headaches for a while when reading, but those seem to have diminished. Just wondering if the therapies are too “little kid” for them.

Lisa B

says:

Yes, Do get her eyes tested. It is not uncommon for vision problems to occur at that age. Academic ( and visual) demands increase considerably at that age. Many school have moving, changing classes which require children to accommodate to a much wider range of situations as well a much greater demand for independent learning. A child with accommodative deficiency will struggle to get comfortable in new surroundings much more than others; this compromises their visual facility for their work. THEY will not realized IF their eyes are the problem because they have always seen through THEIR eyes. A good vision practitioner will explain why they are asked to do each exercise and how it will help them; seek a vision therapy practice that works with students one-on=one as this helps to manage their vulnerability around other students and can dramatically increase their cooperation level as well as the effectiveness of the treatment.

Robin E.

says: Customer Service

Thank you for your insights on this, Lisa!

Robin E.

says: Customer Service

Lisa,
It is never too late for vision therapy if the person needs it. Here is the College of Optometrists in Vision Development’s page on vision therapy for adults.

At the minimum, your child’s symptoms are such that I do feel a comprehensive vision exam is called for. Changes in reading enjoyment and ability such as you described, especially accompanied by headaches, are definitely important to follow up on to find the root cause.

Lindsay S

says:

Our oldest is showing signs of vision problems and her teacher reccomended we look into getting her looked at for it. This info is helpful. Thanks!

Robin E.

says: Customer Service

You are welcome, Lindsay. :D

Beth

says:

I am going to be taking my daughter in to the eye doctor. It seems like she might have vision problems.

Linda

says:

This is such an inspiring story. Our son is just a toddler, but I’ve also been monitoring his vision processing closely as there are some vision problems on my side of the family.

Rebecca Jones

says:

My son completed VT and we have been pleased with the outcome.

Robin E.

says: Customer Service

Rebecca,
Thank you for sharing that vision therapy has helped your son.

Krystal

says:

Great information as always! Thank you for your diligence in making sure we are able to all we can so our kids can succeed

Lisa B

says:

Try entering “efficacy of vision therapy” in your browser and you will get a plethora of articles about what vision therapy does and doesn’t do. Vision therapy develops visual skills that students use for literacy tasks. Vision therapy will not treat a “learning difficulty”, but it sure can make a difference much as physical therapy does not teach “a sport”, but rather provides a way to develop strength and mobility that are needed to participate in a sport. We believe that muscles in our body can be developed and our eyes are also controlled by muscles that can be better developed. I have worked with students who knew phonics rules but could not use their knowledge effectively when trying to decode. They owned the reading tools but could not apply them effectively; that is like purchasing a collection of tools without being able to use them. I had learned reading comprehension tools but was not able to apply them effectively until I had vision therapy intervention.

I work with some children in private schools who enroll their children very young and then use materials with very small print and lots of printing on the pages. Children’s eyes are not fully developed until they are at least 8 years old. If forced to read small print, or forced to use small images on computers, vision may become compromised. AAR uses large dark print with lots of white space and gradually reduces the print size as skill develops. Kudos to you, AAR!

Merry

says: Customer Service

Great explanation, Lisa! Thanks for posting.

Sarah

says:

Great information to keep in mind.

Angie

says:

I tried all about spelling and found it tedious and complicated to ‘teach’

Any suggestions? ..Also now age 10 my child’s reading has improved alot and she can read smaller chapter books but says away from reading somewhat….I noticed most reading programs are for’ BEGINNER readers …how do I help her read faster and deal with long words? What has worked for you?

Robin E.

says: Customer Service

Angie,
Our All About Reading program is designed so students can start at whichever level is most appropriate for them. Since your daughter is reading smaller chapter books, she would be able to start at a higher level. We do have placement tests for All About Reading to help you decide which level would be best. Also, we recommend having your child read the sample stories from the previous level online as a further confirmation. You want your child to be reading fluently with good comprehension before going to a higher level.

Level 1 sample story
Level 2 sample story
Level 3 sample story
Level 4 sample story

Evaluate (without correcting your student) for the following…

Your student’s ability to decode the words in the story.
Your student’s ability to comprehend the story.
Could your student fluently read the story with expression?
Did your student understand the words from a vocabulary standpoint?

As for All About Spelling, in what ways did you find it tedious and complicated to teach? It can take a bit to get used to the program, but after a short while it becomes “open-and-go”. Since All About Spelling is designed to be used for just 20 minutes a day, it isn’t tedious for most either. If you like, we can discuss the issues you had with it and help you make it a better experience.

I mention this, as many find that using All About Spelling helps with their student’s reading. Studying spelling supports reading, especially the skills needed for spelling multisyllable words. When children have mastered the syllable division words, sounding out hard, multisyllables words becomes a straight forward task.

I hope this helps. Please let us know if you have additional questions, or if we can help you in any way to help your daughter.

Angie

says:

I read a lot of the comments.Very helpful. I am going to have more eye tests for my daughter age 10. She often does wide blinks. Even when not reading. Her pediatrician says she has about 20/20 vision. But I had glasses as a young child and alot of astigmatism .The red text you show here as an examoke looks aloy like how my vision was without glasses except there appeared to be almost no spaces between words. Just thought my comment might shed light to parentswhos child may have vision problems. I think it is possible to do well on a M.D.doctor vision ABC test because even when letters are blurry you can still recognize them to a degree.So just be aware of that.
Thank You! Best Wishes to you all.

Robin E.

says: Customer Service

Angie,
Thank you for sharing about your own vision issues, and how they weren’t necessarily apparent through a simple exam.

Indra Remender

says:

Good to be aware!

Rajeeva Jayaratne

says:

helpful article. thank you.

greta collins

says:

I love using AAR and AAS with my 3 grandchildren it has been such a blessing.

Sang

says:

Thank you for this information. I will look for a doctor in our area that can evaluate my son.

Lisa B

says:

This conversation about vision and its role in reading progress has been very enlightening for many! I know how much vision therapy changed my life including reading speed and comprehension, so I refer students for testing when I notice signs of visual challenges. Psychological testing often verifies a “nonverbal learning challenge”; in my experience “nonverbal” means visual. School diagnosticians will not diagnose challenges for which the district does not have an intervention and/or openings in a class with students receiving that intervention.

As to vision professionals, many of them will test each eye individually but have no evaluation tool for the speed and/or efficiency of both eyes working together simultaneously. THIS is the problem that prevents literacy progress most often. This problem prevents an individual from seeing each letter instantly while noticing the letters that follow; most words cannot be read accurately unless you can see the end of the word. The end of many words dictates which sound the vowels will have. Then, due to the fact that the individual has not seen details of quickly all of his life, he has missed the fleeting facial expressions of peers and has not learned how to act socially. When the individual tries to form letters, he will begin and when he sees clearly, he will notice a mistake, erase it and begin again, only to have his pencil do the same thing again because his visual focus is slow. Since images of everything are not super clear, especially at close range, his image (imagination) will also be compromised when learning new things. Spelling images will also be uncertain.

The Bible says that the eyes are the light of the body! I believe that is truly true!

Stephanie

says:

Great article….my son also has vision problems but didn’t realise until he was 9 yrs old. This has made a huge difference :) highly encourage vision testing :)

JR

says:

Also, forgot to mention, the ophthalmologist did light therapy. Most of this, after the initial couple of visits, was done at home. It dramatically and documentable expanded my older son’s visual field by at approximately double, and is a necessity for safe driving.

Really, there needs to be an organized effort to push for medical coverage for these issues. It’s unfortunate that many medical opthomologists are not aware.

JR

says:

I think you have to really dig to find these doctors. In both of our cases, we obtained the names of the various doctors we checked out from other health care practitioners: a chiropractor, a physical therapist. They were not the average quality providers, and were delving into deeper, less obvious issues.

Look for “developmental vision,” “neurological visual disorders,” and especially, “behavioral optometrists.”

JR

says:

In addition to vision therapy, parents who have children with confusing areas of struggle may want to look into Brain Balance Centers. Brain Balance seeks to balance the right and left hemisphere of the brain. They evaluate to see that a child has passed all primitive reflexes, the lack of which can hold a child back in odd and confusing ways.

I spoke to a father at our particular location, who said his son’s behavior was so bizarre, that at times he and his wife wondered if his son was demon possessed. He was not joking when he told me this. He told me that Brain Balance work had dramatically reduced their son’s physically aggressive and total lack of self-control issues. We did not have such dramatic results, but this was a real father (not a ploy to “come to Brain Balance”), who told me this. Our teen age son said that he was able to break some of his rigid way of approaching things after his 3 month Brain Balance program. Our Chiropractor, who had clients who had used Brain Balance, said that they had made significant progress with the Brain Balance program, to the point the mother was willing to drive 2 hours to get to the facility.

Brain Balance works on primitives, balance issues, hearing – but not listening – issues, vision therapy issues, sensory integration issues, reading comprehension issues, etc.. Your child spends about an hour at their center 2-3 times a week. After they graduate, they have “homework” to work on. It costs, like vision therapy, about $3000 for a 3 month stint. It’s not cheap! Our older kids enjoyed going to Brain Balance, but the homework aspect got pretty boring pretty quickly, and I had to work with them to make sure it was being done correctly.

Brain Balance locations are across the USA, but not all facilities are created equal, and in our situation, the office manager was very controlling, non accommodating and adversarial, so that created a constant and frustrating obstacle to work around. If you choose to attempt this route, make sure you check reviews, and meet with the providers in person BEFORE. We also noticed at our facility that the staff was continually changing – like moving on to other jobs, and that some didn’t seem as sharp as others.

There is no guarantee that it will help, but it is, like vision therapy, diet issues and quality eating habits that support proper intestinal flora balance, a stone to turn over.

Back to the topic of vision therapy, really check out the doctor. Check out the facility. In our case, we found that the ophthalmologist who was so sharp and with it also seemed to be incorporating concepts that Brain Balance was working on with our kids. They allowed us to go into the “back” of the facility, and had lots of colorful stuff – balance beam, etc. – which showed that they were more than just about “eyes.” Also, their therapists were ALL certified by a leading organization, not just trained off the streets.

Jenn A

says:

Thank you for this information and the links! I’ll be looking into this further to help my child.

I just took my youngest in for his annual exam. He ask if he struggled with reading. He could tell by a simple follow my finger. Do get your children eyes examine.

Brandi Skidmore

says:

This Ian so helpful! I’ve looked into color vision therapy before but it was so expensive!

Becky Minion

says:

I’m so thankful for you putting the word out there. My first child had vision issues due to birth trauma. I didn’t catch on until age seven. It was a shock to see how many behaviors that I had labeled as inattention and naughtiness (biting pencils, kicking chair, looking away, watery eyes, pouting, slouching, etc) were all flags that he was trying to focus.
Life changed for the better when we got help.
I’m happy every time I read a post that encourages struggling families to rule out vision issues.
Thanks.

Robin E.

says: Customer Service

Becky,
Thank you for sharing your son’s story here.

Amy

says:

Interesting take and a good things to keep in mind as we hit various snags in educating our children.

Raygen

says:

Thank you so much for this post! It might explain some of my 8 year olds problems with reading.

RL

says:

Great information. I will be having my daughter tested as soon as I can!

Very disappointed to see vision therapy as a recommendation for improving reading/ADHD.

Vision therapy for improving reading has been debunked by science. Here is a joint position statement put forth by the American Academy of Pediatrics (AMERICAN ACADEMY OF PEDIATRICS, SECTION ON OPHTHALMOLOGY, COUNCIL ON CHILDREN WITH DISABILITIES AMERICAN ACADEMY OF OPHTHALMOLOGY,AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS, AMERICAN ASSOCIATION OF CERTIFIED ORTHOPTISTS): http://pediatrics.aappublications.org/content/pediatrics/124/2/837.full.pdf

“Diagnostic and treatment approaches that lack scientific evidence of efficacy, includ- ing eye exercises, behavioral vision therapy, or special tinted filters or lenses, are not endorsed and should not be recommended. ”

Another source / joint statement from the American Association for Pediatric Ophthalmology and Strabismus: https://www.aapos.org/terms/conditions/108

“Many scientific studies have demonstrated that ocular coordination, motility, and visual processing are normal in children with dyslexia. The scientific evidence does not support the use of eye exercises or behavioral/perceptual vision therapy in improving the long-term educational performance in children with learning disabilities.”

Students who have difficulty reading do appear to have irregular, erratic eye movements. This is CAUSED by the poor reading. Intervene and instruct using systematic, explicit instruction in how to decode (thereby building the brain’s ability to process phonological and orthographic [letter/spellings that represent sounds] information), and the eye movements will regulate. To state that fixing eye tracking/movements will then improve reading is putting the proverbial horse before the cart.

Read the texts by Dr. Mark Seidenberg (cognitive neuroscientist): “Language at the Speed of Sight: How We Read, Why So Many Can’t, and What Can Be Done About It” to learn more. Also read David Kilpatrick’s: Essentials of Preventing, Assessing, and Overcoming Reading Difficulties.”

Reading is not a VISUAL task. Reading requires the brain to process SOUNDS. It is a phonological task and that is most often the root cause of reading difficulty. Colored overlays, colored glasses, special diets, vision therapy, and the like are wastes of precious hope, time, money. It “appears” to work for some children because the prescribed exercises require children to practice their “therapy” while reading each day…and that additional time reading will of course, improve reading to a degree.

Merry

says: Customer Service

Thanks for commenting, Maria. I think you may have misunderstood the purpose of the blog post. We aren’t advocating this as a cure for ADHD or other learning disabilities (such as dyslexia)– it is a treatment for visual problems such as convergence and/or focusing deficiencies.

The articles you linked actually support our stance. We agree 100% that, as the first article states, “Vision problems can interfere with the process of learning; however, vision problems are not the cause of primary dyslexia or learning disabilities.” We also agree that vision therapy is not an appropriate treatment for learning disabilities (in fact, we have numerous articles on our blog which discuss appropriate treatments for dyslexia, dysgraphia, auditory processing disorder, autism, working memory problems, and so on).

The articles you linked to support the stance of Elizabeth (our featured “Real Mom”), as well as the stance of All About Learning Press. Her son was successfully treated for convergence and focusing deficiencies, and we’re extremely grateful that such therapy exists. Elizabeth’s son has multiple issues, including auditory processing disorder, sensory integration disorders, dyspraxia, and autism. Vision therapy was never seen as a solution for his other unrelated disabilities–but it did help his substantial focusing problems.

Here is a quote from the first article you linked to:

“Children with suspected learning disabilities in whom a vision problem is suspected by the child, parents, physicians, or educators should be seen by an ophthalmologist with experience in the assessment and treatment of children, because some of these children may also have a treatable visual problem that accompanies or contributes to their primary reading or learning dysfunction. Treatable ocular conditions can include strabismus, amblyopia, convergence and/or focusing deficiencies, and refractive errors. Missing these problems could cause long-term consequences from assigning these patients to incorrect treatment categories.”

And the second article adds to this thought, “Refractive errors may make it difficult to see the board or to read.”

Both articles go on to say that exercises can help with many of the diagnosable vision issues—from the second article, “Orthoptic eye exercises as prescribed by pediatric ophthalmologists, orthoptists, and optometrists can be beneficial in the treatment of symptomatic convergence insufficiency.”

You mentioned that reading is not visual, but reading does have a visual component. If someone is farsighted but does not have corrective lenses, he would have a very difficult time focusing on the text. In a similar way, if a child has convergence deficiency problems, he is unable to focus on the text for very long, and reading is difficult. By correcting the double-vision or focusing problem, you remove the visual barrier. Of course, reading instruction still needs to occur.

I hope this helps to clarify our stance. Thanks for taking the time to respond!

Eoin Shanahan

says:

Well posted, Maria.
The Special Education Centre of Macquarie University in Sydney issued the following briefing in 2012.
Behavioural optometrists claim that problems with the visual system can contribute to difficulties with learning, reading, writing, sports activities and attending. They claim that they take an “holistic approach” to vision and
that visual difficulties may be present despite healthy eyes and no sight problems. Behavioural optometrists do not claim to cure dyspraxia developmental co-ordination disorder or DCD), reading difficulties, ADD/ADHD or other disorders, but they do claim that they can alleviate difficulties. After initial assessment, a behavioural optometrist will typically prescribe a course of treatment. They use a variety of treatments that may include the use of lenses and prisms, the use of coloured lenses or overlays, and vision therapy. Vision therapy might include exercises and activities to be completed on a computer or with pencil and paper. Children would typically be asked to complete daily activities at home, with regular visits to the behavioural optometrist. A course of treatment may be for 8-12 weeks.

The theoretical rationale – how does it work?
Vision therapy is claimed to improve the functioning of the visual system. They claim that the visual system may not have developed appropriately, and remediation will reduce difficulties. Activities are claimed to improve eye tracking, visual processing speed, visual sequential memory, visual discrimination, visual motor integration, visual spatial skills and rapid naming.

What does the research say? What is the evidence for its efficacy?
There are many areas where claims are made for the benefits of behavioural optometry but research evidence for efficacy, particularly from randomised controlled trials, is singularly lacking. Although perceptual problems may contribute to dyspraxia/DCD, there is little evidence that skills improve as a result of vision therapy. Again, children with ADD/ADHD may have visual anomalies, but there is no evidence that vision difficulties are causal or that behavioural optometry is beneficial. Moreover, there is clear consensus among reading scientists that visual perception difficulties are rarely critical in reading difficulties and that the problem is typically more to do with language, specifically phonological processing. There is no evidence to support the use of vision therapy for reading difficulties. Finally, there is no evidence that vision therapy improves sporting performance.

Conclusions
Although children with co-ordination, reading, writing and other difficulties should have their vision assessed to ensure that they do not have acuity or refractive problems (or similar problems), additional assessment by behavioural optometrists is not recommended. There is a clear need for further quality research to test the claims made by behavioural optometrists. Until these claims are tested, and clear evidence for efficacy is available, behavioural optometry cannot be recommended.

Tonya

says:

How do you find some one to test for these type of vision problems? Do these problems have to affect all areas of learning or can they only affect reading?

Jen

says:

HI, Tonya. My daughter only struggled with reading, which can affect everything else. Math, comprehension of stories, vocabulary, were all fine. The actual act of reading words was where she was struggling. I asked my pediatrician and she recommended I call the school district for testing. I contacted a local homeschool group and found out how some of them went about testing for reading problems. One mother mentioned vision therapy. Her son’s story sounded just like my daughter’s story. She recommended a vision therapist in our area. We went in for a comprehensive test that included a regular vision test and then testing for other vision problems. While watching the testing, I could see the problems they were finding. They diagnosed her with convergence insufficiency and she went through three rounds of therapy. The improvement was amazing. Both in reading and in self-esteem.

Merry

says: Customer Service

Hi Tonya,

The links in the green box at the bottom of the post can help you with finding a practitioner in your area, and also will have more information on how vision issues like convergence insufficiency can impact a child.

Ans

says:

Enjoyed reading, Great post! My son has an eye doctor appointment next week.

Jen

says:

HI. Just a note. The eye doctor will not diagnose vision problems such as these. My daughter goes to the eye doctor faithfully, every year, but nothing was detected. Not until we looked into vision therapy did we find out she had convergence insufficiency.

Sherry

says:

Our youngest has vision problems, so this was encouraging!

Jen

says:

My daughter was tested at age 10 and found out that she had vision problems as well. Vision therapy changed everything for her! Now with therapy and all about spelling and all about reading, she is reading!!!!

Robin E.

says: Customer Service

Jen,
Thank you for sharing your daughter success with reading with us here!

Allison B.

says:

This is good information. Thank you 😊

Liz

says:

This is a very helpful and sweet story. Thank you for sharing!

Tracey

says:

Great article
We are having our son tested soon.

Nancy Ball

says:

This was so very helpful. My son struggles and complains we’ve had eyes checked they are fine but now maybe I can look to see if there is something else. Thank you.

michelle lee

says:

We were using AAR 1 when my daughter( 7) complained a few times about not being able to see the letters. Sure enough she turned out to be far sighted.

JR

says:

Insurance often does not cover vision therapy, and the therapy IS expensive. However, it is a necessary therapy for children, and adults, with vision issues. The problem doesn’t just “go away” if ignored. Quality therapy is not money wasted but an investment in our children’s future success. Often even “quality” ophthalmologists don’t recognize the problem and/or don’t have the insight as to what other tests they could do in order to discern less apparent issues. In addition, often voiced concern regarding vision will be viewed as an “overly uptight parent.”

On our visual journey, we contacted multiple doctors (even treated with one who wasn’t so great) and paid for additional evaluations before we finally found an ophthalmologist an hour from our home, who was excellent and truly knew what she was looking for, and what to do about it.

A doctor who is really about accomplishing something, not simply about raking in cash through easy therapy, will work with a child in the office, and be willing to teach parents how to help their children at home. Vision therapy is not complicated, but it has to be targeted accurately in order to gain the intended effect.

Robin E.

says: Customer Service

Thank you for sharing your insights and experiences with vision testing and therapy, JR.

Lisa

says:

This seems to be a very under appreciated problem. Doctors focus on 20/20 vision and pretty much on nothing else. I suspect one of my children might have vision issues, despite 20/20 vision, so I need to have her checked out.

lindsey

says:

so helpful thank you

Brenda

says:

My son was diagnosed with intermittent exotropia, so we went to see an vision therapist. After being tested, he qualified for vision therapy, and will start in May. His prognosis is GOOD, which means it’s very likely that they can help him fix this condition. I went in for the parent-doctor conference this morning to discuss his testing and how vision therapy will help him. So excited to begin this journey towards eye health for my son!

robin fillner

says:

Thanks for sharing!

Desiree

says:

This is such helpful information. Thank you.

Becca

says:

We love AAR and AAS!

Teresa

says:

Vision Therapy is amazing! I just wish it were more affordable. All 5 of my kiddos need it.

Lisa

says:

My son has been through 6 months of intensive Vision Therapy…and we are still struggling. I am wondering if he isn’t dyslexic, but I don’t know where to turn to get that diagnosed. The Vision Therapy doctor has said there could be something else going on in his little brain, but she can’t diagnose that – it will need to be a psychologist (read: another expensive doctor not covered by our insurance plan.) While vision therapy did get us over a small hurdle, it did not “fix” most of my son’s reading issues. I’m feeling lost – and would love to hear what others have done, read, who they have consulted…what next?

Kim

says:

You can request testing from the school. Neuhaus. org is a great resource for more dyslexia information.

Tamara

says:

My son is currently in his 3rd month of vision therapy for Convergence insufficiency. We are seeing progress, but we are certain he is also dyslexic. We asked the school to test him, but their answer was that they don’t diagnose dyslexia. According to our district, there aren’t any other dyslexic children in the district and they have no teachers or supplies for a dyslexic child. We are skipping the $2,000 neuropsychological diagnosis and using the AAR and AAS programs with our son at home (after school and on weekends). There is no reason he needs a diagnosis right now (we may seek it out later so he can use audio books in high school and get more time on the ACT/SAT). A diagnosis will not get my son any more help at school. Check with your district. See what resources are available for your child if you do go out and get a diagnosis – maybe you will find it is worth your money to get a diagnosis now. Maybe you’ll be like us and find out our $2,000 will only get us a report verifying what we already know. Best of luck to you!

Robin E.

says: Customer Service

Tamara,
Thank you for sharing this.

Robin E.

says: Customer Service

Lisa,
Some school districts will test for dyslexia, although others only test to determine if the student is behind or not and won’t determine the cause of the student being behind. It might be beneficial to contact your local school, but it may or may not prove helpful.

One option is to look into dyslexia and see if it seems to fit some of the things you are seeing in your son. We have a Dyslexia Checklist that can get you started. We also have a Dyslexia Resources page with other information you may find helpful.

I hope this gives you some direction to start with. Please let us know if you have further questions.

Brandi Vidrine

says:

Thank you for including resources in your post!

Takia S.

says:

Thanks for this information!

Susan

says:

I have been told by my son’s Occupational Therapist that he probably needs vision therapy and has tracking issues for sure, and probably other issues that they could help me diagnose. He has Sensory Processing Disorder, but our signs of that are proprioceptive seeking and auditory avoiding. We didn’t suspect eye problems. But he is delayed in reading, and does rub his eyes and sit super close to things to see them.

When we looked into vision therapy, nobody around here takes any insurance, so our cost would be completely out of pocket, and well, our pockets are emptied completely every month! We would need financial help to make this happen, but I don’t know about any resources for that.

He is a 6 year old on a preK reading/writing level. In the last month of homeschool, we switched to prereading AAR and PreK Handwriting Without Tears (from trying to push him through a Kindergarten curriculum). I love all the multi-sensory ideas in both curriculums, and the gentle pace it has made him feel successful.

Kim

says:

When my son did therapy, we had to request a gap coverage, since no one does therapy in network. The insurance company reimbursed my cost. My son’s doctor helped make the process simple. I got the COT codes and unit amounts and called and asked for approval. All we had to pay was the copay. Still a little pricey, but not the thousands it would have been. Good luck!

Susan

says:

Thanks for that info!

Robin E.

says: Customer Service

Kim,
Thank you for sharing this!

Heather

says:

WOW! What timing! We have been using AAS/R for 2 years and love it. We recently started VT for my son’s convergence insufficiency and I didn’t know AAL knew about this problem and was already helping him with it! I’m grateful others are learning about these other vision problems. I hope insurance will cover the cost soon too! It is a pricey investment.

Victoria

says:

WoW! What a wealth of information, encouragement! Thank you for sharing!

Debbie

says:

Wow! So much to learn that most of us take for granted. Thanks!

Vanessa

says:

I am a carrier of a vary rare eye disease. This was the first thing that we checked with my daughter when she was having problems reading. We actually need to get her yearly exam done, and my boys too!

Jennifer

says:

A good friend of mine had undiagnosed vision problems and struggled all through school. It wasn’t until she went back to college in her 40’s that a professor suggested she get checked for a rare vision problem. After the diagnosis and resulting help she went from barely passing her classes to making A’s and B’s because it wasn’t such a struggle to read anymore. Her perseverance through it all is amazing and I hope with more awareness todays kids won’t have to struggle their whole lives.

Robin E.

says: Customer Service

Jennifer,
Interesting. I think your friend’s story says a lot about her character, as there are not many people that have struggled with reading their whole lives that would go back to school in their 40s. Her perseverance is amazing indeed!

Patricia Vaughan

says:

My 14 year old is doing vision Therapy and loves it. We are blessed to have found the practice we attend. He did vision therapy from age 6 through 9 with a different practitioner but he was young, didn’t see the reason we were doing it and fought against it. Also, now that he is older he can articulate how difficult it was for him as it was very disorientating. I did see gains, mostly in his coordination, but he still couldn’t read. He finally began to read in his tenth year but still missed words, skipped around the page and the words floated around on him. He could not sit still, read up-side-down and suffered debilitating migraines. I had him reassessed six months ago with another Dr. and he was diagnosed with convergance excess, hypermetropia bilateral (farsightedness) and other irregular eye movements. I sat in on all of his vision therapy sessions (twice a week), I saw what he couldn’t do when he started there and now he can do those exercises so well, and more. His eyes team together now, but his visual perception is still behind, as he perceived his world through eyes that didn’t work together he was receiving mixed messages. His reading level has gone from Grade 8 to Grade 11 and he can focus on academics for longer periods of time now. We’ve spent countless amounts of money, time and effort in many therapies (he has additional issues), and whilst I don’t think there was one “fix” for us, we certainly are not home and dry once vision therapy ends. It is a journey for sure, but we can’t give up on these kids, they depend on us to support them and keep their self esteem intact. I will keep searching and trying with the faith he is gaining in confidence and academics. Thank you for bringing this important topic to light!

Robin E.

says: Customer Service

Patricia,
Thank you so much for sharing your son’s story with us. You hit the nail on the head when you said, “but we can’t give up on these kids.” Exactly! There is rarely an easy fix, but failure is NOT an option so we stay persistent.

Laura Scaife

says:

Thank you so much for taking the time to share your story. Especially the part about the “wobbling words.” My second child has been a struggling reader and complains of “wobbling words” and “her eyes going crazy.” I have had her vision examined and was told there was no problem. I now know I need to have her seen by a specialist…and which type! Thanks again!

Robin E.

says: Customer Service

Laura,
I am very happy to know that this article gave you information that you can act upon to further investigate your child’s needs.

Cathy

says:

Thank you for the helpful links! My daughter also struggles with visual processing difficulties. We did therapy too. I am now able to see students in my own classroom that struggle. I wish I could do more in my classroom or at a school level. Unfortunately many of my students’ families don’t have access to resources or the commitment that is needed to do the home exercises. I have seen the benefits in my own daughter and some of the students that I have referred. Thanks for writing about this issue!

Erika Y

says:

Thanks for sharing! I have never heard of vision therapy.

Angela

says:

Fascinating. I had no idea of some of the other kinds of vision problems.

Erika Y

says:

Thanks for sharing!

Jennifer

says:

My son wasn’t doing as well as I had expected him to with reading in public school. When we started homeschooling, it became readily apparent that he needed glasses! Fixing the vision problem was a game changer in his ability to read.

Robin E.

says: Customer Service

Jennifer,
I’m pleased to hear that you were able to focus in on what your son needed to have success with reading. Great catch!

Anne

says:

Awesome story! Hope your son continues to make progress! May have to come back to this one. Will see if glasses helps for my son as step 1

Cara B

says:

My oldest had several vision therapy sessions when he was 6 to help him with tracking. It made a HUGE difference!

Katy

says:

Thank you for sharing this. Some of my boy’s are in need of vision therapy.

Menke

says:

I am not surprised, as my youngest brother had something similar. He did not have trouble reading (even though he was also diagnosed with minor dyslexia) but his handwriting was outright terrible (and for the most part still is). I believe they told him that he had actually started to read too soon and that this had caused an imbalance in his hand-eye coordination for small motor skills… or something like that. He had to wear glasses for a while in order to correct whatever had gone wrong.

It is a good reminder though, especially as I have now entered the season where my own kids are starting to learn how to read and write. Thanks for sharing!

Bethany Eskro

says:

Thank you for going over this!

Will

says:

My daughter has been in vision therapy and has reading issues. Thus sounds like what we need!

Monique

says:

It is always wonderful to be reminded that you should always keep educating yourself for your children. Thank you for the great information.

Mark

says:

Thank you for these resources. Its truly respectable to take the time to help others and I learned a lot

Blakely

says:

My daughter often loves the book around a lot and skips simple words. I’ve wondered if her vision is an issue at all!

Robin E.

says: Customer Service

Blakely,
Skipping small words can be a sign of vision issues, but it can also be related to other causes. Our blog post on skipping small words may help.

Michelle Kiles

says:

This is an excellent blog. So many sensory issues can effect learning. Thank you for sharing!

Susanne

says:

My son is scheduled to see an eye dr. before starting kindergarten. He doesn’t always focus both eyes straight at the same time.

Jill

says:

My oldest son said he wanted to be a better speller. After trying other programs that didn’t help, we were encouraged to try All About Spelling. We have learned so much together and I get “How do you spell…..” much lesx often.

Robin E.

says: Customer Service

Jill,
I love how you put it, “We have learned so much together…” Thanks for sharing this.

Sarah

says:

This is one of the reasons we use “All About Spelling”. My daughter, age 11, has always struggled with spelling and reading. After trying a couple different curriculums with limited success, I found “All about Spelling and Reading”. As a certified special educator, I believed the hands on approach to learning would support her challenges. After a year into the program, my daughter was referred to a vision specialist by our eye doctor and now we finally understand the reason for her struggle. The office staff at our Vision Therapy Clinic wanted to know all about our “Spelling and Reading” program that is working for her. We are passing around the information!

Robin E.

says: Customer Service

Sarah,
Thank you for sharing your daughter’s story. I was especially interested to hear that your clinic wanted to know more our what you were using for reading and spelling. We are very happy to hear that All About Spelling and All About Reading helped you help her.

Jen coleman

says:

This is very interesting. I sometimes suspect this in my child.

Kristen

says:

Been worried about this with our 2nd grader for a bit. This eases my worries! Thank you! We are new to AAR and are enjoying it!

Caroline L

says:

What an encouraging post. We have been enjoying AAR and AAS with my 5, 7, and 9 year old… Wish I had such a wondeful curriculum when my older children were learning to read.

Lisa B

says:

This is an EXCELLENT POST! As a private tutor and educational therapist, it seems that most of the students referred to me for educational help need VISION help. There are 5 kinds of vision professionals and much variety in theory and philosophy within each of those specialties. I refer to a behavioral optometrist, certified by COVD, and set up to provide vision therapy. Having received vision therapy as an adult, I know that this intervention changes lives – not only academically, but physically, and socially as well. I suggest that parents seek a vision therapist who will train students while they walk, balance and physically move about; the results are so much better and less likely to be lost following treatment. Please do not think that a series of pencil and paper tasks will correct the problem. THANK YOU SO MUCH FOR SHARING THIS SUGGESTION WITH YOUR READERS!

Robin E.

says: Customer Service

Lisa,
Thank you for sharing your experiences with vision therapy as an adult and with the students you tutor!

Thank you so much for posting this! My sons just finished up vision therapy, and their reading/handwriting/balance/co-ordination are so much better!

Robin E.

says: Customer Service

Dianna,
I am pleased to hear your sons are doing so well!

Mary

says:

This is very helpful. Thank you for posting this!

Eoin Shanahan

says:

I have had a look at the research and you may be interested in reading some extracts. [Ophthalmologists and Pediatricians are members of the medical profession (doctors) – Optometrists are not].

The following link on the website of the American Association for Pediatric Ophthalmology and Strabismus (August 2016) clarifies their stance on vision therapy and behavioural optometry.

https://www.aapos.org/terms/conditions/108

The American Academy of Pediatrics has very definite opinions on these matters, as evidenced in the following extracts from Joint Technical Report—Learning Disabilities, Dyslexia, and Vision:

“Despite the continued lack of definitive evidence of its effectiveness, vision training for improving visual efficiency and visual processing has been widely used, at great cost, over the last half-century in many thousands of children with learning disabilities….

Scientific evidence does not support the claims that visual training, muscle exercises, ocular pursuit-and-tracking exercises, behavioral/perceptual vision
therapy, training glasses, prisms, and colored lenses and filters are effective direct or indirect treatments for learning disabilities. There is no valid evidence that children who participate in vision therapy are more responsive to educational instruction than children who do not participate. The reported benefits of vision therapy, including nonspecific gains in reading ability, can often be explained by the placebo effect, increased time and attention given to students who are poor readers, maturation changes, or the traditional educational remedial techniques with which they are usually combined…

Visual problems do not cause dyslexia. Scientific evidence does not support the efficacy of eye exercises, behavioral/perceptual vision therapy, training glasses, or special tinted filters or lenses in improving the long-term educational performance in these complex pediatric neurocognitive conditions. Recommendations for multidisciplinary evaluation and management must be based on evidence of proven effectiveness demonstrated by objective scientific methodology. It is important that any therapy for learning disabilities be scientifically established to be valid before it can be recommended for treatment. Because vision therapy is not evidence based, it cannot be advocated.”

LEAD AUTHORS: Sheryl M. Handler, MD – American Academy of Ophthalmology and Learning Disabilities Subcommittee, AAP Section on Ophthalmology
Walter M. Fierson, MD – Chairperson, Learning Disabilities.

I have much more similar research if required.

Angela

says:

I don’t know what your angle is in posting this “research,” but this is a slap in the face to the parent in the article whose son has SUCCEEDED where all other avenues have failed him. It is also insulting to all other parents who have watched their kids struggle to read, have terribly low self-esteem, and are laughed at because they cannot read at “grade level.” It is an affront to all the parents who have spent hundreds, even thousands of dollars on tests, curricula, tutors, programs; who have spent countless hours themselves trying to teach their own child unsuccessfully to read; who have begged, bargained, pleaded with God to allow their child to “catch up” with others their age. And it is most definitely an insult to the children who simply and desperately want to read but can’t. The research and “medical professionals” can say what they want, but a mom and dad who have witnessed their child read because of vision therapy will tell you it is not quackery. It works!

Lena

says:

My son was tested by a developmental optometrist, and he did have a significant, demonstrable convergence issue. It explained, for example, why, when he tried to write, it was as if he couldn’t even see the lines. In short: He couldn’t. At a cost of around $3000 (not covered by insurance), we completed the vision therapy recommended by the optometrist. My then-7yo son … hated it, and the results were limited. I really think he just wasn’t ready for it at the time, to be honest. In fairness to the optometrist, we were just on the cusp of beginning to understand my son’s multiple burgeoning needs, visual convergence being only one of them. Another was sensory integration issues that limited his ability to handle being in the car for long periods of time — which we really did not understand; we thought he was just given to tantrums — and the optometrist was more than an hour away. Anyway, I agree that there are no magic solutions, and when a child has multiple needs (as many struggling readers do), it borders on irresponsible to imply that “fixing” a vision problem will “fix” all your child’s reading and learning issues. I will say that, three years later, my son is finally starting to improve across academic areas, but it is not clear how far he will go nor if he will ever function on grade level. We do daily vision, auditory and writing exercises as part of his academic work (on our own), and have been told by several professionals (OT, Clinical Social Worker, Educational Specialist) that they are making a big difference for him. So I really do think there is something to it, even if the therapy per se really didn’t work out for him directly. I just wish it wasn’t the *first* thing we tried, because I suspect it would’ve been much more effective for him if we’d had a better handle on the broader spectrum of his needs before trying vision therapy.

Merry

says: Customer Service

Thank you for sharing your difficult journey, Lena. It’s heart-breaking when we see our children struggle and hope we’ve found “the solution,” only to discover it’s just another layer of difficulty, like peeling an onion. Many of us here have children who have struggled with various learning difficulties, and we know it’s extremely hard work for both parent and child–there are no easy answers. We are committed to helping in any way we can–we have articles on our site on a variety of learning disabilities, and provide lifetime support for our programs–email any time with questions!

Kudos to you on working so diligently to help your son. I know it’s a long road, but what an encouragement that the practitioners in your son’s life are seeing your work pay off. Don’t give up! (If you’ve never seen Marie’s video about their story, Failure Is Not an Option, I highly recommend checking that out.)

Megan

says:

Unfortunately, some of the best treatments for many diagnoses are not “evidence based” or sanctioned by “the (medical) powers that be”. All the more reason to try them, in my opinion.

Marie Rippel

says: Customer Service

Thanks for commenting, Eoin. I agree 100% that “visual problems do not cause dyslexia.” I also agree that vision therapy is not an appropriate treatment for learning disabilities.

The article you linked to supports the stance of Elizabeth (our featured “Real Mom”), as well as the stance of All About Learning Press. Her son was successfully treated for convergence and focusing deficiencies, and I’m extremely grateful that such therapy exists. Elizabeth’s son has multiple issues, including auditory processing disorder, sensory integration disorders, dyspraxia, and autism. Vision therapy was never seen as a solution for his other unrelated disabilities–but it did help his substantial focusing problems.

Here are several quotes from the article you linked to:
– “Orthoptic eye exercises as prescribed by pediatric ophthalmologists, orthoptists, and optometrists can be beneficial in the treatment of symptomatic convergence insufficiency.”

– “It is appropriate to have a through eye examination to ensure that there are no eye or vision disorders by an ophthalmologist with experience in the assessment and treatment of children because some of these children may also have a treatable visual problem along with their primary reading or learning problem. Refractive errors may make it difficult to see the board or to read. Treatable ocular conditions include strabismus, amblyopia, convergence and/or focusing deficiencies, and refractive errors.”

Thanks again for posting!

Eoin Shanahan

says:

Thank you Marie.
The International Dyslexia Association writes:
Referral for color overlays, tinted lenses, eye tracking, and visual information processing interventions are not supported by research. The fact that vision therapies (and therapies based on visual information processing) continue to proliferate despite decades of research reflects in part the degree to which parents are desperate to remediate reading problems. In addition, on the surface, such interventions can be implemented relatively easily, and they promise success that seems supported by the measurable improvements in the specific task being trained. Unfortunately, the continued availability of these kinds of interventions reflects the more general problem of how evidence is adjudicated in education. Strong claims about efficacy are often accepted on the basis of anecdote, personal experience, and poorly controlled experiments
(Perspectives on Language and Literacy Winter 2011)

The latest magazine of the Royal Australian and New Zealand College of Ophthamologists (RANZCO) includes an excellent article on the role of the Ophthamologist in dyslexia. Starting on p55, it points out that:

“The so-called abnormal eye movements observed in dyslexic children are the result, not the cause, of reading difficulty.
“Eye exercises have been shown to improve convergence insufficiency, help develop fine stereoscopic skills and improve visual field recordings after brain damage. There is no clear scientific evidence published in mainstream literature to support the use of eye exercises in other conditions including learning disabilities and dyslexia.
“There is no evidence that children participating in vision therapy are more responsive to education instruction than children who do not participate.
“The efficacy of Irlen tinted lenses is based on anecdotal evidence. Controlled trials have shown no difference in outcomes in children given tinted lenses.
“Therapies including the Lawson anti-suppression device, syntonics, applied kinesiology, megavitamins and mega oils, the use of trace elements and psychostimulants have all been claimed to improve the reading of dyslexics. The Lawson anti-suppression device, as used in the Alison Lawson clinics, offers a quick fix at stimulating the visual cortex. This treatment is based on a false premise that the visual cortex is responsible for reading. There are no controlled trials to support the claims of efficacy of any of the fringe therapies. Their claim to success is based on anecdotal evidence.
“Eye professionals should not be considered the expert in reading education. A variety of trained specialists are available for children in need of help and there is an enormous body of literature regarding reading and learning from the educational perspective. Effective intervention remediates the underlying problem in phonemic awareness.”

Marie Rippel

says: Customer Service

Thanks again for commenting, Eion. I think you may have misunderstood the purpose of the blog post. We aren’t advocating this as a cure for dyslexia or other learning disabilities – it is a treatment for visual problems such as convergence and/or focusing deficiencies.

You included this quote:

“Eye exercises have been shown to improve convergence insufficiency, help develop fine stereoscopic skills and improve visual field recordings after brain damage. There is no clear scientific evidence published in mainstream literature to support the use of eye exercises in other conditions including learning disabilities and dyslexia.”

We are in full agreement–eye exercises improve convergence insufficiency.
Eye exercises will not treat dyslexia or other learning disabilities.

I hope this helps!

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