My Vision for Twenty Children

Everyone feels the the tragedy at Sandy Hook Elementary School a little more deeply because the victims include 20 children.  Most of us have devoted our professional lives to helping children.  This is not the place to write of my feelings about the tragedy, or my thoughts about gun control.  But perhaps it is a place to for all of us to share our vision.  Vision is output, it is what we do.   My vision is to build a better world.  My vision is not very specific, at least not now; not today.  Here is what I will do.  What is your vision?  What will you DO to remember and honor these children?

For Charlotte, I will question.
For Daniel, I will read.
For Olivia I will speak.
For Josephine, I will collaborate.
For Ana, I will share.
For Dylan I will shine a light.
For Madeleine, I will write.
For Catherine, I will learn.
For Chase, I will create.
For Jesse, I will challenge others.
For James, I will get it done.
For Grace, I will lend a hand.
For Emilie, I will make it count.
For Jack, I will vote.
For Noah, I will tell you why.
For Caroline, I will educate.
For Jessica, I will think twice.
For Avielle, I will repair what is broken..
For Benjamin, I will find what is missing.
For Allison, I will defend.
And for all the children, and Rachel, Dawn, Ann Marie, Lauren, Mary and Victoria, I will love.

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The Splash – From Ripples to Waves

Check out this video highlighting a child that has been helped with vision therapy.  In the feature story, the child says he went from C’s and D’s to A’s and B’s in a matter of months.  To me it is another great example of how these developmental life altering vision problems can impact school performance and beyond.

This child’s developmental optometrist is Dr. Carol Scott.  She is the reason I am a developmental optometrist today.  During my first year of optometry school, Dr. Scott came and lectured about children she was working with.  She talked with passion about how so many of these smart, intelligent children were struggling in school due to treatable vision problems.  She talked about the profound impact treating these vision problems had on these children – in many instances, completely altering the trajectory of their lives.  Unfortunately, in our society,  if you cannot read well and therefore cannot perform well in school, so many doors quickly close to your future.  I knew during that lecture that this was the part of my profession I wanted to practice for the rest of my life.

In thinking about that moment, it is amazing how Dr. Carol’s seemingly small act of lecturing to a group of first year optometry students had such a profound impact on my life.  Before attending her lecture, I had considered vision therapy to be one of the last things I wanted to do in my future practice.  Now as a developmental optometrist I see the lives of children change everyday.

And so it is with vision therapy.  The way we will reach the many people who can benefit from developmental optometry  will be the accumulation of many little ripples.  The ever-growing number of lives affected and the ever-mounting body of evidence supporting vision therapy are becoming the waves that will bring our brand of optometry to the mainland.

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The Splash – Persistent Parents

Our guest blogger this month, Carrie Hall,  is one of the very talented vision therapists at my practice. She brings a unique perspective to the blog since she works with patients every week often times for many months.  Because of this,  she often gets to know the patients and their families on a very personal level and truly gets to know the struggles, trials, and triumphs patients go through.  At the conclusion of COVD’s National Vision and Learning month, I think her perspective into one of our patients is a perfect addition to what has been a great highlight of many inspiring vision therapy success stories.

As a vision therapist, I often see a theme among the parents that I encounter. Though they are of various ages, personalities, beliefs and styles, they often share one certain characteristic that sets them apart as vision therapy parents. They are incredibly persistent. They have been told many times in their lives that their children may not be capable of certain things. Perhaps by a doctor intending to give them a realistic expectation of the future, or perhaps by a teacher who is frustrated by a lack of success in their child. Whatever the source, I encounter parent after parent who has been informed that their child will not be capable of a certain level of ability, be it athletic,  academic, or just general life skill development.

Lynn was one such parent. Her daughter Shelby was simply not blooming in school like her older sister had. Reading was inexplicably difficult for this 8 year-old. Always a fight, often involving tears, Shelby simply would not take to reading. Lynn was baffled. Shelby was obviously bright and determined, a spunky and enthusiastic girl. It just didn’t add up. The pieces did not fit. Her eye doctors confirmed that Shelby’s vision was fine. She had 20/20 acuity, so the only reason why she shouldn’t be learning to read was if she simply wasn’t as smart as Lynn thought.
Perhaps some parents are more inclined to take the words of professionals at face value than others. Perhaps some parents simply refuse to be satisfied with an underwhelming determination of their children’s potential. Whatever is the mitigating factor, Lynn could not and would not be satisfied with this evaluation of her daughter. She persisted in her search. When she eventually found Washington Vision Therapy Center whose symptom checklist of vision-related learning problems read like a specific description of Shelby’s struggles, Lynn knew she had found her answer. When confronted with the financial strain that therapy would mean for her family, her persistence did not waiver. She would make whatever sacrifices were necessary: she would ensure her daughter’s chances for success in school and life no matter what.
Maybe persistence is a genetic trait as well. I certainly saw the same attributes in little Shelby that her mother demonstrated. Months after beginning therapy, after countless lifesaver cards and hart charts, Shelby was burnt out with it all. Who can blame her though? When the goal of all the work is just to get better at doing homework, it hardly seems a fair thing to ask of a girl of 8 who would rather be playing outside than getting better at reading any day of the week.
But like I said, maybe persistence is a genetic trait. Or perhaps it’s more nurture than nature. Whatever the case, Shelby persevered. Not only did she make it through therapy, she did great at it. She learned to be able to coordinate the use her two eyes like the best of them by the time it was all said and done. She and her mother developed a balanced working relationship in regards to this specific area in order to attack vision therapy head-on and accomplish every last bit of what Dr. Winters wanted to see from her clinically. Neither one of them would quit. Lynn pushed Shelby, and Shelby pushed right back in order to finish well. That little girl was the definition of persistence.
It’s the characteristic that marks out the parents, and the patients as well, for success. They are all up against diagnoses and school evaluations that make the future look bleak. They have been told repeatedly that they can’t, that they won’t. But they refuse to listen. Little fighters, they are, coming in and out of our offices defying the odds stacked up against them.
The other day, Shelby came up to her mother after doing some reading and said, “You know Mom, I think I like this reading thing.”  She is now at grade level in reading.  That is the payoff for any persistent mother.  Lynn has continue to fight to get Shelby’s story of hard work and persistence out to the public and she is now being featured on COVD for National Children’s Vision and Learning month. http://www.cisionwire.com/college-of-optometrists-in-vision-development/r/mom-of-struggling-reader-finds-help-and-speaks-out-for-college-of-optometrists-in-vision-development,c9283372 Imagine that. A homeshooling mom from Yakima, Washington who believed her child’s struggles with reading were more than a resistant attitude or just that her daughter wasn’t smart enough. Persistence is a powerful thing.

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Optometry & Vision Development Volume 43 Number 1 Now Online

Editorials

     Single Malt Scotch and Developmental Optometry

by Dominick M. Maino, OD, MEd, FAAO, FCOVD-A, Editor

     Lost in Space

Sidney Groffman, OD, MA, FCOVD

    Articles

     Evidence Based Medicine and CAM: A Review

by Dominick M. Maino, OD, MEd, FAAO, FCOVD-A

Reverse-Engineering of Hyperopic Anisometropic Refractive Amblyopia

by Leonard J. Press, OD, FAAO, FCOVD; Daniel J. Press, OD, FAAO, FCOVD

Dyslexia: An overview

SO Wajuihian,a BSc(Hons)Optom OD(Benin) MOptom(UKZN) PGCertMod L/ Vision(City Univ London) and KS Naidoo,a,b BSc BOptom(UDW) MPH(Temple) OD(PCO) PhD(UNSW)

Literature Review

Current Eye & Vision Science Literature

Review by David A. Goss, OD, PhD, FAAO, FCOVD-A

Book Review

Ocular Therapeutics Handbook, A Clinical Manual, 3rd Edition

Review by Christine L. Allison, OD, FAAO, FCOVD

Practice Management

Computer Tips and Tricks

by Christopher Grant

NewsMakers

Optometry & Vision Development (OVD) is the official journal of the

College of Optometrists in Vision Development.   Read OVD 43-1 Online

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What is Dyslexia?

The following editorial appeared in Visions, which is COVD’s newsletter.  It was written by Dr. David Damari who is presently serving as COVD’s President. 

There has been some interest in the Kelley King Heyworth article in the December article in Parents magazine, “Outsmarting Dyslexia.” Your patients or their parents may be asking some hard questions based on this statement in the article—“Because dyslexia is a language disorder and not a visual problem, experts say there is no evidence that doing vision exercises or wearing special training lenses with colored lenses can benefit kids – even though there are companies that sell them.”  This statement is fraught with errors (I discuss them one by one below), as is the American Academy of Pediatrics political statement on “Dyslexia and Vision” from 2009, but it may raise questions. Here are my suggestions for a reasoned, literature-based response. These suggestions are based on my opinions formed from keeping up on the extensive literature in vision disorders and learning problems; they are not to be taken as official COVD policy.

As is my wont, I will start with my most controversial suggestion.  Our profession should stop using the term dyslexia: I would strongly recommend that we stopusing this term immediately. Why? Because here is how Shaywitz defines the word dyslexia in the December article in Parents: “the learning disability that prevents children from reading and spelling with ease and accuracy.” As everyone (and I do mean everyone) knows, there are a host of disabilities and disorders – learning, visual, auditory, mental, or emotional – that could cause difficulties with reading. The term therefore has no useful meaning; that is, labeling a child as dyslexic does nothingtoward improving that child’s life. For evidence, look no further than the article’s suggestions for treatment of children labeled as dyslexic.  None of the recommended “treatments” have been shown to improve reading to average levels in well-designed, long-term studies, and the remaining suggestions are accommodations, not solutions. Note that the article describes these measures as “methods that have been scientifically studied,” NOT as scientifically proven effective.  As an added irony, the Rave-O and Orton-Gillingham systems mentioned as possible management have elements of vision therapy included to improve the orthographic processing aspects of reading acquisition.

Dyslexia is a word that has been used against our profession time after time. It can be used this way because almost every writer who uses the term uses it broadly to meanany problem with reading but then conflates “dyslexia” with phonological processing disorder.  The logic of their argument then runs like this — dyslexia is any problemwith reading, the reading problems we have studied are phonological processing disorders, phonological processing disorders are language disorders, therefore vision has nothing to do with reading problems. When we use the term dyslexia, we only aid this flawed syllogism. Let’s not. But if you do use the word dyslexia, please be very clear about what you mean by it, and contrast your definition with how others misuse that term.

Continue to aid patients toward a useful diagnosis: If the patient has a binocular, accommodative, or other ocular motor dysfunction, find it and call it what it is. If he has a visual information processing disorder, find it and call it what it is. If she has a fine- or gross-motor delay, find it and call it what it is. If it becomes apparent that the problem is more of an auditory information processing or emotional or psychological disorder, refer appropriately.  The management suggested by the Parents article and most other allopathic medicine-based articles on reading problems are usually just variations on the “try harder and take longer” theme. We offer so much more, including good multidisciplinary approaches to care of complex developmental challenges. Don’t be afraid to demonstrate our capabilities. Educate, and provide references: One of my favorite resources on reading is Beginning to Read: Thinking and Learning about Print by Marilyn Jager Adams. This classic book clearly demonstrates the complexity of the reading process, including how visual the act of reading actually is, and how the interplay between visual and verbal abilities is critical to reading acquisition and reading fluency. This is demonstrated in study after study described in the book.

In fact, there is some good in the Heyworth article. As I mentioned, some of the approaches suggested actually include visual interventions, once you investigate them. What I have found in my review of these suggestions, though, is that they are all far less efficient than vision therapy. The study on Rave-O included 70 hours of interventional instruction! And ophthalmology says that our interventions are expensive! My suggestion would be to review the article point by point with your patients, or train your staff to do this.  Use what is good to reinforce the education you have already given your patient, and point out the flaws in the other aspects of the article. During the review, start with the offensive sentence quoted above, which is made easy by these major mistakes: Heyworth uses the term dyslexia to mean phonological processing disorder, she therefore implies that there is no visual process involved in reading even though every study indicates that is incorrect; she does not offer any references or state which experts make the contention that visual exercises don’t help, she ignores the myriad of studies – some of which were funded by the National Eye Institute – that demonstrate that vision therapy does help reading in certain people with reading problems, and she expands the population supposedly not helped to all kids.

The best places to look for good resources on vision and reading are the COVD andOEP websites. These sites offer a host of good, scientific articles on the subject of reading and the impact visual and other disorders can have on the process. Have your patients write to the magazine: If your patients or their parents would like to respond to the article they can do so at mailbag@parents.com.  Please ask them to send a cc to our Executive Director, Pam Happ at phapp@covd.org.

The CITT and brain injury literature have already had a great impact on reducing these types of articles, but as long as optometry remains an independent profession organized medicine will continue to distort what we do, or distort the science on reading, in order to attack vision therapy. A reasoned, patient-centered response will always serve us well when these attacks occur. Count on COVD  to help you with useful resources when discussing these issues with your patients and referral sources.

References:

1. http://tinyurl.com/8xh7vk5

2. www.covd.org

3. www.oepf.org

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Optometry & Vision Development (OVD): Now Online!

Optometry & Vision Development (OVD)

Aurora, OH – The most recent issue of Optometry & Vision Development (OVD), the official journal of the College of Optometrists in Vision Development has research and other articles that may surprise the general population. Did you know that a simple pair of glasses can significantly improve your quality of life? Researcher, Dr. Janis Winters of the Illinois College of Optometry/Illinois Eye Institute, in her paper, Vision Related Quality of Life among Urban Low-Income Black Seniors Participating in an Eye Care Program: Effect after New Spectacle, has shown that poor, elderly, under-represented minorities show a significant and positive change in the individual’s perception of their overall quality of life. When the National Eye Institute Visual Function Questionnaire was given to the participants before and after spectacle wear a significant difference was found with wearing the glasses. The general health, general vision, ocular pain, and distance activities, as well as near activities, social functioning, color vision, peripheral vision, and mental health subscales compared to first administration of the survey were also significantly different when the spectacles were worn. This paper strongly supports how an individual’s quality of life can improve just by wearing glasses. It is unfortunate that so many cannot afford or do not have access to optometric eye and vision care.

In this same issue of OVD an article by Dr. Marie Bodack, Eye and Vision Assessment of Children with Special Needs in an Interdisciplinary School Setting, found that during a three year period of the 273 children with special needs who received eye examinations (about 1/3 of the children had been diagnosed with autism), 3.7% had amblyopia (lazy eye), 6% presented with an eye turn, and 11% had refractive errors (nearsightedness, farsightedness, astigmatism) requiring correction. Approximately 2.5% were also referred for additional care because of ocular health problems. This paper supports the need for all with special needs to have comprehensive eye care by an optometrist.

And finally, Dr. Dominick M. Maino, OVD editor, wrote in his editorial, 3D in the Classroom: See Well, Learn Well, that the American Optometric Association’s (AOA), The 3Ds of 3D Viewing is great advice for the consumer. If you experience the 3Ds of 3D viewing (Discomfort, Dizziness and lack of Depth, when viewing 3D movies, television, video-games and 3D educational content), you should incorporate 2 more Ds – See your Doctor of Optometry, especially one who is a Fellow of the College of Optometrists in Vision Development (COVD). Dr. Maino also emphasized the AOA’s recognition of the vision problems that cause the difficulties often associated with 3D viewing as a major public health issue. Although the research is just now beginning to be conducted in this area, it appears that problems with focusing, eye teaming and eye movement ability all play a role in the discomfort, dizziness and lack of depth experienced by those viewing simulated 3D. These binocular vision dysfunctions often affect not only how we enjoy our free time, but also how well we perform in school. The good news is that if you have these problems, those who belong to the College of Optometrists in Vision Development have vision rehabilitation/therapy programs available so that you can enjoy all that 3D has to offer.

This issue of OVD also has practice management articles, as well as photographs and information about COVD’s annual meeting recently held in Las Vegas.

About Optometry & Vision Development

Optometry & Vision Development (OVD) is a peer-reviewed open access journal indexed in the online Directory of Open Access Journals. The full text of these articles is available free from www.covd.org. OVD is an official publication of the College of Optometrists in Vision Development. Any questions may be addressed to the editor, Dominick M. Maino, OD, MEd, FAAO, FCOVD-A at dmaino@ico.edu or 312-949-7282.

About COVD

The College of Optometrists in Vision Development (COVD) is an international, non-profit optometric membership organization that provides education, evaluation, and board certification programs in behavioral and developmental vision care, optometric vision therapy, and visual rehabilitation. The organization is comprised of doctors of optometry, vision therapists, and other vision specialists. For more information on learning-related vision problems, optometric vision therapy, and COVD please visit www.covd.org or call 888.268.3770. 

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Take Action! Support Comprehensive Eye Examinations for All Children

For years, the American Optometric Association (AOA)  has worked to make healthy vision for children a national health care priority.  Now, after working to ensure that the 2010 health care overhaul recognized pediatric vision care as “essential” and continuing to advocate for our youngest patients as the law is being implemented, we have what could be our last chance to be heard before the Federal government’s proposed essential health benefits regulations are released, possibly before the end of the month.

Please send an e-mail message to Secretary Kathleen Sebelius at the U.S. Department of Health and Human Services (HHS) in support of AOA’s efforts to ensure that direct access to a comprehensive eye exam and follow-up care will be the foundation of the new pediatric vision care essential health benefit.

Of course, it would help our cause even more if you could encourage others who care about healthy vision to also contact the Secretary in this way. The extra effort will be especially important in helping the AOA counter groups representing insurers and organized medicine that have been calling on HHS to establish a limited children’s vision benefit based on screenings.

Here’s a sample message that can be e-mailed to Secretary Sebelius at externalaffairs@hhs.gov today:

Dear Secretary Sebelius: Please ensure that new pediatric vision care essential health benefit is based on the solid foundation of direct access to and coverage for an annual comprehensive eye exam provided by an eye doctor and follow-up care. There should be no barriers created to restrict access to eye care, especially with 1 out of every four school-aged children suffering from a vision problem that could have been effectively treated if properly detected. As you know from your recent meeting with Dr. Dori Carlson, President of the American Optometric Association (AOA), the 2011 School Readiness Summit, which included experts from the U.S. Department of Education and leading national children’s health and education groups looked at the failing system of vision screenings that leaves millions of children and families to deal with learning difficulties and other serious developmental consequences of undiagnosed and untreated vision problems. The School Readiness Summit issued a joint statement signed by more than 30 leading organizations representing doctors, nurses, teachers and parents as well as large employers, supporting “comprehensive eye exams as a foundation for a coordinated and improved approach to addressing children’s vision and eye health issues and as a key element of ensuring school readiness in American children.” Access to quality eye health care is essential to overall good health. I urge you to continue to work with the AOA to ensure that the pediatric vision care essential benefit provides for direct access to comprehensive eye exams and follow-up care children need. Thank you. Sincerely, (Your Name and Address)

Please take action today!

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The Splash – Success after Long Academic Struggle Highlighted on CBS Boston

This is a great article and video done by CBS Boston.  It beautifully highlights some children similar to the ones I see in my office everyday – children that struggle in school due to undiagnosed treatable vision problems.  Dr. John Abondanzza, a Fellow of the College of Optometrists in Vision Development (COVD), does a great job of describing the types of vision problems with which these children are struggling.  The story highlights a child named Jacob, whose mother is a school teacher, and who has struggled in school and with reading.  I especially love the part at the end of the video with little Jacob saying that he now “loves to read.”  Check it out at http://boston.cbslocal.com/2011/10/18/unusual-therapy-helps-kids-struggling-in-school/.  If you feel that you or your child may struggle with a learning-related vision problem and would like to find a developmental optometrist near you, please follow this link.

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The Splash – Elise Brisco, OD, FCOVD on “The Doctors”

There is no better way to make a splash than to be on a hit TV show.  One of our members, Elise Brisco, OD, FCOVD was featured on “The Doctors” a TV show on CBS that highlights medical issues.

I really appreciated the piece because Dr. Brisco was able to highlight some very key issues on vision.  First, she was able to point out how important it is for children to have more than a vision screening by their pediatrician before entering school.  Your child should have an eye examination as early as 6 months of age!  Many people are probably unaware of a nation-wide program called Infantsee.  This program offers an eye exam for children ages 6 months to a year at no charge by hundreds of participating optometrists throughout the nation.  You may ask, “What can you examine at that age? After all, a baby  can’t tell the doctor which is better, one or two.”  There are many important aspects of a child’s eye health and visual development that should be checked at this early age.  Many problems with your child’s vision could be avoided if diagnosis and intervention takes place early.

Finally, I really appreciated how Dr. Brisco discussed her specialty as a developmental optometrist.  She discussed her role in identifying problems with vision development so crucial to good performance in school and sports.  These skills include the ability to track with the eyes, focus the eyes appropriately, and interpret our complex visual world.  Children with problems with vision development often complain of headaches at the end of the school day,  skipping words and lines when they read, reversing letters and words, or taking longer than average to complete assignments in school.  If a child struggles with vision, he or she will struggle in school.  So, make sure your child receives an eye exam before age 1, at 3 years old, and before they enter kindergarten.  After that, if vision is developing on schedule, children should be seen every one to two years as directed by their eye doctor.  To find a developmental optometrist near you, please click on the “locate a doctor” icon on the COVD website, http://www.covd.org or you can follow the link here.

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Congratulations to the Visions of Hope Winners!

Thank you for all the support for the Visions of Hope vision therapy video contest! In total, there were almost 500 votes from all over. There were some very creative videos and we want to thank everyone who put time into making and submitting one!

And the winning video, as announced by Jillian and Robin Benoit, authors of Jillian’s Story, during the Vision and Learning Month Webinar last night:

Congratulations! Your video will show people around the world what vision therapy can do!

Please visit Covd.org to see all the finalists many other wonderful vision therapy success story videos.

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