This blog post earned its author a $500 Travel Grant for the COVD 2018 Annual Meeting! Students and residents–the application period for 2019 is open thru November 30th, 2018! Apply now and see your COVD Family in Kansas City next April 9-13!
by Carissa Hintz (Pacific U ’19)
Dr. Barry Tannen and Dr. Kenneth Ciuffreda are both currently professors specializing in Vision Therapy and binocular vision at SUNY College of Optometry. Dr. Tannen won the A.M. Skeffington Award in 2016 while Dr. Ciuffreda won the award in 2007. In 2007, their article titled “A Proposed Addition To The Standard Protocol for the Visagraph II Eye Movement Recording System” was published in the Journal of Behavioral Optometry. Dr. Ciuffreda is currently doing more research on normal and abnormal oculomotor systems as well as myopia progression. Dr. Tannen’s research has been focused on visually-based reading disabilities. Both professors have published numerous publications in the area of Vision Therapy and are truly experts in this field.
Tannen and Ciuffreda’s co-authored article “A Proposed Addition To The Standard Protocol for the Visagraph II Eye Movement Recording System” begins by describing the different causes of reading problems: language disability or oculomotor dysfunction. In the standard protocol, patients read a paragraph either one grade level below their current grade (since there is a reading problem) or at their current reading grade level as determined by a standardized test. They will read two paragraphs at this level with the first being a practice trial and the second being included in the analysis. The reading level must be low enough that there is 70% comprehension. In their proposed addition to the standard protocol, a third paragraph is read up to 5 grade levels below their current grade level. Anyone below 7th grade will be reading a first grade level and anyone in high school will read at a 5th grade level. Reading comprehension and fluency should have a minimal impact on deficient eye movements.
Fixations, regressions, and reading rate are the most important components of reading eye movements. From these objective measurements a Grade Level Efficiency (GLE) is calculated. The authors split patients up into two categories. Category I includes patients whose GLE is at least two grade levels below their current grade in school. Additionally, their GLEs do not improve at least three grade levels when reading at the reduced grade level. This suggests an oculomotor efficiency based reading problem. Category II includes patients whose GLE is at least two grade levels below their current grade in school and their GLE does improve at least three grade levels when tested at a decreased grade level. This suggests a language based reading problem.
When a patient with a reduced reading level presents in clinic, it is vital that we can differentiate what the cause behind the reading deficiency is. If an oculomotor based problem is the cause of the reading problem, then Vision Therapy can be extremely beneficial. However, in cases of a language based problem, the patient will not benefit from Vision Therapy which is why we must determine what kind of reading problem the patient has before treating. This addition is a simple and fast method to differentiate the cause behind a patient’s decreased reading level and can be extremely beneficial incorporating into clinical practice.