So You're Thinking About Vision Therapy? - Página 2

Vision TrainingAdvocates of this approach believe that “when a child struggles to read, write or fully participate in school, a visually- related learning disability could be the cause.” In some instances, the entire evaluation takes place in an optometrist’s office. In other instances, the evaluation includes testing by other professionals who assess intelligence, information processing, speech/ language development, academic achievement, attention skills, and social/emotional dynamics.

Visual therapy approaches programs vary widely, but almost always include eye exercises and what is referred to as perceptual training. Behavioral optometrists are the ones who offer this therapy, with treatments involving in-office visits and exercises to do at home, and often, the prescription of low-power lenses. Even when children are found to have good eye health, vision therapists report that those who struggle with learning may have subtle difficulties in such areas as:

• Sensitivity to certain light frequencies
• Eye movements and fixation
• Visual tracking (coordination of eye movements)
• Visual accommodation (eyes focusing)
• Binocular vision (eye teaming)
• Convergence (eyes aiming properly and working together at the same levels of accuracy and performance for different distances)
• Problems with sustaining visual attention, integration of vision with hand and body movements and mild muscle irregularities

According to this approach, these weaknesses can result in:

• Headaches, eye strain and poor posture
• Problems with reading, spelling, attention, hyperactivity, coordination, and learning in general
• Trouble with sports
• Low motivation and trouble working independently
• Impaired potential for achievement

Ophthalmologists and behavioral optometrists disagree about whether vision therapy is beneficial for individuals with LD and AD/HD. The American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology all say that there is insufficient evidence to recommend vision therapy as an effective treatment.

With regard to dyslexia, decades of research, including more recent neuroimaging studies, show us that reading is not a vision problem but rather a problem with language processing that takes place in highly specialized ways in the brain. We are lacking the kind of “proof” needed to determine whether vision therapy can result in any benefit for those with LD or AD/HD, and if so, for which individuals these treatments are likely to be effective.

The bottom line about vision therapy: The theoretic basis of vision therapy (for individuals with LD and AD/HD) does not fit with our scientific understanding of these disorders. While vision therapy seems like a logical approach, is not “invasive” and doesn’t demand that a child be labeled with a disability to receive treatment, it has not been proven to be any more effective than engaging a learning specialist to deliver tutoring or coaching that is targeted to specific areas of need. Vision therapy may not hurt but it may not help; it is often expensive, demands many weeks or months of treatment, and is not a reimbursable expense under most insurance plans. Even if vision therapy does decrease fatigue while reading, and encourage increased time on task because of reduced eye strain, there is no scientific evidence to prove that vision therapy will improve academic performance.