Grade 1 student Alicia rushed through her work, handed the incorrectly-completed sheet in to her teacher, then promptly went over to another student and poured water on her head. It was just one of the many incidents that prompted a phone call home to her mom, Nadine Pyatt, last year. Alicia was also behind her grade level in reading, had difficulty printing and spelling, and was extremely clumsy, constantly falling on the first step in their staircase at home. Her teachers complained she had a short attention span. “I thought for sure we were dealing with ADHD,” says her mom. So sure, in fact, that she had booked an appointment with Alicia’s doctor to discuss putting her on medication.
But a serendipitous visit to their family optometrist put the Pyatt’s on another course. He suggested she see another optometrist in his clinic who was doing something called vision therapy (or neuro-visual therapy). That optometrist was Kiran Ramesh, who explains vision therapy can help many kids whose visual system is not performing as it should be. “Vision therapy is a set of exercises that we do to help to retrain the brain and the eyes on how to communicate better,” she says. Ramesh says that while typical eye exams check eyesight, a neuro-visual assessment will look deeper into the visual system, and examine things like how well the eyes focus together and whether they are pointing at the same place at the same time.
After a two-and-a-half hour assessment, Ramesh recommended Alicia go through 45 weeks of visual therapy, at a fairly hefty price tag–just over $5,000.
Practitioners of vision therapy count people who have had concussions, suffered strokes and even athletes who want to improve their performance among their clients. When it comes to kids, proponents say visual therapy can help kids dealing with the gamut of learning and behavioural issues found in the modern classroom, like ADHD, learning disabilities and even autism. The idea is that if the kid isn’t focusing properly, is seeing double, or has trouble moving their eyes from far to near, or across a page, attention, behaviour and grades are bound to suffer.
“We don’t claim to treat ADHD, none of us optometrists would ever say that,” says Ramesh. But she says a lot of the symptoms of ADHD are the same as those experienced by someone who has an underdeveloped visual system. “These kids are all over the place, they are using their hands a lot, they’re very tactile. They are trying to use their other senses to take control, because their visual system isn’t working.” She says once they treat the underlying visual problems, many parents find their kids don’t act out as much.
But you’ll be hard-pressed to find a doctor or psychologist who recommends vision therapy for these complicated, multi-faceted disorders. Even within the optometry field, many practitioners don’t believe in vision therapy–something Ramesh blames on a lack of information and understanding. In 2014, The American Academy of Paediatrics, along with a number of ophthalmologist associations, issued a joint statement on vision therapy, learning disabilities, and dyslexia. “Vision problems can interfere with the process of learning; however, vision problems are not the cause of primary dyslexia or learning disabilities,” they said, adding, “Scientific evidence does not support the efficacy of eye exercises, behavioral vision therapy, or special tinted filters or lenses for improving the long-term educational performance in these complex pediatric neurocognitive conditions.”
For their part, the Pyatt’s were skeptical that the exercises Alicia was doing at home, like having her track a tennis ball hanging on a shoelace with her eyes, or reading letters in a random order on a chart at different distances, were doing any good. “But we figured, we’ve invested this money, we’d better keep doing it.” Their tune changed after about week 18 or 19. “I noticed a huge change in her behaviour,” says Pyatt. Alicia wasn’t falling down as much and her schoolwork started to improve. By week 30, her grades had gone up and the behaviour issues in the classroom had all but disappeared. “She was a different kid,” says her mom. The visual therapy even corrected a tilt in her neck that had been present since she was a baby. “Apparently, her visual plane was off.” Now in Grade 2, Alicia is at the top of her class.
Kirsten North, an optometrist in Ottawa and the policy and research consultant for the Canadian Association of Optometrists, says parents should get their kids’ eyes checked regularly, and mention any difficulties their children are experiencing in school to their optometrist. Not all will probe past the typical 20/20 eyesight test, though. If you’re looking for vision therapy, you may have to seek out a behavioural optometrist, or someone with extra training in this area.
The Pyatts, once skeptics, are now champions of vision therapy. They were so pleased with Alicia’s success that they had their older daughter, Naomi, tested this year. She was struggling in math, had difficulties copying things off the board, and was a poor speller. She is now nearing the end of her 35 week treatment, and her school work has improved. Pyatt says, thanks to vision therapy, her kids can sit and focus longer, can block out distractions and are more dedicated to their school work and piano practice. “I think all kids should go through this, because I honestly think my children have an advantage now,” says Pyatt.
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