Learning-Related Vision Problems

By: Carla D. Adams, OD, FCOVD

WHAT IS THE VISION TRIANGLE?
Some parents have received a notice that their child needs a complete eye examination.
Parents often take their child to an optometrist and anxiously watch as they are asked to distinguish between lenses. “Which is better -1 or 2?” While a routine exam is a good start it should not be the only test for many students. Since vision and learning are closely linked, problems with vision can often interfere with learning. A routine eye exam alone will not always detect all problems that could affect good vision and thus good learning. Parents should be aware of the vision triangle. There are three types of vision exams, two of which are beyond the routine exam performed by eye doctors. By understanding the vision triangle, it will help avoid frustrations. Parents are armed with options if their child should have academic problems related to how he or she interprets what is being taught, especially if the problems persists with eyeglass.

ROUTINE EYE EXAMS
The first part of the vision triangle is the routine eye exam (just like the example above). Routine eye exams can detect sight imperfections such as near-sighted, far-sighted and astigmatism. Routine exams can also detect more complex problems such as crossed-eyes and lazy eyes. These conditions are often diagnosed during routine eye exams and respond well to eyeglasses and contact lenses. However, if eyeglasses cured all learning related problems, then there would be an overabundance of “A” students. Clear vision or having 20/20 sight is only part of the vision triangle. Unfortunately, most optometrists and ophthalmologists do not proceed further.

FUNCTIONAL VISION
The second part of the vision triangle is centered on functional vision. To read smoothly, a child’s eyes must work well together. This is called binocularity. A depth perception test is one of several tests used to test this skill. Fine eye movements and focusing tests (accuracy, flexibility and stamina) should also be measured. There maybe deficits in this area if your child complains of reading problems such as eye strain, fluctuating vision that will not stay clear, words that float off the page or even headaches. Maybe you even suspect that one of your child’s eyes do not look straight. These types of deficits do not always respond well to eyeglasses or contact lenses which is why some students continue to have problems after a routine exam. Vision therapy is often a good approach to treating such problems. Typically, only a few eye doctors offer therapy. More will be discussed about vision therapy later.

PERCEPTUAL VISION
The third and final part of the vision triangle is perceptual visual testing. Visual perception involves not only the eyes but also the brain and how it interprets and organizes information. This type of disorder surfaces around the age of 6 when children first learn to read. You should consider perceptual problems if your child tends to avoid reading and writing. Children with perceptual problems may reverse letters, print poorly and have trouble learning. Eye glasses alone do not solve perceptual problems. A vision therapy consultation with a pediatric optometrist is advised when learning problems persist.

What is Vision Therapy (V.T.)?
Just as eyeglasses and contact lenses work well to treat sight imperfections (i.e., near sightedness, far sightedness, etc.), functional and perceptual problems are often best treated with vision therapy. It is a type of physical therapy for the eyes. The purpose is to resolve visual problems that interfere with reading and learning. V.T. helps children develop or improve visual skills, read with efficiency and changes how a child processes or
interprets visual information.

Vision therapy is a progressive program of vision exercises or procedures performed under an optometrist’s supervision. The therapy sessions are individualized for each child. The meeting sessions are conducted in-office, once a week.

Following is a list of symptoms that often respond well to vision therapy:

• Blurred or double vision
• Headaches or eye strain
• Crossed eyes or strabismus
• Avoidance or dislike of reading
• Short attention span when reading
• Turning or tilting head to favor one eye
• Rubbing the eyes
• Slow reading speed
• Difficulty remembering what is read
• Omitting or repeating works or confusing letters
• Poor eye-hand coordination
• Losing one’s place while reading or using finger as a guide

For more information regarding vision visit our website:
http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/clinics.html

Editor’s Note:
Dr. Carla Adams is a Developmental Optometrist with a specialization in pediatrics and vision therapy.  Her training includes an emphasis on serving children with special needs.  Dr. Adams is successful in treating children struggling in the classroom as well as children with attention deficit, PDD and autism.  She is a partner of the Easter Seals DuPage & Fox Valley Jayne Shover Center in Elgin.  Learn more about her care via  www.optique-eyecare.com

Tips For Fitness-Focused Activities: Run, Golf, Bike & More

Fitness-focused activities are a great complement to a child’s therapy sessions, and an opportunity to work on therapy goals while also participating in an athletic or recreational activity.  By encouraging involvement in new activities for children of all abilities, they are learning the importance of health and wellness at a young age.

The benefits of fitness-focused activities are far-reaching and can impact a child in many ways.

“We all need to challenge ourselves in order to reach our potential. Our job as therapists is to to see that potential in others and encourage kids to try activities that are outside their comfort zones, so they will truly be all they can be.  Any fitness or recreational activity that interests a child is worth pursuing for the benefits it provides physically as well as emotionally, cognitively and socially.”  – Laura Znajda, PT, C/NDT

Physical Wellness
Children of all abilities should participate in athletic and/or recreational activities as physical fitness is important for ALL.  Physical fitness, as defined by the American Physical Therapy Association, is “a dynamic physical state – comprising of cardiovascular/pulmonary endurance; muscle strength, power, endurance and flexibility; relaxation; and body composition – that allows optimal and efficient performance of daily and leisure activities.”

Just because as individual has a disability, does not mean that physical fitness is any less important.

Building Confidence
Participating in activities outside of a child’s comfort zone help support their emotional development.  Trying something new can be intimidating and challenging. Keep the focus on what makes the activity fun and avoid getting caught up in the competition. Every child approaches new activities differently, but it’s ok to remind them that no one is good at everything.  No one!  You can help temper frustration by celebrating every improvement – no matter how small, and sharing your own example of a time that practice and persistence led to success.

Socialization

Physical activities take many forms and are a great opportunity to increase peer interactions, build friendships and promote health and wellness for the whole family. Embrace a child’s interests and find ways to involve friends and family.

Setting Goals and Staying Motivated
Community based therapy programs and special recreation can target individualized therapy goals. For example, a child with hemiparesis might be working on running in order to use both sides of her body more fluidly, as needed for natural arm swing while walking. A child with sensory processing challenges might be building the strength needed for wall climbing so that he can include this activity in his weekly routine to assist with state regulation.

Motivation comes from finding ways to turn therapy activities into games with friendly competition, involving the whole family and plenty of cheering!

“Therapy activities include dynamic warm-ups which may include animal walks, relay races, and jumping games; a progressive walk/run/bike program building up to increased time running/biking and increased overall distance; client-specific strengthening and agility tasks to target weak muscle groups and to promote the symmetry of movement required to efficiently run or ride a bike; and stretching to promote muscle flexibility and adequately cool our bodies down.”
– Laura Basi, Physical Therapist

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How to Get Involved

Look for organized activities in your community that help bridge the gap between individual therapy and daily life.  Here are some examples of upcoming events at Easter Seals DuPage & Fox Valley that present ways for skills to carry over into home, school and the community.

May 6, 2017              
Run for the Kids: Superhero Hustle 5K Run/2 Mile Walk
Easter Seals DuPage & Fox Valley, Villa Park, IL
This superhero themed run/walk is a family-friendly event for all ages and abilities.
Register here

• Set a goal to run the race, roll or drive the distance in a wheelchair or take a few unassisted steps across the finish line.

  Participants of the Hustle for Health community based therapy program are training to run all 3.1 miles of the race independently.  The Hustle for your Health program began because many children struggled with the 1-mile run in their school P.E. class. A 10-12 week training program is intended to target running pattern and cardiovascular endurance so that participation in community run/walk events becomes a reality.

Rich Howe Photography

Rich Howe Photography

June 9, 2017              
Golf Outing in Partnership with Freedom Golf Association
Cog Hill Golf & Country Club, Lemont, IL
Enjoy 18 holes of golf and help bring the joy of golf to children with disabilities.
Register here

• Try something new by learning the game of golf in an adapted golf clinic.

  The golf clinic welcomes children of all abilities to participate in the fun with adapted clubs and equipment and 1:1 training from expert golf coaches from Freedom Golf Association.

  To register for this golf clinic email spike@eastersealsdfvr.org by May 1.

September 17, 2017               
2nd Annual Bike for the Kids
Easter Seals DuPage & Fox Valley, Elgin, IL
Choose a cycling distance ranging from 12 – 100 miles or participate in a 2.5 mile family ride.  Adapted bicycles and trailers welcome!
Register here

• Go on regular bike rides and train as a family throughout the summer.

All proceeds from these events support infants, children and adults with developmental delays and disabilities at Easter Seals DuPage & Fox Valley. For a complete list of upcoming events visit here.

Interactive Metronome

By: Laura Van Zandt, OTR/L

Did you know that our brains have an “internal clock” that keeps time? This timing is critical for attention, executive functions, speech and language, social skills, reading and other academic skills, motor control and coordination, sensory processing and integration, as well as many other areas common to childhood development.

Interactive metronome is an evidence-based, intensive computer centered assessment and training tool that can help improve timing, rhythm, and synchronization in the brain. Interactive metronome is used around the globe in hospitals, pediatric and adult clinics, school, and homes.  It can be used to improve a child’s processing abilities that affect attention, motor planning, sensory processing, and sequencing. Children who have been diagnosed with ADHD/ADD, Apraxia/Dyspraxia, Autism Spectrum Disorders, Brain Injury, Auditory Processing Disorder, Cerebral Palsy, Dyslexia, Language-Learning Disorders, Non-Verbal Learning Disorders, Sensory Processing Disorder, Stuttering, and much more can all benefit.

The goals of Interactive Metronome include:

• Improve independence with activities of daily living
• Improve physical endurance and stamina for performance in sports and leisure activities
• Improve overall whole body coordination
• Improve focus and attention for longer periods of time related to daily function and filtering out internal as well as external distractions
• Improve academic function performance and ability to follow directions
• Improve self-esteem and social skills
• Improve behavior and impulsivity

  

Interactive Metronome is available through Easter Seals DuPage Occupational, Physical, and Speech Therapy Departments. The therapists at Easter Seals use this program to tailor a treatment plan specific to the child’s needs and family priorities. Interactive Metronome challenges the child to precisely match a rhythmic beat, which can be customized to your child’s unique learning style and challenges, with synchronized hands and feet exercises. Feedback is then is given auditorally or visually based on the child’s goals that tell the child how close they are within milliseconds to the reference tone. This feedback guides the child to attend and problem solve how to stay to the beat for improving their timing and overall coordination.

During Interactive Metronome, the child treatment activities can be customized based on your individual child’s areas of needs. Exercises can include working on crossing midline for integrating both sides of the body together, improving standing balance for strengthening and endurance, improving both upper and lower extremity range of motion for reach and gait, improving impulse control by ignoring specific stimuli, improving attention to increasing longer and more complex exercises, improving working memory  by recalling a series of exercises to shift between with either upper extremities, lower extremities or both, as well as improving coordination tasks with all extremities. The goals of Interactive Metronome are vast and largely customization.

If your child if already enrolled in therapy, talk to your therapist about this exciting new opportunity! If you are not currently enrolled in therapy, discuss this with your pediatrician and obtain a script for a discipline specific evaluation and treatment.

“Interactive Metronome helps me coordinate things. It helps me get better going to the speed of things and getting used to more things. I feel proud of myself and all of my great work and effort. I even ask my parents if they can order it for me.”

More information can be obtained from www.interactivemetronome.com. For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

Cheer Your Kid On with a Smile

As a client of Easter Seals and the Fox Valley Region, sometimes it can be hard to keep your spirits up. You go to therapy and the progress can seem really slow. It can be frustrating to go week after week not to see concrete progress. Parents have to be their child’s biggest cheerleaders. Here are a few tips to keep spirits up during therapy.

 

–         Acknowledge the little things such as a good step during walking if your child is in physical therapy.

–         Tell your child if they are close to reaching a goal.

–         Have the child relay what they did in therapy to another parent, a sibling, or another significant other in the child’s life.

–         You could make a fun progress chart at home and keep track of the progress they are making in therapy.

–         Have siblings or grandparents come in every once in a while and see how far the child has come. Grandparents in particular love bragging on grandchildren!

I recognize it is tough on parents too to see a difference when their child is in therapies week after week. Try to stay positive and remember that smiling at your child can make all the difference.