Is it a Behavior Problem? Or a Vision Problem?

I recently had a discussion with a parent about behavior and vision problems. A mom of

photo from Newsbusters.org

one of our patients told me that the biggest change she has noticed is that,

“It’s not nuclear war anymore,”

when she tells her daughter it’s homework time. This makes perfect sense to me, and we hear similar stories all the time. If you, as an adult, were asked to do something frustrating,

arduous and painful, on a daily basis, you would eventually refuse. You might even throw a temper tantrum.

Maud at AwfullyChipper wrote to me that

“I really want to make others aware of vision therapy because I know there must be many children out there who’ve just been labelled slow readers (or disruptive, ADD, etc.) when in fact they have vision difficulties. I hope I can help spread the word.”

In fact, studies have been published showing that, indeed, “adverse academic behaviors” decrease following successful treatment for Convergence Insufficiency, one of the more common binocular vision problems we see. The behavior questions used in the study were:

  • How often does your child have difficulty completing assignments at school?
  • How often does your child have difficulty completing homework?
  • How often does your child avoid or say he/she does not want to do tasks that require reading or close work?
  • How often does your child fail to give attention to details or make careless mistakes in schoolwork or homework?
  • How often does your child appear inattentive or easily distracted during reading or close work?
  • How often do you worry about your child’s school performance?
weighted symptom checklist

weighted symptom checklist

It’s important to note that there are other symptoms that may point you to a vision problem. For a more comprehensive list, see our Weighted symptom checklist.

Are you mad as hell?

There is a lot of opinion on the internet, some good, some bad, and a lot that is completely confounding. I recently came across a post on mothering.com in which the original poster describes her daughter’s success in vision therapy and the significant positive changes that have occurred in her life as a result. Great! We have patients in our office every day who tell of the improvements they see in school, work, hobbies, and many other areas of daily life. I always love hearing more.

But in this case, another mom replied that VT has only been proven effective for strabismus and convergence insufficiency.

Where does this idea come from? There is an abundance of data showing otherwise, that in fact vision therapy is an effective treatment modality for numerous other visual dysfunctions. For an incomplete yet impressive listing, see the COVD website. It is frustrating to me and the rest of the community of developmental optometrists, educators, and others who care for children that the science gets swept aside and replaced with opinion. The opinions are repeated again and again until they seem to be true.

Just last week a mother brought her son in to see me. He had numerous symptoms consistent with a binocular vision problem. Sure enough, testing showed he had convergence insufficiency. The mother was relieved to find out the reason for her son’s symptoms, but worried that her mother and others in the family would ridicule her for seeking treatment in the form of vision therapy. So opinion not based in fact may stand in the way of this boy’s academic, sports, and life success.

Dr. Len Press posted this morning about a patient with double vision from convergence insufficiency whose ophthalmologist told her that vision therapy was bogus. Yet the Convergence Insufficiency Treatment Trial was published in the Archives of Ophthalmology. Not the archives of Optometry. Biases (opinions) get in the way, even when it’s published in ophthalmology’s own literature. And these biases prevent children from getting the care they need, and result in children suffering needlessly. Which is something that should make us all mad as hell.