Monday, September 14, 2009

A Journey Into A Child's Visual Learning "Disability"

I never realized how important one's vision was until Owen started having education-related problems in school. Oh I know that it's important for one to see things with 20/20 vision. That's not the vision that I'm talking about.

What I'm talking about is how people process things with their vision. Not just seeing things but properly seeing things and then having their visual image tell them what they are seeing and what to do next.

And I sure got schooled on the importance of visual processing this past school year with Owen.

This is going to be a long post but it's important information to have and if it helps just one other person, then I've done a good thing. So before I go into the actual visual problem with Owen, I should probably give you some background information about what led up to my education on vision and just how important it is.

THE BACKGROUND

Back in preschool, Owen had a really hard time learning his letters. Especially the b's, d's and q's. I just chalked it up to his young age and he finally learned them by the end of the year so I wasn't too worried. It was mentally noted though.

Moving into Kindergarten, his writings and drawings were so immature. They looked like his preschool work. His drawings were stick or bowling ball figures with no detail. No color. (The example below is colorful only because the teacher made them use color.) And his written work definitely wasn't up to where the other kids' written work was.



But the thing was that he was falling at the top of his class as far as reading groups and math groups. I spoke with his Kindergarten teacher who said that it could be fine motor skills issues because of his age (he's the youngest in the class). Although she agreed that it could be a problem but said that we should just monitor it until he matures a little. I agreed with her.

Moving into first grade, he was placed in the gifted program at the beginning of the year. His logic and reasoning is impressive for a kid his age and his math is definitely above where he should be. But...he couldn't keep up with the other kids because they were reading and writing at a much higher level so...we pulled him out of the program.

His writing was still a problem. His words and letters ran together. The sentences he wrote were uphill. They were downhill. Letters (and numbers) were flipping around. I spoke to his teacher about it and she agreed that it was a problem. The final straw came when he brought home a mid-term exemplar for math and he got the equivalent of a d/f on it. And these were things that I knew he knew how to do.



I called a meeting with his teacher and then showed the work to Ken. (Just so you know...Ken only sees things that are of utmost importance.) He looked at it and asked if I recognized that Owen had gotten three or four of the problems marked wrong but he had inverted the numbers and had actually gotten them correct for how he did the problem. So instead of doing 17-9, he did 71-9. He also got his sequential ordering wrong for what the teacher wanted but it was right for how he saw it.

STARTING THE PROCESS

In our meeting, his teacher and I both agreed that there was a problem. Her main concern was 1) there has been no progress in his writing since the beginning of the year; and 2) he abilities were much higher than the work that he was showing. I totally agreed with her concerns. Additionally, I thought that there was no way that a kid could start out in the gifted program and then slide down to the middle of the class without something being wrong.

His teacher wanted to do a child study with the various school officials to see if he had a learning disability that would qualify him for an Individual Education Plan (IEP). I was in agreement. Something was wrong and we needed to figure it out.

THE MEETINGS

My friend Beth tried to warn me about what the meetings would be like. But nothing could have prepared me. At the first meeting, I was there along with his teacher, the Vice Principal, the county school psychologist, the county occupational therapist and the school resource teacher. It took place in a small room where there was barely enough room for us to sit around the table...and no windows.

The various individuals were going to observe him during the next 60 days and give their opinions. For my part, I wanted to rule out any factors that we could and make sure that there was nothing going on with his vision. And since he wears glasses, the team wanted to know if it was vision related. I said that I knew that his vision itself was fine because he's been to the eye doctor every year since he was 3 and has been wearing glasses since then and sees 20/20.

But something told me to have him checked anyway so off we go to the eye doctor. I told him what was going on and showed him Owen's classwork. He thought that it was a visual processing problem and referred me over to his colleague who does visual therapy and the other optometrist in his office who deals specifically with children who have visual related learning disabilities.

THE DIAGNOSIS

The eye doctor said that his binocular vision was causing his eyes to cross at a much further point from his face than it should (about a foot away from his face rather than right in front of his face) and he wasn't able to fuse the images together properly.

The result was words and numbers were jumping all over the page. Instead of seeing the words "I love you" he saw "I you love". Instead of seeing "17", he saw "71". The lines on his paper were also jumping all over the place and he was seeing more than one image of the same thing.

It's not a cross-eyed problem. It's not a dyslexic problem. It's a visual processing problem. He simply can not process things that are close to his face (or coming at him such as a tennis) properly or quickly enough. The result also is that his memory isn't very good because he doesn't see it properly, it hinders his ability to remember it.

This is why he was able to recall spelling words in Kindergarten and was able to recall how to spell words that were verbally given to him.

This doesn't affect his ability to see far off though since viewing things far off does not cause his eyes to cross too soon. His eyes are focused straight ahead when doing things like looking at a blackboard.

And to look at him, you'd never know. But the fact that Owen was asking for help told me that it was pretty bad. He never admits to having a problem! He was super frustrated that he wasn't able to complete the work as quickly as the other kids and he hated turning in incomplete assignments.

Dr. Tsai recommended that he go through visual therapy which would help strengthen his eye muscles and help him learn to focus them properly.

She said that it would help him with the writing (spacing) problems and the reversal of letters and numbers and would help him be able to focus and stop fidgiting in class.

THE SECOND MEETING

The end of the 60 day observation was up and it was time to meet with the school IEP team again. Listening to their reports on Owen was a little frustrating to say the least. Basically it boiled down to (for them anyway) the fact that Owen couldn't sit still and focus on his work and, although they can not say that he's ADD, that maybe we should consider ADD as a source of the problem. Not so much in those specific words but to me...that was their impression.

So, I told them what the optometrist had diagnosed him with and told them that while I wasn't disregarding their concerns about him having ADD, I preferred to put the breaks on the IEP meeting process right now and reconvene at the beginning of the year and put him into Visual Therapy with our optometrist over the summer before we incorrectly diagonsis of ADD.

THE VISION THERAPY

He started seeing Colleen at Dr. Powell, Smart and Tsai's office. We decided to do it over the summer with an intense treatment of three times a week at one hour. She worked with him all summer on focusing, tracking things and memorization. Some of the exercises that she did with him required him to track objects, letters and numbers on a page (such as he would have to do in school) and doing memory recall of things that he had seen.

I can tell you right now that I can now understand why Owen had a hard time keeping up in school after seeing some of the exercises that she did with him. As a way of comparing his processing to a "normal" child's, she would have Shane do the same thing that Owen was doing...and Shane had no problem doing it.

She had a baseball sized ball suspended from the ceiling on a string and she would have him lay under the ball. She would spin the ball (slowly) and he would have to track it with one eye, then the other then with both. He wasn't able to track it for long and it was difficult for him to call out the letters or numbers on the ball. Shane did it just fine (it's not an age-related thing.)

Things such as tracking a pencil with his eyes was difficult. Things such as touching something with the opposite hand was almost impossible. Tracking things across a page (like trying to find a specific letter or number) really frustrated him.

Fortunately, he was able to pull it together and make it through the treatment. They tested him at the end of the treatment (with the same test that he had done at the beginning) and he is now testing at age level for his visual processing.

MY OPINION

When I went to the eye doctor for my check up, Dr. Tsai showed me what he was seeing.

THAT WAS ENLIGHTENING AND PROBABLY THE BEST THING THAT SHE COULD HAVE DONE.

I couldn't track the words on the page. I had to use my finger and track the words so I wouldn't lose my place. Everything was fuzzy and the words were jumping all over the place. Nothing was straight.

I can now completely understand why Owen, as a six year old boy, couldn't sit still for more than five minutes. I mean really. Who wants to sit there and do work when it's so hard? Not me. And surely not a six year old boy!

It totally explains why his writings were up and down the page, why the spacings were incorrect and everything ran together and why his math was wrong so often even when I knew he knew the answers and how to do the problems.

OWEN'S OPINION

Okay. So there's one person in all of this whose opinion no one asked while it was going on (except for me of course). After the treatment, I asked him what he thought about before and after.

He said:

1. Now he can open up a door properly because before he would go to grab the handle on the left...but it would be the double image of the handle and the handle was actually on the other side of the door.

2. Now he can hit a tennis ball where as before, he would hit at the ball coming over "here" (which was on his left) but he would miss it because it was actually on his right. (His inability to track a tennis ball was actually one of the things that tipped me off that something wasn't right.)

3. Now the words on a page and the lines on the page weren't fuzzy and jumping all over the place. He said that they look clear now.

That's pretty common with kids who have this problem. They're so use to seeing everything in double or fuzzy that they don't know any other way and will answer "no" when you ask them if they are seeing double images. I asked Owen and he said no. I even described it to him and he still said that he wasn't seeing double.

So, we've started the school year with a new teacher. She introduced herself and said that she had spoken to his teacher from last year and knew all about what was going on, which is encouraging to me because she already had some knowledge coming into the school year. Plus, she'll be his teacher again next year so if we don't have this straightened out, there will be a consistent dynamic in the picture.

I'm hoping that this will solve Owen's learning problem at school. I just know that last year, he came home with papers like this:



And the first paper he brought home this year was MUCH improved in the hand writing department and all of his math problems (including 33 of them on another paper) were correct.



I should add that this problem is not related to his actual vision. A person with 20/20 vision could have this problem.

I'm anxious to see how his work is this year and how his behavior is this year and whether there is an improvement on his ability to focus as well as perform his work up to the standards that we know he is capable of doing. He will continue with an at-home therapy program for a few months as well as see his eye therapist once a week for a month.

But, according to the doctor, once he's done with the therapy, he should be good to go. And that's what we're hoping for!

6 comments:

ginny said...

I must say that I am truly in awe the way you went at this full force to get him the help he needed.You were not going to just let the school figure out what was wrong. You rock as a mom!!!

ginny said...

I should add- Owen really worked hard this summer too. I saw first hand the week we were up there. He really had to struggle with the exercises but he kept going even though I could tell he was tired and frustrated! He rocks too.

Uncle Cliff said...

It is an awsome job that you and Owen are doing.It looks like it is really coming together. We will keep praying that it works all the way.

Uncle Cliff said...

Thanks for this explanation. It makes you wonder how many kids have not been diagnosed properly.

KenDC said...

There are a lot of awesome people in this story. First and foremost is my wonderful wife and the best advocate for our boys. There is no doubt in my mind that a lessor person would have taken the diagnosis, "as-is". As much as I might make the "Ken face" at Kim's stubbornness, it comes in handy when it is working for our family. :) Also, Owen...as you said Ginny, he did work hard! Colleen was also great, she had such a wonderful and positive attitude it was hard not to be on board (and I only met her twice).

Kim Eckhardt said...

Thank you everyone. I know that it's something that you would all do for your kids (and have done...I did learn from the best!)

I am under no disallusionment that this is going to resolve all of Owen's problems at school but we're peeling off the potential issues one at a time. At least now that he can see properly, we can get him moving in the right direction. He's still struggling in school to keep up with the other kids when it's free writing so I'm going to have him evaluated by an occupation therapist in a few weeks.

We'll go down the ADD path if we need to. I'm not one of those parents that says "not my kid!" I just don't want to throw him under the bus without making sure that I need to.