Behavioural optometrist assessment - a bit disappointed, is this a full check?

[betterwhenthesunshines]

Reposting here - no replies in SN!

OK, so my DD is 6yrs 11m and has struggled with reading with a lot of letter complications esp. transposing letters within words, skipping and swapping small words, missing beginnings and endings, losing place on page, fidgety etc School are also concerned that her reading and spelling ability are below the level they would expect. They have recommended an Ed Psych assessment within the next few months but I am concerned that this will just label her without leading to a route to help her. After all I know what she finds hard, just not the best way to deal with it!

I made a BO appt via the BABO website and we had the appt today. It took nearly 2 hours and he took lots of detailed notes but I don't have a very thorough or specific report. For Visual Efficiency it just says that her Eye tracking, eye teaming and focusing are all Unskilled. For the Visual Processing part: Bilateral Integration and Laterality is adequate and there's possible retained reflex (Spinal Gallant?) The form has other things listed: directionality, visual memory, visual figure ground, visual closure, motor integration and visual fine motor. All these are marked as untested.

It was all very low tech. I was expecting some kind of computer eye tracking. We are going back next week but I was interested in any feedback - it this what you would expect from the first visit? Is it just that there is so much to test that he ran out of time?

Interested to follow this thread of what should come out of a BO visit.

My dd2 saw an NHS BO last year, as - although her reading is largely fine - I'm aware that she skips (easy) words, loses her place on the page and also is forever bumping into things, so some sort of visual thing seemed likely. She also claims the words blur on the page and that she gets headaches from reading. The only useful thing that came out of this visit was that the BO assessed my dd's tracking skills as being on the 20th centile, which the BO didn't seem to see as a particular problem, though at my request she gave my dd2 a few exercises to do, and that was that.

The 20th centile seemed pretty low to me, for a child who is otherwise in the top centiles, and would explain the visual difficlties she has. Is it normal to have no follow up like this, though? Had I paid for a private BO rather than gone through the NHS, would they have cared a little more?

Also following this thread. we have a BO appt Fri 16th.

Ok, I've got a confession . It is more complicated than just visiting a BABO.

There appears to be no standard test, nor standard vision therapy. Each optometrist does what they want to (around the same general principles)

Also, the prices vary considerably.

You can test eye tracking manually - but it is not as accurate as using a visiagraph. Ditto for all the other eye tests.

In the US you can get computerised vision therapy, but I don't think many optometrists are doing it over here.

So, here's my big confession. DD did 5 weeks of vision therapy, and was signed off, yet she still had huge vision issues left - and I wouldn't recommend the person I went to :(

So what would I recommend?

Well, now my DD is going to start computerised vision therapy through Tinsley House

I can find 2 different computersied vision therapy products you can buy to use at home:
Top Vision and Visual Dynamics. I think they both look very promising, and I would try Top Vision if I wasn't going to Tinsley House.

If your child can already read then Reading Plus combines improving reading and eye tracking. This is what I would use if my child could already read. And it is what I will use once DD has learnt to read.

If anybody does use any of these products, can they please update me as to how good they are?

Sorry, it's not more simple.

If you don't want to pay any money, these are the type of exercises we did as part of manual vision therapy:

Eye tracking:

• Read the first word then last word of every line (without moving head)
• Get child to follow a torch beam being moved in a figure 8 with their eyes

Convergence:

• look at a near object, then look at a far object.

If you do stuff like that, for a few minutes every day, for a few months, you will improve your child's vision.

If you google for a bit, you'll find more vision therapy exercises.

But you've also got to remember that DD had very extreme vision problems - and I think it's very possible that if her eyes weren't so bad, than the vision therapy she did would have been enough.

The 5 weeks of vision therapy she did, did help - it just wasn't nearly enough.

I'm not suggesting that what he did was incorrect. Just that it wasn't all that I was expecting - I can see that he did test for a lot of things and I'm happy to go back and see what he suggests. But I think I should be given a clearer picture of DDs current position than just 'unskilled'. Self-diagnosed exercises surely defeat theobject of going to a professional in the first place - no point in doing eye tracking exercise if what she needs most is things that will help with focal length / accomodation.

So I suppose I was asking about the extent of the report that I should be given, especially at the start. ... so that I can see if this (somewhat expensive and time-consuming!) course of action is actually resulting in a proven improvement! After some time.

When you do the daily exercises, you will see for yourself that she is improving.

It is obvious that the same exercise gets easier to do.

OK, I'll stick with it then and see what he gives her to do next week.

Where are you, OP? I highly recommend Alexander Kobrin in Potters Bar. They are THE BO practice. They do the visiograph test and all the others. DD has been seeing them for 4 years now and she went from having problems similar to what you describe to reading fluently in 3 months. DD has her perscription changed regularly to keep up with the demands of what her eyes need to cope with. At 10 yrs, she goes through a novel a week.

I'm in West London and travelling to Golders Green which is taking a long time and I think Potters Bar would be even further, which does make weekly visits difficult.

I think I'll ask for more specific details and feedback when we go this week. What level of detail did you get in a written report at the start? It's just me - I like to see everything written down!! Plus it would make it easier to discuss with school who are supportive, and interested.He has suggested 10 visits and has said that we should see an improvement fairly swiftly so I will report back....

Hmmm. Smelling a rat here.
Go to Alexander Kobrin in Potters Bar. Yes, it's a slog but they do a proper assessment and, if necessary, prescribe glasses, patching etc. You go back months later to check progress. We have a report about 5 single spaced pages long with the results of all the tests and the conclusions plus a plan of action.
Why, exactly, are you going weekly? Are there weird excersises? I think you'll find that since it is all private, their are some hucksters out there. Sounds like you found one. The specs actually need time to work and there is nothing to go back for weekly except the opportunity to shell out £££££.

No, it's not a rat.

There are different types of vision therapy. Going weekly and doing exercises in the office is normal.

Also 'about' 10 weeks sounds right. Because we did 5 and it wasn't enough.

Vision therapy doesn't normally involve glasses and patches (although it can)

I think thus guy in golders green sounds OK.

I would also recommend Alexander Kobrin-fantastic and knowledgeable.

We will be going fortnightly, so not surprised some people recommend weekly x
My DS also has glasses, but they were covered by the NHS, so no mega bucks there....

To be fair he has said weekly OR fortnightly, that's up to us. But he suggested 10 sessions would probably be about right and we should see improvement sooner than that. He hasn't suggested glasses yet - he says there may be a need inthe future but that he would rather start with the exercises first. I am keen to go weekly as her headmistress is asking for an Ed Psych assessment and I would rather concentrate on this to see if it is having any positive impact first.

It did seem to be a very thorough testing session and he certainly filled in a lot of paperwork with results of the specific tests, but I suspect I just got a more general report as the stuff he was writing down wouldn't make much sense unless you were trained to interpret the results yourself. Maybe some parents aren't interested in the science detail, or it's too much info, but I'll ask on Friday and see what he says.

I have just seen the same optometrist in Golders Green and I too am disappointed with the vague 'unskilled' comments. I expected to see a detailed report and now I am wondering how qualified he is! Very frustrating. I am seeing a friend whose child was seen by another optometrist and we are going to compare our reports.
it took me two hours to get to this guy and like you, I thought he was nice. he told me more would need to be tested and like you I wonder if he ran out of time or is it that he is just looking for another £150?
Frustrated.....but would love to know if you went back?!
thank you!

It's complete quackery. If you think your child may have any sort of problem with his eyes or vision then I'd suggest you start by seeing a paediatric ophthalmologist.

my children (one of whom has visual problems) go to an optician who also does vision therapy (recommended by someone and approved by our old optician)

We don't pay for the sight tests etc as all covered by NHS. They do tracking tests with a special pair of glasses which record eye movements or something (don't know - we didn't do this test), they have a colorimetry machine which if I remember right is about £45 for the test. they do exercises you can just do at home or others that you have to pay for a short course of using ipads and electronic stuff (again I only know about that through someone else, we haven't got first hand experience) but I think it was a 6 week thing and the exercises were to be done every day at home with 3 trips to the optician during that time to change exercises.

DD has some sight problems, some visual perception/depth perception issues and some problems with not being able to see text on a page, no tracking issues apparently. they are hoping to give her some exercises to do at home next time we go but they wanted to see how her muscles adjust with her long sightedness first over a few months.

I have been impressed with the place we go (nowhere near London though so no help to you)

Not all behaviour optometrist are quacks, but the one in Golders Green is not good.

It's very hard to get an appointment with a paediatric ophthalmologist, so may or may not be possible. They tend to only see children with severe problems.

PlupsTravers - I can highly recommend playing Engaging Eyes ( engagingeyes.co.uk ) as an alternative to vision therapy. It is very effective, and much cheaper than a behaviour optometrist

Not all behaviour optometrist are quacks, but the one in Golders Green is not good.

It's very hard to get an appointment with a paediatric ophthalmologist, so may or may not be possible. They tend to only see children with severe problems.

PlupsTravers - I can highly recommend playing Engaging Eyes ( engagingeyes.co.uk ) as an alternative to vision therapy. It is very effective, and much cheaper than a behaviour optometrist