Anyone who knows anything about visual perception.

[Ineedalife]

After a thread on here I emailed Aston Uni's visual science department to find out about a test for DD3. The OT's said she had visual perception issues.

Anyway they have emailed me back and said they do a clinc called the Binocular Vision Clinic, it is a 2 hour assessment and costs £65 for the first appointment [2hrs] and then £20 there after. They did say part of the test is to see if she needs coloured overlays.

So is this the test we want because I was quoted £400 by an optician!!

Does anyone know if it would be a good idea to do this assessment.

apols for hijack, but i have a dumb question
we know dd2 has issues with binocular vision (she has/ had a long term alternating converging squint which was eventually operated on when she was nearly 7) due to her athetoid cp. so she also has mobility difficulties and pretty crumby fine motor - she uses a laptop at school as her pencil work is slow and randomly illegible/ legible due to her muscle tone fluctuations and whether there's a y in the month...
any opinions as to whether it is worth us getting further info on visual stuff? (she wears regular specs for her long sight to try and keep her squint at bay) she's been seen by eye hosp for her entire life save the first three months but i don't think anyone has discussed any of this further... an area worth looking at? or ignore and write it all off to cp and assume no improvement is possible?

dont is right. Brain gym/mind gym etc programmes often have movements that target bilateral integration and rotation - these are foundation movements that also help eyes dissociate from head movements and help refine fine oculomotor control (have word finding difficulties at this time of night).

Outofbody....that is an interesting question- how much of her visual issues are due to her oculomotor muscles being affected by CP and how much is related to her lack of smooth movement experiences....I think the answer is how long is a piece of string.
But as with her gross/fine motor difficulties...would you leave her without therapy ''cos it's the CP'' - no. So I would imagine that a Behav Opt assessment would give you useful info. Now it's prob not going to impact on refining fine motor like hand writing because that the nature of athetosis...the more refined the movement, the more fluctuating tone.
How is her speech- would she be a candidate for speech recognition software to produce school work?

She has issues with dysarthria which also fluctuate in the same way so I would hazard a guess that a voice recognition programme would have difficulty and it would be more frustrating for her. She manages ok with the lap top tbh, so I'm not too concerned about hand writing/ fine motor (although it would be interesting...) I do wonder about gross motor if that makes sense... Particularly in a spatial/ balance sense. It was really noticeable that she struggled immediately post surgery as she couldn't tell how far objects were away, or even locate them properly - she was trying to put cups on tables that were inches to the left, and trying to push lift buttons but not being able to find the button, just pressing the wall off to the side.

I did have a small wry laugh about whether we would say the same about her motor skills - despite having the squint since 3 mos old, no-one in the uk would operate as it was probably due to her cp, so no point. when we moved to Canada, the first eye specialist was aghast that no-one had offered her surgery. So I guess that's where my 'chalk it up to cp and ignore it' mentality came from! I've been well trained by the Nhs!!

Sorry went to bed after posting. Are you still in Canada? If so I would have thought that you would be able to access an OT who would do Sensory Integration with a child with CP....therapists are moving to integrate the two approaches (i.e. Bobath/NDT and SI).
You could also look at doing some Auditory Integration/Therapeutic Listening focusing on visual control?
What you're saying about gross motor sounds more like visual-motor integration TBH and I would have anticipated her having difficulties post-surgery but that it would have resolved as her brain 're-learned' about putting space, hands, and vision together.
Finally (sorry!) voice recognition is improving all the time and a specialist SALT may know of software coming for children with dysarthria....if her errors are predictable and consistent; then some software will 'learn' her particular speech patterns. Thats getting a bit specialist and you would need a SALT with expertise for that.

outofbody - DS2 has several dx & overlapping conditions (CP, ASD, Bilateral integration & sensory disorder) TBH its difficult to seperate the causes & effects of each condition & symptom BUT all of the exercises, therapys & strategies we use at home & at school are focused on improving his functional ability in one way or another.
So after SIT school can see an improvement in his cordination & planning while we can see an improvement in his anxiety levels
At the same time he is also doing various interventions & exercises at school as recommended by physio, OT & Behav optometrist.

It is very difficult to know what is working & what isnt but as long as he is making improvements (albeit tiny) & they are doing him no harm & he is hapy to cooperate then its all worth a try.

Thanks both. Yes, we are still in Canada. Have moved though, so are still setting up new therapy teams etc. will be interesting to ask the question, anyway!

Yes go for it Aston Universty Vis science dept are v good, all based on fact what they do and you will get an honest assessment. Unfortuntly it is my opinion some of the Behavioural optometrists ( who by the way are generally only qualified dispensing "opticians" ) are only out to make money. One mentioned on here has in actual fact been investigated by the optometrists governing body, for his " money making treatments" .

Prof Arnold wilkins is the leading expert on colorimetry and is fab, the fact he doesnt charge says it all.

Prof Wilkins is a lovely lovely man, completly put ds2 at ease, wasa ble to point out visual stress behaviours just as we were sitting chatting, things that i thought was just ds2, once he altered the lighting in the room ds2's behaviors changed etc.

We are due to go back & see him again as ds2 was not able to give responses to the questions or indicate if things were better or worse etc.
Its hoped now he is a little older maybe he can complete the testing properly but the general advice he ahs given has helped.
I can imagine with a child with better understanding & communication he could be very helpful.

mm, v interesting. dd2 wasn't verbal until v late (we were oroginally told she wouldn't be) but she used to scream blue murder in sainsbos (i know how she feels). in the end we had to resort to online grocery shopping. when she eventually became verbal she managed to tell us the store hurt her eyes - presumably the strip lighting. with a decent pair of sunnies she could tolerate it, which solved a lot of problems.

Tumble - glad to catch up with you again. I promised you an update on DD.

She learnt to read virtually overnight ( her reading has improved by about 2 1/2 years in 2 months) after doing the Tinsley House Therapy which involved HTS/Computer Orthoptics (amongst other things)

This cured her eye tracking problems and convergence insufficiency.

So, you see, I was not 'just disappointed' with her academic ability. Actually she could learn to read, same as any other kid.

I hope at your NHS eye clinic, for children with reading difficulties, you are having equal success at helping children learn to read.

BTW I don't know why you say BOs are generally only opticians, the BABO website is very clear that their training is only available to optometrists.

I was going to say that Indigo. My ds's optometrist told me that BABOs are fully qualified optometrists that then undergo additional and more specialised training to gain BABO status - definitely not dispensing opticians.

I would think its the same as any other field, you get some good practitioners and some bad ones, so best to go by personal recommendation if at all possible.

Good stuff Indigo thats fabulous news. Must learn about the overnight cure , would get my waiting lists down .

I said they were dispensing opticians, very different from opticians. You should have gleaned by now with your vast experience that optometrist and optician are the same. Dispensing opticians are completly differnt. They do a diploma in how to measure for bifocals etc.

I think perhaps I have experience of bad Bo, who have not been qualified, it is a minefield out there and personal recommendation sounds the way to go.

The overnight cure would get your waiting lists down significantly (for children who have dyslexia). It's Tinsley House.

Overnight was an exaggeration. It took 2 months of doing therapy 3 times a day. And during that time her reading went up from a level 1a (Y1 level) to a 3c (Y4 level)

But even if you did believe me, there's nothing you could do about it. You work for the NHS, and this therapy costs and isn't available on the NHS.

It is hugely disappointing though that you're not even interested in finding out about stuff that works - even if you can't prescribe it.

I am interested. Im looking into your above link.

If it works I will use it.

Great. :)

The HTS vision therapy takes 20 minutes and we did it every day.

DS and DD have both done it. It's improved their pursuits, saccades, accomodative rock and vergences (BO and BI).

They hated doing it :)

(The HTS website seems to be down now, but it's normally fine....)

This is the HTS program they followed:

Pursuits
Three minutes every other day until criteria (80% correct, .95 sec. avg. response time with arrow keys) has been achieved at the slowest speed, then the speed is automatically increased until criteria has been achieved six times at the highest speed.

Saccades
Three minutes every other day until criteria (80% correct, .95 sec. avg. response time with arrow keys) has been achieved six times.

Base In
Seven minutes every day until > 13 BI has been achieved on the large targets
three times, then seven minutes every day until > 13 has been achieved on the small targets six times.

Base Out
Seven minutes every day until > 35 BI has been achieved on the large targets
three times, then seven minutes every day until 35 has been achieved on the small targets six times.

Auto Slide
Ten minutes every day (after Base In and Base Out criteria has been successfully achieved) until > 35 BO break and > 13 BI break has been achieved five times.

Jump Ductions
Seven minutes every day (after Auto Slide Vergence criteria has been successfully achieved) until > 35 BO break and > 13 BI break has been achieved 7 times on the large targets and 8 times on the small targets.

Accommodative
Five minutes every day until cycles per minute > 13 and .80 percent correct
responses at level six (+2.00 / -5.00) has been achieved eight times.

What about a QTVI - teacher of the visually impaired. Also a learning orthoptist?

Took our little boy to Ian Jordan in Ayr yesterday. What am amazing experience. An amazing insight into how our little boy sees and senses the world around him. Definitely recommend :-)

DD has been recommended to see a BO by EP and OT to see if any visual problems are contributing to slow processing speed and motor difficulties. Happy to see one. Have looked at BABO website for local therapists. Has anyone any experience of Mrs Burns (Worthing) and Owen Leigh (Peterfield). Both vary hugely in what they offer and cost. Thanks.