The number of children with sensory integration and visual processing problems is skyrocketing and children are being diagnosed with Attention Deficit Hyperactivity Disorder or dyslexia when that might not actually be the issue.
Sensory integration is defined as the process by which we receive information through our senses, organize this information and use it to participate in every day activities. An individual with a visual processing disorder has a hindered ability to make sense of information taken in through the eyes. This is not to be confused with problems involving sight or sharpness of vision; difficulties with visual processing affect how visual information is interpreted or processed by the brain.
These disorders can cause children to become easily frustrated, have double or blurry vision, have trouble focusing when reading, get distracted easily, be uncoordinated or have trouble following directions.
Though no one really knows why more and more children are having these problems, help is available.
Dr. Angela Rose with Rose Eye Clinic in Hot Springs can develop an individualized vision therapy program for patients suffering with the above problems, and she’s one of only 10-12 doctors in Arkansas who offer these services.
Typically, the patient will have a 45-minute session once a week for a minimum of 12 sessions, though Rose said many children need more sessions than that depending on the severity of the problem and how long it’s been going on, so it’s not uncommon for a child to need 24 sessions.
An exam will be done during the first session in which the doctor will test a number of things, including the patient’s acuity, determine if they need glasses just to see clearly, test their ability to focus up close and examine their depth perception and how their eyes move. Then, a second type of testing will be done called developmental testing. This test takes approximately an hour and the patient will receive a six-page report to take with them to school.
The developmental testing will determine the patient’s strengths and weaknesses, allowing the doctor to develop a unique program, and the weekly sessions will commence after that.
“It’s not just kids sitting at a desk doing exercises. That is what we do, but it’s a little more. We try to bring in sensory integration technique,” said Rose. “Kids get so much screen time anyway; there are a few things that are nice to do on a computer but most of it is out here. You know, visual auditory things: jumping on the trampoline, calling out different things. We’ll work on their vestibular sensory spin board and spin them around.”
Rose said her office has been getting a lot of referrals from occupational therapists, as they’re finding that the problems they’re seeing in their patients have a visual component and its affecting their balance and attention. For those patients, they’ll continue their occupational therapy and do therapeutic classes at Rose’s clinic.
Though Rose’s programs are designed for children, she said there are places in the country that work with adults too.
“We see kids — sometimes it’s an obvious problem where they have a crossed eye, but sometimes it’s not. Most of the time it’s more subtle. Inefficient eye movements where they’re skipping words or lines when they read and it’s affecting their reading comprehension, grades, behavior,” she added.
Convergence insufficiency is another problem Rose has seen and it can also mimic other things and be difficult to diagnose.
“If you can’t turn your eyes in a little bit when you’re focusing up close you will get blurry, you will go double, and that’s convergence insufficiency. Well, if you can imagine a child who has that but has not been diagnosed, because it’s kind of subtle — you have to be looking for it — then you can see that they might be reading, go double, get blurry, they get distracted, lose their place; that’s a child that can easily be labeled ADD. That’s just one example,” she said.
“We’re seeing more and more of it now and nobody really knows why. The occupational therapists are seeing lots more kids with sensory integration problems, we’re seeing kids with visual processing problems. It’s neurologically-based, that we know. It’s not as simple as ‘Oh, this muscle is too strong so it’s pulling the eye in.’ That’s old school stuff. Now we know it’s much more complicated than that,” Rose added.
“It’s just so nice to see a kid just turn their whole world around. The changes can be so dramatic and when we’re getting ready to graduate them the mom cries, I cry, and the kids a lot of times don’t want to leave.”
The goal at the end of vision therapy is for the patient to have good visual acuity, good binocularity and 20/20 vision with or without glasses, Rose said, adding that sometimes children will come in and, even with glasses, can’t see 20/20 because their visual processing system is working so slow.
Many children don’t need glasses at all once they graduate the program. Some have no depth perception when they begin and Rose said that’s a big problem, adding that most of the children are on the A/B honor roll at school when they finish the program. If they aren’t, Rose said she doesn’t consider them ready to graduate because sometimes there are other issues that need to be looked at. At the end of the program, the patient should have better comprehension and better behavior.
Vision therapy is only about 20 percent of the practice at Rose Eye Clinic; the clinic also sees adults and children who just need regular eye exams.
“It’s just so nice to see a kid just turn their whole world around,” Rose said. “The changes can be so dramatic and when we’re getting ready to graduate them the mom cries, I cry, and the kids a lot of times don’t want to leave. We try to make it really fun and they become kind of part of the practice family. It is very rewarding.
“There could be a child who’s never been able to play sports because of poor balance and coordination and it opens up a whole new world for them after that. We live in a visual world so when parents come in and say ‘Well, they’re giving little Johnny his test orally because he’s an auditory learner,’ on the one hand it’s great that they are working with you on that but we live in a visual world and eventually, hopefully, he will go to college and/or get a job and they’re not going to cater to him like that. They’ve got to be able to function in a visual world,” said Rose.