Vision Therapy

Joshua's Bio:

Name: Joshua Connor (Hebrew/Irish: JAW·shu·wa KAW·nur)
Meaning: Beloved by all who know him, Lover of Hounds
AKA: Boo, Bug, Bug Boy, Bug-A-Boo
Day: Tuesday
Date: Dec. 30, 1997
Time: 9:08 P.M. CST (-0600 GMT)
Weight: 8 lbs. 9 oz. (4037g)
Height: 21 in. (53cm)

More about Joshua:

Joshua's Favorites:

I want to talk a little bit about Joshua's vision here. Shortly after his fifth birthday Joshua started getting a lot of headaches in the evenings. Being a person who has lived with headaches most of my life I was sad that he seemed to be taking after me. Towards the end of summer I decided I had to at least try to figure out what was causing them. I kept a log of everything he ate for two months, along with anything unusual in his day to day life to see if I could find a common link - I didn't. It was early fall when we decided to take him to have his first eye exam with our family optometrist and then, depending on how that went, take him to see his pediatrician. He had two eye exams. The first one showed that he had nearly perfect vision, being only slightly farsighted (which is normal for young children). However, the optometrist noticed that his eyes were having trouble switching focus. Which is to say that when he goes from looking at something close-up to looking at something far away, his eyes sort of get stuck in the close-up focus and take several seconds to adjust to the distance focus. She recommended a second exam where his eyes would be dilated to rule out a "hidden" vision deficiency. On the second visit his vision was still showing nearly 20/20 so she suggested that he be seen by a developmental optometrist for further evaluation. We scheduled an appointment to have Joshua evaluated and looked over the information that they had sent us, I was surprised at just how many of the symptoms of visual difficulties he was having.

So, my husband took a day off of work and we went up to Minneapolis to the Minnesota Vision Therapy Center for Joshua's appointment with Alex and Caity in tow. They have a great little sibling "waiting" room that was full of coloring books, games, and toys and is separated from the regular waiting room by a glass wall with a sliding glass door. The staff there were very friendly and made us all feel at ease. The testing took about two hours, including his exam with the developmental optometrist. Usually they schedule you to come back on another day to receive the results, but since they had an opening in the afternoon and my husband had taken the day off anyway, they told us to come back in the afternoon to go over Joshua's results. We were all hungry and we had some time to kill so we went to the Mall of America for lunch.

When we got back to the center the kids all went into the siblings' waiting room and we sat down with one of the consultants to go over the results and Dr. Mowbray's recommendations. The abridged version is that Joshua's visual skills are very deficient. His eyes are working together less than 50% of the time and he has trouble switching focus from near to far and back again. They showed us a few helpful examples of how Joshua sees things. I have found one web site that has really good on-line examples - it's called Children's Vision Information Network. If you go to the "Vision & Learning" page and scroll down to "Other Vision-Related Learning Problems" you'll find the examples. The two that relate most to Joshua's problems are under "Tracking" and "Focusing."

Then they went over how much the vision therapy would cost - whoa - no wonder the evaluation is free! We went home praying our insurance would cover it at least as an out-of-network provider. We were dismayed to find out that our insurance (who's name we won't mention but who's initials are BC&BS [and we all know what those last two letters stand for...].) wouldn't cover any of it. We still haven't gotten a reason out of them. From the research I've done it seems that most insurance companies view vision therapy along the lines of snake oil. Some get out of paying for it by claiming it's a learning disorder rather than a medical condition. Personally I don't see how a child suffering from almost daily headaches because his eye muscles aren't functioning properly falls under the "learning disorder" category but maybe that's just me...? We're still working on our insurance company (helpful insurance advice can be found here) but we're also being realistic. So we have held off until now (spring 2004) to use our tax refund for Joshua's therapy.

I feel relieved that the day for him to start has finally been set. Since his evaluation five months ago many of the symptoms of his visual difficulties that we had noticed but written off as Joshua's particular idiosyncrasies have clicked - they now make sense. We used to wonder why he liked to watch television with his body at a right angle to the tv, not turning his head but viewing it out of the corner of one eye. I'm hyper-aware of just how often he rubs his eyes, or covers one of his eyes while drawing or doing book work. I've backed off on the reading for now, leaving behind the frustration that both of us felt at his inability to focus on the printed word. It is as if a great weight, that we didn't even know we were carrying around, has been lifted from our shoulders now that we understand why Joshua is so reluctant to do his work.

Joshua hit the mid-point in his vision therapy around the Fourth-of-July [2004]. We took him back up to Minneapolis for his evaluation with Dr. Mowbray on the 6th. Afterwards she told us that Joshua is doing much better than she had anticipated at this point. His focusing ability has more than doubled and his tracking has improved significantly. This was really wonderful news to hear because I really didn't feel that Joshua was doing very well with his therapy. I guess being with him day to day it was harder to see the progress that he was making. However, I did noticed that he wasn’t rubbing his eyes, covering one up, or turning at odd angles to look at things as often.

I learned a lesson that I'd like to share with all you parents out there - always trust your gut! The therapist that Joshua started out with rubbed me the wrong way at our first session. I went home and fumed to my husband about her but I decided that maybe she was having a bad day and I should give her another chance. Indeed, at our next session she did seem nicer and over the course of Joshua’s first 20 weeks of therapy we got along fairly well. There were occasions when I wondered why she had chosen her path but overall I felt she was a competent therapist but I always had this nagging feeling that she wasn't a good complement for Joshua's personality. Joshua can be a challenging child and she just didn't seem to have the patience or creativity necessary to deal well with him. My husband encouraged me a couple of times to ask that Joshua be switched into her colleague’s care. I hesitated to do so because I felt like his therapist was a decent person and I didn't want to offend her or have to deal with the awkwardness of seeing her there every week afterwards. Then a few weeks after his evaluation Joshua's therapist inexplicably was replaced by a new therapist. I don't know what the circumstances surrounding the incident were, whether she quit suddenly or was fired.... It clearly wasn't planned (either that or I utterly misjudged her character) because she smiled and said, "Have a nice week.” the last time Joshua & I saw her. I worried that this sudden change would set Joshua back but he has adjusted well and actually is making better progress with his new therapist who seems to be much more accommodating.

Joshua graduated from Vision Therapy on November 4th 2004! He had his final evaluation with Dr. Mowbray just before he graduated and he is now right where he should be developmentally. When he started he was having blurred/double vision out to about three feet away. Now he can focus and keep things clear to within a couple inches from his eyes. Before he started we were struggling with trying to get him to read. Now he is reading at the second grade level. His headaches are also much less frequent (and we've realized that his allergies are partially to blame for them). It's been a long, sometimes bumpy road. There were days when I thought I was going to scream, when I swore that I'd had enough. There were days when Joshua had a meltdown at the mere mention of doing his vision therapy again, days when we both wanted to quit - but we made it! On his last day Joshua hugged Ruby (his therapist) and Gerry (another therapist) and asked if he could come back to visit them sometime, of course they said yes. On the way home he started crying. When I asked him what was wrong he said "I don't like long goodbyes" (meaning saying goodbye for a long time, not taking a long time to say goodbye...). I know just how he feels.

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© Kimberly McGee
First On-line 03/22/2004