Saturday, January 31, 2009

The complexities of vision

The below story is fairly lengthy, but is from an elderly pediatrician that underwent vision therapy with the doctor we are scheduled to see on Monday. The pediatrician that wrote it is now deceased, but it gives us a rough idea of what we could be facing. I haven't mentioned it in a while, but Jen saw a developmental optometrist a few times in 2007. The results at that time were pretty mixed, but that was a different doctor, and Jen was developmentally less mature. Monday should prove to be interesting!


Your child goes to school, has a good teacher, gets a good breakfast every day, gets love and support, but he is not keeping up with the schoolwork and is beginning to hate school, the teacher, you and himself. You give him some calcium , magnesium and B6. You stopped the milk, wheat, corn, soy, and eggs because you suspected food sensitivities. He doesn't even get chocolate anymore. What has gone wrong? You know he is bright enough. In September he had such enthusiasm and now, after a couple of months, he is giving up.
I recently received a letter from the PR firm of Fleishman and Hillard, of New York, reminding me that it is important that children should be able to SEE before they attempt to READ. I like that kind of no-nonsense, straightforward approach. In my pediatric practice, eye tests were given. If the child could read the 20 line at 20 feet, he had 20/20 vision. I told the parents that getting a good, sustaining kind of breakfast (protein, complex carbohydrate at least) into a child was the best or the main thing they could do to help their child achieve his potential. We looked at ear drums and did a rough hearing test. We checked for anemia and overall growth and development.
All my life I have had an eye problem. I was cross-eyed as a baby but nothing was done. This was in the 1920's: "He'll outgrow it; we'll wait and see." So I was 20/400 in my right eye by the time I was five years old, a condition called amblyopia exanopsia, or suppression blindness. (My confused brain got tired of seeing double so it blocked out the images coming from my right eye. It was a smart move on my brain's part, as it did not know which image to use.) The ophthalmologist surgically corrected the cross-eyed look, but the loss of vision remained. They tried to patch my left eye, but it was too late. Since I could not see well, I took off the patch. Third dimensional vision was lost to me.
A few years ago I visited Dr. Ted Kadet, a developmental optometrist in Seattle, Washington, who helped me improve my vision up to about 20/200. In the last few weeks I have continued this therapy with another O.D. here near Portland, Dr. Roger Tabb. He first checked for any pathology, and then I started to "play" with his toys: I put pegs in holes on a revolving turntable, I turned off lights on a 5x5 foot board as fast as they came on, I jumped on a trampoline while spelling out words both backwards and forwards, and I recited the alphabet while reading a chart (easy), but had to raise my right or left hand, depending upon whether there was an R or L under the letter (tough).
The message he revealed to me was that the eyes are connected to everything that we do: thinking, feeling, moving, planning, and most of the emotions we experience. The eye exam must be more than determining if the child can see the wall. The child must be able to get the whole picture, then he has to sequence that picture, then develop timing and rhythm. The teacher in the classroom must be able to take each of the children separately and get them all to move as one through the learning-to-read process.
Do you remember how easy the alphabet was to learn when you could sing it? A...B...C...D... etc.? The sequence of the letters was easier when it was sung. But it had to be done slowly and correctly at first until it became fixed in the circuits of the brain, and then it could be speeded up into a more rapid time, and then the rhythm was established.
This optometrist, Dr. Tabb, told me story after story of children who were called dyslexic, stupid, or emotionally blunted, but after a few short weeks of this perceptual sensory training, they were able to read fluently, and become cheerful, willing students. Dr. Tabb discovered one youngster, who had been retained in the special ed. class, had a sequencing problem. The boy could read a word in a sentence and then be flummoxed at to the next step. The space between the words was a barrier. Dr. Tabb had him catch and throw back a large soft beach ball as he said the words in a sentence. "The (catch) boy (throw) went (catch) home (throw)." The sequencing, the timing, and the rhythm were all involved, and the boy soon began to read smoothly. (He may have been so bored he had to do something).
Dr. Tabb knows about the benefits of the even blood sugar levels to nourish the brain, but he also knows about the interconnectedness of the visual apparatus with all the other nerves and circuits of the brain and spinal cord. It ties in with what chiropractors can do for patients with learning difficulties.
To give credence to what Dr. Tabb and others are finding with their dyslexic patients, Sandra Blakeslee, writer for the New York Times News Service (NY Times, September 15, 1991), has outlined the recent research. She reports on the work of Dr. Drake Duane of Arizona State University. He states with authority something that we all had suspected: "The nervous system of those who are dyslexic are atypical." That would help to explain why these basically bright children have so much trouble learning to read; something is wrong with the structure or the connections in the cerebral nervous system. Novel approaches to help these children before they turn off the whole academic scene are all appropriate: color filters in the glasses, trampoline and balance beam work, using the phonics method instead of the look-and-say approach.
Dr. Paula Tallal (Rutgers) emphasized that early poor language expression and clumsiness seem to be correlated with later dyslexia. Dr. Albert Galaburda (Boston) feels that dyslexics cannot break down words into basic word sounds. He said, "The role of vision in dyslexia has been ignored mainly because ophthalmologists could find no difference between the eyes of good readers and bad readers."
All this research shows that the visual system consists of more than one pathway into the brain, its association areas and the sections that put what we see and hear into something meaningful for our conscience and higher judgement centers. The brain distributes language processing over many areas. With modern sophisticated measuring devices, researchers have found different speeds of processing of incoming language and visual stimuli. All this reinforces the perceptual sensory way: get the whole picture, then sequence it, then get the timing down, and finally the rhythm. By George, I've got it.
I'm an old guy, but these methods are working. I can go upstairs to get a couple of things and remember to get both. (If you lose your keys or your glasses occasionally that's okay, but if you find them and don't know what they are for you are over the hill.)
Developmental optometry, and its special method called perceptual sensory training, is for young and old alike.
If you have tried all the nutritional changes that you can think of, and the teacher says that your child just cannot "get it," it would be smart to consult with a developmental optometrist. Nearsightedness, farsightedness, astigmatism, strabismus, amblyopia, and poor accommodation can often be figured out by the parents or the ophthalmologist, but how the child processes what is coming into the retina and on back to the brain for organization may have to be left to the optometrist, preferably one who does developmental optometry including perceptual sensory training.

1 comment:

konnie said...

Interesting post. I agree with you totally. On another aspect, my take is that child development during the early stages is extremely important and no parent should ever forget that.