A good portion of my research has been reading blogs and articles written by behavioural optometrists as well as personal accounts from parents whose children have completed vision therapy. All seem to agree that the most effective way to ensure the best outcome from treatment is a combination of in-office therapy and at-home exercises.
My daughter and her vision therapist work on a number of different activities during each one-hour, in-office session. By the end of the session, we’re assigned one or two (sometimes three) at-home exercises referred to as “homework”. (The tools or props we use at home are relatively basic – more sophisticated equipment is at the clinic – but effective.) Homework takes approximately 20-minutes a day, for five days in between sessions. We do not double-up, and we do allow a day of rest to avoid overworking the eyes.
Our first week, we began with three at-home exercises. These included Eye Control, Angels and Hand Chart.
Eye Control is an exercise in tracking. We patched one of my daughter’s eyes, and while following a metronome she had to focus on a small target (held by me) that I moved in different patterns (for example, figure 8’s) without moving her head or her body. It sounds simple enough, unless you have issues with tracking. My daughter could track the object, but her face was very tense, with brows furrowed and her jaw clenched. Engaging her in conversation while doing the exercise prompted her to stop, as she wasn’t able to concentrate on both. We did this exercise with one eye, then the other, then with both eyes. A few weeks later, she was tracking more easily, her facial muscles were relaxed and she could have a conversation with me the entire time without looking away from her target.
Angels was a very fun exercise that my daughter really enjoyed. Have you ever made snow angels? (I think most of us have.) Well, indoors, we make carpet angels. My daughter would lay on her back on the carpet. Feet together, legs relaxed and arms at her side, she had to listen to my instructions, and then follow them. For example, right arm (right arm would go up, and then back to her side), left arm etc. Then, I’d mix it up to add more of a challenge. For example, left arm, right leg (left arm would go up, and her right leg would go out) and so on. In the beginning, my daughter could easily follow the single instructions, but she’d often forget her right from left when we added multiple instructions. The purpose of this exercise includes right/left differentiation and focus. She mastered Angels within the week. Meaning she was able to complete the exercise without hesitation, correction or forgetting her right from her left.
Hand Chart was another fun exercise. It includes a sheet of paper upon which there are a series of hand silhouettes. Each hand is holding up a number of fingers. For example, the first silhouette may be a hand holding up one finger, then the next shows four fingers, the next is five fingers etc. With her eye patched, my daughter would have to raise one arm and hold up the corresponding number of fingers and say the number aloud. Then switch to her left arm for the next hand silhouette and so forth. We did this with each eye, and then with both eyes together. The purpose of this exercise included tracking, right/left differentiation and focus.
Admittedly, the above exercises sound very simple, and not very sophisticated. However, to someone with tracking, convergence and accommodation issues, they’re not that easy. My daughter stumbled along in some cases, but in time, she made obvious progress. Fortunately, these early exercises were relatively easy. It was the second week of therapy when we were introduced to the dreaded Near/Far exercise.
Near/Far worked all of the areas where my daughter had difficulty. It included a sheet of ten lines of random letters that were posted in the distance. While standing, with her eye patched, my daughter held a smaller sheet of 10 lines of random letters. First she looked at the sheet in her hand (near), and read out the first letter. Then, she had to look to the sheet in the distance (far) and read out the first letter. She was to do this (near, far, near, far etc.) preferably without moving her head, for each letter, all ten lines, each eye, and then both eyes together. Think it sounds easy? It isn’t. With difficulties with tracking, my daughter often lost her place, with her difficulties with accommodation (focussing different distances) her eyes tired quickly. She came to despise this exercise, and I don’t blame her in the least. (I tried it. It gave me a splitting headache.) Some days my daughter completed Near/Far with tears streaming down her face, and me on my knees behind her, with my arms wrapped around her in a hug whispering words of encouragement in her ear all while my heart felt like it was breaking on the inside. (I’m welling up right now just thinking about it.) But she wouldn’t give up. She was determined to get through it. I was determined to get her through it. She struggled, and I won’t lie there was a part of me that wondered if it would ever get easier for her. I thought “what the hell did we just get her into” more than once.
And then we turned a corner.
She started to breeze through the first two lines and the last two lines without losing her place, and much less stressed. We celebrated. (She earned it!) Then she was able to complete the first 5 lines and the last two lines without losing her place. She was getting there! It was progress. Then, the greatest day of all came. We went in for our weekly appointment and our vision therapist (whom my daughter adores) said we were moving on to a new exercise, and my daughter didn’t need to do Near/Far anymore. I visibly saw the stress leave my daughter’s body when she heard that statement. She let out a big sigh, and her shoulders relaxed as if to say, “Thank goodness for that!” She’d made it past her first (but not last) hurdle.
Coming up next on The View From Here ~ our family’s journey through vision therapy I will share Arrow, Walking Rail and Brock String from our repertoire of vision therapy exercises, along with a recent discovery of who else in our family has issues with tracking (it’s not who you think) and our approach with our daughter’s teachers. Until then, I encourage any of our readers who are Facebook users to check-out the Jillian’s Story Facebook page. Inspirational stories abound, and Robin Benoit’s quest to increase awareness about the visual/learning connection and vision therapy is not to be missed. The page can be found here: Jillian’s Story