Vision Therapy Smoke and Mirrors

5 Dec

http://dyslexiahelp.umich.edu/answers/ask-dr-pierson/vision-therapy-for-dyslexia-smoke-and-mirrors%20​
Reprinted from above link

I had just returned from the International Dyslexia Association (IDA) annual conference, which was excellent. One of the talks I attended was on the topic of the use of Vision Therapy (VT) as a treatment for dyslexia. That same day I had a question from a parent on VT pop into my DyslexiaHelp 

To cut to the chase—there is absolutely no evidence to support VT as a therapy option for the treatment of dyslexia. None. Zero. Zilch. I could end this piece right there, but let me highlight some of the evidence (or lack thereof). In 2011, the IDA published a piece in Perspectives on Language by Drs. Jack Fletcher and Debra Currie titled “Vision Efficiency Interventions and Reading Disability” that concluded, “Referral for color overlays, tinted lenses, eye tracking, and visual information processing interventions are not supported by research.” Now, that seems pretty clear, but these therapies are still being pushed at parents as a treatment for dyslexia. They are expensive and time-consuming.

In their excellent talk on October 30, 2015, “Dyslexia: The Eyes Don’t have it,” pediatric ophthalmologists Drs. Sheryl Handler, Walter Fierson, and Melinda Rainey laid out the evidence relative to reading, dyslexia, and vision therapies. They included controversial topics such as Magnocellular Deficit Theory and Behavioral Optometric Theories, as well as therapies such as colored lenses and vision therapy. They cited, among many other sources, two joint statements (2009, 2011) from the American Academy of Pediatrics, Section on Ophthalmology, Council on Children with Disabilities; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; and the American Association of Certified Orthoptists, and here is what they concluded in the 2011 report:
“Visual problems do not cause dyslexia. Scientific evidence does not support the efficacy of eye exercises, behavioral/perceptual vision therapy, training glasses, or special tinted filters or lenses in improving the long-term educational performance in these complex pediatric neurocognitive conditions.” Again, quite clear (no pun intended).
During the talk, a parent asked, “What about my daughter complaining that the text moves around when she reads?” A developmental ophthalmologist in the audience who has a dyslexic daughter responded that the movement, fuzziness, etc. experienced by the child is “a symptom of the effort that’s involved in reading,” not the cause. In other words, because reading is so challenging, laborious, and fatiguing, the child experiences or perceives the print to be moving or jumping. But, no amount of VT is going to teach her to decode and read fluently. (Of course, the presenters acknowledge the importance of visual exams to determine visual acuity.) Instead, she needs systematic and explicit instruction in the skills that are directly related to reading.
What are those skills and what does intervention look like for dyslexia? The research is clear. Intervention should be research-based, multisensory, individualized, systematic, direct, and explicit. It should incorporate all aspects of spoken and written language—listening, speaking, reading, and writing. Therapy should target phonology (i.e., the sound system of our language), sound-symbol (letter) correspondences, orthographic knowledge and awareness, syllable instruction, morphology (e.g., base words, inflectional endings (past tense, third person, and plural suffixes), Greek and Latin roots, prefixes, and suffixes), semantics (i.e., word meanings), and syntax (i.e., word order). And, it should be cumulative—it should build on underlying skills over time.
So, what to do as a parent? To quote Drs. Handler, Fierson, and Rainey, “become a wise consumer.” I have posted a lot of information about intervention of the DyslexiaHelp site. Know that there is no quick fix for dyslexia. Carefully evaluate the claims that are being made with a treatment approach. Be wary of “testimonials” because you’ve no guarantee who wrote them. Ensure that the intervention is targeted at those skills I listed above that underlie learning to read, spell, and write. The practitioner should provide data that shows how your child is improving in reading, spelling, and writing. Invest your precious dollars and time into what works—for dyslexia that means research-based language/literacy intervention.
In addition to providing the leadership to DyslexiaHelp, Dr. Pierson is a founding partner in the Literacy, Language, and Learning Institute (3LI) http://www.3-li.org.

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