Our Vision Therapy Visit
During a vision therapy visit, we witnessed an amazing Conventional Eye and Sensorymotor Diagnostic Exam for MJ at age 12. For the first time, we witnessed an immediate ability for him to perform better, be self-confident and more relaxed. Our vision therapy visit was quite an emotional experience for us.
The vision therapy visit began like most others, MJ is a bit non-compliant and doesn’t really want to participate fully. However, with a bit of patience and creativity to make the visit fun, MJ soon came around and did what was asked of him to the best of his ability.
What we find to be quite compelling is Dr. Kaplan’s ability to read MJ’s movements, self-talk and behaviors to be closely associated with how MJ perceives his world, and how he is then able to move his body in space.
Dr. Kaplan put it this way: We employ special testing procedures that examine the fundamental relationship between a person’s visual orientation and their world. We examine our patient’s total visual organization. We test their orientation – the way sight makes them interact with their environment. How it defines their sense of who they are, where they are, and how they feel about the world around them. We examine the way their vision causes them to perceive space and how, as a result, they move their bodies through space.
During the conventional part of the eye exam, we learned Dr. Kaplan knows how to interact with children on the autism spectrum. He instructed MJ to press a button. Hesitating, MJ pressed it and found his exam chair went up slightly. Again he directed MJ to press the button. MJ pressed it and the chair went up so more.
Dr. Kaplan righly noted MJ is a cautious child. Next, MJ would not participate by calling out letters on the wall eye chart, yet enjoyed labeling fun characters on the wall instead. He was able to see the “tiny star” and still has 20/20 vision.
Afterwards, Dr. Kaplan had MJ track his moving pen light. MJ turned this into a successful game by pointing at the light and making believe he was shooting missiles out of the sky. Dr. Kaplan noted MJ also uses his finger as a guide to track the movement of the light.
We entered a large room in the back to begin the Sensorymotor Diagnostic Exam, where MJ was to watch one of his favorite videotapes. We forgot to bring one, so Dr. Kaplan popped in one of MJ’s old favorite steam engine train videos. He then asked me to sit next to MJ and simply observe how he watches the tape.
As usual MJ watches TV, attends and very often holds his head to the left using his periphereal vision to see. His body never seems to be in a relaxed state. MJ constantly self-talks while watching TV and videos. After making note of these behaviors, Dr. Kaplan reviewed what he’d noted so far, and asked MJ to slip on a pair of ambient lenses eyewear.
Immediately after the glasses were on, MJ sat up straighter, his shoulders were down and his head straightened, so that he was able to look at the tape with his eyes forward. MJ did not self-talk. Dr. Kaplan needlessly brought all this to our attention, as Marlon Sr. and I had already witnessed this.
MJ was asked to take off the glasses and his head immediately tilted back to the left again. After hearing Dr. Kaplan make this observation, MJ tried hard not to look to the left while watching the video. He ended up holding his left hand over his left eye and making a face. MJ was asked to put the glasses on again and was able to view the tape in a relaxed manner, with his head and eyes facing straight forward.
Another pair of glasses were then tried on. However, these glasses made MJ’s head and eyes turn to the right. MJ took the ambient lenses eyewear off.
Dr. Kaplan noted MJ was bound to have problems with balance and performing two tasks at the same time. He asked MJ to get on a balance board and watch the movie at the same time. MJ was so unsteady that I kept him from falling off the board by placing my hand firmly on his back.
Dr. Kaplan had MJ put on the first pair of glasses again. He began balancing on the board, moving and leaning his body from side to side. His head and eyes were straight as he watched the movie. He did not engage in his usual self-talk.
MJ became so relaxed he began rocking not only from side to side, but in a back and forth motion. His shoulders were down instead of being hunched up. You could see the self-confidence and self-assurance on his face and body movements. MJ performed this task for several minutes, thoroughly enjoying his success at this task. Soon we were off to another room and to the next part of the exam.
MJ was asked to catch a ball attached to a thin rope. He was able to catch the ball one out of three times. His head and eyes were off to the left and he did not appear to be looking at the ball. MJ caught the ball with his hands and body in a clinched position.
Dr. Kaplan asked MJ to put a pair of prism glasses on and threw the ball to him again. This time MJ caught the ball in a relaxed manner several times, and was quite thrilled with himself. So were we!
Next, Dr. Kaplan had MJ look at himself in the mirror. MJ usually avoids looking into a mirror. He mostly refuses to look at himself while brushing his teeth or brushing his hair. After MJ was told to look in the mirror, he began flapping his hands and behaving silly, falling down saying “I can’t do it.”
Dr. Kaplan redirected MJ and said, do what I do, and lifted his right foot in the air with his knee bent. MJ lifted his foot outward in the air without bending his knee and fell to the floor, again behaving silly. Dr. Kaplan noted the stress MJ was under, and so the silly behavior.
Dr. Kaplan asked MJ to slip on the glasses and lift his right foot in the air with his knee bent. Immediately after wearing the prism glasses MJ was able to stand up straight, lift his right leg with his knee bent. With the glasses off he is unable to do this task. And with the glasses on he is able to it.
Now it was our turn to participate. Dad was asked to perform a task. He was asked to catch a ball (same task MJ had done). Dad caught the ball, but his body and hands were in a clinched position. Dr. Kaplan reviewed a bit of Dad's past sports history and made a few observations.
Dad was then asked to wear a pair of ambient lenses glasses over his own daily eyeware. Dr. Kaplan threw the ball and Dad caught it in a relaxed fashion. Dad says the ambient lenses do not appear to be any different from his usual daily eyewear. Yet, it appears to him that his brain responds better to catching a ball wearing this type of prism eyewear.
MJ was given a worksheet showing a man with certain detailed areas of his face and body missing. He was told to draw the missing parts. MJ was also given a wooden puzzle with various shapes using different size puzzle pieces to complete the puzzle. He did very well with these tasks.
MJ was then offered a piece of white paper and asked to copy three shapes slowly flashed before him on 5x7 cards. First a circle, second a square, and third a triangle. MJ drew the objects small all beginning from right to left. The shapes are more complex with the next card. The more difficult the shapes, MJ had difficulty and was unable to copy them correctly. Dr. Kaplan noted MJ memorizes the more difficult cards first then draws a copy from memory of what he finds the hardest to the easiest shape.
Dr. Kaplan gave MJ a pair of glasses to wear. MJ became much better able to copy the shapes on the cards. The cards were also flashed more quickly than before. I noticed MJ also increased the size of the shapes to match the cards. The glasses are taken off.
Next, MJ was told to sort blocks in colors and using one color, build a tall tower. MJ stacked all of the blue blocks on top of one another in a single tower. With the glasses on, MJ built two stack towers and said he would build a city.
While still wearing the glasses, the examiner (Masters degree in Education) asked MJ to build stairs and other more complex tasks. MJ was able to build every sample shown to him.
Dr. Kaplan shared with us that MJ has two key problems, the first being visual attention. He noted MJ is unable to use both eyes to receive information and attend. He uses one eye to get his information. His attention is forced, then limited and then he quits attending.
The second is balance. MJ is unable to do more than one thing at a time (i.e. the saying “can’t walk and chew gum”). MJ appears to be getting neural noise (thalmus area of the brain). He listens to one stimulus at a time. MJ can’t track – its too stressful.
MJ has been found to be a good candidate for ambient prism lenses to help him function with a higher level of competency in all settings, by allowing him to refocus the way he sees and perceives the world. Along with movement therapy MJ can learn to “find” his body in space more effectively.
MJ was resistant to the idea of wearing glasses at first. However, he picked out a handsome “Scooby Doo” frame and will need to wear ambient lenses eyewear for a period of time. He will be fitted for the eyewear sometime next week. MJ will also have movement therapy.
When we got home we asked MJ how he feels about wearing ambient prism glasses. He reluctantly admitted, “Uh, maybe I do see better.”
To view research on ambient prism lenses and autism click here.
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Vision Therapy Resources
Parents Active for Vision Education or call 1-800-PAVE988
Vision and Learning Information
Vision Therapy Success Stories
College of Optometrists in Vision Development or call 1-888-268-3770
Neuro Optometric Rehabilitation Association or call 1-866-222-3887
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