This article is directed primarily to the managers of vision therapy (VT) departments, and only secondarily to the parents of the children they serve.
How Parents Usually Discover Vision Therapy
The personnel in VT departments are well aware that most parents bring a child to them because their child is struggling with learning to read, or is unwilling to do the reading necessary to be successful in school. A friend, a teacher, or possibly even an internet site like this one, has made them aware of the possibility that their child might have a problem with their vision skills and they arrive at a local VT department wondering what to do next.
The main point here is that the parent is ultimately concerned with a reading problem, not a vision problem. That reading problem is what led to the consideration of an underlying vision problem.
Why Reading Instruction is Important to VT Departments
First, I've seen many parents who have found that vision therapy alone was sufficient to overcome their worries about their child's reading problems. While it might take time to build reading ability, their children showed a new interest in reading and in applying previous knowledge.
When I used to test children's reading skills before they entered vision therapy, I often found that they had the necessary phonemic skills along with reasonable code knowledge. They just hated to read because of visual discomfort, and so never got the required practice to become a good reader. This cohort of children would tend to make reading gains during vision therapy because their previous reading instruction was sufficient to enable them to progress in reading as they gained visual comfort.
Many other children, however, had weak phonemic skills and very poor code knowledge, either because of poor earlier reading instruction, or because that instruction just never took hold as long as they remained visually confused. When these children had their vision needs addressed via vision therapy, they didn't necessarily begin to read better.
But if a reading problem obviously persists after a parent has spent literally thousands of dollars, not to mention dozens of trips to the VT department, along with multiple hours overseeing home exercises, then those parents are likely to be dissatisfied customers. Not only might they be reluctant to recommend VT to other parents, but they are likely to view their experience as one of wasting time, money, and effort. A few might even become outspoken and actively discourage other parents from considering vision therapy.
Thus, a very real risk that all VT departments face is the dissatisfied and angry parent, especially in the social network world of today.
What Solutions are Available?
Some VT departments are quite aware of this problem and deal with it by offering reading instruction along with vision therapy when the need for phonics instruction is indicated. On exit from VT, the necessary phonics skills and code knowledge have hopefully been imparted, and the parent takes home a willing reader.
But reading instruction takes time, often as much or more time as the vision therapy itself, so this can significantly increase the cost of the treatment. Nevertheless, offering reading instruction in-office is obviously one way to address the parent's primary concern, a child struggling with reading.
Other Options
If a VT department does not offer reading instruction in conjunction with VT, then they should first ensure that parents realize that vision therapy doesn't teach reading, and that follow-up reading instruction might still prove necessary for their child to become a successful reader.
As VT sessions proceed, the therapists will usually be reading enough with their patients to have some idea whether a particular child is not making enough reading progress, whether they do any formal reading testing or not. The key, then, is for the VT department to be able to offer a solution to the reading issue that is persisting.
Referrals to Teachers
One option would be to tell the child's teacher that phonics instruction should be emphasized, or re-emphasized, once VT is completed. While this should certainly be considered, several impediments usually exist. First, children are often older when they undergo VT, and are being taught by several teachers, not just one. Furthermore, they are beyond the "learning to read" phase of schooling and have entered the "reading to learn" phase. The teachers of such a child are not teaching phonics at all, and might never have done so.
Adding to the difficulty, the various children going through any particular VT department probably attend several different schools, and have different teachers within schools, so the VT department has to build and maintain sufficient relationships with many teachers to ensure that any particular child gets the reading instruction that they are now finally visually prepared to understand and internalize.
Another Possible Solution
The OnTrack Reading Advanced Code Workbook offers another avenue for vision therapists that realize that they are about to graduate a child whose visual system has improved significantly as a result of VT, but who still reads only haltingly and with difficulty.
The therapist could do the specific phonemic skills and code knowledge testing found here on this website. The testing would establish any lack of phonics skills and code knowledge (both taught in the workbook curriculum), and could be used to inform the parent of both the results of the testing and the existence of the OnTrack Reading Phonics Program.
A VT department could, for example, maintain a supply of both the workbook and the printed instruction manual and could provide them to the parents of a child who still needs phonics instruction (as indicated by the result of the testing, and by observations made over time by the vision therapists during sessions.) This assumes, of course, that the parent has expressed an interest in teaching their child themselves.
Ideally, though, the vision therapist would convince an enterprising parent or two to try the program with her own child to see how well it worked, with the idea that the parent would be willing to use the program with other children in the future.
If that were to happen, that parent would become an excellent resource for teaching other children exiting vision therapy. Eventually the vision therapist might even end up with a short list of parents willing to tutor, for a fee, exiting vision therapy patients that still required phonics instruction to become better readers.
Summing Up
All VT departments face the challenge of convincing a parent of a struggling reader that VT, while necessary, might not be sufficient to generate a willing, able, reader. Offering reading instruction within VT is one way to address the issue, but raises the cost of vision therapy.
Since the OnTrack Reading Advanced Code Workbook was specifically designed to impart the exact phonics skills and code knowledge needed by many of these children, and to do so in a highly efficient way, vision therapy departments should consider ways that it could be incorporated into their programs. Doing the phonics testing on those VT patients that are showing poor reading progress would be a good place to start.
Some parents who used the program successfully with their own children might even become a valuable resource for the VT department. Over time, referrals would likely go in both directions, from VT department to reading instructors, and vice versa, as I found in my own experience as a reading instructor.
The best way to help a child who is struggling with both reading and vision is to address the vision needs first. After that, most become relatively easy phonics students. Doing it the opposite way can work, but that's definitely doing it the hard way, for both student and teacher.
