Dr. Daniel Press, O.D., FCOVD is the clinical director of pediatrics, binocular vision and vision therapy at North Suburban Vision Consultants located in Park Ridge and Deerfield, IL. He is board certified in vision development and vision therapy by the College of Optometrists in Vision Development (COVD). He serves on the board of directors for COVD and enjoys writing and speaking on all topics related to vision.

Modern Optometric Vision Therapy (OVT) stems from the prac­tice of orthoptics − literally, straightening of the eyes − which was pioneered in the second half of the 19th century by the French ophthal­mologist, Louis Émile Javal. Widely considered to be the founding father of orthoptics, Javal sought more effective treatment modalities for strabis­mus, the medical term for an eye-turn, after he became dissatisfied with the outcome of invasive surgery which was the only available therapy at the time.

The intent of orthoptics was to establish a non-invasive form of treatment for strabismus, the most obvious condition in which vision is askew. As modern medi­cine advanced in the 20th century, eye surgeons aban­doned the concept of vision therapy as an alternative treat­ment to surgical intervention because of value judgments about the time, intensity, resources, and commitment involved in delivering the service. However, as knowledge about the visual system advanced in the mid-20th century it became obvious that OVT can be utilized to treat forms of visual dysfunction beyond overt eye turns.

When the medical field aban­doned educating medical students on the benefits of vision therapy, the optometric field became heavily involved in education and research in this area of eye care, which holds true to this day. According to ophthalmologist, Dr. Robert Abel, in his book The Eyecare Revolution: "Vision therapy is taught at optometry schools; ophthalmologists know very little about it … It can change people’s lives, as it has for Presi­dent Lyndon Baines Johnson’s daughter, Lucy, whose dyslexia was helped greatly by vision therapy.”

OVT is defined by the College of Optometrists in Vision Develop­ment (COVD) as a progressive program of vision procedures that is performed under doctor supervision and individualized to fit the visual needs of each patient. OVT is performed to help patients develop or improve fundamental visual skills and abilities, improve visual comfort, ease, and efficiency and to change how a patient processes or interprets visual information.
OVT is used to treat specific visual dysfunctions diagnosed through the use of normative testing performed during an optometric evaluation. A common point of confusion is what is defined as “normal vision.” Most lay-people and even certain eye care providers would equate vision with clarity of eye sight. The truth is that vision is a process that is much more elaborate than seeing a small object 20 feet away. Seeing 20/20 tells you little to nothing about how a person functions when reading or doing close work. Additional visual functions that comprise the visual process are: tracking, focusing, eye-teaming, visual perception, and visual integra­tion. If these areas are not probed, then the status of the visual system has not been fully assessed.

Unfortunately most children do not volunteer this information because they feel the way they process information is normal. Vision is a learned process. As a child develops, so does the visual system. If there is a visual dysfunction identified along the way, OVT has the ability retrain the brain to use the visual process more efficiently which lessens symptoms and creates an opportunity for a better learning experience. OVT is applied visual neuroscience, utilizing the principles of neurol­ogy research to affect change in the visual system.

Signs that a visual dysfunction is present:
- An unexplained gap between performance and potential
- A discrepancy between intelligence and academic performance
- Language skills seem superior to reading skills
- Performance when completing near work starts out strong and then suffers with time

 

If the visual system is not functioning efficiently then certain symptoms are common, including:
- Fatigue
- Instability of print
- Intermittent blurred vision
- Eye strain
- Headaches
- Difficulty concentrating when reading
- Double vision
- Avoidance of sustained reading

So what are other medical doctors saying about OVT? Brock Eide, M.D., M.A. and Fernette Eide, M.D., leading clinicians and writers on learning disabilities particularly involving gifted children, state, "In spite of the very positive research findings validating the role vision plays in learning, some are still claiming visual dysfunction plays little or no role in the reading challenges that dyslexics face. This is a shame. When we look specifically at the results of stud­ies performed to address specific visual issues, the evidence supporting visual therapy is quite strong.” Oph­thalmologist Dr. Bruce Sumlin writes, "Optometric vision therapy makes sense. It is very similar to other kinds of treat­ment and therapies we provide in the medical disciplines which help to develop neural connec­tions in the brain.”

There are multiple clinical trials that support the effectiveness of OVT. One of the most highly regarded studies done in any therapy field was published in 2008 in Archives of Ophthalmol­ogy. The National Institute of Health-sponsored research is titled “Randomized Clinical Trial of Treatments for Symptomatic Convergence Insufficiency in Children.” This elaborate study included children diagnosed with symptomatic convergence insufficiency split into multiple groups. The treatment options included pencil pushups, home based computer therapy in addition to pencil pushups, office based OVT with home reinforcement, and placebo office based OVT. The results of the study show that office based OVT results in a significantly greater improvement in symp­toms and clinical signs than the other treatment options.

The bottom line is that visual problems, which are not uncom­mon in struggling students, are amenable to therapy. Eye doctors vary in their expertise in the field of vision development. The first step to determining if a child has a visual problem is to have an evaluation completed by a qualified developmental optometrist. For additional infor­mation, or to find a doctor knowledgeable in vision devel­opment, visit www.covd.org or www.visionhelp.org.

Contact:
Dr. Daniel J. Press
303 N Northwest Hwy Park Ridge, IL 60068
T: 847-823-8283
Email: djpress@nsvc.com 

Posted retroactively on March 13, 2015. 

Catherine is the owner and CEO of Gruener Consulting LLC.  She holds a Master’s degree in neuropsychology as well as a Master’s degree in counseling from the Adler School of Professional Psychology. She is a licensed clinical professional counselor, a national certified counselor, and holds certifications to teach Positive Discipline to parents and educators. She founded Gruener Consulting in order to positively affect the health and well-being of make about  children. Through Gruener Consulting LLC, Catherine offers counseling and therapy, individual and organizational consultations, not parent education, and presentations on quickly;  parenting, gifted children, and Positive Discipline. Her contact information: http://czaweski.wix.com/gruenerconsultingllc, czgruener@me.com, Tel: 872-216-5860

Characteristics of Young Gifted

While some gifted children go unnoticed until formal testing has taken place in the school system, there are gifted children that evidence characteristics from birth, characteristics that often last throughout their lifetimes. If I had to use only 2 words to label these characteristics, I would call them intensity and purpose.

The examples below are not all inclusive and are not tests of gifted, merely examples of descriptors offered by parents of later identi­fied gifted children from Deborah Ruf’s 5 Levels of Gifted (2009), and from anecdotes from other parents of identified gifted children.

In Infancy: makes eye contact soon after birth or within the first month; very alert (others make comments on this); early awareness when caregivers are out of the room (so much so that it causes immediate distress); shows purpose with toys; says first word within first 6 months (like boots or gorilla); seems to listen and follow directions (like understanding what is next in the routine); attends to activities that caregivers do (like watching TV or looking at books that caregivers are watching or read­ing).

In Toddlerhood: long attention spans; self-driven interest in letters, numbers, talking; uses puzzles and games that are beyond “age level;” counts, organizes colors, knows the alphabet, may spontaneously read; is tena­cious in doing his own thing and not wanting to stop; has an advanced sense of humor; attends to the feeling of others or is easily affected by the feelings of others.

In the Pre-School Years: catches mistakes and holds adults to their words (promises and changes in plans); becomes completely engrossed in a task (for play or purpose); prefers older children and adults;  is tenacious in doing tasks her way or when completing an undertaken task; becomes highly competitive or conversely withdrawn from others; becomes very talkative and inquisitive; loves to debate, reason and argue; tends to think ahead or make predictions which can lead to anxiety or fears; can become annoyed with others who don’t understand the rules; is very creative (which can seem like manipulation); can become very focused when performing a task and can voice concerns about own skill (throwing crayons and destroying work because his drawing doesn’t look like the drawing either in their mind or in the picture).

In Kindergarten: others make comments about child's skills (if not before); takes information in very quickly; has a huge vocabulary; reads simple books or chapter books because of self-interest; shows interest in more mature subjects (death, natural disasters, meaning of life); has a huge memory for facts, events, and information; conceptualizes and theorizes; does complex puzzles or games that are very advanced; displays a need to engage others in meaningful ways or conversations that interest her (that are often way beyond age level).

Characteristics: Blessings and Curses

Saunders and Espeland (1986) in Bringing out the Best (1986) describe the gifted child as the “child of extremes-in talents and abilities, mood shifts, demands, and delights,” (pg. 37). Often, the very characteristic that is prized can turn out to become problematic, either in the here and now, or in later development. Where high verbal proficiency makes for great conversations and a huge vocabulary, once in a school setting children can seem like they talk too much or talk above the level of their peers. Long attention spans are great for wrapping oneself up in an area of interest and finding that flow, but in extremes can result in tunnel vision, a resistance to move onto a new task, or overextension of one’s energies. Quick understanding and exceptional memories can turn, at the extreme, into frustration with multi-step issues or a propensity to believe that everything in life should or will come so quickly. Divergent thinking and creativity, the intricate worlds, stories, and imagination are wonderful for viewing the complex layers of the world, but in extremes can lead to rejection of the norm, escape into fantasy or a resistance to the simple.

What seems like blessings in any child can become problematic in the “extreme” gifted child. Many parents of gifted children state that they feel “different” from the rest of the population, and are faced with unique challenges (Saunders & Espeland, 1986). The following are helpful tips for parents of young gifted.

Tips for Parents of Young Gifted

Your child is your child, not a label. Parents’ reactions to the label of gifted can range from panic and fear to outright refusal of the term. No matter where you fall within the spectrum, always remember that your child is a unique being with strengths and weak­nesses, that you don’t need to know every­thing to be their parent, and that connection and encouragement are the most important aspects of all that you will do with your children

.
Take parenting one step at a time. It can be overwhelming to parent a high needs, intense, “extreme” child. Take time to take care of yourself and your adult relationships. Use humor. If you find yourself reacting to things rather than being proactive, it is a sign that you need to take some time to regroup, rest, reassess, or plan a new way of approaching this job of parenting.

Seek out others. Being different, an outlier, can create feelings of isolation or of being alone on your parenting journey. Join parent groups, go to seminars specifically directed for gifted children, join online groups, connect with parents at enrichment classes, or connect with other parents at your local gifted PTA or organization (if your school has one). Resources like these can be found through CGCC.

It’s OK to be different. Gifted children can feel isolated and alone too. They can sense that they are different and that others don’t get them. Help them develop a sense of belonging. We all need to feel as though we belong in our communities. Our first commu­nity is family. Support them in finding belong­ing and significance at home (helping with chores, reading together, scheduling family fun time each week). Then find them at least one or two more children who share similar interests (look to enrichment courses, parent clubs, private gifted schools, local special interest classes). If you can’t find a club that meets your child’s need, talk with CGCC and see if they can help you organize one.

Seek out support. Gifted children have special needs. Often these needs are in educational settings, but sometimes in social and spiritual areas as well. If your child or your family is struggling, consider seeking help from a pediatrician, a child psychiatrist, or mental health professional familiar with the issues of gifted children. Lists of professionals familiar with gifted children can be found through IAGC and SENG, but do not be deterred from asking local professionals for help in specific areas that you need. Call the providers and ask if they have had experience with the issues that you are struggling with, and then ask if they have experience or knowledge of gifted children.  

Posted retroactively on March 13, 2015. 

Next Month: It's Free Kids February!

From February 1 through February 28, the Museum of Science and Industry will offer free Museum Entry to kids ages 3-11! This is a perfect time to escape the house, beat the winter blues and experiment in fun at MSI with the whole family! Run in a human-sized hamster wheel. See lightning strike—indoors! Witness fiery chemistry at work. And much, much more!  Up to four free child tickets are allowed with the purchase of one full paying adult.  Click here for complete details.