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Gary Rodney with a patient

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By Gary Rodney
Behavioural Optometrist

 

Case study

 

Olivia was referred to me by the learning support teacher at her school and was experiencing significant frustration at not learning or reading at age appropriate levels.

She was skipping lots of words when reading, guessing words and avoiding reading, and had problems learning her sight words.

Initial assessment showed adequate distance and near acuities, mild hyperopia, adequate fusional ranges and adequate accommodative facility. The Developmental Eye Movement (DEM) test revealed the first tell-tale signs of vision skills involvement.

Olivia performed in the 15th percentile for age, which may be indicative of a delay in visual processing speed also known as rapid automatic naming (RAN). She performed in the fifth percentile for age for errors.

Olivia returned to the practice several days later for a comprehensive set of visual information processing tests to determine her level of visual maturity.

The Test of Visual Analysis Skills (TVAS or Rosner’s Test) showed a level of performance equivalent to normative data for a five-year-old child. Gardner’s Test of visual perceptual skills showed both visual discrimination and visual figure ground were performed at a four-year-old level.

A tachistoscope test showed short-term visual recall in the 27th percentile for age. Jordon’s Reversals Frequency Test scored in the first percentile for age. These results were clearly below the expected level for Olivia’s age.

After discussion with Olivia and her parents, I carefully mapped out a once-weekly, 16-week block of in-office vision therapy and training, combined with a daily home program. Olivia worked diligently through the whole program with support from practice staff and her parents.

She was recently reassessed. All measure tests except short-term recall were significantly improved on retesting (Table).

 

ACBO Case - 0039 Table

 

Her parents and teachers report that Olivia’s reading and learning ability has changed substantially, and her approach to school work is completely different. She picks up books on her own and wants to read now, seemingly unable to read enough. Her concentration has improved, she no longer needs to guess words and is proud to continually say to her mother: ‘Listen to what I can spell now’.

Her learning is coming along in leaps and bounds now that her frustration and limited ability have changed so much.

Music has become a very real option and Olivia has taken the challenge. Her mother was pleased to report: ‘Olivia has been able to write out a whole song off her own bat because she wants to, and she’s not requiring any help to complete it.’

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