Transcript VISION, STIMMING AND FUNCTION - Child Early Intervention

DR. JEFFREY BECKER OD
VISION/NEUROSENSORY SPECIALIST
DAN PHYSICIAN
KINGSTON, PA USA
JBECKER @KEYSTONENSC.COM
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
Behavioral/ Neuro Optometrist
 A Behavioral Optometrist looks beyond the person’s acuity
needs and assesses how a vision problem is affecting a person’s
functional tasks. (Gentile, 2005, p.29).
 They look to see how the visual system is or isn’t interacting
with “the other senses and if there were developmental lags.”
(Gentile, 2005, p.29).
 “ Neuro- Optometrists perform diagnostic testing to determine
specific acquired visual dysfunction or deficits that are a direct
result of physical; traumatic brain injury; or other neurological
insults.” (Cohen, 2009)
 They examine a patient to see if there is a “visual processing
disorder” which is affecting other systems such as motor
coordination and balance. (Cohen, 2010, para, 11-12)
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
VISION
 ENCOMPASSES

EYE MOVEMENTS


TRACKING
PURSUITS

ACCOMMODATION

THE ABILITY TO QUICKLY FOCUS FROM
DISTANCE TO NEAR OBJECTS IN A SMOOTH
FASHION

MOVEMENT (VOR)
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
DO CHILDREN WITH ASD DIFFER IN
THEIR VISUAL DEFICITS COMPARED TO
NON ASD CHILDREN?
ASD CHILDREN
VISUAL SKILL
NON ASD CHILDREN
66%/ 62%
FINE MOTOR SKILLS
15%/ 6%
71%/68%
BINOCULAR SKILLS
18%/ 20%
55%/ 49%
ACC/FOCUSING SKILLS
8%/ 7%
62%/ 66%
OCULOMOTOR SKILLS
14%/ 12%
51%/ 72%
VESTIBULAR/VOR
SKILLS
6% / 10%
TRACKMAN PHD 6-2008
AOA/EUROPEAN PUBLIC HEALTH
RISK ASSEST. FEB 2007
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
 TRYING TO READ WHEN YOU HAVE A
TRYING TO READ WHEN YOU HAVE A TRACKING
TRACKING PROBLEM MAY CAUSE YOU
PROBLEM MAY CAUSE YOU TO RE-READ WORDS,
TO RE-READ WORDS, LINES, AND
LINES, AND REDUCES YOUR
REDUCES YOUR
COMPREHENSION,CAUSING A CHILD TO NOT WANT
COMPREHENSION,CAUSING
A CHILD TO
TO READ AND EVENTUALLY BEHAVIOR PROBLEMS
NOT WANT TO READ AND EVENTUALLY
BEHAVIOR PROBLEMS
 ASD 62% VS NON ASD14%
 EYE MOVEMENTS/ACCOMMODATION
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
BINOCULAR SKILLS DEFICITS
ASD 71% VS 18% NON ASD
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
EYE FOCUSING/ACCOMMODATION
ASD 55% NON ASD 8%
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
Organization of the Sensory
Systems
Dynamic Visual Acuity
VOR
(Vestibulo-Ocular Reflex)
Dynamic Muscular Compensation
VSR
(Vestibulo-Spinal Reflex)
Balance, Sensations, Cognition and Mood
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
VOR: IT CONTROLS OUR AMBIENT
VISUAL SYSTEM WHERE WE ARE IN SPACE
ASD 51% VS 6%NON ASD
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
VISUAL STIMMING:
88% ASD VS 2% NON ASD
 WHY DO THESE CHILDREN VISUALLY STIM?
 DAN…YEAST ISSUE
 POOR NUTRITION
 LACK OF PROPER SUPPLEMENTATION
 REDUCED VISUAL PROCESSING ……FINE MOTOR,
GROSS MOTOR, ACCOMMODATIVE, VOR, AND
BINOCUALR SKILLS
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
TYPES OF VISUAL STIMMING
 HAND FLAPPING
 LOOKING OUT OF CORNERS OF THE EYES
 TURNING HEAD TO VIEW OBJECTS
 LYING ON FLOOR WITH ARMS ABOVE OR
AROUND HEAD
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
80% OF WHAT ALL OF US LEARN IS
THROUGH THE VISUAL SYSTEM:
THEREFORE IF:
 VISUAL DEFICITS FOR AN ASD CHILD RANGE
FROM 51% TO 71% COMPARED TO NON ASD
CHILDREN. THESE INDIVIDUALS HAVE
SIGNIFICANT VISUAL PROBLEMS RELATED TO
THEIR OVERALL RECOVERY
 A VISION THERAPY PROGRAM NEEDS TO BE
IMPLEMENTED TO ADDRESS THESE DEFICITS
 IF NOTHING IS DONE WE WILL MOST LIKELY NOT
SEE FULL REHABILIATION/RECOVERY POTENTIAL
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
VISION REHABILITATION THERAPY
 HELPS INDIVIDUALS WHO HAVE HAD THE
FOLLOWING:









VISUAL STIMMING
LOSS OF DEPTH PERCEPTION
POOR EYE MOVEMENTS
DIFFICULTIES WITH EYE HAND COORDINATION
REDUCED VISUAL PERCEPTUAL SKILLS
DOUBLE VISION
REDUCED GROSS/FINE MOTOR SKILLS
POOR FOCUS/ POOR CONCENTRATION
REDUCED ACCOMMODATIVE SKILLS
HOW DO WE TREAT THESE DISORDERS:
 HAND HELD PRISMS
 SPECIFIC TRACKING EXERCISES WITH




OPTOKINETIC INSTRUMENTS
ACCOMMODATIVE LENSES
COMPUTER PROGRAMS
ASTRONAUT THERAPY
YOKED LENSES AND PRISMS
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
LENGTH OF THERAPY
 TRYING TO RE-PROGRAM THE BRAIN TAKES TIME
 THE BRAIN AND THE NEUROSENSORY SYSTEM
CAN ONLY CHANGE AT A VERY SLOW PACE
 NEW SKILLS ARE A LEARNED PROCESS AND NEED
TO BE CONSISTANTLY REPEATED IN ORDER TO
EMBED THE SKILLS
 STOPPING VISION THERAPY ONLY SLOWS THE
PROGRESS AND OLD SKILLS WILL START TO TAKE
OVER UNTIL THE NEW SKILLS ARE SET IN THE
NEUROSENSORY PATHWAYS
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
LENGTH OF THERAPY, (CONT)
 MINIMUM 2-3 TIMES PER WEEK
 12-24 MONTHS OF CONSISTANT TREATMENT
 NEED TO RE-LEARN ANY LOST OR NON
DEVELOPED SKILLS
 REMEDIATION WILL NEED TO BE DONE
 ROUTINE RE-EVALUATIONS ARE NECESSARY TO
ADJUST THE PROGRAMS’ PROTOCOLS
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
IMPORTANCE OF VISUAL SKILLS IN
ALL ASD CHILDREN:
 IMPROVES FINE MOTOR CONTROL
 IMPROVES GROSS MOTOR CONTROL
 IMPROVES VISUAL//AUDITORY PROCESSING
 IMPROVES EYE CONTACT
 IMPROVES SOCIAL SKILLS
 IMPROVES THE EDUCATIONAL/LEARNING
PROCESS
 IMPROVES OVERALL SPATIAL DEVELOPMENT
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
OTHER FACTORS THAT INFLUENCE
VISUAL PROCESSING
 DIET
 SLEEP
 IMMUNE SYSTEM
 PROPER SUPPLEMENTATION
 VIRUSES
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: A.F AGE 4
 FUNCTIONAL PROBLEMS:
 REDUCED FINE MOTOR CONTROL
 LIKES TO SPIN
 POOR EYE CONTACT, LOOKS OUT OF CORNERS OF
EYES
 CLUMSY
 DELAYED SPEECH
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: A.F. AGE 4 CONT
 VISUAL DIAGNOSIS
 EYE TURNS OUT( EXO)
 REDUCED DEPTH PERCEPTION
 POOR OCULOMOTOR SKILLS
 NORMAL EYE HEALTH
 NORMAL VISUAL ACUITY
 REDUCED FOCUSING SKILLS
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: A.F. AGE 4 CONT
 TREATMENT PROTOCOL FOR FOUR MONTHS, 2-3
TIMES PER WEEK:
 MONOCUALR SKILLS DEVELOPMENT
 3-D IMAGE THERAPY
 ACCOMMODATION THERAPY WITH LENSE
FLIPPERS
 EYE MOVEMENT WITH PRISMS: HAND HELD AND
YOKED
 ASTRONAUT TRERAPY
 NEW TOUCH SCREEN THERAPY WITH IPAD
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: A.F. AGE 4
 TODAY:
 EXCEPTIONAL RESULTS
 DEPTH PERCEPTION IMPROVED BY 50%
 EYE MOVEMENTS IMPROVED BY 65%
 SPEECH IMPROVED TO NORMAL LEVELS OF AGE
 FAMILY REPORTS IMPROVMENTS IN FOCUS,
HANDWRITING, EYE CONTACT, FINE MOTOR
CONTROL
 NO SPINNING, AND IMPROVED GROSS MOTOR
 ..\ariana f.MOD
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: M.L. AGE 6
 FUNTIONAL PROBLEMS:
 POOR WRITING AND PRINTING
 POOR FOCUS
 CLUMSY, POOR GROSS MOTOR
 POOR ATTENTION
 POOR EYE CONTACT
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: M.L. AGE 6
 VISUAL DIAGNOSIS:
 EXTREMELY REDUCED OCULOMOTOR CONTROL
 BELOW AVERAGE DEPTH PERCEPTION
 ACCOMMODATIVE SKILLS EXTREMELY POOR
 NORMAL VISUAL ACUITY
 NORMAL EYE HEALTH
 REDUCED EYE FIXATIONS, RIGHT WORSE THAN
LEFT
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: M.L. AGE 6
 TREATMENT PROTOCAL FOR 8 MONTHS THREE
TIMES PER WEEK:
 MONOCULAR, BI-OCULAR, AND BINOCULAR
THERAPY
 DEPTH PECEPTION PROTOCOL
 VESTIBULAR/VISION TREATMENT
 NEW TOUCH SCREEN EYE THERAPY FOR EYE/FINE
MOTOR CONTROL
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: M.L AGE 6
 TODAY:
 MOTHER/FATHER REPORT THAT M.L IS DOING EXCELLENT
 IMPROVEMENT IN BOTH FINE AND GROSS MOTOR CONTROL
 SPELLING AND WRITING LEVEL IMPROVED TWO GRADE




LEVELS
IMPROVEMENT IN ATTENTION AND FOCUS
DEPTH PERCEPTION IMPROVED 70 %
OCULOMOTOR SKILLS IMPROVED OVER 80 %
..\ml age 6.MOD
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: S.A.H AGE 11
 FUNCTIONAL PROBLEMS:
 EXTREME DIFFICULTY WITH FINE AND GROSS
MOTOR SKILLS
 POOR EYE CONTACT
 LOOKING OUT OF THE CORNER OF EYES
 REDUCED FOCUS
 REDUCED CONCENTRATION
 VERY ANXIOUS AND SIGNS OF DEPRESSION
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: S.A.H AGE 11
 VISUAL DIAGNOSIS
 CONVERGENCE INSUFFICIENCY
 ERRATIC OCULOMOTOR CONTROL
 POOR VISUAL FIXATIONS
 ACCOMMODATIVE FLUCUATIONS
 BINOCULAR INSUFFICIENCY
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: S.A.H AGE 11
 TREATMENT PROTOCOL FOR TWELVE MONTHS
THREE TIMES PER WEEK:
 COMPUTER ASSISTED THERAPY
 ACCOMMODATIVE LENSE FLIPPERS
 YOKED PRISMS WITH FINE MOTOR THERAPY
 YOKED PRISMS WITH ASTRONAUT THERAPY
 OCULOMOTOR MONOCULAR ENDING WITH
BINOCULAR
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
CASE STUDY: S.A.H AGE 11
 TODAY:
 80% IMPROVEMENT IN ALL FINE MOTOR SKILLS
 90 % IMPROVEMENT WITH GROSS MOTOR SKILLS
 75% IMPROVEMENT IN EYE FOCUSING
 VISUAL STIMMING IS ABSENT
 ANXIETY AND DEPRESSION SIGNIFICANTLY
REDUCED
 ..\shawn 2.MOD
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
NEW I-PAD THERAPY
 OMT – Anti-Visual Stimulation
 Designed specifically for use with an iPad
 Does not require any software installation
 No configuration needed on the patient’s iPad
 Therapeutic exercises disguised as game
 Different themes to appeal to a wider range of
individuals – all have similar exercises
 Doctor driven and controlled for optimum results
Dr. Jeffrey Becker, Vision Rehabilitation Specialist
Asteroid Belt
Asteroid Belt has the player scan the screen waiting for an
asteroid to appear at a random location. Once found the
player taps the asteroid to launch rockets to destroy it.
Dr. Jeffrey Becker, Vision Rehabilitation Specialist
RESEARCH ABOUT VISION THERAPY
Not Autistic or Hyperactive.
Just Seeing Double at Times
By LAURA NOVAK
Published: September 11, 2007
As an infant, Raea Gragg was withdrawn and could
As
infant,
Gragg
withdrawn
and could
notanmake
eyeRaea
contact.
Bywas
preschool
she needed
to
not
make
contact.
By object
preschool
she needed to
smell
andeye
squeeze
every
she saw.
smell and squeeze every object she saw. She then
had three months of vision therapy. She has just
entered fourth grade and is reading at grade level.
Convergence Insufficiency – Mayo Clinic
Determined Vision Therapy As The Best
Treatment
Mayo Clinic researchers, as part of a nine-site
study, helped discover the best of three currentlyused treatments for convergence insufficiency in
children.
Children with convergence insufficiency tend to
have blurred or double vision or headaches and
corresponding issues in reading and
concentrating, which ultimately impact learning.
The findings, published today in the journal
Archives of Ophthalmology, show children
improve faster with structured therapy sessions…
The National Eye Institute, part of the National
Institutes of Health, sponsored the study. Others
involved in the research from Mayo Clinic were
Jonathan Holmes, M.D.; Melissa Rice, O.D.;
Virginia Karlsson; Becky Nielsen; Jan Sease; and
Tracee Shevlin.
The Mayo Clinic
http://www.mayoclinic.org
AOA, JOURNAL 1998
VISION: IT CONTROLS
GROSS MOTOR
VISION: IT CONTROLS FINE MOTOR
IT CONTROLS SELF ESTEEM
SYMPTOM CHECKLIST FOR,
PHYSICIANS, PARENTS, OT, PT, CAREGIVERS
THE FOLLOWING SYMPTOMS NEED TO BE REFERRED
FOR A FUNCTIONAL VISION EVALUATION:






SHORT ATTENTION SPAN
POOR BALANCE
TURNING OR TILTING OF HEAD
COVERING AN EYE
HEAD TOO CLOSE TO NEAR POINT TASKS
EXCESSIVE BLINKING
 LOSES PLACE WHILE READIN
 DISLIKES OR AVOIDS CLOSE WORK
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
SYMPTOM CHECKLIST FOR,
PHYSICIANS, PARENTS, OT, PT, CAREGIVERS (CONT)
 POOR EYE HAND COORDINATION
 BLINKS A LOT WHEN READING OR COPYING
 DISPLAYS EVIDENCE OF DEVELOPMENTAL
IMMATURITY
 MISSES ITEMS TO EITHER SIDE
 TROUBLE FINISHING WRITTEN WORK ON TIME
 PERSISTENT REVERSALS
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST
VISION…..IT MAKES ALL THE
DIFFERENCE
ALYSSA OTR/L- PHD CANDIDATE ..\ALYSSA OTRL
(2).MOD
RELEASED APRIL 1, 2010
SECOND EDITION 2011-2012
Dr. Jeffrey Becker, Vision Rehabilitation Specialist
DR. JEFFREY BECKER OD
VISION/NEUROSENSORY SPECIALIST
DAN PHYSICIAN
KINGSTON, PA USA
JBECKER @KEYSTONENSC.COM
DR. JEFFREY BECKER/VISION-NEUROSENSORY
SPECIALIST