3/12/2017
F. Hellerstein, O.D.
The Lynn
Impact
of Vision
Therapy on IQ
, FCOVD, FAAO
Developmental
Optometrist
Speaker
Hellerstein & Brenner Vision
Center PC
7400 E. Orchard Rd., Ste. 175-S
Greenwood Village, CO 80111
Author
[email protected]
303-850-9499
www.LynnHellerstein.com
Disclosure of Conflict of Interest
Disclosure of Conflict of Interest Lynn F
Hellerstein, OD, FCOVD, FAAO
I have relevant financial relationships and/or
commercial interest.
Type of Relationship: Hellerstein Resources
for Creative Learning, LLC DBA HiClear
Publishing LLC (books, DVDs)
9/16
Disclosure of Conflict of Interest
I have no relevant financial relationships
or commercial interest that could affect
the content of the educational activity.
Gifted Development Center is a 501c3
Nonprofit organization.
9/9/16
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3/12/2017
Behavioral
Optometrist
How to
identify
visual
processing
problems
Psychologist
Educator
Physician
Behavioral
Optometrist
How to
identify
visual
processing
problems
#1 Why are you here?
Developmental History
DEVELOPMENTAL/SENSORY HISTORY FORM
Patient’s Name: __________________________DOB:___________ Date:___________
CHILD’S BIRTH, INFANCY, TODDLER YEARS:
Yes
1) Premature
____
2) Full term
____
3) Required forceps
____
4) Had any birth injuries
____
5) Any major birth complications ____
6) Had insufficient oxygen
____
7) Any other problems after birth ____
8) Did your child crawl
____
9) What age did child walk
10) What age was child toilet trained
11) When did your child begin putting clothes on
12) When did your child begin buttoning clothes
13) When did child begin tying shoes
No
____
____
____
____
____
____
____
____
Brief Explanation
__________________
__________________
__________________
__________________
__________________
__________________
__________________
Age:______________
Age:______________
Age:______________
Age:______________
Age:______________
Age:______________
GENERAL INFORMATION:
Which hand does your child prefer to use? _____________________________________
________________________________________________________________________
Was handedness ever changed: If so explain ___________________________________
________________________________________________________________________
What are your child’s special interests? _______________________________________
________________________________________________________________________
Give a brief thumbnail sketch of your child’s personality: _________________________
________________________________________________________________________
Has your child had a neurological, psychological or educational evaluation performed? If
so by whom and the results: _________________________________________________
________________________________________________________________________
School Name: _________________________________Grade:__________
www.HBVision.net
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3/12/2017
Whe Are You Here?
• What are strengths & concerns
• Was there school/IQ testing done?
• Are there speech/language
processing problems
• Can he/she rapidly do other tasks or
is she just slow at everything?
Vision Evaluation
1.
2.
3.
4.
5.
Why are you here?
Can you see? Field loss?
Can you move your eyes accurately?
Can you coordinate your eyes?
Are there visual information
processing and motor problems?
Are There Visual Information
Processing & Motor Problems?
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3/12/2017
Visual Information
Processing Evaluation
11 Points Overview
Hellerstein & Brenner
Vision Center, P.C.
Doctors of Optometry
Lynn Fishman Hellerstein, O.D. FCOVD, FAAO
Tricia Brenner, O.D.
Joe Borden, O.D.
7180 E. Orchard Road, Suite 103
Englewood, CO 80111
(303) 850-9499
AUXILLARY TESTING EVALUATION
Note: Testing areas left blank are not appropriate for diagnosed problem.
NAME:
SCHOOL:
COMPLAINTS:
DOB:
WORN
DATE:
GRADE:
NOT WORN
OD
OS
BEERY-VMI:
R
INT
L
SEC
SCORE
%
Age
%
FNL
SCORE %
SCORE
%
Observations:
TVPS: (Test of vis. per.)
Age
%
Age
%
VISUAL DISCRIMINATION
VISUAL MEMORY
VISUAL SPATIAL RELATIONS
VISUAL FORM CONSTANCY
VISUAL SEQUENTIAL MEMORY
VISUAL FIGURE GROUND
VISUAL CLOSURE
OBSERVATIONS:
GETMAN:
1.
2.
3.
4.
5.
GRADE
GRADE
GRADE
GRADE
GRADE
GRADE
6.
7.
8.
9.
OBSERVATIONS:
HANDWRITING:
TIME:
OBSERVATIONS:
Beery Visual Motor
Integration (VMI)
Visual
Information
Processing
Evaluation
1
Test of Visual Perceptual
– Non-motor
Visual
Information
Processing
Evaluation
2
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Getman Visual Recall
Visual
Information
Processing
Evaluation
3
Wold Sentence Copy
Visual
Information
Processing
Evaluation
4
Speed
Accuracy
Quality
Eye Movement Test (DEM)
Visual
Information
Processing
Evaluation
5
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Eye Movement Test
Visagraph/Readalyzer
Visual
Information
Processing
Evaluation
5
Test of Dyslexia Screener
Visual
Information
Processing
Evaluation
6
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Test of Auditory Analysis
Visual
Information
Processing
Evaluation
7
Referral Criteria
Auditory/visual Integration
Visual
Information
Processing
Evaluation
8
Sequencing
Developmental readiness
Directionality/laterality
Visual
Information
Processing
Evaluation
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VO Star/cheiroscope
Visual
Information
Processing
Evaluation
10
Sensory Motor screening
Reflexes
Visual
Information
Processing
Evaluation
11
Bilateral
integration
Sensory
Processing
•
•
•
•
•
• Jumping
• Hopping
• Skipping
Tactile
Vestibular
Proprioception
Postural security
Body Scheme
Test Results
Ocular motor,
binocular, acc.
Developmental Eye
Movement Test
Reading
concerns
Visagraph
TVPS-especially
visual memory
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Test Results
Test of Dyslexia
Screener
Birch Belmont
Visual/auditory
Reading
concerns
Test of Auditory
Analysis
Directionality
Test Results
Good at sight words
Skimmer
Reading
concerns
80% comprehension
or less
Gets the general
concept, don’t bother
with the details
Test Results
Movement/reflex
screening
VO Star
Writing
concerns
Beery Visual Motor
Integration
Wold Sentence
Copying
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3/12/2017
Test Results
Beery Visual Motor
Integration
TVPS- often high
Math
concerns
Wold Sentence Copywon’t write things downhave answer in head
Sequencing (don’t get
the steps)
Test Results
Movement/reflex
screening
Berry Visual Motor
Integration
Sensory motor
concerns
VO Star
Observations
• Sensory – tactile, vestibular,
auditory, food issues
Test Results
Basic visual skills
Sensory motor
screening
Sports
concerns
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3/12/2017
Test Results
Visual skills deficits
DEM, Visagraph
Work
Completion
Visual motor
integration, Wold
Mindset
• “I can’t”, avoidance, too
hard
Test Results
Test of Dyslexia
Screener – phonetics
Test of Auditory
Analysis
Auditory
processing
Birch Belmont
Refer to audiologist
(who gets these kids)
Test Results
TVPS – very high
Beery Visual Motor
Integration (artists)
Strengths
All tests that are
above age/grade
level
Creative, artistic
visual spatial
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3/12/2017
Brain works faster than their hands
Case Presentation
RELATE
findings to
parent’s
concerns
Discuss
performance
vs. potential
Discuss
“Brain” – it’s
the buzz word!
NO SELLING OF
VT!
People buy
what they
WANT… Not
what they NEED
Do you live in our house?
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3/12/2017
Unique Observations –
Gifted Population
• “Borderline” skills
• Who is to say
what is borderline
or potential?
• Things come easy
or forget it!
• Anxiety
Case Presentation
• Haley - GT in all states + Germanyexcept for Kansas
– 130 IQ, but reading was in the 80s. They
didn't question why
Case Study
Adam (9yr-11mo, 4th grade)
• History
– Referred by GDC
– IQ 140/125
– Used to be avid reader, started age 3resisted at 8 yr. old
– Moved head with reading and computers
– Oversensitivity to auditory stimuli
– Difficulty with writing
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3/12/2017
Case Study
Adam (9yr-11mo, 4th grade)
• Pertinent visual findings
– 20/20 Near & Far
– Refraction +.75DOU
– Ocular health – WNL
– No significant accommodative/binocular
– Ocular motor- jerky pursuits with head
movements; inaccurate saccades
– Stereopsis- 40 Sec.
Case Study
Adam (9yr-11mo, 4th grade)
Initial- Pre VT (6/1/06)
Post VT (2/1/07)
Beery VMI
8yr/9 mo
39%
TVPS
All >12-11 mo except v.form All >12-11
constancy- 39th%
Getman
6th grade level
Wold
>8th grade level speed
Test of Dyslexia
HS words, above normal
spelling & phonics
TAAS
Pass
Birch Belmont
Pass
Piaget Left/right
Pass
Case Study
Adam (9yr-11mo, 4th grade)
Initial- Pre VT (6/1/06)
Post VT (2/1/07)
DEM
Vertical 97th%
Horizontal 37th% (skipped 2
lines)
Vertical 97th%
Horizontal 75th%
(accurate)
Visagraph
4th grade reading level
107 wpm (norm 158)
1.9 grade level efficiency
100% comprehension
Observations: head mover
5th grade reading level
279 wpm (norm 173)
14.5 grade level
100% comprehension
No head movement
VO Star
Disorganized
Organized, equal
Sensory motor
Passed reflexes
Difficulty with hopping
sequences
History-signs of SPD
Passes all screening
tests
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3/12/2017
Treatment Pearls
Optometric Vision Therapy Made
a big difference in my life & my
football career!
Treatment Pearls
• Changed my model for treatmentinstead of looking at scores as
below/above- use the “enhancement”
model similar to that of sports
vision.
• Give child the BEST functional
system for wherever they need to be
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3/12/2017
Vision Therapy Treatment
• Lenses
• Vision therapy
Attitude Is Everything
Speed of Processing
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3/12/2017
Speed of Processing
• Perfectionistic and fear making a
mistake
• Learning style involves taking in a lot
of time to process
– Often over-processing information; i.e.
they don’t trust themselves (or fearful of
not being perfect)
“… students learn to do
visualizations,
deliberately recalling
in detail a place where they felt
happy, calm, and safe.”
Dr. Judith Willis
Reading for Tests
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3/12/2017
Be a SPY/Detective
1.
2.
3.
4.
5.
6.
Carefully look for clues
Look at options
Read all information
Don’t quickly generalize
Be accurate
Then answer the question (mystery)
Visualization: Spelling
Reprinted w/permission from See It. Say It. Do It! (2013)
Creative Writing
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Math Facts
Misaligns Columns
Visualization Process
VISUALIZE
Relax
Breathe
Build awareness
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Stress
Timed Test Anxiety
Improvement in IQ Scores
of Gifted Children after
Vision Therapy
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3/12/2017
Case 2
 WISC-IV
Verbal Comprehension Index
Perceptual Reasoning Index
Working Memory Index
Processing Speed Index
Full Scale IQ
General Ability Index
11-5
16-0
144
129
135
112
[139]
144
142+
135+
148+
164+
157+
147+
9 months of vision therapy with Dr. Lynn Hellerstein
Case 3
 WPPSI-III,
5 WISC-IV, 8
Verbal IQ/VCI
131
Performance IQ/PRI
125
Working Memory Index Processing Speed Index 128
Full Scale IQ
137
134
125
113
130
130
12
14
130
115
94
91
-
140+
121+
97
118
136
Glasses and vision therapy with Dr. Lynn Hellerstein
Case 4
 WPPSI-R
Verbal IQ/VCI
Performance IQ/POI
Freedom from Distractibility Index
Processing Speed Index
Full Scale IQ
4
111
111
113
WISC-III 7
132
127
120
115
131
Vision therapy with Dr. Lynn Hellerstein
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3/12/2017
Case 5
 WISC-III
Verbal IQ
Performance IQ
Verbal Comprehension Index
Perceptual Organization Index
Freedom from Distractibility Index
Processing Speed Index
Full Scale IQ
7-7
8-7
115
110
116
111
104
106
113
127
133
128
136
106
119
133
Vision therapy with Dr. Lynn Hellerstein; Letter sent
Case 6
 WISC-IV
Verbal Comprehension Index
Perceptual Reasoning Index
Working Memory Index
Processing Speed Index
Full Scale IQ
General Ability Index
o
o
7-2
9-10
13-8
124
119
97
106
108
124
124
131
102
109
132
140+
133+
94
112
130+
144+
Seven months of vision therapy, Dr. Roger Dowis.
Six years later rechecked by Dr. Rebecca Hutchins. She
felt that he was holding his basic visual skills and did not
need vision therapy or glasses.
Case 7
 WISC-IV
Verbal Comprehension Index
Perceptual Reasoning Index
Working Memory Index
Processing Speed Index
Full Scale IQ
General Ability Index
8
12
134
131
102
106
139
144+
133+
110
100
132+
147+
Evaluated by Dr. Roger Dowis, Vision Therapy
Clinic, UK, and Dr. Lynn Hellerstein
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3/12/2017
Case 8
 WISC-IV
Verbal Comprehension Index
Perceptual Reasoning Index
Working Memory Index
Processing Speed Index
Full Scale IQ
General Ability Index
7-5
9-9
108
123
126
128
126
-
126
141
120
115
140
Evaluated and did vision therapy for two years
Dr. Stacy Ann Lyons, New England Eye Institute
Case 9
 WPPSI-III
5-5
Verbal IQ/VCI
Performance IQ/PRI
Working Memory Index
Processing Speed Index
Full Scale IQ
General Ability Index
118
103
83
109
-
o SBL-M
WISC-IV 10-9
148
119
94
94
122
140
136
18 months vision therapy, Dr. Rebecca Hutchins
Case 10
 WISC-IV
Verbal Comprehension Index
Perceptual Reasoning Index
Working Memory Index
Processing Speed Index
Full Scale IQ
7-2
9-9
134
137
88
103
124
136
117
97
106
120
Vision therapy was done AFTER our second evaluation.
Parent wrote: “In Reading he jumped 3 grade levels. … His
math score went up 27 percentiles!!!!”
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3/12/2017
Case 11
 WPPSI-III
Verbal IQ/VCI
Performance IQ/PRI
Working Memory Index
Processing Speed Index
Full Scale IQ
General Ability Index
4-0
WISC-IV 8-4
143
105
-
146+
149+
123
91
[139+]
158+
o Letter sent from father after vision therapy
completed.
Case 11
“You were right to recommend a vision test. [She]
had some deficiencies and we completed vision
therapy. Her improvement could be seen both at
home and at school. The most visible improvement
was in reading. [She] started to read books without a
break and she was awarded a first place in the
reading competition among her classmates. She read
1875 minutes over a 20-day period. She read many
Harry Potter books and many books by Roald Dahl.
She can finish a 150-200 page book over a week-end.
We are getting positive feedback in terms of the
effects of the vision therapy from school.”
Case 12
The mother of a gifted child in VT with Dr. Lynn Hellerstein wrote:
“We are extremely thankful that we were referred to you as we are
already seeing the results of her therapy at home, school, ballet and
piano. Her vision therapy has allowed her to participate fully in
gym class, which she hasn’t done since preschool and she is now in
the 2nd grade. Her ballet instructor has noticed improvement and
her teacher said her writing, reading and spelling are
improving. At home she has started to volunteer to read each night
to her sister...she did not like to read aloud before due to the words
she was skipping. She told me that reading is easier now that she
isn't skipping words, and she is now devouring books...we can't
keep enough in the house! I can't thank you enough for helping us
assist E in becoming her best self.”
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3/12/2017
Conclusions
 For more than 2 decades, there has been interest in
whether vision therapy (VT) can improve IQ scores.
 Previous case studies demonstrated a positive impact of
VT on IQ scores of low functioning children.
 Case studies of improved IQ scores of gifted children after
VT were discussed at COVD in Reno (Silverman, 2000).
 In this presentation, several case studies, with varied IQ
tests, VT programs, and locations (US, UK, Australia)
demonstrate higher IQ scores in gifted children after VT.
 A large-scale study is warranted to document the impact
of VT on the IQ scores of gifted children. The gifted have
great potential for demonstrating gains from VT.
References
 Malhotra, K. & Blaskey, P. (1995, Dec.). Vision therapy and its impact on
IQ: A case report. Poster session presented at the annual meeting of the
American Academy of Optometry.
 Omikumura, T., Wakamiya, E., & Suzuki, S. (2003, Dec.). Improvement of
IQ score of WISC-III after vision therapy: A case report. Poster session
presented at the annual meeting of the American Academy of
Optometry.
 Silverman, L. K. (2001). Diagnosing and treating visual perceptual
issues in gifted children. Journal of Optometric Vision Development, 32,
153-176. (Presented at the 30th annual meeting of COVD, Oct., 2000.)
 Silverman, L. K. (2002). Upside-down brilliance: The visual-spatial learner.
Denver: DeLeon.
 Silverman, L. K. (2013). Giftedness 101. New York: Springer.
How Do You Get
More Info?
www.gifteddevelopment.com
25
3/12/2017
How Do You Get More
Info?
www. LynnHellerstein.com
How Do You Get More
Info?
How Do You Get More
Info?
26
3/12/2017
Thank You!
Lynn F. Hellerstein, O.D., FCOVD, FAAO
Developmental
Optometrist
Speaker
Hellerstein & Brenner Vision
Center PC
7400 E. Orchard Rd., Ste. 175-S
Greenwood Village, CO 80111
Author
[email protected]
303-850-9499
www.LynnHellerstein.com
27