Remember the CITT Study? That was the definitive, gold standard study published in Archives of Ophthalmology in 2008 proving that office based optometric vision therapy is far superior to vision therapy done solely at home.
Now the CITT group is back with a marvelous study whose abstract is posted online ahead of publication in Optometry and Vision Science, the journal of the American Academy of Optometry. We all know, looking at the convergence insufficiency symptom survey (CISS) that children with convergence insufficiency have problems that potentially interfere with reading and learning.
We would therefore expect that children undergoing office based optometric vision therapy should show significant improvement in school work and their parents would have fewer concerns. To test this, the CITT research group developed the Academic Behavior Survey (ABS), a six-item survey that quantifies the frequency of adverse school behaviors and parental concern about school performance.
The ABS was administered prior to the start of vision therapy, and after 12 weeks of treatment to the parents of 218 children aged 9 to 17 years. Children were divided into different treatment groups, which included a placebo control. The ABS score after treatment was significantly related to treatment outcome. The score was significantly better for children who were successful or improved after vision therapy as compared to children who were non-responders.
What’s the bottom line? Successful optometric vision therapy is associated with a reduction in frequency of adverse academic behaviors and parental concern associated with reading and school work as reported by parents.
- Leonard J. Press, O.D., FCOVD, FAAO
D.Fortenbacher, OD FCOVD
Leonard J. Press, O.D., FAAO, FCOVD
Carole L. Hong, OD, FCOVD
Carl Hillier, OD FCOVD
Stan Appelbaum, OD FCOVD
Gary L. Etting O.D. F.C.O.V.D.
Dr. Barry Tannen
Nancy Torgerson, O.D., FCOVD
Dr. Press,
It’s so exciting to be practicing at this time. It is becoming increasingly hard for the skeptics to deny that vision plays such a critical role in so much of what we do. For school children in particular, the lack of proper care and attention of visual behaviour leads to too many abuses and children put in harm’s way. There is a shift in the tectonic plates in the realm of treatment of developmental concerns, and vision development is at the epicenter. Schools I deal with easily acknowledge the benefits of appropriate care and love what they see. Addressing visual and developmental concerns early is not only kind, it’s the most cost-effective intervention available to schools for reading and learning concerns. Period.
Things are moving in the right direction.
Comment by Dr. Charles Boulet — November 22, 2011 @ 11:55 pm |
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Pingback by New Study: Vision Therapy Improves Academic Behaviours | Panorama Optometry Surrey BC — December 6, 2011 @ 3:59 pm |
Great article. I think it bears mentioning (not to mention it is responsible reporting) to be clear that the CITT study showed the merits of orthoptic vision therapy for CONVERGENCE INSUFFICIENCY. It did NOT study vision therapy for reading problems, dyslexia, reading comprehension etc etc etc. In fact no well-designed, properly-blinded, randomized control trials have ever been conducted in those regards.
I see too many ads for vision therapy as a miracle cure for a child’s every learning hurdle. They all site the CITT to give themselves legitimacy. Not one of them has any disclaimer saying that the therapy has only been properly studied for convergence insufficiency. Parents and educators are confused, thinking VT is a cure-all. I think we have a responsibility make the distinction.
Comment by Eric Pennock — February 8, 2012 @ 7:03 am |
Thanks, Eric. I was part of the original team that set up the CITT study. The original name of the group pre-CITT was CIRS – Convergence Insufficiency and Reading Study. After all, that was the one thing that everyone in Optometry and Ophthalmology agreed on, from Duke-Elder to Borish to VonNoorden to …. ah, but to no avail. Since we wanted to this to be an airtight study, the bio-statisticians from SUNY said we first had to “prove” what CI was, how to measure it, how to diagnose it incorporating a symptom survey, how to treat it effectively, etc. Then we could move on to the reading portion. The fact however that so many of the CISS questions relate to reading, and showed a strong association (per the 2003 published study) meant it was just a matter of time until the group moved on to that definitive phase. When we first met in 1992 I never imagined it would take this long to get back to reading, but after all these years it was great to see Dr. Scheiman, the PI, present preliminary data at the COVD meeting in October (2011) from the CITT group on “Changes in Reading Performance in School-aged Children with Symptomatic Convergence Insufficiency after Treatment with Vision Therapy”.
So no – VT is certainly not a cure-all. But I think you’ll also have to admit that what the AAP and AAPOS have done with their Joint Policy Statement, and basically painting all VT dismissively as speculative, unscientific, unproven, etc dating back to its first iteration in 1972 – is a 40 year smear campaign to discredit optometric VT. That to me verges on the unethical, and sadly many patients in our area are simply told by pediatric ophthalmologists to stay away from VT because “it’s bogus, and all they want is your money”. I know from colleagues this happens in many other areas of the country as well. If we lift up the carpet and require that pediatric ophthalmology only follow dictates of practice that are supported by the same level of evidence demanded of optometric VT, how many of your procedures would be acceptable?
I was, on the other hand, very pleased in Goggling you to not that you have Optometry and Vision Therapy well positioned on your website http://www.eyemdsforkids.com/content.asp?sectionID=35486.
I commend you for that.
Comment by Len Press — February 8, 2012 @ 9:33 am |