See if this scenario sounds familiar. Alyssa is a 15 year-old three sport athlete in high school. Her mother is a teacher, and always felt that Alyssa was struggling much more than she should be to achieve in school. “Don’t get me wrong”, she said. “Her school has been helpful to a certain extent. They got her Section 504 accommodations, but they said they were unable to help her further because she’s not doing badly enough”.
How has the system failed Alyssa and her parents? It seems a travesty that children like her don’t find their way to the help they need until they’re failing. Among her many wonderful contributions, that is part of the gift that Sue Barry has brought to the public eye – a neurobiologist’s view of how our system fails children with vision problems.
Alyssa had prototypical pediatric ophthalmology management as a child. She had infantile strabismus with patching commencing at six months of age, a trial of atropine penalization, and eye muscle surgery at age 2. Her eyes looked straight, and the doctor reassured her parents that everything was fine. Her parents never thought to mention her difficulties at school to him. As Alyssa became old enough to express her frustrations, she noted that she felt the need to read things over and over to gain full comprehension. Listening to others read felt like much less effort to comprehend. Homework that classmates could complete within an hour was taking her many hours to finish because of her need to re-read time and again to comprehend. They finally thought to mention this to the doctor when Alyssa complained that letters appeared to be jumbled. The doctor “treated” the problem by giving her glasses, with window glass power in the right eye and one unit of nearsighted power in the left eye. Though it made her distance sight a little sharper, it had no bearing on her school struggles. The doctor then referred her parents to a pediatric neurologist, for whom they had to wait months to get an appointment, only to be told that Alyssa was, in the doctor’s word, “puzzling”.
By the time I saw Alyssa two weeks ago, she had diagnosed herself. She reported being aware that it was hard for her to look through both eyes at one thing. Alyssa had intermittent suppression and binocular instability on all of the tests we administered. In addition, we did an extensive visual processing evaluation and documented select lags in her performance according to percentile ranks as well as behavioral observations. I subsequently held a conference with her parents to review my findings, and Alyssa was present. Her mother expressed her gratitude at finally being able to get some answers. Bright, talented, and motivated to improve, Alyssa was also relieved not to be considered a puzzle.
Some children will be less puzzling if we can help other professionals look for the right pieces. There are winds on the horizon that owing to the recognition of visual neuroplasticity, more professionals will be doing so in the near future. Fitting these pieces into place will help seal the cracks through which children such as Alyssa are falling.