Can Vision Therapy Help my Child?

What can vision therapy accomplish?

Vision therapy was developed before the Great Depression.  Also known as orthoptic training, this therapy is designed to improve vision skills such as eye movement control and eye coordination.  These are also called visual motor skills.  In addition, therapy is used to treat lazy eye or amblyopia.

There are a number of specific diagnoses that can be effectively treated with vision therapy.  These include convergence insufficiency, amblyopia, binocular dysfunction, accommodative spasm, strabismus and poor eye teaming to name a few.

First is a comprehensive eye examination and diagnosis of one or more of the above conditions.  Then a behavioral optometrist designs an effective vision therapy program for the patient.

vision therapy
How vision therapy can help your child.

How often is vision therapy done?

Vision therapy is often done through in-office visits, once or more times each week.  A vision therapist guides the patient to perform a series of visual tasks.  Each of these tasks last 2 – 5 minutes.  A complete session may last 30 minutes or more.

Every student’s severity is different, as are their goals.  That is why some programs last 12 weeks and others may run an entire year.

Some prescribed tasks build eye alignment skills.  First a patient aligns both eyes on a distance target, then changes his eye alignment for a near target.  Other tasks strengthen focusing skills so that he can see more clearly when focusing at various distances especially when reading.  We use various lenses, prisms and different colored lenses to control what image each eye is able to see.

For example, to treat convergence insufficiency, we use over 50 different techniques to strengthen the ability to converge and align your eyes for near tasks, such as reading.

Lazy eyes

To treat lazy eye or amblyopia we employ a different set of tasks to strengthen the nerve endings in the retina.  Here we have two goals.  First, we improve the visual acuity of the “weak” eye by stimulating it.  We do this with tasks that require the lazy eye to perform more of the visual work.  We can also patch the “good” eye forcing the weak eye to work more.  For our second goal, we train the two eyes to work as a team.  We strive to create binocular vision.  Then, once the lazy eye’s vision is improved, the two eyes will always work as a team.

This type of therapy can also improve visual perception.  Visual perception is responsible for the way in which we interpret what we see.  Good visual perception allows us to recognize the difference between the letter “b” and “d” as well as words like “saw” and “was”.

So back to your question:  Can vision therapy help my child?

If your student has one of the above conditions, the answer is likely;  Yes, vision therapy can help your child.  Like any personal development program the key is to get on a good program and to stick with it.  Consistency is the key to successful vision therapy.

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Improve Your Child’s DIBELS Score in Just Five Minutes per Day

I am going to share with you a powerful way to improve reading fluency. So much talk in the past few years surrounds improving DIBELS scores.

What are DIBELS?  DIBELS stands for The Dynamic Indicators of Basic Early Literacy Skills.  This benchmark was developed back in the 1970s and 1980s.  It all started at the University of Minnesota.  The goal was to find a cost effective way to measure literacy skills and to identify young students who are at risk for falling behind in reading.

Over several decades numerous researchers and specialists have continued to add to our knowledge base in DIBELS.  These efforts increase the effectiveness of helping students in need.

Improving DIBELS scores has become the holy grail of reading instruction. Here is one of the most effective strategies that we use at Red Apple Learning Center.

We call it Repeated Reading.
I recommend that you do this at least once every day with your student to improve DIBELS scores.  All you will need is a clock with a second hand and a book at your child’s reading level.

Here it is in four steps:

1. Starting at the beginning of a chapter read out loud to your child while he reads silently along with you. Stop when you have read for one minute.
2. Now start back at the beginning of the chapter.  This time you and your child read out loud together for one minute. He should try to match your reading pace and voice inflection.
3.  Starting at the beginning of the chapter again, your child will read aloud by himself for one minute.
4.  Repeat step 3.   Almost always the student is able to read a little more in step 4 than he was in step 3.  Point this out to your student to encourage him in the future.

If you have the discipline to perform repeated reading every day, you will be delighted with the improvement in your child’s DIBELS scores and overall reading fluency.

How do I treat Lazy Eye?

Lazy eye causes and treatments

Lazy eye or amblyopia results when an eye cannot be corrected, with glasses or contacts, to see 20/20.

What causes lazy eye?  The two most common reasons are refractive amblyopia and strabismic amblyopia.

Let’s discuss refractive amblyopia first.  If an eye has a refractive error, this simply means that it needs an eyeglass prescription to see clearly.

Here is an example.  A young child has no eyeglass prescription in his right eye and sees clearly out of this eye.  His right eye focuses the images very crisply on his retina.  His left eye, however, has a moderate to high amount of farsightedness.  Most of what he sees is blurry out of this eye.  This is because the eye sends a blurry image back to his retina.

This child must use his right eye to see detail in his early years.  Over a few months and years his brain will allow much more development of his right eye while restraining the development in his left eye.  The result is a strong, healthy retina in the right eye but weak retinal development in his left eye.  Therefore a lazy eye develops.

Strabismic amblyopia is the other most common type of lazy eye.  Strabismus means that an eye is turned inward or outward.

Here is an example.  A different young child has a right eye that accurately points to each image that he wants to look at.  Therefore, his retina receives an accurate image of each object.  This child’s left eye, however, drifts outward much of the day.  When this boy wants to look at an object his left eye is not able to align on it properly so it points to another object nearby.

Unfortunately, now his brain receives conflicting images.  The picture from his right eye is the picture that he wants to see but the picture from his left eye is not the correct picture.  His brain will see two different pictures, which causes double vision for him.  To avoid this, the child’s brain will “turn off” his left eye much of the day.  Like the child above, the right eye retina develops normally but the left eye’s retina does not develop nearly as well.  Again, a lazy eye develops.

How can you treat lazy eye?

We treat lazy eye by stimulating the retina in the weaker eye.

Years ago, this meant patching the “good eye” and forcing the weaker eye to work.

In modern medicine we usually use a combination of techniques to achieve best results in treating lazy eye.  These strategies can include patching the stronger eye for part of the day.  This time ranges from 2 hours to 6 hours depending on the severity.  It can mean vision therapy to stimulate the lazy eye and promote development in that retina.  And it can include using eye drops in one eye to help develop the weaker eye.

In my office I believe in totally treating lazy eye by combining as many of these tools as possible.  We only have a certain window of time during your child’s development to treat lazy eye, so we must be aggressive in treatment.

The key is that we diagnose lazy eye as early as possible.  This is the best tool we have in fully treating lazy eye.

Convergence Insufficiency – How to help

Convergence insufficiency treatment

Convergence insufficiency results when a patient’s two eyes cannot simultaneously converge, or point inward, to align on a near target.

First, a little background.  When you look at an object at distance, each of your eyes point straight ahead at that object.  Then, your right eye takes a picture of the object it is pointing to and sends it to your brain.  Your left eye takes the same picture and sends it to your brain as well. Next, your brain simply fuses these two images so that you can see one distinct object.

When you change your focus to look at something at near, each of your eyes must converge on the object or word that you look at.  If no convergence insufficiency exists, and your eyes align properly, each eye again transmits the same image back to the brain.  In this fashion, you read from word to word fluently.

The problem starts when your eyes cannot converge properly, which is why it is termed convergence insufficiency.

In this case, one eye points to the word you want to read while the other eye drifts outward slightly.  This results in the second eye pointing to a different word.  Your right eye sends back an image of the correct word, while your left eye sends an image of another word.  Then, your brain tries to fuse these two, unlike words.

When you are reading and this occurs you may say a word that is a blend of the two words that your brain fused.  Or, with convergence insufficiency, your brain may be confused by the blended, nonsense word and may skip over the word.  Other students simply lose their place.

The fact is that this condition affects 1 out of 5 students.

The great news is that there is help.  Through vision therapy you can improve your convergence.  With in office visits once or twice weekly you can build this skill over a period of a few months.  As your convergence improves your reading fluency will improve as well.  You may also notice that other hand-eye tasks are easier.

I have treated over one thousand individuals with convergence insufficiency in the past thirty years.  For a free email or telephone consult about your situation, contact me at


Best reading tutor can boost your child’s reading level by two years or more.

reading tutor

Would you like your reading tutor to improve your child’s reading speed and accuracy?  And, while accomplishing this, would you like to boost your child’s reading comprehension too?

Of course you would.

It is not only possible, I will show you how you can do this.  What makes me so sure?  Because we tutor reading with this type of success every day at Red Apple Learning Center in McMurray, PA.

There are a number of key factors to find the best reading tutor.  Even many reading specialists do not know all of these factors.  Why not?  Simply because the best tutoring methods are a careful blend of medical and educational research.

First of all, for best results, your reading tutor should work one on one with your child.  One tutor to one student.

Most learning centers, especially the chains or franchise centers, have one teacher work with multiple students.  They may call it a “personalized tutoring” program.  Or some franchised learning centers refer to it as “individualized tutoring”.  In each of these cases, your student will usually work along with other students in a group.  This is really one reading tutor with multiple students.

The first key then to helping your student attain wonderful results is to get a reading tutor to work one on one with your child.

Next, multi-sensory teaching techniques are a must.  Why?  Because teaching using a student’s senses of sight, hearing and touch result in the best “stickiness”.  That means that students remember the words and sentences best with this tutoring strategy.  Multi-sensory tutoring of reading has been proven time and time again as the most effective method on the planet.  The methods may be called an Orton-Gillingham program or the Lindamood-Bell program, both well known methods.

Your third component to get the best reading tutor results is multiple tutoring sessions each week.  We have found that two to three reading tutor sessions per week work very well for most students.  Certain students even respond well when we combine multiple sessions in one day for a more intense tutoring experience.

Fourth, your student must practice at home in between each reading tutor session.  Just like piano lessons or gymnastics, practice is essential to becoming a great reader.  Every day devote at least 15 minutes to reading.

So back to the beginning…how can you achieve two grade levels of reading improvement in your child?  Just follow the recipe above.

Learn Tutor secrets to empower your kindergarten or first grade students. Tutor to build strong, fluent elementary school readers. Tutor for success!

Best tutor techniques

Tutor the magic of reading

Want to be a great tutor to your children?

Tutor your young children, using proven research.  Back in 1991 there was a study completed by researcher named Moats.  This study showed remarkable statistics.  Just focus on this fact.  A very good, young reader in first grade knows at least 20,000 words.  Contrast this with “struggling”, young readers in first grade who on average know only 5,000 words.  Tutor your children with this in mind.

If you are a parent or teacher who wants to tutor your children in reading you must immerse your child in words.  Very early on, when your children are one, two, and three years of age, you need to have conversations with them.  Speak in complete sentences.  Use new words when speaking with them to stretch their vocabulary.

Teachers and parents most often think that they must use high tech strategies to tutor reading.  But the truth is, reading development starts much earlier in life.  It begins with exposure to rich language.

The best tutoring actions could be to play with the plastic, magnetic letters on your refrigerator with your preschool children.  Show them how to construct two letter words and put these up for them to see.

Teach them short, fun poems.  The repetitive rhyming phrases are a fun way to tutor sounds.  Poems by Douglas Florian will make you and your children giggle…what could be more fun while learning?

Let TV help you tutor.  Choose good learning programs directed at or slightly above your children’s grade level.  The best programs will use good language skills along with enticing visuals.

Most importantly, read stories to them.  Children love stories.  Let them help you choose which story to read next.

The key to tutoring effectively is to make it a game.  Keep it fun.

Go here and enter your name to receive more great ideas.



Welcome to Red Apple Learning Center’s blog

In this blog I will share with you research and information that can help you with education, concussions, vision therapy and other medical eye procedures.
Many of the posts will provide helps for you to tutor your child. Techniques used by reading specialists pioneered from a combination of medical and educational information will be featured.
To tutor reading, and make significant improvements for your child takes work, of course you will have to work hard. But to tutor effectively, you will need to know what strategies work. I will uncover these here for you.
Multi-sensory strategies will be our focus. These are tutoring strategies developed by Orton-Gillingham and Lindamood-Bell. If you are going to tutor dyslexia, you absolutely must have these in your toolbox.
We will also discuss vision therapy. What vision therapy can improve and what it cannot. Often, readers that have reduced reading fluency suffer from visual perceptual difficulties.
More common visual problems like convergence insufficiency will be discussed. The treatments for concussion will be unveiled. Amblyopia (lazy eye) will also be a topic that we see how vision therapy can help.
Follow me as we discover how technology has improved how you can tutor better.
Dr. Joe Falbo