Dr. called me an "aggressive" parent - Are my expectations too high? - Mothering Forums

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#1 of 18 Old 05-07-2014, 02:01 PM - Thread Starter
 
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First of all, I'm not sure how I'm feeling about being called an "aggressive" parent . . . confused, a little miffed, deflated?

 

My DS, newly 5, has been reading for 3 years and reads very well, IF he or I keep a finger going along with the words.  His stamina still isn't very good.  Without the finger tracking, DS often skips words or lines, gets frustrated and gives up.  It's not his decoding ability that is giving him problems.  He doesn't need to sound out much of anything anymore.  I wondered if his vision was poor, or if he was having trouble with his oculomotor coordination.  

 

We went the the eye doctor this morning. Eye doctor says his vision is fine and physically there is nothing wrong with his eyes. He tested his convergence and said both eyes work well together and they are focusing in on objects just fine.  He then gave him the DEM(developmental eye movement) test to check his oculomotor tracking.  He bombed this test!!  Couldn't even complete it, and I saw the same frustration and line skipping that I see at home with reading.  The doctor said that his coulomotor tracking ability was far below his age norm.  But, since he seemed intelligent, willing to please, and is already able to read, he suggested I do nothing and wait a year.  At one point he even suggested I hold him back and wait another year before kindergarten.  

 

DS has many other gross and fine motor delays, so it does not surprise me that the muscles that control his eyes are also not functioning optimally.  This cognitive vs motor asynchrony is causing DS all kinds of difficulties.  I feel like he is not able to progress cognitively because of his physical limitations.  Is it "aggressive" or pushy of me to want to actively work on improving his tracking ability?  

 

This is not the first time I've heard something that sounds to me like - "Oh, he's really smart, so let's ignore his physical delays. The delays help to even him out."    

 

I guess this is mostly a vent.  Anyone else have kids with similar eye issues, or cognitive vs motor asynchrony?  How do you handle this?   

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#2 of 18 Old 05-07-2014, 02:15 PM
 
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so there isn't any amblyopia?

 

BF's daughter has what we think is 22Q11.2 deletion syndrome (working to get it confirmed). Her gross and fine motor skills are very noticeably impacted.

 

Have you seen a neurologist? Why not do that? You can access occupational therapy to address the motor skills issues.

 

-EG

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#3 of 18 Old 05-07-2014, 06:35 PM
 
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Personally, I'm not against waiting a year. Reading is only one skill of hundreds. Pulling back from the expectation that your frustrated 5-year-old read for himself will not keep him from growing and developing. Visual tracking is not a skill only developed by following a sentence with his finger... he can get it from art, games, sports, play..... which is how a child this age should be learning at this age anyway. 

 

My eldest loved to write and spell phonetically but she didn't sit down and read a book until after her 5th birthday and moved into high level novels in a few weeks. My youngest was picking out words at two and could read even new scientific words individually at 4 but didn't have the stamina or comfort to read fluently until after his 7th birthday (where he rapidly jumped to adult levels in reading in two languages.) We had his eyes checked. He had a visual tracking issue which is actually not so unusual for children under 7. We had other things to deal with like an over-active gag reflex and a host of physical sensitivities that were interfering with real life. Being a fluent reader was just low priority. We just continued to read to him from rich material. When he wanted to read to himself he did but we never asked or required him to "work" on it. Time resolved the issue painlessly.

 

I would at least take some time off if that is what the doctor suggested. Don't ask him to read. Tell him you really miss reading TOO him and pick up an exciting novel to share with him (you read.) Move your activities to play, kitchen science experiments or cooking, creative story making (he tells the story, you write,) building, kick ball, museum trips and so on. If a full year frightens you, try 6 months. It sounds like he has other issues that might be better served being the priority. Occupational therapy really helped in those areas for my son (and he thought it was a blast.) I can't promise that his issue will resolve itself and I'm not saying you shouldn't look into the matter further off your son's radar. I can just promise you that taking the focus off gaining fluency in reading at this moment will not keep him from developing cognitively. 

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#4 of 18 Old 05-07-2014, 07:21 PM
 
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This was my son. 

 

What is your goal with working on his reading?  Does it bother him?

 

I'm a real proponent of balancing remediation with giving time to grow.  He doesn't need to do more than he is now for starting kindergarten next year.  Worksheets and stories will be large print, well spaced - it will work for a child with vision issues who has the mental mechanics of reading down. 

 

Personally, I would find out if there are exercises that help develop these muscles/skills and do them a couple of times a week, very casually.  I would let him lead when he does the reading, and avoid frustration.  If he becomes frustrated and turned off, that's a way bigger problem IME than a developmental issue which may only need some time to resolve. 


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#5 of 18 Old 05-07-2014, 08:52 PM
 
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Did the eye doctor suggest vision therapy?  I don't know about that particular condition but I do think that ophthalmologists can be hesitant about vision therapy.  I know a number of folks who have benefited a lot from vision therapy, working with an optometrist.  

 

I don't understand why an eye doctor would be telling you to hold back your child?  That seems odd to me without considering the whole child.  Is he in preschool?  If not, what does his pediatrician think?  

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#6 of 18 Old 05-07-2014, 10:14 PM
 
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Me, I would be looking at vision therapy, but giving reading work a rest for a long while. 

 

My youngest dd lingered at the "can read anything, but struggles with stamina and small print" stage for a couple of years. I was an idiot, because in the absence of complaints about vision, I assumed it was just her maturity and stamina that were lacking. Turned out she had a profound refractive error, easily fixed by glasses. I regret not picking it up prior to age 5 because her corrected vision will never be as good as it could have been, due to the delay in fixing it. And I feel guilt for this little kid not being in effect legally blind for five years. But I have no regrets at all that she didn't start reading novels before age 6.

 

My older dd was deeply immersed in reading from a very early age and I actually think my younger dd is a more balanced human being as a result of spending her early years not reading, but instead just socializing, playing, imagining, experimenting, creating, conversing, singing, jumping, painting, climbing, cuddling, exercising her aural memory, questioning, pestering siblings and so on. 

 

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#7 of 18 Old 05-08-2014, 08:09 AM - Thread Starter
 
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I absolutely don't push reading and never have even intentionally "worked" on it.  It's just that the reading brought the vision issue to my attention.  I read to him as much as I can, but when I want to stop because I am all read out, DS says, "I'll read it to you then!"  He's so enthusiastic about it.  4 pages in he's crying, throws the book, and is mad at me because I'm mean and won't read to him anymore.

 

I was actually hoping for an easy fix vision problem because I thought that might help his balance, coordination, ball catching ability, etc.  We do work on these skills through play, but he doesn't like this kind of play and it's like pulling teeth to get him to participate.  

 

EG - I'm not familiar with amblyopia - I'll have to look into that.  I do know that he was getting 50% of the letters wrong on the eye chart during the vision screening and the doctor didn't seem concerned about that at all.  The doctor did mention vision therapy, but said to wait a year on this.  DS hasn't seen a neurologist, but we are on a waitlist to see a developmental pediatrician.  I suspect he will get an aspergers/high functioning autism diagnosis.  Maybe then my insurance will cover OT and PT.  

 

I don't know.  It just seems like he's always crying and frustrated over everything - books, games, toys, other kids . . . the only thing that doesn't frustrate him is TV, until Netflix freezes and then I'm screwed - meltdown city!  I take him to a doctor to try and find some help and get told to just wait it out. And being called an 'aggressive parent' certainly didn't help.  

 

I will look into what kind of vision therapy I can do at home.


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#8 of 18 Old 05-08-2014, 10:22 AM
 
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It's the frustration that stands out to me. Both of mine--very different learners--have had pronounced periods where their ability was much greater than their stamina. But both of them were calm about the asynchrony. There wasn't anything in the way, it was just their process. The place where it makes sense to intervene, to me, is when it feels like there is an artificial roadblock, which is what I hear in what you are describing.

 

I have to think there must be loads of strategies out there for scaffolding. A couple of thoughts on what he is reading--could he read through a play with you? Poems? Scavenger hunt through the house? Hope you get a referral soon, or find something useful you can try at home.

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#9 of 18 Old 05-08-2014, 10:35 AM
 
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It's the frustration that stands out to me. 

 

I think this is a useful observation. My kids, in the absence of expectations to the contrary, tended to be fairly blasé about their asynchronicity. At age 7 or 8 my ds felt pressured by his piano teacher's expectation that he get his sight-reading up to a level that more closely matched his playing ability, and with that subtle expectation, he got extremely upset and frustrated. But otherwise, no big deal.

 

On the other hand, frustration sounds like a pretty common thing with pranava's kid, presenting in a wide variety of situations, from social to fine motor to reading-related. Hard to know whether it's a vision-and-reading-related thing that should be tackled, or a more general difficulty with self-regulation or anxiety.

 

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#10 of 18 Old 05-08-2014, 02:22 PM
 
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I think this is a useful observation. My kids, in the absence of expectations to the contrary, tended to be fairly blasé about their asynchronicity. At age 7 or 8 my ds felt pressured by his piano teacher's expectation that he get his sight-reading up to a level that more closely matched his playing ability, and with that subtle expectation, he got extremely upset and frustrated. But otherwise, no big deal.

 

On the other hand, frustration sounds like a pretty common thing with pranava's kid, presenting in a wide variety of situations, from social to fine motor to reading-related. Hard to know whether it's a vision-and-reading-related thing that should be tackled, or a more general difficulty with self-regulation or anxiety.

 

Miranda

 

These are good points, as well as the point about frustration.

 

I highly recommend audio books to bridge this gap.  My son listened to lots and lots of them when his eye stamina didn't keep up with his desire.

 

My son also has some motor delays.  We had a bad patch last year where his piano level was 2-3 grades higher in single handed playing than it was in both hands together.  That was very rough, thinking back.  We managed it by giving him a piece that was at his two hands simultaneously that he could feel that mastery, while giving him a piece that was 1-2 levels higher and learning it single handed then integrating.  We also do lots of emotion and self-regulation coaching to get him through these phases.  It's very difficult for him.  Thankfully he's persistent, as he's now playing beautifully at the higher level.


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#11 of 18 Old 05-08-2014, 08:29 PM - Thread Starter
 
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Thank you, all!  Very good insight and suggestions. Audio books are a great idea - saves my voice and puts him in charge.

 

So it seems that asynchrony is common, but his reaction to his roadblock is not.  His emotional regulation ability is very low and he's persistent in a not so good way - he cries, throws the book, gets mad, picks the book back up, cries again, repeat until I have to take the book away. Even then the fit can continue until I manage to get him interested in something else.

 

He's so intense and hard on himself, definitely not blase about anything.


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#12 of 18 Old 05-13-2014, 10:07 AM
 
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Originally Posted by pranava View Post

 

DS has many other gross and fine motor delays, so it does not surprise me that the muscles that control his eyes are also not functioning optimally.  This cognitive vs motor asynchrony is causing DS all kinds of difficulties.  I feel like he is not able to progress cognitively because of his physical limitations.  Is it "aggressive" or pushy of me to want to actively work on improving his tracking ability?  

 

This is not the first time I've heard something that sounds to me like - "Oh, he's really smart, so let's ignore his physical delays. The delays help to even him out."    

 

 

 

Have you tried having him use a colored strip like those used by people with low vision? I know these are useful for other things, even ADD, but I don't know if it would help him.

http://www.maxiaids.com/products/12414/Reading-Focus-Cards.html

 

I have a daughter who is both gifted and on the autism spectrum, and I totally get your frustration. Are his fine and gross motor skills truly delayed (as in missing milestone dates?) or just on the late side of normal?

 

A gifted child being ahead in some areas and average in others is normal. Being truly delayed in some areas is not normal. It's a red flag. 

 

It's actually really hard to get good services for kids who are both bright and have challenges.

 

I also disagree with the sentiment that he should be held back from K. Holding a child back because of delay rather than providing remediation and therapy for the delay simply makes the child older. There is a really good chance that eventually you'll need to advocate for at least subject acceleration, and holding him back will make it worse, not better.

 

I don't know much about vision issues, but I do think you should keep seeking answers until you figure out what works for him, rather than waste time seeing if he happens to outgrow an issue that is ocuring in multiple systems.


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#13 of 18 Old 05-13-2014, 06:55 PM
 
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Hi. Not much else would have brought me out of the woodwork, but I couldn't let this post go by.

My daughter recently turned five. She has done about 20 weeks of vision therapy and will probably be discharged from it in the next month or so. She doesn't really have a convergence problem, but she did have major tracking issues. She tested only slightly below her age on anything that involved her eyes guiding her hands, but she tested several years above her age on anything where her hands could guide her eyes. She was reading comfortably (though probably mixing up more than I realized because she doesn't vocalize when she reads anymore) but there were a bunch of things that she had problems with that seem to have all been related to her vision.

She was absurdly bad with balls. It took me a couple of hours over the course of several days to teach her to bounce a ball to me. She wouldn't draw. She didn't want to write anything, in spite of all that reading. She bumped into walls, stepped on toys left on the floor, fell out of chairs. She avoided puzzles and blocks. An OT looked at her and said that something was a bit odd, but she could do everything she was supposed to be able to do at that age.

The vision therapy had her doing all sorts of things--jumping on the bed, pretending to tightrope walk, catching a ball on a string, copying a series of lines that I drew, following arrows to jump in patterns. What it didn't have her do was read or write. After about six weeks, she started to draw and write, all on her own. My dad was really sceptical, but he was amazed by how different it was to throw the ball on the string with her after than before.

I think the biggest difference I see is that she seems happier and more confident. She was compensating pretty well for her vision, but life seems to be so much easier for her now that she needs to do less of that work.

I could have done most of it myself, but I didn't know what to do and some of the things they had her do were far from anything I would have thought up. It was also like pulling teeth to get her to do this sort of activity if it was my idea, but she loves the doctor and made minimal fuss over all of it. Maybe if I wanted to homeschool, I could have let it shake out all on its own, but I am sending her to kindergarten in the fall, and I am happy that I can have all this pretty much behind her. I think I had the same sort of problem as a child and it was a pain.
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#14 of 18 Old 05-15-2014, 08:02 PM - Thread Starter
 
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Thanks for coming out of the woodwork Medlar.  I'm glad your daughter is doing so well!  I will definitely look in to this type of vision therapy.  

 

Thanks for the link Linda on the move - I didn't know this type of reading aid existed.  And yes, unfortunately I think his motor skills are quite delayed.  I can't find a good list of normal range motor skills for a 5 year old, but he can't stand on one foot for even two seconds, can barely hop over a pool noodle, can't catch a beach ball unless it's thrown right into his hands.  His fine motor skills aren't quite as delayed.  And I agree, I doubt he is going to grow out of all these delays in a year with no help.  


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#15 of 18 Old 06-23-2014, 11:12 AM
 
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We have similar issues. By the age of 5 my dd was reading at a 4th grade level yet she is now considered to be a student with low vision due to the problems caused be an eye cons toon called nystagmus.

Although she is academically advanced we also run into many people who unknowingly stereotype her & assume she can't be that advanced as she has Down syndrome so getting to the bottom of her vision issues has been frustrating.

We have done several things to help her reading progress in spite of her vision. Early on, before she was reading a lot of commercial print & before we even realized quite how bad her vision is we printed out everything in large print. This helped her to get a great head start on both reading & math.

I approach this two different ways. 1. We do a neurodevelopmental program that includes a number of vision exercises & we have seen improvements.
2. When she is reading we try to make it easier forcher eyes do she can mainly focus on her reading. Fir example we use larger print where possible. Sometimes this means photocopying the page & enlarging it & at other times we use a magnifier that runs along the page - this would also help him keep his place.

We have a CTV machine which was given to us by the CNIB (Canadian national institute for the blind) it magnifies, changes the background colour & can be used to illuminate only the line being read so it stands out from the rest of the page & is easy to follow. Do you have any organizations to this? It would be well worth looking into. The CNIB sent a vision cobsultang out to the school to evaluate our dd & had lots of other great ideas too.

A quick remedy for losing your place is to cut out a narrow line in a piece of card stock that is the same size as each line. Then you just run it down the page revealing only the line he is reading.

If you can talk to a vision consultant I'm sure they'll have lots of ideas.

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#16 of 18 Old 06-25-2014, 09:21 PM
 
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I guess this is mostly a vent.  Anyone else have kids with similar eye issues, or cognitive vs motor asynchrony?  How do you handle this?   
The poor visual tracking was definitely an issue for my dd too. It was challenging because she very much wanted to read, and had a constant need for more information, so she was very frustrated at the physical difficulty. She also has some coordination and sensory issues as well. Dd just finished up a year of Occupational Therapy, and I think it helped her a great deal. She had problems with crossing the midline (with her hands and with her eyes) which made tracking difficult. But in the past year, thanks to OT, her reading improved immensely. She is now able to read at a level much closer to her comprehension level. If there are other motor issues, I would consider looking into an OT evaluation.

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#17 of 18 Old 06-27-2014, 10:13 AM
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You said "eye doctor" ; was that an optometrist or Ophthalmologist? I would take him to the latter if you haven't already done so.

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#18 of 18 Old 07-06-2014, 11:12 PM
 
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My daughter is a little older than your son (7 now) but when she was 6 she spent I think about 4-5 months doing vision therapy. It was really intense. She's a complicated kid - gifted, with ADHD, but also tracking, convergence and visual processing issues. In her case, the ADHD was a big handicap with some, but not all, of the exercises. Some are pretty fun, like the ball on the string. Others are just hard, and if she had been younger she would not have had the emotional control to get through them. She still needs to build endurance, but it was GREAT to have a better understanding of her delays and what we could do about them. It's also great to see what she has gained. When she started, she obviously could not keep her eyes focused on any one word long enough to sound it out, and now she can read.

It can be really hard to find a good provider. Ophthalmology and optometry are not differentiated by one being "better" or "above" the other. Ophthalmologists are MD's and do eye surgery, and traditionally that field has concentrated on finding structural or pharmacologic fixes for problems. Optometrists share much of the same training and can diagnose eye diseases, but they aren't MD's and they don't do surgery. The field that has produced "vision therapy" is optometry. Optometrists interested in how kids use their eyes and helping them with vision therapy are developmental optometrists. In our area, we just found our optometrist by word of mouth. She hooked us up with an occupational therapist to guide the therapy, but the two of them work very closely together and I don't know that a developmental optometrist couldn't do the part of it the OT did for us.

There's a book, "Fixing My Gaze," that isn't directly about the same thing but describes vision therapy and the theories behind it very well. The author writes about doing vision therapy as an adult. It's a quick, helpful read.

So, I've jumped all over. Our doc and OT don't usually start the therapy before 6 because kids have to be able to tolerate the frustration of being challenged and have to be able to follow the directions. But it's not a "have to be 48 inches" kind of thing and if your little guy could follow the instructions and tolerate the process maybe someone would be willing to work with him. It sounds like he's already far ahead of where my daughter started.
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