Cheers to the researchers studying this complex topic.
First, they cite two other studies (Atzmon et al., Dusek et al.) as papers that showed improvement in reading ability with vision therapy. This paper uses convergence insufficiency and accommodation as the areas trained to increase reading ability.
Second, this study had a “control group” that still received a type of therapy. It was hardly a placebo treatment because the children were given individual attention and encouragement. Per the study itself, the tasks required the child to keep the target clear and single (and they were instructed to do so), they required high levels of visual attention and required visual processing skills such as visual closure, figure ground, visual spatial or visual discrimination of patterns. These types of tasks sound exactly like a description of vision therapy, even if convergence and accommodation were not directly trained.
Third, they were average readers to begin with. Why did the study expect to significantly improve reading ability among a group of children who were, on average, already within normal range for reading performance?
Last, the WIAT-III test used to measure reading comprehension and fluency has only one test form, which means the children read the exact same passages at baseline and 16 weeks later. This means that the children would be familiar with the passage and the questions and may remember it from before.
Reading falls within the language category of the neuro exam — it is a network! In other words, there is not one place that makes or breaks the improvement with reading, just like pain, speech and autonomics are networks, to name a few.
In conclusion, isolated splinter skills are difficult to equate to reading. Gross motor skills, peripheral work, movement and visual perceptual skills are included in the structure of vision therapy most optometrists offer. Why? Because it is spatial — reading is a dynamic activity that requires good posture, physical endurance and timing.
Atzmon D, et al. Binocul Vis Q Eye Muscle Surg. 1993;8:91–106.
Dusek WA, et al. BMC Ophthalmol. 2011.doi:10.1186/1471-2415-11-21.
DeAnn Fitzgerald, OD
Private practitioner, Cedar Rapids, Iowa
Vice president and education chair
Neuro-Optometric Rehabilitation Association
Disclosures: Fitzgerald reports no relevant financial disclosures.