Helping special needs students accept and tolerate transitions

A special needs patient has been coming to me for vision therapy for much of the last year. His original skill set included eye movement deficits, convergence excess, delays in most subsets of visual perceptual development, and delays in visual motor integration. In other words, this kid's learning-related visual skills were severely messed up. The progress he has made on all fronts took a quantum leap once he began to see that he could control his visual system and that the strategies he has successfully used to resist frustrating tasks are no longer needed now that the tasks themselves are achievable.

However, like most special needs kids, he continued to struggle whenever he had to make a transition - in the vision therapy context this meant that it took us forever to get him to move through the flipper sequence for monocular and then binocular accommodation.

When I taught in the inner city classroom, the issue of helping children accept and tolerate transitions was one of my big goals especially when students with special needs were mainstreamed into one of my classes. So, I consider myself to be somewhat competent at fostering this skill. My patient, however, was one of the most resistant and I was working with him one on one so I could just imagine the issues he faced in the classroom at school.

Over the past six sessions, I have introduced yoked prism glasses - switching the direction of the prism every few minutes. The patient calls them "drunk glasses". At first he could not manage to walk a taped straight line with yoked six base anywhichway prism glasses. The other day, he tolerated - even enjoyed 20 base up, down, right, and left yoked prisms - he walked straight lines and manipulated a hoop to trap and release a marsden ball without missing a beat.

His father was observing the session and I realized that he did not understand what a huge achievement this indicated. So...... guess what I did?

I put the base 20 yoked prism on the dad and asked him to walk the line - he barely managed it base down. Then I shifted the prisms base right and the man nearly fell off the floor to the delight of his son, my patient. The purpose of the activity was achieved though, because the dad totally understood the huge progress that my patient had made - to handle quick transitions, adjust to them, and enjoy it. Now, to transfer that ability to other areas of his life....