A Sit Down – with Karen Hackfeld

This post appears as part of a series called Sit Down – candid conversations with real people detailing their journeys and experiences with Vision Therapy.

A Sit Down – with Karen Hackfeld


For the benefit of our readers, can you explain how you are involved in Behavioral Optometry?

My husband Mark and I were introduced to this program when our son Jake was around 6 years old.  Jake was born a micro preemie – weighing in at 1 pound and zero ounces so we knew he would have issues with his vision.

At what stage did you first realize Jake was having visual difficulties?

When Jake was 3 he started in a preschool program for children with disabilities (PPCD) – it was then that his teacher noticed he would favor one eye when doing any classroom work.  We took him in for a regular eye exam and were told that it was nothing.  For two years we watched Jake continue to favor that one eye and feared that the vision in his other eye was going to suffer.

When Jake started kindergarten, it became very clear that he was suffering with the smallest of task like coloring and writing.  He would practically lay his head on the table to try and see what he was doing.  His teacher indicated that we might want to talk to our pediatrician and see what she recommended.

Had you ever heard of Vision Therapy prior to those events? 

I had never heard of Vision therapy – ever. Had NO concept of what it even meant…I just knew that we needed to determine what was going on with Jake and his vision.

Karen and JakeHow did you first come to learn about Vision Therapy? 

Jake had been wearing glasses for about a year and the favoring of his left eye was still very prominent.    During an exam with our optometrist, Dr. Ann Voss, we begin talking about things that Jake was struggling with like tying his shoes, riding a bike, jumping up and down, running in a straight line, etc.  As we were talking, Dr. Voss ask me if I had ever heard of vision therapy and begin to explain what it was and what it had done for many others who struggled with some of the same issues.

Can you describe Jake’s experiences in school prior to Vision Therapy?  

Prior to vision therapy – Jake had no concept of physical space, peripheral vision, balance or being able to work with noise/other people in the same room.  He would get extremely agitated when unable to focus on a task because he couldn’t see the chalk board very well and would just shut down.

What other solutions had you tried? 

Nothing – had no idea what to do.  Vision Therapy was the first recommendation we had ever had to help with any of these issues.  Jake had been assigned a teachers aid to be with him at all times (which Jake found very annoying) and he would try to cover up his work so no one would know he couldn’t see.  As he advanced to 1st grade – it was imperative that we “fix” the issue because I knew that he would really begin to struggle with reading and writing.

Was medication ever an option? 

Yes – as we begin working with the Vision Therapist, I had Jake’s school teacher look for different signs during the day that might help with determining specific areas he struggled with at school and she begin to notice that he unable able to stay focused on one thing specifically at a time. He would sit for about 5 min and then want to move on to something else.  After several sessions with the diagnostician at the school and our long chats with our pediatrician- it was determined that Jake suffered with a form of ADHD – primarily with focus.  We then made the decision to start him on a small dose of a medication to which he continues to take to this day.

Did you ever visit an Ophthalmologist?

No- once we were referred to our optometrist, Dr. Voss and she recommended VT – we never went anywhere else.

Were you surprised that Vision Therapy homework was being assigned? 

No – I knew that with the amount work needed to help Jake improved – it would require some work to be done at home.

Was getting it done ever an issue?

At first, yes it was hard and a big struggle. Jake would resort to meltdowns to try and get out of it.  I learned to break the amount of homework time into three sessions making it more fun for Jake and giving him a prize for each assignment completed.  His therapists were great about explaining to both Jake and I what was expected out of both of us at home. They went over each exercise with me and made sure I was comfortable with them.  Of course, working with mom at home is never as fun as working with his friends at therapy, but we quickly got into a routine and he would enjoy showing his father the “cool, new tricks” he could do with his eyes when he would lay on the floor and track the ball (that was tied to the ceiling fan).

The one exercise he hated was wearing a patch over the good eye so he could make the weaker eye stronger.  This was probably the area we struggled the most with because he was so accustomed to utilizing one eye that making the other eye focus was a lot of work

Jake hat

At what stage in your program did you first start to notice progress? 

I can’t really remember when I noticed the changes directly.  His teachers noticed before me.  They would write me little notes and say “Jake had a great day today, no one complained about him being in their face (lack of personal space perception)” or “Jake sat through a whole lesson today without asking for headphones to block the classroom noise”.

I started noticing that he would practice his peripheral vision exercises a lot more when one he realized he didn’t have to turn his whole body to see what was beside him- it was a whole new world!!

When I realized that he was beginning to do his reading or watch TV without his head turned sideways – I think I cried.  That is when I knew – this was really working.

What would you say were the most significant improvements Jake made during his Vision Therapy program? 

Self-esteem and confidence are the two significant improvements by far. Being able to be like his peers and not have to be “different” by using headphones in class, that is a big deal for a 2nd grader. 

A lot is made of the incredible expense associate with Vision Therapy. Some argue that a few thousand dollars to improve a child’s life is a drop in the bucket, while others balk at the exorbitant fees. What’s your opinion? Was cost ever an issue for you? 

I have always been of the mindset that whatever it takes to help Jake achieved his goals with the least amount of struggling – that is what we are doing.  We were very fortunate that our insurance carrier covered a portion of the cost.  It is very sad that because some insurances don’t cover the cost of VT – some parents are not able to provide this amazing therapy for their children.

The efficacy of Vision Therapy is often questioned by parents and other professionals.   What’s your take on this? 

I have to admit, when I first talked with Dr. Voss about some of the issues Jake was having, I couldn’t figure the connection between his eyes and his lack of balance or lack of focus.  I kept saying “I get that we are doing therapy, but when are you going to work on his eyes?  Lol.  I just couldn’t imagine how vision therapy was going to help with all the issues we were discussing (balance, personal space, filtering out noises, tying shoes, etc).  I quickly found out that everything works together – once the brain is trained to send the correct signals to all areas. It was an amazing thing to watch unfold.


What has Jake’s life been like since graduating Vision Therapy?

Jake has quickly come out of his shell.  His self-esteem and confidence is so much greater than before. He is now in the 4th grade.  When he reads a book, he is able to hold the book away from his face versus practically leaning on the table.  He loves being able to sit wherever he wants in the classroom without the teacher asking if he can see the chalkboard.  He ties his own shoes (which was a huge undertaking for jake so he is very proud to tie his shoes every morning). He loves that he can stare straight ahead and tell you what he can see to his left and his right.  Jake is quick to remind me when he is practicing a technique he learned from VT.  I would recommend VT to anyone and would do it all over again if needed.

Some Closing Thoughts: Special thanks to Karen for completing this interview. Jake’s story is pretty incredible and  he has overcome so much. After he graduated from VT, Karen and I have cultivated a friendship and she has be great about updating me on Jake’s continued progress.  He really is an amazing kid. Please join me in wishing Karen, Jake and their family the absolute best! 🙂


Posted on November 22, 2013, in Sit Downs. Bookmark the permalink. 1 Comment.

  1. Jake’s story is a wonderful one – and one we hear over and over!!! It is an amazing gift to be able to see the look on the face of a child who is beginning to be successful and starting to believe the/she is truly “smart” and capable of doing many things. I love these stories and continue to love this great profession that gives us the opportunities to change the lives of children like Jake.


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