Wednesday, May 25, 2011

Vision Issues in Struggling Readers


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Today's Parent Post is written by Dr. Howard Kushner, who is a Developmental Optometrist in Clifton Park, NY. I met Dr. Kushner several years ago by attending a workshop he presented . This workshop opened my eyes to the world of vision issues in struggling readers. Over the years, I've referred several students to him. Through Vision Therapy, these students have made huge progress towards becoming competent and confident readers and students. Not all struggling readers have vision issues but a surprising number do. Please leave a comment if you have questions or a Vision Therapy experience you'd like to share.
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Does Your Struggling Reader have a Vision Problem?
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Does your child:
  • Lose their place when reading?
  • Have poor reading comprehension?
  • Have poor handwriting?
  • Have a poor attention span when doing close work tasks?
  • Have headaches or eye strain when reading?
  • Tilt their head or close one eye when reading or writing?

If you answered yes to any of these questions then your child may have a visual skill deficit.

What does vision have to do with learning? This is a critical question in part because so many children have undiagnosed or misdiagnosed vision problems. These vision problems can interfere with reading,
math, and learning in general.

Vision is the process by which we  interpret and place meaning upon the information that comes in through the eyes. It is critical to understand that vision is a process that involves a connection between the eyes and the brain. 20/20 eyesight does not necessarily mean that you have an efficient visual process. It certainly does not mean “perfect” vision. Skills such as eye teaming, focusing, eye movement control, and the various visual perceptual skills are critical to the visual process.

Vision is our spatial sensory system. It gives us information about where we are in our environment, where objects are relative to each other, and where those objects are relative to us. Yes, we use our visual systems for more than just determining where things are. We use vision to tell us what things are as well. However, the most fundamental function of the system is spatial in nature. The biological advantage that vision offers is directed, meaningful, movement. The visual system is the guidance system for the body, the hands, and the feet. There is such an intimate relationship between movement and vision that I often think of them as one big system. It’s like they are two different sides of the same coin. If we look to nature, organisms that don’t have a spatial sensory system don’t move in a meaningful way. Yes, trees move and they don’t have a spatial sensory system. They sway in the wind, but that is not purposeful and directed.

The point of all this is that our visual systems were not designed to read. The system was designed as a guidance system for the body. Reading is a relatively new activity evolutionarily speaking. In Behavioral Optometric lingo we say that reading is a “socially compulsive, biologically unacceptable task”.

One of the real problems is that the visual system was not designed for sustained precision in coordinating the eyes as a team, focusing the eyes and moving the eyes, when looking up close - which is of great necessity when reading. If we are using excessive effort or attention to coordinate, focus, or move our eyes, we are draining that attention away from the task at hand. So, comprehension suffers, reading fluency suffers, handwriting suffers, etc. Even small visual inefficiencies can lead to big problems academically. Every day I see children in my practice with academic challenges and most of those children have visual skill issues. I always look at visual skills as “learning infrastructure.” Without efficient infrastructure reading and learning cannot be efficient.

So, what can be done to improve visual skills? What can be done to make the visual system more compatible with tasks such as reading and computer work? Often eyeglasses can be prescribed to make it easier to execute visual skills. Also, Vision Therapy is very effective at building better visual skills. Vision Therapy is like Occupational or Physical Therapy, but for the visual system. It is a set of activities designed to improve focusing, coordination of the eyes, and eye movement control. I’ve been in practice for 20 years and I continually see children’s lives get turned around with Vision Therapy. I’ve also developed the Integrative Vision Skills Program. This is an innovative, home based Vision Therapy program. It is very effective at building visual skills and is based on the Vision Therapy activities that I use in my office program. You can check it out here:

Also, for a list of symptoms that could signal a vision problem, you can go here:

Above all, remember that if your child is having difficulty in school, please don’t ignore the fact that visual skill deficits can be part of the problem.

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