Imagine a situation where an elementary school child, who is a bright little girl and should have no problem with school, avoids reading and struggles to do simple homework assignments. Even worse, she has trouble with "letter reversals" such as "b's" for "d's" or "p's" for "q's" when that type of letter confusion should have ended by age 7. Compounding these problems, copying from board to paper or book to paper takes her 2-3 times longer than other children the same age. This child is becoming frustrated and emotional side effects are beginning to affect her self esteem.
What is the cause of these problems and what should her parents or teachers do? Does this child have a learning disability that prevents her from learning and needs special services at school? Maybe she is just not trying hard enough or acting lazy and better discipline will get her on track. Maybe she has ADHD? Perhaps it Is just a problem with her teacher? (After all, this little girl is smart!) Or could there be another cause? Could this little girl have a vision problem?
A vision problem? This seems like a reasonable question to ask. However, in this case the little girl shows no signs of having problems "seeing". She can see a small bird across the playground as well as any other child. This same child loves to play soccer and softball and doesn't seem to have any trouble finding the ball on the field. When asked, she says she has no problem with "blurry" vision.
But, to be on the safe side, the little girl is taken to have her "eyes tested" by the school vision screening and comes back from the test with a "PASS" - 20/20 in each eye. Now what?!
Well, just because this little girl has "detail vision" can we assume that she has the visual readiness skills for the demands of the classroom, reading, paper pencil tasks and effective learning? If a child's eyes are healthy and she (or he) has 20/20 eye sight is anything more required? YES, much more than good eye sight is required for effective learning in the classroom?
Parents and teachers must know that good vision is much like the tools in a toolbox of classroom learning readiness abilities. These are often referred to as vision skills. These skills are developmental and therefore are usually acquired normally as a part of the natural childhood experiences. However, as many as 1 in 4 children in the classroom can have deficiencies in some (or all) of these vision skills placing them at risk of experience learning difficulty.
They are:
- eye tracking skills - eyes following a line of print
- eye teaming skills - two eyes working together as a synchronized team
- binocular vision - simultaneously blending the images from both eyes into one image
- accommodation - eye focusing
- visual-motor integration - eye-hand coordination
- visual perception - visual memory, visual form perception, and visualization
It is important for parents and teachers to not rely on vision screenings that are based simply on testing eye sight alone. 20/20 eye sight (with or without glasses) is not a measure of a child's "learning readiness" vision skills.
The moral to this story is, when ever a child is performing below expected, don't assume that their vision is adequate just because they pass the eye sight vision screening. It is critical that they be seen by a doctor who is trained to evaluate all of the above vision skills and if a problem is identified, will offer office-based vision therapy for the child or refer the child to a doctor will provide office-based vision therapy. This will help a child who needs help acquiring all of their vision skills for effective learning!
For more helpful information click here to go to the College of Optometrists in Vision Development website to learn more about Vision and Learning Problems.
Dan L. Fortenbacher, O.D.,FCOVD
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