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VISUALLY RELATED LEARNING PROBLEMS

VISION – A possible reason why people have reading or learning difficulties OR are labeled A.D.D., A.D.H.D., or dyslexic.

The above are all terms that describe the symptoms or the outcome of a problem. These are not terms that describe the causative factor or the deficit.

For instance: When someone has the sniffles and watery eyes, should we automatically put them on antibiotics, antihistamines or decongestants, or label them as sick? OR do we first try to find the cause of this symptom? Is it a virus, bacterial cold, allergy, dust, emotional crying, physical pain, ate something spicy or did they just come in from the cold outdoors into a warm building?

Ask WHY!!   What is the underlying cause? Is it an emotional, chemical or nutritional imbalance? Or are they physically challenged or mentally impaired? Could they have a sensory problem such as tactile defensiveness, motor overflow, speech or auditory impairments or a VISUAL IMBALANCE?

VISUAL EFFICIENCY AND VISUAL PERCEPTION

VISUAL EFFICIENCY – Are the eyes anatomically and physically capable of performing the visual task at hand?

DO WE HAVE THE TOOLS? – Deals with sight, coordination, tracking, focusing, and color perception.

1. Sight (Optical) – The ability to see clearly. 20/20 vision is the ability to just make out a 5/16” target at 20 feet. Nearsightedness, farsightedness, and astigmatism.

a. Nearsightedness (myopia) is the condition where objects at a distance are blurry, but near sight is good.

b.Farsightedness (hyperopia) is the condition most important with children. Easier to see objects at a distance than it is to see them up close. Small prescriptions ARE significant.

c.Astigmatism is a condition where objects are seen as visually distorted or skewed.

Symptoms – Variable working distance, blurry vision especially later in the day, one eye turns in or wanders, problems copying from the board to paper, near vision blur and poor near point work.

Summary – Nearsighted people are the best visual learners. Farsighted people have the most problems with visual learning.

2. Coordination (Eye teaming) – How well do our eyes turn inward and outward together. Six muscles per eye that align and keep the two eyes together to prevent double vision and achieve 3D vision.

            a. Tropia – Eyes ARE physically turned in or out or up or down.

            b. Phoria – Eyes have the TENDENCY to be turned in or out or up or down.

            c. The ability for the eyes to have the stamina to work together for long periods of      time.

 Symptoms –

Reversals, transpositions, re-read lines/words, omit lines/words, problems copying from board to paper, loss of place, double vision, inattentiveness, rubbing eyes, eyes water, and blurriness.

3. Tracking – The ability of the eyes to follow a line of print and move continuously together. Side to side eye movements.

a. Pursuit movements. This is the smooth following motion of the eyes. They are only capable of this when they are following a moving target.

b. Saccadic movements. This is the short bursts of motion as the eyes move from one point to another. Jerky re-fixation eye movements.

Symptoms –

Head moves with reading, re-reads/loses place, uses finger as a marker, writes up or downhill, turns the book or paper, fine motor control problems, sloppy handwriting, problems catching or hitting a ball, problems riding a bicycle.

4. Focus or Accommodation – The ability to adjust your eyes to keep your sight clear at all distances. Relaxing and working the eyes for clear sight.

a. Is the ability of the eyes inadequate, does it spasm or too much or no flexibility? Each eye has a lens and a muscle that controls it to adjust for clear sight. If either the lens or the muscle are not working properly, you will not be able to see clearly or adjust your sight quickly enough to read comfortably.

b. Presbyopia – Think about people over age “40” who have to wear reading glasses or bifocals. What happens if they try to read without their glasses? They will not be able to read comfortably or they will not be able to read at all. Should they be classified as learning disabled or dyslexic?

Symptoms –

Blurry sight far and/or near, variable working distance, headaches, short attention spans, avoidance of near point tasks, problems copying from the board, holding things too close, fatigue at the end of the day, rubbing the eyes, and the eyes watering.

5. Light/color/glare – The ability to distinguish the entire visible light spectrum and be comfortable with its intensities. We must also be concerned about ultraviolet light and infrared

a. Are they color deficient? Very important in the primary grades.

b. The correct type of lighting. Flourescent versus incandescent versus sunlight.

c. Computer screens, black boards, white boards, overheads and Xerox sheets.

d. Glare from the side and ceiling lights.

e. Syntonics: color light stimulation which either turns on or off visual mal-adaptation.

Symptoms –

Wrong color naming, inability to follow instructions in the first few grades, fatigue, irritability, short attention span, blinking, squinting, watery eyes, red eyelids, pink eye, headaches or eye aches.

VISUAL PERCEPTION – The meaningful interpretation of what you see.

Deals with the processes of: laterality-directionality, visual analysis skills, visual memory, visual integration, and therapeutic light.

1. Spatial Awareness – ability to locate items in relationship to one another. Laterality (internal) and directionality (external), right/left awareness, reversals and transpositions.

Symptoms –

was/saw, (b,d,p,q), writing backwards from right to left, or reading one line left to right and the next line right to left.

2. Visual Analysis Skills:

Form perception – do you know what objects are.

Figure-ground determination – distinguishing fine details.

Discrimination – do you recognize differences.

Crowding phenomena

Symptoms –

Confusion of likes and differences, mistakes with words with similar beginnings, difficulty with recognizing words and determining what is significant.

3. Visual Memory – Visual memory, visual closure (recall) and sequencing. Ability to recall dominant features or remember a sequence, or the ability to obtain meaning from small pieces of information and past experience.

 Symptoms –

Visualization problems, problems with learning new material (quickly), recall-spelling, problems with tasks that take more than one step, not being able to read a word that was just read in a previous sentence.

4. Visual Motor Integration – Visual form recognition COMBINED WITH fine motor ability and hand-eye coordination to produce a pattern. Tracking is involved.

Symptoms –

Sloppiness, staying on a line, can respond orally but not on paper, knows material but does poorly on written tests, using the finger to follow a line, the ORAL-SILENT reader.

If these visual processing skills have not been developed, then a person will not be able to function properly on a given visual task. Tasks such as reading, writing and spelling will be very difficult without having the basic skills of form perception, figure-ground determination, etc.

Symptoms –

Difficult to teach, try to rely on auditory memory, difficulty learning alphabet and word recognition, slow phonetic reader, poor comprehension and spelling, poor written work and excessive time needed to complete work.

If a person does not need glasses to sharpen their sight, and their eyes are medically healthy, they are told that they have NO VISION PROBLEMS. They really should be told that they have NO SIGHT PROBLEMS. They may still be visually inefficient, but glasses will be of no help to them. Eye coordination, tracking, focusing or light perception could still be a problem.

If a person is visually efficient but processes poorly, they also have a VISION PROBLEM.

Most school screening tests screen for sight and gross eye muscle problems only.

TREATMENT

With lenses – glasses, reading glasses, bifocals, prisms, color filters. With behavior modification-ergonomics – adjusting posture, placement in the classroom, lighting conditions, changing the learning environment.

VISUAL THERAPY – Combination of lenses, behavior modification, eye muscle exercises, visual exercises, light/color therapy and sensory integration.

Visual Therapy – An individualized set of procedures to treat or compensate for a visual dysfunction. Of importance, is to break acquired habits of mal-adaptation and teach changes to re-align the ability to compensate to visually presented stimuli. The number of treatment visits vary depending on the diagnosis and the severity of the condition. Normally, 85% of the individuals who are treated with visual therapy are “functionally” cured AND retain their cure.

Functionally cured means that the individual can perform the task without complications. The condition that caused the symptoms may still exist, but the individual has learned how to adapt to the problem.

Therapeutic Light

a) Irlen Lens/Filters – use of color filters

b) Syntonics – short use of color light therapy to stimulate vision and brain activity.

WHO NEEDS TO BE INVOLVED?

TEAM APPROACH

 1) Patient must be willing to change and perform the therapy tasks desired.

2) The behavioral optometrist and optometric vision therapist.

3) Family physician/school psychologist.

4) Teacher, learning/reading specialist.

6) Occupational therapist.

7) Parents.

8) Audiologist

All the above may need to help implement the treatment plan. Some will be more involved than others will and to different degrees depending upon the person and the diagnosis, but everyone can help once we understand the problem.

Does everyone with L.D., A.D.D. OR A.D.H.D. problems have a visual problem? NO.

Does medication work for some of the people? YES

THINGS TO LOOK FOR: Everything that I have already mentioned and those symptoms in your handouts. ERIC, HIDDEN EYE PROBLEMS, TEACHERS GUIDE TO VISION PROBLEMS.

WHAT TO DO:

  1. Evaluate your classroom environment. Is there too much visual or auditory noise for some students? Is the student in the proper place in the classroom? Is the lighting proper?
  2. Allow students increased time to complete a task. Can they complete the task if they are given more time? Do they need one on one attention?
  3. Reduce the workload if they know the concept being taught. Some students will complain that they do not have enough time to play. These students NEED the extra play time to “LET OUT” their energy, or try to combine play with work.
  4. Allow finger reading.
  5. Allow oral-silent reading.
  6. Put the alphabet/numbers on their desk. Emphasize b,d,p,q. Left hand makes and L with the thumb and pointer finger. Combing the word with the digit, 2 two and 5 five.
  7. Increase hand outs to copy from. Decrease overheads. Decrease board to desk tasks.
  8. Watch their body posture when reading or writing. Arms length near point distance.
  9. Watch their paper/book position and orientation and body/head posture.

ACTIVITIES FOR THEM TO PLAY WITH

Pencil push up. Rotations. Hart technique. Map walk/draw.

Parquetry, tanagrams, Seven Pieces of Cleverness, hidden pictures, Waldo, G.O. boards, puzzles(do them upside down), mazes, word searches, dot to dot, color by number, card games (UNO, Fish, Old Maid, Goose Bumps), Simon, Brain Bash, Guess Who, Trouble, etc.

All the above can be modified to be performed with spelling words, reading words, vocabulary words or definitions that the student needs to know.

Try to become more multi – sensory aware.

For more information, below are some helpful links
VisionTherapy.org
Optometrists.org
AllAboutVision.com