We play with blocks during vision therapy. Blocks of different colors, shapes, textures, symbols, some that allow us to make pictures, others to observe, some to build with, but all to help our brain process what we are looking at. Although the games can be fun, that isn’t the primary reason we play them. A visual processing disorder (VPD) exists when the brain is not correctly interpreting what the eyes are seeing. The diagnosis has nothing to do with visual acuity or how clearly the eye sees stimuli. This miscommunication can cause some misunderstood difficulties for those with this diagnosis. In this article we will explore skills that are difficult for children with a VPD, reasons why having a strong visual processing system is important, and how we help train the brain to improve these abilities here at our office. 

 

Difficult skills

A patient could have one, a combination or all of the following types of visual processing disorders. An article by the Optometrists Network¹ shares a quick description of skills that are difficult. 

• Visual Discrimination–noticing similarities/differences between shapes, sizes, objects, colors and patterns. 

Ex: Confusing certain letters and numbers, loses place when reading aloud, struggles to notice details or differences

• Visual Figure-Ground–noticing what is important amidst a busy background.

Ex: slow reading speed, difficulty with copying notes from board, trouble scanning for information/concentrating when page has many small words

• Form Constancy–understanding that a shape stays the same regardless of its color, orientation, size or location.

Ex: can’t find missing items even if out in the open, difficulty recognizing known places or objects in a photograph, trouble reading unusual fonts

• Visual Closure–predicting what a shape or picture looks like if only a portion of it is visible

Ex: words already learned require extra effort to sound out, piecing together a jigsaw puzzle creates tension, can’t find an item if the entire thing is not visible

• Visual Memory–remembering something you saw after it is gone. 

Ex: individual letters and sight words are constantly needing to be relearned, struggles both with retaining information learned when reading and doing math, poor spelling

• Visual Sequential Memory–recalling images or events in the order you saw them/they occurred

Ex: trouble putting shapes/pictures/letters in the order they saw them, switches around letters in a word, patterns are not easily recognizable

• Visual Motor Integration–responding to visual information with an action

Ex: poor hand-eye coordination, often colors outside the lines, sloppy handwriting

 

The Power of Visual Processing

Did you know you have superpowers? I don’t mean the ability to time travel, have super strength or the all time favorite “flying.” A brain that is able to take in sensory information quickly and accurately gives us a tremendous boost in our overall quality of life. It allows us to explore our world so that we can seek, learn and achieve whatever interests us. Reading and writing aren’t the only areas impacted as some others include: recognizing faces and expressions, looking for a lost object, correctly interpreting road signs/billboards, seeing a story in your mind and planning ahead. 

 

Visual Processing Dysfunction at our Vision Therapy office

We have several different means by which we challenge visual processing at our office. At the start of this article we expressed the usage of a variety of blocks. Geoboards are also a great tool to construct pictures, plan ahead, and make proper use of space. You can even add in some memory work too! Visual memory style activities can be done most simply by hiding an image and covering it up again (think of a more age appropriate version of peek-a-boo), or in a more complex manner by noticing an image and creating it turned in a different direction, or even putting letters/words in the order you saw them. Not every patient has a visual processing disorder though we often incorporate these types of activities into their program to some degree because we want to challenge and grow all areas of the visual system. If you would like further information please reach out to us and we would be happy to answer any questions you might have! 

 

Resource

Signs of Visual Processing Information Dysfunction¹

https://www.optometrists.org/vision-therapy/guide-vision-and-learning-difficulties/guide-to-visual-information-processing/signs-of-visual-processing-information-dysfunction/

The term “learning disability” is expressed frequently between concerned parents, educators, and anyone who feels they have one. You may know of a relative, a friend’s child, or even your own child who has been diagnosed during their school years. The LD Resources Foundation¹ states on their website that 8-10% of children under 18 have some form of a learning disability. One of the top 5 most common is Dyslexia, often thought of as a disability in reading. When looking for a cause of symptoms it is important to determine if the person has strong functional vision skills or if a deficit is causing learning problems mimicking Dyslexia.

What is Dyslexia?

What do you know about Dyslexia? Common knowledge leads us to understand it is a problem with reading. While that is true there is a little more to it than that. This definition posted on the Edublox Online Tutor Website² brings to light visual dyslexia. 

“Dyslexia is considered to be a neurological disorder in the brain that causes information to be processed and interpreted differently, resulting in reading difficulties.

The terms visual dyslexia and auditory dyslexia are often used by scholars to describe two main types of dyslexia. Visual dyslexia, also called surface dyslexia, dyseidetic dyslexia, or orthographic dyslexia, is a subtype of dyslexia that refers to children who struggle with reading because they have problems remembering and discriminating visual gestalts.”

 

What are common symptoms of Dyslexia?

Not every person with Dyslexia will present with symptoms identically, though they often have symptoms that affect 3 skill sets. Someone with Dyslexia typically struggles with phonological awareness, verbal memory, and verbal processing speed. The Optometrists Network³ wrote an article giving a detailed description of what Dyslexia is and how it presents in different age groups. This is not an exhaustive list, but it does demonstrate how the person is impacted by the 3 symptoms mentioned above.

• Under Age 5 
• • • Recognizing letters and their sounds
    • Getting the letters confused when saying a word
    • Learning frequently used word progressions (ex. Days of the week)
• Age 5-13
  • • Saying a word backwards/switching letters when reading (ex. saw vs. was)
    • Incorrectly saying/writing letters and numbers that look similar (ex. p vs. q and 2 vs. 5)
    • Remembering math facts
    • Remembering spelling rules
    • Following directions in the correct order
• Age 13 and Above
  • • Reading out loud and/or below grade level
    • Recalling the main ideas of a story/comprehension
    • Understanding jokes
    • Managing time

Can functional visual problems present similarly to Dyslexia?

Before beginning a formal assessment to determine if someone has Dyslexia, it is recommended they undergo a specialty vision examination to evaluate the 3 areas of visual functioning: integrity of the visual pathway, visual efficacy, and visual information processing. Oftentimes binocular vision problems (especially convergence insufficiency) can be confused with Dyslexia or may accompany the diagnosis. Those symptoms, taken from Dyslexia and the Vision System⁴, are listed here:

• Reversing letters like “b” and “d”
• Skipping words or entire sentences when reading
• Struggles to copy off the board
• Words look blurry or move
• Has trouble spelling
• Low reading comprehension
• Reading slowly
• Becomes easily tired and eyes feel strained when reading

Can Vision Therapy help?

Yes! In many circumstances where the person is diagnosed with a vision issue they can work on various skills in Vision Therapy to improve the brains’ ability to coordinate the eye muscles and the connection between the eyes and the brain. Several patients begin therapy citing struggles with reading. We know the importance of reading, writing, memory work and being able to plan ahead as well as several other life skills. A few activities that may help get the eyes into the proper alignment and help the person know where they need to look include: reading charts in a certain way, using a set of special blocks moved in different patterns to form words, and using specific glasses to fuse 2 images together to create 1 image with clarity and depth. It can be a life changing experience to receive Vision Therapy amidst school, work, or life struggles.

If you or someone you know would like to schedule a functional vision exam feel free to contact us by phone at 402-502-0043 or send an email to [email protected]. 

 

Resources:

The Top 5 Most Common Learning Disabilities and their Symptoms¹

https://www.ldrfa.org/the-top-5-most-common-learning-disabilities-their-symptoms/#:~:text=The%20top%20five%20most%20common,dyscalculia%2C%20dysgraphia%2C%20and%20dyspraxia.

Visual Dyslexia: What It Is and How to Treat It²

https://www.edubloxtutor.com/visual-dyslexia/ 

Does My Child Have Dyslexia³

https://www.optometrists.org/childrens-vision/vision-for-school/dyslexia/ 

Dyslexia and the Visual System⁴

https://www.optometrists.org/childrens-vision/vision-for-school/dyslexia/dyslexia-and-the-visual-system/

 

Conclusion: More to School than Meets the Eye

There is more to school than reading a book, writing a paragraph, or solving a math equation. What about all those sometimes forgotten skills that help us to be successful as we take notes, follow directions, play a game, take a test or interact with classmates? These abilities cannot be ignored no matter if the student is primarily an auditory, visual or kinesthetic learner. I have learned that since the eyes take in the information and the brain makes sense of what it sees, the visual system is of high importance. 

 

General School Difficulties

• Having efficient speed/accuracy/ memory needed to copy from the board to their paper
• Forgetting which way was right or left when playing games
• Mixing up cardinal directions
• Following multistep directions
• General ability to process information and remember it
• Wearing shoes on the wrong feet
• Proper organization of school supplies/work
• Needing to touch everything to know how it feels

 

 

Education and Vision Therapy

I am sad when I think of my students who lost confidence to do their work correctly and retreated into themselves. I also had students do the opposite, who acted out behaviorally because doing the work was so hard for them. Staying at either end of the spectrum for too long is not a place we want a child to be. Something that vision therapy offers is the chance to be in an environment where making mistakes is okay. During vison therapy we learn and grow in multiple ways at each session. While working on eye focusing skills we learn patience. We teach our eyes to work as a team, while being a part of a team that encourages each other to do our best. Our eye tracking abilities improve while we push ourselves. We gain spatial awareness and appreciate the body God gave us. A positive attitude helps foster and encourage our visual thinking skills. As a former classroom teacher and current vision therapist, I am blessed to continue my work of helping others learn more than classroom skills, but life skills as well. 

Part 3: Writing as Communication

Once learning has taken place, how do you show what you know? My students demonstrated their learning in the classroom through speaking, teaching another student, acting, drawing, using response cards and playing games. One method used daily in most subjects though was writing. The skill of writing is important on so many levels. It allows us to show what we know and communicate with the world. It’s been said that your brain remembers things better when you write it down. What if the physical and mental act of writing is less than fluid for the participant? We utilized writing for the common worksheet, writing notes, tests, learning cursive, and paragraph writing. Writing a math equation is not surprisingly very different from writing a 3 paragraph essay. In both cases though a student must use their brain to formulate an idea, remember how to form the letters/numbers correctly, how to set up and format the writing to be easily read and understood. 

 

Common Writing Difficulties

• Frequently reversing some letters and numbers (ex. Writing b instead of d or 6 instead of 9, or similarly writing 51 instead of 15)
• Mixing capital and lowercase letters within a word or starting every word with a capital letter
• Disregarding spacing when writing a paragraph (ex. Writing all words on only 1 side of the page)
• Writing words in an appropriate size based on the size of the line on the worksheet, lined writing paper, or free writing
• Setting up the paper correctly with a heading or proper paragraph writing specifications, pencil grip, slanting the page, posture, forming the letters and numbers correctly
• Brainstorming ideas in their head and being able to write them as sentences

 

Writing and Vision Therapy

Sometimes I would ask students if they could find which letters or numbers they wrote backwards…some students would notice and fix the mistake, others didn’t seem to think anything was wrong. This could indicate that the visual system has trouble processing and remembering what each letter and number means/how it should look. Many students did not use the space on a paper well. Some would write as if there was no line at all, some wrote on the line, but made their letters so large they would fill up the entire line space. This potential spatial awareness problem as well as others can be addressed with vision therapy.

 

 

 

Part 1: My Road to Vision Therapy

It is still a shock to me that if I had the knowledge I do now about the visual system and how the brain takes in information, I could have spared some of my students’ continuing struggles. Before 2 months ago I had never heard of the words “vision therapy,” nor even knew that vision was different from someone just needing eyeglasses. As a third grade teacher for 5 years, I figured that with the school screenings we had each year, reminding a student to actually wear the glasses they “forgot” in their backpack, or contacting a parent whose child said they couldn’t see well satisfied their eye needs and any further struggles they had were unrelated.

Now I see things differently, no pun intended. Every parent and teacher wants a child to use his/her God given gifts and abilities to reach full potential. Though everyone will struggle at some point in their lifetime, it is nice to have some extra help along the way, that’s where vision therapy comes in.  I left the classroom behind this summer and began my new journey as a vision therapist. I can say I wish I could check in with some of my past students. Perhaps some of them are doing very well now, others may still encounter the same challenges…I wonder if vision therapy could help.

This will be the first in a series of posts I make about some of the struggles I observed among students from this new perspective. I will go into more detail on some of the reading, writing, math and general challenges I witnessed as a teacher.