Re: Question re convergence, or unspecified LD w/reading delay

[Guest guest]

Below is some information that might help that person who has a child

with a VI related to reading. I have written a rather large

informative booklet about VI realted to learning. I too have a

convergence problem and I have two VI children so I have some insite

into this subject.

If anyone wants the complete version of this vision information you

can read it at brookehaileybrown/ Join

the group and then go to the files section. It is much too large to

post here. If I am not mistaken it is 28 pages long and includes my

story about how I felt as a child not knowing about my convergence

problem. I really just though I was dumb until one terrific teacher

saved my life. I hope that this helps and I will be happy to answer

any questions that I can. Sheri

Vision problems have become an epidemic.

When you ask a person, " What is vision? " The answer is most

often, " What you see. " But that is only part of it. Vision is a

learned skill just as learning to walk you must practice you skill to

become proficiency in it. There are many different ways that people

see things depending on the proficiency of their visual function.

Vision is a complex process involving over 20 visual abilities and

more than 65% of all pathways to the brain. Due to visual systems

not developing sufficiently partially due to television and videos

visual systems are not able to cope with the demand that reading and

writing in primary grades. It is estimated that 1 out of 4 children

and 7 out of 10 juvenile delinquents have vision problems that

affects their ability to achieve.

20/20 vision does not mean that there is not a visual related

problem. The measurement of eyesight provides a false sense of

security because WHAT YOU CAN SEE AT 20 FEET HAS NOTHING TO DO WITH

YOUR ABILITY TO READ AT 8-11 INCHES.

There are many things to take into considerations. I will explain

many of these reasons so that you will have a better understanding of

the needs of students with visual challenges and of low vision

students.

If you think that a child has symptoms of visual challenges it is

always necessary to get confirmation from a qualified Optometrist.

Just because a person has 20/20 vision does not mean that they do not

suffer from a vision impairment or perception problem that goes

unnoticed or diagnosed. A regular vision exam will not evaluate

these impairments it is necessary to evaluate a person specifically

for these types of impairments. Proper diagnosis requires more than

the measurement of visual acuity and it is important to remember that

adequate vision is critical to learning!

The Visual Skills Needed for Academic Success

Since something like 75% to 90% of all a child learns comes to him

via the visual pathways, it stands to reason that if there is any

interference in those pathways, a child will not develop to his

maximum potential.

Visual Acuity: There are many visual skills that are important for

academic success. One of the least important skills is termed visual

acuity (clarity, sharpness). This is the so-called 20/20, 20/400,

etc., eyesight. All that is meant by the notation 20/20 is that a

person is capable of seeing clearly at a distance of twenty feet.

Unfortunately, how well a child sees at twenty feet has little to do

with how his vision functions at the reading and learning distance --

approximately eleven to sixteen inches from the face. In fact, it is

my opinion that the Stellen Eye Chart measuring visual acuity

actually does more harm than good by providing both parents and

educators a false sense of security that vision is normal. When in

fact there are many other important visual skills that might not be

developed even though visual acuity at distance is normal.

Binocular Coordination: One of the more important visual skills is

the ability to coordinate the two eyes together. A child is born with

two eyes, but he must learn to team them together. Some children

learn to do this properly while others do not. For example, some

children develop a problem known as exophoria, which is a tendency

for the eyes to deviate in an outward direction. This is not the same

as a condition known as exotropia where the eye actually can be seen

to be in an outward position.

Adequate Convergence: During the act of reading, the demand is for

the two eyes to turn inward so that they are aimed at the reading

task. If the eyes have a tendency to deviate outward, the child must

use excess effort and energy to maintain fixation on the reading

task. Most studies have shown that the greater the amount of effort

involved in reading, the lower will be the comprehension and the

lower will be the performance. When reading, the eyes do not move

smoothly over a line of print. Rather, they make a series of

fixations looking from word to word. When an exophoria exists, each

time fixation is broken and moved to the next word, the eyes will

tend to deviate outwards and they must be brought back in to regain

fixation. Human nature being what it is, the child generally has an

avoidance reaction to the reading task. This is compounded by the

fact that anything the child doesn't do well, he would rather not do.

This is the child who looks out the window rather than paying visual

attention. He is commonly given labels. He is often accused of having

a short attention span and not trying. He is told that he would do

better if he tried harder, but he has tried harder to no avail. He is

often labeled as having dyslexia, minimal brain dysfunction, learning

disability, etc. Commonly, he loses his place while reading and/or

uses his finger or a marker to maintain his place. While making the

eye movements during the act of reading, he might not land on the

next word, but rather land a few words further on. Consequently, he

commonly omits small words or confuses small words. Often, he just

adds a word or two to make the sentence make sense. If the two eyes

are pointing at the same point in space, a person will see the

fixated object as being single. Double vision or overlapping vision

results if the two eyes are not exactly pointing at the same point.

Don't expect a child to tell you that his vision isn't clear. He has

no yardstick of comparison to inform him that his vision differs from

the vision of anyone else. 12 out of 100 students have a binary

function vision disability.

Attention Span/Span of Perception: The Span of Perception is also

related to success in school. Many children see just one word at a

time with each eye fixation. Reading speed can be improved by

learning to see two, three, or more words with each eye fixation.

This could be compared to reading through a straw.

Ac hild wh o ha sa

pano f p er ce ptio n

p rob le m w oul d s ee

th in gs s om et hi ng lik e

th is .

Astigmatism, Eye-Hand Coordination, Visual-Motor Problems : People

affected with this condition get into distorted postures in an

attempt to get one eye out of the act. They often put their head down

on their arm, cover one eye with their palm or rotate their head so

that the bridge of their nose interferes with the vision from one eye.

Astigmatism causes things to blur.

Esophoria: Another eye coordination problem is termed esophoria,

which is a tendency for the eyes to turn inwards. The educational

implication of this particular problem is that a child with esophoria

sees things smaller than what they actually are. In order to see an

object properly, it is necessary to make the object larger. The only

means at the disposal of the child to make it larger is to bring it

closer. Eventually, the child is observed with his head buried in a

book and still not achieving.

Exophoria:

Exophoria is a tendency for the eyes to deviate in an outward

direction.

Reading Skills and Binocular Visual Skills: One of the tests used in

optometric offices is to have the child read words while looking into

an instrument called a Telebinocular. The performance is compared

between reading with either eye alone and with both eyes together.

The difference in performance is often quite dramatic if there is an

eye-teaming problem. One eye performance might be quite satisfactory,

but reading with both eyes together will be slower and many more

errors will be made.

Form Perception: Form perception is another important visual skill

for academic achievement. The child is shown forms one at a time and

he is simply asked to copy them. It is amazing to see some of the

distortions that a child will make in attempting to copy forms. If a

child can't perceive and copy these simple geometric forms, it is

unreasonable to assume that he will be able to perceive the wiggly

lines which make up letters which in turn make up words, which in

turn make up sentences which stand for abstract ideas. We see

children often who can't tell the difference between a square and a

rectangle or a circle and an oval. This is also a skill that can be

improved through vision therapy.

When asked to copy these simple shapes as seen in row 1 a person who

has a person forms perception problem may draw forms that look

nothing like what we see as seen in row 2.

Row 1

Row 2

Visualization: The ultimate visual skill is visualization. This is

similar to being able to see things in the mind's eye. There are

authorities that state that the ability to visualize is very closely

allied to the ability to think. In other words, thinking is related

to the ability to abstract from specifics and the ability to

visualize is deeply involved in this process. Visualization is also a

trainable skill.

Challenges

Self-esteem issues children with vision problems often have a history

of underachievement and frustration. They often conclude that the

reason for their low achievement is that they are not as " smart " as

other children. Low self-esteem and a lack of confidence are often

the result of this conclusion. Correcting the vision problems, which

have been interfering with normal performance, can have dramatic

affects both performance and self-esteem

Eighty percent of everything a child learns is acquired through his

or her visual system. According to the American Optometric

Association, about sixteen percent of all children suffer from

inadequate visual skills and up to ninety-four percent of children

with reading problems have reduced visual skills.

If your child exhibits any of the following behaviors, he or she may

be suffering from a problem with convergence and/or adequate visual

function and/or visual perception. These visual problems can

contribute to learning disabilities or, in some cases, can be

mistaken or misdiagnosed as learning disability.

If you notice any of the following behaviors, the child exhibiting

the behavior may be suffering from a problem with convergence and/or

adequate visual function and/or visual perception. These visual

problems can contribute to learning disabilities or, in some cases,

can be mistaken or misdiagnosed as learning disabilities.

The Child . . .

• Seems bright, but struggles with reading.

• Fatigues quickly when reading, with frequent signs of

frustration.

• Is unable to sit still; cannot stay on task for any length

of time.

• Reverses words, numbers or letters.

• Has difficulty remembering spelling words.

• Is disorganized and frustrated when studying visual

information.

• Frequently loses his place, skips words or whole lines of

text.

• Has poor reading comprehension.

• Has difficulty copying from the board or a book, has sloppy

handwriting.

• Medication or tutoring has not been successful in improving

school performance.

• Has been labeled LD (learning disabilities), ADD, ADHD, or

dyslexic

You observe the following behavior in your child:

• One eye drifts or aims in a different direction than the

other (look carefully -- this can be subtle). This is significant

even if it only occurs when the child is tired or stressed.

• Turns or tilts head to see

• Head is frequently tilted to one side or one shoulder is

noticeably higher

• Squinting or closing of one eye

• Excessive blinking or squinting

• Poor visual/motor skills (often called, " hand-eye

coordination " )

• Problems moving in spaces, frequently bumps into or drops

things

While reading or doing close work your child:

• Holds the book or object unusually close

• Closes one eye or covers eye with hand

• Twists or tilts head toward book or object so as to favor one

eye

• Frequently loses place and fatigues easily

• Uses finger to read

• Rubs eyes during or after short periods of reading

Your child frequently complains of:

• Only being able to read for short periods of time

• Headaches or eyestrain

• Nausea or dizziness

• Motion sickness

• DOUBLE VISION!

If a child is not working up to potential in school there is a strong

possibility that a vision problem might be present. According to

experts, almost 50% of children with learning difficulties have

vision disorders. In most cases these problems can be successfully

treated leading to improved learning and better grades.

You can determine whether your child might have a learning related

vision problem by completing the following questionnaire. Print Out

the form and then for each question, CIRCLE the appropriate answer.

1. My child has difficulty concentrating and paying attention.

1. never

2. sometimes

3. often

2. My child requires a lot of time to complete homework. 1.

never

2. sometimes

3. often

3. My child complains of blurred vision, or double vision when

reading. 1. never

2. sometimes

3. often

4.

My child complains of eyestrain or headaches when reading. 1.

never

2. sometimes

3. often

5. My child loses his/her place when reading or skips words or

lines. 1. never

2. sometimes

3. often

6. My child has difficulty copying from the board. 1. never

2. sometimes

3. often

7. My child has difficulty with handwriting. 1. never

2. sometimes

3. often

8. My child reverses letters, numbers or confuses similar words.

1. never

2. sometimes

3. often

9. My child becomes tired or sleepy after short periods of time

or his/her reading comprehension deteriorates with time. 1.

never

2. sometimes

3. often

10. My child has struggled in school. 1. never

2. sometimes

3. often

________________________________________

For each question your child's score will be 1, 2, or 3.

Add up the total score for the ten questions and compare it to the

guidelines below.

Score What That Score Means

10-12

Your child probably does not have a vision problem interfering with

school performance.

13-18 Your child may have a vision problem interfering with school

performance.

19-30 Your child almost certainly has a vision problem interfering

with school performance.

If a child has a score greater than 12 it is strongly suggested that

an evaluation be done testing those aspects of vision that might be

contributing to learning difficulties. If a problem is detected, a

Vision Therapy program may be recommended to eliminate the vision

disorders.