When we look at an object our eyes receive that information and send it to our brain to be interpreted and processed. When a child has difficulty making sense of what the eyes “see” it is termed a visual processing disorder. It is possible to have 20/20 vision and still have difficulty processing what is seen, for while we “look” with our eyes, we truly “see” with our brain.
In 1862 Herman Snellen, a Dutch ophthalmologist, developed the Snellen chart (see image on right) which measures visual acuity for distance. In the U.S. that distance is 20 feet. While the Snellen chart is the oldest diagnostic vision test still in use it is, unfortunately, also the most common way in which children’s vision is screened. A child may be able to see the Snellen chart very well at 20 feet with either eye and thus have 20/20 vision, but may not be able to focus the eyes to read at 20 inches. The child may also not be able use the eyes together, may have difficulty separating foreground from background or locating an item in space, may have difficulty judging distance, may miss visual details and social cues, and may have difficulty using vision to guide body movements, etc.
Problems that affect visual perception and organization may sometimes be difficult to recognize. However, they can have a very significant effect on academic achievement as well as motor skills and behavior. The following are some common behaviors that often indicate a child is experiencing problems with vision processing:
A comprehensive assessment of a child’s vision may include evaluation of eye tracking, eye teaming, fusion, depth perception, near and distant visual acuity, visual motor skills, visual closure, visual contrast, visual discrimination, etc.
Treatment may involve glasses, therapeutic activities to do at home, vision therapy, prism glasses, etc. For more information concerning the evaluation and remediation of visual processing problems, please read about the Padula Institute’s “Learn to See” program.
Vision is learned. From our earliest moments in life we develop our ability to use sight to match up information with our movement system and other senses to organize, confirm, and develop experience. This is vision.
The experience of vision should become the primary means by which the child or adult explores his environment. Vision also becomes a primary influence in higher functions such as attention and concentration.
A Euro-Visual Processing Evaluation is a comprehensive evaluation during which the doctor analyzes not only functional vision problems (e.g. problems with eye muscle coordination), but also visual processing problems that affect our ability to attend, concentrate, orient ourselves in our spatial world, and organize movement. A Euro-Visual Processing Evaluation differs from a routine eye exam in that the doctor will spend additional time analyzing vision behaviors to gain more information about visual imbalances.
Children often have vision problems that interfere with learning abilities in the classroom. Frequently the vision problems are not diagnosed even following normal eye examinations and vision screenings at school or in doctors’ offices. Vision problems interfere with and challenge the ability to attend and concentrate. When vision problems are severe they can affect perceptual abilities and can even cause developmental delays.
Functional and/or developmental vision problems can cause interference with teaming of the two eyes. This can cause children to have difficulty maintaining their eyes in alignment, particularly when reading and writing. Focusing problems can also interfere with a child’s ability to sustain visual attention during reading and writing activities.
Vision screenings in school systems often do not evaluate the functional use of eyes for reading and writing activities. Most vision screenings in schools test the child’s visual acuity at 20 feet. Children may have 20/20 acuity at distance but, as noted, may have difficulty maintaining their focus and alignment and thus may have blurred vision when looking at close printed or written material. Some children will even have double vision at close viewing distances but will be able to pass the vision screening for distance vision. While it makes little sense to only screen visual acuity at distance and then to send the child back to the classroom to work for the next several hours performing reading and writing tasks, this is presently the standard that is being used across the United States in our schools.
Doctors performing only standard eye examinations will frequently miss the functional vision problems affecting near vision. If only a standard eye examination is performed, the eye doctor will inform the parents that the child has healthy eyes and that the distance acuity is normal or 20/20. Unfortunately, the doctor will often not test for convergence or focusing abilities. However, these are the visual skills that when not functioning properly relate to the symptoms of eye strain, headaches, and may result in learning difficulties.
A vision examination should include a careful functional analysis of near vision skills including the ability to develop pursuit tracking, saccades (quick eye movements), and sustained focusing ability.
Below are listed some common symptoms of vision problems affecting learning ability. Children who have vision problems are frequently diagnosed with Learning Disabilities and/or Attention Deficit Disorder. It is important to understand that Learning Disabilities and Attention Deficit Disorder are classifications of symptoms and are not a cause in themselves. One of the main reasons for having LD or ADD can be vision problems that are undiagnosed and that cause the symptoms.
After a careful functional vision examination, treatment options may include glasses that relax the visual process enabling improved focusing ability and eye teaming or integration. Glasses may be recommended to be worn in school and for all reading and homework. Frequently parents and teachers as well as children will notice that reading and writing skills may improve from simply using these specially designed developmental lenses.
Another option that is sometimes considered is vision therapy. This is a special approach to train the child to establish improved visual skills necessary to meet the visual demands of reading and writing in the classroom. In vision therapy the doctor will present special activities using instruments, lenses, and prisms, to establish visual skills in order to improve visual function.
Dr. Padula has been specially trained to diagnose and treat vision problems affecting learning abilities of children. He received the E.B. Alexander Fellowship at the Gesell Institute of Child Development where he studied and treated developmental vision problems of children from infancy through school age. Dr. Padula has written many publications concerning vision problems of children and he has lectured extensively on the subject. You may also want to explore: Visual Processing Disorders in Children and See to Learn. Learn to See.
Every child must “learn” to use vision to create experiences necessary for perceptual development. In this way, the child creates a unique visual style and ultimately a learning style that will be used in education, sports, and all aspects of daily life. The visual process is the main way in which children explore relationships affecting social interaction, learning, coordination, and self-esteem.
“Seventy percent of all of the sensory nerves in the entire body receive impulses from the eyes. Over eighty percent of all learning experiences come through a child’s vision. “
– Gesell
Every child must “learn” to use vision to create experiences necessary for perceptual development. In this way, the child creates a unique visual style and ultimately a learning style that will be used in education, sports, and all aspects of daily life. The visual process is the main way in which children explore relationships affecting social interaction, learning, coordination, and self-esteem.
Children’s visual problems require different test procedures than are carried out during routine eye examinations or screenings. The visual examination must provide information for the analysis of vision development and an understanding of the way in which the child’s brain processes visual information for coordination of visual skills. It must also be sensitive to the manner in which the child is attempting to use his vision. Vision problems can interfere with age appropriate development, perceptual abilities, and social skills; they can also cause stress.
The “Learn to See” program is provided by a team of professionals with over seventy-five years of combined experience in working with children who have problems with vision, development, learning, and behavior. In addition to the careful vision assessment, the team will analyze the child’s developmental age, long and short-term memory skills, fine motor and perceptual motor coordination, the ability to follow directions, organizational skills, cognitive maturity, mathematical and logical thinking, clarity of speech, and language expression.
Padula Institute of Vision is an interdisciplinary center devoted to working with children and adults. An in depth understanding of vision problems is obtained through behavioral and/or neuro-optometric rehabilitation assessments of the visual process. This information is used in an integrated approach to vision therapy, occupational therapy, speech /language therapy, and educational assessment and therapy.
At Padula Institute of Vision Rehabilitation, we also provide special visual and therapeutic programs for children and adults with Autism, PDD, ADD, and ADHD.
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