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Learning-Related Visual Problems Overview

A learning-related visual problem directly affects how we learn, read, or sustain close work. Visual problems in any of the following areas can have a significant impact on learning:

  • 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

child-therapy-2Vision and learning are intimately connected.  Someone may have a learning problem that is caused by an underlying  vision problem. A child with a vision problem can be misdiagnosed as having Learning Disabilities, ADHD, or Dyslexia. There are various reasons for this misdiagnosis. For example, children who have learning-related visual problems cannot sustain their close work at school. They may be misdiagnosed as ADHD because children with ADHD also can't sustain attention on their work. Same behaviors, different diagnosis.

 

Treatment of Learning-Related Visual Problems

The treatment for learning-related visual problems at our eye care clinic in Old Bridge, NJ is quite different from that of ADHD, Dyslexia, and Learning Disabilities. Treatment of learning-related visual problems involves the use of appropriate glasses for near work and/or a regimen of Vision Therapy to improve important visual abilities.

When parents observe that their child is struggling in school, it's time to have their vision properly evaluated with a comprehensive vision examination.

In the video below, Dr. Julie Ryan explains how vision is more than just seeing clearly. Vision Therapy teaches someone how to control their eyes to focus, to team, and to move simultaneously through print so that they can work with efficiency and comfort. Vision doesn’t always come naturally.

Does Your Child Need Help with Reading and Spelling?

Vision Screening at School or pediatrician

Yearly Eye Examination for Children

Jennifer and Catherine: A Vision Therapy Testimonial

A mother and her daughter discuss the child’s difficulties with learning.“She knew her letters, but wouldn’t stay on task very long”. Watch this amazing video that features parents, children, educators, and reaseachers.

Children and their parent discuss the difference that Vision Therapy has made in their lives.

Educators and researchers discuss the difference that Vision Therapy can make in an individual's ability to function and do well in school.

What had been a struggle then becomes success.  Self-esteem skyrockets because the individual has been able to demonstrate not only to others, but more importantly to themselves what they are truly able to produce.

This video was produced by the parent's organization, PAVE (Parents Active for Vision Education).

Learning Related Visual Problems are often known but remain unclear because of the eyes' complexity and constant development throughout childhood. Dr. Roth from Family Eye Care at an interview with OBTV provides a thorough explanation how the eyes relate to the brain in a fundamental and clear manner.

Patients Testimonials

Our patients and parents talk about the profound improvements achieved through effective Vision Therapy. Click on the images to hear their stories! We now have a blog which may include even more testimonials!

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BT's mom is thrilled with her son's improved writing after therapy!

AM becomes a better reader!

Vision Therapy helps AM to become a better reader!

GG's attention issues are much better after vision therapy

Vision Therapy helped GG with his reading and attention problems

"Double Amblyopia"

“My son had double amblyopia, all discovered at the age of 7.  That is late in the game for glasses and treatment.

He got glasses and had vision therapy there for 14 months. The first 3 months we were uncertain whether the glasses or therapy were the cause of all the changes we saw. After that we had to attribute the continuing changes to the therapy. Our son is a great kid. The quiet, funny type who is great one on one but lies low in the crowd.

Prior to vision therapy we knew one kid and school and sports teams saw another. The kid we knew was bright and funny. In school he was literally trying to be invisible. He had no confidence. We have seen academic improvement (he went from a 19 on the NJ ASK math portion to an 83), social improvement (he is the same kid everywhere now) to sports improvement.

Prior to vision therapy he could not find a ball in a room if it were the only one. Now he is the one finding things we can't.

He is now so outgoing. I used to speak for him and now he speaks for himself. I used to put him in situations to talk to others "Go ask that lady what time it is, etc." and he always balked. On vacation this year I legitimately asked him to ask someone something, pay the lady, etc. for my convenience without giving it a thought and he just did it. I think this is important because vision therapy changed not only him but us and the way we treat him. Think about what that means.

We, who love and respect him, accommodate him less because he can handle things he could not before. It could have been uglier for him in the years to come when he was not as much of a player in life and he encountered those who did not love and respect him. They would not have had patience, he would have felt helpless…As I wrote to Dr. Moshe: "I can't express enough how I had decided that some things were permanent and had accepted that only to discover that vision therapy made those things temporary. I am convinced his life will be happier because of what you and your staff did. Of all the things I want for him as his mom, happiness and confidence, the two most important things he got from you, I value the most.

"Things you will not like but will accept, as I did, because of what they do to change your child's life.1) It's expensive. There, I said it. But worth it (see above).

“Double Amblyopia”

“My son had double amblyopia, all discovered at the age of 7.  That is late in the game for glasses and treatment.

He got glasses and had vision therapy there for 14 months. The first 3 months we were uncertain whether the glasses or therapy were the cause of all the changes we saw. After that we had to attribute the continuing changes to the therapy. Our son is a great kid. The quiet, funny type who is great one on one but lies low in the crowd.

Prior to vision therapy we knew one kid and school and sports teams saw another. The kid we knew was bright and funny. In school he was literally trying to be invisible. He had no confidence. We have seen academic improvement (he went from a 19 on the NJ ASK math portion to an 83), social improvement (he is the same kid everywhere now) to sports improvement.

Prior to vision therapy he could not find a ball in a room if it were the only one. Now he is the one finding things we can't.

He is now so outgoing. I used to speak for him and now he speaks for himself. I used to put him in situations to talk to others "Go ask that lady what time it is, etc." and he always balked. On vacation this year I legitimately asked him to ask someone something, pay the lady, etc. for my convenience without giving it a thought and he just did it. I think this is important because vision therapy changed not only him but us and the way we treat him. Think about what that means.

We, who love and respect him, accommodate him less because he can handle things he could not before. It could have been uglier for him in the years to come when he was not as much of a player in life and he encountered those who did not love and respect him. They would not have had patience, he would have felt helpless…As I wrote to Dr. Moshe: "I can't express enough how I had decided that some things were permanent and had accepted that only to discover that vision therapy made those things temporary. I am convinced his life will be happier because of what you and your staff did. Of all the things I want for him as his mom, happiness and confidence, the two most important things he got from you, I value the most.

"Things you will not like but will accept, as I did, because of what they do to change your child's life.1) It's expensive. There, I said it. But worth it (see above).

Dyslexia & Vision Therapy

Dylexia can mean different things to different people.  "Dys" means "not".  "Lex" means "read".  Dyslexia therefore literally means not being able to read.  A substantial number of individuals with dyslexia actually have other visual problems that make the problem greater.  At times, the vision problems may be the reason the individual was diagnosed as having Dyslexia to begin with.  If a vision problem affects learning, it can sometimes be misidentified as dyslexia because there are similarities between the two.

Fortunately, the eye health and the eye sight of individuals of children and adults with Dyslexia is good, and although we may think that eyeglasses should solve all vision problems, in fact they don’t.  It is common that children and adults with dyslexia also have a visual component that contribute to and compounds their difficulties.

When a child struggles with reading and learning, the first step should be to determine if there is a vision problem. Treatment may involve eyeglasses, optometric vision therapy, or both.  Optometric Vision Therapy addresses vision problems that can interfere with learning to read, or reading to learn.  Once the vision problem is treated successfully, tutoring and other special services are then much more effective.

According to pediatrician and parent advocate for the National Center for Learning Disabilities, Dr. Debra Walhof:

“It is important to remember that normal sight may not necessarily be synonymous with normal vision...That being said, if there is a vision problem, it could be preventing the best tutoring and learning methods from working.  Now that certainly doesn't mean every dyslexic child needs vision therapy, however in my opinion, skills such as focusing, tracking and others are essential foundational tools for reading. In general, if your child has trouble with reading or learning to read, getting a vision evaluation to assess these skills from a qualified Developmental Optometrist would be a smart move.”

Diagnosis and Treatment for Dyslexia and Vision

Behavioral and Developmental Optometrists in East Brunswick and Old Bridge, NJ have the knowledge and experience to diagnose and treat vision disorders that masquerade as Dyslexia or contribute to the unique challenges presented by Dyslexia.

References

Vision, Learning & Dyslexia
The Joint Organizational Policy Statement of the American Academy of Optometry and the American Optometric Association

Vision and Dyslexia White Paper
COVD’s White Paper on Vision and Dyslexia

Vision Based Learning Problems: The Role Of The Optometrist On The Multidisciplinary Team
A White Paper provided by COVD

Optometric Vision Therapy: The Research
Research on Vision and Dyslexia (published in COVD’s journal, Optometry & Vision Development)

Instability of Fixation in Dyslexia: Development – Deficits – Training
Burkhart Fischer, Dipl Phys; Klaus Hartnegg, Dipl Phys
Centre of Neuroscience, Optomotor Laboratory, University of Freiburg

Saccade Control in Dyslexia: Development, Deficits, Training and Transfer to Reading
Burkhart Fischer, Dipl Phys; Klaus Hartnegg, Dipl Phys
Centre of Neuroscience, Optomotor Laboratory, University of Freiburg

ADD/ADHD & Vision

What is ADD / ADHD ?

Attention Deficit Disorder (ADD) is a widespread problem. If a child has a short attention span, the common assumption is that the child has ADD and should be on medication.

If they have behavior problems, then the assumption is that they have ADHD, Attention Deficit Hyperactivity Disorder.

At times, an underlying vision problem further complicates matters. Addressing the vision problems reduces the symptoms of ADD and sometimes eliminates them entirely.

If a child has difficulty pointing their eyes in to read material (convergence), if they can’t physically focus (as you would focus a camera), or if they can’t sustain those activities, that then makes it difficult for the individual to maintain attention. More energy is needed for the visual system and there is then less energy to concentrate on reading. This then leads to a short attention span.

As stated above, the abbreviation ADD stands for Attention Deficit Disorder. Attention means the ability to concentrate. A “deficit” means “a lack of”. ADD therefore means a lack of the ability to concentrate. If someone can’t physically maintain concentrating for whatever reason, they may be then labeled ADD.

If the underlying reason for the difficulty in concentrating was because the visual system is not working well, and the child is not able to point their eyes in for the amount of time needed to complete their homework, then medication would likely not be able to correct that. As the child develops the visual ability to point their eyes to the reading material and to appropriately physically focus their eyes, they are then better able to attend and concentrate and to do that for longer periods. They are then able to complete their work.

the point is that medication is not always the answer. When a vision problem is at the root of the issue, medication will not correct the problem. Medication may increase the ability to concentrate, but it often causes the physical focusing mechanism of the eye not to work as well. Medication often masks the problem but does not solve it. Wouldn’t it be just easier to address the root problem rather than try to solve the symptoms?

Before a diagnosis of ADD/ADHD is made, (or even once it has been made) and medications prescribed, parents and teachers should first consider a comprehensive eye examination for their children. Much is at stake in the event of a misdiagnosis.

Some people dispute the effectiveness of vision therapy and say it has not been scientifically proven. Numerous scientific studies published in Optometry and Vision Science, Optometry: Journal of the American Optometric Association, American Journal of Optometry and Physiological Optics, Documenta Ophthalmologica and American Journal of Ophthalmology demonstrate that Vision Therapy is an effective treatment for vision problems including eye focusing, eye coordination, amblyopia (lazy eye) and strabismus (crossed eyes).

Please click here to read an article by Dr. David Granet, ophthalmologist, on: The Relationship Between Convergence Insufficiency and ADHD.

You can also read this article embedded within our website by clicking on the link at the bottom of this page. To read definitions of Vision Therapy by outside sources, visit children-special-needs.org.

Looking for more information on ADD/ADHD & Vision?
Send us your questions or comments.

Patients Testimonials

Our patients and parents talk about the profound improvements achieved through effective Vision Therapy. Click on the images to hear their stories! We now have a blog which may include even more testimonials!

AC can read better!

Vision Therapy treats AC's continuous blinking!