Annette Wilkes, MOT, OTR/Owner
As a Pediatric Occupational Therapist for the past 18 years, I have seen children with an array of challenges. One thing we have noticed in recent years is a huge increase in children coming into the clinic with Vision deficits. These vision difficulties manifest themselves in many different ways in the school setting. Many times these children are misdiagnosed or have a dual diagnosis that is often driven by the Visual deficit. If the vision component is not addressed these children will continue to struggle through their school career. Many times these children will be labeled as behavioral issues, unmotivated, hyperactive and the list goes on. This happens because the child is struggling to learn and to comprehend information that he has to work much harder to interpret than a child with no vision difficulties.
Why does the Vision component get missed in school? Vision is often thought of as only acuity. Our children are tested at school and at the Pediatrician for acuity and that is the end of the testing. Why is that not enough? Most children can see 20/20 and if not can get glasses to correct the acuity. When we are discussing Visual skills for learning and becoming successful at school we are talking about much more than acuity. The areas that need to be addressed for learning include:
- Binocular Coordination
- Eye Tracking
- Eye Teaming
- Visual Motor Integration
- Depth Perception
- Visual Form Perception
- Focusing Near to Far
- Visual Memory
- Eye-hand Coordination
If your child is having difficulty with reading, handwriting, copying from the board, letter reversals, number reversals, spelling, or having coordination difficulties such as riding a bike, balancing, or using playground equipment visual issues may be a component that you need to look into. If your child has been diagnosed with ADD, ADHD, Dyslexia, Autism, or is struggling in school for unknown reasons vision therapy may be extremely helpful to your child.
Vision is learned and can be trained when there are deficits. Approximately 75% to 90% of all a child learns comes to him through the visual pathways. Therefore if there is any interference in those pathways, a child will not develop to his maximum potential. Many studies have shown that the greater the amount of effort required for reading, the lower the amount of comprehension resulting in a decrease in the child’s performance.
Complaints commonly stated about children with undiagnosed Visual challenges include: the child looks out the window rather than paying visual attention to the lesson, has a short attention span, the child is not trying and should try harder. These are the children that are putting a huge amount of effort into school and probably working harder than most in the class but are having a hard time being successful. Some common challenges for these children include: losing his place while reading, using his finger or a marker to maintain their place, skipping words while reading, omitting or confusing small words, adding words that are not there to make sense of what he/she is reading, and demonstrating fine motor/handwriting difficulties.
The other area the teachers and parents may notice is the child sometimes uses distorted postures in an attempt to get one eye out of the activity of reading or writing. They often put their head down on their arm, cover one eye with their palm or turn their head so that the bridge of their nose is in the way so that they can use vision from one eye only. These activities are the child’s way to compensate for the vision issue.
I hope that this information is helpful for you and your child. If your child is struggling in any of these areas please talk with his/her teacher and ask about the Visual System. I would highly recommend an evaluation with a Pediatric Occupational Therapist if you have concerns. Every child wants to be successful and feel confident. We just need to know how and where to get assistance for them to make them the best they can be.
For more on Stepping Stones Therapy for Kids and Annette Wilkes contact them HERE