teacher/parent vision and learning guide · vision and learning overview good vision requires your...

www.thevisiontherapycenter.com

Teacher/Parent Vision and Learning Guide


The information in this guide was created for teachers and parents. It provides background information

on the vital connections between vision and learning.

You’ll find the following information:

• VisionandLearningOverview

• Whataresomeofthevisionskills that affect learning?

• ImpactonSubjects

• Whatdoestheworkofsomeonewith vision problems look like?

• StressPoints

• TaketheVisionQuiz

• VisionTherapy

• Studies

• SuccessStories

• ModificationsfortheClassroom

• TheVisionTherapyCenterContactInformation


Vision and LearninG oVerViewGoodvisionrequiresyoureyesight,visualpathways,andbraintoallworktogether.Whentheydon’t,evenapersonwith20/20eyesightcanexperiencedifficultyreading,writingandprocessinginformation,as80%ofallinformationcomestoachildthroughtheirvision.

Mostpeoplethinkthatifaperson’svisualacuityis20/20theirvisionis‘normal’or‘perfect’.That’snotthecase.

Visualacuityisameasureoftheclarityofaperson’svisionandistestedbyhavingapatientreadalineoflettersonaneyechart.Thistestdoesnotrequirethesameamountandtypesofeyemovementsthatreadingdoes,soitcannotbeusedtodeterminewhetherachildhasthevisualskillsnecessarytoread.

Whileclearvisionisimportant,itisonlyoneofmanyvisualskillsrequired to be able to read and learn.

•75-90%ofclassroomlearningcomesthroughthevisualsystem.

•80%ofchildrenwhoarereadingdisabled,includingdyslexics,havevisionproblemsthatcanbesolved.

•25%ofALLchildrenhaveavisionproblemsignificantenoughtoaffecttheirperformanceinschool.

•95%offirstgradenonreadershadsignificantvisionproblems.Theyhadnearly2.5timesmorevisualproblemsthanfirstgradehighachievers.

•Inonestudy,70%ofjuveniledelinquentshadavisionproblem.

•InoneCaliforniafundedstudy,recidivism(repeatoffenders)reducedfrom45%to16%whenwardsreceivedon-siteoptometricvisiontherapy.

•Whenagroupofilliterateadultswerevisionscreened,therewasa74%failurerate.

•Schoolvisionscreenings,suchasaSnelleneyechart,detectonly20-30%ofvisionproblemsinschools.

•Only13percentofmotherswithchildrenyoungerthan2yearsofagehavetakentheirbabyforafunctionalwell-careeyeexam.Yet1out10childrenareatriskforhavinganundiagnosedvisionproblem.

Source: Visionandlearning.org


whaT are some of The skiLLs ThaT affecT LearninG?

convergenceWhenreading,theeyesshouldaiminwardatthesamespotinordertofixateonprint.Iftheeyesaimataspotinfrontoforbehindtheprint,extraenergyandeffortisrequiredtomaintainfixationanddoubleoroverlappingvisionmayoccur.Anexampleisshowntotheleft.

directionalityDirectionalityisimportantinunderstandinghowsimilarshapescanhavedifferentmeaningswhentheyareindifferentorientations.Totheleftisanexampleofsomelettersthatarecommonlyreversedbychildrenwithpoordirectionality.Thelettersaretheexactsameshape,butarecalledadifferent name depending on their orientation.

Thiscanbeadifficultconceptbecauseifanotherobject,suchasachair,is turned on its side or upside-down it is still called a chair.

form PerceptionTo the left is an example of an item from a visual perceptual skills test. Inthisparticulartestthechildisaskedtoidentifywhichformamongthechoicesatthebottommatchestheformontop.Othervisualperceptualskillstestsassessthechild’sabilitytoidentifyaformfrommemory,identifywhichformisorientedinadifferentdirection,identifyaformthathasadifferentsizeororientation,identifyasequenceofformsfrommemory,identifyafigurehiddeningroundandidentifyanincomplete form as if it were complete.

b d p q


span of recognitionChildrenwhocanreadatacceleratedspeedsoftenhaveagoodspanofrecognition,allowingthemtorecognizeandprocessseveralwordsatonetime.Childrenlackingthisskillmayonlybeabletoseeonewordorletteratatime.Inordertoseewhatthiswouldbelike,tryreadingasentence or paragraph while looking through a straw.

VisualizationVisualizationistheabilitytocreatementalimages.Childrenwhohavevisionproblemsmayalsohavedifficultywithvisualization.Thisskillisimportantforsuccessinmanyschoolsubjectsincludingspellingandmath.

Tracking (Pursuits and saccades)Commonlyreferredtoas‘tracking’,maintainingfixationonamovingtarget(pursuits)oraccuratelyswitchingfixationbetweentwotargets(saccades)aretwotypesofeyemovementsthatareessentialforreadingand learning.

Anexampleofthisiswhenyoureyesreachtheendofalineofprintandhavetoaccuratelymovefromtheendofthatlinetothebeginningofthenextlineofprint.Difficultywiththeseeyemovementscancauseachildtoskipwordsorlosetheirplaceeasilywhenreading.


imPacT on subjecTsConsidering80%oftheinformationyouprocesscomesthroughyourvisualsystem,it’snotsurprisingthatavisionproblemcanaffectanumberofdifferentsubjects.Here’sabriefoverviewofhowvisionproblems can manifest in various areas.

readingVisionproblemsaffectreadingintwosignificantways:

•Whenastudentislearningtoread,aseriousvisionproblemcouldreducetheirabilitytoknowwhattheyarelookingatandimpacttheirabilitytoremembernumbersandletters.

•Whenastudentisreadingtolearnandhasblurryordoublevision,theirabilitytoreadforlongperiodsoftimeandcomprehendwhattheyarereadingcanbeseverelyreduced.

Theabilitytoreadandtheabilitytocomprehendwhatisbeingreadaretwodifferentthings.Comprehendingwhatisreadisavisualprocess,andcanbeaffectedwhenthevisualsystemisnotworkingcorrectly.Ifastudentseeswordsonthepageasblurryordouble,heorshehastouseextraefforttokeepthewordssingleandclearandthiscannegativelyimpact comprehension.

Studentswithvisionproblemsspendthemajorityoftheirtimedecodingwords.Insteadofreadingfluidlyandvisualizingthewordsandthemessageasawhole,theyfocusoneachspecificword.Thisisastruggle,makingitdifficulttoquicklyprocesssectionsoftext.

Asaresult,studentswilltracktextwiththeirfingers.They’llreadaslowerpaceandwillhavefluencyissues.Theirreadingwillbemarredbyrepetitions,insertions,omissionsandsubstitutions.

Thesereadingproblemsarealltoooftenmisconstruedaslazinessonthepartofthestudent.Theyarenot.Theyaresimplysymptomaticofavisionproblem.Whencorrected,it’scommonforstudentstoenjoyreading and no longer avoid it.


mathIfastudenthasdifficultyseeingthingsasclearandsingle,theymayhavetroubleseeingdecimalsand/orsigns.Animportantskillinmathistoorganizewhatisbeingwrittenandthestudentmayhavetroubleliningthings up and keeping their place if their visual skills are poor.

Lateralityanddirectionalityarealsoimportantconceptsinmath.Ifastudentseestheorientationofnumbersincorrectly,theywillhavedifficultycompletingtheproblem.

Studentswholackvisualizationskillscanoftenbefoundcountingontheirfingersorverbalizingsequences.Givenenoughtime,theycangenerallycomputeananswer,buttheytendtodopoorlyontimedtests.Awarenessofnumbersandwhattheymeanaswellasbeingabletovisualizenumbersandquantities,arecriticaltosuccessinmathandcanbe impacted if a child has a vision problem.

Itshouldbenotedthatachildwithvisionproblemsmaydowellinmathbutbeapoorreader,primarilybecausemathdoesn’trequireasmanypreciseeyemovementsasreading.

spellingVisualrecall,theabilitytocreateavisualimagebasedonpastvisualexperiencewithoutcurrentlyhavingthatexperience,isavisualizationskillthatiscriticalforspelling.Inspelling,itistheabilitytocreateamental image of a word without being able to look at the word.

writing Writinginvolvesbothhandwritingandcompositionskills.Itisnecessaryforvisiontoleadthehandforhandwritingandthiscanbeverydifficultifthestudentcannotseewell.Infact,oftenyoucanseeinthehandwriting where the student stopped looking or became fatigued. Difficultywritingstraightonapageisoftenaresultofpoorperipheralawareness.

There are several vision-related skills that are critical to good handwritingthatmaybeunderdevelopedinastudentwithvisionproblems.Visualizationisalsoimportantinhandwritingbecausethestudent needs to remember what different words look like in order toreproducethemonthepage.Spatialconceptsareimportantinhandwriting to know and plan how words will go together. Good lateralityanddirectionalityareimportanttodifferentiatesimilarly-shapedlettersindifferentorientations(e.g.b,d,p,q).

Visualizationisalsocriticalforwritingcompositionbecausethestudentneedstobeabletoorganizeandre-organizethecompositioninhisorher head.


whaT does The work of someone wiTh Vision ProbLems Look Like?

Take a look at some of the samples of students with vision problems:

Unequalsizedprint

Wordsmovingorlettersrunningtogether

Wordstakeoffandleavethepage

Double print

Reversed letters

Wordssquishedtogether

Wordsappearassplotchesorstreaks

Wordsareshaky

sTress PoinTsTheseareareasthatcancausestressforstudentswithvisionproblems:

•Smallprint

•Sustained,nearpointwork

•Fullpagesofprint,withblocksoftextclosetogether

•CopyingfromchalkboardorSMARTBoardtopaperondesk

•Fine-motorskills

•Flickeringfluorescentbulbs

•Standardizedtestsheets

•Randomlistsofspellingwords

•Timedtests

•Crosswordpuzzles

•Readingaloudtoagroupwithoutbeinggivenawarning

•Beingaskedtoinstantlyidentifyrightandleftdirections


Take The Vision QuizTheVisionQuizisthefirststeptowardassessingifastudenthasavisionproblem.

Writeinnumberthatbestdescribeshowofteneachsymptomoccurs:

0=Never,1=Seldom,2=Occasionally,3=Frequently,4=Always

sYmPTom score

Headachesfromnearwork

Wordsruntogetherwhenreading

Burning,itchy,wateryeyes

Skips/repeatslineswhenreading

Headtilt/closesoneeyewhenreading

Difficultycopyingfromchalkboard/overhead

Avoidsnearwork/reading

Omitssmallwordswhenreading

Writesuphillordownhill

Misalignsdigits/columnsofnumbers

Reading comprehension down

Holdsreadingmaterialtooclose

Trouble keeping attention on reading

Difficultycompletingassignmentsontime

Alwayssays“Ican’t”beforetrying

Clumsy,knocksthingsover

Doesnotusehis/hertimewell

Losesbelongings/things

Forgetful/poormemory

ToTaL PoinTs:

a score of 20 or more points* indicates the need for a functional vision exam.

Afunctionalvisionexamteststheentirevisualsystem,andis performedbyadevelopmentaloptometrist.Basedonthese findings,itmaybedeterminedthatvisiontherapyisrequired.


Vision TheraPY

what is Vision Therapy?Visiontherapyhelpsthepatientdevelopthevisualskillsnecessaryforgoodvision.Opticaldevicesandexercisesareusedtoretrainthemusclesthatcontroltheeyeinordertomakeeyemovementseasierandmoreefficient.

Inadditiontoretrainingthemuscles,thepatientlearnshowtocorrectlyprocessthevisualinformationthatthebrainreceivesfromtheeyes.Visiontherapycanrangefromonesessionto2-3yearsandinvolvesofficevisitscombinedwithat-homeactivities.Mostprogramslastfrom6-9 months.

who needs Vision Therapy?Patientswhorequirevisiontherapygenerallyhavethefollowingvisualchallenges:

•Learning related visual problems:Conditionssuchaspooreyeteaming,focusing,trackingandvisualizationskillscanallnegativelyaffectlearning.

•Crossed Eye (Strabismus) or Lazy Eye (Amblyopia):Crossedeyesand/orlazyeyescanbetreatedwithvisiontherapyinsteadofconventionalsurgery,glassesorpatching.Visiontherapyisveryeffectivefortheseconditionsatanearlyage,butcanyieldresultsforpatientsofanyage.

•Stress-induced vision problems:Ourhigh-techsocietyrequiresmanypeopletodoalargevolumeofnearworkinfrontofacomputerscreen.Becauseofthis,thereisanincreasingnumberofpatientsthatexperienceeyestrain,headachesandothervisualrelateddifficulties.

•Visual rehabilitation for special populations (strokes, brain injuries, developmental delays, multiple sclerosis, etc.):Aneurologicaldisorderortraumatothenervoussystemcanaffectaperson’svision.Thisincludespeoplewhohavetraumaticbraininjuries,strokes,whiplash,developmentaldelays,cerebralpalsy,multiplesclerosis,andotherneurologicalailments.

•Sports vision improvement:Evengoodvisioncanbecomebetter.Athletesoftenusevisiontherapytoimproveeye-handcoordination,visualreactiontime,peripheralawareness,eyeteaming,focusing,trackingandvisualizationskills.


what outcomes can You expect?Whentheeyesmove,align,fixateandfocustogether,awholenewworld of vision is discovered.

Withsuccessfultreatment,ourpatientsmayfindthat:

•Learningbecomeseasier

•Readinglevelandspeedincreases

•Timespentonhomeworkdecreases

•Theabilitytofollowmovingobjects(aball,acar)improves

•Seeingobjectsnearbyoratadistanceimproves

•Visualizingmentalimagesbecomeseasier

Therateatwhichpatientsexperiencetheseimprovementswillvary,butgenerallyprogressisseenearlyinthetherapyprogram.


sTudies

a randomized clinical Trial of Treatments for convergence insufficiency in children

http://www.thevisiontherapycenter.com/wp-content/uploads/2009/11/randomizedClinicalTrialofTreatmentsforCIinChildren.pdf

TheNationalEyeInstitute,adivisionoftheNationalInstitutesofHealthfortheU.S.DepartmentofHealthandHumanServices,fundedastudytodeterminethemosteffectivetreatmentforConvergenceInsufficiency.

Thiswasadouble-blind,maskedstudywithboth optometrists and ophthalmologists collaborating together. It involved nine sites throughouttheU.S.,includingprestigiousclinicssuchastheMayoClinic,BascomPalmerEyeInstitute,andtheRatnerChildren’sEyeCenter.

Theauthorsofthisclinicaltrialfoundthatvisiontherapy/orthopticswas more effective than pencil push-ups (a visual exercise) or placebo visiontherapy/orthopticsinreducingsymptomsandimprovingsignsofconvergenceinsufficiencyinchildren9to18yearsofage.

research and clinical studies on Vision, Learning and optometric Vision Therapy

http://www.thevisiontherapycenter.com/wp-content/uploads/2009/11/SummaryofResearchClinicalStudies.pdf

Thispaperpresentsover350abstractsfrom77differentjournalswithinthefieldsofeducation,optometry,ophthalmology,neurologyandpsychology.Itincludesallworksrelatingtovisionandlearning,including papers that purport there is no relationship between vision andlearning–ofwhichthereareonly15.

a summary of research and clinical studies on Vision and Learning

http://www.thevisiontherapycenter.com/wp-content/uploads/2009/11/SummaryofResearchonVisionandLearning.pdf

Alistingofsomeoftheresearchreportsandclinicalstudiesontherelationshipofvisiontoreadingandlearningabilityandtheeffectivenessofvisiontherapyinthetreatmentoflearning-relatedvisionproblems.

The scientific basis for and efficacy of optometric Vision Therapy in nonstrabismic accommodative and Vergence disorders

http://www.thevisiontherapycenter.com/wp-content/uploads/2009/11/ Basis-for-efficacy-of-Optometric-VT-in-nonstrabismicaccomodate.pdf

Thisarticlefocusesonthescientificbasisforvisiontherapy.Itreviewsstudiesthatusedobjectiverecordingtechniquesinordertoassesstheimpactofvisiontherapyontheoculomotorsystem.


modificaTions for The cLassroomTohelpchildrenwithvisionissues,considersomeofthefollowingmodifications.Ifthestudentneedsvisiontherapy,besuretocommunicate with the parents and the vision therapist to ensure the correctmodificationsarebeingmade:

•Makelargerprintavailable.

•Allowforvisualbreaksduringsustainednearpointwork.

•Wheneverpossible,besurelearningmaterialsarewell-spacedandwell-organizedonthepage.

•Intheeventthatsomethingneedstobecopiedfromtheboard,movestudentclosertothechalkboardorplacematerialtobecopiedonhis/herdesk.

•Provide“fat”pencilsandcrayons–usespecialpencilgrips.

•Furnishaslantedreadingandwritingsurface.

•Ifpossible,makeuseofnaturallightingandfullspectrumbulbs.

•Providehighlightermarkerstohelpwithreading.

•Makemoretimeavailablefortimedtests.

•Allowstudentstohavetheoptionaboutreadingaloudtoagroup.

•Allowforkinestheticlearning.

•Allowstudentstoverballygiveanswerstotests.

To read our success stories and formoreinformation,visit

thevisiontherapycenter.com

608-406-2652 (Madison)

262-784-9201 (Milwaukee)

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teacher/parent vision and learning guide · vision and learning overview good vision requires your...

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