https://youtu.be/d-FvbUnxGKM

Beyond having a learning disability, a child who has never struggled in school before but suddenly is might be having a functional vision problem. Functional vision involves skills that are learned and developed by the child to gather and process visual information. These are necessary to perform tasks such as copying from the whiteboard, reading lines and staying focused. If problems arise and the child’s eyes are not focusing properly, a domino effect can occur whereby the attention, reading abilities, focus, grades and behaviour will also be affected.

Having perfect vision and sight will not be enough to be able to read as it is more helpful and important to diagnose the skills that are needed for reading. The three main visual skill areas that make up the functional vision are eye teaming (the eyes should work together to align and point at the same place on the viewing object), eye focusing (to allow the child to see objects clearly at different distances) and eye movement (to be able to control how and where the eye moves). Treating these often has a direct, positive impact in reducing problematic behavioural and learning problems.

​At Vision and Perception Practice, we provide the latest equipments and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.

Visual Problems may be more prevalent in Children with Autism

Studies have found that refractive errors, such as near-sightedness, far-sightedness, and/or astigmatism, may be more common in those with autism. These conditions require a simple pair of glasses to improve vision, some other conditions such as strabismus (often called cross-eye or squint), amblyopia (lazy eye), convergence and accomodation (focusing) problems will require earlier Neuro-Optometric intervention to allow child to have good vision as early as possible to allow other professionals to assist the child’s development. 

Children with Autism can have poor visual skills such as

• poor visual attention
• inability to follow things with their eyes (or “tracking”).
• blur near vision
• missing cues that come from peripheral vision.
• double vision due to poor eye teaming
• eyes drifting out at times

In addition, some children with Autism have a visual-sensory problem which can lead to

• poor balance
• frequent knocking into things
• Photophobia (scared of lights)
• Toe walking
• Visual Overload in a place with much visual input 

Standard vision screenings at schools do not assess the learning related visual skills, as they are designed to detect the common refractive errors such as near-sightedness, far-sightedness, and astigmatism. Properly diagnosing and correcting vision problems isn’t a cure-all. However, as Dr. Temple Grandin (A renowned Advocate with Autism) states, “a child who can see his world clearly has a much better chance of benefiting from other therapies.”

​At Vision and Perception Practice, we provide the latest equipments and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.

Read:  Dr. Temple Grandin’s comments on Autism and Visual Perceptual skills 

http://news.cision.com/college-of-optometrists-in-vision-development/r/a-missing-piece-to-the-autism-puzzle–college-of-optometrists-in-vision-development-shares-the-visua,c9567587

Read: Eyes hold key in therapy of autistic kids

https://www.newindianexpress.com/cities/bengaluru/2017/apr/02/eyes-hold-key-in-therapy-of-autistic-kids-1588936.html

Read: ​Understanding the Visual Symptoms of Individuals with Autism Spectrum Disorder (ASD) 

http://c.ymcdn.com/sites/www.covd.org/resource/resmgr/ovd40-3/article_understandingvisuals.pdf

Read: Not Autistic or Hyperactive. Just Seeing Double at Times

https://www.nytimes.com/2007/09/11/health/11visi.html?_r=2&ex=1190260800&en=2&oref=login&referer=http%253A%252F%252Fm.facebook.com

Optometric Vision Therapy

Not to be confused with other forms of eye exercises, the goal of optometric vision therapy is not to strengthen eye muscles. Instead, vision therapy aims to retrain the learned aspects of vision through neuroplasticity. 

Optometric vision therapy should not be confused with any self-directed program of eye exercises which is or has been marketed to the public. In-office vision therapy under the supervision of an optometrist is supported by ongoing evidence-based scientific research (https://covd.site-ym.com/?page=research). 

Because visual skills such as tracking lines of text, coordinating the eyes, and focusing on close objects must be learned during development, these skills can also be improved later in life at any age.

It is estimated that 1 in 10 children have a vision problem severe enough to affect their learning in school but general standard school vision screenings can miss up to half of these problems. A comprehensive vision exam with a developmental optometrist checks all aspects of eye health, vision, and visual skills, and can ensure you or your child is not struggling unnecessarily with an undiagnosed vision problem. 

​At Vision and Perception Practice, we provide the latest equipment and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.

https://youtu.be/ffAy6Hg4iOM

When visual problems are not remediated, they may manifest as ADHD behaviour. Underlying visual difficulties (such as convergence insufficiency, eye tracking) should be treated if any. These problems are usually covert and not well understood by child as well.

Relationship between Convergence Insufficiency (CI) and ADHD

In 2005, Dr. Granet studied 266 patients with a common near vision disorder called convergence insufficiency (CI). The study found that nearly 10 percent of subject with CI also had diagnoses of attention deficit hyperactivity disorder (ADD or ADHD). At the time of the study, Dr. Granet and his colleagues stated that this was three times the percentage of ADHD found in the general population. Estimates of ADHD in the population have continued to trend upward since 2005.

Dr. David Granet, a professor of ophthalmology and pediatrics at the University of California, San Diego, said:

“Everyone is familiar with A.D.H.D. and A.D.D., but not with eye problems, especially not with convergence insufficiency. But we don’t want to send kids for remedial reading and education efforts if they have an eye problem. This should be part of the protocol for eye doctors.”

“When five of the symptoms of A.D.H.D. overlap with C.I. (convergence insufficiency),” he said, “how can you not step back and say, Wait a minute?”

Dr. Granet also commented, “We don’t know if convergence insufficiency makes ADHD worse or if convergence insufficiency is misdiagnosed as ADHD. What we do know is that more research must be done on this subject and that patients diagnosed with ADHD should also be evaluated for convergence insufficiency and treated accordingly.”

DSM-IV Criteria for ADHD:
​
1. Often does not give close attention to details or makes careless mistakes in schoolwork, work or other activities.
2. Often has trouble keeping attention on tasks or play activities
4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
6. Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
8. Is often easily distracted.”

Comparing the Convergence Insufficiency Symptom Survey with the DSM-IV criteria for ADHD, 5 of the 9 symptoms of inattention could also be applied for CI (symptoms 1, 2, 4, 6 and 8 as above). As there is a significant overlap in symptoms, it is not hard to imagine a diagnostic confusion.

A child with ADHD can have poor visual skills too. By improving their foundation in visual skills,  Learning can also be improved.

​At Vision and Perception Practice, we provide the latest equipment and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.

Amblyopia is commonly referred to and known as “lazy eye”. It is when there is a reduction of vision in one eye when compared to the other. Although uncommon, lazy eye may sometimes involve both eyes. According to the National Institute of Health, amblyopia is the most common cause of visual impairment among children. Amblyopia is also a disorder of the brain’s ability where both eyes are unable to work together as a team.

It is best to treat amblyopia as soon as possible as the earlier it is diagnosed and treated, the more successful the outcomes tend to be. Patching the better seeing eye used to be the only proven method to be able to treat amblyopia. However, now the treatment of amblyopia includes vision therapy to help improve the visual abilities of the affected eye including accommodation (focusing), fication, saccades, pursuits (eye tracking) and spatial skills (eye-hand  coordination). Vision therapy may help to reduce the frequency of patching as the goal of therapy is to improve the eye coordination, stereopsis (depth perception) and reduce suppression.

​At Vision and Perception Practice, we provide the latest equipments and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.

Strabismus / Squint is also known as crossed eyes. It is when both eyes do not look in the same direction at the same time. Although it usually happens in infants and young children, it can happen in adults as well.

Some reasons why a person may have strabismus is due to genetics, associated disease such as tumour or problems with their muscles and nerves that control the eye. It may also happen after a stroke or head injury.

Fortunately strabismus can be treated. It is better to treat strabismus earlier as children will not outgrow it. If left untreated, it can lead to vision damage including double and reduced vision or amblyopia (lazy eye). Strabismus is treated through vision therapy which is supposed to help the muscles work together as a team to allow both eyes to look in the same place at the same time.

​At Vision and Perception Practice, we provide the latest equipment and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.

The most prominent case who used Vision Therapy to fix her squint is Susan R. Barry. Susan R. Barry is a professor of neurobiology at Mount Holyoke College. She was born nearly stereoblind and suffered from double vision after attempting to correct her squint with surgeries. Much later in her life, she embarked on intensive vision therapy.

Susan acquired stereovision in 2012 at the age of 67.

Her astonishing success has resulted in much media attention for it challenged the conventional wisdom of missed opportunity for neural change beyond the perceived ‘critical period’ during childhood. She was dubbed as ‘Stereo Sue’ in an acclaimed New Yorker article written by neurologist Oliver Sacks.

Susan Barry has gone on to write her own book that is entitled ‘Fixing My Gaze’. The book describes Susan’s astonishing experience of gaining 3D stereovision after a lifetime of seeing in only two dimensions. Barry offers a poignant and revelatory account of neuroplasticity and change regardless of age. Intensive vision therapy created new neural connections, and with them, a new view of the world.

Read more about Susan’s journey in attaining stereovision.

http://www.fixingmygaze.com/
https://youtu.be/XCCtphdXhq8
https://www.newyorker.com/magazine/2006/06/19/s00tereo-sue

Dyspraxia affects a child’s ability to be able to accurately and efficiently perform gross and fine motor tasks. It is also known as Developmental Coordination Disorder (DCD). Poor motor planning that require complicated movement or multiple movements in sequence can result in a noticeable lack of coordination of both the gross and fine motor skills. Both skills impacts the eye and vision issues associated with this disorder can affect the child’s ability to learn and function severely as it involves  functional vision and visual processing skills.

A child with dyspraxia may show signs of dyslexia such as writing letters or number in reverse. They may also find word memory, spelling and comprehension difficult. This is because people with  dyspraxia may regularly miss words while reading books or other texts making it a difficult and confusing task as when more words are missed, the sentences would start to make less sense.

Research has shown that in-office and at-home eye exercises both address the functional vision and vision processing problems which can help by improving the connection and coordination between the eyes and the brain.

 

​At Vision and Perception Practice, we provide the latest equipments and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.

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.”

A significant number of individuals with dyslexia have other visual problems besides the usual myopia, hyperopia and astigmatism. Poor visual perceptual skills causes problems with letters reversals, word recognition, spelling or cases of convergence problems which may show as the words moving, ultimately leads to poor or impaired reading abilities. A child can have both dyslexia and poor visual perceptual skills.

Nevertheless, when a child struggles with reading and learning, it is important to first rule out the possibility of a learning related vision problem. If a vision problem exists, treatment may involve glasses, Neuro-Optometric therapy, or both. Neuro-Optometric therapy treats visual problems that can interfere with learning to read, or reading to learn. Once the vision problem is treated successfully, tutoring and other special services can become more effective.

​At Vision and Perception Practice, we provide the latest equipment and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.

Convergence insufficiency (CI) is a common eye-teaming problem in which the eyes have a strong tendency to drift outward when reading or doing work close up. Double vision often occurs if an eye drifts out. To avoid seeing double, a child with CI must use extra effort to make the eyes turn back in. This extra effort can lead to annoying symptoms, such as eye strain, blurred or double vision, loss of concentration, and frequent loss of place when reading and working up close.

Children with CI have more symptoms and show worse attention when reading than children without CI. Research has shown that treatment using office-based accommodative-vergence vision therapy improves symptoms in children affected with CI.

​At Vision and Perception Practice, we provide the latest equipments and skills to assess a child’s eye tracking matched with norms, visual perceptual skills, visual information processing skills, and more to fully understand their learning abilities.