Wednesday, December 30, 2009
Tuesday, December 15, 2009
Wednesday, November 25, 2009
Monday, November 23, 2009
Directions: Put about a tablespoon of rice into a small saucer. Tape a dot-to-dot page to the table so it doesn't wiggle. Put a patch over the better eye. Using a regular pair of tweezers, pick up one grain of rice at a time and place it carefully down between the numbers in order. Continue laying down grains of rice one at a time until the entire puzzle is complete.
Why is this an effective monocular activity?
- Because the page is likely to be the same color as the rice, seeing where each piece of rice should be placed depends on good visual acuity
- It also requires good visual-motor-integration skills to manipulate the tweezers, isolate just one piece of rice and maneuver it to the paper
Saturday, November 21, 2009
Monday, November 16, 2009
- Visual spatial relations is the ability to recognize patterns between the puzzle pieces. In a jigsaw puzzle you must recognize that some pieces have a straight edge, for example. Thus, they produce the outer frame of the puzzle.
- Visual closure is the ability to predict what an image will look like when you only see a portion of it. To solve a jigsaw puzzle you have to be able to visualize which pieces fit into openings made by the other pieces.
- Scanning the array of unused pieces is an eye movement skill. People with saccadic deficits will have difficulty finding the right jigsaw piece.
- Visual memory is the skill that allows a person to create a mental image and then refer to it. This skill must be in place when searching for pieces and when returning to the incomplete puzzle to place the selected piece.
- Visual attention is a basic skill that must be in place before the simplest puzzle can be completed. People who do not value the information received by their eyes will not do well at jigsaw puzzles. They tend to try to locate things by touch instead of by sight.
- The ability to transition between a central fixation with peripheral vision is necessary to complete any jigsaw puzzle. This skill is often very under-developed in individuals on the Autism Spectrum
Remember to schedule an annual eye exam with an eye doctor who incorporates vision therapy into their practice. These developmental optometrists routinely examine children's visual perceptual development and can prescribe in-office vision therapy activities to help.
In addition, the Eye Can Too! Read series of e-books contains helpful home-based activities and resources that you can easily adapt for any individual child or classroom.
Monday, November 9, 2009
Monday, November 2, 2009
Friday, October 30, 2009
Even drawing the hopscotch board takes a combination of visual skills. First, using the visual perceptual skill of visual memory, the chalk artist checks the mental image of the board. Then, using visual spatial relations, another visual perceptual skill, and visual motor planning, the chalk artist arranges the lines - oops- don't forget to apply good visual motor integration so that the lines meet at good perpendicular corners and the numbers in the boxes are legible.
Applying visual attention and good saccadic eye movements, the kids scan the yard until they locate a rock that won't roll too much, is colored so that it contrasts with the pavement enough to find after tossing it, and is small and light weight enough to pitch.
Again, it takes good eye movements, visual attention, and the ability to team both eyes on a location in the distance as well as great visual motor integration to make an accurate throw so that the rock lands in the next box.
Next, the vestibular system has to coordinate with the visual system with good bilateral integration skills to hop through the board without stepping on any lines.
Finally, visual memory has to remain at work between turns so that the players can keep track of their next goal.
So, if anyone tries to take away your recess - try challenging them to a game of Hopscotch. And, please, post a comment to share what was your favorite recess activity when you were in grade school.
Thursday, October 29, 2009
Monday, October 26, 2009
Saturday, October 24, 2009
Wednesday, October 21, 2009
If you suspect that your child may have delays in the development of laterality & directionality, make an appointment for a comprehensive eye exam with a developmental optometrist who incorporated vision therapy into the practice. The doctor may decide to administer a series of normed tests to learn whether your child's visual perceptual skills are developing on schedule.
If you would like to have a set of original activities that assist children to grow in the development of the visual spatial skills of laterality & directionality, consider buying the Yellow Book of the Eye Can Too! Read e-book series by Lesley Barker
Tuesday, October 20, 2009
The good news is that all three of these visual diagnoses can be addressed with a program of in-office vision therapy under the supervision of a developmental optometrist. So, if your child has been diagnosed or if you are being encouraged to obtain a diagnosis of ADHD, don't stop there. Arrange an appointment for your child to receive a comprehensive eye exam by a developmental optometrist who incorporates vision therapy into their practice. If the eye doctor finds that your child has any of these visual problems, follow through with the program of vision therapy. To find a developmental optometrist in your area, plug your zip code into the search box at www.covd.org.
You can read more about this in: Borsting, Eric; Michael Rouse, and Ray Chu. Measuring ADHD behaviors in children with symptomatic accommodative dysfunction or convergence insufficiency: a preliminary study. "Optometry", Volume 76. Number 10. October 2005
Saturday, October 17, 2009
Wednesday, October 14, 2009
By the way, the activities in the Purple Book of my Eye Can Too! Read series of e-books all can be used as an addition to a program of in-office vision therapy to improve a child's eye movement skills. Written for homeschooled families, these activities are easy to do and appropriate for elementary school children.
Monday, October 12, 2009
Here is the sequence we came up with to remember a block design so that, without looking at the model, it is easy to rebuild it from memory:
- Start with a simple block design that you want to remember
- Build it
- Analyze it by making associations and by dividing the larger design into manageable chunks
- See if you can close your eyes and see the design in your mind
- Practice referring to the mental image and drawing or assembling it on paper or in space
- Do something else for a while
- After several minutes, hours, or days, see if you can still access, refer to, build, and use the visual image stored in your mind
Thursday, October 1, 2009
Sunday, September 27, 2009
Friday, September 25, 2009
For individuals on the Autism Spectrum, however, coordinating and transitioning between the central and peripheral visual fields may be their most significant visual challenge. Many people on the Autism Spectrum repeatedly focus on spinning objects, or on moving lights and shadows. These are enjoyed via the peripheral system. Other people on the spectrum fixate on a pen or pencil that they hold and rotate right in front of their eyes or they cannot be pulled away from small objects or details. These are enjoyed via the central visual system.
As Patricia S. Lemer explains in her helpful book, Envisioning a Bright Future: Interventions that Work for Children and Adults with Autism Spectrum Disorders, learning to coordinate central and peripheral vision may improve a child's attention, focusing, and visual perceptual skills. It may even reduce toe walking and the need to hold onto a wall when walking. Dr. Melvin Kaplan (www.autisticvision.com) wrote a book, Seeing with New Eyes, that explains how these issues can be addressed using therapeutic prisms.
Children who are on the Autism Spectrum may have other visual challenges that can be addressed with the help of a developmental optometrist and a program of in-office vision therapy. They may need glasses to see clearly. You can easily locate an experienced developmental optometrist in your area by plugging your zip code into the search box at www.covd.org. Even if your child is not on the Autism Spectrum, it is important to schedule an annual eye exam with a developmental optometrist and to follow up with the treatment, prescriptions, or therapy that the doctor advises.
Thursday, September 17, 2009
The adults who probably learned to read early and always performed at the top of the top reading group when they were in grade school often declare that the reason a child is struggling to read is that they are just lazy, do not want to work, don't pay attention, or don't want to learn.
Why don't the well-meaning but demotivating dissing grown-ups ask the child a simple question like: what makes reading hard or frustrating?
Instead of trying to put words in the child's mouth, the next thing to do is wait quietly until the child answers.
Perhaps the child will say that they can't tell where the letters are because the lines are always moving or they are on top of each other or look too blurry to read. Maybe the child will say that reading always gives them a headache. Any of these answers should send you to the optometrist immediately. They are classic symptoms of a binocular dysfunction like a convergence insufficiency. Research indicates that most patients diagnosed with convergence insufficiency resolve the problem after an average of twelve weeks of in-office vision therapy.
Other children may say that they keep losing their place when trying to read which may indicate a deficit of their eye movement skills. This condition, which is often accompanied and/or masked by a diagnosis of AD(H)D, can also be addressed by some guided vision therapy activities (And, if I do say so myself, by the activities in The Purple Book of the Eye Can Too! Read Series that I wrote- but that is shameless self-promotion, after all, so hurry and click on the link to that sale page.) Seriously, not being able to control their own eye movements is a common reason that otherwise healthy, obviously intelligent and articulate children do poorly in school.
Finally, the child may say that reading is confusing or they can't remember how to figure out the words. These answers should prompt you to have your optometrist schedule a developmental evaluation of the child's visual perceptual skills (And check out the other two books in the Eye Can Too! Read Series. The Yellow Book provides activities to improve dyslexia-like symptoms and The Green Book provides activities that rely on visual perceptual or processing skills.)
But, whether you buy my books or never look at them ever, take the advice of this mother of seven, grandmother, master teacher, and optometric vision therapist, please.
Children want to please there parents and teachers for the most part but when they don't know how to tell you why they are struggling and when you don't ask the right questions, they can only respond by resisting, refusing to cooperate, getting angry, or passively avoiding the dreaded school work.
Ask what makes it hard.
Don't put words in their mouth.
Respect their answers.
Believe what they say.
Be their best advocate.
Find real help and keep hunting if the first helper turns out not to work after all.
If you still don't know how to help your child or student, why not post your question or tweet it or Facebook it to the Eye Can Too! Read page's wall - I'll try to put in my two cents but I'll bet that the optometrists, vision therapists, parents, and educators among us will weigh in.
On behalf of all the children who went to bed tonight angry and confused about why reading is hard for them, thank you for reading this.
Monday, September 14, 2009
Developmental optometrists whose practices include vision therapy have lots of activities that serve to address poorly developed ocular motilities. They usually start as monocular activities so that the student wears a patch over one eye to do the task, switching the patch to the other eye to repeat it. Once a student demonstrates equivalent accurate and efficient eye movement skills with each eye by itself, the therapy advances to binocular tasks. Not only does each eye need to move appropriately to gather visual information, the eyes together have to coordinate to point at the same time to the same point in space. Otherwise the image will wiggle, appear blurred, or seem to be double.
If you have a student who moves their head back and forth when reading, recommend that they see a developmental optometrist for a comprehensive eye exam. They may have a deficit of their ocular motilities which is easily diagnosed by a Developmental Eye Movement Test (DEM). The earlier in a student's academic career that these deficits are identified and addressed, the better that student will do overall in school.
The Purple Book in my Eye Can Too! Read series provides lots of academic activities for the home school classroom which can also be adapted for the regular classroom. Each activity provides review in language arts or math skills for Pre-K through eighth grade. I also included helpful observation questions to assist the teacher or parent to evaluate a student's performance. The activities in The Purple Book will help you identify if your child's eye movement skills are under-developed. They can also be used even by people who do not have eye movement deficits to increase their reading speed and efficiency.
Thursday, September 10, 2009
Thursday, September 3, 2009
In the vision therapy context, I have worked with quite a few adults who had never experienced seeing in 3-D. When it begins to emerge, the delight they express is amazing- in spite of the headache that seems to accompany the adjustment to true binocularity. It takes time but to enrich the way the world looks is a reward that is truly worth the investment of time, money, and discomfort.
Tuesday, September 1, 2009
Thursday, August 20, 2009
Vision is much more than the ability to see clearly at near and in the distance. It involves gathering visual information, intake skills; interpreting visual information, processing skills; and responding to visual information, visual motor integration skills.
The root of a student's difficulty, frustration, dislike of, and inaccuracy with reading or writing could be their visual skills. In fact, even when a student passes a vision screening, they could still have undetected learning-related visual challenges.
If they do not have independent, automatic, voluntary control of their eye muscles, they will have difficulty with gathering visual information. This aspect of vision can also be impacted by poor eye teaming skills.
If they do not have effective strategies for processing the visual information that the eyes send to the retina, they will have difficulty recognizing, remembering, or manipulating it.
If either the visual intake skills or the visual processing skills are under-developed, they will have difficulty with the motor response such as writing a word neatly, or finding the beginning of the next line, or hitting a baseball.
Teachers and parents are the first line of intervention when a student has a learning-related visual issue. If you notice that a student has a consistent problem with a certain type of assignment, ask the student what they think is going on before you tell them how to fix it. Then make sure to arrange a comprehensive vision examination with a developmental optometrist who is experienced with children and binocular vision. The doctor will be able to recommend an assortment of options for how to address any learning-related visual diagnosis with glasses, in-office vision therapy, or by suggesting activities for you to do with the student at home or in the classroom.
When otherwise healthy, intelligent, articulate, and curious children experience difficulty in academics, suspect that the problem has a visual root. At least, rule out any learning-related visual problem by taking them to a developmental optometrist for a thorough check-up.
Friday, August 14, 2009
Wednesday, August 5, 2009
- Education generally does not consider that other than for low vision issues, vision could be the root of a child's difficulty in learning to read. It isn't profiled in the graduate school reading courses. (I would love to offer such a course at the graduate school level here in St. Louis- I even have a course proposal written!) Vision therapy and binocular vision evaluations are not typically included in an IEP (of course not because then the budget-strapped public school districts might have to pay for the services). The school nurse's vision screening doesn't usually deal with anything other than acuity and obvious ocular health issues. So when a child has received all the reading interventions at school, gets read to at home regularly, is otherwise intelligent, articulate, and healthy, but still cannot read on grade level, he gets labeled learning disabled in reading, given a diagnosis of dyslexia, or placed in still more sedentary tutorials. If these children were to be sent to a developmental optometrist for a binocular vision evaluation and, if indicated, a developmental evaluation of their visual-perceptual skills, and again if indicated, enrolled in a program of in-office vision therapy, many of them would gain the skills they need within 12 to 48 weeks.
- Home schooling parents frequently choose to home school because their struggling readers are not well served in a traditional school setting. Then, in their frustrated search for interventions, they end up spending too much money without achieving the result they hoped for. Since vision therapy providers are hard to find, are usually very expensive, and their services tend not to be covered by health or vision insurance, these parents suspect that the prescribing doctor may just be another person looking to separate them from their money without bringing any real change.
- Optometry and ophthalmology are not always friends. Optometrists are the eye doctors who generally provide vision therapy services as well as binocular vision evaluations. Ophthalmologists are the medical doctors who specialize in the treatment of eyes. They also do eye surgeries. While there is more than 40 years of documented optometric research to prove that vision therapy works, there is limited awareness about it partly because of the disconnect between optometry and ophthalmology. Since 2008, though, both professions agree that in-office vision therapy is effective to treat convergence insufficiencies. This is real progress. Ophthalmology also agrees that vision therapy is helpful in the treatment of amblyopia.
One reason that I started blogging about these issues (other than as a marketing strategy for the books, of course) is that I know that a lot of children who don't like to read and who are not "living up to their potential in school" change after their unaddressed learning-related visual challenges get fixed. I see it every day when I work in the vision therapy context. I'd love to be considered a resource for parents and teachers around the issues of vision and learning so please, post your questions as blog comments or on the wall of the FaceBook page. Or email me at email@example.com. I'll answer what I know- probably I'll suggest you schedule an appointment with a developmental optometrist too.
For optometrists, the Eye Can Too! Read series of e-books is a great resource for your home-schooling families. The books work as stand-alone solutions or as resources for home therapy in connection with a program of in-office vision therapy for saccadic deficits, laterality & directionality delays, and visual perceptual delays. Let me know if you are interested in receiving preview copies or in having them available on CD for sale at your office.
Friday, July 31, 2009
If you are a homeschooler, a member of a home school support group, or an optometrist with a vision therapy practice that services homeschoolers, let me know, please. Follow me at @eyecantooread on Twitter or "fan" the Eye Can Too! Read page on Facebook.
Monday, July 20, 2009
Both pursuits and saccades are developmental eye movements. Like learning to swim or ride a bicycle, once a person knows how to do them, they continue to improve. With experience, the person can coordinate the movement automatically and fluently enough to do other things at the same time like carry on a conversation, for example. However, for patients whose developmental eye movements are delayed, basic tasks like reading, lining up digits in a math problem, or hitting a baseball can be very difficult.
There is a simple test that optometrists use to test a child's eye movements called the Developmental Eye Movement Test (DEM). It is available exclusively from the Bernell company (www.bernell.com). Bernell provides an assortment of tools for optometrists and vision therapists. The DEM can be used for children as young as first grade. First the child is asked to read a column of 80 single-digit numbers arranged vertically. The examiner times the child with a stop watch. Then the child must read the same 80 numbers arranged in rows horizontally with random gaps in the rows. By the time a child is twelve years old, the speed with which they read the vertical numbers should match their speed reading the horizontal numbers. The test has been validated over a period of years so norms for a child's performance scores have been established according to both age and grade. Besides comparing the vertical and horizontal reading speeds, the DEM also measures the number of errors made by the child. It only takes about three minutes to complete the entire DEM but the results may explain why a child is having difficulty in school in spite of having 20-20 vision.
If your child scores poorly on the DEM, vision therapy may be indicated. Your child may also be helped by the activities in the Purple Book of the Eye Can Too! Read Series. While I wrote the series for home-schooling families, anyone can implement the activities which are similar to what we use in in-office vision therapy to address eye movement deficits.
Tuesday, June 30, 2009
Friday, June 5, 2009
Why did I include these scans in the Eye Can Too! Read blog? I wanted to make a statement about what kinds of activities were done at the reading readiness, preschool level in the eras before television, plastic playgrounds, and Game Boys. The eye-hand coordination required to do any of these crafts is far more mature than we expect from fifth graders today, let alone from five year olds. Not only did these children have to demonstrate very fine motor control, this kind of close work would have strengthened their eye movements so that they could gain experience converging on near point images long before they were expected to use those eye movements to decode the meaning of text.
Sunday, May 17, 2009
The first place I taught was a tiny church-based school in Santa Ana, CA - in around 1978. I taught first grade. A developmental optometrist pioneer in vision therapy did an inservice training workshop for us teachers and I learned how to recognize when a child's vision problems were at the root of their academic difficulties. We toured his amazing vision therapy clinic. I ended up referring about four students to this doctor and all of them benefited by either a prescription for glasses or a series of in-office vision therapy sessions. Then I forgot all about it.
Until....perhaps fifteen years later. Now I was a home-schooling mom with seven children who also taught students from a total of six families over the course of a 17 year period. One daughter struggled with penmanship and resisted any form of written work in spite of being a very fast reader with great comprehension way above her grade level. Another daughter struggled to learn to read and write, made frequent reversals when writing, and could not progress past the primary readers in spite of an obvious ability to comprehend what ever I read aloud to her, and who had an uncanny gift for organizing people and things.
I took the girls to an optometrist at a major store outlet. Both passed the vision examination as far as acuities and ocular health. So they did not need glasses. Fortunately, the doctor had been a student of Dr. Gail Doell at the UMSL -School of Optometry in St. Louis. She taught binocular vision and owned her own optometry practice where she provided in-office vision therapy. The first daughter was diagnosed with a convergence insufficiency which resolved in about 8 weeks. She went on to be an air traffic controller in the US Air Force. The other daughter's problems were more related to visual perceptual developmental delays - they also resolved enough for her to make the dean's list at college every semester and to become a successful accountant. Of course, Dr. Doell became our family's eye doctor forever.
Fast forward another twelve years to 2004. I was in Gail's office for a regular eye exam. My marriage had failed leaving me the single parent of six (my oldest was grown already). This meant that my home-schooling days were ended. The children, enrolled in public schools, all thrived as top students earning scholarships and awards every year. I went back to teaching - in the St. Louis City public schools. I had also earned a Masters in Teaching. Gail and I were laughing over funny stories about my classroom experiences when she happened to mention that she was hiring a new vision therapist. She wanted someone with a graduate degree either in education or occupational therapy to train in-house. Was I interested? After observing several times, I started working for her as a part time vision therapist. Six years later, I still do that in her pediatric office, the Center For Vision & Learning in Creve Coeur, MO.
Most teachers are never told about how fundamental the development of the visual system is to a child's academic success. Many students who are intelligent and excited about learning but who also have undiagnosed learning-related visual problems lose motivation, engage in deteriorating behavior, and become discouraged about their potential success. It begins in kindergarten for many. In fact, many academic challenges could be avoided if every teacher knew how to incorporate activities to improve eye movements and to build visual perception. Even more students would do better at school if every teacher knew how to recognize the symptoms of convergence insuffiencies or excesses and accommodative disorders so they could refer the students to a developmental optometrist who specializes in binocular vision. Special education teachers could help many of their students who have Autism or Asperger's Syndrome by understanding the visual issues these individuals often face and by collaborating with developmental optometrists and skilled vision therapists.
IT IS NOT ENOUGH FOR A CHILD TO PASS THE VISION SCREENING IN THE SCHOOL NURSE'S OFFICE - THIS JUST DEALS WITH DISTANCE VISION AND WITH OCULAR HEALTH - EFFICIENT READING RELIES ON SEVERAL OTHER VISUAL SKILLS
As I participated in optometry training workshops and conferences I discovered that as much as teachers don't know what optometry has to offer, optometrists don't know how classrooms work either. I have experience in the classroom, the homeschool, and the vision therapy contexts. That's why I wrote the Eye Can Too! Read series of curriculum activities for homeschoolers. Of course, they can be adapted for classrooms too. I'm working on a big book of learning related vision activities for the primary classroom learning center now.
Besides finding it personally rewarding to see my patients advance several reading levels within a few months of starting vision therapy and gain self-confidence so that they can begin to enjoy school, I am passionately convinced that the more than 40 years of optometric research about addressing learning-related visual problems through vision therapy activities should be made more widely available. That's why I write this blog and hope to be a resource to parents and teachers for the sake of the kids.
Please feel free to share the links to this blog. Follow me (@lesleybarker) on Twitter and become a fan of the Eye Can Too! Read page on FaceBook. Leave your questions on one of these sites and I'll get back to you with some kind of response that I hope will help.
Friday, May 15, 2009
Fortunately, saccadic eye movement skills are fairly straight forward to improve. Starting with monocular activities that exercise each eye by itself, the eye muscles get strengthened enough to become much more reliable within a few weeks. Like I tell my younger vision therapy patients who are struggling with saccadic eye movement deficits, "You are supposed to be the boss of your eyes but they are mocking you and saying, 'We don't have to do what you say. We can do anything we want." After several weeks of consistent practice, most patients gain significantly better skills.
Until they can manage quick and accurate saccadic eye movements while also doing a cognitive task at the same time, though, the optometrist typically will not discharge a patient from vision therapy.
While there are other learning related visual issues which can result in poor reading fluency like a convergence insufficiency or a visual perceptual delay, improving your student's saccadic eye movement skills will usually result in an increase in reading speed, fluency, and comprehension.
The good news is that even if you do not have a diagnosed deficit of your saccadic eye movements, anyone can improve their reading speed, fluency, and comprehension using the activities in the Purple Book of the Eye Can Too! Read series. (Click on the links at the right of the blog to preview the series at Home School Incorporated.) While written with the home school context in mind, the activities are appropriate for anyone and can even be adapted for use in a classroom learning center. The book contains graded academic activities that all also rely on and build saccadic eye movements.
Of course, every child should be examined by a developmental optometrist or other eye doctor once each year to make sure that their vision is developing normally, the eyes are healthy, and if they need glasses, they have the correct prescription. If you are concerned about the possibility that your child has a learning related visual problem, be sure to let the doctor know.
Thursday, May 7, 2009
Here is an activity that can help teach students how to overtly access their visual memory.
- Have the student close his eyes and describe from memory the items in the classroom.
- Ask whether there is an alphabet chart posted anywhere in the room.
- Ask the student to tell you from memory what color the chart is and what color the letters are. If the student does not know, give them an assignment to find out the next time they are at school.
- Ask whether your student can see a picture of that chart in their mind. Then ask how many "w's" are on it.
- Ask if the student can read the chart by looking at the mental image and find the letter that comes two before "q".
Here is a spelling activity to help students put visual material into their visual memory.
- Take any word on the spelling list. Perhaps you want to learn to spell picnic.
- Write picnic in neat manuscript letters as a model.
- Direct the student to trace the word with a pencil five times.
- Next tell the student to imagine that it is a very damp cold day. There is moisture on the car window. Tell the student to use her finger to write the word picnic on the window.
- Ask her if she can see the word on the imaginary car window. Then ask her to spell it by reading the letters from the window in her mind. Next, ask her to spell it backwards.
Saturday, April 25, 2009
Tuesday, April 14, 2009
Friday, April 10, 2009
Another cause of your child's head tilt could be the result of a convergence insufficiency or a convergence excess. These conditions may indicate that she is having difficulty teaming both eyes together without experiencing blur or double vision. Her coping strategy could be to suppress the visual information received by one eye, shutting it off, in effect, by tilting her head.
If your child has always experienced these visual conditions, she may not even realize that it is abnormal.
So, if your child has a head tilt, don't scold her about her posture until after you take her to a developmental optometrist for a comprehensive eye exam. She may need glasses or a program of professionally supervised in-office vision therapy. You can find a developmental optometrist in your area at www.covd.org by plugging in your zip code.
Thursday, April 2, 2009
Friday, March 27, 2009
Tuesday, March 24, 2009
Monday, March 9, 2009
But, students whose learning-related visual skills are challenged by ocular motility deficits of either their saccadic or pursuits eye movements may have a very difficult time completing the assignment. Since these students have not yet developed adequate automatic control of their eye muscles (there are six muscles connected to each eye), they may not be able to hold a visual fixation on a single math problem long enough to find it in the first place. So, the paper they turn in may look like a piece of Swiss cheese because so many problems are left undone. In addition, for the same visual reason, these students may start to answer one problem, look away for a second (perhaps to look up while thinking or trying to remember the math fact) and be unable to find the problem again. So the answer to one problem may be written on a different problem nearby.
So, after attacking all the problems (not really) that they perceive, the students assume that they have completed the work and hand it in. "You didn't do all the problems," says the teacher (probably for the 50 thousand time since the year started), surprising and frustrating the student who really really tried. "Go back and finish the paper." A few minutes later, the student returns, again thinking that the whole assignment is done. A few more problems may be, but there are still many left undone, leaving "holes" on the worksheet. Yet, if the teacher points to a problem while the student completes it, or assesses the students' learning another way, these students may be able to show mastery of the mathematical skills that the worksheet was meant to assess.
It isn't that they do not understand how to solve the arithmetic. It could be that they have deficits of their eye movements. They probably are the same students who lose their place when reading, skip little words, and find paper and pencil tasks laborious, frustrating, and terribly time consuming. But, they are obviously intelligent, articulate, and engaged when the learning is delivered and assessed without a need for reading and writing.
These students do not have to spend 12 years of their lives being frustrated and feeling a sense of failure. Recommend that they see a developmental optometrist for a complete binocular vision examination. Then, follow up with in-office vision therapy if it is indicated.
In addition, these students may be assisted to improve their eye muscle control with the activities in the first (Purple Book) of the Eye Can Too! Read series. While the activities are designed with the home school context in mind, many of them are appropriate for use in the regular elementary school classroom. They each serve an academic as well as a visual objective and come with suggestions for what to do when you observe certain behaviors as your students do the activities.
Friday, February 27, 2009
So, here's the good news. Six months later, this week, Charlie's mother told me that she couldn't find him when she wanted him to do something last week until she looked in the living room. Charlie was curled up in a chair reading a Hardy Boy mystery book all by himself. It was the first time that his mother had ever seen him choose to read and also continue to read for an extended period so she left him alone. 40 minutes later she asked him why he was reading.
"I like the book," he answered. "The words do not disappear at the end of the lines [like they used to]. My eyes are not in pain anymore. It doesn't hurt. It's easier."
Once again I conclude that children who resist reading or who seem to find it excessively difficult may have learning related visual issues which can be addressed through a program of optometric vision therapy under the supervision of a developmental optometrist.
Wednesday, February 18, 2009
Tuesday, February 17, 2009
Here is a simple test that anyone can do at home to check how well their eyes can team. It is called a pencil push-up. Hold a pencil in front of your face about arm's length away and slightly below your nose. Try to focus both eyes on the writing on the pencil keeping it clear. Slowly pull the pencil towards your nose, keeping the letters clear. Can you pull the pencil to within an inch of your nose without it becoming blurred or doubled? That is normal. If the pencil doubles or gets so blurry that you cannot see the writing, you should go to a developmental optometrist who specializes in binocular vision and who incorporates vision therapy into their practice.
If you sit opposite the person who is doing the pencil push-up, watch their eyes. You should see them move closer and closer towards the nose as if they are becoming "crossed." You may notice that one or both eyes suddenly stop crossing and bleep out towards the ears. When this happens, the person will probably report that they see two pencils. That is because the eyes stopped teaming to point to the same place in space at the same time so the brain received two separate visual images instead of one fused image with depth and detail.
This could be due to a condition called convergence insufficiency. Recent research demonstrates that it takes an average of 12 in-office sessions of vision therapy to address a convergence insufficiency. There are even some computer programs that can be purchased to address eye teaming problems at home which can be used in conjunction with in-office vision therapy with some patients who have adequate stereo vision.
So, don't accuse your child of being lazy if they report that the words wiggle or look double or blurry. Take them to a developmental optometrist who will be able to provide therapeutic interventions to address the problem in a few short months afterwhich reading should become much more efficient and enjoyable.
Saturday, February 14, 2009
- Hold a bean bag at waist level, palm up in one hand
- Hold the other hand also at waist level, palm up
- Toss the bean bag from one hand to the other in a large soft arc
- Watch the bean bag from the time it leaves the first hand, following it constantly until it lands in the second hand
- Toss the bean bag back and forth without taking your eyes off the bean bag
If it is difficult for your child to catch the bean bag, suggest that he make sure to look at the hand with which he needs to catch the bean bag right before the bean bag lands there. You may need to issue the same cue with every new toss at first.
When this becomes easy for your child, make the activity more difficult.
- Hold one bean bag in one hand as before with the other hand at the waist, palm-up, in order to catch it
- Toss the bean bag as before
- When the bean bag is flying, clap one time. Then, catch the bean bag
- Toss it back, clapping and catching with the other hand
When this becomes easy, make the activity even more difficult.
- Hold two bean bags, one in each hand at waist level, palms up
- Toss one bean bag in an arc
- Watch the bean bag that is flying
- When the bean bag is in the air, mid-flight, clap the other bean bag into the hand that threw the first bean bag (DO NOT Throw the second bean bag - CLAP It!)
- Catch the first bean bag with the now empty hand
- Continue for as many repetitions as possible
As your child masters these simple and quite entertaining activities, she will become more aware of how to direct her eyes. The longer she can sustain the activity, the more she will exercise her eye muscles. While this activity alone will not remediate a severe eye movement deficit, it will begin to give your child experience using and developing their ocular motilities.
If your child has difficulty reading because he loses his place, skips words or misses whole lines you should not assume that he will grow out of it. Instead, schedule your child for a complete eye exam at a developmental optometrist who has experience with binocular vision and who incorporates vision therapy into his practice. Click on the link (at the top right of this blog) to the College of Optometrists in Vision Development to find a member eye doctor in your area.
You may also be interested in purchasing the first book (the Purple Book) in my Eye Can Too! Read series because it provides a series of academic activities for elementary school students which rely on the eye movement skills of saccades and pursuits. All of these activities are designed to be done at home facilitated by a parent. Every child can improve their eye movement skills just like every athlete can improve their strength and dexterity. To purchase your copy of this book, just click on the link at the top right corner of this blog.
Monday, February 2, 2009
3-D glasses work by providing the right eye with different visual information than the left eye so that a more complex image will be perceived when the two pictures are combined in the retina. ( See http://www.3dglassesonline.com/how-do-3d-glasses-work/ for a discussion of how 3-D glasses work.) For them to work requires that the individual has good binocular vision. Strabismus, eye teaming disorders, and amblyopia all correlate with reduced or absent binocularity. People who have these conditions usually have difficulty with depth perception. Some of these conditions also impair the individual's ability to read efficiently because, with a convergence insufficiency, for instance, the words may seem to be unstable on the page. They may also get headaches or report seeing double when they read.
Fortunately, with appropriate diagosis and vision therapy, these conditions can be helped. New research demonstrates that convergence insufficiencies can be addressed with a program of in-office vision therapy. Children who have been diagnosed with other binocular disfunctions have the best prognoses but even adults can be assisted to gain ground as has been demonstrated by the experience of Sue Barry, dubbed "Stereo Sue". (See ttp://www.newyorker.com/archive/2006/06/19/060619fa_fact_sacks for her story.)
What is my point? If you or someone at your Super Bowl party was unimpressed by the 3-D glasses because they didn't seem to change anything about the picture, or if anyone found wearing the glasses uncomfortable or intolerable, it probably means that they need to schedule a comprehensive eye exam with a developmental optometrist who specializes in binocular vision and who also is a vision therapy provider. Then, if there is a diagnosis that can be helped by vision therapy, know that the benefit of seeing in stereo is worth the investment of time, money, frustration, and effort.