Sunday, May 17, 2009

How I Got Interested in Vision & Learning

I grew up with great vision - well, I didn't need glasses and was an avaricious reader from early on, loved school and always wanted to be a writer and always wrote stuff I hoped other people would read.

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.


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

Poor Reading Fluency May Indicate a Learning-related Visual Challenge

Efficient readers move their eyes quickly across a page of text decoding words and processing meaning. The most efficient readers even scan and recognize familiar words by their shapes. It takes more than good phonetic skills and a good visual memory to read fluently though. People who have deficits of their saccadic eye movement skills can't usually do it. Because their eye muscles are not developed well enough for them to control where to point their eyes, they may not be able to maintain a fixation long enough to process the word or its meaning. When they lose the fixation, they also lose their place in the text.

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

Teaching Students Visual Memory Skills

Do any of your students have difficulty identifying or properly sequencing letters or numbers even though they have been given plenty of instruction and guided practice and seem otherwise bright, articulate individuals? Over the years, several of my vision therapy patients have had this problem and I have discovered that when they learn how to access their visual memory, they begin to have a strategy to solve the embarrassing dilemma.

Here is an activity that can help teach students how to overtly access their visual memory.
  1. Have the student close his eyes and describe from memory the items in the classroom.
  2. Ask whether there is an alphabet chart posted anywhere in the room.
  3. 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.
  4. Ask whether your student can see a picture of that chart in their mind. Then ask how many "w's" are on it.
  5. Ask if the student can read the chart by looking at the mental image and find the letter that comes two before "q".
Note that many students who have difficulty remembering visual material have not been assisted to look carefully and analyze the visual images. These students may prefer to learn using an auditory or kinesthetic mode but they can still develop more visual competence with help.

Here is a spelling activity to help students put visual material into their visual memory.
  1. Take any word on the spelling list. Perhaps you want to learn to spell picnic.
  2. Write picnic in neat manuscript letters as a model.
  3. Direct the student to trace the word with a pencil five times.
  4. 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.
  5. 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.
Notice that this method does not rely on any phonetic skill at all. It is a visual activity. The most efficient readers mix their ability to remember visual cues with their ability to sound out words. In English, especially, because there are so many equally correct ways to write a single sound, we have to use both our auditory and visual memory to become good spellers and readers.