Friday, September 25, 2009

Peripheral Awareness & Autism Spectrum Disorders

If you stare in front of you at a small visual target like a sticker or a spot on the wall you are using your central vision. The longer you maintain that fixation, the more you should become aware that you can also see objects in your peripheral field of vision. The ability to coordinate between your central and peripheral visual systems is very important. Athletes depend on it to sense when an opponent is approaching from behind. Everyone relies on it to remain aware of cars or other potentially dangerous obstacles that should be avoided. Peripheral awareness can actually be improved with practice and certain activities.

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 ( 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 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

Find out why a child is a struggling reader by asking the right question

In my opinion, one of the most common reasons that parents and teachers don't bring their children to the optometrist when they first start having trouble learning to read is that the grown-ups don't ask the children the right questions. So, they never hear what the child is really experiencing.

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

Does your student move their head across the page when reading?

Do you notice that one of your students moves their head across the page when reading? The same student probably also struggles with losing their place, skipping lines and little words, and finishing worksheets arranged in rows and columns. Someone who habitually moves their head when reading may be compensating for inadequately developed eye muscle movement skills. However, this strategy ends up hurting their reading speed, efficiency, accuracy, and comprehension. In fact, they are using their neck muscles to point their eyes to the text when each eye has a total of six muscles specifically designed to work together to make very specific, accurately focused eye movements.

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

School-induced Headaches- What should you do?

Students with some learning-related visual problems tend to complain that school or reading gives them a headache. This makes them dislike school and reading even when they initially looked forward to it. What could really be going on? The student may have an undiagnosed, unaddressed learning-related visual problem. For instance, if the teacher projects material on a smartboard or writes on a blackboard expecting the class to copy information from the board into their notebooks at their desk, students have to adjust how their eyes are focusing from near to far and back again. This is the visual skill called accommodation. Children with inflexible accommodation skills often cannot handle that kind of classroom activity without getting a headache. It takes a skilled developmental optometrist to identify the problem. Sometimes the appropriate treatment includes glasses. It can also be addressed through in-office vision therapy using various near/far activities and special lenses. Headaches can also be caused by the eyes failing to team well together. A child diagnosed with a convergence excess may be unable to relax their eyes when they get tired from reading because when the look away they may not be able to return to the word without it seeming to blur, wiggle, or double. On the other hand, a convergence insufficiency diagnosis may indicate that the child cannot coordinate the eyes well enough to keep a word in focus when reading. These children may also complain of having headaches at school and when reading. Many of them suppress the vision from one eye without even being aware of it which, unfortunately, can cause additional visual problems to emerge. So, if your child has frequent headaches at school or when reading but is otherwise perfectly healthy, here's what you should do. First, believe that your child is telling the truth. Second, make an appointment with a developmental optometrist to have a comprehensive binocular vision examination. Third, follow your eye doctor's recommendations regarding glasses and vision therapy. Fourth, make sure that your child understands that the condition is not permanent and they should optimistically participate in the work it will take to overcome the problem. Don't ignore the complaints until you find a caring professional who doesn't quit until the correct diagnosis and treatment plan are made.

Thursday, September 3, 2009

3-D Vision Therapy

Some people whose eyes do not team properly don't see in three dimensions. In other words, they may lack stereo vision (stereopsis). The cause may be an eye turn (strabismus), the suppression of one eye, or some other condition to be identified by an optometrist. Until recently the experts believed that unless the condition was addressed in a young person, either by vision therapy and/or surgery, it would become "hard-wired" in the brain. In other words, no one even held out hope for an adult to obtain stereopsis. That began to change with the experience of psychologist, Dr. Sue Barry, now nicknamed "Stereo Sue." Check out how she explains what happened to her on her website,, or in her book by the same title. You can also watch her on You Tube:

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

Now Available

All three Eye Can Too! Read books by Lesley Barker are now directly available at Team Lesley's Store. Just click on the links to the left here or go to Then click on the button to take you directly to the store. The books are e-books sold in PDF downloads. First, you buy a copy. When I get the notice of your purchase from Paypal, within 24 business hours, I'll send your copy attached to an email for you to download.