For Teachers About Learning & Vision

Teachers should be the first line of intervention when one of their students has a learning-related vision problem since they get to see the children at work every day. When a student covers one eye or puts their head down so that only one eye points towards the text or paper, the teacher should recognize that this child needs to see an eye doctor to rule out amblyopia, or problems teaming the eyes to keep a word or other image single. When a student squints or complains of having a headache often during school - especially when asked to copy work from the board or smart-board to a piece of paper on their desk, the teacher should suggest that the student's parent make an eye appointment to make sure that the child knows how to accommodate i.e. switch their focus from near to far and back again efficiently. When a student cannot line up the digits in a math problem or appropriately space words on their paper, the teacher should first offer some practical hints but if these do not seem to help, it is time for a referral to an eye doctor to make sure that the child's eye movements and visual perceptual skills are developing on schedule. When a student makes frequent reversals when reading or writing - especially after the second grade, this may be a visual spatial delay in the skills of laterality and directionality. Finally, when a student has trouble in PE or on the playground catching or aiming balls or, in general, has under-performing gross motor skills, the root of the problem could the visual-motor-integration. While each of these symptoms can make success in school very difficult, all of them can be addressed by a few weeks or months of in-office vision therapy under the supervision of a developmental optometrist. No child should be left behind in school because of addressable learning-related vision problems.

Before you Medicate, Investigate- ADHD & Vision

Clinical research has established that there is a link between a diagnosis of ADHD and certain vision deficits or delays in children. Many children with ADHD also test positive for a saccadic eye movement deficit. This means that they have difficulty moving their eyes efficiently and accurately from one fixed visual target to another as in going from one word or line to the next on a page of text. Many children with ADHD also test positive for a convergence insufficiency (CI). This means that they are unable to cross their eyes or team them appropriately and may experience words moving, blurring, or doubling on a page. They may get headaches when reading or they may, without ever being aware of it, suppress the vision in one eye. Many children with ADHD also test positive for accommodative infacility (AI) which means that they have trouble adjusting their focus when looking from a near image to a different image in the distance.

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

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.