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Dyslexia

August is National Children’s Vision and Learning Month

As school starts across the United States, the pressure is back on teachers, parents and students to meet or surpass the requirements set forth by the No Child Left Behind act. However, most parents and teachers are unwittingly being tackled by leaving their students’ vision behind.

“In football you know when you are being tackled, but unfortunately it is more subtle for parents and educators,” Larry Fitzgerald states, “When a student passes a vision screening everyone assumes their vision is fine and the door is closed on the possibility that a correctable vision disorder is contributing to the student’s difficulty with reading. Yet the majority of vision screenings don’t test how well, or how long, the student can see clearly at reading distance.”

As we enter the 15th year of observing August as National Children’s Vision and Learning Month, Larry Fitzgerald joins the campaign again this year to help set the record straight on the critical link between vision and learning. “The purpose of this observance is to make sure everyone knows that there are 17 visual skills required for academic success and seeing 20/20 is just one of those visual skills,” Fitzgerald states.

“I was one of those students who didn’t have all the visual skills required for learning. But I was fortunate that my vision problems were caught early in life,” shares Fitzgerald. Fitzgerald, who turns 27 on August 31st, is continuing his education through the University of Phoenix as a communications major.

Fitzgerald had a vision problem that was making it difficult to pay attention in school and his grandfather, Dr. Robert Johnson, a developmental optometrist in Chicago, Illinois, diagnosed the vision problem and prescribed the appropriate treatment, optometric vision therapy.

Dr. Stephanie Johnson-Brown, Fitzgerald’s aunt supervised his vision therapy program. Dr. Johnson-Brown is currently the executive director of the Plano Child Development Center, a not-for-profit vision care service corporation which was co-founded by her father, Dr. Johnson, in 1959. The center specializes in vision education and the identification and remediation of vision development problems in children and adults.

Fitzgerald credits the optometric vision therapy he received as a child as one of the keys to his success. Because children don’t know how they are supposed to see and rarely complain, this past March, Fitzgerald made sure his 2-year-old son, Devin’s vision was developing properly, by having his aunt do a thorough vision evaluation. Dr. Johnson-Brown was pleased to report all is well.

Optometric vision therapy treats vision problems that make reading and learning difficult. According to Dr. Bradley Habermehl, President of the College of Optometrists in Vision Development, “It doesn’t take a rocket scientist to understand that if a child is seeing double, ghosty or unstable text it will be hard to read. Yet, if you assume vision is fine, the only possible conclusion one can reach is the child has a learning disability such as ADHD or dyslexia.” According to the American Optometric Association, studies indicate that 60 percent of children identified as “problem learners” actually suffer from undetected vision problems.

Even though there is a wealth of optometric research which proves vision therapy works, there is false or misleading information in the medical community about vision therapy. It can be confusing for parents and educators when they get conflicting opinions.

However, Brock Eide, M.D., M.A. and Fernette Eide, M.D., leading clinicians and writers on learning disabilities state, “In spite of the very positive research findings validating the role vision plays in learning, some are still claiming visual dysfunction plays little or no role in the reading challenges that dyslexics face. This is a shame. When we look specifically at the results of studies performed to address specific visual issues, the evidence supporting visual therapy is quite strong.”

The Eides run the Eide Neurolearning Clinic in Edmonds, Washington, are authors of the popular book, The Mislabled Child: How Understanding Your Child’s Unique Learning Style Can Open the Door to Success, and lecture throughout the U.S. and Canada to parents, educators, therapists, and doctors. Drs. Eides have published extensively in the fields of gifted education, learning disabilities, and twice exceptionalities such as giftedness and dyslexia, and served as consultants to the President’s Council on Bioethics.

“While not all children or adults with dyslexia have visual processing problems, many –at least two-thirds in some studies– do. This makes sense from a neurological standpoint, because several of the structural neurological features associated with dyslexia appear to predispose to visual difficulties,” Dr. Brock Eide adds.

“Not surprisingly, several types of visual difficulties are more common in dyslexic than non-dyslexic children. In one study of dyslexic children, just one type of visual problem, near-point convergence insufficiency, was present in 30-40% of the dyslexic children, compared to just 20% of controls. As can be seen from this control figure, visual processing problems are also quite common in non-dyslexic school-age children,” Eide continues.

Dr. Fernette Eide explains, “The bottom line is that visual problems are common, though not universal, in children who struggle to read; and optometric vision therapy can help address visual problems in children with significant visual dysfunction. A good visual examination is an important part of the workup of every struggling reader.”

Dr. Jen Simonson at Boulder Valley Vision Therapy diagnoses and treats vision problems that interfere with academic success, “When students understand the lesson when it is read to them yet struggle to read it this is a very strong sign that a vision problem may be contributing to their difficulties.” The five most common signs that a vision problem may be interfering with your student’s ability to read and learn are:

1. Skips lines, rereads lines

2. Poor reading comprehension

3. Takes much longer doing homework than it should take

4. Reverses letters like “b” into “d” when reading

5. Has a short attention span with reading and schoolwork

Any one of these symptoms is a sign of a possible vision problem. A more in-depth symptoms checklist is available on COVD‘s website.

Not all eye doctors test for learning-related vision problems, so it is important for parents to ask the right questions. Call your eye doctor’s office and ask the following two questions:

1. Do you test for learning-related vision problems?

2. Do you provide an in-office vision therapy program when indicated, or will you refer me to someone who does?

If the answer is no to either one or both of these questions, visit COVD‘s website, www.covd.org, to find a developmental optometrist near you.

“Vision therapy made a big difference in my life and my career,” shares Fitzgerald; “It is my hope that parents will take the time to learn more about how vision problems can interfere with success in school and in sports.”

About COVD

The College of Optometrists in Vision Development (COVD) is an international, non-profit optometric membership organization that provides education, evaluation and board certification programs in behavioral and developmental vision care, vision therapy and visual rehabilitation. The organization is comprised of doctors of optometry, vision therapists and other vision specialists. For more information on learning-related vision problems, vision therapy and COVD, please visit www.covd.org or call 888.268.3770.

Brain Storm

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Dr. Simonson was part of a panel of speakers at the Brain Storm Event at Boulder Valley School District on May 5th. She talked about what type of vision problems there are, what it is like to “see” with a vision problem, and what can be done to correct vision disorders.

Dr. Simonson represents a state-wide non-profit organization called the Vision and Learning Forum. This is a group of parents, teachers, occupational therapists, and optometrists who are dedicated to providing information about visual learning. More information can be found at their website: http://www.visionandlearning.org/index3.htm.

If you would like Dr. Simonson to speak at your next event, please call our office at 303-443-2257 or send an e-mail to bouldervt@yahoo.com.

Answers to Questions from the Brain Storm Event

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1. Where do I find the visual symptom checklist? You can call or e-mail Dr. Simonson to forward you a copy by mail or e-mail, or download a pdf version here: http://vision-learning.org/spotprobs.html

2. Can Dyslexia actually be a vision problem?

Dyslexia is a neurological dysfunction marked by the inability of the brain’s language centers to efficiently decode print or phonetically make the connection between written symbols and their appropriate sounds. Not all children who struggle to read, however, suffer from phonological processing problems. Although the symptoms are similar, the culprit for many may be vision, not a language-based deficit.

Margaret Livingstone, et al, from the Department of Neurobiology, Harvard Medical School and the Dyslexia Research Laboratory, Beth Israel Hospital in Boston reports that poor visual processing plays a significant role in a large majority of children who struggle to read: “Several perceptual studies have suggested that dyslexic subjects process visual information more slowly than normal subjects. Such visual abnormalities were reported to be found in more than 75% of the reading-disabled children tested.”

A complete eye exam by a developmental optometrist trained to diagnose and treat vision-based learning problems can determine for certain if vision is the basis of a child’s struggle to read. For more complete information on this topic, see our “Vision and Reading” page.

Below is the position statement of the American Academy of Optometry and the American Optometric Association on the relationship between vision and dyslexia. Children who have been labeled “dyslexic” need to have a complete eye examination by a pediatric optometrist to evaluate their learning-related vision skills to determine to what degree poor visual processing is contributing to the problem. For a specialist near you, contact the national certifying board of the College of Optometrists in Vision Development at 1-888-268-3770 or visit their web site at www.covd.org.

Here is the policy statement of the American Optometric Association on Learning related vision problems: http://www.aoa.org/x5420.xml

More information: http://www.visionandlearning.org/dyslexia08.html

3. What is dyslexia?

The three most common types of dyslexia and how optometrists can help:

1. Dysphonesia – A dysfunction where the primary problem is letter-sound integration. They are unable to identify words or letters with their accompanying phonetic sounds. They cannot attack unfamiliar words using skills such as phonics, syllabication and/or structural analysis. This is a decoding problem. Dysphonetics rely on eidetic coding (word attack skills). You can think of eidetic coding as memorizing words instead of sounding them out. Words like “pneumonia” and “mnemonics” are eidetically coded. Dysphonetics may recognize familiar words, but are incapable of efficiently decoding unfamiliar and multisyllabic words because they have difficulty sounding out and blending sounds together. For example, if they were taught the word “deal” they may still have difficulties with the word “seal” or not know how to read the word “dealing.” These children tend to need more educational help rather than optometric remediation, though remediating any vision problems that could be causing some of the difficulty is always helpful.

2. Dyseidesia – A dysfunction that involves whole word decoding, a more global process in which words are recognized based upon their shape and configuration. This is the opposite of dysphonesia. People that are considered dyseidetic lack the ability to take whole words or configurations and perceive them as a unit symbol (or gestalt), but can use skills such as phonetics (sounding out words), syllabication and structural analysis. This means they don’t have good word attack skills. It is more of an encoding problem. They have problems storing information, which involves sequential memory (knowing the right order of things). Consequently, retrieval of information is difficult. People who experience this dysfunction rely on phonetic coding instead, which can lead to incorrect spelling. Some researchers have found that these individuals have deficient short-term visual memory (the ability to recall previously presented visual experiences), visual discrimination (the differentiation between visual patterns), visual figure ground (differentiating a particular part of a visual field, e.g. Where’s Waldo), and visual sequential memory (visualizing in a particular order). These problems are often remediated by visual perception training. Visual perceptual therapy can improve a person’s reading skills and comprehension, assuming they are still provided the proper educational instruction.

3. Dysnemkinesia – A dysfunction that involves memory and motor movement. Individuals with this dysfunction tend to be distinguished by their abnormally high frequency of letter reversals. It is the dysfunction most people think about when they hear the word dyslexia. This is actually a developmental issue. It occurs due to poor development of the visual spatial skills known as laterality and directionality. They have problems with things like symbol orientation. For example, “p” “b” “q” and “d” are all the same symbol oriented in different ways. Dysnemkinesics will not see this symbol as being different letters when oriented differently and will confuse them. Consequently, Dysnemkinesics tend to transpose letters and syllables, exhibit faulty eye movements, demonstrate excessive reversals, and have spatial difficulties. They often have poor sight recognition, and tend to have trouble building up a sight vocabulary. Reading tends to be slow and difficult, since they often read and spell phonetically. Dysnemkinesia is the easiest type of dyslexia to identify and treat by an optometrist skilled in vision training.

http://www.visiontherapystories.org/dyslexia_eyesight.html

http://www.visionhelp.com/dyslexia.htm

http://www.optometrists.org/therapists_teachers/dyslexia_dyslexic_vision.html

4. What is the best dyslexia test?

IMPORTANT: Dyslexia cannot be officially diagnosed using one single test. That’s because dyslexia can be mild, moderate, severe, or profound.

Also, dyslexia can impact many different areas.

That’s why a Dyslexia Testing Specialist will use from 10 to 12 tests to investigate every area that might be impacted by dyslexia.

Dyslexia should be diagnosed by a psychologist. I recommend educational psychologists who understand visual processing as well as auditory processing ability.

A standard battery of tests can include, but is not limited to, the following:

  1. Wechsler Intelligence Scale for Children-Third Edition (WISC-III)
  2. Kaufman Assessment Battery for Children (KABC)
  3. Stanford-Binet Intelligence Scale
  4. Woodcock-Johnson Psycho-Educational Battery
  5. Peabody Individual Achievement Tests-Revised (PIAT)
  6. Wechsler Individual Achievement Tests (WIAT)
  7. Kaufman Tests of Educational Achievement (KTEA)
  8. Bender Gestalt Test of Visual Motor Perception
  9. Beery Developmental Test of Visual-Motor Integration
  10. Motor-Free Visual Perception Test
  11. Visual Aural Digit Span Test (VADS)
  12. Test of Auditory Perception (TAPS)
  13. Test of Visual Perception (TVPS)
  14. Peabody Picture Vocabulary Test-Revised
  15. Expressive One-Word Picture Vocabulary Test
  16. Test for Auditory Comprehension of Language

http://www.medicinenet.com/dyslexia/article.htm

http://www.dys-add.com/testing.html