WHEN GLASSES AREN'T ENOUGH

"When my son's eyes were examined the optometrist found that he had 20/20 vision, but he is still struggling in the classroom."
 
"My child was found to be shortsighted. Glasses helped her to see more clearly but her teacher reports that her reading is not what it should be
 

The majority of people are born with the potential for good eyesight, but the ability to interpret and understand what is seen is a learned skill which begins to develop from birth. Visual skills include being able to focus, fixate and use both eyes together in order to be able to process visual information. As well as this, there needs to be coordination between the eyes, the other senses and the brain. Problems in any of these areas may manifest as learning problems. Being able to read letters on an eye chart may not guarantee that a child has adequate skills for reading and learning. While glasses may be beneficial for a child with acuity problems, vision therapy may be necessary to address the issue of visual perceptual problems.
 
Vision therapy is an individualised supervised treatment programme designed to correct visual perceptual deficiencies. The goal of vision therapy is to train the child's brain to use the eyes to receive information effectively, comprehend it quickly and react appropriately. Vision therapy can play an important role in the overall treatment of a child's learning problem. As well as eyestrain, headaches and double vision, children with learning difficulties often experience feelings of frustration, lack of confidence and low self-esteem. Although many children with learning problems have average to above average intelligence, they feel that they are not as smart as other children, and this may impact on their behaviour, motivation and social interaction. Correcting the vision problems can have a positive impact in all areas of the child's functioning and help him to reach his potential.
 
Following a comprehensive assessment, a therapy plan is created to address the child's specific areas of difficulty. Vision therapy programmes are individually designed for each child based on the severity of the conditions being treated and the child's motivation and level of readiness.
 
Vision therapy sessions include procedures designed to develop and enhance the following skills:
 
 Visual attention and figure-ground perception - the ability to focus on important visual information while filtering out irrelevant background information, for example identifying the first letter of a word or finding a particular word in a list of words;

 Tracking - the ability to follow a line of text or a moving object smoothly and accurately with both eyes, for example a ball in the air or the words in a sentence;

 Fixation - the ability to use both eyes at once to quickly and accurately locate a series of stationary objects, such as words on a page while reading;

 Focusing - the ability to look quickly from something close by to something further away and vice versa while maintaining clear vision, for example from the teacher to a book or a book to a computer screen;

 Peripheral vision – the ability to monitor and interpret what is happening around one and gather visual information from a wide area while focusing on something specific;

 Depth Perception - the ability to judge the relative distance of objects, and to see and move accurately in three-dimensional space, such as when hitting a ball or being aware of the position of words and letters on a page and in relation to each other;

 Binocularity or eye teaming - the ability to smoothly, equally, simultaneously and accurately use both eyes together;

 Visual discrimination – the ability to visually recognise differences and similarities, for example between numbers or letters;

 Visualisation – the ability to form mental images in the mind's eye, to retain and store information for future recall, and to create new ideas.

As well as working on these specific skills, vision therapy helps children to maintain their attention on a task without being distracted.
 
Vision therapy utilises procedures, programmes and activities designed to enhance and improve specific visual perceptual skills. Optical devices such as therapeutic lenses, prisms or tinted filters may be used. Computers have produced major advancements in the administration of vision therapy. State-of-the-art technology and software allow vision therapists to offer their clients challenging programmes for the enhancement of their visual skills.
 
Visual therapy sessions usually take place in the therapist's rooms, but eye exercises may be given for the child to do at home under parental supervision, to reinforce what has been achieved during the therapy session. Emphasis is placed on integrating the visual skills with the other perceptual skills that are essential to the learning process. Generalising the newly acquired visual abilities to the activities of daily life allows these new visual skills to become self-reinforcing and efficient vision becomes a habit.
 
Vision therapy has proven to be effective in helping children with learning-related visual problems. As with most problems, the earlier visual perceptual deficits are detected and treated, the better the prognosis for future schooling. Enhancing the skills of the young child who is struggling to learn to read will make it easier for him to read to learn later in his school career.