The Visual Learning Center provides the diagnosis and treatment of many visual disorders that can have a profound impact on learning. Often students suffer unknowingly because they have passed a school screening and believe their vision is normal. Vision is much more complex than the ability to read a chart on the wall
Make sure you view our video page.
If you know someone with learning problems or who complains of eyestrain you should have them complete our checklist and call our office for more information.
We offer many educational resources and opportunities for those who want to know how visual problems can affect learning.
Need medical proof that vision therapy is effective? Visual Learning Center provides in office based vision therapy (OBVAT) as shown to be the treatment of choice for Convergence insufficiency according to the CITT study.
- Learn more about vision therapy
- Read success stories of patients who have had vision therapy
- Learn more about visual disorders that benefit from vision therapy
- Read research on the effectiveness of vision therapy
- Download more information on vision therapy
- Learn more at other web sites
- View a video on Vision in the Classroom or Vision and Learning
Contact us if you are interested in:
- Attending a vision and learning seminar to learn how to test your students for visual problems.
- Scheduling Dr. Doud to speak with your group about vision and learning.
Register for our mailing list to keep updated on vision and learning. Scroll down for the following topics:
When it's not working, a child's visual system can contribute to learning problems. Professionals have also found that often it's not "memory," "attention span" or "intelligence" that causes children problems in school. It is a lag in their ability to recognize what they see, relate it to what they already know and then use it as a base for future understanding.
Sound complicated? It is, a little. A child's ability to perform visual tasks (such as reading and studying) depends on the ability to synchronize thinking and seeing. These work together to give a perceptual and conceptual understanding of the material and therefore gain meaning from what is taught.
Visual skills such as focusing, following moving objects, aiming, turning the eyes as a team, depth perception, and other abilities can be inefficient or poorly integrated. This can put great strain on a child. His attention is spread between trying to make the visual system work and understanding the material. Experts have found that when anyone's attention is spread between a number of tasks, it reduces the efficiency of the tasks. Think of the last time you tried to do two things at once. Was it easy? Did you do both as well as you wanted to? Or did one (or both) tasks suffer?
The ability to gain knowledge from what is seen is reduced when energy is used to see. This energy would be spent "comprehending" the information instead. With an inefficient visual system, a person works harder to gain meaning from what he is trying to see or understand.
What behavioral optometrists know is that there is a very important relationship between vision and the brain. The two work together so closely that vision and intelligence and understanding are almost synonymous.
Vision therapy serves to help patients strengthen the link between vision and intelligence. Through the use of lenses and activities, it provides a patient with both development and learning experiences. The patient experiences conditions in which the old inefficient visual habits are changed into new behaviors. More efficient vision gradually develops by replacing old habits. Once visual skills are improved through vision therapy and become subconscious, it frees up energy and focus for actual learning. The less stressed mind is freed to focus on the task at hand.
That's why so many children with severe vision problems never report them to parents or teachers. To such a child, double vision, blurred objects and the tiresome work they do when trying to read seems normal. After all, the fuzzy-looking view they see is "normal" to them!
Even before these visual symptoms appear, the youngster is attempting to cope with the visual stress. It is important to have a visual evaluation by a behavioral optometrist in order to get a preventive program started before eye damage occurs.
This makes it critical for parents and teachers to watch children for signs of vision problems. Do they see double images? Do distant objects seem blurry? Do they have to close or cover one eye to see well? (Our office can provide you with other signs and symptoms as well.)
Delaying visual care for a youngster who needs it can increase the risk that permanent vision problems will develop.
Youngsters need all three to be ready for school.
But a large number of students in all grades have another unmet need: their visual abilities aren't up to the vision demands of learning and the classroom.
Up to 80% of learning is done visually. Reading, spelling, audio-visual material, writing, chalkboard work and, in many schools, computers, are the tasks students tackle day after day. Each one requires the ability to quickly see and understand visual information at less than arm's length from the eyes.
And clear eyesight isn't all that's required for these close vision tasks. Youngsters must have a variety of eye movement, focusing and eye teaming skills for learning and for getting meaning from reading.
If these skills are missing or poorly developed, learning becomes stressful and youngsters typically react in one or a combination of several ways:
- They do the work anyway, but with lowered understanding and often experience discomfort.
- They adapt by becoming nearsighted or by suppressing the vision of one eye.
- They avoid near visual work entirely.
Behavioral optometrists provide a battery of visual performance tests that reveal these shortcomings and other potential vision problems. These tests also guide the development of a vision care program that builds needed skills and reduces the stress of seeing and understanding, especially for near work.
Special stress-relieving lenses for nearpoint work to make learning easier are widely used.
Visual training, sometimes called vision therapy, also may be prescribed to enhance focusing agility and ability, eye coordination, depth perception, side (peripheral) vision and the ability to process information taken in visually.
High school and college students also may benefit from a complete behavioral vision examination.
Before entering school, most children learn primarily through experience. Once in school, the majority of learning takes place visually (for example, copying from the chalkboard, reading from books, watching movies, etc.). In fact, nearly 85% of all learning is done visually.
An infant learns through help and guidance from his parents. He experiences movement of his body, head, arms, and legs. He also experiences use of his eyes, first locating an object visually, and then "learning" what the object is. As he grows, the child combines body movements with the movement of his eyes to learn in an integrated manner. Sometimes, for one reason or another (illness, confinement, isolation, etc.), a child may skip an "experience" stage. When this occurs, the child loses step in his normal development and growth cycle. The result is that he probably won't be ready for the visual demands school learning will make upon him.
Unless the child is "visually ready," he cannot be taught effectively how to read, write, or learn. With these deficiencies, it is not uncommon for a child to experience frustration and disappointment in school. And, a negative experience in his early school years may make his continuing education and career efforts more difficult than they need be.
If a child is not "visually ready" to learn, it does not mean that something is wrong with his eyes. Instead, it means that he is not ready to use his eyes effectively for learning. You can use the following checklist to help you observe whether your child is visually ready to learn.
"Tommy was such a good boy until he started school."
"Andy appears bright but he does so poorly in reading."
"We've done everything we could, but it seems Nancy is just a bad kid!"
Is Nancy "just a bad kid," or is she one of the millions of school-aged children who has an undetected vision problem?"
Visual problems which interfere with learning and success in the classroom may sometimes lead to behavior problems, according to optometric studies.
Some children with poor visual skills may misbehave in school or may have short attention spans. They are soon labeled "daydreamer," underachiever," "disruptive" or "learning-disabled."
Several studies on the subject of vision and its relationship to behavior problems have been conducted throughout the country.
In a San Bernardino, California, juvenile facility, it was found that 90 to 95% of juvenile delinquents had undiagnosed visual problems that contributed to their reading and comprehension deficiencies.
This is not to say that all children with deficient visual skills will become juvenile delinquents, but this and other research indicates that vision plays a significant role in academic success-which, in turn, can affect a child's behavior.
How will you know if your child has deficient visual skills? Behavior signs you can look for include closing one eye when looking at close work, rubbing their eyes, daydreaming, headaches or growing tired after a short period of reading, and avoiding close work altogether.
Tommy and Nancy may disrupt the classroom or not sit still during work time. They may concentrate for only a few minutes and may have poor test and homework scores. These behavior problems do not necessarily mean Tommy and Nancy are "bad" or "underachievers" or even "learning-disabled."
A complete examination by your behavioral optometrist will identify if your child's visual system has developed the skills necessary for school work.
Teachers are in a unique position to observe children at work and play. This is important because children seldom complain about vision problems. To these children, the world has always looked distorted or blurred. Or they have always skipped words or lines while reading. They say, "It's always been this way."
These children can't see through another's eyes, so they have no "normal" vision to compare with their own. And since they often avoid uncomfortable visual tasks, they seem to be symptom free. Yet, children do reveal learning-related vision problems in their behavior. One of the most common is a child who fails no matter hard he tries. In fact, increased effort actually interferes further with a child's ability to take in and use his visual information.
Providing appropriate vision care for children does not cure learning problems, but it does provide a solid foundation of visual abilities that a learning team can build upon.
Here is a checklist parents and teachers can use to "screen" students for learning-related vision problems. If more than one or two signs are checked, a complete behavioral optometric evaluation is in order.
- Headaches in forehead or temples when studying
- When reading, head (instead of eyes) turns to follow lines of print across the page
- Requires a finger or marker to keep place while reading
- Displays short attention span while reading or copying
- Repeatedly omits small words while reading
- Orients drawings poorly on page
- Extreme tilting of head while working at desk
- Must touch things to assist if any interpretation is required
- Writes crookedly, poorly spaced; cannot stay on ruled lines
- Repeatedly confuses left-right directions
- Confuses the same word in the same (or next) sentence
- Unable to describe what has just been read
- Whispers to self (subvocalization) for reinforcement while reading silently
- Comprehension declines as reading continues; loses interest too quickly
- Makes errors in copying from chalkboard to notebook
- Makes errors in copying from reference book to notebook
But she noticed that he was skipping over words, taking an hour to do simple reading homework and had trouble paying attention to any task that required more than a minute or two of reading.
And, Michael was beginning to fall behind the other children in his class. She just had to do something.
The hardest-to-understand aspect of vision isn't the complex interaction of brain, movement and intellect that vision entails.
It's how a person can never complain about his or her vision and still have a vision problem that seriously interferes with his or her life.
That's the problem Michael is having.
He has great distance vision, but he takes many seconds to locate, zero in on, focus and scan a word on a page.
It takes special testing to identify the kind of inefficient vision skills that make reading an ordeal to children like Michael. The ordinary eye chart adults must read when applying for a driver's license doesn't test for vision problems that only appear when the person is doing work closer than arm's length. Michael could identify the letters on the eye chart just fine.
When behavioral optometrists test children like Michael, they frequently ask that a short passage be read aloud from a book. Listen carefully and you may hear the child has learned the phonic sounds very well. But all that effort spent trying to focus and get both eyes aligned makes it hard to string all those sounds together fast enough to turn the separate sounds into a whole word or sentence.
And children like Michael also have a way of just skipping over short words.
Massive effort spent sounding out a single word doesn't mean the child knows the word, either. The same word in the next sentence or page must be sounded out again, just as laboriously as the first time. So much effort for so little understanding.
That's why Michael avoided visually demanding work whenever possible, and why he took so long to do his homework.
And by avoiding demanding visual work, he also avoided developing any complaints or symptoms. (Bad feet may not cause a limp until a person takes up jogging.)
Michael was lucky. His mother trusted her feeling that something was wrong with her son's vision.
Among many other things, learning requires the ability to distinguish small differences in form, yet many children are very poor at form perception. How can you tell whether your child needs help in building this visual ability?
Here are some common signs of form perception problems?
- Mistaking words with same or similar beginnings
- Failure to recognize the same word in the next sentence
- Reversing letters/words in writing or copying
- Confusing likenesses and minor differences
- Confusing similar beginnings and endings of words
- Confusing the same word in the same sentence
- Failure to visualize what is read
- "Drawing" with fingers to decide similarities and differences
Substandard form perception is only one of a number of visual problems that may be present in someone who still has 20/20 eyesight, and optometric visual training can be very helpful in dealing with these form perception problems.
Other signs of learning-related visual problems are outlined in the pamphlet, "Educator's Guide to Classroom Vision Problems," available by contacting your behavioral optometric office.
Writing up or down hill; irregular letter or word spacing; holding a book very close; reading at an angle; covering one eye; poor posture when working close; poor attention span; drowsiness or headache after prolonged work less than arm's length away; reports of occasionally or persistently seeing double while reading or writing.
These symptoms signal the need for optometric vision care.
By third grade, 58.3% failed. By grade five, 71.4% were found to be deficient in some of their vision skills.
Why do so many problems with vision become evident in the third grade? Is there a connection between school work and vision problems?
Grade three marks a turning point in the child's educational process. The first two grades are all about learning to read. In grade three, reading has become a tool for learning. The print in books is smaller, and there is an increasing amount of reading demanded of the student.
When a child's vision skills are poor (as the research project found), school work becomes a demanding, stress-producing task.
Behavioral optometrists find that children react in several ways to deal with this stress:
1. They avoid the work, often substituting careful listening for visual work. These children often have 20/20 eyesight since they just don't do any more visually-demanding work than is forced upon them.
2. They do the work, but suffer fatigue, eyestrain, headaches. Overcoming visual limits also divides attention and reduces the understanding of what's read.
3. They adapt in some physical way in an attempt to cope with the visual work.
Adaptations - actually maladaptations - allow a child to compensate for his or her limited visual abilities. A nearsighted child, for example, has trouble seeing distant objects, but frequently "eats up" books at a voracious rate.
Nearsightedness and many other vision problems were not common just a century ago. Neither was universal education and work requiring intensive near vision! Yet today, about 36% of the population is nearsighted-dependent on lenses to see clearly in the distance.
Behavioral optometrists find that relieving a child's near visual stress to be one of the keys to preventing many vision problems. This can be done by building visual skills and by providing stress-relieving lenses that help reduce the effort required to do other near work.
By the time a child complains about symptoms of visual maladaptations, it is difficult to implement a preventive program.
This makes it critical for parents and teachers to watch children for signs of vision problems. Do they see double images? Do distant objects seem blurry?
Delaying visual care for a youngster who needs it can increase the risk that permanent vision problems will develop.
Behavioral optometrists urge parents and teachers to watch for these early signs of developing vision problems:
- Book held very close to child's eyes
- Avoiding all possible near vision work
- Poor or twisted posture when reading
- Covering one eye with arm or hand when reading
- Headaches after reading or other near work
- Skipping words or lines while reading
- Frequent bumping into furniture or other objects
Other signs of learning-related visual problems are outlined in the pamphlet, Educator's Guide to Classroom Vision Problems, available by contacting our optometric office.
But a significant amount of research on the connection between vision and learning disabilities now suggests the need to add one more member-the behavioral optometrist.
Behavioral vision care does not teach a child to read. Behavioral care can help children whose vision is inefficient to develop better visual skills, and to avert the consequences of visual stress.
The result is that the child is better able to utilize the reading and learning help provided by the rest of the helping team.
It's comparable to building a young gymnast's sense of balance and ultra-fine control of movement. Children with this special training are more likely to advance to more sophisticated gymnastic moves than those without.
Behavioral optometrists apply a scientific model that involves looking at the whole person. A person with vision problems often has difficulties with self-esteem that has been lowered by years of school failure. Sometimes it's just that schoolwork is difficult, stressful and "too much work."
A child whose vision limits his reading ability could benefit from the help of a special tutor after he has had counter-stress lenses and optometric visual training. A child with physical problems may need the help of a pediatrician, psychologist or other specialist.
Many parents and teachers are amazed to see a child who has been doing poorly at school improve once the child received effort-reducing lenses or visual training.
Yet, these children have often had a lot of prior help from teachers. The visual intervention simply provided the visual skills the child needed to be able to better put to use what was taught.
Multi-disciplinary cooperation is vital in many vision-related problems.
Juvenile offenders benefit from behavioral vision care. However, involvement of probation officers or court-appointed counselors can help speed up the child's return to more acceptable behavior.
(From "Preschool Vision," by R.J. Apell, O.D., and R. W. Lowry, Jr., O.D., Gesell Institute of Child Development.)
Note: Many children exhibit symptoms listed below at some stage of childhood. This does not necessarily mean the child has a problem. However, if symptoms persist, a thorough preschool vision and physical examination is recommended. Every child should be examined for visual and physical learning readiness by 6 months of age.
- Seeks and needs excessive individual attention and encouragement
- Lacks self-direction when left alone
- Shows little spontaneity in play
- Has short visual and listening attention span; becomes easily bored and restless
- Restless-refuses to sit still-prefers "running around"
- Squirms, fidgets, and is hyperactive
- Ignores directions and commands
- Stubbornly persists at task that is "beyond him"
- Is easily frustrated or upset-frequently "overwhelmed" by small situations
- Destructive with toys and playthings
- Cries easily and displays temper tantrums
- Becomes upset when separated from home environment
- Suffers from car sickness
- Tires easily
- Acts babyish-behaves in manner of much younger child
- Talks baby talk
- Is difficult to understand; has trouble describing what he sees
- Shows poor motor coordination-trips and stumbles repeatedly
- May have difficulty learning to ride a bicycle or to roller skate
- Unable to dress himself
- Unable to skip
- Moves head rather than eyes when looking at objects
- Must "feel" things to "see" them
- Has little or no interest in books beyond mechanical turning of pages
- Does not question meaning of new words
- Rejects hand-eye activities such as crayon drawing and puzzles-is more interested in domestic games such as playing with dolls or dressing up
Observable Visual Behavior:
- Squints, frowns, scowls
- Blinks excessively
- Tilts and/or turns head to see
- Rubs or shuts one eye
- Complicated birth
- By-passed crawling
- Failure to creep
- Walking delayed
- Speech delayed
- Serious illness
Optometry can help in these cases where learning-by-experience has not taken place properly. Optometric visual training includes development of body movement, muscle memory, touch, hearing and speech skills-all of which must be integrated with the visual perception process.
As his skills develop in this sequence, a child's visual learning process ultimately becomes dominant. Then, he will be "visually ready" for school.