80% of learning at school is done through the visual system, meaning vision problems can play a huge role in struggles at school. But most vision problems don’t have easily detectable symptoms, and the symptoms presented can be mistaken for various learning and behavioural problems in kids.
Here are some common symptoms that could be due to visual problems:
- Talking/interrupting in class
- Refusal to read/do homework
- Not following directions
- Not working well alone
- Inability to play/study quietly
- Easily frustrated
- Lacking motivation
- Forgetting/lying about doing homework
They might have medical symptoms as well:
- Eyestrain/eye fatigue
- Itchy, watery or burning eyes
- Double vision
- Poor hand-eye coordination
- Dizziness/motion sickness
A child with undetected vision problems may get frustrated or bored in school because they can’t see the board or read easily. This can lead to the child acting out, which then leads to suspicions of ADHD, autism, or behavioural problems. Studies have shown that 60% of children diagnosed with a learning problem actually suffer from undetected vision problems. And 20% of all school age children are affected by visual dysfunctions, whether they are diagnosed or not.
Now that we are at the beginning of a new school year, many kids will be struggling in school and showing signs of learning or behavioural problems. For many of these kids, visual problems are affecting their concentration, their self-esteem, and their overall success in school.
Why aren’t regular vision tests catching these issues? It’s because typical screenings only test for 20/20 vision, and do not look for issues with tracking, convergence, binocular coordination or focus. A child can have 20/20 vision and still suffer from these other problems. Here are some vision problems that commonly lead to behavioural issues:
- Strabismus (crossed or misaligned eyes)
- Lazy eye (weak eye-brain connection)
- Convergence insufficiency (difficulty focusing the eyes inward)
- Eye teamwork
- Eye Tracking
- Visual perception deficiencies
Children with these vision problems are often characterized as being difficult children by their teachers and parents, when in reality they don’t have the visual skills to stay focused on the material. And to top it off, they can’t communicate these vision problems because they aren’t aware that they are seeing differently – they’ve never seen any other way.
Once diagnosed correctly with a visual dysfunction, however, vision therapy can help! A specialized vision therapy program can allow children to gain confidence and find more success in and out of school.
There is a story in the New York Times by Laura Novak entitled ’Not Autistic or Hyperactive. Just Seeing Double at Times’ which highlights this very real problem. Here’s an excerpt:
Photo by Thor Swift for The New York Times
As an infant, Raea Gragg was withdrawn and could not make eye contact. By preschool she needed to smell and squeeze every object she saw.
“She touched faces and would bring everything to mouth,” said her mother, Kara Gragg, of Lafayette, Calif. “She would go up to people, sniff them and touch their cheeks.”
Specialists conducted a battery of tests. The possible diagnoses mounted: autism spectrum disorder, neurofibromatosis, attention-deficit hyperactivity disorder, anxiety disorder.
A behavioral pediatrician prescribed three drugs for attention deficit and depression. The only constant was that Raea, now 9, did anything she could to avoid reading and writing.
Though she had already had two eye exams, finding her vision was 20/20, this year a school reading specialist suggested another. And this time the optometrist did what no one else had: he put his finger on Raea’s nose and moved it in and out. Her eyes jumped all over the place.
Within minutes he had the diagnosis: convergence insufficiency, in which the patient sees double because the eyes cannot work together at close range.
For Raea Gragg, the treatment was relatively simple. For nine months she wore special glasses that use prisms to help the eyes converge inward. She then had three months of vision therapy. She has just entered fourth grade and is reading at grade level.
“Raea didn’t know how to describe it because that’s all she’s ever known,” her mother said. “She felt like she had been telling us all along that she couldn’t see, but nobody listened.”
Here’s another example from an article on Today’s Parent, ‘Learning begins with your child’s vision’:
Photo from Today’s Parent
Melanie Mutch, a mom of two in Miramichi, N.B. gets emotional when describing how a chance encounter with a Doctor of Optometry nine years ago solved her daughter’s learning challenges – and much more.
At five, Lindsay repeated kindergarten, having been held back due to lagging literacy skills. She had a speech delay and sometimes failed to follow instructions, leading teachers to conclude she had behaviour issues, and might even be autistic. Even physical activities posed problems; in her second season of skating lessons, Lindsay still wasn’t able to stand up on her blades.
“We had Lindsay’s hearing tested. We took her to a child psychologist, who told us she wasn’t autistic and didn’t have ADHD. We even had an occupational therapist do a coordination and reflex test,” Melanie recalls. Consultations with a speech-language pathologist and behavioural analyst didn’t yield answers either.
The day everything changed, the Mutch family was at the office of Doctor of Optometry Greg MacDiarmid for their older son’s eye exam. Lindsay was in the waiting room when Dr. MacDiarmid came out to share his findings about her brother. Something about Lindsay’s manner and expression prompted him to ask about her vision history.
Melanie told him that Lindsay had been screened through a public health program, which was part of the preschool entry process. When Dr. MacDiarmid explained that the screening test would not pick up every problem, they discussed Lindsay’s school struggles and agreed to have her eyes examined.
It turned out that Lindsay was very far-sighted, meaning her eye muscles had to strain to focus up close. Essentially, “she could sustain that just long enough to pass the screening test,” says Dr. MacDiarmid.
But it wasn’t until Lindsay’s new glasses were ready that it became clear just how much they would change her life. Overnight, Lindsay’s reading level skyrocketed. Within weeks, she was skating in her club’s annual ice show. And, once every bit of her mental bandwidth was no longer required to simply stand without falling, Lindsay’s speech delay disappeared. “We’re so thankful we went to the optometrist,” says Melanie. “It just changed Lindsay’s life in so many ways.”
So how can you find out if vision problems are the culprit to learning and behavioural issues for your child? Take them in to a Behavioral Optometrist who can conduct a comprehensive eye exam on all areas of vision.
By Dr. Nazima Sangha of Family Eyecare Centre