Monthly Archives: August 2014

Can an attention problem actually be a vision problem?

Many parents question their child’s attention span. When a child will not sit still, stay focused on a task long enough to complete it, stares into space too often, hops from subject to subject, jumps from activity to activity, or simply appears to have too much energy, the child’s spirited behavior can go from charming to concerning to, in some cases, alarming.

Could there be a problem with your child’s attention span?

You may wonder how long a normal attention span is, begin to compare your child’s attention span to those of their friends, and you may even start to suspect that your child has an attention problem, such as Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD).

Attention disorder diagnoses have become commonplace. However, most parents, teachers, and even trained psychologists and other professionals are unaware that childhood behavior that appears to be an attention problem could actually be caused by a vision problem in disguise.

Unfortunately, many parents only begin looking for alternative causes to attention problems when diagnosis, treatment, and medication for ADD/ADHD does not improve a child’s behavior or performance in school. This is because awareness about learning-related and behavioral-related vision problems is not as widely spread as knowledge of attention deficit disorders.

Attention is the ability to focus consciousness on a task. Studies show attention is the most essential factor for academic success; and in order for a student to be successful, he or she must first come to attention and then maintain attention on the task at hand. In school, these attention requirements largely involve strong visual processing skills.

What does attention have to do with vision?

The ability to stay on a task is often adversely affected by poor visual processing skills. If a child is unable to keep his or her eyes aimed properly, for prolonged periods, comfortably and easily, this deficit in the functioning of their eyes and visual processing system can interfere with their ability to maintain attention.

When visual processing skills are weak, the effort a student must put forth to keep their eyes turned correctly, aligned, and focused can cause unease, fatigue, and headaches. It’s easier and more natural for the child to give up on a task that requires sustained focus and move on to an activity that allows for more sporadic and unfocused eye movement. Talking in class and moving around the room causes far less frustration for them than aiming their eyes at the text on a paper in front of them, on a screen, or on the board.

Unable to enjoy the ease many of their peers experience in remaining focused on a visual task, a student may choose to doodle, talk in class, act out, or cause disruptions. So what looks like ADD/ADHD could very well be the result of a vision problem.

Research shows visual attention skills can be dramatically improved with intense, one-on-one vision training, also known as vision therapy.

In Olney, MD and convenient to Silver Spring and surrounding areas, Dr. Philip Nicholson, OD’s Visual Learning Center provides comprehensive evaluations to determine if your child might significantly benefit from vision therapy.

girl reading

How will vision therapy help my child in reading?


Although it may not seem apparent at first, reading can be extremely difficult for a child with visual problems. When learning-related vision problems go undetected, a child might seem to be picking up on words and demonstrating comprehension initially, but overall performance and literacy will suffer.

Studies have revealed that the greater the amount of effort a child must put forth to read, the lower the child’s overall reading performance and comprehension will be. Reading requires prolonged fixation on reading materials, so the effort necessary to read is particularly challenging if the child has visual deficiencies, such as oculomotor and binocular weakness.

For a person to read, it is necessary for the two eyes to be properly aimed at text, so the eyes must turn inward. For some children, the eyes will naturally turn outward; and this deviation — even if slight and unnoticeable to parents or teachers — means that the child must use excess effort and energy to maintain fixation on the reading material.

If a child is unable to aim his or her eyes inwardly easily, he or she may not see every word in sequential order.  Instead, the child’s eyes may skip words or phrases, bounce around the text, and land at words sporadically.

A parent or teacher might notice that a student omits or adds words to make sense of a sentence, without actually seeing those words.

A child may be seeing double due to overlapping vision and experiencing headaches and eye fatigue as a result. But the child is often unable to express “seeing double” because he or she is unaware that the way they are seeing is not the correct way to see.

Vision therapy or vision training treats and quickly improves eye disorders by facilitating exercises and activities that strengthen existing weaknesses within the visual processing system.

Many children who participate in our vision therapy programs in Olney, Md. come to us having tested far below their current age levels in sensory skills, such as those related to oculomotor or binocular weakness.  Upon completing therapy, they retake the initial screening tests with impressive results.

Read some of our vision training success stories to learn more about how vision therapy can help your child in reading.  Contact us to learn more about how vision training can improve speed and accuracy of eye movements, visual concentration, letter reversals and other skills, making learning easier, faster, and more enjoyable.

Do Children Who Reverse Letters Actually See Them Backwards?

Children are introduced to letters when they learn to read, spell, and write. And although most children are able to differentiate between similarly shaped letters, such as b and d, or q and p, early in the learning process, some students struggle with reversing letters as they read or write them.

Difficulty with letter reversals is not uncommon; however, when parents notice that their child is having a problem with letter reversals, sometimes it causes alarm.  Many parents assume letter reversals are automatically signs of dyslexia or a learning disability.

In many cases, reversing letters early in the learning process is simply a matter of trial and error while acquiring a new skill.  Imagine looking at an alphabet through a young child’s eyes and trying to remember what each letter looks like and sounds like. It’s easy to make mistakes, including letter reversals. A ‘b’ simply looks similar to a ‘d‘ for a new learner.

With practice and coaching, most children will quickly improve. In some cases, children who reverse letters persistently actually have dyslexia, and parents will need to seek proper professional help. But in often-overlooked cases, children are reversing letters because of a learning-related vision problem.

Does this mean children who reverse letters because of a vision problem actually see the letters backwards?

Not quite. Children who reverse letters and numbers do NOT actually see them backwards.  Letter reversals are a symptom of poor laterality and directionality concepts.  This means their vision is not yet trained to process the letter in one particular direction, and they may require vision therapy (also known as vision training) to correct the problem.

Parents should also note that just because a child writes a letter correctly does not mean the child is processing the letter accurately and easily. Children with symptoms of letter reversals often do not reveal these symptoms through their handwriting; sometimes, only when asked to decode and identify letters, will children show poor ability. 

It is possible that weakness in laterality and directionality, which manifests in reversing letters, can slow work down and cause confusion of word meanings. Poor eye tracking is also linked to problems with letter reversals.  So while children who struggle with letter reversals are not seeing letters backwards, they are having trouble processing the letter visually, which contributes to learning difficulties. The good news is, vision therapy or vision training usually results in rapid improvement.

If your child is reversing letters, click here to see if he or she might benefit from a comprehensive exam, or contact us to schedule an exam in our Olney, MD office.

Can Vision Therapy Treat Signs of Dyslexia?

Visual Learning 1

When a child has difficulty learning to read, despite normal to above-average intelligence, teachers and parents often suspect that the child may have a learning difficulty, such as dyslexia.

However, what looks like a learning disability might actually be an overlooked vision problem. Many children are misdiagnosed as dyslexic without thorough vision screening by an optometrist trained in functional and developmental vision care. Standard eye exams will not detect problems that affect reading.

Some of the most commonly recognized signs of dyslexia include transposing letters, writing words in reverse order, and letter reversals. So when a students’ writing includes letter reversals, the adults in their lives may jump to the conclusion that the child is dyslexic. Most people are not aware of other possible diagnoses that can be confused with dyslexia, included vision problems.

Other signs of dyslexia that could also be symptoms of a visual problem include losing place while reading or reading words that are not on the page. The child may also complain of eyestrain and headaches, and he or she may resist reading or attempt to avoid reading altogether. While these signs and behaviors are all-too-often assumed to be dyslexia or other learning disabilities, the student may not actually have trouble learning.

Professionals who are trained to recognize visual problems may suggest an alternative diagnosis — poor visual processing skills. The good news is that visual processing skills can be improved dramatically and quickly with vision therapy.

So while vision therapy does not treat learning disabilities or reading difficulties due to dyslexia, vision therapy does treat vision problems that interfere with reading.

If a child does have true dyslexia, that will need to be addressed by the appropriate professionals. But vision therapy can help develop the visual skills the child may be lacking. In this way, reading interventions provided by other professionals will have the best chance of success.

On the other hand, if teachers or parents suspect a child is struggling with dyslexia, common red flags such as letter reversals might not be symptoms of dyslexia at all. If these symptoms turn out to be due to a vision problem. vision therapy will help significantly.
If your child has been diagnosed with or suspected of having dyslexia, click here to learn more and take our online assessments.