Monthly Archives: August 2014

Does homework in your household drag on for hours? Convergence insufficiency could be the cause

If your child spends hours completing homework each evening, your initial frustration might be with his teacher. You may complain that too much homework is being assigned and worry that the school is to blame for interfering with family time, play time, or outdoor and extracurricular activities; but over time, you eventually realize that your child is taking much longer to complete his homework than his peers.

You know that your child is bright, so why is he struggling to complete homework in a timely manner? You could suspect a learning disability or attention deficit disorder, but your child could actually have a vision disorder, even if he was found to have “20/20” eyesight during a vision screening at school or an exam by your family’s eye doctor.

Vision disorders and poor visual processing skills are sometimes to blame for “homework wars” and poor performance in the classroom.

As a parent, it is important to pay close attention to your child’s symptoms. You might be tempted to dismiss complaints as excuses and urge your child to push forward and try harder. However, if your child has a vision problem such as convergence insufficiency, his symptoms could be presenting significant challenges to performing well on school assignments.

Convergence–the ability to aim ones eyes at a near distance–is a required skill for reading and other schoolwork. Children with a healthy visual system are able to aim their eyes naturally and easily.

Convergence insufficiency is a medical condition in which the brain has trouble accurately, efficiently, and comfortably coordinating the eye muscles to see properly for a prolonged period of time at reading distance.

If your child often complains of headaches or claims that his eyes hurt, feel like they are pulling, tired, or uncomfortable, this could be a sign of convergence insufficiency. Difficulty concentrating or remembering what he has read could be symptoms as well. A child may also complain of double vision, or say that that words float, swim, or move in and out of focus. He may read slowly, lose his place, or read the same line more than once.

If your child is having difficulty in school or completing homework, and you notice any of these red flags, schedule an evaluation with a functional or developmental optometrist, trained to detect and treat learning-related vision problems, as soon as possible. If diagnosed with a vision problem such as convergence insufficiency, the good news is vision therapy can treat and improve your child’s convergence problem significantly and quickly.

If you are in the Olney, MD or Silver Spring, MD area, contact the Visual Learning Center today to schedule a comprehensive evaluation with Dr. Philip Nicholson and his staff.

What Appears to be Attention Deficit Disorder Could be a Vision Problem

Have you received a note from school saying your son or daughter is having difficulty paying attention? Did your child’s teacher or counselor recommend testing for attention deficit disorder (ADD/ADHD)?

Teachers might describe your child as distracted or antsy, report that your child daydreams in class, stares out the window, or looks around the room when he should be focusing on his paper or the board. You may have noticed that your child has a short attention span, trouble reading, and difficulty staying on task or following instructions.

Your pediatrician or a pediatric psychiatrist might have diagnosed your child with attention deficit disorder and prescribed medication, such as Ritalin or Adderall.  No parent wants this diagnosis for their child or to medicate their child unnecessarily. But if a child truly has attention deficit disorder, caring parents want what’s best, so the child can improve, learn, settle down, behave, feel more in control, and get along better with peers. If a child does have ADD/ADHD, proper treatment can work wonders.

However, some children are misdiagnosed with attention deficit disorder, when the symptoms they are experiencing are actually related to a vision disorder. Many parents only learn that vision can be at the root of the problem when a child’s behavior and attention does not improve with treatment for attention deficit disorder.

Vision is not usually suspected. Suggestions that a vision problem could be to blame are often initially dismissed; because after all, most children undergo vision screening at school or have an annual exam by their family eye doctor. The child either has “20/20 vision” or he already wears corrective lenses.

However, “20/20 vision” is not enough, as it simply indicates that a patient can see clearly at 20 feet of distance. It does not test how well the child can see close up, how eyes function when they move across a page or from a desk to the board and back again. Screening for 20/20 eye sight also does not assess how well visual processing works, meaning there is no measurement of how well the child is able to remember or make sense of what he sees.

In fact, the eye chart test only catches a small percentage of vision problems. Unfortunately, screening for distance only is outdated and inadequate, considering the tasks and learning activities children need to complete in school.

When a child has a learning-related vision problem and his visual processing skills are weak, he must put forth a tremendous amount of extra effort just to keep his eyes turned correctly, focused, aligned, and recall or process what he is learning. This extra effort can cause fatigue, headaches, and unease.

As a result of experiencing visual difficulties, the child may choose to stare into space, respond to irritability by moving around or choosing an activity that does not cause as much stress on his visual system, or react to his frustration with disruptive behavior. What appears to be daydreaming, distraction, or ‘acting out’ may simply be avoidance or coping behaviors. He does not understand that something is wrong; he is simply adapting to his environment and expectations as best he can.

If your child’s attention or behavioral problem is resulting from a vision deficiency, the good news is a personalized intensive vision therapy program can result in significant and lasting improvement within a relatively short period of time.

To be clear, not all attention problems are related to vision. A child may be dealing with neurological, psychological, nutritional, environmental, auditory processing, or any number of factors. Vision therapy only helps with attention and behavioral problems if a child has a vision problem.

To determine if your child has a vision problem that may be affecting his attention or behavior, he should undergo a functional vision exam and through vision assessment by an optometrist that specializes in functional and developmental vision care.

If you suspect a vision problem, or you want to rule out a vision problem in your child, and you live near Olney, MD or Silver Spring, MD, contact us to schedule an appointment with the Visual Learning Center.

What’s the difference between “Instantaneous Testing” and “Performance Based Testing ”?

Any typical vision exam always includes a check for clear vision. School screenings, pediatrician screenings, and visits to an eye doctor (Optometrist or Ophthalmologist) will follow procedures necessary to check for clear eyesight.

However, if eye exam results indicate clear eyesight, it is important for you to understand that this does not mean your child has been cleared of having a vision problem that may interfere with learning. Too often, after years of struggle, we find children with serious vision problems that easily passed all prior vision testing.

According to the educators Allen and Virginia Crane, in their book Buzzards to Bluebirds (Wolf Creek Endeavors) the key is performance based testing.  The Cranes described a regular eyeglass or medical eye exam as “Instantaneous testing.” This type of testing determines if the child has “clear and single vision” right now, right here.

But if the child does have “clear and single vision” during the exam, the unanswered question is: “can they sustain that clear single vision for a sustained period of time?” To understand how a child can pass a vision screening and also have a serious vision problem that interferes with learning, it is critical that you are aware of this difference.

Viewing the letters on an eye exam chart for a few seconds is not the same as viewing text on a book’s page, the screen of an electronic device, or words on a whiteboard at school. Learning-related activities require repeated and coordinated eye movements, prolonged effort, and visual skills that require processing and associate meaning with images.

Many vision problems will remain hidden if a child with learning problems is not properly evaluated. “Performance based testing” is exactly what a functional or developmental vision exam is. It seeks to determine whether the child is ready to learn visually.

An optometrist who specializes in functional or developmental optometry is trained to test the following areas of performance in your child:

  • Processing speed and accuracy: Reading words, sentences and numbers quickly and accurately
  • Selective concentration: Staying on a visual task, even with distractions present
  • Visual memory: Accurately remembering what is seen
  • Letter reversals: Confusing letters such as b, d, p and q.
  • Visual-motor integration and speed:  Eye-hand coordination and speed
  • Visualization: Creating a mental picture in the mind that is used to solve a problem

Before you can determine whether or not your child has a vision problem, you have to rule out performance based vision problems. For more information and to download our free guide “10 things you need to know about vision” please click here.

Dr. Philip Nicholson is an Optometrist who specializes in functional and developmental vision care located in Olney, MD, convenient to Silver Spring, MD.  If you suspect your child might have a vision problem that is interfering with learning, contact us to schedule an appointment for a thorough vision assessment.  The good news is, if your child does have a learning-related vision problem, a vision therapy program can help.

Is vision therapy a “proven therapy” or is it “quackery”?

Vision therapy is a proven therapy that is well-documented in medical journals, scientific literature, and supported by the National Institutes of Health (NIH) in Bethesda, MD, not far from our center.

Despite vision therapy’s solid reputation in the scientific community, awareness about learning-related vision problems and vision therapy’s effectiveness is not widespread. Lack of familiarity sometimes creates a healthy dose of skepticism, which we discuss regularly with parents.

When you learn about something new that challenges previously held beliefs, it is natural to view it with a critical eye. If a child has considerable difficulty reading or writing, your first thoughts are likely to suspect a learning disability or dyslexia. If a child has attention or behavioral problems, popular opinions point to attention deficit disorders (ADD/ADHD).

Learning-related vision problems may be new on your radar; and as a parent, caregiver, teacher, or pediatric occupational therapist, it is your duty to scrutinize new information and work in a child’s best interest.

Obviously no doctor or practice ever wants to be accused of quackery or placed in the same category as a snake oil salesmen. Vision therapy is sometimes confused with “the Bates Method” or the “See Clearly Method” which do not have the same scientific basis or reputation as vision therapy, which is known in the medical literature as Orthoptic Therapy.

Rest assured, vision therapy has been proven effective in treating visual processing problems.

The NIH published results of a study, which proved vision therapy’s efficacy for the most common problems we find in students struggling in school. The Journal of the American Optometric Association has published articles about vision therapy’s effectiveness citing more than 260 peer-reviewed journals.

The reason you are not more familiar with vision therapy is simply that you have not read the studies and journals, and the information has not been picked up by the media or distributed through other outlets. As practitioners of vision therapy, it is our job to inform you about it, and you will find many helpful resources on our website about it.

At the Visual Learning Center, our vision therapy program is based on the latest scientific studies, and we have a proven track record of vision therapy success. Learn more about visual processing skill deficiencies and vision therapy by downloading this guide and watching this webinar.

We offer vision therapy to children and adolescents with learning-related vision problems in our Olney, MD, office, which is convenient to families in Silver Spring.