Monthly Archives: August 2014

child reading below grade level

Is Your Child Reading Below Grade Level?

Are you concerned that your child is reading below grade level? Many children find learning to read challenging, but some students struggle significantly more than others and fall behind their peers in their reading assessment scores.

Reading assessments measure factors such as vocabulary, decoding skills, and reading comprehension. The tests serve to identify reading competencies in individual students relative to a set standard.

When a student is considered to be reading at grade level, that child’s reading assessment score falls within the approximate range of the average score of a normalized standard sample of students in that grade level group.

When a student is considered to be reading below grade level, it generally means the child’s reading assessment score was lower than the average assessment score of students in the normalized standard sample for his grade level.

Some critics challenge the fairness of grade-level standards, arguing that the results only reflect how students performed relative to other students, rather than measuring the achievement of a certain proficiency. The relative nature of a grade-level standard does not take into account environmental factors and various advantages or disadvantages.

However, if a student is not doing as well as his peers or performing up to expectations on reading assessments, you will want to look into all possible causes.      

One common, but often overlooked, problem that may be hindering your child’s ability to read at grade level could be a functional vision problem that interferes with learning. A vision problem can cause a student to read below grade level, even with “20/20” eyesight.

Unlike typical eye exams, school standardized tests and reading assessments may require activities that are challenging for a child with a learning-related vision problem.

Routine vision screenings involve little more than testing to see if the child can see clearly at a distance for a few moments. Reading assessments and standardized tests often require intense and sustained focusing of the eyes for a prolonged period time, looking from the problem to the answer sheet repeatedly, and the ability to bubble-in answers without losing his place.

Undergoing assessments and testing for hours can intensify a problem that was not otherwise apparent during classroom or other reading activities, because the child’s eyes can become even more strained and tired than usual.

Poor visual skills that interfere with reading assessment performance include visual processing speed and accuracy, visual memory, selective concentration, visual-motor integration and speed, and visualization.

A few examples of learning-related vision problems that may cause a child to read below grade level include:

Eye tracking problems

Eye tracking skills are the eye movements we use to scan a line of text. Even in a normal healthy visual system, these movements are not smooth, left-to-right shifts. Instead, the movements are a series of “jumps” and “fixations.”

Reading requires the eye to jump across text and fixate on certain points; with each fixation, we take in either a whole word or part of a word while the eye is momentarily stationary. We decode and process each word, and then our eyes fixate on the next word and pause briefly to decode and process it.

Eye tracking problems can contribute to below grade level scores on a reading assessment.

Accommodative dysfunction:

An accommodative (eye focusing) disorder causes a person to have trouble using eye muscles efficiently to bring an object into focus clearly or to maintain focus for a sustained period of time. The muscles that focus the lenses in our eyes need to adjust often and quickly to see various visual points and planes clearly, or to sustain that clear focus over a period of time without vision becoming fuzzy or blurred.

If a child is struggling to focus his eyes during a reading assessment, he will see blurred text and slow down, contributing to a possible lower score.

Amblyopia (lazy eye)

Amblyopia causes reduced vision in one eye due to an abnormal or unhealthy connection between the child’s eyes and brain, which occurred during developmental stages. This common deficiency causes the brain to favor one eye over the other and suppresses images from the affected eye. Strabismus, for example, is a condition in which the eye is either constantly or intermittently turned, usually inward or outward, and the eye that points straight becomes dominant.

When a child’s brain preferences one eye over the other, the deficiency can cause strain or headaches, which can lead to reading below grade level.

Visual Processing Deficiencies

Many bright children lack good visual processing skills. Normal visual processing requires a complex system of neurological activity to develop and function properly. Because of a visual disorder or visual system developmental delay, a child may have trouble computing visual input, which can lead to difficulties with visual memory, visual-motor integration and speed, visualization, or other problems.

For example, visualization is the ability to create a mental image in one’s mind, which is important for processing and remembering information for comprehension. Visual memory is the ability to retain information that you have learned–to recognize and remember a word from one page to the next, and one day to the next. Reading requires the ability to create images of words and to recall words or set of words as needed.

Poor visual processing skills may cause a child to read below grade level.

To learn more about how important vision is to your child’s ability to read, download our free guide here and watch our pre-recorded webinar here.

If a vision problem is what’s preventing your child from reading at grade level, the good news is vision therapy can help.

The first step is to schedule an evaluation with a functional or developmental optometrist, trained to detect and treat learning-related vision problems, as soon as possible.

For a functional vision exam and vision therapy in Olney, Maryland or the Silver Spring area, contact the Visual Learning Center today to schedule a comprehensive evaluation with Dr. Philip Nicholson and his staff.

letter reversals

Letter Reversals: Is it dyslexia or something else?


When parents notice a child reversing letters, they often suspect that the child could potentially have dyslexia. Dyslexia is a language-based learning disability that causes difficulty with reading, writing, and spelling.

Writing letters in reverse is one of the most well-known and recognizable signs that a child may have dyslexia. So when a child is experiencing difficulty learning to read and also reverses letters, it’s reasonable to speculate that dyslexia could be to blame.

However, many parents and educators are unaware that letter reversals are also a common symptom of vision problems, such as eye movement disorders and visual processing deficiencies.

Click here to learn more about how vision problems interfere with learning.

If you notice that your preschooler through first grader is reversing letters, there’s no reason to be concerned. When a child is learning to read and write, confusing left with right and writing letters backwards is a perfectly normal part of the early development process. But if you notice that your child is still reversing letters in second grade and beyond, it’s time for a proper evaluation — a comprehensive vision exam by a developmental optometrist who specializes in functional vision care and vision therapy.

Typical vision screenings do not test for the learning-related vision problems that have similar symptoms to dyslexia. An exam by your family eye doctor usually only evaluates clarity of vision at a distance. So it is important to note that children with 20/20 eyesight may also have a vision disorder.

In addition to reversing letters, children with learning-related vision problems face many of the same challenges as children with dyslexia. They may confuse left with right and transpose words, have messy handwriting, experience and experience difficulty with peripheral vision and depth perception. Many struggle with reading comprehension. Some also have trouble staying on task and paying attention.

transposing letters and letter reversals


There are subtle differences between the symptoms of some vision disorders and dyslexia. Even a professional trained to recognize dyslexia may not suspect a vision deficiency without specific awareness.

Whereas dyslexia is a lifelong learning disability that many people learn to cope with successfully, functional vision problems can be treated and overcome. That’s why if you suspect dyslexia, it would be in your child’s best interest to rule out a functional vision problem that can be treated successfully with vision therapy.

To be clear, vision therapy does not cure dyslexia, but learning-related vision deficiencies that have symptoms similar to dyslexia can be improved and even eliminated by vision therapy. 

See our vision therapy success stories.

This video demonstrates a vision therapy activity that can improve letter reversals in children with vision problems:

Click here to learn more about this vision therapy activity.

To schedule a comprehensive functional vision exam and to learn more about vision therapy in Olney Maryland or Silver Spring, Maryland, contact Dr. Philip Nicholson’s Visual Learning Center.