Category Archives: Learning Disabilities


Dyslexia or Learning Disability Diagnosis? Get a Second Opinion from a Developmental Optometrist

The Visual Learning Center offers
developmental optometry & vision therapy
in Olney, Maryland,  near Silver Spring.

Has your child been diagnosed with dyslexia or a learning disability? You may want to get a second opinion from a developmental optometrist.

When a child has trouble with reading, learning, or test performance, teachers and parents often suspect a learning disability or dyslexia. However, what appears to be a learning disability might actually be an undiagnosed learning-related functional vision problem that can be treated successfully with vision therapy.

Although parents would rather their child not have to face the challenges of living with a learning disability, sometimes a diagnosis can come as a relief. Now that you’ve identified the problem, you can begin working with specialists who can help your child develop healthy and productive coping strategies.

But if your child’s diagnosis is not correct, they could be struggling unnecessarily with a condition that is treatable with vision therapy.

Here’s why so many children are misdiagnosed:

  • Standard eye exams and vision screenings will not detect learning-related vision problems. So, unfortunately, many children are misdiagnosed with learning challenges without ever undergoing a comprehensive vision exam by a developmental optometrist trained in functional vision care.

  • The signs and symptoms learning-related vision problems practically mimic dyslexia and other learning disabilities, sometimes with only subtle differences.

  • Most teachers, educational specialists, and occupational therapists have never been trained to recognize the symptoms of learning-related vision problems. They receive training in detecting possible learning disabilities and other special needs. However, the majority of education professionals are unaware of how common learning-related vision problems are.

A learning disability is a neurological disorder that indicates a person’s brain is “wired” differently. Children with learning disabilities are no less intelligent than their classmates, but they may have difficulty learning through conventional teaching methods. A child with a learning disability may struggle with reading, writing, math, organizing information, memory, or with reasoning skills.

Examples of learning disabilities include auditory processing disorders (difficulty understanding spoken language), dysgraphia (difficulty with writing), dyslexia (difficulty understanding written language), dyscalculia (difficulty with math problems and concepts), and nonverbal disabilities (difficulty with spatial and facial cues).

Learning-related vision problems may present almost identically to some learning disorders. But many vision deficiencies and disorders can be significantly improved or even eliminated permanently with vision therapy.

Both a child with a learning disability and a child with a vision deficiency may:

  • Transpose, omit, substitute, and reverse words and letters when reading and writing.
  • Appear restless, fidgety, or distracted in a classroom setting or while doing homework
  • Have difficulty staying on task, paying attention, zoning out, and daydreaming
  • Have poor coordination or fine motor skills
  • Struggle with reading, writing, spelling, comprehension, and memory
  • Seem bright, articulate, and may have a high IQ, but they are unable to read, write, spell, or perform as well as expected on exams and standardized tests 
  • Learn well through hands-on experiences; dyslexics tend to be helped by being able to observe and use visual aids, but those with visual deficiencies do better with oral coaching.
  • Have difficulty with time; dyslexics have trouble with sequences and time management; those with vision problems have trouble telling time on a clock dial.

But your child might not need to learn differently. Instead, your child may need to undergo a treatment program to train and reinforce vision skills, with lasting results.

To be clear, vision therapy does not cure dyslexia, developmental delays,  or learning disabilities unrelated to vision. A child with an undetected vision disorder may be misdiagnosed with a learning disability; but a learning disability such as an auditory or language processing disorder, cannot be treated with vision therapy.

Additionally, it is important to note that many children who have learning disabilities and developmental delays also struggle with vision problems. If your child has been diagnosed with developmental delays, and they are not making expected progress from working with an occupational therapist or in another type of learning developmental therapy, it could be due to an undetected vision problem that can be treated with vision therapy.

The only way to rule out a vision problem is with a comprehensive vision exam by a developmental optometrist who specializes in functional vision care.

For a comprehensive exam and vision therapy in Olney, Maryland or Silver Spring, schedule an appointment with Dr. Philip Nicholson’s Visual Learning Center.

Register for an upcoming webinar here.

dyslexia or vision problem

Is it Dyslexia or a Visual Processing Problem?

When you notice your child reversing letters or words, your initial suspicion might be that your child has dyslexia. The truth is, reversing letters is common when children are first learning to read and write. If you notice letter reversals in Kindergarten or first grade, there is no reason to be concerned, because reversing letters, confusing left with right, and mixing up words are normal behaviors in the learning and development process. If a child continues to reverse letters and struggle with reading in second grade and beyond, it is time to start paying closer attention to other signs and symptoms.

If you suspect dyslexia, have your child evaluated by a reading specialist and your family doctor, who may refer you to a cognitive psychologist or another professional for testing. There is not one simple test to diagnose dyslexia, but instead a series of comprehensive evaluations and the systematic elimination of other problems.

Visual processing skills deficiencies and oculomotor disorders are sometimes overlooked, because awareness about how closely their symptoms overlap with dyslexia is not as widespread as it should be.

Determining whether your child has dyslexia or a vision problem is critical for your child’s well-being. Dyslexia cannot be cured, though many learn to cope with it well and succeed; however, learning-related vision deficiencies that have symptoms similar to dyslexia can be treated and even eliminated by developing skills through an individualized intensive vision therapy program.

Only an optometrist trained in developmental vision care can diagnose a learning-related vision problem through a comprehensive functional vision exam.

In both dyslexia and learning-related visual processing problems, children:

  • May confuse left with right, while dyslexics might also be ambidextrous and just as often confuse over with under.
  • Have difficulty with writing and messy handwriting; dyslexics may also grip their pencil in an unusual way and tend to have illegible writing.
  • Have problems with depth perception and peripheral vision; but dyslexics are also known to have keen and observant vision skills.
  • Tend to have trouble reading with little comprehension.
  • Transpose, omit, substitute, and reverse words and letters when reading and writing.
  • Have difficulty staying on task, paying attention, zoning out, and daydreaming.
  • Complain of dizziness, clumsiness, nausea, and headaches while reading, playing sports, or while doing fine-motor visual tasks.
  • Seem bright, articulate, and may have a high IQ, but they are unable to read, write, spell, or perform on standardized tests on grade level; those with vision problems will have trouble with other visual tasks that do not involve words or numbers.
  • Tend to be called lazy, careless, or labeled with behavioral problems. Struggle with low self-esteem get emotional about testing and school; dyslexics are known to cope by covering their weaknesses and compensating or distracting with other talents and skills.
  • Learn well through hands-on experiences; dyslexics tend to be helped by being able to observe and use visual aids, but those with visual deficiencies do better with oral coaching.
  • Have difficulty with time — Dyslexics have trouble with sequences and time management; those with vision problems have trouble telling time on a clock dial.

As you can see, the signs and symptoms of dyslexia and learning-related vision problems practically mimic each other, with subtle differences. Even a professional trained to recognize dyslexia may not suspect a vision deficiency without proper awareness.

If you are in the Olney, MD or Silver Spring, MD area and suspect your child might have a learning-related vision problem that has similar symptoms to dyslexia, contact Dr. Philip Nicholson’s Visual Learning Center to schedule an appointment.

Teacher Appreciation Week: How Vision Therapy Can Help Teachers

It’s Teacher Appreciation Week, and we want to express a big thank you to all of the teachers who support students in the classroom. At the Visual Learning Center, we work daily with children who have struggled in school due to learning-related vision problems, sometimes for years before receiving a diagnosis; and their caring, patient, and skilled teachers deserve appreciation for their dedication to each child’s success.

Classroom teachers serve as our allies and partners in vision therapy, so we wish to celebrate their service to the community and welcome the opportunity offer our support in return.

When a child has difficulty in school — particularly if parents feel confident that their child is smart — teachers sometimes endure undue blame. Parents are understandably frustrated when a child performs poorly and may assume the teacher should know what to do to improve their child’s performance.

Teachers are educated in a wide variety of subject matter, teaching methods, and classroom management skills; and they receive training in detecting possible learning disabilities and special needs. However, the majority of teachers are unaware of how common learning-related vision problems are, and most teachers simply do not know how to recognize the symptoms.

Once teachers learn about how vision affects learning, they begin to recognize vision problems in their classroom right away and realize this is something they have been dealing with for years.

So, how can teachers get the help they need?

First, they have to be able to recognize vision symptoms that may affect learning, such as:

  • Squinting while reading near or far
  • Rubbing eyes continuously throughout the day
  • Rubbing temple or forehead and complaining of headaches
  • Complaints of dizziness or motion sickness
  • Skipping words or losing place while reading
  • Confusing similar words
  • Reversing letters
  • Easily distracted, inattentive, unable to stay on task
  • Disruptive behavior, especially after expressing frustration with work
  • Poor hand-eye coordination, depth perception, or awkwardness and clumsiness
  • Performs noticeably better orally than written

As you may recognize, many of these symptoms can also indicate learning disabilities, dyslexia, ADD/ADHD, or even health problems; and consequently, misdiagnosis is common. A possible vision problem is often overlooked.

If you are a teacher, you can expect that parents may dismiss your suggestion that their child has a vision problem because he or she has “20/20 eyesight.”  It is important for teachers to understand that the vision problems that affect learning are not usually detected during routine vision screenings at school or typical vision exams with the family’s eye doctor.

Typical vision exams only test for eye sight, or vision clarity at a distance. However, vision involves an entire vision processing system — the coordination of eye muscles and the brain.

A healthy vision system can function well over prolonged periods of time in a classroom setting; but if the child has a vision problem, he will grow tired and frustrated, not understanding why he has so much trouble doing tasks that seem easy for his peers. So a child with vision problems might seem to give up, have low self-esteem, or act out as a result.

Once a child is properly diagnosed by an optometrist who specializes in functional and developmental vision care, he can take part in an intensive individualized vision therapy program, which is likely to bring about remarkably fast and long-term results.

To learn more about vision and vision therapy, download our free guide, watch our webinar, and see our resources for teachers and parents.

If you are a teacher in Olney, Silver Spring, or the surrounding area, invite Dr. Philip Nicholson to speak at your school or association. Click here to learn more.

The Real Reason Your Smart Child Might Be Testing “Below Grade Level”

Standardized tests have long been part of the education system in the United States; but over the past decade mandated standardized testing has increased significantly to become a core component of schooling and a critical measure of your child’s success as a student.

Proponents of standardized tests claim that they are a fair, effective, and efficient way to measure students’ progress and hold schools accountable to goals and expectations. On the other hand, critics argue that standardized tests distract from deeper learning, and that they are unfair because some children do not test well, despite knowing the material.

As a parent, no matter where you stand on this controversial issue, if your child is testing below grade level, it is important for you to find out why.

If your child seems bright, but does not perform well on standardized tests, your first response might be that the teacher is not doing a good job, or that the school is not offering an optimal learning environment, or that the test is unfair. You may have performed well in school and on standardized tests yourself, and feel that someone must be failing your child.  You know that your child is smart, so something must be wrong.

Teachers and counselors will probably suggest testing for a learning disability, or they might suspect dyslexia or attention deficit disorder. The teacher’s performance review and the school’s performance goals are often dependent on students meeting grade level expectations; so it is in everyone’s best interest to get your child the help he needs.

However, there is a common, but often overlooked, problem that may be hindering your child’s test-taking ability. The real reason your child might be testing below grade level could be due to a learning-related vision problem. A vision problem could be to blame for your child’s “below average” reading comprehension or slow test taking, even with “20/20” eyesight.

Vision problems that affect eye muscles and coordination may cause your child to see double or blurry, lose his place often, or experience fatigue and distracting headaches. A visual processing problem related to memory or visualization could be the reason behind delayed reading comprehension.

Unlike a routine vision screening or typical eye exams, school standardized tests require prolonged reading, intense focusing of the eyes for hours at a time, looking from the problem to the answer sheet repeatedly, the ability to follow straight lines to bubble-in answers, and more activities seemingly simple for a child with a normally functioning vision system.

Testing for hours may exacerbate a problem that has not yet surfaced during normal classroom activities, because the child’s eyes may become even more tired than usual.

Poor visual skills that interfere with standardized testing include processing speed and accuracy, selective concentration, visual memory, letter reversals, visual-motor integration and speed, and visualization.

If there is any possibility that a vision problem could be to blame for your child scoring “below grade level” on standardized tests, the first step is to schedule a comprehensive vision exam by a doctor of optometry who specializes in functional and developmental vision care.

If diagnosed with a learning-related vision problem, an individualized vision therapy program can significantly, and relatively quickly, improve your child’s performance. With proper treatment and practice, these vision problems can be overcome.

If you are in the Olney, MD or Silver Spring, MD area, contact Dr. Philip Nicholson’s Visual Learning Center to schedule an appointment today.

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.