Tag Archives: eye tracking

Eye Movement Recordings Demonstrate Learning-Related Vision Problems

Is your child having trouble reading? Have you noticed them skipping letters, words, or entire lines of text? Perhaps they start off strong and then seem to get tired or lose interest quickly.

Getting to the bottom of what’s causing reading problems in children can be challenging. You may wonder if their difficulties are caused by dyslexia, a learning disability, or Attention Deficit Disorder (ADD/ADHD). What you may not have considered is that a learning-related vision problem could be to blame.

If a student has passed a typical vision screening, the child’s teacher or reading specialist will rarely suspect a vision problem to account for their reading difficulties. Most educational professionals are trained to believe 20/20 eyesight rules out the possibility that vision deficiencies could cause reading difficulties.

A typical eye exam only tests for clear vision at a distance for as long as it takes to look at a chart. But reading requires close, focused, sustained vision, smooth and coordinated eye movement, and the efficient processing of information through the visual system.

Normal oculomotor movement while reading occurs as a series of “fixations” and “jumps”– the eye fixates on certain points within the text and then jumps to another point. When we read, we take in either part of a word or a whole word each time we fixate or pause. Next, that word processes through the visual system. And then our eyes fixate briefly on the next word or word fragment, just long enough to see and process it.

In a healthy visual system, this process of fixating and jumping occurs without disruption or weakness. But a child with an eye tracking or eye teaming problem strains to accurately and efficiently control eye movements. While their classmates’ eyes move along a line of text smoothly with little effort, oculomotor dysfunction causes the eyes to jump erratically.

You may not be able to detect the irregular eye movement upon observation because even subtle problems can interfere with learning and performance. Slight eye movement deviations can make it challenging to read and write without becoming fatigued, skipping text, or losing one’s place.

Eye tracking is a complex function that involves our ocular muscles as well as many different areas of the brain. When someone with a healthy visual system reads or writes, eye tracking movements are not smooth as they scan along the text from left to right; however the movements are controlled, efficient, and unconsciously effortless.

For a child with oculomotor dysfunction, reading requires strained effort that becomes especially apparent as paragraphs and reading assignments grow longer. So you may notice a child who reads “on level” in Kindergarten begins to fall behind by second or third grade.

Because the eye muscles are not functioning in a normal healthy way, the child will often lose their place while reading or copying from the board, reread words or lines repeatedly, or try to cope by sliding a finger or pencil across the page as they read.

The video below is an actual eye movement recording using state-of-the-art technology to analyze for the presence of teaming and tracking problems.

As you will see in the recording, the child noticeably slows down as she gets to the last few sentences. This suggests that she grew tired of the strained effort required to follow the text. Imagine what this would look like after reading a chapter.

The video demonstrates one aspect of a comprehensive functional vision exam conducted in our office by an optometrist who specializes in developmental vision care to diagnose or rule out a learning-related vision problem.

If you suspect your child may have a learning-related vision problem, contact your local developmental optometrist as soon as possible. To schedule a comprehensive vision exam and access vision therapy in Olney, MD near Silver Spring, contact us at Dr. Philip Nicholson’s Visual Learning Center.

skipping letters when reading

Skipping Letters When Writing and Reading

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

Is your child skipping letters when writing or skipping letters when reading? Perhaps they are even skipping words or entire lines of text. This is a common symptom for patients who come into our office, and it may indicate a vision disorder or deficiency, even if the child has 20/20 eyesight.

To learn more how vision can affect learning, download our free guide here and watch our pre-recorded webinar here.

When a child skips letters or words, parents and teachers often initially blame carelessness. They encourage the child to try harder and to concentrate and mistakenly believe the child is simply distracted. At first, adults tend to attribute skipping letters, words, and lines to too much screen time, lack of interest, or laziness.

But when they observe over time that the child is trying yet still struggling to read or write, skipping words and letters may seem to be a sign of impatience or sheer frustration.

However, children with eye tracking problems– an oculomotor dysfunction–may actually be experiencing difficulty with eye muscle coordination.

A child with an eye tracking problem strains to accurately and efficiently control eye movements. Oculomotor dysfunction causes their eyes to jump erratically, rather than move along a line of text smoothly. The irregular eye movement may be subtle enough not to detect by observation. But even slight eye movement deviations can make it challenging to read and write without skipping text.

Without the eye muscles functioning in a normal healthy way, you may notice your child losing their place while reading or copying from the board, rereading words or lines, or using a finger, pencil or some other tool in an attempt to maintain his place while reading or writing.

Eye tracking is a complex function that involves both muscles and many different areas of the brain. When someone with a healthy visual system reads or writes, eye tracking movements are not smooth as they scan along the text from left to right.

Normal oculomotor movements occur as a series of “jumps” and “fixations” on certain points across the text. Readers take in either a whole word or part of a word with each these pauses and fixations. Next, they process the word through the visual system. And then their eyes fixate on the next set of text, just long enough to see and process it.

All of this has to happen in a healthy manner without disruption or dysfunction. If your child is struggling with oculomotor weakness, reading is challenging and requires strained effort, especially as the paragraphs and reading or assignments grow longer.

If oculomotor dysfunction causes a child to continues to skipping letters, words or lines by third or fourth grade, they will likely fall below expected grade level performance. Fortunately, if your child is diagnosed with an oculomotor problem, vision therapy can treat and even cure the deficiency.

See our vision therapy success stories.

Only a functional vision exam by an optometrist who specializes in developmental vision care can diagnose or rule out a learning-related vision problem.

To schedule a comprehensive vision exam and access vision therapy in Olney, MD near SIlver Spring, contact Dr. Philip Nicholson’s Visual Learning Center.

Register for an upcoming webinar here.

problems copying from the board

Why Copying From The Board is So Difficult for Some Children

Does your child complain that copying from the board at school is difficult? Does he or she come home with partial notes with a lot of errors or missed assignments? Perhaps your child’s teacher regularly states that the instructions, due dates, or lessons were written clearly on the board, and your child claims to have missed important information.

As a parent or teacher, it may be hard to believe that a child is truly having difficulty copying from the board, particularly if that child has 20/20 eyesight, wears corrective lenses, or has been moved closer to the board for a clear line of sight. You may attribute the child’s behavior to carelessness, laziness, or an excuse.  However, certain functional vision problems that often go undiagnosed can make copying from the board extremely challenging for some students.

Vision disorders that interfere with a child’s ability to easily copy from the board at school include:

Poor eye teaming:

Binocular vision skills include the ability for two eyes to work together as a team. When a visual deficiency prevents both eyes from moving precisely in the same direction at the same time, reading and copying from the board can pose a problem.

If a child has an eye teaming disorder, he may be able to fixate on the vision chart in a typical eye exam and see it clearly, but moving his eyes together from one point to another is difficult. Moving the eyes together to look up at the board, down at the desk, and then back up without getting lost should be easy. But children with eye teaming problems will experience visual fatigue and tire quickly when attempting to copy from the board.

Accommodative dysfunction:

Weak accommodative facility refers to difficulty with visual focus. In a typical vision exam, a child may have clear 20/20 eyesight, but the exam usually does not require the child to sustain focus for an extended period of time or to shift focus quickly from far to near and back to far again.

The student may see the board clearly and see his paper clearly, but looking up and down, back and forth, from the board to the paper could be where the difficulty comes into play. If the focus mechanism in a child’s visual system is weak or not fully developed, the adjustment period as he looks from one point of sight to another will be slower than average, which can be challenging and frustrating.

Oculomotor deficiency:

If a student has deficient oculomotor skills, also known as an eye tracking problem, he will strain to accurately and efficiently control eye movements. Whereas in people with healthy visual systems, eyes move somewhat smoothly, in people with poor oculomotor skills, the eyes will jump or skip around the text.

Copying from the board is difficult for students with eye tracking problems because each time they look up at the board or back down at the paper, they have to struggle to point the eyes in the intended direction again. They tend to lose their place often and fall behind or make errors.

Visual processing problems:

If a student has a visual memory problem, a deficiency in the visual system interferes with retaining information that was just learned; so recalling a line of text just read from the board long enough to write on paper is difficult. If a student has a problem with visual sequential memory, he will have trouble remembering the proper sequence of words or letters in the order just seen. A child who struggles with visual spatial skills and visual discrimination skills may process letters or words they see backwards as they copy text from the board, so you may notice letter reversals and suspect dyslexia.

Children with learning-related vision disorders struggle now more than ever, because today’s classrooms often require students to spend hours each day interacting with boards and screens. In a typical school, you might find whiteboards, large projected screens, Promethean Boards, and ActivBoards. A child may spend a significant portion of the day straining to look at boards and then back down to the paper on the desk in front of them, and then back up to the board. If that student has a functional vision problem, copying from the board will interfere with learning the lesson or keeping up with classmates.

Trouble copying from the board can contribute to slow progress, low grades, and frustration. When a child is not able to learn and participate efficiently alongside his classmates, self-esteem or behavioral problems may arise.

Many teachers, learning specialists, occupational therapists, and other education professionals are not trained to detect functional vision problems. Most learning-related vision problems even go undetected during school vision screenings or exams with your family eye doctor.

Click here to learn more about learning-related vision problems.

If you suspect a vision problem could be to blame for your child’s problems copying from the board, find an optometrist in your area who specializes in developmental or functional vision care. If you live near Olney or Silver Spring, Maryland, schedule an appointment with Dr. Nicholson’s Visual Learning Center for a full visual analysis.

The good news is and intensive vision therapy program can significantly improve functional vision problems in a relatively short period of time. Within a few months, copying from the board could become much easier quickly.

Does your child complain of dizziness while reading?

Has your child ever complained of feeling dizzy while reading? Dizziness can have many causes, and it’s a symptom that should be taken seriously. But if you’ve noticed that your child tends to complain of mild dizziness, queasiness, malaise, or nausea, specifically when reading or doing homework, it could be due to an undiagnosed functional vision problem that can be treated with vision therapy.

If your child says, “I don’t feel well,” too often at homework time, you may assume it’s an excuse to avoid work in favor of play time. However, most parents and teachers would not know to associate complaints of dizziness while reading with a vision disorder, particularly because learning-related vision deficiencies almost always go undetected in typical vision screenings or eye doctor exams.

Click here to read 9 signs that your child could have a learning-related vision problem that may cause headaches.

Click here to watch a pre-recorded webinar to learn more about vision problems in children.

We often think of dizziness as something that stems from an inner-ear problem. Many people are aware that the inner-ear and brain work together to control balance. So you probably wouldn’t be surprised to find that your child has fluid or an infection in his ear or a problem in the vestibular system when complaining of dizziness.

In a healthy visual system, our brain and eyes also work together to maintain a stable and even visual plane, which we need in order to read efficiently. When we point our eyes at text, we need to be able to fix and maintain our gaze so that the page and the text remains steady and still. If you have a properly functioning visual system, you can do this without extra effort. But for someone with a functional vision problem, the text may be misaligned or blurry, or it may seem to move, jump, go in and out of focus, appear wavy, or slide down the page. Experiencing any of these effects can cause dizziness while reading.

Children with poor convergence or divergence skills have difficulty with eye teaming. Their eyes move somewhat independently of one another, which causes double or blurry vision, distorted depth perception, and sometimes dizziness.

Children with an eye tracking problem strain to accurately control eye movements. Instead of their eyes moving smoothly across a line of text while reading, their eyes skip or jump, which makes it challenging to read without feeling disoriented and sometimes dizzy.

Children with accommodative dysfunction, or trouble focusing, have difficulty sustaining focus on text or maintaining a clear image for a reasonable length of time. Reading is challenging because the texts grows fuzzy or blurred, and straining to keep the text in focus can contribute to dizziness.

The only way to know if your child’s dizziness while reading is caused by an underlying vision problem is by scheduling a comprehensive vision exam by a developmental optometrist who specializes in functional vision care.

The good news is, learning-related vision problems that cause dizziness when reading can be treated effectively with vision therapy. Students often experience remarkable improvement in a short period of time.

If you are looking for vision therapy in Silver Spring or vision therapy in Olney, Maryland, and you suspect your child’s complaints of dizziness could be related to a functional vision problem, make an appointment with developmental optometrist Dr. Philip Nicholson at The Visual Learning Center today.

child in occupational therapy session

3 Vision Problems Occupational Therapists Can Recognize When Working with Patients

At the Visual Learning Center, we often receive referrals from Occupational Therapists who notice that a child in their care may be struggling with vision problems. OTs are trained to work with children to improve and strengthen specific skills and abilities, and deficiencies in the visual processing system can interfere with a child’s ability to make progress.

However, many skilled and experienced Occupational Therapists simply are not trained on how to detect vision problems. Further, many OTs are unaware that Vision Therapy can supplement or enhance the work they are doing with a child.

If you are an Occupational Therapist who works with children, here are 3 main types of functional vision problems you may notice during your assessments or sessions:

1. Accommodation Skills

If you work work with a child who often gets frontal headaches or eye aches, squints, blinks, or rubs his eyes excessively, or often complains that his eyes sting or itch, these may be signs of an eye focusing problem.

Children with poor accommodation skills, or trouble focusing, are unable to easily sustain focus on an object or text or maintain a clear image for a reasonable length of time. Reading and writing are difficult because objects become fuzzy or blurred, and the child will strain to perform well on assignments or tests, compared to his peers.

2. Convergence Skills

If you notice that a child tries to avoid reading, looks away from the text often, shows fatigue easily while reading, or indicates that the words are moving around on the page, this could be due to an eye teaming problem.

If a child has poor convergence or divergence skills, or an eye teaming problem, this means he has trouble using his eyes together as a team. His eyes move somewhat independently of one another, causing blurry or double vision, difficulty with depth perception, and fatigue. Performance and reading comprehension suffer because the child has to work harder than his classmates just to properly see and efficiently process the text.

3. Ocular Motor Skills

If you are working with a child who reads slowly, struggles with reading comprehension, has difficulty copying from the board at school, or loses his place or skips words while reading or writing, this could be due to an eye tracking problem.

If a child has poor ocular motor skills, or an eye tracking problem, he strains to accurately control the movements of his eyes. Instead of moving smoothly, his eyes will skip or jump, making it difficult to read, write, or look up at something in the distance and then back down to the page in front of him. What should be simple tasks prove challenging.

To learn more about signs and symptoms of functional vision problems, download our free guide “10 Things You Need to Know About Vision” here and watch our recorded webinar on vision here.

If you suspect that a child may have a functional vision problem, the next step is to refer him or her to a developmental optometrist for a comprehensive functional vision exam.

For occupational therapists in Olney or Silver Spring, Maryland, contact Dr. Philip Nicholson at The Visual Learning Center to speak to our staff.


How Vision Problems Interfere with Reading Comprehension

Reading comprehension refers to a child’s ability to not only read the text on a page, but also process it and understand its meaning.

For a child to develop reading comprehension, the entire visual processing system must work efficiently. Seeing the text clearly is only the first step in the process. Your child must know how to sound out a word or remember a word on sight, understand each word’s meaning, and then make sense of sentences and paragraphs.

Intelligence is one factor in reading comprehension, but there are many more factors that come into play in a child’s ability to both read and comprehend. Some bright children have difficulty with reading comprehension due to problems with their visual processing system.

In order to read, we take in visual information in the form of text and then decode it into mental images to which we assign meaning, and then retain and use those images to categorize and recall for future use.

Taking in visual information efficiently requires the coordination of hundreds of eye muscles and strong oculomotor control. If there is a weakness or deficiency, this can affect a child’s ability to focus both eyes on the same spot simultaneously or to move their eyes smoothly as a team across a line of text. Poor eye tracking,  eye teaming, or focus leads to difficulty and frustration for a child, and the extra effort to take in visual information may cause fatigue, headaches, or the inability to maintain attention.

Once the visual information is taken in through the eyes, the process of comprehension has only just begun.  Next up, a child’s brain will have to run the information through the process of visual perception, meaning they will have to be able to extract the information they see and use it appropriately.

Efficient visual perception is needed for a child to recognize and remember letters, words, and their meaning. If a child has a deficiency related to visual perception, he will struggle with minor differences in similar words or letters. This may lead to confusing p with q or d with b, for example; or it may also mean conflating words with similar beginnings, reading words backwards, or having difficulty distinguishing the main idea of a story from a minor detail. Recognizing, remembering, and applying information quickly and easily is critical for performance in reading comprehension, and student must have a healthy vision system to do so.

The following are specific ways visual perceptual processing may interfere with reading comprehension:

Visual Spatial Skills and Visual Discrimination are required to organize visual space and understand directional concepts and orientation. A child with poor visual spatial and discrimination skills may process a letter or word backwards.

Visualization is the ability to create a mental image in one’s mind, which is important for processing and remembering information for comprehension. When someone says, “I see what you mean,” we think of this a an idiom, but when it comes to reading and visual processing, we really are creating mental images that help us to comprehend. We’re essentially seeing something in our mind.

Visual Memory is the ability to retain information that you have learned. A child must be able to recognize and remember a word from one page, assignment, and day to the next. He must create an image of that word or set of words in his mind and recall it as needed.

Visual Sequential Memory refers to the ability to remember the proper sequence of words, letters, or story narrative, in the same order it was seen originally. Keeping the images of what they recall in order is of course critical to comprehension.

So, as you can see, the ability to comprehend is not simply a function of intelligence.

If a child is having difficulty moving and coordinating his eye muscles properly and then the child also has difficulty processing that information visually in his brain, he is going to perform poorly in the area of reading comprehension as a result.

If a student has a visual processing problem, reading comprehension can be improved significantly and relatively quickly with an individualized comprehensive vision therapy plan. If you suspect your child has a learning-related vision problem that interferes with reading comprehension, contact a developmental optometrist for a functional vision exam and vision therapy program.

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

child skips words when reading

Does your child lose his place while reading? Here’s why…

One of the most frequent complaints by parents who visit the Visual Learning Center is that their child loses his place while reading. You may notice when you read with your child that he misses words and sometimes skips whole sentences.

Initially, you might suspect he is is being careless or impatient, that he isn’t paying attention closely enough, or that he is choosing to skip unfamiliar or challenging words. However, a visual processing problem such as poor eye tracking skills could be to blame for your child’s difficulty with reading.

Tracking skills are the specific eye movements a child uses as they 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.”

To read, the eye jumps across the text and fixates on certain points; with each fixation, the child takes in either a whole word or part of a word while the eye is momentarily stationary. The child decodes and process a word, and then the eyes fixate on the next word and pause briefly to decode and process it. Eye tracking is a very complex process and involves many different areas of the brain.

Readers with normal healthy visual processing systems can control the eye tracking process well, and their eyes move mostly in a left to right manner across the page, jumping from word to word and sometimes around the page, but without skipping words or losing their place.

When a child skips words or sentences, they have to go back to re-read and work hard to grasp the meaning of a given passage. As a result, these children may score poorly in reading comprehension, not because of a low level of verbal intelligence, but simply because their visual processing system does not function as it should.

During a functional vision exam at the Visual Learning Center, we test for eye tracking ability and compare it to established normal values. For more information about eye tracking and other important visual skills, download our free guide “10 things you need to know about vision” here.

If you notice your child loses his place or skips words and sentences while reading, and you are in the Olney, MD or Silver Spring, MD area, schedule a comprehensive functional vision exam today. If your child is found to have poor visual tracking skills or another learning-related vision problem, a vision therapy program can result in significant improvement quickly.

Philip Nicholson, O.D.

Q&A: How is your program different from other providers of vision therapy?

When a child struggles with vision problems, such as deficiencies in eye focusing, eye teaming, eye tracking, or visual processing, the first step to getting help is diagnosis.

Many Montgomery County families come to the Visual Learning Center in our Olney, Maryland office because their child has been having difficulty with reading, writing, or behavioral problems in school. Often, learning disabilities, dyslexia, and attention deficit disorders have been ruled out, or traditional attempts to help the child improve in school are not working.

After an initial assessment, we encourage parents to schedule an appointment for a comprehensive visual analysis, which takes up to two hours and includes a written report and follow-up consultation, and a unique treatment plan individualized for each child.

What sets our vision therapy treatment plan apart from other approaches is that it is based in the best scientific research available in the field of vision and learning, and our methods are continually modified to incorporate new scientific data to achieve the best results.

Our vision therapy program is a highly targeted treatment program designed to correct visual-motor and perceptual-cognitive deficiencies. Vision therapy sessions include procedures designed to enhance the brain’s ability to properly control the whole vision system. At the Visual Learning Center, our vision therapy exercises target and train visual skills that are most likely to have a meaningful impact on learning performance and a child’s academic abilities.

Each child is treated individually, on a one-on-one basis, to achieve significant results quickly and allow for immediate feedback. Both positive reinforcement and gentle and direct error correction encourages the child to feel greater confidence early in the process and make progressive improvements throughout the vision therapy program. One of the first things you will notice, is that your child’s self-esteem will improve as he sees the difference in his performance.

The vision therapy exercises are designed with a discouraged young student’s needs in mind. Children work through sequenced procedures that aim to challenge–not bore or frustrate them–unlike their school work, which carries negative associations for them. Instead, the activities are designed to help your child practice and develop new skills in a non-academic way that does not remind them of their difficulty with schoolwork. Because of this approach, newly developed visual skills will become habitual in a fun and safe manner, and then your child will be able to apply his new skills to his academics automatically, and with a high level of retention.

Something else that sets our program apart is that we encourage parental involvement. The program requires practice outside of in-office sessions. Practicing at home provides an opportunity for cost-effective repetitious procedures and helps your child to transfer learned skills to everyday activities. But what parents tell us they enjoy most about their participation is that it often mends the parent-student relationship. We understand that homework wars and punishments for getting in trouble at school can strain your interactions with your child, so we are delighted to play a part in making a positive impact on your relationship.

Overall, vision therapy at the Visual Learning Center produces invaluable results when considering committed effort, time, and finances. I chose to become an optometrist who specializes in developmental and functional vision care because I struggled with vision problems as a child, and I can attribute my success as a student to the results of vision therapy. Click here to read some of the vision therapy results and success stories our patients have experienced.

To schedule an appointment for a comprehensive vision assessment and learn more about our vision therapy program in Olney, MD, call 301-570-4611, or complete this form.

My child has “20/20” eyesight but still has trouble copying off the board at school. What could cause that?

You probably remember struggling from time to time to see the blackboard in school when you were a child. Maybe you sat in the back of the classroom, behind the tall kid, or someone with big hair sat in front of you. Perhaps you needed your first pair of glasses before you could easily make out the letters and numbers on the board without squinting.

If you remember those brief periods of frustration, you understand how some children with certain vision problems feel throughout the day while struggling to copy from the board, even with 20/20 eyesight.

Modern classrooms include whiteboards, ActivBoards, and Promethean Boards. Students spend a lot of time looking at boards, and then back at their desks, during a school day. If a child has a vision problem, it may be difficult for the child to copy off the board and follow the lesson.

A child may have “20/20” clear eyesight but may also lack the ability to refocus from near to far and from far to near. As the child looks down at his paper to read or write, he may see clearly. After he is looking at the board for some time, he can see clearly too. However, looking up and down, back and forth, from the board to the paper might be where the difficulty comes into play.

The focus mechanism in the child’s eyes might be weak, slowing down the adjustment period as he looks from one point of site to the other. In functional optometry, focusing is called “accommodation.” A full functional vision exam tests “accommodative facility,” which is the ability to sustain clear vision and to shift focus.

Weak accomodative facility (focusing) is not detected during most normal vision screenings.

Another vision problem that would make it difficult for your child to copy from the board at school is poor eye teaming. Eye teaming, known in functional optometry as “binocular vision skills,” refers to the ability for the two eyes to work together as a team. If both eyes are not moving at the same time in the same direction, a child will struggle to look up at the board, down at her paper, and back again without experiencing visual fatigue and tiring quickly.

Your child could also have poor eye movements, such as tracking and pursuits. Tracking eye movement skills help the child “locate” the words on the board and then locate the space on the paper where they are to place their print. A child with poor tracking skills loses her place often, and getting lost frequently is frustrating and tiring.

Poor teaming and tracking skills are not detected during most normal vision screenings.

If your child has been complaining that he is having trouble copying from the board, or your child’s teacher complains that he is not copying down the lessons or assignments as instructed, a vision problem could be to blame.

Even if a school vision screening or visit to your family vision care clinic indicated that your child has 20/20 eyesight, problems with focus, eye teaming, or eye tracking might be interfering with his or her ability to copy from the board and learn efficiently alongside his classmates.

Find an optometrist in your area who specializes in developmental or functional vision care. If you live near Olney or Silver Spring, Maryland, schedule an appointment with Dr. Nicholson’s Visual Learning Center for a full visual analysis.

The good news is intensive vision therapy can improve eye teaming, eye tracking, and focusing skills. Within the next few months, your child could experience significant improvement, and copying from the board can become easier.

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.