Back to School Blues? Why 20/20 isn’t enough

I used to think I didn’t like to read because I was stupid. Now I realize it was a problem with how my eyes work.

After years of crying every single day before school, this is the first year he said during the summer he is excited to return.

Every August, many parents face resistance from their children about returning to school. For some, it’s due to the loss of outdoor fun that is the hallmark of summer time. But for too many kids, the dislike of school comes from the fact that they struggle academically.

Have a look at this abbreviated checklist to see if one or more patterns apply to your child:
  • Skips lines/repeats lines or loses place while reading
  • Uses a finger while reading
  • Skips or omits small words
  • Reports words moving or overlapping
  • Sees double
  • Avoids small print (reads graphic books)
  • Poor spelling
  • Letter reversals (past age 7)
  • Sloppy writing/letter formation
  • Poor hand-eye coordination
  • Headaches
  • Difficulty paying attention to near work
  • Trouble completing assignments on time
  • Low interest in academic work
Many children who struggle with reading or attention issues in school actually have underlying issues with how their visual system works. Most of them may have also had vision tests where they were found to have normal ’20/20’ vision, demonstrating that they were able to see the small letters on a chart positioned at the end of the room (and up close if tested for near vision, as well). However, there are other visual skills that are crucial to reading and academic success that may not have been evaluated. These include:
  • Eye tracking skills – eyes correctly following a line of print
  • Eye teaming skills – two eyes working together as a synchronized team
  • Eye teaming – simultaneously blending the images from both eyes into one image and coordinating all movement
  • Accommodation – eye focusing
  • Visual-motor integration – eye-hand coordination
  • Visual performance – attention, and processing

These issues are not related to intelligence because the problem lies with how the eyes are coordinated and how the brain processes the incoming information. The analogy that I give to most parents is that of a computer. A computer requires its hardware or physical components to be properly installed and in working order. However, the software of the computer is what allows the information to be processed, the components to talk to each other, and for commands to be accurately executed.

Now, most of the kids that I see have already passed regular eye exams and vision screenings because their ‘hardware’ is fine – all the physical components are there and are healthy. However, the most important processes for reading, comprehension and sustained attention (to reading), actually come about within the ‘software’. This is where the brain learns to control the eyes accurately, interprets and then processes the information given to it by the eyes.

What does this all really mean? Quite simply, as I often explain to my younger patients: “Sometimes your eyes and your brain don’t always know how to talk to each other. It has nothing to do with how smart somebody is but can make reading and school work much more difficult than it needs to be.”

All children that are being considered for a learning disability assessment should have their tracking, visual coordination, and visual processing evaluated. In fact, a study in Ontario just showed that many children on IEP’s have these problems. Furthermore, there are also many children who don’t reach their potential, who just get by well enough to avoid being red flagged at the school. This can include students who are working very hard to maintain satisfactory grades or children that are often referred to as ‘just not trying’.

One parting thought for parents this year: If your child fights you over doing reading or school assignments, remember that it may be because it is less stressful for him or her to fight with you than it is for them to do the work. The behaviour is secondary to the underlying issues.

If any of the above pertains to your child or if you would like to rule out a tracking or visual processing difficulty, please find your nearest developmental optometrist. They will be able to assist you in diagnosing and treating these conditions.

 

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