Throughout the school year, parents and teachers assess academic and behavioral progress for students, with parents sometimes learning that their child is struggling, underperforming, inattentive or disruptive. When issues appear, parents must begin searching for answers and help. Experts estimate that roughly 80% of academic learning is presented visually, so there is an intimate connection between vision and learning. For concerns about academic performance, one of the first professionals parents and school advisors should consider consulting is an optometrist who can assess the child’s functional vision.
What is functional vision? Beyond simple refractive problems like nearsightedness, farsightedness and astigmatism, functional vision relates to the way the eyes function together and send visual information to the brain to process it. Functional vision involves four visual skills necessary for learning: tracking, focusing, eye teaming, and visual processing.
According to Melissa Lambright , OD, of West Hartford and Farmington, Connecticut, a member of the College of Optometrists in Vision Development (COVD) and the Neuro Optometric Rehabilitation Association, one in 10 children has a vision problem significant enough to affect learning. “Even the most gifted students struggle when their vision is compromised,” explains Dr. Lambright of SIGHT Multispecialty Center. “Typical vision screenings at school or in a pediatrician’s office test only a child’s distance vision when the majority of a student’s day is spent using close vision, which requires good eye focusing, tracking, teaming and visual processing.”
Dr. Lambright continues, “A pronouncement of 20/20 vision means only that a child can see clearly at a distance of 20 feet. It does not confirm healthy coordination, tracking and focusing. These movement-related functions are critical to effective processing of visual information, and can directly affect learning, social interaction, physical coordination and attention.”
Children with functional vision problems can be misdiagnosed with ADD, ADHD, learning disabilities or other conditions. Before starting treatment with doctors or behavioral specialists, parents of children suspected of having attention deficit disorder-related conditions should understand that vision plays a significant role in attention and learning, and consider having their child’s functional vision assessed.
For parents concerned about their child’s school performance, regardless of age, here are 10 signs that a child of any age may have a problem with their functional vision:
- Avoids/dislikes reading, writing and homework.
- Develops disruptive classroom behaviors, cannot sit still, or exhibits a short attention span.
- Tests poorly despite knowing the material and verbalizing the answers.
- Takes longer than average to complete assignments.
- Covers one eye with their hand or arm.
- Uses their finger to track while reading.
- Makes “careless” mistakes on work; reverses letters or numbers.
- Performs strongly early in an assignment but struggles to finish.
- Has difficulty with hand-eye coordination in academics, sports and physical activities.
- Holds reading material too close to eyes.
Functional vision problems affect executive function—cognitive processes involved with planning, attention and time/space management. When a child is young, they can develop coping mechanisms that allow them to achieve success in the classroom. But as they enter middle and high school and the curriculum becomes more challenging, these coping skills no longer allow them to compensate, and visual learning problems often become more obvious.
“To determine if your child has a vision problem that impacts learning, find an optometrist that specializes in the assessment of visual function and visual processing,” Dr. Lambright suggests. “Parents can find specialists near them by visiting the COVD website. Once you’ve found a specialist and made an appointment, collect important information about your child including relevant medical testing results, neuro-psych evaluations, reading coordinator evaluations, and/or occupational therapy assessments and results. A good optometrist will work collaboratively with other medical professionals and school specialists in a team approach to deliver optimum results for the patient.”
Dr. Lambright shared a story about a fifth grade boy who came to her struggling with reading, academic performance and athletics. He was performing below grade level for reading and math and was receiving extra support through the school’s special education program. After completing his routine exam for acuity and eye health, Dr. Lambright conducted a functional and perceptual vision assessment. These tests confirmed that the patient struggled with Convergence Insufficiency, a condition where his eyes did not work well together at close range, resulting in blurred or double vision. After three months of vision therapy, this patient’s all-around performance had changed dramatically. According to his mom, “He is at grade level for reading and math after vision therapy. We’re so appreciative of his newfound love of reading. Also, his confidence in sports has soared and he’s so much happier socially.”