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Oregon Family Magazine

What if an Attention Problem is Really a Vision Problem?

01/01/2016 22:14 ● By Sandy Kauten
Brandon was an eight year old with the curiosity of a scientist; however, he couldn’t sit still when he tried to read. He tilted and turned his head so much that his body tipped until he often fell right out of his chair. After Brandon’s successful treatment for a hidden vision problem, his father described what he was living with… “We thought it was an attention problem, but we now know it was as if he was trying to follow the words, but the words tumbled right off the page,” Brandon had “perfect eyesight.” 20/20 vision in each eye, just as previous vision screenings had reported; however, he could not comfortably and accurately maintain good efficient eye teaming.

So, the question is, how is it that someone with clear eyesight might have a reading or a learning problem? 20/20 vision is only one of many vision abilities that must work as a unified accurate and comfortable system for peak performance in academics, sports, and daily life. Simply put, each eye sees the world and we must be able to align the two images accurately, quickly and comfortably for as long as we need to be attending any task.

Brandon is like many students whose behaviors resemble attention deficits. A hidden vision problem will interfere with a student’s performance rather than support his or her efforts. For some children the strain of trying to team their eyes at a close distance, such as with reading, causes dizziness, nausea or headaches. Children learn to avoid reading in order to protect themselves from the discomfort — and the behaviors often look like attention deficits.  (see additional resources below)

Carly used to fight against reading and did her best to avoid sitting down to her home-school studies by wandering around the table – around and around and around. “We were sure she had an attention problem. Now, we know she really couldn’t pay attention and focus on her schoolwork, because she did not know how to team and focus her eyes! Carly’s behavior has completely changed from acting like a 5 year-old to being the 10 year-old she really is,” her mother described. “And now, she is able to read at grade level!”

Allison is a bubbly chatty 7 year-old, bright and eager to share her stories. With a vocabulary far advanced for her years, she delights others with her astute observations about life, relationships, and the world. However, her reading was labored and far behind her peers. “Once she got her glasses, we thought her vision was fine”, Mom reported, “but she was still talking up a storm when she should have been reading. Then someone suggested we find out about how well she could move and team her eyes, especially at the near distance necessary for reading. That’s when we went to an eye doctor who checks for eye teaming. Now she thoroughly enjoys reading!” Allison is excited about reading because “the words don’t bounce around anymore. They used to go bounce-bounce- bounce and now they are steady as a rock,” which she emphasizes with dramatic hand gestures.

Brandon no longer has daily stomachaches - no longer detests going to the library – and no longer falls out of his chair when reading. He described, “The words and letters don’t split up anymore. It was like you took letters and split them in two and shifted them over by one. It was garbled and I couldn’t even read a sentence.”

Oregon has taken important steps towards recognizing the importance of visual readiness for school success with the passing of HB 3000 in 2013. But we must be aware of the difference between a screening and a comprehensive eye exam by an eye care professional. It is possible for a screening to indicate that a child has clear eyesight but might not have checked other visual abilities such as focus flexibility, eye movement control and fusion (eye teaming.) Sometimes a child can perform well for the brief time a screening is conducted but does not have the endurance to maintain performance throughout the day and into the evening with homework demands.

Children who struggle with learning because of undetected vision problems rarely talk about their eyes or vision. Because we cannot compare how we see to how anyone else sees, a child assumes how they see — such as blurry or shifting words — is normal and how everyone else sees. Secondarily, they will too often conclude, “Other kids can read but I can’t… I’m just dumb.” Not until we ask the right questions can we understand that a child’s inability to pay attention might be related to hidden visual problems.

Penelope Youngfeather, MS, COVT has a Master’s Degree in Early Childhood Special Education. She worked for 17 years as a Certified Optometric Vision Therapist serving students of all ages and formerly the Director of the Lifetime Eye Care Vision Therapy Center in Eugene, Oregon. To learn more about Vision and Learning, visit www. Contact Lifetime Eye Care to arrange a presentation on “The Critical Link Between Vision and Learning” for your organization or group.

Resources for More Information:

Children’s Vision Foundation

Oregon Optometric Physicians Association

College of Optometrists in Vision Development

Parents Active for Vision Education

Optometrists Network

Lifetime Eye Care