Vision and Learning
Convergence Insufficiency
The Developmental
Optometrist
Research
The Big Picture
Getting the Word Out
Parents and teachers are very aware that children’s eyesight is an important part of learning. If a child is having difficulty in the classroom, one of the first things to be evaluated is the child’s vision, and eyeglasses provided, if needed.
However, there is a field called developmental optometry, also known as behavioral optometry, which has a whole other perspective on vision. Specialists in this field say that a child or adult may have perfect eyesight, yet still have visual problems that interfere with learning. These types of problems have more to do with things like muscular coordination and integration than with eyesight per se. A behavioral or developmental optometrist is an optometrist who has gone on for further training, and specializes in the assessment and treatment of visual “information processing” disorders. Those specialists make a distinction between vision and eyesight. Their programs are focused on vision skills, rather than eyesight, per se. The belief is that vision skills can be developed, at any age.
Convergence Insufficiency
One such disorder is called convergence insufficiency, which basically means that the two eyes are unable to effectively work together to look at one object or place such words on a page. In order to read, the two eyes must coordinate, look forward and down at the same spot, easily and efficiently. If this is a problem, the effort to read will be overwhelming, because all the energy is going into trying to focus the eyes, and reading comprehension must suffer.
Convergence insufficiency (CI) is an example of a “teaming” problem: inability of the two eyes to work together. Other potential problems that can be treated by developmental optometry are: difficulty tracking objects smoothly; difficulty with eye-hand coordination; difficulty with eye movement control; difficulty differentiating the figure from the background; and difficulty with the ability to focus, or shift focus, easily.
These are functions that most of us take for granted, and do without even thinking. But without these skills, words on a page may blur while one is trying to read; letters may appear to be different sizes, slanted, or move on the page. But, since the child or adult has always had this problem, he does not know that he is any different than anyone else in that way; he assumes that everyone sees the same way that he does. Therefore, he may not complain about it, and the problem may be overlooked.
The Developmental Optometrist
In a developmental optometrist’s office, a team headed by the optometrist administers a series of assessments, to determine what the problems are, followed by a program of vision therapy (VT). Very specific exercises are done to strengthen the areas that need help. These programs boast very high success rates.
Some sources link many of these problems, not only to learning disabilities, but also to many cases that appear to be ADD/ADHD, and even juvenile delinquency, perhaps because of the feelings of frustration and helplessness these problems cause. In various studies, 50% to 90% of juvenile delinquents assessed at various times were found to have these types of vision problems.
Research
A great deal of research has been done in this field. Here are two examples:
In the early 1970’s, a behavioral optometrist named Dr. Roger Dowis gave visual therapy to 48 juveniles in Colorado; of those who were given vision therapy, only 2 were re-arrested, a very significant drop for that population (18% to 4%).
In 1989 in San Bernadino, CA, re-arrests were drastically reduced (going from 45% to 16%) consistently for eleven consecutive years, when delinquents were given vision therapy.
One judge in San Diego, CA, was reported to be sending his repeat offenders for vision therapy, and finding a lower rate of re-arrest for his population of offenders.
The Big Picture
The concept that developmental optometrists have of vision goes beyond what we usually consider vision to be. Vision, which occurs in the brain, helps us to orient ourselves in space and within ourselves; beyond seeing itself, vision helps to inform our perception of ideas and viewpoints. Vision is not considered to be an isolated function, but a function that “centers and organizes the self.” It either integrates the individual, or leaves him feeling scattered and fragmented. According to Gerald Leisman (1976) the child “sees with his whole being.”
In this view, having problems in the visual sphere leads to problems orienting oneself in the world and feeling comfortable and centered in one’s own body, as well as being able to move in the world smoothly and effectively. Problems in the visual system at any level have been found to cause symptoms like difficulties with focus and attention; confusion; being accident-prone; depression; tiredness; vague aches and pains; behavior problems; and lack of motivation, especially for school work. The cause of these can be overlooked, because they can occur even in children and adults who have 20/20 vision. If the problem is caused by a problem in the visual system, vision therapy can correct all of these problems and more.
Getting the word out
Why is this field and its contributions not more well known? This is difficult to say. It is a well established field with highly trained professionals in it.
More information, and help in finding a developmental optometrist in your area, can be found at the website of the College of Optometrists in Vision Development: www.COVD.org; and the website of the Optometric Extension Program Foundation at www.oepf.org.
Sources
Catalyst! Vision and Learning Guidebooks, copyright Catalyst Solutions, LLC, 2002.
www.sensoryprocessingcourses.com
Kasseno, S. “The Visual Anatomy of the Juvenile Delinquent” Intervention in School and Clinic, September, 1985 Academic Therapy, 21:1, 99-105: http://academic.research.microsoft.com/Publication/44818721/the-visual-anatomy-of-the-juvenile-delinquent.
Leisman, G. (1976) Basic Visual Processing and Learning Disability. Springfield, OK: Charles C. Thomas, cited in: Dennison, Paul, E. & Dennison, Gail E., “Vision, the Centering and Organizing of the Self,” Brain Gym Journal, VIII, No. 2, summer 1994
“Vision Therapy” Family Focus: a production of Piscataway Community Television: 2004. Host: Steve Weiss; guests: Dr. Wm Moskowitz and Nan Miller, MS.
