Visual Information Processing Evaluation (VIPE)
Visual processing refers to a group of skills used for interpreting and understanding visual information. These skills are important for many tasks that children perform in the classroom. For example, a child might need to look at something on the board and then write down the information or solve the problem. In this example the child needs to remember what they saw (visual memory) and write the information accurately (visual motor integration). Children who have problems in visual processing typically have one or more of the following symptoms: reversal errors, difficulty remembering what is read, poor understanding of right and left directions, and poor handwriting.
If a visual processing problem is suspected, an evaluation using standardized tests may be recommended. We typically evaluate visual spatial, visual analysis, and visual motor skills. Following testing, an individualized treatment plan is designed that targets the weak areas. Vision therapy is expected to improve the deficient visual processing skills, which should in turn help remove barriers that affect classroom performance.
What is a Learning-Related Visual Problem?
A learning-related visual problem is identified when vision problems keep a child from performing optimally in school. Cildren found to have learning related vision problems may have a number of symptoms which may include reversal errors, poor written work and/or difficulty recalling and recognizing letters and words.
Individuals having difficulty achieving in school should be evaluated to identify any vision problems, which may contribute to their difficulty. Visual efficiency or visual information processing deficiencies may result in inattentiveness and an inability to accurately acquire information important in the learning situation. The optometric evaluation of these individuals is not intended to diagnose and treat learning problems, but rather visual efficiency and/or visual information processing difficulties, which may be one of many factors contributing to poor achievement. Also, awareness of vision problems will assist the classroom teacher in planning or modifying educational programs to best serve the student.
Visit http://www.aaopt.org/about/position/index.asp for Optometry's position paper on vision and learning.
Colored Filters: A Treatment for Reading Problems?
In recent years the notion of treating individuals with tinted spectacle lenses or colored overlay-filters has become popular. Some schools have advocated the use of colored filters for students with reading dysfunction in the hopes that reading skills will improve. Moreover, there are commercial centers that "test the scotopic sensitivity syndrome" (referred to as the SSS). Claims have been made that testing for SSS can lead to the exact color to treat an individual's reading dysfunction. This process can be expensive, which could be justified providing such a regimen is effective. The question is whether or not tinted lenses or filters actually help. Are they really effective for treating reading problems?
The scientific basis of treatment with colored filters has been questioned.a First: the word Scotopic refers to night vision. We need photopic levels of illumination as in daylight, in order to read. Second: There may be a placebo (psychological) effect resulting in anecdotal statements that reading is "improved" with the colored filters. Third: Research is lacking that validates the use of colored filters.
Of particular interest is that reported symptoms of SSS seem to be very closely related to vision disorders.b Such common complaints as fatigue, skipping words, shimmering of print, blurring, headaches, watery eyes, and difficulty concentrating while reading can almost always be treated optometrically with lenses or vision therapy.c Recommendations of the Studt Center for Vision Therapy at the Eye Care Center (ECC) are as follows:
- Individuals with reading dysfunction should have a basic eye and vision examination, either by their local optometrist or in the Primary Eye Care Service at ECC. This testing is to rule-out problems such as refractive errors, binocular vision problems, and eye diseases.
- If referral to the Studt Center for Vision Therapy is indicated, a thorough evaluation of visual efficiency skills and developmental visual information processing can be done. Dyslexia and other special testing can also be administered.
- Appropriate vision therapy, and sometimes special prescription lenses, may be recommended to treat vision problems associated with reading dysfunction.
- In a few selected cases colored filters may be tried at little, if any, cost. These filters are most often tinted blue but they may be rose or various other colors, or even a neutral gray. The faculty optometrist may recommend these for certain patients to determine if, in fact, any comfort or improvement in reading performance is attained. Performance can be objectively measured with word decoding accuracy and reading comprehension tests. Vision therapy, however, is practically always the preferred treatment for lasting effects in such cases, even in those few patients who subjectively report benefiting from colored filters.
a Cardinal DN, Griffin JR, Christenson GN. Do Tinted Lenses Really Help Students with Reading Disabilities? Intervention in School and Clinic 1993; 28:275-279.
b Blaskey P, Scheiman M, Parisi M, Ciner E, Gallaney M, Seiznick R. The Effectiveness of Irlen Filters for Improving Reading Performance: A Pilot Study. Journal of Learning Disabilities 1990; 23:604-612.
c Special Report: The Efficacy of Optometric Vision Therapy. Journal of the American Optometric Association 1988; 59:95-105.
Dyslexia: What is it?
Dyslexia means poor word recognition. Although vision is involved, dyslexia is mainly a language processing problem. This learning disability affects reading and writing, particularly spelling. Dyslexia results in specific patterns of reading dysfunction, as opposed to general reading dysfunction caused by such broad factors as poor visual or auditory skills, lack of education, attention problems, and reduced intellectual capacity.
When general factors affecting reading are accounted for, specific testing for dyslexia is done. Dyslexia affects all ages. Both children (as young as kindergartners) and adult patients can be screened or tested for dyslexia at the Studt Center for Vision Therapy at the Eye Care Center (ECC). Faculty optometrists and student interns at ECC test for three basic types of dyslexia: 1. Dysnemkinesia ("motoric"); 2. Dysphonesia ("auditory"); and, 3. Dyseidesia ("visual"). The dysnemkinetic type is associated with letter reversals when writing linguistic symbols; for example, doy for boy. Letter reversals, as well as other right/left problems, can often be treated successfully with optometric vision therapy. The two other types of dyslexia require special educational therapy. The dysphonetic type of dyslexia results in poor word attack skills (phonetic decoding) and transposition of letters when writing, for example solw for slow. The dyseidetic type of dyslexia results in poor sight-word recognition and inaccurate spelling, although phonetically correct, for example, bisnis for business.
Faculty consultants at the Studt Center for Vision Therapy are part of a multidisciplinary team of professionals that consists of physicians, psychologists, educators, and other professionals who are concerned with learning disabilities. When the type and severity of dyslexia are determined, appropriate referrals for educational therapy can be made, which may then be carried out at the child’s school or other locations. Educational therapy for adults may be provided by local organizations such as Literacy Volunteers of America. Appropriate referrals can also be made when other evaluations or therapies, such as for attention deficit disorders, are indicated. Vision Therapy may be recommended if contributing problems such as poor eye teaming, tracking, focusing, and visual information processing are found in combination with dyslexia. The goal of vision therapy is to decrease visual symptoms and improve the child’s “visual” readiness for the classroom.