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The SPD Companion, Issue #011-- Visual Processing Deficits; Often Misdiagnosed, Clearly "Visible"
February 01, 2007
Our topic this month? Visual processing disorders.
Before I get started, I want to give you a quick update on my world and the site. As some of you know, because I've responded to your e-mails, the past two months have been rough. I have not had the time nor the physical abilities to do all that I've wanted to do for you personally, and as a group. The holidays were incredibly busy, my dad was in the hospital, I was away from home for a month, and had an unexpected surgery on my wrist which left me unable to type (and still am). I was lucky enough to find dictating software that is allowing me to write to you right now without hardly touching the keyboard. I've also realized this program's potential for so many with disabilities and/or poor typing skills. It is so simple to use! (more on this another time)
So I thank you for your patience and understanding in my delayed responses to e-mails. I am just now trying to catch up. If you have written me, and I have not responded please know that I will soon! I also sincerely apologize that in the midst of all the chaos I was unable to get a newsletter out in January. Please know this is a rare occurrence and I ask for your understanding in this situation. I hope this newsletter finds you all well and that you survived the holiday season. I hope the new year is bringing you new hope and renewed strength to continue learning and fighting for our SPD kids.
AND, one more note...I want you to know that when I write, I often refer to kids, and I often make reference to them from a parent's perspective (because I am one)...but, this does NOT mean that the same concepts don't apply to younger children, professionals, and/or adults. So, please bear that in mind when you read my articles...if you are a teacher, doctor, OT, SLP, psychologist, adult with SPD etc...these same concepts apply to you. This topic in particular!
Now, onto our topic of the month...
Did you know, statistics say about 80% of our SPD kiddos will also have VISUAL and/or AUDITORY processing deficits? Yes it's true... 80%! That is a huge number! Additionally, according to Patricia S. Lemer, M.Ed,. NCC, Executive Director, Developmental Delay Registry, “Vision plays a major role in language and social–emotional development. Children with language delays, attention deficits, pervasive developmental disorders and autism all have inefficient visual systems. If a toddler is not speaking or relating to others, a vision evaluation is essential. Given this information, it is something that we as professionals and/or parents should be acutely aware of.
By visual processing deficits I am not talking about the information you get from a normal eye exam... simply put, these usually only mainly test for acuity. What we are talking about here is the way our brains PROCESS visual stimuli and input. There is a BIG difference between processing and acuity. And there is a BIG difference between eyesight and vision. There will be many children misdiagnosed as having poor eyesight, dyslexia, dysgraphia, fine motor problems, ADHD, etc. that actually have visual processing deficits. For a detailed explanation of both auditory and visual processing issues, go to:
Areas of Perception That Affect Learning
We have to understand that it may not be easy for a child to know something is wrong or explain it to us, as they don't know that everyone doesn't see like they do. You know the famous song that says...”Don't know what you've got until it's gone”? Well, in this case we could say ...“Don't know what is gone until you get it.” This is particularly true of visual processing deficits! You will see this clearly (no pun intended) in the Jess Oppenheimer article I will be referring you to.
Visual processing involves how the visual system takes in information (“Information Input”), organizes it (“Visual Pattern Processing”), and uses it to perform a functional task (“Output For Action”). (The Mislabeled Child, 2006) as is the case with Sensory Processing Disorders, each part of this processing loop has the potential of being “disordered”. For example, it is important to understand visual input problems will often cause pattern processing problems. And, it is important to note, pattern processing problems can occur in isolation OR be caused by visual input deficits. Lastly, output could be inefficient due to input, processing, or inefficient motor responses.
It will take a training BEHAVIORAL OR DEVELOPMENTAL OPTOMETRIST to evaluate where the process is breaking down.
For help in finding one and understanding what they do, click here.
The difficulties we are referring to under visual processing include :
- Eye Teaming
- Visual Memory
- Visual-Motor Integration
(The Mislabeled Child, 2006)
In one study, “up to 50% of children referred to vision specialists have brain-based visual impairments...Unfortunately, most children with brain-based visual impairments remain undiagnosed and untreated for far too long. Their problems are usually too subtle to show up on a routine eye exam and required detection by a specialist in visual processing, an expert in central visual impairments, or neurologist.” (The Mislabeled Child, 2006)
Do you want to know more about how to choose the right doctor, the right discipline? You will find it explained here...
EXPLANATION OF OPTOMETRY VS. OPTHAMOLOGY... “Choosing An Eye Doctor”
(including links to doctors, vision therapy providers, the difference between eyesight and vision, why school eye screenings aren't enough, and other important visual processing / visual input information!!) I learned so much from this article myself!
One of the greatest gifts I want to share with you this month is an incredibly insightful, although lengthy, account from Jess Oppenheimer... a TV writer, producer, and creator of the “I Love Lucy Show”.
As I read his story I was floored by the insight that he had into his own disability, at a time when what we know today was not even available to him. Here was a real-life story of a legend who had significant visual processing deficits (and most likely SPD) yet overcame them with incredible determination and hard work.
When you read this story I hope you too will see the brilliance in him and the sadness that exists when one is misunderstood and misdiagnosed. To say the least, it is unbelievably inspiring!! As I said it is lengthy, so if you do not have time today I ask that you come back another day and read his story. It will change you.
Do you think your child might have some visual processing deficits? There are some simple tests that you can do with a child to let you know if further evaluation may be needed. When doing these tests, it is important to know we are looking for fluid movement of the eye muscles... no jumps, skips, or jerkiness of the eyes.
The first is a test of convergence: take a pencil ( if you have a colorful eraser to put on the end even better) and ask your child to follow the pencil with their eyes only, keeping their head still. Hold the pencil about 12 inches from their face at eye level and slowly move the pencil in towards the bridge of their nose. Watch how both eyes move, making sure there is even, fluid movement of both sides inwardly converging to the bridge of the nose.
The second test has to do with visual tracking. With that pencil again or a finger, hold it about 12 inches from the child's face, and move the pencil up, down, side to side and watch the child's eyes track the object. Again we are looking for fluid movement, no jerkiness or jumping around (especially watch when going left to right that the child's eyes continue to move fluidly across the middle portion, midline. Particularly at midline observe whether the eyes stop, jump, or jerk before continuing to follow the object all the way to the other side.
A third test you can do is to write a paragraph of letters including d's, b's, p's, q's, m's, and w's and ask your child to circle all of the d's or b's, p's or q's, etc. and notice if he/she has difficulty identifying them correctly.
Besides these three tests (which are NOT to diagnose an actual visual problem...just to observe the child's eye movements and visual processing skills)... below you will find links to some great online checklists, “tests”, articles, and explanations on various vision and vision therapy topics which will alert you to potential visual processing issues in YOUR child.
For the ULTIMATE book relating to visual processing, memory, auditory processing, attention difficulties, autism, SPD, dyslexia, dysgraphia,, math problems, learning challenges and giftedness I highly recommend one of the greatest resources I've seen in a long time...
This book, by Drs. Brock and Fernette Eide is truly a gift to professionals, parents, and our children! I do hope you have the resources to order it, or even request it to be ordered from your local library. But, I suggest having your own copy as you will want to refer to it often! It is THAT good!
If you are looking to order it (and the link above did not work in your email program), you can find it at my bookstore. Here is the link:
Spread the word and keep your "eyes open" for this difficulty in the children you see, play with, and work with every day! YOU can change a life.
Together we WILL make a difference!
Take good care.
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