Visual Processing Deficits... Often Misdiagnosed... Clearly "Visible"

Did you know, statistics say about 80% of our SPD kiddos will also have VISUAL processing 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

“The signs that a child has visual problems are frequently subtle and clearly visually related.” (The Mislabeled Child, 2006) Given that many kids may not even know they are battling any visual deficits, it is particularly important if they DO complain about their eyes...Believe them!

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, read Choosing An Eye Doctor.

The areas of vision we are talking about here go FAR BEYOND the usual areas tested by a “normal” I exam... i.e., acuity, nearsightedness, farsightedness, astigmatism, 20/20 vision, etc. (although acuity is ONE type of visual input). The difficulties we are referring to under visual processing include :


- Eye Teaming
- Convergence Insufficiency
- Visual Field Cuts
- Depth Perception

Pattern Processing...

- Visual Memory
- Visual-Motor Coordination
- Visual-Spatial Perception
- Visual Attention
- Visual Field Cuts / Blind Spots (which can be ONE explanation for clumsiness)
- Visual Closure
- Figure-Ground Discrimination
- Visual-Gestalt Perception
- Face Blindness
- Visual Attention / Visual Task Persistence/ Visual Distractibility


- Visual-Motor Integration
- Hand-Eye Coordination

(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. Ophthalmology... “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 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.

The Jess Oppenheimer Story

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.

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Related Resources

The Mislabeled Child - the ULTIMATE book relating to visual processing, memory, auditory processing, attention difficulties, autism, SPD, dyslexia, dysgraphia,, math problems, learning challenges and giftedness. This book, by Drs. Brock and Fernette Eide is truly a gift to professionals, parents, and our children!

A Parents' Guide to Children's Visual Development

A Questionnaire To Help You Determine If Your Child Has A Learning Related Vision Problem

A Parent's Checklist To Identify Early Signs Of Vision Impairments

Terms And Definitions Of Visual Skills That Should Be Included In An Eye Exam

Vision And Learning Disabilities Checklist

Is It ADHD Or A Visual Processing Deficit?

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