Pediatrician: Vision Contributes to Learning Difficulties

Vision has traditionally been recognized as the main sense in about 80% of what children do in a classroom. Today, with the heavy reliance on text-based learning, especially that which presented on digital screens at near distances, we find that strong vision plays an even greater role. This is explained in much more detail in a recent collaboration between myself and Dr. Noella Piquette, an Associate Professor in the Faculty of Education at the University of Lethbridge.

If you have not had your child’s vision checked, it’s time you do. If someone tells you it’s not important, take it as a sign they’re not interested in your child’s total health, and perhaps not fully equipped professionally.

There are many possible visual impediments to learning, and most are not immediately visible to untrained eyes. Conditions such as Convergence Insufficiency (CI), where vision cannot bring both eyes onto near targets simultaneously, is one example of a visual impediment where children will at times show so-called ’20/20′ vision, but no other outwards signs of trouble with vision to the untrained eye. ‘CI’ affects some 5% of children. Difficulty in targeting near objects causes children to have trouble with reading in an orderly fashion, and the strain of near vision combined with frustration of ‘moving words and lines’ makes the child lose attention and become fidgety. There are very effective means of detecting and treating Convergence Insufficiency, but the great majority of affected children generally end up in psychological and medical testing and treatment that does little to no good at addressing the underlying causes. To be clear, medications will not help with Convergence Insufficiency but can often mask the problem while making functional vision more difficult.

Regular readers will know that my particular area of interest, visual impediments to learning, stems from my background in neural science, education, and behavioral optometry. What I know is this: What we’re not doing for our children is harming them, and costing families and taxpayers millions each year. Some detractors maintain that it’s the optometrist’s job to sell glasses, so it’s not surprising that I would raise alarms about the role of vision in child development, learning, and behavior. Aside from being silly and truly ‘back woods’ thinking, such comments are frankly dangerous to those children who suffer but whose parents are convinced to follow ill-informed advice from inadequately educated professionals. When your family doctor requests blood work, it is not because he is simply trying to fill his appointment book, it’s because he has the expertise and good reason to look further. Such is the job of the developmental optometrist when it comes to your child’s vision.

10 years ago, I had no idea that vision was any more than eyeballs, or that it matters in a child’s life. I had the same simple view that most developmental professionals share today: Adquate ‘vision’ is a matter of being able to read an eye chart at 10-feet and not having pink-eye. It’s one of those things where when you learn more, you can never go back.

Such is the case with Dr. Debbie Walhof, a US pediatrician who, with friend and colleague Dr. Len Press, very succinctly describes the role of vision in the appearance of conditions like ADHD and dyslexia related to Convergence Insufficiency in this article from the National Center for Learning Disabilities. As a pediatrician, I am quite sure Dr. Walhof has no direct interest in selling glasses, as are many of the researchers involved in the studies quoted in this post. Furthermore, the application of glasses is most often not a part of therapy for convergence insufficiency, though they can help in some cases.

From the NCLD Article:

Why do some doctors say vision therapy is controversial or that it lacks research?

Even though there is a wealth of optometric research which proves that vision therapy works, there are some in the medical (ophthalmology and pediatric) community who have the misimpression that there is insufficient evidence. The fact is that vision therapy is an optometric specialty and therefore the bulk of the research is in the optometric journals, not the medical journals. Vision therapy is not new; it has been around for 85 years!

In the end, it’s what is done for a child that counts. Guessing whether a child is troubled with vision concerns is not an appropriate clinical approach to health or education. The best part of child exams for me is when I get to review visual function with parents and watch their eyes open and smiles broaden as they learn things they never even knew about their children. Research and clinical experience shows vision is not only important, it’s critical. If you have not had your child’s vision checked, it’s time you do. If someone tells you it’s not important, take it as a sign they’re not interested in your child’s total health, and perhaps not fully equipped professionally.

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