close up of child's eye and their hand holding purple glasses up to their face

Precilla Pena'southward story started out like many stories in the special education world. Things seemed to go well for her daughter Ava throughout preschool and kindergarten. In that location were fiddling things, here and in that location, she said, a turned alphabetic character, typical pre-literate confusion. No 1 was worried.

"They told us she'd grow out of it," Pena said.

Ava got by on memorization, and avoided written work whenever possible. She memorized what she could and had other things read aloud to her. Such patterns are typical of children with reading disorders, but they are difficult to spot in the early years.

By 2nd grade, all the same, things were going downhill quickly. Not only was their girl struggling in school, Pena said, but she was as well coming home with splitting headaches.

"We were at our breaking bespeak," Pena remembers. She didn't know how much the two concerns were linked, but both had her worried.

Clues to a Need for Vision Therapy

Ava's teacher recommended dyslexia evaluation. While they were waiting for that, a friend suggested vision therapy, which was not available in Corpus Christi, where the Penas live. Most optometrists are not trained in vision therapy, which has more to do with strengthening muscles and coordination than corrective techniques like lenses or surgeries. However, a relatively simple evaluation to recommend  occupational therapies can be life changing for immature children whose mysterious and seemingly unconnected symptoms all come together in the visual system.

Though bright and like shooting fish in a barrel to talk to, Ava had ever seemed shy and averse to the chaotic playscapes of babyhood. She came across as uncoordinated and a little impuissant, and was decumbent to severe motorcar sickness. Considered separately, each of those attributes could exist the quirk of a completely neurotypical child— definitely not something that would compel parents to drive three hours for an evaluation. However, Pena and her married man were at that familiar stage in the diagnostic process in which every personality trait, every quirk, every challenge becomes a clue in unraveling a mystery.

They traveled to Austin for an evaluation. Upon learning that Ava had been using one eye for 70 percent of her visual intake, with the other centre considered amblyopic (a "lazy heart"), had reduced peripheral vision, and had binocular dysfunction that affected her depth perception, many of the quirks and habits that Pena had observed started making sense. Ava's optics were not working together as a team, and were sending information to her brain in scrambled, irregular patterns. As a result, the brain didn't recognize letter and number patterns as familiar. Her visual information gathering, at age viii, was like that of a five-year-former.

Realizing the strain her daughter had been under, Pena began crying. "We'd spent a yr and a half thinking that she just wasn't trying," she said.

Vision Issues in the Classroom

No amount of unstructured "trying" can resolve the vision problems that make it hard for some children to thrive in a classroom setting, vision therapist Melody Lay explained. They don't know that what they are seeing isn't what they are supposed to be seeing, and they certainly don't know what their visual arrangement is doing to compensate. Their vision may exist blurred, doubled, going in and out of focus, or discolored, Lay said, "But kids don't know that'due south not where they're supposed to see."

A 24-hour interval of reading, looking at a blackboard or smartboard, iPad, teacher, and the numerous other visual tools of the classroom requires ii eyes to work together to get together information far and near and ship it to the encephalon for interpretation. Repetition creates familiarity as long as every repetition is sent to the encephalon in a reliable way. For students whose eyes go in and out of focus, whose field of vision is compromised, or whose eyes are perpetually seeing unlike things (think difference between letters "c" and "o" when your optics are tired or if you squint) the day is frankly, Lay said, exhausting. Vision experts say that 90 percentage of human sensory input is visual. If that input is chaotic or strenuous, Lay explained, kids cannot translate or "learn" it.

The exhaustion—actual ocular muscle fatigue too every bit brain burnout—leads to frustration and lost focus. Many of these students stop upwardly identified as having ADHD and dyslexia. It's difficult to know, said Lay, how often the vision problem is creating the inability to focus or the disordered reading. She's not sure how frequently years of untreated vision problems could atomic number 82 to comorbidities, and how often solving the vision problem leads to a resolution of other issues.

"Vision therapy is all almost neurology," Lay explained, and the mode stimuli shape and wire the encephalon is not often as simple equally a unmarried diagnosis or therapy.

Vision Evaluation and Therapy

Vision therapy begins with a dr. visit, and at Vision Therapy of San Antonio that is Jason Deviney. Then therapists assign various exercises and therapies to do at home betwixt weekly check ins, either in office or by video briefing. Some of the therapies target the eye muscles directly, such as wearing a patch over the stronger middle. Others have to practice with coordination and reflexes.

Learning to read requires 17 distinct visual skills, Lay explained, and each of them is continued to a whole suite of encephalon functions. Balancing exercises, manus-center coordination, following movement with both optics—all of these create connections in the brain that will exist used to read.

For most children, Lay explained, all of these skills develop naturally over the class of infancy and early childhood. Babies are constantly beingness picked up, whizzing around on their parents' shoulders, rolling, falling, grabbing, climbing, and establishing balance in a world that is moving far faster and more deftly than they are. Nearly will slowly develop the sensory systems they need to navigate, but others—ane in vi, Lay says—develop differently. Without any concrete or mechanical reason (no injuries or birth defects), their muscles and brains do not make the necessary connectedness and the necessary time. Considering they don't know they've missed something, they will compensate and reinforce the less ideal pathway.

Unless the vision event results in wandering or turned eyes, Lay said, many struggles become unnoticed. No one says a person must be fantabulous at throwing and catching balls. Kids trip all the time even if their optics are working fine; they're kids. It is reading—a skill adult well into a child's neurological development—that ordinarily sounds the alarm. Lay would like to see screening happen earlier. Therapy for infants is as simple as swinging, bouncing, and other natural movements done at college frequencies or sustained periods. Uncomplicated things could aid the brain rewire faster without the years of struggle and bounty.

Vision Therapy to See the World More than Clearly

After almost a twelvemonth of therapy, Pena said, Ava has made huge strides. Her school district, London ISD, did not have experience with vision therapy, but was prepare to learn and help, she said. They put Ava on a 504 plan to ensure accommodations similar large print text and visual aids close to her desk.

At present in third class, Ava is reading at a fourth grade level. She loves mystery novels. Well-nigh of her grades are A'due south and high B's. She's started playing volleyball and dancing, neither of which she would have tried before. In fact, ane of the most heady changes for Pena, she said, was the confidence her daughter now shows, and the pride in her progress.

A lot of piece of work went into seeing the world as it is. Pena said, "There'southward so much appreciation for information technology."

Heart graphic and title "Towards a Kinder World: A Series on Special Education"

About the Writer

Bekah McNeel is a San Antonio-based education writer who focuses on disinterestedness, innovation, and social-emotional learning for publications such asThe 74. Over the years, we have republished local education coverage from her Hall Monitor site, and last November she wrote for u.s.a. a four-office series, "Punished, Not Served," most unfair bailiwick for students with disabilities.

Read More

  • "One Mom's Feel with a Dyslexia Simulator," Bekah McNeel, San Antonio Lease Moms, June 24, 2020
  • "Gloat Dyslexia: Teaching, Identification, and Celebration of Dyslexic Students," Bekah McNeel,San Antonio Charter Moms, June 10, 2020
  • "What Special Education Parents Want to Go along From COVID-19," Bekah McNeel,San Antonio Charter Moms, May 27, 2020
  • "MTSS: Beliefs Support That Comes Before Special Teaching," Bekah McNeel,San Antonio Charter Moms, May thirteen, 2020