self-care, leisure and productivity
Below is a chart that provides examples of some behaviours that children with visual processing difficulties may exhibit. Parents, teachers and therapists should be aware of these behaviours as they often go unnoticed (Benbow, 1992). Regardless of the child's age, visual processing disorders can affect a variety of activities of daily life, including productive occupations, self-care and leisure pursuits. There will be an increased focus on productivity as school health occupational therapists are often referred for assessment and intervention regarding academic performance and hand writing (Feder et al, 2000). A more detailed explanation within each area will be discussed below.
productivity
ACADEMIC PERFORMANCE
▪ 70 - 90% of learning is stored as visual memory (Benbow, 1992).
▪ Impaired ability to spell, read and write can occur due to difficulties with visual memory and difficulties with shifting focus of the eyes from near to far, such as when copying off of the board in class (Benbow, 1992).
▪ When figure-ground is impaired, the child will get easily distracted by background images or alternate print on the page (Center for Learning Disabilities, 2014).
▪ Children with eye-teaming problems find it difficult to remain focused for long periods of time since eye-strain is overwhelming (Children's Vision Information Network, n.d.)
▪Children with visual processing disorders are often misdiagnosed as having attention deficit disorder (Children's Vision Information Network, n.d.)
▪ Impaired ability to spell, read and write can occur due to difficulties with visual memory and difficulties with shifting focus of the eyes from near to far, such as when copying off of the board in class (Benbow, 1992).
▪ When figure-ground is impaired, the child will get easily distracted by background images or alternate print on the page (Center for Learning Disabilities, 2014).
▪ Children with eye-teaming problems find it difficult to remain focused for long periods of time since eye-strain is overwhelming (Children's Vision Information Network, n.d.)
▪Children with visual processing disorders are often misdiagnosed as having attention deficit disorder (Children's Vision Information Network, n.d.)
READING
Eye Teaming/ Eye Tracking Problems
▪ Could be due to strabismus (cross-eyed) or amblyopia (lazy eye), or convergence insufficiency (CI). (Advanced Vision Therapy Center, 2014).
Strabismus (Cross-eyed)
▪ Occurs when one, or both eyes turns inward, upward, out or down (Adanced Vision Therapy Center, 2014).
▪ Each eye aims independently when trying to focus, which results in double vision. The brain, however, suppresses one eye from working as a protective mechanism, and therefore the child only sees out of one eye and experiences 2D vision (Children's Vision Information Network).
▪ Could be due to strabismus (cross-eyed) or amblyopia (lazy eye), or convergence insufficiency (CI). (Advanced Vision Therapy Center, 2014).
Strabismus (Cross-eyed)
▪ Occurs when one, or both eyes turns inward, upward, out or down (Adanced Vision Therapy Center, 2014).
▪ Each eye aims independently when trying to focus, which results in double vision. The brain, however, suppresses one eye from working as a protective mechanism, and therefore the child only sees out of one eye and experiences 2D vision (Children's Vision Information Network).
Amblyopia (Lazy eye)
▪ Inward turn of one eye causing blurriness in the affected eye because the brain compensates by turning off vision in one eye and therefore clear vision does not develop in the lazy eye (Advanced Vision, 2014).
▪ An estimated 3% of children under six have some form of amblyopia
▪ Inward turn of one eye causing blurriness in the affected eye because the brain compensates by turning off vision in one eye and therefore clear vision does not develop in the lazy eye (Advanced Vision, 2014).
▪ An estimated 3% of children under six have some form of amblyopia
Convergence Insufficiency (CI)
▪ A binocular vision disorder that causes reading or performance of close work to be difficult.
Common complaints/behaviours to be aware of : Eye-strain, headaches, blurred vision, diplopia (double vision), fatigue, loss of place, difficulty concentrating, poor comprehension after reading, skipping lines or words while reading, covering one eye while reading, reading slowly, having to re-read sentences, losing their place when reading.
▪ Moving of print occurs due to unstable binocular alignment relative to the convergence demand of the eyes when using near vision, such as when reading and writing.
▪ A study by Barnhardt et al (2013) found that performance-related symptoms were reported to occur more frequently than eye-related symptoms in children.
▪ 50% of children reported performance deficits such as "losing place when reading, and 45% lose concentration and 40% have to re-read as a result of their convergence insufficiency (Barnhardt et al,2013). Children with CI had a significantly greater occurrence of blurred vision and diplopia, double vision ( Borsting et al, 2003).
See the assessment section for more information about the Convergence Insufficiency Symptom Checklist if the child is having any of the above symptoms.
▪ A binocular vision disorder that causes reading or performance of close work to be difficult.
Common complaints/behaviours to be aware of : Eye-strain, headaches, blurred vision, diplopia (double vision), fatigue, loss of place, difficulty concentrating, poor comprehension after reading, skipping lines or words while reading, covering one eye while reading, reading slowly, having to re-read sentences, losing their place when reading.
▪ Moving of print occurs due to unstable binocular alignment relative to the convergence demand of the eyes when using near vision, such as when reading and writing.
▪ A study by Barnhardt et al (2013) found that performance-related symptoms were reported to occur more frequently than eye-related symptoms in children.
▪ 50% of children reported performance deficits such as "losing place when reading, and 45% lose concentration and 40% have to re-read as a result of their convergence insufficiency (Barnhardt et al,2013). Children with CI had a significantly greater occurrence of blurred vision and diplopia, double vision ( Borsting et al, 2003).
See the assessment section for more information about the Convergence Insufficiency Symptom Checklist if the child is having any of the above symptoms.
behaviours |
Common difficulties with reading because of a visual processing disorder (Benbow, 1992):
▪ Reading slowly ▪ Poor comprehension ▪ Avoidance of reading ▪ Losing place while reading ▪ Using finger to underscore words while reading ▪ Complaints of being tired when reading |
WRITING
▪ Writing is an occupation for school-aged children, since it is an expected skill in the classroom environment ( Feder et al, 2000).
Hand writing performance is often judged as a reflection of an individual's capabilities, and thus can have an effect on a child's self-image, academic achievement, attitude and behaviour ( Feder et al, 2000).
▪ Writing is a complex skill that encompasses visual-motor integration, visual-perceptual skills as well as tactile and kinesthetic awareness (Feder et al, 2000).
▪ Visual-perceptual issues can be the cause of handwriting difficulties due to poor visual-motor skills for formulating letters, poor visual discrimination for writing within the lines, and poor visual memory required to remember the formation of the letters and copy from the board.
Hand writing performance is often judged as a reflection of an individual's capabilities, and thus can have an effect on a child's self-image, academic achievement, attitude and behaviour ( Feder et al, 2000).
▪ Writing is a complex skill that encompasses visual-motor integration, visual-perceptual skills as well as tactile and kinesthetic awareness (Feder et al, 2000).
▪ Visual-perceptual issues can be the cause of handwriting difficulties due to poor visual-motor skills for formulating letters, poor visual discrimination for writing within the lines, and poor visual memory required to remember the formation of the letters and copy from the board.
Letter and symbol reversal problems
▪ Letter reversals commonly occur in beginner non-dyslexic readers between the ages of 3-7 years old
▪ Often, children with visual processing disorder will continue to make letter reversal errors past age 7 (Blackburne et al, 2014).
▪ Developing the perception of individual letters is functionally neglected after the earliest stages of reading acquisition as children focus on word reading, and recognize letters within words rather than individually (Blackburne et al, 2014)
▪ Orientation sensitivity (i.e. reading from left to right) is slow to develop in children, and the experience of reading is needed to promote orientation sensitivity ( Blackburne et al, 2014).
▪ This was confirmed in the study by Blackburne (2014), which used fMRI imaging shown to adults and children. Children up to twelve years old did not demonstrate any brain imaging differences between correctly oriented and reversed letter, whereas adults exhibited larger responses on the fMRI for the reversed letters.
▪ Letter reversals commonly occur in beginner non-dyslexic readers between the ages of 3-7 years old
▪ Often, children with visual processing disorder will continue to make letter reversal errors past age 7 (Blackburne et al, 2014).
▪ Developing the perception of individual letters is functionally neglected after the earliest stages of reading acquisition as children focus on word reading, and recognize letters within words rather than individually (Blackburne et al, 2014)
▪ Orientation sensitivity (i.e. reading from left to right) is slow to develop in children, and the experience of reading is needed to promote orientation sensitivity ( Blackburne et al, 2014).
▪ This was confirmed in the study by Blackburne (2014), which used fMRI imaging shown to adults and children. Children up to twelve years old did not demonstrate any brain imaging differences between correctly oriented and reversed letter, whereas adults exhibited larger responses on the fMRI for the reversed letters.
behaviours |
Common difficulties with writing because of a visual processing disorder (Benbow, 1992):
▪ Difficulty writing within the lines of a page, or aligning numbers such as when doing math ▪ Making spelling mistakes when copying from the board ▪ Taking a longer time to write than other children ▪ Poor handwriting; unevenly spaced, difficulty writing within the margins of the page |
leisure
physical activity
▪ Difficulty with judging distances (i.e. bumping into things/placing objects too close to an edge (The National Center for Learning Disabilities, 2014).
▪ Fluid movements are impaired, such as getting out of the way of a moving ball, knocking things over (The National Center for Learning Disabilities, 2014).
▪ Poor hand-eye coordination creates difficulty with catching a ball or responding to moving targets such as while playing sports in gym class. The child has difficulty responded to what their eyes see with their body movements (Benbow, 1992).
▪ Fluid movements are impaired, such as getting out of the way of a moving ball, knocking things over (The National Center for Learning Disabilities, 2014).
▪ Poor hand-eye coordination creates difficulty with catching a ball or responding to moving targets such as while playing sports in gym class. The child has difficulty responded to what their eyes see with their body movements (Benbow, 1992).
self-care
ACTIVITIES OF DAILY LIVING
Dressing
▪ Independence with dressing is a common occupational performance issue for those with visual processing disorders (Kidsense Child Development, 2014).
▪ Recognizing what articles of clothing go where, and in what order requires visual-sequential and visual-spatial awareness
Finding clothing among similarly colored clothing requires figure-ground visual processing
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▪ Recognizing what articles of clothing go where, and in what order requires visual-sequential and visual-spatial awareness
Finding clothing among similarly colored clothing requires figure-ground visual processing
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