Spotlight TEDx Talk: Why childhood vision disorders often are mistaken for learning disabilities

Dr. Vicky Vandervort at TEDxLincoln

Dr. Vicky Vandervort at TEDxLincoln

“Two in five children have vision conditions which affect learning,” reports the American Optometric Association, and yet it is estimated that over 10 million American children have vision problems that are undiagnosed and untreated.

Why? Because vision disorders are not placed on the list of usual suspects when it comes to learning issues, says optometrist Vicky Vandervort at TEDxLincoln. Though vision disorders can contribute to issues with reading comprehension, attention, concentration and focus for children in school, these disorders go undetected, and children get misdiagnosed, because diagnosing vision disorders can be a tricky matter. “Children can have normal intelligence, 20/20 vision and still have a learning problem caused by a vision issue,” she says.

One of these disorders, convergence insufficiency (CI), occurs when a person’s eyes have trouble working as a team. CI causes double vision, headaches, eyestrain and difficulty reading and focusing, as people with CI often perceive text to be moving across the page as they read. “When eye coordination isn’t on autopilot like it should be, it takes extra thought and concentration [to do things like read a book or a chalkboard],” Vandervort says, “and that depletes the brain’s ability to comprehend [what's been read].”

What it's like to read with convergence insufficiency disorder. (Courtesy Dr. Vicky Vandervort)

What it’s like to read with convergence insufficiency disorder. (Courtesy Dr. Vicky Vandervort)

Despite CI’s negative symptoms, “children usually don’t report [CI symptoms] because they think this is how everyone sees. And if they do, they’re likely to hear, ‘Words can’t move around on a page,’” Vandervort says. “Millions of children suffer silently while the adults in their lives rationalize their symptoms or mistake them for ADD,” she says, “[because] most health and educational professionals are unaware of convergence insufficiency and other learning-related vision disorders.”

“And since 75% of what children learn in school is processed by the visual system,” Vandervort says, “when a child has this condition, it’s devastating.”

Learn more in Vandervort’s talk below:

Insight from the TEDx office — why we like this talk:

The speaker — a trained optometrist — explores a significant problem that affects both her field and the public: lack of awareness of learning-related vision disorders. She presents a talk that is clear, evidence-based and supported by her experience in the field, strong visuals and straightforward language.

12 Comments

  1. Kirsten Ferguson

    My son was diagnosed with a problem which is namely that the nerves in his eyes are growing over his pupils so he always sees the light reflecting off the nerves. This makes his eyes watery at times and proves to be very distracting when reading at school. Nobody seems in the least bit interested in the issue at school or his consultant / optician.
    It really affects him, so I can totally appreciate this talk. I just wish I could seek some solutions for him. He too has 20/20 vision.

  2. Similarly, there are also hearing disorders, both conductive (the ability to hear) and spatial processing disorders that impact learning and are often overlooked or misdiagnosed.
    In Australia, a new game based test -Sound Scouts – will soon be released to test children for these conditions.

  3. Shannon Harner

    Dr. Vicky worked with both of my children (this is an hereditary problem and I can see hints of it in myself and siblings). The vision therapy was a game changer for us. It was initially surprising to me that within two months of taking my first child for a first grade vision exam, where no one even looked for this and were told she had 20/20 vision, we discovered she had a significant problem tracking through a line of written words, as well as having convergence insufficiency.

    I hope all standard eye exams for young children starting school incorporate these important tests. And that insurance will begin to cover the treatment when appropriate. The increase in overall learning and lifetime productivity would merit it.

  4. Cathy

    My daughter has CI and a small visual field. We discovered this the summer between 5th and 6th grade. All vision exams were fine until we saw a developmental optometrist, that changed everything! She has improved, but now that she is 15, she does not complete the exercises she needs to. I wish someone had noticed this earlier when it would have been easier to make her do the exercises! Great article! I know my daughter had a lot of trouble explaining what she sees. It was described as boxes around everything. Last fall when she saw the high school marching band, she said that is what it looks like when she reads.

  5. Elaina Carr

    As a school based OT, I am finding that a lot of my kiddos that are being referred at the Intermediate level (3rd-5th) have significant deficits with their visual perceptual skills. The Diagnosticians do not have a test that is picking up on these deficits early on. If I could have gotten these kiddo’s in K-2nd – they would be so much further ahead. Is there a resource out there that we can utilize in the beginning stages of a school referral that could red flag us?
    This is a great article! Thank you!

    • Narelle

      If a child can’t follow a pen into the bridge of their nose and hold the focus without their eyes jumping away then they most likely need to be properly assessed for CI.

  6. Cindy Lawson

    My son had issues like this. Special Ed at school said it was a medical problem and wouldn’t provide services. Health insurance said it was a learning issue and they wouldn’t pay for it. We paid out of pocket for treatment until we couldn’t afford it any more. Sad that is so over looked.

  7. As an Educational Kinesiology (Brain Gym®) instructor/consultant, I’ve learned that many reading problems are the product of challenges in eye teaming and tracking. This is often a result of both brain hemispheres not fluidly sharing information with each other (perhaps because the child never went through the crawling stage, or has significant retained infant reflexes).
    Most of the clients I’ve worked with who have eye teaming issues are also not able to “cross the midline”, meaning that they have difficulty (for example) in bringing the right elbow over to the left knee, and vice versa. This is the movement called the Cross Crawl in Brain Gym, one of its activities called Midline Movements. Some of my clients who repeated the Cross Crawl and other Midline Movements over time have improved eye teaming and tracking to the point where reading issues have actually disappeared. In other cases, I have facilitated a process called Dennison Laterality Repatterning (DLR), a key Brain Gym protocol for supporting whole-brain integration, which often has an immediate effect on ability to cross the midline. In many cases, following DLR, children are suddenly much more able to use both brains simultaneously, and therefore both eyes suddenly team and track together with much greater facility. This process is taught in the entry level Brain Gym class, BG101.
    These Brain Gym processes may not be the entire solution for every child, but I repeatedly see significant, immediate changes in the children I work with – sometimes (remarkably) in a single session, and sometimes in sessions over time, perhaps using other tools of Educational Kinesiology to address deeper challenges. I am a former classroom educator (23 years teaching K-6) and I truly wish I’d understood the need to address these vision challenges for success in reading, and had the tools to do that, while I was still teaching.
    While Brain Gym instructors are trained in identifying and helping to resolve these issues, which may require more complex interventions, anyone, with no further training, can at the very least begin with buying a book about Brain Gym or doing some online research about the Midline Movements of Brain Gym like the Cross Crawl, the Double Doodle, and Lazy 8s, and share them with their child in a playful way, and see what kinds of improvement may follow. Doing these movements may at first be challenging for the child, but with repetition, in a non-pressured atmosphere, may reap huge rewards.
    Let’s get every child reading!

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