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Special Needs

Signs and Symptoms of a Vision Problem in Special Needs Children

If your child displays any of these symptoms, an undetected, underlying but treatable vision problem may be contributing to the problem.

  • Skips/repeats lines when reading
  • Omits small words when reading
  • Poor reading comprehension
  • Homework takes longer than it should
  • Reduced visual attention
  • Trouble keeping attention on reading
  • Difficulty completing assignments on time
  • Difficulty copying from board
  • Burning, itchy, watery eyes
  • Tilts head/closes one eye when reading
  • Closes or covers one eye
  • One eye turns in or out
  • Avoids near work/reading
  • Unable to listen and look at same time
  • Holds reading material too close
  • Poor handwriting
  • Clumsy/knocks things over
  • Car/motion sickness
  • Unusual neck and body postures
  • Visual perceptual problems
  • Short attention span
  • Uncontrolled eye shaking (Nystagmus)
Vision Problems and Special Needs Children

Children with Special Needs have the same vision problems as neuro-typical children. These disorders may include, nearsightedness or farsightedness, as well as other eye-coordination disorders such as eye turns (strabismus); eye movement dysfunction, “lazy eye” (amblyopia); or poor eye teaming and coordination, causing the child to have a distorted sense of what he is viewing. Depth perception and other visual information-processing problems are also common.

Vision problems of this nature can add to your child’s challenges.

A hidden visual dys-function may be affecting the child’s behavior, interfering with his ability to read and learn, and reducing his ability to perform routine tasks.

Vision Problems Often Get Overlooked

Often, the Special Needs child is unable to sit still for a normal eye exam, which can result in an inaccurate or incomplete evaluation. The child may have an intermittent (occasional), rather than a constant eye turn that could go undetected. The eye chart exam measures what the child can see at 20 feet away, but will miss how he sees things up close, such as words in a book. And, unfortunately, children don’t know how they are supposed to see, so they rarely complain, leaving certain problems hidden.


Visual Perceptual Delay

It’s no surprise that visual-perceptual delays are common in children with Sensory Integration dysfunction. Visual-perceptual skill refers to a person’s ability to interpret, analyze, and give meaning to what he sees.

Visual attention lets a child pay attention to what she is doing while blocking out extraneous stimuli. A child who is easily distracted has trouble sustaining visual attention. When reading, a child may feel compelled to look at visual stimuli around him- even visually scanning around all the words on the page rather than just focusing on the words he is currently reading. Some kids have trouble shifting their visual attention, getting so absorbed in what they are looking at that they don’t notice anything else happening around them. A visually hyporesponsive child may have problems noticing a visual stimulus or sustaining visual interest, tiring quickly. A child who is not looking and visually attending misses out on vital developmental opportunities. However, it should be noted that many children are soaking in information all the time through their other senses, even if they aren’t looking (or don’t appear to be listening).

Visual discrimination lets your child identify distinct features of objects such as color, shape, size, and orientation, and helps her match and categorize objects. As she grows, she can perceive the difference between a triangle and a circle, or B and b. The child with visual discrimination problems may have trouble recognizing faces, or noticing the difference between a rectangle and a square.

Visual memory lets your child remember things he has seen, a skill that’s essential for imitating new gestures and movements, sequencing writing and spelling tasks, recognizing words and people, and more. With a poor visual memory, he may have excellent memory for life experiences rather than factual information, and may have difficulty relating new visual information to what he already knows.

Figure ground lets your child differentiate between foreground and background, which is essential for attending to important visual stimuli while ignoring distracting surrounding. This skill lets him find his favorite dump truck in a box full of toys and keep his eyes on the teacher in a busy classroom. The child with figure-ground difficulty may have trouble reading because he can’t select specific words on a page to read.

Visual closure lets your child use visual clues to recognize objects without seeing the entire image. This skill lets him find lunchbox if it’s partially hidden behind a milk carton and recognize a complete word if he has only seen a part of that word (proficient readers do not have to look at every letter).

Form constancy lets you child perceive things as the same regardless of environment, position, size, and other details. When she’s younger, she learns that a spoon is a spoon whether it’s upside down, turned sideways, a silver tablespoon, or a plastic toy spoon. In school, she learns that the letter S is an S whether it’s handwritten or typed, in print or cursive, or sideways.

Laterality, directionality, and spatial vision: Laterality lets your child differentiate between right and left sides of his own body. Directionality lets him perceive the right and left side of external objects. Both are essential to spatial vision, which tells him how an object is positioned in space. He learns that his right hand goes into the left sleeve of his jacket when it is facing him. When he is school-age, he learns that the lowercase b has a line on the left side, and the d has a line on the right side. A child with poor spatial vision may have difficulty playing with toys learning to climb stairs and catch a ball (both require depth perception), and developing many self-care tasks. He may have persistent letter reversals (beyond age eight), be confused about letter or number sequences, have trouble understanding directional words such as up, down, in, out, under, and over, and have poor topographical orientation and become easily lost.

Your child also needs to develop her visual-motor integration skills. Her eyes and body must work together to accomplish many developmental tasks, from stringing beads to catching a ball. Also referred to as eye-hand coordination skills, visual-motor integration is the term used for the interaction of motor skills, visual skills, and visual-perceptual skills.

Behavioral & Neuro- Developmental Optometrist’s Role

A Behavioral & Neuro-Developmental Optometrist is a vision specialist skilled in identifying and treating vision problems including Visual perceptual skill, which interfere with reading, learning and activities of daily living. These vision problems are not found during routine eye chart exams, yet are so often found in Special Needs children.*

Visual skills & Visual Perceptual skill like any other skill, are developed and can be improved with proper therapeutic techniques. Mr. Tien is trained and skilled in the delivery of optometric vision therapy, a non-invasive, individualized treatment program using specialized lenses, techniques and/or equipment to teach the patient to use his eyes correctly.

After conducting a set of Neuro-Developmental visual tests and evaluating them, he discusses his findings and recommended treatment program with the parents or guardians, after which he closely supervises each patient through his or her tailor-made, in-office and at-home program of non-invasive optometric vision therapy to achieve the goals of the program.

We understand that you might have a number of questions; especially if this is the first time you are hearing that you may have a vision problem. Please feel free to call our office with your questions. 

Click Here to schedule an appointment or  please call us at +603- 2110 3967.