Vision problems can make school a struggle

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SEATTLE, Washington (AP) -- Adam Schunke used to think he was just dumb.

Schoolwork that came easily to his friends was a monumental struggle for him. He loved making up creative stories in his head, but he hated reading and writing. His mother, Wilma Schunke, didn't know what to do with the 15-year-old. Three years of intensive tutoring didn't seem to help. Adam just wasn't getting it, and she started to feel that she was the one failing.

Schunke didn't get her hopes up when a friend recommended an optometrist who specialized in something called vision development. With glasses, which he had worn since the age of 5, Adam's eyesight was 20-20. Surely his eyes couldn't be the problem, Schunke thought. But she was desperate enough to try anything, so she made an appointment.

The optometrist led Adam through a series of simple tests designed to tell whether his eyes were tracking and working together properly. She held up a finger and asked Adam to follow it with his eyes. As her finger passed in front of Adam's nose, Wilma Schunke saw her son's eyes quiver, something she had never seen before. Clearly, something was wrong with his vision. She started to cry. "Why couldn't someone have done this before?" she wondered. "It was such a relief. A mother's heart hurts when your kid does not do well."

'I feel smarter'

Adam was diagnosed as having problems with eye movement (ocular motility) and eye teaming (binocularity). Daily vision therapy exercises -- like physical therapy for eyes -- and regular optometrist visits changed his life. He doubled his reading level, increased his confidence in school and dreams of becoming a zoologist or marine biologist. "I feel smarter," said Adam, now 16 and in 10th grade. "I don't feel so down on myself anymore."

An estimated 10 million children in the United States suffer from problems with their vision, ranging from simple nearsightedness to more complex problems of the type that plagued Adam. Good vision, as the Schunkes learned, requires more than good eyesight. Kids who can see the blackboard perfectly may still have vision problems that make it impossible for them to read. And simple eye tests in school won't catch many problems. In Adam's case, when he tried to read, his eye would skip around constantly. He'd start on one line and end up reading a line several paragraphs down the page. Nothing made sense. His vision therapy consisted of a series of computer exercises that he did for about 20 minutes five days a week. One program was a picture of an arrow inside a box. Adam had to click on the location of the arrow.

At first, Wilma Schunke said, she thought the exercise looked too easy. Then she saw that Adam was clicking way outside of the box -- that's where he saw the arrow. Over time, the exercises reshaped his vision so he could locate the arrow in the box and follow words on a page.

Easy to miss

Optometrists can become board-certified in vision development after three years of practice, a course of specialized study, a written exam and an oral interview by the College of Optometrists in Vision Development. These specialists say vision development problems are often misdiagnosed as attention deficit disorder. Many of the symptoms are the same, and the clues of vision problems are easy to miss. "The problems we're talking about are more subtle, and more difficult to detect," said Dr. Stephen Miller, executive director of the College of Optometrists in Vision Development.

Not everyone in the eye care community is convinced of the wonders of vision therapy. The American Academy of Ophthalmology, representing eye specialists with medical degrees, has issued a position paper saying, "Visual problems are rarely responsible for learning difficulties." The academy's doctors believe vision therapy and eye exercises can correct some eye problems, but generally won't help kids with learning disabilities. "We feel that medically there is not good evidence that a learning disability is caused by an eye problem," said Dr. Stuart Dankner, a pediatric ophthalmologist and a spokesman for the academy. The naysayers can't convince parents like Wilma Schunke, who has turned into something of a vision therapy evangelist after seeing what the treatment did for her son.

"The change in him was so phenomenal," she said. She now volunteers with a group called PAVE, Parents Active for Vision Education, and has spoken to teacher and parent groups about her son's story. Optometrist Dr. Nancy Torgerson treated Adam Schunke and has been working as a vision therapist for 23 years. She said both the research and the dramatic turnaround of patients like Adam convince her that it works. "That's what I see daily, and I don't want those kids missed and thinking they're dumb," Torgerson said. "I hope we can work together" with ophthalmologists, she added: "I hope we can help show them there is more to vision than eyesight."

Related Vision Problems Education And Evaluation

Whereas, It is estimate that more than 10 million children (ages 0 to 10) suffer from vision problems; and

Whereas, Many visual skills are necessary for successful learning in the modern classroom; and skill deficiencies may contribute to poor academic performance; and

Whereas, typical "vision" evaluations/screenings only test for a few of the necessary learning related visual skill (distance acuity, i.e. 20/20 eyesight, stereo vision, and muscle balance), leaving most visual skill deficiencies undiagnosed; and

Whereas, Learning related vision problems, when accurately diagnosed, can be treated successfully and permanently; and

Whereas, Knowledge regarding the relationship between poorly developed visual skills and poor academic performance is not widely held among students, parents, teachers, administrators and public health officials; now therefore be it

Resolved, That National PTA, through its constituent organizations, provide information to educate members, educators, administrators, public health officials and the public at large about learning related visual problems and the need for more comprehensive visual skill tests in school vision screening programs performed by qualified and trained personnel; and be it further

Resolved, That National PTA, through its constituent organizations, urge schools to include in their vision screening programs tests for learning related visual skill necessary for success in the classroom.

Why Is School So Challenging For Your Child?

It has been determined that 80% of what a child learns in school, is learned via the visual system. This is not surprising when you realize that 67% of all the nerves that enter the brain originate from the eyes!

Why would the brain dedicate so much of itself to vision? Survival. Our visual system can process more information, more quickly and simultaneously, than any other sensory system. It gathers information from a distance, so that we can move our bodies when and where we need to; to survive.

Then something happened that changed the visual requirements for survival forever; the invention of the printing press (about 450 years ago), and the technology to mass produce paper (about 150 years ago). Then, compulsory education came into play. Physiologically though, our brains are no different than they were 50 to 100 thousand years ago.

So survival today isn't running from a beast, or hunting one. In clear contrast to the skilled movement through dynamic three dimensional space required by our ancestors, survival in the 21st century is sitting quietly, looking at a two-dimensional language symbols placed 16" in front of your eyes for hours a day: reading and writing. If you are skilled with this, you will "survive"; that is, get good grades, go to college and get a good job.

Many children's visual systems are simply not developmentally prepared to contend with this. For them, it is a biologically unacceptable yet socially necessary task. Children's natural drive is to move, talk and engage in the manipulation of dynamic three dimensional space. Confinement to no movement, no talking, just sitting and looking at a flat surface of language symbols can result in significant behavioral consequences. Some of these behaviors masquerade as ADD or ADHD.

To test the visual system only with the antiquated Snellen Chart (the 20/20 eye-chart), is cruel to a child. If passed, it gives everyone a false sense that the visual system is prepared for learning.

What we know today is that the visual skills necessary for learning go far beyond the ability to see clearly. Only a full battery of physiological and perceptual tests can help determine if a child is developmentally prepared to engage in the demands of school.

"The problem is not with their eyesight, but with the way their brains process visual information."

--Corinne Smith, Ph.D.
Associate Dean of Education at Syracuse University.

"There is no question that there are a large number children who are diagnosed at some point during the course of their education as learning disabled. I firmly believe that one possible cause for this, is the failure of the visual system to process information in a normal way."

--Thomas Albright, Ph.D.
The Salk Institute for Biological Studies

"I feel guilty because I thought that my son was lazy"

--Joe Figuereo- Father of a child with a learning related visual problem

"Examining the research on school dropouts, juvenile delinquents, gangs and drug-abuse, points to one common factor - lack of school achievement. If one were to carefully choose a target for improving all the aforementioned areas, it would be improvement of the visual system which undergirds the ability to read"

--Professor Emeritus
Program Director Special Education
San Diego State University