Vision and Dyslexia

There’s little question that dyslexia comes with it’s visual complications. No one has done a better job of summarizing these than John Stein and Zoi Kapoula in their landmark book from 2012 “Visual Aspects of Dyslexia” (Oxford University Press, 2012).

This book is not a light read and is not designed for a pedestrian crowd. It’s a refreshing summary of bits of good research I myself had read along the way and added a few surprises, too. My inner scientist appreciated how the editors were able to draw expertise from a broad spectrum and go into some depth in pursuing the finer details of how vision and dyslexia are intertwined. It’s a great book, just maybe not the best beach material. Then again, …

When we look at a child who struggles with reading, we are compelled to ask why – this is a response to the fact the child is not meeting our expectations. There are often reports of visual deficits, like skipping lines, reversing words and letters, difficult maintenance, and so-called ‘tracking’ errors. In the absence of obvious clues, we assume there is a psychological or neurological deficit and pursue psycho-educational assessment and a battery of medical tests and imaging to look for something, anything. Hours, even days of testing, from paper and pencil to laboratories all over town.

Following the research trail presented in Visual Aspects of Dyslexia we can conclude two things: a) Dyslexics often show difficulties with different aspects of visual function, and b) there is no set pattern to the findings – and not all dyslexics show trouble with visual function.

In my own clinic, 9 out of 10 children who come through who are said to be dyslexic are not. In most cases, the children had not had anything like a comprehensive vision exam that looked at more than eyesight. And, in most cases, there were functional deficits from restrictive convergence, to difficulties in targeting, to difficult or impossible refractive aka focusing concerns.

There is little doubt that most kids, given a rich enough environment, will be able to read by 7 years – whether they do or not, or learn to or not is another question. Forcing children to read too early may be harmful in some cases, and simply irritating in others. Young learners need more multi-sensory and primary motor skills development than they do forced learning of words, spelling, and grammar. When the physiological elements are in place and well-watered, reading will follow given proper exposure.

When reading doesn’t follow, when it’s laboured, that doesn’t mean there’s some ‘neurobiological’ mystery diagnosis. In the 9 of 10 cases in clinic, we can usually make concrete recommendations for a variety of therapeutic steps to take. In these cases of reading trouble that is based in visual dysfunction, there are patterns seen that are so common, we can often identify them just on the basis of a good history and a few behavioural demonstrations. Even refractive errors like hyperopia (farsightedness) and astigmatism show up in facial expressions and in different squint responses.

Dyslexia is complex and multifaceted. Visual dysfunction is slightly less mysterious, and easily observable to those who know how to look and what to look for. Children with visual dysfunction-based dyslexia are often back on track within months of diagnosis and start of treatment – so in other words, they were never really dyslexic to begin with.

You can learn a lot more about eyes and vision and how it impacts on learning and development by taking our courses at VisionMechanic.net, so feel free to go over and have a look. You’ll be especially interested in spending time with us if you’re a parent, a teacher, therapist or doctor working with reading, developmental, and learning disorders, or even brain injuries – we’ve got a load of good advice we all should have been taught in school.

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