Helping your students - a guide for teachers
As everyone becomes familiar with the new school year routine, students with persistent problems will begin to emerge. Those children who seem to appear on a regular basis complaining of headaches, dizziness, nausea, and various other recurring symptoms may be struggling with vision problems that are undiagnosed.
It may surprise you to find out that many of these children could have vision problems at the root of their difficulties. According to the National PTA, "It is estimated that one in four children suffer from vision problems that may cause them to fail in school". Don't be lulled into thinking that because a child sees an eye chart across the room clearly that he or she has perfect vision either. '20/20' vision is simply the ability to see the bottom line of the chart and does not mean a child is not struggling visually.
To help in understanding some of the visual skills required for school work, think about the classroom environment. A child sits at a desk, writes, alternately reads from a textbook and from the whiteboard and usually follows your movements around the room while listening to the lesson.
Some of the visual skills required in the classroom are:
• Distance vision: being able to see the board
• Near vision: being able to see the words in a book
• Focusing flexibility: being able to maintain clear vision while shifting focus from a distant object to a near one
• Tracking/eye movement skills: being able to aim both eyes accurately and move smoothly across a line of print or from object to object with ease
• Eye-hand coordination: being able to use the eyes to guide the hands
• Eye teaming: being able to coordinate the two eyes together so that they are precisely directed at the same object at the same time
• Eye focusing: maintaining, for long periods of time, completely clear vision while looking at near or distant objects
Students who have eye teaming, tracking and focusing deficiencies often have complaints of dizziness, nausea, headaches and/or red, burning and itchy eyes. They usually occur after the student is required to maintain visual concentration. For example, doing a reading lesson is enough to stress a student's visual system when it is deficient in any of the above skills and may cause fatigue, restlessness and difficulty paying attention.
Children lacking these visual skills may not report symptoms even though they may tire easily, see double or have 'ghost images' at times whilst reading for long periods. Their school work may be poor, or they may not be reaching their full potential. It is not uncommon for these children to have difficulty with reading, paying attention or even to exhibit behavioral problems.
Since these are also symptoms of ADHD it is easy to understand how one could be mistaken for the other, resulting in ineffective treatment.
Students with Persistent Problems - Checklist
Do you see the same children at the same time, with the same symptoms day after day? If yes, do they:
• Complain of headaches, pain around the eyes, dizziness or nausea?
• Complain of itching or burning of their eyes and possibly excessive tearing?
• Look tired, with red, irritated eyes?
• Have red eyes with debris in the corners or on the lashes?
• Have allergies?
• Have these complaints after classes such as reading, social studies or science?
The signs above indicate a possible vision problem that requires further evaluation by a behvaioural optometrist.
Children with convergence insufficiency will start out satisfactorily, but after a short period of working up close will find it difficult to continue reading due to the amount of difficulty with their vision. Their tendency to look away will make them appear to be disinterested or have a poor attention span. These same children will appear more interested when they are being read to, or listening. They will then be labelled as having an "attention deficit," or worse still as "lazy" when they are simply limited based on their visual abilities.
When you find you have a child appearing with the same symptoms around the same time of day, find out what the child was doing in the classroom. Was it a reading assignment or some other visual task that could be challenging the child's visual system? If so, when you speak with the child's parents, you should recommend the child's vision be evaluated by an optometrist who provides specialised testing for all the visual skills required for learning. Specifically, eye movement control, focusing near to far, sustaining clear focus, eye teaming ability, depth perception and visual processing should all be checked.