Thursday, March 28, 2013

Empowering vs. Enabling

Posted by Lynn Lott and Jane Nelsen on 12/5/2011 on Positive Discipline

Tuesday, March 19, 2013

Vision & Reading

The following are excerpts from an article on Vision, Learning and Nutrition
by Donald J. Getz, OD, FCOVD, FAAO

This article by an eye doctor discusses children's problems with reading, learning, and behavior caused by convergence insufficiency, eye tracking problems, esophoria, exophoria, and other visual problems.

Vision and Eyesight

Eyesight is simply the ability to see something clearly, the so-called 20/20 eyesight (as measured in a standard eye examination with a Snellen chart). Vision goes beyond eyesight and can best be defined as the understanding of what is seen. Vision involves the ability to take incoming visual information, process that information and obtain meaning from it.

Two general statements can be made about vision. First, vision is learned. A child learns to see just like he learns to walk and talk. When learning to walk and talk, he has the added opportunity of imitating his parents and siblings. In addition, parents can observe their children to determine if walking and talking are developing properly. Vision development, however, generally proceeds without much concerned awareness on the part of parents. Because of these differences in development, no two people see exactly alike.

Vision Is Learned

Vision is learned; therefore vision is trainable. If a child does not possess the necessary visual skills, he can be taught to possess them through the proper Vision Therapy techniques.

Adequate Vision Is Critical to Learning

Since something like 75% to 90% of all a child learns comes to him via the visual pathways, it stands to reason that if there is any interference in those pathways, a child will not develop to his maximum potential.


The Visual Skills Needed for Academic Success

Visual Acuity: There are many visual skills which are important for academic success. One of the least important skills is termed visual acuity (clarity, sharpness). This is the so-called 20/20, 20/400, etc., eyesight. All that is meant by the notation 20/20 is that a person is capable of seeing clearly at a distance of twenty feet. Unfortunately, how well a child sees at twenty feet has little to do with how his vision functions at the reading and learning distance -- aproximately eleven to sixteen inches from the face. In fact, it is my opinion that the Snellen eye chart test which measures visual acuity actually does more harm than good. It gives both parents and teachers a false sense of security that vision is normal. There are many other important visual skills that might not be developed even though visual acuity at distance is normal.

Binocular Coordination: One of the more important visual skills is the ability to coordinate the two eyes together. A child is born with two eyes, but he must learn to team them together. Some children learn to do this properly while others do not. For example, some children develop a problem known as exophoria, which is a tendency for the eyes to deviate in an outward direction. This is not the same as a condition known as exotropia where the eye actually can be seen to be in an outward position.

Adequate Convergence: During the act of reading, the demand is for the two eyes to turn inward so that they are aimed at the reading task. If the eyes have a tendency to deviate outward, the child must use excess effort and energy to maintain fixation on the reading task. Most studies have shown that the greater the amount of effort involved in reading, the lower will be the comprehension and the lower will be the performance. When reading, the eyes do not move smoothly over a line of print. Rather, they make a series of fixations looking from word to word. When an exophoria exists, each time fixation is broken and moved to the next word, the eyes will tend to deviate outwards and they must be brought back in to regain fixation. Human nature being what it is, the child generally has an avoidance reaction to the reading task. This is compounded by the fact that anything the child doesn't do well, he would rather not do. This is the child who looks out the window rather than paying visual attention. He is commonly given labels. He is often accused of having a short attention span and not trying. He is told that he would do better if he tried harder, but he has tried harder to no avail. He is often labeled as having dyslexia, minimal brain dysfunction, learning disability, etc. Commonly, he loses his place while reading and/or uses his finger or a marker to maintain his place. While making the eye movements during the act of reading, he might not land on the next word, but rather land a few words further on. Consequently, he commonly omits small words or confuses small words. Often, he just adds a word or two to make the sentence make sense. If the two eyes are pointing at the same point in space, a person will see the fixated object as being single. Double vision or overlapping vision (Figure #3) results if the two eyes are not exactly pointing at the same point. Don't expect a child to tell you that his vision isn't clear. He has no yardstick of comparison to inform him that his vision differs from the vision of anyone else.

[ Figure 3 ]
Figure 3

Astigmatism, Eye-Hand Coordination, Visual-Motor Problems and more: I have maintained for many years that I could walk into a classroom and pick out those children with coordination type visual problems. They get into distorted postures in an attempt to get one eye out of the act. They often put their head down on their arm, cover one eye with their palm or rotate their head so that the bridge of their nose interferes with the vision from one eye.

Esophoria: Another eye coordination problem is termed esophoria, which is a tendency for the eyes to turn inwards. The educational implication of this particular problem is that a child with esophoria sees things smaller than what they actually are. In order to see an object properly, it is necessary to make the object larger. The only means at the disposal of the child to make it larger is to bring it closer. Eventually, the child is observed with his head buried in a book and still not achieving.

Reading Skills and Binocular Visual Skills

One of the tests used in optometric offices is to have the child read words while looking into an instrument called a Telebinocular. The performance is compared between reading with either eye alone and with both eyes together. The difference in performance is often quite dramatic if there is an eye teaming problem. One eye performance might be quite satisfactory, but reading with both eyes together will be slower and many more errors will be made.

Other Visual Skills

Directionality: Directionality is another visual skill important for academic success. One test for this skill is illustrated in Figure #5. Look at Figure #5 and determine what you see. If the visual reflex is from left to right, a duck will be seen. However, if the visual reflex is from right to left, a rabbit will be seen. This is just one test out of a series to determine the directionality of the visual reflex.
[ Figure 5 ]
Figure 5

It is just a convention of our culture that the English language proceeds in a left to right direction. Other languages proceed in a right to left direction and still others have a vertical orientation. Many people feel that it would make more sense if the language proceeded as illustrated in Figure #6. If a child does not visually proceed from left to right, through Vision Therapy he can be taught to develop this skill just like he can be taught to team his eyes together.

[ Figure 6 ]
Figure 6

Form Perception: Form perception is another important visual skill for academic achievement. This can best be illustrated by referring to Figure #7. The child is shown these forms one at a time and he is simply asked to copy them. It is amazing to see some of the distortions that a child will make in attempting to copy these forms. If a child can't perceive and copy these simple geometric forms, it is unreasonable to assume that he will be able to perceive the wiggly lines which make up letters which in turn make up words, which in turn make up sentences which stand for abstract ideas. We see children often who can't tell the difference between a square and a rectangle or a circle and an oval. This is also a skill which can be improved through Vision Therapy.
[ Figure 7 ]
Figure 7

Attention Span/Span of Perception: The Span of Perception is also related to success in school. Many children see just one word at a time with each eye fixation. Reading speed can be improved by learning to see two, three, or more words with each eye fixation. This could be compared to reading through a straw. This is illustrated in Figure #8. It is easy to see the difference in reading for meaning when the span of perception is wide.
[ Figure 8 ]
Figure 8

Visualization: The ultimate visual skill is visualization. This is similar to being able to see things in the mind's eye. There are authorities that state that the ability to visualize is very closely allied to the ability to think. In other words, thinking is related to the ability to abstract from specifics and the ability to visualize is deeply involved in this process. Visualization is also a trainable skill.

There are many other visual skills that time and space do not permit me to mention. However, it is hoped that the reader will realize from the above discussion that there is a lot more to vision than just 20/20.

Nutrition and Vision

When I see a child with a learning problem, I feel very strongly that there usually is more than just a single cause. For example, when I find a visual problem, if I probe a bit further, a nutritional problem will be found as well. Children often walk into the office eating a candy bar or sipping on a cola or other soft drink. When they are asked what they had for breakfast, the response usually falls in the frosted, sugary flake category or the answer is that they had no breakfast at all.

When I am asked which nutrients are important for optimum visual functioning, I respond that the same nutrients essential for the rest of the body are the ones needed for vision. This is because vision does not operate independently of the rest of the body.

In all cases, a diet of high quality, nutrition-rich, unprocessed foods is important if we are going to be successful in Vision Therapy. Vision therapy involves a learning process and, as with any learning process, learning will be maximized if a healthy body and a healthy mind are brought to the learning task.

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Reprinted with permission from The Journal of Applied Nutrition Volume 28, Winter, 1976

This complete article may be purchased by writing to College of Optometrists in Vision Development, 243 N. Lindbergh Blvd., Ste. 310, St. Louis, MO 63141-7851 and requesting the article: Getz, Donald J., O.D., "Vision and Perception Therapy," 1973.

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Feingold, Ben F., M.D., Why Your Child Is Hyperactive, Random House, New York, 1975.

Lane, Benjamin. O.D., "Myopia," 1976. College of Optometrists in Vision Development

Ludlam, William, O.D., "Visual Evoked Response," 1974. College of Optometrists in Vision Development

McDonald, Lawrence W., O.D., "Visual Training," 1962-1963. Optometric Extension Program

Ott, John. Sc.D., Health and Light, The Effects of Natural and Artificial Light on Man and Other Living Things, Devin-Adair Co., 1973.

Skeffington, A.M., O.D., Continuous writings, Optometric Extension Program

To locate an eye doctor who provides comprehensive pediatric vision examinations and treatment, including Vision Therapy, request a referral through our Referral Directory: Find a Pediatric Eye Doctor.

Monday, March 11, 2013

Coping Strategies for Children with Learning Disabilities: Enhancing Skills for Success in Life


By Annie Stuart

The secret to success seems elusive to many people. Is there really a reliable roadmap to health and happiness? And if you have a learning disability (LD), do you need take a different course? Not really. Although research has identified several attributes that form the foundation of life success for people with LD, you'll likely recognize the universal relevance of many of these traits, such as perseverance and proactivity. Another is the use of healthy coping strategies, the topic of this article.

Here are six things to keep in mind as you teach your child with LD how to navigate the ups and downs of his or her own emotional terrain.

1. Get your own house in order. If you're anxious about your child's learning disability, if you're fearful about his or her future, if you find yourself tearing your hair out every time you turn around, then you may need to first take a look at your own coping strategies. How do you handle stress? What messages are you sending yourself about your parenting skills? What kind of support system do you have in place?

If you learn to relax and better address your own emotional challenges, you'll be doing yourself and your whole family a big favor. Remember the flight attendant's advice: Put the oxygen mask on yourself before you put it on your child. Doing so helps you to breathe, to accept your child's differences, and to build on his or her strengths. Yes, it's true a child with LD may never be a great reader, but many successful people – from Greg Louganis to Whoopi Goldberg to Richard Branson – have had LD and they've done just fine – in fact, better than fine.

2. Use and teach a vocabulary of emotions. You want your child to know what it means to have empathy for others or to demonstrate gratitude or to savor nature's beauty. In addition to modeling behaviors like these, name and praise these positive behaviors when you see them in your child. This will help cultivate a sense of emotional awareness and sensitivity.

Likewise, kids need to also know how to name negative emotions. Ask what stress feels like for them, where they notice it in their bodies, and what they think might have caused it. This isn't always an easy exercise, particularly for a child with language-processing issues, says Chris Schnieders, Ph.D., director of teacher training at the Frostig School. It takes some work to figure this all out, and that's where a parent’s gentle questioning and calm explanations can make a difference.

3. Recognize — and trip up the triggers. The better your child gets at recognizing stress triggers, the more successful he or she will be at handling life's curve balls. Research underscores this point, says Frostig researcher Roberta J. Goldberg, Ph.D. All children in the Frostig success studies1,2 had been greatly challenged by anxiety or stress — largely as a result of LD, she says. "But the ones who recognized stress triggers, especially of LD, and demonstrated coping strategies were the most successful."

Goldberg admits that it can be difficult to know how to help your child identify his or her own triggers, but with time, he can recognize the signs. Do you know what your child's triggers are? Being asked to turn off the TV? Making transitions from one activity to another? Getting stuck on a math problem? Talk about these with your child and problem solve ways to "cut them off at the pass" — before your child's stress hormones go into overdrive. If the problem is television or transitions, maybe you agree on five-minute warnings before turning off the TV or you make sure your child has plenty of down time between activities.

What about your child's coping mechanisms? You'd be surprised at how much your child has intuitively figured out. Help support healthy ways of coping. It's idiosyncratic, says Goldberg, so the options are practically unlimited. Is music soothing to your child? Then listening to an iPod may not be an idle activity — even when doing homework. Does your child enjoy texting friends? Well, then those messages — within limits — might bring a helpful distraction. Or maybe writing in a journal or a walk in the woods has a calming effect on your child.

Look for signs of stress and intervene when your child is unable to do this for herself. If she's been hitting the books for two hours and is starting to unravel, you might want to enforce a trampoline break, or jumping jacks, or at the very least, some deep breathing.

"My son — who's now a mechanical engineer — struggled in school and had meltdowns in college," says Goldberg. "I didn't say, 'Go study.' I'd tell him to go for a run or swim 22 laps. I knew those were his coping mechanisms."

And, don't forget to play to your child's strengths. If sports, music, or theatre is his strong suit, then allowing time for these pursuits can greatly enhance self-confidence and positive coping behaviors.

4. Make coping strategies concrete. If your child struggles with developing specific coping mechanisms, try priming the pump with some questions like these:

  • If you were having a problem, who would you talk to?
  • What are the fun things or activities that you like to do when you are sad or down?
  • What motivates you? In other words, why do you do what you do?
  • How do you handle peer pressure? For example, what would you do if a friend or peer asked you to try drugs?
  • Who are your role models or people you look up to?

Depending upon your child's age and personality, don't necessarily expect (or request) a direct answer to these questions. You can simply throw these out as food for thought. This may help your child describe and acknowledge — if only to himself — what works best for him. And this will take him a step closer to actually using these concrete strategies.

5. Learn healthy ways to communicate. Jeff Rice is principal of one of the Briarwood Schools in Houston, TX, serving students with LD and developmental delays. He reminds parents that the normal teen mentality is to interact as little as possible with adults, especially parents. "It may seem like you've got a stranger living in your home, but trust me, they will come around," says Rice. And, he tells parents they'd be amazed if they knew how often kids identify parents as their "go-to person" in times of trouble.

Rice suggests tips like these for moving toward healthier communication with kids.

  • Ask open-ended questions. Don't be satisfied with the curtness of a yes-no response from your child. You can get around this by asking open-ended questions like: What was the most surprising thing that happened at school today? Or: What was the school assembly all about? Or: What was something you did to manage your stress? A longer response provides a better opening for give and take. Without lecturing, you're also modeling the art of conversation. Just remember that with open-ended questions, you'll also need to stay open — without judgment — to your child's fears, frustrations, and failures.
  • Be present. Even more important than questioning is simply being present and listening. When your child is talking with you, don't get distracted by opening bills or checking your phone messages. If you do, you're communicating — without saying a word — that something else is more important. And, though there's a place for "history lessons," don't always cut in with responses like, "Well, when I was a kid…." Checking in and displaying empathic listening can often go so much further.
  • Reflect back what your child says. Restate what your child has said, in his or her own words — not yours. You might say: "What I'm understanding is that you felt bullied today at lunch…." Again, this helps your child feel heard and understood.

6. Seek outside help when needed. Remember that a big part of having a healthy coping strategy is knowing how to find and use support systems. For example, if your child is falling behind in math, a tutor may help in more ways than one — by not only shoring up academic weak links, but also circumventing power struggles over homework. And, if your child struggles with anxiety or depression, seeking outside resources such as counseling may be in order. Remember that you cannot be all things to your child.

Help your child identify both internal and external sources of support for better coping. And, do the same for yourself. This can be critical for developing a healthy approach to emotional challenges — which, as you know, won't disappear with adulthood!


1 Raskind, M.H. et al. Learning Disabilities Research and Practice. 1999; 14(1): 35–49.
2 Goldberg, R.J. et al. Learning Disabilities Research and Practice. 2003; 18(4): 222–236.

Annie Stuart is a freelance writer and editor with nearly 25 years of experience. She specializes in consumer health, parenting, and learning disabilities, among other areas.

This article is made possible by a grant from the American Legion Child Welfare Foundation.

Sunday, March 10, 2013

How Inefficient Visual Processing Can Affect a Student's School Performance

From The Vision Therapy Center
Published on Feb 21, 2013
Dr. Kellye Knueppel of The Vision Therapy Center discusses how vision problems affect each academic subject, including reading, composition, math and handwriting.