How to Help That Bright But Struggling Student

By Dr. William Moskowitz, F.C.O.V.D.

Parents are very often confused by the fact that their child is very bright, yet has difficulty with schoolwork. How could this be? And, why do so many children continue to struggle with schoolwork despite in-school assistance, tutoring, medication, counseling and other supports which parents and school systems provide?

Eighty percent of learning is done through our vision. School screenings and most eye exams are designed to test only a few of the many visual skills required for learning. This is fine for the majority of the population. However, one out of four children has (and seven out of ten juvenile delinquents have) vision problems that would not be detected with a vision screening. So, you could be told that your child's eyes are fine, and maybe that he/she has "perfect" vision. Still, your child could be struggling with an undiagnosed vision problem that is interfering with the entire learning process. Why is that?

In order to understand this, we must first understand the famous "20/20" and what it really means. In the 1800's, Dr. Snellen created a chart that is still used today as a standard of measure for distance vision. "20/20" simply means that a person can see, at a distance of 20 feet, a line of letters that he should be able to see at 20 feet. Yet, when asked for a definition of "20/20", most people would say it means "perfect vision", in all respects. However, if we think about how we use our eyes on a daily basis, we would begin to understand how many more visual skills are required in order to succeed.

Aside from the obvious skills of being able to see up close for reading for long periods of time (near vision) and far away to see that chalk board (distance vision), some examples of the types of basic vision skills required for success in school are:

• Seeing a clear, single image with both eyes at the same time (binocular coordination)
• Aiming both eyes accurately and moving them fluidly across a line of print or from object to object with ease (eye movement skills)
• Guiding the hands with the eyes (eye-hand coordination)
• Maintaining completely clear vision while reading (focusing)

If one or more of these skills are inadequate or missing, performance will suffer. In some cases, children will even be labeled as learning disabled, ADD/ADHD, dyslexic, or simply lazy (an "under achiever"). However, it is important to understand that when a child has an undiagnosed vision problem, that child will continue to struggle despite all attempts to help. Research has shown that when the vision problem is treated, the student will then respond to academic assistance.

If you wear glasses, think back to when you put on your first pair. Can you remember seeing things clearly for the first time? What a revelation! Well, children don't have a clue as to how they are supposed to see their world. If it is blurry, they have no way to know that isn't how everyone sees! For this reason, many children don't tell their parents or teachers that they don't see well. It doesn't take much to realize the disadvantage of being unable to decipher blurry print, all the while feeling stupid as others (who have clear vision) are able to make sense out of what they are seeing. If you were to ask these children what it looks like when they try to read, you might be surprised to hear that the letters "move on the page", or that entire lines of print "split apart" after only a few minutes of reading. Imagine how exhausting that would be!

A child who hates to read, yet is bright and has no physical problems, may have an undiagnosed vision problem. How can you tell? Following are some symptoms to look for:

• poor concentration, comprehension and attention span
• fatigue
• squinting
• complaints of double vision or blurring
• loses place while reading
• points to words while reading
• avoids close work
• rubs eyes or blinks a great deal while reading
• has nausea and/or headaches after close work
• reverses letters or words in reading and/or writing
• omits small words or makes substitutions while reading
• homework takes FOREVER when it shouldn't

If you know a child who has one or more of the above symptoms, it is possible that child is struggling with an undetected vision problem.

Why, you may ask, are these problems not always uncovered by standard eye exams? Optometric specialists, typically called developmental optometrists, are looking for different things during the course of an exam. As a result, they offer different interpretations based upon the type and quality of the patient's responses.

So, let's now see how a developmental optometrist becomes an integral part of the support system for that child who is struggling? In addition to testing acuity (clarity of sight), he/she will assess all the visual skills required for learning: specifically, eye movement control, eye focusing at distance and near, depth perception, visual motor integration, visual memory, form perception, and eye teaming ability. When deficits are found, therapeutic lenses and/or vision therapy are prescribed which are designed to remediate the problems and enhance the child's ability to understand and apply the information that comes through his/her eyes.

By the way, don't, for one minute, think that only children experience these problems. Many adults find that they have always struggled with the same difficulties, never realizing that they are symptoms of a vision problem and that they are correctable. Maintaining concentration, completing tasks at work, reading a good book, or even playing a good golf or tennis game are all things that we would like to do well - and with ease. Yet, they may be compromised by undetected vision problems. Just look at the symptoms checklist (except for the homework!) with one of your typical days in mind. If you have any of these symptoms yourself, a behavioral vision evaluation may also be in order for you.