Visual Tracking and Academic Performance – Part 1

In my experience, “visual tracking” is a term that seems to be universally recognized by classroom teachers, yet frequently misunderstood for the relationship of this visual ability to reading and learning. In a general way, teachers have learned that visual tracking refers to an eye movement and coordination ability. Plus when a child has trouble with visual tracking it typically results in behaviors that usually involve skipping lines when reading and copying which can lead to reduced reading skill. However, while most educators are familiar with this, they often have questions about what to do when a child has a problem with “tracking”.

Specific to this point, recently I heard from Jennifer R., a 4th grade teacher from Indiana, who emailed me with some questions about this topic of “visual tracking”. Jennifer was particularly interested in trying to understand how this one area of eye coordination, visual tracking, could impact performance of her 4th grade students. Furthermore, once identified, what can be done if a child has poor visual tracking ability. It is because of Jennifer’s thought provoking questions that begins this series – Visual Tracking and Academic Performance. The following are Jennifer’s questions:

  1. How do professionals define visual tracking?
  2. What types of symptoms/ actions do children exibit who do not develop these skills normally?
  3. How/ when do visual tracking skills normally develop in children?
  4. At what age does this typically become noticeable?
  5. What type of implications can a lack of these skills have on children academically?
  6. Is there a way to tell that reading problems are the result of a visual tracking problem rather than something else (learning disability, etc.)?
  7. What does therapy in an office such as yours include, generally?
  8. What kind of modifications can teachers use in the classroom to help these students be successful?
  9. Are there any commercially available programs you recommend for use in schools or homes to work on developing visual tracking skills?

To begin this series, we begin with Jennifer’s first and second question: How do professionals define visual tracking and what are the signs and symptoms?
“Visual tracking” is a common term applied to a function of eye movement abilities that is otherwise known in the optometric literature as “ocular motility” or “oculomotor function”.  In general this refers to the ability to quickly and accurately look (fixate), visually follow a moving object (pursuit) and efficiently move our eyes so we can fixate on objects from point to point as in reading (saccades). The American Optometric Association Clinical Practice Guideline (CPG): Learning Related Vision Problems, lists the following table of common signs and symptoms associated with ocular motility dysfunction:

Signs and Symptoms of Ocular Motility Dysfunction

 • Moving head excessively when reading
• Skipping lines when reading
• Omitting words and transposing words when reading
• Losing place when reading
• Requiring finger or marker to keep place when reading
• Experiencing confusion during the return sweep phase of reading
• Experiencing illusory text movement
• Having deficient ball-playing skills

The optometric testing of visual tracking is usually broken down into 2 general categories: 1. Qualitative chairside observation.  2. Quantitative (measurable) standardized tests.

First in the category of qualitative chairside observation the doctor typically uses a fixation target like as a pencil, pen or toy object on the end of a wand and positions it about 8-10 inches in front of the patient’s eyes. The patient is asked to look at and follow (with their eyes only) the target as the doctor moves it horizontally, vertically and in rotation. The examiner may also see how well the patient can perform the visual tracking task while answering some simple questions. This “loading” technique is a way to assess the patient’s ability to think and visually track at the same time…a skill that is a prerequisite for attention, concentration and efficient processing in the classroom.

To demonstrate this the following  video shows a child who initially presented with a visual tracking problem that negatively affected school performance.

Kevin’s 1st exam Oculomotor Assesment

Kevin’s 1st exam Oculomotor Assesment

This next video shows the same child at his second progress evaluation. Note the improved eye movement skill even with cognitive loading.

Kevin’s 2nd Progress eval

Kevin’s 2nd Progress eval

Additional tools for standardized measure of visual tracking is also available. The AOA CPG on Learning Related Vision Problems further states:

“Assessment tools are available for a more quantitative evaluation of saccadic eye movements. These tests simulate reading, using a rapid number-naming strategy in which numbers are placed in horizontal spatial arrays to be read in the left-to-right and top-down fashion of normal reading. The time to complete the task and the number of errors are the clinical outcomes. Presumably, slower and/or error prone performance would indicate poor saccadic eye movement control.

The following available tests, which are norm referenced for the patient’s age and grade in school, clearly indicate the developmental course of skill improvement:

Developmental Eye Movement Test (DEM)
• King-Devick Saccade Test (K-D)

 Infrared eye-monitoring systems that directly measure eye movements during reading (e.g., Visagraph II) are also available.  These assessment tools can provide data on the number of fixations required to read a sample of text, as well as the number of regressions and the reading rate.”

Understanding the role of visual tracking on academic performance begins in this post with bringing clarity to how visual tracking is defined and measured. In Part II we will explore the developmental aspects of visual tracking.

Dan L. Fortenbacher, O.D.,FCOVD