vision issues in special needs children

Often our clients come in and have questions related to vision. They notice that their kids have trouble with things like catching a ball—they may close their eyes and shy away from it, or it will be obvious that they’re having trouble tracking it. 


Or, the kids might have trouble with handwriting, not placing their letters on the line correctly, or having trouble managing the spacing between words or letters. Sometimes kids even have trouble manage the size of their letters—some of their letters will be big, and others small. 

These kinds of problems don’t mean that your child is having trouble with their visual acuity. They can have these problems and still have perfect 20/20 vision. What they are having problems with is the ability to coordinate their eye muscles to let their eyes fixate on objects and track them through their environment. 

For example, when we read a sentence or a paragraph, our eyes track straight across the line of text. But when these kids read, their eyes jump around from point to point. They have trouble tracking across the line, so they lose their place. These jumpy movements are called saccades.


Another problem kids have with saccades is when their eyes don’t just jump around on one line, but on different lines in the same paragraph. Their eyes will jump too far down or too far up, and again, they’ll lose their place a lot. (We help them by having them trace the lines they read with their finger, or even putting an overlay on the page so that they can only see that one line of text.)

We look out for these things when we do evaluations. We watch for the ability for their eyes to move smoothly when they track objects from point to point. We also look at convergence, which is the ability for the eyes to track things coming towards them and away. Convergence issues really come into play with school, because of needing to look up and down at the blackboard. When you look up at the blackboard, your eyes are focused for that distance. But then when you look down at the paper, your eyes have to converge to focus on the paper. If kids are having difficulty with convergence, they’ll have trouble finding their place on the paper after looking at the blackboard. It takes them longer to adjust. 

Sometimes, only one of the eyes struggles. When that happens kids will actually tune that eye out and just use the “good” eye. If they do this, they start to lose depth perception. 

What we look for in an evaluation

We look at all these things when we do an evaluation. We also look at how the vision issues affect the sensory system as a whole—are they having vestibular issues, and is that contributing to a vision problem? Is there a postural control problem? We break all of these issues down and work on each skill. If we find that there’s something going on that’s out of our field, we refer out to vision specialists. We work very closely with the vision specialists in areas that coordinate, so that we’re both addressing the same areas and really helping the kids to succeed. Do you have specific questions regarding your child? If so, please give us a call! 

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