Why Some Kids Just Don’t Give a Dime About Reading

The following article is posted “As Seen In HAVEN for Families” magazine. Feb 2014 issue.

When a child struggles with reading, it can be frustrating and confusing for both child and parent alike. Finding a solution to reading difficulties requires time and commitment, and for parents, knowing where to start can be overwhelming. In my experience, there is one factor that is frequently overlooked.

The Reading Process

Here is a simple way to look at reading. There are 3 steps involved:

1. COORDINATE EYES & VISION. Quite simply, you can’t begin with eyes closed! The visual system must focus the eye muscles for the close distance required for reading. Next, the muscles must converge the eyes so that they are turned towards the close point making the print appear single, otherwise words will runs together. Both of these muscle actions must be sustained comfortably. Lastly, the muscles must coordinate to be able to sweep and jump the eyes very precisely across the pages. Notice, I haven’t mentioned sight. The ability to read a letter chart across the room is not highly correlated with reading.
2. READ THE WORDS. This involves knowledge of the alphabet, sounds, language experience and an ability to decode what is seen.
3. COMPREHEND THE MESSAGE & MAKE MEANING. Reading is not just decoding words. It involves understanding the author’s message and comparing it to things or events we know, or have experienced before.

The Reading Investment

We know that we have a limited amount of attention to spend on any given task. Now imagine having a “dollars worth of dimes” to spend on attention for reading. Ideally, 5-10 cents or dimes, should be spent on step 1 – coordinating the eyes and maintaining visual attention. The balance is then left over for the cognitively challenging steps 2 & 3. But what happens if step 1 doesn’t come easily? Well, the brain must work harder to coordinate the muscles and maintain the visual effort. All of a sudden, a large portion of your dollar is spent on step 1. Consequently, steps 2 & 3 are allocated less dimes and the outcomes can be as follows:

• Avoidance of reading
• Headaches, sore eyes, or fatigue with reading
• Good decoding, but poor comprehension
• Skipping & repeating words and lines
• Read laboriously and slowly whilst trying to comprehend, resulting in difficulties completing work on time.

In my experience, most teaching & remediation for reading involves steps 2 and 3. But ignoring the first can be a critical mistake. This is similar to putting a poor driver in control of a well-tuned vehicle. You can refine the mechanics of a car all you like (steps 2 & 3), but without someone to watch the road and coordinate its movement, it will never drive well. The two are not mutually exclusive. You must have both.  And so it is with reading. The visual system must work well, in addition to good reading instruction and grasp of language.

Reading & Attention

Recent research has linked attention problems with eye problems. Firstly, children with ADD/ADHD have been shown to be 3 times more likely to suffer with eye teaming or convergence problems. However, treatments for vision problems are promising. The Journal of Attention Disorders recently published a study that showed that treatment of eye teaming difficulties resulted in an improvement in ADD/ADHD behaviours².

In summary, a child’s reading performance might be a sign of a hidden vision problem. Some people mistakenly assume signs of an eye problem are obvious but experience shows that children often won’t complain of blur, double vision, headaches or sore eyes for a number of reasons:

• If they avoid work, then eye-related symptoms don’t occur;
• the symptoms only occur during schoolwork and so they don’t remember to mention them at home;
• they may think it’s normal or don’t know how to describe what’s happening.

Check Your Child in 7 Steps

Consequently, research into parental concerns about a child’s school performance can be a good way to screen children who are at risk of related vision problems⁴. It also shows that these adverse academic behaviours improve when the vision problem is treated. Parents should look for the following 7 signs of Undetected Vision Problems^3,4.

1. Does your child have difficulty completing schoolwork or homework?
2. Does your child avoid or say he/she does not want to do tasks that require reading or close work?
3. Does your child make “silly” mistakes or fails to pay attention to detail?
4. Is your child easily distracted during reading or close work?
5. Are you concerned about your child’s school performance?
6. Does your child show signs of visual discomfort eg afternoon headaches, sore eyes, eye-rubbing, blinking, squinting or getting close to TV or page?
7. Does your child lose their place when reading or copying, and/or read more slowly than expected?

Finally, it is important to remember that children suffering from these symptoms will frequently read a letter chart easily during a standard sight check. Specific testing is required to detect and diagnose these eye muscle and coordination issues so they can be treated. If in doubt, then check it out, and ask questions about the type of eye tests that will be done. For some children vision problems simply reduce the enjoyment they get from reading. But for others it can have a devastating impact on their ability to attend and concentrate, resulting in frustration, avoidance and reduced self-esteem. There are multiple factors involved in reading difficulty, but awareness and treatment of eye problems means that more children can develop and enjoy this important life skill.

References

1.Granet DB etal. 2005 The Relationship between Convergence Insufficiency and ADHD. Strabismus.13, 163–168.

2. Borsting, E et al. Behavioral and Emotional Problems Associated With Convergence Insufficiency in Children: An Open Trial. Journal of Attention Disorders published online 22 November 2013

3. Borsting, E et al. 2012. Improvement in Academic Behaviors Following Successful Treatment of Convergence Insufficiency. Optometry and Vision Science 89, 12-18

4. Borsting, E.J., Rouse, M.W., Mitchell, G.L., Scheiman, M., Cotter, S.A., Cooper, J., Kulp, M.T., London, R., 2003. Validity and reliability of the revised convergence insufficiency symptom survey in children aged 9 to 18 years. Optometry & Vision Science 80, 832–838