Reading, Attention and Vision Training for Convergence Insufficiency

When it comes to reading, the experts agree that phonological decoding is an important aspect of the ability to learn how to read.   But when a child struggles with efficient reading, it is not always about a phonological difficulty or dyslexia.

Unfortunately, vision is assumed to not be important as long as a person can see “20/20”.  Often overlooked is vision’s primary role in attention while learning any task – a skill that has little to do with “20/20”  Reading and writing in particular demand accurate control over visual attention, and the sub-components – convergence and accommodation.  Otherwise known as “eye-teaming”, “focussing” and “tracking”.

Vision and Reading

Learning to read involves many different components.  Many children learn to read, despite having eye-teaming and focussing problems, like Convergence Insufficiency and Accommodation Dysfunction.  Though these children often start to struggle as print gets smaller, or suffer with headaches and sore eyes.  Many just suffer concentration loss, leading to symptoms of avoidance. Children who read from meaning, rather than word by word, might cope with mild visual difficulties until they have to do a task that requires more sustained attention on each letter or word such as required when writing.

Because of the over-emphasis of sight being the main measure of the visual process, the impact of visual problems on learning is ignored or worse, actively scoffed at.  The worst case scenario occurs when a child is forced to continue partcipating at a activity despite the discomfort of headaches, sores eyes and concentration loss, only to be labelled lazy, motivated or poorly behaved.  The child suffers with self-esteem issues which further dissuade them from engaging in the learning process.

It seems rather obvious that anyone who has to maintain conscious effort to maintain focus, and eye alignment on the printed page is going struggle compared to those who can see without effort.

Vision Training and Reading

The CITT group has provided very strong evidence to support vision training or optometric vision therapy in the treatment of convergence insufficiency and accommodation dysfunction.  Further studies have looked at an association between “Academic Behaviour Scores”, ADHD and convergence insufficiency.  “Academic Behaviour Scores” effectively relate to symptoms of inattention, homework completion, homework avoidance, and academic performance.  The same group is currently researching  into whether attention and reading performance can be improved by treating convergence insufficiency with vision therapy, after their pilot studies have provided some promising results.

Does this make vision training the panacea or a direct treatment reading problems?  Definitely not.  Some children will get the benefits of improved comfort and improved attention, but still require help with other aspects of reading performance.  But it is becoming increasingly clear that vision therapy has a very important role in allowing that child maintain attention for the time required to help them overcome their reading difficulties.  Kids who struggle with reading are required to put in more effort than those who don’t – this places even more importance on good visual skills.

Paul Graham

Paul believes that what he truly practices is “Optometry for the Individual”. Whether it be vision training, glasses, custom or disposable contact lenses, orthok or precision tinted lenses, Paul will consult with you, completely assess your vision and custom design a treatment approach that is right for you. If you want a fresh approach, then Paul is the Optometrist for you!