Visual Skills - Beyond Visual Acuity

When a child struggles with school work, one of the first recommendations I make is to have an evaluation completed by a developmental optometrist. A child can have 20/20 vision, which means that her visual acuity is within a normal range. Yet some children with good visual acuity may not have good vision skills for other visual processing tasks. "Eyesight" is not the same as "vision". In my son Josh's case, his eyesight was excellent. But when I had him evaluated by a developmental optometrist at age 6, I found out that he had difficulty with some visual processing tasks. First, the optometrist confirmed for me that Josh was colorblind. I had suspected that, since my brother is also colorblind and I had noticed some indications that Josh might be as well, but the simple test done in the eye doctor's office made it official. Second, and to me this was even more important because I hadn't noticed any indication of difficulty, the doctor was able to assess many aspects of Josh's visual processing abilities and revealed that Josh's eyes were not working optimally to complete vision tasks. Josh was unable to sustain focus at a set distance without quickly fatiguing during the task. I watched the examination with fascination, as the doctor held the stimulus in front of Josh's eyes with the instruction "Tell me when this starts to get fuzzy." After three trials, with Josh's response coming sooner each time, it was clear he was having a hard time with this particular task. I had no idea that Josh was having trouble seeing clearly when items were fairly close to him. This information was hugely important for me to be aware of, since at age 6 Josh was beginning to do more up-close academic work during homeschooling with writing and various workbooks. I had also been spending time each day working with Josh on his reading skills while unbeknownst to me, the words were going out of focus while Josh was just learning to decipher print. Josh, of course, didn't know that what he was experiencing was any different than what others experience so he had no reason to try and tell me what he was going through with the various visual activities we engaged in each day. Josh's visual processing difficulty was significant, though fairly mild when compared to some of the visual processing challenges children can experience. Josh was prescribed glasses to wear only for school tasks requiring close-up work. Within a year, Josh's struggles with vision tasks had resolved and he no longer needed glasses. Other students who struggle with visual processing skills may need to practice exercises designed to help them develop their vision so that both eyes are working together efficiently. If a child has undiagnosed vision problems, he may present as inattentive, hyperactive, fidgety, unmotivated, and more. Think about it. If you are trying to read and the letters appear to be wiggling around on the page or go out of focus while you are trying to decode them, you might become a reluctant learner. Some of our children don't stay in their seats and seem to have a short attention span, which makes perfect sense if we are asking them to do something that is beyond challenging for them. Yet they don't realize that their experience is different than others' so they have no way of telling us what is going on with their vision. Would you enjoy reading if you couldn't sustain visual tracking across a line of print and instead picked up words above and below what you were trying to read? If reading is that difficult, it is not pleasurable and someone who experiences those types of vision challenges is not likely to choose to read for enjoyment and may become quite resistant for tasks that prove so frustrating time and time again. Some of our students do not do well with academic tasks, and it's important to be aware that they may be capable of understanding the material but struggles with vision may hinder them. A developmental optometrist can do a full battery of tests and provide precise information on what vision struggles, if any, are impacting a child's ability to function in accordance with her ability. They can offer treatment suggestions and strategies to address any areas of deficits in the visual realm. Heads Up offers two books that are packed with ideas for working on vision skills at home for additional practice. Seeing Clearly offers checklists and activities to help children and even adults improve visual skills. Developing Your Child for Success offers information and activities for young children (beginning around age 4 years) to work on vision skills needed for reading, writing, eye-hand coordination and more. I never would have known just by looking at Josh that he had any difficulty with his vision. I could easily have drawn the wrong conclusion about him and lowered my expectations as a result. I am so grateful that I had him evaluated and that his vision problem was identified and treated. Josh had several other learning challenges, but at least we could eliminate one of the many hurdles in his path.

Be The Match!

I am both excited and nervous when I think about finding a match "out there". Once I send in my information and it is put on file, anybody looking for someone like me could find it. It might happen soon, or there might not ever be anybody out there who is a match for me. I have to be ready at any time to respond to my potential match. I can't control if and when things might happen. But if it does, I know it will be worth it and I will be ready at the right time. Let me explain.

For those of you who know me personally, try to stop freaking out now. I am NOT leaving my husband of 25 years. Scott and I are doing fine. I'm talking about "Be The Match", the National Marrow Donor Program. I work with medically fragile children. I have friends and relatives who have gone through serious illnesses. I have heard stories of people struggling with health issues, and I've often wished I could do something more to help them. The Be The Match program allows me to be available in a way that could be life changing. Signing up is easy and straightforward. Just go to this site: http://www.marrow.org/ and read the information. If you decide to join the registry you simply fill out some information on line. Then, if you qualify to be a potential donor, you will be sent a kit and further information. Once the kit arrives, just follow the directions, do the cheek swabs and mail the completed kit back. Your kit will be processed and you will be added to the donor registry. If you are matched for a donation, the doctor will decide which of two different procedures to do. From what I read, it seems that the discomfort is minimal and the recovery time is brief. It seems like a small sacrifice when there is the possibility of saving a life.

If your health is good and the desire to make a meaningful difference in this way appeals to you, I encourage you to consider joining the registry. Even with the millions of people who are already part of the registry, there are still many people who are unable to find a match. You might be the one among millions who could be an answer to prayer.

Tickle My Back, Mom!

My youngest child, Beckie, has always been cuddly and affectionate. As a newborn, she quieted as soon as I picked her up and held her cheek next to mine. I thought she recognized my voice, but it was the skin-to skin contact at least as much as my words to her that seemed to calm her. As she grew, I noticed that when others picked her up her little hands immediately started fingering the material of the holder's clothing. She gently explored the feel of earrings, necklaces, scarves, and even daddy's whiskers. At age three, I took her with me to a craft show. Knowing how she loved to touch different textures, before we went in to the show I reminded her to look with her eyes and not her hands. She looked both sad and surprised as she protested, "But Mommy, to look IS to touch." Those were her exact words, and it confirmed that I had a very tactile learner and that I needed to allow her to touch some of the items that caught her interest. I ended up telling her that if she saw something she wanted to feel, she could ask me first and I would find out from the vendor if Beckie could touch the objects to see how they felt in her hand. As she grew older still, I heard the same request every day during our homeschool time when I was reading to the children: "Tickle my back, Mom!" If you are familiar with sensory integration (AKA sensory processing), you know that tickling can be aversive and irritating to some children. In Beckie's case, she was sensory seeking and had lower registration for tactile input so the tickling was alerting to her. When she is just listening and not actively moving, it is hard for her to focus. Her AD/HD leads her into daydreaming and distractions. She recognized this about herself, and one strategy she found that seemed to help was to have her back tickled. The light touch was enough to help her stay alert and focus on listening to what I was reading. I became adept at one-hand holding or propping a book, depending on the size of the book, and using my other hand to trace lightly over Beckie's back. I tried using a wooden backscratcher once, but that didn't have the same effect for Beckie. I tried a backscratcher with metal scratchers, but that was also not acceptable to Beckie. When I became too absorbed by what I was reading or needed a drink of water and would thus cease the tickling, Beckie noticed immediately and either wiggled against me to prompt me back to task or grabbed my hand and placed it where it clearly belonged - on her back again! Sensory input can be calming or alerting, and each individual's response to input varies. Often, as in Beckie's case, our children show us over and over what they need and what works for them. Be observant and sensitive to individual differences, and take advantage of the strategies that work.

Right Brain Learners

The "right brain" learners tend to see the big picture and don't focus on all the details. These are the students who take a more gestalt approach to learning. With my right brain learners, I've found that they are satisfied if they just get the gist, and "close enough" is good enough for them. I may have been a bit too successful in not passing along my own perfectionist tendencies! I am also a "left brain" learner, preferring to do things in a logical sequence with attention to detail. This video is a reenactment of part of a geography lesson I did with my daughter, Beckie, who is definitely presenting as a right brain learner. I hope you enjoy this clip of "right" meets "left" during our homeschooling moments. For more ideas about working with your "right brain" and "left brain" learners, see my workshop "Adapting Curriculum for Learning Differences".

Inexpensive Game You Can Make

Today I want to share an idea with you for an inexpensive game that you can make using simple household items. The inspiration for this game was a young boy I am working with to develop simple turn-taking skills. I wanted to begin by teaching him a short, simple game like Tic-Tac-Toe, but his fine motor skills aren't yet developed enough for him to make the marks on a page without great effort. I wanted the game to be fun and easy for him to play so he would stay engaged in the learning activity. My young friend does better with 3-D manipulatives at this stage of development, so I took an empty cardboard egg carton and cut it to the size I wanted. That left me with a perfect grid for Tic-Tac-Toe as you can see in the picture above. Next, I gathered up blocks in two different colors so we could use those instead of writing X's and O's. I removed the label from an empty frosting can and washed it clean so I could store the blocks in it. The child and I took turns placing a block in one of the egg cup spots, working to get three in a row. The game is more visually appealing to the young child, and it's easy to show when there are three blocks of the same color in a row. It also offers some tactile input for the hands-on learner, and removes the demand of writing for the child with fine motor difficulties. If you don't have blocks, you could substitute two different colors of another object such as milk caps or pom-poms. Just find something that will fit within the egg carton space and that is available in two colors, and you are set to go.

For some children, this game can be used to focus on taking turns without the added task of learning the rules for Tic-Tac-Toe. In that case, you don't even need to sort manipulatives by color since you just need objects that are small enough to fit in the egg carton compartments. The simple back and forth of placing items might be a starting point for some children who have difficulty sustaining attention and interacting with others. For children on the autism spectrum, this is one more way to work on extending interactions and giving a sense of task completion.

In addition to using this game to teach Tic-Tac-Toe and turn-taking, you could use it as a reinforcer. Each time the child completes a task, they could put a block in the egg carton. Another idea is to put a number of blocks in the egg carton to represent tasks the child is asked to do, and remove one block each time another task is completed. When the carton is empty, it's break time. Put some non-skid shelf liner under the carton to stabilize it so it doesn't slip around too much. For children with fine motor challenges, I've used Velcro on the bottom of each egg cup and stuck the egg carton onto strips of Velcro on a plastic cafeteria tray so the egg carton stays put while the child works with it.

There you go! An easy and inexpensive game that can be used multiple ways and made with items you probably already have on hand! Have fun!