A behavioural or developmental optometrist looks at the sensory system of vision in adults and children, not just sight. They take a holistic approach to vision, appreciating that the eyes do not function independently of the rest of the body and are influenced by stress levels, nutrition, visual activities, personality, medication and health issues. The eyes are a moving, dynamic, adaptable organ that needs to perform a number of mechanical functions with ease before a person can use their eyes together efficiently.
A behavioural optometrist will assess the health of the eye and the ability of the eyes to see to the bottom line on the letter chart but they will also assess the ability of the focus or accommodation, convergence and directed eye movements. These mechanical movements must be able to work together easily and efficiently throughout the school or working day and are referred to as the Visual Skills. If too much effort is going into these visual skills then it will detract from a person’s performance and can lead to a lack of attention, poor schoolwork, fatigue, frustration, and avoidance behaviours.
A behavioural optometrist will also look at Vision Processing. This is the ability of the brain to understand the pictures that are being sent through from the eyes. Vision processing skills must link in with other systems of the body such as auditory processing and fine motor skills.
Behavioural optometrists also study how the visual system develops over the years of childhood to assess if a child is visually ready to begin learning to read and write at school. Understanding this sequence of development is vital in the programming of vision therapy or training activities which will improve visual skills and/or visual processing to an age appropriate level. This knowledge is also vital to ensure that those with learning disabilities, dyslexia, ADD, developmental delays, autism, or Asperger’s Syndrome are able to reach their full visual potential.
Processing skills must link in with other body systems such as hearing, balance and our muscles.
Vision Processing skills are involved in helping us to:
- Move when we walk
- Judge speed and distance when we drive
- Be aware of peripheral movement when we play sport
- Guide our pencil when we write
- Know what sounds to say when we see writing on a page
- See images in our head when we think or read which helps us to plan and create
- Remember in our mind’s eye words, pictures or surrounding that we have seen before
- To prevent vision problems and eye problems from developing.
- To provide correction or therapy for vision or eye problems that have already developed (eg. eye turns , lazy eye, shortsightedness, eye coordination problems etc)
- To develop and enhance the visual skills needed to achieve more effective visual performance in the classroom, work place, when playing sport and following recreational pursuits.
- Poor organisation on a page
- Reversals of numbers, letters or words
- Poor handwriting
- Problems with sight words
- Poor spelling
- Poor letter or word recognition
- Not recognising the same word in the next sentence
- Constantly re-reading the text to gain meaning
- Poor attention
- Poor comprehension
- Reading and writing skills that do not match maths ability
- Dropping of school performance for no apparent reason
- Avoidance or disruptive behaviours during class
- Difficulty following a series of instructions
- Learning Difficulties
- ADD or ADHD
The visual information processing assessment looks at how a person uses visual information to understand and analyse what they see.
The tests are designed to investigate vision at the next higher level of the brain rather than the eye itself.
A visual information processing assessment is suitable for any child (or adult) who may show difficulties with aspects of their learning. This includes reading, writing, spelling, and math. Well developed visual processing skills are needed to learn efficiently. This assessment is suitable for any child, included gifted children, on the autism spectrum, or with special needs.
- Visual Spatial Awareness is the ability to visually plan and organise our space and to work within it efficiently.
- Laterality is the knowledge of our right and lefts
- Directionality is the knowledge of right and left in space. This is important for learning about which way b/d/p/q and was/saw goes
- Rapid naming Ability (visual verbal processing speed) is the ability to see something and quickly think of its name
- Eye Movements – smooth (pursuit) eye movements measure how well a target can be tracked and followed with the eyes.
- Jumping (saccadic) eye movements are the rapid hopping eye movements used while reading.
- Visual–Motor Integration – evaluates the ability to match motor output with visual input. It is crucial for handwriting accuracy and efficiency as well as eye-hand coordination in sports.
- Visual Analysis is the ability to see the small likenesses and differences between similar objects (for example, the letters h/n)
- Visual Memory is the ability to memorise an object of considerable detail and is used in whole word reading strategies
- Visual Sequential memory is the ability to process information in the correct sequence and is used in reading, writing, spelling and math.
- Visual Span is the amount of information that can be seen in one quick glance (for example 3 or 4 letters of a word). This influences how successful a child will be at whole word decoding
- Visualisation is the ability to see something in our mind's eye.
- Short Term Memory (visual and auditory) is the ability to put information into storage for a period of a few minutes and to use it appropriately
- Auditory Analysis (phonemic awareness) is the ability necessary to hear and analyse sounds and blends within words. A screening of these skills is done to establish whether further assessment by an audiologist or speech therapist is recommended
Visual processing problems may also occur in association with auditory and language difficulties. Visual and auditory skills are integrated during efficient learning
Vision Therapy programs are recommended to develop skills that may be inefficient so that the child may be more visually ready to learn.
The Readalyzer is a computerised system that assesses how a person’s eyes are moving when they are reading. One of the most frequent presenting issues that we hear in our office, is that a student is having trouble keeping their place on the page when reading. This can become a significant issue for children who are learning to read, or who may have already learned to read well but keep losing their place, skipping words or lines of print, re-reading words, moving their head, using their finger to point at the words, or seem like they just read one word at a time, with a slow plodding style that doesn’t let them develop any fluency.
Eye movements are a part of our fine motor system. We need firstly learn how to move our eyes in isolation without moving our head, and then to able to make tiny little movements with our eyes and land just at the right spot within the word to make sense of it, and then use our peripheral vision to know where we’re going to move our eyes to next, and so on. When these skills become automatic, we start to read fluently and begin to easily take meaning from what we read, .and ultimately that’s what reading is all about.