Our visual system functions through interconnected pieces. What occurs in the eye is considered to be the hardware component of vision and what occurs in the brain is considered to be the software component.
This is a bit simplistic because in humans at least 10 to 15% of the information regarding what we see is passed on to the visual centers of the brain from sources other than the eyes. We refer to this as subcortical vision, and it includes pivotal centers for balance and movement.
It is widely recognized now that in sensory systems the distinction between what occurs in the brain and what occurs through the end organ is crucial. When we speak of a child with auditory processing problems, no one says “Oh, do you mean she needs a hearing aid?” It is understood by ENTs, audiologists, speech-language pathologists, and educators that how the brain processes incoming sound is quite distinct from the condition of the ears, and they must work in concert.
Yet somehow we persist with a very antiquated notion that if the condition of the eyes is normal, everything is fine with vision. This one misconception results in a false sense of security that allows thousands of children to continue to struggle with learning. Much as ENTs do not proclaim that all aspects of hearing must be fine if the ears are normal, eye doctors should not conclude that all aspects of vision must be fine if the eyes are normal.
All eye doctors agree that the earlier a problem with visual development is detected and treated, the better the chances are of overcoming any visual impairment and developing normal vision. Where we differ is what we define as “normal” vision.
More importantly, there are many aspects of vision development that extend beyond straight and sharp eyes. Normal development of the visual brain is as important as normal development of the eyes. There are many distinct areas of the visual brain that operate in parallel, and vision and proper eye movement is a learned process.
Developmental optometrists are adept at evaluating the visual system in its entirety so that infants and toddlers can receive the benefits of early intervention. This adds to awareness of the opportunities for early intervention through occupational therapy, physical therapy, and speech therapy services.
If you know that your child has an eye disease that requires treatment by an M.D., by all means go to a pediatric ophthalmologist. They are superb in the application of a wide variety of surgeries and treatment of diseases. But if you have a concern over whether or not your child is developing appropriate visual function in the context of sensory processing or visual behavior, you want the opinion of a developmental optometrist. It really is that simple.
There are two complementary forms of evaluation for visual processing; clinical observations and standardized testing. A patient’s observation begins from the moment they enter our office, extending to the way they are able to interact with our doctors and staff. Therapists in our office are carefully selected so that they are sensitive to children who have special needs.
When patients are old enough and cognitively ready, we use a variety of standardized visual processing tests to identify if there is a potential vision problem and diagnose the underlying cause. The goal of these tests is to generate a score in terms of a percentile rank. This allows us to compare the performance of your child on the test to other children who are his age level.
During school-aged years, our battery of tests include other standardized instruments that cluster into visual perception or processing without motor involvement versus tests that incorporate movement. In movement categories we differentiate gross-motor from fine-motor, or eye-body coordination from eye-hand coordination.
When treatment is indicated, we carefully weigh which activities and in what time frame a patient will receive the most benefit. The length of treatment, and the balance between home therapy and office therapy is individualized for each child. All therapy in our office is done on a one-to-one basis so that each patient receives the undivided attention of the therapist. Our therapists work closely with our doctors who guide programming and monitor progress on a regular basis.
The environment in our office is much like Liberty Science Center. Our patients’ performance on the visual processing evaluation and response to visual stimulus helps us pinpoint the areas of greatest need. While we celebrate each patient’s individuality, we set conditions to help explore how each individual interprets visual space, visual sequencing, laterality and directionality, visual memory, and other components of visual processing including auditory-visual integration.
Visual processing is a key aspect of your child’s readiness for learning in general and reading in particular.
