two-kids-reading-togetherWe’ve heard it time and again from ophthalmology, pediatricians and even some educators. “Vision has nothing to do with reading.” Those of us who diagnose and treat binocular vision problems know this to be false at several levels.

Clinically, almost on a daily basis, we see that when our patients improve their binocular vision skills, they concurrently improve academically (especially in the areas of reading). Scientifically, we read peer reviewed article after peer reviewed article that strongly links vision and academic performance. We consistently note research published in the best journals that demonstrates a significant link between oculomotor, accommodative and vergence ability and academic outcomes. Finally our major optometric organizations have come together utilizing a nationally recognized panel of experts that, armed with this research, supports the importance of diagnosing and treating learning related vision problems.

A recent paper published in Clinical Pediatrics (see bibliography below) by a group of authors representing both optometry and medicine clearly demonstrates this link between vision function (in this case saccades) and reading fluency. Seventy-six students from a private urban elementary school enrolled in kindergarten through 3rd grade were utilized as subjects after completing a vision screening. Reading fluency was assessed using the Reading Fluency subtest of the Wechsler Individual Achievement Test Third Edition and King-Devick Test.  King-Devick Remediation Software was used for treatment.

Kinig-DevickIn this prospective, single-blinded, randomized cross-over trial, treatment was conducted for 6 weeks for 20 minutes per day, 3 days per week using the remediation software noted above. The outcomes showed that the treatment group had significantly higher reading fluency scores after treatment and post-treatment scores were significantly higher compared to the control group.  At the 1 year follow up, scores for fluency were higher for all grades compared to the treatment group as well. In the kindergarten group significant improvement also showed similar improvements in fluency post treatment and at the 1 year follows up.

The authors state that “We hypothesize that this improvement in reading fluency is a result of the rigorous practice of eye movements, both saccades and vergence, and shifting visuospatial attention, all of which are vital to the act of reading.” Improving saccades and vergences are linked to improved reading fluency that not only shows immediate improvement, but also long term positive results as well.

This paper reflects outcomes by researchers not only from optometric institutions (Illinois College of Optometry) but also the Children’s Hospital of Philadelphia, University of Pennsylvania and the Department of Neurology, Mayo Clinic. This research is an ecumenically derived publication involving individuals with outstanding reputations within their respective fields that represent diverse backgrounds, education and training. [e.g. Dr. Yi Pang is an expert in disorders of the binocular vision system. Dr. Leonard Messner is noted for his expertise in retina and neurological anomalies. While the MDs involved have their areas of expertise as well.]

The Take-home Message:  Those who dispute the link between vision and academics must critically review and change these misguided beliefs. We cannot afford to let unfounded, dogmatic opinions, professional animosities and political agendas stop our children from achieving single, clear, comfortable and binocular vision while attaining their highest academic level possible.

If you have a colleague, an educator or education specialist who has not stayed current with the research in this area to take a look at the annotated bibliography below. Tell the parents that you work with of this critical research support of what we do for our patients on a daily basis. In the past we have always stated we do not teach reading when conducting vision therapy. This is true. However, the evidence supporting a link between vision and academics and an improvement in academic achievement after vision therapy is growing at an exponential rate.

Yes, Virgina, there is a link between vision and learning. And yes, vision therapy improves academic performance.

(Watch for additional evidence once the CITT+Reading study is completed in 2016.)

 

Bibliography

Leong D, Master C, Messner L, Pang Y, Smith C, Starling A. The effect of saddic training on early reading fluency. Clin Pediat 2014;pages 1-7 (Published online before print May 1, 2014, doi:10.1177/0009922814532520   http://www.ncbi.nlm.nih.gov/pubmed/24790022

Vision, Learning and Dyslexia http://www.aoa.org/optometrists/education-and-training/clinical-care/vision-learning-and-dyslexia?sso=y

AOA Clinical Practice Guidelines http://www.aoa.org/optometrists/education-and-training/clinical-care/vision-learning-and-dyslexia?sso=y

COVD summary of research in vision and learning  http://c.ymcdn.com/sites/www.covd.org/resource/resmgr/Research/10a_SummaryofResearchonVisio.pdf

Association between reading speed, cycloplegic refractive error, and oculomotor function in reading disabled children versus controls.  http://www.ncbi.nlm.nih.gov/pubmed/?term=quaid%2C+vision%2C+learning

 

Dominick M. Maino, OD, MEd, FAAO, FCOVD-A

Professor of Pediatrics/Binocular Vision Illinois College of Optometry/Illinois College of Optometry;
Lyons Family Eye Care (Chicago, Il)

 

 

 

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