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Did you know 65% of the population are visual learners? Now, what do you do when you have a child that has vision loss in one eye, reduced peripheral vision in the other eye, BUT is STILL a visual learner?  Think about that for a minute.  Yes, Joseph, my son with only one “good” eye, is a visual learner. Joseph has problems with visual-spatial reasoning among other visual processing issues.  As it turns out, all my children have visual-spatial problems. They all score in the 5 to 18 percentile in visual-spatial reasoning.  So how does an issue with visual-spatial reasoning impact learning?  I hadn’t a clue so I wrote this post to understand!  Hopefully, you will find it helpful too!

The most researched areas in visual processing you see in peer-reviewed literature tends to involve visual-spatial and visual-motor processing as these areas are likely to be associated with learning difficulties. In a 2014 article by Dr. Timothy W. Curby and Dr. Abby G. Carlson, they discuss that fine-motor skills are a reliable predictor of academic achievement. It was not just the fine motor skills that were a reliable predictor of academic success but more specifically the child’s visual-spatial integration ability in fine motor tasks.
 
Tam et al. (2019) found spatial skills are positively related to mathematical abilities, yet the mechanism of such relation remains unclear. This study examined the mediating role of mental number line representation in the relations between spatial skills and performance in various mathematical tasks. One hundred and nine second-graders were tested on mental rotation, perspective taking, mental number line representation, visuospatial working memory, arithmetic fact retrieval, calculation and word problems. Using structural equation modelling with the bootstrap procedure, we found that after controlling for age, gender and visuospatial working memory, mental number line representation fully mediated the relation between spatial skills and calculation and the relation between spatial skills and word-problem solving. However, it was not a significant mediator between spatial skills and arithmetic fact retrieval. This study highlights the important role of mental number line representation in explaining the relation between spatial skills and mathematical abilities.
 

McClellanda & Cameronb (2019) determined, first, both EF and motor skills help children transition to school. EF involves multiple components that are used separately and together in many classroom tasks and academic learning. Second, the evidence is strongest for the visuomotor integration aspect of fine motor skills—it predicts both literacy outcomes and mathematics . Third, EF and motor skills develop together, a relative strength in one may make up for a weakness in the other, and the association between the two skills appears stronger among younger children . Fourth, assessing EF among young children is challenging but progress is evident; assessors and researchers need to decide if they want an overall assessment or to focus on individual comp. Both direct assessments and observer ratings (especially teacher ratings) of children’s skills have the potential to provide information that can be used to support children during the transition to school. Finally, interventions can be effective although more work is clearly needed to understand the conditions where interventions would have the most success with a given group of children. Overall, EF and motor skills are foundational learning skills that develop together as children move through the early childhood years and can be fruitful targets for promoting school readiness across cognitive and academic domains.

In an 2018 article by Critten et al., she examined the relationship between children who have cerebral palsy (CP) and their mathematical abilities. The children with CP had significantly poorer mathematical and visual-spatial abilities than the neurotypical group. For the neurotypical group, age was the best predictor of mathematical abilit. In the CP group, receptive vocabulary and visual perception abilities were the best predictors of mathematical ability. The CP group had extensive difficulties with visual perception; visual short-term memory; visual reasoning; and mental rotation all of which were associated with their mathematical abilities. These findings have implications for the teaching of visual perception and visual memory skills in young children with CP as these may help the development of mathematical abilities.

Hawes et al. (2019) found spatial visualization skills were an especially strong predictor of children’s maths achievement. Current evidence suggests that numerical, spatial, and executive function (EF) skills each play critical and independent roles in the learning and performance of mathematics; however, these conclusions are largely based on isolated bodies of research and without measurement at the latent-variable level. Thus, questions remain regarding the latent structure and potentially shared and unique relations between numerical, spatial, EF, and mathematics abilities. The purpose of the current study was to (i) confirm the latent structure of the hypothesized constructs of numerical, spatial, and EF skills and mathematics achievement, (ii) measure their unique and shared relations with one another, and (iii) test a set of novel hypotheses aimed to more closely reveal the underlying nature of the oft reported space-math association. Their analytical approach involved latent-variable analyses (structural equation modeling) with a sample of 4- to 11-year-old children (N = 316, Mage = 6.68 years). Results of a confirmatory factor analysis demonstrated that numerical, spatial, EF, and mathematics skills are highly related, yet separable, constructs. Follow-up structural analyses revealed that numerical, spatial, and EF latent variables explained 84% of children’s mathematics achievement scores, controlling for age; however, only numerical and spatial performance were unique predictors of mathematics achievement. The observed patterns of relations and developmental trajectories remained stable across age and grade (preschool – 4th grade). Follow-up mediation analyses revealed that numerical skills, but not EF skills, partially mediated the relation between spatial skills and mathematics achievement. Overall, their results point to spatial visualization as a unique and robust predictor of children’s mathematics achievement.

In a 2018 article by John and Renumol, they look at the use of digital technology in education as a potential to influence children’s learning experience and quality. In particular, how integration of an appropriate technology tool plays an important role in learning environment and cognitive development. The primary objective of this study is to explore the dexterity-performance outcome of children with dysgraphia in a technology-enhanced learning environment. The study participants were nine elementary school students in an age group of 5 to 10. They had writing difficulties (dysgraphia), according to the occupational therapists and clinical psychologists. An iOS application namely dexteria was used in this study. A pretest was conducted in them by paper-and-pencil method to know their current performance. After that they were introduced to the software dexteria in a tablet computer. This touch-based training software provides three sessions of activities – ‘Tap it’, ‘Pinch it’ and ‘Write it’. The tap and pinch activities are intended to improve their fine motor skills and the ‘Write it’ is a letter tracing activity. Fifteen minutes were allotted for each activity per child per day for the training, so a total of 45 minutes spent by each participant in a day. Each participant received a total of 27 hours training on iPad to develop handwriting readiness. After the training a post-test was conducted. The results show that these children have improved in their handwriting legibility and speed. The study concluded that the iPad-based training program focusing on visual motor skill training appeared to be effective in enhancing the handwriting readiness and time taken for completing the activity among children with dysgraphia. This pilot study is part of an ongoing research to design and develop a sophisticated technology tool for dysgraphic children.
 
In a paper by Franceschini et al., there is a strong correlation to visual-spatial attention and learning to read. The children who had the most difficulty with visual-spatial discrimination had most difficulty in learning to read and often went on to be diagnosed with dyslexia.  Mayer et al., found a correlation in visual-spatial reasoning, along with cognitive ability and problem-solving skills, were the deciding factors in determining the scientific reasoning skills of elementary school students. What I really found interesting was the paper by Tosto et al., which studied the visual-spatial abilities of several sets of 12 year old twins. By 12, a bit over half of your visual spatial skills you got from your parents (genetics) but the rest is learned (this was true for both boys and girls).  The part of the paper I found interesting is that the same pathways in the brain for visual-spatial reasoning is used for math and science. Who knew?  This explains a lot as to why children with developmental dyscalculia have issues with processing visual-spatial information.
 
Waal, Pienaar, & Coetzee (2018) examined the role that visual perception plays an important and integrating role in the development of cognitive abilities and perceptual-motor skills. Visual perception comprises different independent constructs that may function in an integrative manner. This study aimed to determine whether (and the extent to which) various visual-perceptual constructs influence the academic achievement of 12-year-old school children. In a cross-sectional analysis, we extracted only 2016 data from 581 learners (mean age = 12.92 years, SD = 0.42) who were participants in the North-West Child Health, Integrated with Learning and Development longitudinal study (2010–2016). We used the Test of Visual Perceptual Skills, Third Edition, the North-West Provincial Assessment and mid-year school examination reports to determine visual perceptual abilities and academic achievement of this participant group. We calculated correlations between visual perceptual constructs and academic performance using Spearman rank order correlations and separately analyzed the influence of gender and socioeconomic status with independent T tests. Different visual perceptual constructs did have significant influences on specific areas of academic learning and on academic achievement generally (r = .26 to r = .41). Spatial relationships showed slightly greater correlations with academic achievement (r = .15 to r = .33) than did other basic visual perceptual constructs, possibly because spatial relationships are not completely developed at age 12. Complex and basic visual perceptual skills had medium significant retrospective correlations with grade point average (r = .40 and r = .41) and first additional language (r = .30 and r = .33). We concluded that basic and complex visual perceptual constructs remain important for academic achievement in this age-group, while gender and socioeconomic status influence both visual perceptual abilities and academic achievement.
 
An article by Sullivan (2018) examines the use of the Visual Perceptual Skills (TVPS) evaluation. Occupational therapists embrace evidence-informed and occupation-centred practice, the use of standardised visual perceptual tests remains a strong feature of typical paediatric practice. Yet, the research evidence for the use of such tools is inconclusive at best. This study compared the results of the Test of Visual Perceptual Skills (TVPS) with a checklist of reported functional difficulties in 30 children attending occupational therapy. The purpose of this paper was to determine the usefulness of visual perceptual testing in relation to occupation-centred practice. A descriptive correlational study design was used. Participants were 30 primary school-age children who were on a paediatric occupational therapy caseload. An additional 30 typically developing children participated in the development of the checklist. Correlations were found between reported functional visual skill difficulties and two subtests of the TVPS (visual memory and visual discrimination). No correlation was found between the reported functional difficulties and any of the other five subtests of the TVPS or the total score. Results highlight the weak relationship that existed in this study between standardised measures of visual perception, as measured by the TVPS, and functional difficulties. Therapists are cautioned to explore both the evidence base for continued use of standardised visual perceptual measures to inform occupation-centred practice and the need to embrace a more comprehensive person-centred approach to visual perceptual assessment.
 
Brock et al. (2017) found an interesting connection between visuospatial skills and executive functioning. Executive function (EF) describes a complex set of skills, including flexible attention, inhibitory control, and working memory, that coordinate to achieve behavioral regulation. Visuospatial skills (VS) describe the capacity to visually perceive and understand spatial relationships among objects. Emerging research suggests VS skills are associated with classroom functioning, including behavioral adjustment. Children from socioeconomically disadvantaged backgrounds are more likely to enter school with EF and VS deficits, with consequences for classroom adjustment. In response, we developed and experimentally tested an after-school intervention that incorporates fine and gross motor activities targeting EF and VS skills in a sample of 87 kindergarten and first-grade students from low-income communities. The aim of the present study was to preliminarily explore whether EF and VS skills were bolstered by the intervention and subsequently whether EF and VS skills mediate or moderate intervention impacts on learning-related and problem behaviors in the classroom. Intent-to-treat analyses confirm intervention effects for EF and VS skills. Using full information maximum likelihood and bias-corrected bootstrapping, results indicate that improvements in EF mediated the impact of assignment to the treatment condition on improvements in learning-related behaviors and reductions in problem behavior. Taken together, findings suggest out-of-school contexts are a reasonable point of intervention for improving daytime classroom behavior.
The way text can look when you have a visual processing disorder.

What are the signs of Visual Processing Disorder?

Visual Discrimination
  • Can’t match clothing, socks, or cutlery, especially when the differences are subtle
  • Doesn’t noticing the similarities and differences between certain colors, shapes, and patterns
  • Will not see differences between similar looking letters and words (eg b / d, b / p, 5 / S, won’t / want, car/cat)
  • Will have a hard time reading maps
Visual Figure-Ground Discrimination
  • Struggles to find information on a busy blackboard
  • Finds it hard to copy work from the board as the child keeps losing his place when copying
  • Loses his/her place on the page while reading
  • Has poor dictionary skills
  • Struggles with map work
  • Struggles to find personal items in a cluttered place
Visual Sequencing
  • Has difficulty using a separate answer sheet
  • Cannot stay in the right place while reading a paragraph. Example: skipping lines, reading the same line over and over
  • Problems reversing or misreading letters, numbers, and words
  • Has difficulty understanding math equations
Visual Motor Processing
  • Has difficulty writing within lines or margins of a piece of paper
  • Struggles to copy from a board or book
  • When moving around often bumps into things
  • Has problems participating in sports that require well-timed and precise movements in space
Visual Closure
  • The inability to know what an object is when only parts of it are visible
  • Not recognizing a picture of a familiar object from a partial image. Example: A truck without its wheels
  • Misidentifying a word with a letter missing
  • Not recognizing a face when one feature (such as the nose) is missing
Visual-Spatial Relationships
  • Difficulty getting from one place to another
  • Has a problem spacing letters and words on paper
  • Cannot judge time
  • Reading maps and giving directions is difficult
  • Difficulty in math
Plus there are other vision processing disorders like Irlen Syndrome, visual dyslexia, and visual dyspraxia.
Examples of colored lenses used in glasses for Irlen Syndrome

Who Diagnoses Visual Processing Disorders and How to Treat It?

This is hard to determine.  Visual Processing Disorder is NOT a learning disability by itself.  It is only a learning disability IF it interferes with the learning process.  Ah, the fun of public education! If you homeschool, it is easier because you can implement the accommodations and modifications at home to see if academic function improves.

 

If you are looking to pursue a diagnosis, look for an ophthalmologist, vision specialist, vision therapist, or a neuropsychologist. One of these professionals should be able to run the psychometric tests needed to make a diagnosis.

 

There are three kinds of therapies that are important to be aware of as you’re considering ways to help your child with visual processing issues.

 

Optometric vision therapy: It’s important to note that there is more than one kind of vision therapy. Optometric vision therapy has been proven to help with vision problems that involve eye movements or eye alignment. These eye coordination issues are different from visual processing issues. Visual processing issues involve the way the brain processes the information the eyes take in.

 

You may hear some kinds of optometric vision therapy referred to as “orthoptic vision therapy.” Both can help with eye muscle and eye alignment. These kinds of therapy can help with vision problems such as convergence insufficiency (when the eyes don’t work together properly when trying to focus on a nearby object).

Optometric vision therapy doesn’t “cure” learning and attention issues. But if your child has vision problems in addition to dyslexia and other issues, resolving vision problems can help him devote more energy to finding strategies that can help with the way his brain processes information.


Behavioral vision therapy: This is different from optometric vision therapy. Behavioral vision therapy involves eye exercises that are designed to improve visual perception. These eye exercises are also designed to improve visual processing skills. But there is no scientific research that shows this kind of therapy helps the brain process visual information. For that reason, behavioral vision therapy is considered a
controversial treatment for learning and attention issues.

 

Anecdotal evidence suggests that it may help some children. But be wary of any treatment that claims to “cure” learning and attention issues. Learn more about how to know when a treatment is reputable.

 

Educational therapy: Children with visual processing issues may benefit from educational therapy. This type of therapy teaches kids strategies for working around their weaknesses. Learning how to approach problems can reduce frustration, increase self-confidence and lead to greater success in school.
Possible accommodations for visual processing disorder

What are appropriate accommodations or modifications?

  • Use books, worksheets, and other materials with enlarged print
  • Read written directions aloud. Varying teaching methods (written and spoken words; images and sounds) can help promote understanding
  • Be aware of the weakness but don’t overemphasize it. While helping a child work on the weakness is important; it is just as important to build other skills and function in any setting
  • Break assignments and chores into clear, concise steps. Often multiple steps can be difficult to visualize and complete
  • Give examples and point out the important details of visual information (the part of a picture that contains information for a particular question)
  • Provide information about a task before starting to focus attention on the activity
  • Allow the student to write answers on the same sheet of paper as the questions or offer opportunities for the student to explain answers orally
  • Provide paper for writing and math work that has darker or raised lines to make the boundaries more distinct
  • Organize assignments to be completed in smaller steps instead of one large finished product
  • Use a ruler as a reading guide (to keep the focus on one line at a time) and a highlighter (to immediately emphasize important information)
  • Provide a tape recorder to supplement note-taking
  • Color code important information
  • Have a proof-reading buddy for all written materials including notes and essays
  • Use a tape recorder when getting important information
  • Before writing letters or essays, create an outline to simplify and organize ideas
I hope this post has been helpful. Please take the time to click on the links in the post as it contains the reference material used to write this post. As always, you are welcome to join us for more discussion on visual impairments in the educational setting at our FB group, IEP/504 Assistance for parents of public school students from all over the United States.
 
AESA also runs a special needs homeschool group, Homeschooling Special (Needs) Kids, and we also have a group for all parents and caregivers of special needs children called Special Needs Parenting Advice and Support where we discuss ALL things related to special needs care and Educating Gifted Children is where we discuss topics concerning gifted children and those that are twice exceptional (2e).  I hope to see you there! 
Michelle Reed-Harris

Michelle Reed-Harris

CEO and Advocate

Michelle Reed-Harris is the mother of six children including surviving quadruplets. Her frustration with doctors and educators led her on a quest to learn about all the facets that touch the quads lives as children with disabilities. In the process, she gained a lot of useful information she could share with others so she started a Facebook group focusing on special education advocacy. The group quickly grew to over 6,000+ members. Recognizing the overwhelming need for assistance, she founded a nonprofit, AESA, allowing her to provide support, advice, and advocacy to parents with children who are outside the (Bell) curve.

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