Visual-spatial integration is the ability of the brain to process visual input to develop an awareness of the body in space and its relationship to other objects. Children who have problems in this area often have trouble with reversals of letters or words, and may be quick to be labeled as “dyslexic.” While dyslexia is a general term for a reading disability, spatial processing disorders are specific to problems with laterality and directionality. Laterality is an internal awareness and control of the body, for instance, knowing the difference between left and right. Directionality is the ability to project that awareness into space, for instance, being able to tell someone else to turn left or right to get to a destination. For a young child, laterality and directionality are importantåÊin developing balance, coordination, gross motor skills, and awareness of a midline. At a young age, awareness begins to take place through the help of the vestibular system. If gross motor skills such as crawling, walking, and hopping are delayed, fine motor skills become even more difficult to learn.
As a child grows, spatial skills become increasingly important and essential for tasks such as navigation and understanding and orienting symbols such as letters and numbers. If the child has a spatial processing delay, academic tasks such as reading and math become frustrating, especially when demands are increased from the second grade to third grade, third to fourth, and so on. If a good sense of individual symbol orientation is never learned, there may also be problems with orienting letters within a word. The child who has problems doing this may read the sentence “the dog saw a cat” as “the dog was a cat.” Clearly, reading comprehension will become increasingly difficult with demands as well.
What does this have to do with vision? Although a child may have good eyesight and healthy eyes, his or her brainåÊmay have trouble interpreting what is seen by the eyes. These children may struggle in school, especially with visually demanding activities such as reading and math, even though they have no problems with blurry or double vision. In addition to interpretation of symbols, eye movement and alignment requires very fine motor skills. Testing by a developmental optometrist can check visual-spatial integration abilities, as well as other areas of visual processing. Vision therapy for this area includes working with children individually to develop an awareness of laterality and directionality, and fine-tuning fine motoråÊmovements to make these skills automatic. For more information on this topic, go to the College of Optometrists in Vision Development website to learn more about vision and learning problems.
Paula Smith, Intern
Michigan College of Optometry