Wow Vision Therapy Blog

Letter Reversals…Does my child have dyslexia or a vision problem?

HannahWhen a child confuses and reverses letters, such as “b’s” for “d’s” and “p’s” for “q’s”, parents often wonder, “does my child have dyslexia?”. This is largely due to the fact that theåÊmedia has drawn public attention to a problem in visual perception where the person who reverses their letters or numbers usually has trouble reading effectively. However, dyslexia is a broad term that indicates an unexpectedåÊreading disability that exists in a person who otherwise has no cognitive impairmentåÊand has had adequate educational instruction. The causes can vary as outlined in Wikipedia’s reviewåÊof dyslexia.åÊA more general overview of “Vision and Dyslexia” has been written in a White Paper by the College of Optometrists in Vision Development.

Letter reversalsåÊareåÊdevelopmentally normal up to age 7, however several other developmental factors must be considered before assuming that a child is experiencing normal letter reversal tendency’s at a younger age. When a child is behind in theiråÊvisual processing it isåÊreferred to asåÊa delay in visual spatial orientation or visual directionality. A child who is developmentally delayed in visual directionality will exhibit confusion in reading simply because of the letters that are symbolically the same, have a different meaning because ofåÊtheir visual spatial orientation, ie,åÊ “b”, “d”, “p” “q”…same symbol different meaning!

Delays in the visual brain’s ability to process information, such as letters, numbers and words, based on visual-spatial orientation,åÊåÊwillåÊindeedåÊcomplicate reading, writing and other learning activities. As a result,åÊa child or adult who has this form of visual processing problemåÊwill also have a vision related learning problem. And yes thisåÊcan be one of the causes for a reading disability or dyslexia…visual spatial dyslexia.

What shouldåÊyou do if you suspect your child has a problem with visual spatial orientation skills? Seek out help from a Doctor of Optometry who is Board CertifiedåÊin Developmental Vision and Vision Therapy. Those doctors skilled in the diagnosis and management of a patient with these problems will utilize a complete battery of visual perceptual tests and be able to offer treatment, in the form of office-based vision therapy to treat and remediate the patients delay in vision.

To help doctors with the best methods of practice in treating patients with learning related vision problems, the American Optometric Association has published anåÊevidenced based Clinical Practice Guideline entitled:Care of the Patient with Learning Related Vision Problems (CPG20)

The best treatment for a child (or adult) with a vision related learning problem is office-based vision therapy. An example of one of our patientsåÊsuccess, ie “no more reversals”, åÊcan be seen at Hannah’s Story.

Dan L. Fortenbacher, O.D, FCOVD