LIving in two different worlds can feel weird at times. Inhabitants of one world are either completely unaware, or else actively avoid, the people in the other, despite sharing in most life experiences. The two worlds I live in are the dyslexia/phonics/reading world and the vision-skills/vision-therapy world. When I enter one, I sometimes feel pressure to avoid mention of the other.
I wasn't even aware of the vision therapy world until about the year 2000 when I had my encounter with Dr. Richard Foss, a developmental optometrist. Here's the most relevant part of that piece:
I left the meeting with one overriding impression. Dr. Foss felt that every poor reader should be evaluated to see if vision therapy was indicated, whereas I felt that every poor reader should be evaluated to see if phonics instruction was indicated. Furthermore, neither of us felt that the other’s services would be needed all that often if our own advice were just followed, though we each were willing to allow that there might occasionally be a need for the other's services.
Within a few years, I had enough experience with both phonics instruction and vision therapy to realize that Dr. Foss had the better position.
I'm making one assumption when I say that. I'm assuming that those poor readers have had some basic phonics instruction, and that they were in that group of kids that find phonics either hard to pick up or that don't easily achieve fluency. First and second grade teachers, you know who those kids are; you've each had at least a couple every school year.
Reading Researchers Studiously Avoid Vision
Here's the problem: Pick up almost any study looking at reading problems, or dyslexia specifically, and, if it has an index, look for the word vision or vision skills or visual skills. You won't find them mentioned, except to claim that they aren't relevant to reading problems.
This astounds developmental optometrists who repeatedly tell us that 80% of our daily brain input comes through our eyes. I would add, that especially includes the printed word, something we can't smell, hear, taste, or feel with meaning. So, the only way we input a printed word is via our visual systems. (Braille excepted.)
And yet reading research ignores that indisputable fact. And I used to buy into that research, even after my meeting with Dr. Foss, described above. But then I ran into David. If you're an elementary teacher and can read David's Story without recognizing a few of your own students, I'd be very surprised. Don't forget to read David Returns, as well.
Since that time I've worked with dozens of students who either clearly need vision therapy, or who had it and then saw me. The difference between the two groups was this: The latter group was easy to teach; the former was less so, although a vision-challenged child can learn phonics.
I eventually put together this free Vision Assessment Checklist to help teachers and parents pick out the kids who exhibit symptoms of vision skills problems.
Teachers, Assess Your Sources
Has anyone in any of your trainings brought up vision therapy as a way to address your slower readers' problem? Granted, a vision therapist may have given an in-service at your school, but how about all those other people trying to help you.
Did the doctor or school nurse who recommended drugging your student also say that maybe vision therapy should be considered first?
Did the special ed teacher who has your students pulled from classes, to teach what you couldn't teach them, tell you that the parents might want to consider investigating vision therapy before removing their child from your classroom?
Did the principal who gave you a couple of tough kids in the middle of the school year (because you're one of his best and he hopes you can "get through to the kid") tell you that the parents had been told to check with a developmental optometrist to see if vision skills were inadequate?
If you can answer "yes" to any of those questions, or all of them, that's great and you've already seen the results, as I did with David (and many more after that.) But if you can't, then the students that you pour the most effort into educating might not be getting what they need. It's not your fault. You don't assess and develop vision skills. And that's what, in my experience , many of your poor readers need most, assuming of course that they've already had some good phonics instruction.
You see, despite mountains of reading research, phonics really doesn't sink in with some poor readers. Call them dyslexic, if you will; I call them vision-challenged until proven otherwise by a thorough examination of their visual skills. It's that old elephant problem again. The researchers have found the elephant's ears, but they haven't gotten around to the elephant's eyes. Or to the eyes and visual systems of your students who you work with the hardest.
About Those Two Worlds Again
The reading world needs to join up with the vision therapy world to help many, if not most, of the kids we now consider dyslexic, or just poor readers. That won't help all of them, but in my experience it will help most of them. But to do that, each side needs to be open to the other side's arguments, and their research too.
This isn't climate change where you just decide that it's an issue you don't discuss with your best friends because you don't want to lose them. This is about not ruining any more kids' futures simply because we refuse to consider the arguments of the other side.
I live in both worlds, and I tread far more carefully on the reading side because that's the side that most refuses to listen. On balance, the vision side goes about its business helping kids overcome vision issues and doesn't bother talking to those who won't listen, with the possible rare exception of that occasional visit to your school by a vision therapist hoping to counter all that reading research that ignores the role the visual system plays in learning to read.
Merging the Two Worlds: A Short Story
This is the "in a nutshell" version because the long one isn't ready yet. While I was on the school board at Melrose-Mindoro, the board adopted a vision therapy plan that covered all kids in 5th grade and below. It lasted five years, from 2009 to 2014. Update: It's now ready. See School-Based Vision Therapy.
The only public data available from that effort is comparison of the 10 students who had vision therapy in 5th grade versus the 30 who didn't. We compared their 4th grade state reading scores before going into therapy with their 7th grade state reading scores three years later.
Vision therapists came to the school weekly to work with every student in the program one-on-one for thirty minutes and trained aides worked with them on the other days, also one-on-one, for about two-thirds of their fifth grade year. It wasn't reading instruction; it was vision therapy.
The average reading score on state testing of the thirty non-VT students versus the state average declined slightly from 4th grade to 7th grade, by 1.8 points on a 100-point scale. Meanwhile, the average reading score of the ten VT students increased by 16.6 points. That was a large enough increase to raise the entire class's reading score by 2.8 points against the state average. Only one of the VT student's scores declined, and that by only 3 points. The largest increase among all 40 students was 44 points by a VT student. The next two largest were each 30 points, also by VT students.
What Needs to Happen
My opinion, based both on my personal experience working with struggling readers and on observing what vision therapy has done in one school, is that vision skills issues have to start being considered in reading research circles. The two worlds of phonics research and vision therapy need to come together for the sake of struggling readers everywhere.
