The Gift of Vision for the Gifted

Since 1985, Gifted Development Center (GDC) has referred thousands of children to optometrists. Approximately half of the 6,500 children assessed at GDC show patterns on IQ and achievement tests suggestive of visual processing issues. GDC’s Director, Dr. Linda Silverman, has observed “red flags” in the assessment battery that differentiate children with potential visual processing deficits who are likely to profit from developmental vision care. 

Profiles of gifted children referred for developmental vision evaluations will be shared in this article, along with caveats regarding interpretation of the complex profiles of gifted children with learning disabilities. These “twice exceptional” (2E) children are the most at-risk.  Giftedness masks disabilities and disabilities depress IQ scores. Due to their advanced abstract reasoning, gifted children have the capacity to compensate for visual processing deficits, which prevents their detection. However, compensation comes with the price of fatigue and frustration. Early detection is essential.

 
What is visual information processing?

Visual processing describes the way the brain processes visual information—including visual input, brain processing and motor output.  This includes information from academics (reading, spelling, writing), sports, facial cues, and social interactions. Visual processing difficulties affect many gifted students with learning disabilities (2E), dyslexia, ADHD, autism, or sensory processing disorders.

What are some indications of potential visual processing deficits in gifted children?

·       Obvious visual difficulty (blurred vision, double vision, covering an eye, squinting when focusing on targets, headaches especially with sustained near work)

·       Prefers reading books with larger print or fewer lines on the page

·       Slow reading speed or comprehension

·       Shows reversals of numbers (3/5, 6/9) or letters (b/d, p/q) after age 7.5

·       Avoids writing tasks or completion of written tasks take longer than expected

·       Is frustrated and gives up quickly if task can’t be completed easily

What are the “red flags” on the WISC IQ test that help psychologists identify those who are appropriate referrals for developmental vision care?

·       Verbal subtests are higher than the visually presented tests

·       Relatively lower processing speed scores

·       Visual-motor coordination is often not as advanced as their abstract reasoning

·       Significantly lower performance on timed tests

·       Can accurately complete items after the time limit

·       Difficulties with Block Design, Coding, Symbol Search

“Lower” scores may not be below age level, but relatively lower compared to other high scores.  A disability is often not documented; yet the child suffers in performance, self-esteem, and emotional distress.  Dr. Silverman maintains that the appropriate question to ask is: “To what extent does the discrepancy between the child’s strengths and weaknesses cause frustration and interfere with the full development of the child’s abilities?”

What is vision therapy?: 

(Reprinted with permission from Optometrist network)

Vision therapy is designed to teach the person how the brain controls the eyes, to improve their visual skills and how to apply these new skills to improve reading, learning, concentration and attention.

Vision therapy is a fully customized and personalized treatment program designed to improve and strengthen visual skills, and re-train the child’s visual system to interpret visual input with increased accuracy and ease.

Vision therapy is more than just simple eye exercises — it improves brain-eye communication and the effective operating of the child’s visual system.

The aim of vision therapy is to enhance visual skills— eye-tracking, focusing, convergence, eye-hand coordination, visual processing speed, visual memory and more!

What is the impact of optometric vision therapy on the gifted population?

Vision is more than 20/20.  There are at least 17 visual skills important for performance. “Adequate” vision is inadequate for gifted children.  The goal of vision therapy for the gifted person should go beyond remediation of vision deficits (tracking, eye teaming, focusing, visual information processing).  The goal should be enhanced visual abilities.  Children with higher intelligence need much higher-than- average visual processing skills to actualize their gifts.  This is analogous to super athletes.  They typically have extraordinarily higher than average visual skills to support the athlete’s high-level performance demands.

The impact of vision therapy may include:  Improvements in reading, writing, sports, processing speed, behavior, and confidence.  IQ scores in follow-up testing often show improvement.  To learn more about vision therapy and its success, check out COVD and Neuro-Optometric Rehabilitation Association (NORA).

Optometric vision therapy is provided by Doctors of Optometry (O.D.) often referred to as developmental or behavioral optometrists.  To find an O.D. who provides vision therapy contact the College of Optometrists in Vision Development (COVD).

Case studies of the gifted demonstrating the impact of vision therapy:

·       GDC has documented significant improvement in processing speed in gifted children after vision therapy—as much as 52 points.

·       A fourth grader’s reading ability jumped from first grade level to college level.

·       A second grader who avoided reading aloud because she skipped words began “devouring books” after completing vision therapy. Her teacher saw improvement in her reading, writing, and spelling. Even her ballet teacher noticed improvement.

·       Joey, a 3-year-old with crossed eyes (esotropia), lazy eye (amblyopia), and hyperopia (farsightedness) was an early reader and highly verbal.  However, he was very “active,” distracting and frustrated with motor tasks.  With bifocal glasses and vision therapy, significant behavior changes were noticed: he was calmer, more focused and less distracted.

·       Ellie, an 11-year-old, was an excellent reader, but she avoided paper/pencil tasks.  She had great ideas for creative stories and would only dictate them to her mother to write.  After vision therapy, her visual-motor integration skills increased, and she started to write more frequently.  She still “thinks faster than her hands can write.” However, now that she is accomplished with keyboarding skills, she has become a gifted story writer.

Clinical pearls to help gifted children reduce their anxiety and increase their overall performance:

·       Understand the gap in potential and performance in the physical difficulties as well as emotional overlays.

·       Allow additional time for written assignments.

·       Reduce the amount of written work, allowing for oral answers and brainstorming.

·       Utilize breathing strategies for calming/relaxing.

·       Increase visualization skills for academics (reading comprehension, creative writing, math facts, spelling) and for calming anxiety.  Specific activities can be found in See It. Say It. Do It!

·       Teach keyboarding skills early (by 3rd grade) so that your child can utilize technology to assist with the visual-motor speed challenges.

·       Referral to a developmental optometrist can help identify and treat gifted children with visual processing problems.  A referral for a developmental optometrist can be found here.

Summary

Parents and professionals need to recognize how a child can be so bright and have gifts in some areas, yet still suffer from learning difficulties which can hinder classroom performance as well as affect emotions and behaviors.  Encouragement, praise, nurturing, and special help enable the child to be happy, successful, and gain confidence to reach his or her potential. 

Dr. William C. Lee, O.D. (1989) writes of the gift of vision:

In LIGHT there is SIGHT

In SIGHT there is VISION

In VISION there is SUCCESS

In SUCCESS there is HAPPINESS

The gift of excellent vision is one gift all children deserve.

About Dr. Lynn Hellerstein

Lynn Hellerstein, O.D., FCOVD, FAAO, is a developmental optometrist and co-owner of Hellerstein & Brenner Vision Center P.C. For more than 45 years, Dr. Hellerstein has treated children and adults with learning and reading deficits, visual processing disorders, or brain injuries. She has inspired thousands of individuals to improve their vision and enhance their school/work success, sports performance, and confidence. In 1985, she introduced Dr. Linda Silverman to vision therapy. Since that time, Linda has sent hundreds of gifted children to Lynn Hellerstein, establishing Lynn as one of the foremost world leaders in the evaluation and treatment of gifted children with visual processing issues.

An international speaker and author of the award-winning books series, See It. Say It. Do It!, Dr. Hellerstein is an adjunct faculty member at five schools of optometry, and past-president of the College of Optometrists in Vision Development.  Dr. Hellerstein works with several non-profit organizations, including Von’s Vision Foundation (which provides low-income students with eye care and fashionable corrective eyewear) and she is Chair of the Sock It To ‘Em Board (providing socks to those experiencing homelessness).

Her two beautiful adult daughters and four grandchildren fill her life with fun and joy!