Visual Processing

When most people think of 'vision' they think in terms of visual acuity; such as seeing 20/20. However, vision is a much more complicated process. Vision is the combination of eyesight (how well we see), how our eyes function (tracking, eye teaming, etc), and visual processing / visual perception (how the brain interprets and understands the information our eyes see). When we do not process visual information properly it leads to Visual Processing Disorder, also called Visual Perceptual Disorder or Visual Processing Issues.

Visual Processing Disorder is very different from conditions affecting visual acuity, which is the sharpness and clarity of eyesight, and cannot be corrected by using glasses or contact lenses. It is important to note that individuals do not “outgrow” Visual Processing Disorder. However, individuals typically develop compensatory techniques to overcome some of their challenges.

Visual Processing Disorder involves difficulties interpreting and understanding visual information, which also includes movement, spatial relationships, form, and direction. These are the visual processing skills required to identify similarities and differences in objects (such as differentiating the letters b and d), identify visually-important information in a crowded background (such as a friend in a crowd) and quickly make decisions based on a changing environment (quickly stopping a car if someone walks in front of it).

Visual Processing Disorder will not be detected on an eye chart. Instead, parents and educators typically notice visual processing disorders when a child is learning. An individual with Visual Processing Disorder will require a greater number of exposures, more typically in the range of 10 to 15 times more often in order to recall visual information, for example a word. It is easy to understand why an individual with Visual Processing Disorder will learn to read at a significantly slower rate, and with greater effort by the individual as well as the parents and educator, than someone with intact visual processing skills. Additionally, individuals with visual processing disorder are overall slower readers and usually with below grade-level comprehension rates. Again, visual processing disorder is not a condition that someone outgrows. It is a lifelong challenge unless diagnosed and treated.


Who Should Have a Visual Processing Assessment?

A Visual Processing Assessment should be performed, for children, when there are concerns regarding their ability to learn from visually-presented material. Visual Perceptual and Visual Processing Deficits affect people in different ways. Signs and symptoms of a Visual Processing Deficit can include:

  • Difficulties with matching
  • Difficulties identifying subtle differences (ex: mistakes words with similar beginnings)
  • Difficulties completing work under timed conditions (ex: runs out of time with tests or assignments)
  • Struggles as a visual learner (ex: prefers auditory presentation)
  • Difficulty visualizing concepts (ex: spatial problem solving, picturing a story in their head)
  • Difficulties remembering what has been viewed (ex: trouble with sight words)
  • Overwhelmed with visually busy environments (visual clutter)

A Visual Processing Assessment is also important for adults who have suffered an acquired brain injury. Visual perceptual deficits, or visual agnosia, and prolonged visual processing speed are common following a head injury. These vision conditions cause difficulties when attempting to return to normal life. Many people are overwhelmed by the day's work. They have difficulties keeping up with the pace of the work day, cannot multitask and 'feel in a fog'. While they may see clearly, they are unable to think clearly about what they are seeing.

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Why Have a Visual Processing Assessment?

There are several different types of visual processing deficits, which together comprise the overall condition that is referred to as Visual Processing Disorder. Visual Processing Disorder often times goes undetected because the deficits are not tested during routine eye exams or during vision screenings at school or at the pediatrician's office. In addition, most eye doctors are not trained to accurately identify or diagnose these deficits.

During a Visual Processing Assessment specific, age-appropriate, research-based testing is used to identify how an individual perceives and processes visual information. This allows our team to identify deficits in these areas of vision. Diagnosing the specific visual processing deficit(s) allows a treatment plan to be prescribed, successfully treating the vision problem and removing barriers to success.

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What is Tested During a Visual Processing Assessment?

Several visual skills are evaluated during a Visual Processing Assessment. These skills include:

Visual Closure
Deficits in this skill lead to difficulty identifying “part” versus “whole”. The ability to recognize an object or word when only parts of it are visible. In the classroom setting this can have tremendous impact on spelling as it is difficult to recognize a word if a letter is missing.
Visual Discrimination (Form Discrimination)
Deficits in this skill lead to difficulty, or the inability, to discriminate differences between objects based on their individual characteristics. In the classroom setting this leads to difficulty in reading and math, with difficulty identifying patterns; difficulty in correctly identifying letters, numbers or symbols; reading from left to right; difficulty in perceiving differences between similar letters or words such as m and n, b and d, p and q. Visual discrimination affects reading fluency.
Visual Figure-Ground
Deficits in this skill lead to difficultly, or the inability, to see a shape or character hidden in a background; visually discriminating a shape or image from its background. In the classroom setting this leads to difficulty locating a specific piece of information on a page.
Visual Memory
There are two different types of visual memory (1) short-term visual memory and (2) long-term visual memory. Short-term visual memory is the ability to recall something seen within a very short period of time and with little interference or distraction. Long-term visual memory is the ability to recall something seen some time ago. In the classroom this leads to difficulty with reading comprehension or performing well on tests.
Visual Sequencing
Deficits in this skill lead to difficulty recalling the order of letters, symbols, words or pictures. In the classroom setting this leads to difficulty remembering sight words, or reversing or misreading words, letters or numbers as well as aligning numbers in math problems or organizing and solving math problems.
Deficits in this skill lead to difficulty identifying position in space, both of one's self as well as other objects. This is the ability to understand “near” and “far”. In the classroom setting this leads to difficulty writing or coloring inside the lines, spacing letters and words properly on the page when writing, judging time or reading maps.
Visual Processing Speed
This visual skill allows an individual to quickly make sense of incoming visual information. Deficits in visual processing speed creates difficulties performing timed activities, keeping up with the pace of an activity, or prevents them from making decisions when viewing quickly changing visual stimuli.

Here in the U.S., studies have shown that 1 out of every 4 children (25% of all children) have a vision problem that affects learning. Unfortunately parents have come to rely on school screenings or vision screenings at the pediatrician's office to replace comprehensive eye exams with a pediatric optometrist or a pediatric ophthalmologist. These screenings give parents a false sense of security when they are told their child's vision is “normal”. The vast majority of people with visual processing disorder have 20/20 eyesight. In order to address vision problems such as visual processing disorder, parents must become better educated on the vision conditions that can affect their children, and hinder both academic and sports performance as well as negatively impacting self-esteem and self-confidence.

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When Should a Visual Processing Assessment be Performed?

A Visual Processing Assessment should be performed when signs or symptoms of a problem are noticed. Remember, visual processing deficits are not something that a child will “out grow”. Early diagnosis means early intervention and treatment.

Prior to the actual Visual Processing Assessment, it is important that the patient first have an eye examination with a Residency-Trained Pediatric Optometrist or a Residency-Trained Neuro-Optometrist. During this visit, the doctor will evaluate several aspects of 'visual input'. Blurred vision or double vision, for example, will negatively impact testing during a Visual Processing Assessment. Ensuring proper visual mechanics allows for accurate evaluation of higher level visual skills; visual perception, processing and working memory – testing performed during a Visual Processing Assessment.

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