Non-verbal Learning Disorder (NLD), Eye Tracking, Special Education Students

Vision Therapy Helps Children with "Hidden Disability", an article by Agnes Blum which appeared in the Education section of the Boston Sunday Globe on December 1, 2002.

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Micah is one of the lucky ones, with parents who didn't immediately accept a diagnosis of a "non-verbal learning disorder [NLD]," said [Dr.] Orfield. . "Now he says school is so much easier." said Motenko of Brookline, [Micah's parent].

... tested about 800 children for three major vision issues: tracking, converging (having both eyes lock onto the same object at the same time), and focusing. More than 50 percent of the students failed, and many of these students had 20/20 eyesight, Orfield said. That's because the traditional eyesight test - the Snellen wall chart - tests only whether a child can clearly see letters 20 feet away. It does not test the ability to see objects that are close.

A study done of 6,000 students in New York state showed that while 23 percent had vision problems, 93 percent of those who were in some sort of special education program suffered from vision problems, said Paul Harris.

Vision Therapy Helps Children with "Hidden Disability"

Tossing beanbags to a child while he walks on a balance beam with a patch over one eye may seem an unusual way to improve reading skills, but Aluma Motenko swears it worked for her son.

Two years ago, when Micah Motenko was 9, he couldn't sit still in class, couldn't read assignments, and was unable to finish homework. So his mother took him to Antonia Orfield, an optometrist who specializes in vision therapy and prescribed several eye exercises-including the balance beam one.

After a few months, the Motenkos saw results that have stuck, his mother said. "Before he would sit forever and cry. Hours would go by and he still wasn't able to do his homework," said Motenko, of Brookline. "Now he says school is so much easier. He used to wear glasses all the time, and now he only wears them for reading."

Micah is one of the lucky ones, with parents who didn't immediately accept a diagnosis of a "non-verbal learning disorder [NLD]," said Orfield, one of about 400 vision therapists certified in vision development by the College of Optometrists. Founded in 1971, the association represents eye care professionals who specialize in vision therapy and rehabilitation.

Thousands of other children suffer with vision problems that never get addressed, said Orfield, who works at Harvard University Health Service and runs a private practice.

Between 1993 and 1999, Orfield, who worked at the New England College of Optometry at the time, started a vision clinic in the Mather Elementary School in Dorchester. She tested about 800 children for three major vision issues: tracking, converging (having both eyes lock onto the same object at the same time), and focusing. More than 50 percent of the students failed, and many of these students had 20/20 eyesight, Orfield said. That's because the traditional eyesight test - the Snellen wall chart - tests only whether a child can clearly see letters 20 feet away. It does not test the ability to see objects that are close.

"Vision and eyesight, Orfield said, are two different things. Vision is a learned skill, just like learning to walk, she said.

"We're looking for the wrong things," she said, "and the system does not deliver. A lot of the kids have middle-aged-type vision."

And those children often give up on reading because it's just too hard, Orfield said.

The letters swim on the page, giving the children headaches. Children try to compensate by bobbing their heads back and forth to constantly refocus their eyes, or shutting one eye and reading with the other. They invariably fall behind and become frustrated with reading, Orfield said. Most do not report a problem reading because they do not realize that their experience is abnormal, she said. And administrators often mislabel these children as suffering from a learning disorder, such at attention deficit hyperactivity disorder or dyslexia, when in fact it is their vision that is impaired.

Gary Orfield, a professor of education and social policy at Harvard University and Antonia's husband, said too often students with such problems end up in special education classes instead of getting vision therapy. "It's a tragic situation because these are solvable problems," he said.

A study done of 6,000 students in New York state showed that while 23 percent had vision problems, 93 percent of those who were in some sort of special education program suffered from vision problems, said Paul Harris, an optometrist who practices vision therapy in Maryland and runs the Baltimore Academy for Behavioral Optometry.

"It's a hidden disability," Harris said. "There's a strong implication that we may be over-medicating our kids." Vision therapy, he said, can make a huge difference.

"Kids who go through my program make a 73 percent jump in reading, on average," Harris said. "This is a school problem that should be treated in school. It's much less expensive to do it in school than in private practice."

Inner-city children are the most vulnerable because they are least likely to receive adequate medical care, Harris said. Studies have shown that children from low-income families who are given prescriptions for glasses, or appointments with doctors outside of school, seldom pursue them. The only way to serve these children, Harris said, is to offer the services in school.

"And the problem is exacerbated by television, a major cause of vision development disorders, especially among low-income children, Harris said. The average American child, between the ages of 2 and 17 years old, watches 25 hours of television a week. One in five of those children watch more than 35 hours a week, according to the National Institute on Media and the Family, a non-profit organization that promotes research about the impact of media on children and families.

"The good news, Harris said, is that the human eye can be retrained to visualize properly. The only hurdle is access to the proper medical professionals and treatments.

Aluma Motenko was so impressed with the progress her son made with vision therapy that she enrolled her whole family. Motenko, who has worn glasses for most of her life, said the treatments have almost eradicated her stigmatism.

"I can wake up in the morning and open my eyes and see," she said. "My world is totally different now."