Visual difficulties explained Part 1 Visual Perception

Visual perception is the term used to describe the way in which the brain processes visual information. There can be differences in the way that visual information is perceived, processed, organised and understood.  This is different from the idea of 20/20 vision and being long sighted or short sighted.

We assume that when we show someone information visually on an interactive white board or a page in a book or a poster that they are seeing what we are seeing.  We also assume that they will be able to readily pick out the information that they need from a visual source. For many children and adults this is not the case.

Good visual perception is important for all aspects of life. We need the ability to process visual information to make sense of the world around us. We need to be able to understand shapes, colours and distance. We use visual perception to develop our understanding of everyday concepts.  For example: to know what a cup is, we need to see many cups and remember what are the key features that make a cup, as not all cups are the same.  This understanding and visual memory will help us see that while a jug is similar to a cup it is not the same. We can mentally compare and realise that a jug has a lip for pouring that a cup does not.

Good visual perception is vital to learn to read and write. We need to distinguish letters and spaces between words. We need to remember spellings and organise words on a page.  Visual perception should be one of the first things that is checked if a child is having difficulty learning to read or write.

It is not always easy to identify children who have difficulties with visual perception.  Children usually don't realise that what they see is not what others see. It is also very hard to verbalise what we see or explain exactly what the problem is.

Some of signs to look out for are:

- difficulty remembering visually presented information
- difficulty with the order of letters and objects
- difficulty picking objects out from a busy background
- difficulty organising themselves or materials in space 
- they may not realise that an object orientated differently is actually the same
- they may not notice big or small differences
- they may appear clumsy

Visual perception is complex and is made up of a number of skills. 

• Visual memory
• visual sequential memory 
• visual closure
• visual discrimination
• visual form constancy
• visual figure ground
• visual motor intergration

Children do not usually have weaknesses in all these areas,  a weakness in just 1 or 2 of them can cause significant difficulties both at school and in every day life.

www.eyecanlearn.com is a very useful website for parents that explains both visual efficiency and visual perception clearly.

If you have any concerns use should consult a behavioral optometrist who can test these areas using standardised tests. Check these websites to find a suitably qualified professional  http://www.babo.co.uk or https://www.covd.org

Over the next couple of weeks I will explain some of these areas in more detail and some strategies that can be used to help.

Early interventions for early signs of dyslexia

The signs of dyslexia show up very early, long before a child starts school, we may choose to ignore them because we hope they will go away....
Or we may be worried that there is nothing we can do at this early stage...
Or we may think that if we acknowledge a difficulty it will only make it worse....

In order to learn to read, write and do basic maths there are underlying skills that are needed:

Good spoken vocabulary
Coordination/motor skills
Visual skills
Auditory skills
Working memory skills

The foundations of these skills start between 0 - 2 and continue to develop (or not develop) throughout the preschool years.  This is why some school systems wait to teach reading and writing in order to give these skills more time to develop.

If one skill is weak we can usually compensate with our stronger skills. The difficulty with dyslexia is it is normally of a combination of skills that are weaker.  The combination is slightly different for each person which is why identifying and supporting dyslexic children is not straightforward.

Even as a very young child we will gravitate towards activities we enjoy and very often these are those we find easy or are good at.  As a result in those early years some skills become well practiced and very strong, while often our weaker skills become even weaker.

The key is to build up our child's confidence with their areas of strength but to be brave and expose them to things that may be more challenging.  It is also important to keep things fun and game based to avoid any sense of failure.

Difficulties with language skills are usually one of the first noticeable signs of dyslexia.  Vocabulary may be slow to develop, words may be mispronounced or muddled, 'thingy' or 'that' may be used as the child has 'word finding' difficulties. Research shows that around 60% of dyslexics are late talkers.

One of best ways of developing language skills is to talk to your child about things in their environment but always using the proper words or terms for example use the word 'rose' rather than 'flower'. Use everyday conversations and events as an opportunity to explain words and introduce new vocabulary.  Reading stories from the earliest age is another enjoyable way to develop a wide range of vocabulary. As soon as a child can sit up at around 6 months it is possible to share books and stories. Many people worry that the child will not understand what is being said but in fact young children 'drink' in the language both its rhythm and sounds and when they are ready they will imitate and draw on this language. Some children do find it harder to hear and distinguish sounds correctly and they may need specialist support.  Don't hesitate in consulting a Speech and Language therapist early on if their language development is slow or laboured.

Many people underestimate the importance of developing good coordination early on.  It is not that everyone needs to be a great sports person but our physical skills are the foundation of future learning. Even basic skills like crawling are an important foundation. About 20 % of dyslexics are late walkers and some do not crawl at all and are 'bottom shufflers'.  This affects the neuro pathways in the brain and makes future learning more challenging.  If you notice coordination difficulties early on consulting an Occupational Therapist can be very helpful.  Young children will consider a session with an OT as fun and will have none of the concerns that you have about something being wrong.

In addition, we want fine motor skills to develop naturally. There are lots of fun craft and mark making activities we can try at home.

In our modern age TV, video, ipads and smart phones are so part of our everyday life and we as parents enjoy their baby sitting benefits. Our children are happily engaged and we do not really consider the skills that they are not developing as a result.  In past when we went to a restaurant a child would do colouring or a dot to dot puzzle or we might engage in a conversation with our child. Think about the number of skills a child would develop in these activities compared to the passive skills that develop when using an electronic device.

Developing good visual skills should be a high priority for every preschool child but even more so for a dyslexic child where this could be an area of deficit. Fun activities that help to develop visual skills are Spot the difference, Mazes, Jigsaws, Dominoes, finding objects in a busy picture like 'Where's Wally'

Equally we should purposely try to develop auditory skills, again this can be done in a fun play based way. Saying and learning Nursery rhymes is so important for early language and memory development.  If child can say a remember a nursery rhyme early on then later they will be able to remember the alphabet sequence, simple instructions or sentences in a story.  Nursery rhymes also introduce children to the rhythm of language as well as the concept of rhyme.  Word play is important; games like 'I spy with my little eye', I went shopping... all help develop early auditory skills

We mistakenly think we have progressed in terms of activities for children.  However it is in fact the traditional games and childhood activities tend to be the most beneficial in developing the pre skills that children need for future learning and for success at school. For example building blocks, shapes sorters and wooden puzzles develop early visual and motor skills. Games like pairs, dominoes and ludo develop visual and counting skills. Dressing up and role play develop listening and language skills.  Many of us played happily as children without even realising how many skills we were developing.  We need to try to offer this same opportunity for our children.

Dyslexia is genetic and as we become more aware of it we can predict children who are likely to have dyslexic difficulties before they start school. Parents can take positive action and work on prereading skills to lessen the challenges faced by these children as they begin to learn to read and write.  This will need a deliberate effort as parent, as typically the games and activities we do with our children tend to be those we also enjoy or find easier ourselves. If we have poor coordination and do not enjoy sports, we are less willing to kick a ball around. If we did not enjoy reading as a child, we are less likely to read stories to our children when they are very young.  We often unknowingly perpetuate our own deficits as we avoid tasks we found difficult as a child with our own children.

There are so many fun and playful activities we can do with our children that can make such a difference in the long run.  I would encourage every parent to embrace to chance to help their child develop their early skills.

All about me - disorganised me

I’m not sure whether disorganised is the best way to describe it, but I find it very hard to work in what others consider to be a logical, ordered sequence.

When I am in my office catching up on administrative tasks I work in a very haphazard way. I often wish I could video myself as I am sure my boss and many of my work colleagues would be surprised if they knew this was the way I worked. Firstly, I have a pack of post its next to me because as I start working through one task my mind will remember something else I am meant to do. I always write this down on a post it so that I don’t forget it. However, sometimes I will leave the first task and start this second task straight away. Then about half way through this second task I might notice something on my desk that I need to sort out. Again, I will stop the task I am doing and start this third task. But as I work through the third task I will remember that I didn’t finish the first or second task and I will go back to one of these. And so, the merry go round will continue of me flitting from task to task and adding new tasks to my post it list until I have completed my tasks or time runs out. Over the years I have tried to fight it and work sensibly through my to do list but I end up being less productive.  I spend so much energy trying to stay on task that the first task will take forever and I rarely get to start the other tasks. In addition, I feel frustrated that I have worked so slowly. On the other hand, if I allow myself to go with the flow and work the way I feel comfortable I feel energised and seem to complete more work.

The same is true when I write, I really struggle to organise my thoughts one at a time in a logical order. My mind seems to flit from one thought to another and my hand cannot keep up.  When I write a Blog article I do start with the title and I usually manage the first couple of sentences but then my mind will jump to ideas that belong at the end or in the middle of the article.  I will write a sentence for each idea and then go back to working on the introductory paragraph. Then other ideas pop into my mind and I will add these to which ever part of the article I think they belong to. I will continue to go back and forth between ideas, adding sentences and developing paragraphs. I will read and re-read, change the order and edit until I am happy. I am very grateful for word processors that allow me work in a fluid way, jumping from idea to idea. Again, when I work like this my brain seems to flow and feel happy.  If I try to write an article in order I get distracted and frustrated.

Perhaps this is way everyone would work this way if they had the choice – I just know from observing my work colleagues it does not seem to be the case!

There are 2 things I take from my working style and experiences.  First, we need to learn to accept ourselves and the way our minds work best. Second, we need to accept that what works for us and seems logicial and straightforward may not work for someone else. Unfortunately, schools seem to spend too much time trying to get all children to work in the same way rather than accepting that our minds are wired differently and trying to help children play to their strengths.

Different types of dyslexia

While there are key characteristics of dyslexia, every person with dyslexia has a slightly different cluster of difficulties.  This is why individual intervention and support is most effective.

Anyone who works with dyslexic students or parents who have more than one child with dyslexia will tell you that there are different types of dyslexia.  While cumulative, systematic multisensory teaching benefits all dyslexic students, there are different materials and approaches which can be used depending on the type of dyslexia.  In any intervention, it makes sense to utilise a child’s strengths and work on improving areas of weakness.

Different websites and authors explain these differences in their own way and use different terminology. Some choose to split the main areas of difficulty while others group certain difficulties together. Some sources mention 4 types of dyslexia, while others list 7 or even 12 types. This can be confusing and is perhaps unnecessarily complicated. Nessy.com is one of the clearest and lists different types of difficulties and explains how these impact a learner.  

In essence, there are 3 main types of dyslexia.   Nearly all dyslexics struggle with working memory however some have more visual difficulties and some have more auditory difficulties and some have equal difficulties in both areas. In addition, all of these groups may have slow processing (this may be identified as rapid naming deficit) and motor skills difficulties (this may include dysgraphia or dyspraxia).

1.    Those dyslexics who have more difficulty with processing auditory information but have strong visual skills have dysphonetic dyslexia (it is also called phonological dyslexia.) This group also includes double deficit dyslexia which is children with difficulties with phonological awareness and rapid naming. 

These are the children who muddle words that sound similar like ‘bag’ and ‘back’ or ‘rag’and ‘rug’. They will have trouble identifying all the sounds in a word when they try to segment a word for spelling. They will try to use their visual memory and could spell chased as ‘cashed’ or farmer as ‘framer’. They often miss sounds or syllables or suffixes from longer words like ‘epty’ for empty, swim for 'swimming'.  These children will have trouble reading names or sounding out polysyllabic words. They can often say the sounds in a word but have trouble blending them together and they may swap over the order of the letters.

When the child starts to learn to read they may initially do quite well as they use their strong visual skills to learn key sight vocabulary and use picture cues to decipher simple texts. However, their decoding skills do not develop in the same way.  If the school uses a scheme that is based on introducing sight vocabulary a little at a time, with predictable sentence structure like Oxford Reading Tree then the child will appear to be learning read. However, as texts become more varied, complex and less predictable they will have no skills to work out new words. Suddenly, the teacher and/or the parents will realise the child has reading difficulties. If the school uses a phonic based scheme like Read Write Inc then these reading difficulties will be evident earlier.

These children also tend to be good at maths as they recognise patterns and so do not rely on memory for number bonds and times tables. 

2. Other dyslexics struggle more with visual perception and are said to have dyseidetic dyslexia (this may also be called surface dyslexia or visual dyslexia.) These children often struggle with Maths as well as reading and writing. They find it hard to visualise maths concepts and develop a concept of number. They do not notice visual patterns and rely on their weak working memory skills to try to remember number facts and calculation methods.

These are the children who struggle to learn irregular high frequency which make up so much of our early reading (in more transparent languages these children would have fewer difficulties.) If the school uses a phonic based reading scheme these children will learn to decode simple 3 or 4 letter words but it will be noticeable that they will sound out words again and again. They do not commit words to memory. In their writing, high frequency words are spelt phonetically like ‘becos’ and ‘sed’ and they may reverse letters and words. These difficulties are considered normal in the early stages of writing. However, as other children begin to master letter formation and key vocabulary these errors will persist. Verbalising what is tricky about a word is helpful in learning spellings, as are mnemonics.

3. Some dyslexics have both visual and auditory difficulties.  These tend to be the children who are noticed early on and are most readily identified as dyslexic by teachers and parents. They struggle to develop reading and writing skills at all in a normal school context as they cannot use stronger skills to compensate. Practical, hands on activities are needed for them to learn to read and grasp basic maths skills. They will have difficulty accessing and processing information that is presented verbally or visually. In essence, they will learn through doing. It is vital that these children receive structured, cumulative, multisensory support.