How Visual Tests Determine School Readiness, Learning Difficulties and More

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My beloved Step-Mother-In-Law (you read that right… I’m from California after all…) Judyth tutors kids for a living and told me how visual testing can determine whether a child is ready for school, the best way for a child to learn and more. Per her recommendation, I contacted Dr. Valenti – “the best Developmental Optometrist” – to answer my questions on how the eyes can be the bridge to brainpower.

What sorts of problems can a visual test uncover that determines whether a child is not ready to enter Kindergarten or uncover why a child is struggling in school no matter the age?

After examining thousands of children in the United States and around the world I have seen that children can experience vision problems that can cluster into any combination of 4 broad developmental categories: problems with focusing, tracking, eye-coordination, and visual perception. In the overwhelming majority of cases these are normal children with inefficient or incomplete vision development that can be completely cured with appropriate care and go on to be successful in school and life.

Once a problem is discovered, how can parents help a child work on it so they are ready for school/ what can be done?

As a parent, getting your child to the appropriate doctor, a behavioral optometrist, who is trained to know what to look for, recommend and provide treatment is the first and most important step. A parent can’t be expected to fix the problems themselves without help. The most common treatments include improving vision developmental skills with professionally guided activities in vision therapy, developmental lenses to be used in the classroom and for homework, and proper school placement.

For parents who have kids who’s birthdays are in the fall, will this test once and for all indicate to them whether they should hold off a year before having their child enter Kindergarten?

In most cases yes, but it is not always a clear cut decision. The results of a developmental vision exam may show a global difficulty in all areas indicating that starting school the following year is the best decision. Even though a child is chronologically 5 years or older, he may have the vision development that is much younger. However, a child might have mild problems in one or two areas that can be worked on during the school year if the child has already started in the fall, or in the summer if school has not yet started, so that the child is fully prepared visually to begin school later that year. When in doubt it is best to delay beginning school, for if a child begins to do exceptionally well, it is far more easier to move up a grade than move down, if on the other hand, school struggles become apparent as the school year progresses.

What does the testing involve?

Behavioral optometrists will spend an hour or longer with an examination. First, and most important, a rapport must be established early between your child and the doctor. When a child is in a comfortable environment then he is asked to do certain things in the guise of enjoyable and interesting games. Such things could be to watch a puppet show while the doctor is shining a light in the eyes to determine if there is any nearsightedness, farsightedness, or astigmatism; build blocks from a model; track moving targets with the eyes; or copy basic shapes with a pencil on paper. From observing how these tasks are carried out a very accurate determination can be made as to the competency and skill of visual development and how that ability compares to age and physiological norms.

Where can moms take their kids to be tested?

Here are two websites to locate the right doctor for your child to be tested by a behavioral optometrist.

The College of Optometrists in Vision Development

The Optometric Extension Program Foundation

If a parent has no choice but to send their child to school (can’t afford day care costs any longer, etc.), can they still spend extra time tutoring and working through the problems discovered within the visual tests with their child?

Most of the vision problems that play a role in learning are developmental in nature and therefore improve with time accompanied by guided experience. Knowledgeable tutoring can help to make it easier on the child. As a parent you can get books that teach you what visual skills are important and give you ideas for activities to train these skills with your children. Three excellent books written by behavioral optometrists are How to Develop Your Child’s Intelligence, by Dr. G.N. Getman, Developing Your Child for Success, by Dr. Kenneth Lane, and Your Child’s Vision, by Dr. Richard Kavner, all three available through the Optometric Extension Program Foundation website.
(1921 E. Carnegie Ave., Suite 3-L, Santa Ana, California, USA, 92705-5510
Telephone: 949-250-8070 FAX: 949-250-8157)

In addition, you can email me ( for a copy of an article I’ve written for parents which outlines ideas for vision training activities to do with your infant so that you can help prevent problems from occurring later in life.

If it is determined a child is not ready for school, is there something parents can do over the course of the year they wait before entering their child or does the child sometimes just need to continue to develop naturally?

Generally another year of development will help visual skills improve but a child can also compensate for a weakness, leading to less than desirable learning. For example, if eye hand coordination is weak a child may compensate when writing with a close working distance and a distorted pencil grip, contributing to poor and uncomfortable handwriting. They never enjoy writing assignments and more time doesn’t solve the problem. When I was doing my fellowship in developmental vision at the Gesell Institute in New Haven, Connecticut, I learned that when a child was judged not to be ready for school, the appropriate grade placement combined with vision training over the ensuing year was the best combination that invariably led to success with the greatest number of children throughout the following years in school.

If a child is in junior high (or any grade for that matter) and having trouble learning, can a visual test help determine the best way to tutor them?

Yes. Understanding how a child is seeing the world can guide a tutor to present material in the easiest way to facilitate learning. For example, a child who has a weakness in accommodation and tracking will sustain reading instruction longer if the words are larger and they use their finger to track underneath the words. I am a strong advocate for all children who are reading below their grade expected reading speed to go through a prolonged period of several months of using their finger while reading aloud. This is a good way to help the visual system get stronger for tracking and improve reading efficiency. Working on a sloped surface will usually improve handwriting with a child who has poor eye-hand coordination, and highlighting all the “b’s” in a passage with a highlighter helps the child to not confuse it with a “d” when they have been diagnosed with poor visual perception for directionality and spatial awareness. There are many such strategies that can be helpful to a tutor. Finally, if a behavioral optometrist has prescribed developmental lenses to help with desk work, particularly reading, then the tutor can make a big contribution by insuring that they are worn.

Anything else you’d like to share regarding determining whether a child is ready for school?

Start with a vision exam within the first month of birth, then consider finding a behavioral optometrist who can begin a series of evaluations every three months thereafter through the first year of life. The doctor can tell what stage of vision development your child is in and then recommend guided activities for you to do with your child at home. In this way a parent is educated to the visual skills that are important for their individual child and that should develop during the first 18 months of life. With this awareness the early environment can be shaped to include enough activity to provide exposure, experience, and practice to lay down strong neurological pathways to tip the scales for strong vision development in all of the important areas, all of this happening while your child’s nervous system is at the most optimal time for positive and rapid change.

Anything else you’d like to share regarding how visual testing can help a child no matter the age learn more effectively?

Any person at any age and with any condition can be examined. I often work with teenagers and adults in vision therapy to improve reading efficiency, math efficiency, and visual concentration. These are individuals who had visual interferences in elementary school years but were left untreated. Their success came with much effort, with little or no enjoyment for reading, and usually a fear of math. They often feel they are “just not good” at reading and math, or they have ADD. They fail to realize they have inefficient neurological habits that can change for the better when they are shown what to do and then apply themselves. When shown how to look at words and numbers in a different way, what steps they need to take to visually concentrate, and then practice these skills, in addition to practicing the physical visual skills of tracking, eye coordination, and focus, that they may have been diagnosed to be deficient in, what follows usually within a few months is a feeling of control and a sense of conquering what they used to avoid. This does wonders for self esteem and they actually look forward to applying their newfound abilities to reading, working with numbers and applying visual concentration for all of their favorite endeavors. I know personally, I used to be one of these people until I helped myself when I started doing vision therapy along with my patients some 25 years ago.

Do you have anything to add as far as visual development and learning or anything else you’d like to share?

It is estimated that over 80% of what a child learns in school is through their visual system. Accordingly, when a child has visual interference school performance not only suffers, but learning becomes a chore and not the uplifting and exciting experience that we want it to be for all of our children. Behavioral optometrists would like to see all children receive early developmental vision evaluations and vision therapy as part of the standard curriculum in early education. Imagine if all children were in the classroom with exceptionally intact and efficient visual skills for readily keeping visual attention, observing fine likes and differences, easily scanning across lines of print, visualizing math and reading, remembering what they saw, writing with comfort and ease, easily looking from the whiteboard to their papers, having the stamina to carry out homework assignments, and being visually creative. This can be a reality, only if we take the time to train visual skills in preparation for the known visual challenges that will occur in every classroom, and do this with the same commitment and in the same manner as training an athlete before they compete, thereby giving each and every child the chance to develop their visual capabilities to their fullest potential, and ultimately develop a true love, excitement and passion for lifelong learning, individual self expression, development and happiness.

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About Dr. Valenti:

Claude A. Valenti, O.D., F.C.O.V.D., is director of the Optometric Vision Development Center in La Jolla, California. The Center specializes in the diagnosis and treatment of functional and perceptual vision problems.
Dr. Valenti was graduated from Rutgers University in 1976, and from the Pennsylvania College of Optometry in 1981. As an optometry student , he received the Knight-Henry Memorial Award for his clinical contributions and extensive knowledge in developmental optometry. He served a clinical internship at the Skeffington Alexander National Optometric Education Learning Center (SA-NOEL Center) in Lancaster Ohio. In 1982 he was the sole recipient of the E.B. Alexander Fellowship in Visual Training at the Gesell Institute in New Haven, Connecticut. Since 1983, Dr. Valenti has been fully involved in the La Jolla practice. He is past president of behavioral optometric organizations and served on state legislature committees dealing with the issues of children and learning difficulties. He has lectured internationally on all aspects of behavioral vision care as it relates to the topics of infant vision guidance, learning related vision problems, strabismus and amblyopia, sports vision, head trauma, lens prescribing, autism, head trauma and Parkinson’s disease. Since 1990 he has been lecturing to osteopaths on the topics of vision, health, learning, children and osteopathy, as well as teaching a yearly course at the Ecole Supérieure D’Ostéopathie in France, entitled “Vision: What Every Osteopath Needs to Know”. Dr. Valenti is the author of the short book for behavioral optometrists,
THE FULL SCOPE OF RETINOSCOPY, as well as many other professional articles pertaining to behavioral vision.

For contact information, click here.

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  3. Grandma Sharon says:

    Very interesting information. Thanks to Judyth for connecting us with Dr. Valenti.

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  12. OK I am actually commenting on the great article – although I would still love to win :). We had my daughter tested at age 2 by a fluke and it was determined she needed glasses as well as other optical therapy (patching, etc.). I’m so thankful she was tested then as I can’t imagine what her development would have been like had we not known early. She is since a great little reader and a happy glasses-wearin girl…I would encourage everyone to test early, well before school age if possible.

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