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Twice Exceptional Child in the Age of Virtual School - Preparing for Fall in a COVID-19 World

Presented Carol Dimas, May 21, 2020

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Our newsletter, The Spark, offers articles from professionals who work with gifted children, details on our events, and more!

Fall 2016

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Fall 2013

Spring 2013


Bright Child-Gifted Learner.pdf

The Link Between Vision & Learning

By Dr. Monika Spokas, Developmental Optometrist

Have you ever considered the question, “What role does vision play in a child’s learning?”  You might be surprised.  Vision is our dominant sense, especially when it comes to learning.  It is estimated that as much as 80% of all learning takes place through our visual system.  When vision works well, it guides; when it does not, it interferes. 

The National Parent Teacher Association (PTA) estimates that there are 10 million children under 10 years of age in the U.S. alone that have vision problem.1  As many as 1 out of 4 children have an undiagnosed vision problem significant enough to impact their academic performance.  And gifted children are no exception.

So, what does a vision problem look like?  How can you tell if a child might have a vision problem?  There are several observable signs a child may experience when vision is interfering with learning:

  • ·         Looses place while reading
  • ·         Omits small words while reading
  • ·         Uses a finger or marker to guide reading or to read
  • ·         Poor reading comprehension
  • ·         Headaches or fatigue, especially with near work
  • ·         Rubs or closes an eye
  • ·         Blurred vision
  • ·         Letters move or double vision
  • ·         Difficulty copying from the board
  • ·         Difficulty with writing (sizing, spacing, copying)
  • ·         Difficulty with spelling (often spells more phonetically)
  • ·         Poor gross and/or fine motor coordination
  • ·         Avoids school work or near work

Visual perceptual and visual motor problems are often a contributing factor with gifted children whose IQ performance testing scores are much lower than their verbal testing scores.  Gifted children often find ways to compensate for the visual deficiency through creative thinking, verbalization, and high abstract reasoning.

  Mark was 12 years old, attending a school for the gifted, when he was referred to a developmental optometrist by his teacher.  He was significantly below age level in reading, spelling and writing.  He complained of blurriness, intermittent double vision, words “moving” on the page and fatigue with near work.  Vision testing revealed a significant accommodative (focusing) and binocular (eye teaming) problem as well as deficiencies in visual motor integration, visual memory for symbols and auditory discrimination.  Previous IQ testing indicated his Performance IQ score at 30 points lower than his Verbal IQ score – a significant spread.  After a year of vision therapy treatment, Mark showed tremendous improvement in all visual areas.  He was no longer symptomatic.  He made great strides in his academics.  Self esteem had greatly been enhanced as he now knew he could perform and be successful.

Learning problems are often masked in gifted children as many compensate or avoid the task.  This can results in a profile of an “average student.”  Learning disabled gifted children can be so frustrated that they will not attempt to do the schoolwork, or they can be straight “A” students who have to work extra hard to get the grade.  Self esteem is often compromised when children struggle, adding an additional complication to the emotional and behavioral picture. 

Lisa was 9 years old when she was referred to a developmental optometrist by her teacher.  She was an excellent reader.  Her main difficulty was handwriting.  Her writing was slow and difficult.  Sizing and spacing of letters were variable.  She had wonderful ideas for stories but would do anything to avoid having to write anything down on paper.  Because writing was so frustrating for her, Lisa would tell her stories to her mother so her mother could type them for her.  Vision testing revealed that Lisa did have good visual and perceptual skills, yet her visual motor integration (copying shapes and forms) was a concern.  Although she only scored 6 months below her age level, all of her other testing was way above age level leaving a large gap in the scores.  A short term vision therapy program was recommended and after four months, Lisa’s hand writing had improved.  More importantly, though, she was much less frustrated by the task of writing and not nearly as reluctant to attempt it.

Since vision is our dominant sense and 80% of all learning comes through the visual system, any interference in these pathways can cause difficulty with learning.  While most children are born with healthy eyes and brain, vision itself is a learned process.  There are more than 17 visual skills a person must have to learn easily and effortlessly.  These include visual motor skills (focusing, tracking, teaming) which we use to see and gather information.  Accurate eye movement skills are necessary for following an object as well as being able to fixate correctly and quickly when reading, copying, or playing ball sports.  If eye movements are uncoordinated, this could cause the child to lose his or her place, skip words, or miss the ball.  Accuracy of clear, single vision depends on the precision of pointing and focusing the two eyes together.  Eye teaming and focus problems create fatigue, discomfort, and blurriness, which may result in inconsistency of performance or avoidance of task

Once the information reaches the brain, we then use our visual perceptual skills (visual discrimination, visual memory, imagery) in order to understand what is being seen.  Difficulties in this area may cause slow and hesitant reading.  A child may show symptoms such as misread words, have poor reading comprehension, reversals and poor directionality skills.  In addition, there are the eye-hand coordination skills which are essential to the accurate production of written language as well as efficient and successful sports performance.  Vision affects our understanding of space as vision leads us and without good vision symptoms such as clumsiness, poor coordination, and poor sports performance may result.

With most school systems offering visual screenings, parents frequently get a false sense of security that their child’s vision is good when they pass the screening.  The truth is these screenings are frequently inadequate. The screening usually consists of the Snellen 20/20 chart, which is given at 20 feet.  Today, only a small percentage of classroom learning happens at 20 feet.  The majority of a child’s learning happens at an arm length or closer.  A child could actually see double when reading and still pass this screening!  Even the most gifted students will struggle academically if they have trouble seeing the board or focusing on a book.  A tremendous amount of learning happens visually, so proper vision care is crucial to helping students reach their full potential.

If your child’s school performance is inconsistent, your child performs below their potential, or you are simply puzzled with their performance in school, consider evaluating their vision.  A developmental vision assessment will reveal any necessity for glasses for compensation, prevention, or stress relief.  In addition, if deemed necessary, vision therapy options would be discussed.  The majority of vision disorders are very treatable.  Studies have shown that the correction of vision problems with vision therapy leads to significant reduction in visual symptoms and improvements in reading performance.2,3  To find a developmental optometrist, go to the College of Optometry in Vision Development website at

When making an appointment, in order to insure an adequate visual evaluation is done, the parent should ask the following questions:

  • 1)      Do you give a full series of near point visual tests?
  • 2)      Do you give academically related visual perception tests?
  • 3)      Do you provide one on one vision therapy in your office?
  • 4)      Will you send a written report that all adults concerned can understand and apply to assist this child?

About Dr. Monika Spokas

Dr. Spokas is a Developmental Optometrists who diagnoses and treats vision problems that interfere with a child’s ability to read, to learn, to comprehend and even to pay attention.  Dr. Spokas has been practicing in the western suburbs for more than a decade and has recently completed a number of post-graduate courses in the field of Developmental Optometry.

Dr. Spokas is committed to teaching parents, teachers, and professionals how to identify children with learning related vision problems.  As an expert in vision development, she regularly offers educational seminars and workshops.  If you know of a group that should hear about vision and learning, please contact Lisa Henderson at 630-323-7300 or email to schedule a free workshop.

References and for more information:

  • 1.        National Parent Teacher Association
  • 2.        Optometry and Vision Science
  • 3.        Optometry: Journal of the American Optometric Association

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