During the second semester of our daughter’s first-grade year, we started receiving notices and messages from her teacher: “She can’t focus,” “It takes her 40 minutes to complete what others are doing in 10 to 15 minutes.”

When she did write, her letters were too large for the lines provided, and she did not space her words properly. Instead, they looked like a string of letters. Our daughter would also complain that books had “too many words” and would refuse to read them despite the fact that she could read any single word we showed her.

We knew that our daughter is very social and would much rather play and socialize than sit and do any pencil and paper activity, yet we started worrying about the cause and consequences of all this. Was she still adjusting to the change from Kindergarten to Grade 1, which was more academically demanding? After all, she’s the youngest in her class. Can she not focus properly? Does she have reading difficulties?

Where do we start with figuring out what’s wrong?

 

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Her teacher offered her a quiet work space that she could use when she felt the classroom environment was too noisy. That worked – sometimes. Our daughter had participated in the school’s yearly Hearing and Vision testing, and the results for acuity in both were ‘within normal limits.’

How can we help her before it is too late and the academic gap widens?

It was also around that time when I was starting to learn more about functional eye movements, how they develop, and what impact any difficulties might have on learning. As an Occupational Therapist working with school-aged children, I wanted to learn more about this to better service the children I work with.

Little did I know, this information would also be helpful closer to home.

As part of my training, I learned to screen for functional eye movements: visual pursuits (smoothly and constantly following a moving object visually while keeping one’s head stationary), saccades (shifting focus/jumping from one object to another quickly and accurately), and convergence (maintaining visual contact on an object as it comes closer to the eyes).

Pursuits are needed for following a ball along its path of movement – so essential for learning to throw and catch. Saccades are needed for reading. Convergence is required for looking at an object close-up.

I tried this screen on my daughter and saw that one of her eyes was not always moving along as quickly as her other eye. During the convergence screen, her eyes didn’t appear to actually “look” at the close-up object. The variations were all very subtle, but with time, the ‘slow’ eye got even slower, as if it was getting tired.

We decided to take our daughter to an optometrist for a Functional Eye Exam, which we then realized can also be done by a Developmental Optometrist. The optometrist found out that our daughter had a lazy eye, even though typically both her eyes seem to be well aligned.

She explained that each eye has six muscles that control its movement. All 12 muscles have to work in synchrony for us to see comfortably and accurately in a three-dimensional world. Sometimes, one eye’s muscles are weaker than the other, which affects the eye teaming (working together). In my daughter’s situation, this showed up only after a period of close-up work.

The doctor explained that it was too strenuous for our daughter’s eyes to do pencil and paper activities – especially reading and writing. After awhile, they begin to fatigue and cannot ‘focus’ on a paper that is up close, so she loses ‘focus’ and chooses to talk with her friends instead.

This explained what her teacher was observing in the classroom, why she seemed inattentive at times, and why it was taking her a long time to complete her classwork. Our daughter was prescribed glasses. The optometrist also recommended that she do Vision Therapy to strengthen her lazy eye and limit any further decline in her eye function.

A year later, our daughter ‘focuses’ better, completes her work even if the classroom is noisy, and her reading has progressed to above grade level. She no longer feels overwhelmed by the “many words” in a chapter book. She can also write more clearly and spaces her words correctly.

Functional eye skills are part of the foundational skills that children need for learning. Difficulties should not be overlooked when trying to determine possible causes of a child’s inattention. I am grateful that we were able to find a cause and a solution for our daughter.

She is still very social and would rather socialize than do classwork, but she has caught up academically and has become an avid reader.