From Dr. Karen’s files:

“My 10-year-old son seems to be reading fine and loves to listen to audio books.  But it’s like pulling teeth to get him to read a book on his own. And lately I’ve noticed that he’s having some trouble with math. It seems like there is some sort of problem, but what is it?”

Reading Assessment:  I quickly realized that he was having a really hard time keeping his place.  He was rubbing his eyes; he was concerned about the size of the font in the books, and he asked right away ‘how much more’ he was going to have to read.

There was a lot of head movement as he read.  We call that ‘head pointing’ - a common accommodation when children are having trouble with print.  He turned his head sideways and moved back and forth trying to get the print focused properly.  

His decoding of new words was excellent, and he read fluently from a Magic Tree House book. I only helped with three new words.  I gave him a short spelling test as well.  He could sound out the words easily. 

Conclusion: This is a visual alignment problem.  Even though he likely has 20/20 vision in each eye separately, his eyes aren’t working well together.  That makes the print blurry.  Every time he sees a word it looks different.  It’s also interfering with his fluency because he keeps losing his place.  That, in turn, creates terrible fatigue and effects his comprehension. 

This problem will not go away over time and needs to be treated by a knowledgeable pediatric optometrist.  It is a muscular misalignment that creates neurological confusion and neurological fatigue.  Their eyes are like popcorn all over the page, the smaller the font the more quickly they fatigue, and their comprehension tanks because they are working so hard to keep the print clear.  Sometimes children just shut one eye down (suppression) and can hobble along a little while longer, but eventually, if left untreated, this condition bleeds into all subject areas, especially math, because they can’t keep the numbers lined up or remember story problems. 

Remedy: I have referred the family to a local pediatric optometrist who can diagnose and treat this issue. Sometimes it can be fixed with glasses, sometimes children will need short term vision therapy to correct the problem.

Karen J. Holinga, Ph.D.

Reading/Curriculum Specialist