By Dr. Ann Harvey, Associate Professor of Reading, Western New Mexico University

Young children spend much time in front of a screen.  Whether it is a TV screen or a computer screen, there seems to be one result:  the child’s near point vision development suffers.  Even the American Academy of Pediatrics has noticed the problem because they have recommended that no more than one to two hours of quality TV, video, or internet be viewed each day for older children and no screen time should be given to children under the age of two.  Beginning readers need to have all the physical benefits of learning to read with minimal effort.  Since 80% of information gathered is visual, this is an important aspect of learning.  Having both eyes move, align, fixate, and focus as a team enhances the ability to interpret and understand the potential visual information that is available.  Extra effort spent on getting print in focus should be used on comprehension efforts.

An emergent reading assessment measures problems with eye movement, as well as cognitive, motor, social-emotion development and concepts of print.  The information that follows will offer simple remediation efforts to correct delay in the eye movement development.

Schools regularly screen students for far-point vision while near point vision abilities are largely ignored.  Near-point visual conditions are those that correlate with learning problems and are prevalent with children in poverty.  W. C. Maples did a study of 679 rural poor children in Oklahoma and found that near-point vision problems were a bigger predictor of school failure than either race or poverty, (Orfield, 2001).

The DIAL test directs three month old babies to track a light from a flashlight both vertically and from side-to-side by moving both their eyes and heads.  By six months, they are expected to perform the same task with small motor eye muscles while holding their heads stationary.  If these babies have delayed development, they are given practice to remediate the problem by Parents as Teachers professionals.  However, by kindergarten, not much attention is paid to eye muscle movement or development.

Behavioral Optometry is concerned with eye movement disorders, inefficiency in using both eyes together, misalignment of the eyes, lazy eye, focusing problems, visual information processing disorders and visual sensory and motor integration.  At this point, optometry and education share concerns about reading achievement and need to collaborate to encourage children to have efficient visual performance.

Vision is a set of abilities.   It is a skill that involves more than 20/20 acuity.  Vision involves the ability to identify, interpret and understand what is seen.  This ability is developed starting from birth.  A child begins to walk by creeping, crawling, standing, and finally walking unassisted.  A similar process from gross to fine motor control takes place in the development of vision.  The eye has six muscles.  Two of the muscles control the up and down movement while two control the right to left movement.  A final two muscles control diagonal movement.  All of these muscles must be controlled with finesse which comes with practice. Having both eyes move, align, fixate and focus as a team enhances the ability to interpret and understand the potential visual information that is available.

Near-point vision problems include inability to track, focus, or converge on near print.    Students must be able to track, focus, or converge on near point print with their eye movements.  Awareness of this problem and suggestions for remediation will help students approach print more successfully.  Simple movement games conducted for twenty minutes per day would help with visual tracking.  When the child is able to control eye muscles adequately, less energy is exerted on tracking and focusing on print, and more energy is spent on creating meaning from the print.

Research which precipitated the assessment

During the 2006-2007 school year, 2,789 K-3 students were screened.  1,213 of those students or 43.6% were found to have vision challenges.  These vision issues are probably a result of the change in culture.  In the last 30 years, games that encourage development of good vision skills have been replaced with passive activities such as watching television and playing video games.

A vision assessment program was developed by Successlink, a consortium promotion technology in the classroom which is funded by the Gates Foundation and the state of Missouri. A vision assessment devised by Dr. David Peirce was a result of a 2004 Proven Practices Award winning program in Blue Eye, Missouri.  After using vision enhancement exercises, the second graders at the school all scored above grade level in reading.  The vision enhancement program was replicated through the state in as many as 30 schools.

The screening instrument that Dr. Peirce devised was composed of five sections:  visual pursuit, cover test, saccades, near point convergence and form reproduction.  In the visual pursuit test, the examiner who was trained for sixteen hours, held the target twelve inches from the nose.  The student watches the target without moving his head.  The target is moved in a large circular motion from 12 o’clock back to the 12 o’clock position.  The examiner repeats this task but starts in the center and moves the target up, down, left, right and diagonally.  He progresses from slow to moderately fast and continues for one minute.

In the cover test, the examiner also holds the target twelve inches away from the nose and directs the student to fixate on the target.  Then the examiner covers the right eye and notices movement through the occluder. Then the examiner uncovers the eye and again watches for movement. Any jerky eye movement is noted. This task is performed three times. Then it is repeated in the same manner for the left eye.

The third test was the saccades test.  The examiner held the target at eye level about twelve inches from the nose.  Then the examiner told the student, “When I say yellow, look at the yellow pencil.  When I say blue, move your eyes to the blue pen.  Please move only your eyes and not your head.”  Any undershooting or overshooting of the eye is noted. Any observable behavior such as watering eyes, changes in posture, or excessive blinking should also be noted.  Next the examiner positions one pencil on the midline at twelve inches from the child’s nose.  The examiner moves the other pen six inches from the fixed pencil at the 1 o’clock position.  The child is asked to look form one target to the other.  This activity was repeated several times.

The next test was the near point convergence test.  The examiner held one target two feet from the student’s nose.  He asked the student to fixate on the target with both eyes and hold the focus.  Then he asked the student to watch the pencil come toward him and then away.  The student should say “one” when he sees one target and “two” when he sees double as the object approach his nose.  The examiner smoothly moves the target toward the nose of the child.  He observes both of the eyes.  He notices if one eye moves away from the target.  The distance at which the child states that he sees two objects is noted.  It is also noted at what distance he sees only one object.

The final test of the vision assessment was the form reproduction test.  The student is given a form master and told to look carefully at the page.   The student is also given a blank paper with a pencil.  He was asked to make the blank paper look like the first one.   The examiner didn’t give any further instruction except to tell the student to do the best job possible. The examiners watch for signs of eye fatigue such as closing eyes frequently, shaking the head to refocus or excessive movement during the test.

As a result of this research, an Early Emergent Literacy Assessment has been developed to assess eye movement as well as cognitive development motor development, communication development, social and emotional development and Concepts of Print.

Types of Intervention for Visual Motor Deficits

In order to improve the skill of body and motor planning, have students lie on the floor like a pencil and move one area of their body while other parts are still (snow angels).  Have them do hopscotch exercises with one foot, two feet, and then one foot.  Then raise their head up and down to make the neck muscles stronger.  Have them walk on the balance beam to increase body awareness and balance.

An easy to incorporate skill which improves eye movement is this exercise which develops eye muscle control to track moving objects.  Ask the student to track a swinging ball by moving only his eyes.  Have the student look at red and green targets and move them vertically and horizontally.  Darken the room and use a flashlight to make a spot light dance.  Have the students follow the spot light with their own flashlights.

To increase visual discrimination, have students sort, match, and sequence color, shape, size, and textures of objects.    Students practice this skill when they string beads in sequence. Playing dominoes, where the child matches picture to picture or word to word, is another helpful activity to develop visual discrimination.  I Spy, played both inside and outside, is an engaging game for improving this skill. Classroom centers lend themselves to these activities.  Finally, the alphabet game, which involves looking for letters in different fonts on billboards using far point vision, is yet another beneficial activity.

When students have visual spatial integration difficulties, they cannot use both hands efficiently.  Thus, they have difficulty following directions using word that describe positions in space such as below, above, in front of, behind, or beside.  To correct this developmental delay, students benefit from playing hokey-pokey, doing treasure hunts with maps, and completing dot-to-dot and mazes.

To work on eye-hand coordination, try playing bean bag toss. The old-fashion game of dropping a clothes pin into the mouth of a glass jar involves similar skills.  Copying a pattern on a geo-board with rubber bands also expands this skill.

Visual Form Constancy is the ability to recognize forms when they are smaller, larger, or rotated in space.  To improve this skill, give the students a page with similar objects to identify on a line.  Have the student mark out or color certain shapes.

Visual closure requires that a child predict what a finished shape would look like.  A child who lags in this skill often isn’t able to recognize familiar chunks in a new word.  The child reads letter by letter instead of word by word or phrase by phrase.  To correct this problem, encourage the child to finish a simple line drawing.  Have them play hangman and Wheel of Fortune for spelling words or to practice vocabulary.

Finding an object on a busy background requires the skill of Visual Figure Ground.  In order to improve this skill, a child might play Where’s Waldo.    Finding objects in a glass jar of sand is another activity requiring Visual Figure Ground.  Scribble trails and word searches can improve the skill also.  Playing a game where the teacher puts objects on the table and then takes one away is another activity that focuses on this skill.

Eye teaming requires the eyes to work together and focus on the same point on the page.  If there are problems with eye teaming, vision becomes fuzzy and the task of focusing becomes uncomfortable.  Students will cover or close one eye or lay their heads to one side when reading or drawing.  In order to improve the skill of using both eyes together, the space docking game is a good choice.  Have the student stand tall as you hold a paper towel roll vertically in front of him at eye level.  The student should be able to take his pencil and move it to the hole on the paper towel roll and dock his space ship pencil without touching the sides of the dock.

Gross motor development insures that the child has a good understanding of the body’s relationship with its surrounding space.  Both sides of the body should be communicating for proper visual motor development.  Playing jump rope, hopscotch, four square, balance beam, follow the leader, and hula hoop all help to improve gross motor development.   Using the wobble board also helps develops balance.  Have the students pretend to be a pirate and try not to drop the gold when walking on the balance beam.  Use a geo-board and copy a design with rubber bands.  Have the students reproduce the shapes on a worksheet or describe objects inside a bag by touch, rather than looking at them.  These exercises help students visualize their relationship to other objects in space.   Gross motor activity is especially good at promoting brain activity that integrates sensory motor development.

Cultural changes affect child development.  Being aware of developmental patterns and adapting teaching methods to respond to the changes is the mark of proactive teaching.  Using assessment to measure developmental lags helps teachers plan activities which will meet specific goals.  Assessment is an important part of the emergent literacy classroom. Marie Clay’s (1993) idea of Kid Watching is using daily observations systematically to inform instructional plans. These daily observations in conjunction with informal assessments prove useful in spotting eye movement difficulties and then remediating them. The results should contribute to successful emergent readers.

BIBLIOGRAPHY

Adams, Marilyn. (1998) Beginning to Read:  Thinking and learning about print. Cambridge, MA:  MIT Press: ISBN 0-26201-112-3.

Armistead, S. B, &  Duke, Neil K..(2005)  Literacy and the youngest learner:  Best      practices for educators of children from birth to five. Boulder, CO.

Armbruster, S. B., Lehr, F.  & Osborn, J. (2001). Put reading first: The research                                            building blocks for teaching children to read (kindergarten through grade 3). Jessup, MD: National Institute for Literacy at ED Pubs. (Partnership for Reading: Bringing Scientific Evidence to Learning—National Institute for Literacy, National Institute of Child Health and Human Development and U.S. Department of Education)

Bredekamp, Sue & Copple, Carol. (1997).  Developmentally appropriate practice in  early childhood programs. Washington, DC: National Association for the Education of Young Children [NAEYC].

Byrd, R., Stephens, P., Dyk, L,, Perry, E., & Rous, B. (1998). Sequenced transition to education in the public schools: Project STEPS replication manual, (3rd ed.) Lexington, KY: Project STEPS [Sequenced Transition to Education in the Public Schools].

Cohen, Vicki L. & Cowen, John Edwin (2008). Literacy for Children in an Information Age. Belmont, CA:  Thomson Wadsworth. ISBN:  0-534-61119-2.

Davis, Deborah, & Lewis, Jan Patricia (1997). Tips for parents about reading. Portland, OR: Northwest Regional Educational Laboratory.

Dickinson David K., & Neuman, Susan B. (2006).  Handbook of early literacy research. : New York: Guildford Press.  ISBN 1-59385-184-7.

Flynn, Michael. (2011)  Vision’s Impact on Learning.  Presented to the Spring Delta Kappa Gamma teaching conference, Silver City, N.M.

Hemmeter, Mary Louise & Beth Rous. (1992). Project STEPS : Developmental Ages for the skills included on the helpful entry level skills checklist. Lexington, KY:  Project STEPS [Sequenced Transition to Education in the Public Schools].

Linder, Toni W. (1999). Read, play, and learn! Storybook activities for young children: Collection 1 [Storybooks and Teacher’s Guide; Modules 1-8]). Baltimore, MD: Paul H. Brookes Publishing Co.

McGee, Lea M. (2003).  Designing early literacy programs:  Strategies for at risk preschool and kindergarten children New York: Guilford Press:  ISBN: 1-57230-890-7.

Meisels, Samuel J. & Fenichel, Emily. (1996).  New visions for the development assessment of infants and young children [Chapters 1, 2, 15, 16]. Washington, DC: ZERO TO THREE: National Center for Infants, Toddlers and Families.

Pisarchick, Sally E. (1993). Project Prepare: Model for competency-based preschool personnel preparation in early childhood education [Overview of Project Prepare Modules]. Columbus, OH: Ohio Department of Education.

Project ELIPSS [Emergent Literacy Instructional Program and Support Services]. (1996). Project ELIPSS: Module One: Building a Firm Foundation for Literacy Development: Macomb, IL: Language and Literacy Learning [Video] Project ELIPSS:

Project ACT. (2006).  Planning for transition into preschool. What works Volume IV. Boulder, CO:  Project ACT.

Roskos,  Kathleen A. (2005).  Oral Language and Early Literacy in Preschool:  Talking, Reading, and Writing. International Reading Association.

Schickedanz, Judith A. (2004). Writing in preschool:  Learning to orchestrate meaning and marks. International Reading Association.  ISBN 0-8720-7546-X.

Strickland, Dorothy. (2004). Learning about print in preschool:  Working with letters, words, and beginning links with phonemic awareness.  International Reading Association. ISBN 0-7720-7550-8.

Teal, William & Sulzby, Elizabeth. (2003).   Emergent literacy:  Writing and reading Vol. 6  New York: Ablex Publishing. ISBN:  0-89391-385-5.

Verkelicht, Carl &  James Christie. (2004). Building a foundation for preschool literacy:  Effective instruction for children’s reading and writing development. International Reading Association.   ISBN 0-87207-547-8.

Yopp, H. K.. (1988). The validity and reliability of phonemic awareness tests. Reading Research Quarterly. 23: 159-177.