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Did You Know That 1 out of 4 children has a vision challenge significant enough to affect their academic performance in school ?

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My child may have a vision challenge significant enough to affect their academic performance in school. What should I do?

First, look for these vision challenge warning signs.  If your child loses their place or uses their finger when reading, is unable to sustain visual attention to near tasks, struggles with reading comprehension, takes forever to complete their homework, tilts their head when reading, or closes or covers an eye when reading. Any of these signs could indicate a vision challenge that we can help your child overcome.

Complete this convenient form to schedule a comprehensive personal evaluation for your child with Occupational Therapist and Scribble 2 Script Founder, Megan Eldridge.

    We’ll contact you no later than the next business day to schedule.

    The information on this page is vital to read. Children with vision-related learning problems often go undetected because many have 20/20 vision. 80% of what you perceive, comprehend and remember relies on the efficiency of the entire visual system. Gaps or delays with visual skills create a weak foundation for building academic achievement, including reading, writing, attention, school performance, and even sports. The development of good visual skills is necessary to become an efficient learner and for a child to perform at their highest potential.

    Vision is a learned process just like learning to master abilities such as sitting up, rolling over, walking, and talking. This is the reason you should view vision exams as wellness checkups rather than need-only exams. The type of vision exam we’re describing goes well beyond the quick eye health check with pediatricians or the school nurse. They, along with most ophthalmologists and optometrists, do not check all areas of the visual system.


    What are the building blocks of vision needed for efficient learning?



    Eyesight is only a tiny part of the entire visual system. It is essential to distinguish between eyesight versus the active and dynamic process of vision. “Normal” vision does not always mean well-functioning eyes. Eyesight is how clearly your child can see (e.g., 20/20) from a certain distance.  However, what does that tell us about the ability to sustain near work?

    What about the ability to change focus from far to near and near to far?  The ability to read words on a page smoothly? Or the ability to process visual information effectively? Beyond an initial eye exam, it is important to also check visual efficiency skills along with visual information processing skills. Visual efficiency skills refer to how the muscles outside the eyeball direct sight and communicate with the brain.

    For the eyes to read easily, they need to be able to aim, jump, and track. In order to see something clearly and comfortably, both eyes need to work well as a team. Focus control happens inside the eyeball.  This control needs to be accurate to see clearly both at near and far as well as to sustain clarity over time. Vision information processing happens in the brain. It is our ability to interpret, analyze, and give meaning to what we see.

    Good processing skills make it easier to understand, remember, and learn at school.

    Good visual processing skills include:

    • Visual Discrimination: The ability to identify similarities and differences between shapes, symbols, objects, and patterns for matching and sorting. This is needed for perceiving small likenesses and differences of letters while reading (sun, bun, run) or distinguishing the main idea from insignificant details.
    • Visual Memory: The ability to remember what is seen for immediate recall. This is needed for visualizing what is read, reading comprehension, spelling, math facts, and sight words.
    • Visual Spatial Relations: The ability to perceive the position of two or more objects in relation to oneself and in relation to each other. This is needed for sequential tasks as well as for problem-solving.
    • Visual Form Constancy: The ability to accurately recognize and interpret that a form or object remains the same despite changes in its presentation such as size, direction, orientation, color, texture, or context; for example, a horizontally oriented math problem vs. a vertically oriented math problem or clock face vs. digital. This is needed for learning to read, preventing reversals, and working with symbols.
    • Visual Sequential Memory: The ability to remember and recall a sequence of visual images such as letters, shapes, or numbers in the correct order.  This is used for spelling, following directions in the proper sequence, copying off the board, reading comprehension (visualizing the sequence of events), playing games with multiple steps
    • Visual Figure Ground: The ability to see an object/form when presented with a lot of visual information at one time. For example, “find the third sentence in the fourth paragraph.” This is needed for aligning math problems correctly, keeping your place while reading, staying focused, looking up information in literature, and attention to details.
    • Visual Closure: The ability to identify or recognize a form or object from an incomplete presentation (when the entire object is not visible). This involves visualizing and mentally “filling in” the visual information that is missing. This is essential for speed and fluency with reading.
    • Visualization: The ability to create mental images. This is needed for spelling, math, and reading comprehension.


    Several mechanisms come into play when a child is asked to read.

    The skills needed for effective reading include:

    • Good visual acuity (eyesight)
    • Eye tracking
    • Eye focusing
    • Eye teaming
    • Visual form perception
    • Visualization

    From birth to 5 years old, children are ‘learning to see.’
    From Kindergarten to 2nd grade, most children are ‘learning to read.’
    From 3rd grade and up, they are ‘reading to learn.’

    When a child is ‘learning to read’ vision, problems can reduce their ability to know what they are looking at and impact their ability to remember numbers and letters. An aspiring reader will struggle to keep pace with classmates as they acquire this new skill. When a child is ‘reading to learn’ and has blurry or double vision, their ability to read for long periods of time and comprehend what they are reading can be severely reduced.

    They won’t be able to process information as quickly as their fellow students and will fall behind. 75% of children identified as learning disabled have their most significant challenge in reading. They are often labeled as having “dyslexia.” Out of those children who are reading disabled, 80% of them have difficulties with one or more basic visual skill.


    A vast majority of children that are diagnosed as suffering from dyslexia also experience a visual related reading challenge that can be related to focusing, eye teaming, and eye tracking deficiencies. Harvard Medical School and Boston Children’s Hospital team discovered that a staggering 79% of children who struggled with dyslexia also had problems with eye teaming, tracking and focusing versus 33% in typical readers.

    In their article, they concluded that the “…assessment of vergence [eye teaming], accommodation [focusing], and eye movements may be helpful in the initial evaluation of children with dyslexia and will supplement the findings of a comprehensive ophthalmologic examination and a detailed literacy evaluation.”

    What is dyslexia?

    Dyslexia is a term used to describe a condition that affects reading and spelling. In its truest form, dyslexia can be described as a neurological dysfunction in which the brains’ language center struggles with the translation of written symbols to spoken sounds. Children that have dyslexia frequently reverse letters and words, and have issues reading.

    How is dyslexia related to vision?

    To be able to see effectively to read, you need to have clear vision as well as have efficient eye teaming, eye focusing, and eye tracking. Too often, people believe that 20/20 sight should mean that vision is effective for reading, but this is not the case. An undiagnosed eye problem can often cause an issue which may present itself as dyslexia. Eyesight is only a tiny part of the entire visual system. Remember, “normal” vision does not always mean well-functioning eyes.

    If visual skills are compromised, a child may experience:

    • Blurred or double vision
    • Suffer from headaches
    • Experience eye strain
    • Have difficulty sustaining clear and single vision up close
    • Avoid near work tasks
    • Often skip lines when reading
    • Reverse letters or pronounce words wrong

    Experiencing even one of these symptoms can cause problems with reading which can closely resemble dyslexia. Vision problems do not cause dyslexia, but there is a higher incidence of vision problems in children diagnosed with dyslexia. It is important to distinguish if your child has a vision-related learning challenge, an actual reading disability, or both.


    The eyes must lead the hand when writing. Several vision-related skills are critical to good handwriting that may be underdeveloped in a student with vision problems. They can include:

    • Poor peripheral awareness, which may cause difficulty writing straight on a page.
    • Challenges with visualization make it hard for a student to remember what different words look like in order to reproduce them on the page.
    • Spatial concepts are important for proper sizing, spacing, and margins as well as the ability to differentiate similarly shaped letters in different orientations (e.g., b, d, p, q).
    • Visualization is also critical for writing composition because the student needs to be able to organize and re-organize the composition in his or her head.
    • Visual recall, the ability to create a visual image based on past visual experience, is a visualization skill that is critical for spelling. In spelling, it is the ability to create a mental image of a word without being able to look at the word.


    There is no dispute that a diagnosis of ADD/ADHD can be valid. However, difficulty focusing or staying on task is not always related to ADD/ADHD. In some cases, vision related challenges are often diagnosed as ADD/ADHD. Attention and concentration issues can often be related to vision, focusing, eye teaming, eye tracking, and how a child’s brain perceives visual information. Interestingly, the signs and symptoms of ADD/ADHD and vision related learning disorders overlap.

    Here is a chart that compares the signs and symptoms of ADD/ADHD and Vision Related Learning Challenges:

    Signs and SymptomsADD/ADHDVision Related Learning DisordersNormal Child Under age 7
    Inattention (at least 6 are necessary):
    Often fails to give close attention to details or makes careless mistakesXX
    Often has difficulty sustaining attention in tasks or play activitiesXXX
    Often does not listen when spoken to directlyXX
    Often does not follow through on instruction or fails to finish workXXX
    Often has difficulty organizing tasks and activitiesXXX
    Often avoids, dislikes or reluctant to engage in tasks requiring sustained mental effortXXX
    Often loses thingsXXX
    Often distracted by extraneous stimuliXXX
    Often forgetful in daily activitiesXX
    Hyperactivity and Impulsivity (at least 6 are necessary):
    Often fidgets with hands or feet or squirms in seatXXX
    Often has difficulty remaining seated when required to do soXXX
    Often runs or climbs excessivelyXX
    Often has difficulty playing quietlyX
    Often “on the go.”XX
    Often talks excessivelyXX
    Often blurts out answers to questions before they have been completedXX
    Often has difficulty awaiting their turnXXX
    Often interrupts or intrudes on othersXXX

    If your child is struggling with any of the challenges discussed on this page, it is essential to thoroughly evaluate your child’s entire visual system which includes eyesight, eye tracking, eye teaming, focusing and visual perception. The Scribble 2 Script evaluation is a multistep process that we coordinate with  developmental optometrists Drs. Stephen Cohen, O.D., and Amanda Goldberg, O.D. to evaluate your child’s specific issues.

    The evaluation ensures that we have a full understanding of how your child’s visual system is functioning and how that affects their learning process. Once the evaluation process is complete, a coordinated treatment plan is created to address your child’s needs, along with an estimated timeframe for intervention, to ensure your child is ready of optimal lifelong learning.

    Be sure to review the results other parents and children have attained in the Scribble 2 Script Smart Moves PLUS program.

    “My son visited Scribble 2 Script once a week to improve his handwriting. During our time together, the Scribble 2 Script program greatly improved all aspects of his fine motor skills. His confidence soared, and he always had fun during his sessions. ”
    ~ Laura Cole

    “Before we found Scribble2Script, William’s frustration with schoolwork and school, in general, had reached an all-time high.  Nothing we tried at home helped and our family had become very discouraged – it seemed the more we practiced and tried to “fix” his handwriting, the worse things got. 

    During our Scribble 2 Script evaluation with Megan, she uncovered and explained the reasons behind his handwriting trouble, and we finally saw a light at the end of the tunnel. The Scribble 2 Script team’s demeanor with William was warm and encouraging. We watched him truly blossom during his sessions, and his confidence grew.

    Every time we left, he had a smile on his face, and he felt proud of his accomplishments of that week, and that positive attitude spilled over into home, school, and even into sports.  The difference this [the Scribble 2 Script] program has made in our lives is immeasurable.”
    ~ Sarah Kleck

    “Megan and her team of dedicated and wonderful teachers have made such a difference in my 8-year-old son’s life. He is finally proud of his writing & beams when he shows me his school work now. 

    His skills have improved so much that he clearly has confidence that he didn’t have 6 months ago. I truly believe this is going to make his academic future so much brighter.”
    ~ Alison Rose

    See more results children (and their parents) experience at Scribble 2 Script

    Contact us today!
    Is your child’s handwriting atrocious? Are they struggling to keep up in school? Do you want to give your child every opportunity to enjoy learning but you are not sure what to do?
    Poor handwriting is just the tip of the child development iceberg.
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    • If your child gets frustrated and gives up easily
    • Lacks self-confidence
    • Or has a hard time focusing and concentrating

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    Now you can learn how to ensure that your child’s future is not limited due to poor academic performance because of a childhood developmental barrier.
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