The multi-sensory approach to the optometric management of children with specific learning difficulties (such as dyslexia and dyspraxia)

Abstract

In the 1920's Skeffington portrayed vision as a product of the interaction of four component subprocesses. These sub-processes were depicted as four overlapping intertwined circles, with vision emerging as a product of their interaction. The circles represent the antigravity system, centring, identification and speech auditory processes. He postulated that if any of these sub-processes fails to develop correctly, the emergent vision will be affected. In children with specific learning difficulties these sub-processes can be affected to different degrees. So as well as the more well documented problems with tracking eye movements, convergence insufficiency, reduced fusional reserves and accommodative facility, all of which can be improved with specific exercises, attention should also be given to multisensory exercises. Visual space is a varying mix of central and peripheral vision. The attention given to each will vary with visual task, and also from person to person. For best visual performance the correct balance between the two systems is required. If a person is too centrally oriented they tend to be very “focal” in their behavior, ignoring peripheral stimuli and paying too much attention to detail and tend to process sequentially. In contrast the peripherally biased person has poor concentration, jumps from one thing to the other and is easily distracted by peripheral stimuli; a particular problem in a busy classroom environment. The types of problems commonly found in youngsters with specific learning difficulties will be presented, with the emphasis on a multisensory exercise programme specifically designed to improve these problems.