Jimmy, a Request of you

For me, hard evidence does not seek to deny the existence of vision perception problems as a primary reading instructional issue, there is a lack of evidence about what is needed for those children. I have not been able to find well-constructed experiments about how many people are affected by this problem and what must be done to aid them. It is not, however, a field of study or practice for me.

I don’t think anyone would deny the fact that there is a very small percentage of the population that has visual perceptual issues (intentionally separated from the larger population with visual acuity issues). My question is: What do the hard data show about identification and treatment of these folks as it pertains to reading?

Reliable and replicable research should move toward confirming an answer to a question—not deny other studies. Folks involved in the field should have a better handle on research supporting their practices than those in other fields of study. So, I ask you: What citations have you for us that indicate a manner for identifying and treating those with visual perceptual problems?

As a teacher and reading clinician, I would like to just go with “what feels right” or “good” or even from case studies and anecdotal evidence. However, I cannot refer private reading clients for vision treatment or spend public school money chasing rainbows without evidence that these students will have *predictable* success.

For a suggestion that the visual, phonological, and even vestibullary difficulties noted in most dyslexics may stem from an overall rapid-processing sensory deficit, see the following links:

http://www.macalester.edu/~psych/whathap/UBNRP/Dyslexia/sensory.html

http://www.macalester.edu/~psych/whathap/UBNRP/Dyslexia/mag_theory.html

Hi Susan,

You’re obviously well informed and serious about these issues, so let me seriously address three points in your post.

You said “I don’t think anyone would deny the fact that there is a very small percentage of the population that has visual perceptual issues.” Where’s the evidence for that statement of “fact” buried in the research? First, visual perception is a higher order visual skill. To the extent that almost all of the kids with poor reading skills have problems recognizing the visual representation of words, they, by definition, have a visual perception issue. The real question is whether their visual perception problem is due to an underlying deficit in a basic visual skill (binocularity, eye-hand coordination, efficient eye movements, etc.) or is their lack of visual perception due to some other factor, such as a lack of phonological processing skills or a deficit in rapid naming ability, etc.

You also said “Reliable and replicable research should move toward confirming an answer to a question—not deny other studies.” I agree, and to the extent that the phonological processing studies have confirmed a lack of phonemic skills among poor readers, they have proven extremely useful. However, they then purport to do exactly what you say they shouldn’t do…deny other studies. Those same PPS studies which are held in such high regard seek to do exactly that, by claiming to prove that vision skills are not a factor in the reading equation. This is a question that no study can be designed to answer conclusively, for to do so, one must test for, and control for, all possibilities. This, as you well know, is impossible, yet that is what the PPS studies claim to accomplish.

Finally, you ask me “What citations have you for us that indicate a manner for identifying and treating those with visual
perceptual problems?” If I could cite the definitive study to support what I’m saying here, I would. But if it was truly the “definitive study” then we wouldn’t have anything to discuss, would we? It hasn’t been done, to my knowledge, though there is a tremendous amount of vision research that supports my view. Much of it is shoddy, as is much of the PPS research, and some of it is good. However, none of us are using it to claim to prove a negative. Yet that is what Jimmy claims the NIH-supported research does. So, my answer is that I don’t have such a citation. My question remains, does Jimmy, or do you Susan?

Again, I want to see a citation to the research piece that makes you so comfortable that you can safely ignore what I, and many vision professionals (which I’m not,) think is a major, not minor, piece of this puzzle. Then we can debate its conclusions. Unfortunately, the “facts” thrown around in these discussions often are just synopses of one strongly-held point of view.

Susan, I know you are deeply involved in all this. So am I. I wrote the above with no disrespect for you, and I am not irritated in any way. I simply disagree with you on some things, which is essential to productive debate. I look forward to continuing this discussion….Rod

Dear Rod,

*If* visual perception exists, then people will possess the ability in varying degrees—just as with other mental processes. We *think* visual perception exists because different people perceive what they see differently. The questions on this BB seem to center on measuring normal/abnormal visual perception and what to do to help those with alleged skill deficits so that they may read better.

You propose to be the visual expert. Let’s get really serious here and have you give me some replicated research to read before we begin any type of discussion.

Here is a list of 96 pieces of research (The NICHD/NIH citation you requested from Jimmy) about the effect of Phoneme Awareness (PA) on reading:

http://www.nichd.nih.gov/publications/nrp/report.htm. I refer you to the PDF file of the National Reading Panel’s report. Chapter 2, Part I, Appendix F: Studies in Phonemic Awareness (PA) database. I haven’t read them all, but I’ve have studied a very large number of them. I have read the “Cliff Notes” and the Executive Summary is there for you, too. You could pull all the literature yourself, if you prefer.

Now, do me the courtesy of a few pieces of research to substantiate some of your dialogue. That seemed to be missing from your last post, despite your claim to a serious discussion. ;-)

I *think* that it is *possible* for both visual perceptual and phonemic awareness issues to exist in the same person. However, I cannot send clients off for diagnosis and therapy that is void of reliable, replicated research. Maybe you’ll be able to help me out by providing some solid, replicated data. Until then, all this visual therapy is just someone’s idea with nothing to back it up.

Hi Susan,

Okay, I give. I’m not the one making the assertion that research disproves or proves something. Jimmy started that and you joined in. Since neither of you wants to provide the “replicated research” that supports your contention that visual issues are not worth worrying about, I’ll let it drop.

But just remember, I’m not the one claiming research backs up everything I say, you guys are. Yet, for some reason I’m the one that’s supposed to dig up the research first????

I could do that, but why? I’m relating what I see in practice. You don’t have to believe it if you don’t want to, but if you’re not going to believe it because of what some researcher somewhere claims to have found, then you could at least provide the source of your beliefs. Now, on the other hand, if you don’t believe it because of what you see in your specific practice area, I’m all ears. But don’t tell me research supports you without telling me which piece of research….and please don’t give me a list of 90-plus documents without first finding at least one line in one of them that supports your position.

Again, I’m simply telling people in here what I see, not what I’ve determined as the result of conducting a double-blind study with thousands of subjects, control groups, etc. Some parents, seeking help for their kids in here, will believe me, will seek out vision therapy using the guidelines I’ve discussed elsewhere, and, in my opinion, in many cases they will have found help for their child’s problem…..Rod

I would not recommend vision therapy for all showing significant reading problems. However, if I’m working with a child showing insignficant results - when 99% of the children I work with show positive movement, I then find vision testing (from a professional with reading experience) and follow recommendations. Sierra, a young girl we piloted the K-2 books with, had serious vision issues - which, when worked with, allowed her to read.

Re: above there was a statement about those with problems never enjoying reading: I think this is an issue of punishment and escape rather than related to dyslexia. I have seen many dyslexics, ater breaking the code and achieving reading fluency, read for pleasure.

***
Rod wrote:> Okay, I give. I’m not the one making the >assertion that
> research disproves or proves something.
***

My reply—
Reliable and replicable research does indeed provide solid evidence on many things; however, let me be very clear on one thing: Research on P.A. has never mixed visual processing into its work on phonological processing. That isn’t a logical thing to do because this isn’t an either/or world. I have not been, nor will I ever be, attempting to determine that any PA research voids the existence or potential treatment of those with visual processing disorders, if such a thing exists. PA research identifies PA, its effect on reading, and the treatment impliciations.

I have simply been asking you for research on what is visual processing disorder/visual perceptual disorder and how, according to reliable research, it is effectively treated. I am assuming that you don’t know or don’t have any evidence to support your practices, except the anecdotal evidence from case studies. This just isn’t enough to help me know how to help others. (It is sort of like going to a gambling casino, putting down money for a game one doesn’t understand, and just telling the dealer ‘let me know when I win’.) If you are collecting money for treating people, I believe you should have a clear set of rules for their diagnosis and treatment. Perhaps you do not share that belief.

***
Rod wrote: Jimmy started that
> and you joined in. Since neither of you wants to provide the
> “replicated research” that supports your contention that
> visual issues are not worth worrying about, I’ll let it drop.
***

My reply—
Rod, without information defining visual processing and reliable research supporting treatment, one does not know 1) What it is; 2) Who suffers from it; 3) What provides positive treatment; 4) What provides no treatment; 5) What makes it worse.

I am asking you for some evidence of what it is and what to do about it. I’m not looking to disclaim it, I’m looking to embrace it. (I *feel* that there are differences in how folks process what they see; however, I cannot base my professional practice on feelings!) I cannot embrace it without reliable evidence telling me who are the researchers in the field. You obviously don’t know that much about your field of practice.

***
Rod wrote: > But just remember, I’m not the one claiming research backs
> up everything I say, you guys are. Yet, for some reason I’m
> the one that’s supposed to dig up the research first????
***

My reply—
I gave you tons of research to read—if you choose—and it has already been sifted through. Just read the P.A. report by the National Reading Panel. (Chapter II, Section 1) Why don’t you try to give me just one citation at this point to support up *your* vision therapy practices.

***
>Rod wrote: I’m relating what I see in
> practice. You don’t have to believe it if you don’t want to,
***

My reply—
This has nothing to do with “want.” I’d like to understand what I’m looking for and what to do about it. Not because some guy on the Internet said so, but because researchers tested it and found some consistent evidence that was published in stable, peer-reviewed journals.

***
> Rod wrote: but if you’re not going to believe it because of what some
> researcher somewhere claims to have found, then you could at
> least provide the source of your beliefs.
***

My reply—
I have not said the visual processing disorders/visual perceptual disorders do not exist. I’ve not read anything that says this—nor have I stated that I have. Perhaps you are believing that if phonological processing is an important skill mix, then visual processing isn’t a bonofied problem. Never said that. Have no evidence to say that.

***
Rod wrote: Now, on the other
> hand, if you don’t believe it because of what you see in your
> specific practice area, I’m all ears. But don’t tell me
> research supports you without telling me which piece of
> research….and please don’t give me a list of 90-plus
> documents without first finding at least one line in one of
> them that supports your position.
***

My reply—
I am simply asking you—the “expert” on vision therapy—to provide some data supporting the existence of visual processing disorder(s), their definition, identification, and treatment effect on reading. At this point, I’m assuming that, as a professional, you have no solid evidence from leaders in your field on which you base the diagnosis and treatment in your practice.

***
> Rod wrote: Again, I’m simply telling people in here what I see, not
> what I’ve determined as the result of conducting a
> double-blind study with thousands of subjects, control
> groups, etc. Some parents, seeking help for their kids in
> here, will believe me, will seek out vision therapy using the
> guidelines I’ve discussed elsewhere, and, in my opinion, in
> many cases they will have found help for their child’s
> problem…..Rod
***

My reply—
I’m sure you are trying to help people, Rod. Please remember that research does not have to include thousands of people in the sample group. Any of us can add to the data if we structure experiments correctly. I work off of data every day as a teacher.

I am truly sorry that you cannot give me any real information about visual perceptual disorders from a structured, reviewed forum. I would love to receive the kind of reference that I gave to you: A document supporting the existence and treatment of a disorder with 90+ solid references.

Just another Internet guy, I guess.

I wish to also add that first hand experience counts for a lot in my books.

<>

Hi Ken,

With all due respect, I disagree. When I couldn’t focus on the printed page, reading was pure torture for me even when the topics interested me greatly. Since my discovery in finding that the dark letter opener helps me process the text so much better, I love reading.

If it was really an issue of punishment and escape, I would continue to avoid it as my problems in comprehension have not disappeared. But when you can focus on the printed page, somehow those problems while they are important and I do want get help for them, just aren’t as bad.

PT

Hi PT,

I saw your comment about the dark letter opener experience earlier, but don’t recall any detail.

Could you please describe your visual experience without the letter opener, and just what you are doing with the letter opener and what then appears to happen?

Also, speaking to your comprehension problems….If you were reluctant, or unable, to learn the alphabetic code due to your underlying vision problem it’s quite possible that you are over-relying on a system of mnemonics to recognize words. If this is the case, your comprehension is likely to suffer. Any thoughts in this regard?

Thanks….Rod

Susan,

I’ll leave it to others to decide who’s being reasonable, who’s making assumptions, and what’s helpful to people on here.

Should you decide to refocus on the original issue, Jimmy Kilpatrick made the following statement on the previous thread:

“The NICHD doesn’t even include vision issues with their research. Their conclusions as well as other respected researchers throughout the world states deficits in phonemic awareness as the issue….. This isn’t to conclude there are not a few children with visions problems. I would be very suspect of a huge number.” (End of Jimmy’s statment)

Actually, Jimmy isn’t accurate in his assertion that these researchers don’t include vision issues, but he is accurate in his conclusion that these researchers feel phonemic awareness is “the issue.”

In any case, Jimmy followed his original comment above with a post or two that clearly implied that, based on the NICHD research, vision deficits were not an important factor. I take issue with that and, if you will read my first post in this thread, I simply asked him to point me to the research that justified his claims in here, since he is clearly basing them primarily on research, not personal observation. You then jumped in and started giving me “we’ll tell you if you tell us first” assignments.

Try going to Google and type in “vision therapy” Susan. You’ll be busy reading for a long, long time. Vision-therapy.com has a research link with a lot of abstracts.

Just another internet guy…..Rod

Hi Ken,

You mention that 99% of kids you work with show “positive movement.” Same here. Obviously, I would be disappointed if what I did caused them to regress. However, I’ve found that, using a good reading method which seems to do an excellent job of training blending, segmenting and phoneme manipulation and a thorough job of teaching the code, I was still getting plenty of kids who did not convert to pleasure reading.

What I’m suggesting is that a fairly large number of these kids would benefit from working with a good vision therapist. I understand that underlying deficits in phonological processing skills and poor code knowledge, once corrected, will turn a lot of kids around. And frankly, I probably see an unbalanced sample of kids due to my source of referrals….many come from vision therapy.

Nevertheless, since you obviously feel that vision work is sometimes useful, have you considered the possibility that it might work well for some of the 99% also? Just curious, because that’s where I am ending up on this issue based on my experiences with, as I said, an admittedly unbalanced sampling of these kids.

Unless, of course, you are saying that all of that 99% are becoming pleasure readers……Rod

P.S. Ken, I think it’s Great Leaps that you’ve developed, right? Would you at some point take the time to describe your experiences using it and working with kids? Do you work directly with them now, or are you making observations of the work of others, etc. It would be interesting to get a better feel for your involvement…..Thanks

I would concur with Jimmy’s opinion: When an estimated 80% of disabled readers suffer from poor phonemic awareness, it is the major issue at this time. When I read what number are estimated to suffer from visual processing issues, I guess I’ll decide where it fits in the scheme of things.

I did not feel that Jimmy’s comments implied the same things you felt they implied. I don’t feel visual perceptual to be an important factor because I don’t have a clear definition of it or treatment idea for it. Can’t say what Jimmy feels about it. He hasn’t posted on this thread yet.

In any case, I am not accustomed to doing my research on “Google” and “dot-com’s.” ERIC seems to be a better choice, for me at least. If others wish to cite their “Google” sources, that is for them to decide.

I was hoping you could give me some pointers about the foundations of your philosophy. Sorry that hasn’t been the case. Thanks, anyway, Internet-Guy.

Hello,

I don’t want to get involed with the visual perception thread, although I’ve found it fascinating, but I want to clarify something. Rod wrote:

<>

Almost all of the kids with poor reading skills don’t have problems recognizing the VISUAL representation of words and therefore they do not by definition have a visual perception issue. Many years ago, we did think the problem was primarily visual (after all, we have to look at the letters, don’t we?), but in fact most people who have difficulty reading the words have difficulty because they can’t decode the words or remember the irregular spellings. Phonological processing, and in particular phonemic awareness, has been shown to be the core deficit in reading disability and the reason why poor readers have so much difficulty decoding or remembering the irregular spellings. (However, there may well be SOME people who have difficulty reading because of visual perceptual difficulty, but that’s not what Rod wrote.)

He also wrote:

<>

Because most children do not by definition have a visual perception problem (see above), the rest of Rod’s statement doesn’t follow. In particular, a lack of visual perception (if there is a lack) cannot be due to a lack of phonological processing skills. And incidentally, rapid naming is one kind of phonological processing, not a separate category.

Visual perception is visual. Phonological processing is auditory. I’ll leave it to the rest of you to continue this discussion of whether and to what extent visual perceptual difficulties exist.

i agreee 100% with all of your posts Andrea, agreee PA is the root cause of reading failure,

you just have to watch a very proficient sound processor attack a word and the difference becomes obvious between the good sound processor and the weak processor,

i think what many of us think may or may not be a vision issue is just the by-product of weak PA and then incorrect instruction,

i think the strategies often used for kids with weak PA may contribute to what appears to be wondering eyes or whatever fancy terms some use for vision problems ( i really do not know any vision terms other than blind or not blind),

i think word families contribute to weak PA kids not really knowing which direction to go in a word, with a word family of /at/, the child often is asked to look at the /at/ part first, then go back and look at the initial letter and then go right again in this word and by this time a weak segmenter is lost in the word, no wonder the kid looks at /was/ and says /saw/

we actually taught this kid that you can go every which way in a word, how is he to know reading /was/ as /saw/ is wrong,???

for the good readers this teaching strategy rarely confuses them as they know which way to go in a word

another incorrect strategy for weak PA kids is when told to look for little words in the word,

again, for the good PA kid, this probably will not ruin him, but for the weak PA kid, this also implies to the child that your eyes can all over the word, no matter, just look for little words wherever you can find them,

the poor kid is twisting and turning literally through the word,

often times when the child cannot read a word such as /stop/ because the initial blend is hard for him to do, a teacher will cover the /s/ and have him read /top/ thinking this is going to fix what is a blending problem,

again, little Johnny is now again in the middle of the word and being asked to turn around and go back and start the word,

if all kids were taught efficient segmenting in kdg, maybe some of the kids who end up with the reading teacher would not be there in 2nd grade,

and i know many will write and say my kid can segment and cannot read, i have seen some kids come to me, all PA skills are perfect but for some reason the code patterns are just not connecting ,

i find with as few a 6 sesssions using PG reading and mapping of the code variation, these kids are on their way,

i have tutored many many kids, what i see most often, is poor segmenting as the root cause, poor blending is also an issue but it does not present as often as poor segmenting,

and of course there are those kids with weak RAN, but nonetheless, these kids have to know that they must learn the code to read, if it is harder than the kid next to them in school, that is just the way it is, they will have to work much harder than the good PA kids,

is it fair, no way but that will not change anything, if we are weak at a sport’s skill we have to choice to choose not to do the sport, but if we are weak at a sound processing skill, we have no choice, we have to try to get good at it if we ever want to read,

and my theory is, fix PA as early as possible, and then use a good method to present code, kids as young as 4 and 5 should start seeing code that involves more than one letter representing a sound, do away with the word walls unless they focus on the vowel patterns,

possibly an “o-e” wall with words such as boat, throw etc,

but never the initial letter, /oa/ is actually a very easy piece of code, way easier than plain old /o/ or plain old /a/,

these two vowels have so much overlap, that in reality it makes them harder to learn than /oa/

libby

Hi Andrea,

Yes, I knew I was skating on thin ice with that one, but to some extent it’s a problem with how we’re using the phrase “visual perception.” Some are using it to mean basic vision skills (which it isn’t) and some, like you (if I read you right,) think of it as able to accurately recognize the components of the words they’re looking at.

However, in vision therapy literature it’s considered an ability to integrate visual information using other underlying skills. For instance, symptoms of a visual perception problem include

- failure to recognize same word in the next sentence
- reversing letters and/or words in writing and copying
- repeatedly confusing words with similar beginnings or endings.

Most of the poor readers I encounter demonstrate at least some of these symptoms. I tend to think of the problem as being one of “failing to infer.” That is, these kids don’t easily learn to draw inferences from past experience with print. This kind of kid will decode “cat” ten times today and again tomorrow, and then start the process all over again with “bat.” Or, “then” and “when” remain interchangeable words when reading a book. And, as you likely have seen, b/d reversals persist much longer than with most kids.

I believe a lot of effort was put into remediating visual perception decades ago, as I think you may have even stated here. The reason it proved fruitless is that there are basic vision skills underlying visual perception, just as there are basic phonemic skills underlying efficient word recognition.

My point was that most poor readers fail to recognize words that they have seen again and again. I doubt anyone would argue with that, but the way it’s been going lately, who knows?

My second point was that the failure to recognize words correctly could be due either to poor underlying vision skills such as lousy binocular vision, or to poor phonemic skills such as being a lousy segmenter, or to yet a third or fourth factor or to a combination of some or all of these.

I find it interesting that the abbreviated list of symptoms above would probably be felt to be due to a PPS deficit by most of the people on the other side of this discussion, if I read everyone correctly, yet those symptoms often are relieved by vision therapy. Once the child has decent binocular vision skills (assuming that was the problem) things start falling into place.

For instance, I recently saw a child gain over a year in word recognition (3.6 to 5.1 grade level) following just three months of vision therapy. And she was still a poor segmenter after the three months of vision therapy, incidentally.

My point in all this is that everyone is so darned sure that the research they’re trusting has given them all the guidance they need to lay out programs, but that same research ignores another body of research, a bunch of practioners, and some real success stories. Until that changes, I’ll keep chipping in my two cents worth. (And yes, I’ve got a side bet with my wife as to whether someone takes a shot at the “two cents worth” comment….*s*)…Rod

Please elaborate what the dark letter opener is and how it affects reading problems. My son Hunter who is 9 years old has been diagnosed with visual perception and visual spatial problems, he hates reading and I would like some more information on the dark letter opener. Thanks Teresa Sewell

Do you have any research that supports the point that phonological processing is all auditory? I have read this alot but not seen it specifically supported. Phonological processing is a pretty broad skill. How can we be sure that it is fully auditory?

How does a deaf person learn to read?

Some work done at oxford on multisensory processing. http://www.physiol.ox.ac.uk/Research_Groups/multisensory/what_is.html

An exerpt….

That such cross content integration can even change perceptual outcome is clearly illustrated by the McGuirk effect. When a heard syllable (eg. “ba) is dubbed onto a videotape of a speaker mouthing a different syllable (eg “ga”) subjects typically report “hearing” another syllable altogether (usually “da”) which represents some combination of the two sensory inputs.

My take…
Isn’t it possible that the assumptions and they are assumptions because they have not been proven through research that phonological processing is auditory are incorrect. Treatments that involve teaching the sounds in words also involve vision because they are not done with the eyes closed. The person must use their vision to see the sound in order to process it. Intense practice with looking at and saying the sounds could help to improve both the visual and the auditory component well enough to get them reading but perhaps not well enough that it is not difficult. It used to be all about vision and now hurrah the pendulum has swung and it is all about auditory.

We also don’t have any evidence that supports the idea the tracking is not a real issue. I haven’t seen any studies that look at children reading for long periods of time to assess symptoms such as headaches, moving print etc. I have two family members who read well but experience these symptoms. They compensate but it is arduous and painful. One is an adult who functions at a very high level and takes alot of advil.

Hello,

First, I don’t appreciate being told to leave my comfort zone behind to read a post. I’m perfectly capable of comprehending all kinds of information whether or not I agree with it.

The example you noted about seeing one syllable while saying another and therefore becoming confused and repeating yet a third (which is articulated in the same way but the /d/ is voiced and the /b/ is unvoiced) is not evidence that phonological processing involves visual processing. I can’t remember the name for that effect. Psychologists often use something similar when they administer the Stroop test in which the subject sees one color but has to read another. It’s a matter of the two variables competing for our attention.

I never said that visual skills weren’t needed to read. Unless we’re blind and using braile, we have to see the words and use whatever visual processes are needed. What I said was that visual processing and phonological processing are separate entities and that a massive amount of research has confirmed that phonological processing is the core deficit in reading disability. I never said, and as far as I know no one on this board ever said, that reading was entirely phonological.

I strongly advocate multisensory reading instruction for children with reading difficulties, maybe for all children. Not only that, but I advocate programs that use the multi modes simultaneously, so that the visual, auditory, kinesthetic, and tactile channels are all tapped at the same time rather than sequentially. Just because phonological processing is the core deficit in reading disability does NOT mean that we should present our instruction totally to the auditory channel. In fact, this would be impossible because as you point out, we have to look at the words. Beyond that, it would not serve children well. I don’t even think that purely visual-auditory instruction is enough. That’s the old look-say approach and a lot of the poorer readers aren’t going to get it that way. How we teach is a separate issue from what the core deficit is. I’m not sure why you’re making this a challenge. I don’t disagree with this.

<>

Research doesn’t go around searching for what doesn’t work; it looks for what does. Do you know of any good research—scientifically carried out and replicated and published in refereed journals—that supports your theories? I’m sure that tracking is a real issue. I don’t think it’s a core deficit, but I think it’s a problem. In fact, I know that when I’m tired, I need to use a marker to track text. The question is, where is the research? If this is the problem we think it is, albeit from my point of view not one that’s a major problem for most readers, then I want to know if there’s a way to remediate it and if so, what’s the best way? Personally, I just accommodate it with a blank index card as a marker. I know that behavioral optometrists use other methods, but as Susan Long wrote, I’m not going to make recommendations to parents that cost them money unless I know there’s a research base that supports it. And that goes for moving print, headaches, etc.

So, what I’m saying is that visual is visual and phonological is phonological and never the twain shall meet, or something like that. I don’t have to find research to support that. It’s a matter of definition. And I’m saying that although phonological processing is the core deficit in reading disability (in scientific terms, it accounts for most of the variability in reading), reading does involve other processes, including visual processing. I’m also saying that there very well may be kinds of visual processing difficulties that can be remediated, but to the best of my knowledge there is no solid research base to support that remediation. And finally, I’m agreeing with you that multisensory reading instruction is preferable to a look-say method for many children.

I am sorry I did not mean to insult you with that subject heading. It really was just about thinking beyond what is considered common knowledge and how things become common knowledge some is research and some is presumption. Thinking outside one’s comfort zone is asking the question, “Has that been proven or is that just what everyone assumes has been proven.” I still believe that it is a presumption to assume that phonological processing is all auditory. Phonological processing is the basis for reading but it has not been proven that this skill is only acquired through the auditory channels. We are talking about methods that are used to teach phonological processing, methods that are held up as proof that phonological processing is the main component to teaching reading. These methods use visiual along with auditory inputs.

think it is similar to the former widely held belief the reading was visual because it just seems to make sense.

Honestly, I am not a fan of multisensory techniques. The very qualified teacher who showed up at my house using those techniques did not teach my child to read. The only thing that worked was phonographix. I am just not buying the widely held belief that all the subskills that encompass phonological processing are auditory just because everyone says that is the way it is. Phonographix does use vision as an important component to teaching those skills. I don’t know of a phonological processing based program that encourages children to close their eyes to learn to read. If phonological processing was purely an auditory skill I would think eliminating distracting visual input would be beneficial. I think that when researchers discovered just how important auditory channels were in acquiring these skills they threw the visual baby out with the bathwater.

My interest is more in seeing core deficits identified and addressed.

I think that parents and tutors have seen things in the kids they have worked with that suggest that there is more to the visual component than reading researchers think there is. These are not controlled studies—more like one shot designs. Understandably, you and many others want research before making recommendations to others.

I teach research methods at the college level so I appreciate the value of well designed studies. But honestly, as a parent of severely LD child, I can’t always wait for the research to make decisions for my child. The fact that research doesn’t exist doesn’t mean that something isn’t beneficial. It just means that there is no solid evidence that it is beneficial. I don’t ignore the research that exists about the core deficit of reading—I have taught my child segmenting, blending, and the code ect. But that when my child still skipped words and lines and read more fluently with larger text than small, I suspected that something visual was also going on.

Beth

Juat a side comment…I think PG IS multi-sensory to a certain extent and that is part of it’s success.

Janis

This is actually a great question, Linda. Actually, congenitally profoundly deaf children with no usable hearing or cochlear implant are almost always very poor readers. To me, it definitely proves that phonological processing is auditory. The average deaf high school grad reads at the 3rd or fourth grade level. This is the level one can attain with sight based reading alone. We know so much more now about reading and have technology that will allow us to teach the sounds of our language to deaf children…improved hearing aids as well as cochlear implants. It is an exciting time to know that we can give deaf children the opportunity to become proficient readers. They will need multi-sensory approaches to reading just as do dyslexic children. But teachers will need to be taught new methods as sight based instruction is what has been primarily used by teachers of the deaf.

Janis

When someone, like Dr. Kotula, attends a highly prestigious school and earns a doctorate, one has been out of their comfort zone on many, many occasions. They probably don’t even need the term explained to them.

Professionals cannot base a field of practice on one case. As a mother, I base my interests on one case—my child. You, too. (And with right to behave that way.) It is the difference between being a professional in a field and being a mother.

As professionals, we just cannot compare one child (whom we’ve not met or observed) against piles of published information.

Moms have a tough time with this, Linda. Especially dedicated ones like you.

I am glad for your son that you have been a successful teacher for him.

For whatever reason, Beth, the field of visual perceptual diagnosis and treatment has not been thoroughly researched. Do I *feel* that some people perceive what they see differently than others? Yes.

My colleagues from the psychological profession truly wish that visual perceptual had the solid experimention to set us on a course for kids with these sorts of issues. These people aren’t wishing to “withhold” treatment for kids with visual issues—they just don’t see it very often. they’d love to read something stable to demonstrate otherwise.

When my mom was dying of cancer many years ago, I couldn’t afford to wait for cancer research—so we participated in it. So I would do for my child if I suspected visual perceptual problems. The doctor didn’t tell me to do this—I asked about it because her chances were nill. I understand desperation.

Now, if I’m collecting money for services—I’ll not be spouting stuff that has no solid, replicated data behind it. That’s the issue I have with professionals who refer to the literature without ever citing any of it directly, despite a request for it.

On this BB, we could be seeing a disproportionately higher number of parents whose children have severe and multiple deficits. I don’t know we have a representative sample of the whole LD community. I cannot know because I don’t know the children we discuss.

Families with dollars can go out and experiment. Many families do not have that kind of money and need to play their odds.

Hello Linda,

Part of the difficulty with this long thread is that some people are talking about whether there is such a thing as visual perceptual deficits and if so, whether there are successful ways of remediating them. Some people are discussing whether there’s an overlap between visual and phonological processing. And some people are talking about how to teach phonological processing. And I’m sure there are other issues being bantered about in this thread besides those. I only wanted to address the differences, _by definition_, between visual and phonological processing. I just looked at The Literacy Dictionary, edited by Theodore Harris and Richard Hodges. “Phonology” is defined as “the study of speech sounds and their functions in a language or languages.” A “phoneme” is “a minimal sound unit of speech that, when contrasted with another phoneme, affects the meaning of words in a language, as /b/ in book contrasts with /t/ in took, /k/ in cook, /h/ in hook.”

Phonemes are sounds. I didn’t make that up; that’s what phonemes are. It’s the graphemes that represent the letters. This is not meant to be argumentative; those are the definitions. Now in your last post, you were discussing ways of _teaching_ phonological skills. Instruction is another story. If you’ll reread my previous post, you’ll see that I did not suggest that phonological processing could only be acquired through the auditory channel. In fact, this is absolutely untrue. Different methods are used and they almost always have a visual component, especially if letters are involved. Nobody as far as I can tell is arguing that point.

Instruction is the route we use to get to a certain place. The destination, in this case phonological processing, is separate from the road taken to arrive there. Naturally, if we want to help children to process sounds, we’re going to have to have them say and hear those sounds, but they can also see the letters that represent those sounds and can visualize words, and so on.

Some people in this thread are debating the relative importance of visual versus phonological processing and the merits of teaching visual processing skills. However, I think it’s important for us all to at least be on the same page about what we mean when we use the terminology and to understand the difference between the means of acquiring a skill (the instruction) and actually applying it.

Hi Linda,
Just a side note to what you have said, PG can become a great visual program for those kids that suffer from visual memory problems, depending on how you teach PG. The posts that speak about kids who can’t remember the diphthongs and digraphs for the specific sounds are those that need the visual component of PG emphasized. If anyone wants this way of presenting PG, please email me. I am in the middle of moving, closing the 20th of Dec. so I may not get back to you right away.

My son(6th grade) is unable to read cursive at all; despite much intervention, he cannot recognize even cursive font, nor can he write in cursive. I think it is the visual element, as he now scores above 110ss in auditory processing, PA, sound blending, etc. and can read, decode, comprehend above grade level. He has somehow adjusted despite a very low(80s) rapid picture naming ss. His problem in recognizing letter shapes in differing handwriting and recalling them is I think his biggest challenge now.

My only point was really that phonological processing in much of the literature I have read seems to always be assumed to be auditory. I am not saying that is what you think but it does seem to be what is accepted. My point by illustrating the Mcguirk effect was to show that we can process sounds through more than our auditory channel. Our processing of sounds is affected by what we see.

I think I presented some interesting research to illustrate my point. It really was just that one point that I was trying to make.

Thank you Janis. I really didn’t know the answer to that but I did know that deaf people can learn to read at least some. No doubt their deficits hinder them. I agree that phonological processing is primarily auditory. I just don’t think it is all auditory and I think this is illustrated in the McGuirk affect.

You stated, “Visual processing is visual, phonological processing is auditory.” I was just trying to show phonological processing has a visual component to it by illustrating that what we hear is affected by what we see.

Hi Rod,

Some excellent questions. You said:

> Could you please describe your visual experience without
> the letter opener, and just what you are doing with the
> letter opener and what then appears to happen?

You have to realize Rod that you’re asking this question of someone with a poor visual memory:)) but let me take a shot. I think prior to using the letter opener, I just couldn’t focus or track properly the printed page. So essentially, I was reading each word by itself and nothing related to anything else.

Using the letter opener keeps my attention focused on particular area and now I can make sense of what I am reading.

Also, speaking to your comprehension problems….If you
> were reluctant, or unable, to learn the alphabetic code due
> to your underlying vision problem it’s quite possible that
> you are over-relying on a system of mnemonics to recognize
> words. If this is the case, your comprehension is likely to
> suffer. Any thoughts in this regard?

Again good questions but I think because of the whole language method as that was the method that people my age learned under, I learned words by looking at the whole word and not learning how to sound it out (not sure if that is exactly it but I think everyone knows what I am talking about). I didn’t think that was through mnemoics but it certainly is possible.

Here are my theories on my comprehension problems. I think what you are advocating is definitely part of the problem. But I also have a non verbal learning disability and the longer the passage I read, such as a book, the harder it is for me to integrate the details into a whole comprehensive picture.

I still think on shorter passages, that isn’t a problem but as I seem to test well on comprehension passages. But now that I can focus on the printed page and actually do some long streches of reading, I realize it is true on longer sections. If there is a good summary of the book, looking at that helps alot as I can say to myself “Oh, yeah, I remember reading that, now it makes sense.” But if there isn’t one, I am in big trouble:))

I definitely would like to pursue the L&B V&V program but being unemployed, I am sure if it is doable. But I am still very happy that I now enjoy reading as that makes a big difference.

Again, good questions Rod. I realize my combination of problems is unusual but thanks to this board, I have a much better understanding of the issues.

PT

Could you mean:

What we *think about* in our language area of the brain *may* also be influenced by what we see. Pure phonological processing does not have a visual component to it. It is auditory.

As it relates to reading; however, students with some knowledge of writing code will often *think about* the visual aspect (letters—graphemes) when they are thinking about the related sounds (phonemes). This can happen when no visual stimuli (letters) are present.

Yes, we’ve discussed this situation for dyslexic kids. Part of the problem is the variation in letter formation for kids who may have some sort of memory issue. (RAN is considered to be a memory-related issue.)

Most of the LDer’s I to whom I teach reading/writing have major problems with cursive. This isn’t a complete list, but does provide some reasons:

1. Varies a lot in style—between adults and other students.
2. Isn’t used *as much* anymore—many teachers don’t really teach it thoroughly enough for LDer’s to get good at it, especially when they are modified and accommodated out of it to the keyboard, for example.
3. Hard to memorize with little practice and varying styles

Practice, practice practice is the key. Select a style like modern cursive (or use Handwriting without Tears). Practice, practice, practice.

It really is much faster to write in cursive than print, once one gets good at it. (Same is true for typing.)

All: Please don’t imply that I’ve made a value judgment on #2 above. I have not. In an effort the “get the work out,” we often accept manuscript from kids. At least they are showing what they know. But, in a discussion about why cursive is difficult, this is a factor.

Hi PT,

You say you have an unusual combination of problems, but I read all your posts avidly because your diagnosed disorders are so similar to my son’s. He’s 10 and has inattentive ADHD (medicated), an anxiety disorder (medicated), an auditory processing disorder, a non-verbal learning disorder, and a visual processing disorder. He is a very reluctant reader and also reads with a ruler or card under the lines of type in his book (he tells me they go “crooked” when he doesn’t). I’ll have to try him with something dark - maybe that will make it better for him.

Anyway, I just want to say thanks for posting here. You are very insightful re: your own self, and what does and doesn’t help. That helps me since it is rather difficult to get that information out of a 10 year old boy, who doesn’t know how to articulate it! :-)

Thanks again - reading your posts really helps me understand what may and may not help my son, and why. I am currently looking at IM privately for him, and trying to get the school system to do the Lindamood Bell V/V for him. We’ll see. Thanks again,

Lil

According to Dr. Wolf’s research orthographic recognition is an important key in remediating kids with RAN deficits.

I think maybe phonemic awareness is sufficent in helping the large majority of poor readers, but for those with a severe RAN deficit they seem to require MUCH more repetition of orthographic patterns.

Perhaps this is just a much smaller group with reading disabilities (the majority having a more auditory component)?

My son had much more of an auditory component, that has improved greatly over time with tutoring and millions of hours of reading at home, and he is a high achieving reg. ed. student in 6th grade; but he does not have or want to spend the time now on any more “fixing” of his orthographic and visual/spacial problems; his teachers do not want the middle school students to write in cursive and he asks them to print or give him typed assignments(it was more of a problem in elementary school because the teachers wrote on the board in flowing cursive). Drawing maps is a problem in social studies, as are a million other things but I don’t think every weakness has to be remediated, especially by expensive commerical prorams. Nor do I hold the school responsible for bringing all his skills up to an average range, in a kid with a RAN score 3 standard dev. below his IQ.

Susan,

I totally agree that the first efforts ought to go to good reading instruction. I will tell you though, from personal experience, that for some kids that won’t be enough. I will also say my son is not a typical LD child–with APD, visual processing deficits, and RAN. I do think there are more parents of atypical LD kids on these boards—I think this is because parents often come here AFTER what the school has tried hasn’t worked. The schools are at best oriented towards the average LD child.

I also want to say that the program that has helped my child the most, Neuronet, is not well researched. It was developed by a clinician and there are only small studies of its effectiveness. She gets clients by referrals—because the program has helped kids. We also have done sound therapy—The Listening Program. This is not well researched either. I honestly was put off earlier by the lack of research but I did it when my child hit a brick wall. So I guess you could say I was desperate. Afterwards, my son could manipulate sounds–Neither I or the school I had been able to teach him in months of daily auditory proccessing work. My only regret was that I had not done it much earlier.

I do research for a living but I have to say that my experience with my own child has changed my perspective.

Beth

I know when my son started to automatically recognize short versus long vowel patterns like tube versus tub his fluency increased. This seemed to be a visual task—internalizing the visual pattern.

Beth

I keep seeing the same misunderstandings cropping up, so here’s another try at clarifying:

Any new discovery is unproven for a time. It has to be tested and refined. That’s why new drugs take years to come to market — and they should; I’ll explain thalidomide to anyone who doesn’t understand this point.

Some things have been proven to do good in the great majority of cases. In medicine, antibiotics come into this category, and in reading teaching, systematic phonics instruction.
That doesn’t mean the treatment is perfect or that it’s the only answer. If you have a viral disease, a genetic disease, or a drug-resistent bacterium, antibiotics won’t work. If you have a hearing problem, a processing problem, or an undetected visual problem, then basic phonics instruction won’t be sufficient and you need special tutoring and/or other treatments as well.
It also doesn’t mean that the treatment is universally successful. Antibiotic treatment fails if the dosage is not taken regularly and completely, or if the wrong drug is prescribed, or if the medicine has spoiled with heat, and so on. Phonics teaching fails if it is inconsistent, if the student has other problems such as absenteeisn or health or personal issues, if the program is not at an appropriate level for the student, and so on. This is not a disproof of phonics teaching, only a limitation of the real world.

Some new discoveries work for particular special cases. Virus-fighting medications can now reduce cold sores, but they do nothing against the flu, which is a different bacterium. I am quite ready to believe that vision therapy works for people who have particular types of vision problems, but not that it is the only answer for all reading problems.

Some therapies depend on having a highly knowledgeable provider who can make judgements and apply the treatment in the best way, adjusting with constant feedback. This is why doctors spend twelve years in training. It’s also why we need reading teachers with much better training. It’s why most of my students do learn to read, while other people with more money and all sorts of materials continue to have vast numbers of failures. From what I hear from Rod, vision therapy is in this category.

The fact that vision therapy has yet to be proved in large-scale studies means only that it is a new and experimental treatment, not that it is wrong. I would reserve judgement and look for measurable results from various providers (Rod apparently knows some good people) and then send people to a provider with a track record of success. I would also have more faith in a provider whose diagnosis was different for different clients, and who turned down clients with problems out of his field.

Hi Susan,

This reply is bypassing all comments on the comfort zone issue since I have not read all the posts. But as I am sure you’re well aware, there are exceptions to every rule and I wanted to point out a few regarding the fact that esteemed professionals like Dr. Kotula are trained to step outside their comfort zone. By the way, I definitely agree with you about Dr. Kotula based on what I have seen in her posts.

However, the perfect example of someone who hasn’t in my opinion, is Dr. Byron Rourke, who did alot of the initial research on non verbal learning disabilities. He seemed to indicate that in his early research, if you didn’t have remediation as a kid with NLD, adulthood was going to be a disaster for you. Well, I admit I don’t have the double binded studies to claim what I am saying as fact to dispute Dr. Rourke but I know plenty of adults with NLD who did not have remediation and our lives are not that way.

Also, I had a friend who did hear someone with good credentials from a reputable place dispute some of his research. But of course, if it isn’t published where it can be subject to scrutiny, then I admit you have to take it for what it is worth.

On a more personal note, a PhD psychologist said I couldn’t have learning disabilities because I spoke too well. It was an employee assistance counselor who wasn’t as well trained who felt I definitely needed to get tested for LD/ADD.

PT

Hi Lil,

You’re not going to believe this but I read all your posts too because I know your son has similar problems. I also remember all the frustrations you have had with the school system.

Thanks for your kind words and I am so glad I could help. Yeah, definitely try something dark to see if that will help him. If someone had told me a year ago, a trick like that would help considerably with my reading difficulties, I would have looked at the person like he/she was nuts.

Good luck in getting the school to do the V&V Program. I did it briefly with a tutor several years ago but quit for various reasons. But I definitely feel it would work for me if I stayed with it and hopefully, you’ll have the same good luck with your son. Gosh, you’re overdue for some.

PT

Teresa Sewell wrote:
>
> Please elaborate what the dark letter opener is and how it
> affects reading problems. My son Hunter who is 9 years old
> has been diagnosed with visual perception and visual spatial
> problems, he hates reading and I would like some more
> information on the dark letter opener. Thanks Teresa Sewell

Hi Theresa,

I’ll be happy to share my experience with the dark letter opener. I have been diagnosed with various LD’s, including NLD which affects my visual perceptual process. As long as I can remember, absolutely hated reading even though alot of subjects interest me. I just couldn’t focus on the printed page and when I was able to, it was a struggle to make sense out of what I was reading.

One day, I was searching an ADD newsgroup for the issues of reading and working memory impairments because I thought that could be a major cause of my problem since I also have ADD. Someone in a post suggested using a ruler and I thought what the heck, I have nothing to lose.

To be honest, I didn’t expect anything would happen but lo and behold, by using a dark letter opener, which was better for a book than a long ruler, all of a sudden, I could focus on the printed page and make sense out of what I was reading. Please understand that my comprehension problems have not miraculously disappeared but the key is, I now love reading and actually look forward to getting books for gifts whereas before, I cringed when that happened.

Prior to this trick Theresa, it was like nothing I read, registered in my brain. Now, after reading something, a question will occur to me about what I read and that never happened before. I still have to do alot of rechecking but that is ok.

Anyway, I make no promises as to whether it will work for your son or not. Someone I know who had a similar situation to mine tried it and didn’t find it useful. But what do you have to lose except for the cost of the letter opener if you don’t have one?

Good luck Theresa and I hope you discover the solution to your son’s reading difficulties. I know how painful it is to hate to read so I can only imagine how a child must feel.

PT

> Any new discovery is unproven for a time. It has to be tested
> and refined. That’s why new drugs take years to come to
> market — and they should; I’ll explain thalidomide to anyone
> who doesn’t understand this point.

Hi Victoria,

A perfect example of this in my opinion is the weight gain that many patients including yours truly experienced in taking antidepressants like Zoloft and Prozac. For several years, doctors said this couldn’t be true even though it sure as heck did seem to be the case. Finally, doctors are listening to their patients as the research is now catching up to what we long realized.

Anyway, my doctor continued to insist that Prozac was a weight neutral drug. I was very tempted to say something smart allecky but I decided to be on my best behavior:)) During another office visit, this subject came up again and I was able to remind the doctor in a nice way that once I was off that weight neutral drug and switched to St. Johns Wort, the pounds came off without any effort. Love it when I can make my points in that manner.

PT

Thanks, libby; I agree with you 100% about poor directionality being actually taught by many poorly-thought-out programs.

An interesting point.

I am teaching ESL to a lot of Chinese adults. These are very highly educated people, half with PhD’s, but the teaching of English, especially oral English, is very weak in mainland China.

These students are a wonderful group to look at for learning patterns because they do not think in the English alphabet. Their natural written form is Chinese ideograms. They also know the International Phonetic Alphabet, but it is not their first choice when they think of sounds.

The interesting observation is that English-educated people naturally speak of sounds and letters together. You can’t discuss pronunciation with the average English-educated person for two minutes without someone either spelling something or writing an example or both. When my students give me their names, I naturally ask them to spell them for me.
But my Chinese students don’t do that. When they speak of pronunciation, they try at first to do it all orally (a problem because of some sounds they do not pronounce). When giving their names, they don’t understand me when I ask for the spelling. They just don’t think that way.

Most of them have trouble segmenting, too, which tends to reaffirm my belief that you learn a lot of segmenting by working with phonics.

Gee, Shay, I just moved into the uninsulated, unplumbed, partially heated handyman’s special on November 1; just before the sudden cold snap and one of the coldest falls in recent years …
It’s a wonder any plumbers are left alive in the world, isn’t it?

Reading cursive writing is rarely easy, especially sloppy writing, and it is a skill that has to be taught. Usually you learn to read cursive at the same time you learn to write it. As the teaching of cursive is rapidly declining in both quantity and quality, I see a concurrent rise in the number of students wh can’t read it. Since reading cursive is a valuable classroom skill — some teachers will print on the blackboard, and some won’t or can’t (Europeans never learn to print at all) — and he will meet more and more teachers through high school and college — I would recommend working on cursive, starting from the writing front. I have posted some methodologies earlier and you can look up the old posts, or after getting the plumbing finished I can re-post them.

Hind sight is always closer to 20/20.

Further, adult life is hell for a great many NLD folks. I haven’t read Dr. O’Rourke’s blanket statement that adult life will be so for *all*. Something tells me, though, that few good researchers use words like “never,” “always,” 0% and 100%. If they do, their statistician will likely raise a big eyebrow. Then again, life may have been worse when LD got less press.