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| LEARNING PROBLEMS ARE BRAIN PROBLEMS: WHAT NEUROLOGY, OPTOMETRY, EDUCATION, PSYCHOLOGY AND PSYCHIATRY HAVE IN COMMON. |
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| DRAFT |
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| Q. What do neurology, optometry, education, psychology and psychiatry have in common? |
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| A. All of these professions deal with the BRAIN and its operation, both physiologically and behaviorally. |
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| Q. What role does optometry play in the brain`s ability to learn? |
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| A. Vision is the dynamic process by which the brain receives by far its largest amount of data - vision is different from sight, which is a static, fixed response. 80% of what we know has come through the vision process. Any barriers to visual processing will slow down learning ability. Optometrists are in a position to enhance visual processing and integration of vision with the other senses. |
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| Q. How does the brain learn? |
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| A. Information from motor experiences (visual-motor, primarily) is sorted and ordered, then integrated into concepts and operations. The brain uses the learned operations to act and react to the world, which further modifies and adjusts the operations. This is perception. This is learning. This forms the building blocks for Mind and Person. The five professions deal with this core set of processes in the brain`s input, association, and/or its output, both directly and indirectly. |
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| Be aware: a brain that isn`t learning is a brain that needs to change in some way. |
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| Q. How does perception affect performance and personality? |
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| A. School grades are one simple way by which we can measure brain function. (Most people don`t think of this - especially teachers, who often undervalue themselves and their role - but it`s no less true.) When grades are off, it`s because the brain is "off" in some way or other. Martha Denckla, a neuroscientist, said, "Every teacher is a brain surgeon…making little dendrite sprouts and connect(ing) up neurons," 1 Perception is as much or more a neurophysiological process as it is a psychological process, though it has elements of both. |
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| Perceptions affect associations, which in turn affect relationships in the brain`s understanding of its environment - both the physical world and the social/emotional one, as well. Social relationships help to mold much of our ego concepts. Virtually all problem solving suffers when perceptual problems exist and because of this, perceptual problems wind up creating not only learning problems but interpersonal and ego problems. |
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| Editorial Note: Please do not read this as saying that perceptual problems cause all psychological and psychiatric problems, far from it - but as A.M. Skeffington, the father of behavioral optometric science often said in his lectures: |
| "A person insecure in his visual state will be a person insecure in his ego state." |
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| Q. How do we change the brain? |
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| A. There are five primary ways by which we can influence the brain, to make it change: |
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| 1. Surgically: as in Parkinson`s, epilepsy, and unrelenting depression. |
| 2. Chemically: with pharmacological drugs, customarily the most often used avenue. |
| 3. Retraining: education, rehabilitation, and experiential instruction. This is actually the most common mode of brain change. (All educational strategies are rehabilitative, shaping brain circuitry.) |
| 4. Optically: via lenses, prisms and filters. They: |
| A. Change the motor responses to one`s space world; |
| B. Change the ratio of action between the voluntary and involuntary nervous systems; |
| C. Change the ratio of action between the sympathetic and parasympathetic nervous systems; and, |
| D. Change the signal quality, perhaps altering the rate at which the brain processes visual input. |
| 5. Biofeedback: changes of muscle activity by internal modification of signals. (This is actually a retraining, but it is primarily a self-generated, conscious neurophysiological reorganization.) |
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| Q. Why does optometric therapy affect learning skills? |
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| A. First of all, visual problems do not cause learning problems as such. No credible authority has ever said so.2 Yet, visual problems and inefficiency are often collateral parts of learning problems. Most of the time, the impact is indirect - learning activities cannot be sustained because of visual distress. In this way at least, visual problems can masquerade as attentional problems. (ADD/ADHD). [Be aware that reading occurs at two levels: decoding alone, and decoding with comprehension. We`ve all experienced reading while fatigued and getting to the bottom of a page without any comprehension of what was read - yes, decoding occurred, but no comprehension did. Visual problems - again, not sight problems - often affect the student in the same way.] |
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| Lenses and prisms, (and more rarely, filters) affect the perception of space, they alter the inborn response of the nervous system, and they reduce the impact of the element of time upon the activities of the visual system. The element of time is one of the most overlooked factors in the genesis of disease conditions. Visual-motor perception, farsightedness, and suppression of vision in one eye have all long been shown to relate negatively with school performance.3-5 Remediation of visual perceptual skills and their effect upon academics has been known for some time to those who have looked for the information6; orthoptic training has been shown to improve reading in at least one prospective study7; and visual therapy has been shown to affect self-perception8. |
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| Q. How do psychology and psychiatry fit in? |
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| A. Depression and other emotional problems have been measured as being more prevalent with students with learning difficulties9. One study found that learning disabled students were more often depressed over school performance than a control population10. Schizophrenics have poorer eye motilities and dramatically altered spatial perception than normal populations11. There are ongoing studies and reports in the popular press that are demonstrating the effects of visual rehabilitation in some of these cases12,13. Mental abuse and stress are known to have direct effects on the hippocampus, a structure of the brain associated with learning and memory14,15. A mental health clinician may be consulted for any of the above reasons and these may involve learning problems either in a primary fashion, or may be merely responses to a primary problem of perceptual problems and learning disabilities. |
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| Q. What can be done for learning disabilities? |
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| A. Evaluation of, and rehabilitation of learning skills (visual analysis, auditory analysis, and motor movement abilities) and of visual functioning are the two most fruitful areas for enhancing learning abilities. Emotional problems may be reflecting problem-solving difficulties and may therefore be minimized by the same process. Also, counseling help may be needed for students who have been subjected to sustained, repeated academic failure. |
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| Teachers need to understand how to teach to strength learning modes and how to recognize the symptoms of visual and perceptual dysfunction and to then refer those students with learning skills problems to competent care, since visual-auditory-kinesthetic-tactual (V-A-K-T) strategies have yet to be demonstrated to help over the long run16. Tutoring and therapeutic educational techniques have to be considered, as well. |
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| Behavioral, developmental, or neurodevelopmental - no matter what it`s called - optometric retraining (using lenses, prisms, filters and biofeedback) has - arguably - had the greatest impact on learning problems out of the five professions with the five intervention strategies. It results in the most rapid response, frequently in mere weeks, sometimes in months. Learning must operate in a hospitable environment for it to flourish. That starts in the home, continues in the classroom, and is mediated by efficient visual skills. Optometric visual therapy can be a powerful healing tool in many, many learning problems. |
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| REFERENCES |
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| 1. TV interview for Dana Corporation`s "Exploring Your Brain", 1998. |
| 2. Wold, R; Vision and Learning Update, Tape Series, Am. Optom. Assn., 1973. |
| 3. Helveston, E; The Draw-a-Bicycle Test, J Ped Ophthalmol & Strab 22(1), 917-919, 1985. |
| 4. Rosner J, Rosner J; The Relationship Between Moderate Hyperopia and Academic Achievement: How Much Plus is Enouhg?, J Am Optom Assoc, 1997 Oct; 68(10):648-650. |
| 5. Benton, C; in Dyslexia : Diagnosis and Treatment of Reading Disorders, Keeney and Keeney , Eds., CV Mosby 1968. |
| 6. Rosner J; The Development and Validation of an Individualized Perceptual Skills Curriculum, LRDC Publication 1972/7, 1973. |
| 7. Atzmon D, Nemet P, Ishay A, Karni E; A Randomized Prospective Masked and Matched Comparative Study of Orthoptic Treatment Versus Conventional Reading Tutoring Treatment for Reading Disabilities in 62 Children, Binoc Vis Eye Musc Surg Qtrly 1993; 8:91-108. |
| 8. Bachara, G, Zaba, J; Psychological effects of visual training, Academic Therapy, Vol. XII, No. 1, Fall 1976. |
| 9. Walzer S, Richman J,; The Epidemiology of Learning Disorders, Pediatric clinics of North America, 20(549-566) 1973. |
| 10. Abrams J; An Analysis of Learning Disabilities and Childhood Depression in Pre-adolescent Students, doctoral dissertation, Indiana University of Pennsylvania, 1990. |
| 11. Flach, F, Kaplan, M Bengelsdorf H, Orlowski B, Friedenthal S, Weisbard J, Carmody, D; Visual Perceptual Dysfunction in Patients with Schizophrenic and Affective Disorders Versus Control Subjects, J Neuropsych, 1992, Fall, 4(4) 422-427. |
| 12. Flach F; Resilience, Fawcett Columbine, NY, 1989. |
| 13. Flach F; Rickie, Ballantine Books Edition, NY 1991. |
| 14. Bower B; Child Sex Abuse Leaves Mark on Brain, Science News, 1995 June 7, 147(340). |
| 15. Sapolsky R; Why Stress is Bad for Your Brain, Science, 1996 August 9; 273(749-50). |
| 16. Tarver SG, Dawson MM; Modality Preference and the Teaching of Reading: A Review, J Learn Dis, 1978, Jan. 11(1) 17-29. |
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| Additional information may be found |
| in the following resources: |
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| 1) Parents Active for Vision Education (P.A.V.E.) National Headquarters 4135 54th Place San Diego, CA 92105-2303 (619) 287-0081 / FAX (619) 287-0084 or 1-800-PAVE-988 + You may also contact P.A.V.E ® at http://www.electriciti.com/vision/ |
| 2) Optometric Extension Program Foundation, Inc. + 1921 E. Carnegie Ave., Ste. 3-L + Santa Ana, CA 92705-5510 + (714) 250-8070 |
| 3) Neuro-Optometric Rehabilitation Association International, Inc. + P.O. Box 1408 - Guilford, CT 06437 |
| 4) American Optometric Association + 243 North Lindbergh Blvd. + St. Louis, MO 63141 + Voice: 314-991-4100 Fax: 314-991-4101 |
| 5) College of Optometrists in Vision Development + 243 N. Lindbergh Blvd., Ste. 310 + St. Louis, MO 63141 + 1-888-COVD-770 + email: info@covd.org; or at: http://www.covd.org/ |
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