Gifted Issues Discussion homepage Forums Twice Exceptional Visual Perceptual Processing Disorder

Further testing by a developmental pediatric optometrist just this week has revealed that not only does DS6 have intermittent convergent strabismus (intermittently crossing eyes) (which I have posted about here before) but that it looks like he also has a “visual perceptual processing disorder.” I was suspecting dylexia/dysgraphia...But he didn't quite fit that I realized. I didn't know about VPD. He fits all of the symtoms of that.

Not sure how familiar you all are with visual perceptual processing disorder but I will give youmy basic understanding. After an image enters the eye, the brain's visualperception capabilities tell the child what it means. It connects the image tosomething the child has seen before and gives it meaning. Something round thatrolls is probably a ball. Visual perception skills also include the ability totell similar images apart (p and q or words like “skate” and “stake”; "new" and "now" etc), or to separate important details from a background of information (taking the vowels out of the word), or to recognize the same symbol being used in different ways. Confusing words “saw” with “was” and "new" and "now"(and vice versa) is a very frequent mistake made by people with this disability, and my DS is no exception, because he lacks the sequencing skill needed to perceivethe difference. What may seem simple to the average student, copying a sequence of numbers or letters correctly from the board becomes a monumental task nomatter how short the list. This contributes to the slow pace with which Benwrites his numbers and letters and almost guarantees papers wrought with reversals and omissions.

Anyone else dealing with this disability? We have a conference scheduled with the developmental optometrist regarding the pending diagnosis of visual processing disorder on Tuesday and I know he will answer my questions and concerns but I am so anxious. So, if anyone can jump on and give me some info on living with this, I would so appreciate it. Is it lifelong, like dyslexia? Or does it "get better" or "cured"?

Also, does anyone have any tips on how to talk with DS about his having this? Without him feelign broken or defective. How do I tell him about his having these diabilities without destroying his confidence?

As a side note, it's no wonder my poor child has anxiety. He has this incredible brain stuck inside a body that can't see properly, read or write anywhere near the level of his intellectual capabilities and no one had any idea of his struggles. I have been suspecting some sort of learning disability or visual issue for awhile now (which is why I pushed to have him take the WISC IV in the first place) but it really hit me when I observed him doing the WISC IV. (Thank goodness I was able to observe!) It was so obvious to me he doesn't "see" the way most people see. It was very disheartening to hear the psychologists attribute it to various behavioral/psychological issues (that he is so rigid he just see others' perspectives" - so not Ben at all!), anxiety and to hear and read in various reports people 'hinting' that he is on the spectrum or has ODD or ADHD - when I KNOW what "on the spectrum" looks like and I know he is not (anyone who takes some time to get to know Ben can see that he is not "on the spectrum.") And I KNOW what ADHD looks like and I also know that is not Ben. I said to the Dupont psychologists that I when I observed him taking the test it seemed really obvious to me that he has a learning disability or some sort of vision problem and they sort-of treated me like I was crazy. And here we are. I am so glad I valued my observations and suspicions over that of the "professionals" with their stupid "checklists" and pushed the vision and learning disability testing. I am not glad that he has these vision disorders (on the contrary, I am so heartbroken) but I am glad I am finally getting accurate labels and diagnoses rather than him being labeled with (and possibly medicated for) various disorders that he does not have. It frightens me how easily that could have happened and would have happened, if I were not the way I am (as annoying as "the way I am" may be to various people).

It sounds simialr to what I and my son have experienced related to amblyopia. I find when things swim, closing one eye helps. I think it is also a case where giftedness aggrevates the issue, as I notice my DS6 would make a confident guess when a little more time might have illustrated that something wasn't making sense. It also kept us in the dark as to his vision problem until the school physical a year ago.

As I understand it, the brain is trained to not trust the integration of the eyes or one of the eyes at an early age due to strabismus, amblyopia, or a huge mismatch in acuity.

Retraining his brain with two hours a day patching made a huge difference for DS. I would hope you find a similar outcome as behavioral optometry seems to have come a long way in recent years.

My youngest dd has something sorta similar - it's a little bit different in that her challenge is with a deficit in a type of memory that is used to associate symbols with meanings. She was able to learn to read, but it was much slower than we would have expected compared to her verbal abilities and ability to do math. Her writing looks a lot like she has dyslexia, but she's not dyslexic (per testing). She has a TON of anxiety.

We haven't had her tested yet by a neuropsych so I don't really have a name for what 's up with her - we instead had her go through ability/achievement testing with an educational consultant (former sped teacher). When dd was in the midst of the testing she was given audio phones to listen to a story (rather than read it) and it was like turning on the music for her - she came out of her testing so excited because she realized how much easier it was for her to "read" via audio than by trying to look at the words.

Anyway, it is probably not exactly the same type of challenge, but fwiw some of the same accommodations might be helpful for your ds. DD is supposed to listen to audiobooks to develop her comprehension and read lower level books to develop her ability to read visually. She's supposed to have a calculator to use for math work unless it's a test on timed math facts (which she's actually really good at).

She's also supposed to have a developmental optometrist evaluation soon, so that's our next step.

BTW, Zen Scanner - I think I've conversed with marytheres about this before, but fwiw my older dd has had severe double vision due to muscle weakness, and for her vision therapy was very successful. The reason I mention her here is that you mentioned shutting one eye to help - we learned that our dd's brain actually shut off the eyesight in one of her eyes subconsciously in order to help her get around having double vision - we could usually tell when it was shut off (once we knew) because she tilted her head to read etc. Just a thought, but if your ds has some of the same visual challenges you do, his brain might be switching one eye off without him realizing it. This significantly limits peripheral vision and I think it led to my dd being somewhat clumsy.

Best wishes,

polarbear

Omgosh, thank you for this thread. (Light bulb moment!) DS8 has strabismus and is a very visual-spatial kid. Imagine if you had a brain with a preference for the visual but a wonky eye... good golly. Here I thought the French Immersion wreaking havoc with his language processing disorder was his only issue, lol. (sigh)

Fyi, his strabismus is better now than when he was 6. He got the right care early enough (hasn't needed surgery yet) and things are getting better

Marytheres: could your son's visual perceptual processing disorder be connected to his strabismus? Not sure which brain region(s) are at work here. We know about the potential "brain vision loss" that can result when a brain starts to disregard an untreated strabismus eye, but I wonder if it can cause visual processing delays as well. Interesting.

I tell my DS8 that everyone has different strengths and weaknesses and that he's no different. Where he has a weakness and another child has that strength the reverse is also true in another area: there are other strengths he has that other kids have as their weaknesses, etc etc. He seems ok with it.


I hear you. We have that diagnosis (ADHD) but I take it with a grain of salt. Some kids benefit from meds, but DS8 is not medicated because I question the diagnosis. Docs can have whatever opinions they want - it's up to parents to educate themselves and decide for themselves whether or not they agree. The docs may have more experience with more kids and more education in this area, but no one knows our kids the way we do.

Thanks, CCN. I'm going to "keep an eye open" for that with him.

I've always figured my brain has appropriated all the processing that is usually dedicated to stereo vision and made use of it for mapping anything I want inside. Seems like a paradox from the outside, poor vision leading to superb visual-spatial reasoning, but it makes a certain amount of sense from a brain resources perspective.

Yes apparently my DS does this too - starts shutting off one eye.

His tracking has improved already - both I and his OT have noticed it.... plus the VT does assesments every so many weeks so they noticed it too but it's nice to notice it on my own... and for others to notice it. Like today his OT said how she cpuld see him getting so much better at the tracking stuff they do.

Oh my gosh my typing errors are horrible...LOL sorry!

Yes I believe it is. I think Zen touched on this - I will quote her: "As I understand it, the brain is trained to not trust the integration of the eyes or one of the eyes at an early age due to strabismus, amblyopia, or a huge mismatch in acuity." and that is what leads to the processing problems. So hopefully th estasbisms gets foxed, we retrain the brain and he is fine, rigth? I'm not sure though.... I guess I will see what the doc says.

I feel better about it today. I was really bummed yesterday even though it's kind of good news - I was right and I am glad we are getting to the right problem - accurate lables and diagnosis...I was even prepared for something like this. I am prepared to hear he has a learnign disorder. But still bummed and sad for my child... you hate to see your child struggle and be mislabled, misunderstood, etc... Just hard. I had a c-section with him (b/c of the docs and b/c I just didn't know what I was doing) and as a result DS stopped breathing twice ... i think that is why he has these problems. I am not sure, of course, but I feel like I failed the poor kid to a certain extent. Did it right with DS2 (pushed him out natural screaming and cussing the whole time and he was never in NICU or away from me for a second and he is much different). And yes I know there are so many worse things... but, you know, all of this can still be such a bummer. I get jealous of hearing about all these kids who LOVE school and are doign so well I am starting to hate school time... But hopefully this year will be good. DS teacher is already being VERY accomodating, really receptive really wanting to help make DS' year a good one and we are getting an IEP and everything so maybe this year will really be a good one.

I just wanted to offer support on the strabismus front. My DS6 was experiencing intermittent strabismus (the same kind). He developed a distinct head tilt because he had double vision all the time unless he tilted his head. Going back into his old pictures, we can see it but we didn't notice it until he was older and the tilt and wandering eye was more pronounced. His PO told us that vision therapy would be no help for him so we did surgery on both of his eyes last Nov. She considered him "cured" now although he does wear bifocals b/c his up close vision was weaker (he should grow out of the bifocals but will likely have to wear glasses for regular nearsidedness anyway).

In my DS case, they couldn't find any reason for the strabismus other than congenital fourth nerve palsy (they even did an MRI on him to check for tumors, etc.)

What did you find out? I was reluctant to go with surgery so young but it turned out great for him and completely fixed his vision. His gross motor skills improved because he got depth perception back (he had poor depth perception before).

Good luck to you.