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Sensory Issues.

Every autistic person on the spectrum may be affected in different ways with regards to sensory issues. It can cover any of the senses hearing, smell, sight, touch, independently and sometimes with any combination creating a sensory overload.
Sensory overload, in my opinion, takes the form of a severe kind of tantrum, which brings with it a complete collapse of coping abilities. Some autistics tend to shut down when they get to this stage, a possible solution to this is it may be a good idea to retreat to a quite zone in order to let it all subside. There are some autistics that, as they reach this stage may hit, kick, and scream, or even self harm as a direct result of reaching a sensory overload. Basic everyday noises may be extremely painful and may even start the process of the overload as there may be no escape from it and the stress levels build up. There are some professionals that do feel some of the typical autistic behaviours may even be a result of some sensory Integration difficulties.

Sometimes eye contact can be a problem for autistic people, when talking with someone eye contact may not always be made a possible explanation for this, is that it is easier for the person to just listen, so that the overload does not occur, there are other times when eye contact may be uncomfortable perhaps it a response to submissiveness or stranger anxiety, Other autistics may have different feelings on this subject.

A study by Paroma Basu, University of Wisconsin march 07 2005 - eye contact triggers threat signals in autistic children's brains. Click here for full story.

 

For more information on Hyperacusis which is sensitivity to sound please click here there is also a site dedicated just to hyperacusis this can be accessed by clicking here

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The following Information has been given to me for use on this page by Ian Jordan who is my optician and also works in the field of visual perceptual research and development.

 

Visual ergonomics in the classroom and workplace by Ian Jordan. Copyright ©

 

Introduction

 


.Visual and other symptoms
.The room
.Lighting
.The peripheral environment
.The layout
.Work set
.Visual tasks
.Positions
.Text and presentation
.Boards
.Computers
.Secondary effects of inappropriate visual stimulus
.The sick and healthy building

Introduction


It has gradually become apparent that there is an increasing need to understand the basic principals of visual ergonomics in the classroom and work environment due to the adverse effects of inappropriate design. Currently, little thought is given to the visual processing aspects in education or workplace design but this is becoming an increasingly untenable position. There is increasing evidence that many conditions have a vision linked stress component and that inappropriate visual stimulus can create many problems, some directly attributable, some as a secondary effect. Underachievement is common in both classroom and workplace, and physical effects vary from minimal to devastating. Visual ergonomics cannot continue to be ignored, the costs of inertia are enormous. It estimated that at least one in five of the population may be adversely affected by current classroom and task design, and whilst it is impossible to eliminate problems for everyone, by utilizing good design features, it is possible to reduce symptoms significantly. It must be made clear that a standard eye examination does not look for or respond to difficulties introduced by an inappropriate environment and that specialist assessment e.g. an Orthoscopics assessment, may be essential in some cases.

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The visual environment

A suitable visual environment is one in which the maximum amount of people can work optimally, have little distress or discomfort, have optimum vision and sensory performance.
The unsuitable visual environment may be defined as one that provokes visual or other physical symptoms, reduces efficiency or achievement and is detrimental to the well-being of the person.
Visual and other symptoms

There are many symptoms associated with an unsuitable visual environment. These range from hardly noticeable to those that create distressing or life altering effects. They may be categorized into two types, visual primary effects and non visual secondary responses.
Whilst this booklet does not intend to describe symptoms in detail (see other books from Ian Jordan from Desktop Publications ) it is necessary to have a list of those symptoms that may be provoked by the visual environment.

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Visual symptoms

Unstable vision in dyslexia and dyspraxia
Including
Reversals and inversions
Displacement
Metamorphosis
Visual sequencing
Visual and attentional field reduction
Accommodation and convergence difficulties
Eye movement problems
Eye muscle problems

Unstable vision in migraine
Including aura

Non visual symptoms that may be due to visual stimulus

Balance problems
Hearing problems
Sensory hypersensitivity
Underperformance
Migraine and frontal headaches
Rarely epilepsy
Memory difficulties
Attention and concentration problems
Sick building problems
Panic or anxiety attacks

In addition it is likely that truancy, work attendance and aggression may have some direct links.

The effects of poor visual ergonomics are far reaching. Examinations may be giving a distorted picture and failing able people, others may be underperforming at work or taking time off due to "stress" migraines or headaches and panic attacks.

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The room

The room itself can both create and reduce problems. The ideal room is quiet, with adequate lighting, and not too many visual distractions. This can be contrasted with an open plan classroom, relatively busy visually and with a lot of distractions. For hyperactive children this environment may keep them amused, for those who do not need constant stimulus change, it can be appalling.

The walls and / or furniture must not result in striped patterns, this can cause a stroboscopic like effect for some people and results in headaches, vestibular and visual disturbances.

It is essential that furniture position i.e. desk position, takes into account the visual demands and it is crucial to realize that the visual systems of the children may not have developed in a "perfect" way.

Desks should face directly the front when the child needs to look at the teacher or the board. It is NOT acceptable to have a child at a desk at which the child has to look at the teacher or board when they are sitting facing sideways or with their backs to the front. There are significant risks to performance, posture and academic achievement by retaining the "modern" idea of placing desks in the round. This applies particularly for those with a strong visual dominance, squint or lazy eye and those with a strong brain bias.
If a child has a lazy eye and they are placed on a table with the lazy eye closest to the teachers side they will be strongly disadvantaged. This must not be underestimated. This positional effect must also be taken into account when sharing or copying from a neighbour's book. The effect may be amplified if the child has to look over their shoulder to see the teacher and is unacceptable.

The ideal blueprint for seating is the "Greek" theatre design; all the children face the teacher, although pragmatism determines the optimum plan in each classroom. Group work may necessitate some variance at times, but the teacher must be aware of the harm they can do if ergonomics are not considered when designing the classroom.
The colour and design of the furniture may also be significant. In general a lectern is better for reading than a flat desk and the height of both the desk and chair should be comfortable. Posture will inevitably change as a response to visual needs.

The position of boards (of all types) relative to both the child and the teacher can be critical. Reflections can make it impossible to see what is written and this may vary depending on time of day (the position of the sun changes) and the time of year (the lights may get switched on earlier in the autumn). Teacher position (standing / sitting) when talking to the class can also make a difference. As significant importance is placed on facial expression (it is often essential that a child can see the teacher's mouth), it is critical that the teachers face can be seen when they are talking.

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Lighting

Lighting is an extremely complex subject and there are numerous regulations governing its specifications in classrooms and offices. These specifications determine the types of lights that can be used and their brightness. The specifications do not take into account responses from an individual to the brightness, colour (lights are all coloured to some extent) and flicker (from fluorescent fittings) except in rare circumstances. Whilst the pupil in the eye does control to some extent the brightness, it cannot vary in size sufficiently to compensate for illuminance levels changes. The visual system responds in a complex way and has the ability both to amplify and reduce the effects of illumination.

Ideally daylight should be the primary illumination, the size and position of the windows should allow sufficient light on work surfaces without reflection.
It should be remembered that daylight can vary significantly, from extremely bright sunlight (a blue bias colour) to a dull cloudy day (more blue, less red/green). The colour of the light can cause major difficulties in dyslexia and dyspraxia in susceptible children. Do not underestimate the potential effects.

In most classroom daylight is supplemented by low frequency fluorescent lights as they are generally considered the lowest cost alternative. There are a number of problems associated with these lights that can have major effects on education. The lights flicker at 100Hz (one hundred times a second) when they are new but this frequency may reduce significantly on older or badly maintained lights.
The peripheral visual system is designed to respond to flicker and the effects of fluorescent lights can be very unpleasant to some children. For those that are particularly sensitive it is comparable to sitting under a constant strobe light (even on new lights), on old badly maintained systems it can be unforgivable. It is not acceptable for a child to be able to see the lights flicker in the classroom. In rooms where moving machinery is present it may be illegal to use these lights as for some people the stroboscopic effect may give the appearance that moving parts are static when in fact they are moving!
Flicker sensitivity is associated with migraine, epilepsy and dyslexia. There is a significant amount of evidence emerging that other conditions can also be affected by flickering lights (or TV screens) and it is prudent to be extremely careful with flicker in cases of autistic spectrum disorders, hyperactivity, those who are susceptible to headaches, and those with balance or proprioceptive difficulties
In addition to flicker difficulties the emission of colour in a fluorescent light system is unstable and erratic, with sharp peaks in the visual spectrum which can migrate causing the ambient light to change its spectral characteristics. Fluorescent lights usually have a red / orange bias which can cause problems to a significant number of children.

The best type of light is a high frequency daylight fluorescent. This must be fitted with a dimmer switch as the level of light needed with this type of bulb is usually significantly less than normal. Do not be afraid to turn the lights down!

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The position of the lights may cause problems with reflection from some surfaces. This can produce a waterfall effect within the visual system that makes it impossible to see adequately and may be mistaken for inability to see due to visual problems.
Reflection of light from the text presented can be of extreme importance. In essence if the paper used reflects all light equally, the colour of the paper becomes the colour of the illuminant. However, if the colour of the paper is changed or an overlay used (such as in dyslexia) the colour of the reflected light becomes changed. As the paper can only reflect light, the colour and energy levels can vary enormously depending on both the light spectrum and the absorption of the paper / overlay. Therefore the colour of the paper can vary enormously and overlays / paper colour are virtually impossible to prescribe accurately.

If a child is sensitive to colour or flicker then there are two options
1 to change the lighting
2 to wear spectacles that allow the colour to be changed in the lighting condition in which they are having difficulties to one in which they will not have problems. The best method for addressing this is the Orthoscopics method www.orthoscopics.com as other methods cannot find the optimum colour in many cases.

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Overlays may be used as a stop gap measure but they are not acceptable as a solution.

Task lighting may be essential for some children. Daylight bulbs may be adequate in some cases but if a child is sensitive it is unlikely that these will be adequate. The Optimeyes task lamp is the best specialist light for these children and can be used to reduce or alleviate many symptoms.
As the numbers of children with problems due to visual stimulus are so high it is essential that all children undergo adequate screening by a trained teacher and action is taken if necessary. The minimum level of assessment would be using a PAT light; overlay testing is not acceptable to screen a child (even by an optical professional).

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The peripheral environment

The peripheral visual system is extremely sensitive to edges as well as flicker. In some children this means that the classroom with lots of posters and pictures can be very disturbing. In fact they find the classroom to be stressful and unpleasant. This clearly is a difficult area, to balance out the need for high levels of visual stimulus required for some against the over stimulus found by others. The logical thing is to reduce the stimulus for those with difficulties whilst at the same time giving individual extra stimulus to others. A challenge for the teacher!
The classroom walls should ideally be matt (not glossy - reflections) and any essential posters information should conform to a few simple rules
" It should not be too colourful i.e. not too bright and with varying text colours or fonts
" It should use text which is designed to be read by a child coming to the wall and reading it at around a metre
" Text should all be same size and font - be careful on emphasis
" Text should be in small narrow boxes
" Lighting should be principally daylight
" Do not use unnecessary text
" The more exciting it is - the worse it is! (this also applies to pictures)

Noise levels also play a part in the overload experienced by some children and it is of great importance that the classroom is quiet.

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The layout of text

It is of vital importance to present text in the best possible way for an individual child.

Font style
Font style is a matter of personal preference, but some aspects of font type should be remembered. Do not mix fonts styles on a page; it can cause significant levels of confusion in dyslexic children. In general, italics or sloping text are the most difficult to process.

Size of text
In general when there is doubt - make it bigger! Small characters may be unable to be distinguished by a significant number of children. In addition the amount of words that can be seen in an individual eye fixation increases and may be beyond the processing ability of a child. When a child is having difficulty with a smaller text it may be a good idea if a visual tracking magnifier is used to help both fixation and reduce processing area.
However, it is usually faster (and more pleasurable) to read small sized text and therefore desirable to use the smallest text that is able to be processed adequately by the child.

Spacing of text
Crowding is a particular problem and results in reduction in ability to differentiate letters in a word, stroboscopic effects during eye movement and pattern glare. Crowding is affected by the font size, style, the area covered by the text and the spacing between the characters. In general, increase letter, word and line spacing; reduce the "boldness" of the text, reduce the area covered by the text and choose the font carefully.

Colour of the text
Whilst colour of the can be useful to highlight information it can be detrimental in some cases. In general, do not use coloured text as it can cause confusion to the focusing system, and do not under any circumstances have a lot of changes of colour within text. In particular, do not change font style and colour within the same area of text.

The position of the text
The position i.e. how close it is, whether it is positioned to one side, whether it is tilted, of the text may be critical for some children. For those with dyslexia the symptoms can be provoked by position and may be rectified by change. Mid line crossing can be problematical, and the jump between board work and text may be difficult for those with convergence problems. This is very common in those with reading difficulties. Sharing a book may be inadvisable and in some cases very difficult for the child.

The size of the text block
The larger the area of the text block, the more likely that difficulties will be provoked for some children. It is of particular importance that the width of the line is not too wide, those with eye movement problems will find it extremely hard.

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Paper


The paper used can either provoke or prevent difficulties. Avoid glossy paper, coloured paper may be beneficial or create difficulties (some people will respond well to a colour, others may have problems with the same paper!). To make it more difficult, for some people it is possible that the same colour paper will be positive in artificial lighting but negative in daylight! The effect of the coloured paper is determined by the light source.
Some paper have dyes that make the paper appear brighter, this can be counterproductive.
If the paper is too thin, text may be visible through the paper.
The best paper is usually not too white and relatively heavy.

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Pictures
In books for the very young there are often many pictures. Whilst this has obvious benefits there can be a number of disadvantages. Peripheral disturbance due to the picture may make it hard for some children to fixate on the text. When text is placed on top of the picture it may be impossible for some to read. In general, do not put text on top of pictures or diagrams.

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Pattern glare
Pattern glare is one of the most common problems found in text presentation. It creates discomfort during viewing, anomalous figures may be seen within the text (often geometric patterns such as diamonds or triangles), coloured blotches may appear, and flickering or flashing may be seen within the text. It is caused by the size of the text, the contrast (and sometimes colour), the area covered and the font style. It can be very unpleasant. It causes headaches, inability to fixate on the words and unpleasant visual sensations. Do not take too lightly the effects of pattern glare.
To determine whether pattern glare is present use the visual tracking magnifier I, it will stop immediately within the area of the magnifier. If pattern glare is found to be present, modification of text or treatment is essential.

A well produced area of text will be (may have to be determined for each child to achieve optimum results)
" A good font style for the child
" Optimum size
" Generally black (although in specific cases it may be desirable to use a particular colour)
" Optimum weight and spacing
" Narrow width column- in a central position
" On non shiny paper (coloured possible - but better to get lighting right or wear lenses that will modify lighting - if using coloured paper / overlays there must be a full visual processing assessment)
" When giving homework do not set it at the end of class, the dyslexic child will have problems due to inability to copy quickly enough

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Writing

Writing also has a visual component. Whilst it is essentially an output process rather than input as in reading there is visual feedback that is critical to best performance. The child with poor handwriting will usually be given instruction, and perhaps exercises to improve their performance. Whilst this is important the fastest way to improve writing is often to change the lighting. This can be achieved using the Optimeyes task lamp or properly prescribed lenses.
E.g.
This change took place immediately using the Optimeyes lamp.

Visual tasks
Copying from the board, a book or alternatively the child next to them presents a number of problems. For a child with eye movement difficulties or convergence problems it can be almost impossible to achieve these tasks adequately. Those children with mid line crossing problems, squint or a lazy eye may have difficulty in copying from one side (sharing books can be difficult - it may be fine on one side, the other could be difficult) For those with dyspraxia, dyscalculia or dyslexia it can be particularly difficult.

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Posture

Posture may also be modified by visual input. Torticollis (head tilt) may be a direct response to visual stimulus and posture changes as a result. Back problems can be due to vision! Pay particular attention to the child that rotates its book to read or write, they are often saying that they need to do this to see the text adequately or be able to write well. Do NOT ignore this if it persists.
Posture can also be affected by the position of the chair relative to the board / teacher. It is necessary to ensure that the child can see without having to twist their head significantly, multitasking may be a problem, so may their visual processing.

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Blackboards - or whiteboards, interactive boards

There are a number of factors to be taken into account with all types of boards.
The position of the board should be in front of all the children. They should not have to turn to see it!
Reflections from lights should be minimized - it may be impossible for a child to see a poorly positioned board
The height should be adequate to see it, but not too high for comfort
The dimensions of the board should be determined with the length of the class in mind

Text must be easy to see,
" The optimum font must be used - size, style, weight, spacing
" Colour should not be used except in special circumstances and the teacher should make sure that ALL children can see when using colour for emphasis

Flicker from screen or projector should be eliminated
Ambient (room) lighting should ensure contrast without being in a "too dark" room

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Computers

Computers can provoke many vision linked stress problems in the susceptible child.

The screen type is important, flat LCD screens are usually better than CRX , the refreshment rates of old CRX screens are usually worse than up to date flicker free models. Brightness can also be a factor in introducing visual difficulties, and the colour of the screen and text should be modified when the child is susceptible to vision linked stress. A proper assessment should be carried out as the colour coordinates of each computer screen can vary and it is important that colour and brightness matching is not attempted by the teacher as they cannot possibly be competent using naked eye matching techniques.

Position of the screen is important too, ideally below eye level and at a sufficient distance so as not to cause problems with convergence or tracking. The room lighting must also be addressed and the combination effect considered with the computer screen. When a child underachieves on a computer it is a job for a professional, a well intentioned amateur cannot be expected to understand the complex issues involved.

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Sports halls and other rooms

Flickering lights in a sports hall can cause visual search difficulties i.e. children may not be able to follow a moving ball adequately. In addition, some research indicates that posture, strength and balance may also be affected. The clumsy malco-ordinated child may be responding to the environment!
In addition visual refreshment may be difficult in a sports hall, lighting modification or prescribed filtered safety goggles should be worn.
Daylight is best where possible for the majority of children although this statement is often not true in autistic spectrum disorders. For these children it is imperative that a full professional assessment is carried out.
Auditory input

There is a strong effect on the visual system of inappropriate auditory input.
In conditions of excessive auditory input ( a noisy classroom perhaps) the visual system does not function efficiently. Visual and attentional fields can reduce significantly. Children with problems benefit from a quiet room.

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Visual diseases and conditions

There are many visual diseases and conditions that can be affected by stimulus.
It is a good idea if a teacher has a basic knowledge of the conditions commonly found in children and I have included a brief background of the most obvious. For a teacher with a particular condition in a child in her class it is advised that professional guidance is sought.

The most common conditions in children are refractive (long sight, short sight, astigmatism), muscle anomalies resulting in eye movement and focusing difficulties, developmental problems and physiological or pathological conditions. In addition it is becoming clearer that sensitivity to stimulus also is common and may cause significant underachievement within the class. Colour blindness or mixing problems do not cause any major problems although a teacher may be surprised at the boy (it is usually a boy) who colours his picture in an unusual way e.g. the sea may appear purple!

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Refractive conditions

Long sight (hyperopia) - a child uses up some of its focusing reserves to see in the distance thereby reducing the potential for near work. It may result in over-convergence, a breakdown in fusion causing a squint or double vision or there may be no apparent symptoms. Eye rubbing and headache may be found. Treatment may be to use spectacles or contact lenses or in some cases if the degree of refractive error is small it may be ignored. Dyslexia /dyspraxia / dyscalculia are much more common in long sighted children than in those without the need for spectacles.
In addition to hyperopia, focusing on a near object may be erratic for a child with dyslexia.

Short sight (myopia) - a child will have a blurred image in the distance. The stronger the error, the shorter the range of clear vision. The child will often have difficulty with the blackboard. They may appear to screw up their eyes. It often develops at around 7, puberty and around 17. Dyslexia is rarer although dyspraxia is often suspected.

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Astigmatism

- when a child has an astigmatic error it is impossible to accurately bring an object into focus. Small errors can usually be ignored and even sometimes larger amounts may be tolerated. High degrees of astigmatism may result in visual development problems. Whilst rare they are often associated with dyslexia and dyspraxia.

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Squint (strabismus)

- where two eyes do not work together (sometimes one eye is suppressed, sometimes the eyes alternate suppression) is commonly found in children with dyslexia. Professional advice must always be sought and I would recommend that all children with squint have a visual processing assessment (a refractive assessment is not sufficient in many cases. This is a controversial statement, I do not apologize, the results of a visual processing assessment can be impressive, immediate and may reduce the need for surgery. However, peer review has not been undertaken as yet -2005)

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Eye movement problems - convergence and tracking.


It is clear that in many cases of reading difficulty and dyspraxia that children have significant eye movement problems.
In addition there may be difficulties on crossing the mid line for those with cross lateral difficulties.
The child may appear clumsy or have reading problems.

Pathological problems with vision
Whilst serious eye disease in children is relatively rare, some minor conditions are common.

Infection e.g. conjunctivitis may be found in almost every class at some time. Red eyes, watering, mucus discharge, eye rubbing are the most likely symptoms. It is usually found in both eyes and will often spread around the class quickly as it is highly contagious. Pain and visual acuity drop are not usually present.
There are a number of more serious infections and conditions that can appear to have similar symptoms; therefore it is essential that professional advice is sought.

However every teacher will have occasions in which they will have a child with a more serious problem.
These fall into a number of categories, visual acuity reduction, peripheral visual field loss, central field loss and progressive changes.

Presentation of work MUST be modified to help these children
Visual acuity reduction.
Visual acuity reduction means the child cannot see the eye chart very well
Increase size of text - the child will help decide
Modify lighting - usually increase brightness but confirm colour using an Optimeyes lamp
Consider magnifiers and fixation help (professional advice needed)- Visual tracking magnifier, standard magnifiers or closed circuit TV system
Reduce width of text to only a few words
Make contrast adjustments to furniture to increase visibility

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Peripheral field loss


A person suffering only from field loss may be able to see even the smallest letters on the eye site chart. However, depending on the type of field loss they can have some of the worst visual problems. The most common types of field loss are hemianopias (where one side of the visual field is lost in one or both eyes - often caused by trauma) and concentric field loss (tunnel vision). In both cases the position of the child within the class can be critical. Ask the child, they will usually know the best position. They may well be clumsy and fall over badly positioned chairs, be aware that they may not see them! Magnification may / may not be necessary but the width of the line should be reduced significantly. A typoscope or visual tracking magnifier may be helpful. Glare may be a problem, and the extent of the field loss may be influenced by lighting. In cases of retinitis pigmentosa the brightness, colour and type of light can be critical.

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Central field loss


In cases where the central visual field is reduced or missing (such as maculopathy), magnification is often essential. The child has a hole in their central vision and cannot make out fine detail. Reading speed and accuracy (fixation is eccentric) is often poor although practice can often produce remarkable results. There are many types of magnifiers available and other visual aids may be appropriate. Getting around is usually possible if peripheral vision is intact.
Progressive changes
Many visual problems deteriorate with time and whilst coping strategies may improve, the degree of disability may become overwhelming. Routine, and keeping the same position for desks, chairs etc is important.

If a child has been diagnosed with a visual disability it is essential that the teacher is made aware of the effects of the disability and what actions are required.

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Dyslexia and dyspraxia

 

There is a massive importance of the visual environment in dyslexia, dyspraxia and in autistic spectrum disorders.

Provocation of dyslexia / dyspraxia
The classic symptoms of dyslexia can be provoked by the visual environment and the presentation of text. Position, size, font, brightness and colour all contribute to producing symptoms. It is essential that every teacher is aware of this and is trained to recognize and screen for the visual symptoms found in reading underachievement. If the reading environment causes the problem it is unsatisfactory for the teacher to use language based remedies. Many cases of underachievement are due to vision linked stress syndrome.
In dyspraxia there is a significant visual component in the majority of cases. The child cannot determine where they are visually without stimulus modification. It is unsatisfactory to attempt exercises until the visual system is working appropriately. Eye movement is often poor and tracking of a moving object may be impossible, making catching a ball a matter of luck!
With ASD the size of the attentional field can change depending on lighting which can have major effects on recognition of facial emotion - a major problem in autism!

Wearing tinted or clear glasses

It goes without saying that if a child should be wearing glasses in school that the teacher should be aware and ensure that they are being used correctly. If they are meant to be worn all the time then protective goggles should be worn during games as to ask a child to play when they cannot see can be dangerous. When swimming, goggles made to prescription should be worn. In some cases children are asked to dive into the pool when they cannot see the water, never mind whether there is any obstacles in the way - a very brave (or foolhardy) act.
When using tinted spectacles colours can be distorted e.g. a green felt tip marker on a white board may disappear when green lenses are worn! Copying coloured drawings or maps may also produce interesting results.


Secondary effects of inappropriate visual stimulus

There are a number of secondary effects of inappropriate visual stimulus.
These include hearing problems, speech difficulties, swallowing and taste problems, balance and strength difficulties. It is advised that all teachers are aware of recognition techniques and for those with a special interest in special needs it is a fundamental requirement.

Assessment and treatment

Medical, educational or psychological testing is totally inadequate for children with vision linked stress.
A standard eye test is not good enough, a specialist test is required. There are a number of screening tests that can be performed - an overlay assessment is not sufficient, it will usually miss a high proportion of children with problems and in particular the worst cases cannot be addressed!
The optimum test may take an hour or more subsequent to the eye test. The best test by a long way (in my opinion) is the Orthoscopics assessment and the lenses they can prescribe are significantly different to other tinted lenses. All lenses are not the same, the range addressed by Orthoscopics is over double the range of others and can address a greater range of conditions and difficulties. They can also give optimum lights and check the effect of flicker (if necessary).

The sick and healthy building

Sick building syndrome is common and is often caused by the visual environment. It is a misnomer; it is the people that inhabit the building that get sick, underachieve and have their life blighted. And it is unnecessary, and in future it must change. Visual ergonomics are very important and must be taken into account both in general design and modified or action taken for those that have problems. It is a health and safety matter, everyone has the right to expect their work or school environment to be well designed. The challenge is set.

Copyright ©

Ian has also allowed me to use the following PDF an Essential handbook by Ian Jordan Visual dyslexia, visual dyspraxia and other linked vision stress. Copyright ©

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