When to Evaluate Your Child's Vision and Development
Vision Needs to Be Evaluated: Four Times Parents Should Look Deeper
When a child has developmental, movement, communication, or sensory concerns, vision should not be treated as a separate issue that is considered only when a child says, “I can't see.”
Young children may not know that they are seeing differently. Nonverbal children may not be able to tell us what they see at all. And a child's ability to recognize or respond to something does not necessarily tell us how well their visual system is functioning.
Vision plays an important role in how a child organizes movement, responds to their environment, develops spatial relationships, and learns to interact with the world around them.
Here are four situations in which I believe a child's vision needs careful evaluation.
1. Your Child Has a Neuromuscular Condition or Diagnosis
The eyes are muscles, too.
When a child has a condition affecting neuromuscular development, we should not examine the body while treating the eyes as though they exist outside that organization.
Eye function, binocular organization, convergence, midlines, visual attention, and the relationship between the eyes and movement can all provide important information about how the child is functioning.
At Movement Lesson, I don't look only at whether a child can see something.
I want to understand:
How are the eyes functioning individually? How are they functioning together? How does visual organization interact with the child's movement?
Vision belongs in the developmental conversation.
2. Your Child Has Developmental or Global Delays
If development is delayed, vision needs to be part of the investigation.
A child who does not consistently respond to visual stimuli may appear to have difficulties in other areas because we are judging the child's response without first understanding what visual information is functionally available.
Development doesn't occur as a collection of unrelated milestones.
Visual organization develops in relationship with the hands, feet, developmental midlines, movement, spatial awareness, and eventually the child's ability to function within increasingly complex environments.
When development is not progressing as expected, don't simply ask:
“Which milestone is the child missing?”
Ask:
“Where is the developmental stress?”
Vision may be an important part of answering that question.
3. You Have Any Concern About Your Child's Vision
A school screening or pediatric visit is not a substitute for a comprehensive eye examination.
For young children and children who cannot reliably report what they see, I teach parents about the importance of retinoscopy performed by an optometrist or ophthalmologist to objectively establish refractive information.
Why does this matter?
A child doesn't know how everyone else sees.
Their vision is the only vision they know.
And responding correctly doesn't necessarily prove what we think it proves.
Ask a child:
“Do you see the tree?”
You've already supplied the word tree. Language, memory, recognition, expectation, and auditory information can become part of the response.
We need to distinguish between a child producing the expected answer and establishing what visual information is actually available.
Parents also need to understand their child's visual report. Terms such as strabismus, refractive error, acuity, binocular function, and convergence can have significant functional implications. A report shouldn't simply disappear into the child's medical file.
4. Your Child Has Speech or Sensory Processing Concerns
Vision should also be considered when there are concerns involving speech, communication, or sensory processing.
A child's ability to respond to and interact with the environment is related to the visual information available to them and how that information is being functionally organized.
If a child doesn't respond as expected, we shouldn't immediately assume we know why.
What did the child visually access?
How were the eyes functioning?
Could the child organize the visual information within the environment?
What happened when movement or environmental complexity was added?
These questions can help us understand the child's abilities more completely.
Don't Wait for Vision to Become an Obvious Problem
Vision is more than acuity.
It includes how each eye functions, how the eyes work together, convergence, midlines, peripheral vision, environmental visual function, neurological visual processing, and how visual organization interacts with development and movement.
That is why vision deserves attention before we simply work harder on the milestone, behavior, communication skill, or movement that appears to be difficult.
At Movement Lesson, we have developed an extensive library of videos, courses, books, assessments, and educational materials to help parents and professionals better understand functional vision and development—including Cognitive Vision, Functional Vision, Cortical/Cerebral Visual Impairment, visual development, and the relationship between vision and movement.
The goal is simple:
Understand what you are seeing so you can better understand how to help your child.
— Michelle M. Turner
Movement Lesson | Cognitive Vision | Functional Vision