Hyperlexia, Heterophoria, and Julia


Hyperlexia is a term used to describe precocious early reading abilities.  It is the opposite side of the coin of dyslexia.  There are three basic types of hyperlexia:

Type 1: Neurotypical children who are early readers

Type 2: Early readers who are on the autistic spectrum (ASD)

Type 3: Early readers who have autistic-like traits, some of whom have Asperger’s (AS)

As a general rule, individuals with ASD tend to have a language learning disorder.  They may be early word identifiers, but much less prolific with comprehension as compared to their sight word vocabulary.  Individuals with AS tend to have a rich spoken vocabulary and comparatively good reading comprehension abilities.

There are neurotypical children tend to read well above their grade level at an early age, and retain that ability throughout life without any remarkable sequelae.  In the spectrum of hyperlexia, we tend to see those children who read early but subsequently struggle, and their disinterest or labor in reading has become a mystery to those around them.  Julia was one such patient.  It is less important to categorize Julia, who came to us as a very bright 10th grader with intermittent exotropia at near greater than distance (convergence insufficiency), than it is to read the startling composition that she wrote.  Her narrative speaks for itself:

“For as long as I can remember, school has always been a challenge for me.  Although my grades prove otherwise, I’ve always had a tough time staying focused and engaged.  After reading one sentence in a book, I’m ready to throw it against the wall and call it quits.  In first grade, I could read at an eighth grade level, but no one understood how challenging it was for me.  All my life I thought everybody felt that pain while doing close-up work.  I thought it was normal for words to ‘move’ and for lines to merge together.  I didn’t know any better.

It’s gotten tougher as I’ve moved forward in school.  It’s not just reading that’s difficult; it’s everything from seismographs in science to graphing and protractor work in math.  When copying notes from the board, I can’t keep my place.  As you can imagine, this can get discouraging.  Being the last one to finish an assignment got to me after a while.  How could everybody read that fast when I was reading so slowly?  It was so embarrassing when a teacher asked me to read out loud.  I constantly have to refocus every word, which means that I stop and start, stop and start.  It’s gotten so bad that now I read at the pace of a student just finishing kindergarten!  My mom has to read to me just so I can finish assignments on time.  This one question remains on my mind: How can I keep up when my peers are performing eight grade levels ahead of me?

I get stressed out a lot, probably more than normal.  While stress is mostly associated with emotions, I get visually stressed too.  Most days I’m stressed out both emotionally and visually.  These days usually just crash down on me without any warning.  My visual stress causes me to skip lines and lines of words.  On my Social Studies test last year, I totally skipped over a question and lost three points.  On my French homework, my eyes leaped over half a page of work.  No matter how big text is, school is still extremely hard for me.

When I stop to think about how I made it through my eighth grade year, I really couldn’t have done it without the help of my teachers.  If they hadn’t done what they did for me, I wouldn’t have survived.  All of them were extremely supportive and did anything they could to help me.  They went out of their way to enlarge anything and everything for me, and I really can’t explain of much I appreciate that.  They kept a close eye on me and told me to tell them if I needed help.  Some of them were willing to read to me when they saw me struggling!  They gave me all the time I needed to get something done, which really saved me big time.

Convergence insufficiency also causes double vision.  My brain resorted to something that astounded me: It shut off my left eye.  It’s common sense; using only one eye results in one image instead of two.  Great, problem solved!  No, not really.  Since my brain shut off my left eye, my right eye is doing all the work.  This can be very strenuous.  There have been days in school where I try to hold back the tears.  It’s just so painful, but I do my best to hide the pain.  My eyes, instead of working as a whole, are separate.  They don’t know how to work together anymore.  To put it in perspective, my eyes have a love-hate relationship (they don’t like to cooperate with each other!).

These are the kind of things vision therapy is working to fix.  It’s not a quick process; it’s actually rather slow.  The eye is a muscle, just like a leg or foot.  When something is wrong with that muscle, it takes time and effort to fix.  Therapy will ‘slowly but surely’ fix my problem.  But just because therapy will fix my problem doesn’t mean it’s easy for me.  Therapy is like school.  There’s homework.  There are assignments and activities.  Since therapy is like school, I find it miraculously difficult.  It strains my eyes and makes me exhausted.  At this point in time, though, I’m just really happy I found something that will help me.  I’m very willing to give therapy a chance no matter how tough.  Balancing high school and therapy, however, is a whole different challenge for me.  It might be hard to grasp at first, but I will definitely do my best to succeed at both.”

 

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