More on Dyslexia and Vision

The University of Michigan has launched a website designed to help students with Dyslexia.  Though information about vision is predictably scant, they do note regarding evaluation that the examiner will typically discuss the case history form with you and may ask for more specific information such as vision difficulties, hearing difficulties, delay in development of speech and language, and specific medications being taken.  I logged on to their Facebook page and posted a link to information we’ve discussed on this blog about the role of vision in dyslexia.  There is some irony in that the Wolverines are located in Ann Arbor, home of “Michigan Letter Tracking”, one of the core procedures we use in vision therapy to alleviate the visual noise or crowding.

Now for some further irony.  On the U of M site there is an intriguing story about a 95 year-old individual who has a Ph.D. to go along with his dyslexia, and who has recently written an ebook on his breakthrough treatment for his condition.  Not the condition of having a Ph.D., but the challenges of learning to read and reading to learn as an individual with dyslexia.  For the $19.95 it’ll cost you to download the ebook, I’d recommend it.  Collin Corkum dropped out of medical school when the reading load got to the point that he couldn’t visually sustain the demands any longer.  I’ve blogged elsewhere on how visual disabilities can be accommodated all the way up to candidates taking the USMLE exam, and many of us have had heart-rending clinical interactions with medical students struggling to keep pace with visual demands, yet who have been given clean bills of visual health by practitioners who’ve told them “your eyes are fine” or, “vision has nothing to do with dyslexia”.  Dr. Barry Tannen’s personal success story comes to mind.

Here’s where it really gets interesting.  In Part One, Dyslexia and the Eye, Dr. Corkum writes that near the end of his fifth year in medical school, “his dyslexic reading extremely fatigued the orbital muscles” and was the basis for him dropping out of the program.  He hired a reading specialist to help him, undertook a Master’s Degree at Claremont Graduate School with an emphasis in Reading, and earned his Ph.D. at La Jolla University where he dedicated himself to helping others with dyslexia including helping teach inmates to read at a prison located guess where?  The irony is too much.  It was in Santa Ana, CA, which was to become the future home of the Optometric Extension Program Foundation.

On p. 8 of his ebook Corkum highlights his theory on the importance of peripheral vision to reading.  In bold letters he writes: “Peripheral vision is so important that we must insure its retention even before we start to teach beginning reading.”  Corkum, citing no literature references, proceeds to emphasize how to probe and develop peripheral awareness.  One wonders if Corkum had any influence from behavioral optometry, as we have long utilized these concepts in vision therapy, as reviewed by Marrone.  He concludes Part One with noting how crucial it is to develop visual attention along with peripheral awareness.  This may be familiar to you from the work of Solan in the latter stages of his prolific research career.

Jerome Lettvin was a brilliant cognitive neuroscientist at MIT who passed away quietly this April at the age of 91, a mere kid in the eyes of Collin Corkum.  He was perhaps best known for his 1959 paper, What the Frog’s Eye Tells the Frog’s Brain, one of the papers that Steve Cool would always cite to show the folly of dissociating eyes from brain in discussions about dyslexia. Along with his colleague Gadi Geiger at the Center for Biological and  Computational Learning in the Department of Brain and Cognitive Sciences at MIT, Jerry Lettvin published a paper on their view of dyslexia.  Published in 1997, the paper reviews their research, largely done in the 1980s, work which led to Dr. Don Getz importing them to a COVD meeting around that time to present their work.

As you can see from not only Geiger & Lettvin’s work, who refer to peripheral awareness as the Form Resolving Field (FRF), and from other researchers who derive the same concept from a Periphery-to-Center Ratio (PCR), Corkum’s basic idea is correct though overly simplistic.  A significant visual problem in dyslexia is not that peripheral vision is narrow or tunneled.  In some respsects it’s actually too good in terms of its extent.  Dyslexics have a wider window to the right periphery when reading; the problem is that the non-selectively of this extraneous information interferes with the accuracy or efficiency of the normal parafoveal preview that guides the eyes through saccades to the next stop.  In one sense it’s a form of sensory overload which takes a big toll on a crowded printed page, and consistent with reports that dyslexics have difficulty excluding perceptual noise.

Actually, when you read Corkum’s Dyslexia Breakthrough, a significant portion of his material is oriented toward phonemic awareness and hinges on theory very similar to Ken Gibson’s Master the Code.  The best way to approach dyslexia, no matter how you slice it, is to both help an individual find their most efficient way to build better word attack skills, then build an inventory of identified words so that they don’t have to phonologically pour over the printed page.  There are many routes to this, but all successful forms of intervention have in common that they are able to get the brain’s phonological regions to communicate better with the visual word areas.   To be a reader, yet alone a fluent reader, rather than a word caller, eyes must be able to glide through words instead of tripping on them.  Give me mastery of Hart Chart Saccades, Michigan Letter and Word Tracking, and Phonetic Focus with a metronome, and I’ll give you the type of improvement that you can measure on a Visagraph or Readalyzer, and that parents talk about who have a realistic approach to intervention.

I love the tenor of discussion on The Well-Trained Minds forum about Dyslexia and vision therapy.  VT isn’t a panacea, but those children with undetected or unresolved visual issues contributing to dyslexia are being asked to climb needlessly steep hills while in school when the role of vision is discounted.

– Leonard J. Press, O.D., FCOVD, FAAO

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