The Role of Visual Processing in Reading Disorders

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Thanks to our colleague Dr. Dan Fortenbacher for pointing me in the direction of an intriguing article published 27 October 2015 in the Educational Psychology section of the journal Frontiers in Psychology.  The article is part of the research topic Phonological and visual processing, reading and writing skills in children with dyslexia and ADHD.  This original research article by Kibby and colleagues at the Department of Psychology and Center for Integrated Research in Cognitive and Neural Sciences of Southern Illinois University, titled Visual processing in reading disorders and attention-deficit/hyperactivity disorder and its contribution to basic reading ability, was funded in part through grants from the NIH (National Institutes of Health) and NICHD (National Institute of Child Health and Human Development).


The visual processing test used in this study was the TVPS-R (Test of Visual Perceptual Skills – Revised), and the three sections utilized were Visual Discrimination, Visual Memory, and Visual Sequential Memory.  Here is a key figure from the paper:

Kibby - Frontiers - Graph

This bar graph shows the TVPS-R marginal means for each group adjusted for the covariate, Verbal Comprehension Index (VCI) results of the WISC III/IV. Error bars were derived using Standard Deviation (SD).  A single asterisk (*) demonstrates results that are significantly different from the control group.  A double asterisk (**) demonstrates results that are significantly different from both the ADHD and control groups.  You’ll notice that Visual Sequential Memory was significantly poorer in the Reading Disability group (RD) but neither Visual Discrimination nor Visual Memory was.  Notice as well that the poorer VSM was even more pronounced in the Cobmorbid group having both ADHD and RD.

The raw data presented in a table in the paper shows that the results for all three TVPS-R subtests were poorer in children with RD than in the controls, but the statistical power was most impressive for VSM.  The p value for VD was 0.026; for VM was 0.005; and for VSM was <0.001.  The take home message here is that Visual Sequential Memory as a visual processing skill appears to be particularly significant for children with RD, and even more so if they have comorbid RD and ADHD.

What optometric vision therapy procedures do you employ to engage and cultivate VSM?

15 thoughts on “The Role of Visual Processing in Reading Disorders

  1. VSM/part and simultaneous/whole memory is probably on a continuum. If you rely more on VSM, you are less likely to see patterns within words as you are relying more on the parts. Phonics may be overemphasizing parts, but if done in a fashion with patterning of more simultaneous patterns, more likely to take hold. The key to reading is your anticipation to predict what is coming up, not simply stimulus-response with letters. Letter sound correspondences are variable, visual patterns are more consistent. That is why letter names always shows up as a key to successful reading…not the sounds. They are consistent.

    Similarly in ADHD, kids are stimulus bound to the parts of their world. Simultaneous processing allows them to see and make relationships between objects in their world. They can attend longer and load memory. Thanks for sharing!

  2. In 2010, I read a book by Addie Cusimano, M.Ed. Learning Disabilities:There is a cure. The key associated phenomenom with the diagnosis of RD was Sequential memory dysfunction both auditory as well as visual. After reading that, I concluded that many of our mis-labeled patients were needing more visual processing skills than our opposing colleagues assume.

    Daniel L. Weinberg, OD, FCOVD 4414 Shelbyville Road, Suite 204 Louisville, Kentucky 40207 Phone (502)894-4434 Fax (502) 894-9912

    • I always wonder if when someone is classified with “sequential memory dysfunction”, are they perhaps “overly” sequential in processing. By working visual processing, we are generally more simultaneous(picture worth a thousand words). When you overwork auditory-you are generally more sequential(you have to remember all the words!).

      • As is generally my philosophy, I believe there’s a lot of complexity here than we try (most often of necessity) to simplify. As with other seeming dichotomies (C/P; Ambinent/Focal; Magno/Parvo etc.), I don’t see it as productive to overclassify simultaneous “versus” sequential. A healthy blend of both, and the skill to toggle between leaning more on one than the other as the task dictates, is likely best.

    • Will you determine the condition of intermittant exotropia for a 17-year-old boy, born with an orbital hemangioma of the right eye? Will you prepare vision therapy to intervene in non-convergency of the eyes, that is, reverse this condition? Dr. Carol Scott of Springfield recommended you.

  3. This knowledge should be part and parcel of a standard Optometric education. If not, than Functional/Behavioral vision care should be regarded as a specialty requiring additional formal education and certification. Then, the standard Optometric education should include the information necessary to detect such disorder and the proper procedures to refer such cases to certified Optometric specialists.

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