Sometimes you come across a synopsis of a complex subject that is so concise that it deserves a wider audience than its original source. That is my intent in sharing an explanation of Skeffington’s Circles by vision therapist extraordinaire, Tom Headline, COVT. It actually popped up in my Facebook feed yesterday morning, having originally been posted by Tom on the Vision Therapy Parents Unite page in 2017. Without further fanfare, here is Tom’s response to a poster who queried: “Can anyone explain skeffington’s concept of vision in totality??“
I don’t know if I’m officially qualified, but I’ll give it a go. I do love to include a discussion of Skeffington’s 4 circle model of vision when I am lecturing to vision therapists who are new to the field so that we can have some common language to discuss the concepts which follow later in the course. I am sure there are others on here who can provide more of a historical account of when Dr. Skeffington came up with the official model; however, I’ll discuss some of the items I am familiar with and count on others to add to the discussion as well. There are many journal articles that have discussed Dr. Skeffington’s model in much more depth than would be practical for a FB post, but I’ll try to be brief.
Basically, Dr. Skeffington looked at 4 primary questions that vision provides us an answer. The first question involves, “Where am I’ in space. This was termed ‘Anti-Gravity’ and refers to an individual developing general motor control (working against gravity), learning how their own bodies/limbs/extremities, etc. work. We need to have a solid understanding of our position in space and how our bodies work, so that we can eventually be able to direct the finer muscles of the eyes effectively. The next question involves, “Where is it” in space, which is referred to as ‘Centering”. So, once I understand where I am in space, next I become aware of things around me. This involves our eyes moving to those object and would also involve binocular vision to provide the depth perception so I get a more precise understanding of how far away that object resides in space from me. The next question involves, “What is It?” which is termed ‘Identification’. Here is where things like 20/20 visual acuity would reside and the ability to adjust our accommodation and also the area of getting meaning from what we are observing. The question involves, ‘What about it?” which is referred to Speech-Auditory. This would involve the ability to process that which you are observing and can you now communicate that to the outside world? Dr. Skeffington used the overlapping model of the circles to illustrate that the intersection of all of the circles signifies what ‘Vision’ really is…Unfortunately, for those professions who only look at 20/20 visual acuity, they are limiting vision to a very small piece of the overall puzzle. As a vision therapist, it is important for us to have a working understanding of this because we may see our patients struggling in activities of daily living and better be able to identify those VT procedures that would target the specific areas they need assistance with. Also, we are able to have a better understanding about their visual strengths and have some framework to build upon. So, I hope this helps a bit.