By Nora Heston Tarte

As parents, we want our children to succeed in everything they do—be it sports, academics, music or hobbies they enjoy. When kids struggle, it can be hard on both child and parent. When they struggle with a necessary life skill—like reading—it can affect many other areas of their life, including other academics and self esteem. Many would be surprised to hear that reading difficulties affect up to 10 percent of people, including those of average and above average intelligence. In fact, 10 million children struggle with learning how to read.
The cause for many reading difficulties—including those with possible diagnoses such as dyslexia, phonemic awareness deficit and visual inefficiencies—is unknown. Some are linked to environmental factors such as how often a student was read to early in life while others show a potential link to genetic makeup.

Visual Inefficiency

“There is no known cause at this time,” said Alicia Feis, clinical assistant professor and assistant dean at Midwestern Eye Institute in Glendale, of visual inefficiencies. However, “there is some speculation that there may be a genetic component to visual inefficiency, but this has not been proven,” she says. Furthermore, she suggests a third possibility that the rise in academic loads is affecting diagnoses of children’s visual efficiency. “We are asking the visual system to be efficient at an early age.”
So what is a visual inefficiency? Children must maintain normal vision as they read in order to be effective readers. When vision is compromised and a child struggles to read for long periods of time, especially from short distances, it affects their ability to comprehend the information and stay on task. Children who experience a visual inefficiency may have trouble tracking words with their eyes, using both eyes together, focusing and/or seeing clearly.
When a child doesn’t appear to be performing up to their potential, parents and teachers can take a closer look at their reading habits to determine if a visual inefficiency is at play. The following is a partial list of potential red flags that may cue a visual inefficiency.

• Use of the finger while reading
• Headaches after reading for a small amount of time
• Eye rubbing after doing near work
• Avoidance of near work
• Reading and re-reading of lines or skipping of lines
• Transposition of letters (especially B’s D’s P’s and Q’s) and numbers
• Inattention or poor performance on a task that requires them to read something in comparison to when something is read and they perform at potential or above
• Covering of one eye when reading
• Double vision when reading
• Words moving around on the page when reading
• Words are unequally spaced when writing on the paper or they often can’t stay on the line
• Squinting
• Poor reading comprehension

If your student exhibits any of these signs and is consistently performing below expectations, consider having their vision checked. Feis recommends going to a pediatric optometrist. “Although all optometrists are trained in the field of vision therapy, pediatric optometrists routinely perform specialized testing for patients that have been struggling in school and/or with reading,” she explains. “Many are often residency trained in this area and most provide vision therapy in their offices.”
If a problem is detected, remain positive. In many cases, there is a cure for visual inefficiency. “Depending on the diagnosis, sometimes glasses or contact lenses can fix the problem,” Feis says. In addition, vision therapy, which focuses on specific movements and activities that enhance binocular vision skills used for reading, can be utilized to increase the efficiency of the eye movement skills to make the student a better reader.
“They focus on getting the two eyes to work independently at the same level and then work on coordinating the eye movements so that when used in a reading related task the reader can focus on the content of the story and not just the words on the page,” she says. “With good compliance in a vision therapy program this is a very treatable diagnosis.”

Phonemic awareness deficit and dyslexia

Phonemic awareness is classified as the ability to distinguish and manipulate phonemes, or the smallest units of speech that carry a sound. It is often used as an indicator of whether, or not, someone will be a good reader and speller.
When a deficit in this skill occurs, it means a child has trouble connecting the sounds of language to letters. They often can’t listen inside of a word and separate the sounds within it. It can be a key indicator that a person has dyslexia—a term that encompasses all disorders that involve difficulty in learning to read or interpreting words, letters and other symbols without affecting general intelligence.
Children who experience phonemic awareness deficit or dyslexia often display the following signs:

• Guesses when reading
• Memorizes spelling words for test
• Spells poorly when writing
• Avoids reading aloud
• Mixes up letters in words (first/fist, form/from)
• Unexpectedly poor reading skills
• Weak in reading vowels

If a child exhibits these issues and also consistently performs below expectations, parents and teachers should take the necessary steps to determine if there is a larger underlying problem.
“Assessment is the first step,” says Pam Rupprecht, owner of The Reading Clinic in Tempe. “Identifying dyslexics early offers them the best chance to be successful readers.” If an assessment suggests a problem, get informed. Parents can join the International Dyslexia Association and attend conferences to learn the newest advances in treatment and become advocates for their children.
There are existing treatments that can help a child experiencing these issues get better at reading, as well. Through therapy, students can relearn to interpret text through research-based multisensory methods.
“In my practice, the most effective methods involve training the right hemisphere to do what the left hemisphere is not efficiently transmitting,” Rupprecht says, likening it to how blind people learn Braille. “Some dyslexics can compensate by memorizing or using their visual cortex to make pictures of words to make up for their flagging sound system.”
Having dyslexia does not mean a person cannot be successful—Anderson Cooper, Steve Jobs and Albert Einstein all have/had dyslexia. The key is finding competent therapists that can help children establish new neural pathways for both reading and writing.
Over the years, doctors have determined several risk factors that could contribute to dyslexia, including premature birth, chronic ear or respiratory infections, genetic predisposition, an injury to the left hemisphere of the brain and seizures. If your child falls into any of these categories and is experiencing difficulties with reading, it’s important to get them checked out.

Regardless of a child’s specific diagnoses, the blueprint for treatment is fairly clear-cut for parents when it comes to reading issues and can be broken down into three easy-to-follow steps:

1) Monitor a child’s attitude toward reading as well as their reading habits to determine if one of the aforementioned reading difficulties could be at play.
2) Get a professional diagnosis, if applicable.
3) Seek therapy.

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