How Vision Can Support or Delay Learning in a Child with Down Syndrome: Part 2

NOTE: This is the second article in a multi-part series about vision and individuals with Down syndrome. Read part one.

Individuals need several important visual skills to navigate their environment and participate successfully in daily activities at home, school and work. This article will focus on the visual component, specifically on visual efficiency skills and eye movements.

Visual efficiency refers to the effectiveness of the visual system to gather visual information clearly, efficiently and comfortably. Eye movements and binocular vision skills (the ability of both eyes to work together as a team) are the primary visual efficiency skills. There is a higher prevalence of strabismus – eyes that turn in, out, up or down – in individuals with Down syndrome. Learn more about visual efficiency and the importance of addressing strabismus at an early age in Part I.

Eye movements include two key skills: saccades and pursuits.

Visual saccades are rapid eye movements that allow an individual to quickly scan a visual scene. Visual saccades can range from small movements like reading a book and scanning across the page, to larger movement such as scanning a room looking for someone. For school-aged children, difficulty coordinating these rapid eye movements can affect a child’s ability to read comfortably, quickly and with adequate comprehension. Individuals with poor visual saccades often lose their place when reading, skip lines or use excessive head movements which can negatively impact reading and comprehension of the material. Children with saccadic dysfunction may also seem to have a poor attention span due to how often they lose their place when doing schoolwork.

Visual pursuits are the coordination of eye movement as both eyes follow a moving object. For example, the ability to follow a moving ball as it approaches during a soccer game or following a moving car that passes you before changing lanes. Like saccadic eye movement dysfunction, difficulties with visual pursuits can negatively impact reading and reading comprehension. Additionally, difficulties with visual pursuits can lead to difficulty with driving, sports and other activities in which the individual is moving or the object (a ball, for example) is moving.

There are standardized tests that can evaluate a child’s eye movement skills including visual saccades and pursuits. You can schedule an appointment with an occupational therapist or developmental optometrist to have your child’s eye movement skills evaluated.

If you have concerns about your child’s ability to read and learn, you can have their eye movement skills evaluated to see if this difficulty could be negatively impacting your child’s school performance.

It’s important to note that children do not fully develop their eye movement skills until 7 years old, and it is normal for children younger than age 10 to move their head when completing visual saccades and/or pursuits.

To have your child’s eye movement skills or other vision skills screened at Children’s Hospital of Philadelphia, call 215-590-5819 to schedule a remedial vision evaluation with the occupational therapy department, or 215-590-2791 to request an appointment with the Division of Optometry. Lindsey E. Perno, OD, can provide a vision evaluation that includes assessment of the child’s eye movement skills.

If your child is found to have decreased eye movement skills for their age, your child’s occupational therapist can provide intervention to improve their eye movement skills.

Jordan Porter, MS, OTR/L, is an occupational therapist on the rehabilitation team at Children’s Hospital of Philadelphia.