Vision therapy does not only treat functional vision disorders but perceptual ones as well. A visual processing disorder is not a physical disability of the eye, but a deficit in the brain’s ability to identify, organize, and process visual information. A person  can have 20/20 vision and still have a visual processing disorder. The eyes are purely a vessel to transmit what the brain sees. Having this disorder does not mean that one has an attention disorder, intellectual disability, or learning deficit.

It is not clear how many people are affected by vision processing disorders because they are not easily diagnosed or recognized by teachers. Read through the symptoms below, and if you believe your child is experiencing a visual processing disorder, do not hesitate to make an appointment with a developmental optometrist!


  • Difficulty discriminating between certain letters/numbers
  • Omit, substitute, repeat, or confuse similar words
  • Confuse left/right directions
  • Difficulty with sizing, spacing, or copying written words
  • Reversing numbers/letters
  • Easily distracted by too much visual information
  • Difficulty writing within lines or margins
  • Difficulty completing puzzles
  • Trouble spelling or recognizing familiar words with irregular spelling patterns
  • Eyestrain

There are several different types of visual processing skills needed for both academic and daily success. Those skills include:

Visual discrimination: the ability to identify similarities and differences in visual images such as shapes, sizes, colors, objects, and patterns.

  • Ability to quickly see the small details in things
  • A child might have difficulty distinguishing between similar letters such as b, d, p, and q.
  • Treatment Example Activity: Attribute blocks: We have blocks of different shapes, sizes, thickness, and color. We work with the patient on being able to quickly recognize all of the differences and similarities.

Visual memory: the ability to recognize information about what one has seen (short or long term).

  • Treatment Example Activity: We use blocks of differing shapes and colors and arrange them to form a design. The patient has as much time as they need to memorize this design. It is then covered up, and they have to recreate it from memory.

To ensure a child is using their visual memory as opposed to auditory, we sometimes have them listen to music or sing the alphabet while they are memorizing.

Spatial Relations: the ability to be aware of oneself in space. An organized knowledge of objects in relation to oneself in that given space (even when there is a change of position).

  • Issues with this can manifest in being clumsy, bumping into things, and knocking things over.
  • This can affect handwriting as well as they may have difficulty with the spacing of letters and words.
  • Treatment Example Activity: Estimating Distances: The patient must use their spatial reasoning and visualization skills to guess how many of their feet (heel to toe) it will take to get to a certain point. Their errors show them the difference between their perceived judgment of distance and the actual distance.

Form Constancy: the ability to identify or sort objects, shapes, symbols, letters, and/or words despite differences in size or position (or when viewed from a different angle or in a different environment).

  • This can cause difficulty recognizing words they know that are presented in a different manner.
  • Treatment Example Activity: Mirror rotations: We have them practice writing letters, shapes, etc. as a mirror image. We use an x- and y-axis so that they have to flip the image both horizontally and vertically.

Sequential Memory: the ability to remember a series of forms, numbers, letters, objects in order.

  • Treatment Example Activity: Visual Presidents: The patient is presented with a series of images each representing a president (ex.: a picture of a mad sun is Madison). After learning what each picture represents, they practice recalling the presidents in order simply by looking at the pictures. This also exercises their visual memory.

Figure-ground: The ability to identify a figure from its background.

  • You see words on a printed paper as the “figure” and the white sheet as the “background.”
  • This affects the ability to easily complete things such as crossword puzzles and word searches.
  • Treatment Example Activity: Magic Eraser: Letters and words are hidden within a combination of shapes, the patient must guess and find the word/letter within the shapes and then create their own.

Visual Closure: the ability to recognize an object, letter, or number without seeing all of the object (visualizing a complete whole).

  • Treatment Example Activity: Multi Matrix: The patient completes a puzzle in which they move blocks around in the order they are presented on a card. The card has incomplete images on it, but the blocks have the complete images.

Visualization: The ability to form a mental image.

  • The inability to visualize makes it difficult to process texts as a whole and see the story in a patient’s head as they are reading.
  • Treatment Example Activities: We give the patient an image to picture in their head, and they must manipulate that image how we tell them to (turning a yellow pencil blue).
  • Another activity we like to use is called word movies. They are given a series of words which they must create a story out of.

A visual processing disorder can not only negatively affect a child’s academic success but their self-esteem as well. Understanding what to look for is the first step on the road to increasing your child’s confidence in reading and learning!

-Emily Thompson, Vision Therapist

Center for Vision Development

Phone: (615) 791-5766
Fax: (615) 791-5767

400 Sugartree Lane, Suite 310
Franklin, TN 37064

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