The Mislabled Child

Assessing and Helping Children with Learning Challenges

The Mislabled Child is one of the first books I would recommend for concerned parents and educators. The authors, Brock and Fernette Eide, are neurologists who were invited to address the College of Optometrists in Vision Development in 2006, due to their enlightened understanding of children with learning difficulties. They recognize that learning problems have neither a single cause nor a single treatment. They explain why children with learning problems require a thorough, multi-disciplinary evaluation based on their signs and symptoms. They also explain who should do the evaluations and how diagnosed problems should be treated.

mislabeled childjpg            While I am partial to the book because one of the first chapters is, Overlooking the Obvious: Visual Problems in Children, it is their over-all approach which is most important. Other chapters in the book address memory, auditory processing, attention, autism, sensory processing, giftedness, and problems with math. The following excerpts are from the chapters on dyslexia and handwriting.

Visual abnormalities have been shown to be present in as many as 80% of children with dyslexia…. These visual difficulties correlate highly with reading and especially with the ability to recognize words by sight.

This ability to perceive letter sequences correctly is important for all aspects of reading, including word decoding and sight-word reading. Any process that impairs the ability to correctly see a sequence of written letters will make it all but impossible to discover the relationships between spoken word sounds and letter symbols…. Unfortunately, this is precisely the kind of visual problem many children with dyslexia have, and it greatly compounds their difficulties learning to read.

Skilled reading is characterized by the ability to recognize whole words (or word parts) “by sight”… bypassing the need for decoding. This visual recognition system is the primary mechanism most skilled readers use when they read, because it’s much faster and more efficient than sound-based decoding. The ability to store a word properly in the visual word form area appears to be at least partially dependent upon the ability to form a stable and consistent visual tracing of the word. Because children with dyslexia often have difficulty forming such stable and consistent tracings, they may also have difficulty both storing and recalling words.

The following are their recommendations:

  • Dyslexic children with extensive visual symptoms such as headaches while reading, eyestrain, blurry vision, and letter wobbling, blurring, switching, or otherwise moving should be referred to a developmental optometrist for evaluation.
  • Dyslexic children with diffuse motor-planning and coordination problems are especially likely to have visual movement problems and should be referred early for a visual evaluation.
  • Dyslexic children with visual symptoms but no demonstrable phonological deficits should be referred immediately to a developmental optometrist.
  • Significant visual perceptual problems also deserve early referral.
  • When a dyslexic child with phonological deficits has received a course of phonological remediation but has failed to make the expected degree of progress, an evaluation from a developmental optometrist is in order.


The visual system plays several key roles in handwriting. It provides handwriting feedback, which is especially important when a child is learning to write, before the motions needed to produce letters have become automatic…. Accurate visual input is essential for accurate visual feedback. Children who have problems with visual acuity and focus or eye-movement control in particular can have difficulty monitoring written output. This often results in problems with spacing, letter formation, and following lines.

The ability to integrate visual input with motor output also plays a crucial role in handwriting. This ability is often called hand-eye coordination or visual motor integration.

Visual-spatial processing also plays an important role in word and letter formation and in the proper spatial organization of writing. These children may have difficulty planning and organizing their use of space, such as centering their writing on the paper, observing lines and margins, and giving each letter and word its appropriate space.


Challenges of Decoding

VHG, Education, and Visual Dyslexia

Visual Aspects of Dyslexia