Here is a Vision Assessment Checklist you can download to help determine whether your child’s reading problem could be related to undiagnosed vision problems.
There are other vision skills checklists, but the problem with most of them is that it is hard to sort out whether items are checked because a child is frustrated, misbehaving, doesn’t know how to read, or has other issues going on in his life. On this form I've attempted to narrow the questions down to those most pertinent to reading problems that are caused by vision problems and also to rank each item’s relative importance.
Explanation of the Checklist Items
The checklist is divided into six sections, depending upon who makes the observations and when they are made. The website address of this page is also listed on the checklist so you can return here later to review the information below.
The number at the left is intended to give you some perspective as to how important any particular observation is, with the higher numbers indicating that you should be more concerned about a vision problem. The numbers are not intended to be added up, but if your child has just either a couple of 4’s and 5’s checked, or a lot of lower-numbered items, you should consider having him examined by a developmental optometrist.
Section 1: These observations are made by the parent. The first item refers to a parent having an obvious vision problem unrelated to acuity, such as a lazy eye. However, very few parents who had a vision problem as a child actually realize that they had one, or even that they still might have one.
Instead, they will remember that the early years of school were very unpleasant because they were not able to keep up with others in reading. That is why item number 2 is asked.
The third item is another way of determining whether dyslexia is running in the family.
The last two items have lower points because, by themselves, they don’t necessarily indicate vision problems.
Section 2: This section covers observations made by the child. If your child volunteers information that he is experiencing any of these five behaviors, count yourself fortunate that he has provided you with all the information you need to justify having him evaluated by a developmental optometrist, even if he can read as well as his peers. These five symptoms are each strongly indicative of problems with your child’s visual system, but many children won’t realize they are even going on because that’s the way it’s always been for them. They all have 5’s because they are each important on their own.
Many children learn to read (though they might struggle at it for a bit) but still have vision problems that are getting in the way of them meeting their potential. If your child gets headaches when he reads, and your family optometrist says his acuity is fine, take him to a developmental optometrist for further evaluation.
Section 3: In this section observations of the child are made by the parent and the behaviors tend to occur any time during the reading process, including right away when the child starts reading.
The first two sections had high numbers in front of the items because they almost always indicate vision issues. This section, assuming none of the items in the first two sections were checked, is tougher, which is why the numbers range from 1 to 5. A child who consistently covers one eye almost certainly has something going on visually and so it gets a 5. On the other hand, while a vision problem might cause a child to prefer finger tracking, a lot of younger children track print with their fingers and learn to read just fine, so it gets a 1 assigned to it.
Section 4: In this section observations of the child are made by the parent and the behaviors tend to occur after the child has been reading for at least a page or so.
These are the reading behaviors that result from an inability to sustain the effort of reading or doing other close-up work because the child’s visual skills are not well developed. Here, too, the numbers reflect the importance of the behavior being observed. The lower-numbered items might also be symptoms of other reading issues, such as having been poorly instructed and getting frustrated at not understanding how print works, for example.
These are also the behaviors that are demonstrated by a child who can often pass a standard optometric test battery easily. This is because the signs of visual discomfort don’t manifest themselves right away. The child can converge his eyes on print for a time, but he can’t sustain the effort. He passes your family optometrist’s tests, but fails the more extensive testing done by a developmental optometrist.
Section 5: This section covers handwriting skills and should only be considered in conjunction with a child’s reading problem. That is, if your child’s handwriting is terrible, but he reads fine, and your family optometrist sees no problem, don’t be overly concerned about items in this section. Nevertheless, children with vision issues do manifest these symptoms regularly, so this section is added for further confirmation of a vision problem.
Section 6: Frankly, this is the fall-back section. A child who has no other symptoms on this checklist, but hates to read should be seen by a developmental optometrist to rule out vision as the reason. Similarly, a very young child who just can’t seem to pick up the concept of how print works, but otherwise has normal intelligence, should probably have his vision checked.
The hardest referral I ever made was in just such a case. Only later did I find out that one of the parents struggled with reading in the early grades. This section is on the checklist to make sure that a vision problem is ruled out when reading problems persist and it assumes that a child has had sufficient phonics instruction as well. Children who don’t understand how to read will manifest symptoms in this section but might not have vision problems.
If the results on the Vision Assessment Checklist suggest the existence of a vision problem, your next step should be to have a developmental optometrist assess your child's vision. The information on the next page should help you find one.