Visual Perceptual Disabilities

Following a full standard eye examination, to exclude any refractive error or visual efficiency concern. Your optometrist may recommend what is called a Vision Perceptual evaluation.

At this point we know the eyes can see (with or without glasses) and are focusing properly.

The visual perceptual tests probe the child’s ability to understand, interpret and remember what they see, together with their ability to link vision to language. All tests used are standardised, enabling us to determine whether your child’s present visual perceptual development is at the expected level for their age/grade.

A visual perception evaluation is recommended for children from age 4 (with no upper age limit) who are:

  • Needing assessment to ensure they have the ‘readiness’ visual skills for school.
  • Experiencing learning difficulties.
  • Not performing academically at the level that it is felt they should be capable of.
  • Appears to have problems with some of the visual aspects of learning.


A visual perceptual assessment will take approximately 1.5 hours. We usually will schedule these first thing in the morning, so a child is fresh.


What will be determined following a visual perceptual assessment?

Recommendations made following assessment will be individual to each student. There may be the need for Vision Therapy, a program of exercises and activities specifically designed to enhance the child’s areas of visual weakness.

Some students will also show the coexistence of other potential difficulties and will recommended referral to other practitioners including educational audiologist, speech pathologists, occupational therapists and educational psychologists.

Visual perceptual evaluations are not billable under Medicare and a gap payment will be required.


What is a visual perceptual problem?

Even if our eyesight is normal and we do not need glasses, some of us get the messages that are sent from our eyes to our brains mixed up. It means that we have difficulty interpreting what we see – we see things differently than other people see them. When our eyes play tricks on us like this, we have a type of learning problem called visual perceptual disability.


Following are some examples of what it is like to have a visual perceptual disability:-

Sometimes we mix up letters that look alike. Instead of seeing ‘b’ we see a ‘d’, ‘g’, ‘p’ or ‘q’. When we are reading we can’t automatically see which letter it is.

We might read ‘god’ or ‘pop’ instead of ‘dog’,

‘peg’ or ‘bed’, instead of ‘beg’;

or put ‘put’ or ‘gut’ instead of ‘but’.


Other letters that might confuse us are:

‘m’ and ‘n’   or ‘n’ and ‘h’.

So we see ‘mose’ instead of ‘nose’ or ‘hot’ instead of ‘not’.

A story can be pretty confusing when you cannot read some of the most important words! And it is pretty embarrassing when you read out loud and everybody hears you making one mistake after another. That’s why we hate to read out loud unless we know for sure that we know all the words.

Letters aren’t the only things that confuse us. Shapes sometimes look alike too. We might not see the difference between a square and a rectangle.


We may also mix up numbers because they look alike to us.

‘6’ and ‘9’, ‘3’ and ‘8’, ‘2’ and ‘5’ and ‘4’ and ‘9’ are real toughies! Lots of numbers together are especially difficult, like 9496273. It looks harmless, but can really throw you when you have a learning disability.


We may even confuse letters and numbers.

‘E’ may look like ‘3’ or ‘5’ might look like ‘s’.


Sometimes we see whole words or letters and numbers upside down. For example:

‘on’ seems like ‘no’,

‘was’ might appear as ‘saw’,

‘sung’ seems like ‘snug’,

or ‘720 becomes ‘270’ or ‘072’ or ‘702’ or ‘207’.


We might see all the letters of a word but see them all in the wrong order:

‘spot’ is seen as ‘pots’

‘lisp’ comes out ‘lips’ or ‘slip’.

That would certainly change the meaning of a sentence! It could come out: ‘When he fell, he cut his slip!’


Or we get the words in a sentence mixed up.

Instead of ‘He lived in the house under the hill’, we might read: ‘He lived under the house in the hill.’

It sounds funny, but it’s not funny when you are taking a test that is important to your grade!


Sometimes we might also have trouble with focusing and teaming our eyes, so the letters and words might go blurry or look as if they are moving or the words might seem to run into each other, like this:


Fortunately, reading glasses are often an easy solution for these problems, and often we will outgrow the need for them as we get older.


Sometimes we have eye-tracking problems as well, so the words might do a crazy dance like this:

W R             E M       O   D     C E   L O E         H     L             E

O         S               T     N   A                   V   T                   A

DS   E                                     A   L       R     E   P             C


When words seem all mixed up like this, we often skip words or whole sentences, or we read them twice.

Math book pages can be confusing too. The math book page seems like a jumble of confusing numbers spread all over the page. Sometimes it’s hard to tell where a problem begins and where it ends.

Sometimes we make mistakes because we can’t tell if we are supposed to add, subtract, multiply or divide because the symbols (+ – x ÷) look the same to us.

We may also have trouble telling time because the hands on the clock look the same length to us. Counting money is hard when you can’t tell the difference between the coins.


Visual perceptual problem’s make it hard to read, write, copy and to do math. But they also make it hard to do other things like:

  • Buttoning buttons
  • Tying shoelaces
  • Cutting with scissors
  • Colouring within the lines
  • Reading a map
  • Reading music

 Vision, reading and learning are complex processes. A child’s difficulties with reading or learning can be the result of multiple factors. The role of vision in learning is to allow the person to maintain good attention and concentration easily, without experiencing blur, discomfort or double vision. Vision guides fine motor control when writing and helps us understand spatial concepts. Because vision is a sense that we rely on heavily, even relatively mild dysfunction in the automatic operations of vision can, for some people, result in significant difficulties with attention, concentration and visual comfort. So regardless of the primary cause of difficulties with reading or learning, treatment of vision problems is important in any person not achieving his or her potential.