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It has been presumed that children who reverse letters or words see them backwards. This is false. They have directional confusion. In the real world direction has no meaning. For example, a chair is a chair no matter which way it is placed. Changing direction does not change interpretation. In the world of language direction changes meaning. Connect the bottom of a chair and it looks like a "b". Turn it 180 degrees it becomes a "d", flip it upside down and it becomes a "q" and flip it again it becomes a "p". Thus, direction changes meaning. The difference between "was" and "saw" is direction.
Reading requires very accurate saccadics, which are fixations from one spot to another. Children who have poor eye movements are easily distracted and lose their place. Remember, the eye movement system was designed so that peripheral vision detects motion and danger. Imagine what happens when the system works correctly in the class room. As soon as there is peripheral movement, the eyes move toward the source of movement. This results in the complaint of inattention. Thus, reflexive eye movement skills must be socialized so that they do not respond reflexively to peripheral information. In addition, speed and accuracy must be trained so that one does not lose one’s place.
The skills are easily improvable with vision therapy. Once the information is brought into the eyes, it must be sent back to the brain for appropriate processing. The information must be utilized and integrated with the sensory and motor areas of the brain. Defects in the perceptual (interpretation of visual system) and motor (the integration with output, e.g., hand-eye coordination) may interfere with the reading process. Perceptual motor skills are key in the early acquisition of reading skills. A deficit is important to identify very early on-- i.e., five to seven years of age. Remediation of the skills at a later date, such as age 12, will be less effective for reading. Thus, early identification and treatment is essential. It is evident that there is more to good vision than 20/20.
