Where What When

Tips for Teachers and Parent - Simple, Low-Cost Learning Accommodations

by Shoshana Shamberg OTR/L, MS

Why are reading and attention span difficulties, migraines, and stress-related sensory processing problems increasing among school-aged children? Why are adults increasingly complaining of stress-related conditions? Could it be because both children and adults are spending most of their time sitting still for long periods under artificial lighting, working at their school desks or computer screens? The lack of movement, as well as auditory and visual stress, can affect our ability to listen, understand, and remember what we read or hear. It can also affect our ability to relax and use our bodies comfortably. Such stress may even lead to illness and learning disabilities, and then to low self-esteem, chronic depression, pain, and anxieties.

These issues often follow a person into the college and work environment, and affect his or her ability to successfully sustain employment and personal relationships. Many of these people are intelligent, but their performance and test scores do not indicate their abilities, and they often give up in despair and see themselves as stupid without really understanding why.

For parents, it is frustrating and overwhelming to weed through the maze of resources and interventions in order to address each child's unique challenges, not to mention the high cost involved. For society, the tax dollars going into prisons, drug rehabilitation, and unemployment is rising even though modern medicine and technology has been trying to find answers for decades.

Simple Solutions

Fortunately, there are some simple assessments that can be tried first. For over 30 years, I have researched these simple solutions and implemented them in public and private schools, at jobsites, and in my private practice. Many were introduced to me by my friends and clients, rather than the professional training programs within my career track. They include Brain Gym sensory-motor exercises, simple mental exercises, nutritional interventions over medications, and visual perceptual technologies like the Irlen Method.

No one intervention works for everyone, and that is why careful assessment is recommended. However, the following suggestions can be implemented by anyone in a school, home, or work environment, and may minimize or eliminate the need for support services, therapies, specialized schooling, and long-term tutoring. Math and reading can become enjoyable learning experiences, with less fidgeting and increased fluidity, accuracy, focus, and memory.

1) Positioning and movement: When students or workers sit at a desk with proper alignment, it is less fatiguing on the neck, shoulders, back, and eyes. They are more relaxed and able to attend to their tasks. Feet should be flat on the floor, with hips and knees at 90-degree angles and the back supported by a chair with back support. Forearms should rest on the desk comfortably, not too high or low. (Diagrams for proper positioning are available upon request.) Periodic stretching and vision-exercise breaks release tension and enhance mental function.

2) Lighting: Many people are sensitive to glare and fluorescent lighting. The discomfort is perceived through the symptoms like eye strain, headaches/migraines, neck and back pain, fidgety behavior or fatigue. The light sensitive person may prefer to read in darker than normal lighting, and may read better at home under incandescent lighting than at school or work.

Help this person by lowering the intensity of the light, and/or allowing natural lighting into the room. Wearing a sun visor or baseball cap helps filter out adverse glare from fluorescent lighting or bright daylight. In addition, a tabletop cubicle made from a decorated box provides an enclosed space to minimize visual distraction, as well as glare.

In many cases, light sensitivity is caused by a visual perception issue known as Scotopic Senstivity Syndrome, or the Irlen Syndrome. This syndrome, which often mimics dyslexia and ADD/ADHD, is detected through an evaluation by a professional trained and certified in the Irlen Method. Those with this syndrome can get relief by using simple color overlays ($7) or lenses that filter out adverse light frequencies. Reading with the specially prescribed color overlay minimizes glare and visual distortions considerably.

3) Written materials and writing: Some children simply need larger print materials or a way to reduce the discomfort of reading black letters on a white shiny paper. The teacher can photocopy text on different colored papers from any office supply store and ask the student which color is more comfortable and makes the letters easier to read. Reading aloud can also help the teacher determine which color is easier for the student to read from.

Use graph paper for math assignments to ensure that columns line up accurately, which prevents needless mistakes.

For proper letter and number formation, use specially lined paper to minimize visual confusion. (The Handwriting Without Tears company sells lined paper resembling Hebrew notebook paper, which is ideal.)

An angled desktop or easel, like a large tabletop shtender, provides ergonomic positioning and comfortable vision when copying from a blackboard or reading and writing in an upright position. Make one yourself from notebooks, rubber bands, and a clip. (Directions are available upon request.)

Use a tiny pencil to facilitate pincer grasp or, alternatively, try a variety of pencil grippers to see which one is best for the student.

Soft pencils make a darker mark than regular pencils and are less fatiguing to the hands.

Shorten writing assignments to test for knowledge without the stress of too much handwriting or keyboarding. Instead of sentences and essays, use methods like circling the answer or filling in the blank.

4) Math skills: Check to see if has trouble reading math symbols, numbers, and columns, especially during sustained attention. If the child is accurate in the beginning of an assignment of the same level of difficulty but makes progressively more mistakes, and has difficulty sustaining attention, it is likely due to fatigue and possibly visual distortion, not lack of knowledge. This must be addressed by a vision specialist or appropriate professional, or the child may be at risk for greater levels of learning problems. While the child may compensate somewhat, he will be under undue mental and emotional stress. Try copying work onto color paper, with more spacing and larger type, to see if accuracy and attention improve.

Other written materials, like musical scores, standardized test sheets, and computerized assignments, may also be very difficult to decipher and use.

5) Visual perception and motors skill strategies: Have the child close one eye and read; then switch eyes. If the child states that reading and seeing the type are more comfortable with one eye, this may indicate a vision problem related to how the two eyes work together (binocular vision). If impaired, it can affect performance in reading, writing and other activities involving seeing up close.

If a child has trouble following an object or looking across and up and down the page without moving his head - or if the eyes look jerky as they move and he has trouble finding and keeping the place, or if he cannot accurately catch a ball - there may be a visual motor deficit that can adversely affect academic learning and sports performance.

Visual stress in childhood as well as adulthood can be mistakenly diagnosed as a learning disability, like dyslexia, or various mental conditions related to anxiety, attention deficit and more. But when the visual stress is addressed successfully, other sensory systems, such as auditory processing and tactile sensitivities, are helped as well.

A traditional eye exam may not pick up these problems. A developmental optometrist, educational psychologist, or specially trained occupational therapist is trained to assess these issues and will also have ideas for intervention.

6) Behavioral and psychological challenges: Children and adults may exhibit symptoms resembling ADD/ADHD, oppositional defiance disorder, and severe depression or manic behavior. Their behavior may actually be due to stress overload caused by the inability to process sensory information and to balance mental, physical and emotional skills. Compensation techniques may increase functioning, but the person is still working much too hard to accomplish what others do with much less effort.

Specialized sensory-motor exercises and controlling the environment can make a huge difference in behavior. A trained specialist can assess the person and provide ideas for implementation at home and school. Some of these might be extended time for assignments and test taking, books on tape, using a computer, shorter assignments, a less distracting environment, ear phones to block noise, periodic sips of water to address dehydration, healthy snacks to prevent low blood sugar, and scheduled breaks to recharge.

These are just a few of the many problems and solutions that can be easily implemented without undue cost or time. They may save thousands of dollars in specialized services and help maximize the performance of students and adults in school and work environments. For a list of resources and more ideas, email Shoshana Shamberg, OTR/L, MS, at IrlenVLCMD@yahoo.com or call the Irlen Visual Learning Center of MD at 410-358-7269. I am offering free phone screenings and free in-service training for parents, teachers, and therapists in assessment and implementation of low-cost learning accommodations.

Mrs. Shamberg is a Special Education Consultant and Certified Irlen Screener/Diagnostician and Brain Gym Consultant. She is president of Abilities OT Services and Seminars, Inc. and co-director of the Irlen Visual Learning Center of Maryland.

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How to Track Improvement

As you implement the strategies in this article, use the following list of adverse symptoms to track any improvement. First eliminate the symptoms that do not apply, then track those that do, using the scoring key at the end of the list.

Comfort level with lighting indoors

Comfort level with lighting outdoors

Strain or fatigue

Attention span

Endurance/tolerance for reading

Glare

Blurriness

Words moving, jumping, flickering

White stands out/sparkles

Black stands out

Spacing

Error rate

Fluidity of reading - smoothness/hesitation

Memory for what is read

Comprehension

Losing place/skipping lines

Skip words/add words

Reading for pleasure

Effort to keep place

Using finger to hold place

Blinking/opens eyes wide/squinting

Move up or away from page

Eyes hurt, ache, itchy

Rubbing eyes

Dizziness or nausea

Fatigue, drowsiness

Headaches

Reading musical notes/ scores

Reading numbers and words

Writing reports

Repeats what is read

Stress tolerance

Fidgeting

Problems with stair climbing

Problems with driving/changing lanes

Problems looking at the computer screen

Problems with depth perception, such as parking your car

Color overlays or lenses feel too light, dark, change the colors you see, or cause discomfort after using for a few days

Score on a scale of 0-5: NA (not applicable), 0 (no improvement), 1 (slight improvement but inconsistent), 2 (slight improvement consistently), 3 (moderate improvement), 4 (moderate to considerable improvement but inconsistent), 5 (excellent, consistent improvement most or all of the time

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Article List - November 2009