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Reading, OCD, and Light Sensitivity
Q: My 16-year-old has always had trouble reading. She reads very slowly and has a hard time with comprehension. She recently told me that she skips words or sometimes switches them around. She also transposes some letters when she writes occasionally. She seems very aware of this. When reading, she seeks out dimly lit places and really is unable to concentrate in brightly-lit areas.
She also has a history of OCD issues -- a need to be perfect on details that don't matter in the scheme of things. Any thoughts?
A: She may be reading slowly because it's hard for her eyes to process the printed letters and words. She may have visual tracking problems that make it difficult for her move her eyes smoothly across the page. Transposing letters while writing (at her age) signals that she does not have a good visual image of the letters, so that she "draws" them inaccurately. I would have her evaluated by a clinical neuropsychologist, asking him to focus on her visual-perceptual-motor skills. Someone should assess how well her eyes, the visual centers of her brain, and her hand work together. OCD might slow a reader down if she's got some rituals about reading the words at a certain rate, or if she silently "sings" the words in her head, or repeats every third word, or something like that, but it would be unusual.
Your daughter's difficulty with brightly lit areas may be an indication that she's sensitive not to the light itself, but to how it reflects off the page. While somewhat controversial, there is a condition known as scotopic sensitivity syndrome, which attempts to describe this difficulty. Some students find it helpful to put a sheet of soft-colored acetate (plastic you can get at an art store) over the page. They say it cuts down the glare and helps the letters stand out more. You might want to contact an experienced developmental optometrist who can look into the eye tracking issue and the light sensitivity. Find someone who has a proven track record working with students with reading problems of this nature. Have the optometrist compare his findings with those of the neuropsychologist before you decide on any intervention.
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Jerome (Jerry) Schultz is the founding clinical director of the Learning Lab @ Lesley University, a program that provides assessment, tutoring, and case management services for children with learning challenges. Schultz holds a Ph.D. from Boston College, and has completed postdoctoral fellowships in both clinical psychology and pediatric neuropsychology.