Visual Difficulties Screening in SpLD Assessments

The performance of an individual during a Dyslexia assessment can be significantly hindered by unmanaged vision issues. If a student is struggling to track text or is experiencing “jumping words,” their reading score may reflect a visual processing error rather than a cognitive one.

To address this, the Specific Learning Difficulties Assessment Standards Committee (SASC) has established a rigorous protocol for screening visual difficulties. This guide explores why screening is vital, the specific role of the practitioner, and how the Visual Difficulties Screening Protocol (VDSP) ensures every individual receives a fair and accurate assessment.

The Role of the SpLD Practitioner: Screening, Not Diagnosis

It is essential to understand the boundaries of professional practice. The primary role of an SpLD practitioner (such as a specialist teacher or assessor) is screening and referral, not diagnosis or treatment.

Understanding the Boundaries

Visual difficulties can stem from numerous sources, including:

• Refractive errors: Myopia (near sightedness) or Hyperopia (farsightedness).
• Ocular pathology: Physical health issues within the eye.
• Visual system dysfunction: Issues with how the eyes work together.

Because these are medical and physiological concerns, any formal diagnosis and subsequent management must be handled by a registered optometrist.

The Prohibition on ‘Visual Stress’ Assessment

A key point within the SASC guidelines is that SpLD practitioners and specialist teachers should not undertake assessments aimed at identifying or treating “visual stress” (sometimes referred to as Irlen Syndrome). Practitioners must avoid suggesting diagnoses or proposing treatments like specific colored overlays. Instead, they should gather evidence of symptoms and refer the individual to a professional who can rule out underlying medical or refractive issues first.

Recognizing the Signs: Feels, Sees, and Does

Visual difficulties often manifest as physical discomfort or behavioural changes, particularly during tasks that require sustained focus, such as reading or studying. Practitioners categorize these signs into three distinct areas:

1. What the Individual FEELS (Visual Discomfort)

Discomfort is subjective, but it is a major red flag. Symptoms include:

• Headaches or eyestrain.
• Tired, gritty, or sore eyes.
• General fatigue after short periods of visual work.

2. What the Individual SEES (Visual Disturbance)

These symptoms relate to the clarity and stability of the visual field:

• Blurred vision (at a distance or up close).
• Text going in and out of focus.
• Double vision or words “jumping” and moving on the page.
• Visual illusions, such as shimmering, flickering, or seeing patterns in the white space of a page.

3. What the Individual DOES (Coping Strategies)

Behavioural responses are often the most observable signs for an assessor:

• Holding reading material at unusual distances (too close or too far).
• Screwing up eyes (squinting) to see more clearly.
• Frequent eye rubbing or blinking.
• Using a finger to keep place on a line.
• An active aversion to reading or specific types of visual patterns.

While common conditions like Astigmatism, Accommodation Dysfunction, and Convergence Dysfunction often correlate with these signs, the practitioner uses this information only to inform a referral, never to label the condition themselves.

Navigating the SASC Visual Difficulties Screening Protocol (VDSP)

The VDSP is a structured decision-making process usually integrated into the “Gathering Information” stage of an SpLD assessment. It consists of two primary questionnaires.

The Questionnaires

1. Visual History Questionnaire (VHQ): This provides the context. It looks at whether the individual wears glasses, when they last saw an optometrist, any history of “lazy eye” (patching), or previous use of tinted lenses.
2. Visual Difficulties Questionnaire (VDQ): This is a simple “Yes/No” survey focusing on current, persistent symptoms (occurring several times a week).

The Traffic-Light Decision System

Once the questionnaires are complete, the practitioner follows a standardized “Traffic-Light” system to determine the next steps:

Integrating Screening with the SpLD Assessment

The ultimate goal of the SASC protocol is to ensure that the results of an SpLD assessment are “clean”—meaning they aren’t being muddied by an uncorrected vision problem.

When to Pause the Assessment

If a screening returns a RED outcome, the practitioner faces a critical decision: Should I continue or pause?

If the individual reports severe disturbances—such as double vision or print losing focus—this will almost certainly negatively impact their performance in reading rate, orthographic skills, and Rapid Automatized Naming (RAN). In these instances, the practitioner should pause the assessment. Proceeding would likely result in data that underestimates the individual’s true cognitive ability.

Concurrent Investigations

In some cases, due to time constraints or external deadlines (such as Exam Access Arrangements), a practitioner may choose to run the SpLD assessment and the optometry referral concurrently. However, the practitioner must state whether the resolution of the visual assessment is required before a final SpLD diagnosis can be safely reached.

The Referral Process

For all RED outcomes, a formal referral letter is sent to the optometrist. This letter includes the completed VHQ and VDQ, providing the medical professional with the specific behavioral observations gathered during the screening. This professional-to-professional communication ensures a holistic approach to the individual’s learning journey.

Conclusion: Ensuring a Clear Path to Success

Visual difficulties screening is not an “extra” step in an SpLD assessment; it is a foundational one. By identifying visual barriers early, practitioners ensure that any subsequent diagnosis of dyslexia or other learning difficulties is accurate and that the individual receives the correct interventions.

For parents, students, and adult learners, this protocol offers peace of mind. It ensures that the difficulties they face are being looked at through a wide lens—one that considers the health of the eyes as well as the processing of the brain.