Visual Perceptual Difficulties: Extended Version

By Ms. Fíona de Buitléir
 
According to Professor Helen Irlen who identified this phenomenon in 1983, Irlen Syndrome (also Meares-Irlen Syndrome, Scotopic Sensitivity, and Visual Stress in the literature) affects five per cent of the mainstream population and over 40 per cent of the learning disabled population (chiefly dyslexia, and autistic spectrum disorders). (www.irlen.com) It involves a cluster of visual perceptual difficulties which means sufferers experience high levels of visual ‘noise’ when looking at (in particular) black and white pages. This abnormal light sensitivity leads to print distortions / text instability, slow reading rate, attention deficits, and poor depth perception. It is a sensory, rather than an optical, issue - vision appears normal.

The efficacy of coloured overlays and colour lenses in addressing these problems has been validated by researchers across the globe.  However, no research in this area has ever been published in the Irish situation. This study set out to explore and document it.

Aims
* To investigate the incidence of Irlen syndrome in Irish primary schools
* To identify pupils with Irlen syndrome and their issues
*  To examine the effects of colour interventions (overlays and lenses) on them and on reading speed in particular
* To identify any conditions commonly co-existing with Irlen syndrome

The overarching aim was to create knowledge for those engaged in teaching reading, and benefit children struggling due to Irlen Syndrome
 
Background Information

Irlen syndrome is the ‘subjective experience of unpleasant visual symptoms when engaged in reading and some other visual tasks’ (Singleton and Trotter, 2005). It occurs most frequently in cases of black symbols on white background, where the high contrast causes extreme visual discomfort for some. Symptoms include perceptual effects (text instability [words or letters that ‘move’], illusions of colour and movement, pattern glare, depth perception difficulties), and somatic effects (photosensitivity, headaches, sore eyes, nausea) (Conlon et al., 1999). Effects range from mild to severe, and can interfere with ability to learn to read, with reading fluency, and notably with the ability to read in a sustained manner for long periods of time.   

Placement of a coloured overlay on the troublesome white page, or the wearing of coloured lenses, has been found to neutralise the unpleasant visual symptoms (e.g. Robinson and Conway, 2000; Kriss and Evans, 2005). The effective colour varies from person to person.   

Research Methodology

This research project was carried out on two sites - Ennis National School, Co. Clare (a large, mainstream primary school), and St. Killian’s N.S., Cork (specialist school for students with severe dyslexia).

Ennis N.S. Co. Clare
Stage One in Ennis N.S. involved whole-class pre-screening of all third to sixth classes - 360 students - , using a ten-point questionnaire, e.g. “Do your eyes get sore when you read or use a computer?” and “Does white paper ever seem to glare or flicker?”. Those who answered ‘Yes’ to four or more questions (81 children) were selected for individual screening, with parental permission.

Stage Two involved this individual screening using an adaptation of the scale used by Irlen screeners ( see www.irlen.com and www.irlen.ie ). As well as visual perceptual tasks, children were asked about discomfort while reading, e.g. “Would you ever get a headache from reading?”, “Do you have to rub your eyes a lot?”.

Students with Irlen syndrome were given the colour overlay(s) appropriate for them. The Rate of Reading Test (Arnold Wilkins, 2003) was administered with and without their overlay(s).

Parents completed a questionnaire on family history of conditions like migraine, epilepsy, etc. to see if issues associated with Irlen syndrome could be identified. Two months later, teachers and parents were asked to complete a further questionnaire about perceived changes in reading and behaviour.

St. Killian’s N.S. Cork City
The same methodology was used at St. Killian’s in Cork, except that class teachers administered the initial 10-point questionnaire themselves.

Findings and Recommendations

At Ennis NS, initial pre-screening of 360 students found 81 pupils (22 per cent) to be at-risk of Irlen syndrome while at St. Killian’s NS, the number was 21 (40 per cent).   

The individual screening process confirmed that 63 children (17.5 per cent) at Ennis NS had significant symptoms. In the Reading Class, incidence was 50 per cent. At St. Killian’s NS, 19 children were found to have symptoms - an incidence of 37 per cent.
 
All children with Irlen symptoms were given the Rate of Reading Test (in Wilkins, 2003). The percentage increase at Ennis NS ranged from 3.3 per cent to a staggering 194 per cent.

The average increase was 25 per cent. In St. Killian’s, the increases ranged from one per cent to 82 per cent. The average increase was 28 per cent.

Family History Survey

Issues which correlated with Irlen syndrome in terms of family history were left-handedness (58 per cent), migraine (41 per cent), allergies (33 per cent), and travel sickness (29 per cent).

Interestingly, while 82 per cent of the children had been brought for eye-tests, most had been told that their eyesight was good. A typical optical eye-test does not pick up Irlen symptoms because it does not look for them. Irlen symptoms are sensory issues, not optical issues.

Opticians dim the lights while testing in order to eliminate glare. This research found that glare is a serious issue for Irlen children in a classroom.   

Parent and Teacher Observations Questionnaires

Two months later, parents and teachers were surveyed about observed changes in reading or in behaviour. The overwhelming majority reported positive effects:
* Greatly increased motivation to read
* Increased time spent reading
* Increased speed of reading / fluency

Reductions in negative factors cited included:
* Less headaches
* Less irritability
* Less impulsivity
* Less frustration

One parent stated that her child had “much less need to re-read”.  Using the overlay, she could now take in meaning from the first reading of a passage. This has huge implications for efficiency of learning and time spent on study. 

However, the most significant finding to emerge was the problem posed by whiteboards.

Over 50 per cent of the children complained about the whiteboard, and many more cited it as a problem when asked specifically.  The glare from the board made it difficult for many students to look at it for long, and for some to look at it at all.

Many reported that they found it difficult to actually see what was on the board and had to guess. The white background was “dazzling”. Some pupils said it gave them an instant headache and nausea. This led to what appeared to be irritability and restlessness but was essentially extreme physical discomfort. Many pupils were not explicitly aware of all this until asked directly about it. 

This has huge implications for classroom management. The background colour on electronic boards should default to a mute colour, rather than white. This will help a significant number of the pupils and may reduce what appear to be behavioural difficulties for some. Even non-Irlen pupils reported the board was more comfortable to view with a non-white background.

Conclusions

Irlen difficulties are indeed present in our schools, essentially to the same extent as in other western societies:-
* Irlen (1997) in the USA found that 14 per cent of the general population had Irlen syndrome - the figure at Ennis NS was 17.5 per cent.
* Kriss and Evans (2005) in the UK found that 37.5 per cent of dyslexics had this condition - at St. Killian’s school for pupils with dyslexia, incidence was 37 per cent.
* Irlen found that 46 per cent of dyslexic students benefited from Irlen overlays / filters - 50 per cent of the Reading Class pupils at Ennis NS did so.
   
Problems reported by children in this Irish research mirrored that of similar research abroad.

* “My eyes go everywhere - I keep missing things”.
* “I see double vision - my eyes are very tired”.
* “The page glares at me”.

The children did not realise that these undesirable phenomena were unusual and that not everyone saw the page like that.

If a pupil has Irlen syndrome, no interventions will succeed until this is addressed:

Recommendations

1. Information about Irlen syndrome should be disseminated to all teachers 
2.  All primary school children should be screened routinely as in many American states.
3. All students with dyslexia or autism should be screened for Irlen syndrome - there is a 40+ per cent overlap between Irlen syndrome and dyslexia, and Irlen syndrome and autism.
4. A panel of trained screeners should be available to visit schools and carry out this screening.
5. Difficulties posed by glare from whiteboards should be publicised. Teachers should change the background colour automatically.
6. It helps if worksheets, standardised tests, etc are copied onto non-white paper.
7. Glare can come from many sources - windows, shiny surfaces, fluorescent lights. Teachers should ask the class what makes their eyes / head uncomfortable, using open-ended questions.
9. Lighting in classrooms should be adjustable and pupils given the opportunity to sit where the light suits them best. Susceptible pupils should wear a sun visor or cap to block troublesome light.
10. For further information, see www.irlen.ie The Self-Test’ will indicate if further screening is warranted.