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In this episode, I’m sharing a very real, very personal story about my daughter and what led me to take her to a developmental optometrist. As both a COTA and a mom, I always tell families “when in doubt, rule it out,” and this was one of those moments where I had to take my own advice.
I walk through what I started noticing at home, from how she was positioning her head while writing, to her difficulty with attention during fine motor tasks, to hesitations with sports and play. At first, it was easy to brush some of it off as personality or age, but the patterns kept showing up.
I share what our appointment actually looked like, what they were assessing, and the moment that really clicked for me when the doctor showed me what she might be seeing on a daily basis. It was one of those experiences where everything suddenly made more sense.
I also talk about the difference between visual acuity and how the eyes actually function together. Just because a child can “see” doesn’t mean their visual system is working efficiently. That was a big takeaway for me, and I think more families need to understand it.
This episode is really about awareness. Ocular motor skills, accommodation, and visual processing play a huge role in attention, behavior, reading, and overall development, yet they’re often overlooked or mistaken for something else.
I also share how to know who to go to if you’re noticing similar concerns, what a developmental optometrist actually does, and why this can be such an important piece of the puzzle.
This is just the beginning of our journey, and I’ll continue to share updates as we learn more, especially if we move into vision therapy.
Thanks for listening 🩷
If this made you think about your own child’s vision in a new way, share it with someone who might need to hear this, too.
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All Things Sensory Episode #75 The Power of Vision Therapy with Dr. Ryan Johnson
All Things Sensory Podcast Instagram
As parents, we notice the little things: The awkward pencil grasp and the head laying flat on the table during coloring. The frustration during sports or the avoidance of crafts, reading, or close-up work.
Sometimes we brush these things off as personality traits or developmental phases. And sometimes, they’re clues that something deeper is going on.
Recently, Rachel Harrington, pediatric COTA/L, shared her personal experience taking her daughter to a developmental optometrist after noticing concerns related to visual processing and ocular motor skills. What she learned was eye-opening and it’s a conversation more parents and professionals need to hear.
If you’ve ever wondered whether your child’s challenges with attention, writing, reading, or coordination could be connected to vision, this post is for you.
Rachel first began noticing subtle signs when her daughter was around three years old.
Whenever she sat down to color, draw, or attempt early writing activities, she would:
Lay her head completely flat on the table.
Cover one eye.
Hold her head in unusual positions.
Avoid fine motor tasks.
Lose attention quickly during seated activities.
At first, these behaviors were easy to explain away.
“She’s only three.”
“She’s left-handed.”
“She just prefers movement over crafts.”
And while all of those things may have been partially true, something still felt off.That instinct led Rachel to schedule an evaluation with a developmental optometrist.
Many parents are familiar with traditional vision screenings or visits to an ophthalmologist. These evaluations are important, but they primarily assess:
Eye health.
Visual acuity.
Whether your child can see clearly at a distance (like reading an eye chart).
But vision is about so much more than “20/20 eyesight.”
A developmental optometrist evaluateshow the eyes work together and how visual skills impact learning, behavior, coordination, and daily activities. These assessments often look at:
Eye teaming.
Visual tracking.
Convergence.
Accommodation (switching focus from near to far).
Ocular motor skills.
Visual perception.
Depth perception.
Coordination between the eyes and body.
A child can technically “pass” a school vision screening and still struggle significantly with functional vision skills. That’s why developmental vision evaluations can be incredibly valuable for children who struggle with reading, handwriting, attention, sports, or coordination.
During the assessment, the developmental optometrist demonstrated how difficult it can be for some children to adjust their vision when shifting focus between near and far objects. Rachel described trying on specialized lenses while reading letters on a stick; when the lenses were removed, her eyes struggled to re-adjust.
“It was really uncomfortable,” she shared. “It almost seemed like she was having a really hard time adjusting and accommodating.”
The doctor explained that her daughter appeared to have difficulty with visual accommodation — the ability to quickly and efficiently shift focus from near to far distances. This can affect everyday tasks like:
Copying from a whiteboard.
Reading books.
Writing.
Catching balls.
Following moving objects.
Completing puzzles.
Paying attention during table work.
For many children, these challenges can lead to frustration, avoidance, or behaviors that may be misunderstood as laziness or inattentiveness.
Every child is different, but some common signs include:
Losing their place while reading.
Skipping lines or words.
Covering one eye.
Tilting the head.
Complaining of headaches.
Avoiding reading.
Poor comprehension.
Difficulty copying from the board.
Laying the head on the table.
Sitting extremely close to paper/screens.
Difficulty coloring within lines.
Fatigue during writing tasks.
Poor pencil control.
Difficulty catching or hitting balls.
Clumsiness.
Poor coordination.
Avoiding sports.
Trouble tracking moving objects.
Frustration during schoolwork.
Short attention span during visual tasks.
Meltdowns during homework.
Low confidence.
Avoidance behaviors.
Sometimes these struggles are mistaken for ADHD, behavioral concerns, or learning difficulties when visual processing challenges may actually be contributing to the problem.
One especially fascinating part of Rachel’s experience was learning that the developmental optometrist also assessed primitive reflex integration. This connection is something occupational therapists frequently observe.
Primitive reflexes are automatic movement patterns present in infancy that should gradually integrate as the nervous system matures. When retained reflexes remain active, they can impact:
Posture.
Coordination.
Attention.
Emotional regulation.
Balance.
Visual tracking and ocular motor skills.
For example:
May contribute to:
Difficulty crossing midline.
Challenges with handwriting.
Trouble visually tracking across a page.
May contribute to:
Slouched posture during desk work.
Difficulty sitting upright.
Challenges with visual focus.
May contribute to:
Visual sensitivity.
Poor attention.
Difficulty filtering visual information.
This is why many therapists take a holistic approach when supporting children with visual and sensory challenges. Everything is connected.
One of the most powerful takeaways from Rachel’s appointment was hearing that many children are not identified until much later. Often, developmental vision challenges are first noticed when children begin struggling with:
Reading fluency.
Comprehension.
School performance.
Attention.
Self-esteem.
By that point, many children have already spent years feeling frustrated or believing they “aren’t good at school.” Early identification can help children build confidence and develop foundational skills before academic and emotional challenges snowball.
And that’s important to remember:
Seeking support early is not about labeling a child. It’s about understanding how to help them thrive.
If a developmental optometrist identifies challenges with ocular motor or visual processing skills, they may recommend vision therapy. Vision therapy is a specialized program designed to strengthen and improve how the eyes and brain work together.
Depending on the child’s needs, therapy may focus on:
Eye tracking.
Convergence.
Visual attention.
Coordination.
Depth perception.
Accommodation.
Visual processing.
Sessions often include playful, movement-based activities that target these underlying visual skills. For many families, vision therapy can be life-changing.
However, it’s important to know that:
Vision therapy is often not covered by insurance.
Outcomes can vary depending on the provider and approach.
Some children may also benefit from occupational therapy or primitive reflex integration support alongside vision therapy.
If you suspect your child may be struggling with visual processing or ocular motor skills, consider:
Asking your child’s occupational therapist for recommendations.
Searching for “developmental optometrist near me.”
Looking for providers who offer vision therapy.
Reading reviews and parent experiences.
Asking local parenting or special needs Facebook groups for referrals.
Remember: not all providers take the same approach, so finding a good fit matters.
While every child’s needs are different, playful movement activities can help support visual and sensory development at home.
Some ideas include:
Ball play and catching games.
Obstacle courses.
Puzzles.
Mazes.
Crossing-midline activities.
Swinging.
Crawling games.
Fine motor crafts.
Visual tracking games like bubbles or flashlight tag.
These activities help strengthen coordination between the eyes, body, and brain in fun, engaging ways.
One of the most important messages from Rachel’s story is this: Trust your instincts.
If something feels off, it’s okay to ask questions. It’s okay to seek evaluations and it’s okay to explore additional support.
Sometimes small signs can reveal underlying challenges that deserve attention and support. And sometimes, understanding thewhy behind a child’s struggles changes everything.
BORING, BUT NECESSARY LEGAL DISCLAIMERS
While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science & art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views & opinions on how to address common sensory challenges, health related difficulties & what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.
Keep in mind that we may receive commissions when you click our links & make purchases. However, this does not impact our reviews & comparisons. We try our best to keep things fair & balanced, in order to help you make the best choice for you.
This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.
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