Double Vision: The Importance of Understanding Visual Processing for the Twice Exceptional Community

There is no ONE way to be twice exceptional or 2e. In fact, there are almost endless ways for this profile to present. First, the gifted part can mean giftedness in one or more areas. It means a social and emotional orientation toward “doing this thing we call life,” and it means intensity in a myriad of ways. The learning difference part of being 2e can include just about anything from ADHD to Autism, from dyslexia to dysgraphia, from processing speed challenges to working memory struggles, from auditory processing to visual processing, and many other conditions. While many of these diagnoses are straight forward – you know them when you see them – some are invisible, and some are completely misunderstood. Visual processing is one of those differences that many people simply don’t understand but is often part of the 2e profile.

Whenever we talk about vision – most people assume we are talking about the eye. With visual processing, we are actually talking about the brain. The eyeball does the mechanics of seeing things but the brain processes what we see and interprets that data. You can have 20/20 vision but still have visual processing disorder. The ability to process visual information is demonstrated in ways like hand-eye coordination, tracking words on a page, balance, depth perception, knowing where things are in space, integrating what you see with other senses, and visualization.

When I read a book, I see a movie in my mind. It’s part of the reason I love reading so much, the rich imagination it elicits in my brain. That is part of visual processing. Visualization skills – when our brains process our visual input – are necessary for many skills like reading, writing, playing sports, playing music, and being socially successful. 

It’s somewhat shocking how many people miss the signs of visual processing disorder. It’s almost staring them in the face! (pun intended).  If you or your child has a neuropsychological evaluation and you see discrepancy in verbal and anything vision based, likely there is a visual processing deficit. Processing speed may be lower, there may be a demonstrated weakness in visual motor coordination, or you might see lower performance on timed tests, the block design test, coding, or symbol search.

At the recent 2024 SENG (Supporting the Emotional Needs of the Gifted) conference, I had the opportunity to learn from Dr. Carole Hong, who shared the following specific symptoms for various visual processing challenges:

Symptoms of Eye Teaming difficulties:

• Print moving or swimming on the page
• Turns or tilts head when reading/watching tv
• Brow ache, headaches
• Fatigues quickly with reading/schoolwork
• Double vison covers or closes one eye
• Avoids reading
• Avoids ball sports

Tracking Difficulties

• Loss of place when reading
• Re-reading words or paragraphs
• Difficulty copying from the board
• Head movement while reading
• Re-reads lines of print
• Uses finger or line guide

Eye focusing difficulties

• Intermittent episodes of blurry vision
• Headaches
• Asthenopia
• Fatigues quickly with reading or schoolwork
• Complains that print is too small
• Difficulty shifting focus from near to far to near

Visual Processing problems

• Reversals of numbers and letters
• Messy handwriting, difficulties writing straight on a page or with proper spacing
• Difficulty remembering and seeing what different words look like to read or reproduce them on a page, ie spelling
• Difficulty matching sounds to a visual pattern

Symptoms of visual processing challenges may also include distractibility, executive function challenges especially with organization, and emotion dysregulation due to overwhelm. There may be task avoidance and unexpected behaviors in the face of what seem like “easy” tasks. As a parent of 2e child, a teacher, or a 2e adult, you know that many of the symptoms I just listed often go hand-in-hand with being 2e.

The important thing to note is that a typical evaluator will not identify visual processing challenges, and neither will a typical ophthalmologist. To identify and treat visual processing challenges, one must see a Developmental Optometrist. The good news is that there are great resources out there including, www.COVD.org (Optometric Vision Development and Rehabilitation Association). There are also recent scholarly articles written about the topic that address visual processing and twice exceptionality (See, De Bonte, Austina, et al, Journal for the Education of the Gifted, 2024, Vol. 47(I) 30-53.)

The first step is to notice any of the symptoms listed above. Next is to get an evaluation by a developmental optometrist and to request that they recommend accommodations. If you or your child needs immediate adaptations, you might try using a ruler to help track with reading, using pastel colored paper for worksheets and homework, including white space on the page, enlarging font or any illustrations on a page, including one math problem per page, and taking vision breaks from a computer and phone screen.

I recently had the great pleasure of interviewing a pioneer in the field of visual processing, Dr. Lynn Hellerstein for our Haystack 2e Adult Membership. She takes a holistic view of visual processing and addresses both the skills of training the brain to process visual information, but also incorporates visualization into her practice. Remember the movie that plays in my head when I’m reading? Dr. Hellerstein develops that ability within patients with visual processing challenges so they can see in their “mind’s eye” how they want something to go. A person with writing challenges may take a moment and envision the letters the way they want to see them on the page. She describes this process as “unleashing the intuitive resources to crack the deeply rooted and traumatic events/limited beliefs/self-sabotaging feelings impacting a person’s current happiness and success.” Wow! If that doesn’t address typical 2e “stuckness” I don’t know what does! 

The bottom line is that there are many ways to be 2e. Not all conditions are obvious or understood. It’s important when addressing your child’s, your student’s, or you own behaviors, frustrations, emotion dysregulations, that you avoid negative assumptions – calling behaviors lazy, unmotivated, or uninterested. It’s important to consider with an otherwise gifted person, what else might be underlying those inabilities. 

Unfortunately, the most common response to a 2e person’s inability is that they aren’t trying hard enough, when really, they are trying OH. SO. HARD. If you can’t seem to crack the nut of what underlies perplexing behavior – don your detective hat and find clues that might lead you to consider something unique. When 2e people are misdiagnosed or seen through a deficit lens without understanding the true underlying cause or condition, they develop negative self-affect and lose their self-confidence. They lose sight (pun intended, again) of their giftedness and doubt their abilities. Visual processing is just one of the many misunderstood conditions that keeps the 2e person in your life from truly enjoying their life. Become an advocate for the complex 2e person in your life and explore what might be standing in their way – because I promise you, they want to meet expectations, they want to soar, they want to feel accomplished.