How Adam Failed His Vision Test and Added Shapes to His Class Curriculum

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ChildTest2The boys had their three-year pediatrician appointment a few weeks ago and it was full of firsts. It was the first time they wore a johnny, the first time they had their reflexes checked, and the first time they had a vision test. When it was time to bring Adam out for his vision test I was curious about how it would work for someone so young. It turns out that it was much like an adult test except the chart had shapes instead of letters or E’s. Adam was asked to stand behind a line while the nurse pointed at each symbol and asked him what it was. She moved down the chart and then repeated any that were iffy the first time.

The shapes included squares, circles, hearts, triangles, stars, moons, and a few others. Adam did fine with the first couple of rows but started to fumble towards the middle. After the second row everything was pretty much a square, regardless of what shape it actually was. The nurse did not indicate if he got any wrong, simply saying “good job” and coming back to it again later. He ended up redoing almost the entirety of the middle chart. I knew it wasn’t going well.

When we got back to the exam room the pediatrician told us that Adam had failed the vision test while Zachary had 20/40 vision. I told her that Adam didn’t know all of the shapes on the chart (particularly stars and triangles) and that he was having trouble focusing during the test. He wandered over the line and behind it, swaying side to side, and turning around. When he answered a shape incorrectly he giggled. He lost all focus a third of the way through. She took note of my comments but still suggested that we bring him to a specialist just to make sure there wasn’t anything wrong.

We want to make sure that Adam doesn’t have vision problems but we want to make sure that everything else is in place first. He was overwhelmed during the appointment and was already having trouble paying attention when we started the test. He is one of those kids – very busy, short attention span. We also know that he doesn’t know all of his shapes. Zach is very good with them, which is no surprise, but Adam has trouble because of his focus challenges. We decided that we would work with him to learn more of the common shapes before brining him to a specialist.

We mentioned the situation in passing to his teachers the next day at school and thought nothing of it. A few days later we got the classroom calendar for April and noticed that each week was shape themed. The children would learn about a specific shape each week and had to bring in an item of a specific shape as well. We thought it was a convenient coincidence until we talked with his teachers later on. They said that they felt guilty that he didn’t know his shapes and wanted to make sure they covered it for all of the children. In addition to finding that amazingly touching, we were happy that he’d have some additional practice outside of what we were doing at home.

In the past few weeks Adam’s shapes have become much better. We have been asking him what different shapes are and he has started to identify triangles and squares correctly. He will still need some more practice but he is getting much better. We are also making a more concerted effort to help him focus when he is having trouble paying attention. This is something we know we will have to work on going forward so we might as well start now. Thanks to some help from his classroom, we hope Adam will be able to ace his next vision test. If not I guess he just needs glasses. Eeeh.

3 comments


  • Sue A.

    Worry not about Adam’s vision. It is probably fine. I can not tell you how many times a child has come into the office for an exam because they failed their vision screening test at school. Most of the time their vision is fine and they do not need glasses. Sometimes it is just they are not paying attention or the person testing them makes them nervous and they don’t want to get it wrong. If they should need an exam with an optometrist or an ophthalmologist, request that their vision be tested using the HOTV match instead of pictures. The HOTV match gives them a board to point to the letter that matches the one being projected on the screen. The HOTV match also goes down to the 20/20 level. The children’s pictures are often confusing and only goes down to the 20/30 level. That’s my professional, unprofessional input from working in the field for 32 years!

    April 13, 2014
    • Jason Taylor

      Thanks, that makes me feel better!

      April 14, 2014
    • Nikki G

      I know this post is old but thank you so much! My boys age 4 and 5 saw and optometrist today after failing the vision test at the pedi. This man was so mean and made me feel horrible. My kids get nervous when being tested and I felt it wasn’t accurate at all but he told me my boys vision was terrible and they may not be able to drive later and blah blah blah. I came home and found pics of the same charts they used and my boys read them to me with no problem. I think it was just nerves. I didn’t know about the HOTV testing but when I get a second opinion I will request it. Thank you so much for your opinion and information.

      October 31, 2015

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