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Orthoptic Visual Processing Difficulties

The Orthoptic Visual Processing Difficulties Clinic is a clinic run by Orthoptists to help children with eye problems related to or contributing to a specific learning difficulty.

A specific learning difficulty is classed as a problem that a child in mainstream school has with their learning for example, dyslexia. An Orthoptist is an eye specialist who is trained to diagnose and to treat eye movement disorders in adults and children and to help children with poor vision. In the specific Learning Difficulties clinic, we look at other problems such as eye movements during reading and other vision related problems such as visual perception difficulties.

1.    What does your service do?

  • The purpose of the service is to identify and correct visual difficulties that will in some way contribute to a child having a specific learning difficulty.
  • Our service allows a child a better access to the curriculum by correcting visual difficulties and helping to provide an equal footing with other children. An example of a good outcome would be to correct a child’s inaccurate eye movement. This would allow them to track a line of text correctly and gain greater comprehension of what was read. Another example would be to enable a child to concentrate on text for a longer period without fatigue or eye strain/discomfort thereby allowing them to keep up with their peers and/or contribute to the lesson.
  • Our typical activities in the clinic are visual tests looking at binocular vision, eye movement control and the way the brain ‘sees’ the written word and how we make sense of what we see.
  • Welcome Sheet for Parents

2.    Where is it located and what areas does it cover?

  • We are based at Warrington Hospital and we also do clinics at Halton Hospital and HCRC at Widnes. We see patients from areas such as Manchester, Northwich and Stockport. We provide a comprehensive, NHS funded service to any school age child across the North West provided the meet the referral criteria (see later). Directions to the hospital.

3.    Who does your service provide for?

  • We specialise in children with specific learning problems rather than general learning issues. For example we see children with problems such as dyslexia rather than general learning issues such as Down’s syndrome.  (These children are cared for by a separate eye care team headed by my Orthoptic colleague Tom Lomas who is in charge of the Warrington and Halton Orthoptic SEN team).
  • In the VPD team we see children age 7 upwards. We also occasionally see adults.

4.    How can I start using the service?

  • Parents are very welcome to ring for advice if needed. 01925 662772 
  • Referral into the service is through the local authority. This can be via the GP or the school. The parents can take the child to the GP and explain their concerns or the school can fill in the school screening questionnaire and send in a direct referral without the need to see the GP. School screening questionnaire.
  • The majority of referrals are through the SENCOs. We would appreciate a little cover note to accompany the screening tool. Please also make sure that the parents are happy for their child to be referred.
  • The service is provided free via the NHS so no fee is payable.
  • The waiting times can vary throughout the academic year depending on how many referrals we receive. But comply with the 18 week waiting time     

Please address all referrals to:

Kathryn Whitfield
Advanced Orthoptist
Specific Learning Difficulties Clinic
Warrington and Halton Hospital foundation Trust
Warrington Hospital
Orthoptic Department
Daresbury Wing
Lovely Lane

5. How are decisions made about who can use your service?

  • The decision about who is referred into the service is ultimately the responsibility of the referrer. Using the questionnaire as a guide should eliminate inappropriate referrals. School screening questionniare  Audits show that although there are a small proportion of children who are referred in and have no eye related problems which contribute to learning; this is only a small proportion. Statistics show that 80% of children who have problems learning will have a problem that an Orthoptist can treat.

6. How do you communicate with service users and how are they involved in decision making/planning?

  • After the first assessment a detailed report is sent to all the professionals involved in the child’s care. For example a child who is referred in via school because they are losing their place when reading and who is also under the care of a paediatrician for ADHD and who is also under the care of the Occupational Therapists for dyspraxia. A copy of the report will also be sent to the rest of the team.  After each subsequent visit a letter will be given to take to school detailing that day’s assessment. The parents will also  get a copy, as will the GP
  • There are no parent events but parents are sometimes invited into schools if we are doing an update for the teachers. We value parents and teachers input and are always ready to listen.

General comments about the VPD clinic

"Without this help following my daughters diagnosis I am not sure that she would have improved the way she has with her school work. This I believe has allowed her to now go onto college and study A-levels"

This service has been of great value to my daughter, it has enabled her to receive further support and understanding from teachers in school. It has also helped her to understand why she finds some tasks difficult and now she can improve her reading skills to help her. Thank you

The support provided and advice given has helped my child's school understand his needs and better accommodate him. Ensuring he is seated in correct place, using coloured paper and overlay. This has reduced some of the stress my child feels at school when writing/reading. Highlighting this problem has been vital in understanding his problems and seeking solutions where possible.

Thank you for all your help. I really feel it has made a huge difference to my Son’s school work and most importantly his confidence. I am sure helping him so much at this age will make a difference to all his schooling.

My child was continually assessed and we felt that her difficulties although maybe minor compared to other diagnoses, the department were thorough, consistent and approachable. My Daughter was made to feel important and was helped to achieve her potential at school. I feel that although she has been discharged should we have any difficulties in the future, the department would still be there for us for any support/advice. Thank you.

Thank you for providing such a worthwhile and important service at Warrington. I will and already have recommended your service to others. My son is dyslexic, it is easy to get swamped and lost in a sea of trying to help but your report has proved pivotal in getting my Son’s high school involved and the recommendations are clear and achievable. Thank you. 

7. Is your service fully accessible?

  • The buildings at Warrington and Halton are both fully accessible in line with hospital policy.

8. What training are the staff supporting children and young people with SEND had or are having?

  • The Orthoptist have completed a 3 year BSC Honors degree or equivalent and had extensive experience and  post graduate training in SpLD. As Orthoptists we are all used to seeing a diverse range of ages and levels from babies to school children, to elderly patients with dementia. The SEN team are trained in treating children with developmental and visual maturation problems and the VPD team are trained to communicate with and treat children with specific learning difficulties such as dyslexia, dyspraxia and ASD.
  • All staff are DBS police checked in line with hospital policy.
  • We work very closely with school SENCos and teachers.

9. Who can I contact for further information?

Please contact Kathryn Whitfield who is the Lead Orthoptist for the Orthoptic Lead Specific Learning Difficulties Clinic at Warrington and Halton - 01925 662772

Warrington and Halton Hospital NHS Foundation Trust
Orthoptic Department
Daresbury Wing
Lovely Lane


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