August 24, 2025

My Child received a psychoeducational evaluation… Now what?

Why visual function deserves a second look after psychoeducational testing

Has your child had a psychoeducational or neuropsychological evaluation? These tests are often ordered when a child is struggling in school despite appearing smart, attentive, or even gifted. Parents want answers, teachers want to help, and pediatricians want to rule things out.

The evaluation process—often involving a full battery of tests—gives insight into how a child thinks, learns, remembers, and regulates behavior. For many families, it’s a critical step toward understanding their child’s learning profile and building an appropriate support plan.

But here’s the question few parents are told to ask:
What if your child’s struggles aren’t just cognitive or behavioral?
What if they’re visual—and no one caught it?

Key Takeaways:

• Psychoeducational evaluations may flag issues in visual-spatial reasoning or working memory.
   

• Many children with visual inefficiencies are misidentified as inattentive, anxious, or unmotivated.
   

• Functional vision problems do not show up on a standard eye chart—and are often missed entirely in psychological testing.
   

• Developmental optometrists trained in functional vision care can evaluate visual skills that impact reading, learning, and focus.
   

• Treatable conditions like convergence insufficiency, accommodative dysfunction, and poor eye tracking can dramatically affect performance.
   

What Psychoeducational Testing Covers—and What It Doesn’t

Standard psychoeducational evaluations often include:

• IQ testing (like the WISC-V)
   

• Academic achievement tests (e.g., Woodcock-Johnson)
   

• Executive functioning assessments
   

• Behavioral and emotional rating scales
   

• Working memory, attention, and processing speed assessments
   

These tests measure how a child learns, not just what they know. But they don’t always identify why a child struggles—especially when visual skills are involved.

Take the Visual Spatial Index on the WISC-V. This subtest measures a child’s ability to analyze and synthesize visual information, such as completing puzzles, identifying patterns, or visualizing how objects fit together. It’s often labeled as a reflection of cognitive strength or weakness.

Visual spatial reasoning relies on skills like:

• Visual attention and accuracy
   

• Eye teaming and alignment
   

• Visual motor integration (how the eyes and hands coordinate)
   

• The brain’s ability to combine images from both eyes into one unified picture
   

If a child has trouble with any of these areas, they may underperform—not because they don’t understand the task, but because their visual system is working inefficiently.

How Vision Plays a Role in "Cognitive" Challenges

Let’s look at Working Memory, another commonly assessed area. This refers to a child’s ability to temporarily hold and manipulate information—such as remembering a phone number long enough to dial it or doing math in their head.

The WISC-V and other tests often ask kids to repeat number sequences, reorder digits, or recall images shown just seconds before.

These tasks may seem purely cognitive, but they rely heavily on visual attention, processing, and memory. If a child has trouble keeping images clear, or their eyes don’t coordinate well, the brain has to work overtime. That added load can skew the test results—and make it seem like the child has a learning or memory deficit when the issue is actually visual.

A research paper published in the Journal of Learning Disabilities reported that children with undiagnosed visual deficits often show reduced scores in working memory and processing speed—both of which are critical for school success. Yet these kids frequently pass routine vision screenings.

You Can’t Test What You Can’t See

One of the biggest misconceptions about vision is that if a child can see the 20/20 line on the eye chart, their eyes must be “fine.”

But 20/20 simply means a person can see a certain-sized letter from 20 feet away. It doesn’t measure how well the eyes move, focus, or work together—skills essential for reading, writing, and classroom learning.

Statistics show that 70% of sensory input comes through the visual system, and 80% of all learning is visual.  That means nearly every academic task—especially reading—depends on efficient visual function.

Functional visual skills include:

• Tracking: Smooth, coordinated eye movements across a line of text
   

• Saccades: Quick shifts between two visual targets
   

• Convergence: Ability to turn both eyes inward to read up close
   

• Accommodation: Focusing clearly and sustaining that focus
   

• Binocularity: Using both eyes together as a team
   

If any of these skills are underdeveloped, a child may experience:

• Words moving or blurring on the page
   

• Difficulty copying from the board
   

• Losing their place while reading
   

• Skipping lines or guessing at words
   

• Eye strain, headaches, or fatigue after short reading sessions
   

These symptoms don’t show up on a standard psychoeducational test. Nor are they typically flagged in a basic school vision screening or general eye exam.

What a Functional Vision Evaluation Looks At

That’s where functional optometry comes in. A developmental optometrist evaluates the visual system as it relates to performance. This includes:

• How the eyes team and align
   

• How well they move and track
   

• How quickly and accurately they focus
   

• How visual information is processed and interpreted by the brain
   

These exams are often recommended after psychoeducational evaluations if a child shows:

• Below-average visual-spatial scores
   

• Slow processing speed
   

• Poor handwriting or clumsiness
   

• Reading comprehension struggles despite strong vocabulary
   

• Emotional or behavioral issues tied to school frustration
   

Real-Life Example: Misdiagnosed or Misunderstood?

Consider a 10-year-old child labeled as having ADHD and working memory deficits. The child complains of headaches after school and avoids reading. The psychoeducational report notes strong verbal skills but poor visual-spatial ability and inconsistent attention.

A functional vision evaluation reveals that the child has convergence insufficiency—a condition where the eyes don’t turn inward correctly when reading. As a result, the child sees double after a few minutes of near work, which causes fatigue, frustration, and difficulty concentrating.

After a program of vision therapy focused on improving eye teaming and focus, the child begins reading longer without complaints. Headaches disappear. Attention improves—without any medication.

This story isn’t rare. In fact, convergence insufficiency affects up to 1 in 8 school-age children. But because it’s not caught in standard evaluations, kids are often misdiagnosed with ADHD, anxiety, or learning disabilities.

Why This Matters—And What Parents Can Do

When a child is bright but struggles with tasks that seem like they should be easy—reading, writing, paying attention—it’s time to look beyond the labels.

Psychoeducational testing is an important tool. But it’s not the full picture.

If your child has already had an evaluation and the report mentions:

• Low visual spatial index
   

• Low working memory or processing speed
   

• Difficulty with visual organization
   

• Suspected visual processing disorder
   

…it’s time to dig deeper. These are red flags that the eyes may not be functioning efficiently—even if acuity is normal.

What’s Next?

Parents who suspect visual issues should seek a comprehensive functional vision evaluation from a developmental optometrist. This isn’t the same as getting glasses or a quick screen at the pediatrician’s office.

It’s a detailed look at how your child’s visual system is performing during the tasks that matter most: reading, learning, and focusing.

Many of the conditions identified during this type of testing—such as accommodative dysfunction, convergence insufficiency, or oculomotor delays—are treatable through in-office vision therapy. This specialized program retrains the eyes and brain to work together more efficiently.

And when visual function improves, kids often catch up academically, feel less anxious, and regain their confidence.

Don’t Let a Missed Diagnosis Hold Your Child Back

If your child has had a psychoeducational evaluation and something still feels off—trust that instinct. The problem may not be their ability to learn, but how their eyes and brain are processing the world around them.

20/20 isn’t enough. Ask for more.

Your child deserves to see clearly, comfortably, and confidently—every day.