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Vision in Children with Down syndrome

Children with Down syndrome are often described as ‘visual learners’ – vision is even more important to them that it is to typical children. Yet studies show that children with Down’s syndrome do not have as good vision as typical children and are at a disadvantage in the classroom for reasons over and above any learning disability that they have. The main affected areas are:  detail vision (visual acuity), ability to discriminate low contrasts and detecting when a scene is out of focus.

It is important that teachers acknowledge that even if children are wearing glasses or do not need glasses their vision will be still poorer than normal. Thus reading materials, for example, do not look the same to a child with Down’s syndrome as they do to his/her classroom peers. The difference is the equivalent of perhaps two or three lines in a conventional letter chart at both distance and near.

For fluent reading, we need to use print that is 3-4 times larger than our limit. Since a child with Down’s syndrome has a vision 2-3 times poorer than an average child, he or she will eventually need print enlarged to 2-3 times larger than other children in the same class.

Recommendations for parents, carers and teachers:

  • Children should write in PEN, not pencil;
  • Faint lines on the page should be emboldened in black pen so they are readily visible;
  • Text should have a plain light background (no text overlying images)
  • Print should be BIG and BOLD
  • Learning materials, images should be of high contrast.


From the perspective of the classroom teacher – making sure that all materials are readily visible to a child with Down’s syndrome is not detrimental to the other children. So if all material is big and bold, there may be no need to do extra work to modify material for one child.

Since the visual deficit in children with down’s syndrome is permanent and will become increasingly significant as a child progresses through school, and the work becomes more demanding, it is clearly essential that the visual problems are included in every child’s Statement of Special Educational Needs/ Education and Health Care Plan.

Based on the research conducted by Down’s Syndrome Vision Research Unit, School od Optometry & Vision Sciences, Cardiff University, CF24 4LU




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