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Letter Reversals in Children - Doig Optometry - Calgary Optometrist

During the back to school season, parents bring their children in for an eye exam to make sure that their child’s eyes and vision will have every possible advantage for learning.  

One common concern expressed by parents of elementary aged children has to do with letter reversals. A parent might say, “My child has been making a lot of letter reversals and I want to make sure there’s nothing wrong with their visual system.”  In the vast majority of cases, there’s nothing wrong with the visual system, thankfully. In most cases, there is a simple skill that parents can easily teach their children to make issues with letter reversals much less common.

Pictures and Symbols have Meaning:

Give a young child a piece of paper and some coloured pencils and ask them to draw their family on the piece of paper.  
They’ll most likely draw you a picture of the people in their family that looks something like this:

Image result for child's drawing of family







A young child would never draw a picture like this to represent their family:

S:\Zeuss\Family Symbols.jpg


This picture is very symbolic.  The shapes used represent people’s gender.  The shapes of the letters represent the sounds of their names.  It takes learning to know the names and sounds of the various letters and to understand which shapes represent male and female.

Concrete Thinkers Understands Things As They Are

Knowing, understanding or even imagining that certain shapes can represent the sounds of language requires abstract thinking.  Concrete thinking and reasoning always develop first. Concrete thinking can only take you so far in learning letters and language.  Here’s why…

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Concrete thinking tells us that each of these four photographs is a picture of a man holding a wrench.  He’s still holding a wrench no matter what it’s orientation.

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It’s Still A Wrench…

D:\Letter Reversal Images\RWD_8534.JPG And It’s Still A Wrench.

Abstract Thinkers Understand What Things Represent

It takes abstract thinking to understand that a shape can represent something different and have a different name depending on it’s orientation.  That’s what’s happening in the following pictures:

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Depending on the font of the text used, the single unique shape in these photos can represent four different letters!

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The font used in this article is a good example of that… ..p     d q    b

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Each of these symbols represents a different sound used in language.

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If a young learner has not yet developed abstract thinking skills, and if they perceive the b,d,p,q symbols as interchangeable, then we can understand why they might struggle with letter reversals in their writing and basic confusion in their reading.  Imagine how difficult it would be to read the following sentence if d, b, q, and p were all perceived the same way by the language centers in the brain:

The pied piper quit and quietly went to bed.

Experienced teachers will tell you that the most commonly confused letters are b and d.  These two letters are often written backwards. Another common “mirror reversal” occurs between p and q.  It’s possible to imagine an “up/down” letter reversal between m and w, but it’s far less frequent.


“Right/Left” mirror reversals so much more common in novice writing than the “Up/Down” mirror reversals:

Children learn the difference between “Up” and “Down” very early in life.  Children who want to be carried will ask, “Up, please!” Children who want to explore will say “Want down, want down!”  Knowing the difference between “Up” and “Down” is very useful to them, so they learn it early on in life. Having a strong sense of Up/Down directionality, children more readily identify the difference between the stem upward pointing w and the downward pointing m.  This also explains why “stem up” letters are usually not confused with their “stem down” mirrored letter. For example, “b” and “d” are often confused, but “b” and “p” are not.

Using the words “Right” and “Left” Helps Children Develop Strong Laterality

Imagine the following conversation between a parent and their young toddler:

Parent:  “Ok, it’s time to put on your shoes”

Child:  “OK”

Parent:  “This foot first…  OK, now your other foot…  There. All done”

This gets the shoes on, but it doesn’t develop a child’s sense of right and left.  What if the conversation went like this:

Parent:  “Ok, it’s time to put on your shoes”

Child:  “OK”

Parent:  “This is your right shoe.  It goes on your right foot…  Oops! That’s your left foot.  Your right foot is on the other side of your body.  There, that’s correct. OK now your left shoe goes on your left foot.”

Laterality is awareness of the difference between the two sides of the body.  Right/left directionality means having awareness of the two sides of the body, and then applying it accurately to the world around you.  Children who have a strong awareness of the difference between the right and left side of their body (Laterality) and can apply it accurately to the world around them (directionality) will be better prepared to know the difference between the letters b, d, p and q.  They will be better prepared to learn reading and writing skills without struggling through difficult issues with letter reversals. Parents can take advantage of everyday opportunities to use the words “right” and “left” appropriately when communicating with their children and this will help their children develop good laterality and strong directionality.  

Dr. Russell W. Doig is an Optometrist practicing in south Calgary.  The ideas and concepts shared in this article are for informational purposes only and cannot replace a thorough eye exam.  Specific laterality training exercises can be recommended. Dr. Doig recommends every child have a thorough eye exam at age 6 months, 18 months, age 3, age 5 and then each year through the school years.