Problems of letter and number reversals in children have concerned parents and educators for many years.  Some have considered reversals as a symptom of dyslexia.  More commonly reversals reflect a lag in spatial development.  Most research has shown that there is no structural or medical basis for these reversals.  Although reversals are common and expected in five to six year old children, they may persist through childhood.  Some adults may even continue to manifest these problems.

For many years, scientists have studied children with reversal problems, particularly regarding orientation to right and left as related to their own bodies (laterality), and to objects around them (directionality).  By three the child should have grasped the concept of top to bottom, and right side up or upside down (even though still looking at books upside down).  Four year olds show reversals as they put on shoes by themselves.  Some four to five year olds may start printing numbers and letters from left to right.  At these ages, this is a normal stage of orientation development in children.

Although most children master this concept of directionality by age seven, this confusion in orientation may continue, in some people, all their life.  Reversals are a manifestation of a developmental lag in the process of orientation.  They are indicative of an underlying problem in the integration of the vestibular and visual systems in the brain.  Learning to write letters and numbers correctly by repetition learning right and left hands by rote may help us pass a test, but it does not solve the underlying problem of delayed orientation development.

The development of orientation starts in the prenatal period with attitudinal reflexes which help the fetus orient in utero.  Development continues through learning and experience.  Interference in movement activities involving vision and neuromotor relationships limits the development of orientation.  According to the neurologist J.D. French, orientation contributes in an important way to the highest mental processes-the focusing of attention, and the ability to think, to learn and to act.

Specific vision therapy, including the unique application of lenses and prisms during visual-neuromotor activities (movement with awareness and feedback), provides learning opportunities to improve the development of laterality, directionality and orientation, and the related problems of reversals.  When a child learns to orient easily, this indicates a well integrated and effectively operating individual.