VISION AND LEARNING

Making the Connection

A child’s ability to learn is severely compromised when he goes through school with an undetected vision problem. Here’s a look at some of the research

BY SUSAN TARRANT

vision plays an important role in the development of children. Much of what they learn occurs by visually processing the world around them. However, according to the National Commission on Vision and Health, one in four children has an undetected vision problem. Additionally, a quarter of school-age children suffer from vision problems that could have been addressed or eliminated if appropriate eye assessment programs and follow-up care had been in place when they started school.

Why do these problems go undetected? School vision screenings (in the states that require them) and simple Snellen Chart tests are designed to test the ability to see at a distance, such as the blackboards of yesteryear and the white boards of today. However, much of the schoolwork in contemporary classrooms takes place close-up, in front of computer screens as well as books.

In addition to missing near-zone issues, screenings will not detect convergence insufficiency and other problems with tracking and teaming—two major visual components of reading and, consequently, learning.

A white paper sponsored by HOYA Vision Care and PPG Industries, “Engaging with Today’s Parents to Promote Pediatric Vision,” cites research that while one in 10 preschoolers have vision problems, children this age will generally not voice complaints about their eyes.

Furthering the problem is the fact even when a vision screening does detect a problem, 40 to 67 percent of children do not receive the recommended follow-up by an ECP, as evidenced in two studies published by the American Academy of Ophthalmology’s Ophthalmology journal.

STUDIES AND RESEARCH

For decades, the optometric, ophthalmic, and medical communities around the world have been conducting research into the connection between visual acuity and learning. What follows is just a sampling of the research and its conclusions.

School Performance – In a white paper prepared for The Essilor Vision Foundation, “Children’s Vision Care In The 21st Century & Its Impact On Education, Literacy, Social Issues, & The Workplace: A Call To Action,” Joel N. Zaba, M.A., O.D., outlined the following research.

• Eighty percent of what we learn comes through the visual processing of information, yet two out of three children in the U.S. do not receive any preventive vision care before entering elementary school.

• Of Title I students in the fifth through eighth grades and academically and behaviorally at-risk children ages eight through 18, up to 85 percent of these children had vision problems that were either undetected or went untreated.

• Teens with mediocre high school academic records and low SAT scores have been found to have significant undetected or untreated vision programs, and are at risk of not completing their college programs.

• Children from poor urban areas experience more than twice the normal rate of untreated vision problems. Without treatment and proper vision skills, those children are at risk of dropping out.

Failing Grades – In a study in Brazil by Ellen Zatti Ramos Simionato and others for a South American journal, children ages four to 15 were tested with the Snellen Chart and interviewed about their school performance history. The conclusion? School-age children with a visual acuity below 20/20 have a risk around three times greater of failing in at least one grade when compared to children of normal visual acuity of the same age.

Reading and Writing – A study published in BMC Ophthalmology in 2010 focused on two groups of kids ages six to 14 (one comprising students who were referred with reading and writing difficulties and the other a control group). The referred group were found to be statistically more likely to have poorer distance visual acuity, an exophoric deviation at near, reduced accommodation abilities, reduced vergence, a reduced near point of convergence, and a slower reading speed than the control group.

ADD/ADHD – Several studies have indicated a connection between undetected vision problems­, convergence insufficiency (CI) in particular, and attention deficit or hyperactivity disorders. In one, “The Relationship Between Convergence Insufficiency and ADHD,” David B. Ganet, M.D., found that of a group of 266 students with a CI diagnosis, nearly 10 percent also had a diagnosis of ADHD—a percentage that, at the time of the study (2005), was three times the rate of ADHD found in the general population. This could be an indicator of possible misdiagnosis of ADHD among children with undiagnosed CI, Dr. Ganet noted, but it also points to the need to consider vision therapy in possible treatment regimens for ADHD.

Many other experts have spoken to the fact that the symptoms of disorders such as ADHD (fidgety, inability to focus on work, etc.) are also symptoms of common visual disorders.

Autism – According to research by the College of Optometrists in Vision Development (in its white paper, “Vision and Autism”), vision problems are common in people with autism. Many patients with autism exhibit poor integration of central and especially peripheral visual input and have difficulty processing visual information, which then can affect motor, cognitive, speech, and perceptual ability. Treatment can include an Rx that compensates for near- or far-sightedness and/or astigmatism, with or without yoked prism. After a period of wear, an evaluation would determine whether the child would benefit from vision therapy, including activities to stimulate visual arousal, eye movement, and the central visual system. The goal would be to help the young patient “organize visual space and attain peripheral stability to better attend to and appreciate central vision.”

Social and Emotional – The effects of undetected vision problems do not stop at educational and behavioral issues. Research has been pointing to emotional problems in children with visual problems. One study found children with vision-related learning problems were experiencing lack of direction, a sense of not belonging, low self-esteem, and feelings of inadequacy and inferiority. (“Social, Emotional, and Educational Consequences of Undetected Children’s Vision Problems,” Joel Zaba, M.A., O.D.)