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How Vision Impacts Literacy:
An Educational Problem That Can Be Solved

Harvard Graduate School of Education
April 17, 2001
by Kathleen Gillespie

"Although our nation's school systems are no longer physically segregated, inequalities still exist which have been created by poverty's continuous assault on neurological integrity and development and the barriers it creates to academic achievement."
- Rochelle Mozlin, Associate Clinical Professor of Optometry, State University of New York

On Tuesday, April 4, 2001, optometrists and educators came together at HGSE to share their findings on how visual problems associated with poverty affect children's ability to read, and to discuss solutions.

A day-long conference on Visual Problems of Children in Poverty and Their Interference with Learning was capped off by an Askwith Education Forum focused on the policy implications of research on vision problems in poor children and adolescents. "It's time we had a discussion between people concerned about vision and people concerned about education," said moderator Gary Orfield, Professor of Education and Social Policy at Harvard University.

Gary Orfield
Professor Gary Orfield welcomes the panelists, including Robert H. Duckman (seated)

An Epidemic of Vision Problems
Antonia Orfield, an optometrist specializing in vision therapy at the Harvard University Health Services Eye Clinic and chief investigator of the Boston Mather School Inner-City Vision and Learning Project, led off by emphasizing the epidemic proportions of visual problems in urban poor children. She noted that 53% of the children tested at the Mather School had visual problems that could affect their ability to read.

Traditional school visual acuity screenings pick up a relatively small percentage of the children with vision problems because they don't screen for far-sightedness or visual tracking, Orfield continued. "We need to test [children's] visual function at near for reading and writing, rather than just their visual acuity at distance for looking at blackboards," asserted Orfield. She recommended modifying current school screenings to better identify visual problems like far-sightedness and visual tracking problems that affect reading, and to make free eyeglasses and visual therapy available to all children who need them.

Rochelle Mozlin
Rochelle Mozlin, Associate Clinical Professor of Optometry at the State University of New York

Turning Diagnosis into Treatment: A Difficult Task
Rochelle Mozlin, Associate Clinical Professor of Optometry at the State University of New York, spoke about her research on vision problems among urban adolescents at risk for dropping out of school, and the difficulties in delivering treatment. In two inner city high schools, 52% of the students tested failed Mozlin's vision screening, which was more stringent than the usual elementary school screening.

Because Mozlin's project focused on students deemed at risk for dropping out of school, 58% of the students tested were in special education; of these, 56.6% failed their vision test. But turning diagnosis into treatment proved difficult, because parents and students usually failed to follow-up in spite of repeated offers of free services. In the end, only 17 of the 62 students designated as priority cases received the vision care they needed.

Robert H. Duckman, Professor of Optometry at the State University of New York and a specialist in pediatric optometry, discussed his research on vision problems in foster care children in New York City. The results were sobering:

  • Only 16.5% of the 351 children he tested had no visual problems at all

  • Duckman identified a total of 676 visual dysfunctions, with 29.5% of the children each having three to seven visual problems

  • 34.6% of the children had vision problems which had previously gone undiagnosed but which Duckman determined had probably existed at the time of their last vision screening

Dr. Duckman said that it is clear that the screening now being provided to this population is not sufficiently identifying children with moderate or severe visual problems.

Rick Weissbourd
Rick Weissbourd, HGSE Lecturer and ReadBoston Founder

The Public Policy Perspective
Rick Weissbourd, a lecturer at HGSE and founder of ReadBoston, brought a public policy perspective to the discussion. He noted that vision problems in learning need to get on policymakers' radar screens: "In my experience, policymakers [concerned with]...reading don't talk about vision much; practitioners do." Weissbourd suggested that researchers gather more solid evidence that test scores will improve if children are given glasses and visual therapy as needed, and that addressing visual problems would be a better or more efficient use of resources than other strategies to improve student achievement and learning.

The forum ended with a wide-ranging Q&A and policy discussion. Among other topics, participants discussed how providing adequate visual correction services to more students might reduce the number of children in special education, and how certain services and research projects might be funded through Medicaid and Title I funds.

Gary Orfield concluded by noting that while research findings suggest that making visual services more readily available would reduce achievement and learning difficulties in poor children, stronger data was necessary to convince skeptics. He urged concerned constituencies to work together to bring that data to the attention of policymakers. "Today's event has been a good step in that direction," Orfield said.

About the Conference
The Visual Problems of Children in Poverty and Their Interference with Learning conference was sponsored by the Harvard Graduate School of Education, the Massachusetts Society of Optometrists, and the New England College of Optometry. The conference papers will be published soon by the Journal of Behavioral Optometry and the Journal of Optometry and Vision Development. For more about the conference, contact Gary Orfield.

For More Information
The Forum was sponsored by GSE's Askwith Education Forum series. Visit the Askwith Education Forum page for a schedule of upcoming Forums.


News & Views,
Harvard Graduate School of Education
© 2001 President and Fellows of Harvard College.

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