OSU researchers find conclusive link between vision problems and children with IEPs


Written for parents as “insider advice on how to navigate the system and help your child succeed”, authors, Linda Wilmshurst, Ph. D. and Alan W. Brue, Ph. D. published their book entitled: A Parents Guide to Special Education. Included in this easy to read text are the revisions to the Individuals with Disabilities Act which offers a wealth of information about services and strategies for parents to understand when they have a child with learning problems who qualify for special services which gives them access to other educational support within the public school system.

One such program is an Individualized Education Program (IEP). The purpose of the IEP is to mobilize all of the educational team to bring a coordinated, goal oriented, measurable process of educational support services to the child who qualifies. Therefore, an IEP is the individual plan for the child who has been shown to have a learning problem or disability.

But, what if a child with an IEP also has a vision problem? Wouldn’t that pose a risk to the child responding effectively to their IEP?   To attempt to answer this question, 3 states in the US (Illinois, Kentucky and Missouri) have mandatory eye examinations for children before Kindergarten. Only Arkansas, North Carolina, Oklahoma and Massachusetts require examinations for children who fail a school vision screening. And only Ohio and Massachusetts require examinations for children with learning difficulties. Sixteen states do not even require vision screenings for children.  Regardless of the state laws, when an eye examination has not been performed by a qualified eye doctor, the school will typically provide a vision screening to determine that vision is functioning “normally”. However, here is where problems begin to surface. Vision screenings are predominantly an eye sight test. That is, if the child’s visual acuity (eye sight) is better than 20/40 they pass the vision screening!

Indeed, as an informed reader of the VisionHelp Blog you are aware of the fact that many vision problems exist that do not result in reduced distance visual acuity. For example take a look at this one minute video…

Yes, while there exists scientific evidence that shows vision problems can cause reading problems, what scientific evidence exists that shows children with learning problems, for example those with an IEP, are at higher risk of having vision problems compared to the general population?

To answer this question a team of researchers from Ohio State University, with support from the Ohio Optometric Association, conducted a study of  255 children with IEPs to determine the prevalence of vision problems. The age range was 5-18 years old with an average age was 9.6.  The research was published in the latest JBO Volume 23/2012/Number 4. I first reported this in the VisionHelp Blog on November 5, entitled,  Serious vision problems in children…what does it take to open our eyes? where the research team concluded, “There is considerable association between ocular anomalies and poor school performance. These problems are illustrated by the high prevalence of a variety of eye problems experienced in patients with IEPs.”

Even more critical to the question of the validity of a school vision screening was another startling conclusion of the team which found that out of the 179 that required treatment, 124 (69%) of the children with IEPs would have passed the school vision screening test. That is to say, nearly 70% of those children with an IEP were identified with treatable vision problems and yet would pass the vision screening because their vision problem did not affect their distant eye sight!

Here are more of the details in the study that shows the prevalence of vision problems that significantly exceeded the general pediatric population in the following diagnosis:

Convergence insufficiency: 17.5%, Accommodative dysfunction: 17.3%, Strabismus: 11.5%, Amblyopia: 8.4%. These four categories are effectively treated with vision therapy. For more insights on these categories click on the highlighted word above.

The category of refraction (myopia, hyperopia and astigmatism) showed a significantly higher prevalence than the general population. These refractive categories are effectively treated with prescription lenses.

The final concluding statement by the Ohio State University research team was, “Children with IEPs are likely to have a greater prevalence of nearly all vision-related problems compared to pediatric samples represented in the general population reported in the literature. Because students with IEPs are likely to experience vision-related problems more often than the general population, these children should undergo comprehensive vision examinations to identify and treat these conditions.”

Now as a reader of this post, how can you use this evidence-based research showing the link between learning problems and vision problems to help children? It is my hope that you will pass this on to parents, teachers, school administrators, doctors and all those who work with children who struggle. It will only take a moment of your time, to share on Facebook, Twitter, email or blog; but that little bit of  time you spend could save a child from further frustration and the emotional consequences of struggling to learn. Children with vision-related learning problems should be identified with a comprehensive vision examination so that effective treatment can be prescribed. Please help share this message, won’t you?

Dan L. Fortenbacher, O.D., FCOVD

6 thoughts on “OSU researchers find conclusive link between vision problems and children with IEPs

  1. Me too, Sarah. I’m a pediatrician. Words can’t describe the change in my son’s life after vision therapy. I’ve lost track of how many kids I have referred to dev opt.

  2. Sadly even children with an IEP or at least the ones who are receiving academic intervention at school are at the mercy of the special education committee who may or may not “buy into” the idea that this is even a real problem. My nephew has been finally evaluated in the 5th grade by a behavior optometrist and was found to have a SEVERE tracking problem as well as several other areas of vision difficulty. The doctor said that because his problem went on so long he is going to need extensive therapy sessions to correct his vision. He has struggled immensely since 2nd grade to the point now where his self esteem and confidence at school is nearly non existent. His sister who entered 2nd grade this year was evaluated at my sister’s request by the special ed committee and tested “too high” to justify a referral to the same eye doctor. She was beginning to show the SAME pattern of difficulty with reading that her brother had shown and when my sister tried to demand the vision screening as a preventive measure, the committee told her that special education services were not meant to be preventive. My niece was evaluated yesterday at my sister’s expense (small price to pay to get the help your child needs) and was found to have slight tracking, focusing and peripheral vision issues. The good news is that caught EARLY, she will only need a pair of lenses and some light therapy followed by minimal if any actual vision therapy. I will tell everyone and anyone who will listen about this issue and the remedy. Next step is to advocate for all special ed students in our school to be afforded vision screening with the behavioral optometrist.

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