The Alberta Vision Crisis: Who is taking care of children’s vision needs?

Research and experience in vision clinics around the Province show that there are a great many children who struggle with serious vision concerns, and that these are mostly undetected and uncorrected. These children move through school grades and find things progressively more difficult, and for some, they simply quit. First Nations children are most affected, although Caucasians also experience very high rates of these ‘visual impediments to learning’, or VIL. This is not only a problem in Alberta, and it affects schoolchildren everywhere.

The cost to the child, family, healthcare, and education are fully avoidable, yet they currently remain staggering.

These children with VIL are not blind, but they are affected by their vision so strongly that it interferes with their ability to read, learn, and concentrate. These problems include farsightedness, astigmatism, and a number of other concerns relating to eye alignment, focus, and the control of fine movements required for reading. These are not visible to parents, family doctors, or psychologists unless they are familiar with concepts of vision science and optics. (It is not sufficient, for example, to say ‘Can you see that?‘) As a result, they are easy to forget when ensuring children are ready for school. The cost to the child, family, healthcare, and education are fully avoidable, yet they currently remain staggering.

Some basic facts:

  • 1 in 4 children on average have some degree of visual impediment that interferes with reading, learning, and behaviour. Fewer than 20% of those affected are ever diagnosed before it’s academically ‘too late’.
  • Greater than 80% of children with diagnosed learning and behaviour concerns have some degree of visual impediments.
  • First Nations children suffer much higher rates of visual impediments to learning, as many as 35% in a given classroom. Fewer than 5% of those affected are ever diagnosed and treated.
  • People with significant visual impediments to learning are much more likely to leave school early, suffer health concerns, be given drugs to control behaviour.
  • Prison populations show very high rates of visual impediments to learning.
  • Correcting visual impediments is the most cost effective intervention to avoid preventable health and learning concerns.

Strained vision makes classwork difficult and leads to increased failure rates. The problem comes in where affected children don’t know what ‘normal’ is supposed to feel like and can’t describe the problem. The appearance of dyslexia and other classroom behavior concerns related to vision are significant, and still the Province does not require any school to insist on vision assessment as part of a treatment protocol. Schools will ensure there are psychological and medical assessments and will even advocate for the use of drugs to calm children, but vision is rarely assessed as a first thought. Children and families go on to experience great inconvenience, cost, and even physical and emotional hardship while specialists look for other causes. It is perhaps not surprising, for example, that a child with difficult vision, such as farsightedness, will find it hard to concentrate on schoolwork at a close distance and will appear to be ill or distracted.

Children with visual impediments are now forced to suffer through countless hours of schoolwork and homework that does not take their needs into account, and they find it generally very uncomfortable. In some cases, even severe health concerns result from extended near work. These children will often show emotional turbulence, defiance, and they almost never get to succeed to their full potential. Montessori-like programs are helpful because they tend to rely less on high visual demand activities, but these are hard to find.

Because visual impediments are invisible to the untrained eye, and because they have such a significant impact on health and education over a person’s lifetime, the only way to protect children’s basic rights is to ensure all children are checked as they begin school, or as soon as possible afterwards. Parents who wait to check are taking unnecessary risks with their children’s health and education.

The Province already provides vision exams for children under health care, but more needs to be done to facilitate the process for parents.

Schools are slowly coming around to the reality of what strong unimpeded vision really means to children, and more and more you see children being referred for visual assessments early in the care sequence when trouble arises. With abysmal capture rates in our schools, more needs to be done Province-wide to meet the needs of all students, especially those in isolated First Nations reserves. Vision assessment is now not mandatory, but it should be. The Province already provides vision exams for children under health care, but more needs to be done to facilitate the process for parents.

When we don’t check a child’s vision early, we are potentially violating their rights as Canadians. It’s time the Province’s schools and school authorities started treating vision with the care and respect it deserves and ensure all children are checked early.

Parents need to ensure children’s vision is assessed, period. It’s the only way to know if there is a problem. Schools need to help parents ensure vision is assessed. Without strong vision, a child cannot succeed. When we don’t check all children for possible vision concerns, we are violating the rights of at least some by leaving them to struggle in health, education, and life. It’s time the Province’s schools and school authorities started treating vision with the care and respect it deserves.

There are also many cost and efficiency benefits that come from mandatory vision exams, and these will be discussed in the next post.

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