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Universal Screening for Prevention of Reading, Writing, and Math Disabilities in Spanish
Published on: July 18, 2020
Project Universal Preschool Vision Screening: a demonstration project
E Eugenie Hartmann1, Geoffrey E Bradford, P Kay Nottingham Chaplin
1Department of Optometry, School of Optometry, University of Alabama, Birmingham, Alabama, USA. eehartmann@uab.edu
Insights
Implementing preschool vision screening showed varied success rates. Further review is needed to achieve universal screening for young children, addressing differences in screening and follow-up care.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Visual disorders are prevalent in preschoolers, yet screening rates remain low.
- Established guidelines exist for preschool vision screening, including visual acuity and stereopsis testing.
Purpose of the Study:
- To implement and evaluate vision screening recommendations from the Maternal and Child Health Bureau and National Eye Institute Task Force.
- Assess the feasibility and outcomes of standardized vision screening in preschool settings.
Main Methods:
- Four diverse sites piloted the task force's vision screening recommendations for 3- and 4-year-olds.
- Screening was conducted in primary care practices by staff and in community programs by volunteers.
- Key metrics tracked included screening rates, referral proportions, and follow-up evaluation documentation.
Main Results:
- Successful screening rates varied, ranging from 70% to 93% for 3-year-olds and 88% to 98% for 4-year-olds.
- Referral rates fluctuated significantly (1%-41% for 3-year-olds, 2%-40% for 4-year-olds), as did follow-up rates (29%-100%).
- Treatment proportions differed significantly between community-based and primary care sites for both age groups.
Conclusions:
- Observed variability in screening and referral success highlights challenges in widespread implementation.
- Thorough review of all preschool vision screening components is essential before universal screening goals can be met.
- Site-specific factors, including setting and personnel, appear to influence screening and treatment outcomes.
Objectives:
Visual disorders among preschool-aged children are common, yet screening is infrequent. The purpose of this project was to implement the vision screening recommendations proposed by the Maternal and Child Health Bureau and National Eye Institute Vision Screening in the Preschool Child Task Force: monocular visual acuity and stereopsis testing.
Methods:
Four sites fully participated in the implementation of the task force recommendations with 3- and 4-year-old children. Two of the sites worked with primary care practices (testing performed by staff); 2 worked with community-based programs (testing performed by lay volunteers). Each site tracked number of children screened by age, as well as proportion testable, referred, and with documented follow-up evaluation.
Results:
Variations in implementation of the recommendations were observed. Successful screening among 3-year-olds ranged from 70% to 93%; referral rates were 1% to 41%, and follow-up rates were 29% to 100%. Successful screening among 4-year-olds ranged from 88% to 98%; referral rates were 2% to 40%, and follow-up rates were 41% to 100%. The proportion of 3-year-olds who were treated was significantly different between the community-based sites (n = 20) and the primary care sites (n = 2). Similarly, the proportion of 4-year-olds who were treated was significantly different between the community-based sites (n = 36) and the primary care sites (n = 11).
Conclusion:
. The variability across pilot sites in numbers successfully screened and numbers referred suggests that all aspects of preschool vision screening need thorough review before the goal of universal preschool vision screening can be realized.
