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Astigmatism and early academic readiness in preschool children
Gale Orlansky1, Jeremy Wilmer, Marc B Taub
1*OD, MEd †PhD ‡OD §OD, MS ∥PhD, MA Pennsylvania College of Optometry at Salus University, Philadelphia, Pennsylvania (GO, EC); Wellesley College, Wellesley, Massachusetts (JW); Southern College of Optometry, Memphis, Tennessee (MBT); SUNY College of Optometry, New York, New York (DR); and Friends Research Institute, Baltimore, Maryland (JG).
Insights
Uncorrected astigmatism in preschool children is linked to lower academic readiness. Early vision screenings and refractive correction may improve educational outcomes for at-risk youth.
Area of Science:
- Pediatric Ophthalmology
- Developmental Psychology
- Educational Readiness
Background:
- Early childhood academic readiness is crucial for long-term educational success.
- Vision impairments, such as astigmatism, can impact a child's development and learning.
- At-risk preschool populations may have undiagnosed vision issues affecting their readiness.
Purpose of the Study:
- To investigate the association between uncorrected astigmatism and early academic readiness in at-risk preschool children.
- To determine if vision screening can identify children with astigmatism who are at risk for academic challenges.
Main Methods:
- A cohort of 122 preschool children in Head Start programs underwent vision screening and academic assessment.
- Astigmatism was defined as >|-0.25| diopters in either eye.
- Academic readiness was measured using the Work Sampling System (WSS) and Ages and Stages Questionnaire (ASQ), with statistical analyses controlling for age and spherical error.
Main Results:
- Children with astigmatism showed significantly lower scores in multiple WSS domains (Personal/Social, Language/Literacy, Physical Development) and ASQ domains (Personal/Social, Communication, Fine Motor).
- These associations remained significant after adjusting for age and spherical refractive error.
- Findings were corroborated by nonparametric tests for specific domains.
Conclusions:
- Uncorrected astigmatism is associated with reduced academic readiness across various developmental domains in at-risk preschoolers.
- Early vision screenings and timely refractive correction are vital for supporting academic success in young children.
- This research highlights the importance of addressing vision health to enhance educational opportunities.
Purpose:
This study investigated the relationship between uncorrected astigmatism and early academic readiness in at-risk preschool-aged children.
Methods:
A vision screening and academic records review were performed on 122 three- to five-year-old children enrolled in the Philadelphia Head Start program. Vision screening results were related to two measures of early academic readiness, the teacher-reported Work Sampling System (WSS) and the parent-reported Ages and Stages Questionnaire (ASQ). Both measures assess multiple developmental and skill domains thought to be related to academic readiness. Children with astigmatism (defined as >|-0.25| in either eye) were compared with children who had no astigmatism. Associations between astigmatism and specific subscales of the WSS and ASQ were examined using parametric and nonparametric bivariate statistics and regression analyses controlling for age and spherical refractive error.
Results:
Presence of astigmatism was negatively associated with multiple domains of academic readiness. Children with astigmatism had significantly lower mean scores on Personal and Social Development, Language and Literacy, and Physical Development domains of the WSS, and on Personal/Social, Communication, and Fine Motor domains of the ASQ. These differences between children with astigmatism and children with no astigmatism persisted after statistically adjusting for age and magnitude of spherical refractive error. Nonparametric tests corroborated these findings for the Language and Literacy and Physical Health and Development domains of the WSS and the Communication domain of the ASQ.
Conclusions:
The presence of astigmatism detected in a screening setting was associated with a pattern of reduced academic readiness in multiple developmental and educational domains among at-risk preschool-aged children. This study may help to establish the role of early vision screenings, comprehensive vision examinations, and the need for refractive correction to improve academic success in preschool children.

