It took four years of testing to finally conclude that Timothy Scott, a 6th grader at Herzl Elementary School in Chicago, had a mild learning disability.
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Two years later, Timothy continued to struggle with reading and hadn’t been able to progress beyond 2nd-grade books. It wasn’t until April that teachers began to close in on why he wasn’t showing improvement: An eye examination at school revealed his vision was so poor that focusing on small letters was nearly impossible. He saw two sentences as one blurry line.
“I knew something was wrong,” Timothy, a soft-spoken 11-year-old, said last week as he tried on a new pair of black wire-framed glasses that he obtained under a Chicago Public Schools initiative to provide needy students with free prescription glasses.
“I didn’t know my eyes were that bad, and when they told me I needed glasses, I was shocked. This feels really good,” he said.
In the three years since the school system announced the end of social promotions and established tougher academic standards, officials have pursued a variety of strategies to help underachieving students who seem to defy even intense intervention.
But only recently has the school system begun to quietly focus on a little-explored factor in persistent, sometimes baffling, academic failure: eyesight.
Schools chief Paul Vallas said he was stunned to discover last spring that 38 percent of 8th graders at one academic transition center–for students who have flunked repeatedly–also failed an eye exam.
For large urban school districts in particular, the link between vision and underachievement might reveal the long-term ripple effects of a pathology long connected with impoverished, inner-city births: prematurity and low birth weight.
Because the eyes are among the last organs to develop fully in the womb, it has long been known that prematurity can result in sight problems; the recognition of the possible effects on education further heightens the need for ongoing projects to stem prematurity, health officials suggest.
The Chicago Board of Education recently upgraded its estimate for the number of children it believes need glasses, saying that 15 to 20 percent of its 430,000 students–most of whom live in poverty–have undiagnosed vision problems. Roughly one in three 8th graders who recently flunked also had failed a vision screening, officials added.
Part of the problem can be attributed to infrequent screenings in the schools.
Often, however, parents do not act upon letters from schools about their child’s poor vision.
Such developments have prompted Chicago schools to expand a $3 million vision and hearing screening initiative this fall to include nearly 75 percent of its students by the end of the academic year, and to pay for a child to see an eye doctor and to receive a free pair of glasses, if needed.
“This is the school system once again expanding its role because there’s a serious need,” said Vallas, adding that he wants the schools to buy at least 50,000 pairs of glasses this year for students.
“At the end of the day, we find students with poor eyesight aren’t reaching their potential,” he said.
Public health officials say vision problems among inner-city public school students aren’t a complete surprise. They’ve long suspected a link between poor vision in children in the primary grades and life in inner-city neighborhoods.
Dr. Harold Koller, chairman of the ophthalmological section of the American Academy of Pediatrics, said research in this area is relatively new. But it is becoming clear, from a handful of professional papers written on the subject, that poor prenatal care hampers the normal development of sight, making it far more likely that a child will be born with such problems.
Thus, bad vision hurts a child’s ability to learn if the problem goes undetected.
“Nobody has been putting this all together,” said Koller, who has a private practice in suburban Philadelphia. “Teachers may notice a child has poor vision, but they have no idea why the child is having this difficulty. If you want to address this problem on a larger scale, then you have to go back to how much care the mothers are getting.”
Children who are born prematurely are at least twice as likely to have eye disease as kids who are born at full-term, according to Dr. Richard Hertle, medical officer and investigator with the National Eye Institute.
Nationwide, the incidence of prematurity and the rate of very low birth weight babies–3.3 pounds or less–is as much as two to three times higher in minority populations, particularly African-Americans, than in the white population, said Dr. James Lemons, professor of pediatrics and director of the section of neonatal and prenatal medicine at Indiana University Medical Center.
In Chicago, about 10.5 percent of the infants born in 1997 had low birth weight, compared with 8 percent statewide, according to the most recent state public health statistics. That same year, 15 percent of black mothers in the city had low birth-weight babies.
“Children of premature birth are at higher risk of vision problems,” said Michael Repka, a pediatric ophthalmologist at Johns Hopkins Hospital in Baltimore, who is planning a study to compare vision problems in affluent and non-affluent children.
In particular, myopia, or nearsightedness, is associated with early-term births. And because African-American and low-income children have a higher incidence of prematurity, the theory is that they also should have a higher incidence of myopia, said Repka.
If poor eyesight is the root of a child’s reading problem, for example, then glasses will take care of it, said Paula Tallal, a professor in the center for molecular and behavioral neuroscience at Rutgers University at Newark and an adviser to the March of Dimes.
But if the student’s reading difficulties stem from the brain’s inability to take what the eye sees and organize and understand it, glasses won’t fix the problem. Such vision problems are neurological and require more intervention than just eyewear, experts note.
The Illinois Department of Public Health requires that pupils in pre-kindergarten, kindergarten, 2nd grade and 8th grade be given sight and hearing screenings in the public schools. Transfer students and any child referred by a teacher also must be tested.
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But under the Chicago schools program, screening was expanded to include 3rd graders, 5th graders, 6th graders, 9th graders and all students who flunk.
Sue Gamm, director of special services for the Chicago Public Schools, said the school system’s efforts are the most comprehensive in the country.
In the past, the schools simply sent home letters to parents encouraging them to have their child examined by an eye doctor. Under the new program, school officials do more parental outreach to ensure signed releases are obtained so children can receive glasses.
The free glasses distributed in the public schools are furnished by the Illinois Department of Public Aid, which has its frames made and lenses ground by inmates at the Dixon Correctional Center. Typically, it costs about $40 to have a student screened, examined by an eye doctor and then fitted with glasses. At most retail outlets, such service can cost more than $100.
In New York, the nation’s largest school district, only one of 31 sub-districts offers children free glasses. Most schools just screen children and refer them to hospitals where they must go with a parent to receive free prescription eyewear.
“There’s a proposal to standardize our approach in helping to screen children and get them glasses,” said Pam McDonnell, a spokeswoman for the New York Board of Education. “There is no real coordinated effort, right now,” she said.
On the Southwest Side of Chicago, 7-year-old Sherece Hoard, a 2nd grader at Dore Elementary School, said she told her mother about her blurry vision six months ago. But with her, two older sisters, a brother, an aunt and her mother all sharing the same home, there wasn’t enough money to buy her glasses right away, she said.
“I was like, well, that’s fine and maybe I don’t really need them after all,” Sherece said.
When an ophthalmologist delivered her free glasses on Thursday, Sherece could hardly contain herself. She was afraid she would get a pair of unfashionable 1950s-style black plastic glasses with thick frames.
“These are so cool,” she said, clutching a pair of amber-colored wire-framed glasses with oval-shaped lenses. “I’m going to wear these every day. I love them.”